Objective:This study compares the magnetic resonance imaging (MRI) appearance of two types of breast tissue markers to investigate the appropriate clinical application of the markers.Methods:Breast MRI of 69 patients (78 masses) with breast tissue markers had been placed were analyzed retrospectively from November 2015 to August 2018 in our hospital. The sizes and shapes of breast tissue markers were assessed in axial fat-suppressed T2-weighted images, T1-weighted images and contrast-enhanced T1-weighed images.Results:The length of the coil nickel-free stainless steel markers were greater than ribbon titanium markers, with statistical difference in fat-suppressed T2-weighted images ( P=0.039). In contrast-enhanced T1-weighted images, all coil nickel-free stainless steel markers showed >6 mm diameter and round shape, and ribbon titanium markers showed >6 mm diameter ( n=20) or ≤6 mm diameter ( n=8), and round ( n=20), dot ( n=7) or band ( n=1) shapes. The categories of sizes and shapes in two types of breast tissue markers both had statistical significance ( P<0.001, P<0.001). Conclusions:Small breast lesions with breast tissue markers are not suitable for MRI evaluation. The artifact of ribbon titanium markers is smaller than coil nickel-free stainless steel markers, so they have less impact for lesions. The choice of the breast tissue markers and image evaluation methods should depend on the different clinical conditions.

目的 对比分析钆喷酸葡胺(Gadolinium-diethylene triamine pentaacetic acids,Gd-DTPA)增强的三维液体衰减反转恢复(three-dimensional fluid-attenuated inversion recovery,3D FLAIR)与三维真实重建反转恢复(three-dimensional real inversion recovery,3D real IR)磁共振成像(magnetic resonance imaging,MRI)在梅尼埃病内耳内淋巴积水中的诊断价值.材料与方法 回顾性分析29例梅尼埃病患者,男10例,女19例,年龄22～71岁,12例为双侧耳发病,17例为单侧耳发病,共患侧耳41只.29例患者均经咽鼓管向中耳鼓室内注入Gd-DTPA稀释液,24 h后行3D FLAIR序列及3D real IR序列MRI内耳造影,在两种序列图像上分别定量测量前庭最大切面及穿过窝轴的耳蜗底旋短轴切面的内淋巴间隙与总淋巴间隙面积比值R(前庭为RV,耳蜗为RC)及定性评估相应内淋巴积水分级G(前庭为GV,耳蜗为GC),比较两组扫描序列图像所测得的RV、RC、GV及GC的差异.结果 29例梅尼埃病患者41只患侧耳中,3D FLAIR与3D real IR两种序列所测得的RV、RC、GC及GV均具有统计学差异性(PRV=0.000,PRC=0.000,PGV=0.000,PGC=0.001),3D real IR序列测得的RV及RC值大于3D FLAIR序列测得值,GV及GC达1～2级(即发现内淋巴积水)患耳数量大于3D FLAIR序列.结论 相比于3D FLAIR序列,3D real IR序列内耳造影对于梅尼埃病患者内耳内淋巴积水的检测更敏感,检出率更高.

目的 探讨双能CT(DECT)定量参数在术前诊断直肠癌区域性淋巴结转移中的价值.方法 前瞻性收集经手术病理证实的90例直肠癌患者,每例患者术前进进行三期增强DECT检查,每例选取区域最大淋巴结,测量林巴结短径及动脉期、门静脉期、平衡期增强DECT定量参数标准化碘浓度(nIC)、标准化有效原子序数(nZef)和能谱衰减曲线斜率(λHu).90例患者共选取90枚最大淋巴结,其中36枚为转移性,54枚为非转移性.采用独立样本t检验分别比较转移性与非转移性淋巴结短径及nIC、nZef和λHu的差异,采用LASSO回归分析预测淋巴结转移的独立DECT定量参数,采用ROC曲线分析淋巴结短径及DECT定量参数诊断淋巴结转移的效能.结果 非转移性淋巴结肝动脉期、门静脉期nIC、nZef和λHu及平衡期nIC、nZef高于转移性淋巴结,两者之间差异均具有统计学意义(P<0.05),而平衡期λHu两者之间差异无统计学意义(P>0.05).LASSO回归显示门静脉期nZeff-P为预测淋巴结转移的独立定量参数,ROC分析其鉴别诊断转移性和非转移性淋巴结的曲线下面积(AUC)为0.881,准确率为83.3％;高于淋巴结短径的AUC(0.714)及准确率(74.4％).结论 DECT的定量参数nZef-P有助于提高术前评价直肠癌区域淋巴结转移的诊断能力.

