On the rotation mode of standardized residency training of non-imaging professional residents in the department of radiology / 中华医学教育探索杂志

The department of radiology, as one of the public platforms for standardized residency training, is very crucial to the training of high level clinicians and essential to improve quality of medical care. According to the present situation and existing problems of standardized residency training for the non-imaging professional residents in the department of radiology in China, combining with our practice, this article primarily explores the improvement of the rules and regulations, the specific arrangement of the rotation, daily and graduation examination forms, and training quality supervision, etc. We hope to improve the training quality of the non-imaging professional residents' rotation in the department of radiology and explore more suitable and effective medical educative strategies.

Assessment of coronary artery by prospective ECG-triggered 256 multi-slice CT on children with congenital heart diseases / 中华放射医学与防护杂志

Objective To investigate the image quality and radiation dosage of the prospective ECG-triggered 256 multi-slice computer tomography (MSCT) angiography in accessing coronary artery (CA) on children.Methods Coronary arteries of ninety-three children were evaluated using prospective ECG-triggered 256-MSCT with the same system setting.Seventy-four patients had the heart rate records and a four-point scoring system was applied to study the capability of MSCT in detecting CA.The signal,noise and contrast-to-noise ratio (CNR) were analyzed to investigate the association of image quality with age (n =74).Then volumetric CT dose index (CTDIvol),dose-length product (DLP) and effective dose (E) were utilized to study the association of radiation dosage with age (n =93).Results On 74 patients with heart records,the detection rate for original,proximal,middle,distal and all 11 segments of CA was 100％,97％,92％,78％ and 91％,respectively.No influence of age was found on their detection (all P＞0.05).E of group A,B,C and D were 1.8,1.3,0.8 and 0.7 mSv,respectively.A strong negative correlation was found between E and age (r =-0.803,P ＜ 0.01).Higher DLP was found on elder patients,though no correlation was found between ages vs.DLP(r =0.124,P ＞ 0.05).No correlation was found between noise vs.age (r =0.041,P ＞ 0.05).Significantly larger signals,CNR and E(t =3.386,2.073,3.825,P ＜ 0.05) were found on younger patients (age ＜ 3 years).Conclusions Prospective ECG-triggered 256-MSCT has considerable performance for the evaluation of coronary arteries on children.However,children under the age of 3 are not recommended for this examinary,but for examination on children ≥ 8-year old,the tube current could be further needed.

Low-dose 16-slice spiral CT thoracic angiography using Z-axis modulation / 中华放射学杂志

Objective To explore the feasibility of low dose in MSCT thoracic angiography using Z-axis modulation. Methods The consecutive 60 patients were averagely divided into 3 groups and underwent thoracic angiography with a Toshiba Aquilion 16 scanner. The whole chest acquisition was commenced in automatic exposure control with Z-axis modulation 20-25 seconds after the contrast material was administered at the rate of 3.5-4. 0 ml/s. With the noise index (SD) as the variable, three study groups were classified as A (SD = 12) , B (SD = 15 ), and C (SD = 18 ). The mAs value per slice and the number of slices were recorded. The noises and artifacts of the axial images and the acceptability of CT angiogram were evaluated. The difference among the groups was compared by using ANOVA or nonparametric Kruskal-Wallis test. The threshold of the P value was 0. 05. Results The mean mAs value (46. 4 ± 15.6) mAs in group A was the highest but the SD value (21.6 ±7.7) was the lowest. The mean mAs value ( 37. 0 ± 13.5 ) and the SD value ( 24. 0 t 5.4 ) in group B were the mediate. The mean mAs value ( 20. 7 ±6.3) mAs in group C was the lowe(s)t but the SD value ( 30. 7 ± 6.9) was the highest ( H = 31. 390, P =0. 000). The middle slice images in all patients had the smallest mAs (40. 9,31.3,17. 1 for group A,B,C,respectively; F =9. 578, H =22. 230, F =21. 180,P =0. 000) and SD values( 16. 3, 20. 0,25.4 for group A,B,C, respectively; H = 28. 982, H = 20. 824, H = 24. 396, P = 0. 000). The acceptability of CT angiogram in all patients was excellent. The CT value of descending aorta in group A, B, and C was ( 335 ± 85 ) HU,(334 ±56)HU, and (427 ± 63 )HU, respectively. Conclusion Low dose in MSCT thoracic angiography using Z-axis modulation is feasible. We can use low dose (20 mAs, etc. ) for CT angiography when the contrast is significant.

Relationship between the level of plasma homocysteine and coronary calcification in patients with different blood glucose levels / 中国综合临床

Objective To determine the relationship between the level of plasma homocysteine and coronary calcification in patients with different blood glucose levels. Methods By measuring plasma homocysteine and coronary calcification in 30 cases of diagnosed diabetes (T2D) ,29 cases of diagnosed impaired glucose tolerance (IGT) in patients and 27 cases with normal, we compared the level of plasma homocysteine and coronary calcification in patients with different blood glucose levels. Results We found significant diffieronces among three groups of the level of plasms homocysteine and coronary calcification (P ＜ 0.01). The plasma homocysteine levels were(19.31 ±3.17) μmol/L, (13.85 ± 1.62) μmol/L, (9.80 ± 1.78) μmol/L in the T2D,IGT and normal groups,respectively. The coronary calcification scores were 207.80 ± 154.10,63.24 ± 10.46,14.47 ± 5.16 in the T2D, IGT and normal groups, respectively. The plasma homocysteine level and coronary calcification score increased with the glycosylated hemoglobin rise in the normal,IGT and T2D groups((4.51 ±0.48)%, (6.13 ±0.31)% and (7.69 ±0.81)%, respectively). Conclusions The plasma homocysteine level is a strong independent predictor of type 2 diabetes and also an important factor of coronary artery event occurrence and develepment.