Manifestations of the connective tissue associated interstitial lung disease under high resolution computed tomography / 中南大学学报(医学版)

Objective:To analyze the features of the connective tissue associated interstitial lung disease (CTD-ILD) by high resolution computed tomography (HRCT).Methods:A total of 127 patients with CTD-ILD,who were diagnosed by clinic laboratory examination and pathology in Xiangya Hospital of Central South University form September 2013 to September 2015,were enrolled for this study.Their lung features of HRCT imaging were retrospectively analyzed.Results:The classifications for 127 patients were as follows:36 cases of rheumatoid arthritis (28.3%),34 cases of dermatomyositis and polymyositis (26.8%),31 cases of systemic sclerosis (24.4%),18 cases of Sj(o)gren syndrome (14.2%),7 cases of mixed connective tissue disease (5.5%),and 1 cases of systemic lupus erythematosus (0.8%).According to the features of HRCT imaging,the patients were divided as follows:77 cases (60.6%) ofnonspecific interstitial pneumonia (NSIP),46 cases (36.2%) of usual interstitial pneumonia (UIP),2 cases (1.6%) of lymphocytic interstitial pneumonia (LIP),1 case (0.8%) of cryptogenic interstitial pneumonia (COP),and 1 case (0.8%) of acute interstitial pneumonia (AIP).The HRCT findings for 36 cases of rheumatoid arthritis associated interstitial lung disease were UIP (24 cases,66.7%) and NSIP (12 cases,33.3%);the HRCT findings for 34 cases of dermatomyositis and polymyositis associated interstitial lung disease were NSIP (32 cases,94.1%),UIP (1 case,2.9%) and COP (1 case,2.9%);the HRCT findings for 31 cases of systemic sclerosis associated interstitial lung disease were NSIP (21 cases,67.8%),UIP.(9 cases,29%),LIP(1 case,3.2%);the HRCT findings for 18 cases of Sj(o)gren syndrome associated interstitial lung disease were NSIP (9 cases,50.0%),UIP (8 cases,44.4%),LIP (1 case,5.6%);the HRCT findings for 7 cases of mixed connective tissue disease associated interstitial lung disease were UIP (4 cases,57.1%),NSIP (3 cases,42.9%).SLE-ILD was rare,with only 1 case of AIP.Conclusion:Different types of CTD-ILD patients display relatively unique manifestation of HRCT.

Optimal Blood Suppression Inversion Time Based on Breathing Rates and Heart Rates to Improve Renal Artery Visibility in Spatial Labeling with Multiple Inversion Pulses: A Preliminary Study

OBJECTIVE: To determine whether an optimal blood suppression inversion time (BSP TI) can boost arterial visibility and whether the optimal BSP TI is related to breathing rate (BR) and heart rate (HR) for hypertension subjects in spatial labeling with multiple inversion pulses (SLEEK). MATERIALS AND METHODS: This prospective study included 10 volunteers and 93 consecutive hypertension patients who had undergone SLEEK at 1.5T MRI system. Firstly, suitable BSP TIs for displaying clearly renal artery were determined in 10 volunteers. Secondly, non-contrast enhanced magnetic resonance angiography with the suitable BSP TIs were performed on those hypertension patients. Then, renal artery was evaluated and an optimal BSP TI to increase arterial visibility was determined for each patient. Patients' BRs and HRs were recorded and their relationships with the optimal BSP TI were analyzed. RESULTS: The optimal BSP TI was negatively correlated with BR (r1 = -0.536, P1 < 0.001; and r2 = -0.535, P2 < 0.001) and HR (r1 = -0.432, P1 = 0.001; and r2 = -0.419, P2 = 0.001) for 2 readers (kappa = 0.93). For improving renal arterial visibility, BSP TI = 800 ms could be applied as the optimal BSP TI when the 95% confidence interval were 17-19/min (BR1) and 74-82 bpm (HR1) for reader#1 and 17-19/min (BR2) and 74-83 bpm (HR2) for reader#2; BSP TI = 1100 ms while 14-15/min (BR1, 2) and 71-76 bpm (HR1, 2) for both readers; and BSP TI = 1400 ms when 13-16/min (BR1) and 63-68 bpm (HR1) for reader#1 and 14-15/min (BR2) and 64-70 bpm (HR2) for reader#2. CONCLUSION: In SLEEK, BSP TI is affected by patients' BRs and HRs. Adopting the optimal BSP TI based on BR and HR can improve the renal arterial visibility and consequently the working efficiency.

