Objective To compare CT and MRI images of patients with central airway lesions and explore the advantages of MRI enhanced scanning in the diagnosis and evaluation of treatment efficacy for central airway lesions. Method A total of 35 patients with central airway lesions were collected and underwent chest CT plain scan, enhanced, multi plane reconstruction, and MRI plain scan and enhanced scan. By comparing and analyzing the imaging data of two different scanning methods, the diagnostic advantages of MRI enhanced scan for central airway lesions were summarized. Result 1. Magnetic resonance imaging is significantly superior to CT in analyzing the internal components of lesions, especially in analyzing the internal mucus, necrosis, and other components of smaller tumors, which can avoid excessive and ineffective examinations caused by low CT soft tissue resolution to the greatest extent possible; 2. DWI can serve as a scout to identify the location of hidden lesions, which helps to locate the target lesion during bronchoscopy; 3. Clarify the depth and range of infiltration of central airway lesions, more accurately evaluate the relationship with surrounding tissues, accurately evaluate the depth of forceps before surgery, and avoid irreversible injuries such as trachemediastinal fistula and tracheoesophageal fistula; 4. It helps to evaluate the blood supply of the lesion and avoid the risk of tracheal bleeding during bronchoscopy treatment due to misjudgment of blood supply. Conclusion MRI enhanced scanning is superior to CT enhanced scanning in identifying the location, range, composition, and blood supply of central airway lesions. It has clear auxiliary diagnostic significance for preoperative evaluation, diagnosis and treatment plan determination, and treatment efficacy evaluation of lesions.

Purpose: To determine the diagnostic value of multi-slice spiral computed tomography (CT) after adiponectin treatment of tracheal malignancies. Methods: Sixty patients with tracheal malignancies admitted to Emergency General Hospital from February 2017 to February 2021 were assigned to the study group. After physical examination, 60 healthy subjects in the same period served as the control group. All patients were treated with adiponectin. The control group was subjected to serum tumor marker testing before and after treatment, while the study group received multi-slice spiral CT before and after adiponectin treatment. Results: The 60 patients enrolled in the study group comprised 30 cases of squamous carcinoma, 22 cases of adenocarcinoma, and 8 cases of mucosa-associated lymphoma. Multi-slice spiral CT before treatment showed that 35 patients with tracheal malignant tumors had expansive lumen hyperplasia, while 25 patients with bulging tumors had saddle-like hyperplasia with irregular surfaces, uneven margins, and mean thickness of 5.96 ± 0.65 mm in the tracheal and bronchial walls adjacent to the luminal nodule. After treatment, the thickness of the tracheal and bronchial walls adjacent to the luminal nodule decreased to a mean value of 4.65 ± 0.48 mm. Prior to treatment, the mean enhancement value of contrast-enhanced CT was 18.98±1.23 Hu, and mean tumor diameter was 3.68 ± 0.23 cm. However, after treatment, the mean enhancement value increased to 25.98 ± 1.44 Hu, while mean tumor diameter decreased to 2.54 ± 0.20 cm in the study group. Conclusion: Multi-slice spiral CT has promising diagnostic value for patients with tracheal malignancies after adiponectin treatment. Therefore, it can potentially be used in the diagnosis of patients with tracheal malignancies.

目的:探讨MSCT在老年或癌症晚期等难以耐受食道造影的食管气管瘘患者中的应用价值.方法:回顾性分析2016年至2020年在我院因高度怀疑食管气管瘘行MSCT及气管镜检查的病例,共纳入研究48例.所有图像经过横断位、冠状位、矢状位多平面、气管树容积再现及经气管树中心曲面重建后传至PACS,由两位医师盲法阅片,记录是否有食管气管瘘及阳性病例的大小;气管镜由操作者记录是否有食管气管瘘及阳性病例的大小.比较不同方法间对瘘口、大瘘口(直径>1 cm)、小瘘口(直径<1 cm)的检出率及MSCT与气管镜间大小比较.比较MSCT与气管镜检查对真阳性病例瘘口的大小.两位医师间采用Kappa一致性检验,不同评价方法间采用卡方检验,MSCT与气管镜检查的大小比较采用配对样本t检验,当P<0.05时有显著差异.结果:联合所有图像对所有食管气管瘘的检出率最高,其敏感性、特异性及准确性分别达93％、75％及86％,不同方法对所有瘘口的检出有显著差异,其中矢状位与横断位对瘘口的检出率较高.在所有阳性病例中不同方法间对大瘘口的检出率,各方法间有显著差异,其中联合所有图像对大瘘口的检出率达100％,矢状位与横断位对大瘘口的检出率较高;而对小瘘口的检出,各方法间无显著差异.在所有真阳性病例中,气管镜中所测量的瘘口大小(13.70±11.70)mm,高于MSCT中测量的瘘口的大小(10.83±10.15)mm,两者有显著差异.结论:MSCT及其常见后处理方法在难以耐受食道造影的食管气管瘘患者评估中起重要作用.

