Objective To evaluate the diagnostic accuracy of digital subtraction bone removal CT angiography(DS-BR-CTA)and dual energy bone removal CTA(DE-CTA)compared with conventional and rotational DSA.Methods A total of 264 patients underwent 3D-DSA were enrolled,190 of them underwent also DS-BR-CTA,while 74 underwent DE-CTA as well.Aneurysms detected with DS-BR-CTA and DE-CTA were analyzed compared with 3D-DSA on per-patient and per-aneurysm basis.The sensitivity,specificity,positive predictive value and negative predictive value of two methods for diagnosis of aneurysm were calculated.Results Taking DSA as the standard,the sensitivity and specificity of DS-BR-CTA to detect intracranial aneurysms was 96.90% and 98.36% on per-patient basis,while 97.37% and 99.97% on per-aneurysm basis,and the sensitivity and specificity for the detection of aneurysm ≤3 mm was 88.89% and 98.36%.The sensitivity and specificity of DS-BR-CTA to detect intracranial aneurysms was 98.25% and 100% on per-patient basis,95.52% and 100% on per-aneurysm basis,and the sensitivity and specificity for the detection of aneurysm ≤3 mm was 90.91% and 100%.Conclusion DE-CTA has a comparable diagnostic accuracy with DS-BR-CTA to diagnose intracranial aneurysms,and can be used in the routine workflow for detection of intracranial aneurysms.
Objective:To analyzed the appearance of cerebral developmental venous anomaly(DVA)on CT MRI and DSA imaging and to evaluate imaging diagnostic value.Methods:The imaging appearance of 17 DVA cases were analyzed,including MRI imaging in 15 cases,CT in 6 cases and DSA in 4 cases.The location,type,draining vein and others of DVA were evaluated.Results:17 cases with 21 DVA included supratentorial in 7 and infra tentorial in 14 and 4 case associated CA.The characteristic Caput Medusas imaging appearance of DVA and numerous radiation medullary veins were gathered together into one or two larger drain veins and flowed into superficial or deeper veins were showed on all CT and MRI enhancement imaging or DSA.Conclusion:Postcontrast CT,MRI and DSA are effective methods for DVA diagnosis and evaluation,and DSA is the golden standard in differential diagnosis with other vascular malformation.With multi sequence,MRI could be evaluated DVA and associated parenchymal abnormalities overall,it is the most commonly method.
Objective To explore the correlation between the manifestation of MRI and pathology, and to improve the knowledge in spinal cord ependymal neoplasms. Methods The MRI manifestation, pathology, operational records and follow-up data were analyzed retrospectively in 44 cases with spinal cord ependymal neoplasms. Results Among 44 cases of spinal cord ependymal neoplasms, 24 were ependymoma (WHO gradeⅡ); 10 anaplastic ependymomas (WHO grade Ⅲ) and 8 mucinous papillary ependymomas (WHO gradeⅠ); 2 mixed type glioma with ependymas (WHO grade Ⅱ). There were 19 lesions in the cervical, 6 in the thoracic, and 19 in the lumbar and sacral segments in MRI. Clear tumor margins were seen in 84.1% (37/44) of all patients; on T1-weighted MRI, most were isointensive or hypointensive signals. Most tumors were hyperintense or confounding on T2-weighted MRI. 86.4% (38/44) enchanced markedly; 77.3% (34/44) were heterogeneous enchancement. Rostral and caudal cysts were seen in 43.2% (19/44) of all patients. Well-defined margins, though 90.9% (40/44) of all patients lacking true tumor envelopes, were seen in 72.7% (32/44) of the operational findings. Statistical analysis indicated that pathology types and grades in spinal cord ependymal neoplasms were correlated with lesion positions (P0.05), operational residua with tumor margins in operation or MRI, without correlation with pathologial types and grades (P0.05). No significant statistical difference was found in tumor margins between operation and MRI. Conclusion The spinal cord ependymal neoplasms show characteristic manifestations on MRI. MRI can show the intra-tumor structures and the extent of the tumor very well, which is helpful in differential diagnosis, respectability prediction metastases detection and eveluation of the response to treatment.
Objective:The purpose of this study was to evaluated the accuracy of positron emission tomography(PET)/computer tomography(CT) imaging in the diagnosis of primary lung cancer.Methods:Forty-three cases of pathologically proved primary lung cancer underwent early and dual time point Fluorodeoxyglucose PET/CT scanning.The standardized uptake values(SUV) were calculated for both time points.The rates of accuracy and false negative of PET,CT and PET/CT were calculated(respectively.) Results:Among the 43 cases of primary lung cancer,40 cases showed SUV2.5,and the other 3 cases showed SUV2.5.The rates of accuracy and false negative were 93.0 % and 7.0 %,(respectively.)Dual time point scanning with a threshold value of 10 % increase resulted in the rates of(accuracy) and false negative as 68.5 % and 31.5 %,respectively.The other rates of accuracy and false negative were 83.7 % and 16.3 % for CT,86.0% and 0% for PET/CT,respectively.Conclusion:(PET/CT) scanning is valuable for the diagnosis of primary lung cancer.Dual time point PET/CT scanning may be helpful in differential diagnosis.
