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Objective The aim was to evaluate the diagnostic value of MRI in lesions with architectural distortion manifested in mammography. Methods A retrospective analysis of MRI was performed in 60 patients with 61 lesions manifested as architectural distortion in full?field digital mammography (FFDM) and subsequently confirmed by pathology or two year's follow?up, 30 were malignant and 31 were benign. All the patients underwent MRI within 2 weeks of mammography. MRI protocol included conventional MR, DWI and dynamic contrast?enhanced MRI. The breast imaging reporting and data system (BI?RADS) was used as the reference standard. BI?RADS categories 1 to 3 were considered as negative for malignancy and BI?RADS categories 4 to 5 were considered as positive for malignancy. ADCs of suspicious lesion of interest and glandular tissue were calculated. nADC was then calculated using the following formula:nADC=ADC(lesion)/ADC(glandular tissue). ADC and nADC were compared by using t test. ROC analysis was carried out to define the most effective threshold ADC and nADC value to differentiate malignant from benign lesion in the breast. Diagnostic performance of the FFDM, DCE?MRI and DCE?MRI combined nADC were calculated. Results ADC value of malignant and benign lesions was (1.35±0.31)×10?3 mm2/s and (1.07±0.40)×10?3 mm2/s, respectively . nADC values were 0.83±0.17 and 0.59± 0.25, respectively (t values were 2.82 and 4.54, P<0.01). Area under the curve of ADC and nADC were 0.829 and 0.753 respectively. When threshold of ADC was set at 1.19×10?3mm2/s, sensitivity and specificity were 71.0%and 86.7%, respectively. For a nADC value threshold of 0.589, sensitivity and specificity were 93.5%and 76.7%, respectively. Sensitivity, specificity and accuracy with FFDM were 80.0%(24/30), 9.7%(3/31) and 44.3%(27/61), Sensitivity, specificity and accuracy with DCE?MRI were 90.0%(27/30), 41.9%(13/31) and 65.6%(40/61), Sensitivity, specificity and accuracy with DCE?MRI combined nADC were 93.3%(28/30), 77.4%(24/31) and 85.2%(52/61), respectively. Conclusion Sensitivity and specificity with DCE?MRI combined nADC is higher, and DCE?MRI combined nADC values is helpful to differentiate malignant from benign lesions with architectural distortion manifested in FFDM.
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Objective To evaluate the diagnostic value of non-invasive imaging modalities to evaluate lower limb arterial disease associated with diabetes.Methods Two hundred and twenty seven patients (292 lower limb arteries) with lower limb arterial disease due to diabetes underwent both DSA and one of the pre-operative imaging modalities including CTA,CE-MRA and DUS were included in this study.The diagnostic consistency of CT angiography(CTA),contrast enhanced magnetic resonance angiography (CE-MRA) and Doppler ultrasonography(DUS) compared with DSA were calculated respectively.CTA was performed in 169 lower limb arteries,while 123 in CE-MRA and DUS in 192.DSA was used as the gold standard.Consistency analysis was performed to evaluate the three imaging modalities with lower limb artery classified as Grade 1,Grade 2 and Grade 3.Results The sensitivity of CTA to evaluate mild stenosis in Grade 1 to Grade 3 was 100％(56/56),97.6％(82/84) and 93.8％(30/32) respectively,while 100％(19/19),94.4％ (34/36)and 61.5％ (8/13) for severe stenosis.The diagnostic accuracy of mild and severe stenosis was 95.9％ (162/169) to 99.4％ (168/169),which showed good consistency with the result of DSA with Kappa value of 0.760 to 0.916,and P＜0.05.The sensitivity of CE-MRA to evaluate mild stenosis in Grade 1 to Grade 3 was 93.2％(68/73),97.2％(103/106) and 93.2％ (69/74)respectively,while 91.3％ (21/23),80.8％ (42/52)and 42.1％ (8/19)for severe stenosis.The diagnostic accuracy of mild and severe stenosis was 86.2％ (106/123) to 96.7％ (119/123),which showed good consistency with the result of DSA with Kappa value of 0.767 to 0.868 and P＜0.05.The sensitivity of DUS to evaluate mild stenosis in Grade 1 to Grade 3 was 89.9％ (62/69),88.8％ (87/98) and 79.2％ (42/53) respectively,while 73.1％ (19/26),84.8％ (39/46) and 44.4％ (8/18) for severe stenosis.The diagnostic accuracy of mild and severe stenosis was 89.7％ (174/194) to 93.8％ (182/194),which showed good consistency with the result of DSA with Kappa value of 0.476 to 0.864 and P＜0.05.Conclusions The non-invasive imaging modalities,namely CTA,CE-MRA and DUS all have good diagnostic consistency compared with DSA.CTA is superior to CE-MRA and DUS in evaluating the severe stenosis of lower limb arterial disease in diabetes patients.
