Construction of finite element model of left atrial diverticulum based on computed tomography and reverse engineering softwares / 生物医学工程学杂志

This paper aims to explore the feasibility of building a finite element model of left atrial diverticulum (LAD) using reverse engineering software based on computed tomography (CT) images. The study was based on a three-dimensional cardiac CT images of a atrial fibrillation patient with LAD. The left atrium and LAD anatomical features were accurately reproduced by using Geomagic Studio 12 and Mimics 15 reverse engineering software. In addition, one left atrial model with LAD and one without LAD were created with ANSYS finite element analysis software, and the validity of the two models were verified. The results show that it is feasible to establish the LAD finite element model based on cardiac three-dimensional CT images using reverse engineering software. The results of this paper will lay a theoretical foundation for further hemodynamic analysis of LAD.

Application of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound in the diagnosis of uterine space-occupying lesion / 上海交通大学学报（医学版）

Objective·To evaluate the clinical value of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound in the diagnosis of uterine space-occupying lesion.Methods·A total of 75 patients with uterine space-occupying lesion were enrolled in this study from March 2015 to February 2016 at Hospital of Southwest Medical University.Patients received both two-dimensional ultrasound and four-dimensional color Doppler ultrasound to determine the location,number and nature of the lesions,as well as the clinical staging of malignant lesions,then the diagnostic accuracy was evaluated.Results·Among 75 patients,there were 26 cases with endometrial carcinoma,21 cases with hysteromyoma,16 cases with metropolypus,and 12 cases with uterine adenomyosis.The diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the uterine space-occupying lesion was 88.0％,which was significantly higher than that of two-dimensional ultrasound (64.0％) (P＜0.05).What's more,the diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the clinical staging of endometrial carcinoma was 88.5％,which was significantly higher than that of two-dimensional ultrasound (61.5％) (P＜0.05).Conclusion·Two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound is more effective to improve the diagnostic accuracy of uterine space occupying lesion and clinical staging of endometrial carcinoma in comparison with two-dimensional ultrasound,which will favor the clinical strategy for the treatment of uterine space-occupying lesion.

Evaluation of ulcer-like projections and penetrating atherosclerotic ulcers of aortic intramural hematoma using dual-source computed tomography / 实用放射学杂志

Objective To evaluate the imaging features of ulcer-like projections (ULP)and penetrating atherosclerotic ulcers (PAU)of intramural hematoma(IMH)using dual-source CT (DSCT).Methods Retrospectively analysis of DSCT imaging data of 1 12 patients in our hospital was performed.The shape of hematoma and location of ULP and PAU were evaluated Stanford A and B IMH depicting on DSCT images.The maximum diameter of aorta,maximum thickness of hematoma,deepness of ulcer were com-pared between in patients of IMH with or without ULP and PAU.Results IMH manifested as circular or crescent high density on plain scan and without contrast enhancement on DSCT images in 1 12 cases.Among of them,68 cases(68/1 12,61%)of IMH had ULP or PAU,in which there were 21 cases(21/1 12,1 9%)with ULP and 47 cases(47/1 12,42%)with PAU,the mean maximum depth was (0.48±0.1 5)cm in ULP and (1.08±0.56)cm in PAU.There were 4 cases with ULP and 9 cases with PAU in 29 cases of Stanford type A,while 1 7 cases with ULP and 38 cases with PAU in 83 cases of Stanford type B.There were 14 cases with single ULP and 7 cases with multiple ULP in 21 patients with ULP,while there were 27 cases with single PAU and 20 cases with multiple PAU in 47 patients with PAU.There were 1 9 cases with both PAU and ULP.There was statistical significance that PAU occurred more likely in the descending aorta and distal aorta than that in ULP (P =0.028).Conclusion IMH patients are susceptible to ULP and PAU,DSCT can objectively evaluate CT features of ULP and PAU of IMH.

Clinical value of ECG-gated dual-source computed tomography and angiography in assessing coarctation of aorta / 生物医学工程学杂志

The purpose of this study was to explore the clinical value of ECG-gated dual-source CT angiography (DSCTA) in evaluating coarctation of aorta (CoA). 23 patients suspected with CoA underwent DSCTA and transthoracic echocardiography (TTE). Surgical results were taken as reference standard. 23 patients were diagnosed with CoA, 12 cases had focal stenosis of aorta, while 11 had tubular stenosis. 19 cases were associated with other cardiovascular malformations, including 5 cases of hypoplastic aortic arch, 5 of patent ductus arteriosus, 10 of ventricular septal defect, 2 of bicuspid aortic valve, 4 of collateral arteries, 2 of aberrant left subclavian artery and 2 of persistent left superior vena cava, respectively. The mean diameter of stenotic segment of aorta was (7.0 +/- 3.7) mm. In 9 patients with tubular CoA, the diameter and length of stenotic segment of aorta were (6.2 +/- 7. 3) mm and (29.2 +/- 5.9) mm, respectively. The accuracies of DSCTA and TTE in the diagnosis of CoA were 100% and 91.3% (P > 0.05), respectively. It is well concluded that ECG-gated DSCTA could accurately evaluate CoA and associated cardiovascular malformations, and provide detailed anatomic information before surgery.

