肝内型胆管细胞癌与肝细胞癌CT表现对比分析

目的 探讨肝内型胆管细胞癌与肝细胞肝癌螺旋CT鉴别诊断.方法 回顾性分析经病理证实的肝内型胆管细胞型肝癌15例,肝细胞肝癌30例,对MSCT双期(动脉期及门脉期)增强及延迟扫描的CT特征和临床表现进行对照分析.结果 肝内型胆管细胞癌在增强扫描过程中为动脉,门脉期强化不明显或边缘强化,并有延迟强化(10/15例).肝细胞型肝癌为动脉期不均匀强化.而门脉期较周围正常肝组织密度低,无延迟强化(25/30例).胆管细胞癌呈片状,无占位效应(15/15例),其内或周围有胆管扩张(15/15例),可伴胆管结石(3/15例),所在肝叶萎缩(5/15例),可有淋巴结转移(8/15例).而肝细胞癌则伴肝硬化(14/30例).AFP升高(23/30例),少有淋巴结转移(2/30例).结论 MSCT动态增强扫描加延迟扫描是诊断原发性肝癌组织来源的关键技术,两种病理类型肿瘤的强化方式的差别是其影像诊断的重要依据.其它CT征象有辅助诊断价值.     

肝细胞癌的螺旋CT双期增强特征及其诊断价值

目的探讨肝细胞癌的螺旋CT双期增强特征及其诊断价值。方法回顾性分析42例经临床及手术病理证实的肝细胞癌双期增强表现。结果42例共发现60个病灶。平扫呈低密度或等密度;肝动脉期91.7%强化,8%无明显强化;门脉期80%呈低密度或稍低密度,病灶密度呈"速升速降"的变化特点。结论螺旋CT双期扫描可充分反映肝细胞癌的特征,对肝细胞癌的检出和定性准确率的提高有重要价值。     

肝癌螺旋CT双期增强扫描的特征分析及诊断价值

目的探讨原发性肝癌的螺旋CT双期增强扫描特征及诊断价值。方法回顾性分析36例经临床及手术、病理证实的原发性肝癌双期增强扫描的表现。结果36例平扫呈低密度或等密度;肝动脉期33例强化,占91.7%,3例无明显强化占8.3%;门脉期32例呈低密度或稍低密度,占88.9%,病灶密度呈"速升速降"的变化特点。结论螺旋CT双期增强扫描可充分反映原发性肝癌的增强特征,对原发性肝癌的诊断有重要价值。     

螺旋CT双期增强扫描对原发性肝癌诊断的初探

目的探讨螺旋CT诊断原发性肝癌的可行性。方法回顾分析笔者所在医院诊治的34例原发性肝癌的临床资料。结果本组34例,其发现47个病灶。平扫呈低密度或等密度;门脉期77%呈低密度或稍低密度;肝动脉期92%强化,8%无明显强化,无论在上升阶段还是下降阶段,病灶密度变化幅度都比较大。结论螺旋CT双期扫描可充分反映原发性肝癌的特征,对提高肝癌准确的诊断提供了重要的依据。     

胰腺实性假乳头状瘤的CT影像特点分析

目的分析胰腺实性假乳头状瘤的CT影像特点。方法对2004年6月至2010年5月我院诊治并经术后病理检验证实的25例胰腺实性假乳头状瘤患者的CT影像进行观察、分析、总结。结果肿瘤大小不等,平均7.4cm,呈分叶状、椭圆形及类圆形,多发于胰腺头、尾;25例中肿瘤表现为囊性1例、实性3例、实性与囊性混合存在21例;肿块钙化6例,肿瘤实性成分在动脉期出现轻度强化,延迟期和门脉期强化明显;肿瘤包膜强化明显、囊性成分未出现强化;包膜完整且同其周围分界清晰者21例、包膜不完整且同其周围分界不清晰者4例。胆管及主胰管未发现明显扩张、远端胰腺未出现萎缩、周围组织如腹膜后、肝门、胰头旁均未出现淋巴结的明显肿大。结论 CT影像的特点分析、掌握有助于临床诊断的准确性的提高,可作为临床诊断的参考标准。     

螺旋CT在诊断肝脏局灶性结节性增生中的应用研究

目的提高对肝脏局灶性结节增生(FNH)CT表现的认识,探讨多层螺旋CT的诊断价值。方法对21例经手术病理证实的FNH的CT表现进行回顾性分析。结果18例为单发病灶,3例为2个病灶。CT平扫22个病灶呈低密度,2个为等密度。CT强化特点:病灶动脉期快速显著增强而门静脉期及延迟扫描为等密度,22个病灶检出瘢痕。结论多层螺旋CT多期增强扫描能显示FNH的增强特征性改变。     

