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Introduction: The objective of this study was to describe the CT and MRI features of sclerosing angiomatoid nodular transformation (SANT) of the spleen with pathologic correlation. Materials and Methods: Ten patients with surgically resected and pathologically confirmed SANTs were included. Clinical history was reviewed, and gross pathologic, histologic, and immunohistochemical findings were recorded. CT and MRI examinations were evaluated by two radiologists. Results: Patients included seven men and three women, with a mean age of 42.9±16.7 years. Pathologic features of SANTs involved multiple angiomatous nodules in a radiating pattern with a central stellate fibrous scar and evidence of hemosiderin deposition. 9 cases showed a lobulated demarcated margin, 8 cases a slight hypoattenuating, 1 isoattenuating, and 1 case with two lesions demonstrated a slight hyperattenuating margin, respectively. Multiple scattered punctate calcifications were involved in 2 cases. 5 cases manifested hypointensity on in-phase imaging, 1 iso-intensity, and 4 iso-hypointensity on out-of-phase imaging. Progressive and centripetal enhancement were exhibited in 10 cases, spoke-wheel pattern in 3 cases, and nodular enhancement in 4 cases, respectively. The central fibrous scar was identified in 8 cases during delayed enhancement. Conclusion: Characteristics of SANTs on CT/MRI reflected the underlying pathology. Hypointensity on DWI and T2WI, and change of signal on T1 chemical-shift imaging were found to be due to hemosiderin deposition and fibrous tissue. Typical features were a solitary, round, lobulated mass with a fibrous scar. Progressive and centripetal enhancement, spoke-wheel pattern, nodular enhancement, and delayed enhancement of central fibrous scar were observed.

Background: Renal cell carcinoma (RCC) is one of the most common malignancies worldwide. Noninvasive imaging techniques, such as magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET), have been involved in increasing evolution to detect RCC. This meta-analysis aims to compare to compare the value of MRI, SPECT, and PET in the diagnosis of RCC, and to provide evidence for decision-making in terms of further research and clinical settings.Methods: Electronic databases including PubMed, Web of Science, Embase, and Cochrane Library were systemically searched. Studies concerning MRI, SPECT, and PET for the detection of RCC were included. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), with their respective 95% confidence interval (CIs) and the area under the summary receiver operating characteristic (SROC) curve (AUC) were calculated.Results: A total of 44 articles were finally detected for inclusion in this meta-analysis. The pooled sensitivities of MRI, SPECT, and PET were 0.80, 0.81, and 0.88, respectively. Their respective overall specificities were 0.90, 0.54, and 0.87. Results in the subgroup analysis of the performance of SPECT that the pooled sensitivity, specificity, and AUC of the prospective SPECT studies included were 0.80, 0.42, 0.80, respectively. In the analysis of 18F-FDG PET, the pooled sensitivity, specificity, and AUC were 0.88, 0.86, and 0.92, respectively. PET studies showed a pooled sensitivity, specificity, and AUC of 0.80, 0.85, and 0.85, respectively in the diagnosis of primary RCC. The pooled sensitivity, specificity, and AUC of PET studies in detecting recurrent or metastatic RCC were 0.93, 0.88, and 0.94.Conclusion: Our meta-analysis manifests that MRI and PET present better diagnostic value for the detection of RCC in comparison with SPECT. PET is superior in the diagnosis of recurrent or metastatic RCC.

Semi-autogenous grinding pebbles were used as a grinding medium and compared to steel balls in terms of their effect the flotation behavior of the products and their industrial application. The peb...

