应用基因芯片技术研究原发性腹膜后脂肪肉瘤组织特异性候选基因

目的:原发性腹膜后脂肪肉瘤是一种少见的恶性肿瘤,发病率大约占全部恶性肿瘤的1％,但其却是腹膜后最常见的软组织肿瘤.通过研究原发性腹膜后脂肪肉瘤和正常脂肪组织间的基因表达差异,可以寻找到与原发性腹膜后脂肪肉瘤发生、发展相关的候选基因并为其防治研究提供线索.方法:应用基因芯片技术检测2例原发性腹膜后脂肪肉瘤和相应的正常脂肪组织全基因组序列,分析其基因表达差异.结果:两组间的差异表达基因3828个,其中表达上调有1837个基因,表达下调有1991个基因.其中涉及细胞增殖、黏附、凋亡以及信号通路等多种生物学过程.结论:通过基因表达谱芯片筛选出与原发性腹膜后脂肪肉瘤发生和进展密切相关的基因为其基础研究及临床早期诊断、预防和治疗提供潜在的分子标记和靶基因.     

超声和CT在诊断腹膜后冷脓肿中的应用

目的：评估超声和ＣＴ诊断腹膜后冷脓仲的价值。材料与方法：用超声和ＣＴ对４１例腹膜后冷脓肿作了检查,观察了腹膜后冷脓肿的形态、大小、位置、内部回声或密度情况、活动度以及对周围组织、脏器的影响。结果：肾周腹膜后的大脓肿,其形态呈前后径小,上下径大的不规则梭形,小脓肿或髂窝处的脓肿多呈类圆形。超声的内部回声有低回声、无回声、等回声和强回声,ＣＴ为脓肿内见斑点及沙砾样钙化灶,增强扫描后的病灶更为清楚。所有     

乙肝相关性肝癌组织BCLAF1、SETDB1表达与临床病理特征和术后预后的关系研究

目的：探讨乙肝相关性肝癌组织Bcl-2相关转录因子-1(BCLAF1)、组蛋白甲基化酶SET结构域分支型1(SETDB1)表达与临床病理特征和术后预后的关系。方法：选择2018年1至2020年6月南方医科大学珠江医院和高州市人民医院收治的127例行根治性手术切除的乙肝相关性肝癌患者,取手术切除的癌组织和旁组织,采用免疫组化法检测BCLAF1、SETDB1表达,分析BCLAF1、SETDB1表达与临床病理特征的关系。术后随访3年,Kaplan-Meier生存曲线分析BCLAF1、SETDB1不同表达患者生存差异,多因素Cox回归分析影响乙肝相关性肝癌患者预后的因素。结果：癌组织BCLAF1、SETDB1阳性表达率高于癌旁组织（P<0.05）。低分化、TNM分期Ⅲa期、门脉侵犯、淋巴结转移患者癌组织中BCLAF1、SETDB1阳性表达率高于中高分化、TNM分期Ⅰ～Ⅱ期、无门脉侵犯、无淋巴结转移患者癌组织（P<0.05）。BCLAF1阳性表达、SETDB1阳性表达乙肝相关肝癌患者3年总生存（OS）率低于BCLAF1阴性表达、SETDB1阴性表达乙肝相关肝癌患者（P<0.05...     

