Feasibility study of low tube voltage and low contrast medium combined with IMR technology in 3DCTA of vertebral artery V3 segment / 重庆医学

Objective To investigate the feasibility of low-voltage,automatic tube current adjustment(ATCM)and low contrast agent concentration,dose and injection rate combined with full-model iterative re-construction(IMR)in vertebral artery V3-segment three-dimensional CT angiography(3DCTA).Methods A total of 60 patients with suspected upper cervical spine,craniocervical junction lesions undergoing cervical vertebral artery V3 segment 3DCTA in this hospital from November 2019 to May 2020 were selected and divided into the group A and B by adopting the random number table method,30 cases in each group.The group A adopted the ATCM technology of 80 kV,average tube current of 50 mAs,25 mL of contrast agent io-hexol(iodine content 300 mg/mL)combined IMR technology with an injection rate of 3 mL/s,while the group B adopted 120 kV,150 mAs fixed tube current,50 mL injection rate of 5 mL/s contrast agent iopamidol(iodine content 370 mg/mL)combined filter back projection(FBP)reconstruction technology.CT value,noise,signal-to-noise ratio(SNR),contrast noise ratio(CNR)and image sensitivity(FOM)were measured and compared between the two groups and the quality of the resulting images was evaluated.The CT volumet-ric dose index(CTDIvol)and dose-length product(DLP)were recorded,and the effective dose(ED)was cal-culated.Results There was no statistically significant difference in the vertebral arterial CT value between the two groups(P＞0.05),but the noise of the group A was lower than that of the group B(P＜0.05),SNR,CNR and FOM of the group A were greater than those of the group B(P＜0.05).The image quality of the two groups met the requirements of clinical diagnosis[(4.78±0.41)points vs.(4.85±0.35)points],and there was no statistically significant difference in the subjective evaluation of image quality(P＞0.05).The CTDIvol,DLP and ED levels in the group A were lower than those in the group B(P＜0.05).The iodine in-takes of contrast medium in the group A and group B were 7.5 g and 18.5 g,respectively,and the iodine flow rates of contrast agent were 0.9 and 1.85 mg/s,respectively,and compared with group B,the iodine intake and iodine flow rate of the group A were decreased by 59.5％and 51.4％,respectively.Conclusion Low tube voltage ATCM and low contrast concentration,dose and injection rate combined with IMR technology can not only ensure the 3DCTA image quality of vertebral artery V3 segment,but also reduce the radiation dose re-ceived by the patients,and reduce the iodine intake and iodine flow rate of contrast agent.

Predictive value of non-enhanced CT combined with clinical indicators in severe acute pancreatitis / 中华急诊医学杂志

Objective:To establish and validate a nomogram model for early prediction of the risk of acute pancreatitis (AP) progressing to severe acute pancreatitis (SAP).Methods:CT signs and clinical laboratory parameters of 361 AP patients admitted to our Hospital from January 2016 to July 2022 were retrospectively collected. There were 221 males (61.2%) and 140 females (38.8%). According to the Atlantic score, all patients were divided into the SAP group (64 cases) and the non-SAP (NSAP) group (297 cases). Univariate analysis was used to screen out variables with statistically significant differences. Multivariate Logistic regression analysis was used to screen out the independent risk factors of SAP, and finally a nomogram prediction model was established. Receiver operating characteristic (ROC) curve, calibration curve and decision curve (DCA) were used to evaluate the predictive efficacy, accuracy and clinical practicability of the model, and Bootstrap method was used to verify the model internally.Results:Univariate analysis and multivariate Logistic regression analysis showed that pleural effusion ( OR=7.353, 95% CI: 3.344-16.170), posterior pararenal space (PPS) involvement ( OR=3.149, 95% CI: 1.314-7.527), serum creatinine concentration (Cr) ( OR=1.027, 95% CI: 1.017-1.038) and serum calcium concentration (Ca 2+) ( OR=0.038, 95% CI: 0.009-0.166) were independent risk factors for SAP ( P<0.05). A Nomogram model was established based on these four factors. The area under the ROC curve (AUC) of this model was 0.905 (95% CI: 0.869-0.933), indicating high predictive efficiency. Internal verification showed that the model had good accuracy in predicting SAP, and C-index was 0.90. DCA analysis showed that the model had high clinical practicability. Conclusions:The Nomogram model combining pleural effusion, PPS involvement, Cr and Ca 2+ had a good effect on early prediction of SAP, which could provide a new reference tool for clinical diagnosis and treatment.