Purpose To prospectively assess the feasibility of diffusional kurtosis (DK) imaging for distinguishing prostate cancer(PCa) from benign prostate hyperplasia (BPH) in comparison with standard diffusion-weighted (DW) imaging, as well as low-from high-grade malignant regions. Materials and methods 147 consecutive patients with suspected PCa underwent multi-parametric 1.5-TMR. Diffusion kurtosis imaging was acquired with with 5 b values (0,600,800,1600,and 2400sec/mm2).Region of interest (ROI)-based measurements were performed on ADC, D, and K map by two radiologists. Data were analyzed by using mixed-model analysis of variance and receiver operating characteristic curves. Correlations among the three parameters (ADC,D and K) in all patients, and correlations between three parameters with the tumor Gleason score (GS) in PCa group were analyzed using Pearson's correlation coefficient in peripheral zone(PZ) and transiton zone(TZ). Results 58 patients were proved with PCa (9 GS 3 + 3[PZ/TZ = 4/5], 49 GS ≥ 7 [PZ/TZ = 26/23]), and 89 patients were with BPH. ADC,D and K were able to distinguish benignance from tumor tissue both in PZ and TZ(P＜0.01), but performed poorly in neither differentiating low-(GS 3 + 3) from high-grade (GS≥3 + 4) disease, nor GS(3 + 4) from GS(4 + 3).There was a weak correlation between the GS and ADC, D (PZ:ADC r=-0.113, D r=-0.139; TZ:ADC r=-0.104,D r=-0.103), while a moderate correlation between the GS and K(PZ:K r = 0.492; TZ:K r = 0.433, P＜0.01).K had significantly greater area under the curve for differentiating PCa from BHP than ADC both in PZ and TZ. Conclusion DK model may add value in PCa detection and diagnosis, but none can differentiate low-from high-grade PCas (including GS=3+4 from GS=4+3).

Stroke-associated pneumonia (SAP) often increases high hospital mortality, prolongs length of hospital stay, and has considerable economic impact on healthcare costs. We aimed to explore independent predictors of SAP in acute anterior large artery occlusion patients who treated with endovascular treatment (EVT).Consecutive patients with acute anterior large artery occlusion stroke who underwent EVT from the Nanjing Stroke Registry from January 2019 to January 2020 were identified retrospectively. Patients were divided into SAP group and Non-SAP group. In the univariate analysis, variables including demographics, clinical factors, labs, and EVT features were compared between the two groups. Then a multivariable logistic regression analysis was conducted to determine independent predictors of SAP.One hundred and twelve patients were enrolled. Patients with SAP, compared to those without SAP, had lower modified treatment in cerebral infarction (mTICI) score 2b-3 rate (54.8% vs 85.2%; P = 0.001), higher asymptomatic intracerebral hemorrhage rate (48.4% vs 28.4%; P = 0.046), lower modified Rankin Scale (mRS) score 0-2 rate at 90days rate (9.7% vs 60.5%; P 0.001), and higher mortality at 90days (38.7% vs 11.1%; P = 0.001). The independent predictors of SAP were dysphagia (Unadjusted Odds ratio[OR] 6.49, 95% Confidence interval[CI] 2.49-16.92; P = 0.02; Adjusted OR 3.59, 95% CI 1.19-10.83; P = 0.02), neutrophil-lymphocyte ratio (Unadjusted OR 1.19, 95% CI 1.1-1.3; P = 0.001; Adjusted OR 1.15, 95% CI 1.06-1.25; P = 0.001), and mTICI 2b-3 (Unadjusted OR 0.21, 95% CI 0.08-0.54; P = 0.001; Adjusted OR 0.3, 95% CI 0.1-0.92; P = 0.04).Dysphagia, higher neutrophil-lymphocyte ratio, and failed recanalization were associated with SAP in acute ischemic stroke patients underwent endovascular therapy. Identification and prevention of SAP was necessary and important.

To retrospectively review the MRI characteristics and clinic features and evaluate the effectiveness of MR imaging in differentiating intraspinal schwannomas and meningiomas, with the excised histopathologic findings as the reference standard. One hundred and four schwannomas (M/F, 57:47) and 53 meningiomas (M/F, 13:40) underwent MR examinations before surgical treatment. Simple clinic data and imaging findings were considered:(a) location (craniocaudal and axial), (b) size, (c) morphology, (d) dural contact, (e) signal characteristics, (f) enhancement degree and patterns. The usefulness of the algorithm for differential diagnosis was examined between the two tumors. Interobserver agreement was good (κ = 0.7–0.9). Ten cases meningiomas demonstrated multiple lesions. There was a female predominance in the meningiomas (P

