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Objective To explore the CT features of gastrointestinal tract diospyrobezoar and its complications,to improve the recognition. Methods The plain CT scan of 36 patients with gastrointestinal tract diospyrobezoar confirmed by gastroscope and surgery were analyzed retrospectively.Results The number and location of diospyrobezoar showed by CT were consistent with the results of gastroscope and surgery.There were 1 1 cases of stomach diospyrobezoar,1 9 cases of small intestine diospyrobezoar,and 6 cases of stomach and small intestine diospyrobezoar.32 cases were solitary lesion,and 4 cases were multiple lesions.A total of 41 diospyrobezoars were removed, most of which were wel-l defined ovoid mass.3 1 lesions presented mottled internal gas bubbles with high-density encapsulating wall.6 lesions showed mottled gas pattern without encapsulating wall.4 lesions showed uneven high density.Over time,1 lesion moved in the digestive tract and the boundary and density were changed.Complications:gastric and duodenal diospyrobezoar accompanied by gastric retention,which manifested as a significant expansion of the gastric cavity effusion.Small intestine diospyrobezoar was accompanied by small bowel obstruction,which showed that the proximal intestinal tube of the diospyrobezoar was obviously dilated,and the distal intestine was suddenly collapsed.There was a focal transition zone between them.Conclusion Gastrointestinal tract diospyrobezoar has a variety of CT manifestations,of which oval shape,clear boundary,uneven mass composed of gas and soft tissue are common.
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Objective To explore the CT manifestations of primitive neuroectodermal tumor (PNET) of adrenal gland,aiming to increase the cognition on this disease.Methods The CT manifestations of 7 patients who were pathologically diagnosed with adrenal gland PNET were analyzed retrospectively.Results The age of patients was 24-63 years old,with average age of (47.6±13.7) years,including 6 females and 1 male.Location of PNET:4 in left adrenal gland and 3 in right adrenal gland.Clinical manifestations:3 cases had upper abdominal distension,2 cases suffered from pain of waist and back,1 case was discovered in physical examination and another 1 had fever.No abnormality was found in laboratory and endocrinological examinations.After operation,4 cases had recurrence and 2 had distant metastasis.During follow-up,6 patients died and only 1 still alive.CT showed that the tumor,whose maximum diameter was 10.1-19.4 cm,was elliptic or lobulated in shape.The tumor was clear in boundary in 2 patients,but was unclear in boundary and involved adjacent organs in 5 patients.The plain scanning showed equidensity or slightly low density,complicated with necrosis and cystic lesions without calcification.The enhanced scanning suggested progressive uneven enhancement,with multiple interatrial septum-like changes and latticed enhancement inside.Conclusion CT manifestations of adrenal gland PNET can prompt the diagnosis,pathological examination is still required for confirmation.CT can accurately describe the internal structures,adjacent relationship and the metastasis of tumors.
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Objective To investigate the imaging findings of giant cell glioblastoma(GCG).Methods Imaging findings of 8 cases with pathology-confirmed GCG were retrospectively reviewed and correlated with pathologic findings.Results All of the 8 cases were located in the cerebral hemisphere.On CT images, 1 lesion case was shown appeared as mixed density,4 lesions were shown as cystic and solid mass.Mural nodule were slightly hyperdense.On MRI images, all of 4 cases lesions were hypointensity on T1WI, mixed signal intensity or hyperintensity on T2WI and FLAIR, low signal intensity on DWI.The lesion showed nonuniform enhancement,with enhanced mural nodules and cyst walls,and mildmoderate or no peritumoral edema.Microscopically, the cells were arranged in perivascular pseudorosettes to form palisades.Cellular pleomorphism was a typical feature, including monstrous and multinucleated giant cells.Mitotic figures were usually numerous.Reticulin was abundant in the stroma.Immunohistochemistry showed staining for S-100, Vim, p53, GFAP.The proliferation rate determined by Ki-67 immunohistochemistry was 30%.Conclusion GCG has certain imaging characteristics,CT and MRI are effective in detecting the disease.
