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Objective To explore the diagnosis value of 320-row detector dynamic volume CT in complex congenital heart disease (CCHD)with double outlet right ventricle(DORV).Methods Seventy-eight patients who proveed DORV by surgery in Xinqiao Hospital of Third Military Medical University were reviewed.Thirty-six patients of group A performed 320-row detector dynamic volume CT by using segmental analysis,and were compared with the group B(42 Cases) performed conventional 64-slice CT respectively.Results In 36 cases of DORV confirmed by surgery in group A,MSCT provided accurate qualitative diagnosis in all cases.The accuracy rate of diagnosis of the group B was 90.7％.There was no significant differences compared with the group A (P＞0.05).There were ventricular septal defect in all the 78 cases,pulmonary stenosis in 56 cases,atrial septal defect in 34 cases,pulmonary hypertension in 21 cases,patent ductus arteriosus in 16 cases,coarctation of aorta in 9 cases.Conclusion The 320-row detector dynamic volume CT has important diagnostic value for DORV of the anatomical diagnosis.
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With the development of computer network technology,network teaching has become an important mode of continuing medical education.There are many kinds of medical imaging websites from both domestic and foreign.In general,they can be divided into three main categories,in terms of society official websites,academic journal websites,and educational resource websites.On the basis of the introduction of the representative domestic and international medical imaging websites,this paper analyzes the advantages and disadvantages of them,and emphasizes some measures to improve the application value of them in continuing medical education,including to establish an authoritative academic website to achieve continuing medical education credits,to strengthen the resources and function of various medical image sites,and to promote intelligent and personalized self-learning,etc.We hope the combination of medical imaging websites with continuing medical education will be much closer,so as to provide a good platform for imaging personnel to improve their professional level and scientific research ability.
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This paper introduced the current situation of WeChat's official accounts of medical imaging.According to the operation agents,they can be divided into different categories,including professional societies,hospitals and departments,medical companies,academic journals,medical imaging websites and personal accounts.This paper also analyzed the advantages and disadvantages of WeChat's official accounts of medical imaging.Some measures were proposed to improve their application value in continue medical education (CME),such as establishing a platform of WeChat's official account with high approval and authority to award CME credit,integrating various kinds of network resources,strengthening the abundance,systematicness,chronergy and practicality of the resources,setting up and improving the evaluation mechanism of CME credit award,so as to provide a CME platform for the staff of medical imaging.
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Objective To analyze the clinical and CT characteristics of pancreatic metastasis to improve the correct diagnosis rate.Methods The clinical and CT data of 14 patients with pancreatic metastasis were reviewed retrospectively.Results Among the 14 patients,the primary malignancy was lung cancer in 6 cases,renal carcinoma in 3 cases,colon carcinoma in 2 cases,laryngeal cancer in 1 case,gastric cancer in 1 case and ovarian carcinoma in 1 case.Pancreatic metastases from renal carcinomas often developed a long period after initial nephrectomy and survived for a relatively long time.Abdominal CT plain scan and enhanced scan was performed in all cases.Four cases were of solitary type,9 cases were of multiple types and 1 was of diffuse type.Totally 28 lesions were found,which were usually located in the neck and body of the pancreas,the diameter of 28 pancreatic lesions was ranging from 0.5 cm to 11 cm,with a mean diameter of 2.3 cm.On CT plain scan,there were 19 hypodense lesions,7 slightly hyperdense lesions and 2 isodense lesions,5 necrotic lesions.On enhanced CT,the lesions showed moderate enhancement in 7 cases,circular enhancement in 6 cases,moderate and circular enhancement in 6 lesions,obvious enhancement in 8 lesions and no enhancement in 1 lesion.All patients had extra-pancreatic metastases,and 2 cases had peripheral vascular invasion.Conclusions Pancreatic metastases are rare,often accompanied with multiple lesions and extra-pancreatic metastases.The CT features of pancreatic metastases from renal carcinomas are slightly hyperdense and obvious enhancement; in other metastases,there are hypodense,morderate and/or circular enhancement lesions.Accurate diagnosis can be achieved by knowledge of patients' medical history.