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Objective To summarize the clinical nursing experience for patients with malignant obstructive jaundice after receiving percutaneous biliary radiofrequency ablation (RFA) and stent implantation. Methods The postoperative nursing experience in 9 patients with malignant obstructive jaundice who received percutaneous biliary RFA together with stent implantation were retrospectively analyzed. The postoperative complications and the nursing intervention measures were analyzed and evaluated. Results Biliary RFA and subsequent stent implantation were successfully carried out in all 9 patients. After the procedure, biliary fistula occurred in one patient, biliary hemorrhage in 2 patients and biliary infection in 2 patients. The patient, who developed biliary fistula, died one week later, and the clinical conditions in the remaining 4 patients were improved after symptomatic treatment. During the follow-up period of one month, the patients were in good condition. Conclusion The main purpose of postoperative nursing for patients after receiving percutaneous biliary RFA is to prevent the occurrence of bile duct perforation, hemorrhage, infection, etc. It is very important to keep the patients under close observation and comprehensive nursing so as to make an early detection and timely treatment of such complications, thus to reduce the incidence of complications causing serious consequences as well as to promote an early recovery.
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Objective To evaluate the application value of 64-row spiral CT coronary angiography(CAG)in myocardial bridge (MB)and mural coronary artery(MCA) .Methods Imaging data of 436 consecutive subjects underwent coronary CT angiography in Hospital of Beijing Puren were enrolled in this study .The prevalence ,clinical effects of patients ,precise location and incidence of each branch were evaluated .In addition ,the length and depth of MB ,as well as their relationship with MCA in stenosis were evalua-ted .Moreover ,the group of subjects with MB was compared with the control group(subjects without MB)in the probability of ath-erosclerosis .Results Among the total of 436 subjects ,76 subjects(17 .4% ,76/436)were found to have MB .The left anterior de-scending artery(LAD)was the most common coronary artery involved(68 .4% ,52/76) .The pressure level of MCA associated with the length and depth of MB .A significant difference was found between the LAD-MB-MCA group and the control group in the presence of coronary artery plaques(P<0 .05) .Conclusion The anatomic relation between MB and MCA can be precisely displayed on 64-row spiral CT coronary angiography ,which is considered to be an excellent diagnostic method to screen MB-MCA initially . There is a relationship between stenosis of MCA and the length and depth of MB .The present and stenosis of MB-MCA are meant to form coronary artery plaques in LAD segment more easily .
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Objective To investigate the curative effect of percutaneous transhepatic cholangial drainage(PTCD) on patients with non-anastomotic stricture after liver transplantation when treated with endoscopic retrograde cholangio-pancreatography(ERCP) unsuccessfully.Method The clinical data of 29 patients with non-anastomotic biliary stricture after liver transplantation were retrospectively analyzed,who failed to respond to ERCP and underwent PTCD from January 2005 to December 2007.Result All patients were performed PTCD successfully including cholangiography in 141 cases,drainage tube replacement in 115 cases,and balloon dilation of bile duct stricture in 39cases.The intubation time ranged from 2 months to 65 months.The mean levels (x ± SD) of alanine aminotransferase,aspartate aminotransferase and total bilirubin were 68.0 ± 29.1 U/L,52.6 ± 34.8 U/L,63.2 ± 33.3 μmol/L after treatment in comparison to 178.3 ± 63.3 U/L,144.0 ± 59.1 U/L,154.2 ± 92.0 μmol/L before treatment.Conclusion PTCD,which could improve the symptoms and prolong the survival time of both grafts and patients in spite of inconvenience of intubation,is suggested for patients with non-anastomotic biliary stricture if they are not suitable for liver retransplantation.
