Objective To study CT characteristic findings of pancreatic rupture caused by closed abdominal trauma.Methods The clinical and CT data of 6 patients with pancreatic rupture caused by closed abdominal trauma were analyzed retrospectively.CT plain scan and the tripple-phased enhancement scan were performed,multi-planar reformation(MPR)and maximum intensity projection(MIP)were used after CT scanning.Thin slice of CT scan and post-processing technique of imaging were used furthermore.Results The rupture of pancreatic neck and tail were shown in 2 cases,the rupture of pancreatic head and body in 1 case.Main CT findings were such as following:(1)Hematomas in pancreas or in pancreatic surrounding tissues were shown in 6 cases,they were hyperintensity or slight hyperintensity in plain scan and were not enhanced in three-phase dynamic scan of pancreas.(2)Pancreatic splits,which were relative hypointensity after administration of CT contrast agent in the pancreatic phase,were found in 6 cases,they were like slit-shaped or wedge-shaped or pancreas separated completely in situs.In the pancreatic phase,pancreas parenchyma enhanced obviously but hematoma in the splits did not enhanced,and this drew the outline of pancreatic splits clearly.(3)Contrast agent in the pancreatic hematomas,which leaked from vessels of pancreas,were shown in two patients,like dot or nodule or pond,were highly intensity in artery phase,and there were more leaking of contrast agent in the pancreatic phase,whose intensity was same as abdominal aorta in the same slice image.In the delayed phase,the volume of leaking contrast agent enlarged and they had higher intensity while intensity of abdominal aorta in same slice image decreased obviously.(4)Dilation of the Wirsung duct,which was like curved-tube,was shown in one patient.(5)Meanwhile the contusion of liver,kidney or spleen with pancreatic rupture were found in 4 patients.Conclusion The pancreatic rupture has typical CT findings.It is helpful to improve the accuracy rate of diagnosis with reasonable scanning techniques and understanding correctly CT appearances of pancreatic rupture.

Purpose To explore the feasibility of optimizing monochromatic images in reducing iodinated contrast dose in CT pulmonary angiography (CTPA). Materials and Methods Sixty-eight patients undergoing CTPA were randomly divided into two groups, with half in research group and half in conventional group to evaluate image quality. Research group underwent spectral CT imaging with the injection of 30 ml Omnipaque (300 mgI/ml) and optimal monochromatic images were postprocessed using the software of GSI viewer. Conventional group underwent conventional CTPA with the injection of 80 ml Ultravist (370 mgI/ml). The CT values were measured respectively in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery. The contrast noise ratio (CNR) in two groups were calculated, and image quality were subjectively assessed. Results The total iodine intake in research group (9000 mg) was significantly lower than that of conventional group (29 600 mg). CNR in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery in research group was significantly higher than that of conventional group (t=2.07-2.71, P<0.05). Subjective image quality scores in research group were also higher than that of conventional group but had no statistical difference (Z=-0.944, P>0.05), while there was a good agreement between the two readers (Kappa=0.8, P<0.05). Conclusion It is possible to reduce iodinated contrast dose using spectral CT imaging and improve the image quality of CTPA.

Objective To evaluate the value of 3.0T MRI diffusion-weighted imaging (DWI)in diagnosis and staging of cervical cancer. Methods A total of 65 cervical carcinoma patients were enrolled and performed T2 WI,DWI and LAVA-Flex dynamic contrast-enhancement before operation.MR images were analyzed by two radiologists to evaluate the staging performance.Results All the cervical cancers were detected in DWI,while three lesions were missed in T2 WI and one lesion was missed in LAVA-Flex dynamic contrast-enhanced MRI.Respectively,the accuracy of staging with DWI,T2 WI and LAVA-Flex dynamic contrast-enhanced MRI was 90.8%,78.5%and 87.7%.Accuracy of DWI was significantly higher than that of T2 WI(P =0.04),while there was no significant difference of accuracy between DWI and LAVA-Flex dynamic contrast-enhanced sequence (P =0.39).Conclusion DWI shows relatively higher accuracy than T2 WI in the staging of cervical cancer which makes it an ideal method to replace LAVA-Flex dynamic contrast-enhanced MRI for exact staging.

