Aberrant expression of Fos-related antigen-1 (Fra1) is commonly elevated in various malignant cancers and is strongly implicated in invasion and metastasis. However, the molecular mechanisms underlying its dysregulation in human glioma remain poorly understood. In the present study, we demonstrate that up-regulation of Fra1 plays a crucial role in the glioma aggressiveness and epithelial–mesenchymal transition (EMT) activated by Wnt/β-catenin signal pathway. In glioma cells, activation of Wnt/β-catenin signalling by Wnt3a administration obviously induced EMT and directly activated the transcription of Fra1. Phenotype experiments revealed that up-regulation of Fra1 induced by Wnt/β-catenin signalling drove the EMT of glioma cells. Furthermore, it was found that the cisplatin resistance acquired by Wnt/β-catenin signalling activation depended on increased expression of Fra1. Analysis of clinical specimens verified a positive correlation between Fra1 and β-catenin as well as a poor prognosis in glioma patients with double-high expressions of them. These findings indicate that an aberrant Wnt/β-catenin signalling leads to the EMT and drug resistance of glioma via Fra1 induction, which suggests novel therapeutic strategies for the malignant disease.

OBJECTIVE This study aims to investigate the application value of three-dimensional arterial spin labeling (ASL) perfusion imaging in detecting cerebral hemodynamics of neonates with hypoxic-ischemic encephalopathy (HIE). METHODS Sixty normal full-term neonates and 60 HIE neonates were enrolled in this study and were respectively divided into three groups: the 1-3 days group, the 4-7 days group, and the 8-15 days group. The brains of these neonates were scanned with the 3D ASL sequence, and cerebral blood flow (CBF) images were obtained. The CBF values of the bilateral symmetrical brain regions and brain stem were measured on CBF images, and the values were averaged. The cerebral blood flow of HIE neonates in the 1-3 days group, the 4-7 days group, and the 8-15 days group was compared with normal neonates at matched ages, and the characteristics of cerebral hemodynamics in HIE neonates at different ages were summarized. RESULTS The CBF values of the basal ganglia, thalamus, and brainstem in the 1-3 days HIE group were higher than normal neonates at matched ages, and the CBF value of the frontal lobe was lower than the normal group, and the differences were statistically significant (P < 0.05). The CBF values of the basal ganglia, thalamus, corona radiata, and frontal lobe in the 4-7 days HIE group were lower than the normal group, and the differences were statistically significant (P < 0.05). There were no significant differences in CBF values of different brain regions between the 8-15 days HIE and normal groups (P > 0.05). CONCLUSION Early hyperperfusion of the basal ganglia and thalamus is helpful for early diagnosis and prognosis of HIE.

We describe a case of congenital esophageal stenosis in which the patient underwent ineffective balloon dilatation twice and eventually required surgery. The case was initially misdiagnosed as achalasia. Pathological findings revealed tracheobronchial remnants (TBRs) in the muscular layer of strictured esophageal tissue. Most TBR strictures are located in the middle and lower thirds of the esophagus. Esophagography is the main examination method for esophageal stricture, and the appearance of the “rat tail sign” is a key diagnostic indicator. Endoscopic ultrasonography can reveal hypoechoic cartilaginous structures. The gold standards for TBR treatment include esophageal stricture resection, end-to-end esophageal anastomosis, and the construction of structures to prevent reflux. At present, endoscopic longitudinal resection and transverse anastomosis of the anterior esophageal wall with partial cartilage resection without pyloroplasty are novel and practical TBR procedures. To avoid further complications, patients with congenital esophageal stenosis should be promptly treated surgically if balloon dilatation is ineffective.

