肾癌不同病理分型的CT影像特征分析

目的:对比肾癌不同病理分型的CT影像特征,总结鉴别诊断特点。方法:回顾30例经病理证实肾癌患者临床资料,概括其CT影像特征。结果:不同病理分型肾癌形状、边界比较,差异无统计学意义(P>0.05)。肾透明细胞癌平扫表现为低密度12例,其中1例病灶内可见钙化,增强扫描呈不均匀强化;嫌色细胞癌平扫低密度6例,等密度2例,增强扫描呈均匀轻中度强化,均基本呈持续性强化,各期强化程度均低于肾透明细胞癌;乳头状肾癌平扫2例均匀低密度,5例不均匀低密度,增强扫描3例呈均匀强化,4例呈不均匀强化,7例均基本呈持续性强化,各期强化程度均低于肾透明细胞癌。肾透明细胞癌动脉期CT值及CT值增强量均高于嫌色细胞癌、乳头状肾癌,差异有统计学意义(P<0.05)。结论:根据动脉期CT值及CT值增强量可诊断典型肾透明细胞癌,在CT影像的基础上,可综合发病特点、临床表现进行判断。     

纵隔支气管源性囊肿的CT特征及鉴别诊断

目的:分析纵隔支气管源性囊肿(Mediastinal bronchogenic cyst,MBC)的CT特征及鉴别诊断依据。方法:分析18例经病理检查确诊的MBC患者临床及影像资料,分析病变部位、CT平扫及增强扫描表现、误诊情况,据此总结MBC的CT特征与鉴别诊断依据。结果:误诊13例,误诊率为72.22%。MBC病灶最大径19~85 mm,平均(36.02±10.81)mm,均为单发病变,其中7例位于前纵膈,4例位于中纵膈,7例位于后纵膈。内部密度分型:液性密度4例,软组织密度14例(球灶型8例,不确定型6例)。增强扫描示:仅1例可见囊壁强化。18例病灶中,13例边缘清晰、完整,其余5例边缘欠光滑;不确定型病灶中,6例CT值超过60 Hu,其CT值分布范围为65~137 Hu,1例CT值未超过60 Hu的病灶可见囊壁与周围实变肺组织紧密相连,囊内密度不均匀并可见点状钙化,囊壁强化呈条片状。结论:MBC的术前误诊率较高,根据囊肿边缘光滑、密度均匀及增强扫描一般无强化的CT特征,综合与周围解剖结构的关系及临床表现,一般可达到定性诊断。     

肾上腺节细胞神经瘤的多排螺旋CT诊断价值

目的:探讨肾上腺节细胞神经瘤的螺旋CT表现及鉴别诊断。方法:回顾分析9例经手术病理证实的肾上腺节细胞神经瘤的螺旋CT扫描资料,重点分析其强化特点。结果:9例肾上腺节细胞神经瘤6例位于右侧,3例位于左侧。病灶呈圆形或椭圆形,边界清晰。9例患者CT扫描可见肿物为实性7例,病灶密度均匀,2例病灶内伴有钙化。增强扫描后8例病灶呈进行性均匀强化。结论:肾上腺节细胞神经瘤CT影像表现具有一定的特征性,多排螺旋CT不仅能作出正确定位并且能比较准确进行定性诊断。CT平扫及增强扫描是本病手术之前的主要诊断依据。     

胸部孤立性纤维瘤的CT表现与鉴别诊断

目的:观察胸部孤立性纤维瘤(pleural solitary fibrous tumor,PSFT)的CT表现,总结鉴别诊断策略。方法:分析24例PSFT患者CT平扫和增强征象以及病理表现。结果:均为胸腔内单发肿块,CT平扫可见软组织肿块且边缘光滑,与胸壁或纵膈间夹角呈钝角,可见胸膜轻微局限掀起,呈胸膜尾征;19例肿瘤密度相对均匀,5例瘤体较大者,肿瘤内部密度欠均匀。12例增强扫描可见不均匀强化,以肿瘤中心点状、条状、斑片状不明显强化为主;10例肿瘤不同区域可见轻度、中度、显著强化同时存在,以轻度、中度强化为主;9例肿瘤内部可见血管影像,局部血供丰富;3例瘤体增强无特殊变化。22例肿瘤边缘与周围组织界限清晰,肿瘤包膜完整,周围组织受压明显,1例肿瘤可见瘤蒂,1例肿瘤因侵犯纵膈、心包局部致使界限不清。病理结果显示24例中18例来源于脏层胸膜,6例来源于壁层胸膜。结论:PSFT的CT表现具有较高特征性,结合肿瘤定位及其与周边组织结构的关系有助于本病的鉴别诊断。     

