Diagnostic value of 1.5T MRI for analyzing left ventricular structure and cardiac function in dilated cardiomyopathy / 重庆医学

Objective To investigate the diagnostic value of 1.5T magnetic resonance imaging(MRI) in the left ventricular structure and cardiac function of the patients with primary dilated cardiomyopathy(IDCM).Methods Sixty-seven patients with ID-CM(IDCM group) in this hospital from January to December 2016 were selected and contemporaneous 45 healthy volunteers served as the control group.The left ventricular structure parameters[end diastolic diameter(EDD),end systolic diameter(ESD),densifying thickness (C),trabecular thickness (NC),interventricular septal basement thickness (IVS),short axis shortening rate (△D),wall thickening rate(△T)],and cardiac function status[left ventricular end diastolic blood volume(EDV),end-systolic blood volume (ESV),ejection fraction(EF),stroke volume(SV) and cardiac output(CO)] were analyzed in the two groups.Results The levels of NC,NC/C,IVS,EDD,ESD,TDD,ESV and EDV in the IDCM group were higher than those in the control group,while C,C/IVS,△D,△T,MM,TSD,CO,EF and SV were smaller than those in the control group,except for C and IVS,the difference in the intergroup comparison was statistically significant(P＜0.05).In the IDCM group,compared with the grade Ⅰ-Ⅱ,ESV and EDV in the grade Ⅲ and Ⅳ were cncreased,while SV,CO and EF decreased,the difference statistically significant(P＜0.05).With the grade increase and ESV and EDV values were increased,SV,CO and EF were decreased,the difference had statistical significance (P＜0.05).Conclusion MRI can early analyze the left ventricular structure parameters and cardiac function status in the patients with IDCM,and can pre-judge the heart function situation effectively and qualitatively.

Differential diagnosis of vater ampulla carcinoma with MRI combined sequence examination / 实用放射学杂志

Objective To investigate the value of multiple sequential MRI in the differential diagnosis of vater ampulla carcinoma (VPC).Methods MRI data of 53 patients with VPC confirmed by surgery and pathology were analyzed retrospectively,which included 17ampullary carcinomas,15 pancreatic head carcinomas,10 duodenal papillary carcinomas and 11 distal common bile duct carcinomas.All patients underwent routine MRI plain scan,MRCP and multi-phase dynamic enhancement scan for the upper abdomen.The morphological characteristics and model of multi-phase dynamic enhancement of the tumor,and the morphological changes of pancreaticobiliary duct were focused,and relevant data were also measured.Results The differences of tumor size,central location,and signal homogeneity among the four different histological types showed statistical significance(P＜0.05),and their patterns of multi-phase dynamic enhancement also had differences.Double-segment sign was most found in VPC (26/53),four-segment sign was easy showed in pancreatic head carcinoma (8/15)and three-segment sign in distal common bile duct carcinoma (8/11).Beak sign was common seen in ampullary carcinoma(10/17),rat-tail sign was easy discovered in pancreatic head carcinoma (7/15) and truncated sign in distal common bile duct carcinoma(10/11).Diameter of major pancreatic duct in pancreatic head carcinoma was maximum and minimum in distal common bile duct carcinoma,and their difference had statistical significance(P＜0.05).Distance between obstructive end of bile common duct and major papilla of duodenum,and between obstructive end of major pancreatic duct and major papilla of duodenum as well as the pancreaticobiliary conjunction angle in pancreatic head carcinoma and distal common bile duct carcinoma were greater than that in ampullary carcinoma and duodenal papillary carcinoma.Conclusion MRI can prominently demonstrate various imaging characteristics of VPC with different histological origins.It is very valuable in the differential diagnosis of VPC with different histological types by comprehensive analysis of these findings.

Comparative Study for Diagnostic Value Between Dual Energy CT Lung Perfusion Imaging and CT Pulmonary Angiography in Patients With Pulmonary Embolism / 中国循环杂志