目的 通过对煤工尘肺结核和单纯性煤工尘肺2组患者影像资料的对比分析,探讨活动性尘肺结核早期影像诊断特点,为尘肺结核早期影像诊断提供科学依据.方法 收集2018年1月-2020年1月应急总医院及3家合作医院职业病科的煤工尘肺结核患者及单纯性煤工尘肺患者各60例(分别包括壹期、贰期、叁期患者的资料各20例),对2组患者影像资料进行分析、记录,对结果进行分析及统计学处理.结果 正确识别58例煤工尘肺结核,影像诊断正确率96.67％.玫瑰花样小结节、磨玻璃影、树芽征、卫星灶、实变影、空洞、纵隔及肺门淋巴结肿大(直径＞1.5 cm)、支气管壁增厚及扩张、单/双侧胸膜肥厚并胸腔积液等影像学表现在尘肺结核组的检出率分别为100.00％、75.00％、65.00％、41.67％、26.67％、63.33％、58.33％、46.67％和26.67％;单纯性尘肺组检出率分别为3.33％、8.33％、1.67％、0.00％、11.80％、1.67％、6.67％、31.67％和0.以上影像学表现除支气管壁增厚及扩张外,差异均有统计学意义(均P＜0.05).结论 活动性煤工尘肺结核早期薄层CT影像学表现具有特征性,其有助于提高煤工尘肺结核早期诊断率,对尘肺结核早期诊断具有指导意义.

目的:探讨通过64层螺旋CT螺距参数的设置,降低新型冠状病毒肺炎患者筛查的辐射剂量和扫描时间的可行性.方法:前瞻性选择需进行新型冠状病毒肺炎筛查患者,按扫描时间随机分为大螺距组和对照组,每组各16例.大螺距组选择1.375:1螺距,对照组选择0.984:1螺距.对肺纹理、支气管、纵膈结构的图像质量;胸主动脉、竖脊肌、双肺肺实质;辐射剂量的客观数据进行评价和分析.结果:32例图像均符合影像诊断要求.伪影、肺纹理评分差异有统计学意义(P<0.05).两组右肺CT值分别是(-804.62±45.43)HU和(-852.12±28.13)HU、左肺CT值分别是(-808.13±37.74)HU和(-858.77±19.95)HU,均具有统计学意义(P<0.05).两组的扫描时间分别为(2.14±0.15)s和(3.14±0.28)s,具有统计学意义(P<0.05).两组记录所得的容积CT剂量指数(CTDIvol)是(7.88±0.89)HU和(11.17±1.08)HU、剂量长度乘积(DLP)是(279.14±36.33)HU和(387.25±47.86)HU均具有统计学意义(是P<0.05),有效剂量(ED)分别是(3.91±0.51)HU和(5.42±0.67)HU具有统计学意义(P<0.05).结论:新型冠状病毒肺炎患者CT筛查检查中,使用大螺距扫描,能够减少辐射剂量、显著缩短了扫描时间,在不影响病灶诊断的前提下,降低病人接受到的辐射剂量和放射技师感染的风险,具有实际工作意义,有待进一步推广验证.

目的 探究不同术式治疗单纯腰椎间盘突出症患者的临床疗效及对腰椎动态的远期影响.方法 回顾性收集2011年3月-2016年1月治疗的腰椎间盘突出症患者120例,其中60例行椎间孔镜TESSYS技术行髓核摘除,作为TESSYS组;60例行开放性髓核摘除术,作为开放组.比较两组患者手术情况和术后VAS评分、ODI指数;采用ELISA检测手术前后患者血清中C反应蛋白(CRP)、白细胞介素6(IL-6)及肿瘤坏死因子-α(TNF-α)的含量,比较两组患者末次随访时的病变腰椎动态变化.结果 TESSYS组切口长度、手术时间、出血量、住院时间,以及术后血清中CRP、IL-6和TNF-α水平等数据均显著低于开放组(P<0. 05);两组术后VAS评分、ODI评分均显著降低(P<0. 05),但组间无显著差异(P>0. 05);两组患者随访均未出现复发,病变椎间隙均显著变窄(P<0. 05)、邻近节段出现退变,而邻近节段椎间隙高度无显著变化(P>0. 05),两组无显著差异(均P>0. 05).结论 两种技术治疗单纯腰椎间盘突出症的近期疗效、对腰椎动态的远期影响相差不大,但TESSYS技术创伤更小,患者术后恢复更快.

