目的 探讨新型带线锚钩在CT引导下肺小结节(SPN)术前定位中的应用价值.方法 应用带线锚钩定位装置在CT引导下对86例患者(94个SPN)在电视胸腔镜手术(VATS)前进行标记定位.对标记的成功率、定位时间、并发症和辐射剂量进行统计分析.结果 SPN直径(5.2±2.2)mm,病灶边缘距离胸膜最短距离(24.9±9.7)mm,SPN的定位时间为(8.7±1.8)min.94个SPN均成功植入带线锚钩,定位成功率为100％,在VATS前均未出现移位.在定位后出现气胸30例(34.9％),肺内出血22例(25.6％),咯血2例(2.3％).定位过程中的辐射剂量为(2.2±0.2)mSv.结论 带线锚钩定位装置适合肺内病变定位且操作简单,定位后患者术后不适感轻微,值得推广应用.

目的 分析mDIXON-Quant测量非酒精性脂肪性肝病(NAFLD)患者肝脂肪含量与肝功能及脂质代谢指标间的关系.方法 对135名体检者行mDixon-Quant序列全肝脏扫描,经后处理测量肝脂肪分数图(FF);记录受检者身高、体质量、血压及肝功能、血脂、空腹血糖(FBG)等实验室指标.根据肝脏FF将受检者分为NAFLD组(96例)和对照组(39名),NAFLD组分为轻度(62例)、中度(25例)和重度(9例)亚组,比较各亚组间指标差异,并对肝脏FF与其他指标进行相关性分析,比较不同程度NAFLD亚组间代谢综合征的分布差异,分析代谢综合征的危险因素.结果 NAFLD组与对照组体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)差异均有统计学意义(P均＜0.05).肝脏FF与BM1、FBG、SBP、DBP、TC、TG、ALT、AST及高密度脂蛋白(HDL)均存在相关性(P均＜0.05).NAFLD组53例(53/96,55.21％)合并代谢综合征,不同程度NAFLD亚组间代谢综合征分布差异有统计学意义(x2=9.32,P＜0.05).肝脏FF、BMI、DBP、FBG、TC及TG均为代谢综合征的危险因素(P均＜0.05),HDL则为其保护因素(P=0.006).结论 NAFLD患者肝脏FF与代谢综合征密切相关.mDIXON-Quant可用于实时评估NAFLD患者肝脂肪含量,对临床治疗及监测病变具有重要指导意义.

Objective To investigate the lens and pituitary dose impacted by additional filtration and collection field in head and neck DSA examinations. Methods All images were acquired by a Philips ALLura Xper FD 20 DSA machine. The combination of the different collection fields (48 cm, 42 cm, 31 cm, 22 cm) and additional filtrations (0.9 mmCu+1.0 mmAl, 0.4 mmCu+1.0 mmAl, 0.1 mmCu+1.0 mmAl) were adjusted when the anthropomorphic phantom filled with dosimeter was scanned in anterioposterior and lateral positions with 2D?DSA and 3D?DSA. The dose area product (DAP), air kerma (AK) and the radiation dose values of bilateral lens and pituitary were measured and recorded. The 2D and 3D?DSA regional absorption dose on lens and pituitary were analyzed using t' test, the correlations between DAP and AK parameters and different regional absorption doses were evaluated by Pearson rank correlation coefficient. Results Absorption doses of left lens, right lens and pituitary with 2D?DSA (n=12) were as following:(2.77 ± 0.68), (6.23 ± 3.54), (8.65 ± 2.62) mGy, while the parameters with 3D?DSA (n=12) were (1.78 ± 0.82), (2.18±1.15), (3.32±0.64) mGy, respectively;the results revealed a significant difference (t'=3.20, 3.76 and 6.85, P<0.01). DAP [(8 739±5 731) mGy·cm2] had a relationship with absorption dose of pituitary, left lens and right lens [(5.988 ± 3.299),( 2.258 ± 0.872),( 4.207 ± 3.303) mGy, r values were 0.766, 0.684, 0.727; P<0.01]. AK values was (31 ± 23) mGy and it had a relationship with pituitary absorption dose (r value was 0.894, P<0.01). The lens dose was reduced when the additional filtration was increased and the collection field was decreased, the radiation dose of the pituitary was reduced when both the additional filtration and the collection field were increased. Conclusions In the head and neck DSA examinations, the radiation dose of the lens and the pituitary had different changes with the different additional filters and collecting fields. The organ dose with 3D?DSA was significantly less than that with 2D?DSA.

