胰腺实性假乳头状瘤CT和MRI诊断

目的:分析胰腺实性假乳头状瘤的CT和MRI表现。方法:回顾性分析经我院手术病理证实10例胰腺实性假乳头状瘤CT及MRI的影像资料,其中CT检查8例,MRI检查6例,同时行CT及MRI4例。结果:8例肿瘤呈类圆形,边缘光整,2例肿瘤边缘呈分叶。肿瘤表现为囊实性结构5例,囊性结构为主3例,实性结构2例。CT增强扫描肿瘤实性部分及分隔呈轻度至中度强化,囊性部分各期均无强化。肿瘤MRI信号不均匀,实性部分T1WI稍低、等信号,T2WI呈高信号,囊性部分呈T1WI低信号,T2WI呈高信号。结论 :胰腺实性假乳头状瘤的CT及MRI表现有一定特征性,结合临床,较好地做出术前正确诊断及鉴别诊断。     

侧脑室中枢神经细胞瘤的MRI分析

目的:分析侧脑室中枢神经细胞瘤的MRI表现。方法:回顾性分析经手术证实的CNC6例。男4例,女2例,年龄15-48岁,平均年龄38.5岁。结果:本组6例病例肿瘤均位于侧脑室透明隔近孟氏孔处。在MRI T1WI像呈不均匀等或低信号,T2WI呈不均匀高信号,肿瘤内可有囊变区,增强扫描呈不均匀中等强化,边界清楚。结论:中青年位于侧脑室腔明隔的肿瘤,应考虑致CNC的可能。结合临床及MRI表现有助于此病的诊断。     

卵巢透明细胞癌的CT和MRI诊断分析

目的:探讨卵巢透明细胞癌(Ovarian Clear Cell Carcinoma,OCCA)的CT和MRI影像学表现的临床价值。方法:回顾性分析5例经病理证实的OCCA的CT及MRI资料。3例患者行CT平扫及增强检查,2例患者先后行CT及MRI平扫及增强扫描。结果:5例中平均发病年龄50岁左右。CT表现:14例位于左侧卵巢,1例位于左侧跨中线生长,瘤体直径4-11cm。25例为囊实性肿块:3例囊性为主,1例实性为主,1例多房囊性肿块。3病变均有完整包膜,实性部分及分隔动脉期呈中度强化,静脉期持续强化,延迟包膜强化呈稍高密度。4MRI表现:1例为以囊性为主的囊实性肿块,囊性部分呈长T1长T2信号,实性部分呈稍长T1稍长T2信号,DWI均呈高信号;1例多房囊性肿块,囊液信号不均,分隔呈等T1稍长T2信号。增强扫描2例肿瘤实性部分及分隔动脉期轻中不均匀强化,静脉期呈持续性明显强化,延迟期包膜持续强化呈稍高信号。结论:OCCA的CT和MRI影像学表现具有特征性,结合临床表现及相关实验室检查,有助于提高诊断OCCA准确性。     

对比分析MRI与CT诊断颅内肿瘤的临床价值

目的:探讨核磁共振成像(magnetic resonance imaging,MRI)技术与计算机断层扫描(computer tomography,CT)在颅内肿瘤临床诊断中的效果差异。方法:纳入2014年1月至2019年1月期间曾在我院放射科检查后经外院穿刺检查或手术病理确诊为颅内肿瘤的患者共60例为研究对象,对所有患者的MRI与CT成像结果进行回顾性分析,以病理检查结果为金标准分析MRI与CT诊断准确性及肿瘤定位方面的差异。结果:经病理检查诊断出恶性肿瘤29例,良性肿瘤31例,观MRI检查方法的灵敏度要高于CT诊断,假阴性率低于CT诊断法,结果差异相比P0.05;MRI检查中良性肿瘤表现为T1WI的等信号、低信号或高信号影像,而T2WI呈现高信号或等信号影像,在进行增强扫描后均呈现强化特征。在T1WI低信号或等信号,T2WI呈现高信号或混杂信号的情况下,实施增强扫描后存在有花环状、斑片状、不规则结节样的强化影像则为恶性肿瘤影像;在CT检查中良性肿瘤的形态主要为圆形或类圆形,一般边界清楚,如成像结果显示存在高密度的块状或混杂密度块状影像,瘤体呈现低密度改变,实质块影像或伴随散在的钙化灶影像,边界不清晰,则诊断为恶性肿瘤。结论:MRI诊断方法具有更高的准确性,更低的误诊率,在颅内肿瘤临床诊断应用中具有更好的效果。     

