Objective To evaluate MRI appearancs and its diagnostic value on sacral insufficiency fractures.Methods Sacralinsufficiency fractures in 21 patients(19 females and 2 males,mean age 72.4 years old) with osteoporosis(n=21) and post-radiation for pelvis malignant tumors(n=7) were performed MRI examination with sagittal,axial,and coronal SE T_1WI,FSE T_2WI,and Fat-Sat FSE T_2WI,respectively.Contrast-enhanced SE T_1WI were performed in 14 patients.X-ray plain film(n=21),CT scans(n=21),and bone scans(n=14) were used to confirm each diagnosis of the fractures.Results Thirty-seven fractures of the patients were involved in the sacral alae in 16 cases(76.2%) with bilateral and 5 cases(23.8%) with unilateral.The fracture lines were demonstrated as low signalintensity on all of the sequences in 32 of 37 fractures(86.5%).The edema areas around the fracture lines were long T_1 and long T_2abnormal signal intensity in all of the fractures.The fracture lines and edema areas in 14 patients with contrast-enhancedscans demonstrated without enhancement and with inhomogeneous enhancement respectively.Three of 21 patients had multiple insufficiency fractures in other bones.Conclusion MRI is sensitive and specific in diagnosis of sacral insufficiency fracture.

Objective To study MRI manifestation of lymphoma of bone marrow. Methods Ten patients(8 males and 2 females) with lymphoma of bone were performed MRI. Two cases were primary (1 HD and 1 NHL) and 8 were secondary NHL. Results (1)Location: All cases involved axial bones; (2)Number: 9 cases involved multiple bones, only 1 primary NHL involved solitary bone; (3)Signal Intensity: The marrow infiltration were showed low and high signal intensity on T 1WI and T 2WI respectively; (4)Shape: 9 cases were showed multiple focal features, another one showed diffuse changes; (5)Pathological Fracture: 3 cases associated with pathological fractures of vertebrae. Conclusion The sensitivity of MRI was excellent for detecting marrow infiltration of lymphoma, but the specificity was poor.

Objective To study the pathogenesis of acute spinal epidural hematomas (ASEHs), MRI features, and its value on diagnosis and differential diagnosis. Methods Fifteen patients with ASEHs (8 males, 7 females, mean age 37.8 years) were reviewed. Seven of the patients were secondary to spinal injuries(5 spinal trauma, 1 post-spinal operation, and 1 post-lumbar puncture)and 8 were spontaneous. Eleven patients were confirmed by operation. MRI was performed in all patients in sagittal SE T 1WI and SE or FSE T 2WI, 12 in axial FSE T 2WI, 8 in axial SE T 1WI, and 4 in contrast-enhanced SE T 1WI. Results Fifteen ASEHs involved 18 spinal segments, 6 of the segments (6/18) in cervical spine, 9 segments (9/18) in thoracic spine, and 3 segments (3/18) in lumbar spine. The hematomas located at pre-epidural space in 7 segments (7/18) and at posterolateral epidural space in 11 segments (11/18). The craniocaudal extent of the hematomas varied from 1 to 13 vertebral levels (average 4.87 vertebral level). There were low signal intensity lines between hematomas and spinal cord in all of the cases on T 1WI. The low signal intensity line between hematoma and subarachnoid space was demonstrated in 8 cases (8/12) and 4 cases (4/15) on axial T 2WI and sagittal T 2WI, respectively. The figure of hematomas was biconvex on axial imaging in all of the cases, and long lentiform on sagittal imaging in 13 cases (13/15). The hematomas showed variable signal intensity. On T 1WI, 5 showed isointensity to cord, 6 with hyperintensity, and 4 with inhomogeneous iso-hyperintensity. On T 2WI, 5 showed hypointensity, 10 with inhomogeneous hypo-hyperintensity. There was no special MR manifestation after contrast administration. Conclusion ASEHs is a rare disorder, and MRI features are characteristic for the diagnosis and differential diagnosis.