Objective: To explore the value of dual energy CT lung perfusion imaging (DEPI) for diagnosing pulmonary embolism (PE) in comparison with CT pulmonary angiography (CTPA). Methods: There were 49 patients with suspected PE received DEPI scanning and 19 with CTPA conifrmed diagnosis were enrolled in this study. CTPA image was obtained by 80 kv data, and DEPI image was obtained by PBV software. The location, type of PE in CTPA image, and the location, shape of perfusion defect in DEPI were observed and compared by segment basis. The correlation and agreement of CTPA and DEPI for diagnosing PE were calculated and the un-agreement was analyzed. Results: A total of 380 segments were included for analysis. CTPA detected 162 segments of PE and DEPI detected 155 segments of perfusion defect or reduction, partial PE were mainly presented by perfusion defects as speckles, patches or without perfusion defect, and complete PE were mainly showed segmental or sub-segmental perfusion defects. CTPA and DEPI were correlated for PE diagnosis (χ2=305.5,P=0.000), the diagnostic agreement was 83.42% and KAPPA value was 0.659. Conclusion: The perfusion defect in DEPI is related to the degree and type of PE presented in CTPA, their combination is helpful for diagnosing PE.

Clinical value of dual-source CT angiography in diagnosis and following-up observation after endovascular exclusion of Stanford type B aortic dissection / 实用放射学杂志

Objective To investigate clinical value of dual-source CT angiography (DSCTA)in diagnosis and following-up obser-vation after endovascular exclusion (EVE)of Stanford type B aortic dissection (AD).Methods 63 cases with type B aortic dissection were diagnosed by DSCTA,and 24 cases among these cases underwent EVE were following-up observed by DSCTA.Imaging recon-struction and analysis were finished at special workstation.All CT findings of dissection were carefully observed in every case,CT values of true and false lumens were measured at arterial-phase.The length and the width of proximal neck,and the maximum di-ameter of AD were measured in those cases that initial crevasse located at aortic arch or proximal descending thoracic aorta.The out-comes and complications of 24 cases underwent EVE were focused.Results The extension of dissection,the site of crevasse,mor-phological features of true and false lumens and tearing intimal flap,and involving main branches of aorta were accurately shown by DSCTA.Average CT value of true lumen was higher than false lumen at arterial-phase in all cases (P=0.000).In 60 cases that ini-tial crevasse located at aortic arch or proximal descending thoracic aorta,the length and the width of proximal neck of dissection changed from 0.3 cm to 9.6 cm(average 3.4 cm)and from 2.3 cm to 3.8 cm(average 2.9 cm)respectively,and the maximum di-ameter of AD was between 3.1 cm and 9.0 cm(average 5.3 cm).AD after EVE did not unceasingly enlarge in all 24 cases,false lu-men shrinked in 1 1 cases,thrombus in false lumen added in most cases,stent endoleaking were observed in 1 1 cases.Conclusion DSCTA with convenient,effective and non-invasive advantages,is one of important imaging methods in diagnosis and following-up observation after EVE of type B aortic dissection.

Comparative analysis of dual resource computed tomography angiography and 3.0T magnetic resonance angiography in the diagnosis of intracranial aneurysms / 生物医学工程学杂志

To comparatively study the diagnostic value of dual resource computed tomography angiography (DSCTA) and 3.0T magnetic resonance angiography (MRA) for intracranial aneurysm, we analyzed retrospectively radiographic data of DSCTA, 3.0T MRI and three dimensional digital subtraction angiography (3D DSA ) in cases suspected intracranial aneurysms during Jan. 2010 to Dec. 2011. With 3D DSA as "gold standard", the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DSCTA and 3.0T MRA in diagnostic of intracranial aneurysms were analyzed, and the accuracy of both methods on evaluation of aneurysms size was compared as well. Totally fifty-three suspected cases were included, and forty-two intracranial aneurysms in thirty-five cases were identified by 3D DSA. For DSCTA, 37 aneurysms were detected in 32 patients, and 3 patients and 5 aneurysms were missed in all patients. However, for 3.0 T MRA, 33 aneurysms were detected in 33 patients, 5 patients and 8 aneurysms were missed, and 3 patients who did not have aneurysms were misdiagnosed as ones with intracranial aneurysms. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DSCTA and 3.0T MRA were 91.4% vs. 85.7%, 100% vs. 83.3%, 100% vs. 90.9%, 85.7% vs. 75.0% and 94.3% vs. 84.9%,respectively. There was no significant difference in evaluation of aneurysms size between using the two methods. Data suggested that both DSCTA and 3.0T MRA had high accuracy for detection intracranial aneurysms and evaluation of aneurysms size, but as for detection of microaneurysms, DSCTA was superior to 3.0T MRA.