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Objective +o evaluate percutaneous intervetional therapy for portal vein anastomotic occlusion after liver transplantation.Method From July 2005 to July 2013,13 patients (9 male and 4 female; aged 25-65 years) with portal vein occlsion underwent interventional therapy.All patients accepted the imaging examation and 8 patients had typical clinical signs of portal hypertension.Percutaneous hepatic balloon venoplasty and stent placement was performed,trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways performed if necessary.+echnical success rate,complication rate and clinical symptoms were analyzed.Follow-ups including clinical course,stent patency and potal vein thrombosis which evaluated by imaging were performed.Result +echnical success was achieved in l1of 13 patients (84.6％) and 15 stents were deployed.Seven patients with localized portal vein occulsion accepted balloon dilation and stents deployment,4 patients with long segment cculsion also accept trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways.Portal vein flow recovered in all 11 patients.Procedure related complication occurred in 2 patient with hemothorax.During the follow-up period of 4-42 months,the clinical signs of portal hypertension were not observed in all patients.Stent stenosis was found in one patient with ultrasound in 23 months,but stent patency was proved by the percutaneous portal angiography.Conclusion Interventional therapy is effective for portal vein occulsion after liver transplantation,comprehensive interventional therapy should be performed in long segment portal vein cculsion.
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Objective To explore the optimal low-dose protocol of volumetric high-resolution CT (VHRCT) of the lung and evaluate its diagnostic value.Methods Catphan phantom were scanned using GE Lightspeed VCT with different parmeters from 120 kV,10 mAs to 120 kV,250 mAs in 10 mAs increments.Other parameters included 0.969 pitch,20 mm scan coverage,0.625 mm collimation and 30 cm display field of view and bone recon kernel.The spatial and density resolution,noise and radiation dose of each scanning were measured to determine the low-dose VHRCT protocol.In clinical study,105 patients with diffuse lung diseases underwent standard-dose VHRCT with 120 kV,250 mA according to the clinical needs.Low-dose VHRCT was performed with 120 kV,120 mAs in follow-up.Two radiologists who were unaware of the CT technique reviewed randomized images for the detail of diffuse lung diseases,including linear or reticular opacities,micro-nodules or tree-in-bud patterns,bronchiolectasis,ground-glass opacities and emphysema using a 4-point scale.Results In phantom study,the spatial-resolution maintained at 9 LP/cm from 250 mAs to 120 mAs.Below 120 mAs,the spatial-resolution and density-resolution decreased and noise increased with the decrease of tube-current.In clinical study,there were no statistical differences between standard-dose and low-dose VHRCT in demonstrating the detail of diffuse lung diseases(P ＞0.05).The CTDIvol was 23.44 mGy at 250 mAs and 11.25 mGy at 120 mAs,with 52％dose reduction by low-dose VHRCT.Conclusions Low-dose VHRCT at 120 kV,120 mAs offers maximum dose reduction without compromising spatial resolution and diagnostic value.
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Objective In-hospital mortality rate in patients undergoing percutanous transhepatic biliary drainage for malignant obstructive jaundice remained high.This study aimed to assess pre-,intra-and post-procedure risk factors which were independently associated with increased in-hospital mortality.Methods One hundred and fifty-five consecutive patients with malignant obstructive jaundice received initial PTBD drainage.Twenty-five pre-procedure,4 intra-procedure and 6 post-procedure factors potentially related with in-hospital mortality were assessed by univariate and multivariate analysis.Results In-hospital mortality rate was 16.8％ (26/155).Of 25 pre-procedure variables analysed,Child-Pugh classification C,creatinine (≥ 6.93 μmol/L) and quality of life (≤ 30) were found to be significant in univariate and multivariate analysis.Increased mortality was seen in this study with two or more risk factors,significantly different from patients who had none or one risk factor(P ＜0.01).None of the intra-procedure factors were important in identifying patients at risk of death.Multivariate analysis indicated post-PTBD cholangitis and unsuccessful drainage as post-procedure risk factors that correlated with in-hospital death.Conclusions Three pre-procedure and two post-procedure risk factors were identified associated with in-hospital mortality.
