Objective To investigate the necessity of preoperative use of prophylactic antibiotics in percutaneous transluminal angioplasty (PTA) of lower extremity. Methods A total of 86 patients with arteriosclerosis obliterans of lower extremity (101 invalid lower extremities in total) were enrolled in this study. The patients were prospectively and randomly divided into study group (n=41, 51 limbs) and control group (n=45, 50 limbs). The patients in the study group received intravenously prophylactic antibiotics two hours before PTA, while no antibiotic was employed for the patients in the control group. The improvement of symptoms and the occurrence of infection after PTA in the two groups were compared. Results After PTA, fever was seen in 27 patients, including 12 patients of the study group (29.3%) and 15 patients of the control group (33.3%). Elevation of neutrophil count (>70%) was observed in 6 patients (14.7%) of the study group and in 7 patients (15.6%) of the control group, but the difference between the two groups was not statistically significant (P>0.05). Septicemia occurred in one patient in each group, both were aged patients with diabetes. The post-treatment infection rate in the study group and in the control group was 1.96% and 2.00%respectively, the difference between the two groups was not significant (P>0.05). Conclusion There is no significant correlation between the use of prophylactic antibiotics and the infections after PTA of lower extremity. Therefore, the clinical value of using prophylactic antibiotics for patients with high risk of infection needs to be verified by further randomized controlled trials.

Objective To study the postoperative MRI changes of the intracranial tumor.Methods 105 cases of brain tumor comfirmed by operation and pathology were analyzed and 15 cases of those were examined within a week after surgery prespectiviely.All cases were performed by postcontrast MRI at least one time after surgery.Results The findings of postoperative brain tumor on MRI were as follows:(1)The incidence of the benign postoperative enhancement was 52.4%.Its feature between 7 to 30 days presented as circular without any nodular or mass-like enhancement.The margin of enhanced ring was clear,thickness(usually

l 1H-MRS was good for clinical purpose.

Objective The application value of CTA for BA in interventional theray of lung cancer.Methods 15 patients with lung cancers including central type(13 cases)and peripheral type(2 cases) proven by pathology were analyzed prospectively.They were all examined with contrast enhanced.MDCT and the data were sent to the workstation and reconstructed with thin section multi-planar reformation(MPR),maximum intensity projection(MIP)and volume rendering(VR).Results All cases of central type lung cancer were supplied by the bronchial artery including two by the bronchial artery and intercostal artery,clearly demonstrated on the scans with the origin,branches and routes.One case of peripheral lung cancer was supplied by the bronchial artery and the other could not find the definite supplying artery.Conclusions CTA of BA for lung cancer can provide the accurate localization and other reference data for interventional therapy.

The clinical manifestations and CT findings of 26 patients,who were full-time cooks working in small restaurants,were analyzed retrospectively.The main clinical manifestations were chest congestion,shortness of breath,chest pain,cough and hemoptysis.Lung CT scanning revealed lung carcinoma in 1 case,pulmonary nodules in 16 cases including 2 cancerous nodules confirmed in the followup review,puhnonary bulla in 6 cases,emphysema in 4 cases,fibro-proliferative lesions in 8 cases,interstitial pneumonia in 4 cases and fungal ball in 1 case.Among 26 patients,12 had two or more concurrent intrapulmonary lesions.The results suggest that long-term exposure to cooking oil fume may lead to a series of pulmonary pathological changes,and attention should be paid to the occupational hazards of cooks.

The value of combined application of both ECG-gated cine MRA and 3D-CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty-four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery (n=12), vertebral artery (n=3), basilar artery (n=4), anterior cerebral artery (n=2), middle cerebral artery (n=2), anterior communicate artery (n=2) and posterior communicate artery (n=1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG-gated cine MRA was performed with 2D multi-phase fast gradient-recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analyzed by statistic "t" test. 3D-CEMRA was performed with spoiled gradient-recalled echo and one dose of Gd-DTPA. All data was processed with multi-plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D-CEMRA. Compared to DSA and conventional 3D-MOTSA, its sensitivity and specificity figures were both 100%. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8 +/- 37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2 +/- 6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue (P=0.025, <0.05). 3D-CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D-CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.
Angiography, Digital Subtraction ; Contrast Media ; Evaluation Studies ; Image Enhancement ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional/methods ; Intracranial Aneurysm/*diagnosis ; Magnetic Resonance Angiography/*methods ; *Magnetic Resonance Imaging, Cine

The purpose of this study is to define the appearance of normal epiphyseal and metaphyseal marrow and normal changes of marrow due to fatty conversion on Gadolinium (Gd)-enhanced MR Imaging. Unenhanced and enhanced T1-weighted MR imaging were performed in proximal and distal femoral ends of 8 healthy piglets at the ages of 2, 4, 6 and 8 weeks, respectively. The changes with age in signal intensity and enhancement ratio of the epiphyseal and metaphyseal marrow with age were examined. The correlation of MRI characteristics with histological findings was studied. Our study showed that marrow of the metaphysis and of periphery of the 2nd ossification center were well vascularized hematopoietic marrow and had great enhancements. The enhancement ratio of metaphysis was greater than that of epiphyseal marrow and both enhancement ratios degraded gradually with age. The central regions of the epiphyseal ossification center and of the diaphysis were of fatty marrow and had little enhancement. It is concluded that on Gd-enhanced MR imaging the hematopoietic marrow of metaphysis and of periphery of the 2nd ossification center had greater enhancement than that of fatty marrow of central region of the 2nd ossification center. All of their enhancements decreased gradually with age.
Epiphyses/*anatomy & histology ; Femur/anatomy & histology ; Femur/*growth & development ; Gadolinium/*diagnostic use ; Growth Plate/*anatomy & histology ; Growth Plate/blood supply ; Growth Plate/growth & development ; Image Enhancement ; Magnetic Resonance Imaging ; Swine ; Swine, Miniature