Abdominal CT scan in predicting complications of acute pancreatitis / 中华普通外科杂志

Objective To evaluate abdominal CT scan in predicting complications and mortality of acute pancreatitis patients. Methods CT imaging data of 606 AP patients from June 2010 to October 2011 were analyzed retrospectively. Fatty liver, pleural effusion, suprahepatic space effusion, biliary tract disease,gastric bare area involvement (GBAI),adrenal gland involvement (AGI) and perirenal space involvement (PSI) were evaluated,and the relationship between CT findings and complications and mortality was analyzed. Results (1) The Logistic regression analysis showed six risk factors for complications of AP,including obesity,fatty liver,PSI,AGI,GBAI and suprahepatic space effusion.The sensitivity,specificity and accuracy of Logistic regression model for predicting complications were 81.3％,89.1％ and 85.3 ％,respectively. (2) The Logistic regression analysis showed four risk factors for mortality of AP,including obesity,AGI,GBA and suprahepatic space effusion.The sensitivity,specificity and accuracy of Logistic regression model for predicting mortality were 33.3％, 98.6％, 96.0％, respectively.Conclusions Abdominal CT scan effectively indicates the signs of tissue and organ involvement in AP.These CT findings relate with the prognosis of AP.

Imaging findings of Bachmann bundle and its arterial supply on dual-source CT coronary angiography / 中华放射学杂志

Objective To investigate the morphologic features of Bachmann bundle (BB) and its vascular supply on dual-source CT coronary angiography(DSCTCA) in healthy volunteers and patients with coronary artery lesion (CAL). Methods Clinical histories, electrocardiograms (ECGs), and images of DSCTCA of 106 patients ( CAL group) and 100 healthy volunteers ( Control group) were reviewed. All 106 patients underwent conventional coronary angiography ( CCA ). The Gensini scoring system was used to assess the results of CCA. The patients were divided into three groups according to their Gensini scores. The length, width and superoinferior diameter, CT value, and vascular supply of BB were studied. Rank sum test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results ( 1 ) BB visualization rate of control group was higher than CAL group [86.0% (86/100) vs 51.9%(55/106), x2 = 27.726, P ＜ 0.01]. The higher the Gensini score of CAL subgroup, the lower the visualization rate of its BB [80.0% ( 28/35 ), 55.6% ( 20/36 ), 20.0% ( 7/35 ), x2 = 25.530, P ＜ 0.01].(2)The median of measurements of length,width and superoinferior diameter of control and CAL group were 13.0 vs 13.8,5.0 vs 5.2 and 5.9 vs 6.2 mm, respectively ( P ＞ 0.05 ). (3) The CT value of the BB region in control group( median :42.6 HU ) was higher than that of CAL group( median: 13.0 HU) ( Z = - 7.061, P ＜0.01). The CT values of BB regions in patients with nonvisualized BB (median: -16.0 HU) were lower. The CT values of the BB regions in CAL group were negatively-correlated with Gensini scores( median:19.0) (r = -0.553, P ＜0.01 ). (4)The blood supply of BB and BB region was provided by right sinuatrial node artery ( SNA, 58.7%, 121/206 ), left SNA ( 35.9%, 74/206 ) or both SNAs ( 5.3%, 11/206 ).Conclusions DSCTCA could can show the anatomical characteristics of BB and its arterial supply. The serious the degree of CAL , the lower the BB display rate, and the higher the abnormal ECG incidence,which indicate that the occurrence of BB lesions is probably related to ischemia.

Clinical application of 64 multi-slice CT angiography for the follow-up of endovascular stent-graft exclusion / 中华放射学杂志

Objective To investigate the clinical applications of 64-MSCTA for the follow-up of endovascular stent-graft exclusion (EVE). Methods Between Oct 2006 and Feb 2008, forty-four 64-MSCTA examinations were performed in 30 patients with aortic dissection (AD) and 5 patients with abdominal aortic aneurysm (AAA) who underwent EVE. Imaging reconstruction including MPR, MIP and VR were finished on workstation. The outcomes and complications after EVE of aortic dissection and aortic aneurysm were evaluated. Results (1) Of 30 patients with aortic dissection, large thrombosis in false lumen was observed in 28 cases and small thrombosis in 2 cases. The cavity of aortic aneurysm outside the stent was thrombosed completely in 5 patients with AAA. (2) Thrombosis in the innominate artery on follow-up CTA after EVE was found in 1 AD patient with the innominate artery involved, Thrombosis in the superior mesenteric artery was observed on 15 days follow-up CTA but thrombolysis on 3 months after EVE in 1 case, lntimal tear in right common iliac artery was found in 1 case. Of 5 patients with AAA, occlusion of right inner iliac artery was observed in 1 case, and instent thrombosis in distal right common iliac artery was found in 1 case. (3) Endoleak was found in 14 patients with AD, including 8 with type Ⅰ and 6 with type Ⅲ endoleaks, one type Ⅲ endoleak was disappeared on follow-up CTA after 3 months. Conclusions 64-MSCTA with fast, non-invasive and effective merits, combining multiple reconstructive methods, has become one of preferred imaging methods in post-operative evaluation of EVE.

