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>

Significance of the preoperative guidance of dual-source CT in carotid body tumor / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Accurate views of the head and neck vessels, tumor angiogenesis and the relationship of tumor and the surrounding blood vessels are especially crucial to carotid body tumor (CBT) patients. The aim of this study was to explore the value of dual-source CT (DSCT) cerebral and carotid angiography in CBT diagnosis.</p><p><b>METHODS</b>DSCT cerebral and carotid angiography was performed on nine patients with CBT. Two-dimensional and three-dimensional reconstruction images were obtained by means of multiple planar reconstructions (MPR), maximum intensity projection (MIP) and volume rendering (VR). All patients were subjected to color Doppler flow imaging (CDFI) examination. Two kinds of examinations were performed in 3 days, and all patients were confirmed by surgery.</p><p><b>RESULTS</b>DSCT angiography was successful in all patients. CBTs were diagnosed in 9 patients with 10 lesions (1 case had multiple bilateral CBTs). The largest lesion was 12 cm in diameter, and the smallest one was 1.6 cm in diameter. All patients had clearly demonstrated head and neck vessels, tumor angiogenesis, and tumor relationship with the surrounding blood vessels. The internal and external carotid artery (ICA, ECA) were involved in 2 cases. There were 7 cases with basilar artery ring integrity, and 1 case had the posterior communicating artery absent; 1 case had middle cerebral artery stenosis; 4 cases (4 tumors) showed arterial phase homogeneous enhancement; 5 cases (6 tumors) had obvious heterogeneous enhancement where irregular low-density necrosis could be seen in the tumors. CDFI could demonstrate the nearby blood vessels and tumor structure, instead of tumor angiogenesis. However, DSCT can display both the tumor and the peripheral vascular tumor angiogenesis consistent with surgical findings.</p><p><b>CONCLUSIONS</b>DSCT cerebral and carotid angiography can provide reliable information for the operation. It might be a valuable CBT diagnostic method by showing accurate views of the CBT along with the bilateral neck and brain blood vessels.</p>

Functional magnetic resonance imaging on acupuncturing Yuan-Source and He-Sea acupoints of stomach Meridian of Foot-Yangming / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the functional brain localization with magnetic resonance imaging (MRI) after acupuncturing the Yuan-Source and He-Sea acupoints of Stomach Meridian of Foot-Yangming (ST).</p><p><b>METHODS</b>The study was performed in 30 healthy volunteers who underwent acupuncture at Yuan-Source acupoint (Chongyang, ST42) and He-Sea acupoint (Zusanli, ST36) (ST group). Ten of these were also underwent acupuncture at the non-acupoints as the control group. Blood oxygenation level dependent functional MRI was performed.</p><p><b>RESULTS</b>In the ST group, signal increasing areas were demonstrated in bilateral superior temporal gyri (Broadmann 22), bilateral supramarginal gyri (Broadmann 40), bilateral cerebellar hemispheres, bilateral cingulate gyri and isthmus of cingulate gyri (Broadmann 32, 30), bilateral superior parietal lobules (Broadmann 7); signal decreasing areas were shown in bilateral orbital gyri (Broadmann 11), bilateral temporal pole (Broadmann 38), right inferior frontal gyrus (Broadmann 47) and right medial occipitotemporal gyrus (Broadmann 36). In the control group, signal increases areas were demonstrated in superior temporal gyri, precentral gyri, cingulate gyri, thalamus, insula and cerebellum. The size, signal intensity and number of increasing areas in control group are less than in ST group.</p><p><b>CONCLUSION</b>Combined acupuncture of Yuan-Source and He-Sea acupoints of ST can activate and decrease the multiple brain regions of "splanchnic brain" and thus reach a new functional balance to relieve pain.</p>

