Schwannoma originating from the common bile duct is rare. We presented a patient who was diagnosed with biliary cystadenoma preoperatively and pathologically confirmed as a choledochal Schwannoma, analyzed the CT and MRI imaging manifestations, and illustrated its anatomical and pathological basis, and to improve the understanding of clinicians and radiologists for choledochal Schwannoma.
ObjectiveTo summarize the mechanism, risk factors, clinical manifestations, and medical treatment of hungry bone syndrome (HBS) in patients with hyperparathyroidism after parathyroidectomy, and to provide clinicians with reference for disease diagnosis and treatment.MethodThe related literatures about HBS in patients were collected and reviewed with clinical experience.ResultsHBS was a group of clinical syndromes mainly manifested as hypocalcemia after parathyroidectomy in patients with high bone turnover state before operation, with a high incidence, and the main purpose of treatment was achieved by supplementing calcium and vitamin D.ConclusionsHBS requires reasonable diagnosis and timely treatment by clinicians. Patients can achieve long-term blood calcium and phosphorus stability and bone mass growth through medical treatment.
Inflammatory myofibroblastic tumor (IMT) involving stomach, liver, biliary tract, and peritoneal mesentery was very rare, nonspecific clinical manifestations and laboratory examination were the main reasons for the difficult preoperative diagnosis of IMT. An IMT case involving multiple systems and multiple sites of the abdomen was presented, the CT and MRI imaging signs and pathological basis of IMT were illustrated, so as to strengthen the understanding of IMT for clinicians and radiologists.
Methods of evidence-based medicine were used to discuss the drug treatment of postmenopausal osteoporosis. After clinical problems were put forward, we searched for and assessed the evidence. A rational treatment plan for osteoporosis patients with fractures was developed according to the results of systematic reviews and Meta-analysis.
Objective To summarize the pathological, clinical features and research progress of CT diagnosis of signet ring cell carcinoma of the stomach, in order to help further understanding and early clinical diagnosis and treatment of this disease. Method The literatures related to pathological classification, clinical manifestations, metastasis patterns, prognosis and CT features of gastric signet ring cell carcinoma were searched and reviewed. Results Gastric signet ring cell carcinoma often had no special clinical symptoms and signs in the early stage, and often entered the advanced stage when symptoms such as gastric ulcer appeared. Gastric signet ring cell carcinoma is more prone to peritoneal and ascites metastases than other types of gastric cancer. The more specific metastases include diffuse infiltration along the bile duct and portal vein to the hepatic hilar area and extension to the Glisson sheath. Compared with other types of gastric cancer, there is no prognostic advantage. even worse. CT showed that the lesions were mostly located in the middle and lower 1/3 of the stomach, with a diffuse infiltrating gross appearance, obvious thickening and enhancement of the gastric wall, and delayed enhancement, especially in the low-enhanced area. The emerging dual-energy/spectral CT has shown good application prospects for the diagnosis of gastric cancer. Conclusions The pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma have certain characteristics, but there are still many controversies, which are related to the fact that some pathological characteristics or infiltration patterns of gastric signet ring cell carcinoma itself have not been clearly studied, which will be discussed in the future direction of continuing research.
Inflammatory myofibroblastic tumor (IMT) occurring in the pancreas was rare and few clinical cases had been reported. The specificity of clinical presentation of IMT was lacked and its CT imaging manifestations were diverse. The enhanced CT images of a rare patient with IMT of the pancreas with liver metastases were presented to the readers, and the pathophysiological mechanisms associated with the CT imaging manifestations were briefly described, so as to enhance the readers’ understanding and knowledge of the CT imaging manifestations and raise the diagnostic awareness of the disease.
ObjectiveTo systematically evaluate the efficacy and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 RCTs were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95%CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95%CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95%CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95%CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤5 mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased. The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The CADe system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.
Schwannoma originating in the retroperitoneal space is relatively rare. The author reported a case of retroperitoneal Schwannoma confirmed by surgery and pathology, presented the typical CT and MRI manifestations of Schwannoma——“target signs”, described the pathophysiological mechanism and image differential diagnosis of the disease, so as to strengthen readers’ understanding of the typical signs of Schwannoma and improve the correct diagnosis rate of the disease.
With the development and popularization of imaging technology, the discovery of gallbladder lesions has become common, among which non-neoplastic lesions (such as gallbladder stones, cholecystitis, gallbladder polyps, gallbladder adenomyosis, etc.) are common but sometimes the imaging manifestations are not specific, and there are many kinds of such diseases, so accurate imaging diagnosis is still quite challenging. Familiarity and understanding of the typical imaging manifestations of these diseases will help to improve the early and accurate diagnosis and help to distinguish them from gallbladder malignant diseases, which is of great significance to the diagnosis, guiding treatment and prognosis of patients.