Application of low-tube current using adaptive statistic iterative reconstruction in the accuracy of spinal quantitative CT / 中华放射医学与防护杂志

Objective To investigate the reproducibility and accuracy of spinal BMD (bone mineral density) by low mA using adaptive statistic iterative reconstruction based on phantom model.Methods European spine phantom (ESP) was scanned with 5 different tube currents (40,60,80,100 and 120 mA) on the GE Revolution prototype.All data were transferred to the quantitative CT (QCT) PRO workstation for measuring the bone mineral density (BMD).And all data were reconstructed using different adaptive statistical iterative reconstruction veo (ASiR-V) weighting percentages from ASiR-V 0 filtered back projection(FBP) to ASiR-V 100％,at interval of 20％.Quantitative measurements of CT value,noise,and contrast noise ratio (CNR) of L1,L2 and L3 were measured in each group.The singlefactor analysis of variance (ANOVA) was used to compare the bone mineral density values of different mA and ASiR-V weighting percentages.Results Volume CT dose index(CTDIvol) and dose length product (DLP) were positively correlated with tube current(r =1).The BMD of ESP phantoms had no statistically significant differences among the multi-center lumbar spines L1,L2 and L3 at different doses under the same ASiR-V weighting percentages (P ＞ 0.05),as well as at the same dose under different ASiR-V weighting percentages(P ＞ 0.05).The error of bone density accuracy was within 6％.Conclusions Low dosage of 120 kV and 40 mA using ASiR-V without affecting the accuracy of BMD has the potential effect to reduce radiation dose without compromising image quality.

An analysis of pathogenic bacterial distribution and its effect on the expression of apoptosis protein in patients of acute cerebral infarction complicated with pulmonary infection / 中国中西医结合急救杂志

Objective To investigate pathogenic bacteria distribution and its effect on the expression of apoptosis protein in patients with acute cerebral infarction (ACI) complicated with pulmonary infection. Methods A retrospective analysis was conducted. From January 2014 to October 2017, the clinical data of 178 patients suffered from ACI hospitalized in Department of Neuromedical Center of Affiliated Hospital of the Chinese People's Armed Police Force Logistics Academy were collected, including 86 cases with ACI complicated with pulmonary infection selected as the observation group, and 92 cases with ACI without pulmonary infection assigned in the control group. The identification and classification of pathogenic bacteria were carried out by using the French BioMieux microorganism fully automatic identification instrument; the contents of serum interleukins (IL-8, IL-17), soluble intercellular adhesion molecule-1 (sICAM-1) and B type lymphocyte tumor-2 related X protein (Bax), B lymphocyte tumor-2 protein (Bcl-2) in two groups were detected by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to observe the correlations between sICAM-1 and Bax, Bcl-2 protein expression. Results From the bacterial cultures of 86 patients with ACI complicated with pulmonary infection, 86 strains of pathogenic bacteria were isolated, including 41 strains of gram positive (G+) bacteria (47.67%), mainly Staphylococcus aureus (25.58%); 37 strains of gram negative (G-) bacteria (43.02%), mainly Acinetobacter baumannii (11.63%); 8 strains of fungi (9.30%). The serum levels of IL-8 (μg/L: 0.72±0.15 vs. 0.68±0.09), IL-17 (μg/L: 9.31±3.58 vs. 8.12±2.76), sICAM-1 (ng/L: 421.36±39.74 vs. 385.13±28.59) and Bax (μg/L: 4.52±0.47 vs. 3.86±0.34) in the observation group were significantly higher than those in the control group, while the level of Bcl-2 in the observation group was significantly lower than that in the control group (μg/L: 0.84±0.26 vs. 1.13±0.31), all the differences were statistically significant (all P ＜ 0.05). In the observation group, sICAM-1 was significantly positively correlated with Bax protein (r = 0.401, P ＜ 0.001), while sICAM-1 was significantly negatively correlated with Bcl-2 (r = -0.447, P ＜ 0.001). Conclusion The pathogenic bacteria of ACI patients complicated with pulmonary infection is mainly G+bacteria, the infection can induce elevation of serum pro-inflammatory factors and sICAM-1 levels in the patients, and the mechanisms may be related to the up-regulation of Bax protein expression and down-regulation of Bcl-2 protein expression.

