Objective To determine how the pulmonary ligament affects the helical CT appearances of the lower thoracic disease on the basis of the anatomic findings. Methods Four cadavers were cut transversely, with the section thickness of 11.3-13.4 mm. 57 patients with the lower thoracic disease were scanned using Somatom Plus 4, with administration of intravenous contrast material. The correlation of the anatomic findings of the pulmonary ligament and the helical CT appearances of the lower thoracic disease was evaluated. Results On cadaver sections, the right pulmonary ligament attached the lower lobe of the right lung to the esophagus, while the left ligament attached the lower lobe of the left lung to the esophagus or the descending aorta. In 40 pleural effusion and 7 pneumothorax cases, the pulmonary ligament tethered the medial aspect of the collapsed lower lobe and limited the shift of the lower lobe. In 40 pleural effusions, the ligament divided the medial pleural space into an anterior and a posterior compartment. The ligament showed thickness due to the invasion of the lesions of lower lobe including 7 tumors and 3 inflammatory diseases. Conclusion The pulmonary ligament can affect the helical CT appearances of the lower thoracic disease, such as lobe collapse, pleural effusion and pneumothorax; while the intraparenchymal and mediastinal abnormality can extend into the pulmonary ligament.

Objective　To study the scan technique that can completely demonstrate the structures of middle-inner ear.Methods　Ninety volunteers underwent 30° axial and 105° coronal HRCT scan.The manifestations of the ministructures of middle-inner ear were observed and their demonstration rate was calculated.The demonstration of different structures of middle-inner ear was evaluated and compared on HRCT.Results　(1)The scan planes of 30° axial and 105° coronal were correspondent to some structures of middle-inner ear and could completely demonstrate them.(2)30° axial and 105° coronal HRCT scan had their own advantages respectively in demonstrating the structures of middle-inner ear.Conclusion　The technique of 30° axial and 105° coronal HRCT scan of middle-inner ear is useful in demonstrating the structures,including the nerve,joint,ligament etc and the relationship among them.

Objective To analyse the normal helical CT appearances of the bronchial stump or anastomosis after pulmonectomy for central bronchial carcinoma.Methods The available 110 contrast-enhanced spiral CT images in 55 patients undergone different surgical procedures for central bronchial carcinoma were evaluated retrospectively.Results The CT findings of bronchial anastomosis in shape appeared as smooth,concave and convex,sharp angle,obtuse angle,spininess,irregulated or short tube.The thickness of anastomosis was (3.26?1.46) mm.Conclusion Spiral CT can display the bronchial anastomosis clearly after pulmonectomy for central bronchial carcinoma.

Objective To assess the usefulness of spiral CT examination in detecting the local recurrence and the metastatic lymph nodes of chest in the patients with post-pulmonectomy for central lung cancer.Methods The data of 110 contrast spiral CT of chest in 55 patientswith central bronchial carcinoma post-operation were retrospectively analysed.Results 12 person-time in 9 cases recurred in thebronchial stump or anastomose.The short diameter of lymph nodes in the thorax ≥1 cm was showed in 33 person-time of 26 cases,of them,14 cases was considered as metastasis in combination with the clinical data.Conclusion Spiral CT is the one of the best examination indetecting the post-operation recurrence in the patients with central bronchial carcinoma,but it is still of limitation in evaluating the nature of lymph nodes.

Objective To describe CT features and misdiagnosis of lung cancer in young patients.Methods The clinical data and CT findings of primary bronchogenic carcinoma in 33 young patients proved pathologically were reviewed.Results Masses,nodules andpulmonary consolidation were found in 13,8 and 7 cases on chest CT respectively.The soft nodule in bronchus with obstructive pulmonary atelectasis was found in 3 cases,the thickening of bronchial wall and bronchiarctia with obstructive pulmonary infection,plumonary cavity and multicenter lesion were found in 1 respectively.There were thoracic effusion or with nodulous pleurae in 8 cases,nodules in lungs in 7 cases,enlarged lymph nodes in 6 cases,destruction of thoracic skeleton in 2 cases and mass involving mediastinum or large vessels in 4 cases.The chest metastatic rate was 81.8%.Pulmonary inflammation and tuberculosis were firstly diagnosed in 6 and 15 cases,the misdiagnostic rate was 63.6%.Conclusion Masses,nodules and pulmonary consolidation are the common CT features of lung carcinoma in young patients.Most cases are advanced stage of lung carcinoma and misdiagnosed as pulmonary tuberculosis in initial examination.

Objective To study the CT features of cerebral infarction and the relation to blood glucose level in diabetes mellitus.Methods The CT features and relation to the level of blood glucose were retrosepectively analyzed in 41 cases of cerebral infarction diabetes mellitus.The diagnosis of diabetes mellitus was based on the WHO criteria in all cases.Results The focus of infarction located at the area of base ganglion,brain stem and thalamencephalon in 38 cases(92.7%).Multiple focus was found in 30 cases(73.2%)and there was positive correlation between focus number and the level of blood glucose.Lacuna cerebral infarction was observed in 38 cases(92.7%) and large patchy cerebral infarction in 3 cases.Brain white matter demyelination was complicated in 24 caese(58.5%).Conclusion Cerebral infarction of diabetes mellitus mainly manifestes as multiple lacuna cerebral infarction and has close relation to the level of blood glucose.