【Objective】To approach the difficulties in laparoscopic common bile duct exploration (LCBDE),in order to choose the appropriate laparoscopic surgery cases with cholelithiasis. 【Methods】To analyse the reasons of reversed to open operation in 31 cases who have been performed LCBDE retrospectively,meanwhile the pre-operative radiography were studied.【Results】31 in 213 cases have been converted to open surgery (14.5%),of which 13 cases for abdominal adhesion,11 cases for incomplete taken stone or removed difficulty by fiber biliary endoscopy,5 cases for beyond control hemorrhage,the other 2 cases were due to other causes (1 case for severe cholangitis and 1 case for common bile duct cancer),account for 42%,35.4%,16.1% and 6.5%. 【Conclusions】Although there are numerous difficulties,LCBDE is feasible. However,to guarantee the smooth progress of surgery,we need to select the appropriate case.
Objective To investigate the electro-physiological substrates of the alteration of regional homogeneity(ReHo)in mesial temporal lobe epilepsy(mTLE).Methods Six patients with unilateral mTLE underwent simultaneous electroencephalogram(EEG)-functional MRI(fMRI).Twenty-one normal controls underwent fMRI only.For facilitating the performance of statistical analysis,all the fMRI data were segmented to 42 sections.Then,a correlation analysis was conducted between the ReHo value and the number of the interictal epileptic discharges during each section.Results Compared with normal controls,ReHo increased obviously in right hippocampus,right temporal lobe and bilateral lobi parietalis.Significant positive correlation was found between the ReHo value of ipsilateral mesial temporal lobe,thalamus,pons and the number of the interictal epileptic discharges.Conclusion The increased ReHo value in mTLE is related to the occurrence of interictal epileptic discharges,suggesting that the epileptic activity is the physiological substrates of the alteration of ReHo in epilepsy,therefore supplying the biological evidence for the application of the ReHo analysis in the epileptic activity detection by using fMRI.
Purpose: Hepatocellular carcinoma(HCC) is one of the most common malignancies in China, but its 18F-FDG-PET diagnosis was reported far from satisfactory. The aim of this study was to evaluate the value of 18F-2-fluoro-2-deoxy-D-glucose(18FDG) PET/CT in patients with HCC. Materials and Methods: 28 patients were divided into 3 groups. In Group 1, 13 HCCs had not received any treatment before; In Group 2, 9 cases were confirmed to have benign liver tumors. The remaining 6 patients (Group 3)were coming for follow-up post therapy for their HCCs. Images were compared with the histopathologic findings at surgery or with clinical follow-up findings. The sensitivity of 18FDG PET/CT was calculated and the influencing factors of standardized uptake value (suv) were analyzed. Results: The 18FDG PET/CT findings in Group 1 showed 7 ‘hot’ lesions in liver,(TypeⅠ), 4 and 1 of equal or less uptake than surrounding liver tissue( TypeⅡand Type Ⅲ), respectively. None in Group 2 showed TypeⅠuptake, but 4 TypeⅡand 5 Type Ⅲ, respectively. The sensitivity of 18FDG PET/CT diagnosis of HCC was 53.8%. The SUV had the relationship with the biological properties of HCCs. Five HCCs in Group 3 had TypeⅠ uptake, the remaining one had Type Ⅲ uptakes. The SUV related with the tumor residue. Conclusion: 18FDG PET/CT had obvious advantages in evaluating the biological properties of HCCs and in monitoring the response after therapy.
Objective:To determine the characteristics on DSA and to discover the pathogenesis of bone marrow edema in patients of non-traumatic avascular necrosis of the femoral head.Methods:Thirty-five patients with 55 hips showing avasculer necrosis of the femoral head were divieded into two groups according to with or without bone marrow edema pattern on MR images,then compared with the result of DSA accordingly.Results:Thirty-six of 37 hips with marrow edema around focal osteonecrsis on initial MR inages showed congestion on DSA,one showed no congestion;whereas only three of 18 hips without bone marrow edema showed congestion,fifteen showed no congestion.Conclusion:The bone marrow edema around focal osteonecrosis on magnetic resonance images is strongly associated with medullary cavity congestion on DSA and assocoated with the grading of ANFH,the form of bone marrow edema may associated with blockage of the venous outflow or high pressure in bone medullary.
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