Value of machine learning models based on structural MRI for diagnosis of Parkinson disease / 中华放射学杂志

Objective:To explore the value of machine learning models based on multiple structural MRI features for diagnosis of Parkinson disease (PD).Methods:The clinical and imaging data of 60 PD patients (PD group) diagnosed in the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2017 to August 2019 and 56 normal elderly people (NC group) recruited from the community were retrospectively analyzed. All subjects underwent brain MR imaging. Multiple structural MRI features were extracted from cerebellum, deep nuclei and of brain cortex based on different partition templates. The Mann-Whitney U test, as well as least absolute shrinkage and selection operator regression were used to select the most discriminating features. Finally, logistic regression (LR) and linear discriminant analysis (LDA) classifier combined with the 5-fold cross-validation scheme were used to construct the models based on structural features of cerebellum, deep nuclei and cortex, and a combined model based on all features. The receiver operating characteristic curves were drawn, and the diagnostic performance and clinical net benefit of each model were evaluated by the area under curve (AUC) and the decision curve analysis (DCA). Results:In total, four cerebellum (asymmetry index of Lobule Ⅵ volume, asymmetry index of Lobule ⅦB cortical thickness, asymmetry index of total gray matter volume and absolute value of right Lobule Ⅵ gray matter volume), 3 deep nuclei (absolute value of right nucleus accumbens volume, absolute and relative value of total nucleus accumbens volume) and 3 cortex features (local gyration index of left PFm, local fractal dimension of right superior frontal gyrus and sulcal depth of left superior occipital gyrus) were selected as the most discriminating features, and the related models were constructed. In validation set, the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LR classifier were 0.692, 0.641, 0.747 and 0.816; the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LDA classifier were 0.726, 0.610, 0.752 and 0.818. The diagnostic efficiency of the combined models based on LR and LDA classifiers were significantly better than those of other models ( P<0.05). The DCA curve demonstrated that the combined models based on LR and LDA classifiers showed the highest clinical net benefit. Conclusion:The combined models with all structural features of cerebellum, deep nuclei and cortex included based on LR and LDA classifiers showed favorable performance and clinical net benefit for diagnosis of PD, which have the potential application value in clinical diagnosis.

Construction and mechanism of Mindin gene macrophage-specific knockout mice in lung ischemia-reperfusion injury / 中华器官移植杂志

Objective:To explore the construction and mechanism of Mindin gene specific macrophage knockout mice in acute lung injury induced by lung ischemia-reperfusion injury(IRI).Methods:Mindin gene knockout mice were constructed by CRE-LOP system, Mice were divided into four groups of C57/B6 wild-type mice sham operation(n=10), C57/B6 mice operation(n=10), Mindin-/-macrophage-specific knockout mice operation(n=10)and C57/B6 mice operation + Mindin recombinant protein intervention(n=10). And lung ischemia-reperfusion injury model was established by clamping pulmonary portal.The effects of Mindin gene knockout and recombinant protein intervention on acute lung injury were observed in vivo and in vitro.t-test and ANOVA test were employed for data processing.Results:Mindin gene macrophage specific knockout mice was successfully constructed.Surgery(Mindin-/-)group significantly reduced pulmonary edema, release of inflammatory factors(IL1β: 2.73±0.19 vs. 5.81±0.61; IL-18: 6.52±0.63 vs. 11.03±0.34; TNF-α 2.18±0.14 vs. 4.76±0.20; HMGB1: 4.57±0.33 vs. 8.76±0.87), expression of NLRP3(2.07±0.27 vs. 4.91±0.22)and secretion of GSDMD(2.78±0.37 vs. 5.78±0.29)as compared with surgery group in vivo.In surgery(WT)+ Mindin group, the expression of lung IRI, inflammatory factors and cell pyroptosis were opposite, And the results were consistent in vitro and in vivo.As compared with surgery group, the above parameters were up-regulated in surgery(WT)+ Mindin protein group.And inter-group differences were statistically significant(all P<0.05). In vitro, the expressions of NLRP3(1.00±0.36, 0.41±0.06, 4.13±0.23), GSDMD(1.00±0.17, 0.34±0.16, 6.32±0.46)and integrin β4(1.00±0.11, 0.28±0.07, 3.53±0.17)were detected in different groups including hypoxia-recovery oxygen(HR), HR+ Mindin siRNA and HR+ Mindin protein groups in macrophage cell line(J774A); As compared with HR group, the above parameters were up-regulated in HR+ Mindin protein group and down-regulated in HR+ Mindin siRNA group.And the differences were statistically significant( P<0.05). The expressions of NLRP3(1.00±0.07, 1.13±0.11, 0.51±0.14)and GSDMD(1.00±0.09, 0.87±0.16, 0.37±0.12)were detected in Mindin, Mindin protein+ vehicle and Mindin protein+ integrin β4 knockout groups.The above parameters were down-regulated in Mindin protein+ integrin β4 knockout group as compared with Mindin protein and Mindin protein + vehicle groups.And the inter-group differences were statistically significant(all P<0.05). Conclusions:During pulmonary IRI, Mindin knockdown can alleviate pulmonary IRI.Mindin gene may promote the expression of inflammatory factors, NLRP3 and GSDMD protein by activating integrin β4 and aggravate cell pyroptosis to promote the development of pulmonary IRI.

