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Objective To investigate the impact of quantitative measurement for lung volume using iterative model reconstruction (IMR),hybrid iterative reconstruction (iDose4 )and filtered back projection (FBP),and to compare the image noise between different reconstruction methods.Methods 70 subjects were performed with low-dose chest CT scan (Philips Brilliance 256 iCT),and the original data were reconstructed with IMR (algorithm:Routine,SharpPlus,Soft Tissue,level:1 - 3 ),iDose4 and FBP respectively.We set less than -950 HU as emphysema threshold,calculated the total lung volume (TLV),total emphysema volume (TEV),emphysema index (EI)and objective image noise (OIN),and then compared the quantitative parameters and OIN between different groups.Results All parameters showed a significantly statistical difference (P =0.000)except TLV (P =1.000).The TEV and EI are significant higher in IMR-S group than in other groups.The OIN in IMR-S-L1 group was the highest,and the FBP group was the second-highest.OIN in iDose4 group was lower than that in IMR-S groups but higher than that in IMR-R and IMR-ST group.Conclusion SharpPlus algorithm of IMR will affect the quantitative measurement of lung volume under low-radiation-dose condition,and the OIN in IMR-S groups is obvious.Therefore SharpPlus algorithm is not recommended for quantitative analysis of lung volume.The Routine and Soft Tissue algorithm will not affect the quantitative measurement,and can distinctly reduce the OIN compared with idose4 and FBP.
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Objective To investigate the impact of quantitative measurement for lung volume using iterative model reconstruction (IMR),hybrid iterative reconstruction (iDose4 )and filtered back projection (FBP),and to compare the image noise between different reconstruction methods.Methods 70 subjects were performed with low-dose chest CT scan (Philips Brilliance 256 iCT),and the original data were reconstructed with IMR (algorithm:Routine,SharpPlus,Soft Tissue,level:1 - 3 ),iDose4 and FBP respectively.We set less than -950 HU as emphysema threshold,calculated the total lung volume (TLV),total emphysema volume (TEV),emphysema index (EI)and objective image noise (OIN),and then compared the quantitative parameters and OIN between different groups.Results All parameters showed a significantly statistical difference (P =0.000)except TLV (P =1.000).The TEV and EI are significant higher in IMR-S group than in other groups.The OIN in IMR-S-L1 group was the highest,and the FBP group was the second-highest.OIN in iDose4 group was lower than that in IMR-S groups but higher than that in IMR-R and IMR-ST group.Conclusion SharpPlus algorithm of IMR will affect the quantitative measurement of lung volume under low-radiation-dose condition,and the OIN in IMR-S groups is obvious.Therefore SharpPlus algorithm is not recommended for quantitative analysis of lung volume.The Routine and Soft Tissue algorithm will not affect the quantitative measurement,and can distinctly reduce the OIN compared with idose4 and FBP.
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Objective To investigate the expression and clinical significance of lactate dehydrogenase A (LDHA) in breast cancer.Methods Tissue samples of 76 breast cancers and corresponding paired adjacent normal tissues were collected and made into tissue micrcarrays (TMAs).Immunohistochemistry (IHC) analysis was performed to detect the expression of LDHA and further analyzed the correlation of LDHA expression and clinicopathological variables and prognosis of breast cancers.Results LDHA was frequently upregulated in breast cancer tissues compared to the normal breast tissues (P ＜ 0.05).High LDHA expression was associated with distant metastasis (P ＜ 0.05) and worse patient prognosis (P ＜ 0.05).Conclusions LDHA is closely related to the occurrence and clinical progress of breast cancers.LDHA might be a potential novel molecular marker for diagnosis,prognosis and therapy in breast cancers.