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Picture archiving and communication system ( PACS ) based on digital teaching platform of medical imaging consists of web teaching system and teaching resource library of medical imaging.The web teaching system includes four function modules of classroom management,work management,teaching management and test management.The teaching resource library includes script,pictures,and audio,video and animation materials of theoretical books,typical cases,examination techniques and medical imaging equipments.Utilized in theoretical and practical classes,the teaching characteristic of medical imaging is made prominent,and the subjective motility of the students is brought into play.
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OBJECTIVE To make a further understanding of the imaging findings of the carotid artery pseudoaneurysm (CAPA) in head and neck and to explore the clinical value of imaging in diagnosis of it, especially the angiographic diagnosis. METHODS The clinical and imaging data of 36 patients with CAPA were analyzed retrospectively. The imaging appearances in all of the patients were observed by two experienced radiologists together and formed a consensus interpretation. RESULTS Imaging examination can establish definitive diagnosis in all cases. The parent arteries included the common carotid artery (2 case), common carotid artery bifurcation (18 cases), internal carotid artery (10 cases) and external carotid artery (2 cases). The imaging features of the CAPA were:the contrast media retained in the aneuysm in all cases;the aneuysm lumen with turbulent flow in 18 cases;the"jetting sign"at the leak of the parent artery in 14 cases;increase of bifurcation angles of internal and external carotid arteries in 24 cases. CONCLUSION Imaging examination is the most valuable examination method in diagnosis of CAPA, and it can not only make definitive diagnosis, but also play an important role in selection of therapeutic planning.
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BACKGROUND: Clinical researches found that portal vein occlusion was beneficial to inhibit growth of hepatocarcinoma, promote compensatory hyperplasia of un-blocking hepatic tissue and decrease metastasis of portal vein occlusion; however, it should be fu~her proved by animal experiments.OBJECTIVE: To investigate models of portal vein occlusion of hepatic VX2 tumor in rabbits and evaluate value of multi-slice CT.DESIGN: Randomized grouping design and animal study.SETTING: Department of Radiology, Xinqiao Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Imaging Department of Xinqiao Hospital of the Third Military Medical University of Chinese PLA from July 2002 to January 2005. Forty New Zealand rabbits were divided according to digital table into 4 groups: immediate group (transplantation of tumor after immediate portal vein occlusion), 3-week group (transplantation of tumor at 3 weeks after portal vein occlusion), negative control group and positive control group, 10 in each group.METHODS: Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation at immediate portal vein occlusion and 3 weeks after portal vein occlusion. Meanwhile, they were divided into negative control group (Left external branch of portal vein was done sham-operative block,and left exite was embedded and inoculated pseudoly) and positive control group (Transplanted tumor did not suffer from portal vein occlusion). All rabbits were scanned with multi-slice CT.MAIN OUTCOME MEASURES: General changes of liver, changes of tumor, metastasis of tumor, vascular-imaging displaying rate of multi-slice CT of hepatic artery and portal vein, blood flow of liver, blood volume,mean transit time, permeability of vascular surface and fraction of hepatic arterial infusion (HAI).RESULTS: All 40 animals were involved in the final analysis. ① Tumor did not grow in both immediate group and 3-week group. In 3-week group,left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was smaller than that in positive control group [(2.55 ±0.46), (3.59±0.37) cm, t=5.57, P ＜ 0.001]. Incidences of metastasis in liver and lung were lower in 3-week group than those in positive control group (10%, 40%; 100%, 90%); however, there was no significant difference. ② Scanning with multi-slice CT, displaying rate of branches hepatic artery was lower in grade Ⅲ than that in grade Ⅰ and Ⅱ (40%, 70%,100%, P ＜ 0.05); but there was no significant difference of displaying rate of portal vein at various grades (P ＞ 0.05). ③ Values of blood flow of liver,blood volume, mean transit time and permeability of vascular surface were lower in immediate group and 3-week group than those in control groups,but values of HAI were increased.CONCLUSION: Ligating left external branch of portal vein is an ideal way to establish models of portal vein occlusion of hepatic VX2 tumor in rabbits; furthermore, multi-slice CT plays a key role in evaluating effect of portal vein occlusion.