乳腺癌组织FOXP3、HMGA2、RASAL2的表达及与临床病理特征和预后的关系

摘要 目的：探讨乳腺癌组织叉头框蛋白P3（FOXP3）、高迁移率族蛋白A2（HMGA2）、大鼠肉瘤蛋白活化因子2（RASAL2）的表达及其与临床病理特征和预后的关系。方法：选取2014年6月至2015年6月期间我院收治的102例乳腺癌患者作为研究对象。检测乳腺癌组织以及癌旁组织中FOXP3、HMGA2、RASAL2表达,分析FOXP3、HMGA2、RASAL2表达与临床病理参数的相关性。Kaplan-Meier生存曲线分析不同FOXP3、HMGA2、RASAL2表达患者总生存率的差异。Cox比例风险回归模型分析乳腺癌患者预后的影响因素。结果：与癌旁组织相比,乳腺癌组织中FOXP3、HMGA2阳性表达率升高,而RASAL2阳性表达率降低（P<0.05）。FOXP3、HMGA2、RASAL2表达均与TNM分期和淋巴结转移相关（P<0.05）。FOXP3、HMGA2阳性患者的生存率明显低于FOXP3、HMGA2阴性患者,RASAL2阳性患者的生存率明显高于RASAL2阴性患者（P<0.05）。TNM分期Ⅲ期、FOXP3阳性表达、HMGA2阳性表达是影响乳腺癌患者预后的危险因素（P<0.05）,而RASAL2阳性表达是乳腺癌患者预后的保护因素（P<0.05）。结论：乳腺癌组织中FOXP3和HMGA2阳性表达率升高,而RASAL2阳性表达率降低,FOXP3和HMGA2阳性表达以及RASAL2阴性表达与乳腺癌患者TNM分期、淋巴结转移相关,并且是患者预后不良的影响因素。     

急性弥漫性轴索损伤CT与MRI对比的研究

目的:比较急性弥漫性轴索损伤患者CT及MRI表现的不同。方法:选取60例急性弥漫性轴索损伤患者,而CT无异常改变或改变轻微的病例行MRI检查。全部检查均在损伤后6天内完成。GCS评分＜8分44例,9—12分16例。结果:MRI显示具有DAI损伤表现的共41例,阳性率68．3%,其中单独具有DAIⅠ、Ⅱ和Ⅲ型损伤表现的分别为7例、12例和1例,同时具有DAIⅠ和Ⅱ型损伤表现的共12例,同时具有DAJⅠ和Ⅲ型损伤表现的共2例,同时具有DAJⅡ和Ⅲ型损伤表现的共2例,同时具有三型DAI损伤表现的共5例;CT显示具有DAI损伤表现的共3例,阳性率5．0%,其中具有DAIⅠ型损伤表现的2例,具有DAIⅡ型损伤表现的1例,具有DAIⅢ型损伤表现的0例。结论:CT缺乏异常表现或轻微异常表现的急性弥漫性轴索损伤,MRI常常能显示损伤,包括特殊的损伤部位和一些其他类型合并损伤。     

CT与MRI对肝硬化背景下小肝癌检出率的比较

目的:分析比较CT与MR对肝硬化背景下小肝癌检出情况,探究CT与MR在肝硬化背景下小肝癌的诊断价值。方法:选择2010年6月~2015年6月期间,我院收治确诊为肝硬化背景下小肝癌患者91例为研究对象,病理及临床相关方法确诊102个病灶,其中小肝癌69个和微小肝癌33个,患者均在不同时期或序列下行多排螺旋CT与MRI检查,分析比较两者对小肝癌和微小肝癌的检出率。结果:多排螺旋CT检查发现肝癌小病灶91个,其中66个小肝癌,25个微小肝癌;MRI检查发现95个病灶,小肝癌67个,微小肝癌28个;69个小肝癌病灶,检出率最高的为CT动脉期(92.75%)与LAVA动脉期(92.75%),检出率最低的为CT平扫(76.81%);33个微小肝癌病灶,检出率最高为LAVA动脉期(75.76%),检出率最低的为LAVA平衡期(36.36%);CT平扫、门静脉期、动脉期、平衡期、MRI-IN-PHASE、LAVA平衡期、LAVA平扫对小肝癌的检出率显著高于对微小肝癌的检出率(P0.05);CT对小肝癌的检出率显著高于微小肝癌的检出率(P0.05),MRI对小肝癌与微小肝癌的检出率无显著差异(P0.05);MRI与CT对小肝癌的检出率不存在差异(P0.05),但MRI对微小肝癌的检出率显著高于CT(P0.05)。结论:MRI-LAVA的动脉期序列对小肝癌病灶与微小肝癌病灶的检出率最高;CT与MRI在对小肝癌的检出率不存在差异,但MRI对微小肝癌的检出具有更明显的优势。     