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Objective To analyze the morphological features of smokers' lung on MDCT scan,measure the CT volumetric parameters,and explore the correlation with pulmonary functional test(PFT) indexes.Methods 59 smokers were enrolled,in which 14 were chronic obstructive pulmonary disease(COPD) patients,and 39 non-smokers were chosen as control group.All subjects underwent inspiratory and expiratory phase MDCT scan and PFT.Eleven pulmonary CT features caused by smoking among three groups were analyzed and compared.The emphysema index (EI 95) and mean lung density (MLD) were measured.The correlation between above mentioned parameters and PFT indexes were analyzed.Results ①Among three groups,significant differences were found for the score and incidence of entrilobular emphysema,paraseptal emphysema and brochiectasis or bronchial wall thickness(P＜0.01).②In COPD patients,paraseptal emphysema and DLCO/VA,brochiectasis or bronchial wall thickness and DLCO SB(％P),DLCO/VA(％P),as well as EI and MEF25％ (％P),DLCO SB(％P),DLCO/VA (％P)were negatively related.In smokers without COPD,there were negative correlation between centrilobular emphysema and FEV1/FVC,MEF25％ (％ P),MEF5％ (％ P),DLCO SB (％ P),DLCO/VA (％ P),paraseptal emphysema and DLCO SB(％P),DLCO/VA(％P),brochiectasis or bronchial wall thickness and DLCO/VA(％P),as well as EI and FEV1/FVC,MEF5％ (％P),and MLD and FEV1 (％ P),MEF25％ (％ P)were positively related.Conclusion MDCT can be used to analyze smokers' pulmonary morphology,and the morphological features and volumetric parameters are good predictions for pulmonary function.
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Objective To explore the application value of quantitative assessment of emphysema using CT in CT subjective evaluation of normal population,and compare the quantitative parameters of emphysema among groups.Methods A total of 1 231 volunteers with negative results of subjective assessment in low dose CT screening were included in this study.The threshold of emphysema was set at -950 HU,and the total lung volume(TLV),total emphysema volume(TEV),emphysema index(EI)and 15th percentile lung density(PD15)were quantified.The presence of emphysema was defined by an EI higher than or equal to 5%.The volunteers were divided into different groups by gender and age,and the quantitative parameters were compared among different groups.Results A total of 102 cases of emphysema were detected in 1 231 volunteers,with a detection rate of 8.29%,with 76 male volunteers,accounting for 9.93%,and 26 female volunteers,accounting for 5.58%,respectively.There were statistically significant differences in TLV,TEV, EI and PD15 between genders and age groups,with TLV,TEV,EI higher and PD15 lower in male(P<0.001)and with TEV and EI higher in older than 60 years old group(P<0.001).Conclusion Quantitative assessment of emphysema using CT exhibites relatively high clinical value in CT subjective evaluation of normal population.There are statistically significant differences in the quantitative parameters of emphysema among different groups.
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Objective To assess the CT image quality of the pure ground glass nodule(pGGN)in chest phantom by using different field of view(FOV)and matrix.Methods CT(Philips Brilliance 128 spiral CT)scans were performed on chest phantom containing 9 artificial pGGNs(diameter≥5 mm)in 3 different FOV (50 mm,150 mm,300 mm ),and were reconstructed in 2 different matrix(512×512, 1 024×1 024),standard kernel.Recorded the CT values and standard deviations (SD)of the nodules and surrounding regions in different FOV and matrix,and calculated the mean standard deviation(MSD),contrast noise ratio (CNR)and signal noise ratio (SNR),then compared the difference among them.Two radiologists assessed the image quality of the pGGNs in blind method respectively,then evaluated the coherence between them using Kappa testing.Results The coherence of 2 observers was substantial or almost perfect.No significant differences were found on MSD,CNR and SNR in different FOV (P value>0.05)when matrix was kept,whereas the visibility of the nodules improved with the FOV changing smaller.And there were significant differences all on MSD,CNR and SNR by using different matrix when FOV was kept.The MSD increased and the CNR,SNR decreased in high-resolution group.The visibility of the pGGNs was not improved obviously in high-resolution group.Conclusion The image quality of the pGGN(diameter≥5 mm)won’t be changed by using smaller FOV when matrix is kept ,but the visibility will be improved with the FOV changing smaller.When FOV is kept,the MSD increased and the CNR,SNR reduced in high-resolution group,but the visibility will not be improved obviously compare to the standard resolution group.