Evaluation of anomalous pulmonary venous connection: comparison between dual-source CT and echocardiography / 生物医学工程学杂志

This paper is to compare dual-source computed tomography (DSCT) with trans-thoracic echocardiography (TTE) in the evaluation of anomalous pulmonary venous connection (APVC) to explore the advantages of DSCT. Thirty-one patients with APVC detected by DSCT were enrolled in this study. In this cohort, 16 patients underwent echocardiography followed by operative treatments; and among the remained 15 patients who did not received surgical treatment, echocardiography was performed in 10 patients. The numbers and drainage sites of anomalous pulmonary veins, and accompanied defects on DSCT and TTE were retrospectively analyzed. In terms of diagnosis of the numbers and the drainage sites of anomalous pulmonary veins, the accuracy of DSCT was 98% (49/50) and 93.8% (15/16), while the accuracy of echocardiography was 80% (40/50) and 56.3% (9/16), respectively. There were statistical differences between the two modalities (P < 0.05). Although the detection rates of accompanied defects were 89.1% (41/46) and 78.3% (36/46) for DSCT and echocardiography, respectively, no statistically significant difference was found between the two modalities (P > 0.05). The 15 patients without receiving surgical treatments were partial APVC confirmed by DSCT, but APVC was found in 40% (4/10) patients by echocardiography. In conclusion, DSCT could be superior to evaluating APVC in comparison with echocardiography, and should be recommended as an important procedure for preoperative assessment of the anomaly in patients with APVC.

Contrast-enhanced MSCT features and predominant anatomic distribution of mediastinal tuberculous lymphadenitis / 生物医学工程学杂志

We retrospectively analyzed the features of the size, morphology, attenuation, the enhancement patterns, and anatomic distribution of 45 patients with mediastinal tuberculous lymphadenitis shown on contrast-enhanced multislice spiral CT (MSCT). 80% of the patients showed peripheral enhancement, and 38% of them showed multilocular appearance. deltaCT (The CT on enhanced scan minus that on the unenhanced scan) in the central area (15 +/- 12) HU was less than that in the peripheral area (27 +/- 16) HU (P < 0.01). The enlarged lymph nodes were predominantly distributed in the regions of 4R (87%), 2R (76%), 7 (73%), 10R (62%), and 4L (51%). MSCT could reveal the enhancement patterns and predominant anatomic distribution, which was of great value for the diagnosis of mediastinal tuberculous lymphadenitis.

Value of dual-source CT in diagnosis of single ventricle / 生物医学工程学杂志

This paper was aimed to explore the features of single ventricle with dual source computed tomography (DSCT) and the value of the modality in diagnosis of the single ventricle disease. Dual-source computed tomography imaging of 14 cases of single ventricle compared with the results of surgery and cardiac catheter were retrospectively analyzed. Firstly, 14 cases were classified into three types according to Anderson classification method, including 7 cases(50. 0%) left ventricular type, 3 cases(21. 4%) right ventricular type and 4 cases (28. 6%) undecided ventricular type. Secondly, in accompanying malformation respect, pulmonary stenosis, bilateral superior vena cava, atrial septal defect (ASD) and common atrioventricular valve were presented frequently. Thirdly, affiliated cardiac chamber of left ventricular type were mostly in front of the major cardiac chamber (5 cases,71. 4%), while affiliated cardiac chamber of right ventricular type were behind of the major cardiac chamber totally. Fourthly, more than half of aortas and pulmonary arteries stemming from common cardiac chamber can be seen (8 cases, 57. 1%). Meanwhile the aorta valves were more on the right of pulmonary valve (9 cases, 64. 3%). The classification of 10 cases of single ventricle was compared with the results of surgery, and the coincidence rate is 100%. DSCT can diagnose the single ventricle disease accurately. The aorta, pulmonary artery and coronary artery can be displayed completely and simultaneously as well.

