Dynamics of the surface carbonate system in oil fields with a high concentration of wells on the northwestern South China Sea shelf.

Oil exploitation may pose adverse effects on marine ecosystems, but its impacts on surface carbonate dynamics remain unknown. In a carbonate system with low air-sea ∆pCO2, such as the South China Sea (SCS), human activities may affect the pCO2 distribution patterns and potentially alter CO2 sink or source at the surface. This study investigates the surface carbonate system in two oil fields, namely the Wenchang Oil Feld and Enping Oil Feld, located on the northwestern SCS (NWSCS) shelf. In Enping Oil Field, although there is a slight increase in surface pCO2 due to probable total alkalinity (TA) consumption from CaCO3 precipitation, strong biological production makes the plume water a strong CO2 sink. Similarly, the biological processes dominated the pCO2 variability in Wenchang Oil Feld, exhibiting high values in its central area. In NWSCS, the influence of shelf water was observed during both cruises. And the pCO2 drawdown caused by the decreased sea surface temperature (SST) and CO2 outgassing outweighed their increases via enhanced vertical mixing, leading to a pCO2 drawdown from September to October within this water mass. More importantly, there were no significant disparities observed in carbonate parameters at stations along transects with and without wells, and the observed parameter values in this study fell within the range reported previously on the nSCS shelf with similar controlling processes. Thus the impact of oil exploitation on carbonate dynamics is negligible, and the characteristics of the carbonate system in oil field are primarily governed by natural processes such as the mixing of plume water and basin water, CaCO3 precipitation and the changes in SST. The provided data establish a crucial baseline for detecting future alterations in carbonate chemistry within oil fields, and the rapid fluctuations in sea surface pCO2 highlight the need for higher spatiotemporal resolution observation.

Total Synthesis of Vilmoraconitine.

Vilmoraconitine belongs to one of the most complex skeleton types in the C19-diterpenoid alkaloids, which architecturally features an unprecedented heptacyclic core possessing a rigid cyclopropane unit. Here, we report the first total synthesis of vilmoraconitine relying on strategic use of efficient ring-forming reactions. Key steps include an oxidative dearomatization-induced Diels-Alder cycloaddition, a hydrodealkenylative fragmentation/Mannich sequence, and an intramolecular Diels-Alder cycloaddition.

Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT.

OBJECTIVES: Cardiac lead perforation is a rare but potentially life-threatening event. The purpose of this study was to investigate the diagnostic performances of chest radiography, transthoracic echocardiography (TTE) and electrocardiography (ECG)-gated contrast-enhanced cardiac CT in the assessment of cardiac lead perforation. METHODS: This retrospective study was approved by the ethics review board of Sun Yat-Sen Memorial Hospital at Sun Yat-Sen University (Guangzhou, China), and the need to obtain informed consent was waived. Between May 2010 and Oct 2017, 52 patients were clinically suspected to have a cardiac lead perforation and received chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT. Among them, 13 patients were identified as having cardiac lead perforation. The diagnostic performances of these three modalities were evaluated by receiver-operating characteristic (ROC) curves using a composite reference standard of surgical and electrophysiological results and clinical follow-up. The areas under ROCs (AUROCs) were compared with the McNemar test. RESULTS: The accuracies of chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT imaging for the diagnosis of cardiac lead perforation were 73.1%, 82.7% and 98.1%, respectively. ECG-gated contrast-enhanced cardiac CT had a higher AUROC than chest radiography (p < 0.001) and TTE (p < 0.001). CONCLUSIONS: ECG-gated contrast-enhanced cardiac CT is superior to both chest radiography and TTE imaging for the assessment of cardiac lead perforation. KEY POINTS: • ECG-gated contrast-enhanced cardiac CT has an accuracy of 98.1% in the diagnosis of cardiac lead perforation. • The AUROC of ECG-gated contrast-enhanced cardiac CT is higher than those of chest radiography and TTE imaging. • ECG-gated contrast-enhanced cardiac CT imaging has better diagnostic performance than both chest radiography and TTE imaging for the assessment of cardiac lead perforation.