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Objective To study the method and efficacy of double chemoembolization of hepatic carcinoma by transcatheter arterial cheomembolization (TACE) and portal vein port catheter system (PCS). Methods PCS was implanted in portal vein in 17 cases of irresectable primary hepatocellular cancer (HCC) during operation. One month later, chemoembolization of portal vein via PCS was performed, meanwhile TACE was also done (hepatic arterial portable vein chemoembolization, HA PVCE). A total of 120 cases of HCC treated simply with TACE were served as the control. Results The technical success rate was 100% in both TACE and portal vein PCS. Hepatic arteriography showed rich or moderate blood supply of HCC in 134 cases and PCS portography showed tumor staining in 6 cases. In groups of HA PVCE and TACE, the positive alpha fetoprotein (AFP) level decreased in 80% and 71.6% cases; half a year survival rate was 85.7% and 74.4%, and one year survival rate was 71.4% and 52.4%, respectively. Conclusion Double chemoembolization by TACE and portal vein PCS is a safe procedure with high technique success rate and therapeutic efficacy for irresectable hepatic carcinoma.
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Objective To study the correlation of CT perfusion imaging ( CTPI) of induced rat breast cancer with tumor pathological grade and microvascular density ( MVD) ,and the diagnostic value of CTPI for breast cancer. Methods Breast cancer was induced in 35 Wister male rats with intragastric 7,12-dimethyl-1,2-benzanthracene ( DMBA) treatment. Routine breast CT scanning and CTPI were performed. After processed at a workstation,CTPI parameters were obtained including blood flow ( BF) ,blood volume ( BV) ,mean transit time ( MTT) ,permeability surface ( PS) ,and time density curve ( TDC). The rats were sacrificed and breast tumor tisue samples were collected. Breast tumor tisue samples were stained with HE and factor Ⅷ-related antigen immunohistochemistry to observe the pathological type and MVD of tumor. Results Breast tumor was successfully induced in 30 rats ( including 8 with breast hyperplasia and 22 with breast cancer). The BF and BV were higher in rats with breast cancer than in those with breast hyperplasia 151. 72 ? 93. 43 vs 42. 96 ? 32. 42 ml/( min.100 g) ,9. 55 ? 7. 88 vs 2. 17 ? 1. 36 ml/100 g,P 0. 05). The positive correlation of MVD with BF,BV and PS was increased with the decreased tumor differentiation with a correlation coefficient of 0. 701,0. 441 and 0. 521,respectively ( P
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Objective To summarize the imaging features of neurofibromatosis.Methods Imaging data of 7 patients with neurofibromatosis proven by operation and clinical syndrome,were retrospectively analyzed.Results In 7 cases of neurofibromatosis,the findings of CT and MRI displayed 3 cases of bilateral vestibular schwannoma,2 of which were combined with optical nerve glioma;1 case of optical nerve glioma complicated with neurofibromatosis under cervical dura;1 case of meningioma and 2 cases with the changes of dura spinal sac.The last two cases displayed abnormal skull and spinal canal,concave change of vertebra and enlarged dura spinal sac,partially stretched to never root on CT plain flim and MRI.Conclusion Neurofibromatosis can be definitely diagnosed by optimal imaging examination based on comprehensive analysis of imaging features and typical syndromes.
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Objective To analyze CT features of retroperitoneal tumors or tumor-like lesion and to evaluate CT in localizating and qualitative diagnosis of diseases.Methods CT findings in 45 cases with pathologically-proved retroperitoneal tumor were retrospectively analyzed and compared with pathological results.Results There were 25 cases of benign tumors and 20 cases of malignant tumors.The CT features of benign tumors were homogeneous density,smooth peripheria with clear border,while mixed density,large and irregular in malignant tumors.The accuracy of localizating lesions was 89%,the accuracy of qualitative diagnosis was 78%,the accuracy of histologic evaluation was 49%.Conclusion CT imaging is valuable in diagnosing retroperitoneal tumors.CT can make accurate localization of tumors and identify the nature of tumors,but is limited in evaluating histologic types.
