Background: Some patients with cancer-administered anti-cancer drugs may develop renal lesions with low-level enhancement on follow-up abdominal computed tomography (CT). Objective: To explore the clinical significance of renal lesions with low-level enhancement on CT after exposure to anti-cancer drugs. Methods: Medical records of patients with cancer who developed renal lesions on CT after exposure to anti-cancer drugs were retrospectively reviewed. Renal lesions were scored according to the extent of involvement, CT attenuation values of lesions and normal parenchyma were measured on precontrast CT and three phases of contrast-enhanced CT, and changes in serum creatinine (SCr) from one week before exposure to drugs to one week before and after the appearance of renal lesions were recorded. Results: This study included 54 patients (86 lesions). Lesions were slightly lower density on pre-contrast CT, and less enhancing than normal renal parenchyma, especially in the delayed phase. Lesions were wedge-shaped, and involved the renal pyramid and associated renal cortex, as well as, were single or multiple, and occurred in the unilateral or bilateral kidneys. There were patchy and cord-like shadows of increased density in adjacent perirenal adipose tissue. During follow-up, lesions disappeared in 15 patients and persisted in 39 patients without significant progression. There were significant differences in renal lesions and normal renal parenchyma CT attenuation values in each phase of contrast-enhanced CT. Change in SCr level was significantly positively correlated with lesion score. Conclusion: Renal lesions with low-level enhancement on CT suggest early drug-induced kidney injury. These findings will inform clinical decision-making.

ObjectiveTo analyze the CT and MR features of Primary hepatic neuroendocrine neoplasms (PHNENs) in order to enhance the diagnostic accuracy of this disease.MethodsA retrospective analysis was conducted on patients diagnosed with hepatic neuroendocrine neoplasms, excluding other sites of origin through general examination and postoperative follow-up. The CT and MR signs were analyzed according to the 2018 version of Liver Imaging Reporting and Data System (LI-RADS), along with causes of misdiagnosis.ResultsTwelve patients, including 6 males and 6 females, were enrolled in this study. There was no significant increase in liver tumor markers among all cases. Most masses were multiple (9/12), exhibiting low attenuation on pre-contrast CT scans, T1-hypointense signal, T2-hyperintense signal, and restricted diffusion. The majority of these masses (7/10) demonstrated similar rim arterial phase hyper-enhancement as well as peripheral “washout” during venous portal phase and delayed phase imaging. Three cases had incomplete capsules while one case had a complete capsule. Cyst/necrosis was observed in 7 out of all cases following administration of contrast agent, with 5 mainly distributed in the periphery. All masses lacked fat, calcification, vascular or bile duct tumor thrombus formation.ConclusionThe imaging findings associated with PHNENs possess certain specificity, often presenting as multiple masses within the liver accompanied by peripheral cyst/necrosis, similar rim arterial phase hyper-enhancement during venous portal phase and delayed phase imaging.

目的 探讨磁共振动脉自旋标记(ASL)灌注成像对老年局部晚期鼻咽癌(LA-NPC)放化疗疗效的预测价值.方法 纳入接受放化疗治疗的LA-NPC患者 96 例,于治疗前完成鼻咽部磁共振检查(含ASL),疗程结束后完成磁共振复查;记录患者治疗前ASL定量灌注参数肿瘤血流量(TBF);疗程结束后,根据实体瘤疗效评价标准将患者分为有效组(n=68)与无效组(n=28),采用受试者工作特征(ROC)曲线评价TBF对患者放化疗疗效的预测能力,并采用Logistic回归模型分析TBF及临床特征与放化疗疗效的关系.结果 有效组TBF值显著高于无效组(P<0.05).TBF值预测放化疗疗效的ROC曲线下面积为 0.810(95%CI:0.718～0.883),以TBF=99 ml/(100 g·min)作为截断点时,敏感度为 82.4%,特异度为 69.1%.单因素分析显示,老年LA-NPC患者放化疗疗效与临床分期、病理类型、肿瘤最大径和TBF值有相关性(P<0.05).Logistic回归分析显示,低TBF值、临床分期为ⅣA期是老年LA-NPC患者放化疗疗效的不利因素(P<0.05).结论 基于磁共振ASL灌注成像的肿瘤TBF对预测老年LA-NPC患者放化疗疗效有潜在价值.