MDCT and MRI findings of localized Castleman's disease and its pathological basis / 生物医学工程学杂志

To evaluated the multi-detector CT (MDCT) and magnetic resonance imaging (MRI) features of localized Castleman's disease (CD), we retrospectively analyzed the clinical data, MDCT and MRI findings of 13 patients with CD proved pathologically. All patients underwent plain MDCT scan, 11 underwent enhanced CT, and 2 MRI. 14 lesions were detected in the 13 patients, and all of them were hyaline-vascular type (HV-CD) histopathologically. On plain MDCT scans, all lesions were homogeneously attenuated soft tissue mass; intra-tumoral calcification with punctate and "arborizing" patterns was detected in the center of 2 lesions each. Of the patients with enhanced MDCT, all lesions showed obvious enhancement homogeneously except two lesions with central stellate and 1 lesion with dotted low attenuation. Tortuous vessels could be revealed at the periphery of 8 lesions. Of the 2 patients with MRI, the lesions showed slightly hyper-intensity on T1WI, hyper-intensity on T2WI and marked homogenous enhancement. In addition, one of them showed signal void appearance in the center on unenhanced MRI and large supplying artery with tortuous vessels at the periphery on enhanced MRI. In a word, Localized HV-CD usually demonstrated as soft tissue mass with obvious enhancement on MDCT and MRI. Central stellate area of low attenuation and calcification with punctate or "arborizing" pattern may also be present.

Evaluation of regnant anatomic distribution and metastatic type in skeletal thorax metastasis of breast cancer with multi-detector CT / 生物医学工程学杂志

To determine the characteristics and regularity of multi-detector CT (MDCT) in breast cancer with skeletal thorax metastasis, we retrospectively analyzed the imaging findings of MDCT in 72 cases of breast cancer with bone metastasis before treatment. There were totally 455 metastasis involved sites. The most common metastatic site was thoracic vertebra. And the fourth left rib was most common lesion in rib metastasis. Right breast cancer was more likely to take place at the bilateral ribs (65%) and pectoral girdle (54.5%) metastasis. The lesions in 28 cases demonstrated osteolytic destruction (38.9%), while 30 cases showed osteogenic appearance (41.7%). In conclusion, the development of breast cancer with skeletal thorax metastasis has certain characteristics and regularity.

Assessment of the morphological and dynamic features of normal pulmonary valve in a cardiac cycle using dual-source CT / 生物医学工程学杂志

The purpose of this study was to determine the morphological and dynamic features of normal pulmonary valve by using dual-source CT. Thirty patients who underwent dual-source CT angiography with right ventricular outflow tract well-opacified were enrolled. Ten phases of images were reconstructed at 10% R-R interval, and pulmonary valve area and pulmonary annular diameter were measured on all 10 phases. As the pulmonary valve opened, its orifice appeared as oval or proximate triangle. As the pulmonary valve closed, it appeared as "Y-shape". Pulmonary valve opened from 10% to 30% phases, with maximum pulmonary valve area of (4.74 +/- 0.69) cm2 in 10% phase. Pulmonary valve closed from 40% to 90% phases. Pulmonary annular diameter varied with cardiac cycle, with maximum pulmonary annular diameter of (2.36 +/- 0.24) cm in 0% phase and minimum pulmonary annular diameter of (1.82 +/- 0.32) cm in 40% phase (P < 0.001). The proximal phase for assessing pulmonary valve was 70% phase. Dual-source CT may evaluate the morphological and dynamic features of normal pulmonary valve.

Clinical value of ECG-gated dual-source computed tomography and angiography in assessing pulmonary atresia with ventricular septal defect / 生物医学工程学杂志

The purpose of this study is to explore the clinical value of ECG-gated dual-source CT angiography (DSCTA) in evaluating pulmonary atresia with ventricular septal defect (PA-VSD). We carried out retrospective analysis on 20 patients who had DSCTA with PA-VSD. The emphasis of the work was on analyzing the types of PA-VSD, pulmonary artery development, major aorto-pulmonary artery collateral arteries (MAPCAs) and associated intra- and extra-cardiac malformations. In the 20 cases of PA-VSD, there were 6 cases of type A , 13 cases of type B, and 1 case of type C. 12 cases of the patients had patent ductus arteriosus (PDA). The pulmonary blood flow was mainly supplied by PDA in 6 cases and by MAPCAs in the rest of 14 cases. The diameter of MAPCAs was (7.2 +/- 3.4) mm (range, 2.0-14.3 mm). The experiments proved that ECG-gated DSCTA was a convenient and noninvasive cardiovascular imaging method, and it could accurately evaluate the types of PA-VSD, pulmonary artery development, MAPCAs, and it could also provide detailed anatomic information before surgery.

Features of Debakey III aortic dissection after endovascular graft exclusion: evaluation with DSCT angiography / 生物医学工程学杂志

The purpose of this study was to evaluate the prothesis and vascular features of Debakey III aortic dissection by DSCT angiography after endovascular graft exclusion. We performed a retrospective analysis of 39 Debakey III aortic dissection patients who underwent DSCT angiography after endovascular graft exclusion. After the operations in this study, all the 39 patients had no stent fracture and migration, 15 among all the 39 had endoleaks (type I 12 patients, type II 2 patients, 1 patient had no reason), 17 had large amount of thrombosis in false lumen, and 1 had false lumen outside the stent absorbed completely. While before the operations, 15 patients had abnormal renal perfusion pre-operation, and 9 of them had recovered after the operations. And the nearer located to the initial exclusive place, the more obviously the aortic remodeling occurred. In conclusion, DSCT angiography can accurately evaluate the prosthesis and anatomic-pathologic features of Debakey III aortic dissection after endovascular graft exclusion.

