Objective: To assess the ability of strain rate imaging for assessment of left ventrical systolic function and to explore the relationship among left ventricular(LV) peak systolic strain rate and left ventricular ejection fraction(LVEF) in essential hypertension patients with different left ventricular patterns. Methods: The left ventricular mass index(LVMI) and relative wall thickness(RWT) were evaluated by echocardiography in 55 cases with essential hypertension and 30 normal control subjects. According to level of LVMI and RWT, patients with hypertension were divided into patterns of normal geometric LV(LVN, n=22) and remodeling LV(LVR), which including concentric remodeling(n=13), concentric hypertrophy(n=7) and eccentric hypertrophy(n=10). The apical views were used to determine the SSR. Strain rate imaging was applied for obtaining peak systolic strain rate(SSR) of the LV basal and middle segments. The left ventricular systolic function was evaluated by means of SSR in all sites. LVEF was determined by Simpson's rule in all patients and control subjects. Results: In all groups, mean SSR by SRI of LV wall correlated negatively and closely with the LVEF(r1=-0.82, r2=-0.84 and r3=-0.94, P0.001). Mean SSR was significantly descending in the control groups, LVN group and LVR group(P0.05). Although LVEF were significantly lower in LVR group than in LVN group(P0.05), there had no significant difference between control group and LVN group(P0.05). Conclusion: SRI provides a sensitive, simple and trustful tool to assess globle LV function in patients with essential hypertension.
幕上原始神经外胚层肿瘤(PNET)是一种罕见的颅内原发肿瘤,起源于未分化的神经外胚层细胞,高度恶性,侵袭性强.经检索,国内外成人原发于幕上脑质PNET影像学文献报道病例总数少于30例,但影像学表现有一定的特征性.作者见到1例,报告如下.鉴于国内缺乏成人幕上PNET影像学表现的系统论述,作者对国内外有关文献资料进行复习,总结成人幕上PNET的CT与MRI表现,以提高对本病的认识.
Objective: To compare the efficiency of left heart opacification of homemade phospholipid-coated microbubble and albumin microbubble contrast agent. Methods: The phospholipid-coated microbubbles were prepared by the sonicated cholesterol and lectithin liposome solution. The efficacy of the homemade lipid contrast agent was evaluated by comparing with parentarel solution and Different doses(very high 0.225ml kg, high 0.15ml kg, middle 0.1ml kg, low 0.05ml kg, very low 0.025ml kg, only in very low dose) were inject in bolous in random order. Left heart opacification grades and numbers of endocardial border delineation segment observed after each contrast injection. Results: Very low and low doses groups of lipid microbubbles had a good right but bad left heart opacification. There were no differences in left heart opacification between lipid microbubbles in middle dose group and Quanfuxian in very low dose group and Dongguan in very high dose group. But opacification time was still shorter in lipid bubbles groups than that in Quanfuxian group. Myocardium opacification could only be significantly seen in very high dose group in lipid microbubbles. Conclusion: The lipid shell microbubbles consist of cholesterol and lecithin can provide left ventricular and myocardium opacification. It is hopeful to develop a new kind of microbubble. Compare with Dongguan and Quanfuxian in opacification, the lipid microbubbles are superior to Dongguan but inferior to Quanfuxian.
Objective: To evaluate the efficacy of endoscopic variceal ligation(EVL) combined with partial splenic emboliza-tion(PSE) in the treatment of cirrhotic patients with portal hypertension. Materials and Methods: Thirteen cirrhotic patients with portal hypertension underwent EVL-PSE therapy. The sessions of EVL and PSE were recorded. Before and after operation, conditions including clinical symptoms, hepatic function, peripheral blood cell counts and splenic volume were compared. Complications were also observed after operation. Results: The mean session of EVL was 1.5 and all but one patient underwent PSE only once. After the combined therapy, no rebleeding occurred. Patients showed a good response on hypersplenism, congestion of alimentary tract, ascites, hepatic function, peripheral blood cell counts and splenic volume. Except one patient died of upper alimentary tract bleeding, no other serious complication due to EVL-PSE therapy was found. Conclusion: The combination of EVL and PSE is safe and simple. Its recent curative effect on portal hypertension due to cirrhosis is definite.