Rathke囊肿的MRI诊断

目的:探讨Rathke囊肿的MRI表现及其诊断价值。方法:回顾性分析12例经手术和病理证实的Rathke囊肿病例的MRI资料,观察其MRI表现。结果:12例Rathke囊肿中,单纯位于鞍内者4例,鞍内鞍上者8例,MRI信号多样,其中T1WI低信号,T2WI高信号者4例;T1WI高信号,T2WI高信号者6例;T1WI高信号,T2WI低信号者2例,增强后其中11例均无明显强化,仅1例囊壁有环形强化。结论:MRI在Rathke囊肿的定位、定性及鉴别诊断中具有重要价值。     

老年双侧亚急性及慢性硬膜下血肿的低场MRI表现

目的：探讨老年双侧亚急性及慢性硬膜下血肿低场MRI表现特征。方法：回顾性分析15例手术证实的老年双侧亚急性及慢性硬膜下血肿的0.35T MRI资料。结果：病灶呈新月形或梭形,MRI亚急性期和慢性早期表现T1WI及T2WI高信号,慢性期呈T1WI低T2WI高信号,信号可均匀或不均匀。2例增强MRI显示病灶无强化,可见强化皮质血管内移。病灶最厚处1.1-3.8cm,平均2.5cm。结论：MRI可准确诊断老年双侧亚急性及慢性期硬膜下血肿。     

颅底孤立性骨浆细胞瘤的影像表现特征及鉴别诊断

目的:探讨颅底浆细胞瘤的影像特征及鉴别诊断。方法:回顾分析10例经手术病例证实的浆细胞瘤的患者,均行CT或MR扫描,影像检查重点观察了肿瘤的发生部位,信号特点,侵润范围,骨质破坏情况,和增强扫描特征。结果:10例有5例发生斜坡,3例发生岩尖区,1例发生鞍区,颅底骨孤立性浆细胞瘤的CT和MRI特点如下:1CT平扫肿瘤表现为等或稍高密度实性肿块,邻近颅底骨质呈溶骨性破坏,无骨质硬化边缘。肿瘤内常见斑片状高密度影,为瘤内钙化或骨质残片。2MRI平扫肿瘤呈等T1或稍长T1、等T2或短T2信号,增强后明显均匀强化。结论:颅底孤立性骨浆细胞瘤的MR表现与肿瘤起源部位和侵润范围有着密切关系,肿瘤的MR表现与某些肿瘤十分相似,不易鉴别。MR能够清楚地显示肿瘤及其与周围组织的关系,是显示浆细胞瘤及其侵润范围的最佳影像学检查方法。     

CT及MRI在黄色肉芽肿性胆囊炎诊断中的应用

目的:探讨CT及MRI在黄色肉芽肿性胆囊炎诊断中的应用。方法:选取于2012年10月-2015年10月在我院接受治疗的黄色肉芽肿性胆囊炎患者共15例。采用CT与MRI进行检查,分析检查结果。结果:15例患者的胆囊均存在不同程度的增大、胆囊壁增厚现象,其中,局限性增厚共4例,弥漫性增厚共11例。增强扫描后,有6例可见"夹心饼干征",另有7例邻近肝实质一过性强化。采用MRI检查的8例患者中:胆囊壁内结节T1WI呈现为低信号或等信号,T2WI均呈现为高信号。结论:临床上诊断黄色肉芽肿性胆囊炎时,CT显示"夹心饼干征"是重要标志,而MRI则显示胆囊内结石、胆囊黏膜线的完整性及胆囊周围的病变情况更具优势,因此,两者结合用于黄色肉芽肿性胆囊炎的临床检查中能够提升诊断率。     