Objective To investigate the effect of different additional filtration thickness of DSA on image quality and radiation dose with cerebral angiography. Methods Prospective collected 90 patients with DSA examination of the whole cerebral artery, patients were divided into A, B and C group according to the time of the examination, each group included 30 cases. Patients underwent conventional DSA, the additional filtration of group A, B and C were (1.0 mmAl+0.1 mmCu), (1.0 mmAl+0.4 mmCu) and (1.0 mmAl+0.9 mmCu), respectively. Dose area product (DAP), air kerma (AK), tube current and tube voltage of anteroposterior and lateral radiography of the whole brain were recorded, and scored the image quality. Eye lens organ dose values were obtained by using simulation phantom and LiF dosemeter under A, B and C groups with three different additional filtrations for cerebral angiography. The image quality scores and the radiation dosewere analyzed by one-way ANOVA tests or Kruskal-Wallis tests. Results The image quality comprehensive score of three groups showed significant difference (F=40.07,P<0. 01), which were (3.8±0.4), (3.6 ± 0.5) and (3.0 ± 0.6), respectively. The DAP and AK value of anteroposterior and lateral radiography of three groups also showed significant difference (P<0.05), B and C group were lower than the A group. Left and right eye lens organ dose were decreased along with the increase of the additional filtration thickness, and the difference between the 3 groups also had significant difference (P<0.01). Conclusion Both the image quality and radiation dose can acquire when conducted the whole brain DSA with 1.0 mmAl+0.4 mmCu additional filtration.

目的 探讨头颈部血管造影过程中采集野及附加滤过对受检者辐射剂量的影响.方法 采用扫描仿真体模、热释光剂量计实测剂量,比较Philps Allura Xper FD20血管造影机的不同采集野(22、31、42、48 cm)及附加滤过(0.1 mmCu十1mmAl、0.4 mmCu+1 mmAl、0.9mmCu+1 mmAl)组合下,2DDSA及3D-DSA数据采集时的管电压、管电流、累积剂量面积乘积(DAP)、空气比释动能(AK)及各采集点的剂量值;并在单次曝光模式下,调整不同的采集野及附加滤过组合,分别对矩形波测试卡摄影,采集单幅图像,通过矩形波测试卡图像,探讨采集野及附加滤过与空间分辨率的相关性.结果 3D-DSA数据采集时采集野22 cm,附加滤过0.1 mmCu+1 mmAl时,AK为103.90 mGy,垂体的吸收剂量为(13.48±0.12) mGy,枕骨入射皮肤剂量为(134.76±0.55) mGy,均为最大值;采集野48 cm,附加滤过0.9 mmCu+1 mmAl时,AK为15.00mGy,垂体的吸收剂量为(4.66±0.06)mGy,枕骨入射皮肤剂量为(21.30±0.26)mGy,均为最小值.3D-DSA数据采集时采集野为48 cm,附加滤过为0.9 mmCu+1 mmAl和0.1 mmCu+1 mmAl时,矩形波测试卡显示值最低,为1.2 Lp/mm;采集野为22 cm,附加滤过为0.4 mmCu+1 mmAl时,矩形波测试卡显示值最高,为3.1 Lp/mm.结论 采用适中的采集野、适当增加附加滤过厚度,在保证图像空间分辨率的同时,可降低受检者辐射剂量.

Objective:To explore Radiographer in daily work to make the equipment best status, by regularly calibration and maintenance of DSA.Methods: Calibrating and maintain the X-ray tube, flat panel detector,focus of x-tube using the procedures and the phantom come with the DSA equipment.Results: Testing data as a basis for the adjustment of DSA equipment, will keep the equipment stable performance.Conclusion: The daily maintenance and calibration can ensure the accuracy of clinical diagnosis, and provide a reliable basis for the development of new technology and the medical research.