Objective: To evaluate the diagnostic value of DWI in children with virus encephalitis and to observe the ADC values. Methods: Thirty-eight cases with acute viral encephalitis were included. DWI and conventional T1WI, T2WI sequences were performed in all cases. The appearances on DWI, T1WI and T2WI were recorded. The ADC values of lesions were calculated, which were compared with normal ADC values of gray matter and white matter of healthy children. Results: Twenty cases had positive findings on MRI with 76 lesions detected. Three lesions showed high signal intensity on DWI but were normal on T1WI and T2WI. Fifty-two lesions showed high signal intensity on both DWI and T2WI, but 25 showed clearer and more distinct on DWI than on T2WI. Thirteen lesions showed isointense on DWI, with high signal intensity on T2WI. Eight lesions showed hypointense on DWI with high signal intensity on T2WI. Of the 11 follow-up cases, 11 encephalomalacia lesions were detected in 4 cases, which showed long T1 and long T2 signal intensity with low signal intensity on DWI. Conclusion: DWI can serve as a method of detecting early viral encephalitis, in which DWI could give quantitative information for different pathological changes in different clinical stage. DWI has great potential value in the diagnosis, differential diagnosis and the prediction of prognosis in viral encephalitis.
Objective: To explore the CT features and TNM staging of renal cell carcinoma. Methods: Fifty-four cases of renal cell carcinoma confirmed by operative pathology were retrospectively reviewed. On CT images,the site of renal cell carcinoma were located according to the anatomy of renal segments. The diameters of the lesions were measured on CT images for TNM staging based on AJCC 2002. Results: The length of all lesions varied from 17～71mm with an averaging 43mm. The sites of renal cell cancers were in the renal parenchyma including right kidneys(n=34) and left ones(n=20). The histological types of carcinoma in this group were clear cell carcinoma(n=46),papillary renal cell carcinoma(n=6) and chromophobe cell carcinoma(n=2). The TNM staging of all patients were stage I(n=17),stage II(n=22),stage III(n=6),and stage IV(n=9). Conclusion: CT is a rapid and practical tool in diagnosing renal cell carcinoma. The TNM staging by CT is accurate before operation.
病例女,孕39周,使用日本岛津线性电子扫描超声波诊断仪(SDL-32),探头频率3.5MHz.检查前,膀胱中度充盈有利于观察前置胎盘情况,检查时,孕妇仰卧位,先常规扫描胎头、脊柱胎盘位置、胎心搏动次数、羊水及脐带回声等.常规检查发现子宫下段靠近胎儿头部上方,大小60.1mm×27.7mm混合性包块,突入羊膜腔内,胎头轮廓清晰,沿着脊柱走行经胸、腰、骶、尾椎作全面检查未见异常.然后着重检查胎盘位置,胎盘位于子宫后壁,胎盘实质呈现三级回声现象,胎盘基底层未见早剥.胎盘实质未见静脉池、静脉窦,也未见血管瘤.羊膜腔外包块在子宫前壁,说明与胎盘无关.该妇孕40周后,行剖腹产手术,取出一个健康的婴儿,在羊膜腔外取出一个完整的包块,里面有陈旧血块,经病理证实,是血液凝集包块.
病例女,41岁,因右上肢发凉肿胀伴麻木15天入院.体检:右前臂轻度肿胀,右前臂尺侧、手尺侧针刺痛觉减退.Wright试验(+),Adson实验(+),Roos实验(+).
Objective To study the value of the hypotonic MRI in the diagnosis of diseases in the duodenal papillary region. Methods Forty six patients studied with the hypotonic MRI combined with MRCP CT endoscopy and gastrointestinal barium meal study. Their radiological characteristics were analyzed. Results The ability of MRI combined with MRCP in diseases of duodenum was similar to endoscopy superior to CT and gastrointestinal barium meal study and MRI combined with MRCP in evaluating tumor was superior to other methods. Conclusion Hypotonic MRI combined with MRCP may be taken as a non invasive and detailed method in evaluating diseases in the duodenal papillary region.