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Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms.81 aneurysms were confirmed by DSA,all of them were sac aneurysms,among which 75 cases (body/neck≥ 1) were treated with balloon-assisted coiling,29 narrow-necked (body/neck≥2) aneurysms and 30 wide-necked (1 ≤ body/neck＜ 2) aneurysms were treated with balloon-assisted coiling successfully,but 6 narrow-necked (body/neck≥2) were treated with balloonassisted coiling in emergency,followed by a stent-assisted coiling in secondary embolization,4 cases with body/neck＜1 were treated with stent-assisted coiling technique in emergency,2 non ruptured aneurysms could not be treated.The times of balloon dilation were (2.1 ± 1.3),single expansion of filling was (33.4±14.1)s. Results The arterial thrombosis happened in two patients (2.7 ％),two aneurysms ruptured (5.3％) during the procedure. No stent-related thrombosis happened. 86were elevated as good,8 as serious according to the Glasgow outcome scale,neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.
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ObjectiveTo evaluate the effectiveness of the interventional treatment for portal vein stenosis in patients who had undergone liver transplantation.MethodsFromApr.2004 to Oct.2011,30 patients with portal vein stenosis after liver transplantation were referred for angiographic analysis and interventional treatment. All patients had typical clinical signs and symptoms or surveillance by imaging.After percutaneous transhepatic portography and balloon angioplasty,stents were deployed.Embolization was performed on patients with varices or portal vein flow changes.The therapeutic results were monitored by the follow-up on clinical symptoms,laboratory tests and imaging examinations.ResultsAngiography was performed successfully on all patients.Twenty-four patients received balloon dilation and 26 stents were deployed subsequently.The guide-wire cannot pass through the lesion of portal trunk in 1patient.Four patients received balloon angioplasty only.The technical success rate was 96.7％ (29/30).Stainless steel coils were applied in 7 patients for varices embolization.The complication related to interventional treatment was bleeding in thoracic cavity which happened in 2 patients.Portal vein patency was maintained in all the patients who received interventional treatment for 1-72 months (mean 21.5 months).No re-stenosis was identified.ConclusionInterventional therapy is an effective method for the treatment of portal vein stenosis after liver transplantation and excellent patency can be achieved by this method.
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ObjectiveTo investigate the risk factors for percutaneous transhepatic biliary drainage (PTBD) related cholangitis in patients with malignant obstructive jaundice.MethodsOne hundred and fifty-four consecutive patients with malignant obstructive jaundice and without leukocytosis,fever and other manifestations of biliary tract infection received initial PTBD drainage.They were enrolled in this study.An uncontrolled prospective study was conducted of cholangitis occurrence within 30 days after PTBD.Twenty potential preoperative risk factors were assessed by univariate and multivariate analysis.ResultsFifty-five patients (55/154,35.7％ ) developed PTBD-related cholangitis,which composed of cholangitis group.Other patients composed of non-cholangitis group (99/154).The cholangitis-related mortality rate was 2.6％ (4/154).Intraoperative bile culture were performed for 131 patients (131/154),including 45 in cholangitis group and 86 in non-cholangitis group.Positive result occurred in 26 patients (26/45) in cholangitis group and 17 patients (17/86) in non-cholangitis group.There was statistical significant difference between these two groups ( x2 =19.357,P ＜ 0.01 ).By univariate analysis,diabetes ( x2 =10.470,P ＜ 0.01 ),Child-Pugh C grade ( x2 =36.324,P ＜ 0.01 ),undrained biliary duct ( x2 =9.540,P ＜0.01 ),external-internal drainage ( x2 =9.856,P ＜ 0.01 ),history of ERCP or cholangiojejunostomy (x2 =14.196,P＜0.01),QOL (t =-3.288,P ＜0.01),KPS(t =-2.099,P＜0.05),ALT (t =-2.112,P＜0.05),PT (t =-3.648,P ＜0.01),albumin (t =-2.071,P ＜0.05),WBC (t =2.022,P ＜ 0.05 ),proximal obstruction ( x2 =6.190,P ＜ 0.05 ) and cirrhosis ( x2 =5.439,P ＜ 0.05 )were significantly different between cholangitis group and non-cholangitis group.By multivariate analysis,diabetes ( OR =5.093,P ＜0.01 ),Child-Pugh C grade ( OR =13.412,P ＜0.01 ),undrained biliary duct ( OR =3.348,P ＜ 0.05 ),external-internal drainage ( OR =3.168,P ＜ 0.05 ) and history of ERCP or cholangiojejunostomy (OR =8.330,P ＜ 0.01 ) remained significant difference.ConclusionsPTBD is an effective and safe palliative treatment for patients with malignant obstructive jaundice.Sufficient preoperative preparation and effective control of risk factors may reduce the incidence of cholangitis after PTCD.
