Objective: To investigate the value of synchronous application of MR angiography(MRA) and dynamic contrast-enhancement in one station scanning of hepatic tumor with 3.0T MR for clinical diagnosis and surgical decision. Methods: Forty-one cases, including 10 normal volunteers and 31 patients with malignant and benign hepatic lesions, were scanned with multi-phase dynamic contrast-enhanced 3D MR imaging adopting 3D fast spoiled gradient recalled(3D FSPGR) and array spatial sensitivity encoding technique (ASSET) and zero-filling interpolation(ZIP). The image data was reconstructed with maximum intensity projection(MIP) on the ADW 4.2 workstation. The signal intensity of hepatic solid lesions was measured and signal intensity-time curve was derived. Results: Common hepatic artery, proper hepatic artery, right and left hepatic arteries, artery branches of grade 4 and above were clearly showed in 10 volunteers, so it was with the portal vein trunk and branches of grade 4 to 6. The diagnosis of 31 patients, including 23 cases of hepatocellular carcinoma and 8 cases of hemangioma, were made correctly with multi-phase dynamic contrast-enhanced 3D MR imaging. Destruction and deformity of hepatic arteries caused by tumor invasion, cancerous embolus of portal vein, and formation of collateral circulation were demonstrated clearly, too. Conclusion: The diagnosis of hepatic tumor and the display of hepatic vessels can be finished synchronously in multi-phase dynamic contrast-enhanced MR scanning with 3D FSPGR, which is of great value for clinical diagnosis and surgical decision.

Objective: To explore the clinical value of CT manifestation and methods of measurement of adenoid vegetation in children. Materials and Methods: Nasopharyngeal CT plain scans and dynamic CINE CT scan were obtained in 50 children aged 9 months to 14 years with operation proved adenoid hypertrophy as study group and 50 age and gender matched children without adenoid hypertrophy as control. Measurement of maximum thickness of adenoid/anterior-posterior diameter of nasopharyngeal air space ratio(A/N ratio), effective anterior-posterior diameter of nasopharyngeal air space(D value), effective sectional areas of nasopharyngeal air space(Sn) and difference of Sn on dynamic CINE CT(△S) were carried out at the level of sphenoccipital junction on midline sagittal plane. Results: On the transverse CT, hypertrophy adenoid manifested as soft tissue mass that was symmetric, unilateral or embedded into choana. Measurements of study group were: A/N ratio ranged from 0.61 to 0.86, D ranged from 1 to 2.8mm, Sn ranged from 0 to 97.86mm2 and △S ranged from 0 to 32.54mm2. The correspondent measurements of control group were 0.34~0.61, 7.5~12.2mm, 217.87~623.98mm2 and 175.87~274.02mm2 respectively. Conclusion: CT is much better than the lateral X-ray plain film measurement of nasopharynx in the diagnosis of adenoid vegetation for CT can provide much more information and can clearly depict the nasopharynx and CT CINE is especially useful to reflect the changes of nasopharynx with respiration. A/N ratio and D value can be used as indicators: pathologic adenoid hypertrophy should be considered when there is an A/N ratio greater than 0.71 and a D value less than 3mm.

Objective: Summarize the experience of echocardiographic diagnosis on 12 patients with C-TGA underwent double switch procedure. Materials and Methods: Twelve C-TGA patients, 11 were attributed to SLL type, one was IDD type. Surgical procedure included that atrial switch was performed in 1 patients. Modified sinning procedure was performed in 11 patients, which involved opening of left atrium, atrial septum, connecting both superior vena cava and inferior vena cava into pathological right ventricle and tricuspid valve, meanwhile connecting pulmonary veins and pathological left ventricle and bicuspid with pericardium respectively. There were 10 patients with VSD and PS surgically performed by establishing a tunnel between VSD and aorta by Dacro Vessel and by putting extra-conduit between pathological right ventricle and pulmonary artery. Last two cases with normal pulmonary valve were corrected by patching VSD and switching between aorta and pulmonary artery. Instrument routinely used in the study is Toshiba 6000 and Philips IE33 with probe frequency ranging from 2.5 to 3.75MHz. Results: All patients were correctly diagnosed as C-TGA by TTE. Echocardiography and angiocardiography all were consistent with surgical finding. Of the 12 patients corrected by double switch, 9 patients survived and others died. During follow-up with TTE, all of the 9 patients were in normal right and left ventricular function, conduits from right to pulmonary were in normal state, except 1 patient had a residue VSD. Conclusions: Echocardiography plays an important role in diagnosing C-TGA with heart malformation and also helps to confirm indication for double switch, and TTE has clinical significance in following up of surgical procedure as well.

Objective: To analyze the imaging characteristics of hereditary spastic paraplegia with thin corpus callosum(HSP-TCC), so as to get a better understanding of the disease. Methods: Three patients from the same family with HSP-TCC were reported with reviewing of the literature. Results: Thin corpus callosum, long T2 signal in the thinning cervical and thoracic spinal cord were seen. Diffused unspecific white matter lesions with mild brain atrophy, were also seen in the three HSP-TCC cases of this group. Conclusion: The central nervous system may be affected extensively by HSP-TCC, characteristic MRI signs including thin corpus callosum, long T2 signal in the white matter around lateral ventricle and in the spinal cord, atrophy and abnormal signal of the spinal cord, as well as subsequent mild or moderate brain atrophy.