Objective: To evaluate the method of rectum and anal measurement with axial CT. Material and Method: Eighty-four cases with CT study of pelvis were included,and 15 of them took double-contrast barium enema. The anus was marked before the study. The length from protruding of rectal ampullae to anus to its slice distance was measured and calculated. Length of anal canal,anorectal angle and the slice distance from anus to the plane through two ischial tuberosities were measured on both CT and double-contrast barium images. The data of result were analyzed with SPSS 11.5 software. Result: The anus could be localized where the shape of the anal canal transformed from ring-like to U-shaped opening posteriorly. There was no significant difference between CT and double-contrast barium in respect to the distance from anus to the plane through two ischial tuberosities,length of anal canal and anorectal angle. The ratio of length to slice distance from rectal ampullae to anus was 1.3 calculated from CT. Conclusion: The anal canal and anus can be observed on CT images. There is difference between the distance from lower rectum to anus out of counting the number of the image slices and the actual length. With the ratio method introduced in our study,the length from low rectum to anus can be measured rather accurately with axial CT images.
转移性骨肿瘤在恶性骨肿瘤中甚为常见,据统计,在死于恶性肿瘤的患者当中70%以上病例有骨转移,但发生于颌骨的转移瘤却比较少见.现将我院经病理证实的5例颌骨转移瘤报告如下.
Objective: To evaluate the reliability of 16-slice spiral CT angiography(MDCTA)in displaying atherosclerotic plaques of coronary artery and its clinical application. Materials and Methods: Thirty-nine patients underwent both 16-slice spiral CT coronary arteriography and selective coronary angiography(31 patients suspected to have CAD and 8 post-PTCA patients). In all cases, visibility of coronary artery segments was recorded. Vessel diameter reduction 50% was defined as significant stenosis. The MDCTA results were compared with DSA, the sensitivity, specificity and accuracy were calculated. Results: Coronary artery segments could be visualized by 16-slice spiral CTA in 94.8%(333/351). The sensitivity, specificity and accuracy of 16-slice CT coronary angiography were 82.2%, 94.7% and 86.0% respectively. The 16-slice CT showed stenosis caused by mixed calcified and uncalcified plaques in 21 lesions, in which 3 lesions were overestimated compare to DSA; stenosis caused by mid-density plaque in 8 lesions, in which 3 lesions were overestimated. Soft plaque in 3 lesions did not cause stenosis. The 16-slice CT can clearly show the location, shape of stents and distal blood perfusion in the post-PTCA cases. Patency of 11 stents, 1 occlusion and 1 serious restenosis were diagnosed accurately. In addition, 16-slice CT found 2 cases with variant of coronary artery opening, 1 case of LAD aneurysm, 1 case of left ventricular protuberance and 1 case of atrial septal defect. Conclusion: 16-slice spiral CT scanner provides a very promising approach to non-invasive coronary artery examination, combined with heart rate control, reliable noninvasive detection of obstructive coronary artery disease can be achieved successfully.
Objective: To evaluate the role of diffusion weighted MR imaging(DWI) in the preoperative diagnosis of brain gliomas. Methods: Twenty-one histologically verified brain gliomas were studied with DWI and conventional MR imaging. ADC values and relative ADC(rADC) of different portions of gliomas and contralateral normal brain were measured. Cellularity of the gliomas were analyzed with Scoin Image software. Results: ①ADC value of the necrotic portion of gliomas is highest, followed by peritumoral edema, solid portion of tumors and normal brain. ②ADC value and rADC of solid portion of gliomas correlated well with cellularity of tumors(P0.01, r=-0.739; P0.01, r=-0.748). ③ADC value and rADC of low grade(grade I～II) gliomas is higher than that of high grade(grade III～IV) gliomas(P0.01). ④Peritumoral ADC value of recurrent group is lower than that of non-recurrent group(P0.01). Conclusion: DWI can reflect cellularity of gliomas, as a complementary method of conventional MRI, DWI has predictive value in the preoperative evaluation of malignancy of gliomas. Peritumoral ADC value can provide useful information of aggressiveness of gliomas.