Objective: This study aims to investigate the correlation between cerebral blood flow (CBF) values and neonatal behavioral neurological assessment (NBNA) in hypoxic-ischemic encephalopathy (HIE), the relationship between early CBF value changes and the prognosis of neonatal HIE, and the consistency between the clinical grading and magnetic resonance (MR) grading of HIE. Methods: Forty neonates with HIE were scanned using the three-dimensional arterial spin labeling (ASL) sequencing of the cranial Magnetic Resonance Imaging (MRI). These newborns were classified as having mild, moderate and severe HIE, according to the clinical grading, and as being normal or having mild, moderate, or severe HIE, according to the MRI grading. Then, the consistency of these two grading systems was compared. Afterwards, the differences in the CBF values of neonates in groups with mild, moderate and severe HIE were compared. In addition, these neonates were grouped according to their NBNA scores. A score of ≥35 was considered a good prognosis, while a score of ≤35 was considered a poor prognosis. The differences in CBF values between these two groups were compared, and the correlation between the CBF values and NBNA scores was determined. Results: There was a strong consistency between the evaluation results for the clinical grading and MR grading (kappa value = 0.672, P<0.001). The differences in CBF values for the basal ganglia (BG) area and thalamus, and the differences in NBNA scores for groups with mild, moderate, or severe HIE were statistically significant (P<0.05). The differences between the poor prognosis group and the good prognosis group, in terms of the CBF values for the BG area and thalamus, and the NBNA scores were statistically significant (P<0.05). The CBF values in the BG region and thalamus were closely and negatively correlated with the NBNA scores. Conclusion: Early CBF values in the BG area and thalamus can objectively and visually reflect the severity of the HIE, and be used to predict the outcome of functional brain damage, allowing early neuroprotective treatment to be initiated. The higher the perfusion in the BG region and thalamus, the lower the NBNA score, and the worse the prognosis would likely be. ASL combined with the NBNA score provides a more comprehensive classification for HIE and a more accurate assessment of the clinical prognosis, providing more medical imaging information for early clinical treatment.

目的 探讨心外膜脂肪组织(EAT)与急性冠状动脉综合征(ACS)的相关性.方法 选取175例ACS患者作为研究组,选取同期住院慢性冠状动脉病变(CCAD)患者180例作为对照组,对比两组患者临床资料及EAT体积(EATV)、EAT平均密度(EATD),筛选ACS的独立影响因素并利用受试者工作特征曲线分析这些独立影响因素的预测价值.结果 ACS组患者年龄、体质量指数、EATV、EATD、血糖、甘油三酯及射血分数均高于CCAD组,且组间差异有统计学意义(P值均＜0.05),二元多因素Logistic回归分析结果显示年龄、EATV和EATD是ACS的独立影响因素(OR=1.108、OR=1.053、OR=1.159,P值均＜0.05),其中EATD对ACS的预测效能最高,曲线下面积为0.803,最佳截断值为-100.50 HU,预测ACS敏感性80.6％、特异性63.9％.Peanon相关性分析结果显示EATV与体质量指数呈显著性中度正相关(r=0.579,P＜0.01),与年龄呈轻度正相关(r=0.150,P=0.005);EATD与体质量指数、年龄均无相关性(P值均＞0.05).结论 EAT与ACS关系密切,EATD、EATV均是ACS的独立影响因素,且两者预测ACS效能较高.

Neurite outgrowth is the basis for wiring during the development of the nervous system. Dl-3-n-butylphthalide (NBP) has been recognized as a promising treatment to improve behavioral, neurological and cognitive outcomes in ischemic stroke. However, little is known about the effect and mechanism of NBP on the neurite outgrowth. In this study, we used different methods to investigate the potential effects of NBP on the neurite extension and plasticity of immature and mature primary cortical neurons and explored the underlying mechanisms. Our results demonstrated that in immature and mature cortical neurons, NBP promoted the neurite length and intersections, increased neuritic arborization, elevated numbers of neurite branch and terminal points and improved neurite complexity and plasticity of neuronal development processes. Besides, our data revealed that NBP promoted neurite extension and branching partly by activating Shh signaling pathway via increasing Gap43 expression both in immature and mature primary cortical neurons. The present study provided new insights into the contribution of NBP in neuronal plasticity and unveiled a novel pathway to induce Gap43 expression in primary cortical neurons.

To investigate the relationship between the epicardial adipose tissue density (EATD) and the coronary plaque components as assessed by coronary computed tomographic angiography (CCTA). The study cohort included 240 patients with chest pain or precardiac discomfort (mean age 62.01 ± 7.45 years, 55.83% male). Patients were assigned to the high-risk plaque (HRP) group (n = 133) or non-HRP group (n = 107). All patients underwent CCTA to assess plaque composition, and quantitative analysis of EATD and epicardial adipose tissue volume (EATV). Age, gender, EATV, EATD, diabetes history and family history were all correlated with HRP. There was no linear correlation between EATD and EATV among the subjects (R2 = 0.008, p = 0.177), but there was a curvilinear correlation (R2 = 0.102, p < 0.001). After adjusting other traditional factors, and we observed robust associations of EAT volume and density with HRP (all p < 0.05). For per 1 standard deviation increase in EATD, the risk of HRP was 3.120 times the risk than that of non-HRP. For per 1 standard deviation increase in EATV, the risk of HRP was 1.499 times the risk than that of non-HRP. The receiver operating characteristic curve showed that EATD was more predictive of HRP than EATV (AUC = 0.761, 95% CI 0.701–0.822). Our study found that EATD and EATV are both independent factors affecting the presence of HRPs, and EATD had a high predictive value for the presence of HRP.