乳腺癌的动态增强MRI影像学分析

目的:回顾性分析乳腺癌平扫及动态增强MRI影像学表现,提高乳腺癌的诊断准确率。方法:对19例乳腺癌患者(23个病灶),行常规MR平扫及动态增强检查。所有病例均经病理证实,分析病灶的MRI形态学、信号强度及其动态增强特点(强化方式、时间-信号强化曲线)。结果:1、19例23个乳腺癌的形态学表现以边界不清、分叶状、毛刺征为主,占73.4%。2、MRI显示病灶内部信号多不均匀,T1WI呈等、低信号,T2WI信号多样化,强化多不均匀,可以强化始于病灶边缘,向灶中发展,也可以始终边缘强化。3、时间-信号强化曲线表现为流出型57.2%、平台型48.8%。结论:在乳腺癌诊断中,早期增强率(及强化方式)、信号强度一时间曲线及动态增强MRI病灶形态3项指标有利于乳腺癌的诊断和鉴别诊断。     

超声造影对肾透明细胞癌的诊断价值

目的:分析超声造影对肾透明细胞癌(Renal clear cell carcinoma,RCCC)的诊断价值及分期判断价值。方法:分析113例经病理证实的RCCC超声造影图像特征。分析超声造影诊断RCCC的准确度、灵敏度,并比较不同分期、分级RCCC的超声造影声像图、定量特点。结果:RCCC声像图特征以增强不均匀、存在假包膜征及弥漫性增强为主。以超声造影声像图不均匀增强、假包膜征及弥漫性增强联合诊断RCCC的灵敏度、特异性、阳性预测值、阴性预测值分别为98.23%、100.00%、100.00%、95.92%。与RCCC比较,pT_2~pT_3期RCCC声像图特征不均匀增强率高于pT_1期,其假包膜征出现率低于pT_1期;Fuhrman分级Ⅲ~Ⅳ级RCCC声像图△P%高于Ⅰ~Ⅱ级,差异有统计学意义(P<0.05)。结论:超声造影声像图对于RCCC的诊断与TNM分期评估具有较高价值,结合声像图定量特点可进一步明确Fuhrman分级,为临床诊治提供更为完善的参考。     

应用电子束CT低剂量扫描在冠状动脉CT成像病人中筛查早期肺癌

目的:探讨新一代电子束CT(e-SPEED)在行冠状动脉CT成像检查病人中联合筛查早期肺癌的扫描方法及应用价值。方法:对104例健康查体者先行肺部低剂量电子束CT扫描,扫描参数为130kV,895mA,50ms,层厚6mm,层距3mm,重建层厚3mm。平扫后再经静脉注射对比剂进行CT冠状动脉成像检查,其中48例(心率≥70次/分)行电子束CT扫描,扫描参数为Multiphase Dual方式,140kV,1010mA,100ms,层厚1.5mm;57例(心率<70次/分行16排螺旋CT扫描,扫描参数为120kV,370mA,500ms,层厚0.625mm。对比剂选用非离子型Ommipaque 350mgI/mL。肺平扫图像采用肺算法及标准算法重建,由两位放射诊断医师在工作站显示器上进行观察,统计病变检出例数并观察肺叶、段支气管显示情况;并对冠状动脉CT增强图像以VR、MIP、CINE、CTVE方式重建后进行观察,利用其薄层扫描的优势重点观察肺门结构及支气管开口情况,并观察可疑病变的强化情况。所有图像存贮至图像存储与传输系统(PACS)。结果:100%肺叶、段支气管可显示,共检出3mm以上非钙化肺结节4例,其中1例经活检证实为I期周围型肺癌。结论:在冠状动脉CT成像检查同时配合电子束CT低剂量平扫,适于联合筛查早期肺癌,并有助于提高肺内非钙化小结节及支气管细微病变的检出。     