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Objective To evaluate the value of CT perfusion imaging (CTP)for solitary pulmonary nodule (SPN)by Meta-analysis.Methods Literatures about SPN diagnosed by CTP were filtered.PubMed,EMBASE,CNKI,VIP and WANFANG databases were searched for the relevant articles.The retrieved studies were screened according to the criteria for diagnostic research published by the cochrane methods group on screening and diagnosis.The quality of the articles was accessed and the basic data in the articles was extracted.Review Manager 5.3 software was used to compare the blood volume (BV)among different nodules,to perform heterogeneity test and analyze publication bias.Results A total of 1 7 studies with 877 lesions were included in the study.The random effect model was used for the existence of heterogeneity.The result showed the BV value of malignant SPN was higher than that of benign ones.Conclusion The result indicates that there exists significant difference in BV between malignant and benign SPN.The BV value,as one of the hemodynamic parameters of CTP,can be used as the diagnostic basis of SPN.
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Objective To determine the change of bronchial artery (BA)caused by COPD and its character on CTA.Methods 43 patients with COPD were collected and divided into 4 groups according to the Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease (GOLD).10 healthy persons were collected as control group.Data of enhanced chest CT from all cases were collected.In combination with 0.625 mm thin slice reconstruction,MPR,MIP and VR,counted the number of BA (main trunk and branch),analysised characteristic change of BA in patient with COPD.Results Compared with con-trol group,quantity of main trunk of BA was increased in GOLD 2 -4 (P ≤0.05 ),and quantity of branch BA was increased in GOLD 3-4(P ≤0.05).Compared with control group and GOLD 1,morphology of BA was significantly tortuose in GOLD 3-4(P ≤0.05). Conclusion Tortuosity BA could be observed in patient with COPD.Increased quantity of BA is showed on enhenced CT and 3D re-construcion CT image with the exacerbation of the disease.Character change is significant in those serious and very serious COPD patients (GOLD 3-4).Feature of BA with COPD is different with other diseases.
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Objective To study the characteristics of DWI in nude mice models of hepatic Bel7402 tumors after treatment with adenovirus-mediated cytosine diaminase-thymidine kinase ( Ad.CD-TK) double suicide gene therapy, and then to identify whether DWI can be used for assessing curative effect of postoperative tumors.Methods Thirty nude mice models of hepatic Be17402 tumors were successfully created using cell suspension method,after the tumor grew to more than 1 cm in diameter,20 tumor models were treated by intratumoral administration of Ad.CD-TK for 3 days plus intraperitonea( i.p.) treatment with 5-Fc and GCV for the duration of the study.Then they were randomly divided into three groups during 5-Fc and GCV treatment.The remaining 10 tumor models were used as controls.MR scanning were performed in 10th day before and after tumor implantation in all models by using EPI-SE series and SENSE technology for treatment group. Tumor volumes and ADC values were calculated pretreatment and posttreatment. Cell apoptosis were determined by using TUNEL method.Analyze the change of ADC and apoptosis index (AI) in different times,t test was used for comparison the difference of AI and ADC values respectively. Results After 10 days,the tumor volumes of the treatment groups and controls were respectively (724.16 ±57.45 ) mm3,( 754.57 ± 66.84 ) mm3,with no significant difference ( t =0.488,P ＞ 0.05 ).The ADC values of the treatment groups were (0.98 ±0.11 ) × 10-3 mm2/s,the ones of the control groups were (0.68 ±0.04) × 10 -3mm2/s;AI of the treatment groups were(23.25 ±6.57)％,the ones of the control groups were (2.57 ± 0.58) ％.There were difference in both groups ( t =4.473,5.874 ; P ＜ 0.01 ).Conclusion DWI can be effectively to monitor the early pathological changes of hepatic Bel7402 tumors after Ad.CD-TK double suicide gene therapy,and provide experimental evidences for clinical application.