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Objective This research is one of the sub-researches of"The comparative study of the standards of interventional therapies and the evaluation of the long-term and middle-term effects for common malignant tumors",which is one of the National Key Technologies R&D Program in the eleventh five-year plan. Based on the project,the authors need to establish an international standard in order to set up the national tumor interventional therapy database and registration system.Methods By using the computing programs of downloading software,self-management and automatic integration,the program was written by the JAVA words.Results The database and registration system for the national tumor interventional therapy Wag successfully set up,and it could complete both the simple and complex inquiries.The software worked well through the initial debugging.Conclusion The national tumor interventional therapy database and registration system can not only precisely teU the popularizing rate of the interventional therapy nationwide,compare the results of different methods,provide the latest news concerning the interventional therapy,subsequently promote the academic exchanges between hospitals,but also help as get the information about the distribution of the interventional physicians,the consuming quantity and variety of the interventional materials,so the medical costs can be reduced.
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Objective To investigate the correlation between relative cerebral blood volume (rCBV) and tumor character of meningiomas. Methods Thirty-six (GradeⅠ: n=30, GradeⅡ+Ⅲ: n=6) patients with meningioma underwent conventional MR and perfusion weighted imaging (PWI) . The pulse sequence of PWI was single shot GRE-EPI-T2~*WI. The CBV maps were calculated from the original data of perfusion images and the maximum rCBV of meningiomas was acquired from CBV maps through measurement on the region of interest (ROI). The differences of rCBV in tumor and edema between benign and malignant tumors were analyzed. Results The mean rCBV in tumor of benign meningioma (9.78±4.69) was higher than that of malignant ones (3.59±0.28) (t=7.168, P0.05). Conclusion CBV map and quantitative study of rCBV are feasible for differential diagnosis of meningiomas and have instructive function for clinical treatment and assessment of prognosis.
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Objective To discuss the correlative factors affecting the short-term prognosis in treating malignant obstructive jaundice with percutaneous transhepatie biliary drainage (PTBD) and/or percutaneous transhepatic biliary stenting (PTBS). Methods During the period of December 2008-June 2009, PTBD and/or PTBS were performed in 67 patients. The clinical date were reviewed and analyzed. According to the reduction degree of serum bilirubin and survival condition in 30 days, the patients were divided into effective group (54 cases) and ineffective group (13 cases). Single factor affecting the short-term prognosis was analyzed by using X~2 test and multi-factors were analyzed by using non-conditional logistic regression mode. Results Single variable analysis showed that time of obstruction, way of drainage, preoperative biliary infection, Child-Pugh grade, TBIL, HGB and Cr level were of statistical significance. The logistic regression analysis showed that there were obvious correlation among preoperative biliary infection, Child-grade ≥ 11 and Cr > 115 μmol/L. Conclusion The infection of the bile duct before operation, Child-grade ≥ 11 and Cr >115μmol/L carry a close relationship with the short-term prognosis of PTBD and PTBS. Therefore, an overall preoperative evaluation for malignant obstructive jaundice is of great importance.