64层CT三维重建对肾癌分期及后腹腔镜肾癌手术的应用价值

目的 :探讨分析64层CT三维重建对确定肾癌分期、了解肾脏血管变异情况价值,为肾癌术前诊断和后腹腔镜手术治疗提供参考依据和指导。方法 :选取2012年2月到2014年2月我院收治的70例肾癌患者为研究对象,均行Somatom Sensation40/64螺旋CT检查,参考Robson分期方法对64-SCT扫描结果肾癌患者进行分期,与手术病理结果进行比较。统计分析肾脏血管变异情况。结果:CT分期结果总准确率为95.71%(67/70),其中Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期准确率分别为92.00%、94.12%、95.65%、100.00%;CT分期Ⅲa期、Ⅲb期、Ⅲc期准确率分别为100.00%、100.00%、50.00%;对肾癌患者静脉栓诊断准确率为100.00%,对淋巴结转移诊断准确率仅为66.67%,对临近器官或远处转移诊断符合率为100.00%。70例患者35只肾脏发生动脉血管解剖异常。结论 :64-SCT多期扫描及三维重建可以对肾癌患者进行准确术前分期,为术前手术方案选择提供准确信息;同时可清楚显示肾脏肿块血供情况,及肿块与周围器官、血管、收集系统关系,为实施后腹腔镜手术提供丰富信息。     

肾细胞癌中鸟嘌呤核苷酸解离抑制因子2的表达及意义

目的 :探讨肾细胞癌组织中鸟嘌呤核苷酸解离抑制因子2(Rho GDI2)的表达及其与临床病理因素关系。方法 :选择2010年1月至2014年8月期间60例肾细胞癌患者为研究对象;检测癌及癌旁组织Rho GDI2表达,分析Rho GDI2的表达与肾细胞癌临床病理关系。结果 :肾细胞癌组织中Rho GDI2的表达水平高于癌旁组织,肾细胞癌组织中Rho GDI2表达的阳性率(70.0%)显著高于癌旁组织(38.3%),差异有统计学意义(χ2=12.1175,P=0.0005);肾细胞癌组织中Rho GDI2的表达与病理分期、分化程度、淋巴结转移、肿瘤大小有显著相关性(P<0.05)。结论 :Rho GDI2在肾细胞癌中呈高表达;肾细胞癌中Rho GDI2的表达参与了肾细胞癌的发病、转移和进展。     

肉芽肿性乳腺炎与乳腺浸润性导管癌的磁共振鉴别诊断

目的 :总结肉芽肿性乳腺炎与乳腺浸润性导管癌的鉴别诊断依据。方法 :回顾性分析经病理证实的37例肉芽肿性乳腺炎与62例乳腺浸润性导管癌患者的临床资料,所有患者磁共振成像(MRI)及扩散加权成像(DWI)资料均保存完整。将肉芽肿性乳腺炎、乳腺浸润性导管癌患者分别纳入肉芽肿性乳腺炎组、乳腺浸润性导管癌组,使用χ2检验对比两组常规MRI、增强MRI图像特点,使用t检验对比两组动态增强扫描参数以及表观弥散系数(ADC)值,总结肉芽肿性乳腺炎与乳腺浸润性导管癌的鉴别诊断思路。结果 :肉芽肿性乳腺炎与乳腺浸润性导管癌病灶象限分布、边缘、强化特点比较,差异有统计学意义(P <0.05)。肉芽肿性乳腺炎病灶早期强化率(EER)、峰值强化率(Emax)及ADC值均高于乳腺浸润性导管癌病灶,差异有统计学意义(P<0.05)。结论 :肉芽肿性乳腺炎与乳腺浸润性导管癌的临床与常规MRI表现存在一定相似之处,综合分析病灶象限分布、边缘、强化特点,以及动态增强扫描参数、ADC值,可进行鉴别诊断。     

MSCT和MRI对胫骨平台骨折的临床诊断价值

目的 :考察MRI和MSCT对胫骨平台骨折的临床诊断价值,以及其在胫骨平台骨折AO分型方面的指导价值。方法 :以我院2009年5月至2013年11月间收治的183例胫骨平台骨折患者为研究对象,对其MSCT和MRI检查结果进行汇总分析。对比分析两种影像手段对不同AO分型的胫骨平台骨折的诊断情况。结果 :经手术和联用其它检查手段,最终确诊AO分型中B型骨折患者96例(B1型46例、B2型31例、B3型19例),C型患者87例(C1型50例、C2型22例、C3型15例)。MSCT和MRI的诊断结果显示,MRI和CT在B1型、B2型、B3型、C2型的检出比例和确诊精度均相似,且差异无统计学意义(P>0.05)。但在C1和C3型骨折的检出比例和确诊精度方面,则以MRI较为理想,且差异具有统计学意义(P<0.05)。在合并伤方面,MSCT和MRI的检出情况接近,差异无统计学意义(P>0.05)。治疗效果显示,参考MSCT和MRI诊断结果制定的治疗方案合理、可靠,表明MSCT和MRI在对胫骨平台骨折的诊治具有明确的临床指导价值。结论 :MSCT和MRI对不同AO分型的胫骨平台骨折和其合并伤均有较好的诊断能力。     

