ObjectiveTo investigate clinical value of MRI examination in diagnosis of xanthogranulomatous cholecystitis (XGC), and to analyze pathologic correlation of various imaging findings. MethodsMRI imaging data of 7 patients with XGC proved by surgery and pathology who underwent entire MRI sequences examination in Sichuan Provincial People's Hospital from Jan. 2013 to Dec. 2015, were analyzed retrospectively. The thickness and contrast enhancement of gallbladder wall, gallbladder wall nodules, completeness of gallbladder mucosa lines, gallbladder stones, and the changes around the gallbladder were focused in every patient. ResultsIn 7 patients with XGC: gallbladder wall thickening occurred in all patients, in which 2 patients were local thickening, 5 patients were diffuse thickening; ‘hypodense band sign' was found by enhance scan in 4 patients; the multiple intramural nodules were presented in 5 patients, which were low signal intensity on T1WI image and high signal intensity on T2WI image; the mucosal lines were continuous in 6 patients and discontinuous in 1 patient; 6 patients combined with cholecystolithiasis. The fat layer around the gallbladder was found fuzz in 7 patients, liver and gallbladder boundaries were not clear in 7 patients; temporal enhancement of arterial phase in liver parenchyma was observed in all patients, and 1 patient combined with liver abscess. Hilar bile duct narrowed and intra-hepatic bile duct dilated in 2 patients, intra-hepatic and extra-hepatic bile duct slightly dilated in 2 patients (lower part of the choledochus stone was found in 1 patient), liver cyst was observed in 3 patients, single or double kidney cyst was observed in 4 patients; all patients were not found intraperitoneal or retroperitoneal swelling lymph nodes. ConclusionMRI examination can accurately describe various imaging features of XGC, so MRI has important value in diagnosis of XGC.
ObjectiveTo investigate the CT and MR imaging manifestation of solid-pseudopapillary neoplasm of pancreas (SPNP), deepen the understanding of imaging and clinical pathological characteristics of SPNP and improve the level of diagnosis. MethodsBetween Jan 2010 and Dec 2015, the CT and MR imaging data of seven patients with SPTP proved by surgery and histopathologically were analyzed retrospectively. The following imaging features were reviewed: tumor size, location, shape, margin, encapsulation, calcification, hemorrhage, solid-cystic ratio, pancreatic and bile duct dilatation, the manifestation of plain scan and dynamic pattern of enhancement. ResultsThe population comprised 7 women, the average age was 28.3 years oldwith a median tumor size of 5.7 cm. Tumors were located at body tail of pancreas in 5 cases, at the head in 1 case, and at the tail in 1 case. The tumor were exogenous in 5 cases, endogenous in 2 cases. Five tumors showed the regular margin, inregular in 2 cases. Four cases of plain and enhanced CT scan showed cystic-solid tumors, the solid and encapsulation part ofSPNP presented as hipo-, iso-density, and gradually enhancement after injecting contrast medium. Three cases were examined by MRI, 2 cases appeared hemorrhage, tumor located in the head of pancreas leaded to the secondary ducts dilatations in 1 case. Conciusions There are some characteristics in CT and MRI manifestation of SPNP. Accurate diagnosis meybe created by the imaging study combined with the clinical feature.
ObjectiveTo investigate clinical value of magnetic resonance imaging (MRI) in differentiating xanthogranulomatous cholecystitis (XGC) with gallbladder cancer (GBC). MethodsMRI data of 7 patients with XGC and 13 patients with GBC proved by surgery and pathology were analyzed retrospectively. The main contents of the observation included:①Maximum thickness of gallbladder wall; ②Diffuse thickening or localized thickening of gallbladder wall; ③Enhancement pattern (uniform or nonuniform) of gallbladder wall; ④Gallbladder wall sandwiches enhancement; ⑤Gallbladder wall nodules; ⑥Completeness of gallbladder mucosa lines; ⑦Obstruction of biliary tract; ⑧Calculus in gallbladder or bile duct; ⑨Involvement of adjacent liver; ⑩Definition of surrounding fat layer; Lymphadenopathy. ResultsIn above 11 MRI comparing features, these features such as the gallbladder wall sandwiches enhancement, the gallbladder wall nodules, the completeness of gallbladder mucosa lines, the biliary obstruction, and the lymphadenopathy were statistically significant between the XGC and the GBC (P < 0.05), while the rest features such as the maximum thickness of gallbladder wall, the type of gallbladder wall thickening, the gallbladder wall enhancement pattern, the calculus in gallbladder or bile duct, the involvement of adjacent liver, and the definition of surrounding fat layer were not statistically significant between the XGC and the GBC (P > 0.05). ConclusionMRI has important values in differentiating XGC with GBC.
Objective To investigate the CT and MR imaging manifestation of rare pancreatic tumors in order to deepen the understanding of their imaging characteristics and improve the diagnostic accuracy. Methods Clinical and image date of 34 cases with rare pancreatic tumors proved by surgery and histopathologically were analyzed retrospectively. Including neuroendocrine tumors of the pancreas (NETP,n=13), solid-pseudopapillary tumors of pancreas (SPTP,n=10), intraductal papillary mucinous neoplasms (IPMN,n=2), serous cystadenoma (SCA,n=7), and mucinous cystadenoma (MCA,n=2). Examined by CT in 19 cases, by MRI in 11 cases, examined by CT and MRI at the same time in 4 cases. The characterized imaging features of each kind of tumors were analyzed emphatically. Results Of the 13 cases of NETP, solid lesions in 6 cases, predominantly soild in 4 cases, predominantly cystic in 3 cases. Homogenous enhancement in 6 cases, heterogeneous enhancement in 7cases, the soild constituent of all cases were showed moderate to marked enhancement. Of the 10 cases of SPTP, predominantly soild in 2 cases, soild and cystic in 5 cases, predominantly cystic in 3 cases. The solid part of 10 cases presented as gradually enhancement, 2 cases appeared hemorrhage, 1 case appeared stippled calcification. Of the 2 cases of IPMN, both of them were combined type, showed multilocular cystic tumors due to the dilated of the pancreatic duct. Of the 7 cases of SCA, microcystic partten in 3 cases and single cyst partten in 4 cases, showed unilocular or multilocular cystic with clear boundary. The 2 cases of MCA, showed unilocular cystic with clear boundary. Conclusion Different histological types of pancreatic rare tumor appeared different kinds of imaging characteristic, we may improve the diagnostic accuracy by analyzing their features.