2018年 · 第52卷第02期

prostatic artery embolization (PAE) is an endovascular interventional technique for the treatment of symptomatic benign prostatic hyperplasia (BPH). Clinical studies have proved its safety and efficacy^[1,2,3,4]。 The basic technique of PAE is to accurately identify and embolize the prostate artery (PA). The origin of PA varies greatly, usually originating from the branch of the anterior trunk of the internal iliac artery^[5]。 The presence of complete occlusion of the internal iliac artery is mostly regarded as a contraindication to PAE, or only unilateral PAE is performed^[6,7]。 The author treated a patient with symptomatic BPH combined with complete occlusion of the right internal iliac artery, and the blood supply to the right prostate came from the branch of the right external iliac artery, and successfully performed PAE. The report is as follows.

Male, 52 years old. Half a month ago, I came to our hospital on December 12, 2016 due to sore throat after a cold and a foreign body sensation in my pharynx. When climbing the stairs 10 days ago, I suddenly felt dyspnea and shortness of breath, without dysphagia, cough, fever and other symptoms. Otolaryngology examination: congestion, redness and swelling of the pharyngeal mucosa, symmetrical lifting of the soft palate, hyperplasia of lymphoid follicles in the posterior pharyngeal wall, and indirect laryngoscopy for unclear peeping. The skin color of the neck was normal, and no obvious masses and swollen lymph nodes were palpable. Fiber laryngoscope: Subglottic stenosis, globular neoplasm visible in the right laryngeal wall, superficial mucosal congestion, right vocal cord fixation.

Female, 72 years old. He was admitted to hospital for more than 3 months due to nasal congestion and purulent discharge, aggravated with headache for half a month. Physical examination: There was no deformity in the external nose, purulent secretions attached to both nasal cavities, gray-white new organisms were seen in the right nasal cavity, and the nasal septum was deviated to the left.

Female, 73 years old. He was admitted to hospital for more than 20 days due to drooping of his left eyelid for 1 month, aggravated with forehead swelling and pain, and blood in his nose. Physical examination: the left forehead is slightly raised, tender, the skin is not red and swollen, and the skin temperature is not high.

Female, 53 years old. 8 months for a mass in the left shoulder joint. Eight months ago, mild swelling of the left shoulder joint and limited movement were found. After symptomatic treatment, there was no obvious improvement and gradually worsened. The patient had a history of rheumatoid arthritis for 10 years and was intermittently treated with oral anti-rheumatoid drugs. Physical examination: 8 cm ×6 cm ×7 cm mass at the anterior edge of the deltoid muscle of the left shoulder, soft, fluctuating, no tenderness, abduction of the left shoulder joint 60° ~120°, negative pain arc test, no abnormalities in sensation and blood supply of the left upper limb. Tumor markers, blood routine normal, tuberculosis antibody (negative), erythrocyte sedimentation rate 29 mm/1 h, C-reactive protein 9.6 mg/L, rheumatoid factor 258 U/ml, anti-streptolysin O test 90 U/ml, anti-cyclic citrulline peptide 69.90 U/L.

Female, 25 years old. The left breast mass was found for more than 4 months. The patient found a mass of 1.6 cm diameter in the upper outer quadrant of the left breast 4 months ago. Specialist examination: A mass, 1.6 cm ×1.1 cm, was palpable in the left breast 6 cm away from the nipple at 1 o'clock, with tough texture, unclear boundaries, slightly mobile, no tenderness, and no skin and chest wall involved. Bilateral axillary and supraclavicular lymph nodes were not swollen.

Female, 65 years old, was seen on September 9, 2016 due to nasopharyngeal cancer for 3 years, cough with chest tightness for 3 days. Physical examination: pulse 78 beats/min, breathing 20 beats/min, blood pressure 145/85 mmHg (1 mmHg =0.133 kPa). Tumor indexes: carbohydrate antigen 50, carbohydrate antigen 125, cytokeratin 19 fragment and ferritin were all increased. Electrocardiogram: Sinus tachycardia (heart rate 115 beats/min), left axis bias, counterclockwise transposition, left ventricular high voltage. Cardiac ultrasound: mild aortic insufficiency, small amount of mitral and tricuspid regurgitation, left ventricular diastolic dysfunction, pericardial effusion. In April 2013, the patient was diagnosed with nasopharyngeal carcinoma, followed by radiotherapy, chemotherapy, and supportive therapy. In May 2015, re-examination in other hospitals revealed lung metastasis of nasopharyngeal carcinoma and pericardial effusion. CT examinations in our hospital in May and July 2016 showed lung metastasis of nasopharyngeal carcinoma, multiple lymph nodes in the mediastinum, and pericardial effusion. On 13 Sep 2016, the patient suffered from sudden fatigue, obvious chest tightness and shortness of breath after activity, pulse 88 beats/min, breathing 21 beats/min, and blood pressure 120/76 mmHg. Blood gas analysis: partial pressure of carbon dioxide was 54 mmHg (normal 35~48 mmHg), partial pressure of oxygen was 35 mmHg (normal 85~108 mmHg), and plain chest CT scan was performed.

According to the 2015 Chinese cancer statistics, there were 4.292 million new cancers and 2.814 million deaths in China in 2015^[1]。 colorectal cancer (CRC) is a common malignant tumor of the digestive system. The prevalence and mortality rate are increasing year by year. Early diagnosis and treatment can significantly improve the prognosis of patients^[1]。 At present, colonoscopy is the gold standard in diagnosing CRC, and different imaging methods have their advantages and limitations in diagnosing CRC. Molecular imaging examination of biomarkers based on genetic and epigenetic characteristics has gradually become a new method for diagnosing tumors^[2,3]。 Tumor immunology is one of the hotspots in the field of tumor research in recent years. With the cross-penetration of oncology, immunology and molecular biology, immunotherapy has developed rapidly, and the technology of immune checkpoint pathway has made a major breakthrough^[4]。 The author reviews the role of immune checkpoint in colorectal cancer and its molecular imaging progress.

The 25th Annual Meeting of the International Society of Magnetic Resonance in Medicine (ISMRM) was held from April 22 to 29, 2017 at the Honolulu Convention Center in Hawaii, USA. ISMRM was founded in 1994. Its research content involves the research, development and clinical translation application of MR technology in the fields of imaging medicine, physics and biomedical engineering. It is the most important and largest medical MR society in the world. The author mainly summarizes the technological innovations, hot spots and new findings in clinical application of MRI in central nervous system research presented at this conference.