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Objective To analyze the imaging characteristics and to evaluate the application value of color doppler ultrasonography (CDUS)combined with CT angiography (CTA)and contrast-enhanced magnetic resonance angiography (CE-MRA)in patients with cervical vertigo.Methods 62 patients diagnosed with cervical vertigo clinically were enrolled.Neck CDUS and neck CTA were per-formed on 39 patients.Neck CDUS and neck CE-MRA were performed on 23 patients.Neck CDUS and CTA/MRA were performed on 30 normal volunteers,which were chosen as control group.Neck CDUS and neck CTA were performed on 18 normal volunteers. Neck CDUS and neck CE-MRA were performed on 12 normal volunteers.Hemodynamics and morphology were evaluated and com-pared between the two groups.Results In aspect of morphology:The incidence of vertebral artery (VA)stenosis (46.77%)and VA variation (29.03%)in cervical vertigo group were higher than VA stenosis (23.33%)and VA variation (6.67%)in control group with significant difference (all P 0.05).In aspect of hemodynamics:The decline incidence of peak systolic velocity de-tected by CDUS in cervical vertigo group (66.13%)was higher than that in control group (10.00%)with statistically significant difference (P <0.05).The peak systolic velocity decline incidence of VA stenosis (86.21% )and VA variation (72.22%)were high-er than that of VA tortuous (28.57%)and VA normal (12.50%)patients in cervical vertigo group.Conclusion The application of CDUS combined with CTA or CE-MRA could provide valuable diagnostic and therapeutic information for cervical vertigo in the as-pects of change in vascular morphology and cerebral hemodynamics,which could further provide objective basis for clinical diagnosis and treatment.
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Objective To estimate the value of computed tomography perfusion for clinical stage and approach the correlation of perfusion parameters and Cyfra21-1.Methods 63 patients with head and neck squamous carcinoma were confirmed by pathology and follow up underwent CT perfusion,which were divided into three groups by international clinical staging criteria(stageⅠ,stageⅡand stageⅢ-Ⅳ).BF,BV,MTT,TTP and Cyfra21-1 were recorded and compared with correlation in different clinical staging.Results There was no significant difference of Cyfra21-1 between stageⅠand stageⅡ(Z =1.439,P =0.1 62).There was significant differ-ence of Cyfra21-1 between stageⅠand stageⅢ-Ⅳ(Z =3.356,P =0.000),stageⅡand stageⅢ-Ⅳ(Z =4.959,P =0.000).There was significant difference of BF and BV between stageⅠand stageⅡ,stageⅠand stageⅢ-Ⅳ(P 0.05),of MTT and TTP between stageⅠand stageⅡ(P >0.05).Cyfra21-1 and perfusion parameters in all groups have relationship(r=0.76,0.76,-0.82,-0.82,P <0.05).Conclusion The statistically significant of positive correlation be-tween Cyfra21-1 and perfusion parameters in head and neck squamous carcinoma suggests that CT perfusion could play a complemen-tary role in clinical assessment.
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Objective To approach the application value of diffusion weighted imaging with background suppression (DWIBS) combined with routine MR sequence in differentiating benign and malignant lymph nodes,and assessing therapeutic effect of lympho-genic tumors.Methods 48 patients with cervical lymph node enlargement who were confirmed by pathology and follow up under-went DWIBS and routine MRI examination,malignant lymph nodes were 83,benign lymph nodes were 79.16 patients with malig-nant lymph nodes were rechecked after radiotherapy and chemotherapy,Apparent diffusion coefficient (ADC)values of the solid part for lymph nodes were compared.Results More lymph nodes can be detected in DWIBS than conventional sequence.ADC values of the solid part for malignant lymph node(0.898±0.111)×10-3 mm2/s were lower than that of benign lymph node(1.043±0.106)× 10-3 mm2/s,there was significant difference between them (P<0.05).ADC values of all malignant lymph nodes after treatment (1.205±0.121)×10-3 mm2/s were significantly higher than that of pretherapy (0.883±0.090)×10-3 mm2/s (P<0.05).Conclu-sion DWIBS could more sensitively detect lymph node than conventional MR sequence.ADC value could provide some reference values for differentiating benign and malignant lymph nodes and assessing therapeutic effect.