Multi-slice CT angiography in the diagnosis of lesions of mesenteric artery and mesenteric vein / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the value of multi-slice CT angiography (MSCTA) in the diagnosis of super mesenteric artery (SMA) and super mesenteric vein (SMV), and discuss the 3D reconstruction method for detecting mesenteric vessel lesions.@*METHODS@#Thirty-three patients suffering from mesenteric vessel diseases were analyzed. There were 14 SMA lesions, including 9 thromboses, 3 dissecting aneurysms, 1 pseudoaneurysm, and 1 malrotation. There were 19 SMV thromboses. The 3D reconstruction included volume rendering (VR), maximum intensity projection (MIP), and multi-planner reformation (MPR).@*RESULTS@#The lesions appeared clear by MSCTA in the 33 patients. The SMA thrombosis was shown clear in the MIP in all 9 patients, and only 4 of them were detected in the VR. There was significant difference between MIP andVR in detecting SMA thrombosis (P=0.0294). Three dissecting aneurysms were best shown in the MPR; 1 pseudoaneurysm and 1 malrotation were clearly manifested in the VR. The thrombosis of SMV was clearly shown by both MIP and MPR in all 19 patients. Collateral vessels were clearly shown in the MIP in 12 patients; the collateral vessels were detected by VR only in 5, and the other 7 failed to show the collateral vessels. There was significant difference between the MIP and the VR in showing lateral collateral vessels (P=0.0046).@*CONCLUSION@#Both lesions of SMA and SMV can be detected by MSCTA. MIP is an ideal reconstruction method for SMA thrombosis and collateral vessels around the SMV.

Application of case introduced method based on PACS system in medical imaging course / 中华医学教育探索杂志

Objective To evaluate the teaching effects of case introduced method based on picture archiving and communication system (PACS) system in medical imaging course.Methods Totally 148 students (2009 grade) majored in five-year clinical medicine from Xiangya Medical College were divided into 10 groups; the 10 groups were taken randomly as control group (n=75) and experimental group (n=73).Control group used traditional teaching methods (film teaching) while experimental group used case introduced method based on PACS system.Effects of teaching between were evaluated by questionnaire and test.x2 test was used to compare students' theoretical test scores,with α level =0.05.Results Based on results of questionnaires,more students in experimental group than in control group hold that case introduced method based on PACS system can achieve the purpose of teaching,improve interests in learning,and strengthen the mastery of knowledge.Test scores showed that the percentage of students scored 90-100 and 80-89 (respectively 14％,75％) in experimental group was significantly higher than that in control group (respectively 5％,66％) (x2 =17.932,P=0.000).Conclusions Application of case introduced method based on PACS system in medical imaging course not only improve students' motivation to learn and their clinical ability,but also allow teachers to find and correct shortcomings of students timely,therefore,it is worth promoting.

Evaluation of three-dimensional tumor microvascular architecture phenotype heterogeneity in non-small cell carcinoma and its significance / 中南大学学报(医学版)

OBJECTIVE@#To explore the degree, mechanism and clinical significance of three-dimensional tumor microvascular architecture phenotype heterogeneity (3D-TMAPH) in non-small cell carcinoma (NSCLC).@*METHODS@#Twenty-one samples of solitary pulmonary nodules were collected integrally. To establish two-dimensional tumor microvascular architecture phenotype (2D-TMAP) and three-dimensional tumor microvascular architecture phenotype (3D-TMAP), five layers of each nodule were selected and embedded in paraffin. Test indices included the expressions of vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), EphB4, ephfinB2 and microvascular density marked by anti-CD34 (CD34-MVD). The degrees of 3D-TMAPH were evaluated by the coefficient of variation and extend of heterogeneity. Spearman rank correlation analysis was used to investigate the relationships between 2D-TMAP, 3D-TMAP and clinicopathological features.@*RESULTS@#3D-TMAPH showed that 2D-TMAP heterogeneity was expressed in the tissues of NSCLC. The heterogeneities in the malignant nodules were significantly higher than those in the active inflammatory nodules and tubercular nodules. In addition, different degrees of heterogeneity of CD34-MVD and PCNA were found in NSCLC tissues. The coefficients of variation of CD34- MVD and PCNA were positively related to the degree of differentiation (all P0.05). The level of heterogeneity of various expression indexes (ephrinB2, EphB4, VEGF) in NSCLC tissues were inconsistent, but there were no significant differences in heterogeneity in NSCLC tissues with different histological types (P>0.05).@*CONCLUSION@#3D-TMAPH exists widely in the microenvironment during the genesis and development of NSCLC and has a significant impact on its biological complexity.