目的 应用扩散张量成像技术(diffusion tensor imaging,DTI)研究急性缺血性卒中机体功能障碍与锥体束损伤程度的相关性.材料与方法 收集急性缺血性脑卒中患者在发病急性期内的常规MRI平扫、扩散加权成像、DTI检查、工作站自动生成各向异性指数(fractional anisotropy,FA)图及ADC图,从中筛选出病变累及单侧基底节区的急性缺血性脑卒中患者16例,分别测量病灶区与大脑对侧相应部位的FA值、ADC值、纤维束数量,并计算出纤维束数量健侧与患侧差值,使用mimics软件对病灶体积进行测量,同时使用美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)、临床医学肌力分级对机体功能障碍程度进行评价.使用统计学方法研究健、患侧纤维束数量、FA值、ADC值的差异;统计出数量差值与病灶体积、NIHSS评分、肌力评分的相关性;统计16例患者出现的所有神经系统阳性表现.通过扩散张量纤维束成像(diffusion tensor tractography,DTT)和3D slicer软件在病变区和健侧对应部位重建,对比观察纤维束的形态变化.结果 健、患侧锥体束数量、FA和ADC配对t检验有统计学差异(P<0.05,分别为0.001、0.005、0.001).纤维束数量差值和病灶体积、肌力分级有显著相关关系(r=0.632,P=0.009;r=-0.554,P=0.026);病灶体积和NIHSS评分有显著正相关关系,差异及相关性有统计学意义(r=0.789,P=0.000).健、患侧纤维束数量差值和NIHSS评分无相关性(P=0.061),FA值减少程度和ADC减少程度无相关性(P=0.890).患侧纤维束走形异于健侧,部分患侧纤维束受压、变形、移位、断裂,部分健侧纤维束向患侧延伸.结论 急性缺血性脑卒中患者机体功能障碍与锥体束损伤程度有相关性,病灶体积越大,锥体束损伤程度越严重,脑组织损伤程度越重,机体功能障碍程度越明显.

BACKGROUND Respiratory function usually worsens in the elderly with aging. This study aimed to retrospectively investigate tracheal changes caused by "normal aging" through use of low-dose CT (LDCT) in non-smoking asymptomatic urban residents and the related factors influencing tracheal changes. MATERIAL AND METHODS A total of 733 Chinese subjects who underwent LDCT were recruited. The trachea shape, width, and calcification degree of the tracheal wall were measured and compared between males and females and among different age groups. The effects of age, sex, trachea morphology, BMI, BP, GLU, TC, TG, HDL, and LDL on the width and calcification of tracheal wall were analyzed by multiple linear regression. RESULTS Significant sex differences in trachea shape were found, as type II and type I were found mainly in the males and females, respectively. The values of anterior-posterior inner diameter (AP), left-right inner diameter (LR), width, and calcification score of tracheae in the males were higher than that in the females. In both males and females, trachea AP, wall width, and calcification scores increased with age, but this trend was not observed in tracheal LR. Age, sex, and trachea shape had significant effects on the width and calcification scores of tracheal walls, and trachea calcification was one of the factors influencing tracheal wall width. CONCLUSIONS Tracheal aging can be evaluated by measuring trachea shape, thickness, and the degree of calcification of the tracheal wall by LDCT, while sex and age should be taken into consideration comprehensively for judging normal trachea aging. In addition, obesity may aggravate trachea aging.