MR imaging features and staging of neuroendocrine carcinomas of the uterine cervix with pathological correlations.

OBJECTIVE: To determine MR imaging features and staging accuracy of neuroendocrine carcinomas (NECs) of the uterine cervix with pathological correlations. METHODS: Twenty-six patients with histologically proven NECs, 60 patients with squamous cell carcinomas (SCCs), and 30 patients with adenocarcinomas of the uterine cervix were included. The clinical data, pathological findings, and MRI findings were reviewed retrospectively. MRI features of cervical NECs, SCCs, and adenocarcinomas were compared, and MRI staging of cervical NECs was compared with the pathological staging. RESULTS: Cervical NECs showed a higher tendency toward a homogeneous signal intensity on T2-weighted imaging and a homogeneous enhancement pattern, as well as a lower ADC value of tumour and a higher incidence of lymphadenopathy, compared with SCCs and adenocarcinomas (P < 0.05). An ADC value cutoff of 0.90 × 10-3 mm2/s was robust for differentiation between cervical NECs and other cervical cancers, with a sensitivity of 63.3 % and a specificity of 95 %. In 21 patients who underwent radical hysterectomy and lymphadenectomy, the overall accuracy of tumour staging by MR imaging was 85.7 % with reference to pathology staging. CONCLUSION: Homogeneous lesion texture and low ADC value are likely suggestive features of cervical NECs and MR imaging is reliable for the staging of cervical NECs. KEY POINTS: • Cervical NECs show a tendency of lesion homogeneity and lymphadenopathy • Low ADC values are found in cervical NECs • MRI is an accurate imaging modality for the cervical NEC staging.

[An experimental study on catheterization in rat's hepatic artery and interventional therapy through carotid artery].

OBJECTIVE: To investigate the feasibility and safety of catheterization in rat hepatic artery and interventional therapy through carotid artery. METHODS: A total of 30 Sprague-Dawley rats were randomly divided into 2 groups. All were punctured through left common carotid artery (LCCA) under intraperitoneal injection anesthesia. Microcatheter was inserted through a puncturing outer cannula into celiac artery and angiography performed to investigated the anatomical structure. Then a microcatheter was inserted into proper hepatic artery. One group was perfused with epirubicin 5 mg while another embolized with lipidol and polyvinyl (PVA). The status of vascular patency was re-examined by celiac angiography after perfusion and embolization. The 2-week survival rate (SR) and related complications were observed. RESULTS: Except for one failed case, all other cases were successfully inserted and celiac-gastroduodenal arteriography was completed with a success rate of 97% (29/30). The anastomosis between gastroduodenal artery (GDA) and superior mesenteric artery (SMA) was demonstrated in 28 cases (28/29, 96.6%). In 14 cases with perfusion therapy, arteriography demonstrated all branches of celiac artery had no occlusion while 10 embolized cases (10/15, 67%) had the main branch occlusion of gastroduodenal artery and 5 (5/15, 33%) stayed open. No postoperative abnormality was found in the limb motor function. Five had the drooping of left upper eyelid during 12 - 24 h after intervention and subsided after a week. And 10 embolized via main branch of gastroduodenal artery showed a poor appetite within 3 days postoperation and recovered gradually after 3 days. After intervention, 27 rats survived in 2 weeks. The survival rate was 93% (27/29). One died of incision infection and another neck hematoma. CONCLUSION: Catheterization in hepatic artery and interventional therapy through carotid artery is both feasible and safe. It may have a high application value.

A novel biliary stent loaded with (125)I seeds in patients with malignant biliary obstruction: preliminary results versus a conventional biliary stent.