Objective: To evaluate the effect of age, size of foci, the CT value of foci, serum glucose level, menopausal status on the 18F-FDG uptake in normal breast tissue and breast cancer by quantitative standardized uptake values(SUV). Methods: Twenty-seven patients(premenopausal 13; postmenopausal 14) highly suspected of breast cancer underwent FDG PET/CT imaging. The semi-quantitative analysis methods of FDG uptake were used. We analyzed for contralateral normal breast tissue. To analyze the correlations between the SUVmax and age, size, the CT value, menopausal status. Results: Thirty-two breast lesions were found in operation and all were confirmed histologically. Of the 32 lesions, 25 were malignant and 7 benign. SUVmax of malignant lesion, benign lesion and contralateral normal breast tissue were 5.08±3.55, 1.17±0.31, 0.76±0.52, respectively. The SUV of malignant lesion was significantly higher than those of contralateral normal breast and benign lesion(all P<0.01). There was no significant difference between benign lesion and normal breast in SUV(P>0.05). Significant correlation of breast disease was found between the SUVmax and age, size. There was no correlations between SUVmax and size of foci, the CT value or menopausal status. There were no significant correlations of normal breast tissue between them. Conclusions: The age and size of breast disease have significant effect on SUV of 18F-FDG uptake. 18F-FDG PET is a reliable method in differentiating malignant and benign lesions of the breast.

Objective: To study the correlation between high resolution CT(HRCT) findings, recovery of respiratory function tests and clinical data of SARS patients in the convalescent phase. Methods: Forty-nine patients with confirmed SARS underwent initial thin-section CT and forty patients underwent respiratory function tests. Sixteen and thirteen patients underwent follow-up examination. The clinical data were retrospectively analysed. CT visual score were quantitatively analyzed for lung abnormalities. Results: Ground-glass opacities and interstitial opacities were found in 25(51%), 22(45%) of the 49 patients on initial HRCT and in 6(38%), 7(44%) of the 16 patients on the follow-up HRCT examinations. The initial and follow-up CT visual score indicated a significant reduction in the extent of ground-glass opacity(P<0.001) but not in that of interstitial opacity. Scan from patients with adult respiratory distress syndrome(ARDS) had a significantly higher score for ground-glass opacity than did those from patients without ARDS(P<0.05). Dlco％ were correlated with sex and ground-glass opacity score. Conclusion: HRCT findings were correlated with clinical data, laboratory tests and respiratory function tests, residual abnormalities and respiratory function tend to be better over the time, but interstitial opacity persists.

Objective: To describe the difference of the clinical symptoms and radiologic features between Ewing sarcoma(ES) and peripheral primitive neuroectodermal tumors(pPNETs) of bone, and to benefit from the differential diagnosis and treatment. Materials and Methods: We retrospectively reviewed 18 cases of ES and 10 cases of pPNETs all were confirmed pathologically. Radiologic and clinical studies were reviewed by two musculoskeletal radiologists. In ES, radiographs(n=18), CT(n=12), MRI(n=9) were performed. In pPNETs, radiographs(n=10), CT(n=7), MRI(n=10) were performed too. The evaluation included clinical presentation,lesion location and size,bone erosion/destruction,periosteal reaction, soft tissue involvement and intrinsic characteristic findings on CT and MRI. Results: Patients’ average age was 18.5 years (range 10～28) and 24.4 years(range 8～86) in ES and pPNETs respectively. For the ES, the lesion locations included femur(n=6), humerus(n=4), clavicle(n=2), tibia(n=1), fibula(n=1), ulna(n=1), ilium(n=1), sacrum(n=1) and acetabulum(n=1); Radiographs(n=18) showed lytic lesion(7/18), with irregular sclerosis and matrix mineralization(11/18), soft tissue mass(10/18), periosteal reaction(10/18), eccentric(6/18), scalloping of cortex(3/18); CT(n=12) showed lytic lesion(4/12), lesion with irregular sclerosis and matrix mineralization(8/12), soft tissue mass(10/12), periosteal reaction(6/12); On MRI(n=9), T1WI showed isointensity(8/9) and slightly hyperintensity(1/9), T2WI and STIR images showed heterogeneous hyperintensity(9/9), soft tissue mass(8/9), the size ranged from 2cm×3cm to 3cm×10cm. For the pPNETs, the lesion locations included ilium(n=3), humerus(n=2), corpus vertebrae(n=1), arcus vertebrae(n=1), scapula(n=1), sacrum(n=1), sphenoid(n=1); Radiographs(n=10) showed lytic lesion(8/10), with irregular sclerosis and dilation(1/10), and normal(1/10), soft tissue mass(7/10), periosteal reaction(0/10). CT(n=7) showed lytic lesion(6/7), lytic lesion with irregular sclerosis and dilation (1/7), soft mass(7/7), speculate calcification(2/7), periosteal reaction(0/10); On MRI(n=10), T1WI showed isointensity(9/10) and slightly hyperintensity(1/10), T2WI and STIR images showed heterogeneous hyperintensity (8/10), uniform hyperintensity(2/10), soft tissue mass(10/10), the size ranged from 2.5cm×4cm to 7.5cm×13.5cm. Conclusion: The clinical and radiologic features of ES and pPNETs were different, compared with pPNETs, the patients with ES were younger, the commoner locations were long tubular bones, radiography and CT showed periosteal reaction and matrix mineralization, MRI showed the similar intensity but with smaller soft tissue mass, these features were helpful in differential diagnosis if combining with pathology.

Objective: To determine the effect of computer aided detection(CAD) system on the diagnosis of pulmonary nodules. Methods: One hundred and fifty cases with solitary lung nodules up to 9~30mm in diameter were examined. All nodules had been verified by means of biopsy. One hundred and fifty cases of healthy individuals were selected as control group on the basis of chest CT. All chest radiographs in the two groups were obtained with a digital radiography system. Five experienced chest radiologists and five residents detected the chest radiograph with or without CAD output images. The scales of performance was evaluated with receiver operating characteristic analysis. Result: The average area under the curve value increased significantly from 0.766 without CAD to 0.833 with CAD output images. Individually, the use of CAD output images was more useful to radiology residents than to experienced radiologist. Conclusion: This CAD system for digital radiograph can assist radiologist and has the potential to improve the detection of lung nodules.