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Italian medical imaging education includes two parts: training for radiologists and for radiologic technologists. To be a radiologist, the six-year medical students after graduation must complete specialty training in radiology and pass the examination. Radiologic technologists are selected from the three-year bachelor graduates of medical imaging technology. There are basic medical science courses, cultural practice and clinical practice in medical college every year. Continuing medical imag-ing education includes lectures, case discussions and other forms. Radiologists are required to master all kinds of imaging techniques, working as clinical rotation in every section of medical imaging depart-ment. Patients need to make an appointment before having the medical imaging examination. Through the analysis of the characteristics of Italian medical imaging teaching and clinical patterns, the author puts forward the suggestion of putting emphasis on medical imaging curriculum reform, the full imple-mentation of the early clinical contact, and at the same time improving the professional medical image training mode to improve the radiologists' clinical ability.
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Objective To study the value of the application of 320-row detector dynamic volume CT in diagnosis of complicated congenital heart diseases(CCHD).Methods Datas of 43 cases with CCHD,who examined by ECC-gated 320-row CT angiography (CTA)as preoperative examinations were collected.All the CT data were processed by combined application of multi-imaging post-processing technique to show the anatomic malformation based on segmental analysis,and were compared with the transthoracic ech-ocardiography (TTE )and surgical results .Results 1 97 various malformations were found in 43 cases and proved by operation, among which there were 87 intracardiac malformations,the diagnostic accuracy with CTA and TTE were 86.2%,89.7%,and there was no obvious difference between them(P >0.05 ).1 10 extracardiac malformations (including connection malformations between heart and vessels,extracardiovascular malformation,bronchial or other nonvascular structure malformation)were found ,the accura-cy with CTA and TTE were 91.8% and 76.4%,the former was superior to latter (P <0.05)Conclusion 320-row detector dynamic volume CT in diagnosis of CCHD has very important meaning and practical application value,should be used as the significant choice for clinical diagnosis of CCHD.
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Objective To study the value of diffusion weighted imaging (DWI)in Marchiafava-Bignami disease.Methods (1)12 cases of Marchiafava-Bignami disease (MBD)patients with 6 month follow-up and 12 hedthy adults were clone MRI DWI;(2)MR imaging characteristics of 12 patients were observed on the corpus callosum and the other gray-white matters;(3)The ADC values of the central part and marginal area of the corpus callosum and the other gray-white matters were measured,data analysis were carried out completely by random design.Results Hyperintensity on the corpus callosum were showed in 12 patients on DWI,typical“sandwich sign”was seen on the sagittal T2 WI in 1 1 cases,and gray-white matters beside the corpus callosum were involved other in 6 cases;The ADC values of central and marginal area of the corpus callosum and the other gray-white matters had significant differ-ence between the improved clinical symptom group and,unimproved clinical symptom group and the control group (P < 0.05 ). There were no significant differences in the ADC values for the other white matters.Conclusion DWI can be used to reflect the change of MBD.Low ADC values in the corpus callosum and cortex are associated with a poor prognosis.
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Objective To explore the MRI diagnostic value for pernicious placental abnormalities.Methods MRI findings of 1 5 patients with pernicious placenta previa were retrospectively analyzed after cesarean section.Results Among all cases,total placenta previa was,1 1 cases and partial placenta previa was 4 cases.The placenta located in the anterior wall in 8 cases,posterior wall in 4 cases,lateral wall in 3 cases.4 cases were diagnosed as normal placenta,6 cases as adhesion,4 cases as implanted,and 1 case as penetrating.These cases had certain special MR features.Conclusion MRI is helpful in diagnosing the location and type of the perni-cious placenta,and showing whether complicated with previa implantation and penetrating.