BACKGROUND & AIMS: Stenting is a palliative therapy method for relieving malignant biliary obstruction. The aim of this study was to evaluate the safety and effectiveness of an irradiation stent compared to a conventional biliary stent in patients with biliary obstruction caused by both primary and metastatic adenocarcinomas. METHODS: Participants were randomly assigned to receive treatment with a biliary irradiation stent (irradiation stent group) or a conventional biliary stent (control group). After stent implantation, the outcomes were measured in terms of relief of obstructive jaundice, survival time, complications related to the procedure. A p value of less than 0.05 indicated a significant difference. RESULTS: The stents were successfully placed in all the 23 patients. The obstructive jaundice was relieved in all patients except three in the control group. The median and mean overall survivals in the irradiation stent group were higher than those in the control group (7.40 months versus 2.50 months, 8.03 months versus 3.36 months, p=0.006). The patients with stent patent at 3, 6, and 12 months in the irradiation stent group were 11 (91.7%), 7 (58.3%), and 1 (8.3%), respectively. While in the control group, 4 (36.4%), 1 (9.1%), and 0 (0%), respectively. There were no significant differences in the complications related to stent insertion between the two groups. CONCLUSIONS: This interim analysis shows that treatment with the biliary intraluminal irradiation stent in patients with biliary obstruction caused by adenocarcinomas appears safe and technically feasible, has benefits in relieving jaundice, and seems to extend survival when compared to a conventional biliary stent.

[Combination treatment of vertebral and paravertebral metastatic tumors by transarterial chemoembolization and percutaneous vertebroplasty].

OBJECTIVE: To evaluate the efficacy and safety of combining transarterial chemoembolization and percutaneous vertebroplasty (PVP) in the treatment of vertebral and paravertebral metastatic tumors. METHODS: A retrospective review was conducted in 49 patients with severer painful tumor metastasis in 72 vertebrae and paravertebral tissue who had failed noninvasive treatment at our institution from March 2003 to December 2009. Among them, there were intractable radicular pain (n = 17) and slight or no motor and sensory function (n = 6). All patients under transarterial chemoembolization were followed within 6 days by PVP. Computed tomography (CT) was performed within 3 days after PVP to observe the distribution of PMMA (para-methoxymethamphetamine)in vertebrae and whether or not there was any leakage. The efficacy was assessed by the change of pain level after combined treatment. RESULTS: Bilateral vertebral arteries were selected in 44 cases with 65 vertebrae. And only unilateral vertebral artery was selected in 5 cases with 7 vertebrae. Except for 2 vertebrae with simple artery infusion, 29 vertebrae were embolized by 1 - 2 ml of lipiodolization and gelfoam particles and 41 vertebrae by gelatine particles. And an average volume of 4.23 ml and 5.39 ml was injected in each thoracic and lumbar vertebra respectively. The rate of efficacy was at 87.8% within 3 months after combined therapy. There were CR (complete response) 21 cases (42.9%), PR (partial response) 22 cases (44.9%) and MR/NR (minimal/no response) 6 cases (12.2%). No serious complication related to the technique occurred. Only 12 cases with asymptomatic PMMA leakage around 16 vertebrae were demonstrated on post-operative CT. CONCLUSION: Transarterial chemoembolization plus PVP is an effective and safe procedure in the treatment of severe painful vertebral and paravertebral metastatic tumors.

Arterial embolization hyperthermia using As2O3 nanoparticles in VX2 carcinoma-induced liver tumors.

BACKGROUND: Combination therapy for arterial embolization hyperthermia (AEH) with arsenic trioxide (As(2)O(3)) nanoparticles (ATONs) is a novel treatment for solid malignancies. This study was performed to evaluate the feasibility and therapeutic effect of AEH with As(2)O(3) nanoparticles in a rabbit liver cancer model. The protocol was approved by our institutional animal use committee. METHODOLOGY/PRINCIPAL FINDINGS: In total, 60 VX(2) liver-tumor-bearing rabbits were randomly assigned to five groups (n = 12/group) and received AEH with ATONs (Group 1), hepatic arterial embolization with ATONs (Group 2), lipiodol (Group 3), or saline (Group 4), on day 14 after tumor implantation. Twelve rabbits that received AEH with ATONs were prepared for temperature measurements, and were defined as Group 5. Computed tomography was used to measure the tumors' longest dimension, and evaluation was performed according to the Response Evaluation Criteria in Solid Tumors. Hepatic toxicity, tumor necrosis rate, vascular endothelial growth factor level, and microvessel density were determined. Survival rates were measured using the Kaplan-Meier method. The therapeutic temperature (42.5°C) was obtained in Group 5. Hepatotoxicity reactions occurred but were transient in all groups. Tumor growth was delayed and survival was prolonged in Group 1 (treated with AEH and ATONs). Plasma and tumor vascular endothelial growth factor and microvessel density were significantly inhibited in Group 1, while tumor necrosis rates were markedly enhanced compared with those in the control groups. CONCLUSIONS: ATON-based AEH is a safe and effective treatment that can be targeted at liver tumors using the dual effects of hyperthermia and chemotherapy. This therapy can delay tumor growth and noticeably inhibit tumor angiogenesis.