Objective: To evaluate the value of interictal PET and ictal SPECT brain imaging in localizing the foci of intractable epilepsy in children. Methods: Thirty pediatric patients with intractable epilepsy were performed with interictal PET and ictal SPECT brain imaging. The results were compared and analysed. Results: In interictal PET, 16 patients showed local single lobe hypo-metabolism, multi-lobe and diffuse hypo-metalism in 14 patients. During ictal SPECT studies, 18 showed hyper-perfusion in solitary lobe, multi-hyper-perfusion foci in 10 patients. Compared the two examinations, 26(86.7%) were accorded with each other in 30 patients. Of the 12 patients with multiple and diffuse hypometabolism in interictal PET, 6 patients showed foci changed to solitary focal hyper-perfusion in ictal SPECT. Conclusion: Interictal PET combined with ictal SPECT can learn from others’s strong points to offset one’s weakness, elevate the accuracy in localizing epileptic foci, offer more reliable messages for treatment.

Objective: To investigate the value of Lung RADS grading in the screening of lung cancer and the characteristics of malignant nodules, and to improve the diagnostic accuracy. Methods: The findings on baseline screening in 2 580 persons at high-risk for lung cancer were retrospectively analyzed. According to the Lung RADS grading standards, solid and part solid nodules ≥6 mm, ground-glass density nodules ≥20 mm served as a positive value for screening to observe lung cancer positive predictive rate of RADS 3-4 pulmonary nodules, and followed-up to analyze nodule in detail characteristics change. Results: Compared with the screening positive results of the international early lung cancer action program(I-ELCAP), baseline screening overall positive rate was decreased from 22.9%(591/2 580) to 13.8%(357/2 580), lung cancer-positive prediction rate was increased from 6.9%(41/591) to 11.5%(41/357). 8 cases of lung cancer were confirmed by surgery and pathology among 246 cases(Grade 3), 33 cases of lung cancer were diagnosed by pathology among 111 cases(Grade 4A+4B), 41 cases of lung cancer were diagnosed among 357 cases(Grade 3+4), and the number of lung cancer was the same as that of I-ELCAP. Conclusion: Lung RADS grading may be more reasonable to classify the results of lung cancer screening, and reduce the follow-up frequency of patients with low risk, improve the positive rate of lung cancer, combined with the characteristics changes of the nodules, the diagnostic accuracy of pulmonary nodules was greatly improved.

目的:回顾性分析心电门控多层螺旋CT(MSCT)经静脉注射对比剂冠状动脉成像的可行性,探讨MSCT在冠状动脉疾病诊断的可行性及对冠脉狭窄的显示能力。方法:30例窦性心律患者经MSCT检查1~3天后行定量冠脉造影。以3.5ml/s速率经静脉注入对比剂,延迟15s,用GE公司MSCT机进行扫描,要求患者1次屏气30s,采用回顾性心电门控显像窗进行显像重建。分析所有直径≥2mm冠脉及分支并识别狭窄(≥50%)及闭塞病变。其结果与定量冠脉造影进行对比。结果:在253支冠脉(左主干、左前降支、左回旋支和右冠脉,包括≥2mm的侧支)中218支(86.2%)可评价;11例(36.7%)患者所有冠脉均可评价。检测明显狭窄(≥50%)的敏感性是82.6%、特异性是97.9%;阳性预测值(PPV)是82.6%、阴性预测值(NPV)是97.9%;高度狭窄(≥75%)的敏感性、特异性分别是83.3%、98.1%。总的敏感性(包括MSCT不可评价的血管)是68.4%。对于右冠脉近段、左主干、前降支的MSCT直径测量与定量冠脉造影相比相关性较好。结论:采用回顾性心电门控多层螺旋CT冠脉成像在显像质量较好的情况下,具有较高的准确性。由于目前MSCT不能有效消除冠脉运动的伪影影响,限制了该技术的临床应用,但仍然是一项有前途的冠状动脉疾病诊断方法。

Objective: Assessment of both transthoracic echocardiography(TTE) and X-ray measuring ductus arteriosus pre-occlusion and the occluders after operation, in order to direct choice of occluder. Methods: All 132 cases of patent ductus arteriosus(PDA) had been measured by TTE and X-ray before operation, and all the occluders had been measured after operation with the same ways. Comparing the best narrow diameter of PDA, the diameter of occluder’s waist with the size of the occluder. Evaluating correlation of the two methods, which TTE and X-ray measured pre-occlusion and after operation. Results: ①There was significant correlation about the best narrow diameter measure of PDA with TTE and X-ray before closure(r=0.82, P<0.05), and did so after closure(r=0.79, P<0.05). ②The equations of linear regression about the size of the occluder compared with the best narrow diameter of PDA pre-occlusion by TTE and X-ray: Y＝1.35X1＋2.20（t＝11.90, P<0.05）, Y=1.49X2＋2.66（t＝14.87, P<0.05）; the equations of linear regression about the size of the occluder compared with the diameter of the occluder’s waist after closure by TTE and X-ray: Y=0.92X3+4.01(t＝10.5, P<0.05), Y=1.30X4+2.02(t=15.08, P<0.05). Conclusion: Both TTE and X-ray played an important role in choosing occluder of PDA, but X-ray was superior to TTE.

To study the CT and MRI features of primary NK/T cell non-Hodgkin’s lymphoma in nasal cavity so as to promote the diagnostic accuracy. Materials and Methods: CT and/or MRI findings of 16 cases with nasal cavity NK/T cell lymphoma verified by pathology were analyzed retrospectively. Sixteen cases were examined with CT plain scans and 2 of them were done with CT contrast scans. Eight of the 16 cases were examined with MRI plain scans and 1 of them were examined together with MRI contrast scans. Results: Of all the 16 cases, the tumors involving unilateral nasal cavity in 6, bilateral in 10. The tumor was confined in the nasal cavity in 4, and with extranasal extension in 12. The tumor involvement of adjacent structures in 13 and into subcutaneous soft tissue of the nasal labial fold or face in 8, with the bony destruction in 9. CT showed the nasal cavity was filled with soft tissues and spread along the nasal mucosa, there were mild-to-moderate heterogeneous enhancement on post contrast CT. On T1WI showed the tumors were homogeneous and isointense, the signal intensity was similar to or slightly lower than muscle. On T2WI the tumors showed slightly heterogeneous and hyperintense, the signal intensity was higher than muscle but lower than sinonasal mucosa, there were mild-to-moderate heterogeneous enhancement after gadolinium injection. Conclusion: Primary NK/T cell lymphoma of nasal cavity has certain characteristics in its imaging appearances, the imaging findings can suggest the diagnosis and show ranges and degrees of the lesions and provide more accurate informations for clinical staging.

