AIM:To compare the imaging results with histology and to evaluate the diagnostic sensitivity of imaging modalities for hepatocellular carcinoma(HCC)smaller than 2 cm.METHODS:Nodules smaller than 2 cm(n=34)revealed by ...AIM:To compare the imaging results with histology and to evaluate the diagnostic sensitivity of imaging modalities for hepatocellular carcinoma(HCC)smaller than 2 cm.METHODS:Nodules smaller than 2 cm(n=34)revealed by ultrasonography(US)in 29 patients with liver cirrhosis were analyzed.Histological diagnosis of HCC was performed by ultrasonographic guidance:moderately-differentiated HCC(n=24);well-differentiated HCC(n=10).The patterns disclosed by the four imaging modalities defined the conclusive diagnosis of HCC:(1)contrast-enhanced computed tomography(CECT),hypervascularity in the arterial phase and washout in the equilibrium phase;(2)Sonazoid contrast-enhanced US(CEUS),hypervascularity in the early vascular phase and defect in the Kupffer phase;(3)gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOBDTPA)-enhanced magnetic resonance imaging(MRI),hypervascularity in the arterial phase and/or defect in the hepatobiliary phase;and(4)CT arterioportal angiography:hypervascularity by CT during arteriography and/ or perfusion defect by CT during arterial portography.RESULTS:Overall,the sensitivity of diagnosing HCC smaller than 2 cm was 52.9%(18/34)(95%CI:35.170.2)by CECT;67.6%(23/34)(95%CI:49.5-82.6)by Sonazoid CEUS;76.5%(26/34)(95%CI:58.8-89.3) by Gd-EOB-DTPA MRI;and 88.2%(30/34)(95%CI: 72.5-96.7)by CT arterioportal angiography.The diagnostic sensitivity of detecting moderately-differentiated HCC by CECT,Sonazoid CEUS,Gd-EOB-DTPA MRI and CT arterioportal angiography was 62.5%(15/24)(95%CI: 40.6-81.2),79.2%(19/24)(95%CI:57.8-92.9),75.0% (18/24)(95%CI:53.3-90.2)and 95.8%(23/24)(95% CI:78.9-99.9),respectively.A significant difference(P< 0.05)was observed between CECT and CT arterioportal angiography in all nodules.There was no difference between Sonazoid CEUS,Gd-EOB-DTPA MRI,and CT arterioportal angiography.The combined sensitivity of Sonazoid CEUS and Gd-EOB-DTPA MRI was 94.1%(32/34).CONCLUSION:Changing the main diagnostic modality for HCC smaller than 2 cm from CT arterioportal angiography to Sonazoid C展开更多
AIM:To review the clinical course and the management of pseudoaneurysms post-pancreaticoduodenectomy.METHODS: Medical records of 907 patients who underwent pancreaticoduodenectomies from January 1995 to May 2007 were ...AIM:To review the clinical course and the management of pseudoaneurysms post-pancreaticoduodenectomy.METHODS: Medical records of 907 patients who underwent pancreaticoduodenectomies from January 1995 to May 2007 were evaluated retrospectively. The clinical course, management strategy, and outcome of ruptured pseudoaneurysms cases were analyzed.RESULTS: Twenty-seven (3.0%) of 907 cases had post-operative hemorrhage from ruptured pseudoan-eurysms. Pancreatic fistula was evident in 12 (44%) cases. Sentinel ble...展开更多
目的 分析急性非ST段抬高心肌梗死（NSTEMI）患者的临床及冠状动脉病变的特点.方法 对自2006年1月至2011年12月在北京顺义区医院心内科住院并确诊的154例NSTEMI和166例急性ST段抬高心肌梗死（STEMI）患者的临床及冠状动脉造影结果进行分...目的 分析急性非ST段抬高心肌梗死（NSTEMI）患者的临床及冠状动脉病变的特点.方法 对自2006年1月至2011年12月在北京顺义区医院心内科住院并确诊的154例NSTEMI和166例急性ST段抬高心肌梗死（STEMI）患者的临床及冠状动脉造影结果进行分析.结果 与STEMI患者相比,NSTEMI患者的危险因素较多,NSTEMI组既往心绞痛与陈旧性心肌梗死史多见（32.5% vs 13.3%,11.7% vs 2.4%,P〈0.01）,NSTEMI组合并高血压的比例及女性所占比例较STEMI组高（70.8% vs 53.0%,P〈0.01;27.9% vs 16.9%,P〈0.05）;NSTEMI组梗死后心绞痛比STEMI组增多（19.5% vs 1.8%,P〈0.01）.NSTEMI组肌酸激酶、肌酸激酶同工酶水平低[（650.7±625.4） vs（1825.8±1318.1）;（77.2±71.4） vs（208.5±147.5）,均P〈0.01].NSTEMI组三支病变及左主干病变的比例较STEMI组高（56.5% vs 42.2%,13.6% vs 6.0%,P〈0.05）;NSTEMI组中度狭窄（76%～89%）、重度狭窄（≥90%）病变较STEMI组多（14.3%vs 7.2%,P〈0.05;55.2% vs 27.1%,P〈0.01）;NSTEMI组完全闭塞病变较STEMI组少（24.0% vs 61.4%,P〈0.01）; NSTEMI组侧支循环比STEMI组多（23.4% vs 10.8%,P〈0.01）.结论 NSTEMI组患者危险因素较多,冠状动脉病变严重,三支病变、左主干病变及严重狭窄病变发生率高,梗死后心绞痛常见,应重视对其治疗.展开更多
