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Incidence and treatment of brain metastasis in patients with esophageal carcinoma

World Journal of Gastroenterology 2015年第19期21卷 5805-5812页

作者： Wei Feng Peng Zhang Xiao Zheng Ming Chen Wei-Min Mao Department of Radiation Oncology Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus) Zhejiang Key Laboratory of Radiation Oncology Zhejiang Cancer Hospital

Brain metastasis from esophageal carcinoma(BMEC) is very rare, but its incidence has increased in the United States, Japan, China and other counties. Reports on BMEC have largely been focused on examining whether adjuvant therapy for esophageal cancer influences the survival duration of BMEC patients and on the imaging characteristics of BMEC determined using new medical equipment. The difference between different pathological types of esophageal cancer, especially adenocarcinoma and squamous cell carcinoma, is one important factor used to assess the influence of BMEC. Adjuvant therapy, including radiotherapy and chemotherapy, for esophageal cancer with different characteristics in different countries may affect BMEC treatment outcomes. The degree of popularization of advanced medical equipment is a major concern related to the prevalence of BMEC. Furthermore,targeted BMEC treatment is under development in developed countries. In this article, we reviewed the debate surrounding BMEC and analyzed BMEC studies from different perspectives.

关键词： Brain metastasis Esophageal carcinoma Magnetic resonance imagin Computed tomography

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Computed tomography and magnetic resonance imaging features of lipid-rich neuroendocrine tumors of the pancreas

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World Journal of Gastroenterology 2015年第34期21卷 10008-10017页

作者： Yoshihiko Fukukura Toshikazu Shindo Michiyo Higashi Koji Takumi Tomokazu Umanodan Tomohide Yoneyama Takashi Yoshiura De-partment of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Department of Human Pathology Kagoshima University Graduate School of Medical and Dental Sciences

AIM:To clarify the computed tomography(CT) and magnetic resonance imaging(MRI) characteristics of lipid-rich pancreatic neuroendocrine tumors(Pan NETs).METHODS:Enhanced CT and MRI performed before pancreatectomy in 29 patients with 34 histologicallyconfirmed Pan NETs was retrospectively reviewed. Tumor attenuation on CT and signal intensities on conventional(T1- and T2-weighted) and chemical shift MRI were qualitatively analyzed and compared alongside adipose differentiation-related protein(ADRP) immunostaining(ADRP-positive:lipid-rich; ADRP-negative:non-lipid-rich) results using Fisher's exact test or the Mann-Whitney U test. Signal intensity index on chemical shift MRI was quantitatively assessed.RESULTS:There were 15 lipid-rich Pan NETs(44.1%) in 12 patients(41.4%). Tumor attenuation during the early,portal venous,and delayed phases of enhanced CT(P = 0.888,0.443,and 0.359,respectively) and signal intensities on conventional MRI(P = 0.698 and 0.798,respectively) were not significantly differentbetween lipid-rich and non-lipid-rich Pan NETs. Four of the 15 lipid-rich Pan NETs exhibited high signal intensity on subtraction chemical shift MRI,and the association of high signal intensity on subtraction imaging with lipid-rich Pan NETs was significant(4 of 15 lipid-rich Pan NETs,26.73%,vs 0 of 19 non-lipid-rich Pan NETs,0%,P = 0.029). Lipid-rich Pan NETs showed a significantly higher signal intensity index than non-lipidrich Pan NETs(0.6% ± 14.1% vs-10.4% ± 14.4%,P = 0.004). Eight of 15 lipid-rich Pan NETs,vs 0 of 19 nonlipid-rich Pan NETs,had positive signal intensity index values in concordance with lipid contents.C O N C L U S I O N :C T c o n t ra s t e n h a n c e m e n t a n d conventional MR signal intensities are similar in lipidrich and non-lipid-rich Pan NETs. Chemical shift MRI can demonstrate cytoplasmic lipids in Pan NETs.

关键词： Neoplasms Chemical shift magnetic resonance imagin

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