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Objective:To explore the characteristics of collateral circulation of moyamoya disease in CT angiography imaging.Methods: Data of 120 moyamoya disease patients diagnosed by the 94th hospital were collected. All the patients underwent CT angiography imaging and were divided into groups according to compensatory ways of collateral circulation. Lightspeed VCT was used in all patients to conduct CTA check, and assessed the clinical performance of 4 groups. Results: Group 1 consisted of 15 cases (12.5%) of ischemic type moyamoya disease. Group 2 had 53 cases (44.2%), 8 cases were ischemic type moyamoya disease, and 45 cases were beeding type group moyamoya disease. Group 3 had 38 cases (31.7%), who showed moyamoya vessel formation in the bottom of the brain, 7 of these cases were ischemic moyamoya disease, and 31 were bleeding type moyamoya disease. Group 4 had 14 cases (11.6%), all of whom belonged to bleeding type moyamoya disease, characterized by ophthalmic artery, temporal artery, middle meningeal artery, occipital artery communicating with terminal cortex intracranial vascular.Conclusion: Compensatory characteristics of collateral circulation vessels were closely correlated with the types of moyamoya disease.
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Objective: To study the characteristics of CT imaging of adult ischemic type moyamoya disease, involving CT plain scan, CT perfusion imaging (CTP) and CT angiography (CTA). Methods:A retrospective analysis was made of the imaging data of 20 adult ischemic type moyamoya patients, including CT plain scan, CT perfusion imaging and CT angiography. CT vascular imaging features were graded I-VI with reference to Suzuki vascular grading. Results:Among the 20 patients with adult ischemic type moyamoya , ①CT plain scan: Old infarct lesions occurred in 13 cases(65%), 1 case suffered from acute cerebral infarction(5%), and negative patients totalled 6 (30%);②CT perfusion:5 cases(25%) were normal perfusion, 15 cases(75%) showed obviously low perfusion and local high perfusion;③CT angiography:patients of grade I to VI were respectively 1, 2, 5, 6, 4 and 2. Conclusion:Cerebral infarction lesions associated with adult ischemic type moyamoya disease are distributed mainly in the frontal and parietal cortex, or in watershed regions. Cerebral perfusion is characterized by normal or uneven blood perfusion, especially low perfusion. Vascular imaging manifests mostly degree III and IV, which belong to the middle phase of moyamoya disease.
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Objective: To improve the accuracy of forecasting hemorrhagic moya-moya disease by analyzing the difference in MR imaging between ischemic moya-moya disease and hemorrhagic moya-moya disease. Methods: Retrospective analysis was conducted of clinical and MR imaging data of 64 patients with moya-moya disease between 2009 and 2014 years in Hospital 94 of PLA. Results: Among the 64 patients aged 26 to 49 (average age was 38.2), 21 cases (32.8%) were diagnosed with ischemic moya-moya diseases, while 16 cases (76.2%) diagnosed with hemorrhagic moya-moya diseases, ischemic lesions were distributed mainly in frontal and parietal area, while hemorrhagic lesions were mainly distributed in the dorsal thalamus (28 cases, 65.1%), in the basal ganglia (9 cases, 20.9%), in the simple intraventricular (4cases, 9.3%) and in pure subarachnoid (2 cases, 4.6%). In the ischemic-typed moyamoya disease and hemorrhagic-typed moyamoya disease, cerebral bottom dorsal smoke abnormal vascular network, anterior choroidal artery and callosal artery thickening of the posterior cerebral artery, cortical pial vascular thickening, thickening of vascular branches of ophthalmic artery and external carotid artery thickening were respectively occurred in 15 cases of 28 branch (71.4%) and 38 cases of 62 branches (88.4%), 12 cases with 24 branches (57.1%) and 35 cases with 45 branches (81.4%), 8 cases with 16 branches (38.1%) and 30 cases with 58 branches (69.8%), 5 cases with 10 branches (23.8%) and 13 cases of the 24 branch (30.2%), 7 cases with 11 side branches (33.3%) and 27 patients with 54 branch (62.8%). Conclusion:The tortuous and dilated choroid artery and abnormal hyperplasia vascular network in skull base are the main causes of bleeding in moya-moya diseases.
