Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose

Abstract Objectives: To highlight the prevalence of respiratory epithelial adenomatoid hamartomas in the olfactory cleft of patients with nasal polyposis. To demonstrate characteristics indicative of hamartoma on the CT scans of paranasal sinuses during surgery and in histopathological exams. Methods: Cross-sectional study carried out in Hospital das Clínicas da UFMG and Núcleo de Otorrino BH. We performed 114 nasal endoscopic surgeries for polyposis, between February 2015 and November 2019. We assessed the olfactory cleft width in all preoperative CT scans. Upon seeing an indication of hamartoma on the CT scan, we took a tissue sample from the olfactory cleft during the surgery and sent for histopathological exam. We referred the samples to a pathologist experienced in the anatomopathological diagnosis of respiratory epithelial adenomatoid hamartomas. Results: Of the 114 patients with polyposis, 54 (47.4%) had olfactory cleft enlargement and, 100% of them had tissue with a dense and hardened polypoid aspect, with a slight cerebri-form appearance in this region during the surgery. Histology confirmed a respiratory epithelial adenomatoid hamartoma. Conclusion: This observation suggests that the presence of hamartomas in polyposis is common, but underdiagnosed. Level of evidence: Step 3 (Level 3).

ThevalueofspectralCTimaginginmultiGparameterquantitativeanalysisof lungcancerwithdifferentpathologicaltypes / 实用放射学杂志

Objective ToexplorethevalueofspectralCTimaginginmultiGparameterquantitativeanalysisoflungcancerwithdifferent pathologicaltypes.Methods SpectralCTimagesof72patientswithlungcancerprovedbypathologywereanalyzed,includingadenocarcinoma (ADC)in44cases,squamouscellcarcinoma(SQCC)in23casesandsmallcelllungcancer(SCLC)in5cases.Theslopeof40－100keVspectralattenuationcurve(λH),effectiveatomicnumber(EffectiveGZ),Calciumconcentration,hydroxyapatite(HAP)concentration, normalizediodineconcentration(NIC)and Waterconcentration were measuredandcomparedrespectively.The O n eG W a y analysisof variance (ANOVA ) was used and a value of P＜0.05 was considered statistically significant.Results (1 )O n plain C T ,there were statisticallysignificantdifferencesinEffectiveGZandλHamongthreeGdiseasegroups(F＝3.423,P＝0.04,F＝3.476,P＝0.038,respectively). (2)IncontrastGenhancedarterialphase,theWaterconcentrationandλHshowedstatisticallysignificantdifferencesamongthreegroups (F＝6.303,P＝0.003,F＝5.833,P＝0.005,respectively).(3)Invenousphase,thedifferenceinNICandλH wasstatisticallysignificant amongthegroups(F＝3.974,P＝0.023,F＝6.766,P＝0.002,respectively).(4)Apairwisecomparisonshowedtherewerestatistically significantdifferencesinallquantitativeparametersofspectralCTbetweenADCandSQCCgroups.ROCcurveanalysisshowedthat thosequantitativeparametersinvenousphaseappearedtohavehighdiagnosticefficiencyindifferentiatingADCfromSQCC,especiallyfor theλHinVP,withaAUCof0.754,sensitivityof79.5%,specificityof69.6%andthresholdvalueof1.78.Conclusion CTSpectral multiGparameterimagingprovidesanewsupplementarymethodforpreoperativediagnosisofADCandSQCC,andλHinvenousphase hasthehighestvalueindifferentiatingADCfromSQCC.