The purpose of this study was to review the clinical presentation, imaging, pathology and outcome of patients with giant cell-rich osteosarcoma (GCRO) of long bones. Radiography (n=9), magnetic resonance imaging (MRI) (n=6), computed tomography (CT) (n=3) and clinical course of nine patients (five males and four females; mean age, 26 years) with pathologically confirmed GCRO were retrospectively reviewed. Specific imaging findings, including size, eccentricity, ossification, lysis, cystic change, expansile growth, periosteal reaction, cortical destruction, soft tissue extension and joint involvement were documented. Presenting symptoms were pain in six patients and pain and palpable mass in three. An ill-defined margin surrounding a predominantly osteolytic lesion was detected at the proximal tibia (n=7) or femur (n=2) on imaging studies. Seven cases showed limited ossification. Three cases had tumours in the metaphysis and six in the metaepiphysis. The average maximum tumour dimension was 4.7 cm×5.2 cm×7.8 cm. Microscopically, tumours were composed of atypical cells with scanty osteoid formation and multinucleated giant cells. All patients received chemotherapy, and surgery was performed in eight patients. Three patients were dead and six were alive at the last follow-up. GCRO is a rarer variant that has very close resemblance to giant cell tumour. Patients usually present nonspecific symptoms of pain and palpable mass. It usually shows an osteolytic lesion with locally spared new bone formation in the metaphysis and/or metaepiphysis on imaging. Histologically, the atypical tumour cells with osteoid formation and multinucleated giant cells are the key factor in the diagnosis and differential diagnosis.

Objective To investigate the value of dual-energy MDCT in spectral imaging in the differential diagnosis of chronic mass-forming chronic pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) during the arterial phase (AP) and the pancreatic parenchymal phase (PP). Materials and methods Thirty five consecutive patients with CMFP (n = 15) or PDAC (n = 20) underwent dual-energy MDCT in spectral imaging during AP and PP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in iodine concentration between the AP and PP, contrast-to-noise ratio (CNR) and the slope K of the spectrum curve were calculated. Results Normalized iodine concentrations (NICs) in patients with CMFP differed significantly from those in patients with PDAC during two double phases (mean NIC, 0.26 ± 0.04 mg/mL vs. 0.53 ± 0.02 mg/mL, p = 0.0001; 0.07 ± 0.02 mg/mL vs. 0.28 ± 0.04 mg/mL, p = 0.0002, respectively). There were significant differences in the value of the slope K of the spectrum curve in two groups during AP and PP (KCMFP = 3.27 ± 0.70 vs. KPDAC = 1.35 ± 0.41, P = 0.001, and KCMFP = 3.70 ± 0.17 vs. KPDAC = 2.16 ± 0.70, p = 0.003, respectively). CNRs at low energy levels (40–70 keV) were higher than those at high energy levels (80–40 keV). Conclusion Individual patient CNR-optimized energy level images and the NIC can be used to improve the sensitivity and the specificity for differentiating CMFP from PDAC by use of dual-energy MDCT in spectral imaging with fast tube voltage switching.

Background Crohn's disease (CD) and intestinal tuberculosis (ITB) have similar clinical, radiological, and endoscopic features. The objective of our study was to investigate the values of clinical features and computed tomographic (CT) enterographic manifestations in the differential diagnosis between CD and ITB. Methods Clinical features and CT enterographic manifestations in a cohort of 141 patients with CD and 47 patients with ITB were reviewed retrospectively. Parameters were screened by logistic regression analysis. Furthermore, the diagnostic efficacy of screened parameters was analyzed by regression equation (mathematical model) and receiver operating characteristic curve. Results The clinical features indicative of CD were hematochezia and perianal disease; features indicative of ITB include positive purified protein derivative skin test, occurrence of ascites, pulmonary tuberculosis, and night sweats. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of regression mathematical model established by clinical features were 94.3, 80.4, 91.0, 93.7, and 82.6%, respectively. CT enterographic manifestations indicative of CD were the involvement of the left colon, asymmetric pattern of involvement and abscess, comb sign; manifestations indicative ITB were the distribution of the lymph nodes along the right colic artery, contracture of ileocecal valve, fixed patulous ileocecal valve and lymph nodes with central necrosis The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of regression mathematical model established by CT enterographic parameters were 96.5, 93.6, 95.7, 97.8, and 89.8%, respectively. Conclusions The accuracy of CT enterographic model suggests the possibility of using CT enterography as an alternative to endoscopy in the differentiation between CD and ITB.