Technical feasibility and histopathologic studies of poly (N-isopropylacrylamide) as a non-adhesive embolic agent in swine rete mirabile / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Non-adhesive liquid embolic agents are increasingly gaining importance in the embolization of cerebral arteriovenous malformations (AVMs). We investigated the use of poly (N-isopropylacrylamide) (PNIPAM) as a non-adhesive embolic agent in swine rete mirabile.</p><p><b>METHODS</b>The PNIPAM hydrogel was mixed with iohexol and embolization was performed in swine rete mirabile in 30 animals. The microcatheter was examined after embolization. Follow-up angiography was performed for embolic efficacy after embolization. Embolized retia were examined histopathologically, and the alterations of inside rete and surrounding tissue were observed.</p><p><b>RESULTS</b>The copolymer hydrogel was used for rete embolization in 30 swine, 28 swine survived the procedure, 2 swine died, 1 swine died of cerebrum infarction and the other died of embolic agent reflux into the occipital artery. The inside wall of the microcatheter was smooth, without copolymer adhering to it. Follow-up angiography was performed in 22 swine, there was no rete recanalization in 20 swine and partial rete recanalization in 2 swine because of the trunk embolization of ascending pharyngeal arteries. Histopathologically, the copolymer was found diffused into vessels of 100 - 150 microm in diameter. In acute group, neutrophils scattered surrounding the copolymer and endothelial integrity was observed, without endothelial denuding and necrosis. In subacute and chronic groups, the copolymer was found inside retia, a few mononuclear cells and eosinocytes scattered inside and surrounding it. The muscular layer was loosened with most muscular nuclei degraded.</p><p><b>CONCLUSION</b>Experimental rete embolization with PNIPAM, made radiopaque with iohexol, is technically feasible in swine. Because of its properties, PNIPAM has great potential as a therapeutic non-adhesive embolic agent.</p>

Multi-slice spiral CT using spinal structure assessment in elderly patients with osteoporosis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the clinical value of 64-slice spiral CT for spinal structure assessment in elderly patients with osteoporosis.</p><p><b>METHODS</b>The computed radiography (CR) films and 64-slice spiral CT isotropic scanning images of 40 patients who had been diagnosed as osteoporosis by dual-energy X-ray absorptiometry (DXA) were retrospectively analyzed. The patients were divided into two groups according to their T-scores by DXA: group A (T-score was -1.0 - (-2.5)); and B group (T-score was below -2.5).</p><p><b>RESULTS</b>The diagnostic results of axial CT images combined with multi-planar reconstruction (MPR) was negatively correlated with the measurement results of DXA in the diagnosis of spinal osteoporosis, and such correlation was higher in group B than in group A. Compared with CR films, axial CT images combining with MPR showed superior effectiveness in the diagnosis of osteoporosis.</p><p><b>CONCLUSIONS</b>64-slice spiral CT is better than CR in diagnosis of osteoporosis. CT-MPR and 3D reconstruction not only can be used to diagnose osteoporosis early, but also to observe the changes of skeleton's shape and overall structure.</p>

The application of multi-slice CT dynamic enhancement scan in the diagnosis and treatment of colonic lymphomas / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To discuss the value of multi-slice CT dynamic enhancement scan in the diagnosis and treatment of colonic lymphomas.</p><p><b>METHODS</b>16 patients with colonic lymphomas underwent multi-slice CT dynamic enhancement scans, images of axial and reconstructive images of VR, MPR and CTVE were analyzed, patients were respectively diagnosed.</p><p><b>RESULTS</b>Appearances of primary colorectal lymphomas were categorized into focal and diffuse lesions. Focal and diffuse lesions were 6 and 10 patients, respectively. The accuracy rate of diagnosis was 87.5%.</p><p><b>CONCLUSION</b>MSCT dynamic scan has distinctive superiority in diagnosis and treatment of colonic lymphomas.</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.

The value of 64-slice CT angiography in diagnosing pulmonary arteriovenous fistulas / 中华放射学杂志

Objective To explore the value of 64-slice spiral CT angiography in diagnosis of pulmonary arteriovenous fistulas(PAVF).Methods 12 patients with suspect PAVF were performed by enhanced scan with 64-SliceCT.Two-dimensional and three-dimensional reformation were performed in all cases including coronal multiplanar reconstruction(MPR),maximum intensity projection(MIP),volume rendering(VR).Resnlts 12 cases were diagnosed as PAVF by 64-SliceCT angiography.Single PAVF in 7 cases,Multi-PAVF in 5cases.We found 20 lesions in 12 patients,Except direct multi-pulmonary arteriovenous fistulas in the area of near the heart in one case.Conclusion 64-slice spiral CT angiography is a useful and noninvasive means to identify PAVF and is also useful for therapeutic planning and postoperative follow-up.

