Objective To study the value and the superiority of multi-slice spiral CT angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing pulmonary embolism (PE). Methods CT pulmonary angiography (CTPA) and lower limb deep vein venography were performed in all suspected patients of PE with single or multi-slice spiral CT.The number and type of the embolus were calculated.Results Among the 44 patents of pulmonary embolism,34 patents had both PE and deep vein thrombo embolism (DVT) ,10 patients had only PE.The total ratio of the PE diagnosed with single slice spiral CT and multi-slice spiral CT was 12.1% and 19.0%, respectively , there were statistical significance, (P=0.004); the ratio of the PE upon deuto-segment pulmonary arteries was 25.3% and 29.7%, respectively, there was no statistical significance, (P=0.104); the ratio of the PE below deuto-segment pulmonary arteries was 1.1% and 10.2%, respectively, there was statistical significance, (P=0.000).Conclusion The technique of angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing PE is a non-invasive, fast, sensitive and specific method for PE. Multi-slice spiral CT is superior to single slice spiral CT in the diagnosis of PE.

Objective To study the value in predicting the postoperative pulmonary function of the patient with quantitative MSCT.Methods 16-slice spiral CT scanning of lung was performed in 24 patients with pulmonary carcinoma before and after the operation during eupnea.Then the postoperative forced expiratory volume in one second(FEV1) and forced vital capacity(FVC)were calculated according to the preoperative lung capacity which was measured by quantitative MSCT,FEV1 and FVC which were measured by pulmonary functional test(PFT),then the results of FEV1 and FVC predicted by MSCT were compared with that two months later after operation.Results There was significant relativity in FEV1 and FVC between predicted by MSCT before operation and measured by PFT after operation ( P was 0.190 and 0.563 respectively).Conclusion Quantitative MSCT can predict the postoperative pulmonary function exactly,which provides dependable reference data for lung resection in the patients.with pulmonary carcinoma.

Purpose With the progression of brain tissue aging, the transport and drainage characteristics of metabolites and secretory products for neurons in extracellular space occurs irreversible change. This paper aims to investigate and quantify MR tracer diffusion characteristics in cerebral interstitial fluid of elderly SD rats. Materials and Methods MR contrast agent Gd-DTPA was injected into the caudate nucleus of two groups of rats including 8 in experimental group (15-17 month old) and 15 in control group (7-10 month old). MR scan was performed at 0.25 h, 0.5 h, 1 h, 2 h, 3 h and 4 h to observe the dynamic distribution in the caudate and measure the diffusion and clearance rate. Results There was no statistically significant difference in diffusion rate and D* between control group with (3.32±0.70)×10-4 mm2/s and experimental group with (3.25±0.46)×10-4 mm2/s (t=1.739, P>0.05). The clearance rate k' was significantly different between control group (0.62±0.12)×10-4/s and experimental group (0.29±0.08)×10-4/s (t=11.602, P<0.05). Conclusion The degeneration of aging brain tissue changes the composition of extracellular space resulting in decreased speed of ISF clearance. This may cause accumulation of metabolites which eventually triggers a variety of age-related diseases.

Objective To explore the value of MRI T2*quantification of visceral iron deposition in patients with β-thalassemia major. Methods A total of one hundred and two patients with β-thalassemia major were retrospectively analyzed. They underwent genetic testing and the cardiac and (or) abdominal MRI scanning. Among them, 47 patients underwent splenectomy operation, 95 patients underwent cardiac MRI scanning, 102 underwent abdominal MRI scanning for their livers, pancreases and kidneys, and 55 underwent splenic MRI scanning. The T2* values of the hearts, livers, pancreases and kidneys were measured, meanwhile the liver iron concentrations (LIC) were measured. The levels of serum ferritin (SF) patients were measured in 81 patients. The Spearman rank correlation was employed to analyze the relationship between SF, LIC, age and each organs T2* values. Independent sample t test (normal distribution) or the Mann- Whitney U test (non-normal distribution) were used to compare the hepatic, cardiac, renal and splenic T2* values differences between patients with splenectomy and those without. Results Serum ferritin were highly positively correlated with LIC, moderately correlatied with age, moderately negatively correlated with hepatic and pancreatic T2* values, with r values of 0.833, 0.537,-0.623 and -0.403, respectively (P<0.05). There was significantly negative correlation between hepatic T2*value and LIC (r=-0.925, P<0.01). There were moderately correlations between hepatic and splenic T2*values (r=0.634, P<0.01), hepatic and pancreatic T2*values (r=0.530, P<0.01). However, those T2*values of other organs had no correlation (P>0.05). The hepatic and pancreatic T2*values were reduced (P<0.05), the renal T2* value was increased (P<0.05) in the patients with splenectomy. The cardiac T2* value was not statistically different (P>0.05). Conclusions The patients with β-thalassemia major have prone to suffer from excessive iron deposition in the heart and abdominal organs. The technology of MRI quantification of T2*values could reflect the body iron overload.

