Diagnosis of 320-row detector dynamic volume CT in complex congenital heart disease with double outlet right ventricle / 重庆医学

Objective To explore the diagnosis value of 320-row detector dynamic volume CT in complex congenital heart disease (CCHD)with double outlet right ventricle(DORV).Methods Seventy-eight patients who proveed DORV by surgery in Xinqiao Hospital of Third Military Medical University were reviewed.Thirty-six patients of group A performed 320-row detector dynamic volume CT by using segmental analysis,and were compared with the group B(42 Cases) performed conventional 64-slice CT respectively.Results In 36 cases of DORV confirmed by surgery in group A,MSCT provided accurate qualitative diagnosis in all cases.The accuracy rate of diagnosis of the group B was 90.7％.There was no significant differences compared with the group A (P＞0.05).There were ventricular septal defect in all the 78 cases,pulmonary stenosis in 56 cases,atrial septal defect in 34 cases,pulmonary hypertension in 21 cases,patent ductus arteriosus in 16 cases,coarctation of aorta in 9 cases.Conclusion The 320-row detector dynamic volume CT has important diagnostic value for DORV of the anatomical diagnosis.

Clinical application of MRCP for the diagnosis of the 60 cases of biliary pancreatitis / 重庆医学

Objective To explore the clinic value of magnetic resonance cholangiopancreatography(MRCP)for the diagnosis of biliary pancreatitis(BP).Methods MRCP manifestation of 60 cases of BP proved by clinic records was analyzed retrospectively. Results Of all the 60 cases,41 were found pancreatitis combined with gall bladder stones or biliary cystitis,19 combined with stones in common biliary duct.Dilation of biliary duct was found in 23 cases,dilation of pancreatic duct in 9 cases,dilation of both in 5 cases.Conclusion MRCP can clearly display the signs of biliary pancreatitis,and have high clinic value for its diagnosis.

Construction and application of picture archiving and communication system based on digital teaching platform of medical imaging / 中华医学教育探索杂志

Picture archiving and communication system ( PACS ) based on digital teaching platform of medical imaging consists of web teaching system and teaching resource library of medical imaging.The web teaching system includes four function modules of classroom management,work management,teaching management and test management.The teaching resource library includes script,pictures,and audio,video and animation materials of theoretical books,typical cases,examination techniques and medical imaging equipments.Utilized in theoretical and practical classes,the teaching characteristic of medical imaging is made prominent,and the subjective motility of the students is brought into play.

Establishing models of portal vein occlusion and value of multi-slice CT in the evaluation of hepatic VX2 tumor in rabbits / 中国组织工程研究

BACKGROUND: Clinical researches found that portal vein occlusion was beneficial to inhibit growth of hepatocarcinoma, promote compensatory hyperplasia of un-blocking hepatic tissue and decrease metastasis of portal vein occlusion; however, it should be fu~her proved by animal experiments.OBJECTIVE: To investigate models of portal vein occlusion of hepatic VX2 tumor in rabbits and evaluate value of multi-slice CT.DESIGN: Randomized grouping design and animal study.SETTING: Department of Radiology, Xinqiao Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Imaging Department of Xinqiao Hospital of the Third Military Medical University of Chinese PLA from July 2002 to January 2005. Forty New Zealand rabbits were divided according to digital table into 4 groups: immediate group (transplantation of tumor after immediate portal vein occlusion), 3-week group (transplantation of tumor at 3 weeks after portal vein occlusion), negative control group and positive control group, 10 in each group.METHODS: Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation at immediate portal vein occlusion and 3 weeks after portal vein occlusion. Meanwhile, they were divided into negative control group (Left external branch of portal vein was done sham-operative block,and left exite was embedded and inoculated pseudoly) and positive control group (Transplanted tumor did not suffer from portal vein occlusion). All rabbits were scanned with multi-slice CT.MAIN OUTCOME MEASURES: General changes of liver, changes of tumor, metastasis of tumor, vascular-imaging displaying rate of multi-slice CT of hepatic artery and portal vein, blood flow of liver, blood volume,mean transit time, permeability of vascular surface and fraction of hepatic arterial infusion (HAI).RESULTS: All 40 animals were involved in the final analysis. ① Tumor did not grow in both immediate group and 3-week group. In 3-week group,left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was smaller than that in positive control group [(2.55 ±0.46), (3.59±0.37) cm, t=5.57, P ＜ 0.001]. Incidences of metastasis in liver and lung were lower in 3-week group than those in positive control group (10%, 40%; 100%, 90%); however, there was no significant difference. ② Scanning with multi-slice CT, displaying rate of branches hepatic artery was lower in grade Ⅲ than that in grade Ⅰ and Ⅱ (40%, 70%,100%, P ＜ 0.05); but there was no significant difference of displaying rate of portal vein at various grades (P ＞ 0.05). ③ Values of blood flow of liver,blood volume, mean transit time and permeability of vascular surface were lower in immediate group and 3-week group than those in control groups,but values of HAI were increased.CONCLUSION: Ligating left external branch of portal vein is an ideal way to establish models of portal vein occlusion of hepatic VX2 tumor in rabbits; furthermore, multi-slice CT plays a key role in evaluating effect of portal vein occlusion.