[Development of a new biliary intraluminal irradiation stent and the primary results of clinical application].

OBJECTIVE: To evaluate the feasibility, safety and efficiency of a new biliary intraluminal irradiation stent system loaded with (125)I seeds. METHODS: The study was approved by the institutional ethics committee of our hospital, and informed consent was obtained from each patient. Patients with malignant biliary obstruction were treated with a new biliary irradiation stent system loaded with (125)I seeds according to a treatment plan system. All of the biliary seeds carrying devices combined with the matched biliary stents were placed by the procedures of percutaneous transhepatic biliary puncture. After stents implantation, all patients were followed-up. RESULTS: The whole biliary stent systems loaded with (125)I seeds were successfully placed in 12 patients, no (125)I seeds exfoliation during the procedure and no radioactive leakage by general emission computed tomography reexamination during the follow-up were observed. The obstructive jaundice relived and the systemic conditions improved remarkably in all patients. There were no complications related to the stents, such as biliary perforation or hemobilia, were observed. And no significant change in the blood routine and immune parameters detected before and after operation during the follow-up were observed. The median survival period was 7.40 months (95%CI 6.204 - 8.596) and the mean survival period was 8.03 months (95%CI 6.142 - 9.909). CONCLUSION: Development of a new biliary intraluminal irradiation stent system loaded with (125)I seeds is technically feasible and safe, treatment of this stent system has potential benefits of extending survival, however the long-term clinical efficacy needs to be certificated by further follow-up observation and control trials.

[Diagnostic value of 64-slice spiral computed tomography coronary angiography for coronary artery disease].

OBJECTIVE: To assess the diagnostic accuracy of 64-slice computed tomography coronary angiography (64-SCTCA) in individuals with suspected coronary artery disease (CAD). METHODS: The study enrolled 285 individuals undergoing 64-SCTCA with calcium scoring and thereafter invasive coronary angiography (CAG) within 4 weeks for suspected CAD. Pretest probability of having obstructive CAD was determined using the Duke clinical score, which was estimated by type of chest discomfort, age, gender, and traditional risk factors and stratified into 3 levels of probability: low (≤ 30%, n = 80), intermediate (31% to 70%, n = 92), and high (≥ 71%, n = 113). CAD was defined as the presence of at least one vessel of ≥ 50% coronary stenosis on CAG. RESULTS: The patient-based diagnostic accuracy of 64-SCTCA for detecting CAD according to CAG revealed a sensitivity of 81.2%, a specificity of 93.3%, a positive predictive value of 68.0% and negative predictive value of 96.6%. The CAD prevalence in the low, intermediate and high risk groups according to Duke probability was 46.3%, 72.8% and 82.3%, respectively. The sensitivity and positive predictive value were lower in the low probability group than those in the intermediate and high probability groups. For those with coronary artery Agatston calcium score > 400, the diagnostic accuracy was linked with a higher sensitivity but lower specificity. The diagnostic value of 64-SCTCA for proximal and mid-segment of coronary artery was superior to that for distal segment. CONCLUSIONS: 64-SCTCA is mainly indicated in individuals with an intermediate probability of having CAD. The diagnostic value of 64-SCTCA could be affected by coronary artery calcium, lesion location and vessel diameter.