Objective To determine the measurement consistency of diffusion coefficient D, perfusion fraction f and pseudodiffusion coefficient D*in rectal cancers based on different ROIs. Methods Forty-three patients with histologically proven rectal cancers were examined using echo-planar DW-MRI with eight b values (0 to 1 000 s/mm2). Intravoxel incoherent motion parameters were measured on intravoxel incoherent motion map that contained the largest tumor cross-section, according to two distinct ROI protocols:freehand outline ROI and semi-automatic tumor center ROI. The two protocols were compared for differences in IVIM parameters and the interclass correlation coefficient (ICC) were also calculated. intra-and inter-observer variability using paired t test and Bland-Altman plot. Results The IVIM parameters(D, f and D*) obtained by ROIs for outlined and center analysis were (1.08 ± 0.24) × 10-3mm2/s, (0.16 ± 0.06), (26.59 ± 19.54) × 10-3mm2/s and (1.06 ± 0.27) × 10-3mm2/s, (0.17 ± 0.07), (30.79 ± 20.85) × 10-3mm2/s, respectively. No significant differences were observed between the means of the IVIM parameters (D, f, D*) calculated by the two methods (t=1.113,-0.259,-1.660;P=0.272, 0.797,0.104, respectively),and the relative ICC were 0.863, 0.469, 0.663, respectively. The intra-observer 95% limits of consistency of IVIM parameters were (-0.012—0.038) × 10-3mm2/s, (-0.003—0.007), (-0.923—1.166) × 10-3mm2/s with ROI outline tumor, respectively;(-0.024—0.044)×10-3mm2/s, (-0.005—0.015), (-1.670—4.195)×10-3mm2/s with center ROI, respectively. The inter-observer 95% limits of consistency of perfusion parameters were (-0.047—0.009) × 10-3mm2/s, (-0.015—0.009), (-7.206—3.190) × 10-3mm2/s with ROI outlined tumor, respectively;(-0.068—0.048) × 10-3mm2/s, (-0.005—0.041), (-17.657—0.779) × 10-3mm2/s with center ROI, respectively. Conclusions There was no statistically significant difference between the outlined ROI and tumor center ROI analysis of rectal cancers' IVIM parameters. The tumor analysis by outlined ROI protocol appropriately improves intra-and inter-observer consistency and can provide more reproducible and stable results.

Objective To evaluate the prevalence,anatomic features of right superior septal artery (RSSA) with 256-slice MSCT.Methods A retrospective analysis of coronary artery computed tomography angiography with 256-slice CT was performed in 1 646 consecutive patients.Multi-planar reconstruction (MPR),maximum intensity projection (MIP) images on coronal and sagittal planes,and three-dimensional volume rendering (VR) reconstruction images were obtained and used for the evaluation of the anatomic features of the RSSA.The images were transferred to EBW4.52 workstation to trace the vessel and to analyze the origin,diameter,and length of the RSSA.Student's t test was performed to compare the differences in the length and diameter of the RSSA between patients with different coronary artery distribution dominant types,different genders.Analysis of variance (ANOVA) was used to compare the differences in the length and diameter of the RSSA among patients with and without coronary artery stenosis.Results The RSSA was present in 130 (7.9％) of 1 646 patients.The origin of RSSA was from the proximal portion of the right coronary artery in 104 patients,from the right sinus of valsalva in 26 patients.The artery co-existed with the conus artery in 22(16.9％) of 130 patients.The mean length of RSSA was (31.7±15.6) mm (range from 8.9 to 70.7 mm),and the mean diameter was (1.0±0.4) mm (range from 0.2 to 2.5 mm).The average length and diameter of RSSA in men were (33.5±15.7) and (1.0±0.4) mm,respectively; The average length and diameter of RSSA in women were (24.5 ± 13.0) and (0.9 ±0.4) mm,respectively.There was a significant difference in RSSA length between men and women (t=2.718,P=0.007),but there was no significant difference in the RSSA diameter between men and women (t=1.134,P=0.259).There was no significant differencein RSSA length and diameter between different coronary artery distribution dominant types (t=-0.219 and-0.080 respectively,P＞ 0.05).In the patients with left anterior descending artery (LAD) and right coronary artery (RCA) stenosis,the mean length and diameter of RSSA were (38.9±17.9),(1.1 ±0.4) mm,respectively.In the patients without LAD and RCA stenosis,the mean length and diameter of RSSA were (28.9±14.4),(0.9± 0.4) mm,respectively.Patients with coronary artery stenosis tended to have longer RSSAs in comparison to those without coronary artery stenosis (P＜0.05).Conclusions RSSA variantions can evaluated with a cardiac 256-slice MSCT scan.The recognition of this vessel is useful for physians dealing with diagnosis and treatment of coronary artery disease.