Swirl sign and black hole sign on CT scanning in predicting early hematoma expansion in intracerebral hemorrhage: a comparative study / 中华神经医学杂志

Objective To compare the predictive values of swirl sign and black hole sign on CT scanning in early hematoma expansion in spontaneous intracerebral hemorrhage (SICH) patients.Methods Two hundred and ten firstly diagnosed SICH patients,admitted to our hospital from January 2012 to December 2018,were enrolled in the study.All patients were divided into hematoma expansion and non-hematoma expansion group according to whether early hematoma expansion appeared;and they were also divided into positive imaging sign group and negative imaging sign group according to whether imaging signs appeared;the clinical and imaging data were compared between these groups,respectively.The accuracies of swirl sign and black hole sign in predicting early hematoma expansion were analyzed using receiver operator characteristic (ROC) curve.Multivariate Logistic regression analysis was performed to determine the independent risk factors for early hematoma expansion.Results (1) In the 57 patients with early hematoma expansion,21 (36.8％) had swirl sign,and 17 (29.8％) had black hole sign;in the 153 patients without hematoma expansion,12 (7.8％) had swirl sign and 22 (14.4％) had black hole sign;the differences between the two groups were statistically significant (P＜0.05).As compared with those in the non-hematoma expansion group,the admission systolic blood pressure increased significantly and number of patients with intraventricular hemorrhage was significantly larger in the hematoma expansion group (P＜0.05).(2) There were no statistical differences in clinical and imaging data between the patients with swirl sign (n=33) and patients without swirl sign (n=177,P＞0.05);the hematoma volume in patients with black hole sign (n=39) was significantly increased as compared with that in patients without black hole sign (n=171,P＜0.05),and there were no statistical differences in other clinical and imaging data between patients with and without black hole sign (P＞0.05).(3) The areas under ROC curve of swirl sign,black hole sign,and "swirl sign combined with black hole sign" were 0.645,0.577,and 0.570,respectively.(4) Multivariate Logistic regression analysis showed that admission systolic blood pressure,swirl sign and black hole sign were independent risk factors for early hematoma expansion (P＜0.05).Conclusion In comparison to black hole sign and "swirl sign combined with black hole sign",the swirl sign has higher predictive value in early hematoma expansion in ICH patients.