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Objective To observe clinical significance、anatomy and variation of normal internal cerebral veins and their tributa-ries.Methods The studies included 284 sides in 142 patients.The patients were performed with 320-detector Row CT One-stop Scanning.Then,the anatomical features of internal cerebral veins and their tributaries were evaluated.Results The detection rate of internal cerebral veins(ICA)、thalamostriate veins(TSV)、septal veins(SV)、anterior caudate nucleus veins、posterior caudate nucleus veins and lateral direct veins was 100%、100%、98.9%、95.4%、93.7%、48.6%.Type of IA was seen frequently in four types of ICA,the parts of ICV and their tributaries were mirror symmetry,the majorities of ICA were located the same plane.Anterior cau-date nucleus veins were classified four types on basis of these different draining patterns,they were drained to TSV commonly.There was no significant difference between venous angle or false venous angle and type of their draining(P>0.05).There was significant difference between detection rate of lateral direct veins and development of posterior caudate nucleus veins(P<0.05).Conclusion 320-detector Row CT One-stop Scanning was an important method that internal cerebral veins were detected effectively and non-inva-sively,observed anatomy,course and morphological change of ICV.
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Objective To evaluate the value of 64-slice spiral computed tomography angiography(CTA) in diagnosis of acute severe chest pain caused by vascular diseases.Methods 34 cases with acute severe chest pain caused by vascular lesions confirmed clinically underwent CTA examinations.The images were processed with multi-planar reconstruction,maximal intensity projection,curved planar reconstruction and volume rendering,then the imaging features were analysed.Results CTA showed acute aortic dissection in 13 cases,acute pulmonary embolism in 9 cases and acute coronary syndrome in 12 cases,all cases were confirmed by clinic.Conclusion 64-slice CTA has very important practical value in diagnosis of acute severe chest pain.
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Objective To explore the relationship between the classification and imageology,the dynamic changes of bronchoscopy and CT features of endobronchial tuberculosis(EBTB).Methods CT findings and bronchoscopic findings in 48 cases with EBTB proved by sputum culture , bronchoscopic biopsy and surgical pathology were analyzed.The classification,dynamic changes and CT characteristics were also evaluated.Results Bronchoscopic results showed 13 of edematous-hyperemic type, 8 of caseous nocrosis type, 5 of fibrostenotic type, 2 of tumorous type, 6 of granular type, 7 of ulcerative type and 7 of mixed type. CT manifestations in different types were intersected,including thickened bronchial wall (64.6%) , bronchial stenosis (41.7%) , aerated bronchus sign ( 37.5% ) ,intra-luminal nodules ( 25% ), bronchial structure with obstructive atelectasis ( 37.5% ) and pneumonia (25% ) .The corresponding rate between bronchoscopy and CT was 83.3% in detecting diseases.19 cases were followed-up by bronchoscopy during the initial 1~5 months of treatment,and 12 cases (3 edematous-hyperemic,4 caseation,3 ulcerative,2 mixed type) were resolved or healed without sequelae,6 cases changed into the other type,4 cases changed into the fibrostenotic type, 2 cases remained in a fibrostenotic state in spite of drug therapy.28 cases were followed-up by CT during the initial 1~5 months of treatment, and 20 cases (6 edematous-hyperemic,4 caseation,3 ulcerative, 1 granular,2 fibrostegnotic 1 tumorous,3 mixed type) were improved,6 cases changed into the other type,2 cases turned into the fibrostenotic type, 2 cases did not improve despite antituberculosis chemotherapy.CT correlated well with fibrobronchoscope(88.5%) in predicting the therapeutic outcome of EBTB.Conclusion CT as a non-invasive method has high clinical value in observing the evolution , predicting the complications and evaluating the therapeutic effect of EBTB.