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Objective To explore the feasibility of low dose in MSCT thoracic angiography using Z-axis modulation. Methods The consecutive 60 patients were averagely divided into 3 groups and underwent thoracic angiography with a Toshiba Aquilion 16 scanner. The whole chest acquisition was commenced in automatic exposure control with Z-axis modulation 20-25 seconds after the contrast material was administered at the rate of 3.5-4. 0 ml/s. With the noise index (SD) as the variable, three study groups were classified as A (SD = 12) , B (SD = 15 ), and C (SD = 18 ). The mAs value per slice and the number of slices were recorded. The noises and artifacts of the axial images and the acceptability of CT angiogram were evaluated. The difference among the groups was compared by using ANOVA or nonparametric Kruskal-Wallis test. The threshold of the P value was 0. 05. Results The mean mAs value (46. 4 ± 15.6) mAs in group A was the highest but the SD value (21.6 ±7.7) was the lowest. The mean mAs value ( 37. 0 ± 13.5 ) and the SD value ( 24. 0 t 5.4 ) in group B were the mediate. The mean mAs value ( 20. 7 ±6.3) mAs in group C was the lowe(s)t but the SD value ( 30. 7 ± 6.9) was the highest ( H = 31. 390, P =0. 000). The middle slice images in all patients had the smallest mAs (40. 9,31.3,17. 1 for group A,B,C,respectively; F =9. 578, H =22. 230, F =21. 180,P =0. 000) and SD values( 16. 3, 20. 0,25.4 for group A,B,C, respectively; H = 28. 982, H = 20. 824, H = 24. 396, P = 0. 000). The acceptability of CT angiogram in all patients was excellent. The CT value of descending aorta in group A, B, and C was ( 335 ± 85 ) HU,(334 ±56)HU, and (427 ± 63 )HU, respectively. Conclusion Low dose in MSCT thoracic angiography using Z-axis modulation is feasible. We can use low dose (20 mAs, etc. ) for CT angiography when the contrast is significant.
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Objective To study the influence of traction on the blood circulation of femur head and its evaluation by DSA. Methods Using micro-catheter, transfemoral selective femoral circumflex arteriography in 22 healthy dogs was performed in unilateral hip before (Group A,n =22) and immediately (Group B,n=22) ,30( Group D,n =22) ,60(Group E,n=20) ,90( Group F,n = 10),120 (Group G,n=10) minutes during 2 kg skin hip traction, and immediately after traction removal (Group H,I,J,L and 0), and 30 minutes after traction removal with 60,90 and 120 minutes continuous traction(Group K,M and P),and 60 minutes after traction removal with 90 and 120 minutes continuous traction(Group N and Q). DSA was also performed immediately during 4 kg weight traction before continuous traction in 12 hips( Group C).Blood circulation of the femoral head was evaluated mainly by observing its perfusion and time of circulation. Femur head perfusion was assessed as good scoring 3,poor scoring 2 and extremely poor scoring 1. Femur head circulation time was assessed as normal scoring 3 .prolonged scoring 2 and remarkably prolonged scoring 1. Analysis of variance was employed for analysis of the angiographic findings between different groups.Results Good femoral head perfusion in Group A to Q was 22,0,0,0,0,0,0,22,22,1,18,0,0,8,0,0 and 1 hips respectively, poor one was 0,22,8,22,15,4,1,0,0,15,2,4,6,2,1,3 and 8 hips, respectively,extremely poor one was 0,0,4,0,5,6,9,0,0,4,0,6,4,0,9,7 and 1 hips, respectively; and normal femoral head blood circulation time was 22,0,0,0,0,0,0,22,22,1,18,0,0,8,0,0 and 1 hips, respectively, prolonged one was 0,22,9,22,15,4,2,0,0, 15,2,5,7,2,2,4 and 8 hips, respectively, remarkably prolonged one was 0,0,3,0,5,6,8,0,0,4,0,5,3,0,8,6 and 1 hips, respectively. F value of femoral head perfusion among group A and B,group B and C,group B,D,E,F and G,Group H,I,J,L and O,group K,M and P,Group N and Q was 437. 48,30. 25,29. 04,132. 69,143. 73,25.20, respectively, and their P value was all <0. 01. F value of femoral head circulation time among group A and B,group B and C,group B,D,E,F and G,Group H,I,J,L and O,group K,M and P,Group N and Q was 386. 26,31. 83,22.43,141. 94,119.69,21.68, respectively, and their P value was all < 0.01. Conclusions Traction could lead to ischemic response and circulation disorder of canine femoral head. The longer the traction time or the bigger the traction weight was, the poorer the femoral head perfusion and the longer the femoral head circulation time were, and the slower they recovered. DSA could directly reflect these changes in the femoral head with these angioarchitectural and hemodynamic indexes.