MSCT features of subepithelial lesions of the urinary bladder / 实用放射学杂志

Objective To analyze the MSCT features of subepithelial lesions of the urinary bladder.Methods Thirty-one patients with subepithelial lesions of the urinary bladder proved by pathology were enrolled in this study.The MSCT findings were analyzed. Results Among the 3 1 cases with subpeithelial lesions of the urinary bladder,7 cases were non-epithelial tumors (including 3 cases of leiomyomas,2 cases of paragangliomas,1 case of hemangioma and 1 case of granulocytic sarcoma),and other 24 cases were inflammatory/reactive lesions,all as cystitis glandularis.MSCT findings were as follows:paragangliomas were solitary masses with homogeneous density,smooth border and wide base,with rapid wash-in and wash-out enhancement pattern and peak enhancement in the arterial phase.Hemangiomas and leiomyomas both presented as single round mass with slight enhancement.Granulocytic sarcoma appeared as diffuse bladder wall thickening with pebble-like projections,and slight enhancement.Cystitis glandularis was characterized by local thickening of the bladder wall with nodular or aquatics-like uplift,and was also characterized by diffuse thickening,with slight and progressive enhancement in 22 cases,and significant enhancement in venous phase in 2 cases.Conclusion The subepithelial lesions of urinary bladder may present with tumor-like appearance.The key characteristic feature for cystitis glandularis is local thickening of the bladder wall with nodular or aquatics-like uplift.Rapid wash-in and wash-out enhancement pattern is considered to be diagnostically significant for paragangliomas.However,the rest of the lesions overlap in the imaging appearances,and the diagnosis should be combined with clinical manifestations to improve the accuracy of preoperative diagnosis.

IdentificationofCTtargetreconstructioninpersistentinvasivepureground-glassnodules / 实用放射学杂志

Objective ToexplorethevalueofCTtargetreconstructionforpureground-glassnodules(pGGN)onidentifyingthe invasivenessofthelungadenocarcinoma.Methods ThepGGNs weredividedintopre-invasivegroup[atypicaladenomatoushyperplasia (AAH),andadenocarcinomainsitu(AIS)]andinvasivegroup[minimallyinvasiveadenocarcinoma(MIA),andinvasiveadenocarcinomas(IA)] accordingtothepathologicresults.ThemorphologicfeaturesofpGGNonCTincludedthelargestdiameters,CTvalue,pleuralindentation,air bronchogram,bubblelucency,vesselconvergence,vesseldilatation,lobulationandspeculation.Twodiagnosticiansevaluatedthemorphologic featuresofpGGNonCT.Binary L o g istic regressionwasusedtoassesstheassociationbetweenCTfindingsandhistopathological classification.ROCcurveanalysiswasusedindiameterandCTvalue.Results Betweenpre-invasiveandinvasivegroup,therewere significantdifferencesindiameter,CTvalue,spiculationandvesseldilatation(P<0.05).Nodifferencewasfoundinlobulated-margin,bubble lucency,airbronchogram,vascularconvergenceorpleuralindentationbetweenthetwogroups(P>0.05).Thediagnosticthresholds forpredictingpGGOinfiltrationwere8.75mminmaximumdiameterand-605HUinCTvaluerespectively.Conclusion ThepGGNwitha diametermorethan87.5mm,theCTvaluemorethan-605HU,andpresencesofspiculationandvesseldilatationsuggeststhatpGGOisinvasive.

ThevalueofspectralCTimaginginmultiGparameterquantitativeanalysisof lungcancerwithdifferentpathologicaltypes / 实用放射学杂志

Objective ToexplorethevalueofspectralCTimaginginmultiGparameterquantitativeanalysisoflungcancerwithdifferent pathologicaltypes.Methods SpectralCTimagesof72patientswithlungcancerprovedbypathologywereanalyzed,includingadenocarcinoma (ADC)in44cases,squamouscellcarcinoma(SQCC)in23casesandsmallcelllungcancer(SCLC)in5cases.Theslopeof40－100keVspectralattenuationcurve(λH),effectiveatomicnumber(EffectiveGZ),Calciumconcentration,hydroxyapatite(HAP)concentration, normalizediodineconcentration(NIC)and Waterconcentration were measuredandcomparedrespectively.The O n eG W a y analysisof variance (ANOVA ) was used and a value of P＜0.05 was considered statistically significant.Results (1 )O n plain C T ,there were statisticallysignificantdifferencesinEffectiveGZandλHamongthreeGdiseasegroups(F＝3.423,P＝0.04,F＝3.476,P＝0.038,respectively). (2)IncontrastGenhancedarterialphase,theWaterconcentrationandλHshowedstatisticallysignificantdifferencesamongthreegroups (F＝6.303,P＝0.003,F＝5.833,P＝0.005,respectively).(3)Invenousphase,thedifferenceinNICandλH wasstatisticallysignificant amongthegroups(F＝3.974,P＝0.023,F＝6.766,P＝0.002,respectively).(4)Apairwisecomparisonshowedtherewerestatistically significantdifferencesinallquantitativeparametersofspectralCTbetweenADCandSQCCgroups.ROCcurveanalysisshowedthat thosequantitativeparametersinvenousphaseappearedtohavehighdiagnosticefficiencyindifferentiatingADCfromSQCC,especiallyfor theλHinVP,withaAUCof0.754,sensitivityof79.5%,specificityof69.6%andthresholdvalueof1.78.Conclusion CTSpectral multiGparameterimagingprovidesanewsupplementarymethodforpreoperativediagnosisofADCandSQCC,andλHinvenousphase hasthehighestvalueindifferentiatingADCfromSQCC.