TheapplicationofspectralvirtualnonGcontrastCTinthyroiddiseases / 实用放射学杂志

Objective ToinvestigatethefeasibilityofspectralvirtualnonGcontrast(VNC)takingtheplaceoftruenonGcontrast (TNC)inthyroiddiseases.Methods CTimagesof30patientswiththyroiddiseasewerecollected,includingTNC,spectraldualGphase contrastandconventionaldelayedcontrastimaging.36lesionswithcorrespondingsurgeryandpathologicalconditionswereselected forretrospectiveanalysis.Theradiationdose,imagequality,meanCTvalues,SNRanddiagnosticefficacybetweenTNCand VNC werecompared.Results Theeffectivedose(ED)andtotaldoseGlengthproduct(DLP)ofthespectraldualGphasecontrastscanswere bothsignificantlylowerthanthoseofTNCincombinationwithconventionaldualGphasecontrast(P＜0.05).Thesubjectivequality scoreofVNCwasslightlylowerthanthatofTNC (P＜0.05),howeveritwasacceptableforradiologistwithascoreabove3.The SNRofVNCimageswassignificantlylowerthanthatofTNC (P＜0.05).The meanCTvaluesofVNCimageswerelowerthan thoseofTNCimagesbutwithoutasignificantdifference(P＞0.05).TheabilityofVNCtodelineatenecrosis,calcification,andlymph nodemetastasisinthelesionwasconsistentwithTNC (k＞0.75).Conclusion TheimagequalityofVNCissatisfiedinthediagnosis ofthyroiddiseases.VNChassimilardiagnosticefficacytoTNCwitheffectivelyreducdingradiationdose,whichisapromisingclinical application.

ThepredictiveanalysisofspectralCTportalveinimagingforesophagealGgastricvaricealbleeding / 实用放射学杂志

Objective ToinvestigatethevalueoftheoptimalCNR monoenergeticimagesofportalveininpredictingesophagealGgastric varicealbleeding(EVB).Methods FortypatientswithlivercirrhosisandportalhypertensionunderwentcontrastGenhancedspectral CTscan.TheoptimalCNR monoenergeticimagesand70keV monoenergeticimagesoftheportalveinphasewereselectedtocompare theimagingquality.TheconsistencyoftheoptimalCNR monoenergeticimageswithendoscopyforesophagealGgastricvaricealwas analyzed by Kappa test.A ccording to the E V B history ,the patients w ere divided into bleeding group and nonGbleeding group.T he ROCcurveswerecalculatedtoassessthevaluesofthemainportalvein(MPV)anditstributariesdiameterstopredictingEVB.Results TheCNRandobjectivescoreoftheoptimalCNR monoenergeticimagesweresignificantlyhigherthanthoseofthe70keVimages(P＜0.05).TheoptimalCNR monoenergeticimageshadgoodconsistency withgastroscopeintheclassificationofesophagealGgastric variceal(k＝0.769).ThereweresignificantdifferencesofthediametersofMPV,intrahepaticleftbranchofportalvein(LPV),splenic vein(SV)andleftgastricvein (LGV)betweenthebleedinggroupandnonGbleedinggroup (P＜0.05).ROCcurveanalysisshowed thattheincidenceofEVBwashighestwithasensitivityof76.92%andaspecificityof85.71%,whentheLGVwasgreaterthan6.1mm. Conclusion TheoptimalCNR monoenergeticimagesofportalveincouldimprovetheimagingquality,andLGVdiametershouldbe ariskindicatorforpredictingEVBinlivercirrhosis.

Imagingfeaturesofextramedullarydiseaseinmultiplemyeloma / 实用放射学杂志

Objective Toexploretheimagingfeaturesofextramedullarydisease(EMD)in multiplemyeloma(MM).Methods Theclinicalandimagingdataof17patientswithpathologicallydiagnosedMMcombinedwithEMDwereanalyzedretrospectively.Results EMDhadcertainpredilectionsites,Centralnervoussysteminvasion (6):meningealinvasion (3:1 multiple,2focal),spinalcanal invasion (1focal),thelefttemporalpoleinvasion(1focal),theleftsideforeheadinvasion(1focal);Headandneckinvasion(3:allfocal);Thoraxinvasion(8):pleuralinvasion(6:5 multiple,1focal),intrapulmonaryinvasion(1focal),anteriormediastinalinvasion(1focal);Subcutaneoussofttissueinvasion(5:allmultiple);Muscleinvasion(2focal);Lymphnodeinvasion (1 multiple).BothCTand MRI showedsofttissuenodulesormasses.ThevaluesofCTwereabout30~70HU,especiallyin30~45HU,whileMRIpresentedequal orslightlylowsignalonT1WI,equalorslightlyhighsignalonT2WI,andhighsignalinthesequenceofDWIcombinedwithmoderate toobviousenhancement,Generally,theboundaryofEMDwereclearandtheshapeoftheselesionswereregular,However,theinvasion tomuscleinsomelesionsshowedthepatternofinvasivegrowth.Conclusion EMDofmultiplemyelomamayhappenanywhere,and thepleural,meningesandsubcutaneoussofttissuesarethemostcommonlocation.CTandMRIcanshowtheEMDverywell.Thelocation, size,shapeandrelationshipwithsurroundingtissuesoftheselesionshavecertainreferencevaluesforthediagnosisanddifferential diagnosisofEMD.