小肾癌的螺旋CT诊断与鉴别诊断

目的探讨肾脏小肾癌的影像学特征和鉴别诊断。方法对2001年至今我院经手术和病理证实的直径≤3cm的小肾癌的影像学表现进行分析,总结其影像学特征,并进行鉴别诊断。结果本组小肾癌9例9个病灶,全部行螺旋CT三期扫描,动脉期8个病灶明显强化,1个病灶轻度强化,实质期病灶内造影剂明显退出。本组病例病理诊断均为肾透明细胞癌。结论小肾癌螺旋CT三期扫描多数病灶动脉期呈明显强化,这反映小肾癌的多血供特点[1],实质期强化明显减低,呈典型的"快进快出"特点,少数少血供病灶强化不明显。     

多层螺旋CT对肝实质异常灌注的评价

目的用多层螺旋CT研究各类肝脏异常灌注的CT表现,并探讨其病理基础。方法回顾性分析2年半内接受上腹部螺旋CT平扫及三期增强检查的400例病人的CT表现,其中35例发现肝脏实质异常灌注,对各种类型的异常灌注病例进行病因和发生机制的探讨。结果肝细胞肝癌导致肝动脉-门静脉瘘7例,炎症充血8例,门静脉癌栓13例,肾癌导致下腔静脉癌栓1例,胆道梗阻2例,转移瘤周围异常灌注4例。结论多层螺旋CT三期增强是评价各类肝脏异常灌注的有效方法.熟悉肝脏异常灌注的CT表现有助于对其所反映的病理生理状况作出准确推断     

肝脏局灶性结节增生的CT和MRI诊断价值的比较

目的探讨肝脏局灶性结节增生(FNH)的CT和MRI及诊断价值。方法回顾性分析31例经手术病理证实为肝脏FNH的CT和MR表现,研究其影像的诊断价值。结果31例FNH的CT和MR中21例表现较为典型,CT平扫等密度,T1WI为等信号,T2WI为等信号或稍高信号;部分病灶可见中央区低密度瘢痕,增强动脉期除中央瘢痕外均明显强化,门静脉期常见明显强化,延时期多为等密度,瘢痕可稍有强化;术前作出正确诊断。10例FNH表现不典型,CT低密度灶,T1WI为低信号,T2WI为高信号,无瘢痕和轻度强化;术前5例诊断为恶性肿瘤,5例诊断为血管瘤。而MRI注射特异性造影剂后能正确诊断为FNH。结论FNH的CT和MR表现在术前进行综合分析,多数可明确诊断。对于不典型表现的FNH,MRI对FHN的诊断价值高于CT。     

47例肝脓肿CT诊断与分析

目的探讨肝脓肿的CT影像学特征,提高诊断准确性。方法回顾性分析经临床、手术、穿刺和病理证实的47例肝脓肿病例的临床及CT影像学资料。结果肝脓肿的CT平扫均呈低于邻近正常肝组织的低密度病灶,肝脓肿增强可表现为环靶征、簇状征、肝段强化和脓腔内气体CT诊断的特征性征象,本组诊断准确率为80.9%,误诊为肝癌5例,血管瘤4例。结论螺旋CT平扫及增强扫描可以较准确地诊断肝脓肿及减少误诊率,因此可作为肝脓肿的首选诊断方法。     

肝门区胆管癌的多层螺旋CT术前评估价值

目的探讨肝门区胆管癌的MSCT表现及术前评估价值。方法对31例肝门区胆管癌进行前瞻性研究,分析MSCT平扫及增强表现,术前评估肿瘤的手术可切除性,并与手术病理对照。结果31例肝门区胆管癌均显示肝内胆管不同程度扩张,胆管狭窄、中断,其中可见肝门区肿块24例,MSCT以增强延迟强化为主。术前可切除性评估与手术病理对照,其差异性无统计学意义(P>0.05)。结论MSCT平扫结合三期增强对显示肝门区胆管癌的直接和间接征象有较大帮助,大大提高了术前评估的准确性。     

多层螺旋CT多期增强扫描对小肾癌的诊断价值

目的探讨64层螺旋CT多期增强扫描对小肾癌的诊断价值。方法回顾性分析23例经手术或活检证实的小肾癌的螺旋CT资料及病理结果。结果 CT平扫中8例为等密度,14例为略低密度,1例为囊实性混杂密度。增强扫描皮质期18例强化程度高于或相当于正常肾皮质,3例强化低于肾皮质但高于肾髓质,1例强化程度等于肾髓质,1例囊实性病例囊壁明显强化。肾实质期扫描23例均显示肿瘤强化迅速减退,肾盂期扫描肿瘤密度进一步减退。结论多层螺旋CT多期增强扫描对小肾癌的诊断是可靠有价值的诊断方法,特别是小肾癌皮质期强化明显,实质期强化迅速减退,呈快进快出表现,有重要的定性意义。     