Influence of low-tube current in combination with simultaneous iterative reconstruction algorithm on bone mineral density of T12 and image quality of chest in phantom / 中国医学影像技术

Objective To investigate the influence of low-tube current in combination with simultaneous iterative reconstruction algorithm on bone mineral density (BMD) of T12 and image quality with a chest phantom.Methods An adult male chest phantom was selected.CT scan of the chest was performed at tube voltage of 120 kV and five different tube currents (20,30,40,50,60 mAs) in combination with filtered back projection (FBP),iDose4 (Level 4) and iterative model reconstruction (IMR,Level 2),respectively.BMD of T12 in chest phantom and objective evaluation results on different tube currents and simultaneous iterative reconstruction techniques were compared.The subjective scoring of mediastinum and lung window imaging qualities at tube current of 20 mAs with IMR and tube current of 60 mAs with FBP were compared.The consistency between two observers was evaluated.Results There was no significant difference between BMD values nor CT values on different tube currents and simultaneous iterative reconstruction techniques of chest phantom (all P＞ 0.05),but the differences between SD values were statistically significant (P＜ 0.001).SD values obtained with IMR were lower than those of iDose4 and FBP at same tube currents (all P＜0.001).At tube current of 60 mAs with FBP,the consistency of two observers in mediastinum window was the best (Kappa=1,P＜0.001),while in lung window was medium (Kappa=0.64,P=0.002).At tube current of 20 mAs with IMR,the consistency of two observers in mediastinum window was medium (Kappa=0.64,P=0.002),while in lung window was the best (Kappa=1.00,P＜0.001).Conclusion Low-tube current in combination with simultaneous iterative reconstruction algorithm can reduce radiation dose without affecting the accuracy of BMD.

WeChat network service in military hospitals / 中华医学图书情报杂志

The function and contents of WeChat public account service in military hospitals were found out by in-vestigating the WeChat public account, which showed that WeChat public account service is provided in more and more military hospitals, but its function should be further expanded and its management should be strengthened.

Organ dose modulation in chest CT scan in female: protection of breasts / 中华放射医学与防护杂志

Objective To study the effects of organ dose modulation (ODM) technique on dose reduction of the breasts and the related thoracic image quality in female chest CT.Methods One hundred and twelve female patients with chest CT were enrolled in this study and divided into two groups according to the order:control group (n =56,using conventional scan) and experimental group (n =56,using ODM technique).The tube currents in different directions (A/L/P/R) were analyzed in the two groups.The effects of ODM on the radiation dosage and image quality were assessed.Results The tubc currents in anterior and posterior direction were both (128 ± 43)mA in the control group.However,the tube current in the anterior was lower than that in the posterior in experimental group (t =-18.701,P ＜0.01).The tube currents in all direction in the experimental group were all lower than those in the control group (t =11.71-20.22,P ＜0.01).The CTDIvol and E in the experimental group were lower than those in the control group(t=3.58,3.55,P ＜0.05).There were no significant differences for the objective and the subjective scores between two groups (P ＞ 0.05).Conclusions ODM technique could protect the female breasts by reducing the radiation dose without image quality degrading during chest CT scan.

The combined application of low molecular dextran, papaverine and low molecular weight heparin sodium to improve testicle survival rate after the reduction of testicular torsion in rabbits / 中华泌尿外科杂志

Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits.Methods From October 2014 to June 2015,36 male rabbits (weighing 1.8-2.4 kg,10-14 months of age) were randomly divided into experimental group and control group,18 in each group.Produced by surgical testicular torsion model (720° counterclockwise rotation of the left side testicle),every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water,all the testicles were observed no significant improvement in colors,and no fresh blood flow after opening tunica albuginea,then all the testicles were retained and fixed.Low molecular dextran(5 ml/kg,ear marginal vein injection,1/d),papaverine(1.5 mg/kg,intramuscular,3/d) and low molecular weight heparin sodium (200 IU/kg,subcutaneous,l/d) were applied to promote testicular revascularization for 5 days in experimental group,and penicillin (40 000 U/kg,intramuscular,1/d) for 7 days.Control group was only given penicillin (40 000 U/kg,intramuscular,1/d) to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0,1,2,3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened,according to color,texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened,to determine whether the testicle was alive.The testicle was ruddy,flexible,and fresh blood was observed,which could prove testicular survival.Results In experimental group,the testicular blood flow siganals:0 class 4 cases,1 class 3 cases,2 class 4 cases,3 class 7 cases.In control group,the testicular blood flow siganals:0 class 9 cases,1 class 2 cases,2 class 4 cases,3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group,which was significantly difference (P ＜ 0.05).Conclusions The combined application of low molecular dextran,papaverine,low molecular weight heparin sodium can promote the recovery of testicular blood after reduction of testicular torsion,and improve testicular survival rate.