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Objective To explore the characteristics of MR perfusion imaging in normal pancreas and pancreatic cancer.Methods 20 cases of normal pancreas(without pancreatic diseases)and 20 cases with pancreatic cancer,underwent MR perfusion imaging using PHILIPS 1.5T unit with T1WI 3DFFE.12?4 collimation, 4 mm slice thickness ,20ml Gadopentetic Acid Dimeglumine 0.5mmol/ml Magnevist were used, the flow rate was 3.5 ml/s with a power injection,5 seconds delay,and data acquisition lasted for 90 seconds.These data were processed on a View Forum workstation using MR Brest Imaging(in Qualitity Analysis)software package ,and the mean maximum relative enhancement,wash in rate, wash out rate, time to peak, time of arrival and area under the curve were measured and statistically analyzed.Results The data of perfusion imaging in normal pancreas and carcinous pancreas were as followed respectively:maximum relative enhancement 95.69% and 50.74%,wash in rate 19.511/s and 4.471/s,wash out rate 26.051/s and 19.151/s,time to peak 31.33 s and 106.84 s,time of arrival 20.53 s and 64.70 s,area under the curve 15924.56 ml/(min? kg) and 5542.85 ml/(min ?kg).t-test showed that the difference of the perfusion data between normal pancreas and carcinous pancreas were significant(P
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Objective To evaluate the possibility and efficiency of early lung cancer screening using low-dose spiral CT,and to investigate the effects of prognosis of lung cancer. Methods 3005 routine chests check-up were carried on the low-dose prospect research of the SHIMADZU 7800 TX spiral CT. According to the result by tracing and long-term CT follow-up based on the baseline screening, biopsy or surgical excisions were recommended in "malignant change" or enlarged nodules. Two doctors separately interpreted all the images blindly.Results 29.9 rate of nodules in all of cases were detected. Smoking group was 1.3 times incidence of non-smoking. A whole incidence of lung cancer was 1.2, including 2.9 in people at high risk of lung cancer and 0.9 in common people. The sensitivity and specificity of lung cancer screening using low-dose spiral CT were 82.9 and 88.8 respectively, and the diagnostic accuracy of lung cancer screening in diameter of nodules less than 10 mm was high than in ones more than 10 mm. Histologically, 33 non-small cell lung cancers (19 stageⅠ, 10 stageⅡand 4 stageⅢ), 2 small cell lung cancers and 1 scar carcinoma were proved based on baseline screening by biopsy or surgery. By the end of 2007, the average survival for clinical stageⅠlung cancer was more than 4 years, clinical stageⅡwas 2～3 years and clinical stageⅢ was 1～2 years. Conclusion Low-dose spiral CT is of high sensitive and specificity in detecting early lung cancer. Preliminary screening study indicates that low-dose spiral CT can greatly improve the likelihood of detection for early lung cancer and situation of survival.
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Objective To analyze the MR features of atypical meningiomas,so that to improve the diagnostic accuracy of this tumor pre-surgery.Methods There were 12 cases of atypical meningiomas proved by surgery and pathology.All of these patients underwent plain and contrast-enhanced MR examinations.Results Totally 12 cases,included 2 cases of multiple meningiomas,2 cases of lateral ventriclar meningiomas,2 cases of completely calcific meningiomas,3 cases of cystic meningiomas and 3 cases of malignant meningiomas.Conclusion The external cerebral signs of the tumors are the important basis for the localizing diagnosis of atypical meningiomas.Atypical MR signs of meningiomas are of complimentary value in qualitative diagnosis.
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Objective To probe into the optimization of scanning parameters of chest with low-dose spiral CT.Methods The phantom was scanned with different scanning parameters.The image quality obtained with the standard dose parameters and the low-dose technique were compared to evaluate the spatial resolution,low contrast resolution,noise level field uniformity and radiation dose,then the optimal scan parameters were defined.The scanning parameters were 120 kV,0.75 s,Pitch 1.0,FOV 360,RF3 reconstruction model(standard filter).Different thickness and tube electricity were used and the data were analyzed with the statistical method.Results There was significant difference about the data of the CTDI between the 160 mA conventional spiral CT and the low dose groups(30 mA,50 mA,70 mA,90 mA).There was no significant difference about the CTDI between 30 mA and 50 mA,and between 50 mA and 70 mA.There was obviously significant difference about the image noise on 1 mm slice and 10mA with other groups.The spatial resolution and low contrast resolution increased along with the increase of tube electricity,and 50mA was a inflexion of low contrast resolution.Conclusion 50mA and 5mm slice are the best scanning parameters in low-dose lung scanning and adapt to routine screening and early lung cancer screening.