Self-expandable esophageal stent loaded with 125I seeds: initial experience in patients with advanced esophageal cancer.

PURPOSE: To prospectively compare the response to treatment with a self-expandable esophageal stent loaded with iodine 125 ((125)I) seeds for intraluminal brachytherapy versus the response to treatment with a conventional self-expandable covered stent in patients with advanced esophageal cancer. MATERIALS AND METHODS: The study protocol was approved by the institutional ethics committee, and informed consent was obtained from each patient. Patients from one institution who had dysphagia caused by inoperable esophageal cancer were randomly assigned to receive treatment with a stent loaded with (125)I seeds (irradiation stent group) or a conventional covered stent (control group). After stent implantation, the outcomes were measured in terms of relief of dysphagia, survival time, and complications related to the procedure. Dysphagia was assigned a grade. A P value of less than .05 was considered to indicate a significant difference. RESULTS: The stent was successfully placed in the diseased esophagus in all 53 patients (27 patients in the irradiation stent group and 26 patients in the control group). The dysphagia grades significantly improved in both groups within the 1st month after stent placement but were better in the irradiation stent group than in the control group after 2 months (P < .05). The median and mean survival times were better in the irradiation stent group than in the control group, and the differences were significant (P < .001). Hemorrhage occurred in 16 (30%) patients in both groups combined during follow-up. CONCLUSION: In patients with advanced esophageal cancer, treatment with an esophageal stent loaded with (125)I seeds, compared with that with a conventional covered stent, has potential benefit in that it allows a slightly longer relief of dysphagia and extended survival.

Enhancement of p53 gene transfer efficiency in hepatic tumor mediated by transferrin receptor through trans-arterial delivery.

Transferrin-DNA complex mediated by transferrin receptor in combination with interventional trans-arterial injection into a target organ may be a duel-target-oriented delivery means to achieve an efficient gene therapy. In this study, transferrin receptor expression in normal human hepatocyte and two hepatocellular-carcinoma cells (Huh7/SK-Hep1) was determined. p53-LipofectAMINE with different amounts of transferrin was transfected into the cells and the gene transfection efficiency was evaluated. After VX2 rabbit hepatocarcinoma model was established, the transferrin-p53-LipofectAMINE complex was delivered into the hepatic artery via interventional techniques to analyze the therapeutic p53 gene transfer efficiency in vivo by Western blot, immunohistochemical/immunofluorescence staining analysis and survival time. The results were transferrin receptor expression in Huh7 and SK-Hep1 cells was higher than in normal hepatocyte. Transfection efficiency of p53 was increased in vitro in both Huh7 and SK-Hep1 cells with increasing transferrin in a dose-dependent manner. As compared to intravenous administration, interventional injection of p53-gene complex into hepatic tumor mediated by transferrin-receptor, could enhance the gene transfer efficiency in vivo as evaluated by Western blot, immunohistochemical/immunofluorenscence staining analyses and improved animal survival (H = 12.567, p = 0.0019). These findings show the transferrin-transferrin receptor system combined with interventional techniques enhanced p53-gene transfer to hepatic tumor and the duel-target-oriented gene delivery may be an effective approach for gene therapy.

Repeat vertebroplasty for unrelieved pain at previously treated vertebral levels with osteoporotic vertebral compression fractures.

