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Predictive value of multi-detector computed tomography for accurate diagnosis of serous cystadenoma:Radiologic-pathologic correlation

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World Journal of Gastroenterology 2009年第22期15卷 2739-2747页

作者： Anjuli A Shah Nisha I Sainani Avinash Kambadakone Ramesh Zarine K Shah Vikram Deshpande Peter F Hahn Dushyant V Sahani Department of radiology Division of Abdominal Imaging and Interventional RadiologyWhite Bldg.270Massachusetts General Hospital Department of Pathology Massachusetts General Hospital

AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reader performance. METHODS： The MDCT scans of 164 patients with surgically verified pancreatic cystic lesions were reviewed by two readers to study the predictive value of various morphological features for establishing a diagnosis of SCAs. Accuracy in lesion characterization and reader confidence were correlated with lesion size （≤3 cm or 〉≥3 cm） and scanning protocols （dedicated vs routine）. RESULTS： 28/164 cysts （mean size, 39 mm; range, 8-92 mm） were diagnosed as SCA on pathology. The MDCT features predictive of diagnosis of SCA were microcystic appearance （22/28, 78.6%）, surface Iobulations （25/28, 89.3%） and central scar （9/28, 32.4%）. Stepwise logistic regression analysis showed that only microcystic appearance was significant for CT diagnosis of SCA （P = 0.0001）. The sensitivity, specificity and PPV of central scar and of combined microcystic appearance and Iobulations were 32.4%/100%/100% and 68%/100%/100%, respectively. The reader confidence was higher for lesions 〉 3 cm （P = 0.02） and for MDCT scans performed using thin collimation （1.25-2.5 mm） compared to routine 5 mm collimation exams （P 〉 0.05）. CONCLUSION： Central scar on MDCT is diagnostic of SCA but is seen in only one third of SCAs. Microcystic morphology is the most significant CT feature in diagnosis of SCA. A combination of microcystic appearance and surface Iobulations offers accuracy comparable to central scar with higher sensitivity.

关键词： Pancreas Serous cystadenoma Multidetector computed tomography Central scar Lobulations Microcystic

Four-dimensional flow magnetic resonance imaging incirrhosis

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World Journal of Gastroenterology 2016年第1期22卷 89-102页

作者： Zoran Stankovic University Institute of diagnostic Interventional and Pediatric RadiologyInselspital-University Hospital Bern3010 BernSwitzerland

Since its introduction in the 1970’s,magnetic resonance imaging(MRI)has become a standard imaging *** its broad and standardized application,it is firmly established in the clinical routine and an essential element in cardiovascular and abdominal *** addition to sonography and computer tomography,MRI is a valuable tool for diagnosing cardiovascular and abdominal diseases,for determining disease severity,and for assessing therapeutic *** techniques have improved over the last few decades,revealing not just morphologic information,but functional information about perfusion,diffusion and hemodynamics as ***-dimensional(4D)flow MRI,a time-resolved phase contrast-MRI with three-dimensional(3D)anatomic coverage and velocity encoding along all three flow directions has been used to comprehensively assess complex cardiovascular hemodynamics in multiple regions of the *** technique enables visualization of 3D blood flow patterns and retrospective quantification of blood flow parameters in a region of *** the last few years,4D flow MRI has been increasingly performed in the abdominal *** applying different acceleration techniques,taking 4D flow MRI measurements has dropped to a reasonable scanning time of 8 to 12 *** new developments have encouraged a growing number of patient studies in the literature validating the technique’s potential for enhanced evaluation of blood flow parameters within the liver’s complex vascular *** purpose of this review article is to broaden our understanding of 4D flow MRI for the assessment of liver hemodynamics by providing insights into acquisition,data analysis,visualization and ***,in this article we highlight its development,focussing on the clinical application of the technique.

关键词： Four-dimensional flow magnetic resonanceimaging Phase contrast-magnetic resonance imaging Liver cirrhosis imaging technique Hemodynamics Bloodflow Visualization Quantification TIPS Splanchnic system

Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

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World Journal of Gastroenterology 2016年第20期22卷 4891-4900页

作者： Davide Ippolito Silvia Girolama Drago Cammillo Talei Franzesi Davide Fior Sandro Sironi School of Medicine University of Milano-Bicocca Department of diagnostic radiology H. San Gerardo Hospital

AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer ***: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner(ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 m As. imaging data were reviewed as axial and as multiplanar reconstructions(MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images(DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. diagnostic accuracy of both modalities was compared and statistically ***: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91(41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged(45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value(PPV) 80.4%, negative predictive value(NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared