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Objective To study the spatial variation of T2 relaxation time of cartilage of knee in healthy adults.Methods T2 values of cartilage of knee in 21 asymptomatic young male adults ( age ranged 24 to 39 years ; mean age , 30 years) were calculated by using a multiecho,spin-echo MR imaging sequence at 1.5T MR scanner on sagittal T2 maps,including the patellar,distal femoral weight and non-weight-bearing as well as proximal tibial weight-bearing cartilages,the differences in the spatial variation between them were analysed using F test.Results All 21 asymptomatic volunteers demonstrated a consistent pattern of spatial variation of T2 values cartilage of knee with longer T2 values near the subchondral bone,decreased in deep zoon and increased in articular surface , there was difference between them (F=70.892 , P＜0.05 ) . The greates spatial variation occurred in the patella.T2 value(26.56 ms±4.4 ms) in the deeper zoon of cartilage of the patella was obviously lower than that of the weight-and non-weight-bearing articular cartilage (P = 0.001 ) . Lateral femoral weight-bearing articular cartilage showed lower T2 value ( 35.2 ms ± 6.31 ms) in the outer transitional superficial zone than thatof the patella and non-weight-bearing cartilage,P=0.002,P=0.000 respectively.Lateral tibial weight-bearing articular cartilage showed showed lower T2 value(37.11 ms±6.6 ms)in the outer transitional superficial zone than that of non-weight-bearing cartilage(P=0.000). Conclusion The spatial variation of T2 relaxation time of cartilage of knee in the vivo in the asymptomatic young adults is like slightly concave curve at 1.5T MR system,that is of reference value in study of degenerative osteoarthritis.
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Objective To evaluate the radiosensitization effect of gemcitabine in human cholangiocarcinoma cells(QBC939)in vitro. Methods The IC10,IC50 and IC90 of gemcitabine in QBC939 cells were determined by clonogenic assay,which were adopted in the following experiments.The cells were divided into five groups:control group,chemotherapy group,radiation group,radiation after chemotherapy(C+R)group and radiation before chemotherapy(R+C)group.The radiation dose ranged from 1 Gy to 10 Gy.The cell survival Curves were fit using two-component equation and the sensitive enhancement ratio(SER)was calculated.Results The IC10,IC50 and IC90 of gemcitabine in QBC939 cells were 0.1 nmol/L(low concentration),11.0 nmol/L(moderate concentration)and 21.5 nmol/L(high concertration),resDectively.Gemcitabine in low concentration radiosensitized the cells at low irradiation dose(≤2 Gy)in R +C group(SERDq=1.52).Gemcitabine in moderate concentration had radiosensitization effect at all irradiation doses in C+R group(SERD0=1.27,SERDq=116.93),and at low irradiation dose(≤2 Gy)in R+C group.Gemcitabine in high concentration had radiosensitization effect at all irradiation doses in both R+C and C+R groups,which was most markedly at low irradiation dose(≤2 Gy)in R+C group(SERDq =323.30). Conclusions Gemeitabine has radiosensitization effect in QBC939 cells,which is based on the optimal scheduling and concentration.