STUDY DESIGN: A retrospective study was performed in patients with a repeat percutaneous vertebroplasty (PV) at the vertebral levels previously undergoing vertebroplasty. OBJECTIVE: Our purpose of this study is to examine if a repeat PV is effective on pain-relief at the vertebral levels previously undergoing vertebroplasty. SUMMARY OF BACKGROUND DATA: Although pain-relief is usually high with the treatment of PV in the painful osteoporotic vertebral compression fractures, there are still about 5% to 22% of such patients experiencing no improvement on pain after PV. A repeat PV at the same vertebrae previously treated with PV may be an option for these patients without a pain-relief. METHODS: Out of 334 procedures of PV in 242 patients with osteoporotic vertebral compression fractures from October 2000 to June 2006 in our institute, 15 vertebrae in 15 patients with unrelieved pain in 4 to 32 days after an initial PV were treated with a repeat vertebroplasty. The clinical outcomes were assessed by measurements of visual analog scale, and the imaging features were analyzed pre- and postprocedure. RESULTS: The mean volume of Polymethylmethacrylate injected in each vertebra was 4.0 mL (range, 1.5-9 mL) in the repeat PV. During the first month of follow-up after repeat PV in this series, a mean visual analog scale scores of the pain level was reduced from 8.6 (range, 7-10) preprocedure to 1.67 points (range, 0-4) postprocedure, with a mean reduction of 6.93 points (range, 4-8). Complete and partial pain relief were reached in 11 (73%) and 4 patients (27%), respectively in a mean follow-up of 15 months. No serious complications related to the procedures occurred, but asymptomatic Polymethylmethacrylate leakage around vertebrae was demonstrated on radiograph or computed tomography in 2 patients. CONCLUSION: The outcomes of this series suggest that repeat PV is effective at the same vertebral levels in patients without pain-relief who underwent previous PV. Absent or inadequate filling of cement in the unstable fractured areas of the vertebral body may be responsible for the unrelieved pain after the initial PV.

[Magnetic resonance imaging of magnetically labeled endothelial progenitor cells homing to the injured endothelium].

OBJECTIVE: Accumulating evidence suggests that the endothelial progenitor cells (EPCs) can reendothelialization the injured endothelium. Superparamagnetic iron-oxide particles are being used for intracellular magnetic labeling of cells and in vivo cells tracking. The aim of this study was to investigate the possibility of depict and track magnetically labeled EPCs in vivo for carotid artery endothelium injured New Zealand White rabbit model by 1.5 T magnetic resonance imaging system after EPCs transplantation. METHODS: The EPCs of New Zealand White rabbit were isolated, confirmed, expanded and then incubated with home synthesized Fe2O3-PLL for 24 hours, Prussian blue stain was performed for showing intracellular irons. The model of carotid arterial injury was performed by 2.5 F balloons. The group A of 5 rabbits were transplanted with magnetically labeled EPCs, the group B of 5 rabbits were received fluorescent-labeled EPCs, and 5 rabbits of the group C were received the same volume of saline injection immediately after the carotid artery endothelium was injured. The transfused EPCs were strictly restricted to the injury site. MR imaging and histology were performed and compared 7 days late. RESULTS: The Epcs labeling efficiency of Fe2O3-PLL was more than 95% identified by Prussian blue stain. Seven days after the transplanted of EPCs, only in group A, the injured endothelium of carotid artery wall had the signal intensity loss in T(2)WI MRI, which corresponding to the injured endothelium where the most Prussian blue staining-positive cells were in histopathological analyses. While histopathological slides showed that the fluorescence-positive cells in the injured endothelium which had been transplanted Dil labeled EPCs also. The group C was either in negative. CONCLUSION: The rabbits endothelial progenitor cells can be effectively labeled with Fe2O3-PLL, 1.5 T magnetic resonance imaging system could depict and monitor the magnetically labeled endothelial progenitor cells homing to the injured endothelium of the artery, which may have much more potential values for studying the engraftment of EPCs in cardiovascular disease.

[The risk factors and preventive strategies of heterotopic ossification after artificial disc replacement in lumbar spine].

