Objective:To detect the expression and methylation of TIA1 in breast cancer and to study its correlation with multi-slice spiral CT signs.Methods:50 patients with breast cancer were collected from Feb.2019 to Mar. 2020. The expression levels of TIA1 in breast cancer tissues and in peritumoral tissues were estimated by quantitative real-time polymerase chain reaction. Bioinformatics software MethPrimer was used for predicting TIA1 promotor and confirmed the existence of cPG island. Methylation-specific PCR (MSP) was performed to detect TIA1 DNA promoter methylation. All patients were examined by multi-slice CT. CT images were analyzed through observing the tumor size, shape, calcification area, lymph node metastasis and margin. The correlation between CT signs and TIA1 methylation status was further analyzed.Results:The expression levels of TIA1 in breast cancer tissues were lower than in peritumoral tissues (0.50±0.12, 0.95±0.10, P=0.00) , while TIA1 DNA promoter methylation rate was higher than in peritumoral tissues (64%, 42%, χ2=4.86, P<0.05) .There were no significant differences in TIA1 DNA promoter methylation rate among patients with different tumor shape and micro calcifications. TIA1 DNA promoter methylation rate in patients with mass diameter≥2 cm were significantly higher than those in patients with mass diameter<2 cm (78.57%, 45.45%, P<0.05) , and TIA1 DNA promoter methylation rate in patients with lymph node metastasis was higher than those without lymph node metastasis (79.17%, 50%, P<0.05) . TIA1 DNA promoter methylation rate in patients with burr at edge of mass was higher than those without burr at edge of mass (80.77%, 45.83%, P<0.05) . Conclusion:There is a correlation between CT imaging signs and TIA1 DNA promoter methylation rate in patients with breast cancer, which can provide more reference for the judgment of malignant degree and prognosis of patients with breast cancer.

目的 观察冠状动脉CTA与冠状动脉造影在诊断心肌桥-壁冠状动脉(MB-MCA)的应用效果.方法 选取我院就诊的167例疑似心肌缺血患者,分别进行冠状动脉CTA和冠状动脉造影(CAG)检查.比较两种检查方法对MBMCA的诊断效果,测量和分析MB-MCA的长度和狭窄程度.结果 冠状动脉CTA共检出MB-MCA患者37例,而CAG检查共检出MB患者20例,冠状动脉CTA对于MB-MCA的检出率显著高于CAG检查,差异有统计学意义(P＜0.05);以CAG检查结果为参照,可计算出冠状动脉CTA诊断MB的敏感性为90％、特异性为87.1％、阳性预测值为48.6％和阴性预测值为98.5％;冠状动脉CTA对MB-MCA测量的长度和狭窄程度结果均大于CAG测量结果,差异有统计学意义(P＜0.05).结论 冠状动脉CTA在MB-MCA的诊断和测量中具有较高的准确性,具有较好的临床应用及推广价值.

目的 探讨MSCT检查在诊断异位嗜铬细胞瘤中的临床价值.方法 收集异位嗜铬细胞瘤的24例CT检查与病理资料.结果 将患者的术后病理检查结果作为金标准进行对照分析,MSCT检查共明确诊断22例,诊断准确率为(91.67%).经MSCT检查显示,本组24例患者的肿瘤均表现为卵圆形或类圆形样,大多数患者的病灶边界均相对比较清晰.最小的病灶处于膀胱,面积约1.3cm×1.6cm,最大的病灶处于后腹膜,面积约8.1cm×10.3cm.大部分患者的CT平扫密度不均,可见囊性低密度区域,实性病灶的CT平均值约为(42.41±3.62)HU,增强扫描显示全部病灶的实性成分均有明显强化,CT平均值为(104.6±6.7)HU,而液化坏死区域则没有强化.双期增强扫描中门脉期时患者的CT值又会进一步上升,且特点比较显著.结论 MSCT能够清晰的显示患者肿瘤的位置、大小、形态及结构.