目的 探讨超敏C-反应蛋白(hs-CRP)与类风湿性关节炎(RA)腕关节滑膜高频超声表现之间的相关性.方法 对经临床确诊为RA的43例患者的腕关节行hs-CRP检查,并通过高频超声对其腕关节滑膜厚度及能量多普勒血流分级进行观察,研究腕关节滑膜高频超声表现与hs-CRP之间的相关性.结果 43例腕关节超声均显示有滑膜增厚,其能量血流分级包括0级3例、1级17例、2级13例和3级10例.腕关节滑膜变化与RA患者hs-CRP(P<0.05)呈正相关.结论 hs-CRP值与腕关节滑膜变化呈正相关,可作为评估类风湿性关节炎早期炎症活动的指标,为诊断提供超声影像学证据.

目的:探讨CT与MRI对肾脏囊性病变的诊断与鉴别诊断的临床价值.方法:回顾性分析2015年1月-2020年10月在本院诊治经手术病理确诊为肾脏囊性病变的90例(共108个病灶,其中良性60个,恶性48个)患者的临床影像学资料,90例患者接受过CT与MRI检查,比较两种检查方法的Bosniak分级结果和诊断效能.结果:CT与MRI的Bosniak分级结果提示,CT与MRI均能有效明确病灶组织,在Bosniak分级鉴别方面比较,差异无统计学意义(P>0.05);在诊断效能方面,MRI下的Bosniak分级诊断符合率95.37％、敏感性95.83％、特异性95.00％均明显高于CT下Bosniak分级的76.85％、72.92％、80.00％,差异有统计学意义(P<0.05).结论:与CT相比,MRI的Bosniak分级在肾脏囊性病变中的诊断效能更显著,建议首选MRI下的Bosniak分级.

BACKGROUND:Long intergenic non-protein coding RNA 1140 (LINC01140), a long non-coding RNA, is highly expressed in various cancers; however, its biological functions in lung cancer (LC) progression and immune escape are still unclear. METHODS:Here, to elucidate LINC01140 function, 79 paired LC and paracancerous tissues were collected. LINC01140 expression levels were determined using fluorescence in situ hybridization and qPCR analysis. Cell counting kit-8 (CCK-8) assay and transwell assays were performed. The interaction between microRNAs (miRNAs) and LINC01140 was confirmed using an RNA immunoprecipitation assay. Cytokine-induced killer (CIK) cell phenotypes were analyzed by flow cytometry. Cytokine secretion levels were determined by ELISA. CIK cytotoxicity was assessed by measuring lactate dehydrogenase release. Besides, xenograft tumor mouse models were used to unveil the in vivo function of LINC01140. RESULTS:We found that LINC01140 was highly expressed in human LC tissues and cell lines. High LINC01140 levels were associated with poor survival in patients with LC. LINC01140 upregulation promoted the proliferation, migration, and invasion of LC cells through direct interaction with miR-33a-5p and miR-33b-5p, thereby contributing to c-Myc expression and also inhibited cisplatin-induced cell apoptosis. In subcutaneous tumor xenograft mice, LINC01140 knockdown markedly reduced tumor growth and lung metastasis. Additionally, LINC01140 directly repressed miR-377-3 p and miR-155-5 p expression levels, resulting in the upregulation of their common downstream target programmed death-ligand 1 (PD-L1), a crucial target in LC immunotherapy. Notably, we proved that LINC01140 knockdown, along with CIK administration, suppressed the growth of subcutaneous LC xenografts by decreasing PD-L1 expression in severe combined immunodeficient mice. CONCLUSIONS:Taken together, LINC01140 overexpression protects c-Myc and PD-L1 mRNA from miRNA-mediated inhibition and contributes to the proliferation, migration, invasion, and immune escape of LC cells. These results provide a theoretical basis that LINC01140 is a promising target for LC treatment.