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Objective To investigate the application value of diffusion-weighted imaging with background suppression (DWIBS) in lymph node metastasis of rectal cancer.Methods 30 patients with rectal cancer diagnosed by colonoscopy underwent routine MRI and DWIBS examinations.Metastatic and non-metastatic lymph nodes were confirmed by postoperative pathology.Apparent diffu-sion coefficient (ADC)values of the solid part of metastatic and non-metastatic lymph nodes were measured and compared.ROC curve analysis was used to define the threshold between the metastatic and non-metastatic lymph nodes.Results In all 73 lymph nodes,there were 52 metastatic lymph nodes and the other 21 were non-metastatic.ADC values of the solid part of metastatic and non-metastatic lymph nodes were (0.881 ± 0.094)× 10 -3 mm2/s and (1.072 ± 0.108)×10 -3 mm2/s respectively,the difference was statistically significant (P <0.05).With the threshold ADC value of 0.957×10 -3 mm2/s,the sensitivity and specificity for dif-ferentiating metastatic from non-metastatic lymph nodes were 90.5% and 80.8% respectively.The diagnostic value was excellent (Az value = 0.91 9,P <0.05).Conclusion ADC values may be used to differentiate lymph node metastasis of rectal cancer,and DWIBS has higher application value in assessing lymph node metastasis of rectal cancer.
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Objective To approach the value of combination mode of different CT post-processing technique in diagnosing rib fine fracture.Methods 98 patients suspected with rib fractures underwent multislice spiral CT(MSCT) scanning,and CT features of rib fractures were observed with the combination of three different images:(A)volume rendering(VR),curved planar reformation(CPR) and axial view;(B)maximum intensity projection(MIP),CPR and sxial view;and(C) VR+MIP,CPR and axial view.The results were respectively recorded.Results 265 rib fine fractures were found among 98 patients.The detecting rate of fine fractures with C group was higher than that with A group (χ~2＝6.67,P＜0.01) and B group (χ~2＝6.75,P＜0.01).Conclusion MSCT four step observation method can improve the detecting rate of rib fine fracture,that is of important clinical value.
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Objective To study the imaging characteristics of the ligaments in craniocervical junction (CCJ), and to optimize the examination methods and scanning sequences of the ligaments in this region. Methods Two groups of 51 healthy volunteers in each were selected to undergo CT and MRI examination respectively. The CT and MRI features of the ligaments in CCJ were assessed. Two senior imaging doctors compared the results of showing the ligaments in CCJ by several MRI sequences, including T1 WI ,T2 WI, proton density weighted imaging (PDWI), T2 * WI and short time inversion recovery (STIR) ,and proton density fat saturate (PDFSAT). Standard normal rank transformation was done according to the primary data,and then analysis of variance of repeated measurement was applied. Results CT and MRI could both demonstrate the ligaments (except the anterior atlantooccipital membrane only seen on MRI) and their adjoins in CCJ, while MRI had more advantages than CT. The display ratio of the anterior atlantooccipital membrane was 100% (51/51) by MRI. The display ratio of the apical ligament was 29.4%(15/51) by CT and 43.1% (22/51) by MRI. The posterior atlantooccipital membrane-dura complex,tectorial ligament-dura complex, transverse ligament, and alar ligament could be demonstrated clearly by CT and MRI, the display ratio was 100% respectively (51/51). The results of PDWi scored by two doctors were both 5.0, there were no significant differences between them (F = 0.000, P > 0.05), which were significantly higher than T, WI (M = 3.0), T2Wi (M = 3.0), T2 * WI (M = 1.0), STIR (M = 1.0), and PDFSAT(M = 3.0)(P < 0.01). Conclusion MRI was superior to CT in demonstrating the ligaments in CCJ. PDWI was the optimal MRI sequence. Imaging research of normal ligamentous structures in CCJ could provide valuable diagnostic and therapeutic information for evaluating the ligamentous diseases.