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Objective To correlate dynamic parameters at contrast enhanced CT and interstitial fibrosis grade of non-small cell lung cancer (NSCLC). Methods Twenty-nine patients with NSCLC were evaluated by multi-slice CT. Images were obtained before and at 20,30,45,60,75,90,120,180,300,540,720,900 and 1200 s after the injection of contrast media, which was administered at a rate of 4 ml/s for a total of 420 mg I/kg body weight. Washout parameters were calculated. Lung cancer specimens were stained with hematoxylin-eosin stain and collagen and elastica double stain. Spearman test was made to analyze correlation between dynamic parameters and interstitial fibrosis grade of tumor. Results Twentynine NSCLC demonstrated washout at 20 min 12. 1 (0. 32-58.0 ) HU, washout ratio at 20 minutes 15.3% (0. 3%-39.2% ), slope of washout at 20 minutes 0. 0152 %/s ( 0. 0007%/s-0. 0561%/s ).Interstitial fibrosis of 29 lesions was graded as grade Ⅰ (10), grade Ⅱ (14) and grade Ⅲ (5). There were significant correlation between washout at 20 min ( r = - 0. 402, P ＜ 0. 05 ), washout ratio at 20 min ( r =-0.372,P＜0.05), slope of washout ratio (r = -0.459,P ＜0.05) and interstitial fibrosis grade in tumors. Conclusion NSCLC washout features at dynamic multi-detector CT correlates with interstitial fibrosis in the tumor.
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Objective To compare the MSCT findings of malignant focal pulmonary ground-glass opacity nodules (fGGO) and solid nodules of 3 cm or less, and try to find specific signs in fGGO. Methods Clinical data (sex ratio, age), size of lesion and MSCT findings (shape, margin, interface, internal characteristics, adjacent structure) of 105 cases pathologically confirmed to have solid lung cancers and 48 cases with fGGO less than 3 cm were retrospectively analyzed. Differences were analyzed by using the Fisher exact test or Mann-Whitney U test. Results The male and female ratio of solid lung cancer(60:45) were higher than that of fGGO (18:30, X~2 value 5.09, P<0.05). But no differences were found in age and size of lesion (P value 0.200,0.673). For solid lung cancer, the incidence of round shape (n=101), irregular (n=4), speculation (n=60), vacuole sign (n=12) and air bronchograms (n=0) were significantly different from those of fGGO (38, 10, 19,25 and 7, respectively), and the corresponding (X~2 values were 11.48,4.07,29.70 and 22.38 respectively, P<0.05). No differences were found in lobulation, cusp angle, spine-like process, well-defined, coarse, ill-defined interface, honey-combing, pleural indentation sign and blood vessel cluster sign (there are 85,0,33,5,100,0,0,59,35 cases for solid cancer, and 42,1,15,3,45,0,2,32,16 for fGGO (X~2 values 1.00,2.20, 0.00,0.15, 4.43,1.50, 0.00, P>0.05). Conclusions Malignant fGGO and solid lung cancer manifest mostly similar MSCT features. The frequency of irregular shape, vacuole sign and air bronchograms was higher in fGGO than in solid lung cancer to some degree, but speculation is more infrequent in fGGO, which may be attribute to thepathological type and basis of tumor.