Imaging diagnosis of the carotid artery pseudoa-neurysm in head and neck / 中国耳鼻咽喉头颈外科

OBJECTIVE To make a further understanding of the imaging findings of the carotid artery pseudoaneurysm (CAPA) in head and neck and to explore the clinical value of imaging in diagnosis of it, especially the angiographic diagnosis. METHODS The clinical and imaging data of 36 patients with CAPA were analyzed retrospectively. The imaging appearances in all of the patients were observed by two experienced radiologists together and formed a consensus interpretation. RESULTS Imaging examination can establish definitive diagnosis in all cases. The parent arteries included the common carotid artery (2 case), common carotid artery bifurcation (18 cases), internal carotid artery (10 cases) and external carotid artery (2 cases). The imaging features of the CAPA were:the contrast media retained in the aneuysm in all cases;the aneuysm lumen with turbulent flow in 18 cases;the"jetting sign"at the leak of the parent artery in 14 cases;increase of bifurcation angles of internal and external carotid arteries in 24 cases. CONCLUSION Imaging examination is the most valuable examination method in diagnosis of CAPA, and it can not only make definitive diagnosis, but also play an important role in selection of therapeutic planning.

Double chemoembolization of hepatic carcinoma by TACE and portal vein PCS / 第三军医大学学报

Objective To study the method and efficacy of double chemoembolization of hepatic carcinoma by transcatheter arterial cheomembolization (TACE) and portal vein port catheter system (PCS). Methods PCS was implanted in portal vein in 17 cases of irresectable primary hepatocellular cancer (HCC) during operation. One month later, chemoembolization of portal vein via PCS was performed, meanwhile TACE was also done (hepatic arterial portable vein chemoembolization, HA PVCE). A total of 120 cases of HCC treated simply with TACE were served as the control. Results The technical success rate was 100% in both TACE and portal vein PCS. Hepatic arteriography showed rich or moderate blood supply of HCC in 134 cases and PCS portography showed tumor staining in 6 cases. In groups of HA PVCE and TACE, the positive alpha fetoprotein (AFP) level decreased in 80% and 71.6% cases; half a year survival rate was 85.7% and 74.4%, and one year survival rate was 71.4% and 52.4%, respectively. Conclusion Double chemoembolization by TACE and portal vein PCS is a safe procedure with high technique success rate and therapeutic efficacy for irresectable hepatic carcinoma.