腮腺良恶性肿瘤的磁共振表现分析

目的:分析腮腺良恶性肿瘤的MRI图像特点,提高腮腺肿瘤的术前诊断率。方法:回顾性分析我院34例腮腺肿瘤MRI图像及临床特点。包括肿瘤部位、形态、边缘,肿瘤的信号特点及强化方式,与周围结构的关系。结果:34个病例中,32例良性,2例恶性。良性肿瘤:混合瘤、腺淋巴瘤、表皮样囊肿、淋巴上皮囊肿;恶性肿瘤:淋巴上皮瘤样癌和腺泡细胞癌。多形性腺瘤共13例,10例浅叶,3例深叶,T2WI序列上高信号9例,高低混杂信号4例。7例明显强化,4例轻度强化,1例环形强化,1例未见明显强化;腺淋巴瘤共13例,均位于腮腺深叶,腮腺的下极。T2WI序列上稍高信号7例,等信号1例,高低混杂信号5例。强化方式13例均为轻度强化;表皮样囊肿4例,3例腮腺表面,1例腮腺浅叶。T2WI高信号,2例不强化,2例环形强化;淋巴上皮囊肿2例,腮腺浅叶。T2WI高信号,1例不强化,1例环形强化;淋巴上皮瘤样癌1例,腮腺深叶,T2WI等信号,轻度强化。腺泡细胞癌1例,腮腺深叶,T2WI混杂信号,轻度强化。结论:磁共振鉴别腮腺良恶性肿瘤有困难,但对多形性腺瘤及腺淋巴瘤诊断影像表现有特异性。     

小脑血管母细胞瘤CT、MR影像诊断

目的:分析小脑血管母细胞瘤CT、MR影像特征,总结诊断价值。方法:2014年2月-2016年12月,医院共诊断小脑血管母细胞瘤14例,MR、CT平扫与增强扫描。结果:患者均表现为小脑半球囊性或实性占位,囊壁强化瘤结节影。MR诊断分型大囊性小结节型患者10例,3例实性型表现,1例囊实性。CT检未发现胰腺、肾、腹睾等囊肿与肿瘤,CT平扫典型表现为大囊小附壁结节表现,CT10-20Hu,4例患者表现为囊性区,4例实质性病灶边缘不清,1例肿瘤进入小脑延髓池,增强扫描CT上升15-20Hu,5例实性或混合性增强明显。CT、MR定位诊断率100%,定性诊断符合率100%。结论 :CT、MR定位、诊断小脑血管母细胞瘤的价值较高,检查后可获得丰富的有关于肿瘤性质、侵袭、大小等信息,为治疗提供依据。     

成像及波谱成像联合运用对乳腺癌早期诊断的价值

目的:探讨成像及波谱成像联合运用对乳腺癌早期诊断的临床价值。方法:收集我院2012年1月-2013年11月诊治的60例乳腺癌患者,均经siemens(西门子)Avanto1.5T超导磁共振检查。结果:60例经过手术病理或穿刺病理检查确诊良性肿瘤31例,肿瘤直径1.8cm-5.1cm,平均2.9cm,其中纤维腺瘤28例,慢性乳腺炎2例,导管内乳头状瘤1例。乳腺癌29例,肿瘤直径1.1cm-4.6cm,平均2.6cm,其中浸润性导管癌26例,导管原位癌1例,髓样癌1例,浸润性小叶癌1例。31例良性患者中流入型17例,平台型10例,流出型4例,29例恶性患者中流入型4例,平台型9例,流出型16例,两组比较有显著性差异(P0.05)。结论:成像及波谱成像联合运用对乳腺癌早期诊断有着重要的临床意义,值得临床推广。     

