ObjectiveTo discuss the diagnosis and treatment of spontaneous carotid artery dissection (SCAD).Methods Clinical diagnosis and treatment data of 9 patients with SCAD were analyzed retrospectively.ResultsVascular ultrasound showed stenoses or occlusions of carotid artery.Angiography showed “flame-shaped ” sign in totally occluded proximal section and free intimal flap in stenoses section.One patient with total occlusion of bilateral internal carotid artery and 6 patients with total occlusion of unilateral internal carotid artery were treated with antiplatelet therapy.Two patients with incomplete occlusion of the carotid were operated with stent implantation in carotid arteries,and the clinical effect of both operations was satisfactory.ConclusionAngiography remains the gold standard in diagnosing SCAD,and stent implantation is an effective treatment of this disease.

Objective To investigate the method and clinical effect of interventional treatment on placenta increta.Methods Fifteen patients with placenta increta were treated interventionally through uterine artery.and Methotrexate 50-100 mg were superselectively infused.Then gel foam particulate or stripes were used for embolization of uterine artery.The therapeutic effect,prognosis and side effects were observed and analyzed.Results All patients underwent uterine artery embolization (UAE) .One week after UAE,curettage was successfully performed.No heavily hemorrhage nor hysterectomy occurred.Conclusion Transcatheter uterine artery intervention is simple,safe and effective with highly successful rate and has little side effects for the treatment of placenta increta.

Objective To assess the value of rigid wall and outer coarse signs in 64-slice CT for pre-operation stages of colorectal carcinoma. Methods One hundred and twenty-three colorectal carcinoma patients underwent 64-slice CT;then rigid wall and out coarse signs were evaluated respectively. The tumors were grouped according to the postoperative pathologic infiltrative depth. Two signs of the neighboring infiltrative depth groups were compared and analyzed, so as the relativity between two signs and tumor infiltrative depth. Results Among all 123 patients, 7 were Tis, 6 were T1, 14 were T2a, 16 were T2b, 75 were T3 (including 22 infiltrate to chorion and 53 infiltrate through chorion) and 5 were T4. According to the pathologic infiltrative depth, the patients were grouped into GroupⅠ: Tis+T1;GroupⅡ: T2a;Group Ⅲ: T2b;Group Ⅳ: T3a;Group Ⅴ: T3b+T4. Significant difference of the incidence of rigid wall was found between GroupⅠand Ⅱ (P=0.013), while of outer coarse between Group Ⅱ and Ⅲ (P=0.004). Coefficient correlation of rigid wall, outer coarse and the infiltrative depth of the tumor were detected (r=0.673, r=0.528, respectively, both P＜0.001), also between the two signs (r=0.725, P＜0.001). To predict the tumor of and above T1 with rigid wall and tumor of and above T3a with outer coarse, the sensitivity, specificity and accuracy was 92.30% and 79.31%, 89.09% and 69.44%, 89.43% and 76.42%, respectively. Conclusion The sign of rigid wall is valuable to distinguish the pathological changes in the tumor of and above T1, while outer coarse is better to distinguish the pathological changes of and above T2a, but not good at distinguishing tumors of T2b and T3 or above. Rigid wall and outer coarse are both in positive correlation with the infiltrative depth of the tumor, and each has different values. Combination of the two signs may be helpful to raise the accuracy for pre-operation staging of colorectal carcinoma.

Objective To estimate the clinical effect and application value of percutaneous transluminal angioplasty and stenting (PTAS) on patients with lower extremity atherosclerotic occlusive disease (LEAOD). Methods Percutaneous transluminal angioplasty (PAT) and PATS were performed on 127 patients with diabetic lower limb arteriosclerosis. Results Total achievement ratio was 97.64% (124/127). PTAS was failed in 3 patients, clinical symptoms disappeared or improved in 124 patients. The average ankle brachial index (ABI) before and after operation was 0.35 (0.11-0.58) and 0.87 (0.67-1.06), respectively. The difference in ABI before and after operation was significant (P<0.05). During 3-60 months following-up, arteria iliaca remained open in 53 patients, and no recurrence of clinical symptom was found. At 6, 12, 36 and 60 months after operation, the encumbered superficial femoral artery kept smooth bloodstream with a proportion of 97.78%, 91.11%, 84.44%, 75.56% in 45 patients in upper 2/3 segment and 89.66%, 79.31%, 72.41%, 65.52% in 29 patients in infer 1/3 segment, respectively. Conclusion Long-term vessel recanalization can be obtained effectively and haemodynamics index be remarkably improved with PTA and PTAS in LEAOD patients.

