Objective To summarize and analyze the MRI imaging findings of advanced gastric cancer in order to improve the level of image diagnosis. Methods The plain and dynamic enhanced MRI findings in 8 volunteers and 30 patients with pathologically proven advanced gastric cancer were retrospectively analyzed. Results The stomach wall of advanced gastric cancer was inhomogeneous thickening with iso intensity or little hypo intensity signal on T1WI， and iso intensity or little hyper intensity signal on T2WI. Cases with serosal infiltration， the serous appearred indistinctly and rough. In some cases， the low signal zones between gastic wall and fat space were interrupted on T1WI out-of-phase image. Cases with adjacent organs invaded， the fat space was rough or disappeared. The lesions showed obvious irregular or hierarchy enhancement on MRI dynamic contrast scanning. Conclusions Inhomogeneous thickening of gastic wall with abnormal signal intensity， indistinctness or disappearance of fat space， irregular or hierarchy enhancement are very valuable as diagnostic signs in patients suspective of advanced gastric cancer.
Objective To discuss the value of 64-slice spiral CT （MSCT） in diagnosis of gastric stromal tumor （GST）. Methods Thirty-two patients proved GST by surgery and pathology from May 2010 to August 2011 in West China Hospital, Sichuan University were classified by Fletcher malignancy degree classification，the CT features including the location，size，boundary，shape，density，growth pattern，metastases，and enhancement and its relationships to GST malignancy degree were analyzed retrospectively. Results All 32 cases were single lesion，the accuracy of CT in localization was 100%. Nine cases were intra-luminal，10 were extra-luminal，and 13 were both intra- and extra-luminal growth. Nine cases were in low degree group，with diameter＜5cm，round or oval in shape，clear border, homogenous density and enhancement （7/9）；Twenty-three cases were in high degree group，with diameter ≥5cm in 19 cases，irregular in shape and indistinct bourdry （18/23），heterogeneous density （20/23） with necrosis，ulcer was seen in 6 cases. Three cases in high malignance degree group showed pancreas and spleen involvements，2 cases of left diaphragm involvement，1 of omentum metastasis，2 of liver metastases，and 1 of lymph node metastasis. Conclusions MSCT is the optimal method to exam GST，there is correlation between the CT features and malignancy degree，MSCT is helpful for analyzing malignancy degree preoperation.
【摘要】 目的 探讨64层螺旋CT尿路造影在上尿路梗阻性病变中的运用及诊断价值。 方法 收集2009年12月—2011年1月132例行螺旋CT尿路造影，并确诊为上尿路梗阻病变患者资料，分析其图像特点并与手术及病理结果对比。 结果 132例患者经临床及手术病理证实，输尿管结石31例，先天异常及畸形51例，输尿管感染性病变16例，尿路肿瘤29例，外源性压迫3例，肾盂旁囊肿2例；所有患者均显示良好，与临床及病理结果基本吻合。 结论 CT尿路造影能多方位清楚显示病变内部及周围情况，可准确的显示、判断尿路梗阻的原因、性质，是一种对泌尿系疾病诊断极有价值的影像学检查方法。【Abstract】 Objective To discuss the utilization and diagnostic value of 64-slice spiral CT urography for upper urinary tract obstruction diseases. Methods We collected the clinical data of 132 patients who were diagnosed with upper urinary tract obstruction by 64-slice spiral CT urography between December 2009 and January 2011. We analyzed the imaging features and compared them with surgical and pathological results. Results Confirmed by surgical and pathological results, 132 patients included 31 cases of urethral stone, 51 cases of congenital variant and malformation, 16 cases of ureteral infection, 29 cases of tumors in urinary tract, 3 cases of extraneous compression, and 2 cases of cysts next to the renal pelvis. CT diagnosis for all cases were basically in line with clinical and pathological results. Conclusion CT urography is an extremely valuable imaging method to diagnose the diseases of urinary system. It can display lesions broadly and reveal their inner and peripheral circumstances clearly, thus can help us determine the reasons and natures of the lesions precisely.
ObjectiveTo investigate the value of diffusion weighted imaging (DWI) combined with three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) in evaluating metastatic lymph nodes secondary to hilar cholangiocarcinoma. MethodsFrom July 2009 to March 2011, DWI examination was performed in 37 patients with hilar cholangiocarcinoma, which was compared with 3D-VIBE sequences. The morphological characteristics and distribution were analyzed for metastatic and nonmetastatic lymph nodes. Signal intensity (SI) was measured on DWI images and apparent diffusion coefficient (ADC) was calculated for each lymph node. The SI of lymph nodes (SILN） and liver (SIliver) were also measured and the ratio of SI was calculated. The ADC and the ratio of SI were compared between metastatic and nonmetastatic lymph nodes. ResultsThere were fifty-nine groups of lymph nodes in 37 patients with hilar cholangiocarcinoma, fifty-one groups were revealed in both DWI and 3D-VIBE sequences, and eight groups were only demonstrated in one sequence (P=0.070). The short diameters were (1.05±0.42) cm and (0.78±0.22) cm on 3D-VIBE images for metastatic and nonmetastatic lymph nodes, respectively (P=0.030). The ADC value in metastatic lymph nodes was (1.64±0.3)×10-3 mm2/s, which was significantly lower than that in nonmetastatic lymph nodes 〔(2.28±0.79)×10-3 mm2/s〕 on DWI images (P=0.033). There were no significant differences in SILN/SIliver between metastatic and nonmetastatic lymph nodes on images of portal venous phase and 3 min delayed contrast-enhanced phase. ConclusionsDifferences of ADC and short diameter can provide valuable information to differentiate metastatic lymph nodes with nonmetastatic lymph nodes. When combined with 3D-VIBE sequence, DWI is more effective in evaluating metastatic lymph nodes secondary to hilar cholangiocarcinoma.