Objective To investigate the MRI characteristics of low grade fibromyxoid sarcoma (LGFMS).Methods The MRI imaging of 13 cases with operation and pathology proven low grade fibromyxoid sarcoma were retrospectively analyzed.Comparative study of the relationship between the signal,boundary,cystic,and the enhancement degree with tumor tissue components was performed.Results The tumors were located in thigh (n=7),lower leg (n=3),elbow,shoulder and upper arm (n=l for each).The average diameter of tumor was (7.01 ±2.89) cm (range from 2.5 to 12.0 cm).The tumors with maximal diameter larger than 5 cm were seen in 11 patients.All tumors had well-defined margin.Necrosis and cystic change was seen in 5 tumors,tumor compartment in 3 cases,intratumoral fluid fluid level in 2 cases,and peritumoral edema in 3 cases.T1WI showed hypointensity in 6 cases,iso-,hopointensity in 4 cases,isointensity with slightly hyperintensity in tumor center in 4 cases,heterogeneous intensity in 1 case.T2WI showed hyperintensity in 6 cases,central higher intensity in 4 cases,hyper-,iso-,hypo-intensity in 4 cases,and hyper-,hypo-intensity in 3 cases.T2WI with fat suppression sequence showed hyper-,iso-,hypo-intensity in 8 cases and high intensity solid part and much higher intensity in tumor center in 5 cases.Heterogeneous enhancement of the tumors was noted,including mild enhancement in 8 cases,moderate enhancement in 4 cases,and marked enhancement in one case.Pathological results showed that the tumors were gray and white or yellow,well-defined,and hard texture,in which 5 cases cystic degeneration with tremelloid material can be seen in 5 cases.Microscopy results showed alternating distribution of fibrous and myxoid areas.Nine cases had rosettes formation and characteristic arcuate vessels were seen in 2 tumors.Immunohistochemical results showed negative Vimentin,Desmin,and S-100 in 5 patients,while 3 patients were positive for SMA and CD34.Conclusions LGFMS has some characteristic MRI finding.Combination of MRI and the clinical findings can suggest the diagnosis of LGFMS,however,the final diagnosis depends on pathological examination.

Objective To study the radiological features of dynamic enhanced multi-slice spiral CT (MSCT) and CTA in pure hepatic arterio-venous fistula (AVF).Methods The radiological features of MSCT imaging and CTA of 100 patients with pure hepatic AVF were retrospectively analyzed.Results Positive signs on the arterial phase were detected in 100 patients with pure hepatic AVF.In 89 patients,they were the peripheral type and in 11 patients they were the central type.There were 128 lesions in the 100 patients.In the peripheral type,the features were (1) in the arterial phase,the lesions appeared as a wedged or a patchy enhancement area at the edge of the liver,showing a halo sign in 68 patients.In 56 patients,the PV was shown also in the early arterial phase;(2) in the arterial phase,arailway track sign was shown in 21 patients as a result of a portal vein branch showing right next to a hepatic arterial branch.In the central type and in the arterial phase,the main portal vein (or the hepatic vein) and the left/right branches of the PV (or the HV) were shown.Conclusion MSCT and CTA were useful in the diagnosis of pure hepatic AVF.

Objective To study the CT findings of traumatic bone cyst and to improve the knowledge of that disease.Methods CT features of 8 cases of traumatic bone cyst confirmed by clinical and pathology were reviewed retrospectively.There were 4 females and 4 males,from 26 to 76 years (the median age was 53 years old)of age.Three patients had traffic accidents,2 patients had trauma unrelated,1 patient had boulder crushing,1 had patient stick wounded and 1 patient had high jump wounding.The bone cyst occurred from 18 to 36 months after trauma(2 at 18 months,4 at 24 months,1 at 30 months and 1 case at 36 months).Results There were 6 fractures,1 joint dislocation and 1 frontal soft tissue hematoma in trauma.The cyst located in the ilium of 3 cases,in the calcaneus of 2 cases,in the frontal bone of 1 case,in the hooked bone of 1 case,in the lunate bone of 1 case.The cyst size was 2.0 cm × 2.6 cm to 3.0 cm × 6.0 cm (average 2.7 cm × 4.0 cm).8 cases all single capsule change,all clear boundaries.6 cystic destruction and 2 cystic expansion destruction of bone.Two see separated and 6 no divider of the cyst region.Five bone sclerosis and 3 no hardening of the cyst edge.Three sclerosis and Five no sclerosis of the adjacent bone.Four osteoporosis decalcification and 4 no osteoporosis decalcification of he adjacent bone.Conclusion The traumatic bone cyst is closely related to trauma,CT manifestations with certain characteristics,combined with a history of trauma can make a definite diagnosis.