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<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>
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This paper discusses the conception of multimedia courseware in the teaching of medical imaging technology, and meaning, features and requirements. It is concluded multimedia courseware can play an important role in the teaching of medical imaging technology. Also, some problems existing in the application are analysed in this article.
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Objective To explore the value of multi-slice spiral CT (MSCT) with three dimensional (3D) postprocessing for assessing the lung volume and compare it with pulmonary function test (PFT). Methods In 60 cases, there were 34 healthy controls and 26 patients with emphysema. CT scan and PFT were performed within 3 d in all case. The total lung was respectively scanned at the end of full inspiration and full expiration, using GE Lightspeed 16 slices spiral CT. The total lung volumes and voxel index (VI) at threshold range of -1023 Hu to -900 Hu were measured by pulmonary quantitative software of AW4.2 workstation. Results The full expiration volume(Vex) significantly correlated with residual volume(RV) (r=0.908) as well as the full inspiration volume (Vin) with total lung capacity (TLC) (r=0.897). The value of (Vin-Vex) well correlated with forced vital capacity(FVC), as well as Vex/Vin with RV/TLC, VI Ain with TLC, VI Aex with RV. Conclusion Significant correlation of lung volume accessed by MSCT with 3D technique with PFT is useful for assessing the pulmonary function.
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Objective To explore the value of angiographic diagnosis and interventional therapy for Takayasu arteritis. Methods Thirty-eight patients with Takayasu Arteritis (TA)(11 men, 27 woman; aged 8-54; average age, 30.5?18) undergone angiography were analyzed retrospectively. The angiographic appearances in all of the patients were observed dynamically in a double blind method by two experienced radiologists together and formed a consensus interpretation. Results According to the classification of Lupi-Herrea, typeⅠwas found in 11 cases, typeⅡin 15, typeⅢin 7 and typeⅣin 5 by angiography. Among 38 patients the arterial involvement ineluded subclavian artery in 20 cases (52.6%), the abdominal aorta in 15 cases (39.5%), the renal artery in 14 cases (36.8%), thoracic aorta in 10 cases (26.3%), carotid artery in 9 cases (23.7%), iliac artery in 9 cases (23.7%), axillary artery in 7 cases (18.4%), superior mesenteric artery in 4 cases (10.5%), coronary artery in 3 cases (7.9%), pulmonary artery in 3 cases (7.9%), and so on. Percutaneous transluminal angioplasty was performed in 22 cases and the stent placement was managed in 12 cases successfully. Conclusions Angiography is one of the ideal and reliable methods for the diagnosis and guidance of the interventional treatment for TA, and the latter is a mini-invasive and effective way for TA.
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Objective To create a further understanding of the angiographic features of the carotid artery pseudoaneurysm (CAPA) and to explore the clinical diagnostic value of angiography.Methods Sixteen cases of CAPA with clinical and angiographic data were analyzed retrospectively. The angiographic appearances in all of the patients were observed dynamically and precisely with a double blind method by two experienced radiologists together and formed a consensus interpretation. Results Angiography provided a definite diagnosis for all cases. The parent arteries included the common carotid artery (1 case), common carotid artery bifurcation (9 cases), internal carotid artery (5 cases) and external carotid artery (1 case). The angiographic features of the CAPA were: All cases showed the contrast media retension in the aneuysms; turblulent flow within aneurysm in 9 cases; the “jetting sign” at the leak of the parent artery in 7 cases; increase angulation of the bifurcation of internal and external carotid arteries in 12 cases.Conclusions Angiography is the most valuable examination method in diagnosis of CAPA, and it can not only provide definite diagnosis, but also play an important role in selection of therapeutic plan.