Objective To evaluate the imaging features of MRI in autoimmune pancreatitis (AIP) and analyze the diagnostic value before and after treatment.Methods MRI data of 20 AIP patients (14 males,6 females;average age:(54.0±10.3) years) from January 2013 to December 2015 were retrospectively analyzed.The sequences of MRI included T1 weighted imaging (WI),T2WI,MR cholangiopancreatography (MRCP),diffusion weighted imaging (DWI) and dynamic enhancement images.Fifteen of the patients received DWI again after hormone therapy.The location and extent of lesions,signal,patterns of dynamic enhancement,"pseudocapsule" sign and other accompanying signs,the apparent diffusion coefficient (ADC) of the lesion and the DWI manifestations before and after treatment were observed,calculated and compared.x2 test and paired t test were used to analyze the data.Results Five patients were confirmed by pathology and 15 by clinical follow-up.In MRI,16 patients appeared diffusive swollen pancreases,and 4 patients were with focal enlargement.Lesions of pancreas showed low signal on T1WI and high signal on T2WI.Twelve patients presented "pseudocapsule" around the lesions and progressive enhance was shown in the delayed phase on dynamic contrast enhanced MRI.Ten patients showed stenotic choledoch in the head of pancreas and segmented stenotic pancreatic duct in MRCP.All pancreatic lesions in the 10 patients presented high signals on DWI.The pancreatic morphology,the signal of the lesion,the "pseudocapsule" sign and the enhancement degree on MRI were significantly improved compared with those before treatment in 15 patients (x2 values:5.000-22.941,all P＜0.05).Mter hormone therapy,the signals on DWI were markedly weakened in pancreatic parenchyma,and ADC was significantly higher than that before treatment ((1.27± 0.14)×10-3 vs (1.05±0.16)×10-3 mm2/s;t=4.15,P＜0.01).Conclusion DWI could reflect the pathological and biological characteristics of AIP and be used to evaluate the therapeutic efficacy of hormone treatment in AIP.