Objective To investigate the characteristics and diagnostic value of multi-slice spiral computed tomography (MSCT) examination of gastrointestinal lipoma.Methods The cross-sectional study was adopted.The clinicopathological data of 96 patients with gastrointestinal lipoma including 32 from the Second Hospital Affiliated to Wenzhou Medical University,30 from the First Hospital Affiliated to Wenzhou Medical University,17 from the Ruian People's Hospital of Zhejiang,11 from the Yueqing People's Hospital,3 from the Wenzhou Central Hospital and 3 from the Wenzhou People's Hospital from December 2006 to September 2015 were collected.All patients were fasted for 8 hours prior to the examination,and partial patients underwent enhanced scan after the conventional CT scanning with breathless scanning and no abdominal pressure.Coronal and sagittal images of gastrointestinal tract including the tumor were administrated with multiple planar reconstruction (MPR)techniques of Reformat software.Based on MPR images,the curves along the gastrointestinal tract were drawn,voxel distributed along the curve track were reconstructed,and curved planar reconstruction (CPR) images were obtained.The patients received operation or follow-up according to individual characteristics after examinations.The patients undergoing operation were followed up for detecting tumor recurrence and metastasis by CT examination and patients receiving follow-up were observed by endoscopy for detecting changes of tumor size and morphology up to June 2015.The analysis indexes included tumor location and size,performance of MSCT examination (tumor shape,density,margin,intussusceptions,enhanced MSCT examination),intraoperative findings,results of pathological examination and results of follow-up.Measurement data with normal distribution were presented as i ± s.Results All the 96 patients received MSCT plain scan and the 42 received enhanced MSCT scan.The CPR images in 30 patients were collected.(1) Tumor location and size:3 tumors were located in the stomach,16 in the duodenal,27 in the jejunum,23 in the ileal,2 in the ileocecus,9 in the sigmoid colon,9 in the ascending colon,3 in the descending colon,3 in the transverse colon and 1 in the appendix.The diameter of tumor was (3.8 ± 2.3) cm.(2) Performance of MSCT examination:of the 96 patients,round or oval tumors were detected in 68 patients,tubular tumors in 15 patients and lobulated tumors in 13 patients.Tumors showed homogeneous density in 67 patients and inhomogeneous density in 29 patients.The CT value of tumors was-110--53 HU with a median value of-80 HU.Tumors of the 96 patients had clear boundaries and smooth margins.Twenty-four patients were complicated with intussusceptions with nested length of (28 ±4)cm,including 10 cases of multiple concentric rings,7 cases of double-target sign and 7 cases of banana sign.Enhanced MSCT scan showed that capsule around tumors in the 96 patients demonstrated slightly intensified,tumor body demonstrated no enhancement and that angiolipoma in 10 patients had cable strip like enhancement in the tumors.(3) Intraoperative findings:of the 96 patients,59 patients underwent surgical resection with single tumor,24 patients were concomitant with intussusceptions,9 patients showed aphtha in the center of tumors and 1 patient had partial lipoma in the prepyloric region dropped into the duodenal.Thirty-seven patients received endoscopic examination,showing submucous nodular protrusive lesions of 1.7-3.5 cm.(4) Results of pathological examination:of 59 patients undergoing surgical resection,submucosal,subserous and intramural tumors were detected in 45,9 and 5 patients,respectively,with complete capsule and pedunculated or non-pedunculated.Of the 59 patients,tumors showed round or oval shape in 41 patients,tubular shape in 10 patients and lobulated shape in 8 patients.The section of tumors showed yellowish-white.Specimens from endoscopic and surgical resections were observed under microscopy,the tumors were composed of mature-differentiated adipocytes,different quantities of fibrous connective tissues,blood vessels and mucus ingredients.Tumor cells were round shape with hypochromatic cytoplast and became polygeal and vacuolated after squeezing,nucleus was compressed to peripheral area and cytoplasm was full of lipid droplets.The results of immunohistochemistry stain showed Vimentin,CD34,D2-40,CD68 were positive and AE1/3 and Calretinin were negative.All tumors were diagnosed as benign lipomas.Fifty-nine patients who underwent surgical resection were followed up for 0.5-5.0 years and 37 patients of which specimens were obstained by endoscopic resection were followed up for 1.0-2.0 years after the pathological diagnosis with no significant change.Conclusion The MSCT finding of the gastrointestinal lipoma has characteristic appearance,and MSCT examination can clearly show lipoma location,size,shape and properties,with a widespread application value.