To study the dynamic changes of CT perfusion parameters during the first 12 h in the embolic cerebral ischemia models. Local cerebral ischemia model were established in 7 New Zealand white rabbits. All CT scans were performed with a GE Lightspeed 16 multislice CT. Following the baseline scan, further CT perfusion scans were performed at the same locations 20 min, 1-6 h and 8, 10 and 12 h after the embolus delivery. Maps of all parameters were obtained by CT perfusion software at each time point. The brains, taken 12 h after the scan, were sliced corresponding to the positions of the CT slices and stained by 2,3,5-triphenyltetrazolium chloride (TTC). On the basis of the TTC results, the ischemic sides were divided into 3 regions: core, penumbra and the relatively normal region. The changes of all parameters were then divided into 3 stages. In the first two hours (the first stage), the CBV dropped more remarkably in the core than in the penumbra but rose slightly in the relatively normal region while the CBF decreased and MTT, TTP extended in all regions to varying degrees. In the 2nd-5th h (the second stage), all the parameters fluctuated slightly around a certain level. In the 5th-12th h (the third stage), the CBV and CBF dropped, and MTT and TTP were prolonged or shortened slightly in the core and penumbra though much notably in the former while the CBV, CBF rose and MTT, TTP were shortened remarkably in the relatively normal region. We experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CT perfusion imaging. The pathophysiology of the ischemia could be reflected by the CT perfusion to varying degrees.
Blood Flow Velocity ; Brain Ischemia/physiopathology ; Brain Ischemia/*radiography ; Cerebrovascular Circulation ; Stroke/physiopathology ; Tomography, X-Ray Computed

Objective To investigate the technique and application of nasolacrimal duct imaging using MR hydrography.Methods Eight healthy volunteers(16 lacrimal ducts)and 17 patients affected by primary epiphora(32 lacrimal ducts)underwent MRl with three.dimensional fast recovery fast spin echo (3D-FRFSE)MR dacryocystography(MRD)sequence after sterile saline solution had been instilled into the conjunctival sac.For all patients affected by primary epiphora,FRFSE T2-weighted oblique coronal and axial images were obtained after MRD.All patients(32 lacrimal ducts)underwem lacrimal endoscopy.which served as a standard of reference for confirming MR findings.Results Eight cases of 16 normal lacrimal passages were showed by MR hydrography with administering topical sterile saline solution,which demonstrated the lacrimal sac well and whole course of the nasolacrimal duct.Endoscopic findings confirmed nasolacrimal duct obstruction secondary to chronic non-specific inflammation:the color of the mucosa of the nasolaerimal ducts was grey-red,and the obstructive sinuses were filled with nonelastic grey-white membrane.The accuracy of 3D-FRFSE MRD sequence in diagnosing obstructive level was 78%(25/32). The lacrimal ducts above the obstructive level showed watery hypo-intensity on 3D-FRFSE MRD.and the lacrimal ducts below the obstructive level could not be showed.Abnormal findings were presented in all cases of obstructive nasolacrimal ducts with Axi-FRFSET2 WI and Cor-FRFSET,WI sequences:long T2 fluid signals were seen in the lumens of tlle lacrimal sac and(or)nasolacrimal duct above the obstructive level. equal or slightly long T2 soft-tissue signals were seen in the lumens of the nasolaerimal duct below the obstructive level.and the mucosa of the ducts thickened Conclusion MR imaging performed after the topical administration of sterile saline solution can reveal normal nasolacrimal duct and is feasible in evaluating obstructive nasolacrimal ducts.

Objective To observe diffusion changes of epiphysis of femoral head with ischemia of difference phases by line-scan diffusion weighted imaging(LSDWI),and determine whether LSDWI can provide temporal information and severity about ischemia of epiphysis.Methods lschemia was surgically induced in one hip of each piglet(n=25)and the other hip served as a normal control.Piglets were imaged before surgery and at 3 hours,72 hours and 1,3 and 6 weeks after surgery by using LSDWI.Apparent difrusion coefficients(A DC)in epiphysis of the femoral heads were calculated.Significant difierences in ADC values between ischemia group and control group were found by using paired t-test.After scan at individual time points,5 piglets were sacrificed for histological study each time.Results The ADC value in the ischemic femoral heads f(1.22±0.37)×10-3 mm2/s]decreased significantiy at 3 hours after surgery (t=3.914,P＜0.01),compared to that in control[(1.73±0.33)×10-3mm2/s},and increased at 72 hours[(2.15±0.32)×10-3mm2/s versus(1.70±0.22)×10-3 mm2/s](t=3.348,P＜0.01).Then ADC valne kept increasing until 6 weeks after surgery[(1.61±0.27)×10-3mm2/s in ischemia side vs (1.11±0.45)×10-3mm2/s in the control](t=4.136,P＜0.01).rrhe percentage change of the ADC value significandy increased at 3 hours,72 hours,1 and 3 week(s)after the surgery(P＜0.01),compared to that at the prior neighboring time point.No significant increase in the percentage change of ADC value was found between the 3rd week and the 6th week after the surgery(t=2.29.P＞0.05).Histological examinations revealed abnormal thickening within epiphyseal cartilage,and cartilaginous islands within ossified tissues.Growth disturbante wag found in form of focal growth plate disruption.Conclusions Dynamic changes of ADC values were found with the prolonged ischemia of the femoral head by LSDWI.It could serve as a useful marker for evaluating duration and extent of ischemic epiphyseal disruption.