Objective To evaluate the value of low concentration of isotonic contrast agent combined with 80 kV and adaptive statistical itera-tive reconstruction (ASiR)technique for bronchial artery with CT angiography (CTA).Methods 40 patients (18.5 kg/m2 ≤ body mass index(BMI)≤25 kg/m2 )with lung cancer were randomly divided into two groups and performed enhanced chest CT examina-tion.20 patients (low concentration group)were scanned with Visipaque 270mg I/mL,scanning protocol of (80 kV,260 mA)and other 20 patients (high concentration group)were scanned with Ultravist 370 mg I/mL,scanning protocol of (120 kV,1 50 mA). The CT value,signal noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR)and effective dose (ED)of the two groups were compared and analyzed statistically.Differences between the two groups were determined with t test(P <0.05).Results The mean CT value of the low concentration group (31 7.33 HU±70.44 HU)was higher than that of the high concentration group (256.39 HU±37.38 HU)(P <0.05).SD,ED and dose length product (DLP)of the low concentration group (SD:7.55 ±1.51 HU;ED:1.74±0.14 mSv;DLP:124.94±9.9 mGy/cm)were lower than those of the high concentration group (SD:9.36±1.26 HU;ED:3.20±0.35 mSv;DLP:228.82±25.13 mGy/cm)(P <0.05).CNR and SNR of the low concentration group (CNR:59.71± 17.36;SNR:44.01±14.71)were higher than those of the high concentration group (CNR:37.61±6.16;SNR:27.75±4.72)(P <0.05).The subjective scores of the two groups were (3.73±0.66)and (3.81±0.59),respectively,with no statistical difference.Conclusion For the patients with normal body mass index ,it can reduce 47% radiation dose and 27% iodine dosage using low concentration of isotonic contrast agent combined with 80kV and ASiR technique for bronchial artery CTA,while maintaining similar excellent image quality.

Aim To study the inhibitory effect of chitosan on peroxidation and monocytes adhesion to vascular endothelial cells induced by high concentration of glucose. Methods Human umbilical vascular endothelial cells (HUVEC) were treated with high glucose, and high glucose with different concentrations of chitosan for 24 h. Hydroxyl radicals (OH?) and malon-dialdehyde (MDA) were measured. Monocytes Raw 264.7 were pre-incubated with Rhodamin123, and then co-cultured with HUVEC for 30 min, followed bymicroscope observation and determination of the monocytes adhesion. Finally, the mRNA expression of vascular cell adhesion molecular-1 (VCAM-1) was evaluated by reverse transcription polymerase chain reaction (RT-PCR). Results Concentrations of OH? and MDA in HUVEC increased after incubation with high glucose. Both of the amount of adhesive monocytes and mRNA expression level of VCAM-1 in HUVEC were induced by high glucose. Inversely, chitosan inhibited these changes in a dose-dependent manner without any cytotoxicity to cells. Conclusion Chitosan can scavenge free radicals and prevent peroxidative injury on vascular endothelial cells, which further down-regulates the expression of VCAM-1 and consequently inhibits the adhesion of monocytes to endothlial cells.

Objective To study CT and MRI features and classification of brain schistosomiasis granuloma. Methods CT and MRI data of 30 cases of brain schistosomiasis granuloma were reviewed.All cases were proved by the surgery or pathological examination and clinical laboratory test.There were 20 males and 10 females, and their age ranged from 5 to 58 years, mean 29.2 years.Plain and enhanced CT were performed in all patients with GE MAX 640 scanner.Ten patients were examined by plain and enhanced MRI with GE Signa profile 0.2 Tesla open scanner.Results The lesions located in supratentorial region in 27 cases and in infratentorial region in 3cases.The nodules were isodense or slight hyperdense on CT plain scan, iso or hypointense on T_1WI, hyperintense on T_2WI, Slight hyperintense on FLAIR.After the contrast material was injected intravenously, CT and MRI findings were multiple or single enhanced nodules at the cortical or subcortical area.There were four types of imaging features: (1) multiple small nodules in 5 cases (presenting as bright stars in the dark sky); (2) single large nodule in 8 cases; (3) mixed nodules in 14 cases; (4) circle-enhanced nodules in 3 cases.Conclusion The brain schistosomiasis granuloma has typical CT and MRI findings.CT and MRI classification is not only helpful to its diagnosis and differential diagnosis, but also might be useful for the choice of clinical treatment.

Objective:To investigate the value of quantitative CT (QCT) body component parameters before and after transcatheter arterial chemoembolization (TACE) as prognostic indicator for patients with hepatic cell carcinoma (HCC).Methods:Retrospective analysis was performed on 40 patients with advanced HCC who received TACE treatment in Anhui Provincial Hospital Affiliated to Anhui Medical University from November 2013 to May 2017, all of them received QCT scanning before and after treatment. The information were recorded, including gender, age, alpha-fetoprotein (AFP), TNM stage, liver function Child-Pugh grade, portal venous thromboembolism, cirrhosis, maximum tumor diameter, tumor type, and frequency of interventional therapy. QCT parameters were measured before and after treatment, including L1, L2 bone mineral density (BMD), L3-level paravertebral muscle area (MA), subcutaneous fat area (SFA) and visceral fat area (VFA), and the change rate of QCT parameters (ΔBMD, ΔMA, ΔSFA, ΔVFA) before and after TACE were calculated after the QCT scan interval was standardized. The cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were obtained by drawing the ROC curves. The Kaplan-Meier method was used to calculate the survival rate, the Log-rank method was used for univariate analysis, and the Cox regression analysis model was used for multivariate analysis to screen out independent factors affecting the prognosis of HCC patients after TACE.Results:ROC curve analysis showed that the cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were -8.64%, -6.84%, -9.84% and 5.70%, respectively. Univariate analysis showed that AFP, TNM stage, liver function Child-Pugh grade, portal venous thrombosis, tumor type and ΔMA, ΔSFA, ΔVFA had statistically significant effects on prognosis ( P<0.1). Multivariate analysis showed that ΔMA, ΔVFA and portal venous thromboembolism were independent influencing factors for the prognosis of HCC patients after TACE treatment ( P<0.05). Conclusions:ΔMA, ΔVFA and portal venous thromboembolism have reference value for prognosis assessment of TACE treatment for HCC patients, and QCT body composition analysis is helpful to evaluate the prognosis of HCC patients.