ObjectiveTo investigate whether the effects of trait anxiety on decision making under risk　and decision making under ambiguity are the same.Methods 185 subjects were grouped into high trait anxiety　(HTA),medium trait anxiety (MTA) and low trait anxiety (LTA) groups based on their trait anxiety scores.All　subjects were assessed by the Iowa Gambling Task (IGT),the Game of Dice Task (GDT) and the Wisconsin Card　Sorting Task (WCST).ResultsHTA and LTA subjects compared to MTA subjects were impaired in decision　making under ambiguity( MTA:2.08 ± 18.51 ; HTA:5.62 ± 20.35 ; LTA:5.94 ± 10.96,F =3.86,P =0.023 ),the relation between trait anxiety and IGT performance resembled the curved shape of an inverted U.Performances　of the three groups had no differences on decision making under risk (MTA:4.55 ± 10.17; HTA:4.00 ± 9.75;LTA:4.33 ± 11.20,F=0.03,P=0.968 ),and had no differences on executive functions and feedback processing.ConclusionTrait anxiety has effect on decision making under ambiguity,but not decision making under risk.The results provide support for the idea that decision making under ambiguity and decision making under risk are　different processes,moreover,support and extend the view that emotion has an impact on cognitive function.

Objective To evaluate the incremental value of 131I SPECT/CT over 131I whole body scan (WBS) in the patients with DTC.Methods A total of 97 patients with DTC (31 males,66 females,mean age:44.1 years,age range:17 to 74 years) were retrospectively reviewed.All subjects underwent 131I WBS and SPECT/CT after 131I treatment.The images were interpreted by 2 experienced nuclear medicine physicians.The final diagnosis was based on the pathologic findings and clinical follow-up.The diagnostic accuracies between 131I WBS and 131I SPECT/CT were compared using x2 test with SPSS 13.0.Results 131I WBS detected 175 lesions (128 neck and 47 distant lesions),while 131I SPECT/CT found 176 lesions (128 neck and 48 distant lesions).Out of the 176 lesions,78 were confirmed as benign and 95 as malignant,including 51 lesions in thyroid bed,67 cervical lymph nodes or local residual lesions,7 lesions related to local physiological uptake,30 distant metastases and 18 distant foci due to physiological uptake.The other 3 lesions were still in follow-up.The sensitivity and specificity of 131 I WBS was 73.7％ (70/95) and 78.2％ (61/78),respectively.The accuracy of 131I WBS (106/173,61.3％) was lower than that of 131I SPECT/CT (171/173,98.8％; x2=72.3,P＜0.05).131I SPECT/CT corrected the diagnosis of 131I WBS in 67 lesions,including 37 local lesions (37/128,28.9％) and 30 (30/48,62.5％) distant metastases.The sources of error for the 67 lesions were due to wrong location (n =27) or wrong characterization (n =40).Compared with 131I WBS,131I SPECT/CT changed the location in 27 lesions,clinical staging in 8 cases and therapeutic strategy in 14 cases.Conclusions 131 I SPECT/CT could improve the differentiation of malignant local lesions from residual thyroid,of distant metastatic lymph node,lung or bone lesions from physiological uptake.Such incremental values would be valuable to the management of DTC patients compared with WBS.

