Differentiating Acute Benign Vertebral Fractures from Vertebral Metastasis by Combining Quantification Analysis of Dual Echo Technique with Apparent Diffusion Coefficient / 实用放射学杂志

Objective To evaluate the value of dual echo technique in combination with apparent diffusion coefficient(ADC) in differentiating acute benign vertebral fracture from metastasis.Methods 43 patients (mean age, 68.2 years) with 79 metastatic vertebrae and 59 patients(mean age,60) with 68 acute vertebral fractures were included in our study.The slices of largest size of lesion on T1WI were selected to measure and calculate the signal intensity ratio(SIR) and ADC of lesions.The difference of ADC values and SIR between benign acute vertebral fractures and vertebral metastasis were compared.Parallel test,serial test and receiver operating characteristic curve(ROC) analysis of logistic model were done.Results ADC values of metastasis and acute benign fracture were (1.32±0.5)×10~（-3）mm~2/s and (2.39±0.4)×10~(-3)mm~~2/s respectively,and SIR of them were 1.00±0.01 and 0.85±0.01 respectively,there were significantly different between these two entities with the two tests(P<0.05).The area under the curve(AUC) for SIR was 0.897 and for ADC was 0.960,there is significantly different between these two tests in AUC(P=0.02).When 0.97 as cut off value for SIR,the sensitivity and specificity were 84.81% and 76.47%% respectively,when 1.87×10~(-3)mm~2/s as cutoff value for ADC , the sensitivity and specificity were 93.67% and 91.18% respectively . The sensitivity and specificity were 99.04% and 69.73% respectively in the parallel tests and 79.44%,97.92% in the serial test.A combining predictor established with logistic regression model showed a high AUC:0.985,which was higher than that of ADC and SIR alone.The AUC under ROC for ADC was significantly larger than that of SIR . When 0.55 as cut off value for this combining predictor , the sensitivity and specificity were 98.73% and 95.59% respectively.Multiple comparisons were performed with LSD-t test :combining predictor>ADC>SIR,it showed that there was significantly different between indexes(P<0.05). Conclusion ADC in combination with SIR can improve the effects in differentiating benign acute vertebral fractures and vertebral metastasis.

Correlation study of multi-slice spiral CT perfusion imaging in liver cirrhosis and portal morphology / 中国医师杂志

Objective To discuss correlation of hemodynamic changes and portal vein diameter with multi-slice spiral CT peffusion imaging in liver cirrhosis. Method 31 cases liver cirrhosis were enrolled in this study. The first porta hepatis were selected for target lay of CT perfusion scan. Liver perfusion parameters were obtained by color perfusion map method. Right to left diameter and occipitofrontal diame-ter of portal vein were measured. 30 cases of normal persons were used as control group. Result Hepatic arterial perfusion (HAP) in liver 0.05). Hepatic perfusion index (HPI) were (19.13±3.33)% and (20.61±8.56)%, which had no statistically significant difference with the other two groups (P>0.05). Conclusion Multi-spiral CT perfnsion imaging is an effectively noninvasive method to evaluate the hemodynamic changes of liver cirrhosis. Occipitofrontal diameter of portal vein with liver cirrhosis can reflect the state of liver hemodynamics.

MRI Analysis of Foot Trauma without Roentgenographic Abnormality / 实用放射学杂志

Objective To probe the diagnostic value of MRI in wounded feet which were negative on X-ray film.Methods 77 cases with wounded feet displayed normally on X-ray film underwent MRI,using SE/T1WI,TSE/SPIR/T2WI and 3D-water sel.-FFE.Results The abnormalities on MRI were found in 54 cases,of them,47 cases were within 30 days including bone contusion in 20 cases,muscle injury in 12 cases,bone contusion and muscle injury in 6 cases,bone contusion and soft tissue space injury in 2 cases,simple soft tissue space injury in 3 cases,tiny bone fracture in 3 cases and bone fracture in combination with contusion 1 case.7 cases were 30 days after trauma including cancellous bone sclerosis and little ossature deformity.Conclusion MRI is of important value in the wounded feet which are negative on X-ray film and have obvious symptom.

Several improvements in our hospital's teaching activities of clinical practice / 中华医院管理杂志

To explore a new mode of teaching activities and management of clinical practice, our hospital adopted various methods, including computer training and exams, selecting practice guiding experts among the three level specialties, establishing labs for the operation of basic skills, using credit books for trainees and adopting integrated education on disease entities. In the past, teachers could teach and set exams in whatever way they liked and students did not have enough opportunities to come across various disease entities or to operate with their hands. Now such shortcomings have been overcome. Students can receive comprehensive, systematic and standard training in clinical operations. At the same time, their quality with regard to professional knowledge and ethics has also been enhanced.