Direct evaluation of fluorescence in single renal epithelial cells using a mitochondrial probe (DASPMI)

The study of distribution and quantitation of a fluorescent probe in living epithelia with the aid of an inverted microscope requires that individual cells can be analysed without optical interference from adjacent cells. This report describes the application of fluorescence microscopy and fluorometry to a recently developed in vitro culture system of renal epithelial cells. Epithelial cells derived from the mammalian renal cortical collecting tubule (CT) and the thick ascending loop of Henle (TAL) are cultivated as continuous monolayers in serum-free, hormone-supplemented media. A specific mitochondrial marker (DASPMI) is added to the medium and incorporated into the cytoplasm. The microscopic image reveals that the mitochondrial fluorescence distribution differs between CT and TAL cultures. The fluorometric quantitation shows a normally distributed histogram of medium-range intensity in TAL cell cultures while CT cultures exhibit a two-peak pattern of mitochondrial fluorescence distribution among epithelial cells.     

多层螺旋CT及多维重建技术对隐匿性肋骨骨折的诊断价值探讨

目的 :考察多层螺旋CT(MSCT)联合多维重建技术对隐匿性肋骨骨折的临床诊断价值,为该类疾病临床诊断提供参考。方法 :以我院2012年7月至2014年2月间收治的73例隐匿性肋骨骨折患者为研究对象,使用MSCT联合VR、SSD、CRP等多种重建技术对患者进行检查,统计并分析影像学检查结果。结果:73例患者经MSCT检查确诊隐匿性肋骨骨折107处,骨折多发于肋骨角(59.81%)且以非完全线性骨折为主(91.59%)。所用多维重建技术的诊断精度依次为:CRP(100.0%)>MPR(97.19%)>SSD(85.89%)>VR(78.50%)>MIP(27.88%)。结论 :MSCT联合多维重建技术对隐匿性肋骨骨折具有较为明确的诊断价值,MSCT与CRP/MPR及VR等联用可获得较为理想的诊断率。     

Silver-enhanced colloidal-gold labelling of rabbit kidney collecting-duct cell surfaces imaged by scanning electron microscopy

The luminal cell surfaces of rabbit kidney cortical collecting-duct cells were labelled with peanut lectin (PNA) and investigated by scanning electron microscopy. Labelling was performed either on 20-μm-thick cryostat sections from prefixed and cryoprotected rabbit kidney tissue or on cultured collecting-duct epithelium using biotinylated PNA and a 6-nm colloidal-gold-coupled antibody against biotin. Colloidal-gold labels were detected at low magnification (2000–4000 x) using silver enhancement. Coating with chromium allowed simultaneous imaging of both cell-surface morphology and labelling topography in the backscattered electron imaging mode. Our results show that PNA binding is specific for a subtype of intercalated cells equipped with microvilli on the luminal surface. The presented method promises to be useful for the identification of specific cell types in heterogeneous tissues.     

A potential impact of A Disintegrin and Metalloproteinase DomainLike Protein Decysin-1 (ADAMDEC1) on clear cell renal cell carcinoma propagation