急性胰腺炎患者的CT、MRI影像学表现及其诊断价值对比研究

摘要 目的：比较急性胰腺炎患者的电子计算机断层扫描（CT）、磁共振成像（MRI）影像学表现及其诊断价值。方法：选择2018年1月-2019年12月我院收治并初步诊断为急性胰腺炎的患者124例，所有患者均同时行CT和MRI检查，并比较两种检查方式诊断急性胰腺炎的影像学表现，以临床最终诊断结果作为参考，比较两种检查方式诊断急性胰腺炎的价值。结果：124例患者，经临床最终诊断为急性胰腺炎96例，28例为非急性胰腺炎，以临床最终诊断结果为"金标准"，CT诊断急性胰腺炎的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为84.38%、75.00%、92.05%、58.33%、82.26%，MRI诊断急性胰腺炎的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为95.83%、78.57%、93.88%、84.62%、91.94%，MRI诊断急性胰腺炎的灵敏度、阴性预测值和准确度显著高于CT（P<0.05），两种检查方式诊断急性胰腺炎的特异度、阳性预测值比较无统计学差异（P>0.05）。结论：CT和MRI影像学表现有利于急性胰腺炎的诊断，两者对急性胰腺炎诊断均具有较高的灵敏度、特异度和准确度， 但MRI诊断急性胰腺炎的灵敏度、准确度优于CT。     

中国数字化可视人体鞍上池的横断面解剖与CT、MRI对照研究

目的:探讨鞍上池在中国数字化可视人体(Chinese visible human,CVH)与CT、MRI上的横断面解剖形态学表现。方法:选择做64层螺旋CT和MRI头部检查的健康志愿者各60例,获得5mm层厚横断面图像。从第2例中国数字化可视人体数据集中选取与CT、MRI相对应层面的头部薄层连续横断面标本图像,对照观察鞍上池在CVH、MRI与CT图像上的正常解剖形态、毗邻及内部结构。结果:CVH图像上,鞍上池表现为六角形和五角形两种形状。CVH薄层横断面图像能连续、清晰地显示鞍上池的正常形态、毗邻及内部结构。60例CT及MRI图像上,鞍上池全部显示,但解剖结构均不及CVH清晰。鞍上池在CT、MRI横断面图像上形状变化更大,以六角形最多,五角形次之,四角形最少,相应毗邻及内部结构也有所不同。六角形鞍上池在CVH、CT、MRI上有良好的对应关系,五角形鞍上池部分相匹配,CVH图像上无四角形鞍上池。结论:通过与CT、MRI进行对照研究,中国数字化可视人体能为颅脑疾病的影像识别和诊断提供断层解剖学依据。     

隐匿性胫骨平台骨折MRI、CT检查的影像学表现及其诊断价值对比的回顾性研究

目的:研究对比隐匿性胫骨平台骨折(TPOF)磁共振成像(MRI)、电子计算机断层扫描(CT)检查的影像学表现及其诊断价值。方法:回顾性分析我院自2016年1月至2019年12月拟诊断为TPOF且X线检查表现为阴性的89例患者的临床资料,分别对所有受试者进行MRI、CT检查,且以手术检查为金标准,比较上述两种影像学检查手段诊断TPOF的效能。此外,比较MRI、CT检查诊断TPOF的表观扩散系数以及节段各向异性值以及对TPOF类型的检出率。结果:MRI检查诊断TPOF的灵敏度、特异度及准确度分别为98.61%、94.12%、97.75%,均高于CT检查的79.17%、64.71%、76.40%(均P<0.05)。MRI检查诊断TPOF的表观扩散系数高于CT检查,而节段各向异性值低于CT检查(均P<0.05)。MRI检查对骨皮质骨折的检出率低于CT检查,而对骨小梁骨折的检出率高于CT检查(均P<0.05)。结论:MRI检查诊断TPOF的价值高于CT检查,且在骨小梁骨折的检出率方面优于CT检查,但CT检查应用于骨皮质骨折的诊断价值更高。临床工作中可能通过联合MRI以及CT检查,继而达到提高TPOF检出率的目的。     