Objective To design a post-peripheral intervention observation form that uses the timepoint and observation project as the framework of contents,and to evaluated its clinical application effect.Methods Non-concurrent patients were used to make a control study.By using the convenient sampling method,101 patients,who received peripheral interventional therapy during the period from June 1,2014 to December 31,2014,were collected and used as the control group;routine nursing care was adopted and the results were documented.A total of 102 patients,who received peripheral interventional therapy during the period from January 1,2015 to June 30,2015,were used as the intervention group,for whom routine nursing care was carried out and self-designed post-peripheral intervention observation form was employed to record the nursing observation.The results of the two groups were statistically analyzed.After using the form,every month 10 patients,5 visiting physicians and 5 responsible nurses were asked to make an evaluation of nursing quality satisfaction.Results The incidence of main postoperative complications in the intervention group was lower than that in the control group,the chi-square test showed that the difference between the two groups was statistically significant (P＜0.05).The average hospitalization days and the mean medical expense of the intervention group were lower than those of the control group,the chi-square test indicated that the difference between the two groups was statistically significant (P＜0.05).After using this form,the nursing quality satisfaction of patients and visiting physicians was improved,the self-rating satisfaction assessed by responsible nurses was also improved,the chi-square test revealed that the difference between the two groups was statistically significant (P＜0.05).Conclusion All the evaluation indexes of the patients in the intervention group are better than those of the patients in the control group,indicating that this observation form is reasonably designed,meets the specialty characteristics,heightening the dynamic observation for patients after peripheral intervention,strengthens the effectiveness of monitoring postoperative complications,and is helpful for the implementation of the observation after peripheral intervention.Therefore,this observation form is worth promoting use.

Objective To detect the dynamic changes of the level of serum Clara cell protein(CC16)and surfactant protein-D(SP-D)in rats with pulmonary fibrosis induced by bleomycin and to evaluate their value in early diagnosis of pulmonary fibrosis. Methods Sixty Wistar rats were randomly divided into two groups, the control group and bleocin-induced pulmonary fibrotic group,with 30 rats in each group. The rats were killed at 1,3,7,14 and 28 days of treatment Pathology changes of lung tissue were observed by HE,Masson stain,alkaline hydrolysis to assess the hydroxyproline concentration of lung tissue, enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum CC16 and SP-D. Results The hydroxyproline concentration of lung tissue in the pulmonary fibrotic group ((913. 1 ±69. 3) μg/g) were higher than those of the control group ((790. 5 ± 36. 8) μg/g) from the seventh day(P <0. 05). The levels of serum CC16 of the pulmonary fibrotic group((27. 34 ± 0. 32) μg/L) were lower than those of the control group((27. 85 ±0. 32)μg/L) since the third day(P<0. 05) ,and tended to decrease with the development of the disease. However,the levels of SP-D of the former group were always higher(P <0. 05), and tended to increase with the development of the disease. Conclusions The levels of serum CC16 and SP-D changed considerably in early-stage of pulmonary fibrosis, thus might be used as biomarker for early diagnosis and have some value for pathogenesis of pulmonary fibrosis.

This study aims to explore the clinical value of the computer-aided diagnosis (CAD) system for early detection of the pulmonary nodules on digital chest X-ray. A total of 100 cases of digital chest radiographs with pulmonary nodules of 5-20 mm diameter were selected from Pictures Archiving and Communication System (PACS) database in West China Hospital of Sichuan University were enrolled into trial group, and other 200 chest radiographs without pulmonary nodules as control group. All cases were confirmed by CT examination. Firstly, these cases were diagnosed by 5 different-seniority doctors without CAD, and after three months, these cases were re-diagnosed by the 5 doctors with CAD. Subsequently, the diagnostic results were analyzed by using SPSS statistical methods. The results showed that the sensitivity and specificity for detecting pulmonary nodules tended to be improved by using the CAD system, especially for specificity, but there was no significant difference before and after using CAD system.
China ; Diagnosis, Computer-Assisted ; Early Diagnosis ; Humans ; Lung ; pathology ; Radiographic Image Enhancement ; Radiography, Thoracic ; Thorax

Objective To assess the value of pulmonary artery CT obstruction index for the evaluation of the severity of pulmonary embolism (PE),and to investigate the relation between pulmonary artery CT obstruction index and D-dimer levels.Methods 125 patients were diagnosed as PE by computed tomographic pulmonary angiography (CTPA)and D-dimer.Patients were separated into high-risk group and non-high risk group.CT obstruction index,D-dimer levels,diameter of the pulmonary artery were compared between two groups. Spearman’s rank correlation coefficients were used to assess the correlation between the CT obstruction index and the D-dimer levels,diameter of the pulmonary artery.Results CT congestion index of high-risk PE group was obviously higher than that of the non-high risk group (P=0.000).The diameter of pulmonary artery in high-risk PE group was obviously greater than that of the non-high risk group,the difference was statistically significant (P=0.000).No statistically significant difference was found in D-dimer levels between the two groups (P=0.103).There was no correction with CT congestion index and D-dimer levels(P=0.71).Conclusion The D-dimer levels of serum was a predictor of pulmonary embolism,cannot evaluate the severity of PE.CT obstruction index can reflect the severity of PE in some extent as an indicator of PE,there was no correlation with CT obstruction index and D-dimer levels.