Objective To assess the value of multi-slice spiral CT angiography (MSCTA) in diagnosis of posterior nutcracker syndrome (NCS). Methods MSCTA of 15 patients clinically diagnosed as posterior NCS (patient group) and 50 subjects with normal renal vessels (control group) were retrospectively analyzed. The anatomy, course and relationship to the adjacent structure of left renal vein (LRV) and its branches were observed. The anteroposterior diameter (d1) and cross areas (s1) of the angle of control group and posterior abdominal artery (AA), the anteroposterior diameter (d2) and cross areas (s2) at the largest lumen near the renal hilar were measured and the ratio of s2/s1 and d2/ d1 were calculated.Results All LRVs posterior AA of patient group were compressed and narrowing with dilating apparently near the renal hilar. The difference of d2 was not significant (P＞0.05), but of other values were significant (P＜0.05).Conclusion MSCTA can show anatomy and three-dimentional trend clearly of LRV for posterior NCS, and evaluate the extent of narrow and dilating lumen accurately with cross areas measuring.

Objective To study the relationship in displaying nasopharyngeal carcinoma(NPC)lesions with different MR imagingprotocols.Methods 67cases of NPC proved by pathology were reviewed. Each patient was scanned with six MR imaging protocols (Tra T_1WI, TraT_2WI , SagT_1WI , CorFSIR , TraCE-T_1WI , CorCE-T_1WI ).Results All cases were displayed as mucosal thickening and /or soft tissue masses of nasopharynx. The involved parts were as follows: parapharyngeal spaces in 49 cases(73.1%) ,carotid sheaths in 33 cases ( 49.3% ) , prevertebral muscles in 32 cases ( 47.8% ) , medial pterygoids in 15 cases ( 22.4% ) , lateral pterygoids in 7 cases ( 10.4% ) , pterygoid plates in 9 cases ( 13.4% ) ,pterygopalatine fossae in 5 cases (7.5%), sphenoidal sinuses in 16 cases(23.9%), ethmoidal sinuses in 6 cases(9.0%), maxillary sinuses in 3 cases(4.5%),orbital cavity in 1 case (1.5% ), sphenoid bones in 12 cases(17.9%), petrous apices in 19 cases(28.4%), clivuses in 41 cases(61.2%), cavernous sinuses in 7 cases(10.4%), temporal lobes in 3 cases(4.5%) and cervical lymphnode mestases in 45 cases(67.2%). The lesions displayed by combination of TraT_2WI, SagT_1WI , CorFSIR and CorCE-T_1WI were corresponded with those displayed by the all six MR imaging protocols . Conclusion One or more MR imaging protocols can be optimized for displaying each lesion of NPC. The combination of Tra T_2WI , Sag T_1WI , CorFS IR and Cor CE -T_1WI can display NPC lesions completely.

The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given beta-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter > or = 1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94% main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of beta-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given β-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter ≥1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94 % main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of β-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver.The soft palate length (SPL),the minimal cross-sectional area of the retropalatal region (mXSA-RP),and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states.These parameters,together with hard palate length (HPL),were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO2)] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI＜26 (P＜0.05 for all).It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI＜26.

OBJECTIVETo evaluate the diagnostic value of spirometrically controlled quantitative CT in silica-exposed workers.

METHODSWhole lung spiral scans at 50% vital capacity (VC) and image with high resolution CT(HRCT) at 10% VC and 90% VC level and 5 cm above/below carina were performed in 62 silica-exposed workers and 54 healthy adults. Automatic evaluation software, Pulmo, was used to evaluate the quantitative parameters and compared with clinical pulmonary function tests.

RESULTS9 workers with emphysema were detected by CT scans from 62 silica-exposed workers. The quantitative parameters of 10% VC and 90% VC were significantly different between the silica-exposed workers and the controls (P < 0.05). With the increasing of length of exposure to silica dust, the difference showed a ladder-like rising.

CONCLUSIONSpirometrically controlled quantitative CT is a sensitive, accurate and objective method. It is superior to conventional CT and pulmonary function tests for the early detection in silica-exposed workers, espicially for detecting early stage of small airway disease.

Humans ; Occupational Exposure ; Respiratory Function Tests ; Sensitivity and Specificity ; Silicon Dioxide ; adverse effects ; Spirometry ; Tomography, X-Ray Computed ; methods ; Vital Capacity

