Objective Application of reduced field-of-view diffusion weighted imaging (rFOV DWI) with renal clear carcino-ma, to investigate the utility of the apparent diffusion coef-ficient ( ADC) in distinguishing Fuhrman grading of renal clear cell car-cinoma RCCC .Methods 33 patients with pathologically proven RCCC who underwent preoperative MRI , including diffusion-weighted imaging with b values of 0 and 800 s/mm2 respectively , were retrospectively assessed .All of the RCCC were divided into four (Ⅰ~Ⅳ) grades according to the Fuhrman classification system , which grades Ⅰ~Ⅱwere considering of low-level group , grades Ⅲ~Ⅳwere considering of high-lever group.The utility of ADC for detecting high-grade RCCC was assessed using receiv-er operating characteristic ( ROC ) analysis .Results ADCs were significantly lower among high-grade than among low-grade ccRCC ( t =5.18 , P <0.001 ) .The area under the ROC curve for identifying high-grade ccRCC using ADC was 0.923 , with optimal thresholds , sensitivity, and specificity as follows:1.26 ×10ˉ3 mm2/s, 81.0%, 100%.There were no significance differ-ence between grade Ⅲ and Ⅳ ( t =-1.22;P =0.09 ) .And there were significance differences between grade Ⅰ and Ⅱ, grade ⅠandⅢgrade, gradeⅠand Ⅳgrade,ⅡandⅢgrade level,ⅡandⅣgrade level ( P≤0.001).Conclusion The ADC of rFOV DWI has high diagnostic efficiency in distinguishing Fuhrman grading of ccRCCC .

目的：比较小视野（rFOV）与常规弥散加权成像（DWI）对肾透明细胞癌的成像质量，探讨小视野弥散加权成像（rFOV DWI）在肾透明细胞癌诊断中的应用价值。方法收集经病理检查确诊的肾透明细胞癌患者25例，病理分级按Fuhrman核分级法分为低级别（Ⅰ、Ⅱ级）13例、高级别（Ⅲ、Ⅳ级）12例。均行rFOV DWI及常规DWI扫描，比较两种序列图像质量分级及表观扩散系数（ADC）值，比较两种序列对不同病理级别组织成像的ADC值，进行受试者工作特征（ROC）曲线分析两种序列对不同病理级别肾透明细胞癌的诊断效能。结果 rFOV DWI序列图像质量分级高于常规DWI序列图像（P＜0．01）。rFOV DWI序列的ADC值低于常规DWI（P＜0．05）。常规DWI低级别组与高级别组透明细胞癌ADC值差异具有统计学意义（P＜0．01），rFOV DWI低级别组与高级别组透明细胞癌ADC值差异亦具有统计学意义（P＜0．01）。常规DWI序列对不同级别透明细胞癌的ROC曲线下面积为0．920，最优阈值、灵敏性、特异性分别为1．28×10－3 mm2／s、76．9％、100％；rFOV DWI序列分别为0．965、1．06×10－3 mm2／s、100％、83．3％。结论 rFOV DWI序列较常规DWI序列的图像质量明显提高，且对肾透明细胞癌的分级具有较高的诊断效能。

Objective To use intravoxel incoherent motion (IVIM)diffusion-weighted imaging of renal cell carcinoma (RCC)for comparing their imaging difference,so as to provide more valuable imaging basis for guiding clinical individualized treatment.Methods A retrospective study was made in 49 patients with RCC demonstrated by surgical pathology and imaged at 3.0T MRI using 8 b values for diffusion-weighted imaging,the values of ADC and IVIM parameters were compared between different subtypes of RCC.Results The values of ADC,pseudodiffusivity coefficient (D*)and perfusion fraction (f)of clear cell RCC(ccRCC)or chromophobe RCC(chRCC)compared with papillary RCC(pRCC)had statistically significant difference (P <0.05),but the value of tissue diffusivity (D) demonstrated no significant difference.Conclusion ccRCC and chRCC are hypervascular tumors,the values of ADC and IVIM parameters were no significant difference in the solid portion between ccRCC and chRCC.The values of ADC,D*and f were lower in pRCC than those of ccRCC and chRCC.The value of D demonstrates no significant difference between common subtypes of RCC.

目前,选择性冠状动脉造影(CAG)仍是诊断冠心病的金标准,但对冠状动脉各种斑块的观察不如多层螺旋CT,因此冠状动脉CT造影(CTA)受到广大患者和医生的青睐.CTA评价冠状动脉狭窄性病变的阴性预测值、阳性预测值高[1,2],但因冠状动脉钙化斑块伪影较大,会不同程度干扰对管腔狭窄的评估.因此,本研究观察了冠状动脉CT造影中钙化伪影对管腔狭窄评估的影响.

目的：探讨钙化斑块所致管腔≥50%狭窄评价的准确程度。方法回顾性分析97例患者冠状动脉成像和冠状动脉造影检查，比较钙化斑块所致冠状动脉狭窄≥50%的64排螺旋 CT冠状动脉成像(CTCA)与冠状动脉造影(CAG)评价的差异性。结果64层螺旋CT冠状动脉成像评价冠状动脉管腔狭窄≥50%的病变中，钙化斑块所致的管腔狭窄≥50%有统计学意义(P<0.01)。结论64层螺旋 CT冠脉成像分析钙化斑块所致冠状动脉管腔≥50%狭窄误差比较大，对混合斑块、非钙化斑块所致冠状动脉管腔≥50%狭窄的评价可信度比较高。

