目的探讨表观扩散系数(apparent diffusion coefficient,ADC)术前无创评估直肠腺瘤瘤体是否癌变的可行性。方法回顾性分析71例已经过手术病理证实的直肠病变患者(直肠腺瘤患者21例、直肠腺瘤并癌变患者14例及直肠腺癌患者36例)的MRI平扫...目的探讨表观扩散系数(apparent diffusion coefficient,ADC)术前无创评估直肠腺瘤瘤体是否癌变的可行性。方法回顾性分析71例已经过手术病理证实的直肠病变患者(直肠腺瘤患者21例、直肠腺瘤并癌变患者14例及直肠腺癌患者36例)的MRI平扫及DWI检查,ADC值由b值为0 s/mm^(2)和1000s/mm^(2)的DWI检查计算所得,测量肿瘤的平均ADC值及最小ADC值,根据直肠腺瘤、直肠腺瘤癌变及直肠腺癌进行分组,采用独立样本t检验分别比较分析。结果直肠腺瘤及腺瘤癌变分组的最小ADC值(1.126±0.134比1.015±0.107,P=0.015)、直肠腺瘤及腺癌分组的平均A D C值(1.277±0.099比1.026±0.096,P=0.000)及最小A D C值(1.126±0.134比0.995±0.087,P=0.000)、直肠腺瘤癌变及腺癌分组的平均ADC值(1.207±0.116比1.026±0.096,P=0.000)及最小ADC值(1.015±0.107比0.995±0.087,P=0.047)具有统计学学意义,仅直肠腺瘤及腺瘤癌变分组的平均ADC值(1.277±0.099比1.207±0.116,P=0.064)无统计学意义,最小ADC值在评估直肠腺瘤瘤体是否癌变中的作用优于平均ADC值。结论ADC值可在一定程度上对直肠腺瘤是否癌变做出较好预测。展开更多
We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma(HCC) through hematogenous pathway.A 72-year-old woman was admitted t...We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma(HCC) through hematogenous pathway.A 72-year-old woman was admitted to the emergency department with right upper abdominal pain for 4 h.Considering her surgical history of Mile's procedure plus liver resection for rectal cancer with liver metastasis three years ago and the finding of urgent computed tomography scan on admission,the preoperative diagnosis was spontaneous rupture of rectal liver metastasis located in caudate lobe and colonic metastasis from rectal cancer. The patient underwent an emergency isolated caudate lobectomy at a hemorrhagic shock status.Pathology reported a primary HCC in the caudate lobe and colonic metastasis of HCC with tumor embolus in the surrounding vessels of the intestine.No regional lymph node involvement was found.It is hypothesized that HCC may disseminate hematogenously to the ascending colon,thus making it a rare case.展开更多
Constipation is a common presenting complaint in children. Rectal duplication cysts are rare congenital malformations that need to be considered in patients with chronic constipation that has not responded to typical ...Constipation is a common presenting complaint in children. Rectal duplication cysts are rare congenital malformations that need to be considered in patients with chronic constipation that has not responded to typical therapy and in pa-tients presenting with rectal bleeding. It is important to maintain a high index of suspicion when diagnosing this condi-tion as other congenital malformations may be present and rectal duplication cysts have the potential for malignant transformation if they go unrecognized. This case report describes a 12 year old female with chronic constipation and rectal bleeding who was found to have a rectal duplication cyst. It discusses the pathophysiology of the disease and highlights the options available for treatment.展开更多
文摘目的探讨表观扩散系数(apparent diffusion coefficient,ADC)术前无创评估直肠腺瘤瘤体是否癌变的可行性。方法回顾性分析71例已经过手术病理证实的直肠病变患者(直肠腺瘤患者21例、直肠腺瘤并癌变患者14例及直肠腺癌患者36例)的MRI平扫及DWI检查,ADC值由b值为0 s/mm^(2)和1000s/mm^(2)的DWI检查计算所得,测量肿瘤的平均ADC值及最小ADC值,根据直肠腺瘤、直肠腺瘤癌变及直肠腺癌进行分组,采用独立样本t检验分别比较分析。结果直肠腺瘤及腺瘤癌变分组的最小ADC值(1.126±0.134比1.015±0.107,P=0.015)、直肠腺瘤及腺癌分组的平均A D C值(1.277±0.099比1.026±0.096,P=0.000)及最小A D C值(1.126±0.134比0.995±0.087,P=0.000)、直肠腺瘤癌变及腺癌分组的平均ADC值(1.207±0.116比1.026±0.096,P=0.000)及最小ADC值(1.015±0.107比0.995±0.087,P=0.047)具有统计学学意义,仅直肠腺瘤及腺瘤癌变分组的平均ADC值(1.277±0.099比1.207±0.116,P=0.064)无统计学意义,最小ADC值在评估直肠腺瘤瘤体是否癌变中的作用优于平均ADC值。结论ADC值可在一定程度上对直肠腺瘤是否癌变做出较好预测。
文摘We report a case of metachronous multiple primary malignancies involving both rectum and liver with colonic metastasis from hepatocellular carcinoma(HCC) through hematogenous pathway.A 72-year-old woman was admitted to the emergency department with right upper abdominal pain for 4 h.Considering her surgical history of Mile's procedure plus liver resection for rectal cancer with liver metastasis three years ago and the finding of urgent computed tomography scan on admission,the preoperative diagnosis was spontaneous rupture of rectal liver metastasis located in caudate lobe and colonic metastasis from rectal cancer. The patient underwent an emergency isolated caudate lobectomy at a hemorrhagic shock status.Pathology reported a primary HCC in the caudate lobe and colonic metastasis of HCC with tumor embolus in the surrounding vessels of the intestine.No regional lymph node involvement was found.It is hypothesized that HCC may disseminate hematogenously to the ascending colon,thus making it a rare case.
文摘Constipation is a common presenting complaint in children. Rectal duplication cysts are rare congenital malformations that need to be considered in patients with chronic constipation that has not responded to typical therapy and in pa-tients presenting with rectal bleeding. It is important to maintain a high index of suspicion when diagnosing this condi-tion as other congenital malformations may be present and rectal duplication cysts have the potential for malignant transformation if they go unrecognized. This case report describes a 12 year old female with chronic constipation and rectal bleeding who was found to have a rectal duplication cyst. It discusses the pathophysiology of the disease and highlights the options available for treatment.