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Objective The purpose of this study was to present the characteristic features on MSCT angiography of arterial sequestration.Methods The MSCT images of 5 patients with arterial sequestration were retrospectively reviewed All patients underwent MSCT contrast-enhanced angiography.3D rendering was made to evaluate the lung parenchyma,bronchial system,and vascular anatomy.Results All S cases demonstrated the anomalous systemic artery(ASA)as an isolated and tortuous artery arising from the descending thoracic aorta,taking a sigmoid course and running along with airway,entering the basal segments of the left lower lobe.The inferior pulmonary vein(IPV)was significantly engorged.The typical AS was diagnosed in 4 patients.Its ASA intercrossed with the IPV and two branches entering segments 7 and 8 over the IPV,and two branches entering segments 9 and 10 under the IPV.The volume of involved lung shrunk with the artery markedly engorged.A characteristic avascular section was found between the pulmonary artery supplying area and the ASA supplying area,and the bronchi did not accompany the arteries.One was diagnosed atypical AS because of coexistence with bronchial atresia.Conclusion The arterial sequestration had characteristic MSCT findings.The typical type can be definitely diagnosed,but the atypical type needs further three-dimensional analysis.
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Objective To evaluate the synergistic effect of DSA and MSCTA in interventional therapy for lung cancer. Methods Interventional therapy was performed in 46 patients with lung cancer. With real time helical thin slice CT scanning, MSCTA of tumor feeding artery was performed in 26 patients. Images obtained from enhanced MSCT scanning were processed at the console workstation. Spatial anatomical characteristics of tumor feeding artery were observed by using different rotations of view. DSA study and the interventional therapy were followed up in 26 patients with lung cancer. Results All tumor feeding arteries in 26 patients with lung cancer were observed by using VR, MIP and MPR, which could exactly display the origin, course and diameter of the vessels. DSA had a high consistency with MSCTA in displaying the tumor vascularity, tumor stain, and the origin of tumor-feeding artery in the patients who received MSCTA and the interventional therapy. The number of catheter used, the dosage of contrast medium, the sequence of subtraction, the fluoroscopic time and operation time in the group with use of CTA was less than that in the group without use of CTA, and the difference between two groups was statistically significant (P < 0.05), while no significant difference in detecting feeding artery existed between two groups (P > 0.05). Conclusion The anatomical characteristics of tumor-feeding artery in patients with lung cancer can be stereoscopically and clearly displayed on preoperative routine MSCTA, providing useful information and thus making the interventional procedure more safe and effective. Simultaneous use of DSA and MSCTA is reasonable and practicable, which has synergistic effect in interventional therapy for lung cancer.
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Objective To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions(SPLs).Methods One hundred and eleven patients with peripheral SPLs were scanned using multi-slice helical CT(MSCT),and multiplanar reconstruction was performed to show the relationship between the lesion and bronchus,the diffefences between the benign and malignancy were compared by using chi-square test.Results Bronchial cutoff rate in malignant lesions(47/95,49.5%)was markedly hi er than that in benign lesions(10/42,23.8%.X12=7.896,P＜0.05),the frequency of type Ⅰ and type Ⅱ air bronchogram presented in malignant lesions(10/11.8/9)was higher than benign lesions(1/11,1/9.X2=6.975,4.818,P＜0.05),but type Ⅳ in benign lesions(12/17)was more common than that in malignant lesions(5/17.X2=7.390,P＜0.05).No significant difference was found in bronchus ran at the periphery of the lesion and bronchus dragged by the lesion between benign(9/24.1/4)and malignant lesions(15/24,3/4.X2=0.641,0.062,P＞0.05).The focal bronchial wall thickening in malignancy(21/22)was markedly higher than benign lesions(1/22.X2=4.185.P＜0.05),whereas the extensive thickening in benign lesiom(4/7)was more common(3/7.X2=8.650,P＜0.05).Conclusion CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions.