Objective To investigate the CT characteristics of ectopic pheochromocytoma in the abdomen.Methods The CT characteristics of 31 cases of ectopic pheochromocytoma in abdomen proved by surgery and pathology were retrospectively analyzed.The relationship between the density,cystic change,calcification,boundary,the enhancement degree and pathological types and tumor tissue components were studied.Results The tumors location was:9 cases in mesentery,8 cases adjacent to abdominal aorta(7 on the left and1 right),3 cases above the adrenal gland(2 on the right and 1 left),3 cases outside the renal hilum(1 on the right and 2 left),3 cases behind the inferior venacava,3 cases in hepatic hilum,and 2 cases in duodenal ampulla.Tumor size ranged from 2.7 cm ×2.5 cm to 18.0 cm × 11.0 cm(average 6.8 cm ×5.6 cm).CT plain scan:the CT value was 32-58 Hu for the substantial part(average 45 Hu),18 to 25 Hu for the cystic necrosis part (average 21.5 Hu).28 cases had clear boundary and tumor boundary in 3 cases was not clear.24 cases had equal density of the substantial part,7 cases had high density of the substantial part.21 had irregular low-density areas of necrosis in the mass center.8 cases had punctiform,patchy or linear calcification in the mass.Enhanced CT:CT value in arterial phase was 47-105 Hu of the substantial part(average 76 Hu),among which tortuous expansion within the enhanced vascular shadow of the tumor was found in 8 cases.CT value in venous phase was 45 to 90 Hu of the substantial part(average 65Hu),among which 7 cases had obviously decreased density in parenchymal enhancement part,19 cases slightly decreased,and 5 cases strengthened constantly.CT value in delayed phase was 42 to 70 Hu of the substantial part(average 56 Hu),among which 26 cases had less enhancement degree of the substantial part compared to that in the arterial and venous phase,and 5 cases had constant enhancement.Conclusions Ectopic pheochromocytoma in the abdomen has certain characteristic in CT.CT characteristics are correlated with pathologic types and tissue components.CT findings combined with clinical manifestation may suggest diagnosis.

Giant hypertrophy of gastric mucosa is rare and lack of typical clinical manifestations. The main treatment measures were minimally invasive surgery and drug intervention. Clinicians should pay attention to it's imaging features, in order to make early diagnosis and treatment, and obtain a good prognosis. The authors introduce the results of gastro-enterography and computed tomography in a case with giant hypertrophy of gastric mucosa, and differentiate the imaging results from gastric cancer, lymphoma and gastric stromal tumor, so as to provide references for the clinical diagnosis of the disease.