目的 探讨640层容积CT回顾性心电门控宽容积(wide-volume)模式在CT肺动脉成像(CTPA)中的可行性及应用价值.资料与方法 收集行640层容积CTPA者90例,按随机数字表法分为非门控组、门控组、wide-volume组,各30例.比较各组患者基本资料、辐射剂量、图像质量评分、呼吸运动伪影及心脏大血管搏动伪影.结果 ①扫描时间:非门控组、wide-volume组及门控组扫描时间依次增加(P<0.05).wide-volume组心率为(82.7±14.1)次/min,明显高于门控组的(68.1±12.1)次/min(P<0.05).②图像评分:门控组及wide-volume组评分明显优于非门控组(P<0.05);门控组与wide-volume组评分差异无统计学意义(P<0.05).3组图像心脏搏动伪影差异有统计学意义(P<0.05).③有效辐射剂量:非门控组、wide-volume组及门控组依次增加(P<0.05).结论 640层容积CT回顾性心电门控wide-volume扫描模式应用于CTPA检查具有可行性,在并不大幅度增加患者辐射剂量的前提下,减少心脏大血管搏动伪影,明显改善肺动脉图像质量.

Fast cine phase contrast magnetic resonance angiography (PC-MRA) has the potential to provide a quantitative measurement method for the diagnosis and treatment of cerebrovascular disease. To evaluation the changes of cerebral blood flow and the characteristics of artery lesion distribution in the patients of transient ischemic attacks (TIA). In all, 98 normal subjects and 106 TIA patients who underwent MRI examination within 72 h after the last symptom onset including the DWI sequence to exclude acute cerebral infarction were enrolled. The blood flow of the cranial total, the area of the internal carotid artery and vertebral artery, the average velocity, and the average blood flow were obtained and compared in normal subjects and TIA group. Analysis of Variance (ANOVA), t-test, and Kruskal-Wallis test were used for statistical assessments. The total cerebral blood flow of the TIA group and normal control group was no significant statistical difference (P>0.05). The total blood flow decreased with increasing age, and the TIA group was much lower than the control group. The blood flow of the right internal carotid artery in the TIA group had a significant difference compared with controls (P<0.05). However, the same situation did not happen in both of the left internal carotid artery and vertebral artery. Phase contrast magnetic resonance imaging has the potential to evaluate the change of cerebral blood flow in TIA patients. The decrease in the total blood flow and the symptom onset of TIA is consistent. Phase contrast magnetic resonance imaging could provide guidance to the diagnosis of TIA.

Objective\r\nTo search for the characteristic CT signs of the new coronavirus pneumonia(NCP) and to explore its clinical significance from the perspective of imaging pathology.\r\n\r\n\r\nMethods\r\nCT images of 40 NCP patients in Hebei province were collected and a total of 459 lesions in 234 lung segments on 72 sides were analyzed. Meanwhile, CT images of totally 258 lesions in 79 lung segments on 28 sides of 20 non-NCP patients randomly selected and treated in our hospital were compared with those of NCP patients above.\r\n\r\n\r\nResults\r\nIn the NCP group, the lesions were mostly located in the lower lobe of the two lungs (30 cases, accounting for 23. 44% respectively), with bilateral involvement (32 cases, accounting for 80.00%). The proportion of lesions involving 5 pulmonary lobes was relatively large, with little difference in the distribution of left and right lung, and only 1 case (2.50%) with pleural effusion. There were statistically significant differences between NCP group and non-NCP group in fan-shaped shape, peripheral distribution, pulmonary hyperemia or pulmonary edema, accompanied by vascular thickening and bronchial wall thickening. These suggested that the lesions of NCP were initially in the periphery and gradually infiltrate and fuses on the basis of fan-shaped structures. And the lesions were mostly accompanied by vascular thickening and pulmonary hyperemia, but with little bronchial wall thickening.\r\n\r\n\r\nConclusion\r\nThe CT signs of NCP are characteristic, and they may be more likely to invade blood vessels and cause vasculitis, which may lead to pulmonary edema and cardiopulmonary circulation disorder.\r\n\r\n\r\nKey words: \r\nnovel coronavirus pneumonia; fan structure; cardio-pulmonary circulation disorder; computed tomography; pulmonary lobule

目的:探讨表皮生长因子受体2(human epidermal growth factor receptor2,HER2)基因突变对非小细胞肺癌临床特征及其与CT征象的相关性.方法:回顾性选择我院2010年1月至2019年12月收治的351例非小细胞肺癌患者,收集351例非小细胞肺癌患者的HER2突变位点、CT影像学征象、一般资料等资料.分析351例患者中的HER2基因突变发生情况;单因素、多因素分析HER2突变情况与非小细胞肺癌患者的临床病理特征、CT表现特征相关性.结果:351例患者中,基因突变者20例,占比为5.70％(20/351).单因素结果表明,非小细胞肺癌患者中,HER2基因突变与有家族史有关(P＜0.05).病灶边界分叶/毛刺、有坏死征、胸膜凹陷征与HER2基因突变存在相关性(P＜0.05).多因素结果表明,有家族史、病灶边界分叶/毛刺、有坏死征、胸膜凹陷征是HER2基因突变的危险因素(P＜0.05).结论:有家族史、病灶边界分叶/毛刺、有坏死征、胸膜凹陷征与HER2基因突变有关,对指导临床治疗有重要意义.