DifferentialandpathologicalstudyofdifferentsubtypesofpapillaryrenalcellcarcinomabyCTimaging / 实用放射学杂志

Objective ToevaluatetheimagedifferencesofCTinsubtypepapillaryrenalcellcarcinoma(PRCC).Methods Aretrospective analysisof30multiphaseCTenhancedimagesofPRCCconfirmedbyoperationandpathologyinourhospitalwasperformed,followed byacomparativestudyofCT multistageenhancedperformanceandpathology.Results typeⅠ16cases,typeⅡ14cases,ofwhich 11casesofⅡtypePRCC wereirregularorlobulated,and4casesoftypeⅠshowedlobulated,therewarestatisticallysignificant differencesbetweenthetwogroups(P＝0.003).Venoustumorthrombusin5casesoftypeⅡPRCC,4casesoftypeⅡPRCClymph nodemetastasis,perirenalinvasionin6casesofⅡtypePRCC,but1caseofⅠPRCChadvenousthrombus,perirenalinvasionin2 cases,nocaseoflymphnodemetastasis,therewereobviousdifferencesbetweenthetwogroups(P＝0.044,P＝0.022,P＝0.025). PRCCplainscanCTvalue,CTvalueofexcretoryperiod,CTvalueaddedinthesubstantiveperiod,CTincrementduringexcretionperiod, therewarenosignificantstatisticalsignificancebetweentypetwogroups(P＝0.893,P＝0.169,P＝0.559,P＝0.155).CTvalueof corticalphase,CTvalueinperenchymalphase,CTvalueincrementincarticalphasehadsignificantlydifferencesbetweentwogroups (P＝0.013,P＝0.046,P＝0.008).Conclusion Therearecertaindifferenceintumormorphology,outsideinvasionsignsandenhancement degreebetweentypeⅠandtypeⅡPRCCandⅡtypePRCCispronetoappearperirenalinvasion,tumorthrombusandlymphnode metastasis.CTscanningishelpfulindifferentialdiagnosisofsubtypesofPRCC.

DiagnosticvalueofMSCTcombinedwithultrasonographyinpatientswithacuteappendicitis / 实用放射学杂志

Objective ToexploretheclinicalvalueofMSCTcombinedwithultrasonographyinthediagnosisofacuteappendicitis. Methods 238patientswithsuspiciousappendicitisunderwentMSCTandultrasonographybeforesurgery.Allpatientsweredivided intoappendicitisgroupandnormalappendixgroupaccordingtoCTappearances.TheefficacyofMSCTcombinedwithultrasoundin diagnosingappendicitiswasanalyzedbycomparisonofsurgicalpathologicalfindings.Results Therewere220casesinappendicitis group,whichhad165casesofappendicitisconfirmedbypathology,and55casesofnormalappendix.Therewere18casesinnormal group,2caseswereconfirmedappendicitisbypathology,and16caseswerenormalappendix.Theoveralldiagnosticperformancesof theCTscanwere98.8%ofsensitivity,22.5%ofspecificity,82.5%ofpositivepredictivevalue,88.9%ofnegativepredictivevalue, and76.1%ofaccuracy.TheperformancesofMSCTcombinedwithultrasonographywere90.4%ofsensitivity,93.0%ofspecificity, 96.8%ofpositivepredictivevalue,80.5%ofnegativepredictivevalue,and91.2%ofaccuracy.Thedifferencewasstatisticallysignificant indiagnosisperformancesbeforeandafterMSCTcombinedwithultrasonography (P＜0.001).Conclusion MSCTcombinedwith ultrasonographyexaminationcouldimprovethediagnosticaccuracyofappendicitis,andmayreducethenegativerateofappendectomy.