关键词： Magnetic resonance Multi detector computed tomography Rectal cancer Mesorectal fascia Multiplanar reconstructions

Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma

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World Journal of Gastroenterology 2018年第23期24卷 2413-2426页

作者： Davide Ippolito Riccardo Inchingolo Luigi Grazioli Silvia Girolama Drago Michele Nardella Marco Gatti Riccardo Faletti School of Medicine University of Milano-Bicocca Department of diagnostic radiology HS Gerardo Monza Division of Interventional radiology Department of RadiologyMadonna delle Grazie Hospital Department of radiology University of Brescia "Spedali Civili" Department of Surgical Sciences Radiology UnitUniversity of Turin

Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation.

关键词： Liver Cirrhosis Hepatocellular carcinoma Magnetic resonance Transarterial chemoembolization Contrast media

Radiomic features from computed tomography to differentiate invasive pulmonary adenocarcinomas from non-invasive pulmonary adenocarcinomas appearing as part-solid groundglass nodules

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Chinese Journal of Cancer Research 2019年第2期31卷 329-338页

作者： Ting Luo Ke Xu Zheng Zhang Lina Zhang Shandong Wu Department of radiology the First Affiliated Hospital of China Medical University departments of radiology Biomedical Informatics Bioengineering and Intelligent Systems University of Pittsburgh

Objective:We aim to investigate radiomic imaging features extracted in computed tomography(CT)images to differentiate invasive pulmonary adenocarcinomas(IPAs)from non-IPAs appearing as part-solid ground-glass nodules(GGNs),and to incorporate significant radiomic features with other clinically-assessed features to develop a diagnostic nomogram model for ***:This retrospective study was performed,with Institutional Review Board approval,on 88 patients with a total of 100 part-solid nodules(56 IPAs and 44 non-IPAs)that were surgically confirmed between February 2014and November 2016 in the First Affiliated Hospital of China Medical *** radiomic features were computed automatically on 3D nodule volume segmented from arterial-phase contrast-enhanced CT images.A set of regular risk factors and visually-assessed qualitative CT imaging features were compared with the radiomic features using logistic regression *** diagnostic models,i.e.,a basis model using the clinical factors and qualitative CT features,a radiomics model using significant radiomic features,and a nomogram model combining all significant features,were built and compared in terms of receiver operating characteristic(ROC)*** curve analysis was performed for the nomogram model to explore its potential clinical ***:In addition to three visually-assessed qualitative imaging features,another three quantitative features selected from hundreds of radiomic features were found to be significantly(all Pdiagnostic nomogram model showed a significantly higher performance[area under the ROC curve(AUC)=0.903]in differentiating IPAs from non-IPAs than either the basis model(AUC=0.853,P=0.0009)or the radiomics model(AUC=0.769,P<0.0001).Decision curve analysis indicates a potential benefit of using such a nomogram model in clinical ***:Quantitative radiomic features provide additional information over clinically-as

关键词： Radiomics lung adenocarcinomas tomography X-ray computed

Radiological features of lung changes caused by avian influenza subtype A H5N1 virus： report of two severe adult cases with regular follow-up

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Chinese Medical Journal 2010年第1期123卷 100-104页

作者： LU Pu-xuan Yi-xiang Wang ZHOU Bo-ping GE Yang ZHU Wen-Ke CHEN Xin-chun RAN Xian-gui Department of radiology Department of diagnostic radiology and organ imaging Prince ofWales Hospital The Chinese University of Hong Kong ShatinNT Hong Kong China Department ofInfectious Diseases Second Municipal Hospital of Fuyang Fuyang Anhui 236015China

Several subtypes of avian influenza A have been shown to cross the species barrier and infect humans, leadingto human cases of avian influenza） Till June 2, 2009, globally there were 433 confirmed human cases of avian influenza caused by H5N1 virus, with a death rate of 60.5%.3 This is far higher than the reported 11% death rate of severe acute respiratory syndrome （SARS）.4 The epidemiologic features of human case of influenza A subtype H5N1 virus infection consist of high incidence rate in cold weather, high susceptibility in population of younger age associated with rapid onset of the disease and devastating illness in humans.12＇5＇6 H5N1 virus is mostly transmitted to humans directly through contact with infected birds or their secretions and the patients present with an influenza type illness with fever, cough, sore throat, malaise, and gastrointestinal symptoms; which can result in a rapidly progressive primary viral pneumonia and respiratory failure.2 Patients above the age of 5 years are likely to have an adverse course of disease.5