MRI与CT检查对卵巢癌病理分期及复发转移的诊断价值对比研究

摘要 目的：对比磁共振成像（MRI）与计算机断层扫描（CT）检查对卵巢癌病理分期及复发转移的诊断价值。方法：纳入2017年1月～2019年1月于我院接受诊治的卵巢癌患者100例进行研究。所有患者术前均进行MRI与CT检查,并以术后病理组织活检结果为金标准,对比MRI与CT诊断卵巢癌与卵巢癌病理分期的准确率。所有患者均于首次检查6个月后进行复诊,对比MRI与CT诊断卵巢癌复发转移的准确率。结果：MRI诊断卵巢癌的确诊率为94.00%（94/100）,高于CT诊断的81.00%（81/100）;漏诊率为2.00%（2/100）,低于CT诊断的10.00%（10/100）（均P＜0.05）。MRI诊断卵巢癌Ⅰ期、Ⅱ期、Ⅲ期的准确率分别为93.33%（14/15）、95.00%（19/20）、93.33%（28/30）,高于CT诊断的60.00%（9/15）、65.00%（13/20）、73.33%（22/30）（均P＜0.05）。MRI诊断肠管及周围、盆腔淋巴结、腹膜后淋巴结、肝脏等远处侵袭和转移中的准确率分别为100.00%（26/26）、88.89%（24/27）、75.00%（18/24）、95.00%（19/20）,高于CT诊断的76.92%（20/26）、48.15%（13/27）、41.67%（10/24）、45.00%（9/20）（均P＜0.05）。结论：相较于CT检查,MRI检查诊断卵巢癌的准确率更高,漏诊率更低,且在卵巢癌病理分期以及复发转移的诊断准确率更高,具有较好的临床应用价值。     

磁共振成像应用于检测胎盘植入介入治疗

为了探讨磁共振成像(magnetic resonance imaging, MRI)在胎盘植入介入治疗中的诊断作用和为临床治疗提供依据,本研究选取30例于2012年6月至2015年12月间在我院进行介入治疗的胎盘植入患者作为研究对象,根据病理诊断标准,分析患者胎盘植入介入治疗前后的MRI检查结果。结果显示,粘连性胎盘的敏感性和特异性分别为77.5%和90.2%,植入性胎盘的敏感性和特异性分别为75.5%和87.7%,穿透性胎盘的敏感性和特异性分别为85%和100%。最好的预测胎盘植入的MRI特征是在T2W磁共振成像(T2W-MRI)序列上存在暗色的胎盘内条带。介入治疗1年后复查时,发现患者子宫恢复为正常大小,宫腔内的胎盘组织基本消失,宫壁与植入胎盘融合、宫腔内膜线和子宫结合带的信号完整。综上结果,说明MRI可作为检测胎盘植入可靠性和可重复性的工具,并且能够显示胎盘植入部位及子宫肌层受侵程度,可用于评价胎盘植入介入治疗的疗效。     

Size and CT density of iodine-containing ethosomal vesicles obtained by membrane extrusion: Potential for use as CT contrast agents

Computed tomography (CT) is the primary non-invasive imaging technique used for most patients with suspected liver disease. In order to improve liver-specific imaging properties and prevent toxic effects in patients with compromised renal function, we investigated the encapsulation of iodine within ethosomal vesicles. As a first step in the development of novel contrast agents using ethosomes for CT imaging applications, iodine was entrapped within ethosomes and iodine-containing ethosomes of the desired size were obtained by extrusion using a polycarbonate membrane with a defined pore size. Ethosomes containing iodine showed a relatively high CT density, which decreased when they were extruded, due to the rupture and re-formation of the lipid bilayer of the ethosome. However, when a solution with a high iodine concentration was used as a dispersion media during the extrusion process, the decrease in CT density could be prevented. In addition, ethosomes containing iodine were taken up efficiently by macrophages, which are abundant in the liver, and these ethosomes exhibited no cellular toxicity. These results demonstrate that iodine could be entrapped within ethosomal vesicles, giving the ethosomes a relatively high CT density, and that the extrusion technique used in this study could conveniently and reproducibly produce ethosomal vesicles with a desired size. Therefore, ethosomes containing iodine, as prepared in this study, have potential as contrast agents with applications in CT imaging.     