目的:分析Chiari I型畸形(CM I)患者脊髓空洞症的可能相关因素。资料与方法:收集我院1991~2001年142例CM I患者,其中无空洞症75例,合并脊髓空洞症67例。对CM I患者脊髓空洞与小脑扁桃体下疝的程度、枕骨大孔前后径(D),小脑扁桃体疝出枕骨大孔时的前后径(d)及d?蛐D及空洞内流空信号(CFVP)的关系进行分析。结果:脊髓空洞的发生与D、d及d?蛐D无相关性,空洞的长度与d有相关性,空洞的最大前后径及左右径与CFVP有相关性。结论:①CM I脊髓空洞的发生与小脑扁桃体疝出的程度,D、d及d?蛐D无关。②空洞的长度与d值有关。③CFVP的发生与空洞的前后径及左右径有关。

目的:探讨经皮穿刺骨水泥(PMMA)治疗椎体及椎体外骨病变中不同粉液比例和不同用量的临床应用,并对椎体外骨病变的骨水泥成形术进行初步应用评价。方法:对37例,其中35例42个椎体病变行经皮穿刺椎体成形术治疗,包括椎体溶骨性转移26例,血管瘤3例,骨质疏松5例,骨髓瘤1例,另外椎体外骨成形术2例,包括髂骨1例,股骨干1例。PMMA的粉液比例为1?押1~1?押4,用量为2~15ml。结果:42个椎体及2个椎外骨病变手术均成功,本组疼痛完全缓解22例,显著缓解12例,轻度缓解3例,无效0例。CT随访未见椎体塌陷加重或发生新的压缩骨折,椎体外骨亦未见骨折,无严重并发症发生。结论:根据不同情况决定PMMA的粉液比例和用量至关重要,椎体外骨病变也适用于骨水泥治疗。

Objective: To assess the follow-up outcome of echocardiography in patients who had interventional therapy of atrial septal defects(ASD). Methods: Of the 778 patients with ASD secundum, 276 were men and 502 women, male∶female is 1∶1.8, age ranged from 2 to 74 years old, mean age (29.6±9.6)years old. All of the 778 ASD patients, 765 patients had central type and single ASD, 13 patients had multiple ASD. In addition, 91 patients accompanied with other malformations. Toshiba Type 6000, Philips IE33 color Doppler ultrasonography and Type 1500 esophagus color Doppler ultrasonography were used. The frequency of detecting probe was 2.5MHz and 5MHz. All the patients after interventional therapy were checked by TTE and inner diameters of the heart chamber were recorded, especially the inner diameter of RVOT and RV. In addition, the closer’s position, residual shunt, valvular regurgitation and cardiac status were observed. Follow-up evaluation was performed in 778 patients by TTE at 1, 3, 6 and 12 months after discharged. The section of TTE was apex cordis and parasternal 4-chamber plane, subappendix 4-chamber and 2-atrium plane, main artery and subappendix short-axis plane. Results: The incidence rate of interventional operation’s complication was 2.3%, including 5 patients had closer shedding, 2 patients had brain infarction, 5 patients had pericardial effusion, 4 patients had residual shunt and 1 patient had pulmonary arteriovenous fistula. Conclusion: TTE had clinical value in follow-up examination for patients who had ASD interventional therapy.

Objective: To study the correlation between blood supply types on multislice spiral CT and hypoxia inducible factor-1α(HIF-1α) expression in hepatocellular carcinoma(HCC). Methods: In 34 cases HCC identified with operation and pathology, the relationship between blood supply types on multislice spiral CT during dual-phase scanning and the expression levels of HIF-1α and vascular endothelial growth factor(VEGF) in HCC with immunohistochemistry staining in SP and Edmondson-Steiner grading. Results: Among the four blood supply types, both the strong positive staining and the positive staining are the highest in the arterial blood supply type, followed by the arterial combining with portal blood supply type. The two lowest types are portal blood supply type and poorly blood supply type(P<0.001). With the increasing of the Edmondson-Steiner histological grades, the expression of HIF-1α levels also increase correspondingly(P<0.05). Conclusion: The blood supply type of HCC and the HIF-1α expression levels that reflects the HCC angiogenesis condition and the histological grades can be judged to some extent by using multislice spiral CT during dual-phase scanning. Hence it will be useful for the selecting of HCC treatment plans including anti-angiogenesis and evaluating the prognosis.

Objective: To explore the effect of perfusion parameters of input different artery in the reconstruction of CT perfusion imaging. Materials and Methods: Thirty-five patients including 8 normals, 27 unilateral middle cerebral artery(MCA) stenosis patients were collected perform normal brain CT scan and CT perfusion imaging. They all had brain CT perfusion imaging after normal brain CT scan. In the reconstruction of cerebral CT perfusion, every data was reconstructed 3 times and the anterior cerebral artery(ACA) were chosen, uninjured side(stroke patients) or left(normal) MCA and injured side(stroke patients) or right(normal) MCA to be input artery respectively, and choosed superior sagittal sinus to be output vein. Drawed region of interest（ROI） in the cortical area of each side and recorded cerebral blood flow(CBF), cerebral blood volume(CBV), and mean transit time(MTT) of ROI. Three data was analysed with one-factor analysis of variance. Results: There is no statistic difference among all parameters in the normals. Otherwise there is statistic difference among all CBF and MTT in unilateral stroke in MCA patients, and there is no statistic difference among CBV. Conclusion: In the reconstruction of cerebral CT perfusion, any large artery can be chosen as input artery in normals, otherwise in the unilateral MCA stenosis patients, the normal ACA should be chosen as input artery.