Objective: To evaluate the accuracy of the preoperative staging of gastric cancer by triphasic scanning of spiral CT(SCT), to determine its efficacy in detection of lymph node metastasis of gastric cancer. Materials and Methods: Triphasic scanning of SCT performed in 30 patients with gastric cancer. Findings at triphasic scanning of SCT were compared with the post-operative histopathological results. Results: Accuracy of the preoperative staging of gastric cancer and advanced gastric cancer by triphasic scanning of SCT was 73.3%, 78.5% respectively. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value of gastric cancer were 73.3%, 75.0%, 70.0%, 83.3%, 58.3% respectively. Conclusion: Triphasic scanning of SCT is effective for detection of gastric cancer and preoperative staging.
本文将实时平滑蒙片DSA法(Real-time Smoothed Mask法,简称RSM-DSA)应用于下肢动脉造影中,旨在探讨RSM-DSA减影方式的优越性及其临床应用价值. 1材料与方法 本组15例临床疑有下肢硬化型动脉狭窄症,男11例,女4例,平均年龄68岁.
Objective To investigate the value of helical CT and MRI in early diagnosis of radiographically negative insufficiency fractures. Materials and Methods Thirty one radiographically negative patients were evaluated with CT and MRI because of high clinical suspicion of insufficiency fractures. The CT and MRI findings were analyzed and the sensitivity specificity accuracy and interobserver agreement of both imaging modalities were calculated and compared. Results The diagnosis was eventually confirmed in 19 patients. The main CT findings were linear obscured low density but linear or patchy high density was observed in vertebra. The main MRI findings were low or slightly low low or high high signal intensity on T1WI T2WI STIR respectively. The sensitivity specificity accuracy of CT and MRI is 89%95% 92%67% 90%84% respectively. However no statistically significant difference was found between the two imaging modalities. Interobsever agreement of CT was better than MRI with Kappa value of 0.728 and 0.459 respectively. Conclusion Helical CT and MRI are both valuable in early diagnosis of radiographically negative insufficiency fractures but helical CT is slightly superior to MRI probably due to its better specificity.
Objective To discuss the relationship between the specific radioactivity uptake of the bilateral striatum with 99Tcm-TRODAT-1 and UPDRS and evaluate the severity of Parkinson diseasePD from the point of imaging. Methods Fifty one patients with PD and a control group of 15 healthy subjects were applied dopamine transporterDAT imaging by SPECT with 99Tcm-TRODAT-1. The radioactive ratio between bilateral striatum and cerebellum(STCB) and the asymmetry indexAI of bilateral striatum were computed by using region of interestROI technology. Meanwhile the PD patients were classified by the improved Hoehn-Yahr disability score and then evaluated by UPDRS. Results There was a negative correlation between the bilateral STCB mean of the PD and the Hoehn-Yahr grading the UPDRS score the patients' self caring ability the ability to move. As for the asymmetry index there was also a negative correlation with the severity of PD. Conclusion There was a significant correlation between the specific radioactivity uptake of the bilateral striatum with 99Tcm-TRODAT-1 and UPDRS and it could monitor the state of PD and showed the symptom severity of PD evaluate the severity of PD.
Objective: To investigate 1H MRS changes early in disease progression, search for the basic mechanism of these alteratives, and make sure the diagnostic value of 1H MRS in Alzheimer disease(AD). Materials and Methods: The animal model, induced by Aβ(1-40) injected into the hippocampus, were divided randomly into 5 groups, 18 mice in each group, and the examinations were performed on these groups at different time point: 1, 2, 4, 6 and 8-week after injection. The items consisted of the in vitro 1H MRS, behavioral examination, neural pathologic examination(including HE, Congo red, Bielschowsky pigmentation and also electron microscopic study) and pathophysiologic examination(testing ATPase, AchE and TAOC). Results: Behavioral, neural pathologic and pathophysiologic examination confirmed the success of AD mouse model. The in vitro 1H MRS of hippocampus revealed the reversible decrease of NAA/Cr, which had negative correlation with TAOC(Pearson correlation coefficient was-0.624, P value was 0.003) and positive correlation with Cho/Cr level(Pearson correlation coefficient was 0.556, P value was 0.011). The increase of NAA/Cr had much value in distinguishing between mouse model and control. Conclusion: The change of 1H MRS in the early course of AD is NAA/Cr. This early reversible alteration of NAA/Cr reflects he status of energy-metabolism, not the absence of neuron. The increase of NAA/Cr would facilitate diagnosis and enhance treatment success of AD.