Objective The purpose of this article was to present the adenosquamous carcinoma (ASqC) of the pancreas: multidetector-row computed tomographic (CT) features and tumor characteristics. Materials and methods The clinical data and CT studies of 12 patients with pathologically proven ASqC of the pancreas between the dates February 2001 and February 2010 were retrospectively analyzed. Results The presenting symptoms of ASqC of the pancreas were nonspecific. Elevated serum levels of carbohydrate antigen 19-9, carbohydrate antigen 12-5, and carcinoembryonic antigen were noted. The tumor was most commonly involved in the pancreatic head in 6 patients, with the dilation of the common bile duct and the upstream main pancreatic duct. All ASqCs exhibited invasive growth. No calcification and intratumoral hemorrhage were noted in ASqCs. Ten tumors showed enhancement in the early arterial phase and persistent enhancement in the portal vein phase. Conclusion The typical CT appearance of ASqC was solitary oval or round without any capsule and a defined margin. The dilation of the main pancreatic duct and/or the common bile duct was always discovered. The huge infiltrative lesion outside the pancreas was detected in the tail and/or the body of the pancreas. Not only the elevation of carbohydrate antigen 19-9 is common, but also Ca12-5 and CEA, whereas human alpha fetoprotein elevation is not observed. The enhancement pattern of tumor showed persistence in the portal vein phase.

Objective This study aims to assess retrospectively the imaging features of diaphyseal osteosarcoma and compare its characteristics with that of metaphyseal osteosarcoma. Materials and methods Eighteen pathologically confirmed diaphyseal osteosarcomas were reviewed. Images of X-ray ( n = 18), CT ( n = 12) and MRI ( n = 15) were evaluated by two radiologists. Differences among common radiologic findings of X-ray, CT and MRI, and between diaphyseal osteosarcomas and metaphyseal osteosarcomas in terms of tumor characteristics were compared. Results The common imaging features of diaphyseal osteosarcoma were bone destruction, lamellar periosteal reaction with/without Codman triangle, massive soft tissue mass/swelling, neoplastic bone and/or calcification. CT and MRI had a higher detection rate in detecting bone destruction ( P = 0.001) as compared with that of X-ray. X-ray and CT resulted in a higher percentage in detecting periosteal reaction ( P = 0.018) and neoplastic bone and/or calcification ( P = 0.043) as compared with that of MRI. There was no difference ( P = 0.179) in detecting soft tissue mass among three imaging modalities. When comparing metaphyseal osteosarcoma to diaphyseal osteosarcoma, the latter had the following characteristics: a higher age of onset ( P = 0.022), a larger extent of tumor ( P = 0.018), a more osteolytic radiographic pattern ( P = 0.043). Conclusion As compared with metaphyseal osteosarcoma, diaphysial osteosarcoma is a special location of osteosarcoma with a lower incidence, a higher age of onset, a larger extent of tumor, a more osteolytic radiographic pattern. The osteoblastic and mixed types are diagnosed easily, but the osteolytic lesion should be differentiated from Ewing sarcoma. X-ray, CT and MRI can show imaging features from different aspects with different detection rates.

Solid pseudopapillary neoplasms of the pancreas (SPN) have been reported increasingly; however, series focusing on portal-superior mesenteric vein (PV/SMV) or adjacent organ resection are limited in the literature. The aim of this study was to present our experience in treating patients with SPN who underwent this extensive resection. Ten eligible patients were retrospectively reviewed and analyzed. Eight females and two males with a median age of 23 years (range, 11 to 58 years) and a median tumor diameter of 12 cm (range, 4 to 20 cm) were observed. All patients had imaging signs of vascular and/or adjacent organ involvement. Resection with curative intent was performed in all patients; eight underwent synchronous PV/SMV resection and two underwent synchronous left nephrectomy. Malignant SPN was confirmed in seven patients. Postoperative mortality was nil and morbidity occurred in five patients. At a median follow-up of 67.5 months (range, 12 to 110 months), nine patients were alive with no evidence of disease and one died of liver metastases. In conclusion, malignant SPN are low-grade tumors with good prognosis. More aggressive attitude should be adopted when PV/SMVor adjacent organ involvement is indicated on preoperative imaging. En bloc synchronous PV/SMV or adjacent organ resection should be applied, when necessary, to achieve complete resection.