In vivo assessment of nodularin-induced hepatotoxicity in the rat using magnetic resonance techniques (MRI, MRS and EPR oximetry)

Acute nodularin-induced hepatotoxicity was assessed in vivo, in rats using magnetic resonance (MR) techniques, including MR imaging (MRI), MR spectroscopy (MRS), and electron paramagnetic resonance (EPR) oximetry. Nodularin is a cyclic hepatotoxin isolated from the cyanobacterium Nodularia spumigena. Three hours following the intraperitoneal (i.p.) administration of nodularin (LD50), a region of 'damage', characterized by an increase in signal intensity, was observed proximal to the porta hepatis (PH) region in T2-weighted MR images of rat liver. Image analysis of these regions of apparent 'damage' indicated a statistically significant increase in signal intensity around the PH region following nodularin administration, in comparison with controls and regions peripheral to the PH region. An increase in signal intensity was also observed proximal to the PH region in water chemical shift selective images (CSSI) of nodularin-treated rat livers, indicating that the increased signal observed by MRI is an oedematous response to the toxin. Microscopic assessment (histology and electron microscopy) and serum liver enzyme function tests (aminotransferase (ALT) and aspartate ALT (AST)) confirmed the nodularin-induced tissue injury observed by MRI. In vivo and in vitro MRS was used to detect alterations in metabolites, such as lipids, Glu+Gln, and choline, during the hepatotoxic response (2-3 h post-exposure). Biochemical assessment of perchloric acid extracts of nodularin-treated rat livers were used to confirm the MRS results. In vivo EPR oximetry was used to monitor decreasing hepatic pO2 (approximately 2-fold from controls) 2-3 h following nodularin exposure. In vivo MR techniques (MRI, MRS and EPR oximetry) are able to highlight effects that may not have been evident in single end point studies, and are ideal methods to follow tissue injury progression in longitudinally, increasing the power of a study through repeated measures, and decreasing the number of animals to perform a similar study using histological or biochemical techniques.     

PETER PHAN: An MRI phantom for the optimisation of radiomic studies of the female pelvis

PurposeTo develop a phantom for methodological radiomic investigation on Magnetic Resonance (MR) images of female patients affected by pelvic cancer.MethodsA pelvis-shaped container was filled with a MnCl₂ solution reproducing the relaxation times (T₁, T₂) of muscle surrounding pelvic malignancies. Inserts simulating multi-textured lesions were embedded in the phantom. The relaxation times of muscle and tumour were measured on an MR scanner on healthy volunteers and patients; T₁ and T₂ of MnCl₂ solutions were evaluated with a relaxometer to find the concentrations providing a match to in vivo relaxation times. Radiomic features were extracted from the phantom inserts and the patients’ lesions. Their repeatability was assessed by multiple measurements.ResultsMuscle T₁ and T₂ were 1128 (806–1378) and 51 (40–65) ms, respectively. The phantom reproduced in vivo values within 13% (T₁) and 12% (T₂). T₁ and T₂ of tumour tissue were 1637 (1396–2121) and 94 (79–101) ms, respectively. The phantom insert best mimicking the tumour agreed within 7% (T₁) and 24% (T₂) with in vivo values. Out of 1034 features, 75% (95%) had interclass correlation coefficient greater than 0.9 on T₁ (T₂)-weighted images, reducing to 33% (25%) if the phantom was repositioned. The most repeatable features on phantom showed values in agreement with the features extracted from patients’ lesions.ConclusionsWe developed an MR phantom with inserts mimicking both relaxation times and texture of pelvic tumours. As exemplified with repeatability assessment, such phantom is useful to investigate features robustness and optimise the radiomic workflow on pelvic MR images.