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Objective:To explore the feasibility of dual-energy CT (DECT) in the evaluation of liver iodine concentration in patients on long-term oral amiodarone treatment (≥12 months).Methods:Eighteen subjects undergoing abdominal dual-energy CT who met the criterion in January 2017 were collected as a control group. Twenty-seven patients who received oral amiodarone treatment for more than 12 months from January 2017 to May 2019 were enrolled as an experimental group. The difference of CT value and iodine concentration of liver, pancreas and spleen in 140 kV, 100 kV and VNC images between experimental and control groups were measured and analyzed. The correlation between liver CT value and liver iodine concentration was analyzed by Spearman correlation.Results:The concentrations of iodine in the liver, pancreas and spleen of the experimental group were 0.2 (0.2, 0.4), 0.1 (0.1, 0.2) and 0.2 (0.1, 0.2) mg/ml, and those in the control group were 0.2 (0.1， 0.2), 0.1 (0.1, 0.2) and 0.1 (0.1, 0.2) mg/ml. The difference in the concentration of iodine of the liver was statistically significant ( Z=-3.354, P<0.05), however there was no significant difference in the concentration of pancreas and spleen between the two groups ( Z=-0.179 and -1.590, P>0.05). The CT values of 100 kV, 140 kV, VNC images in the experimental group [(74±18)， (70±10) and (71±5) HU] were higher than those in the control group [(60±6)， (59±6) and (62±6) HU], and the differences were statistically significant ( t=3.310, 4.205 and 5.241, P<0.05). There was a positive correlation between the CT value of 140 kV image and iodine concentration ( r=0.410, P<0.05). In the experimental group, the time difference of taking amiodarone was statistically significant ( P<0.05). Conclusions:DECT can be used to quantitatively measure the liver iodine concentration of patients with long-term oral amiodarone, and provides some biological indicators for the assessment of amiodarone induced liver injury.
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Objective To assess the diagnostic value of 3D-enhanced T2 ? weighted angiography (ESWAN )in evaluating superficial siderosis of the central nervous system (SS-CNS)after traumatic subarachnoid hemorrhage (tSAH).Methods ESWAN and GRE T2 ? WI sequence were performed on 30 patients with tSAH,detection rate and the number of distribution areas of SS-CNS were compared between the two sequences.A McNemar’s test and Wilcoxon signed-rank test were used to analyze the differences between T2 ? WI and ESWAN images sequences. Results In the tSAH group,29 of 30 patients (96.7%)showed SS-CNS on ESWAN images,the total number of SS-CNS regions was 134.Identified SS-CNS positive rate respectively was 95.8% (23/24)on ESWAN images and 66.7% (1 6/24)on T2 ? WI in 24 patients simultaneously perform ESWAN and T2 ? WI sequences.A McNemar ’s test showed that there was significant difference between the positive rates of two sequences in detecting the SS-CNS (χ2 =7.0,P <0.05).The number of SS-CNS regions on ESWAN images and T2 ? WI was 106 and 34 respectively.The Wilcoxon signed rank test showed that the number of SS-CNS regions difference between two sequences was significant (Z =-4.225,P <0.01).Conclusion Various degress of SS-CNS are detected in a majority of tSAH atients.ESWAN sequence is a reliable and efficient method for assessment of SS-CNS.
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In this article,we reviewed the CT/MRI imaging features of carcinoma of the duodenal papilla in 15 cases.The characteristic CT and MR imaging findings of duodenal papillary carcinoma included mass in the descending part of the duodenum,the mass and duodenum wall showed a "target" sign or " diamond ring" sign;a ring-enhancing lesions around the distal end of the common bile duct/pancreatic duct,and thickening of the wall of the second portion of the duodenum near the papilla.The use of MPR MDCT images and MRI coronal images are very useful to show these imaging features as an aid in early diagnosis of carcinoma of the duodenal papilla.
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In this article,we reviewed the CT/MRI imaging features of carcinoma of the duodenal papilla in 15 cases.The characteristic CT and MR imaging findings of duodenal papillary carcinoma included mass in the descending part of the duodenum,the mass and duodenum wall showed a "target" sign or " diamond ring" sign;a ring-enhancing lesions around the distal end of the common bile duct/pancreatic duct,and thickening of the wall of the second portion of the duodenum near the papilla.The use of MPR MDCT images and MRI coronal images are very useful to show these imaging features as an aid in early diagnosis of carcinoma of the duodenal papilla.