Correlation between CT enhancement parameters and Fuhrman grade in T1 clear cell renal cell carcinoma / 中华泌尿外科杂志

Objective To evaluate the correlation of CT enhancement parameters with Fuhrman grade in T1 (≤7 cm) clear cell renal carcinoma(ccRCC).Methods From September 2011 to November 2017,102 post-operation cases in our hospital proven to be T1 ccRCC were retrospectively analyzed.There were 71 males and 31 females,with a mean age of (59.1 ± 12.7)years (26 ～79 years),mean body mass index(BMI) of (24.0 ± 2.8)kg/m2 (14.3 ～ 31.6 kg/m2).Tumors of 55 patients were in left kidneys,47 in right kidneys.Fuhrman grade 1 and 2 were defined as low-grade group,meanwhile high-grade group included grade 3 and 4.There were 46 males and 21 females in low-grade group,with a mean age of (59.0 ± 13.2) years,mean BMI of (24.0 ± 2.9) kg/m2.In high-grade group,there were 25 males and 10 females,with a mean age of (58.8 ± 11.8) years,mean BMI of (24.2 ± 2.7) kg/m2.The maximum diameter and tumor enhancement value (TEVX),relative enhancement value (REVX) were measured and calculated.In arterial phase,X =1;in venous phase X =2.The total consumption amount of iodine was recorded.Comparisons of maximum diameter,TEV1,TEV2,REV1,REV2 and the total consumption of iodine between the two different groups were performed.The ROC curves of TEV1,TEV2,REV1,and REV2 were drawn to predict the grade of tumors..Results The TEV1 [(146.1 ± 29.1) HU vs.(100.2 ± 32.1) HU],TEV2 [(98.2 ± 22.9) HU vs.(75.6 ± 25.7) HU],REV1 (1.12 ± 0.24 vs.0.70 ± 0.16),REV2(0.67 ± 0.17 vs.0.54 ± 0.18) between low-grade group and high-grade group had statistical difference (P ＜ 0.05).There was no significant difference in the maximum diameter[(41.8 ± 15.4)mm vs.(45.3 ± 17.0)mm] and the total consumption of iodine [(33.3 ± 5.0)g vs.(34.2 ± 4.4)g] between the two groups (P ＞ 0.05).The area under ROC curve of TEV1,TEV2,REV1 and REV2 were 0.856,0.755,0.901 and 0.728,respectively.REV1 had the highest distinguish efficiency and the best critical value was 0.93.Conclusions The enhancement parameters of T1 ccRCC could contribute to predicting the Fuhrman grade.When the REV1 ≤0.93,the tumor tended to be high-grade tumor(Fuhrman grade 3-4).