目的 观察MRI在T2DM合并脑梗死患者中应用.方法 选取于2017年1月-2019年6月的60例T2DM与非T2DM合并脑梗死作为观察对象,均接受MRI检查.结果 研究组MRI大面积梗死、再发性梗死、多灶性梗死高于对照组(P＜0.05),大面积梗死MRI为大片状且不均匀或者均匀异常信号影,腔隙性脑梗死梗死灶直径＜1.5 cm,病灶形态斑点状、斑片状、裂隙状、类圆形等,多发性梗死患者两侧额叶及胼胝体膝部、体部多发片状异常信号,TIWI稍低信号,T2WI稍高信号,FLAIR高信号,DWI稍高信号,增强后病灶环形强化.结论 T2DM是脑梗死的危险因素,要及早治疗.

To observe the effect of nano-artificial bone and bone marrow mesenchymal stem cells (BMSCs) in the treatment of femoral head osteonecrosis. The bilateral femoral head internal bone defect model was established and divided into three groups. Group A was used to make the defect without filling any material as the control, group B was only filled with nano-artificial bone, and group C was filled with composite materials of nano-artificial bone and bone marrow mesenchymal stem cells. The femoral head was examined using radiography and high-resolution focused 48-slice computed tomography (CT) at 12 weeks after implantation. A significant difference was found between groups B and C in the aspect of repairing the defect in osteogenesis of the femoral head as compared with the control group. Nano-collagen-based bone has strong osteogenic and osteogenic effects and is a good graft material for repairing bone defects of the femoral head. The use of bone marrow mesenchymal stem cells can promote the repair of bone defects, which is of great value in the treatment of osteonecrosis of the femoral head.

目的:评价MRI多参数定量分析在肾透明细胞癌(CCRCC)与乏脂型血管平滑肌脂肪瘤(AML)鉴别诊断中的应用价值.方法:回顾性分析经手术病理证实的19例CCRCC与12例乏脂型AML;其中26例行MRI平扫、DWI及动态增强扫描,5例仅行MRI平扫及DWI检查.分别测量T1WI、T2WI、同反相位、动态增强信号强度(SI)值及ADC值,并计算T1 SI比值、T2 SI比值、同反相位SI指数及动脉-延迟增强SI比值.采用两独立样本t检验分析2组各指标间的差异.结果:2组T1 SI比值比较,差异无统计学意义(P=0.117).与乏脂型AML相比,CCRCC具有更高的T2 SI比值、动脉-延迟增强SI比值及ADC值,同反相位SI指数则低于乏脂肪AML(均P<0.05).结论:MRI多参数定量分析能够更好地鉴别CCRCC与乏脂型AML,结合常规影像表现,能够为临床决策提供更多影像学信息.

目的 探究无创影像检查方法诊断糖尿病下肢动脉病变的价值.方法 选取2018年4月-2019年5月为研究阶段,回顾性分析该阶段该院收治的100例2型糖尿病患者,均存在下肢动脉病变,根据检测方法不同分为观察组和对照组,观察组采用无创影像检查方法,对照组采用驾驶安全预警与导航系统(DSA)检查,观察并记录两种检查方法的准确率,后采用统计学软件对比分析组间数据.结果 两组检查方法诊断糖尿病下肢动脉病变准确率无差异,对比差异无统计学意义(P＞0.05).两组检查方法诊断糖尿病下肢动脉病变分级上均处于较高水平,对比差异无统计学意义(P＞0.05).结论 无创影像检查方法诊断糖尿病下肢动脉病变的价值较高,具有操作简单、准确率高、无创伤等优点,可作为诊断糖尿病下肢动脉病变的首选方式.