OBJECTIVE: To analyze the risk factors of heterotopic (HO) ossification after total lumbar disc replacement and probe the preventive strategies for it. METHODS: The radiographs and clinical data of 78 discs in 65 patients who received artificial lumbar disc replacement (ADR) from April 1998 to December 2003 were analyzed retrospectively by two radiologists and one orthopaedic surgeon and then postoperative HO were graded according to McAfee system. The bony formations in disc spaces, time of HO were found, and range of motion (ROM) of the operated levels were measured on radiographic films. In addition, the risk factors such as preoperative peri-annulus ossification, bony endplates injuries, and subsided or mal-position of the prostheses were also analyzed by Logistic regression analysis. RESULTS: Postoperative HO was found in 10 spaces of 9 cases. Class I of HO were occurred in 7 patients at means 2.1 years postoperatively with normal range of motion preserved. Three of them turned into class II or III with 10 degrees of mean ROM in the following 2.5 years. Another 2 (2/9) cases with preoperative peri-annulus ossification had bridging trabecular bone (class III) between the endplates and 9 degrees of ROM 2 years after surgery, then turned into class IV at 6 years with 0 degrees and 4 degrees of motion in the operated levels. As the risk factors of HO, preoperative annulus ossification (2 cases), bony endplates injuries (5 cases), mal-positioned prostheses (2 cases) and subsided prostheses (2 cases) were found simultaneity with significant positive relation to HO occurred (P < 0.05). CONCLUSIONS: Factors such as preoperative ossification of annulus, endplate injuries, prosthesis subsided and mal-position would have higher risks to have HO occurred after ADR, but ROM of most affected levels are preserved. Strict control indication and avoid all above risk factors can prevent HO occurring effectively.

Ultrafine needle CO2 splenoportography: a comparative investigation with transarterial portography and MR portography.

PURPOSE: To evaluate the safety and quality of CO2 splenoportography (CO2-SP) by comparison to 3-dimensional dynamic contrast-enhanced magnetic resonance portography (3D-DCE-MRP) and transarterial portography (TAP). MATERIALS AND METHODS: CO2-SP, 3D-DCE-MRP and TAP were performed within 3 days in 35 patients. CO2-SP was conducted with a 26G needle by puncture of spleen under fluoroscopy and/or ultrasound guidance. A fifty mm3 of CO2 was manually injected within 3s. The safety and the side effects of CO2-SP were assessed with a scoring system based on both the subjective feeling of patients questioned and the objective appearances of vital signs, electrocardiogram (ECG) and saturation of percutaneous blood oxygen (SpO2). The quality of the imaging was compared among the three groups using different methods by a scoring criterion based on visualization of the portal branches. RESULTS: Transient mild discomfortable reaction was present in 18 patients (51.4%). The scores measured for quality of portal vein branch visualization in the groups with CO2-SP, 3D-DCE-MRP and TAP were 226, 196 and 167, respectively (P<0.001, the higher of the scores, the better of the quality). The visibility of collateral veins was not significantly different amongst the three imaging techniques. CONCLUSION: Ultrafine needle CO2-SP is safe and minimally invasive. The quality of CO2-SP is better than that with 3D-DCE-MRP and TAP in terms of the visualizing portal vein branches.

[Value of CT scan in the early diagnosis of nasopharyngeal tumor].

OBJECTIVE: To evaluate the clinical value of CT scan on the early diagnosis of nasopharyngeal masses. METHOD: The results of CT scans and pathological findings to the 59 cases of localized nasopharyngeal masses were summerized. RESULT: Among the 44 cases diagnosed by CT scan as nasopharyngeal carcinoma, their pathological findings revealed 35 cases of nasopharyngeal carcinoma, 2 cases of non Hodgkin's disease, 3 cases of nasopharyngeal tuberculosis, 3 cases of nasopharyngeal lymphadenosis, and 1 case of nasopharyngeal cyst. Among the 11 cases diagnosed by CT scan as local mucal thicking, their pathological findings demonstrated 2 cases of nasopharyngeal carcinoma, 6 cases of chronic inflammation, 1 case of nasopharyngeal tuberculosis, and 2 case of nasopharyngeal cyst. The other 4 cases diagnosed by CT scan as nasopharyngeal fibrohemangioma were confirmed by pathological examination. CONCLUSION: CT scan can correctly reveal nasopharyngeal diseases, and benefit early diagnosis. It shows distinctive advanteges in detecting early stage of submucal nasopharyngeal carcinoma and diagnosing nasopharyngeal fibrohemangioma. But there is limitation in differentiating common nasopharyngeal diseases.