Objective:To investigate the CT and MRI features of meningiomas of the skull.Methods:A retrospective analysis was performed; the CT and MRI findings of 20 patients with meningiomas of the skull confirmed by pathology after surgery in our hospital from January 2008 to December 2020 were collected.Results:Fourteen patients had skull osteolytic destruction, 4 had osteogenic destruction, and 2 had mixed destruction. There were 12 patients with soft tissue masses and 11 with radial spicules. In 16 patients accepted CT examination, uniform density was noted in 10 and uneven density in 6; 8 had high density, 5 had equal density, and 3 had low density; 5 patients were with calcification. In 17 patients accepted MRI examination, 11 had uniform signal and 6 had un-uniform signal; T1WI had slightly low signal in 12 patients and equal signal in 5 patients; T2WI had slightly high signal in 12 patients and slightly low signal in 5 patients; diffusion weighted imaging (DWI) had high signal in 12 patients and slightly high signal in 5 patients. Totally, enhanced homogeneous enhancement was noted in 12 patients and inhomogeneous enhancement was noted in 8 patients; and there were 13 patients with "meningeal tail sign" and 11 with peritumoral edema.Conclusion:Bone in patients with meningiomas of the skull is characterized by osteolytic or osteogenic destruction with soft tissue masses and radial spicules; CT shows uniform or un-uniform tumor density, MRI shows uniform or un-uniform signals, and enhanced "meningeal tail sign" is characterized.

Objective To improve the efficiency of result reporting and ensure the accuracy of the results by establishing autoverification system in Clinical Chemistry and Immunology Laboratory.Methods The study followed the requirements of the Clinical Laboratory Standards Institute(CLSI)AUTO-10A and ISO 15189:2012.In addition,seven categories of verification rules were encoded using the autoverification function of the CentraLink?Data Management System on the Aptio?Automation platform.These rules included Clinical Diagnostic Standard(CS), Sample Status(SS), Quality Control Severity(QS), Instrument Error Flags Severity(IS), Normal Severity(NS), Delta Check Severity(DS), and Logical Assessment Standard(LS).Various modules of Aptio Automation,laboratory information system(LIS)and hospital information system(HIS)were integrated using the CentraLink system to establish the autoverification system.Results The autoverification system was set up and tested from August 2015 to April 2016.In total, the system ran 4 496 425 tests on 366 180 chemistry specimens.The overall autoverification rate for tests performed increased from 53.4% to 87.0%.Glucose had the highest rate (98.3%)while CKMB had the lowest rate(63.6%).Average TAT for result verification decreased by 97.7%,from 46.3 minutes to 3.7 minutes.The system ran 410,040 tests on 160 119 chemiluminescence specimens.The autoverification rate for tests performed increased from 40.2%to 89%.C-P had the highest rate(98.4%)while A-TPO had the lowest rate(58.7%).Average TAT for result verification decreased by 77.4%,from 14.6 minutes to 3.3 minutes.From May 2016 to January 2017(when autoverification was employed),compared with the same period in 2014(when manual verification was employed),the following changes were observed with no increase in staff capacity:a)Volume of routine chemistry tests increased by 46.4%,and median TAT for tests decreased by 41.9%, from 118 minutes to 83 minutes; b)Volume of chemiluminescence tests increased by 24.5%and median median TAT for tests decreased by 52.4%, from 131 minutes to 86 minutes;c)Median TAT for critical values decreased by 50.5%; d)Rates of tests that did not go through autoverification were 88.2% for NS,6.05% for SS, 2.40% for DS,2.00% for LS, 0.97%for IS,and 0.43% for CS; e)Rates of abnormal specimen status identified by Aptio Automation were 7.13‰for jaundice,5.39‰ for blood lipids,2.20‰ for hemolysis,0.17‰ for barcode error, and 0.15‰ for insufficiency;f)Error rate decreased to 0.00%;and g)staff satisfaction increased from 85%to 100%.Conclusion Autoverification of results by using the CentraLink Data Management System can achieve quality control over the entire process of clinical laboratory testing, ensure accuracy of test results, improve work efficiency, decrease TAT, minimize the error rate, avoid skill variation of staff, reduce the pressure of performing manual verification,and improve medical security.