目的:探讨CT轴扫描和螺旋扫描模式对颅脑影像质量和辐射剂量的影响,为颅脑急诊CT患者合理选择扫描模式提供依据.方法:20例患者,急诊CT扫描采用螺旋扫描模式,首次复查时采用轴扫描模式.管电压120 kV,管电流290mA,球管转速0.8s,层厚5mm,间隔5mm,螺距0.969:1,标准重建算法.测量脑灰质和脑白质CT值和背景噪声,计算SNR和CNR,并对图像噪声、颅底伪影、脑灰、白质对比显示情况进行主观评分,扫描后从CT剂量报告中调取辐射剂量值.两种扫描模式影像质量组间比较采用配对f检验和独立样本卡方检验.结果:轴扫描模式时脑灰、白质CT值分别为(38.02±2.23)HU和(27.01±1.72)HU,螺旋扫描时脑灰、白质CT值分别为(37.76±2.22)HU和(26.99±1.69)HU.CT轴扫描和螺旋扫描模式时,脑白质CT值、SNR和CNR差异没有统计学意义(P＞0.05,t=0.045,0.119,0.502),图像噪声、颅底伪影、脑灰、白质对比显示主观评分结果没有统计学意义(P＞0.05,x2=3.142,0.0,3.159).有效剂量在螺旋扫描模式时为66 mSv,在轴扫描模式时为43 mSv,但螺旋扫描模式扫描时间短,后处理重组图像对影像诊断有意义.结论:从影像质量和辐射剂量两方面考虑,对颅脑急诊患者CT检查时首选轴扫描模式,但对躁动不合作患者或体位不合作患者应选择螺旋扫描模式.

[Objective]To discuss the consistence between Digital Radiography(DR) and high kilovoltage(high-kV) chest radiographs in diagnosis of coal workers' pneumoconiosis,evaluate the application value of DR chest radiograph in diagnosis of pneumoconiosis.[Methods]104 coal workers selected from a Coal Mining Group were examined by high-kV and DR chest radiographs.The patients were all men;the range of their age was from 35 to 70 years old,the average was(51.74 ± 9.30) years old;the length of exposure to dust was 9 ~ 40 years,the average was(24.74 ± 13.30) years.The shape,intensity and stages of small opacity of high-kV and DR chest radiographs of 104 coal workers were diagnosed by three diagnostic physicians.The data was checked consistency,which were evaluated by the concordance rate and Kappa(K).[Results]①The diagnosis consistency of the small opacity shape between DR and high-kV chest radiographs was 61.54%,among the concordance rate of p,q,s and t were 15.63%,79.69%,1.56% and 3.13% respectively.The inconsistent diagnostic rate was 38.46%,among the difference of p /q was larger(77.5%).②The diagnosis consistency of the intensity of pulmonary nodules between DR and high-kV chest radiographs was81.75%,among the concordance rate of the grade 0,1,2 and 3 were 11.76%,61.18%,24.71%,and 2.35%.The inconsistent diagnostic rate was 18.27%,among high diagnostic rate of DR was 52.63% and low diagnostic rate was 47.37%.③The consistency of DR and high-kV chest radiographs in diagnosing the stage of pneumoconiosis was 81.73% and the value of Kappa was0.714(P 0.05),among the observation object,stageⅠ,Ⅱ and Ⅲ accounted for 11.54%,36.54%,32.69% and 0.96% respectively.Compared to the gold standard of high-kV chest radiographs,the low diagnostic rate of DR in diagnosing the stageⅠof pneumoconiosis was 7 /51(13.72%),and the high diagnostic rate was 6 /51(11.76%).The low diagnostic rate of stage II was2 /40(5%),and the high diagnostic rate was 0%.The diagnosis consistency of observation object and stage III was 100%.[Conclusion]①There is a better consistency of DR and high-kV chest radiographs in diagnosing the shape of small opacity,but there are differences in diagnosing the shape of p or q small opacity.②There is a good consistency of DR and high-kV chest radiographs in diagnosing the overall density of pneumoconiosis,but there are differences of two methods in diagnosing the density which is 0 or 1.③There is a good consistency of DR and high-kV chest radiographs in diagnosing the stage of pneumoconiosis.④The method of DR has the better application value in diagnosing the pneumoconiosis.

