Objective To evaluate the application value of multi-slice spiral CT(MSCT)in D2 radical total gastrectomy for gastric carcinoma.Methods CT and clinical data of 353 cases with D2 radical total gastrectomy for gastric carcinoma was analyzed retro-spectively.Results Operative time was 236 (1 91-35 1)mins VS.245 (189-308)mins,no significant difference was observed be-tween the CT scan group and the non-CT scan group(P >0.05).The number of lymph nodes dissected was (27 ±3)VS.(20±2), there was significant difference between the CT group and the non-CT group (P <0.05).The blood loss in the CT group and no CT group was less 168 (110-600)mL and 280 (150-720)mL respectively(P<0.01).Postoperative hospital stay was shorter (11.2±2.1)days in CT group than no CT group (14.5±2.0)days (P <0.01).Postoperative complications developed in 1 7 patients in the CT group and in 29 patients in the non-CT group.The difference didn’t show statistically significant between the two groups (P >0.05).Conclusion Multi-slice computed tomography scanning has a great value in D2 radical total gastrectomy for gastric carcinoma.

Objective To analyze the CT features of renal carcinoma associated with Xp11.2 translocations/TFE3 gene fusions (Xp11.2 RCC),and to improve the diagnostic accuracy.Methods Clinical data,CT imaging and pathological features of 12 cases with pathology proved Xp11.2 RCC were analyzed retrospectively.Results All the 12 cases were solid masses.11 cases were oval or quasi-circular,1 case was irregular.Tumors were iso-density or hyperdensity on CT plain scan images.The density was heterogene-ous,combined with necrosis in 11 cases and spotty or patchy calcification in 7 cases.After injection of contrast,moderate or obvious enhancement of tumors was found,1 case had retroperitoneal lymph node metastasis,1 case was found with mass formation in the re-nal hilus,1 case had adrenal metastasis.Another one was found with psoas major muscle and lumbar 5 invaded.Conclusion The Xp11 .2 RCC has certain CT characteristics.This disease should be considered when a renal tumor is iso-density or hyperdensity on the CT plain scan images and has moderate or obvious enhancement,combined with necrosis or calcification.

Objective To determine the value and limitation of water enema spiral CT (WESCT) in staging of colorectal carcinoma.Methods Forty-eight patients with histologically proven rectum or colon carcinoma were included in this study. All of them were examined by SCT ,and the preoperative staging of TNM and Duke were used based on the findings of SCT.The results of WESCT were compared with those of surgical and pathological examination in all cases. Results All lesions in the 47 cases were demonstrated clearly by WESCT and the sensitivity was 97.9% ; 39 cases of 48 patients were correctly staged with TNM and 42 cases with Duke , the accuracy was 81.3% and 87.5% respectively, which were higher than the overall 50 % accuracy reported by references ;⑶The accuracy of WESCT was 89.6% (43/48) in T stage and 81.3% (39/48) in N stage. Three casas in M stage were all diagnosed correctly;Conclusion WESCT scan is a better method of depicting the colorectal carcinoma. It allows for accurate depiction and staging of colorectal carcinoma, especially detecting the invasion of adjacent tissues and distant metastasis. It is the best imaging method for staging the colorectal carcinoma . However the value of WESCT for early T staging in colorectal carcinoma and minute metastasis of lymph nodes or liver is limited.

Objective To evaluate the diagnostic value and clinical significance of preoperative staging in gastric cancer with induced pneumoperitoneum in spiral CT (SCTPP). Methods Both routine SCT and SCTPP were performed in 52 lean patients suffered from gastric cancers, and comparison was made between SCT findings and surgical and histopathologic findings. Results The accuracy of routine SCT and SCTPP in determining the T-staging was 72% and 96%, respectively (?2=8.0, P0.05). The sensitivity in determining M-staging was 61% and 100%, respectively (?2=0.04, P

Purpose　To evaluate the clinical safety of ionic contrast media made in china and compare with nonionic contrast media being imported. Methods　Among contrast-enhanced CT 1096 cases, 76% meglumine diatrizoate were administed in 864 cases and ultravist in 232 cases , comparative studies on adverse drug reactions(ADRs) and image quality were performed. Results　In 76% meglumine diatrizoate group , the prevalence of overall and mild -middle ADRs was higher than in the ultravist group , the prevalence of severe and potentially life-threatening ADRs was approximate in the ultravist group , the image quality was well than in the ultravist group.Preventive inoculation alleviated ADRs at all levels. Conclusion　Ionic contrast media made in china was safe and effective in patients without hyperthyroidism after preventive inoculation.