Theimagingmanifestationsoffocalnodularhyperplasiaofliverwithoutcentralscar / 实用放射学杂志

Objective ToinvestigatetheMSCTand MRIcharacteristicsoffocalnodularhyperplasia(FNH)oftheliverwithout centralscar.Methods Aretrospectiveanalysisofimagingdatawascarriedoutin10patientswithFNH withoutcentralscar,confirmed bypathologyandfollowGupreview.PlainscanandenhancedCT wereperformedin10patients,5ofwhomunderwenttheplainscan andenhancedMRI.Results Lesionswerehomogeneousandslightlylowdensityin10casesonplainMSCT,andhypoGorisoGintensity onT1WIandhyperGorisoGintensityonT2WIin5cases.Nocentralscarwasfoundinalltheselesions.Thecorrelationcoefficientsof thechangeofCTvaluewere0.772onportalvenousphaseand0.827ondelayedphaseinnormalhepaticgroupandlesiongroup(P＜0.05).Theenhancedvolumeof8lesionswasslightlylargerontheportalvenousanddelayedphasethanthatonarterialphase.Conclusion MSCTand MRIcanclearlydisplaytheimagefeaturesofFNH withoutcentralscar.Thereisastrongcorrelationoftheenhancement curvebetweenthelesionsandnormalliverparenchymaonportalvenousanddelayedphase,whichishelpfulformoreaccuratediagnosis.

CTfeaturesofpulmonarycomplicationsfollowinghematopoieticstemcelltransplantation / 实用放射学杂志

Objective ToexploreimagingfeaturesanddiagnosticvalueofCTonpulmonarycomplicationsafterhematopoietic stemcelltransplantation (HSCT).Methods ThoracicCTimagesoffiftyGfourpatientswithpulmonarycomplicationafter HSCT werecollectedandtheimagingfindingswereretrospectivelyanalyzed.Results Accordingtoclinicaldiagnosis,fiftyGfourpatientswere classifiedasfungalinfection (30cases),cytomegalovirus (CMV)pneumonia(6cases),bacterialpneumonia(5cases),diffusealveolar hemorrhage(DAH)(4cases),pulmonaryedema(2cases),idiopathicpneumoniasyndrome(IPS)(1cases),bronchiolitisobliterans (BO)(3cases)andbronchiolitisobliteransorganizingpneumonia (BOOP)(3cases).OnCT,thefungalinfectionappearedasscattered nodule,consolidationorgroundglassopacity,andaircrescentsignwasseeninsixcases.Thebacterialpneumoniaappearedaspatchy, lineandgroundglassopacityorlargeconsolidation.TheDAHappearedasdiffuseexudate,alveolarnodularorconsolidation.Thepulmonary edemaappearedastypical"batwing"pattern.TheCMVpneumoniaandIPSappearedasdiffusegroundglassopacity,nodular,consolidation oratelectasis.TheBOshowedlargegroundglassopacitywithdilatedbronchioles,whiletheBOOPappearedaspatchyconsolidation andgroundglassopacity.Conclusion Patientsafter HSCT mayhavepulmonaryinfectiousandnonGinfectiouslesions.CTfeatures combinedwithclinicalsymptomsandpostGtransplantationtimecanhelptoevaluatecomplicationsaccuratelyandreducemortality.

CTdiagnosisofthepulmonarychondroma / 实用放射学杂志

Objective ToanalyzetheCTfeaturesandthediagnosticvalueofpulmonarychondroma.Methods Tencasesofpulmonary chondromaprovenbypathologywereretrospectivelyanalysed.Thenumber,location,size,shape,margin,calcificationpatternandCT valueofthelesions wereanalysedonnonGenhancedandenhanced CTscans.Results Allthe10casesofpulmonarychondroma showedsolitary,mildlylobulated,wellGcircumscribed masses.6lesionswerelocatedintherightlung,and4lesionswereintheleft lung.Thesizeofthelesionsrangedform1.3cm×0.8cmto10.7cm×9.8cm.OnplainCTimages,9lesions(90%)showedvaried calcification,withpunctatecalcificationin8lesionsandringcalcificationin1lesion.OncontrastGenhanced CTimages,6lesions showedslighthomogeneousenhancement(enhancedvalue≤14HU).Conclusion Pulmonarychondromaisusuallylocatedintheperiphery ofthelung.Thenodulehasasmoothboundary,withsignificantcalcificationandslightlyenhancement,whichcouldbehelpfulindiagnosis ofthedisease.