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Objective To study the applied value of diffusion weighted imaging-DWIBS(diffusion weighted imaging with background suppression) in detecting the body tumour.Methods 10 healthy volunteers and 20 patients with histologically proven tumour were examined by diffusion Weighted MR with different techniques of background/fat body signal suppression.STIR-EPI sequence and spin echo-echo planar imaging(SE-EPI) sequence with chemical shift selective(CHESS) pulse were compared in terms of their degree of fat suppression.The diffusion weighted imaging features of control group and patients with tumour were observed and the values of ADC were measured.Results Fat suppression with STIR-EPI sequence in neck,chest,spine and extremity was well and SE-EPI with CHESS pulse in chest,abdomen,pelvic was satisfying.Signal to noise ratio(SNR) wss higher in SE-EPI with CHESS than that in STIR.The glands,spleen,peripheral nerves,lymph nodes and so forth could be showed by DWIBS in control group.85% malignant lesions were well visualized and appeared as high signal intensity and lower signal intensity in similar PET imaging,but the lesions only in 3 patients are not well visualized including pancreas cancer(1 case),rectum cancer(1 case),prostate cancer(1 case).PET scan was performed in 3 patients and well corresponded with diffusion weighted imaging in 2 cases,the other one was not visualized on diffusion weighted imaging.The highest ADC of malignant tumors was(1.58?2.06)?10-3mm2/s,the lowest ADC of malignant tumors was(0.88?0.74)?10-3mm2/s,the mean values of ADC of malignant tumors was(1.34?0.79)?10-3mm2/s.Conclusion DWIBS is a new method of diffusion-weighted MR,it has high spatial resolution,high contrast to noise ratio(CNR) and high SNR. This technique can be used as a powerful screening tool for tumour and evaluating the pathological lesions by measuring the values of ADC.
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Objective To evaluate the effect of X-ray stereotactic radiotherapy(SRT)with two different methods in curing brain metastases.Methods 41 patients with brain metastases were treated by SRT,including 24 cases by SRT and 17 cases by SRT combined whole brain irradiation.78 lesions in 41 patients fall into two groups:small tumor(3 cm).All patients were followed for 2～19 months after treatment by CT scan.The effect,recurrent and complication were discussed.Results Following SRT,the effect rate was 92.9% in SRT group and 93.7% in SRT combined whole brain irradiation group.The effect rate was 97.4% for small lesions while 90% large lesions.The recurrent rate was much higher in SRT(17%) than that in SRT combined whole brain irradiation group(5.9%),the difference was statistically significant(?
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Objective To study CT diagnosis and differential diagnosis of primary retroperitoneal neoplasm(PRN).Methods CT data in 23 cases of PRN confirmed by pathology were retrospectively analysed.Results There were 11 results of pathology in 23 cases,of them,14 cases were mesenchymal tissue-origin(12 cases were malignant neoplasm),4 cases were nervous tissue-origin(all benign),4 cases were rudimental embryonal tissue-origin(3 cases were benign diseases and one case was malignant),the source of unknown-origin in one case was malignant neoplasm.Most of these PRN showed such common CT manifestations as other tumors in the same location,but they had own special CT features respectively.Conclusion PRN have many typies,CT features of PRN in combination with the history,age and location can improve the diagnosis of histological classification and the diagnosis of the nature of tumors.
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0.05) for children and young people, showing irrelevancy to age. Conclusions The X ray SRS is effective and safe for cerebral AVM, it gives high obliteration rate for AVM of volume