OBJECTIVETo analyze the relationship between the pathological features and 64-multislice spiral computed tomography (64-MSCT) findings of pulmonary nodules in autopsies from patients with coal workers' pneumoconiosis (CWP), to investigate the optimal imaging method for the distribution of pulmonary nodules, and to provide data for the establishment of CT diagnostic criteria for CWP.METHODSCadaveric lung specimens were collected from 7 CWP patients. All of them were men, aged 42∼77 years (mean, 60.00±13.00 years), and their dust exposure time was 5∼30 years (mean, 15.4±8.01 years). The cadaveric lung specimens were treated by aeration, sectioning, and immobilization and were then examined by coronary 64-MSCT. The primitive images were reconstructed into the maximumintensity projection (MIP) images (slice thickness: 3 mm, 5 mm, and 8 mm). The sensitivities of imaging methods with different slice thickness were evaluated based on the pathology and anatomy of local pulmonary nodules, and the correlation between pathological results and radiological findings was analyzed.RESULTSThere were significant differences between the stages determined by pathological examination and high-kV chest radiography (before death) (χ(2) = 4.667, P < 0.05; kappa value = 0.167, P < 0.05). A total of 271 nodules were found in all pathological sections, including peribronchovascular nodules (27, 9.9%), centrilobular nodules (67, 24.6%), interlobular nodules (65, 24.3%), nodules within 5 mm from the pleura (45, 16.5%), pleural plaque-like nodules on the lateral chest wall (45, 16.5%), and nodules on the interlobar pleura (22, 8.1%). The likelihood ratio was the highest (0.981) between 5-mm MIP images and pathological results according to the chi-square test.CONCLUSIONThe stage of pulmonary nodules determined by pathological examination is significantly different from that determined by high-kV chest radiography. The 5-mm MIP images of 64-MSCT provide a good reflection of the local pathology and anatomy of pulmonary nodules in CWP patients.

Objective to study three methods of lumbar pedicle placement in different level based on CT tomographic image reconstruction model in order to determine the location of crest of the Lumbar vertebra and provide objective basis.Methods In 30 cases of lumbar CT three-dimensional reconstruction model,the placement of the screw was simulated,using the method of the ∧ shape crest,the method of above the ∧ shape crest and the method of below the ∧ shape crest,the distance between screw entry point and the pedicle axis was measured,and the anatomic relationship between the upper and lower edges,the internal and the external edges was studied.Differences,advantages and disadvantages of three methods at each segment of lumbar were analysed.Results The anatomic relationship between ∧ shape crest and lumbar pedicle was different in the three methods.The distance between ∧ shape crest and the pedicle axis was shortest in the median sagittal plane,but was slightly higher than pedicle axis in the L1,and was slightly lower than the horizontal axis in L5.The Upper ∧ crest was located above the pedicle axis.Only in 2 cases Upper ∧ crest was lower than the pedicle axis in the L5.Conclusion in the lumbar pedicle screw fixation,∧ shape crest method is safe and reliable,applicable to L1-L5.But in L1 the screw in the median sagittal plane is slightly higher than the pedicle axis,and was slightly lower the axis of the pedicle in L5.