CT appearances of focal organizing pneumonia / 实用放射学杂志

Objective To analyze the radiologic characteristics of focal organizing pneumonia (FOP) and discuss its values in diagnosis of FOP.Methods 57 lesions of FOP proved by histological examination were studied retrospectively.All of the lesions could be classified into types of nodule(diameter≤30 mm, n=40) and mass(diameter>30 mm, n=17),which were analyzed to explore the imaging characteristics such as location, margin, internal state, and enhancement features.Results 39 lesions were located in the right lung and 18 lesions in the left lung, and 51 lesions in the peripheral and 6 lesions in the inner or middle of the lung.The differences between the location of lobe and lung field were statistically significant.The radiographic common features included air bronchogram were seen in 28 cases, while loose composition sign in 18 cases and vessel convergence in 21 cases.49 lesions occurred in subpleural region, including 34 lesions broad contract with pleura.In 54 lesions with contrast-enhanced CT scan, the difference between arterial phase and plain scan in CT value was 35 HU and difference of venous phase and plain scan was 45 HU, presenting gradual enhancement.14 lesions were inhomogeneous enhancement in mass type and 25 lesions were homogeneous enhancement in nodule type.There were statistic differences in margin, shape, round-glass opacity, necrosis, cave and the relationship with pleura between the nodule type and mass type.Conclusion FOP has specific radiographic features.Enhanced CT scan combining multi planar reformation images is helpful in differential diagnosis.

Comparative study on quantitative evaluation of normal salivary glands function by diffusion-weighted MR imaging after gustatory stimulation using two different stimuli / 中华放射学杂志

Objective To investigate the difference of apparent diffusion coefficients (ADCs) changes in three major salivary glands after gustatory stimulation using two different stimuli. Methods Thirty healthy volunteers were examined with a 1.5 T MR unit. A diffusion-weighted MR imaging (MR DWI) sequence was performed once at rest and continuously repeated 13 times after gustatory stimulation using a commercially available lemon juice and vitamin C tablets in the same volunteer by using self-controlled method. The subsequence of two stimuli was random. In addition, the salivary flow rates at rest and after stimulation were measured. Characteristics and differences in ADCs curves of three salivary glands before and after stimulation between two stimuli were analyzed. Comparison of maximum ADCs, maximum ADCs increase rates (IRs) and times to maximum ADCs(Tmax) between two stimuli was performed by using independent-samples t test. Correlation analysis between rest salivary flow rates and rest ADCs, the maximum salivary flow rates and ADCs after stimulation, the maximum salivary flow IRs and ADC IRs after stimulation were performed by using Pearson correlation test. Results In lemon juice stimulation group, the mean ADCs mostly showed a steady increase to peak values during the first DW MRI scan after stimulation in all glands, followed by a gradually decrease fluctuating slightly around the baseline values. In vitamin C stimulation group, the mean ADCs were significantly increased in all glands during the first DW MRI scan after stimulation, followed by a gradual upward trend till peak values. In lemon juice stimulation group, the mean Tmax of submandibular and sublingual glands[(184±122)s, (345±232)s, respectively] were significantly earlier than those[(454 ± 301)s, (528 ± 297)s, respectively] in vitamin C stimulation group (t=-3.517 and-2.548 respectively, P0.05). Conclusion MR DWI with transient stimulation using lemon juice is more stable for evaluating the physiologic changes of salivary glands in vivo.

64-slice Spiral CT in Grading of Colorectal Adenoma and Diagnosis of Adenocarcinoma / 中国医学影像学杂志

PurposeTo evaluate 64-slice spiral CT in grading of colorectal adenoma and in the diagnosis of adenocarcinoma.Materials and Methods Sixty-eight cases of pathology confirmed colorectal adenoma were retrospectively reviewed to analyze CT performance including the location, size, shape and their relationship with adjacent structures and degree of enhancement in arterial, venous and delayed phase. The difference of CT attenuation value before and after enhancement (△CT value) in arterial, venous and delay phase of different pathological types and different levels of adenomas were compared.Results Among 68 lesions, 16 were villous adenomas, 42 were tubulovillous adenomas and 10 were tubular adenomas. Villous adenomas and tubulovillous adenomas were characterized by wide base, villous-like with gyral or frond pattern enhancement in arterial phase. There was a layer of low density mucus covering the surface. Tubular adenomas were featured as narrow base, nodular in shape with homogeneous enhancement.△CT values in each phase between villous adenomas and tubular adenomas showed statistically significant difference (arterial phaset=2.56,P<0.05; venous phaset=3.22,P<0.05; delayed phaset=2.48,P<0.05), however no significant difference was shown between villous and tubule villous adenomas or between tubulovillous and tubular adenomas. Adenocarcinomas showed creeping-type growth along the intestinal wall with a cluster of vessels adjacent to the tumor or enlarged lymph nodes.△CT values in each phase between non-dysplasia group and carcinoma group showed statistically significant difference (arterial phaset=2.49,P<0.05; venous phase t=2.69,P<0.05; delayed phaset=2.75,P<0.05), however no significant difference was shown between non-dysplasia group and dysplasia group or between dysplasia group and carcinoma group. Using 50 HU of△CT value in artery phase as standard, the sensitivity and specificity for diagnosis of adenocarcinomas were 76.92% and 70.91%, respectively.Conclusion CT findings of different pathological types of colorectal adenomas and adenocarcinomas are characteristic and useful in preoperative diagnosis and treatment planning.