目的 探索应用影像组学方法提取房颤患者与动脉粥样硬化患者左心房与左心耳连接处心肌的影像组学特征的可能性.方法 回顾性收集2019年1月至2019年8月84例房颤患者和84例冠脉动脉硬化患者的心脏CTA图像,输入影像组学分析平台,在75％扫描时相勾画左心房与左心耳连接处心肌,利用影像组学Lasso降维分析方法提取影像组学特征.结果 房颤患者与冠状动脉粥样硬化患者左心房与左心耳连接处心肌的特征性影像组学标签为:一阶特征:灰度最大值、灰度变异度、峰度;纹理特征:灰度区域大小矩阵变异度,灰度级长均匀性归一化,灰度相关矩阵均匀性归一化.结论 影像组学Lasso降维分析方法能够提取出房颤与动脉粥样硬化患者的左心房与左心耳连接处心肌的相关影像特征,CTA结合影像组学的方法有可能有助于评价房颤患者的心肌重塑性改变及预后分析.

目的 使初学者尽快掌握3D+人体可视化软件的基本使用方法,提出解决常见问题的相关经验,为学习者减轻学习难度,提高学习效果.方法 通过对软件操作手册的学习和实际操作经验的总结,提出快速学习3D+人体可视化软件的方法与经验,以河北医科大学智能影像实验室16名学生为实验对象,随机分为试验组和对照组各8名,试验组按上述方法进行泌尿系统重建的讲解教学,对照组通过自主学习操作手册和观看实验室老师重建示范进行常规学习,统计2组完成数据的质量情况.结果 试验组动脉血管重建成绩和总成绩均优于对照组,差异有统计学意义(P<0.05).结论 该方法可以提高初学者学习该软件的效率.

目的 利用MRI对不同年龄段中国人优势大脑半球岛叶进行测量,建立正常人岛叶脑沟、脑回的形态正常值标准,为多种岛叶精神疾病诊断提供影像诊断依据.方法 选取75例健康志愿者,进行头部MRI扫描,测量并统计中国人优势大脑半球岛叶各亚回形态学数据,包括各亚回皮质、白质、脑沟宽度值,并对各年龄组形态学数据进行对比分析.结果 横沟长度在各年龄组间差异有统计学意义(P＜0.05);而其他优势大脑半球岛叶各亚回皮质、白质、脑沟宽度差异没有因年龄而发生显著变化(P＞0.05).结论 岛叶属于较低级别脑叶,其形态学参数受年龄影响较小,测量值稳定,故有可能成为较可靠的研究脑部精神疾病的指标.

Objective To investigate the performance of high-order radiomics features and models based on T2-weighted fluid-attenuated inversion recovery (T2 FLAIR) in predicting the immunohistochemical biomarkers of glioma, in order to execute a non-invasive, more precise and personalized glioma disease management. Methods 51 pathologically confirmed gliomas patients committed in our hospital from March 2015 to June 2018 were retrospective analysis, and Ki-67, vimentin, S-100 and CD34 immunohistochemical data were collected. The volumes of interest (VOIs) were manually sketched and the radiomics features were extracted. Feature reduction was performed by ANOVA+ Mann-Whiney, spearman correlation analysis, least absolute shrinkage and selection operator (LASSO) and Gradient descent algorithm (GBDT). SMOTE technique was used to solve the data bias between two groups. Comprehensive binary logistic regression models were established. Area under the ROC curves (AUC), sensitivity, specificity and accuracy were used to evaluate the predict performance of models. Models reliability were decided according to the standard net benefit of the decision curves. Results Four clusters of significant features were screened out and four predicting models were constructed. AUC of Ki-67, S-100, vimentin and CD34 models were 0.713, 0.923, 0.854 and 0.745, respectively. The sensitivities were 0.692, 0.893, 0.875 and 0.556, respectively. The specificities were: 0.667, 0.905, 0.722, and 0.875, with accuracy of 0.660, 0.898, 0.738, and 0.667, respectively. According to the decision curves, the Ki-67, S-100 and vimentin models had reference values. Conclusion The radiomics features based on T2 FLAIR can potentially predict the Ki-67, S-100, vimentin and CD34 expression. Radiomics model were expected to be a computer-intelligent, non-invasive, accurate and personalized management method for gliomas.