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Objective To summarize the computed tomography (CT) features of small intestinal obstruction caused by primary abdominal cocoon and investigate the essentials of diagnosis and differential diagnosis.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with small intestinal obstruction caused by primary abdominal cocoon who was admitted to the Second Affiliated Hospital of Jiaxing University on October 6,2014 were collected.The patient underwent abdominal CT on admission and at 10 hours after admission.The patient received emergency exploratory laparotomy after preoperative preparation,and then postoperative regular symptomatic treatment and pathological examination.Results of abdominal CT were observed,including imaging features of abdominal masses,extent of small intestinal obstruction,situation of intestinal tube within the masses,vessel distribution in the mesentery and fibrous capsules around the mesentery.Situation of operation,routine blood test,biochemical indicator,blood coagulation indexes,postoperative recovery,complications,results of pathological examination and situation of patient during follow-up were recorded.The follow-up by telephone interview and outpatient examination was applied to the patient till October 31,2015,including detecting the dietary,with or without symptoms of abdominal pain and distension,haematemesis and hematochezia,routine blood retest,liver function,renal function and CT.Results Results of abdominal CT on admission:(1) coronal plain scan of abdominal CT showed that there were signs of incomplete intestinal obstruction,and local small intestinal dilatation and gas accumulation in left abdominal region without specific sign.(2) Plain scan of abdominal CT showed that there were the coated sign with thickened fibrous capsules around the intestinal tube, banana shape ' with agglomerate and expanding-distortion intestinal tube and aggregative,stretching and twisting mesentery with abnormal vessel distribution.(3) Sagittal reconstruction images of abdominal CT showed that a huge mass consisted of fibrous capsules as cocoon and agglomerate and expanding-distortion intestinal tube was petal-like and fixed on posterior abdominal wall.(4) Coronal reconstruction images of abdominal CT showed that agglomerate and expanding-distortion intestinal tube was annularly surrounded by uneven thickness fibrous capsules with abnormal vessel distribution in the mesentery.Results of abdominal CT at 10 hours after admission:(1) coronal plain scan of abdominal CT showed that small intestinal obstruction was obviously exacerbated and expanding intestinal tubes were increased and aggravated.(2) Plain scan of abdominal CT showed that a typical sign of small intestinal obstruction was exacerbated and there were multiple air-fluid levels in the agglomerate and expanding-distortion intestinal tube with fluid and gas accumulation.Patient underwent successful enterodialysis + resection of fibrous capsules.During operation,a huge mass in the intestine from suspensory ligament of duodenum to ileocecum was fixed on posterior abdominal wall and surrounded by dense,smooth and white fibrous capsules,partial colon was also surrounded by fibrous capsules and greater omentum was missing.Patient received the postoperative supporting treatments of fasting,anti-infection and inhibition of acid.Number of white blood cells,absolute value and percentage of neutrophils,levels of high-sensitivity C-reactive protein and procalcitonin were 17.10 × 109/L,15.70 × 109/L,91.5％,127.49 mg/L and 1.370 μg/L by blood routine retest at postoperative day 1,respectively.Patient had normal liver,renal and coagulation functions.Fluid diet intake at postoperative week 1 was gradually replaced by normal diet intake.Patient had normal liver and renal functions by blood routine retest at postoperative day 10 and a good recovery without intestinal fistula,abdominal and pulmonary infections and other complications.Postoperative pathological examination showed that gross specimen was mainly composed of cocoon-shaped,grayish white and tough fibrous capsules.Fibrous capsules were consisted of proliferative fibrofatty tissues by microscope observation,with small vascular hyperplasia and large numbers of the inflammatory cell infiltration.Patient was diagnosed with small intestinal obstruction caused by primary abdominal cocoon after operation,and followed up for 1 year with normal diet intake and without abdominal pain and distension,nausea and vomiting,melena and discomfort.There was normal blood routine retest,liver and renal functions and distribution of the intestine in abdomen by CT examination.No dilatation of the intestinal tube was found and strip-like high density shadow in ileocecum was detected and considered as remnant fibrous capsules.Conclusion Imaging features of small intestinal obstruction caused by primary abdominal cocoon include agglomerate and expanding-distortion intestinal tube fixed on abdomen,partial intestinal tubes dilatation,intestinal fluid accumulation and air-fluid level,aggregative,stretching and twisting mesentery with abnormal vessel distribution,thickened fibrous capsules around intestinal loops and among intestinal tubes.
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Objective To evaluate CT features of hemorrhagic and necrotic polyps of maxillary sinus and nasal cavity.Methods Twenty-nine cases of hemorrhagic and necrotic polyps proved pathologically were collected in this study.Axial,coronal,plain and / or contrast enhanced thin-slice CT scans were performed in all the cases.Results The density of lesion was inhomogene (26/29).The lesions had clear boundary and slight enhancement on contrast-enhanced scan.Expanding of nasal and /or antronasal cavity,compressive bony absorption were often seen in inter-wall of maxillary sinus(13/29).The bony destruction in most of the cases were showed with bony sclerosis(25/29).Conclusion The diagnosis of hemorrhagic and necrotic polyps can be confirmed by CT examination.
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Objective To investigate the relationship between X-ray manifestations of breast cancer,pathology and X-ray classification,in order to improve the diagnostic level of breast cancer.Methods X-ray findings of 114 cases of breast cancer were analysed retrospectively.All cases were comfirmed by operation and pathology. Results All cases were divided into five types,including the mass type(34 cases),mass with calcification type(27 cases),calcification type(28 cases),abnormality structure type(21 cases) and latency type(4 cases).Infiltraing duct cancer was a high incidence(61.4%) and the secondary was simple cancer(20.1%).Conclusion breast cancer of the mass type,mass with calcification type and calcification type are characteristic mammographic features.Mammography could get a clear diagnosis.The breast cancer of the abnormality structure type are not characteristic mammographic findings.The imaging diagnostic rate of breast cancer can obviously improve through recognizing its X-ray findings.