[Objective]To evaluate the efficacy of percutaneous kyphoplasty (PKP) in managing vertebral compression fractures due to osteoporosis(OVCF).[Method]Thirty-one OVCFs patients (46 vertebrae) undergoing PKP were retrospectively analyzed.In these patients,there were 9 males and 22 females who were from 61 to 78 years old with averaged 68 years,and the injured vertebrae were from T7 to L3.All the patients had plain X-rays and CT scan as well as MR images preoperatively.With all of the patients,local infiltration anesthesia were performed,20 were injected bilaterally while 11 unilaterally.Before and after operarion,the visual analogue scale (VAS) score was estimated and sagittal index(SI) as well as Cobb′s angle of the vertebrae were measured.The data were statistically analyzed with the method of paired t-test.[Result]The duration of follow up after operetion were 6 to 30 months with a mean of 18 months.The VAS score reduced from 8.7 before operation to 2.5 after operation (P

Objective To improve our understanding of localized Castleman's disease ( Localized Castleman's disease, LCD) ,and to improve its diagnosis and treatment. Methods Clinical characteristics and treatment of 26 LCD cases were retrospectively analyzed, and its clinical features and treatment strategies were reviewed. Results Among the 26 cases, there were 10 cases with clinical symptoms, which mainly showed local pain induced by the compression of the tumors, and 3 in the 10 cases associated with paraneoplastic pemphigus. The swollen lymph node was at a localized area, which was mostly at retroperitoneal (10 cases) and mediastinum (7 cases). The CT scan of LCD had its special characters including local calcification and necrosis. 22 cases were of hyaline vascular type, and the other 4 cases were of plasma type based on histopathologic examination. Twenty-five patients received complete tumor resection and 2 cases of them recurred after a follow-up of 5 to 206 months averaging at 48 ± 13 months. In one case the tumor adjoining vital organs deep in the mediastinum couldn't be completely resected. This patient and another with complete tumor resection recurred and received combined chemotherapy with complete tumor disappearance and were all alive without recurrence as found by follow up to May, 2010. The other patient with recurrent tumor after tumor resection didn't receive chemotherapy and died 11 years later. Conclusions LCD patients mainly have isolated lymphadenectasis, and some patients may have systemic symptom and show abnormal laboratory results. CT scan is helpful in establishing a diagnosis of LCD.Complete surgical resection offers a favorite result for this disease.

Clinical features and related information on diagnosis and treatment of 45 cases of Castleman's disease (CD) were retrospectively analyzed.Based on the clinical classification, localized CD (LCD) was found in 26 cases, multicentric CD (MCD) was found in 19 cases.Most cases of LCD presented the symptoms of compression, while MCD had complicated and non-specific clinical manifestations, making the early diagnosis more difficult.All 26 cases with LCD underwent surgery, among which only 2 cases relapsed.Sixteen out of 19 patients with MCD were treated with glucocorticoids or combined chemotherapy, and 14 cases achieved complete or partial remission.The results show that patients with CD have variant manifestation and the diagnosis depend on CT scan or histopathology examination.Most LCD can be cured by complete surgical resection, and MCD can achieve remission by the treatment with glucocorticoids or combined chemotherapy.

Objective To explore the value of MR dynamic contrast-enhancement in diagnosis and differential diagnosis of infiltrating ductal carcinoma of breast at 3.0T MR magneton.Methods 17 cases of breast infiltrating ductal carcinoma underwent plain MRI and MR dynamic contrast-enhanced scan using 3.0T MR scanners with dedicated breast coil.All cases were confirmed by surgery and pathology.MRI signal intensity,morphology and hemodynamic characteristics of lesions were analysed.Results 17 breast infiltrating ductal carcinomas in 17 cases all appeared as masses,low(8/17)or equal(9/17)signal intensity on T_1WI,high(14/17)or equal(3/17)signal intensity on T_2WI.On morphology,the lesions were irregular and lobulated in shape(82.4%,14/17);undefinite margins(12/17)or non-smooth margins(15/17),glitch sign or astral sign(7/17);the lesions showed non-uniform marked enhancement(10/17)or ring enhancement(5/17)after intravenous administration of contrast agent.82.4%(14/17)of the lesions,the blood vessels could be seen gathering around the lesions on the maximum intensity projection(MIP)image.On hemodynamics,the early enhanced ratio for all cases was over 90%;88.2%(15/17)of the lesions,peak enhancement was less than three minutes;the time-signal intensity curve of the lesions appeared as type Ⅱ was 35.3%(6/17)and type Ⅲ was 58.8%(10/17)mostly.Conclusion Dynamic contrast-enhanced MRI manifestations of breast infiltrating ductal carcinoma are of certain characteristics,which may contribute to the diagnosis and differential diagnosis.

Objective To explore the CT and MRI features of chordoma and analysis misdiagnosis.Methods The CT and MRI imaging data were analyzed retrospectively in 1 8 patients with chordoma.The imaging findings of the preoperative misdiagnosed lesions were analyzed and summarized.Results 1 2 cases were diagnosed correctly preoperatively,6 cases were misdiagnosed.Chordoma was located in the skull base in 9 cases,in the sacrum in 8 cases,and in cervical vertebrae in 1 case.CT and MRI showed oval or round shape lesions in 12,and irregular shape in 6.14 cases of them displayed clear boundary,4 cases displayed unclear boundary.CT showed soluble osseous bone destruction and uneven isodensity or slightly low density mass.Spot or lamellar shaped calcifications or residual substances of bone were found around or inside of the lesions in 9 cases.MRI showed equal or low signal intensity on T1 WI and high signal intensely on T2 WI.After the CT and MRI contrast enhancement,mass showed mild-to-moderate heterogeneity enhancement. Conclusion Chordoma has certain characteristics on CT and MRI imaging.The combination use of CT and MRI scans has an important value in localization quantitative and qualitative diagnosis of chordoma.