Diagnostic value of multi-slice spiral CT for lesions in middle and inner ears / 第三军医大学学报

Objective To assess the clinical value of multi-slice CT(MSCT)in showing the ear lesions.Methods MSCT high resolution scan images of 52 ears of 11 normal adult and 15 patients with hearing loss were reconstructed,by bone plus with 0.625 mm collimation,9.6 cm small field of vision(FOV)and 0.3 mm reconstruction interval before volume rendering(VR)and multiplanar reformation(MPR)were performed.Results VR,MIP and MPR images of 40 normal ears clearly showed the complicated anatomic structures.VR,MIP and MPR images of twelve abnormal ears displayed 3 ears of malformations of crus longum incudis,1 ear of destructed semicircular canals,2 ears of malleus dysplasia,2 ears of fusion of incudostapedial joint,2 ears of bony atresia of external auditory complicated with auditory ossicles dysplasia,and 2 ears of crus stapedis dysplasia.MPR is easier to manipulate than VR that has three dimensional effect butis difficult to handle.Conclusion HRCT images,combined with post-processing technique of VR,MIP and MPR,can clearly show the anatomic structures and lesions of middle and inner ears.

Clinical application of spiral CT virtual endoscopy to stomach / 第三军医大学学报

Objective To explore the imaging method and the value of clinical application of spiral CT virtual endoscopy(CTVE)to stomach.Methods After 36 patients took the aerosis agent or 5% contrast medium,virtual endoscopic images were obtained by using GE-Navigator smooth image model and multiplanar reconstruction.Results Two types of contrasts complemented each other.Normal gastric structure,stenosis and obstruction were clearly visualized in 36 patients.Conclusion CTVE can provide a noninvasive diagnostic method,supplemented to fiberoptic endoscopy,but its sensitivity and specificity should be improved.

Diagnostic value of CT imaging in retroperitoneal tumor and tumor-like lesion / 第三军医大学学报

Objective To analyze CT features of retroperitoneal tumors or tumor-like lesion and to evaluate CT in localizating and qualitative diagnosis of diseases.Methods CT findings in 45 cases with pathologically-proved retroperitoneal tumor were retrospectively analyzed and compared with pathological results.Results There were 25 cases of benign tumors and 20 cases of malignant tumors.The CT features of benign tumors were homogeneous density,smooth peripheria with clear border,while mixed density,large and irregular in malignant tumors.The accuracy of localizating lesions was 89%,the accuracy of qualitative diagnosis was 78%,the accuracy of histologic evaluation was 49%.Conclusion CT imaging is valuable in diagnosing retroperitoneal tumors.CT can make accurate localization of tumors and identify the nature of tumors,but is limited in evaluating histologic types.

Application of MRI PROPELLER Technology in Brain Artifacts Reduction / 医疗卫生装备

Objective To investigate the value of Periodically Rotated Overlapping Parallel Lines Enhanced Reconstruction (PROPELLER) in omitting the motion and susceptibility artifacts in head MRI. Methods Thirty nine cases of restless patients and eighteen cases with fixed metal artificial tooth underwent head MRI using T2WI or DWI with PROPELLER during April and Nov. in 2006 were analyzed respectively. The PROPELLER images and common MRI images were compared. Results The common images of 39 restless patients were not suitable to diagnosis because of moving artifact and pure imaging quality, while the PROPELLER T2WI images eliminate the artifact obviously and display the lesion clearly. Susceptibility artifacts were found in 18 patients with artificial tooth in common MRI images, and the artifacts were almost not found in PROPELLER DWI images and so satisfied the need of diagnoses. Conclusion PROPELLER T2WI and DWI can remove significantly the motion and susceptibility artifacts, and so acquire images of high resolution, low artifacts, and high quality to satisfy the need of diagnoses.

Tissue Equalization Technique Applied in DR Thoracolumbar Vertebral Body Photography / 医疗卫生装备

Objective To assess the examinational value of tissue equalization (TE)technique in DR thoracolumbar vertebral body photography. Methods 48 cases were reformed using the conventional DR method in the thoracolumbar vertebral body photography,compared with the TE technique in DR thoracolumbar vertebral body photography. Results The details in different thickness area of body could be revealed clearly in the same image produced by TE technique. The visualization of image details could be obviously improved by using the TE technique. Conclusion It is important to apply the TE technique in DR thoracolumbar vertebral body photography.