Clear cell renal cell carcinoma (KIRC) is the most common and aggressive malignancy subtype of renal neoplasm that arises from proximal convoluted tubules. It is characterized by poor clinical outcomes and high mortality of patients due to the lack of specific biomarkers for varying stages of the disease and no effective treatment. Proteases are associated with the development of several malignant tumors in humans by their ability to degrade extracellular matrices, facilitating metastasis. Herein, differentially expressed genes in KIRC cases compared to healthy kidneys were screened out from the Gene Expression Profiling Interactive Analysis (GEPIA) database. This data was applied to determine the most elevated protease in KIRC and as a result, A Disintegrin and Metalloproteinase Domain-Like Protein Decysin-1 (ADAMDEC1) was selected. This expression pattern was exclusive for KIRC and not observed for papillary and chromophobe renal cell carcinomas, in which ADAMDEC1 was at the same level in tumors and non-cancer specimens. Furthermore, the ADAMDEC1 significant increase was detected in the fourteen other human malignancies compared to healthy samples, which suggested its strong involvement in cancer development. Next, GEPIA and Pathology Atlas correlated ADAMDEC1 high expression with more advanced tumor grade and shorter survival of KIRC patients. Xena Functional Genomics Explorer presented that ADAMDEC1 could be hypermethylated in some tumor cases and one somatic mutation in the gene sequence was detected. Finally, a Search Tool for the Retrieval of Interacting Genes/Proteins; STRING base was utilized to predict the interactions of ADAMDEC1 with other molecules and construct the signaling network. In summary, ADAMDEC1 showed the tremendous potential to be the predictive marker for the KIRC and its development. Therefore, this review with data analysis can be a good base for further in vitro and in vivo research that experimentally can confirm the ADAMDEC1 as prognostic biomarkers and therapeutic target of KIRC.     

Role of PTX3 and complement modulation in the tumor microenvironment

Pentraxin-3 (PTX3), the prototype of long pentraxins, seems to influence complement system (CS) modulation. PTX3 and CS sustain carcinogenesis, enriching tumor microenvironment (TME) with pro-inflammatory molecules promoting angiogenesis in prostate cancer (PC) and renal cell carcinoma (RCC). Furthermore, cancer cells overexpress complement regulatory proteins, such as CD46, CD55 and CD59, which negatively affect complement pathways for support cancer cells survival. This viewpoint aims to elucidate the ambivalent role of PTX3 and the CS in the context of tumor microenvironment (TME).     

Comparative B‐mode and Doppler renal ultrasonography with histopathological findings in dogs positive for canine visceral leishmaniasis

Morphological parameters and renal flow were assessed and measured in six clinically healthy dogs with negative serological and parasitological examinations for canine visceral leishmaniasis (CVL) and six dogs with CVL‐positive serological and parasitological tests and asymptomatic condition of the disease. Kidney length and diameter were measured and compared with the aorta/kidney ratio. Alterations in flow were measured using the flow velocity (cm/s) and resistance index (RI). Renal function was assessed by serum biochemical examination (urea, creatine, total proteins, albumin, and globulin) and urinalysis. CVL‐positive animals presented heterogeneous kidney echotexture, reduced vascular flow, hypoperfusion, lesser visualization of the arcuate arteries, high RI values (1.06 ± 0.28 for the right kidney and 1.10 ± 0.30 for the left kidney), reduced diastolic flow, and high systolic peak. They also presented positive creatine/RI correlation and between the renal artery vascular flow and kidney diameter. Histopathological analysis of CVL‐positive animals was compatible and confirmed hemodynamic changes observed by Doppler ultrasound. The findings in the present study showed that Doppler ultrasonography is a valid method to assess and detect alterations in flow in renal pathological processes with kidney vascular damage, as in the case of leishmaniasis, and can help in the diagnosis of animals with this infection. Microsc. Res. Tech. 79:637–645, 2016. © 2016 Wiley Periodicals, Inc.     

Automated recognition and mapping of immunolabelled neurons in the developing brain

The cerebral cortex is distinguished by layers of neurons of different morphologies and densities. The layers are formed by the migration of newly generated neurons from the ventricular zone to the cortical plate near the outer (pial) boundary of the cortex, along radial paths approximately perpendicular to the cortical surface. Immunochemical labelling makes these cells' patterns visible in brightfield microscopy so that layer formation can be studied. We developed a suite of programs that automatically digitize the entire cortex, identify the labelled cells and compute cell densities along local radial paths. Cell identification used supervised classification on all the significantly stained objects corresponding to maxima in lowpass filtered versions of the digital micrographs. Classification of all the stained objects as cells or noncell objects was made by a decision rule based on morphometric and grey-level texture features, including features based on Gabor functions. Detection sensitivity and classification accuracy were jointly maximized on training data consisting of about 3000 expert-identified neurons in micrographs. Total program performance was tested on a separate (test) set of labelled neurons the same size as the training data set. The program detected 85% of the cells in the test set with a total error of 019. The identified cells' locations were used to compute population densities along normals to the cortical layers, and these densities served as a measure of neuronal migration. Transcortical density profiles obtained by computation and by manual cell counting were very similar. The cell identification program was built on well-established methods in statistical pattern recognition and image analysis and should generalize readily to other histological preparations.