<正>膝关节是人体最大最复杂的关节,由股骨下端、胫骨上端和髌骨、韧带、半月板等组成,具有屈伸、内收外展、旋转等复杂运动。在日常的生理活动中,负重较大且活动较多,因此也是人体中退化较早、极易损伤的关节,如果不及时治疗,将导致生活质量下降甚至行走功能的丧失,所以早发现早诊断早治疗是非常重要的。

<正>目前对颈椎疾病的影像学常规检查方法有:X线、CT、磁共振成像(magnetic resonance imaging,MRI)等,而MRI具有较高的组织对比度,可行多方位多序列成像,且无电离辐射,尤其在矢状面可以直观的了解椎间盘、椎管内硬膜囊和椎间孔脂肪受压的程度和范围,因此成为颈椎疾病主要的检查方法。

Objective To compare the coronary artery image quality and radiation dose of prospective ECG gating and retrospective ECG gating computed tomography coronary angiography in patients with suspicion of coronary artery disease(CAD).Materials and Methods 70 patients suspected coronary artery disease were divided in two groups.35 patients were taken prospective ECG gating axial scan and the others were taken retrospective ECG gating helical scan.The heart rate was 70bmp.Coronary artery segments were assessed for imaging quality and radiation dose values were calculated.Results There was no significant difference in image quality between two groups(P0.05).Effective radiation dose of prospective ECG gating group(2.5±0.7 mSv) was significantly lower(P0.001) than that of retrospective ECG gating group(9.6±1.7 mSv).The mean effective radiation dose of prospective group was decreased by 74.4% than that of the retrospective group.Conclusion Prospective ECG gating computed tomography coronary angiography yields similar image quality and lower effective radiation dose compared with retrospective ECG gating computed tomography coronary angiography in patients with heart rates 70bpm.

<正>心率是影响冠状动脉CT成像的重要因素。Phil-ips iCT大大提高了扫描的时间、空间分辨力。本研究通过对不同心率的冠状动脉影像进行质量分析,评价心率对Philips iCT冠状动脉成像质量的影响。1资料与方法

Objective:To investigate the value of MRI and CT in pre-operation assessment for artificial cochlear implantation.Methods:All cases performed MRI examinations by GE Signa Excite 0.35T MRI system before artificial cochlear implantation operation.3D-FIESTA axial scan of inner ear were reconstructed by MIP,MPR and VR methods;performed spiral CT from the external auditory canal to the petrous part of the temporal bone by Toshiba Aquilion 16,slice thickness 1mm,slice interval 1mm,pitch 15,with bone algorithm,5mm-intensive reconstruction in both ears.Results:MR findings showed normal structure of cochlear nerve and labyrinth in 59 cases(118 ears),cochlear malformations in 3 cases,stenosis of internal auditory canal in 3 cases,absence of cochlear nerve in 1 case,vestibular and cochlear aqueduct enlargement in 7 cases,and brain white matter disease in 7 cases.Conclusion:MRI and CT play important roles in pre-operation assessment for absolute contraindications and relative contraindications.It can help doctor to select suitable ear and reduce risks of operation.

As the carrier of biomineral aragonite, fish otoliths memorize various messages of environment throughout the fish’s life. In the past three decades, quite a few achievements have been made in the studies of fish otoliths, but no advances in research using medical instruments have been reported. The authors tentatively applied X-ray computed tomography (CT) to the studies of the internal structure of wild carp otoliths, with the CT value determined by variations in the sample density and element composition. The wild carps were collected, respectively, from the Baiyangdian Shallow Lake in Hebei Province and Miyun Reservoir in the Beijing metropolis, whose water environments are quite different. The former has suffered serious pollution and eutrophication, whereas the latter has nearly experienced no pollution. The primary result indicates that differences exists in CT values of otoliths for the carps from the above-mentioned waters. With in-depth studies, it is possible that X-ray computed tomography could serve as a useful tool in the study of fish otoliths, and the CT values can be taken as typomorphic parameters to distinguish the waters with different degrees of pollution.

Objective To investigate the value of low field MRI in pre-operation assessment for artificial cochlear implantation.Materials and Methods Twenty-three cases performed MR examinations by GE SIGNA EXCITE 0.35T MR system before artificial cochlear implantation operation.Conventional brain scan was used to exclude the intracranial diseases.3D-FIESTA axial and T2WI coronal scan of inner ear were reconstructed by MIP,MPR and VR methods.Resu-lts MR findings showed normal structure of cochlear nerve and labyrinth in 14 cases(28 ears),ochlear malformations in 5 cases(7ears),internal auditory canal malformations in 3 cases(5 ears),vestibular and cochlear aqueduct enlargement in 2 cases(3 ears),and brain white matter disease in 3 cases.Conclusion Low field MRI is able to display anatomy of internal ear clearly and play an important role in pre-operation assessment.It can help doctor to select suitable ear and reduce risks of operation.