目的 比较正常肾脏的常规视野( cFOV)和小视野( rFOV) 弥散加权成像( DWI)检测结果. 方法 选取51例(男30例、女21例)肾脏检查结果正常者,分别行cFOV DWI(360 mm ×360 mm)、rFOV1 (320 mm ×260 mm)和rFOV2(280 mm ×200 mm)DWI检查,比较3种序列的图像质量、肾皮质和髓质ADC值差异及不同性别肾皮髓质ADC值差异. 结果 DWI图像质量以rFOV1 最高,与cFOV和rFOV2 比较,P均<0.01. b值为0和1 000 ×10 -3 s/mm2 时,cFOV DWI右肾皮、髓质平均ADC值分别为2.178 ×10 -3、1.987 ×10 -3 mm2/s,rFOVl DWI为2.035 × 10 -3、1.831 ×10 -3 mm2/s,rFOV2 DWI 为1.879 ×10 -3、1.674 ×10 -3 mm2/s;肾皮质和髓质ADC值比较,P均<0.001. 不同性别三种序列肾脏皮髓质的ADC值比较均无统计学差异. 结论 正常肾脏肾皮质的ADC值高于髓质;与cFOV比较,rFOV DWI图像质量高、图像失真少.

冠状动脉钙化(CAC)为冠心病的早期征象之一,冠状动脉钙化量化与 CT 钙化积分扫描(alcification score,CS)是一种可靠的无创筛查[1]。多层螺旋 CT (Multi slice Spiral Computed Tomography,MSCT)是目前定性、定量研究 CAC的最佳无创方式,并成为临床评估冠心病的参考标准之一。国内外对 CAC的研究颇多,但对国内研究的总结性文章鲜有报道。本研究对国内学者近两年在CAC发病的分子水平、检测手段、与冠心病的关系、对冠状动脉介入治疗的影响以及其他方面的研究报道情况作一综述,以更加全面了解国内CAC研究的发展动态。

目的：探讨不同性质斑块对管腔中度以上狭窄评价的准确程度。方法回顾性分析87例患者冠状动脉成像和冠状动脉造影检查，比较不同性质斑块所致冠状动脉狭窄≥50％的CTCA与CAG评价的差异。结果64层螺旋CT冠状动脉成像评价冠状动脉管腔狭窄≥50％的病变中，钙化斑块所致的≥50％狭窄有显著差异性（ P ＜0构．05），而钙化为主斑块、混合斑块、非钙化为主斑块、非钙化斑块所致冠状动脉管腔≥50％狭窄中无显著差异（ P ＞0．05）。结论64层螺旋CT冠脉成像分析钙化斑块所致冠状动脉管腔≥50％狭窄误差比较大，对钙化为主斑块、混合斑块、非钙化为主斑块、非钙化斑块所致冠状动脉管腔≥50％狭窄的评价可信度比较高。

目的：探讨冠状动脉钙化患者钙化斑块与年龄的关系，分析不同性质斑块对冠状动脉CT血管成像（ CTCA）及冠状动脉造影（ CAG）对患者冠状动脉管腔狭窄程度评价效果的影响。方法对行CTCA检查的冠状动脉钙化患者1021例行年龄相关分析，对56例均行CTCA和CAG的患者进行冠状动脉钙化节段统计，比较不同性质斑块所致冠状动脉狭窄≥50％的CTCA与CAG评价效果的差异性。结果冠状动脉钙化与年龄呈正相关（ P＝0．000）；837个冠状动脉节段中307段存在≥50％的管腔狭窄，有钙化斑块67段，钙化为主斑块30段，混合斑块77段。 CTCA在观察斑块的性质方面优于CAG，在对冠状动脉混合斑块和钙化为主斑块的CTCA评价与CAG评价在95％的可信区间内差异性较小，对钙化斑块所致冠状动脉管腔≥50％的狭窄程度评价有统计学差异（ P均＜0．05）。结论冠状动脉钙化程度随着年龄增长而增加。与CAG比较，CTCA评价钙化斑块所致冠状动脉管腔狭窄≥50％的灵敏度高，在评价斑块性质方面优。

冠状动脉≥50％时狭窄是诊断冠心病的重要依据，冠状动脉 CTA作为无创检测冠状动脉病变的方法已被广泛接受［1］，多排 CT 的冠状动脉成像检查越来越多地应用于临床［2］。本研究对近两年冠状动脉狭窄的 CT研究进展情况按 CT设备类型分类综述，以更加全面了解国内此方面研究的最新发展动态。

Abstract:Objective To study the characteristics of distribution of gender differences of coronary artery calcification.Methods The CTA features of 2 596 patients under going CTA were analyzed retrospectively.The study included the patients’age,calcification score,region and tiring index according to gender,and carried out a statistical analysis.Results Groups with CS scored 0,1 to 10,LAD group,group under 54 years old,group aging over 75 years old and coronary single vessel disease group show no statistical significance (P >0.05).Groups with CS scored more than 11 points,group LM、LCX and RCA,group aging 55 to 64 years old, group aging 64 to 74 years old,double-vessel disease、triple-vessel disease and all coronary vessel disease group,the results show statistical significance(P <0.05).Conclusion Groups with CS scored more than 11 points,group LM、LCX and RCA,group aging 55 to 64 years old,group aging 64 to 74 years old,double-vessel disease、triple-vessel disease and all coronary vessel disease group,they have significant difference between men and women.

目的：探讨冠状动脉钙化（CAC）患者钙化积分与年龄、性别的关系。方法回顾性分析行冠状动脉 CT成像（CTA）检查的患者共3597例，将 CS＞1分为检测阳性的患者1422例按年龄分组对 CAC 进行数据统计分析。结果≤44岁、45岁～54岁、≥75岁年龄组差异无统计学意义（ P ＞0．05）；55岁～64岁、64岁～74岁年龄组差异有统计学意义（ P ＜0．05）。结论 CAC 患者钙化积分和年龄呈正相关，男性高于女性。