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Objective To evaluate the double-arterial phase and portal venous phase scanning in the detection of hepatocellular carcinoma with multi-slice sprial CT (MSCT).Methods Ninety-four patients with hepatocellular carcinoma were examined by abdominal plain CT and early areterial phase (EAP),late arterial phase(LAP),portal venous phase(PVP).Contrast agent of 100 ml (300 mg I/ml) was administrated intravenously by 3 ml/s,for scanning of EAP at 20 to 22 s,LAP at 34 to 37s.and PVP at 60 s.Chi-square test was carried out to compare the sensitivity among various phases.Resuits A total 0f 318 1esions was detected pathologically,with 86 lesions less than 3 cm in size and 232 lesions more than 3 cm.For the early arterial phase,late artefial and portal venous phase,the sensitivity was 39.5%(34),67.4%(58),44.2%(38)respectively for the small tumors,which showed significant differences between phases(X2=15.38,P<0.01).For the large tumors,the sensitivity was 89.6%(208),99.6%(231), 99.1%(230),respectively(X2=39.09,P<0.01).All had positive predictive values of 100%.If the tumors were taken together,the sensitivity was 76.1%(242),90.9%(289),84.3%(268).and the positive predictive value was 88.3%(242/274),86.3%(289/335),93.7%(268/286)for the early arterial phase,late arterial and portal venous phase respectively.There was significant difference of sensitivity and positive predictive value between phases(X2=25.62,9.29,P<0.05).Conclusion Double-arterial phase could improve the detection of tumors,especially for small hepatocellular earcinoma. and late arterial phase scanning is particularly important.
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Objective To investigate whether the perfusion of the solitary pulmonary nodules (SPNs) is homogeneous derived with 16-slice spiral CT and 64-sliee spiral CT. Methods Eight-five patients with. SPNs (diameter≤4 cm; 57 maliagnant;15 active inflammatory; 13 benign)underwent multi- location dynamic contrast material-enhanced serial CT. One scan was obtained every 1 seconds during 11- 41 seconds without scanning interval after injection, one scan was obtained at 90 seconds. TOSHIBA AquilionMerconi 16 : The section thickness was 8.0 mm for lesions 3.0-4.0 cm, 6. 0 mm for 2.0- 3.0 cm,4.0 mm for 1.5-2.0 cm,3.0 mm for 1.0-1.5 cm and 2.0 mm for lesions <1.0 cm. GE Lightspeed 64:The section thickness was 8.0 mm for lesions3.0-4.0 cm and 2.5 mm for <3.0 cm. Precontrast and posteontrast attenuation on every scan was recorded. The peak height , perfusion, ratio of peak height of the SPNs to that of the aorta and mean transit time of three central valid sections were calculated. The significance of the difference among groups was analyzed by means of ANOVA. Results The peak heights in three sections were ( 30.95±14.53 ), ( 25.10±13.32), (32.37±15.85) HU, respectively, the perfusions (33.01±21.35), (23.70±12.87), ( 29.00±15.47) ml·min-1·100 g-1, the ratios of peak height of the SPN to that of the aorta (13.58±6.41) %, (10.95±5.76) %, (13.64± 6.20)% and the mean transit times (11.61±5.74),(11.97±3.55), (13.44±3.74) s. Statistically significant differences were found among three sections in the peak height(F= 5.913,P=0.003), perfusion (F=6.464, P=0.002), ratio of peak height of the SPN to that of the aorta (F=5.333, P=0.005) and mean transit time (F= 3.837, P = 0.023). No statistically significant differences were found among three sections in precontrast attenuation ( F =0.032, P = 0.968). Conclusion The volume perfusion of the SPNs is inhomogeneous,it is suggested to evaluate blood flow patterns of the solitary pulmonary nodules with CT volume perfusion imaging.