Objective: To evaluate the therapeutic effect of bFGF and GbE on acute cerebral infarction with MR imaging. Methods: Forty healthy adult cats were equally and randomly devided into 4 groups. All animals were operated to establish the feline models of cerebral focal ischemia-reperfusion by left transorbital approach. They were injected with sodium chloride intravenously for group A, bFGF for group B, GbE for group C and bFGF+GbE for group D. MR scans performed after operation, included T1WI, T2WI, FLAIR, DWI. Philips’s criteria score were evaluated on the cats. Result: The neurological defects score in group D is remarkably lower than that in group B and C. The lesion on T1WI, T2WI, FLAIR, DWI showed more milder. The area of infarct formation were smaller than that in group B and C through the comparison between the ADC images and T2WI images(T2WI-ADC). Conclusion: The treatment results in group D was better than that in group B and C. Both bFGF and GbE can enhance each other’s therapeutic effects. MR imaging could show the therapeutic effect of bFGF and GbE, especially the T2WI-ADC was an important item to evaluate the therapeutic effects.

Objective: To investigate 16-slice spiral CT in diagnosing atherosclerotic ulcer of the aorta. Methods: Fifteen patients with atherosclerotic ulcer of the aorta, who underwent 16-slice spiral CT, were studied retrospectively. Of the 15 patients, 14 patients had acute aortic syndromes, 1 patient with other chronic diseases. More attention was put on the size, shape, depth, number and adjacent structure of the atherosclerotic ulcer. Results: Twelve patients had 1 lesion, 3 patients had multiple lesions. Fourteen patients with acute aortic syndromes had fairly long intramural hematoma and 10 patients with middle pleural, mediastinal, pericardial effusion; however 1 patient with other chronic diseases had local pseudoaneurysm without intramural hematoma and effusion. Conclusion: 16-slice spiral CT is of high value in diagnosing atherosclerotic ulcer of the aorta and may be the first choice diagnostic device for emergency.

目的:本研究旨在评价纵隔大B细胞淋巴瘤Ga67显像预测疗效的临床价值。方法:39例病人中女24例,男15例,平均年龄(48±5.6)岁,临床病史及组织病理学诊断为纵隔大B细胞淋巴瘤。分别在化疗前、化疗结束后1个月和放疗结束后3个月进行常规的Ga67 SPECT和CT显像,图像分析采用常规的定性方法。结果:Ga67显像结果:在39例病人治疗结束后,有32例病人肿瘤Ga67显像结果为阴性,提示治疗完全有效,随访证实阴性预测率为94%(30/32);7例病人治疗后Ga67显像阳性,表示治疗部分有效或治疗无效。随访证实阳性预测率为86%(6/7),提示Ga67显像阴性的病人预后很好,而治疗后Ga67显像阳性预后很差。CT扫描结果:39例病人进行了治疗前后的胸、腹和盆腔CT扫描,其阴性预测率为83%;而阳性预测率只有25%。结果提示与Ga67显像相比,CT预测疗效的结果难于区分治疗有效、部分有效或无效。结论:Ga67显像在评价纵隔大B细胞淋巴瘤病人治疗反应中明显优于CT扫描。

Objective: To investigate the characters of the dynamic sonographic changes of liver cirrhosis in rats after contrast enhancement and evaluate its role in detecting liver fibrosis and cirrhosis. Method: Model of liver cirrhosis was established in 80 rats by subcutaneously injecting CCl4, which were divided into one control group and 4 groups according to modeling time(6, 8, 10 and 12 weeks respectively). The time-intensity curve of rat’s parenchyma was drawn with video frequency analysis after ultrasound contrast agent was injected intravenously and time to peak(TP), peak intensity(PI), half time of descent(HT), descending slope(DS), area under the curve(AUC) and mean transit time(MTT) were measured and compared. Results: The models of rat’s liver cirrhosis in different stages were established successfully and they could reflect the pathological progress of the cirrhosis. With the aggravation of cirrhosis, the values of TP, PI and HT tended to rise gradually while DS was contrary(compared between 6~12 weeks and control groups and between 6, 8 weeks groups and 10, 12 weeks groups, the differences were significant, P<0.01). Otherwise, the changes of AUC and MTT were not significant(P>0.05). Conclusion: The changes of rats’ hepatic sonograph present some regularity with the development of cirrhosis, which can be reflected by TIC. It also provides a new possibility for non-invasive diagnosis of liver cirrhosis.

Objective: To evaluate the value of double-phase 99Tcm-MIBI tomographic imaging and mammography in diagnosis of breast lesions. Methods: Double-phase 99Tcm-MIBI tomographic imaging and mammography were performed within one week for patients with breast neoplasms. The final diagnosis were verified with histological examination. Result: ①The T/NT ratios of early and delayed imaging were 2.08±2.85 and 1.69±3.05 in benign lesions. There was significant difference(P<0.05). The T/NT ratios of early and delayed imaging were 5.00±4.34 and 6.79±11.94 in malignant tumors, there was no significant difference(P>0.05). ②The sensitivity of double-phase 99Tcm-MIBI tomographic imaging in diagnosis of breast cancer was 97.1%; specificity was 94.8%; accuracy was 95.7%; the positive predictive value was 91.9%, and the negative predictive value was 98.2%. The sensitivity of mammography in diagnosis of breast cancer was 82.9% and specificity 70.7% and accuracy 75.3% and the positive predictive value 63.0% and the negative predictive value 87.2%, the two methods showed significant difference(P<0.05). Conclusion: The double-phase 99Tcm-MIBI tomographic imaging is superior to the mammography in diagnosing breast cancer, double-phase 99Tcm-MIBI tomographic imaging has higher sensitivity and specificity in the diagnosis of breast cancer. It is an effective means in differentiating benign from malignant lesions.