Objective To investigate the effect of thrombin and hemoglobin on aquaporin (AQP) and the correlation between AQP and hydrocephalus.Methods Eighty-four clean grade healthy male SD rats were randomly divided into 3 groups:a control group,a thrombin group,and a hemoglobin group using the random number table method.A hydrocephalus model was induced by injecting isotonic saline (0.3 ml),thrombin (0.3 ml[10,U/ml]) and hemoglobin (0.3 ml[150 mg/ml]),respectively into the cisterna magna.According to the deficiency and complement way,each group maintained 24 rats.The relative area of the lateral ventricles,the expression of AQP1 and AQP4,and the correlation between AQP and the area of the lateral ventricles were observed at 1,3,7,and 14 d after molding.Results (1) Compared with the control group,both the thrombin group and hemoglobin group showed hydrocephalus at 1 ,3 ,7 and 14 d,and they were most obvious at 1 day (6.94±0.19% and 6.58±0.15% vs.3.40±0.13%,6.06±0.12% and 5.79±0.09% vs.3.55±0.15%,5.80±0.13% and 5.58±0.08% vs.3.78±0.18%,5.66±0.14% and 5.47±0.13% vs.3.52±0.18 %,respectively).There were significant differences (all P<0.01).(2) The increase of AQP1 was mainly in the basal membrane and apical membrane of ventricular choroid plexus epithelial cells,and the increase of AQP4 was mainly in the ependymal cell of ventricle.The relative expression levels of AQP1 and AQP4 at 1,3,7,and 14 d in the control group were 1.09±0.07 and 1.30±0.15,0.91±0.06 and 1.18±0.12,1.33±0.17 and 1.16±0.08,1.22±0.11 and 1.00±0.10,respectively;the thrombin group were 4.40±0.14 and 3.69±0.11,3.88±0.11 and 3.17±0.07,3.55±0.07 and 2.86±0.13,and 3.36±0.07 and 2.70±0.07,respectively,the hemoglobin group were 4.24±0.07 and 3.55±0.10,3.77±0.08 and 3.04±0.09,3.46±0.07 and 2.76±0.08,and 3.31±0.10 and 2.62±0.08,respectively;the relative expression levels of AQP1 and AQP4 of the thrombin group and hemoglobin group at each time point were significantly higher than those of the control group.There were significant differences among the groups (all P<0.01).There were no significant differences in the relative expression levels of AQP1 and AQP4 mRNAs in the hemoglobin group at each time point (P>0.05);in the thrombin group and hemoglobin group,compared with those at 1 d,the expression levels of AQP1 and AQP4 at 3,7,and 14 d were significantly decreased (all P<0.01);compared with those at 3 d,AQP1 was decreased significantly at 7 and 14 d (P<0.05).The differences were statistically significant (P<0.05).(3) The relative expression levels of AQP1 (r=0.983,P<0.01) and AQP4 (r=0.987,P<0.01) in the thrombin group at each time point were positively correlated with the contralateral ventricular area;and the relative expression levels of AQP1 (r=0.964,P<0.01) and AQP4 (r=0.962,P<0.01) in the hemoglobin group at each time point were positively correlated with the contralateral ventricular area Conclusions After injecting thrombin and hemoglobin into subarachnoid space,it could cause the increased expression levels of AQP1 and AQP4 of ventricles and their surrounding areas.Thrombin and hemoglobin may be the important mediating factors of hydrocephalus after subarachnoid hemorrhage.

Objective To quantify the heart and liver iron overload in thalassemia patients and discuss the relationship of iron deposition between them,and to evaluate the accuracy of using hepatic iron concentration ＞ 15 mg/g dry tissue as an index to predict heart iron deposition as used in clinical practice.Methods One hundred and three transfusion-dependent patients with thalassemia,who were older than 5 years,underwent MRI heart and liver measurement to obtain T2 * values.The Spearman rank correlation was employed to analyze the relationship between cardiac T2 * and liver T2 * values.By using liver T2 * =0.96 ms as standard setting,patients were divided into two groups,and the differences of cardiac T2 * values between the two groups were compared by Wilcoxon rank sum test.Then by using cardiac T2 * =10,20 ms as standard setting,patients were divided into 3 groups,and the differences of liver T2 * values among the 3 groups were compared by Wilcoxon rank sum test.The ROC curves were drawn to predict the possibility of using hepatic iron concentration ＞ 15 mg/g dry tissue as an index of cardiac iron deposition.Results The cardiac and liver T2 * values of the 103 thalassemia patients showed low correlation(r =0.453,P =0.000).With the liver T2 * value reduced,the cardiac T2* value did not decline proportionally.The cardiac T2 * value range and median of 25 patients' group whose liver T2 * ＜ 0.96 ms were 4.70 to 41.70 ms and 12.10 ms,respectively.The cardiac T2 * value range and the median of 78 patients' group whose liver T2 * ＞ 0.96 ms were 4.80 to 51.10 ms and 26.10 ms,respectively.There was statistically significant difference between those of the two groups(Z =-3.566,P =0.000).The liver T2 * value range and the median of 20 patients'group whose cardiac T2 * ＜ 10 ms was 0.68 to 3.83 ms and 1.06 ms,respectively.The liver T2 * value range and the median of 58 patients' group whose cardiac T2 * ≥20 ms were 0.74 to 14.80 ms and 1.76 ms,respectively.There was statistical difference between those of the two groups(Z =-3.553,P =0.000).The liver T2 * value range and the median of 25 patients' group with cardiac 10 ms≤T2 * ＜20 ms were 0.69 to 13.59 ms and 0.99 ms,respectively.The values were significantly different from that of T2* ≥20 ms group(Z =-3.951,P =0.000).The liver T2 * values of cardiac T2* ＜ 10 ms group was not statistically different from that of 10 ms≤T2* ＜20 ms group(Z =-0.046,P =0.964).To predict cardiac iron deposition with the index of hepatic iron concentration ＞ 15 mg/g dry tissue,the area under the ROC curve was 0.771.The sensibility was 42.2％,the specificity was 89.7％.Conclusions There is low correlation between heart and liver iron level in thalassemia patients with long-term transfusions.Patients with hepatic iron concentration ＞ 15 mg/g dry tissue have a higher incidence of heart iron deposition,but the accuracy of using hepatic iron concentration as an index to predict myocardial iron deposition is low to moderate.

