Objective To explore the diagnostic value of 16-slice Spiral CT pulmonary angiography(16-SCTPA) in diagnosing pulmonary embolism(PE).Methods 13 patients suspected with PE were examined with 16-slice spiral CT pulmonary angiography.The volume data of all patients were reconstructed with the 3D techniques including multiplanar reconstruction(MPR) and maximum intensity projection(MIP),and CT features were analysed.Results In 13 patients,58 thrombosed pulmonary arterial branches were displayed by CT-PA,including 3 main pulmonary arteriae,18 lobar arteriae,22 segmental vessels,15 subsegmental or sub-subsegmental arteriae.Conclusion 16-slice Spiral CT pulmonary angiography is non-invasive,fast,and highly accurate method,it would be the modality of choice for the diagnosis of PE.

Objective To analyze the MRI findings of Wallerian degeneration in pyramidal tract after cere-bral injury for improving the diagnosis accuracy.Methods The MRI findings of Wallerian degeneration in pyramidal tract in 25 cases were analyzed in association with the primary cerebral injury.Results All the primary diseases were above the tentorium of cerebellum in 25 cases,MRI in 2 cases demonstrated a continuous thin band -like long T1 or isometric T1 and long T2 abnormal changes in pyramidal tract,hyperintensify on FLAIR and DWI.2 cases showed hypointensify on T1 WI,hyperintensify on T2 WI and FLAIR,isointensity on DWI.21 cases showed hypointensify on T1 WI,hyperintensify on T2 WI and FLAIR,isointensity or hypointensify on DWI with brainstem atrophy.Conclusion MRI is valuable in the diagnosis of Wallerian degeneration in pyramidal tract after cerebral injury.

Objective To improve the recognition and reduce the misdiagnosis of bipartite patella by analyzing and summarizing the imaging features.Methods X-ray,CT and MR images of 1 7 cases of bipartite patella were collected,imaging features were ana-lyzed and summarized.Results X-ray revealed the smooth interface of the main and accessory patella fragments with sclerotic mar-gins,the cleft was slightly wide but not sharp.CT showed the bone sclerosis of interface was mostly smooth,rough and vesicular interface could also be found in a few patients,low density soft tissue could be found in separation zone.MRI could detect the intact but thinned cartilage covering the main and accessory patella fragments,fibrous like tissues could be found in separation zone with MRI.Conclusion Imaging findings of bipartite patella are characteristic,these features are helpful in the diagnosis and differential di-agnosis of bipartite patella.

Objective To investigate the feasibility of hydrogen proton magnetic resonance spectroscopy (1 H-MRS)for detection of Wallerian degeneration of the pyramidal tract after cerebral infarction.Methods Multiple metabolic indices including NAA,Cho, Cr of the bilateral cerebral peduncle were detected by using 1 H-MRS in 1 5 patients with unilateral middle cerebral artery infarction and 1 5 age-matched healthy volunteers,NAA/Cr,Cho/Cr were also calculated.Comparing the difference between cerebral infarction group and the control group ,the ROC curve was analyzed.Results The values of NAA/Cr in the ipsilateral cerebral peduncle of cerebral infarction patients were significantly lower than that of the contralateral,and there were significant differences between the two groups(P <0.05).The values of NAA/Cr in the ipsilateral cerebral peduncle of cerebral infarction patients decreased (P <0.05),as compared with that of the control group.The area under the ROC curve was 0.947,the truncation point was 1.63.The NAA/Cr val-ues of the contralateral cerebral peduncle of cerebral infarction patients had no significant differences compared with the control group (P >0.05),the Cho/Cr values of the ipsilateral and the contralateral cerebral peduncle had no significant difference compared with the control group (P >0.05).Conclusion 1 H-MRS can detect Wallerian degeneration of the pyramidal tract after cerebral infarction.

Objective To investigate the value of the hippocampal subfield's MRI T2 signal intensity in evaluating the effect of the hydrochloric donepezil for mild cognitive impairment(MCI).Methods 20 MCI patients with hydrochloric donepezil (treatment group) and 20 patients with placebo (control group) were scanned by MRI using FSE-T2 sequence.The margin of hippocampal subfields was outlined manually for each side to measure the MRI T2 signal intensity.The relationship between hippocampal MRI T2 signal intensity and MMSE scores was analyzed in the treatment group.Results Before the treatment, there was no significant difference of the MRI T2 signal intensity between groups.After the treatment, the MRI T2 signal intensity in the bilateral head of the treatment group was significantly decreased compared with the control group(P<0.05).There was an inverse relationship between the MRI T2 signal intensity of the bilateral hippocampal head and MMSE scores in the treatment group(P<0.05).Conclusion The MRI T2 signal intensity in the bilateral hippocampal head could be regarded as a valuable marker in making clinical diagnosis and evaluating the effect of the treatment for MCI in its early stage.

