Objective:To observe and analysis the clinical presentations and high resolution computed tomography (HRCT) features of patients with eosinophilic granulomatosis with polyangiitis (EGPA), and to provide support for clinical diagnosis and treatment decision.Methods:Clinical characteristics, relevant laboratory data, HRCT features, treatment and prognosis of 15 clinically confirmed EGPA patients were analyzed retrospectively. Statistical Program for Social Sciences (SPSS) 21.0 software was used for statistical analysis of the data.Results:Among the 15 patients, there were 8 males and 7 females, with a midian age of 48. Four cases (27%) were misdiagnosed as refractory asthma for the first time. The most common clinical manifestation was paranasal sinus inflammation in 14 cases (93%), followed by cough and wheeze in 13 cases (87%). In the laboratory examination, eosinophilia was found in 13 cases (87%) and ANCA positive in 5 cases (39%). The common chest HRCT signs were: fiber stripes in 13 cases (87%), patch ground glass opacities in 12 cases (80%), interlobular septal thickening in 10 cases (67%), and nodules in 9 cases (60%). The five-factor score (FFS) was used to score the patients, and FFS were 5(33%) with score 0 and 6(40%) with score1. Finally, 12 patients (80%) were discharged after remission.Conclusion:The EGPA has a low incidence and no spefic clinical manifestations and chest HRCT features, so it hasto be diagnosed by combination of paranasal sinus examination, electromyography and laboratory tests.

OBJECTIVE:To provide reference for the identification,processing,processing technology and research for ther-mal decomposition products. METHODS:Thermogravimetry- derivative thermogravimetry (TG-DTG) and differential thermal-de-rivative differential thermal (DTA-DDTA) analysis were conducted to scan thermal spectrum of tripterygium from 3 places and T. hypoglaucum,T. regelii,common counterfeits Actinidia arguta and Vitis quinquangularis,determine 7 medicinal materials,its dregs and extractum,and analyze differential spectrum of T. wilfordii and dregs. RESULTS:The TG-DTG and DTA-DDTA thermal spectrum were not only basically similar to each other but also to their dregs. There was a singlet main characteristics peak at about (299±3)℃ only in the DTG curves of extracts of tripterygium from 3 places and T. hypoglaucum extractum with similar intensity, while T. regelii,counterfeits A. arguta and V. quinquangularis showed multiple peaks,and (299 ± 3)℃ was not the main peak. CONCLUSIONS:The thermal spectrum can not distinguish tripterygium and its counterfeits;extractum DTG curves can do it;suit-able processing temperature of tripterygium was 200-380℃. The study can provide reference for the identification,processing,pro-cessing technology and research for thermal decomposition products.

Objective To evaluate the imaging features of ulcer-like projections (ULP)and penetrating atherosclerotic ulcers (PAU)of intramural hematoma(IMH)using dual-source CT (DSCT).Methods Retrospectively analysis of DSCT imaging data of 1 12 patients in our hospital was performed.The shape of hematoma and location of ULP and PAU were evaluated Stanford A and B IMH depicting on DSCT images.The maximum diameter of aorta,maximum thickness of hematoma,deepness of ulcer were com-pared between in patients of IMH with or without ULP and PAU.Results IMH manifested as circular or crescent high density on plain scan and without contrast enhancement on DSCT images in 1 12 cases.Among of them,68 cases(68/1 12,61%)of IMH had ULP or PAU,in which there were 21 cases(21/1 12,1 9%)with ULP and 47 cases(47/1 12,42%)with PAU,the mean maximum depth was (0.48±0.1 5)cm in ULP and (1.08±0.56)cm in PAU.There were 4 cases with ULP and 9 cases with PAU in 29 cases of Stanford type A,while 1 7 cases with ULP and 38 cases with PAU in 83 cases of Stanford type B.There were 14 cases with single ULP and 7 cases with multiple ULP in 21 patients with ULP,while there were 27 cases with single PAU and 20 cases with multiple PAU in 47 patients with PAU.There were 1 9 cases with both PAU and ULP.There was statistical significance that PAU occurred more likely in the descending aorta and distal aorta than that in ULP (P =0.028).Conclusion IMH patients are susceptible to ULP and PAU,DSCT can objectively evaluate CT features of ULP and PAU of IMH.