CT diagnosis of adrenal hyperplasia characterized with solitary nodule and its differential diagnosis with adrenal cortical adenoma / 实用放射学杂志

Objective To investigate the value of spiral CT in diagnosis and its differiential diagnosis of adrenal hyperplasia char-acterized with solitary nodule.Methods 20 cases of adrenal hyperplasia characterized with solitary nodule and 28 adrenal adenomas confirmed by pathology underwent routine CT plain scan and multiphase enhanced CT scan.The density of nodule,capsule and de-gree of enhancement in each period were respectively analyzed and compared with the normal adrenal.The difference of CT value be-fore and after enhancement(△CT value)of the both was compared using pairing t test.Results 20 cases of adrenal hyperplasia nod-ules had no clear boundary with normal adrenal.Of which 1 5 cases showed isodensity,and their degree of enhancement was synchro-nized with normal adrenal;4 cases showed lower density,of which 2 had no enhancement,the other 2 obviously enhanced,but lower than normal adrenal;1 case showed mixed density mass,mainly composed of soft tissue,fat and punctuate calcification could be seen in it.Enhanced △CT values of 20 cases of adrenal hyperplasia nodule and normal adrenal were compared respectively,and there was no significant difference(P >0.05).28 cases of adrenal adenomas presented lower density than that of normal adrenal and had obvi-ous boundary between them.Enhanced △CT values in arterial phase of the lesion and normal adrenal showed significant statistically difference (P <0.05).Conclusion CT performance of adrenal hyperplasia with solitary nodule has specific characteristics,the densi-ty,capsule and enhanced mode will be helpful in differentiating from adrenal cortical adenoma.

Expression and clinical significance of serum ferritin in patients with lung cancer / 临床外科杂志

Objective To investigate the expression and clinical significance of serum ferritin in patients with lung cancer. Methods The relationship between preoperative serum ferritin level and corre-sponding clinicopathological data in 174 patients with lung cancer and 85 patients with benign pulmonary diseases was reviewed and analyzed. Results The level of serum ferritin in patients with lung cancer was significantly higher than that in patients with benign pulmonary diseases. For non-small cell lung cancer, patients with large-sized,poorly differentiated squamous carcinoma in advanced stage had higher serum ferritin levels than those with small-sized,highly or moderately differentiated adenocarcinoma in early stage. Conclusion Serum ferritin may play a promoting role in the development and malignant progres-sion of lung cancer.

CT features and clinicopathological analysis of xanthogranulomatous cholecystitis / 实用放射学杂志

Objective To investigate CT features of XGC in order to improve pre-operative diagnosis of the disease.Methods The CT features of 6 cases with XGC confirmed by histopathology were analyzed retrospectively.Results The gallbladder walls thick-ened in all 6 cases,diffusely thickened in 4 cases and focally thickened in 2 cases.Hypodensity nodules or bands in thickened walls were seen in all 6 cases.The continuous mucosal lines were observed in 4 cases.After contrast administration,the hypodensity band sign was seen in most cases in artery phase.Stones were found in all 6 gallbladders and in 4 common bile ducts,dilatation of biliary tract was seen in 3 cases.There were hepatic involvement in 5 cases,duodenal,hepatic flexure of the colon and antrum of the stom-ach adhesion with gallbladder was seen in 1 case respectively.Conclusion Hypodensity nodules or bands in thickened gallbladder walls and continuous mucosal line are characteristics of XGC,which are helpful in diagnosis and differential diagnosis.