ObjectiveTo investigate the clinical value and pathological basis of peritumoral hyperenhanced rim (PHR) of renal cell carcinomas (RCCs) on CEUS.MethodsCEUS images of 53 patients with 54 renal tumors (27 RCCs,27 renal angiomyolipomas) were analyzed,and the detection and distribution of PHR were evaluated.HE staining and immunohistochemistry of CD34 were performed in tissue surrounding RCCs (TSR) to observe distribution of psuedocapsule,large vessels,and microvasculars among TSR with different modes of PHR.ResultsPHR was found only in RCCs.PHR distribution between RCCs and angiomyolipomas was statistically different (P＜0.05).Using PHR to diagnose RCC,the sensitivity,specificity,positive predictive value,negative predictive value,false positive and false negative was 44.44％ (12/27),100％ (27/27),100％ (12/12),64.29％ (27/42),0 (0/27) and 35.71％ (15/42),respectively.Pseudocapsule distribution between RCCs with PHR and RCCs without PHR was not statistically different (P＞ 0.05).There were rich large blood vessels in TSR with PHR in washin and both phases,and few or thimbleful large vessels were found in TSR without PHR in washout phase.Cancer tissue near the boundary (CTNB) of TSR had the highest microvessel density (MVD).MVD differences in different TSR with PHR were statistically different between washin and washout phases,washin and both phases,both phases with PHR and without PHR (P＜0.05),but no statistical difference was found between washout and both phases (P＞0.05).ConclusionPHR is a highly specific complementary indicator in diagnosing RCC,and it is correlated with rich blood vessels in TSR and (or) a higher MVD value in CTNB.

PET and PET/CT are the methods of displaying the functional and metabolic changes in tissues. With its high sensitivity and specificity, it can be used as a noninvasive systemic functional examination. There are significant values in its diagnosing, staging, treatment directing and prognosis assessing in the malignant lymphoma.

Early diagnosis is the key factor to improve the cure rate and the survival rate of prostate cancer. This article reviewed the main diagnostic techniques of prostate cancer and related progress in research and clinical application.

Right ventricular (RV) function is very important for patients with respiratory and cardiovascular disorders resulting in RV impairments. Since RV has complex geometry of the chamber, it is difficult to accurately measure the RV volumetric parameters with conventional imaging modalities, especially those with dilated and abnormal RV. With the emergence and wide use of new noninvasive imaging modalities in accessing the cardiac anatomy and function, real-time three-dimensional echocardiography (RT3DE), multi-detector row computed tomography (MDCT) and new MRI sequences, noninvasive quantitative assessment of the RV function has attracted more and more worldwide attention.

Objective To assess the diagnostic value of 3D-CE MRA for nutcracker syndrome (NCS).Methods The 3D-CE MRA appearances of 4 patients of NCS and control group ( 30 persons) were analyzed.Results The left kidney vein (LKV) crossed before abdominal aorta in 4 NCS patients and 30 controls- The average angle of the origin of the superior mesenteric artery (SMA) from the abdominal aorta was (84.50±3.60)° in control group,and became small (<30°) in 4 NCS patients.The distance of the origin of the SMA to the beginning of descent was (13.40±5.10) mm,and the SMA and abdominal aorta in the axial plane crossing the LKV was (16.40±5.10) mm in controls,and all decreased in 4 NCS patients whose LKV was obviously compressed.The average ratio of expansion to stenosis caliber of the LKV was 4,5 in 4 NCS patients,whereas 1.4 in the controls.Conclusion 3D-CE MRA can display relation between abdominal aorta,SMA and LKV,thus exactly diagnose the nutcracker syndrome.

Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.