Effect of automatic spectral imaging mode selection and adaptive statistical iterative reconstruction at abdominal CT with low contrast agent dose / 中华放射学杂志

Objective To investigate the image quality and radiation dose of automatic spectral imaging mode selection and adaptive statistical iterative reconstruction (ASIR) at abdominal CT with low contrast agent dose. Methods One hundred cases with the arterial-phase (AP) and portal venous phase (PVP) contrast-enhanced abdominal CT scanning were analyzed prospectively. Patients were randomly assigned to the study group and control group (n=50 each). In the study group, automatic spectral imaging mode selection and contrast agent dose of 300 mg/kg were used and spectral monochromatic images(40 to 60 keV) were reconstructed using either filtered back-projection (FBP) (group A) or ASIR (group B). In the control group, the fixed tube potential of 120 kVp and contrast agent dose of 450 mg/kg were used with images reconstructed using FBP (group C). Quantitative parameters (image noise and contrast-to-noise ratio of the liver, pancreas, aorta and portal vein) and qualitative visual parameters (overall image quality as graded on a 5-point scale) were compared among the groups by using One-way ANOVA or Kruskal-Wallis H test. Two sample t tests were used compare the radiation dose difference. Results There had no significant difference in CTDIvol[both (12±5) mGy] and DLP[(364±142) mGy·cm versus (377±131) mGy·cm] between the study group and control group(t=-0.408 and-0.428,P>0.05). During the AP and PVP, at the energy level of 40 keV, group B showed higher CNRs than group A and group C, lower image noise[ (29±6) HU in AP, (24±6) HU in PVP] than group A[(43±11) HU, (44±10) HU] but higher image noise than group C[ (18± 4) HU, (18±4) HU], lower overall image quality scores[(3.0±0.2) point, (2.9±0.3) point] than group C[(3.6± 0.4) point , (3.6±0.5) point] but similar scores to group A[(2.9±0.4) point,(2.8±0.4)point]. At the energy level of 50 keV, group B showed higher CNRs than group A but higher than or similar CNRs to group C, lower image noise[ (20±5) HU, (20±4) HU] than group A[(31±8) HU, (31±7) HU] but similar image noise to group C, higher overall image quality scores[(3.6±0.4) point, (3.5±0.4) point]than group A[(3.3±0.3) point,(3.3±0.3) point] but similar scores to group C. At the energy level of 60 keV, group B showed lower image noise[(14±4) HU, (14±3) HU], higher CNRs and overall image quality scores[(3.9±0.4) point,(3.9±0.3) point] than group A[(19 ± 5) and (20 ± 5)HU in image noise, (3.7 ± 0.4) and (3.7 ± 0.3) point in overall image quality scores ]and group C. Except for monochromatic images at 40 keV, the overall image quality scores in group B were all greater than 3 point and met the clinical diagnostic level. Conclusions The radiation dose of CT spectral imaging and conventional 120 kVp CT scan is equivalent with the use of automatic spectral imaging mode selection. By combining ASIR technique, monochromatic images at 50 and 60 keV can improve CNR and reduce contrast agent dose while maintain or improve overall image quality.