心尖部室壁瘤是临床上常见的疾病,发病早期如果得不到及时有效的治疗,将会引起心力衰竭、心脏破裂、缺血性心肌病及栓塞等并发症,主要是由于冠状动脉粥样硬化引起的心肌梗死造成[1]. 文献[2,3]报道显示:部分冠状动脉正常患者也可以引发心肌梗死后室壁瘤. 数据报道显示[4,5]:每年全球约有1700万人死于心血管疾病,并且一半以上死于急性心肌梗死,对于存活患者液容易演变为慢性心力衰竭.目前,临床上对于心尖部室壁瘤成形缺血性心肌病患者以经皮左室分区术治疗为主,该手术包括:入路系统、输送系统和心室分隔装置三部分,该手术能实现室壁瘤与左心室正常心肌的分离.但是,部分患者治疗过程中由于缺乏理想的评价方法,导致术后效果较差,对患者心功能影响较大,不利于患者术后恢复[6,7]. 文献[8]报道显示:将CT用于经皮左室分区术治疗心尖部室壁瘤成形缺血性心肌病患者中效果理想,有助于评估患者心功能,促进患者恢复,但是该结论有待验证. 因此,本研究以2015年6月至2017年6月医院收治的心尖部室壁瘤成形缺血性心肌病患者25例作为研究对象,探讨CT在经皮左室分区术治疗心尖部室壁瘤成形缺血性心肌病患者中的应用及对心功能射血分数(EF)的影响,报告如下.

目的 了解糖尿病合并继发型肺结核CT影像学表现.方法 选取2016年9月-2018年1月该院收治的78例患者为研究对象,其中39例糖尿病合并继发型肺结核患者作研究组,另选取39例单纯肺结核患者作对照组,均作CT检查,对两组患者各自检查后的影像学表现进行对比分析.结果 两组患者病灶在肺结核常见部位的发生率比较差异无统计学意义(P>0.05),而相较于对照组,研究组患者病灶在肺结核少见部位的发生率更高,组间比较差异有统计学意义(P<0.05);研究组患者病灶在多个肺叶、多个肺段、两侧肺发生率均高于对照组,组间比较差异有统计学意义(P<0.05);研究组病患厚壁空洞、大片状影与虫蚀样空洞、空气支气管征发生率明显高于对照组,组间比较差异有统计学意义(P<0.05).而树芽征、腺泡结节、薄壁空洞等发生率比较差异无统计学意义(P>0.05).结论 糖尿病合并继发型肺结核患者胸部CT影像表现出多形性,少见部位累及明显,并以空洞、大片状与空气支气管征为主.同时,CT检查可为糖尿病合并继发型肺结核的诊断、治疗与疾病预后评估提供参考依据.

目的 分析糖尿病合并肺结核患者的临床表现及影像学特征.方法 选取该院2016年6月—2017年6月收治的糖尿病结合肺结核患者共计80例作为该次研究对象,把患者按照糖尿病合并肺结核与单纯肺结核的标准,分成试验组与对照组,每组40例,采用回顾分析的方法对80例患者的临床表现及CT检查结果的特征进行分析比较.结果 实验组的患者起病急剧,主要表现是炎症,呼吸道及结核中毒的现象明显,少部分患者无呼吸道症状;两组患者在病变范围及部位、病变类型差异有统计学意义(P<0.01).试验组的临床影像表现为肿块、结节、树芽状、空洞,有纤维状的斑片影、条影,动态影像主要是以大片融合、实质发生病变为主;对照组临床表现主要为支气管扩大、淋巴结肿大、出现空洞及钙化现象,动态影像主要呈现多个小片阴影、大片阴影.结论 相较于单纯的肺结核患者,糖尿病合并肺结核病的患者临床表现及肺部CT均出现一定的特殊性,掌握患者的影像学特征对治疗此病有着重要的临床应用价值.