Objective: To evaluate the diagnostic value of color Doppler flow dynamic changes in patients with vertebral artery course variation. Methods: The blood flow parameters of 113 patients with vertebral artery course variation among 1161 patients with cervical spondylopathy were statistically analyzed and compared to the control group. Results: The sonographic manifestations in the ipsilateral course variation vertebral artery revealed that: the diameter and flow velocity were decreased, PI and RI were increased. Conclusion: Color Doppler flow imaging is a useful noninvasive method for the diagnosis of vertebral artery course variation.

Objective: To study the diagnostic values of 3 different kinds of TDC trend curves by multi-slice CT(MSCT) dynamic scan for prostate nodules. Methods: Nine patients with abnormal PSA level whose diagnosis was confirmed were divided into 3 groups and they all underwent MSCT dynamic scan for prostate nodules retrospectively. To refer the article reports, we conclude 3 different kinds of TDC trend curves. Applied 3 different kinds of TDC trend curves in qualitative diagnosis of prostate nodules prospectively, and compared with the results of pathological diagnosis. Result: Thirty-seven patients underwent MSCT dynamic scan prospectively, 27 cases of them were certified by biopsy or operations, 25 cases of them were in accord with pathological diagnosis. Conclusion: Application of the 3 different kinds of TDC trend curves could improve the accuracy rate of diagnoses in the prostate nodules. It also provides biopsy under guidance of ultrasound and improves the positive rate.

Objective: To investigate the value of diffusion weighted imaging(DWI) in predicting the hemorrhagic transformation(HT) after acute experimental cerebral infarction. Methods: Autologous thrombus was injected into unilateral internal carotid arteries of 75 rabbits to set up acute cerebral infarction model. These rabbits underwent DWI with 3.0T MR equipment at 3, 6, 12, 24, 48 and 72h after arterial occlusion. Apparent diffusion coefficient(ADC) and exponent diffusion coefficient(EDC) map were calculated at work station by using software of function. According to the method of European cooperative acute stroke study(ECASS), the HT of infarcted animals were classified into non-HT and HT groups, the latter was further divided into hemorrhagic infarction(HI) group and parenchymal hematoma(PH) group. The difference of ADC and EDC between non-HT group and various HT groups were assessed by using SPSS 11.5 software. Results: Cerebral ischemic model was successfully set up in 59 rabbits(78.67%). No pathologic findings of HT was found in 21 animals(35.59%, 21/59). Thirty-eight rabbits(64.41%, 38/59) who had HT included 31 rabbits(52.54%, 31/59) with HI and 7(11.87%, 7/59) with PH. The ADC value of non-HT groups and HT group were (0.601±0.128)×10-3~(0.813±0.060)×10-3 and (0.432±0.091)×10-3~(0.618±0.060)×10-3 respectively. There was obvious difference of ADC value between the two groups from 3h to 72h after occlusion(t=2.417~5.986, P=0.000~0.031). Similarly, significant difference of EDC value was found between the non-HT group[(0.415±0.039)~(0.502±0.009)] and HT rabbits[(0.559±0.040)~(0.583±0.064)](t=4.002~6.995, P=0.000~0.002). However, no obvious difference of ADC value was detected between HI group[(0.435±0.091)×10-3~(0.631±0.045)×10-3] and PH group[(0.390±0.180)×10-3~(0.586±0.104)×10-3](t=0.057~1.996, P=0.171~0.956) at every time point, except at 24h(t=4.664, P=0.002). There was no prominent difference of EDC value between HI[(0.545±0.039)~(0.638±0.042)] and PH groups[(0.575±0.054)~(0.649±0.019)](t=0.051~1.698, P=0.150~0.960). Conclusion: There is correlation between the decrease of ADC, the increase of EDC and the occurrence of HT in acute cerebral infarction. The abnormalities of ADC and EDC can probably predict HT. But DWI may play little role in the discrimination between HI and PH.

Objective: To evaluate the clinical value of transrectal power Doppler ultrasonography(PDU) and PDU-directed prostatic biopsy to improve the diagnosis of prostatic cancer. Methods: Fifty-four patients suspected to be prostatic cancer underwent routine gray-scale TRUS, transrectal PDU of the entire gland before biopsy. According to the result, select the protocols of gray-scale TRUS, transrectal PDU and combined use of six-score transrectal biopsy protocols. The sensitivity, specificity, positive predictive value, negative predictive value were compared and analyzed. Results: Abnormal flow was detected by power Doppler scanning in 37 patients, among them 23 cases were of prostatic cancer(two of them were normal on gray-scale image), BPH in 11 cases, prostatic cancer cannot be ruled out in 1 case, prostatic mass of undetermined nature in 1 case, metastatic prostatic cancer of bladder origin in 1 case. Conclusions: Transrectal PDU can improve the sensitivity of cancer detection, and can determine the correct site for PDU-directed biopsy, the Gleason score is significantly higher.

Objective: To investigate the MDCT imaging manifestations and pathological basis of bowel wall thickening due to nontumorous causes. Methods: MDCT findings of 284 patients with bowel wall thickening due to nontumorous causes confirmed by surgery, biopsy or clinical follow-up were studied retrospectively, paying attention to location, range, symmetric or asymmetric, involvement degree of thickening, attenuation, presence or absence of enhancement and associated perienteric abnormalities of thickened bowel wall. MDCT findings were analyzed with correlation with pathological changes. Results: All the non-tumorous disease caused bowel wall thickening included liver cirrhosis(109 cases) , acute pancreatitis(54 cases), bowel obstruction(36 cases), inflammatory bowel disease(14 cases), ischemic bowel disease(12 cases), radiation enterocolitis(13 cases), tuberculosis (12 cases), immune reaction(10 cases), infective enteritis(3 cases), acute appendicitis(3 cases), hypoproteinemia(5 cases), rare diseases(8 cases) and normal variants(5 cases). The attenuation pattern of the thickened bowel wall included high attenuation(1 case), iso-attenuation(144 cases), low attenuation(127 cases), fat deposition(5 cases) and pneumatosis(7 cases). The enhancement pattern of the thickened bowel wall included mild enhancement(249 cases), marked enhancement(32 cases) and unenhancement(3 cases). Degree of bowel wall thickening included mild thickening(279 cases) and marked thickening(5 cases). Two hundred and twelve patients with bowel wall thickening showed multisegmental distribution while 72 patients had single segmental involvement. Associated perienteric abnormalities of thickened bowel wall included swelling of fat(218 cases), ascites(189 cases), lymphadenopathy(5 cases), perienteirc abscess(2 cases), mesenteric vascular lesion(25 cases) and involvement of solid abdominal organs(169 cases). Conclusion: Bowel wall thickening due to nontumorous causes showed mild and homogeneous thickening, iso-attenuation or low attenuation, mild enhancement and multisegmental distribution on MDCT. Paying attention to the characteristics and pathological basis of thickening of bowel wall benefits the diagnosis and differential diagnosis of various intestinal diseases.