文摘AIM:To compare the imaging results with histology and to evaluate the diagnostic sensitivity of imaging modalities for hepatocellular carcinoma(HCC)smaller than 2 cm.METHODS:Nodules smaller than 2 cm(n=34)revealed by ultrasonography(US)in 29 patients with liver cirrhosis were analyzed.Histological diagnosis of HCC was performed by ultrasonographic guidance:moderately-differentiated HCC(n=24);well-differentiated HCC(n=10).The patterns disclosed by the four imaging modalities defined the conclusive diagnosis of HCC:(1)contrast-enhanced computed tomography(CECT),hypervascularity in the arterial phase and washout in the equilibrium phase;(2)Sonazoid contrast-enhanced US(CEUS),hypervascularity in the early vascular phase and defect in the Kupffer phase;(3)gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOBDTPA)-enhanced magnetic resonance imaging(MRI),hypervascularity in the arterial phase and/or defect in the hepatobiliary phase;and(4)CT arterioportal angiography:hypervascularity by CT during arteriography and/ or perfusion defect by CT during arterial portography.RESULTS:Overall,the sensitivity of diagnosing HCC smaller than 2 cm was 52.9%(18/34)(95%CI:35.170.2)by CECT;67.6%(23/34)(95%CI:49.5-82.6)by Sonazoid CEUS;76.5%(26/34)(95%CI:58.8-89.3) by Gd-EOB-DTPA MRI;and 88.2%(30/34)(95%CI: 72.5-96.7)by CT arterioportal angiography.The diagnostic sensitivity of detecting moderately-differentiated HCC by CECT,Sonazoid CEUS,Gd-EOB-DTPA MRI and CT arterioportal angiography was 62.5%(15/24)(95%CI: 40.6-81.2),79.2%(19/24)(95%CI:57.8-92.9),75.0% (18/24)(95%CI:53.3-90.2)and 95.8%(23/24)(95% CI:78.9-99.9),respectively.A significant difference(P< 0.05)was observed between CECT and CT arterioportal angiography in all nodules.There was no difference between Sonazoid CEUS,Gd-EOB-DTPA MRI,and CT arterioportal angiography.The combined sensitivity of Sonazoid CEUS and Gd-EOB-DTPA MRI was 94.1%(32/34).CONCLUSION:Changing the main diagnostic modality for HCC smaller than 2 cm from CT arterioportal angiography to Sonazoid C
基金Supported by Grants from IN-SUNG Foundation for Medical Research (C-A9-810-1)
文摘AIM:To review the clinical course and the management of pseudoaneurysms post-pancreaticoduodenectomy.METHODS: Medical records of 907 patients who underwent pancreaticoduodenectomies from January 1995 to May 2007 were evaluated retrospectively. The clinical course, management strategy, and outcome of ruptured pseudoaneurysms cases were analyzed.RESULTS: Twenty-seven (3.0%) of 907 cases had post-operative hemorrhage from ruptured pseudoan-eurysms. Pancreatic fistula was evident in 12 (44%) cases. Sentinel ble...
文摘目的 分析急性非ST段抬高心肌梗死（NSTEMI）患者的临床及冠状动脉病变的特点.方法 对自2006年1月至2011年12月在北京顺义区医院心内科住院并确诊的154例NSTEMI和166例急性ST段抬高心肌梗死（STEMI）患者的临床及冠状动脉造影结果进行分析.结果 与STEMI患者相比,NSTEMI患者的危险因素较多,NSTEMI组既往心绞痛与陈旧性心肌梗死史多见（32.5% vs 13.3%,11.7% vs 2.4%,P〈0.01）,NSTEMI组合并高血压的比例及女性所占比例较STEMI组高（70.8% vs 53.0%,P〈0.01;27.9% vs 16.9%,P〈0.05）;NSTEMI组梗死后心绞痛比STEMI组增多（19.5% vs 1.8%,P〈0.01）.NSTEMI组肌酸激酶、肌酸激酶同工酶水平低[（650.7±625.4） vs（1825.8±1318.1）;（77.2±71.4） vs（208.5±147.5）,均P〈0.01].NSTEMI组三支病变及左主干病变的比例较STEMI组高（56.5% vs 42.2%,13.6% vs 6.0%,P〈0.05）;NSTEMI组中度狭窄（76%～89%）、重度狭窄（≥90%）病变较STEMI组多（14.3%vs 7.2%,P〈0.05;55.2% vs 27.1%,P〈0.01）;NSTEMI组完全闭塞病变较STEMI组少（24.0% vs 61.4%,P〈0.01）; NSTEMI组侧支循环比STEMI组多（23.4% vs 10.8%,P〈0.01）.结论 NSTEMI组患者危险因素较多,冠状动脉病变严重,三支病变、左主干病变及严重狭窄病变发生率高,梗死后心绞痛常见,应重视对其治疗.