目的:对声辐射力脉冲(ARFI)成像技术在评估颈部血管斑块的价值进行分析.方法:回顾性分析2013年6月-2016年6月于本院医治的缺血性脑卒中患者114例为研究组,同期选取于我院检查的健康人群104例为对照组.两组均予以ARFI成像技术检查,测量记录斑块剪切波传播速度(SWV),观察两组斑块检出率,各类型斑块SWV均值,两组各类型斑块分布情况.结果:研究组共114人,检出有斑块的79例,共检出163个斑块,其中强回声36个、低回声51个、等回声31个、混合回声45个;对照组共104人,检出有斑块的28例,共检出59个斑块,其中强回声19个、低回声16个、等回声10个、混合回声14个;研究组斑块检出率为69.29％,对照组斑块检出率为26.92％,两组斑块检出率比较差异具统计学意义(P＜0.05);强回声、低回声、等回声及混合回声SWV均值两两间比较具可比性(P＜0.05).结论:ARFI成像技术对颈部血管斑块具较高评估价值,提高斑块检出率,可作为诊断颈部血管斑块的理想手段.

Objective:To analyse the MSCT features and enhance the knowledge of retroperitoneal peripheral primitive neu-roectodermal tumors(pPNETs). Methods:7 patients' MSCT data of retroperitoneal pPNETs were reviewed which were proved by surgery and pathology. Results:All 7 cases were single tumor and located in the perirenal space. The tumors' diameters were 6.3~15.7 cm,the mean 9.7 cm. 4 tumors were irregular,3 oval and with unclear boundary. On rountine CT,most tumors showed asymmetrical low density;all tumors showed necrosis,cyst degeneration and no calcification,5 solid-cystic change and 4 haemorrhage. On enhanced CT,7 tumors showed slight to moderate asymmetrical continuous enhancement,the solid part of tu-mors showed enhancement as speckle,nodule or strip. 3 tumors showed tumor angiogenesis. The margin of 6 tumors showed half-baked envelope with small burrs in outsides. 7 tumors showed the invasion to organs,vessels or soft tissue. 3 cases were seen with renal hypofunction,3 with metastasis of lymph nodes in renal hilus,2 with metastasis of pelvic. There were no obvi-ous ascites in all 7 cases. Conclusions:The MSCT manifestations of retroperitoneal pPNETs have no characteristics. MSCT can show the intra-tumor structures and the extent of the tumor very well,which is helpful in differentiating diagnosis.

Objective To observe and evaluate MSCT multi﹣phase dynamic contrast enhancement features of primary ureteral carcinoma. Methods Thirteen cases with primary ureteral carcinoma with operative and pathologic identification were studied by MSCT multi﹣phase dynamic contrast enhancement. There were 11 males and 2 females. Results The peak enhancement of 8 primary ureteral carcinomas by MSCT multi﹣phase dynamic contrast enhance﹣ment were in the nephrogram phase;3 cases in the corticomedullary phase, 2 cases in the pyelogram phase. Conclu﹣sion MSCT dynamic contrast enhancement features of primary ureteral carcinoma have some characteristics. It is easy to diagnose with other image signs. The main differential diagnosis of few primary ureteral carcinoma with con﹣tinuing enhancement pattern was primary non﹣specificity ureteritis.