Objective: To improve recognition of posterior mediastinal ganglioneuroma(PMGN). Materials and Methods: Clinical and imaging materials(five cases were performed CT only, one case was underwent MR only, and four cases were performed both CT and MR scans) of 10 cases histologically proved PMGN were analyzed retrospectively, additionally, CT and MR findings were summarized. Results: On images, vertical diameters of the PMGNs were bigger than both of anteroposterior and transverse diameters, and tumors grew along the vertebrae. Moreover, we classified PMGNs in our study into vertebral canal-associated(n=1) and non-vertebral canal-associated(n=9) GN on the basis of adjacent vertebral canal involved or not. Additionally, we grouped them into unilateral type(n=7) and acrossing middle-line type(n=3) according to the growth pattern. On plain CT, GNs were showed homogeneous or heterogeneous hypointense, scattering punctate calcification and patchy fat-density were seen in one case, respectively. There were non-enhancement or mild to moderate homogeneous or heterogeneous enhancement on enhanced CT. On MRI, T1WI showed homogeneous low signal and T2WI demonstrated obvious heterogeneous high signal intensity. With contrast material, there was heterogeneous enhancement or non-enhancement. Conclusions: PMGNs have some characteristics on CT and MR, we should make right diagnosis after thoroughly analysis.

目的：探讨彩色多普勒超声（CDUS）对下腔静脉滤器置入术后远期预防效果评估的价值。方法：对45例下肢血栓形成后，行下腔静脉滤器置入术，再利用彩色多普勒超声进行随访观察的病人进行回顾性总结分析。结果：下腔静脉滤器置入术后，患者随访8月，其中13例滤器处有俘获栓子，无1例行下腔静脉滤器置入（IVCFI）术后患者发生滤器变形、移位、倾斜等。临床上未发现1例肺血栓栓塞，有1例患者滤器置入半月后健侧下肢发生深静脉血栓并延伸至下腔静脉（IVC）下段。彩色多普勒超声能准确、经济、快速的诊断静脉血栓的发生，确定发生的平面及范围、回声，反应血栓的新旧、血流通过的情况，清楚的显示下腔静脉滤器的位置以及状态，很大程度帮助临床判定滤器的远期预防效果。结论：彩色多普勒超声能对下腔静脉滤器置入术后下肢静脉血栓形成、病变范围、下腔静脉滤器的位置以及状态作出准确的判断，对临床IVCFI术后远期预防效果评估具有重要作用。

Objective: To explore the application value and the guidance for surgical operation of transthoracic echocardiography(TTE) and multiplane transesophageal echocardiography(MTEE) in the diagnosis of Ebstein’s anomaly. Methods: Preoperative TTE features in 13 cases of Ebstein’s anomaly and intraoperative MTEE features in 5 of them were analyzed retrospectively, comparison to the operation results was carried out． Results: Among the 13 cases, 1 case was diagnosed as Ebstein’s anomaly with solitary displacement of septal leaflet, 12 cases with displacement of septal and posterior leaflets by TTE. Among the 5 cases, 2 cases were diagnosed as severe displacement of the leaflets with functional right ventricle hypoplasia and thinning of the wall, 3 cases with severe abnormalities of the leaflets by MTEE. Among the 13 cases with different degree of abnormalities, 6 cases received valvuloplasty, 5 cases received valvular replacement procedure, 2 cases received bidirectional Glenn shunt procedure. Conclusions: TTE can diagnose Ebstein’s anomaly, MTEE can evaluate the function of tricuspid leaflets and right ventricle more accurate, if the two examination methods were combined together, they can help surgeon to choose the better operation methods for treating various degree of anomalies and improve the success rate.

Objective: To investigate the interventional recanalized therapeutic strategy and efficacy of occlusive lesion in iliac-femoral arteries. Materials and Methods: During Feb 2001 to Feb 2006, 42 patients(30 male and 12 female) whose arterial occlusive lesions in iliac artery and/or femoral artery had been diagnosed by DSA accepted interventional therapies. Among the 42 patients, the length of occlusive arteries ranged from 2cm to 30cm, the interval between symptom emerging and interventional therapeutic beginning ranged from 10 hours to 30 years. The interventional therapeutic tools included local thrombolytic therapy through endoarterial catheter, artery recanalization by guide wire, PTA and stent. Results: Immediate technical success was 97.6% (41/42 cases). The arterial occlusions were resolved successfully (local thrombolytic therapy in 26 cases, recanalization by guide wire in 31 cases, PTA in 33 cases and 60 stents in 31 cases). There were no severe complications(such as angiorrhexis, perforation) during interventional process. The symptoms of lower limb ischemia were palliated or vanished in all patients and ABI increased from 0.34±0.14 to 0.65±0.095(P＜0.001) after interventional therapy. During the follow-up (24 months), 11/42 (23.2%) occlusions of an iliac or femoral stent occurred (treated with local intra-arterial thrombolysis, PTA and stent). One patient died of myocardial infarct 15 months post-operation. Conclusions: Interventional recanalized therapy is an effective and safe therapy for occlusive lesion in iliac-femoral arteries.