MSCTimagingfeaturesofcoronaryarteryfistulawithsurgicalindicationsanditsclinicalvalue / 实用放射学杂志

Objective ToinvestigatetheMSCTfeaturesanditsclinicalvalueofcoronaryarteryfistula(CAF)withsurgicalindication. Methods CTfindingsof36patientswithluminaltumorGlikedilationCAFprovedbysurgerywereanalyzedretrospectively.Bymeans ofMIP,CPR,MPRandVRreconstruction,wearrangedtheabnormalvesselsintogroupsaccordingtoitscharacteristics,andmeasured thediameterofdilatation.ThediagnosticaccuracyofMSCTforCAFwascomparedwithtransthoracicechocardiography.Results Among the36cases,drainagesitesof8caseswererightatrium,14casesrightventricle,2casespulmonaryartery,1caseleftatrium,9cases leftventricle,and2casescoronarysinus.Amongallcases,4casesoriginatedfromleftmainartery,2casesfromleftanteriordescending, 5casesfromcircumflexartery,and25casesfromrightCAF.Ofwhich,24casesunderwentfistulaligationwithextracorporealcirculation. 12casesweretreatedwithminimallyinvasivesurgery.ThediagnosticaccuracyofMSCTbeforesurgerywas100%(36/36),andthat ofechocardiographywasabout80.6%(29/36).Conclusion ReconstructiontechniqueofMSCTcanprovidetheinformationofthe CAFvesselsanditsorigin,courseandshapeoffistulaorificium.MSCTcanaccuratelylocateandguidethesurgicalapproach,especially forpreGinvasivesurgery,providingimportantinformationfortreatment.MSCTshouldbethebestimagingmethodforCAF.

Applicationof"blendsign"onCTpredictingearlyhaematomaexpansioninacuteintracerebralhaemorrhage / 实用放射学杂志

Objective Toinvestigatethevalueof"blendsign"onCTtopredictearlyhaematomaexpansioninacuteintracerebral haemorrhage(ICH).Methods SeventyGninepatientswithacuteICH whounderwentbaselineCTscanwithin6hourswereenrolled retrospectively.TheywerealsorecheckedwithCTscanin24hours.Allpatientsweredividedintoearlyhaematomaexpansiongroup and nonGhae m ato m a expansion group according to the change of hae m orrhage volu m e.M ultivariable L o g istic regression analysis w as usedtodetermineindependentriskfactorsofearlyhaematomaexpansion.Results Therewere28cases (35.4%)withhaematoma expansionin79patients."Blendsign"wasobservedin23patientsonbaselineCTscan,16of23 (69.6%)patientsappearedhaematoma expansion.Thesensitivity,specificity,positivepredictivevalue,negativepredictivevalueof"blendsign"forpredictingearlyhaematoma expansion w ere 57.1%,86.2%,69.6%,78.6%.M ultivariable L o g istic regression analysis sho w ed baseline hae m orrhage volu m e and"blendsign"wereindependentlyassociatedwithhaematomaexpansion.Conclusion "Blendsign"canbeusedtopredicthematoma expansioninacuteICH,whichishelpfultoidentifyhighriskpatientswithearlyhaematomaexpansiontomakethetreatmentmore promptlyandaccurately.

Diagnostic value of CT for benign and malignant liver nodules in patients with liver cirrhosis / 中国基层医药