Objective:To explore the characteristics and short-term changes of high resolution CT (HRCT) in subclinical stage of COVID-19.Methods:The HRCT images of 17 COVID-19 patients in subclinical stage were analyzed retrospectively in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Wuhan Jinyintan Hospital from January 15 to 31, 2020. There were 4 males and 13 females, age ranged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with other COVID-19 patients. The follow-up CT examination was performed within 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation and symptomatic therapy, while the other 11 patients were untreated. The subclinical CT findings and short-term follow-up were analyzed, and the CT changes of short-term follow-up were summarized.Results:The lesions of 17 COVID-19 patients were mainly located at the lower lobes of bilateral lungs (at the left lower lobe in 9 cases and at the right lower lobe in 10 cases in the subclinical stage, at the left lower lobe in 9 cases and at the right lower lobe in 11 cases in the short-term follow-up). The number of involved lung segments increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, the multiple lesions were found in 13 cases, while in the short-term follow-up, the number of cases with multiple lesions decreased by 7, however the cases with focal lesions increased by 6 and diffuse lesions by 4. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle(10 cases). In the short-term follow-up, the lesion in 1 case expanded from the subpleural area to neighbouring bronchovascular bundle. There were 3 main types of the lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, the ground glass opacities were seen in all the 17 cases. In the short-term follow-up, the number of cases with ground glass nodules decreased by 4 and crazy-paving pattern increased by 4. In 6 patients after treatment, the multiple ground glass nodules became single one in 3 cases, and in other 3 cases the multiple ground glass opacities were getting smaller. However, the scope of lesions in 11 patients without treatment enlarged.Conclusion:The HRCT features of the COVID-19 in subcilincal stage have some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural area or along the bronchovascular bundle, and the great changes can be seen in the short-term follow-up.

Objective To analyze the image features and prognosis of primary central airway salivary gland-type tumor (SGT).Methods The clinical and imaging data of 25 cases with SGT confirmed by histopathology were retrospectively analyzed in our hospital from October 2009 to November 2017.Follow up of patients for survival was performed.Among 25 cases of SGT,there were 14 cases of adenoid cystic carcinoma (ACC),ten cases of mucoepidermoid carcinoma (MEC) and one case of mucoepidermoid carcinoma (EMC).All cases had non-enhanced CT scans (among which 20 cases underwent CT scan with contrast).Post-processing were performed to evaluate the location,range,density,degree of enhancement of the lesions and involvement of hilar or mediastinal lymph nodes.Eight cases underwent PET/CT imaging and one underwent MR imaging,respectively.Independent sample t test was used to compare difference in ages between ACC group and MEC group.Nonparametric test was performed to compare difference in tumor's diameter between ACC group and MEC group.Comparison of genders,history of smoking,tumor-node-metastasis (TNM) stage and CT features between ACC group and MEC group were tested using Fisher's exact tests.Survival was calculated using the Kaplan-Meier method,and the survival curves were compared by the log-rank test.Results Compared to MEC,patients with ACC were older.There were significant difference between the two groups (t=3.154,P＜0.05).ACC tended to involved trachea or main bronchi (13/14) while MEC were mostly located at lobar or segment bronchi (6/10).The shape of ACC tumors were mainly lobulated or presented as circumferential wall thickening (13/14),while MECs were smoothly oval (7/10).On contrast-enhanced CT scans,ACC mainly showed mild or moderate enhancement (9/10),While most of MEC had shown avid enhancement (8/10).CT findings suggestive of airway obstructive disease were seen more with MEC (9/10) than ACC (4/14).There were significant differences of the above CT features between ACC and MEC group (P＜0.05).A case of EMC in an 43 years old female presented rounded nodule in tracheal;The SUVmax in 6 of 8 cases of PET/CT exceeded 2.2;Overall survival (OS) was 87.5％ in all cases.No significant difference was found between ACC and MEC groups regarding OS (x2=0,P=1.000).Ages,surgical and nonsurgical patients and TNM stage were found to be related to OS (x2=13.799,13.799,13.171,respectively,P＜0.05).Conclusions Primary central airway salivary gland-type tumors are commonly occurred in patients at a low age,with weak invasive feature and good prognosis.The predominant site and CT characteristics between ACC and MEC were significantly different.

Objective: To explore the characteristics and short-term changes of high resolutionCT (HRCT) in subclinical stage of new coronavirus pneumonia (NCP). Methods: TheHRCT images of 17 NCP patients in subclinical stage were analyzed retrospectively in Union Hospital of Tongji Medical College, Huazhong University of science and technology and Wuhan JinyintanHospital from January 15 to January 31, 2020. There were 4 males and 13 females, aged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with NCP patients. The follow-up CT examination was performed 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation andsymptomatic therapy, while the orther 11 patients were untreated. The CT imaging signs of subclinical and short-term follow-up were analyzed, and the CT image changes of short-term follow-up was summarized. Results: Thelesions of 17 NCP patients were mainly located at the lower lobes of both lungs (9 cases at the left lower lobe and 10 cases at the right lower lobe in the subclinical stage, 9 casesat the left lower lobe and 11casesat the right lower lobe in the short-term follow-up). The number of lung segments involved increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, most of the lesions were multiple (13 cases), while in the short-term follow-up, the number of multiple cases decreased (7 cases), focal (6 cases) and diffuse distribution(4 cases) increased. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle (10 cases). In the short-term follow-up, 1 case progressed from subpleural to subpleural and along the bronchovascular bundle. There were 3 main types of lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, ground glass nodules were seen in all the 17 cases. In the short-termfollow-up, ground glass nodules decreased in 4 cases and crazy-paving pattern increased in 4 cases. In 6 patients after treatment, 3 cases were changed from multiple to single ground glass nodule, 3 cases showed multiple ground glass opacity reduced. Therange of lesions in 11 patients without treatment enlarged. Conclusion TheHRCT features of the NCP patients in subcilincal stagehave some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural or along the bronchovascular bundle, and the great changescan be seen in the short-term follow-up.