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.

Multi-slices spiral CT perfusion imaging evaluating of microvessel density in maxillofacial tumors / 中华放射学杂志

Objective To evaluate the relationship between Multi-slices spiral(MSCT) perfusion and microvessel density (MVD) in maxillofacial tumors. Methods Thirty-one cases of maxillofacial tumors were studied with MSCT perfusion imaging before operation. The time-density curve, perfusion, time to peak(TTP), and Peak enhancement imaging (PEI) of tumors were calculated. MVD of the tumors was measured with immuno-histochemical method by means of detecting factor Ⅷ in all the histologic specimens. Relativity analysis was carried between MSCT perfusion imaging parameters, perfusion curve types and MVD. Results MVD of maxillofacial tumors were higher than normal tissue. MVD remarkably correlated with malignancy of the tumors. Perfusion and time to peak (TTP) correlated well with MVD(t=7.09,4.10, P0.05). Significant difference of MVD in three types of perfusion curve was found(F=8.09,P

Treatment of lumbar disk herniation with MRI guidance injection of oxygen-ozone / 中华放射学杂志

Objective To evaluate the applied value of percutaneous oxygen-ozone injection in the treatment of lumbar disc herniation under open 0.23 T MRI guidance.Methods Mounted with ipath 200 optical tracking system,MR-guided injection of oxygen-ozone were performed via a medial border of the articular processes approach in 73 patients with clinically diagnosed LDH.MR compatible 19.5G or 21.0 G biopsy needle was used. Discography was performed in order to select indication before injection oxygen- ozone into nucleus pulposus in 26 patients.Sixty-four patients were injected to three sites:(1)Six to 10 ml oxygen-ozone was injected into discs centers,injected and suctioned alternately in order to make nucleus pulposus oxidation thoroughly.(2)The needle was withdrawn according to the scale of biopsy needle and optical tracking.Then,10 ml oxygen-ozone was injected into disc herniation. (3)After that,needle was withdrawn further about 1.0—1.5 cm to outside of annulus fibrosus.Fifteen to 20 ml oxygen-ozone was injected into intervertebral foramina around nerve roots.The oxygen-ozone concentration was 35—45?g/ml. Nine patients were only performed injection of oxygen-ozone into around nerve root,while not injection oxygen-ozone to nucleus pulposus for considering bad curative effect after discography.Results All of 73 patients were successfully local targeted and treated under MRI guidance without serious complications, such as nerve root injury.After 3—6 months follow-up,total overall efficacy was 91.3% with the excellent in 28,good in 39,and poor in 6,respectively.Conclusion Open MR-guided injection of oxygen-ozone, mounted with optical tracking system,is a safe and effective minimally invasive therapy for treating LDH.

Hypoplasia of cochlear nerve foramen:CT findings / 中华放射学杂志

Objective To observe the CT findings of hypoplasia of cochlear nerve foramen. Methods CT findings of cochlear nerve foramen were observed in 50 volunteers (100 ears)and in 9 cases with hypoplasia of cochlear nerve foramen.The width of the bony canal for the cochlear nerve were measured in both groups.Results The fissure in the cribriform area were seen in every volunteers.The width of the bony canal for the cochlear nerve was (2.32?0.25)mm in normal group.The stenosis of cochlear nerve foramen were shown in 9 cases (10 ears),the lacking of fissure in the cribriform area were seen in 8 ears, while the fissure were shown in 2 cases.The stenosis of internal auditory canal was shown in 4 cases. Abnormality of vestibule and horizontal semicircular canal was shown in one case.The maximum value of the width of the bony canal for the cochlear nerve was 1.5mm,the minimum value was 0.9 mm.Conclusions The typical CT findings of hypoplasia of cochlear nerve foramen were stenosis of cochlear nerve foramen,the lacking of fissure in the cribriform area and cochlear nerve foramen without helix shape.The hypoplasia of cochlear nerve foramen may be a subtype of cochlear dysplasia.