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Objective To investigate the effect of gravity and lung volume on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).MethodsMagnetic resonance imaging of lung perfusion was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner(GE medical system).Five sequentially coronal slices with the gap of 3cm from dorsal to ventral(labeled as P3,P6,P9,P12,P15,respeectivly)were obtained on end respiration and the relative pulmonary blood flow(rPBF)was measured.Another coronal perfusion-weighted image of P3 slice was obtained on end inspiration.Tagging efficiency of pulmonary parenchyma with IR(⊿SI%),the rPBF and area of the P3 slice were analyzed.respectively.Paired Student's t test was used for statistical analysis.Results(1)In the direction of gravity,an increase in rPBF of the gravity-dependent lung was found.rPBF of right lung from dorsal to ventral were 100.57±18.22,79.57±12.36,61.65±11.15,48.92±9.96,41.20±9.88,respectively；and that of left lung were 106.61±26.99,78.89±11.98,64.00±13.64,51.27±8.95,43.04±12.18.No statistical differences between P12 and P15,there were significant statistic differences of any other two coronal planes.But along an isogravitational plane,no statistical difference was observed.Regression coefficients of right and left lung were -4.98 and -5.16,respectively.This means the rPBF of right lung falls by 4.98 for each centimeter above the dorsal and that of left lung falls by 5.16.(2)For(⊿)SI%,rPBF and area,there were significant statistic differences at different respiratory phases(P＜0.05).(⊿)SI%,rPBF,area at expiration phase vs.inspiration phase were 1.12±0.31 vs 0.71±0.18,90.78±17.35 vs 52.85±8.75,(12.59±3.23)×103mm2 vs (17.77±4.24)×103mm2 for right lung;and 1.01±0.24 vs 0.70±0.11,91.08±18.68 vs 54.58±10.70,(12.34±3.08)×103mm2 vs(17.34±4.98)×103mm2 for left lung.Greater (⊿)SI%and increased perfusion were observed on end expiration than on end inspiration.The area was larger on end inspiration than on end expiration.ConclusionsThe FAIR is sensitive to perfusion changes in the gravity-dependent lung.Pulmonary blood flow is less in a state of high lung inflation than in a low state(inspiration vs.expiration).Positioning the patient so that the area of interest is down-gravity and breath-hold on end expiration may improve visibility of perfusion defects.
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Objective To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stenting. Methods The average time duration from transplantation to the on set symptom of TRAS was 6.9 months (3 - 18 months) in 35 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed through contralateral femoral or left brachial approach with ordinary balloon (5 F, length 20 ～ 30 mm) and / or small balloon catheters (2. 6 F, length 36 mm) in all patients, and stents were embedded in 11 of them. Results A total of 46 PTA were successfully performed (1 time, 20 cases; 2 times, 12 cases, and 3 times, 3 cases) via contralateral femoral approach (26) and left brachial approach (15). Stenosis were significantly decreased from 75% ～ 98% pre-PTA to 10% ～ 30% post-PTA.Systolic pressure decreased from 170 mmHg (150 ～ 210 mmHg) pre-PTA to 135 mmHg (100 - 190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90 - 145 mmHg) to 85 mmHg (80 - 125 mmHg) respectively. Restenosis rates were 39% after first PTA and 15% after the second time. All 46 times of PTA used 26 ordinary balloon catheters and 20 microballoon catheters. 8 self-expandable stents (Wallstent) and 3 balloon-dilatation stents (Palmaz) were released in 11 cases. There were healed case (n = 11) , melioration (n = 15), improvement (n = 7), and inefficiency (n = 2) after follow - up of 23 months (3 - 60 month). No complication occured except puncture site hematoma via the brachial artery approach in 1 case. Conclusions PTA is safe and effective in the treatment of TRAS and high rate of procedure success may be achieved with the help of brachial approach and micro-balloon catheter.Reasonable use of stents is beneficial in decreasing the restenosis.
