Biological characteristics of the cerebral venous system and its hemodynamic response to intracranial hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The role of the cerebral venous system (CVS) in intracranial pressure (ICP) regulation remains largely unclear. In the present study, the interaction between ICP and the cerebral venous system and its possible mechanism were investigated with respect to the biological characteristics of the cerebral venous system and its hemodynamic response under increased ICP.</p><p><b>METHODS</b>We created intracranial hypertension animal model, measured and calculated the venous flow velocity and diameter of the outflow terminal of the CVS with color ultrasonic system and recorded the vascular morphology by 3-dimensional anatomical microscopy. Patients who suffered from raised ICP underwent MRI and digital subtraction angiography (DSA) examination to show the length in the vertical direction of the wall of the bridging vein representing the diameter value. Pathological autopsy was performed from bodies of patients who had died from non-cerebral causes to observe the juncture part between the venous sinuses and tributary vertical brain veins.</p><p><b>RESULTS</b>Under increased ICP conditions, venous drainage through the outlet cuff segment, a unique structure between the bridge vein and sinus, was obstructed and in turn venous blood became congested. Therefore, the increased blood volume worsened the pre-existing ICP according to the well-accepted theory regarding volume-pressure relationship. This phenomenon was described as concurrent "venogenic intracranial hypertension", which is characterized by intracranial venous blood stasis responsive to and together with the original increased ICP.</p><p><b>CONCLUSIONS</b>The existence of this special pathophysiological process is prevalent, rather than rare, in various intracranial disorders. This finding would definitely provide new insight into the area of cerebral venous system research.</p>

Diagnostic value of dual-source CT in Kawasaki disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Doppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease (KD). However, the diagnostic accuracy for the whole coronary artery lesions is limited. The purpose of this study was to compare the diagnostic value of dual-source computed tomography (DSCT) and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.</p><p><b>METHODS</b>Sixteen patients, 12 with typical KD and 4 with atypical KD, underwent DSCT and Doppler color echocardiography. The position and internal diameter of each coronary artery lesion was measured. Correlation analysis was used to compare the diagnostic value of the two imaging modalities.</p><p><b>RESULTS</b>In the typical KD group, seven patients did not have any coronary artery lesion as confirmed by both DSCT scans and Doppler color echocardiography; in four patients proximal coronary artery injuries were identified by both modalities; in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography. In the atypical KD group, three cases showed the same results with both modalities, while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography. There was a good correlation between the two imaging modalities (Kappa value, 0.768 (>or= 0.75)).</p><p><b>CONCLUSION</b>DSCT coronary artery angiography is an accurate, non-invasive, and valuable technique for detecting and following up coronary artery lesions in patients with KD.</p>

The value of 64-slice spiral CT angiography based on pre-contrasted raw data in diagnosing pulmonary arteriovenous fistula / 中华放射学杂志

Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

Role of 64-slices spiral CT in acute chest pains / 中华放射学杂志

Objective To explore role of 64-slices spiral CT in differetiation of acute chest pains.Methods Thirty six patients with acute chest pains were performed 64-slices spiral CT chest angiography.Two-dimensional and three-dimensional reconstruction was performed in all patients by means of multiplanar reconstruction(MPR)(coronal,sgittal oblique),curved planar reformation(CPR), maximum intensity projection(MIP),and volume rendering(VR).All images were blindly reading by two experienced radiologist.DSA were performed at the same time in 16 cases.Results The coronary artery branches,pulmonary artery and aortic artery in all patients were showed clearly,The acute myocardial infarction were showed in 10 cases,The pulmonary artery embolism in 14 cases,The aortic dissection in 6 cases respectively,The Coronary embolism in One case ,pneumothorax In One case The constrictive pericarditis in 1 case respectively.Normal findings in 4 cases.Conclusion 64-slices spiral CT is a useful and noninvasive examination in acute chest pain.