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Objective To study the imaging features and possible aetiology of osteonecrosis in adults with acute leukemia.Methods Ten adult patients with acute leukemia for osteonecrosis were reviewed retrospectively.All the lesions were confirmed with MRI.Results Four patients with ALL had accepted chemotherapy contained corticosteroids,two of them were performed HSCT,and one patient suffered GVHD.Six patients with AML had accepted chemotherapy without steroids,five of them were performed HSCT,and four patients suffered GVHD.One patient with AML-M3 had accepted chemotherapy including four courses of ATRA.The mean time between diagnosis of osteonecrosis and leukemia was 25.1 months.Nine cases had multiple lesions,one case had single lesion.The lesions involved femurs,tibias,patellas,iliums,and lumbars.Plain radiographs in six patients can not detect any lesion.Circinal reaction ossification could be detected in CT images of four cases.All the cases had typical feature in MRI.Conclusions In adult leukemia patients,osteonecrosis is a complication after chemotherapy or HSCT.Steroids in chemotherapy protocols or treatment for GVHD,ATRA for APML,chemotherapy-induced direct cytotoxic effect or leukemia itself can be the possible risk factor.For the diagnosis,MRI is the most effective way,and CT features of osteonecrosis in leukemia patients are different from those in non-leukemia patients.
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Objective To investigate the spiral CT findings in hemopathic patients with druginduced pulmonary injury.Methods CT images obtained in 11patients with drug-induced pulmonary injury were retrospectively analyzed.Six patients had antineoplastic agent-induced pulmonary injury and 5 patients had non-neoplastic agent-induced pulmonary injury (immunosuppressor in 2 patients,antifungal in 2 patients,antineoplastic immunomodulators in 1 patient).CT findings were reviewed by a chest radiologist.Results All 11patients had parenchymal abnormalities on MSCT scans,including ground-glass opacities( n =8 ),consolidation( n =5 ),interlobular septal thickening( n =3 ) and focal fibrosis ( n =2 ).The abnormalities were bilateral and asymmetric in all patients.They were mainly in the peripheral lung regions in 6 patients,in the central lung regions in four,and irregularly located in one.The abnormalities involved mainly the lower lung zones in six patients,the upper lung zones in two,and all lung zones homogeneously in three.One patient had fluid in bilateral pleural cavities.Three patients were given the same agent once more after the imaging turned to normal,and they presented with same clinical symptoms and similar but more serious imaging findings.Conclusions Drug-induced pulmonary injury usually manifests as areas of ground-glass opacity and consolidation,which most commonly involves the peripheral lungs and lower lung zones.Drug-induced pulmonary injury shows reproducible but more serious lesions when the patient is given the same agent once more.
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Objective To investigate the changes of quantitative parameters of dynamic enhanced CT in non-small cell lung cancer before and after targeted therapy,and compare them with the traditional evaluation criteria,in order to find the parameters which can be exploited for timely,objective evaluation of the effect of targeted therapy.Methods The study included 21 patients with targeted therapy who had received dynamic enhanced CT before and after treatment.Enhancement time-density curves were obtained based on the CT values of the lesion at individual time points,and the functional indices:peak height (PH),the time to peak height (Tp),the ratio of PH of the mass to aorta (M/A) and perfusion value were calculated.The effects of the treatment on these indices were evaluated and compared with the effect of the treatment on lesion diameter. Results Twenty-one patients had 33 rechecking results. There was a statistically significant agreement between lesion diameter-based treatment evaluation and perfusion-based treatment evaluation ( U =8.761,P ＜ 0.01 ). The perfusion value decreased in patients with disease regression[before treatment:(0.28 ±0.11 ) ml · min-1 · ml-1,after targeted therapy(0.18 ±0.09) ml ·min-1 · ml-1,t =- 3.2722,P =0.0042],but increased in patients with disease progression[before treatment(0.21 ±0.08) ml · min-1 · ml-1,after targeted therapy:(0.34 ±0.11 ) ml · min-1 · ml-1,t =2.6064,P =0.0403].Conclusions On dynamic enhanced CT in non-small cell lung cancer patients after targeted therapy,perfusion value changed in the same trend as the diameter of tumor.The effectiveness of targeted therapy may be evaluated by perfusion value changes.