Application of posterior canal wall reconstruction and mastoid obliteration / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the obliteration of the old mastoid cavity and reconstruction of the posterior canal wall after radical mastoidectomy. Method:Posterior canal wall reconstruction and mastoid obliteration of 11 ears of 10 patients with old mastoid cavity for 1 to 6 years after radical mastoidectomy were done using the pedicle postauricular composite skin flap (PPCSF),and their tympanoplasty were performed at the same time. Follow-up was performed at 3 to 30 months. Result:All PPCSFs survived. The old mastoid cavity of 11 ears vanished and reconstructed posterior canal wall remained in normal position without retraction. The drying ear time took 2 to 3 weeks postoperatively,and the symptoms of the radical cavity disease after radical mastoidectomy were cleared up nearly,and the average hearing threshold decreased 13.6 dB HL. The otorrhea and perforation of tympanic membrane resulted from infection happened to 1 of 11 ears three month after the operation. Conclusion: The PPCSF is an effective method in the obliteration of old mastoid cavity and reconstruction of the posterior canal wall. It can reduce drying ear time postoperatively, treat the radical cavity disease after radical mastoidectomy and is beneficial to the tympanoplasty at the posterior external at the same time.

The Analysis of Craniocerebral Trauma with Negtive Results on Emergency CT (A Report of 51 Cases) / 实用放射学杂志

Objective To explore the causes of negtive results on emergency CT and prevent method in craniocerebral trauma.Methods 51 cases of craniocerebral trauma with negtive results on emergency CT were analyzed respectively during 2002 to 2004.Results The causes of negtive results on emergency CT in craniocerebral trauma were:the insufficient experience for technicians and doctors (12.8%);the atypical signs in early phase(48.6%);the delayed lesions after injury(16.2%) and the limitation of CT (24.2%).Conclusion CT technicians and doctors should be well trained primarily. Furthermore, CT images, clinical manifestations and other examinations should be combined with to obtain precise diagnosis. Finally, uncertaint cases should be examined again with CT or MRI.

CT and MRI Findings of Esthesioneuroblastoma / 实用放射学杂志

Objective To study CT and MRI findings of esthesioneuroblastoma.Methods Nine cases of esthesioneuroblastoma proved pathologically were presented.There were four male and five female,with mean age of 34.6 years.CT scan in four cases and MRI in seven cases were done and 2 cases had enhanced MRI.Results The location of lesions were in nasal cavity in 2 cases and in nasoethmoid region in 7 cases.Among nine cases,six cases were seen in the right side,and three cases in the left side.On CT and MRI,the lesion demonstrated a destructive solid mass,CT value ranged 29～36 HU.The lesions appeared as hamogeneous signal intensity which was higher than tongue muscle on T_1WI,and higher than grey matter on MRI T_2WI . Turbinal and ethmoid bony destruction were showed on all nine cases. The lesions invaded into opposite nose and ethmoid sinus in four cases,intruded into intracrainial cavity in eight cases, frontal sinus in six cases, orbit in eight cases in which two cases had eye protrusion, maxillary sinas in five cases and sphenoid sinus in five cases.Conclusion A esthesioneuroblastoma can be considered if a destructive solid mass occurs in nasal cavity and ethmoid sinus,with a middle signal intensity on T_2WI.

Design and Construction of Medical Mini-PACS / 实用放射学杂志

Objective Based on the technique of computer network communication,to design and construct a mini medical picture archiving and communication systems (mini-PACS) in radiological department.Methods Radiologic information networks were composed of Anke SCT scanner, GMS and SHIMADZU digital radioscopy, SGI picture workstation, laser film printer, Dell server and report terminal computers with DICOM 3.0. Mini-PACS was constructed with radiological networks mentioned above and local area networks (LAN) existing in our hospital. Network parameters were set and network communication software FTP2000 was used to transport data. Radiological diagnosis and report program was edited with Visual Basic 6.0 (VB6.0).Results Five functions such as image acquirement, data transport and share, data archiving, report and print, register and statistics could be realized by mini-PACS. The system was stable for about 2600 cases during 420 days and no obstacle could be found after simple maintenance.Conclusion The mini-PACS can realize the five functions. Mini-PACS is practical, stable, safe and easy to maintain. It playes an important role in economic management and scientific research.