Application of‘index’teaching method in practical teaching of medical imaging / 中华医学教育探索杂志

Objective To investigate the teaching effect of‘index’teaching method used in practical teaching of the medical imaging.Methods A total of 178 medical undergraduates were selected this study,113 clinical medical students using‘index’teaching method were taken as experimental group while others 65 anesthesia medical students using traditional teaching method as control group.The teaching effect of‘index’teaching method was evaluated quantitatively and qualitatively by practical test and questionnaire survey.Results The test scors of experimental group were(80.3±16.5),obviously higher than those of(71.3±25.8)in control group(P＜0.05),especially instudents with low scores.Conclusion The new teaching method had obvious advantages in culturing the thinking of imaging diagnosis and in improving the ability to solve clinical practical problems,the‘index’teaching method was more effective than traditional teaching method.

The use of new teaching method in practical teaching of the digestive system medical imaging / 中华医学教育探索杂志

The authors use the method of combination of PBL teaching and clinic practicing in practical teaching of the digestive system medical imaging.The process is divided in four steps.This method can greatly improve the learning efficiency of the students and get good teaching result.

English literature translation activities applied in experience-oriented teaching approach in the bilingual course of medical imaging / 中华医学教育探索杂志

Experience-oriented teaching approach was introduced into the bilingual course of medical imaging in order to improve the teaching effect.This approach was performed through English literature translation activities and scene-teaching.Meanwhile it points out that this approach has particular advantages in stimulating students' interest and initiative in study.

Correlation between multi-slice spiral CT pulmonary perfusion imaging and cavity of microvessel in lung cancer / 中南大学学报(医学版)

OBJECTIVE@#To investigate the relation between multi-slice spiral CT pulmonary perfusion imaging and the cavity of microvessel in lung cancer.@*METHODS@#Altogether 36 patients with malignant nodules who underwent multi-slice spiral CT perfusion scan were examined.The perfusion parameters were collected and compared with the microvessel density (MVD), the incomplete lumen MVD, and the differentiation of non-small cell lung cancer (NSCLC). The patients were divided into a hyper-perfusion group and a hypo-perfusion group by the value of perfusion parameters. The maturity of microvessel and the degree of differentiation in NSCLC between the 2 groups was analyzed.@*RESULTS@#Blood flow (BF), blood volume (BV), and peak enhancement image(PEI) of the malignant nodules were (39.7±11.5) mL/(100 mg.min), (8.6±3.8)mL/100 g, and (20.1±8.6)HU, respectively. There was a positive correlation between PEI and MVD(r=0.645,P<0.01), and a negative correlation between BF and MVD(r=-0.280,P=0.048). There were negative correlations of BF, BV, PEI with the incomplete lumen MVD (P<0.05). BF had the highest correlation coefficient(r=-0.882,P<0.01).The incomplete lumen MVD of the hyper-perfusion group was significantly lower than that of hypo-perfusion group (P<0.05),but there was no significant difference in MVD between the 2 groups. There were negative correlations of BF, BV,PEI with the degree of differentiation (P<0.05). BF had the highest correlation coefficient(r=-0.751,P<0.01).@*CONCLUSION@#Multi-slice spiral CT pulmonary perfusion imaging is helpful to evaluate the degree of differentiation and status of angiogenesis in lung cancer, and its basis is the cavity of microvessel.