Objective To investigate the predictive value of diffusion-weighted (DW) magnetic resonance imaging (MRI) for invasiveness of hilar cholangiocarcinoma (HC).Methods The retrospective casecontrol study was conducted.The clinicopathological data of 65 HC patients who were admitted to the Sun Yat-sen Memorial Hospital from January 2012 to November 2017 were collected.Patients received DW MRI before treatment,and 2 senior imaging doctors analyzed imaging data and measured the apparent diffusion coefficient (ADC) for the primary lesions of HC.Observation indicators:(1) MRI situations of HC;(2) relationship between ADC and clinicopathological factors;(3) receiver operator characteristic (ROC) curve analysis;(4) treatment and follow-up situations.According to patients' conditions,treatment plans were done within 2 weeks after MRI and patients underwent radical resection of HC.Follow-up using telephone interview was performed to detect tumor recurrence up to December 2017.Measurement data with normal distribution were represented as (x)±s,and comparisons between group and among group were respectively analyzed using the t test and one-way ANOVA.Spearman's rank correlation was performed to analyze the relationship between ADC and clinicopathological factors.ROC curves assessed the diagnostic efficiency of ADC.Results (1) MRI situations of HC:MRI and magnetic resonanced cholangio-pancreatography (MRCP) in 65 patients showed varying degrees of soft rattan-like dilations of intrahepatic bile ducts and truncation signs of bile tracts in hepatic port.Of 65 patients,tumors in 23,7 and 35 patients were respectively pedunculated type,polypoid type and infiltrating type.The pedunculated-type lesions of 23 patients presented as low signal on T1WI and slightly high signal on T2WI;after enhanced scans of MRI,pedunculated-type lesions of 7 patients demonstrated moderate homogenous enhancement in 3 patients,ring-like enhancement with internal liquefaction necrosis in 10 patients and moderate heterogeneous enhancement in 10 patients,respectively.The polypoid-type lesions presented as low signal on T1WI and high signal on T2WI,and moderate homogenous enhancement by enhanced scans of MRI.There were varying degrees of bile duct wall thickness and irregular nodules in the infiltrating-type lesions of 35 patients,showing moderate enhancement by enhanced scans of MRI.All the lesions of 65 patients using DW MRI demonstrated restricted diffusion,showing a clear boundary between lesions and normal surrounding bile ducts or liver tissues;heterogeneous enhancement lesions by MRI scans presented as heterogeneously high signal on DWI and heterogeneously low signal on ADC map,and necrotic area of lesions showed low signal on DWI;homogenous enhancement by MRI scans presented as homogenously high signal on DWI and homogenously low signal on ADC map.(2) Relationship between ADC and clinicopathological factors:ADC was respectively (1.382±0.165)× 10-3 mm2/s,(1.343±0.138)× 10-3 mm2/s,(1.291-±0.226)×10-3 mm2/s,(1.111±0.243)×10-3 mm2/s in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ (TNM staging) and (1.441± 0.355) × 10-3 mm2/s,(1.226 ± 0.177) × 10-3 mm2/s,(1.061 ± 0.228) × 10-3 mm2/s in highdifferentiated,moderate-differentiated and low-differentiated tumors (pathological grading) and (1.403±0.176)× 10-3 mm2/s,(1.121±0.238)× 10-3 mm2/s in Ki-67 score ≤ 10％ and ＞ 10％ and (1.115±0.241)× 10-3 mm2/s,(1.347±0.174)× 10-3 mm2/s in HC patients with and without lymph node metastasis,with statistically significant differences in the above indicators (F =4.158,9.866,t =11.607,13.464,P＜0.05).Results of Spearman's rank correlation analysis showed that ADC had a negative correlation with TNM staging,pathological grading and Ki-67 score (r=-0.532,-0.522,-0.409,P＜0.05).(3) ROC curve analysis:using 1.225×10-3 mm2/s as a critical value of ADC,the sensitivity and specificity of ADC in the diagnosis of stage Ⅰ-Ⅱ HC and stage Ⅲ-Ⅳ HC were 70.5％ and 81.0％,and area under ROC curve was 0.705 (95％CI:0.62-0.84,P＜0.05).Using 1.100×10-3 mm2/s as a critical value of ADC,the sensitivity and specificity of ADC in the diagnosis of lowdifferentiated HC and moderate-and high-differentiated HC were 88.2％ and 64.3％,and area under ROC curve was 0.814 [95％ confidence interval (CI):0.69-0.90,P＜0.05].Using 1.243×10-3 mm2/s as a critical value of ADC,the sensitivity and specificity of ADC in the diagnosis of Ki-67 score ≤ 10％ and ＞ 10％ were 66.7％ and 75.0％,and area under ROC curve was 0.783 (95％CI:0.62-0.90,P＜0.05).Using 1.222×10-3 mm2/s as a critical value of ADC,the sensitivity and specificity of ADC in the diagnosis of lymph node metastasis were 91.3％ and 71.4％,and area under ROC curve was 0.873 (95％CI:0.76-0.94,P＜0.05).(4) Treatment and followup situations:65 patients underwent successful radical resection of HC.Thirty-three patients were followed up for 1-24 months.Of 33 patients,5 had tumor recurrence within 6 months postoperatively,including 4 with ADC ＜ 1.100× 10-3 mm2/s,13 had tumor recurrence after 6 months postoperatively,and 15 didn't have tumor recurrence or metastasis,including 1 with ADC ＜ 1.100× 10-3 mm2/s.Conclusions There are different ADC in differentTNM staging,pathological grading,Ki-67 score and with or without lymph node metastasis of HC.ADC of DWMRI can be used as a preoperative imaging predictor for invasiveness of HC.

目的 探讨自身免疫性胰腺炎CT和MRI的影像学特点,提高对自身免疫性胰腺炎的认识和影像学诊断水平.方法 回顾性分析45例经激素治疗或手术病理证实的自身免疫性胰腺炎患者的CT和MRI影像学资料,观察胰腺及周围组织、胰管和胆管的影像学表现,总结自身免疫性胰腺炎CT和MRI的影像学特点.结果 45例自身免疫性胰腺炎患者中,男性32例,女性13例,其中37例患者表现为胰腺的弥漫性肿大,8例患者表现为胰腺局限性肿大,CT检查中有27例患者的胰腺病灶平扫密度减低;MRI检查中有16例患者胰腺病灶出现信号的改变,表现为T1WI上低信号,T2WI上稍高信号;45例患者胰腺病灶均表现为延迟强化方式改变.10例患者的CT和7例患者的MRI表现为胰管狭窄,2例患者的CT和1例的患者MRI表现为胆总管狭窄.14例患者的CT及MRI表现胰腺周围的"假包膜"征象.结论 自身免疫性胰腺炎在CT和MRI上具有一定的影像学特点,结合实验室相关检查有助于该疾病的诊断.