Diagnostic Value of Low-field MR Imaging in Lumbar Disc Degeneration with End-Plate Osteochondritis / 实用放射学杂志

Objective To investigate the diagnostic value of low-field MR imaging in lumbar disc degeneration with end-plate osteochondritis. Methods Imaging data of 504 patients with lumbar disc degeneration diagnosed by MRI were retrospectively analyzed. Among these cases, the total of 330 end-plate osteochondritis in 148 patients was found. According to MR signal findings of end-plate and it's adjacent vertebra, the lesions were classified as 4 types. Results 330 end-plates were involved in 148 patients,including type I in 68(20.6%),type II in 53(16.1%),type III in 174(52.7%) and type IV in 35(10.6%).Among all 148 patients,the end-plates at one lumbar disc,two disci and over three disci involved in 98(66.2%),42(28.4%) and 8(5.4%),respectively.The lesions were usually found in the lower lumbar vertebra.Conclusion MR imaging could accurately show the end-plate osteochondritis and degenerative lumbar disc.

MR urography of ectopic ureter orifice in children / 生物医学工程学杂志

To elucidate the MR urography (MRU) features of ectopic ureter orifice in children and to explicate its advantages, the clinical data and MRU findings of 4 cases with ectopic ureter orifice were analyzed retrospectively. Among the 4 cases of ectopic ureter orifice, 2 were associated with dysplasia of kidneys, 1 was associated with duplex kidney, and the remaining 1 was associated with cross ectopic and dyplasia kidney. When combining the MRI and MRU examination, we could diagnose the ectopic orifice of the draining ureters. So we concluded that definitive diagnosis could be achieved in most of the cases by integrating clinical information with MRU findings.

Analysis of Multi-Detector-Row Spiral CT Signs in Inflammatory Diseases in Retroperitoneal Space / 中国普外基础与临床杂志

Objective By using multi detector row spiral CT (MDCT), to investigate the CT imaging features of inflammatory diseases in retroperitoneal space with correlation of radiological anatomy.Methods The clinical and laboratory dada of 30 patients with proven inflammatory diseases of retroperitoneal space were collected. All patients underwent MDCT plain scanning and portal venous acquisition. CT imaging data generated at portal venous phase were processed with coronal, sagittal and oblique multi planar reformation (MPR) technique.Results Acute pancreatitis and various types of renal infection were the two main sources of retroperitoneal inflammation. Depending on the specific anatomic locations, retroperitoneal inflammation of different subspaces demonstrated characteristic imaging features. Spreading of inflammatory process across subspaces was also quite common.Conclusion MDCT is the imaging method of choice to depict comprehensively and clearly the inflammatory diseases of various retroperitoneal spaces.

Fatty Replacement of Pancreas:CT Appearances and Clinical Significance (Report of 3 Cases) / 中国普外基础与临床杂志

Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes (one had chronic cholangitis with choledochal lithiasis), another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.

Demonstration of Collateral Cavernous Vessels of Portal Vein by Multi-Detector-Row Spiral CT Angiography / 中国普外基础与临床杂志

Objective To investigate the appropriate reconstruction techniques of multi-detector-row spiral CT angiography (MDCTA) to depict the collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor thrombosis of hepatocellular carcinoma (HCC). Methods MDCTA scanning was performed during the portal venous phase after intravenous contrast materials in 18 HCC patients with CTPV induced by tumor thrombosis. Raw data were reconstructed with thin slice thickness followed by 2D and 3D angiographic reconstruction methods, including maximum intensity projection(MIP), shade surface display (SSD) and volume rendering technique(VRT). Results MDCTA with MIP reconstruction accurately depicted both the tumor thrombus within the portal vein and the collateral vessels of CTPV including the biliary (cystic vein and pericholedochal veinous plexus) and the gastric (left and right gastric veins) branches. However, VRT and SSD methods did poorly in showing the tumor thrombus and the collateral vessels. Conclusion MDCTA with MIP reconstruction is the method of choice to evaluate the collateral vessels of CTPV.