Value of Radiological Equipment of Injury Treatment in Earthquake / 医疗卫生装备

Objective To explore the clinical value of radiological equipment for injury treatment in earthquake. Methods s One hundred and forty-three cases of the injury in earthquake using radiological equipment were analyzed retrospectively. Resultss All of the cases were performed X-ray plain film examination, CT in 78 cases and MRI in 19 cases. Imaging examination could establish definitive diagnosis in 143 cases of the injury in earthquake. Conclusion Radiological equipment is the most valuable examination equipment in diagnosis of the injury in earthquake.

Application of Multimedia Courseware in Teaching of Medical Imaging Technology / 医疗卫生装备

This paper discusses the conception of multimedia courseware in the teaching of medical imaging technology, and meaning, features and requirements. It is concluded multimedia courseware can play an important role in the teaching of medical imaging technology. Also, some problems existing in the application are analysed in this article.

QA and QC of Intravenous Injection in Radiology Department / 医疗卫生装备

Objective To investigate the quality assurance (QA) and quality control (QC)of intravenous injection in the radiology department. Methods The data from 1352 cases of intravenous injection in the radiology department were analyzed retrospectively. Results The bulge in region of the intravenous injection have been found in 28 cases, regional cyanochroia in 52 cases, allergic response in 25 cases, hypoglycemia response in 58 cases. Conclusion It is important to strengthen the QA and QC of intravenous injection in the radiology department.

QA and QC of 16 Slices Helical CT Angiography in Lower Limb / 医疗卫生装备

Objective To investigate the quality assurance(QA) and quality control(QC)of 16 slices helical CT angiography in the lower limb. Methods 42 cases clinically suspected as the arterial disease of lower limb undergoing MSCTA were analyzed retrospectively. All reconstructed images were reformed by means of MIP, VR, MPR and CTVE. Results 22 patients were diagnosed correctly by using MSCTA. Compared to DSA and/or surgical results. Sensitivity, specificity and accurate rate were all 100%. Conclusion It is important to strengthen the QA and QC of the 16 slices helical CT angiography in the lower limb.

Examination of Multi-slice CT in Palata / 医疗卫生装备

Objective To assess examinational methods of Multi-slice CT(MSCT)in diagnosis of palatine lesions. Methods 28 cases were performed MSCT examination with the conventional method,extending -tongue method,colliding-tongue method and pronouncing method. All images were reconstructed by means of multiplana reconstruction (MPR) and CT virtual endoscope (CTVE). Results Correct diagnosis were obtained through the complementarity of the methods. Conclusion Reasonable examination methods of MSCT is apt to display palatine lesions.

Analysis of the causes of misdiagnosis on CT films of 45 patients with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To analyze the causes of computed tomographic misdiagnosis of pulmonary carcinoma.</p><p><b>METHODS</b>From September 1991 to January 2002, 45 cases of pulmonary carcinoma misdiagnosed by CT were analyzed retrospectively. Twenty-six cases of pulmonary tuberculosis and 15 cases of pulmonary pneumonia misdiagnosed as pulmonary carcinoma by CT were studied as control subjects. All of these cases were confirmed by surgery and clinical course. The CT appearances of these cases were independently reviewed in a double blind method by three experienced radiologists. Then they discussed together in order to search for the factors of CT misdiagnosis and formed a consensus interpretation.</p><p><b>RESULTS</b>Forty-five cases of pulmonary carcinoma were misdiagnosed as pulmonary tuberculosis in 19 cases, pneumonia in 14 cases, abscess in 4 cases, pleural mesothelioma in 2 cases, normal in 2 cases, and others in 4 cases. The fundamental manifestations of misdiagnosed cases were lobar or segmental shadows (26 cases), solitary mass or nodule (19 cases).The reasons of CT misdiagnosis were very confusing. The main factors were:(i) Missed diagnosis (2 cases, 4.5%). One case had an endobronchial mass and another had the erosion of rib. (ii) Twenty-four cases (53.3%) due to mis interpretation and lack of experience. (iii) The manifestations in CT were atypical (19 cases,42.2%).</p><p><b>CONCLUSIONS</b>Not identifying accurately the CT appearances and excessively emphasizing the specificity of some signs are the main causes of the misdiagnosis. A reasonable and careful CT examination, summarizing analysis combined with clinical findings, and the accumulation of diagnostic experience will help to reduce the CT misdiagnostic rate of pulmonary carcinomas.</p>