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Objective To study the anatomic characteristics of the infraorbital ethmoid cells on muhislice CT(MSCT)and explore the relationship between the infraobital ethmoid cells and mueosal swelling of sinuses.Methods Two hundred sixty patients(520 sides) of consecutive axial scans by GE HisDeed VCT and the multiplunar reformation(MPR),virtual endoscopy(VE)reconstruction images by GE AW 4.2 workstation were reviewed retrospectively.The following CT features were assessed:(1)the anatomic characteristics of the infraobital ethmoid ceils,including the frequency of identification,origin,classification.(2)presence of mucosal swelling of sinuses,(3)the maximal transversal diameter of the inflraobital ethmoid cells in ostium of maxillary sinus(perpendicular to the uncinate process),and the diameter of the ostium of maxillary sinus,(4)presence of infraobital ethmoid ceils inflammatory findings and a contact between the mucosal surface of the ostium of maxillary sinus.The results were analyzed by using Chi-square test and logistic regression analysis with the statistical software SPSS 11.5.Results (1) UniLateral infraobital ethmoid cells were f10und in 68 patients(26.1%),and bilateral infraobital ethmoid cells were found in 81 patients(31.2%).Infraobital ethmoid ceHs were found in 230 sides on left Bide (120 sides)and right side(110 sides).(2)Infraobital ethmoid cells originated from the anterior ethmoid cells in 124 sides(53.9%)and from posterior ethmoidal cells in 62 sides(27%),originated from both the anterior ethmoidal cells and the posterior ethmoidal cells in 44 sides(19.1%).(3)The classification of the infraobital ethmoid cells included three types.Infraobital ethmoid cells with different origination differed significantly in theirtypes(x2=193.433,P<0.01).Most ofthe infraobital ethmoid cells originated from tlle anterior ethmoidal cells were type Ⅰ(160 sides),while the type Ⅱ(48 sides)and Ⅲ(45 sides) frequently originated from the posterior ethmoidal ceHs(4)The mueosal swelling of sinuses,were found in 165 sides in presence of infraobtial ethmoid cells and 192 sides in absence of infraobtial ethmoid cells.The presence of infraobtial ethmoid cells had no effect on mucosal swelling(X2=1.824,P>0.05).The maximal transversal diameter of the infraobital ethmoid cells in ostium of maxillary sinus did not differ significantly between the cases with or without mucosal swelling of sinuses(t=0.273,P>0.05).and the diameter of the ostium of maxillary sinus were not significantly related with mucosal swelling of sinuse8 (Wald=2.534,P>0.05).Presence of infraobital ethmoid cells inflammatory findings (Wald=10.817. P<0.01,OR=4.125)and a contact between the mucosal surface of the ostium of maxillary sinus (Wald= 6.640,P<0.01,OR=3.728)were significantly related to mucosal swelling of 8inuses. Conclusions (1)MSCT scan could clearly demonstrate the detailed information of infraobital ethmoid ceIIs.(2)The presence of infraobtial ethmoid cells Was not a risk factor for chronics sinusitis. When we assess inflraobtial ethmoid cells as a possible etiologic factor in chronics sinusitis we should observe presence of infraobital ethmoid cells inflammatory findings and a contact between the mucosal surface of the ostium of maxillary sinud.
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Objective To evaluate the long-term safety, efficacy and complications of placement vena cava filter in prevention of pulmonary embolism. Methods Seventy-three patients with proven diagnosis of deep venous thrombosis (DVT) and (or) pulmonary embolism (PE) by Doppler ultrasonography, DSA, CT or MRI, received percutaneous inferior vena cava filters (IVCF) from January 1994 to June 2005. The clinical data and imaging findings were evaluated retrospectively. The patients underwent telephone interview or questionnaire, abdominal X-rays, Doppler ultrasonography, computed tomographic pulmonary angiography (CTPA) or indirect CT venography (CTV) after a follow-up duration of 5 months to 11 years. Results Seventy-eight vena cava filters were used. There was 1 case of incomplete filter opening when placing filter. In follow-up, thrombi were trapped in the filter in 2 cases, filter tilting happened in 1 case, and there were no filter migration, filter disruption, filter perforation. Five of 73 cases were lost in follow-up visit, 14 patients died after implantation (5 days to 41 months, average 14.5 months). Among the 54 living patients, the identified recurrent PE was not noted. Three cases of recurrent DVT, 1 case of inferior vena caval thrombosis and 1 case of thrombosed filters were seen in follow- up. Conclusion Inferior veua cava filter is safe and effective for the long-term prevention pulmonary embolism, and the long-term major complications after filter placement are not frequent.