Right-sided cardiac valvular diseases have traditionally been considered less important than disease of mitral or aortic valve. However, severe tricuspid regurgitation could lead to right ventricle dysfunction and reduce patients' survival rate. In clinic setting, tricuspid valve disease should be paid more attention for patients with secondary tricuspid regurgitation caused by left-sided valvular surgery combined with irreversible annular dilatation increasing the risk of reoperation. In this review, we summarize the epidemiology, anatomy, pathology, diagnosis, ultrasound and cardiac magnetic resonance imaging findings in patients with tricuspid regurgitation.
Echocardiography ; Heart ; Heart Valve Diseases ; diagnosis ; Heart Ventricles ; diagnostic imaging ; pathology ; Humans ; Magnetic Resonance Imaging

Objective To investigate the prevalence of morphological abnormalities of the internal carotid artery and relationship with ischemic cerebrovascular disease and carotid atherosclerosis.Methods A total of 511 consecutive patients were enrolled in this study and carotid abnormalities were classified according to the criteria of Wain and Metz by combining high-and low-frequency ultraaonography prospectively.Relationship of carotid abnormalities to ischemic cerebrovascular disease and carotid atherosclerosis were analyzed.Results Of the 511 cases,abnormalities of the internal carotid artery were found in 256(50.1 ％),the unilateral carotid abnormalities were found in 121(23.7％),and the bilateral in 135(26.4％),respectively.There was significantly difference in prevalence of kinking and coiling between ischemic stroke and asymptomatic group(P＜0.001),and prevalence of carotid abnormalities in the plaques and arteriosclerosis groups were statistically higher than the normal group(P＜0.001).Conclusions The kinking and coiling of the internal carotid artery could be additive risk factors in the pathophysiology of an ischemic stroke,and carotid morphological abnormalities could be responsible for carotid atherosclerosis partly.

0.05).Conclusion The segmental bronchus were visualized reliably by low-dose multi- detector-row CT with 17 mAs. Low-dose CT can be adapted to CT screening for early lung cancer.

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 evaluate the helical CT features of miliary tuberculosis and pulmonary miliary metastatic nodules so thatimproving the correct diagnosis of the miliary lung diseases.Methods Helical CT or high resolution CT features (distribution and size of miliary nodule and attenuation of the lung) of 34 patients with miliary tuberculosis and 54 patients with pulmonary miliary metastatic nodules were retrospectively reviewed.Results The uniformly distribution and size of the bilateral lung were observed in 28 (28/34, 82%) and 23 (23/34, 68%) cases of miliary tuberculosis,5(5/54, 9%) and15(15/54, 28%)cases of pulmonary metastases ( P

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 investigate color Doppler flow imaging features of the ophthalmic artery,external carotid artery,which is known the secondary compensatory collateral circle,in patients with unilateral internal carotid artery occlusion.Methods A total of 42 patients with unilateral internal carotid artery occlusion were enrolled,and ipsilateral and contralateral ophthalmic artery,external carotid artery were examined by color Doppler flow imaging,prospectively,peak systolic velocity,pulsatility index and resistance index were analyzed and compared with findings of control group.Results In the 42 cases with internal carotid artery occlusion,the compensatory collateral circle was observed by the external carotid artery and ophthalmic branches,through their communicating arteries in 40 (95.2％) cases of chronic occlusion.Compared with the contralateral side,the ophthalmic arteries were characterized by retrograde blood flow,peak backward shifting,increase of diameter [(1.91 ± 0.53) mm vs (1.69 ± 0.34) mm,P =0.009] and peak systolic velocity [(43.41 ± 27.28) cm/s vs (29.91 ± 14.16) cm/s,P =0.003],reduced pulsatility index (1.18 ± 0.49 vs 1.69 ± 0.73,P =0.000) and resistance index (0.65 ± 0.26 vs 0.75 ±0.12,P =0.000),and prolonged acceleration time [(147.71 ± 56.16)ms vs (51.80 ± 7.81)ms,P =0.000].Ophthalmic arteries had antegrade blood flow with a decrease of peak systolic velocity and resistance in another two cases of acute thrombosis of ICA.Conclusions External-ophthalmic-internal carotid artery passway is another compensatory collateral circle for the chronic occlusion,but only by ipsilateral and contralateral internal carotid artery circle,for acute thrombosis.