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Objective To investigate the procedure,imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bi-tilted CT scanning.Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT).The patients and yolunteers were given bubble-making powder by mouth and placed in a supine position on the CT table.CTVG and MPR images were obtained using the virtual dissection and reform of GE.Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy.The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening,soft tissue mass,stenosis of stomach,cancerous ulcer,infiltration to adjacent tissues,and lymph node and distant metastases.In comparison with fiberoptic gastroscopy(as the gold standard),CTVG showed a diagnostic accuracy of 92.5 %,a sensitivity of 93.3 %,a specificity of 90.0 %,a positive prediction value of 96.7 %,and a negative prediction value of 81.8 %.Conclusions CTVG is a safe,reliable,non-invasive method for demonstrating the structure of normal and abnormal stomach,and is a good complementory method to conventional fiberoptic gastroscopy.
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Objective To make a futher understanding of the CT features of primary carcinoma of vagina and to explore the clinical value of CT diagnosis of it.Methods Sixteen cases of primary cacinoma of vagina with clinical and CT data confirmed by pathology were analyzed retrospectively. The CT findings were observed in a double blind method by three experienced radiologists together and formed a consensus interpretation. Results The accurate rate of CT diagnosis for primary carcinoma of vagina was 81.3% in the 16 cases. There were 2 stage I, 6 stage II, 4 stage III and 4 stage IV lesions which were diagnosed by CT. The numbers of cases of the elevated type, ulcerative type and infiltrative type were 11, 3, and 2,respectively. The transcatherter internal pudendal arterial chemoembolization were successfully performed in 2 patients with vaginal carcinoma. Conclusion CT is not only a non-invasive method of detecting primary carcinoma of vagina,but also play an important role in differentiating the clinlcal phase and type of it. In more advanced stages of vaginal carcinoma, interventional therapy is chosen as the useful treatment to avoid exenterative surgery, preserve anatomy and function.
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Objective To explore the value of imaging diagnosis on complications after kidney transplantation. Methods The radiologic appearances of 165 patients with postoperative complications were reviewed in a double blind method by two experienced radiologists. Results In the 158 patients with postoperative pulmonary infections, the main etiological causes according to their frequency were bacteria,fungus,virus,and so on. The postoperative pulmonary infections of the patients with renal transplantation were diagnosed as normal(28,17 7%),increased lung markings(44,27 8%) and pulmonary infection(84,53 2%) by chest X-rays and CT. The renal artery stenosis after kidney transplantation was diagnosed in 5 cases, and thrombosis of pancreas blood vessel after operation of simultaneous pancreas-kidney transplantation was diagnosed in 1 case by DSA. Conclusions Radiography and CT scan are very useful in the clinical diagnosis of postoperative pulmonary infections in the patients with renal transplantation,and radiography should be the first choice for the imaging diagnosis. DSA is one of the ideal and reliable measns to diagnose the postoperative vascular complications in kidney transplant recipients.
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Purpose: To summarize the efficiency and the experience of the puncture aspiration and sclerosing therapy of hepatic and renal cysts. Materials and methods: 27 patients were treated with percutaneous aspiration and alcohol injection of the cystic cavity using 20G Greene needles. Among the 27 patients, 11 were with hepatic cyst, 15 with renal cyst, and 1 with polycystic kidneys. The size of cysts ranged from 3.5 to 12 cm, and the amount of aspirated fluid varied from 21 to 550ml. Pure alcohol (99. 7%) was injected into the cavities after apiration. Results: All the puncture procedures were successful, and no major complications occurred, The clinical symptoms were relieved or disappeared after the treatment. 18 cases were followed for 3 months to 5 years. The efficient indices: Grade I one case (polycystic kidneys), Grade Ⅱ 4 cases and Grade Ⅲ 13 cases. Conclusion: CT guided percutaneous puncture aspiration and sclerosing treatment of hepatic and renal cysts can be considered as an effective alternative to surgical treatment. The simple aspiration of polycystic kidneys is very helpful in relieving symptoms and improving renal functions.