Objective To investigate the clinical value of digital subtraction angiography (DSA) interventional thrombolysis in the treatment of acute cerebral infarction.Methods 35 patients with acute cerebral infarction were divided into 6h group and 7-12h group in accordance with DSA from the onset time.Before and after thrombolytic therapy,the nerve function defect angiographic recanalization rate and postoperative score of therapeutic effect evaluation were compared between the two groups.Results In the 6h group,the recanalization rate ＞ 70％ (33.33 ％) and the recanalization rate ＞50％ (83.33％) were significantly higher than those in the 7-12h group (18.18％,55.55％),and the differences were statistically significant(x2 =6.56,5.02,all P ＜ 0.05).Before treatment,the ESS score between the two groups was not statistically significantly different(t =0.83,P ＞ 0.05).After treatment for 1d,7d,14d,ESS scores of the two groups [(62.44 ± 9.82) points,(68.95 ± 11.23) points,(73.89 ± 11.24) points,(54.67 ± 9.11) points,(58.02 ± 10.47) points,(61.43 ± 10.23) points] were significantly higher than those before treatment [(42.12 ± 8.79) points,(41.92 ± 9.02) points,t =6.87,7.03,7.92,6.03,6.56,6.77,all P ＜ 0.05].After treatment for 1 d,7d,14d,the ESS scores of the 6h group [(62.44 ± 9.82) points,(68.95 ± 11.23) points,(73.89 ± 11.24) points] were significantly higher than those of the 7-12h group [(54.67 ± 9.11) points,(58.02 ±10.47) points,(61.43 ± 10.23) points],and the differences were statistically significant(t =5.45,5.10,4.23,all P ＜ 0.05).Conclusion DSA interventional thrombolytic therapy can significantly improve the neurological status of the patients,and the onset time is shorter.The clinical treatment is better.In the clinical treatment,we should grasp the opportunity.

Objective To analyze the clinical value of X ray examination, CT examination and MRI examination in the diagnosis of giant cell tumor of bone.Methods 50 patients with giant cell tumor of bone confirmed by postoperative pathology were selected.The patients' X ray, CT scan and MRI imaging examination data were retrospectively analyzed, and the imaging features of giant cell tumor of bone were discussed and summarized.Results The rate of CT examination and MRI examination in the diagnosis of bone destruction was higher than X ray examination, but the difference was not statistically significant (x2=4.181,P>0.05).CT examination and MRI examination in the soap bubble sign, bone crest, liquid plane and soft tissue mass in the diagnostic rate compared with X ray examination was significantly higher, the difference was statistically significant (x2=5.333,22.941,30.000,38.400,64.000,14.166,6.102,all P<0.05).Conclusion The diagnostic accuracy of CT and MRI in giant cell tumor of bone is higher than X ray, but the value of MRI examination in the diagnosis of edema near the tumor is better.

目的 探讨乳腺X线摄影和增强磁共振(DCE-MRI)在乳腺病变诊断中的应用效果.方法 对收治乳腺疾病患者采用乳腺X线摄影X线和增强磁共振进行检查,对比两种检查应用效果.结果 本组患者经病理检查发现乳腺X线摄影诊断乳腺良、恶性病变的敏感性、特异性及准确性和DCE-MRI诊断乳腺良、恶性病变的敏感性、特异性及准确性(P<0.05);经分析发现DCE-MRI诊断良、恶性乳腺病变的敏感性、特异性及准确性均明显高于乳腺X线摄影,且差异具有统计学意义.结论 增强磁共振对乳腺病变的诊断价值明显优于乳腺X线摄影,能有效为乳腺癌保乳术病例提供指导.

Objective To evaluate the value of dynamic contrast-enhanced MRI( DCE-MRI) in breast tumors diagno-sis. Method A total of 112 patients with breast tumor were enrolled and decided into malignant lesion group and be-nign lesion group according to histological result. All patients were performed with dynamic contrast-enhanced MRI. Record the morphological characters, time-intensity curves, Slopemax , early enhancement rate and time to peak. Result The benign lesions were characterized by clear boundaries, regular shape and homogeneous enhancement. while the malignant lesions as unclear boundaries,irregular shape and inhomogeneous enhancement. TIC type:45 ca-ses in type Ⅰ curve,24 cases in typeⅡ curve and 8 cases in typeⅢ curve for the benign lesion group. 1 cases in typeⅠcurve,8 cases in typeⅡcurve and 26 cases in typeⅢcurve for the malignant lesion group. There were sig-nificant difference between the two groups for morphological characters and TIC type(P<0. 05). Slopmax,enhance-ment ration at 1 min of benign lesion group were significantly higher than the malignant lesion group(P<0. 05). Peak time was about 4 min later in benign lesion group. sensitivity got highest when using typeⅡcurve and typeⅢcurve as diagnostic standards. Conclusion DCI-MRI is an effective method in breast neoplasm diagnosis about be-nign and malignant property. combined morphology and enhancement parameters with TIC type would get higher sen-sitivity.