关键词： chest X-ray tomography, computed infectious diseases lung diseases avian-flu

Multimodality image fusion for diagnosing coronary artery disease

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The Journal of Biomedical Research 2013年第6期27卷 439-451页

作者： Marina Piccinelli Ernest Garcia Department of radiology and imaging Sciences Emory University

Coronary artery disease （CAD） is one of the leading causes of death in the US and a substantial health-care burden in all industrialized societies. In recent years we have witnessed a constant strive towards the development and the clinical application of novel or improved detection methods as well as therapies. Particularly, noninvasive imaging is a decisive component in the cardiovascular field. Image fusion is the ability of combining into a sin- gle integrated display the anatomical as well as the physiological data retrieved by separated modalities. Clinical evidence suggests that it represents a promising strategy in CAD assessment and risk stratification by significantly improving the diagnostic power of each modality independently considered and of the traditional side-by-side in- terpretation. Numerous techniques and approaches taken from the image registration field have been implemented and validated in the context of CAD assessment and management. Although its diagnostic power is widely ac- cepted, additional technical developments are still needed to become a routinely used clinical tool.

关键词： image fusion CAD diagnosis computed tomography angiography nuclear imaging

Giant Hepatic Regenerative Nodule in a Patient With Hepatitis B Virus-related Cirrhosis

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Journal of Clinical and Translational Hepatology 2022年第4期10卷 778-782页

作者： Long Li Jie Feng Division of diagnostic radiology Department of Medical ImagingGuangdong Provincial Corps Hospital of Chinese Peo-ple’s Armed Police ForcesGuangzhou Medical UniversityGuangzhouGuangdongChina Department of Medical imaging Center Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina

Hepatic regenerative nodules are reactive hepatocellular proliferations that develop in response to liver *** hepatic regenerative nodules of 10 cm or more are extremely rare and have only been reported in patients with biliary atresia or Alagille syndrome.A 50-year-old man presented with a pathologically confirmed giant 11.3×9.4×11.2 cm hepatic regenerative nodule and hepatitis B virus-related *** of intrahepatic nodule included mild hyperenhancement in the portal phase of contrast-enhanced CT and the hepatobiliary phase in the gadoxetic acid-enhanced MRI scan,as well as the portal vein crossing through sign in the setting of liver *** case highlights the imaging characteristics of giant hepatic regenerative nodules in hepatitis cirrhosis.

关键词： Regenerative nodules Cirrhosis Hepatitis B virus Computed tomography Magnetic resonance imaging

Enhanced CT and CT virtual endoscopy in diagnosis of heterotopic pancreas

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World Journal of Gastroenterology 2011年第33期17卷 3850-3855页

作者： Dan Wang Xiao-Er Wei Lei Yan Yu-Zhen Zhang Wen-Bin Li Institute of diagnostic and Interventional radiology The Sixth Affiliated People＇s HospitalShanghai Jiao Tong UniversityShanghai 200233China

AIM:To improve the diagnosis of heterotopic pancreas by the use of contrastenhanced computed tomography(CT)imaging and CT virtual endoscopy(CTVE).METHODS:A total of six patients with heterotopic pancreas,as confirmed by clinical pathology and immunohistochemistry in the Sixth Affiliated People's Hospital of Shanghai Jiao Tong University,Shanghai,China,were *** CT and enhanced CT scanning were performed,and the resulting images were reviewed and analyzed using threedimensional postprocessing software,including ***:Four males and two females were *** heterotopic pancreas sites were involved;three occurred in the stomach,including the gastric antrum(n =2)and lesser curvature(n=1),and two were in the duodenal *** one case of heterotopic pancreas lesion occurred in the *** cases had a solid yet soft tissue density that had a homogeneous pattern when viewed by enhanced ***,their CT values were similar to that of the *** ducts of the heterotopic pancreas tissue,one of the characteristic CT features of heterotopic pancreas tissue,were detected in the CT images of two *** images showed normal mucosa around the tissue,which is also an important indicator of a heterotopic ***,none of the CTVE images showed the typical signs of central dimpling or ***:CT,enhanced CT and CTVE techniques provide useful information about the location,growth pattern,vascularity,and condition of the gastrointestinal wall around heterotopic pancreatic tissue.

关键词： Heterotopic pancreas Computed tomography Contrast enhancement Computed tomography virtual endoscopy