Objective To study the relationship between the CT features and pathological grade of malignancy of the gastric stro-mal tumors (GST).Methods A retrospective review was performed based on the database of 80 consecutive patients with GST.Age and gender of the patients were recorded,and the CT findings of GST including growth pattern,morphology,tumor site,boundary, mucosa,serosa,ulcer,volume and maximum diameter of the tumor were also measured.The patients were divided into three groups:very low and low risk group,intermediate risk one and high risk one according to the pathology.All parameters were ana-lyzed by one-way ANOVA or Fisher’s exact test.Results The patients in 3 groups (from low risk to high one)were 30,30 and 20 respectively.There were no significant differences in age,gender,location and mucosa among 3 groups(P>0.05).However,the growth pattern,morphology,boundary,serosa,ulcer,volume and maximum diameter of the tumor were significantly different (P<0.05).Conclusion The CT features including growth pattern,morphology,boundary,serosa,ulcer,volume and maximum diameter of the tumor can be used to evaluate the grades of malignancy in GST.

Objective To investigate the effectiveness of organ dose modulation (ODM) technology with respect to dose reduction and image quality of the sensitive organs during CTA of craniocervical arteries. Methods Ninety one patients suspected of arterial vascular disease and evaluated by CTA of craniocervical arterires were enrolled in this study. Patients were divided into group A (n=46) and group B (n=45) according to the order of examination. All patients hadCTA examination of craniocervical arteries. The ODM technique was used only in plain phase in group A and was used both in the plain phase and enhanced phase in group B. The tube current in the four direction (anterior,posterior,left,right) of thyroid and orbital area and radiation dose were recorded. The image quality of group A and group B was evaluated by objective indicators [CT attenuation values and contrast-to-noise ratio (CNR) of vessels in the thyroid area and orbital region ]and the subjective score. The independent samples t test was used for the statistical analysis of the objective indicators and nonparametric rank sum Mann-Whitney U test were used for subjective score. Results For A group, There were significant differences for the tube current at all directions of the thyroid gland and orbital area between the plain phase and the enhanced phase except the current at the posterior of the thyroid gland area(P value all<0.05),and the current in plain phase lower than that in enhanced phase. The mean current of thyroid gland and the orbital area were (604±43) mA and (656± 22) mA in the plain phase and (341±54) mA and (409±63) mA in enhanced phase. The differences were significant (t values were -10.909 and -38.454,P<0.01).CTDIvol and ED were (15.6±1.4) mGy and (1.44± 0.17) mSv in the plain phase and (17.4 ± 1.4) mGy and (1.60 ± 0.18) mSv in the enhanced phase, the differences were significant (t values were - 42.008 and - 32.130, P<0.01) . There was no significant differences for the objective indicators and the subjective score between group A and group B(P>0.05). Conclusion ODM technique can provide protective effect on the sensitive organs during craniocervical CTA examination without compromising the image quality.

Objective To evaluated the correlations between MSCT features and expression of VEGF-C,lymphatic vessel density (LVD)in gastric carcinoma.Methods Both plain MSCT and triphasic dynamic contrast-enhanced scan were performed in 58 patients with gastric carcinoma.All patients underwent total/subtotal gastrectomy after MSCT scanning.All specimens were collected into liquid nitrogen or deep freeze refrigerator.Detection procedure for VEGF-C mRNA was performed using RT-PCR,and the LVD was detected with 5’-nucleotidase (5’-Nase)histochemistry.Results The VEGF-C positive rate and the LVD in tumor tissue were high-er than those in normal tissue (P < 0.05 ).In the tumors between diffused and intestinal groups and between non-metastasis and lymph node metastasis groups,the VEGF-C positive rate was 87.1% and 59.3%,87.8% and 41.2%,and the LVD was 8.04±4.58 and 4.08±2.44,8.50±4.70 and 3.64 ± 1.41,respectively,indicating statistically significant differences (P <0.05 ).Conclusion Over-expression of VEGF-C and higher LVD are closely correlated with the lymph node metastasis and Lauren types of MSCT fea-tures of gastric carcinoma.VEGF-C can promote the lymphangiogenesis in carcinoma and further lymph metastasis.

Objective To evaluate the correlation between spiral CT ( SCT ) features and expression of cyclooxygenase-2 , nm23 in esophageal carcinoma.Methods Spiral CT scans were preformed in 44 patients with esophageal carcinoma before operation, and the results were compared with that of operation and pathology. Immunohistochemical streptavidin peroxidase conjugate method was used to analyze the expression of Cox-2 and nm23 in esophageal carcinoma. Statistical analysis was performed with SPSS 12.0 software. Results (1) The accuracy of spiral CT scan in judging adjacent- infiltration and lymph node metastasis in 44 patients was 88.6%(39 of 44) and 90.9% (40 of 44) respectively,there was significant coincidence with operation and pathology(P

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.