Objective To analyze the diagnostic value of CT for benign and malignant liver nodules in patients with cirrhosis. Methods From April 2015 to April 2018,135 cases of liver cirrhosis with solitary liver nodules in Shanxi Coal Central Hospital were selected,and all patients received the upper abdominal CT examination. The CT manifestations and diagnostic accuracy of the lesions were observed,and positive for hepatocellular carcinoma and negative for other benign nodules. The diagnostic efficacy of CT was analyzed. Results The CT scan of benign and malignant nodules of liver in the background of liver cirrhosis all showed a slight or low density focus,dynamic enhanced scan,the characteristics of hepatocellular carcinoma were obviously strengthened in the arterial phase,the portal phase was relatively low density,the delayed phase of the capsule was strengthened. The focal nodular hyperplasia was characterized by the enhancement of the middle heart scar in the delay period; the angioma was special. The characteristics of the hepatic adenoma were obvious enhancement of the arterial phase,the slow clearance of the portal phase and the delay period,and the enhancement of the liver parenchyma in the stages of the regenerative nodules of the liver cirrhosis. The accuracy of CT in the diagnosis of benign and malignant liver nodules under the background of liver cirrhosis was 90. 4% (122/135),of which the accuracy of diagnosis of hemangioma was the highest[100. 0% (30/30)],and the lowest rate for the diagnosis of regenerative nodules of liver cirrhosis was 81. 1% (30/37). The sensitivity,specificity,positive predictive value, negative predictive value and accuracy of CT for the diagnosis of benign and malignant liver nodules under the background of liver cirrhosis were 92. 1% ,89. 7% ,77. 8% ,96. 7% and 90. 4% ,respectively. Conclusion In the diagnosis of benign and malignant nodules under the background of liver cirrhosis,spiral CT has high diagnostic effect. Dynamic enhanced scan can accurately differentiate most of the lesions.

Three-dimensional reconstruction of human kidney based on UroMedix-3D system and its application in kidney surgery / 南方医科大学学报

OBJECTIVE@#To explore the feasibility of rapid and accurate three-dimensional (3D) image reconstruction using Uromedix-3D software for urological surgery.@*METHODS@#The original renal thin-slice enhancement CT data were obtained from patients with kidney lesions treated in our hospital between December, 2015 and October, 2018. The self-developed Uromedix- 3D system was used to reconstruct the normal kidney structures, blood vessels, collecting systems and the lesions. The spatial anatomic relationships of the structures were measured and digitized for surgical planning.@*RESULTS@#3D reconstruction of the kidneys was performed in a total of 173 cases, and the mean time for reconstruction was 31.24±2.012 min. Of these cases, 147 (84.9%) had renal tumors, and 2 had renal tumors with tumor thrombus. In addition to renal tumors, the Uromedix-3D system was also used for reconstructing other lesions including UPJO, kidney stones and retroperitoneal masses. Renal artery reconstruction was performed in 170 cases, which allowed observation of the precise terminal branches (up to 7th grade arterial branch) of the artery; 109 (64%) cases showed the 5th grade arterial branch or above. Renal artery variations were detected in 37 cases, including accessory renal artery (24 cases) and multiple renal arteries (13 cases). The renal veins were reconstructed in 164 cases, and second grade or above (up to the 4th grade) vein branches were observed in 138 (84%) cases.@*CONCLUSIONS@#Uromedix-3D system can accurately and efficiently reconstruct the 3D structure of human kidneys and the renal lesions based on enhanced CT data. The reconstructed 3D model allows objective assessment of the spatial anatomical relationship of the lesions to provide assistance in surgical planning.

AnapplicationofMDCTtissuesegmentationtechnologyonthequantitativeevaluation andthevolumedegreedivisionofthepleuraleffusion / 实用放射学杂志

Objective Toexploreasimpleandaccuratemethodfordeterminingthequantitativeevaluationandthevolumedegree divisionofpleuraleffusionbyMDCTtissuesegmentationtechnology.Methods Thevolumeofwaterinjectedintothreecontainersof differentshapeswasmeasuredby MDCTtissuesegmentationtechnique,andwerefurthercomparedwiththevolumeoftheactual waterinjection.Byusingthesamemethod,theliquidvolumeofpleuraleffusionbeforeandafterpumpingfrompatientswasmeasured andthedifferencebetweentheanteriorandtheposteriorwascalculated.Thenthedifferencebeforeandafterthepumpingwascomparedwiththe actualvolumeofclinicalfluidpumping.Atthesametime,thespecificmethodtodeterminethedegreedivisionofpleuraleffusionwas established.Results Forcontainersofdifferentshapes,theresultfromtheCTscanningliquidmeasurementwasthesameasactualwater injection,andhadahighcorrelation.Thedifferencebetweenbeforeandafterfluidextractionandclinicalactualfluidextractionwas linearcorrelated(positivecorrelation,r=0.986,P<0.001).Accordingtothemethodfordegreedivisionofadulthemothorax,MDCT tissuesegmentationtechnologydividedthevolumeofpleuraleffusionbeforethepumpingintosmall,mediumandlargeamounts.There were44caseswithsmallpleuraleffusion,11caseswithmoderatepleuraleffusionand7caseswithlargepleuraleffusion.Conclusion The volumeofpleuraleffusion measuredby MDCTtissuesegmentationtechnologycanreflecttheactualvolumeofpleuraleffusionin clinictoacertainextent,and MDCTtissuesegmentationtechnologycanbeusedtodividethevolumedegreeofpleuraleffusion.