CT Diagnosis of Primary Carcinoma of the Vagina / 实用放射学杂志

Objective To make a futher understanding of the CT features of primary carcinoma of vagina and to explore the clinical value of CT diagnosis of it.Methods Sixteen cases of primary cacinoma of vagina with clinical and CT data confirmed by pathology were analyzed retrospectively. The CT findings were observed in a double blind method by three experienced radiologists together and formed a consensus interpretation. Results The accurate rate of CT diagnosis for primary carcinoma of vagina was 81.3% in the 16 cases. There were 2 stage I, 6 stage II, 4 stage III and 4 stage IV lesions which were diagnosed by CT. The numbers of cases of the elevated type, ulcerative type and infiltrative type were 11, 3, and 2,respectively. The transcatherter internal pudendal arterial chemoembolization were successfully performed in 2 patients with vaginal carcinoma. Conclusion CT is not only a non-invasive method of detecting primary carcinoma of vagina,but also play an important role in differentiating the clinlcal phase and type of it. In more advanced stages of vaginal carcinoma, interventional therapy is chosen as the useful treatment to avoid exenterative surgery, preserve anatomy and function.

Angiographic diagnosis and interventional therapy for Takayasu arteritis / 介入放射学杂志

Objective To explore the value of angiographic diagnosis and interventional therapy for Takayasu arteritis. Methods Thirty-eight patients with Takayasu Arteritis (TA)(11 men, 27 woman; aged 8-54; average age, 30.5?18) undergone angiography were analyzed retrospectively. The angiographic appearances in all of the patients were observed dynamically in a double blind method by two experienced radiologists together and formed a consensus interpretation. Results According to the classification of Lupi-Herrea, typeⅠwas found in 11 cases, typeⅡin 15, typeⅢin 7 and typeⅣin 5 by angiography. Among 38 patients the arterial involvement ineluded subclavian artery in 20 cases (52.6%), the abdominal aorta in 15 cases (39.5%), the renal artery in 14 cases (36.8%), thoracic aorta in 10 cases (26.3%), carotid artery in 9 cases (23.7%), iliac artery in 9 cases (23.7%), axillary artery in 7 cases (18.4%), superior mesenteric artery in 4 cases (10.5%), coronary artery in 3 cases (7.9%), pulmonary artery in 3 cases (7.9%), and so on. Percutaneous transluminal angioplasty was performed in 22 cases and the stent placement was managed in 12 cases successfully. Conclusions Angiography is one of the ideal and reliable methods for the diagnosis and guidance of the interventional treatment for TA, and the latter is a mini-invasive and effective way for TA.

Examination of gastric carcinoma with CT virtual gastroscopy using bi-tilted CT scanning / 中国普通外科杂志

Objective To investigate the procedure,imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bi-tilted CT scanning.Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT).The patients and yolunteers were given bubble-making powder by mouth and placed in a supine position on the CT table.CTVG and MPR images were obtained using the virtual dissection and reform of GE.Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy.The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening,soft tissue mass,stenosis of stomach,cancerous ulcer,infiltration to adjacent tissues,and lymph node and distant metastases.In comparison with fiberoptic gastroscopy(as the gold standard),CTVG showed a diagnostic accuracy of 92.5 %,a sensitivity of 93.3 %,a specificity of 90.0 %,a positive prediction value of 96.7 %,and a negative prediction value of 81.8 %.Conclusions CTVG is a safe,reliable,non-invasive method for demonstrating the structure of normal and abnormal stomach,and is a good complementory method to conventional fiberoptic gastroscopy.