Objective To investigate the anatomical variant rate and models of normal pulmonary venous drainage to the left atrium on multi-slice spiral CT angiography(MSCTA).Methods Thoracic 64 MSCTA of 220 consecutive patients with all pulmonary venous drainage to the left atrium from May 2013 to July 2014 in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University were retrospectively analyzed. The radiographic anatomy of pulmonary veins was revealed by using muti-planar reconstruction ( MPR ) , maximum intensity projection ( MIP) and volume rendering ( VR) image post-processing to identify each segment of pulmonary vein drainage and connection between pulmonary veins and the left atrium. The normal pulmonary vein drainage was defined as the independently opening of upper and inferior pulmonary veins to the left atrium in each side and the right middle lobe vein opening to upper pulmonary vein. Anatomic variations of pulmonary veins were determined as single or more than two ostia opening of pulmonary veins, and pulmonary venous segment passed through another lobe to the left atrium.Results Among 220 cases with normal pulmonary venous drainage, the overall incidence of right and left pulmonary variations was 22. 7%(50/220). Eight types of anatomical variations in the right lung were found in 38 (17. 3%, 38/220) cases, including:(1)The right upper lobe and lower lobe pulmonary vein independently drained to the left atrium with right middle lobe vein joined to right lower lobe in 4 (1. 8%, 4/220) cases. (2)Right upper lobe and lower lobe pulmonary vein independently drained to the left atrium with posterior segmental vein of right upper lobe joined to right lower lobe in 2 (0. 9%, 2/220) cases. (3) the right upper lobe, middle and lower lobe pulmonary vein independently drained to the left atrium in 16 ( 7. 3%, 16/220 ) cases. (4)The right apical-anterior, posterior segment vein and lower lobe vein independently drained to the left atrium in 4 (1. 8%, 4/220) cases. (5)The right upper lobe, superior segment of lower lobe and basal segment of lower lobe vein independently drained to the left atrium with right middle lobe vein joined to right upper lobe in 2 (0. 9%, 2/220) cases. (6) The right upper lobe, lateral and medial segment of middle lobe, lower lobe pulmonary vein independently drained to the left atrium in 6 (2. 7%, 6/220) cases. (7) The right apical-anterior, posterior segment, middle and lower lobe vein independently drained to the left atrium in 2 (0. 9%, 2/220) cases. (8)The right upper lobe, middle lobe, superior segment of lower lobe and basal segment of lower lobe vein independently drained to the left atrium in 2(0. 9%, 2/220) cases. Two types of anatomical variations were found in the left side in 12 (5. 5%, 12/220) cases, including:(1) Lower lobe vein joined upper lobe vein to form a common trunk in 8 (3. 6%, 8/220) cases. (2)The upper lobe, lingular segment and lower lobe pulmonary vein independently drained to the left atrium in 4 (1. 8%, 4/220)cases.Conclusions As revealed by MSCTA,anatomical variations of pulmonary venous drainage to the left atrium are not uncommon and the variant patterns are variable.

Objective : To investigate the method and clinical application of 64-slice spiral computed tomography angiography of the anterior inferior cerebellar artery. Methods : 20 patients planned to surgery in the area of cerebellopontine angle underwent 64-slice spiral CT angiography. The obtained thin-slice images were reformatted by using maximum intensity projection,curved planar reformation and volume rendering to evaluate anterior inferior cerebellar arteries. The visibility and morphological features of the anterior inferior cerebellar arteries were assessed.Results: 38 anterior inferior cerebellar arteries in 20 patients were visualized and all the 38 arteries arose from basilar artery. The mean diameter at starting point of the anterior inferior cerebellar arteries were measured as(1.19±0.66)mm, 86.8% of them penetrates between the ventral side of facial nerve and auditory nerve. Conclusion : 64-slice spiral CT angiography could accurately demonstrate the origin, caliber, course, morphological features of the anterior inferior cerebellar artery,so it’s helpful in discovering morphological features or abnormalities of anterior inferior cerebellar artery, offering us early and accurate clinical diagnosis and treatment guidance.