Bayes analysis in clinical decision-making for solitary pulmonary nodules / 中南大学学报(医学版)

OBJECTIVE@#To explore the feasibility and the value of Bayes analysis in clinical decision-making for solitary pulmonary nodules (SPNs).@*METHODS@#We collected 352 consecutive SPN patients (malignancy, n=135; benignity, n=217) retrospectively to form the training set. Utilizing Bayes analysis, the prior odds of malignant SPNs and the likelihood ratios of clinical and CT findings were derived from the training set, which were then used to calculate the probability of malignancy in each SPN. Bayes analysis was also tested prospectively for its diagnostic validation and precision of predictive probability on the test set of 132 SPN patients (malignancy, n=61; benignity, n=71), and compared with the performance of physicians using routine judgment. The actual results of patients diagnosis were analyzed according to the scale of calculated malignant probability in SPNs.@*RESULTS@#The sensitivity, specificity, and accuracy of Bayes analysis for the training samples were 88.9%, 93.1%, and 91.5%, respectively. In the test set, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of Bayes analysis were 88.5%, 85.9%, 87.1%, 84.4%, and 89.7%, respectively. The accuracy of Bayes analysis had no statistically significant difference with that of senior physician A (80.3%, chi2=2.37, P=0.122) and B (79.5%, chi2=3.12, P=0.076), and was higher than that of junior physician C (74.2%, chi2=7.05, P=0.012) and D (74.2%, chi2=6.56, P=0.009); The Brier score was 0.099, 0.140, 0.137,0.154, and 0.179 for Bayes analysis,senior physician A, senior physician B, junior physician C, and junior physician D, respectively. Excluding the solitary metastasis (n=11) misclassified, the false negative rate of Bayes analysis was 1.0% (5/484) for SPNs with <20% estimated probability of malignancy.@*CONCLUSION@#Bayes analysis is accurate in qualitative diagnosis, precise in forecasting the malignant probability, and has low false negative rate for SPNs. It is feasible to use Bayes analysis for the management of SPNs.

Multi-slice spiral CT pulmonary perfusion imaging and the expression of VEGF/PCNA in non-small cell lung cancer / 中南大学学报(医学版)

OBJECTIVE@#To investigate the relation between expression of vascular endothelial growth factor (VEGF)/ proliferating cell nuclear antigen (PCNA) and multi-slice spiral computer tomography (MSCT) perfusion imaging.@*METHODS@#Sixty-one patients who underwent CT perfusion scan by 16-slice spiral CT were examined. Among them,22 were brought into our research after surgery. The corresponding layers of tumor tissue specimens to the layer of CT perfusion scan were selected to determine the expression of CD34,VEGF, and PCNA. Spearman correlation analysis was used to determine the relation between differentiation of non-small cell lung cancer (NSCLC), the expression of CD34,VEGF/PCNA, and CT perfusion parameters.@*RESULTS@#There was a lot of heterogeneity in VEGF and PCNA expression of NSCLC.The degree of differentiation had positive correlation with the uncomplete lumen of the surrounding area CD34-MVD and the expression of PCNA and VEGF (P<0.05).There were positive correlations between the uncomplete lumen of the surrounding area CD34-MVD and expression of VEGF and PCNA, respectively (both P<0.05). Blood flow (BF), blood volume (BV),and peak enhancement image (PEI) decreased with the decreasing differentiation of NSCLC (P<0.05). The total CD34-MVD showed a positive correlation with PEI (P<0.05),and the uncomplete lumen of the surrounding area CD34-MVD showed a negative correlation with BF,BV, and PEI (all P<0.05). The PCNA expression showed a negative correlation with BF,BV, and PEI (P<0.05).@*CONCLUSION@#PCNA and VEGF expression in NSCLC regulates angiogenesis and proliferation at the same time. Perfusion parameters reflect the expression of microvascular architecture phenotype, and exactly evaluate the malignant degree of tumor.

Role of low-dose spiral CT scan in early lung cancer screening of high risk population: a systematic review of the literature with a Meta-analysis / 中华放射学杂志

0.05),but existed between B0 and B10,B5 and B10(P

The Application of Multi-slice CT Perfusion Imaging in Diagnosing Pulmonary Neoplasms / 实用放射学杂志

benign,of which,there were significan differences in PV and PE value between any two of the three lesions. There were significant differences in BV value only between benign and inflammatory pulmonary lesions(P0. 05). Conclusion CT perfusion imaging is of important value in differentiating inflammatory,malignant and benign masses of the lung and estimating the degree of malignancy of lung cancer.