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Objective To compare the image quality between volumetric high-resolution CT (VHRCT)and conventional high-resolution CT(CHRCT),and investigate the feasibility of VHRCT.Methotis Catphan 412 phantom was scanned with protocols of CHRCT and VHRCT on a set of GE Lightspeed VCE.The spatial-resolution(LP/cm),noise(standard deviation iu an ROI)and radiation dose (CTDI)were recorded for each CT scan.Difference of noise between CHRCT and VHRCT were evaluated by paired t test.In clinical study.32 patients were scanned with VHRCT and CHRCT protocols.The image quality of CHRCT and VHRCT was rated and compared.The quality difference between CHRCT and VHRCT was assessed by Wilcoxon paired signed rank sum test.Results In phantom study.the in-plane spatial-resolution of both VHRCT and CHRCT was 11 LP/cm for axial images and 12 LP/cm for coronal reformatted images.The noise of VHRCT and CHRCT was(69.18±2.77)HU and(54.62±2.12)HU respectively(t=-15.929.P＜0.01)at the same dose level.The radiation dose of VHRCT was 19.09 mGy higher than CHRCT at the same noise level.In clinical study.the quality assessment scores of VHRCT axial images and CHRCT axial images were 3.22 and 3.24 respectively.with no significant difference(Z=-0.319,P＞0.05).The qualily assessment scores of VHRCT coronal reformatted images and CHRCT coronal reformatted images were 3.05 and 1.88 respectively with significant difference(Z=-5.088.P＜0.01).Conclusion The image qualitv of VHRCT cross-sectional image is similar to that of CHRCT.Muhiplanar images with high resolution of VHRCT are recommended.The radiation dose of VHRCT remains to be optimized.
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Objective To evaluate the multi-slice CT perfusion imaging in investigating whether edaravone can prevent and treat pulmonary thromboembolism ischemia-reperfusion injury(PTE-IRI).Methods Twenty mongrel canines were included.A Swan-Ganz catheter wag introduced into the right internal jugular vein using the Seldinger technique,and then was inserted into the pulmonary artery.Balloon occlusion of the right inferior lobe pulmonary artery for 4 h was followed by removing catheter and 4 h of reperfusion.Animals were divided into four groups of A(no edaravone during ischenmia and reperfusion),B(edaravone used only during ischemia),C(edaravone used during both ischemia and reperfusion)and D group(edaravone used only during reperfusion)(n=5 per group).Every group was divided into three time points including before ischemia,4 h after ischemia and 4 h after reperfusion.CT scan and CT perfusionwere performed at the three time points.The blood flow(BF),blood volume(BV)and mean transit time (MTT)of the bilateral inferior regional lung parenchyma were measured with the software of perfusion 3.Results CT examination showed pulmonary edema in the right inferior lung lobe at 4 h after reperfusion.(1)The BF and MTT of A,B,C and D group were[(259.4±15.7)ml·min-1·100 g-1,(293.7±7.9)ml·min-1·100 g-1,(379.4±14.5)ml·min-1·100 g-1,(382.5±16.6)ml·min-1·100 g-1]and[(3.1±0.2)s,(2.6±0.2)s,(2.2±0.1)s,(1.9±0.2)s]respectively at 4 h after reperfusion.The BF and MTT were statistically difierent(P＜0.01)between groups(A and B,A and C,A and D,B and C,B and D)except between group C and D(the P value＞0.05)at 4 h after reperfusion,but the BV was not statistically different between groups(P＞0.05).(2)The BF[(397.2±19.2)ml·min-1·100 g-1and(259.4±15.7)ml·min-1·100 g-1in group A,(393.2±16.1)ml·min-1·100 g-1and(293.7±7.9)ml·min-1·100 g-1 in group B]and MTT[(1.8±0.1)8 and (3.1±0.2)s in group A,(1.8±0.2)s and(2.6±0.2)s in group B]were statistically different(P＜0.01),but the BV[(12.0±0.9)ml/100 g and(12.2±1.0)ml/100 g in group A,(11.9±1.5)ml/100 g and(12.2±1.3)ml/100 g in group B]were not different(P＞0.05)between groups before ischemia and 4 h after ischemia.The BF.MTT and BV were not statistically significant between before ischemia and4 h after reperfusion in group C and D(P＞0.05).ConclusionsEdaravone can attenuate the degree of the PTE IRI.Multi-slice CT perfusion imaging can evaluate effect.