Objective: To investigate the value of quantitative evaluation of inflammatory activity by using wrist dynamic contrast-enhanced MRI (DCE-MRI) in rheumatoid arthritis (RA) patients.Materials and Methods: Twenty patients with clinically and pathologically proved RA underwent wrist DCE-MRI examination, Krenn scoring of synovial inflammatory, clinical scoring of DAS28 and serological examination. Quantitative parameters including the volume transfer constant (Ktrans), rate constant (Kep), extravascular extracellular volume fraction (Ve), plasma volume (Vp) and semi-quantitative parameters including the time to peak (TTP), maximum concentration(Cmax), the area under concentration-time curve (AUC), maximum slope (Slopemax) of wrist synovial lesions were derived from DCE-MRI data. Relationship between quantitative and semi-quantitative parameters and Krenn scores of synovial inlfammatory, clinical score of DAS28 and serological results were analyzed by using correlation analysis. Ktrans values between different grades of synovitis were analyzed by using Studentt test.Results:The average Ktrans value of 20 patients was (1.27 ± 0.59) ml/min, the average Krenn score was 3.38 ± 1.53, and the average DAS28 score was 4.80 ± 0.94. Pathologically, six patients had high-grade synovitis and eleven patients had low-grade synovitis. Positive correlation was found between Ktrans and Krenn scores,as well as between Ktrans and DAS28 scores (r=0.698,P<0.01;r=0.510,P<0.05 respectively). However, no correlation was found between Kep, Ve, Vp, TTP, Cmax, AUC, Slopemax and Krenn scores, DAS28 scores, serological results (P>0.05). Ktrans values in high-grade synovitis group were higher than these in low-grade synovitis group (t=4.05,P<0.01).Conclusion:Ktrans values derived from DCE-MRI can be used to relfect the clinical and pathological inlfammatory activity of RA.

目的 探讨耳鼻咽喉区原发性神经内分泌癌的MRI特点.方法 回顾性分析经病理证实的12例原发性耳鼻咽喉区神经内分泌癌的MR表现,分析肿瘤的位置、形态、大小、边界、信号强度及增强的特点.结果 12例患者中,6例位于鼻腔鼻窦,2例位于声门上区,4例分别位于鼻咽、硬腭、扁桃体及乳突.起源于鼻腔鼻窦及硬腭肿瘤病灶边界不清;起源于其他部位的肿瘤边界清晰.所有肿瘤均呈中度或明显强化,高分化肿瘤为均匀强化,大部分低分化肿瘤呈不均匀强化.起源于鼻腔鼻窦肿瘤多为低分化肿瘤,广泛侵犯邻近结构.结论 原发性耳鼻咽喉区神经内分泌癌的MRI表现与起源部位及分化程度有关.

目的:探讨单侧下背痛患者脊柱核心肌群的变化,为指导制定下背痛运动治疗方案提供一定的研究依据.方法:178例单侧下背痛患者根据病程长短分为急性期组(n=76)和慢性期组(n=102),采用Onis软件和Image J软件分析受试者腰部MRI图像,比较痛侧和非痛侧腰大肌(PM)、腰方肌(QL)、多裂肌(MF)和竖脊肌(ES)的肌肉横截面积(CSA)、肌肉平均信号强度(MSI)和脂肪浸润(FI)比例.结果:急性期组中,痛侧PM和ES的CSA较非痛侧肌肉小(P＜0.05),MSI和FI比例较非痛侧肌肉高(P＜0.05);慢性期组中,痛侧MF和ES的CSA较非痛侧肌肉小(P＜0.05),MSI和FI比例较非痛侧肌肉高(P＜0.05);急性期组痛侧ES的CSA较慢性期组痛侧肌肉大(P＜0.05),MSI和FI比例较慢性期组痛侧肌肉低(P＜0.05).结论:急性期组和慢性期组患者存在痛侧竖脊肌的肌肉萎缩和脂肪浸润,慢性期组患者痛侧多裂肌萎缩明显.通过MRI研究LBP患者腰椎核心肌群情况,可为出现异常变化的肌肉设计针对性训练动作和方法提供依据,有助于尽快恢复脊柱力学,改善功能障碍.