Objective To compare CT-C + with MRI sequences in the detection of normal CS anatomy and artifacts,and to inquire into an optimal and practical methods for the CS examination.Methods Sixty cases with normal sellar region and CS were divided into three groups with each twenty cases respectively.The first group were simultaneously performed SE T 1WI,FSE T 2WI,FS SE T 1WI,GRE T 1WI,and SE T 1WIC +;The second were performed 3D SPGR and HR FSE T 2WI;And the third were performed CT-C +.Then the 8 methods were evaluated and compared each other on the efficacy in the detection of norma anatomy and artifacts.Results (1)SE T 1WIC +and CT-C +were superior to other 6 methods in the detection of Ⅲ,Ⅴ 1and Ⅵ(?

Objective To study diffusion characteristic, diffusion-weighted imaging (DWI) technique and its value in lumbar osteolytic metastases. Methods Twenty patients with lumbar osteolytic metastases and 20 controls were performed with sagittal SE T_1WI, FSE T_2WI, fat saturation FSE T_2WI(FS-FSE T_2WI)and single-shot spin-echo echoplanar DWI, respectively. Contrast noise ratios (CNRs) of the metastases on various series were compared. On DWI, signal attenuation ratios (SARs) and apparent diffusion coefficients (ADCs) of lumbar osteolytic metastases and normal vertebrae were analyzed. Results (1) Routine MRI appearance: There were 23 lesions in the 20 patients. The signal intensity of all lesions showed hypointense on SE T_1WI, hyperintense on FS-FSE T_2WI and DWI, and mixed signal intensity (5 cases), isointense (12 cases) or slight hyperintense (6 cases) on FSE T_2WI. (2) CNR: The CNRs of patient group on FSE T_2WI(5.70?3.82)were lower than those on SE T_1WI(25.62?11.73), FS-FSE T_2WI(23.37?7.48)and DWI (b=600 s/mm2)(24.69?9.87)(U values were 5.393, 6.359, and 5.547, respectively,P

Objective To explore the imaging characteristics of SAPHO syndrome in 11 cases.Methods Clinical features and imaging findings from 11 patients (6 male,5 female, 28 to 68 years old)with SAPHO syndrome were analyzed retrospectively Including DR in 9 cases, CT in 10 cases, MRI and radioisotope scanning in 3 cases. Results Multi-bones of anterior chest wall disorders were shown in 9cases on DR images including superior sternum , anterior first rib and clavicle hyperostosis. Bony fusion and bony bridge were also seen in these cases. Hyperostosis osteosclerosis, bone destruction and bony fusion of sternoclavicular articulation and first rib were shown on CT images in 9 cases. Osteosclerosis of the joint between manubrium and midsternum was seen in 1 case on CT image. Thc sign of flying sea gull was seen in 2 cases on axial anterior chest wall CT images. The disorders of anterior chest wall were bilateral in 8 cases and unilateral in 2 cases. Sacroiliitis and osteomyelitis of ilium were found accompanied in 1 case.Osteomyelitis of thoracic vertebrae were found in 2 cases, while sclerosing osteitis of lumbar vertebrae and ostearthritis of bilateral hands were observed respectively in 1 case. The thicken soft tissue surround clavicle head, thoracic vertebra disease with long T1 ,jumbly T2 and high fat suppression signal ,long T1 and short T2signal under sacroiliac joint were shown on MRI. Radioisotope scanning displayed higher radioactive uptake of radionuclides, with T shape in sternoclavicular area in 3 cases. Conclusions Multi-bones of anterior chest wall involvement was the common imaging characteristics in 11 patients. Sacroiliitis, osteomyelitis of vertebrae and ilium, sclerosing osteitis, ostearthritis of hand could be seen in some cases.

Objective:To evaluate the value of CT in the diagnosis of skeletal metastases from hepatoma.Methods:27 patients proved by clinical or pathological materials were analysed retrospectively.Results:All the lesion were osteolytic on CT scans.The most frequently involved areas were spine(26%),ribs(22%),pelvis(19%)and femur(11%).Conclusion:CT scan is superior to X-ray plain flims in showing the lesions.Most foci can be diagnosed accurately.

50 years) with occipitocervical pain.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.