目的 对煤工尘肺大容量肺灌洗前后影像学改变进行评价.方法 2009年1 1月～2010年5月中国煤矿工人北戴河疗养院肺灌洗煤工尘肺患者102例,其中Ⅰ期57例,Ⅱ期37例,Ⅲ期8例;均为男性,平均年龄51.74岁,平均接尘工龄24.74年.仅对第1次复查结果进行比较分析.分析102例资料齐全的尘肺病患者比较大容量全肺灌洗前、后高千伏X线或DR胸片的期别、总体密度;比较57例尘肺病患者肺灌洗前后支气管管壁的64排螺旋CT支气管内径的影像表现;比较99例尘肺病患者灌洗前后64排螺旋CT双肺平均CT值肺密度值、双肺重量.结果 灌洗前后高千伏X线胸片和DR胸片所显示病变、影像表现均未见明显变化,尘肺期别、总体密集度等方面无明显变化,差异无统计学意义(P＞0.05).57例尘肺病患者尘肺灌洗前后右主支气管内径、灌洗前后右上叶支气管后段段支气管内径、灌洗前后右中叶支气管内侧段亚段支气管内径前后差值比较,差异有统计学意义(P＜0.05).99例尘肺灌洗前双肺平均CT值:(HU)为-803.996±65.955,灌洗后双肺HU为-829.052±65.201,灌洗前后双肺HU比较,差异有统计学意义(t=6.783,P＜0.01).99例尘肺灌洗后双肺平均重量、肺密度较灌洗前降低,差异有统计学意义(P＜0.01).结论 煤工尘肺灌洗后部分支气管内径较灌洗前增宽,肺CT值、肺组织密度、自身重量减小.提示灌洗后增加了肺的含气量,提高了肺的通气功能,改善了尘肺病患者的肺功能。

Objective:To evaluate the role of DWIBS in the diagnosis of thoracic tumorous lesions.Materials and Methods:102 cases(patients suspected chest tumors clinically in Beijing Coal General Hospital from 01,2009 to 12,2010,total 158 lesions)were involved in this study,including 33 lung cancer,18 pulmonary benign tumorous lesions,24 malignant lymphoma,24 mediastinal and subaxillary lymph node metastasis,22 breast cancer,17 breast benign lesions and 20 focal normal breast tissues.All 158 lesions were performed DWIBS(STIR) examination and 33 of them also received DWIBS(SPIR)examination and another 4 cases received thoracic-abdomen-pelvis DWIBS(STIR)scan,then their ADC value were measured and compared.The lesions were displayed by background suppression rebuilding with 3D MIP(3 dimensional maximum intensity projection) and technique with reverse black and white.The ADC values of all lesions were measured.Results:(1)The effect of background suppression of STIR-EPI was better than SE-EPI(SPIR)and could get PET-like images with 3D MIP rebuilding and reverse black and white technique to observe the lesion more clearly.(2)The mean ADC value of thoracic metastatic lymph nodes was 1.37±0.41 mm2/s×10-3 and 0.91±0.12 mm2/s×10-3in thoracic lymphoma.There was significant difference between them(P0.05);The mean ADC value of lung cancer was 1.61±0.18 mm2/s×10 -3and 2.06±0.21 mm 2/s×10 -3in pulmonary benign lesions,and it was significantly ower than that of benign lesions.(3)The ADC value of different types of malignant different between the two types of lesions;The mean ADC value of breast cancer,breast benign lesion and normal breast tissue was 1.01±0.13 mm2/s×10 -3,1.81±0.18 mm 2/s×10 -3and 1.91±0.26 mm 2/s×10 -3respectively,and there was significant difference between either two groups.(3)The ADC values of different types of malignant tumors were significantly different.(4)Among the 4 cases with thoracic-abdomen and pelvis DWIBS examination, 3 cases were with distal metastasis.Conclusions:(1)DWIBS was a safe and effective imaging examination.(2)It benefited to identify the property of the thoracic tumorous lesion that was benign or malignant,the ADC value of malignant lesions was l tumors was significantly different.(4)DWIBS can be used in tumor screening and the therapeutic evaluation due to its large range scan.

4D CE-MRA cinegraphy technique is useful for both radiologist’s diagnosis and clinical treatment of brain tumor,offer more information,depict vessel structures and it’s homodynamic change.It can be named as fluoroscopic MRA according to it’s high temporal and spatial resolution from sensitivity encoding(SENSE), contrast enhanced timing rebust angiography(CENTRA),keyhole and half scan techniques.