Objective To investigate multiple reconstruction of 64-slice spiral CT to display the lymph nodes in rectal cancer. Methods Twenty-eight patients with rectal cancer underwent CT scan. Multiple reconstruction had done in all patients.Conventional methods of three-dimensional reconstruction, including observation in axial, sagittal and coronal plane. Additional methods,including to adjust window width and window level to bowel window(window width 300 Hu, window level 0 Hu), curve reconstruction, and volume reconstruction. The number of lymph nodes were compared between the conventional CT methods and additional methods. Results 2.09±1.41 lymph nodes on average were found in the conventional methods, and the diameters of lymph nodes observed were more than 6 mm. Conversely, 6.64±2.13 lymph nodes on average were found in additional methods, and some lymph nodes of diameter were less than 6 mm.There was significance difference between two reconstruction methods. Conclusion Using bowel window,curve reconstruction, and volume reconstruction could display more lymph nodes than conventional CT methods of three-dimensional reconstruction, and can provide distributive rules of lymph nodes in rectal cancer.

Objective To evaluate the value of 64-slice spiral CT angiogrpahy in displaying portal vein involved in hepatic diseases.Methods 245 patients were selected to analysis that performed the abdominal CT scan from October 1,2005 to October 31,2007 in our hospital.Results Among 245 patients,diseases of portal vein were found in 120 patients.Portal hypertension was found in 52 patients,tumor embolismus in portal vein in 48 cases,cavernous transformation of portal vein in 10 cases,portal vein invaded in 20 cases.Conclusion 64-slice MSCTA could definitely demonstrate the affection of vessels,especially subtle changes,therefore,could be used for optimizing therapeutic regimen and evaluating therapeutic effect.

Objective To observe the accuracy of real-time virtual sonography with three different locating methods.Methods RVS was performed in 18 patients with 21 liver lesions,positioning through one point,three point(dorsal decubitus and lateral decubitus).The difference of distance from the anterior border of the lesion to the liver capsule between CT and ultrasound images was measured.The difference among the distances of the 3 methods was analyzed.Results The difference among distances of the 3 methods were(6.04±2.19)mm(one point),(5.82±3.48)mm(three point-dorsal decubitus)and(6.13±2.51)mm(three point-lateral decubitus),respectively.No significant difference was found(P0.05).Conclusion Different locating has no influence on accuracy of real-time virtual sonography.

Objective To investigate the method and clinical application of 64-slice spiral CT angiography of the transverse cervical artery.Methods Ten patients who were prepared for musculocutaneous flaps reconstruction for oral cancer underwent 64-slice spiral CT angiography.The obtained thin-slice images were reformatted by using maximum intensity projection and volume rendering to evaluate transverse cervical arteries.The visibility and morphological features of the transverse cervical arteries were assessed.Results The source of the transverse cervical artery was thyrocervical trunk in 15 of 20(75%)and subclavian artery in remaining 5 of 20(25%)arteries.The length and the opening diameter at starting point of cervical segment of the transverse cervical arteries were measured as(48.86±1.65)mm and(4.20±0.35)mm,respectively.The length and opening diameter at starting point of thoracic segment of the transverse cervical arteries were(57.21±5.61)mm and(3.31±0.22)mm.Conclusion 64-slice spiral CTA could accurately demonstrate the origin,course,morphological features of the transverse cervical artery,therefore is helpful for patient selection and surgical planning of patients in prepare to skin flap surgery.

Objective To discuss the diagnostic value of spiral computed tomography (CT) in digestive tract obstruction. Methods 44 cases suspected with digestive tract obstruction underwent MDCT. 33 cases of them in the diagnostic results of MDCT were compared with the surgical and pathological findings. The main reconstraction method included multi-planar reconstruction (MPR) and maximum intensity projection (MIP). Results Among 44 cases, 33 cases were confirmed by postoperative pathology. To comparing with the results of surgery, the localization diagnosis was correct in 33 patients(100%) and the pathogenic diagnosis was correct in 33 patients(100%). Conclusion Spiral CT has an important value in the diagnosis of digestive tract obstruction.