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Objective To analyze the characteristics of breast cancer blood supply before and after chemotherapy with low-dose CT perfnsion. Methods Fifteen patients with breast cancer underwent CT breast perfusion examination, which was performed before and after chemotherapy within 1 week on Siemens Sensation 4 scanner with 120 kV and 50 mAs, 50 ml of nonionic contrast agent (320 mg I/ml) was injected at a flow rate of 4 ml/s with a power injector, Scan started after 8 seconds delay and data acquisition duration was 50 seconds. The blood flow ( BF), blood volume (BV) and mean transfer time (MTT) of lesion and contralateral normal breast gland were calculated using Basama perfusion 3 software package before and after chemotherapy. At the same time, the tumor size before and after chemotherapy were measured and correlated with the BF values. The t test and non-parametric test were used for the statistics. Results ( 1 ) The mean BF、BV and MTT of breast cancer were (33.20±4. 17) ml · min-1 · 100 ml-1 , (8. 31±2.43) ml · 100 ml-1 and ( 15. 31 ± 4. 31 ) s respectively before chemotherapy, and ( 13.65 ± 6. 04) ml · min-1 100 ml-1, (5.04±2. 33) ml · 100 ml-1 and (25. 97±9. 07) s respectively after chemotherapy and there were statistically significant (P =0. 000). The mean BF、BV and MTT of normal breast were (4. 31 ± 2.23) ml · min-1 · 100 ml-1, (1.38±0.75) ml · 100 ml-1 and (19.25±3.94) s respectively before chemotherapy, and (4.03±2.35) ml · min-1 · 100 ml-1、(1.44±0.84) ml · 100 ml-1、(22.56 ± 7.71 ) s respectively after chemotherapy and there were not statistically significant (P >0. 05). (2)The BF of breast cancer was higher than the normal breast before chemotherapy ( P < 0. 01 ). (3) There was a positive correlation between the BF values and tumor size before and after chemotherapy ( r = 0. 902, P = 0. 000). Conclusion The BF value has a positive correlation with tumor size after chemotherapy, CT perfusion is more sensitive for the evaluation of chemotherapy response than morphologic assessment.
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Objective To discuss the application of spiral computed tomography and reconstruction technology for patients of depressed nasal bone. Methods The patients of transsection location were backlying on the scan bed and continuously scanning in spiral, and baseline was acou-infraorbital line. The reconstructed image with 2mm layer thickness and 1.5mm overlap can be selected SSD liminal value as bone -wide and surface threshold. Results SSD image can be clearly demonstrated than general nasal bone cross-section profile in the shape, location, size and suitability of filled composite. Conclusion The surface shadow display can be shown nasal bone structure realistically, the three-dimensional anatomic structure images of vessels and the effect of bionics. The bone of volume, distance and angle can be measured exactly by clinical physician, and made the best treatment plan based on the images.