Objective To investigate the imaging manifestations of lung neoplasms in pre- and post- treatment with CT-guided Argon-Helium cryoablation.Methods All the lung neoplasms in 96 patients have been treated with CT-guided percutaneous Argon-Helium targeted cryoablation.All patients have pre- and post-treatment CT scanning in measurement of lesion size and CT value.The CT scanning has been rerpeated afterl,3,6,12 months of treatment.Results Among total 96 cases,there are 82 cases of lung cancer and 14 cases of metastasis with 110 lesions(89 cases with single lesion,7 cases with multiple lesions).The Ar-He cryoablation has been given 103 times in total.The size of each lesion ranged from 1.2 cm to 15.0 cm in diameter with mean value of(4.0±2.5)cm,including 12 lesions less than 2 cm,51 lesions between 2— 4 cm,24 lesions between 4—6 cm,23 lesions over 6 cm.There are 25 patients whose lesions covered by iceball with 1 cm of overloaping it's margin.There are 63 lesions with diameter less than 4 cm gained 100% ablation rate,24 lesions with 4—6 cm diameter gained 95.8% ablation rate,and 23 lesions with over 6 cm diameter gained 69.6% ablation rate.The post-treatment CT show a progressively enlarged round,low density refrigerant area which clearly demarked with non- refrigerant area.The center of each refrigerant area has negative CT value,the mean decreased CT value of lesion instantly after the treatment are about 30— 50 HU with P0.01.The difference between pre- and post-treatment of Ar-He cryoablation has statistical significance,P0.01.All the lesions with less than 2 cm in diameter have disappeared after 3 months.In 12 months follow-up,CT scanning has shown:Among the 81 lesions,16 lesions(19.7%)with complete response(CR),42 lesions(51.9%)with partial response(PR),17 lesions(21.0%)without change(NC), 6 lesions(7.4%)enlarged(PD).The total ablation rate was 92.6%.Conclusion The imaging manifestations of lung neoplasms in pre- and post-treatment with CT-guided Argon-Helium cryoablation plays an important role in the evaluation of its curative effect.

Objective To evaluate the diagnostic efficacy in the diagnosis of emphysema caused by coal worker's pneumoconiosis and the associativity with pulmonary functional indices between spiral CT and high resolution CT(HRCT).Method 96 category I cases of coal worker's pneumoconiosis were selected for 64 row detectors spiral CT and HRCT examinations,qualitative and quantitative analyses for emphysema were made,additionally,the pulmonary ventilation and volume functions were also performed with Bodybox5500 Volume Scanner (Mdeisoft Co,Belgium),using SPSS software to do statistical analysis on the diagnostic efficacy in diagnosis of emphysema and the associativity with pulmonary functional indices between spiral CT and HRCT. Result There was a good positive correlation between the scores either from spiral CT or HRCT and the pulmonary functional indices such as RV、RV/TLC%、TLC (P<0.001),meanwhile,the good negative correlation also existed with FVC、DLCO、FEV1/FVC%、FEV1% and MVV (P<0.001).The positive diagnostic rates of emphysema by spiral CT and HRCT were much higher than that by pulmonary function test (P<0.005). The chi-square test (χ2=2.78,P>0.05) demonstrated that there was no significant difference in the diagnostic rates of emphysema between spiral CT and HRCT. Conclusion There is a good correlation between the 64 row detectors spiral CT or HRCT and the pulmonary function test in diagnosis of emphysema (P<0.001),demonstrating the same sensitivity of these two imaging methods in diagnosis of emphysema,and the diagnositic rate of early emphysema even higher than that by pulmonary function test(P<0.005). There is no significant difference in diagnostic rate of emphysema between 64 row detectors spiral CT and HRCT.

输尿管原发肿瘤较少见,占泌尿系肿瘤的0.1%～1.0%,以恶性肿瘤居多,绝大多数为移行上皮细胞癌,普通影像检查易漏诊.影像学检查方法包括静脉尿路造影、逆行尿路造影、超声、常规CT和MRI等.

Objective To evaluate the diagnostic value of 64-detector helical CT angiography for follow-up the artery of lower extremity after artificial vascular graft.Methods 68 cases with artificial vascular graft of artery of lower extremity underwent 64-detector helical CTA from 2004-06 to 2006-05.The data were transmitted to ADW4.2 workstation and reconstructed by maximum intensity projection(MIP),volume rendering(VR) and curved planar reconstruction(CPR),then generally analyzed with original axial images.Results In 68 cases,87 grafts were showed by 64-detector helical CTA including the location and shape of artificial vascular graft,the narrowing degree of vascular lumen,collateral circulation and complication.Conclusion 64-detector helical CTA is reliable and accurate in evaluating the artificial vascular graft,and can be used as the first modality in evaluating the artery of lower extremity after artificial vascular graft at present.

