Objective To explore the diagnostic value of contrast-enhanced spiral CT after low tension and drinking water in papillary carcinoma of ampulla. Methods CT manifestations of papillary carcinoma of ampulla comfirmed pathologically in 20 cases were analysed retrospectively emphasized in artery phase on contrast CT which was performed after injecting 654-2 20 mg and drinking 300~500 ml water.Results Of all the cases , only 2 cases showed tumor filling defect in the descending part of duedenum nearby pancreas on routine CT, but all the cases showed more or less tumor filling defect on contrast-enhanced spiral CT . The diameters of the tumor were between 0.8 to 2.6 cm,2 cases with head of pancreas affected,the diameters of the tumor were between 2.4 to 2.6 cm.There were 2 cases with lymph node metastasis nearby duedenum.All the cases showed expansion of gallbladder ,intrahepatic duct and choledochus expanding in the liver. Conclusion Contrast-enhanced spiral CT after low tension and drinking water is superior to routine CT in determining the size and morphosis of tumor.

A retrospective study was carried out to analyze 3 cases of renal echinococcosis confirmed by surgery and pathology in the hospital during 1999-2008.The patients were examined by 64-CT plain scan and multiple period enhancement scan.Among them,2 were multi-daughter-cyst hydatid disease,and 1 appeared as solitary one.Two cases were once misdiagnosed as renal cyst and renal hamartoma,and the other was diagnosed correctly before operation.CT signscanning combined with epidemiological information can make an accurate diagnosis for renal echinococcosis.

Objective To study the difference of image quality and radiation dose between different exposure modes with full-field digital mammography (FFDM).Methods The Fluke18-220mammographic phantom was exposed by FFDM system with different exposure modes at automatic exposure control ( AEC ) ,including contrast mode,standard mode and dose mode,and the exposure factors and radiation dose were recorded.The images on monitor with the best window width and window level were read by four independent radiologists.The images of specks groups,nylon fibers and masses was assessed by the four experienced readers at the criterion of American College of Radiology.Results The detection of specks groups,nylon fibers and masses were statistically different at the contrast mode and standard mode (F =41.321,P ＜ 0.05),further at the contrast mode and dose mode.The detection of specks groups、nylon fibers and masses were not statistically different( P ＞ 0.05 ) at standard mode and dose mode,but the radiation doses were different.The ESD at standard mode and dose mode was 4.5 and 3.15 mGy,respectively.The AGD of standard mode and dose mode was 1.18 mGy and 0.78 mGy,respectively.Conclusions The standard mode and dose mode of FFDM might be fit for most patients,especially at the dose mode.Contrast mode of FFDM should be strictly controled in use.

Objective To sum up the surgical characteristics,indications and curative effects of burst fracture by anterior decompression,bone grafting and internal fixation.Methods Since Sep 2004,6 cases with the average age of 32 who were with thoracolumbar spine burst fracture and spinal cord injury of 12-day mean time,were treated with anterior decompression,bone grafting and Z-plate steel plate internal fixation.Before the operation,pateients were classified according to the ASIA classification: 4 cases of grade C,2 cases of grade D;Kyphotic angle(Cobb)15~40?;and vertebral canal 50%~60%.Results The follow-up lasted from 6 to 16 months(average 11 months) and it was found that incision recovered better,no infection of thoracic,abdomen,no grafting loosing or braking occurred.According to the ASIA classification,the functional recovery of spinal cord was 1~2 grade.The Denis assessment showed 5 cases was light back pain,1 case needed medication from time to time but didn't affect the life and work and spine was in order.Conclusion Surgical treatment of thoracolumbar fracture by anterior decompression,bone grafting,internal fixation can provide sufficient decompression,high rate of fusion of the implanted bone,stability in the spine and vertebral body,better recovery of neurological function and satisfied curative effects.It is the best choice for thoracolumbar burst facture and spinal cord injury.

Objective To explore the levels of neuron-speciifc enolase (NSE) of the cerebrospinal lfuid (CSF) in children with convulsion. Methods Ninety children with convulsion were enrolled. According to the frequency of convulsion attack, the children were divided into brief convulsion group 51 cases and prolonged convulsion group 39 cases, further, based on the etiology, the children were divided into viral encephalitis (VE) group, idiopathic epilepsy (EP) group, and febrile convulsion (FS) group. CSF was collected within 24-48 h convulsion attack. Twenty-three children with elective surgery were selected as a control group. CSF was collected before surgery. The NSE level of CSF were measured by ELISA method and compared among groups. Results The NSE levels of CSF in prolonged convulsion group and brief convulsion group were signiifcantly higher than that in control group, while the NES levels of CSF in prolonged convulsion group were signiifcantly higher than that in brief convulsion group (all P<0.05). Among the prolong convulsion group or the brief convulsion group, the VE group had the highest NSE level of CSF, which was signiifcantly higher than EP group and FS group (all P<0.01), and the difference between EP group and FS group was not statistically signiifcant (P>0.05). Conclusions Convulsion contributed to higher NSE levers of CSF, especially in children with prolonged convulsion attack or with VE. The NSE level of CSF can be regarded as an early objective indicator of brain damage after convulsions.

Objective To study a rare CT finding of pulsatile tinnitus(FT)caused by sigmoid sinus abnormalities.Methods The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients(15 female).The median age was 45 years(24 to 63 years).The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years(median time,2.0 years).The tinnitus was at left side in 5 patients and right side in 10 patients.Fifteen patients underwent HRCT of the temporal bone.Of them,12 patients underwent cerebral CT angiography and CT venogram(CTA/CTV),and 9 patients underwent cerebral digital subtraction angiography(DSA).Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus.Of them,the tinnitus was at left side in 2 patients and right side in 7 patients.Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results On HRCT,focal bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients.On CTA/CTV,the sigmoid sinus focally protruded into the adjacent mastoid air cells and formed diverticulum in 10 patients.The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients.The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6(41.5-96.2)mm~2,it was 77.0(92.1-122.4)mm~2 in the nonmal side(Z=2.158,P=0.031).Conclusion Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus,which can be easily identified by imaging examination.