Objective To apply the MRI T2 signal intensity of hippocampal subfield in patients with amnestic mild cognitive impairment (aMCI) as early imageology. Methods From October, 2014 to August, 2015, 20 aMCI patients accepted cognitive training (training group), 20 aMCI patients accepted speech communication (speech group), and 20 age-and gender-matched healthy old people (control group) were scanned with MRI using FSE-T2 sequence. The margin of hippocampal subfields were outlined manually for each side to measure the T2 sig-nal intensity. The correlation between hippocampal T2 signal intensity and the scores of Mini-Mental State Examinatlon (MMSE) was ana-lyzed in the training group. Results Before treatment, T2 signal intensity in the bilateral hippocampal head was significantly high in the aM-CI patients compared with that in the control group (P<0.05). After treatment, T2 signal intensity in left hippocampal head decreased in the training group compared with that in the speech group (P<0.05), similar to the control group (P>0.05). There was negative correlation be-tween left hippocampal head's T2 signal intensity and the scores of MMSE in the training group before and after treatment (r=-0.61, r=-0.54, P<0.05). Conclusion The T2 signal intensity in left hippocampal head may respond to the cognitive function in patients with aMCI in the early stage, that could be used for diagnosis and evaluation in clinic.

Objective To describe the epidemiological and clinical characteristics of fibrous dysplasia of bone admitted to a single center in the past 30 years. Methods We analyzed the clinical features of 744 patients with bone fibrous dysplasia diagnosed by pathology, including age, gender, disease location, monostotic or polyostotic lesions, pathological fracture and malignant transformation. Results There were 1183 lesions in 744 patients. The mean age at admission was 31.1±13.5 years old. The ratio of male to female was close to 1:1. The most common site was the lower extremities (916(77.4%)), followed by the upper extremities (106(9.0%)). The most common sites of lower extremities were the femur (645(54.5%)) and the tibia (224(18.9%)). Polyostotic cases accounted for 25.4%, and monostotic cases accounted for 74.6%. Pathological fracture occurred in 163 (13.8%) patients. There were 6 (0.8%) patients with malignant transformation. The mean age was 40.5 years old. The mean time of malignant transformation was 7.7 years. Conclusion Fibrous dysplasia of bone is a rare group of benign bone tumors, with typical epidemiological and clinical features.

Objective To determine the prosthesis survival and limb function after revision of global modular replacement system (GMRS) tumor prosthesis. Methods We retrospectively analyzed the clinical data of 16 patients who developed aseptic loosening of lower extremity tumor prosthesis and subsequently received revision with GMRS from 2009 to 2012. Kaplan-Meier method was used to calculate the 5- and 8-year survival rates of the prosthesis. The MSTS function scale was used to evaluate the functional outcomes. Results The average follow-up time was 90 months (52-118 months). The 5- and 8-year survival rates of GMRS prosthesis were both 94%. After revision, two patients failed, including one case of infection and one case of repeated aseptic loosening. The average interval between the first joint replacement and revision surgery was 81 months (27-187 months). Until the last follow-up, 93.3%(14/15) of the patients did not develop repeated aseptic loosening, 85.7%(12/14) of the patients who underwent GMRS revision had a longer loosening-free survival than those with the primary joint replacement (90.6±19.3 vs. 43.4±29.7 months, P=0.001). The average MSTS functional score was 27.7(24-30). Conclusion The incidence of repeated aseptic loosening for GMRS prosthesis is low and the limb function is good. The reported technique is satisfactory in the middle and long term.

Objective:To investigate the status of fear disease progression and hope level in patients with transient ischemia attack and to analyze the relationship between them.Methods:From January 2018 to March 2020,a convenient sampling method was used to select 136 patients with transient ischemia attack. The Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF) and Herth Hope Index(HHI) were investigated.Results:The total score of FoP-Q-SF in patients with transient ischemia attack was 32.78±5.34, and the total score of HHI was 34.86±5.12. The total score of FoP-Q-SF and the scores of each dimension were negatively correlated with the total score of HHI and the scores of each dimension ( r values were -0.613--0.376, all P<0.05). Conclusions:Patients with transient ischemia attack have a higher level of fear disease progression, which is related to the level of hope, and can reduce the level of fear disease progression by increasing the level of hope.