新生儿缺血缺氧性脑病的CT诊断

目的探讨新生儿缺血缺氧性脑病(HIE)的CT表现特点及其鉴别诊断。方法对50例新生儿缺血缺氧性脑病的患儿的临床表现及CT影像表现进行分析。结果根据CT表现分为轻、中、重度,其中轻度20例,占40%;中度23例,占46%;重度7例,占14%。结论CT检查能对新生儿缺血缺氧性脑病做出早期诊断及病情分度,并能明确其范围,确定是否合并颅内出血,为临床提供可靠的影像资料。     

脾动脉栓塞对门静脉高压的疗效观察

目的探讨部分脾动脉栓塞术(PSE)治疗肝炎肝硬化门静脉高压症并发脾功能亢进的疗效及临床意义。方法通过我院98例肝炎肝硬化门静脉高压症并发脾功能亢进患者行PSE,观察术前及术后脾脏大小变化、门静脉内径变化及并发症情况。结果与术前相比,脾脏3个月后明显缩小,门静脉内径不同程度缩小,术后无严重并发症发生。结论 PSE治疗肝炎肝硬化门静脉高压症合并脾功能亢进安全有效。     

Enhanced Visible Light Absorption in a Photocatalytic Thin Film from a Decoupled Photonic Crystal

The optical and photocatalytic properties of a photonic crystal structure were examined to elucidate the origin of the enhanced visible light absorption from semiconductor photonic crystals. Both an enhancement in visible light absorption and an increase of the photoactivity of the semiconductor photocatalyst were found when a photonic crystal layer was decoupled from the photocatalytic film. The decoupling clearly shows that the optical enhancement arose from the dielectric mirror effect of the photonic crystal. As such, the enhancement was maximized by matching the high light absorbance region of photocatalytic semiconductors with the characteristic photonic band gap of the decoupled photonic crystal layer under various illumination conditions. For enhanced visible light photocatalytic activity, the decoupled photonic crystal layer does not have to be made from the same light-harvesting materials, but can be synthesized by a wide range of materials for ease of the fabrication process.     

灰阶超声造影对肝肿瘤21例诊断的临床应用

目的：探讨灰阶超声造影在肝肿瘤诊断上的临床应用价值。方法：选取我院2013年1月至2015年1月收治的21例肝肿瘤患者,采用SonoVue造影剂进行灰阶超声造影检查,并且和二维超声、彩色多普勒超声造影检查比较分析。结果：灰阶超声造影准确定性了19例患者,彩色多普勒超声为12例,常规超声为10例,准确定性率依次为90.5%、57.1%、47.6%。结论：二代造影剂SonoVu e能够持续观察病灶内部的血流灌注状况,与增强MRI和增强CT的检查原理以及判断标准相一致,在超声诊断肝肿瘤患者上具有新型性和实用性。     

In Vitro Evaluation of Rigosertib Antitumoral and Radiosensitizing Effects against Human Cholangiocarcinoma Cells

Cholangiocarcinoma is the first most common cancer of the biliary tract. To date, surgical resection is the only potentially curative option, but it is possible only for a limited percentage of patients, and in any case survival rate is quite low. Moreover, cholangiocarcinoma is often chemotherapy-resistant, and the only drug with a significant benefit for patient’s survival is Gemcitabine. It is necessary to find new drugs or combination therapies to treat nonresectable cholangiocarcinoma and improve the overall survival rate of patients. In this work, we evaluate in vitro the antitumoral effects of Rigosertib, a multi-kinase inhibitor in clinical development, against cholangiocarcinoma EGI-1 cell lines. Rigosertib impairs EGI-1 cell viability in a dose- and time-dependent manner, reversibility is dose-dependent, and significant morphological and nuclear alterations occur. Moreover, Rigosertib induces the arrest of the cell cycle in the G2/M phase, increases autophagy, and inhibits proteasome, cell migration, and invasion. Lastly, Rigosertib shows to be a stronger radiosensitizer than Gemcitabine and 5-Fluorouracil. In conclusion, Rigosertib could be a potential therapeutic option, alone or in combination with radiations, for nonresectable patients with cholangiocarcinoma.     

Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings

Lung fibrosis has specific computed tomography (CT) findings and represents a common finding in advanced COVID-19 pneumonia whose reversibility has been poorly investigated. The aim of this study was to quantify the extension of collagen deposition and aeration in postmortem cryobiopsies of critically ill COVID-19 patients and to describe the correlations with qualitative and quantitative analyses of lung CT. Postmortem transbronchial cryobiopsy samples were obtained, formalin fixed, paraffin embedded and stained with Sirius red to quantify collagen deposition, defining fibrotic samples as those with collagen deposition above 10%. Lung CT images were analyzed qualitatively with a radiographic score and quantitatively with computer-based analysis at the lobe level. Thirty samples from 10 patients with COVID-19 pneumonia deceased during invasive mechanical ventilation were included in this study. The median [interquartile range] percent collagen extension was 6.8% (4.6–16.2%). In fibrotic compared to nonfibrotic samples, the qualitative score was higher (260 (250–290) vs. 190 (120–270), p = 0.036) while the gas fraction was lower (0.46 (0.32–0.47) vs. 0.59 (0.37–0.68), p = 0.047). A radiographic score above 230 had 100% sensitivity (95% confidence interval, CI: 66.4% to 100%) and 66.7% specificity (95% CI: 41.0% to 92.3%) to detect fibrotic samples, while a gas fraction below 0.57 had 100% sensitivity (95% CI: 66.4% to 100%) and 57.1% specificity (95% CI: 26.3% to 88.0%). In COVID-19 pneumonia, qualitative and quantitative analyses of lung CT images have high sensitivity but moderate to low specificity to detect histopathological fibrosis. Pseudofibrotic CT findings do not always correspond to increased collagen deposition.     

Photoresponsive permeability of polyelectrolyte complex capsule membrane containing triphenylmethane leucohydroxide residues

To develop a functional capsule, which can be controlled to release materials entrapped in the inner aqueous space responding to light, partly crosslinked poly(acrylic acid)–poly-ethylenimine complex capsules containing a copolymer of acrylic acid and bis[4-(dimethylamino)phenyl](4-vinylphenyl)methyl leucohydroxide as an additional membrane component with radii of ca. 3 mm have been prepared. The triphenylmethane derivative on the copolymer dissociated into an ion pair under ultraviolet light irradiation in the weak alkaline region. Permeation of p-toluenesulfonate through the capsule membrane was enhanced significantly by the photoirradiation after a several minutes time lag under a weak alkaline condition. The photoinduced increase in permeability of the capsule was pH-dependent. The maximum effect of light on the permeability was observed near pH 8, whereas less enhancement was observed above or below the pH value. When the irradiation of the light was stopped, permeation of the permeant decreased. The photoresponsive permeability change of the capsule membrane can be carried out reversibly. © 1995 John Wiley & Sons, Inc.     

The Association of Il28b Genotype with the Histological Features of Chronic Hepatitis C Is HCV Genotype Dependent

The interleukin 28B (IL28B) rs12979860 polymorphism is associated with treatment outcome in hepatitis C virus (HCV) genotype 1 and 4 patients. Its association with the histological features of chronic hepatitis C and disease severity needs further clarifications. To assess the correlation between IL28B genotype, HCV genotype and liver biopsy findings in untreated patients.

Materials and Methods

Pre-treatment liver biopsies from 335 HCV Caucasian patients (59% males, age 50 years) enrolled in the MIST study were staged for fibrosis and inflammation according to the METAVIR and the Ishak scoring systems; steatosis was dichotomized as <5% or ≥5%. IL28B was typed by Taqman Single Nucleotide Polymorphism (SNP) genotyping assay. HCV genotype was 1 in 151 (45%), 2 in 99 (30%), 3 in 50 (15%) and 4 in 35 (10%) patients. IL28B genotype was CC in 117 (34%), CT in 166 (49%) and TT in 52 (15%). At univariate analysis, the IL28B CC genotype was associated with severe portal inflammation in HCV-1 patients (CC vs. CT/TT: 86% vs. 63%, p = 0.005), severe lobular inflammation in HCV-2 patients (CC vs. CT/TT: 44% vs. 23%, p = 0.03), and less fatty infiltration in HCV-1 patients (CC vs. CT/TT: 72% vs. 51%, p = 0.02). Despite the lack of any association between IL28B and fibrosis stage, in HCV-3 patients IL28B CC correlated with METAVIR F3–F4 (CC vs. CT/TT: 74% vs. 26%, p = 0.05). At multivariate analysis, the genotype CC remained associated with severe portal inflammation in HCV-1, only (Odds Ratio (OR): 95% Confidence Interval (CI): 3.24 (1.23–8.51)). IL28B genotype is associated with the histological features of chronic hepatitis C in a HCV genotype dependent manner, with CC genotype being independently associated with severe portal inflammation.