Objective To explore the effect of antidepressant intervention on mood state of at or around the time of radiation therapy. Methods 62 hospitalized patients with cancer receiving radiotherapy were divided into two groups by the order of the time when they accept the radiotherapy which called intervention group ( antidepressant fluoxetine group) and control group. And the two groups patients filled out Hamilton Anxiety Scale( HAMA )and Hamilton Depression Scale (HAMD) at or around the time of radiation therapy to investigate the effects of fluoxetine on anxiety and depression. Results The scores of HAMA and HAMD showed that there was no differences between the intervention group and the control group before the radiotherapy. There was significant difference during the radiotherapy ( 6.41 ± 2.30 ) vs ( 9.29 ± 5.62 ); ( 8.80 ± 3. 048 ) vs ( 12.22 ± 8.32 ) and two weeks after the end of the radiotherapy ( 4.90 ± 1.71 ) vs ( 12.32 ± 7.24 ); ( 6.83 ± 2.47 ) vs ( 16.09 ± 8.61 ) between antidepressant fluoxetine group and control group(P ＜ 0.05 ). Conclusion More attention should be paid to mental health and antidepressant can alleviate anxiety and depression of the cancer patients'at or around the time of radiotherapy.

Objective To explore the value of spectral CT imaging in the preoperative evaluation on histodifferentiation of rectal adenocarcinoma.Methods 90 patients with rectal adenocarcinoma underwent dual-phase enhanced spectral CT scan,and were divided into well,moderately and poorly differentiated adenocarcinoma groups according to the pathology.Single-energy images with energy levels from 40 to 140 keV were generated by GSI Viewer software,and the slope K value of the energy curves were calculated.Iodine concentrations were derived from iodine-based material-separation images and normalized to the iodine concentrations in the aorta. ROC curves were derived to evaluate the differentiation diagnosis efficiency of normalized iodine concentration (NIC)and slope K in rectal adenocarcinoma,respectively.Results There were 22,50 and 18 cases in the well,moderately and poorly differentiated group,respectively.The iodine concentration,NIC and slope K value were statistically different both in the arterial and venous phase (P<0.05).According to the ROC curve,the diagnostic value of NIC was close to that of the slope K,with the sensitivity>76% and the specificity>74% in the arterial phase,and the sensitivity>77% and the specificity>70% in the venous phase by choo-sing the appropriate threshold.Conclusion The spectral CT can provide a new method for preoperatively evaluating the histodiffer-entiation of rectal adenocarcinoma.

Objective To investigate the optimal monochromatic parameters of CT angiography (CTA) on small feeding arteries of abdominal tumors using single source dual-energy CT with gemstone spectral imaging (GSI) technique.Methods The clinical and medical imaging data of 32 patients with abdominal malignant tumor were analyzed retrospectively during January to April 2012.Three phase-enhanced CT scans (Discovery CT750 HD,GE Heahhcare,Milwaukee,USA) of the abdomen were recorded using the GSI technique on 32 patients.The minor feeding arteries of tumor with diameter between 1.5 mm to 3.0 mm were reconstructed by 140 kVp mixed energy,66 keV,and optimal monochromatic mode respectively.After CT scanning,the original data were processed with layer and interval of 0.625 mm,the 140 kVp mixed energy images and 70 keV monochromatic images were obtained with standard algorithm.The original images were conveyed to AW4.5 work-station to process furthermore,then the data of the optimal monochromatic group and 66 keV group were reconstructed.Comparative parameters include contrast-to-noise ratio (CNR),signal-to-noise ratio (SNR) and subjective scores of the small feeding arteries CTA quality.Subjective scores were evaluated by two radiologists according to the sharpness and resolution of the small feeding arteries.One-way ANOVA was used to for statistical analysis.Results CNR of the optimal monochromatic group,the 66 keY group,and the 140 kVp mixed energy group were 21.70 ±9.74,16.63 ±7.60,and 9.85± 6.76,respectively.SNR were 35.05 ± 17.75,26.77 ± 11.51,and 16.32 ± 9.5,respectively.Subjective scores were 4.58 ± 0.40,3.55 ± 0.57,and 2.75 ± 0.46,respectively.CNR,SNR and subjective scores had significant difference among groups (F =17.11,15.73 and 116.01,P ＜ 0.01).The optimal monochromatic group was superior to the 66 keV group and the 140 kVp mixed energy group.Conclusion The optimal monochromatic mode can improve CTA quality of small feeding arteries of abdomen malignant tumors with GSI technique using single source dual-energy CT.