Preliminary study on the validity of whole body diffusion-weighted imaging for the detection of malignant lesions / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the validity of whole body diffusion-weighted imaging (WBDWI) for the detection of malignant lesions.</p><p><b>METHODS</b>Nine healthy volunteers, 4 postoperative cases of malignant tumor and 16 malignant tumor cases were included in this study. 29 cases underwent whole body diffusion-weighted imaging on GE Signa Excite HD MR scanner within one week after or before PET examination. The images were double-blindly evaluated by two radiologists without the knowledge of the original PET results. Clinical diagnoses of malignant lesions were mainly based on PET results taken as gold standard. The malignant lesions were evaluated according to nine locations: lymph node; central nervous system; lung; liver, gallbladder, pancreas and spleen; digestive tract; kidney and adrenal gland; pelvic; skeleton, and soft tissue of each subject. The sensitivity, specificity, positive predicative value, negative predicative value, Youden's index and likelihood ratio of WBDWI were analyzed.</p><p><b>RESULTS</b>The images of all the 9 healthy volunteers were normal. 57 malignant lesions were found in the 20 malignant cases by PET, among whom 48 lesions were detected by WBDWI including 2 false positive lesions. Among the 261 locations of 29 cases, the WBDWI examination showed 21 true positive locations, 2 false positive locations and 3 false negative locations. The sensitivity, specificity, positive predicative value, negative predicative value, Youden's index and likelihood ratio of WBDWI were 87.5%, 99.2%, 91.3%, 98.7%, 86.7%, and 103.7, respectively.</p><p><b>CONCLUSION</b>The validity of WBDWI is high, and it could be a new whole body imaging technique for staging of malignant tumors.</p>

Anatermic separated epiphysis or avulsion fracture: image observation / 法医学杂志

OBJECTIVE@#To explore an approach to distinguish avulsion fracture of articular portion from anatomic separated epiphysis.@*METHODS@#21 cases with suspicioned avulsion fracture of articular portion of tubular bone were reviewed. The cortical continuity of separate small bone and contiguous bone portion was investigated. The swell of soft tissue around these small bones was observed simultaneously. Then the configuration of the fracture was researched by injury mechanics.@*RESULTS@#Continued bone cortex between separate small bone and corresponding bone was seen in 15 cases, so they were considered as a separate epiphysis. Sharp linear fracture between the separate small bone and corresponding bone were seen in 6 cases. The swell of soft tissue around the separate small bone was observed in all cases, so they were considered as a avulsion fracture.@*CONCLUSION@#The meticulous investigation of separated small bone at the articular portion by image observation is of important value for distinguishing avulsion fracture from anatomic separate epiphysis.

CT rendering and mechanical analysis for rib fracture inextricable on X-ray chest film in legal medical practice / 法医学杂志

OBJECTIVE@#To explore an approach of CT rendering and mechanical analysis for rib fracture that was inextricable on X-ray film in legal medical practice.@*METHODS@#17 cases with rib fracture undetermined on X-ray chest film in legal medical practice underwent CT scans. The thin slices (0.75 mm or lmm) of images were reconstructed with smooth and sharp kernel. The multiplanar reformatted images along rib and surface shaded display were obtained to investigate rib fracture.@*RESULTS@#All rib fractures were accurately displayed by CT scan and MPR images along rib. The torque that caused rib fracture was divided presumably into vertical and rotary types. The two kinds of rib fracture, composed of vertical and rotary type, were proposed.@*CONCLUSION@#CT scan with thin slice and MPR images can definitely reveal the rib fracture unresolved on X-ray film in legal medical practice. The proposition of two kinds of torque will be help avoid misunderstanding acute rotary type of rib fracture as old healed one.

Inferior orbital fissure and groove: axial CT findings and their anatomic variation / 法医学杂志

OBJECTIVE@#To show imaging findings of inferior orbital fissure (IOF) and groove (IOG) on axial CT scans and to discover their anatomic variations, so as to avoid misdiagnosing them as orbital fracture.@*METHODS@#25 normal skull were used to investigate the configurations of IOF and IOG. Five skulls were performed axial CT scans. 20 normal orbital axial scans were studied as well. MPR and RT-3D reconstructions were used in this study.@*RESULTS@#Skulls scans and normal orbital images on axial CT showed three sorts of findings: (1) single bony dehiscence between lateral and inferior walls; (2) first type of double bony dehiscence between lateral and inferior walls, among the dehiscence interposing a small bone. The long axis of the small bone was parallel to orbital wall; (3) second type of double bony dehiscence between lateral and inferior walls, but the long axis of the small bone was in anteroposterior direction. Anatomy and variation of three sorts of CT findings were corresponded respectively to: (1) a baseball club-shaped IOF; (2) a "V"-shaped IOF, that is composed of both of lateral and internal ramus, lateral ramus situates between the zygoma and the lateral portion of greater wing of sphenoid, and internal ramus between the maxilla and the internal portion of greater wing of sphenoid, both rami intercross caudally and open upwards in a "V"-shaped configuration; (3) a deep IOG with a protuberant lateral wall.@*CONCLUSION@#Familiarity of imaging features on the axial CT scans and understanding of their anatomy of IOF and IOG would be helpful for avoiding misdiagnosis of orbital fracture.

Tuberous sclerosis complex:skeletal CT findings / 中华放射学杂志

Objective To describe the skeletal CT imaging manifestations in patients with tuberous sclerosis complex(TSC),and to analyze their diagnostic value so as to establish an adequate skeletal change imaging data for the diagnosis of TSC.Methods Thirteen patients fulfilling TSC diagnostic criteria were examined with CT of the brain (n=13)and abdomen (n=7).Examinations from January,2004 to July, 2006 were retrospectively analyzed.Results There were three forms of lesions being demonstrated on CT: (1)Multiple sclerosing nodule (n=13):numerous,ovoid and circular,homogeneous,small and well- defined loci and symmetrical lesions were revealed in all cases in the central marrow portion of the bones, which could mimic blastic metastases.Follow-up CT imaging showed no change in both size and number. The lesions measured approximately 2-10mm.(2)Local sclerosing bone dysplasia with little bone expansion (n=7).Symmetrical and irregular density in the radix of the posterior arch of the vertebral body (n = 5 ).(3 )The spherical periosteal proliferation demonstrating as a cortex double line sign (n=2 ),and cortical thickening of metatarsals (n = 3 ).The appearance of the skeletal manifestation was as that in adulthood.Conclusion CT imaging of the skeletal system in TSC has some characteristics,by which the diagnosis of TSC could be made if combined with other main clinical diagnostic criteria. We suggest that those particular findings can be added as primary diagnostic features in the clinical diagnosis of TSC.