OBJECTIVE:To evaluate the correlation of pathological type,CT and serum tumor markers(CEA,NSE,CYFRA21-1) of solid and aerated peripheral lung cancer.METHODS:Seventy-six cases of peripheral lung cancer patients confirmed by pathology were under 64 row detecters helical CT or HRCT(4 row detectors helical CT) and routine CT examination.The serum tumor markers consisting of CEA,NSE and CYFRA21-1 were measuced.The correlation analysis and regressive analysis were performed according to the two variance.RESULTS:According to the correlation intensity(greater to lesser),there were linear correlation and regressive correlation between the solid peripheral lung cancer and segmented,deep segmented,squeamous carcinoma,vascular involvement,notch sign,adenocarcinoma,CEA,CYFRA21-1,respectirely,P0.05;There were linear correlation and regressive correlation between the aerated lung cancer and CEA,CYFRA21-1,ground glass sign,air-bronchus or vacuole sign,adenocarcinoma,superficial segmented,barb sign,vascular involvement,respectirely,P0.05.There were linear correlation and regressive correlation between the adenocarcinoma and vascular involvement,barb sign,ground glass sign,ill-defined margin,segmented,CEA,aerated sign,air-bronchus,superficial segmented,respectirely,P0.05.There were linear correlation and regressive correlation between the squeamous carcinoma and solid type,notch sign,CYFRA21-1,segmented,deep segmented,CEA,NSE,vascular involvement,respectirely,P0.05.CONCLUSION:The diagenosis can be identified by dividing peripheral lung cancer into solid and aerated type better,and the accuracy and detected rate of peripheral lung cancer(≤3 cm) diagnosis can be improved by combining the results of serum tumor markers.

Objective To evaluate the imaging findings,clinical effect and prognosis of lung neoplasm after treatment with Argon-Helium cryoablation under CT-guided.Methods 96 cases of lung cancer (82 cases)and lung metastasis (14 cases) were treated with percutaneous Argon-Helium targeted cryoablation under CT-guided.Results Among 96 cases(110 lesions),total 103 times of treatment with Ar-He cryoablation(average 1.06 lesions at one time were done.The diameter of tumors was 1.2 cm to 15 cm(mean 4.0 cm±2.5 cm).The effective rate was 100% in 63 lesions with diameter less than 4 cm,95.8% in 24 lesions with 4~6 cm diameter,69.6% in 23 lesions with diameter more than 6 cm.On post-treatment CT,the progressive enlarged round refrigerant low density within tumors could be seen at beginning,the CT value of the center of refrigerant area was negative.Most of the lesions were decrease in size in different degree or disappeared with the time passed after Ar-He cryoablation,P0.001.81 lesions were followed-up for 12 months by CT examination,among them,16(19.8%) were complete response(CR),42 lesions(51.9%) were partial response(PR),17 lesions(21%) were no change(NC) and 6 lesions(7.4%) enlarged(PD).The total effective rate was 92.6%. Conclusion CT study in lung neoplasms after treatment with CT-guided Ar-He cryoablation is of very importance in the evaluation of clinical effect and prognosis.

Objective To evaluate the correlation between the 64-slice spiral CT, high resolution CT (HRCT) and pulmonary function detecting index in the diagnosis of coal worker's pneumoconiosis emphysema and to evaluate the difference between 64-slice spiral CT and HRCT in the detection of coal worker's pneumoconiosis emphysema. Methods Ninety-six cases of coal worker's pneumoconiosis were involved in this study and all with 64-slice spiral CT and HRCT examination, qualitative and quantitative analysis of the emphysema. To measure the pulmonary ventilation and volume function by Mdeisoft Bodybox5500 volume scanner (Belgian). By using SPSS software to do the statistical analysis of the relationship between the Results of 64-slice spiral CT, HRCT and pulmonary function test. Results There was good positive correlation between 64-slice spiral CT, HRCT and pulmonary function test in RV, RV/TLC%, TLC (P0.001) and good negative correlation in FVC, DLCO, FEV1/FVC%, FEV1%, MVV (P0.001). The positive rate of emphysema detected by 64-slice spiral CT, HRCT were higher than with pulmonary function test (P0.005). It demonstrated no significant difference between the 64-slice spiral CT and HRCT in the evaluation of emphysema (χ2=2.78, P0.05). Conclusion There is good positive or negative correlation between 64-slice spiral CT, HRCT and pulmonary function testing in the evaluation of emphysema. The positive rate of emphysema detected by 64-slice spiral CT, HRCT are higher than pulmonary function test. There is no significant difference between the 64-slice spiral CT and HRCT in the evaluation of emphysema.