目的:探讨颈部Castleman病(CD)的CT及MRI表现,以提高诊断的准确性.方法:回顾性分析10例经病理证实的颈部CD患者的临床与影像学资料.8例行CT检查,其中7例行增强扫描；2例行MRI平扫及增强扫描；1例同时行CT与MRI检查,将CT、MRI结果与病理结果对照分析.结果:按Friz2era标准分类:10例颈部CD患者,局灶型7例(透明血管型6例,混合型1例)；多中心型3例(浆细胞型2例,混合型1例).局灶型大多为透明血管型,CT表现为单发、类圆形软组织肿块,周围伴或不伴有子灶或卫星灶,增强扫描动脉期明显强化,强化程度与颈总动脉同步,静脉期及延迟期强化程度减弱,边缘斑点或条状小血管；MRI亦表现为单发异常信号,呈等T1稍长或长T2信号,强化方式同CT增强扫描,边缘多有索条状迂曲流空血管,2个病灶内有裂隙征,呈延迟强化.多中心型CD的影像表现为多发大小不等软组织肿块影,边界不清,早期轻度强化,晚期中度强化.结论:颈部CD的影像表现与临床、病理分型密切相关,透明血管型CD具有一定影像特征,尤其动态增强扫描对其具有重要诊断价值；浆细胞型CD则缺乏特征表现,确诊尚需免疫组织病理学检查.

Objective: To evaluate the proton magnetic resonance spectroscopy(1H-MRS)finding of the peritumoral regions of brain glioma,and to explore the correlation between different metabolic and the degree of tumor infiltration.Methods:Twenty-five untreated cases with glioma were studied.The diagnosis was pathologically confirmed after surgery.All the cases underwent conventional MRI and contrast enhanced MRI,then multiple voxel 1H-MRS was performed on a 3.0 T MR scanner using pointed resolved spectral selection(PRESS).MRI-guided neuronavigation biopsies were performed to gain the tissue samples and the corresponding histopathological examination results.Results:The series yielded 239 tissue samples and the corresponding 1H-MRS and histopathological examination results were obtained.Spearman correlation analysis showed that Cho/nCr and NAA/Cho were appeared to correlate best with the degree of tumor infiltration.Conclusion:The preliminary results support that 1H-MRS accurately reflects the extent and degree of gliomas.This has important diagnostic and therapeutic implications for more accurately assessing the extent of neoplasm as well as for surgical planning and assessing response to therapy.

目的:探讨四肢神经鞘瘤的MRI表现,提高MRI对四肢神经鞘瘤的诊断率.方法:回顾性分析23例经手术病理证实的四肢神经鞘瘤的MRI资料,其中上肢8例,下肢15例.23例均行常规MRI扫描,包括自旋回波(SE)T1WI,快速自旋回波(FSE)T2WI和SE T1WI增强扫描.结果:23例肿瘤有20例呈椭圆形或梭形,边界清楚光滑,14例位于神经血管束走行区,沿神经走行方向生长,并与神经偏心性相连,9例未追踪到起源神经.21例有完整包膜.绝大多数神经鞘瘤T1WI呈中等至低信号,所有肿瘤T2WI呈不均匀高信号或高低混合信号,增强扫描有不均匀强化.其中显示靶征6例,神经出入征14例,脂肪包绕征10例,脂肪尾征12例.结论:MRI有利于明确肿瘤的位置和范围,靶征、神经出入征、脂肪包绕征和脂肪尾征对诊断有重要价值.

患者男,19岁.以"左髋不适2年半,加重2周"就诊.平素体健.血、尿常规、生化系列及肿瘤标志物阴性.查体:双侧腹股沟区及会阴部软组织肿胀,左侧可触及大小约3.00 cm×2.00 cm×0.50 cm肿物,质稍韧、固定、边界不清、轻压痛.影像学检查:X线示骨盆多发骨质溶解、消失,右侧骨质残端变细、变尖,形似"笔尖",无骨膜增生及新生骨形成(图1).CT示双侧髋臼多发骨质溶解,左侧骨质残端变薄、变细,周围软组织明显肿胀(图2).术中见耻骨联合处有软组织覆盖,其上被覆淡红色纡曲血管,左侧耻骨大部分溶解、消失.病理镜下见骨小梁稀疏、萎缩,髓腔扩大,增生血管呈分支状贯穿于纤维结缔组织中(图3).诊断:大块骨溶解症.