Applicationvalueofanewgenerationmodel-basediterativereconstructioninchestCTscan / 实用放射学杂志

Objective ToinvestigatetheimpactofCTimagequalityforfilteringbackprojection(FBP),conventionalmodel-based iterativereconstruction(MBIRC)andnewgeneration model-basediterativereconstruction (MBIRN)onchest.Methods Thirtypatientswith chestCTscanwerecollected.FBP,MBIRCandMBIRN wereusedtoreconstructtheimage.Objectivequality[standarddeviation(SD) valueoftheROI,SNR],thenoisereductionrateandSNRimprovementrateofMBIRCand MBIRN withrespecttoFBP werecom-paredacrossthethreeimages.Atthesametime,tworadiologistsusedtheblind methodtoevaluatetheintrapulmonarystructurein thelungalgorithm FBP,MBIRC,MBIRN,andthemediastinalstructure (5-pointsystem)inthestandardalgorithmsFBP,MBIRC, MBIRN.Results ComparedwithFBP,theimagemusclenoisesofMBIRCand MBIRN were76.71% and86.06%lowerthanFBP,respectively, andthefatnoiseswere66.91% and78.18%lowerthanFBP,respectively.Thedifferencewasstatisticallysignificant(P<0.05).The imageSNRofMBIRCandMBIRN were74.12% and84.97% higherthanthatoftheFBPgroup,respectively.ThefatSNRwere65.63% and 76.02% higherthanthatoftheFBPgroup (P<0.05).Thethreealgorithmsshowedstatisticallysignificantdifferencesinsubjective noise,intrapulmonaryvascular,bronchialresolution,mediastinalbloodvessels,andlymphnodes.MBIRN hadthelowestsubjective noise,andthehighestSNR,mediastinalstructure,andintrapulmonaryvesselsandbronchi.Conclusion Comparedwith MBIRC and FBPwithnormaldosechestCTscan,MBIRN cansignificantlyreducethenoiseofchestCTscanimages,improveSNR,and more clearlyshowthedetailsofthescanrangeandlesionedgefeatures.

CTfeaturesofganglioneuroblastoma / 实用放射学杂志

Objective ToimprovethediagnosticaccuracybyassessingtheCTfeaturesofganglioneuroblastoma(GNB).Methods 38patientswithGNBconfirmedbypathologicalresultsandunderwentplainandcontrast-enhancedCTscanwereanalyzedretrospectively. Results GNBoftenoccurredinchildren.Allthecasesappearedassolitarylesion,7werelocatedinthemediastinum,12intheadrenal,15inthe retroperitoneal,3inthethoraxcavityand1inthepelviccavity.PlainCTshowed36lesionswithheterogeneouslowdensitywithnecrosisand cysticdegeneration,and28caseswithcalcifications,2withhomogeneouslowdensity.Thesolidlessionofallcasesshowedprogressive enhancement(4casesshowedslightprogressivecontrastenhancement,11casesshowed moderateenhancement,23casesshowed markedlyenhancement).Peripheralvesselsweredisplacedbytumorin19casesandembeddedbytumorin13cases.13casesshowed thepresenceofsmallvesselsin/aroundthetumorarrangedinclumpsorinline.Conclusion ThespecificCTfindingsofheterogeneouslowdensity withnecrosis,calcifications,peripheralvesselsdisplaced,moderatetomarkedlyprogressiveenhancement,mightbeusefulforthediagnosisofGNB.