Objective To explore the value of 64 multiples lice spiral CT angiography(CTA) and CT urography for diagnosing ureteropelvic junction. Methods 15 cases with stenosis of ureteropelivic junction underwent CTA and CTU with 64 multiple slice spiral CT were recorded and compared with surgical exploration. Results 15 patients with urinary obstructive diseases were confirmed by CTU or CTA, including plain and multi-phase contrast-enhanced scans. Renal calculus was found in 3 cases, dystopic vascular compression was found in 2 cases. All patients underwent open or minimally invasive surgery, and the imaging results were agreed with operative exploration. Conclusion 64-multiple slice spiral CT 3-D angiography(CTA) and 3-D positive contrast CT urography were effective for evaluating stenosis of ureteropelvic junction. Its usefulness in the guidance of clinical therapy deserves further investigation.

Background: Physiological load on lumbar spine at upright position disappears when a patient is examined at supine position during routine CT or MRI examination. Consequently, the physiological or pathological condition of disc or dural sac cannot be correctly reflected at supine posture. Objective: To investigate the impact of axial load on lumbar dural sac. Design, time and setting: A comparative observation was performed at Second Hospital of Sun Yat-sen University from March 2006 to February 2007. Participants: Forty-five patients with lumbar degenerative changes aged 22-79 years were included in the study. There were 29 male and 16 female. All patients complained of low back pain. The duration of symptoms ranged from one month to ten years. Methods: Conventional CT scanning and axially loaded CT examination were performed in 45 patients with low back pain (scan range L 1-S 1). Main outcome measures: The cross-sectional area of dural sac (D-CSA), intervertebral disc, dorsal fat pad within spinal canal and the thickness of ligamentum flavum were measured on the transverse plane at central part of the disc. Results: Of 45 included patients with lumbar degenerative changes were included, 3 were excluded with L 5 sacralization during L 5/S 1 level scanning. Compared with conventional CT, D-CSA decreased by 8.2 mm 2-19.7 mm 2 averagely during axially loaded examination. While disc appearance did not change during axially loaded examination (P < 0.05), only the severity of disc bulging, protrusion or extrusion aggravated. The thickness of ligamentum flavum increased significantly at L 1/2, L 2/3, L 3/4 and L 4/5 levels (P < 0.05), but no significant changes in thickness were found at L 5/S 1 level or the area of dorsal fat pad during axially loaded examination (P > 0.05). Conclusion: The degree of disc bulging, protrusion or extrusion is aggravated and the thickness of ligamentum flavum increased during axially loaded examination, which are main factors for reduction of D-CSA in lumbar spine.

[目的]探讨64层螺旋CT在肝脏动脉、门静脉和肝静脉血管成像中的时间及效果。[方法]首先将30例患者分为三组,分别行肝动脉、门静脉和肝静脉主干处的灌注CT扫描,取得三种血管的峰值时间,以此为参考,对80例患者行上腹部的多期扫描,进行不同血管的三维重建并评价其效果。[结果]肝动脉、门静脉和肝静脉达到峰值的时间平均数分别为20 s、34 s和42 s,以此为根据扫描的结果,肝动脉显示优良度达100%,门静脉优良的比例为97.1%,肝静脉显示优良的比例为90.0%。[结论]64层螺旋CT肝脏血管造影建议的扫描时间为肝动脉20 s,门静脉35 s,肝静脉45 s,可达到较高的满意度。

Objective To analyze variations of hepatic vein in healthy people with 64-slice spiral CT.Methods Seventy-five healthy subjects underwent multi-slice spiral computed(MSCT)hepatic venography.The anatomy of the junction of the hepatic veins with the inferior vena cava and the intrahepatic drainage territory of the hepatic veins and tributaries were evaluated.The hepatic veins were classified according to three anatomic classification(Nakamura's,Marcos's and Kawasaki's classification)methods respectively.Results There was a common trunk of the middle and left hepatic veins before joining the IVC in 86.7%(65/75)of the cases.In 13.3%(10/75)of the cases,the three main hepatic veins joined the IVC separately.The ratios of Nakamura's classification type A,B,C of hepatic veins were 49.4% (37/75),37.3%(28/75),and 13.3%(10/75)respectively.The ratios of Marcos's classification type A,B,C of hepatic veins were 56.0%(42/75),24.0%(18/75),and 20.0%(15/75)respectively. The ratios of Kawasaki's classification type Ⅰ,Ⅱ of hepatic vein were 40.0%(30/75)and 60.0% (45/75).Conclusion Multi-slice spiral CT hepatic venography can provide visualization of peripheral hepatic venous branches in details.