Application of spectral CT in the differentiation of stage T3 and T4a gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the application value of spectral CT in the differentiation of stage T3 and T4a gastric carcinoma.</p><p><b>METHODS</b>Data of 62 gastric cancer patients of stage T3 and T4a undergoing abdominal spectral CT examination in the First Affiliated Hospital of Zhengzhou University from December 2013 to December 2014 were collected retrospectively. There were 38 male and 24 female patients, with age of 33 to 77(58.6±10.4) years old. Abdominal double-phase enhanced scanning in gemstone spectral imaging mode was used to measure Iodine concentration (IC, 100 μg/ml) and water concentration(WC, 100 μg/ml) of perigastric fat tissue adjacent to the lesion during arterial phase(AP) and venous phase(VP), and normalized iodine concentration (nIC) was calculated respectively(nIC=IC/IC of aorta on the same slice). IC, WC, nIC of arterial phase and venous phase between stage T3 and T4a lesions were compared with double independent sample t test and compared with pathology. The diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><b>RESULTS</b>During arterial phase in stage T4a cases, IC (100 μg/ml) was -5.19±0.81 and nIC was -0.05±0.01, which was significantly higher than -3.44±1.54 (P=0.000) and -0.03±0.01 (P=0.000) in stage T3 cases. During venous phase in T4a cases, IC (100 μg/ml) was -3.78±0.94 and nIC was -0.04±0.01, which was significantly higher than -1.62±1.43 (P=0.000) and -0.02±0.02 (P=0.000) in stage T3 cases. As compared to arterial phase, IC and nIC of stage T4a and T3 of venous phase were more significantly different (all P<0.05). WC of stage T4a during arterial and venous phase was 955.72±15.68 and 949.86±17.36 respectively, while WC of stage T3 during arterial and venous phase was 947.77±18.43 and 942.46±18.53 respectively. There were no significant differences in WC between two stage cases during arterial and venous phase (P=0.106, P=0.143). ROC analysis showed that area under the ROC of IC and nIC during arterial phase was 0.829 and 0.867 respectively, and cut-off value of nIC was -0.039 for differentiation of stage T3 and T4a with corresponding 83.3% of sensitivity and 75.0% of specificity; area under the ROC of IC and nIC during venous phase was 0.873 and 0.905 respectively, and cut-off value of nIC was -0.031 for differentiation of stage T3 and T4a with corresponding 81.0% of sensitivity and 85.0% of specificity.</p><p><b>CONCLUSIONS</b>Abdominal spectral CT scan is useful in the differentiation of stage T3 and T4a gastric carcinoma. The IC of perigastric fat tissue is significantly higher in stage T4a gastric carcinoma compared to stage T3 gastric carcinoma. Higher diagnostic efficacy can be obtained when taking -0.031 as the cut-off value of nIC during venous phase.</p>

Diagnostic value of spectrum CT volume helical shuttle technology in detection of pulmonary arteriovenous malformations / 实用放射学杂志

Objective To access the diagnostic value of volume helical shuttle (VHS)technology of spectrum CT in detection of the pulmonary arteriovenous malformations (PAVM).Methods Thirteen patients with PAVM confirmed by surgery and clinical data underwent CT pulmonary artery angiography with VHS technology,which were regarded as group A.The consecutive images at four different phases were gotten Meanwhile,other thirty patients underwent conventional CT pulmonary artery angiography using bolus tracking scan,regarded as Group B.The enhancement degrees of the pulmonary trunk were measured,and the image quality was also subjectively assessed by two radiologists separately,which were compared between two groups.Results In group A,the proportion of optimal phase in each of the four phases was 15.38% (2/13),46.15% (6/13),30.77% (4/13)and 7.7% (1/13),respectively.The mean CT value in pulmonary trunk was (329.21±41.63)HU in group A and (281.74±49.83)HU in group B,exhibiting no difference (P =0.989). The percentage of enhancement degree of pulmonary trunk more than 300 HU in group A was more than that in group B (P=0.000).However, the image quality of the main pulmonary artery,lobar pulmonary artery or segmental pulmonary artery was not significantly different between two groups (P >0.05).There were no statistically differences in mean DLP between group A of (715.54±195.37)mGy/cm and group B of (558.36±186.81)mGy/cm (t=3.737,P=0.068).Conclusion Spectrum CT VHS with higher image quality and enhancement degree is superior to conventional CT scan,which can be used to reduce the influence of individual circulation difference on image quality.

Imaging of primary chondrosarcomas:radiologic-pathologic correlation / 实用放射学杂志

Objective To study imaging features of primary chondrosarcomas and the correlation with pathologic basis.Methods The imaging materials of primary chondrosarcoma in 21 cases were retrospectively analyzed and correlated with pathological results. Results In 21 cases,the pathologic classifications were as following:15 cases of conventional intramedullary,1 case mesenchymal,2 cases myxoid,1 case dedifferentiated and 2 cases with no subtypes.For 6 cases of conventional intramedullary in gradeⅠand 8 cases in gradeⅡ,bone destruction in varying degrees accompanied with soft tissue mass(n=1 1),regional thickening cortical bone (n=2),“ring-arc”like matrix mineralization(n=6),amorphous (n=3)were showed on X-ray study.CT were performed,in 6 cases in gradeⅠ,6 cases in gradeⅡ and 1 case in grade Ⅲ in which there were intraosseous calcification (n=12),regional thickening cortical bone (n=2)and periosteal new bone formation (n=1).Lesions appeared expansive or osteolytic bone destruction accompanied with soft tissue mass on CT and MRI srudy MRI were performed in 5 cases in gradeⅠ and lesions were heterogeneous high signal intensity on T2 WI with spot like and “ring-arc”like low signal intensity.Conclusion Pathologic classifications and grading of primary chondrosarcoma may be presumed with imaging features.Pathologic characteristic manifestions on MR are superior to that on CT and X-ray.