CT Appearances of Mesenteric Tumors and the Differential Diagnosis / 中国普外基础与临床杂志

Objective To review the CT appearances and important differential diagnoses of various primary and secondary mesenteric neoplasms.Methods By describing the mesenteric anatiomy and major routes for the dissemination of metastatic mesenteric tumors, the article presents both the common and rare types of various primary and secondary mesenteric neoplasms, and addresses the characteristic CT appearances and important aspects of the differential diagnosis.Results CT study, especially the multi-slice spiral CT (MSCT), along with the clinical history and other related information, can nicely depict various mesenteric tumors and well differentiate them from infectious, inflammatory or vascular processes affecting the mesentery.Conclusion CT is the imaging method of choice for the evaluation of tumors of small bowel mesentery.

Preoperative Imaging Evaluation of Donors and Recipients in Liver Transplantation / 中国普外基础与临床杂志

Objective To review the various imaging modalities and their appropriate applications in the preoperative evaluation of both donors and recipients in liver transplantation (LT). Methods All the relevant literatures were reviewed. Different kinds of imaging modalities have been used in potential LT donors and recipients to assess the volume, the parenchyma and the vasculature of the liver, the biliary system, and the extrahepatic region of the upper abdomen and beyond. The techniques, the imaging findings, and the merits and shortcomings of various imaging modalities were presented.Results Traditional imaging techniques are still of valuable, while CT can provide rich and accurate information. "One-stop" comprehensive MR examination is emerging as the method of choice for the preoperative evaluation LT recipients and donors. Conclusion Each imaging method has its merits and limitations. Those imaging methods which can provide accurate and comprehensive information are likely to have better application future.

Value of MR Imaging with Contrast-Enhanced Multi-Phasic Isotropic Volumetric Interpolated Breath-Hold Examination in Diagnosing Primary Liver Carcinoma / 中国普外基础与临床杂志

Objective To evaluate the value of MR imaging with a contrast enhanced multi phasic isotropic volumetric interpolated breath hold examination (VIBE) in diagnosis of primary liver carcinoma. Methods Thirty two consecutive patients with surgical pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two dimensional (2D) T1WI and T2WI images were acquired before administration of Gd DTPA for contrast enhancement. Then, contrast enhanced multi phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results 33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non enhanced T1WI, enhanced T1WI and enhanced 3D VIBE images ( P

Clinical Value of Magnetic Resonance Cholangiopancreatography in Evaluation of Extrahepatic Biliary Obstruction / 中国普外基础与临床杂志

Objective To evaluate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosis of extrahepatic bile duct obstruction. Methods MRCP images of 42 patients presented clinically with obstructive jaundice were retrospectively reviewed to assess the lumen morphological abnormalities of benign versus malignant bile duct obstructions, with clinical pathological correlation. Results The bile duct of the 30 cases of benign biliary obstruction presented regular and symmetric dilation, gradual tapering,regular thickening and had a “beak like” tip. The accuracy of MRCP for evaluating the site and the etiology of the benign biliary obstruction were 100%(30/30) and 97%(29/30) respectively. The bile duct of the 12 cases of malignant biliary obstruction presented irregular and asymmetric dilation,abrupt narrowing or iterruption,irregular thickening and had “dual duct sign”. The accuracy of MRCP for evaluating the site and the etiology of the malignant biliary obstruction were 100%(12/12) and 92%(11/12) respectively. Conclusion MRCP is the noninvasive technique of choice with excellent accuracy for the evaluation of obstructive biliary pathology.

The Value of Low-field MR Imaging in Diagnosing Avascular Necrosis of the Femoral Head / 实用放射学杂志

Objective To analyze MR imaging findings of avascular necrosis of the femoral head(ANFH)with low-field MR unit.Methods MRI appearances of 35 cases of ANFH confirmed by clinical or pathology were analysed.Results There were 56 hips with "line sign" in 35 cases(58 hips)including "single line sign" in 18 femoral heads and "double line sign" in 38,and there were 2 hips without "line sign".Twenty-six femoral heads had marrow edema.According to Mitchell's grade:there were 15 hips in A grade,21 hips in B grade,13 hips in C grade and 9 hips in D Grade.Conclusion Low-feild MR imaging is of significant value in diagnosing ANFH early.