Objective To evaluate the value of 128-slice CT on locating the obstruction site of the upper airway in obstructive sleep apnea hypopnea syndrome (OSAHS)patients by three-dimensional reconstruction technology.Methods There were 52 patients with OSAHS diagnosed by the PSG and 32 cases of healthy volunteers in our hospital.All objects were performed 128-slice CT scan of the upper airway during awake state,and those patients’upper airways were scaned on Muller test.The airway volume of the ret-ropalatal region,retroglottal region and epiglottal region,and the total length of upper airway were measured,and statistical analysis of the each index was obtained.Results During awake state,compared with the control group,the length of upper airway in OSAHS patients increased significantly(P <0.001).Compared with the awake state,OSAHS patients’airway volume of the retropalatal region, retroglottal region and the total airway volume on the Muller test were reduced significantly(P <0.001).OSAHS patients’upper air-way length was correlated negatively to the average MSaO 2 (r=-0.33,P <0.05).Conclusion The three-dimensional reconstruc-tion of upper airway on 128-slice CT can evaluate the position and degree of the obstruction site in OSAHS patients’upper airway better,which has important significance to guide clinical treatment.

Objective To discuss the clinical diagnostic and guiding treatment value of changed positions of hyoid bonein the upper airway of patients with obstructive sleep apnea hypopnea syndrome. Methods 128-slice computed tomography was performed for 52 patients with severe OSAHS and 32normal healthy people to measure thehyoid bone in the upper airway in sober state and Muller maneuver. The correlationsbetweenthese indexes were analyzed under linear relation. Results (1)In comparison of the Muller maneuver with sober state , chinnodules and palatal plane to the hyoid in the OSAHS group were statistically higher than the healthy controlgroup (P < 0.001). (2)The distance of hyoid to chinnodules in the OSAHS group was significantlylonger and greater than that of the healthy control group (P < 0.001).(3)The distance of palatal plane to the hyoid was positively correlated with AHI , while thedistances of palatal plane andchinnodules to the hyoidwere both negatively correlated with MSaO2. Conclusion The changes ofhyoid positionare indicative for the clinical diagnosis and is helpful for the guidance of clinical treatment of OSAHS.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.

OBJECTIVE: To discuss the soft palate, hard palate and mandibule for the pathogenesis and clinical treatment of patients who have obstructive sleep apnea hypopnea syndrome. METHOD: There were 52 patients with OSAHS diagnosed by the PSG and 32 cases of normal healthy volunteers in our hospital. All objects were given 128 slice spiral CT scan of the upper airway. We measured the related indexes of the soft palate, hard palate and mandible, then analysed statistical differences between them and did Pearson correlation analysis with apnea hypoventilation index (AHI), average blood oxygen saturation (MSaO2) in PSG. RESULT: Compared with the control group, the soft palate length [(37.93 ± 5.20)mm VS (33.52 ± 4.25)mm] and the distance between mandible with cervical vertebra [(75.00 ± 7.10)mm VS (69.93 ± 5.58)mm] increased significantly, but the distance of trailing edge of hard palate to inferior margin of slope significantly reduced [(42.57 ± 4.52)mm VS (45.80 ± 2.94)mm, P < 0.01] in patients with OSAHS. Each measurement associated with AHI and MSaO2 had no significant correlation (P > 0.05). CONCLUSION The soft palate, hard palate and mandibular are some of the important risk factors of OSAHS, and they also have reference value for the choice of clinical treatment operation. Preoperative CT examination can offer help in the treatment of OSAHS.
Case-Control Studies ; Humans ; Mandible ; anatomy & histology ; Oximetry ; Palate, Hard ; anatomy & histology ; Palate, Soft ; anatomy & histology ; Sleep Apnea, Obstructive ; diagnosis ; Tomography, Spiral Computed

Objective To explore the diagnostic value of multi-slice spiral CT in clinical stage of nasopharyngeal fi-broangioma. Methods The clinical data and imaging findings of CT in 40 patients with nasopharyngeal fibroangioma confirmed by operation and pathologic examination were retrospectively analyzed. The size, shape, density, boundary, strengthen and the changes of the adjacent structure of the mass were observed and analyzed. Results According to Radkowski classification, 3 cases were evaluated as stageⅠa, 9 cases were evaluated as stage Ⅰb, 8 cases were eval-uated as stage IIa, 10 cases were evaluated as stage IIb, 5 cases were evaluated as stage IIc, 3 cases were evaluated as stageⅢa and 2 cases were evaluated as stageⅢb. Most corrosive location were in nasopharynx, pterygopalatine fos-sa, sphenoid sinus, maxillary sinus, eye socket and followed occurred in fratemporal fossa, and few corrosive location were in sclerotin of pars buccalis, cavernous sinus and basis cranii. The tumor showed uniform and slightly lower den-sity but obviously strengthening after administration of Gd-DTPA. Conclusion Multi-slice spiral CT has important clinical value for the clinical stage diagnosis, preoperative localization, evaluating the postoperative extent and the prognosis of the nasopharyngeal fibroangioma.