ThevalueofGd-EOB-DTPA-enhanced MRIindiagnosisofhepatocellularcarcinoma / 实用放射学杂志

Objective ToexplorethediagnosticvalueofenhancedCTandGd-EOB-DTPA-enhanced MRIinthedetectionofhepatocellular carcinoma (HCC).Methods 41patientswith52HCCsunderwentenhancedCTandGd-EOB-DTPA-enhancedMRIrespectively.The imagingmanifestationswereanalyzed,andthelesionsweregrouped.Theimagingdiagnositicresultswerecomparedwiththepathologicalresults, andtheefficacyofthetwomodalitieswasevaluatedusingtheaccuracyindex.Results Ofthetotal52HCCs,42lesionswereidentifiedexactlyby enhancedCT,and51byGd-EOB-DTPA-enhancedMRI.Foralllesions,includingsmalllesions(≤2cm),theaccuracyratioofGd-EOB-DTPA-enhancedMRIwashigherthanthatofenhancedCT withastatisticallysignificantdifference(P<0.05),however,therewasnosignificant differenceforthelesionsbiggerthan2cm (P>0.05).Conclusion EnhancedCTislimitedindiagnosisoftheHCCssmallerthanor equalto2cm.ThediagnosticefficacyofGd-EOB-DTPA-enhanced MRIishigherthanthatofenhancedCT,anditcansignificantly improvethediagnosisofsmallHCC.

CTcharacteristicsoftracheobronchialtuberculosiswithdifferentpathologicaltypes / 实用放射学杂志

Objective ToexploretheCTcharacteristicsoftracheobronchialtuberculosis(TBTB)withdifferentpathologicaltypes. Methods CTdataof80patientsdiagnosedasTBTBbybronchoscopywereanalyzedretrospectively.Results CTcharacteristicsofTBTBwere follows:(1)Directsignsweredetectedin127cases.Therewere47cases(37.0%)withbronchialwallthickening,57cases(44.9%) withbronchiostenosisand23cases(18.1%)withbronchialocclusion.ForactiveTBTB,therewereonly2caseswithbronchialwall thickeningand1casewithbronchiostenosisin9casesintypeⅠ,40cases(31.5%)withbronchialwallthickeningandbronchiostenosisintypeⅡ, 41cases(32.3%)withallthreedirectsignsintypeⅢ.AmongstableTBTB,22cases (17.3%)withbronchialwallthickeningand bronchiostenosisintypeⅣ;TherewerefewcasesintypeⅤ,butallwithbronchialocclusion.(2)Indirectsign:54cases(45.4%)with bronchialdisseminated,13cases(10.9%)withdestroyedlung,25cases(21.0%)withcavities,27cases(22.7%)withmediastinallymphnodes enlargementamongthe119cases.BronchialdisseminatedlesionsinactiveTBTBweresignificantlymorethandestroyedlungandcavitylesions (P<0.01).Conclusion DifferentpathologicaltypesofTBTBhavedifferentCTcharacteristics.ActiveTBTBischaracterizedbydirectsignsand oftenaccompaniedwithindirectsignssuchasbronchialdissemination.

InfarctionofthearteryofPercheron:5casesandliteraturereview / 实用放射学杂志

Objective Toanalyzetheimagingcharacteristicsandearlydiagnosticvalueofpatientswithinfarctionofthearteryof Percheron(AOP).Methods Theclinicaldataandimagingfeaturesof5patientswithAOPinfarctionwereanalyzedretrospectively, andrelevantliteratures werereviewed.Results Allof5patientspresented withdisturbanceofconsciousness.MRIof5patients showedsymmetricalhighsignalonDWIinthebilateralparamedianthalami,and1patientwithanteriorthalamiclesionand1patient withmidbrainlesionshowed "V"sign.Inaddition,MRAshowedlocalizedstenosisoftheP1segmentoftheposteriorcerebralartery in2patients.Conclusion TheclinicalpresentationsofpatientswithAOPinfarctionarevariable.Thesymmetricalhighsignalinthe bilateralparamedianthalamionDWIishelpfulforearlydiagnosisandclinicaltreatmentofAOPinfarction.