Traceable Nanoparticles with Dual Targeting and ROS Response for RNAi‐Based Immunochemotherapy of Intracranial Glioblastoma Treatment

The chemotherapy of glioblastoma is severely hindered by the immunosuppressive tumor microenvironment, especially the tumor growth factor β (TGF‐β), an immunosuppressive cytokine. In this study, it is proposed to employ RNAi‐based immunomodulation to modify the tumor immune microenvironment and improve the effect of chemotherapy. Herein, a nanotheranostic system (Angiopep LipoPCB(Temozolomide+BAP/siTGF‐β), ALBTA) with dual targeting and ROS response is established for intracranial glioblastoma treatment. The traceable nanoparticles exhibit strong siRNA condensation, high drug loading efficiency, good serum stability, and magnetic property. They can efficiently cross the blood–brain barrier and target to glioblastoma cells via receptor‐mediated transcytosis. The zwitterionic lipid (distearoyl phosphoethanol‐amine‐polycarboxybetaine lipid) in ALBTA promotes endosomal/lysosomal escape, and thus enhances the cytotoxicity of temozolomide and improves gene silencing efficiency of siTGF‐β. ALBTA significantly improves the immunosuppressive microenvironment and prolongs the survival time of glioma‐bearing mice. Moreover, ALBTA can be accurately traced by MRI in brain tumors. The study indicates that this immunochemotherapeutic platform can serve as a flexible and powerful synergistic system for treatment with brain tumors as well as other brain diseases in central nervous system.     

Selectively Potentiating Hypoxia Levels by Combretastatin A4 Nanomedicine: Toward Highly Enhanced Hypoxia‐Activated Prodrug Tirapazamine Therapy for Metastatic Tumors

Hypoxia‐activated prodrugs (HAPs) have the potential to selectively kill hypoxic cells and convert tumor hypoxia from a problem to a selective treatment advantage. However, HAPs are unsuccessful in most clinical trials owing to inadequate hypoxia within the treated tumors, as implied by a further substudy of a phase II clinical trial. Here, a novel strategy for the combination of HAPs plus vascular disrupting agent (VDA) nanomedicine for efficacious solid tumor therapy is developed. An effective VDA nanomedicine of poly(l ‐glutamic acid)‐graft‐methoxy poly(ethylene glycol)/combretastatin A4 (CA4‐NPs) is prepared and can selectively enhance tumor hypoxia and boost a typical HAP tirapazamine (TPZ) therapy against metastatic 4T1 breast tumors. After treatment with the combination of TPZ plus CA4‐NPs, complete tumor reduction is observed in 4T1 xenograft mice (initial tumor volume is 180 mm³), and significant tumor shrinkage and antimetastatic effects are observed in challenging large tumors with initial volume of 500 mm³. The report here highlights the potential of using a combination of HAPs plus VDA nanomedicine in solid tumor therapy.     

MR对椎体终板骨软骨炎的诊断价值及临床意义

目的:探讨MR对椎体终板骨软骨炎的诊断价值及临床意义.方法:选取我院2019年12月至2020年12月共114例椎体终板骨软骨炎患者作为研究对象,分析MR在椎体终板骨软骨炎中的诊断价值以及临床特点.结果:所有患者均可在图像中发现不同程度的椎间盘变性或膨出,椎间盘与相邻椎体边缘呈现为斑片状、条片状异常信号灶.T1WI序列...     