Purpose To investigate the value of contrast-enhanced ultrasound (CEUS) in monitoring hepatic parenchymal perfusion quantitatively during resuscitation after hemorrhagic shock (HS).Materials and Methods Forty-five labeled rabbits were randomly divided into five groups.One group was normal control group,and the other four groups were established reversible HS modes by using modified Wiggers method.In the four model groups,one group was chosen as the shock group,and the other three groups received colloid (hydroxyethyl starch) for resuscitation.The three resuscitation groups were named as 1 h group,4 h group,24 h group according to resuscitation time.The arterial blood was collected for testing blood lactic acid (LAC) in each group.The CEUS was performed to form time-intensity curve (TIC) for quantitative analysis.At the end of the experiment,the rabbits were sacrificed and the liver tissues were examined for pathology.Results Compared with the normal control group,the arrival time (AT) and time to peak (TTP) of the shock group were significantly prolonged,and the peak intensity (PI) and area under curve (AUC) of the shock group decreased,all with significant difference (all P＜0.05);in the 1 h resuscitation group,the PI and AUC increased,and the AT decreased,all with significant difference (all P＜0.05);in the 4 h and 24 h resuscitation group,the PI and AUC increased,and the AT and TTP decreased,but all without significant difference (all P＞0.05).Compared with the shock group,the PI and AUC of the 1 h resuscitation group increased,and the AT of 1 h resuscitation group decreased,all with significant difference (all P＜0.05);all the tested parameters of the 4 h and 24 h resuscitation group were significant different (P＜0.05).Conclusion CEUS can quantitatively evaluate the changes of hepatic parenchymal perfusion during HS resuscitation,which has a certain reference for clinical treatment.

Purpose To study the value of contrast-enhanced ultrasound (CEUS) quantitative technique in evaluating the perfusion of hepatic microcirculation in acute hemorrhagic shock (HS),and to investigate the value of CEUS quantitative analysis in HS diagnosis and treatment.Materials and Methods Sixty healthy adult New Zealand white rabbits of either gender were randomly divided into three groups for establishing mild,moderate and severe HS models,respectively.Before modeling and 30 min after stable modeling,liver CEUS examination was performed,and the original images were stored.Blood test of lactic acid,liver function,and liver biopsy for pathological examination were conducted after CEUS.Finally,the arrival time (AT),time to peak (TTP),rising time (RT),peak intensity (PI) and area under the curve (AUC) were analyzed offiine.Results Compared with pre-modeling,AUC decreased in mild HS group (P＜0.05);TTP and RT were delayed,but PI and AUC decreased in moderate and severe HS groups (all P＜0.05);AT was delayed in severe HS group (P＜0.05).The differences of TTP,RT,PI and AUC between the groups of mild,moderate and severe HS were significant (P＜0.05).Compared with pre-modeling,lactic acid in three HS groups increased significantly,the liver function indexes were changed to different degrees,and the degree of liver cell pathological changes was closely related to the degree of HS.Conclusion CEUS can quantitatively evaluate the changes of hepatic microcirculation induced by HS at different degrees.