目的：探讨128层螺旋CT冠脉成像在临床诊断及分级评价冠心病中的应用价值。方法对120例进行128层螺旋CT检查诊断的疑似冠心病患者的临床检查结果分析，并与CAG 对比评价冠脉狭窄程度分级诊断的准确性。结果120例患者经冠状动脉造影检查确诊冠状动脉狭窄阳性84例，阳性率为70．00％；阴性36例，阴性率为30％。另外，120例患者经冠状动脉造影检查发现冠状动脉内斑块出现钙化82例，钙化率为68．33％，非钙化38例，非钙化率为31.67％。120例患者经冠状动脉成像检查确诊冠状动脉狭窄阳性85例，阳性率为70．83％；阴性35例，阴性率为29.17％。另外，120例患者经冠状动脉成像检查发现冠状动脉内斑块出现钙化83例，钙化率为69．17％，非钙化37例，非钙化率为30．83％（37／120）。经统计学分析经冠状动脉成像检查与经冠状动脉造影检查两种方法对冠状动脉狭窄的阳性率和冠状动脉内斑块检查中钙化率检出情况比较无明显差异。120例患者检出1572段血管节段，在行冠脉狭窄程度检查时，其对狭窄程度分级过程中均清晰显现出较多的低估或高估情况。结论128层螺旋CT冠状动脉成像技术可作为可疑冠心病患者筛查手段或低危冠心病患者的复查手段，具有可靠、简便、准确、快捷的优点。

目的：探讨动态增强MRI与乳腺X线摄影在诊断乳腺病变中的应用价值。方法乳腺病变患者应用动态增强MRI与乳腺X线摄影进行检查，两种检查方法在发现病变及良恶性肿块鉴别方面的诊断能力进行对比研究。结果以病理确诊结果为金标准，计算乳腺X线摄影诊断良、恶性乳腺病变的敏感性为65．63％，特异性为70．64％，准确性为68．79％；DCE-MRI诊断良、恶性乳腺病变的敏感性为87．50％，特异性为90．83％，准确性为89．60％；经统计学分析发现DCE-MRI诊断良、恶性乳腺病变的敏感性、特异性及准确性均明显高于乳腺X线摄影，且差异具有统计学意义。结论动态增强MRI对乳腺病变的鉴别诊断效能要优于乳腺X线摄影，两种技术联合使用可以发挥优势互补的作用。

目的 探讨核磁共振扩散加权成像(MR DWI)技术在肝细胞癌诊断中的应用价值.方法 选取来我院就诊且经病理检查已证实的患有肝细胞癌的患者40例,患有肝血管瘤、肝囊肿的患者分别20例为研究对象,并选取同期来我院体检的肝脏正常的体检者20例作为健康对照组.对所有患者均进行MR扩散加权成像扫描,测定b值(扩散敏感系数)分别取50、400、800s/mm2时的信号强度、背景噪声等指标及表观扩散系数(ADC)值,比较不同b值时同-病变信号强度、质量指数及信噪比的差异,及最佳b值时不同肝脏病变的平均ADC的差异.结果 不同b值下的RM扩散加权扫描图像显示b=800s/mm2为本研究最佳肝脏扩散加权成像b值.临床应用RM扩散加权成像可以对肝细胞癌实质区和坏死区做出鉴别,且可以将肝细胞癌病症如肝血管瘤和肝囊肿等肝占位性病变相区分.结论 DWI在肝细胞癌诊断中具有特征性影像学表现,且对肝脏病变诊断具有较高检出效率和敏感性.

目的 探讨多排螺旋CT对于肺部小结节的临床诊断价值.方法 回顾性分析2013年2月至2013年4月期间我院通过多排螺旋CT对肺小结节分析确认的9例早期肺癌患者的一般资料.结果 9例患者中,经过多排螺旋CT肺小结节分析检查,考虑为肺癌,手术病理结果 为腺癌7例,鳞癌2例,且均为早期.结论 多排螺旋CT肺小结节分析对早期肺癌具有较高的诊断价值,值得临床广泛推广.