Abstract Background This study aims to investigate the application value of three-dimensional arterial spin labeling (3DASL) in investigating cerebral blood flow dynamics in full-term neonates. Methods A total of 60 full-term neonates without known intracranial pathology were recruited for 3DASL examination. These neonates were divided into three groups: 1–3 day group, 4–7 day group, and 8–15 day group. On the cerebral blood flow (CBF) images, regions of interest (ROI) were selected from the frontal white matter, parietal white matter, basal ganglia, corona radiata, thalamus and brainstem, and the CBF values of each ROI were recorded. The CBF values of ROIs at bilaterally symmetric locations, the values of each ROI between males and females, and the values of each ROI among these three different age groups were compared. Results The difference in CBF values of the frontal white matter, parietal white matter, basal ganglia, corona radiata and thalamus at the bilateral symmetric positions were not statistically significant. There was no statistical difference in the CBF values of each brain region between the male and female groups. The CBF values at the basal ganglia region, corona radiata and parietal white matter were higher in the 8–15 day group, when compared to the 1–3 day and 4–7 day groups (P < 0.05). The CBF value at the basal ganglia region was higher in the 4–7 day group, when compared to the 1–3 day group (P < 0.05). The CBF value at the frontal white matter was lower in the 4–7 day group, when compared to the 1–3 day and 8–15 day group (P < 0.05). The CBF value at the brainstem was higher in the 4–7 day group, when compared to the 1–3 day and 8–15 day groups (P < 0.05). Conclusion The 3DASL can quantitatively measure CBF, and be used to evaluate cerebral hemodynamics in neonates. The basal ganglia region and corona radiata CBF increases with the increase in neonatal diurnal age.

目的 探讨640层容积CT在肺动脉弹性评估中的可行性及其与主动脉弹性的相关性.资料与方法 前瞻性收集2015年10月—2016年4月于我院行640层容积冠状动脉CT血管成像检查且符合纳入和排除标准的42例受检者.测量主肺动脉(MPA)、升主动脉(AA)、降主动脉(DA)感兴趣区管腔在收缩期与舒张期的最大及最小横截面积,计算弹性参数动脉扩张度(AD).比较各血管间的AD值,分析各参数间的相关性.结果 随心脏搏动,主肺动脉管径发生周期性变化.MPA、AA、DA的弹性不同,AD值依次为(7.94±3.04)×10-3/mmHg、(4.02±2.16)×10-3/mmHg和(3.23±1.46)×10-3/mmHg.AA与DA、AA与MPA、DA与MPA呈正相关(r=0.689、0.520、0.393,P<0.001、P<0.05).结论 640层容积CT结合回顾性心电门控技术可以在无需额外增加辐射剂量和对比剂用量的前提下,完成肺动脉弹性的评估,且肺动脉与主动脉弹性具有较好的相关性.

Objective To investigate the high-resolution CT image characteristics of lung nocardiosis in patients with normal immune function in order to make early diagnosis.Methods The CT image features of 35 patients with lung nocardiosis were retrospectively analyzed,in whom,there were 20 females and 15 males, with age range being 49~80 years (average 61 years). All the patients had no history of immunosuppressive agents therapy and any immunosuppressive diseases. The traditional biochemical reaction experiments combined with total cell fatty acid gas chromatography (GC) analysis were used to determine the type of infection bacteria. Moreover all the patients underwent high resolution CT scanning.Results CT images showed pulmonary consolidation region in all the cases, with nodules and/or ground glass opacities,which distributed according to lobuli pulmonum,moreover,which also showed air bronchus sign,thickened wall and enlarged lumen of bronchioles in 35 patients.Besides there were multiple nodules with cavities and the diameter of nodules was larger than 1cm in 8 patients.Conclusion In normal immunocompetent patients with lung nocardiosis,the opacity, nodule and ground glass opacity are main features of CT images,and cavity is not a common finding.Therefor,if cephalosporin is not effective,the diagnosis of nocardia pneumonia should be considered.