MRI features of patients with multiple system atrophy and Parkinson's disease / 中华老年医学杂志

Objective To explore the MRI features of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) for providing early evidence in differential diagnosis. Methods The MRI features of 24 patients with MSA, 30 patients with PD and 30 healthy people as controls were retrospectively analyzed. Abnormal intensity in MRI included the hot-cross bun sign and the slitlike changes. The atrophies of brain included cerebellar, middle cerebellar peduncles, medulla oblongata and pon. Cerebral ventricle dilatation included fourth ventricle and cisterna pontis. The midbrain area, pons area and middle cerebellar peduncles width were measured. Results All patients with MSA had at least one of the features observed on MR images, and there were some differences in the subtypes of MSA. The high sensitive features were the atrophies of middle cerebellar peduncles (79.2%), the atrophies of pons (79.2%) and the hot-cross bun sign (75.0%). The parameters with high specificity and high positive predictive value were hot-cross bun sign (both 100%), the slit-like sign (both 100%), the atrophies of middle cerebellar peduncles (93.3% and 90.1%), and the atrophies of pons (96.7% and 95.0%). MSA group had the statistically significantly decreased values of pons area, midbrain area and middle cerebellar peduncles width [(288. 7±75. 4) mm2, (127.8±25.8) mm2 and (10. 7±2.8) mm, respectively], as compared with PD group [(477. 5 ± 54. 3) mm2, (145.9±21.6) mm2 and (16.2±1.3) mm, respectively] and healthy group [(454. 5±36. 8) mm2 , (146.4±17.4) mm2 and (16.7±1.2) mm, respectively] (all P ＜0. 05). Conclusions The routine MRI is helpful in differential diagnosis between MSA and PD and has some values in diagnosing the subtypes of MSA.

The clinical study on myocardial protection in aged patients undergoing coronary artery bypass grafting / 中华老年医学杂志

Objective To compare the myocardial protective effect between off pump coronary artery bypass(OPCAB) and on pump coronary artery bypass in the aged. Methods Four five patients were randomly divided into 3 groups:off pump coronary artery bypass (n=15),tepid blood cardioplegia group(n=15) and cold blood cardioplegia group (n=15).There was no statistical difference in heart function,sex,age and lesion of coronary artery .Venous blood samples were taken for determineing the serum concentration of creatine kinase MB isoenzyme(CK MB),troponin I perioperatively and the clinical situations were observed postoperatively. Results CK MB,troponin I release in beating group during and after bypass was lower than that in on pump groups( P

The Research on Attenuation Value in Solitary Pulmonary Nodules withContrast-Enhanced Computed Tomography / 实用放射学杂志

Objective To assess the value of contrast-enhanced computed tomography (CT) in the differentiation of benign solitary pulmonary nodules(SPN) from malignant ones.Methods Thirty-seven patients with solitary pulmonary nodules(≤3 cm phi)were examined by contrast-enhanced CT.Qualitative and quantitative characters of benign and malignant lesions were analysed after administration of Ultravist in order to evaluate the attenuation value of contrast-enhanced CT in the differentiation of benign SPN from malignant ones .Results A threshold value of 30 HU was selected on enhanced CT images to distinguish malignant( CT value≥30 HU)from benign( CT value

The Diagnosis of Recurrent Rectal Cancer Using Computed Tomography / 实用放射学杂志

Objective To assess the value of CT in diagnosis of recurrent rectal carcinoma.Methods Forty seven patients who had undergone locally curative surgery were examined by CT.All patients received intravenous contrast medium and two oral doses and a intrarectal doses of 500 ml 3% Ultravist were given.The characters of benign and malignant lesions were analysed in order to evaluate the value of the classification on CT in the differentiation of benign masses from malignant ones.Results 26 local recurrences occurred in 47 cases,including 13 cases with an round preasacral mass,8 cases with an irregular rectal wall thickening,2 cases with a flat preasacral mass,3 cases with a preasacral mass with low attenuation.The degree of enhancement of local recurrent masses was higher than that of benign masses.Conclusion The features of recurrence of rectal carcinoma on CT is an round or irregular asymmetrical preasacral mass or an irregular rectal wall thickening.It is useful way in diagnosis of recurrence of rectal carcinoma.