目的：探讨SPECT/CT融合显像对骨良恶性病灶诊断和处理决策的影响。方法：对全身骨显像难于确诊的62例恶性肿瘤患者的74个病灶，行SPECT/CT融合显像。由2名经过放射学培训的核医学科医师对SPECT/CT融合图像进行独立分析，评价病灶性质（恶性、良性），意见不一致时共同讨论后得出一致意见。同时评价SPECT/CT融合显像的诊断对患者治疗方案的影响。所有病灶均以病理、磁共振结果或一年以上的随访为最终诊断结果。结果：62例患者的74个病灶中，恶性病灶24个，良性病灶50个。19例患者经SPECT/CT融合显像诊断为恶性病变，采用放化疗或手术治疗。结论：SPECT/CT融合显像对骨良恶性病灶诊断和处理决策有明显影响，应当成为肿瘤骨转移筛查的首选方法。

Objective: To explore the application value and findings of MR myelogram(MRM) sequence and PROSET sequence in the detection of lumbosacral nerve root anomalies(LSNRA). Materials and Methods: Conventional MRI, 3D MRM and 3D PROSET sequences were performed in lumbosacral nerve roots of 108 cases with low back pain. 3D maximum intensity projection(3D-MIP) reconstruction was used in PROSET and MRM sequences. The lumbosacral nerve roots were observed in the raw images and 3D-MIP images. Results: In the 105 cases with high-quality images, LSNRA were found in the 7, 14 cases with MRM and PROSET sequence. The detection rate was 6.67% and 13.33% respectively. There were statistically significant differences between MRM and PROSET sequence(χ2=5.143, P=0.016). LSNRA were found in only 3 cases with the conventional MRI sequence. Among the 14 cases with variation, there were 10 cases of type Ⅱ(71.43%), which was composed of 4 cases of type Ⅱ-1(28.57%) and each of the type Ⅱ-2, Ⅱ-3 and Ⅱ-4 had 2 cases(14.29% each). There were 2 cases of type Ⅲ, 2 cases of type Ⅵ(14.29% each). Conclusion: PROSET sequence was superior to the MRM sequence in the detection of extradural LSNRA. So it is a good method for the diagnosis of extradural LSNRA.

Objective: To evaluate the imaging features of pigmented villonodular synovitis(PVNS), and improve imaging diagnostic ability of the disease. Methods: The imaging findings of 12 cases with PVNS confirmed by operation and pathology were analyzed retrospectively. Plain film was performed in 9, CT in 4, MRI in 5. Results: There were totally 12 lesions. Swelling of joint was seen in all patients, and 3 cases with calcifications. In total 12 patients, joint space was normal in 7 cases, widened in 1 case, narrow in 4 cases; and bone erosion was seen in 5 patients, the sclerotic margins were presented in all lesions. CT scan showed diffuse form and joint effusion in all of the 4 patients. MRI in 5 patients showed diffuse form(4 cases) and localized form(1 case); in diffuse form of PVNS, joint effusion was present, and low signal proliferated synovium in all of the patients; in localized form of PVNS in 1 patient, the single mass with joint effusion occurred. Conclusion: The MRI findings of PVNS is characteristic, which is of specific value in the diagnosis and differential diagnosis. Calcifications should not be taken as a denial of PVNS.

Objective: To evaluate the response to neo-adjuvant chemotherapy of patients with primary breast cancer in early stage using 18F-FDG PET imaging. Method: 18F-FDG PET tomography fusion imaging were performed on 31 patients with primary breast cancer at pre-chemotherapy, after the first and the third course of treatment. Tumor-to-normal tissue background(T/N) ratios were measured for all scans, all patients were diagnosed by fine-needle aspiration(FNA) cytology. According to the evaluation criterion of WHO for tumor chemotherapy curative effect, all patients were divided into two groups, responders[R(+), n=22] and non-responders[R(-), n=9]. Results: Before chemotherapy, the T/N value of R(+) and R(-) group were 3.18±0.41 and 3.14±0.52(P>0.05) respectively. After the first and the third course of treatment, the T/N value of R(+) group decreased significantly from 3.18±0.41 to 2.62±0.38 and 2.06±0.45(P<0.05) respectively. However in the R(-) group T/N value decreased slightly from 3.14±0.52 to 3.01±0.47 and 2.87±0.27(P>0.05). The decrease percentage of T/N in R(+) group after the first and the third course of treatment were significantly higher than those in the R(-) group, being 16.12%±7% and 33.42%±6%, 4.09%±3%(P<0.05) and 8.89%±6%(P<0.01) respectively. In the R(+) group, the decrease percentage in T/N after the first and the third course treatment had significant difference?穴16.12%±7% and 33.42%±6%, P<0.05), but in R(-) group there were no significant difference(P>0.05). Using a decrease of T/N value≥10% as a threshold for monitoring the treatment response at the end of the first course of treatment, 18F-FDG PET imaging had a sensitivity of 90% and a specificity of 100%. Conclusions: The results suggested that 18F-FDG PET imaging had a certain clinical value to evaluate the chemotherapy response in primary breast cancer in early stage.

Objective: To evaluate the value of CT in diagnosing and staging of nephroblastoma in children. Methods: Clinical and CT manifestations of nephroblastoma in 27 cases with integrate imaging material proved operatively and pathologically were summarized. Results: Thirty-six primary tumors were found in 33 kindeys, 11 in the right kidney, 10 in the left kidney, and 6 in both kidneys. The pathological result of the 33 cases includes epithelial type(10 cases), blastemal type(7 cases), stromal type(9 cases), composite type(7 cases), anaplastic type(3 cases), The preoperative staging of the tumor: stage I in 9 cases, stage II in 7 cases, stage III in 3 cases, stage IV in 2 cases, and stage V in 6 cases. The accurate rate of tumor staging was nearly 88.89%. Conclusions: The CT inspection can show edge, site, size of the tumor, and accurately evaluate tumor invasion, metastasis. It has important value to determine the nature, staging, following-up of nephroblastoma.