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Objective To study the morphological characteristics of tumor microvasculature in primary hepatic cell carcinoma (HCC). Methods From Jan. 1998 to Feb. 2002, 32 cases, consisting of 26 male and 6 female, with age ranging from 28 to 76 years [mean (50.56?10.52) years], underwent preoperative digital subtraction angiography (DSA) without theraputic embolization in General Hospital of PLA and 307 hospital of PLA. The diameters of the tumors measured 2～23 (8.05?6.17) cm. The tumor microvessel density (MVD), type and diameter of the tumor microvessels, width of tumor trabeculae, and the size of the malignancy were measured and statistically analyzed. The outcome of the each patient was also statistically analysed. Results The size of tumor tended to be positivly correlated with the pattern of microvasculature of the tumor. The size of the tumor was negatively correlated with MVD, white the tumor size and the diameter of tumor related vessels were positively correlated with the diarneter of tumor trabeculae. Hoverer, the size of the tumor was not correlated with the diameter of vascular trabeculae. Conclusions The density, configuration and the distribution of tumor microvessels were not even in HCC. The features of tumor microvasculature were distinctive at different phases of tumor growth, having definite rules in the development.
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Objective To discuss the relationship between morphological characteristics of tumor microvasculature and blood supply type of primary hepatic cell carcinoma (HCC) through DSA. Methods From Jan. 1998 to Feb.2002, 32 cases, male 26,female 6,aged 28-76 (mean 50.56?10.52) years, underwent preoperative digital subtraction angiography (DSA) without therapeutic embolization in the 301 hospital and 307 hospital. The intervals between DSA and curative resections were 13-70 (mean 31.89?19.11) days. The diameters of the tumors were 2-23 (8.05?6.17) cm. The blood supply type of tumor, the tumor microvasculature density(MVD), type and diameter of the tumor microvessels, width of tumor trabecular were recorded for these cases. The outcomes were then statistically analysized. Results ① Blood supply of the tumor observed on DSA tended to be positively correlated with type of the tumor microvasculature. ②MVD of hypovascular tumors were lower than those in moderate and hypervascular tumors.③The ratio of diameters between tumor microvessel to the trabeculae of the tumor went higher with the increase of HCC blood supply on DSA. Conclusions ①The density, the configuration and the distribution of tumor microvasculature were not evenly distributed in HCC. ②The features of tumor microvasculature possessed distinctive characteristics in different stages of tumor growth, simultaneously with some definite developing rules. ③ Distinct differences in morphological characteristics of tumor microvasculature between different blood supply types of HCC.
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Objective To analyze the imaging characteristics of thoracic LDRD(Low-dose directly Digital Radiographic Device) and its artifacts.Methods 188 patients were performed with LDRD and common thoracic X-ray film respectively in our hospital during two weeks.Results Among the 188 cases,1.60%(3/188) showed thoracic motion artifacts.46.8%(88/188) appeared as tentorial prominence along left heart edge and 2.6%(5/188) along the right one.1 artifact was in aorta-pulmonary artery window(0.53%).Conclusion(1)Less than 0.5 should be taken as reference in podoid enlargement diagnosis.(2)Pseudomorph from heart motion may result from cardio-phase,cardiac contraction,heart rate,arrhythmia,local abnormal pulse of left heart edge,different enlarged velocity of cardiac cavity during heart beat,etc.(3)The motion artifacts in thoracic LDRD has no important influence in clinical diagnosis and therapy.
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Objective To investigate the features of non-senile colonic diverticula as diagnosed by coloscopic examination in 47 cases. Methods 47 cases of non-senile colonic diverticula were diagnosed by colonoscopy in the Department of Endoscopy, General Hospital of PLA, from Jan. 1996 to Dec. 2001. Results There were 38 males and 9 females, whose age was under 60, with a mean age of 43.2 years. The incidence and detectable rate for simple and multiple diverticula showed no relationship to patients' age. The detectable rate of colon diverticula was higher in males than in females. Right colon was the predilection site for both simple and multiple colonic diverticula, especially for simple diverticula. The ratio of incidence for right to left colon was 20.5∶1. The ratio was 2.8∶1 in senile patients (aged above 60, detectable rate of colon diverticula was16.9‰). Conclusion The incidence of colonic diverticula in non-senile patients showed no relationship to age. The incidence of diverticulum in right colon was higher in non-senile patients than in seniors. The incidence of diverticulum in the left colon or both sides of colon was lower in non-senile patients was in seniors.