彩色多普勒高频超声在女性乳腺增生症中的诊断价值

目的:探讨彩色多普勒高频超声对乳腺增生症的诊断价值,以提高超声对乳腺增生症的诊断价值。方法:观察59例经手术病理或病理活检证实为乳腺增生症患者的乳腺声像图及血流情况。结果:乳腺增生症的声像特点分为以下四种类型:(1)单纯性增生:共28例;(2)囊性增生:共6例;(3)腺瘤样增生:共6例:(4)混合型:以上三型同时存在,共19例。结论:彩色多普勒高频超声诊断女性乳腺增生症具有重要的临床诊断价值。     

Biocompatible Semiconductor Quantum Dots as Cancer Imaging Agents

Approximately 1.7 million new cases of cancer will be diagnosed this year in the United States leading to 600 000 deaths. Patient survival rates are highly correlated with the stage of cancer diagnosis, with localized and regional remission rates that are much higher than for metastatic cancer. The current standard of care for many solid tumors includes imaging and biopsy with histological assessment. In many cases, after tomographical imaging modalities have identified abnormal morphology consistent with cancer, surgery is performed to remove the primary tumor and evaluate the surrounding lymph nodes. Accurate identification of tumor margins and staging are critical for selecting optimal treatments to minimize recurrence. Visible, fluorescent, and radiolabeled small molecules have been used as contrast agents to improve detection during real‐time intraoperative imaging. Unfortunately, current dyes lack the tissue specificity, stability, and signal penetration needed for optimal performance. Quantum dots (QDs) represent an exciting class of fluorescent probes for optical imaging with tunable optical properties, high stability, and the ability to target tumors or lymph nodes based on surface functionalization. Here, state‐of‐the‐art biocompatible QDs are compared with current Food and Drug Administration approved fluorophores used in cancer imaging and a perspective on the pathway to clinical translation is provided.     

Photothermal Therapy Promotes Tumor Infiltration and Antitumor Activity of CAR T Cells

Chimeric antigen receptor (CAR)‐redirected T lymphocytes (CAR T cells) show modest therapeutic efficacy in solid tumors. The desmoplastic structure of the tumor and the immunosuppressive tumor microenvironment usually account for the reduced efficacy of CAR T cells in solid tumors. Mild hyperthermia of the tumor reduces its compact structure and interstitial fluid pressure, increases blood perfusion, releases antigens, and promotes the recruitment of endogenous immune cells. Therefore, the combination of mild hyperthermia with the adoptive transfer of CAR T cells can potentially increase the therapeutic index of these cells in solid tumors. It is found that the chondroitin sulfate proteoglycan‐4 (CSPG4)‐specific CAR T cells infused in Nod scid gamma mice engrafted with the human melanoma WM115 cell line have superior antitumor activity after photothermal ablation of the tumor. The findings suggest that photothermal therapy facilitates the accumulation and effector function of CAR T cells within solid tumors.     

Nanoparticles Targeted to Fibroblast Activation Protein Outperform PSMA for MRI Delineation of Primary Prostate Tumors

Accurate delineation of gross tumor volumes remains a barrier to radiotherapy dose escalation and boost dosing in the treatment of solid tumors, such as prostate cancer. Magnetic resonance imaging (MRI) of tumor targets has the power to enable focal dose boosting, particularly when combined with technological advances such as MRI-linear accelerator. Fibroblast activation protein (FAP) is overexpressed in stromal components of >90% of epithelial carcinomas. Herein, the authors compare targeted MRI of prostate specific membrane antigen (PSMA) with FAP in the delineation of orthotopic prostate tumors. Control, FAP, and PSMA-targeting iron oxide nanoparticles were prepared with modification of a lymphotropic MRI agent (FerroTrace, Ferronova). Mice with orthotopic LNCaP tumors underwent MRI 24 h after intravenous injection of nanoparticles. FAP and PSMA nanoparticles produced contrast enhancement on MRI when compared to control nanoparticles. FAP-targeted MRI increased the proportion of tumor contrast-enhancing black pixels by 13%, compared to PSMA. Analysis of changes in R2 values between healthy prostates and LNCaP tumors indicated an increase in contrast-enhancing pixels in the tumor border of 15% when targeting FAP, compared to PSMA. This study demonstrates the preclinical feasibility of PSMA and FAP-targeted MRI which can enable targeted image-guided focal therapy of localized prostate cancer.