Objective and importance of the resident standardization training for resident doctors in radiology / 中华医学教育探索杂志

Residency training is the mainstream model of doctor training around the world. Radiol-ogy teaching is an important part of the resident practice training. The purpose is improving and upgrading the quality of the residency training by establishing rigorous management system, intensifying the teachers disposition, setting tutorial system and reforming the examination and supervisor system, the residents.

Correlation study of cerebral white matter lesion with cognitive dysfunction after traumatic brain injury / 中华创伤杂志

Objective To analyze the correlation between white matter injury and cognitive dysfunction using diffusion tensor imaging (DTI).Methods Seventeen subjects with TBI hospitalized from October 2012 to September 2013 had Glasgow coma scale (GCS) score of ≥ 13 (mild injury group, 10 cases) and ≤ 12 (moderate-severe injury group, 7 cases).Another 17 healthy subjects were used as controls.All were submitted to DTI examination.Fractional anisotropy (FA) and apparent diffusion coefficient(ADC) values in genu corpus callosum, splenium corpus callosum, posterior internal capsule, anterior internal capsule, and cerebral peduncle were calculated using the Neuro 3D software.Correlations between FA and ADC with the mini-mental state examination (MMSE) score were evaluated.Results Moderate-severe injury group demonstrated significantly reduced FA values in genu corpus callosum and splenium corpus callosum, and significantly increased ADC values of genu corpus callosum, splenium corpus callosum, posterior internal capsule and cerebral peduncle when compared to control group (P ＜0.05 or 0.01).FA and ADC values in the regions of interest did not differ significantly between mild injury group and control group (P ＞ 0.05).In the genu corpus callosum and splenium corpus callosum, FA values were positively correlated with MMSE score (r =0.636, 0.601), while ADC values were negatively correlated with MMSE score (r =0.552, 0.660).Conclusions DTI reveals the cerebral white matter lesion that is undetectable using CT and conventional MRI.DTI is a helpful tool to evaluate the degree of cognitive function in patients with TBI, which provides the basic reference for the clinical treatment and prognosis.

Early diffusion tensor imaging findings in animal models of acute diffuse axonal injury / 中华创伤杂志

Objective To establish animal models of diffuse axonal injury (DAI) and discuss the early functional MRI findings.Methods Twenty-five adult white rabbits were divided into control group (n =5),mild DAI group and severe DAI group (n =6) according to random number.Mild DAI group was subdivided into mild DAI 3 h (n =6),1 day (n =4) and 1 week (n =4) groups.Routine MRI and diffusion tensor imaging (DTI) were performed.Parameters measured were fractional anisotropy (FA),apparent diffusion coefficient (ADC),axial diffusivity (AD) and radical diffusivity (RD).Results Significantly increased FA (P＜0.01) and decreased ADC (P＜0.05) and RD (P＜0.01) were detected in severe DAI group compared to control group,but there was no significant variation in AD between the two groups (P ＞ 0.05).Each parameter remained almost unchanged in mild DAI 3 h group and mild DAI 1 week group,but FA was increased (P ＜ 0.01) and RD decreased (P ＜ 0.05) in mild DAI 1 day group,with no changes of ADC and AD.Conclusion DTI is a sensitive way to detect the occurrence and development of DAI and can provide referential images for early DAI diagnosis.

Clinical application of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma / 中华创伤杂志

Objective To discuss clinical value of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma.Methods A retrospective study was carried out on data of 72 multiple trauma patients diagnosed with systemic 64-slice spiral CT scanning in our hospital from January 2006 to June 2008.Of all,28 patients with traffic injuries,24 with falling injuries,10 with blunt injuries,6 with stab injuries and 4 with explosive injuries.Results There were 72 multiple trauma patients with mean scanning time of 10.2 seconds.The CT scanning showed both craniocerebral and thoracic injuries in 30 patients,brain injuries in 16,thoracoabdominal injuries plus pelvic injuries in 10,extremity and brain injuries in 14 and systemic soft tissue injuries in 2.Isotropic characteristics and postprocessing function of 64-slice spiral CT scanning could accurately diagnose and evaluate injury severity of multiple trauma.Conclusions 64-slice spiral CT scanning is a fast and effective method for fast evaluating injury severity of multiple trauma,for it can not only shorten checking time,reduce movements of the patients and relieve the pain of the patients,but also can avoid defects induced by respiratory movement and provide fairly integrated imaging materials by its isotropic characteristics and pestprecessing function.

Analysis of the causes of misdiagnosis on CT films of 45 patients with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To analyze the causes of computed tomographic misdiagnosis of pulmonary carcinoma.</p><p><b>METHODS</b>From September 1991 to January 2002, 45 cases of pulmonary carcinoma misdiagnosed by CT were analyzed retrospectively. Twenty-six cases of pulmonary tuberculosis and 15 cases of pulmonary pneumonia misdiagnosed as pulmonary carcinoma by CT were studied as control subjects. All of these cases were confirmed by surgery and clinical course. The CT appearances of these cases were independently reviewed in a double blind method by three experienced radiologists. Then they discussed together in order to search for the factors of CT misdiagnosis and formed a consensus interpretation.</p><p><b>RESULTS</b>Forty-five cases of pulmonary carcinoma were misdiagnosed as pulmonary tuberculosis in 19 cases, pneumonia in 14 cases, abscess in 4 cases, pleural mesothelioma in 2 cases, normal in 2 cases, and others in 4 cases. The fundamental manifestations of misdiagnosed cases were lobar or segmental shadows (26 cases), solitary mass or nodule (19 cases).The reasons of CT misdiagnosis were very confusing. The main factors were:(i) Missed diagnosis (2 cases, 4.5%). One case had an endobronchial mass and another had the erosion of rib. (ii) Twenty-four cases (53.3%) due to mis interpretation and lack of experience. (iii) The manifestations in CT were atypical (19 cases,42.2%).</p><p><b>CONCLUSIONS</b>Not identifying accurately the CT appearances and excessively emphasizing the specificity of some signs are the main causes of the misdiagnosis. A reasonable and careful CT examination, summarizing analysis combined with clinical findings, and the accumulation of diagnostic experience will help to reduce the CT misdiagnostic rate of pulmonary carcinomas.</p>