Purpose To summarize the CT features and clinical characteristics of atypical primary fallopian tube cancer (PCFT) and ovarian cystadenocarcinoma (OCA), in order to improved the diagnosis. Materials and Methods CT findings and clinical data of 12 patients with atypical PCFT (PCFT group) and 20 patients with OCA (OCA group) were retrospectively studied. All patients were confirmed by pathology. Serum CA125 level, clinical characteristics and CT features of two groups were compared. Results Serum CA125 level of PCFT group and OCA group were (486.13±23.89) U/ml and (1606.94±62.86) U/ml, respectively. There was statistic difference between the two groups (P<0.01). There was significant differences on vaginal bleeding and vaginal discharge between the two groups (P<0.01). There were 4 cases with solid mass, 8 cases with cystic solid mass in PCFT group. And in OCA group, 16 cases with cystic solid mass and 4 cases with cystic mass were revealed, which showed statistic differences between the two groups (P<0.05). Some other findings also showed statistic differences including the diameter of ovarian vein on the affected side, the diameter of the round ligament of uterus on the affected side, tumor volume, and CT values of the mass in venous phase and delay phase (P<0.05 or P<0.01). However, there were no statistic significance in the size of metastatic lymph nodes, the mean CT value of the mass on plain scan and in the arterial phase (P>0.05). Conclusion Clinical findings of serum CA125 level, vaginal bleeding, and vaginal discharge combine with imaging findings of diameter of the ovarian vein in the affected side, diameter of ipsilateral round ligament of uterus, tumor volume, CT values of the mass in venous and delay phase would be the key points for differential diagnosis of PCFT and OCA.

Objective To observe the effect of piperine (PA) on experimental gallstone formation in the gallbladder of C57BL/6 mice. Methods 3 dietary groups of C57BL/6 with 10 mice each group were allocated as control (normal mice chow),lithogenic (1% cholesterol diet) and PA (1% cholesterol diet + PA 30 mg/kg body weight) group respectively for 4 weeks. The expression of Scp2 gene in liver tissue was measured by RT-PCR and the bile lipid contents was measured chemically,the cholesterol saturation index (CSI) was calculated by Carey’s method. Results Cholesterol crystals and stones were found in 10/10 and 9/10 gallbladders respectively in lithogenic group,but not found in control and PA groups. Comparing with the lithogenic group,the expression of Scp2 gene in liver tissue and CSI in the gallbladder bile were significantly decreased in PA group. Conclusions PA inhibit the experimental gallstone formation induced by high cholesterol feeding in C57BL/6 mice,with simultaneous decreasing of both the Scp2 gene expression in the liver tissue and the CSI value in the gallbladder bile. The further study of the preventive effect of gallstong formation of PA,whether or not related to the above results,is strongly suggested.

Objective To investigate the radiation dose differences of DTS,DR and CT in diagnostic imaging of the skeletal system and analyze the sensitivity and specificity of each modality in skeletal disease diagnosis.Methods 100 relevant patients with skeletal diseases were randomly selected,who were performed with DR,DTS and CT from Feb 2010 to Mar 2012.They were divided into three groups,respectively as the DR group,the DTS group and the CT group.The complete information including DR,DTS,CT data and the final clinical diagnosis were collected and the statistical analysis after comparing radiation dose of DR,DTS and CT examination.Two experienced experts evaluated the image of three examinations and made judgments.ROC curves of reader A and B were made by using the final clinical diagnosis as gold standard.Results The average absorbed dose and effective dose of DR,DTS,CT group were [(1.9±1.8)mGy,(0.03±0.03) mSv)],[(3.5±1.5)mGy,(0.05±0.02) mSv)],[(397.7 ± 106.0) mGy· cm、(5.60 ± 1.50) mSy] respectively.The difference among the three groups was analyzed by one-way ANOVA test(F =1377,P ＜ 0.05) and had statistically significant(P ＜ 0.05).ROC curve was drawn through analyzing lesion detection credibility of three groups.The Az values of reader A and B was (0.870 ± 0.035,0.966 ± 0.018,0.974 ± 0.015) and (0.852 ± 0.038,0.951 ± 0.021,0.959 ±0.019)respectively.Do the Z-test to these examinations' area under ROC curve of lesion detection credibility.Between DR and DTS or DR and CT,there was statistically significant(P ＜ 0.05).While for CT and DTS,there was not statistically significant.The two readers' sensitivity and specificity in diagnosing skeletal lesion with DR,DTS and CT were investigated using the x2 test:CT and DTS were no statistical significance,CT and DR were statistically significant (x2 =4.833,P ＜ 0.05).Conclusions Radiation dose of DTS only accounts for about 1％ of CT examination.While its sensitivity and specificity can meet the requirements for clinical diagnosis as CT.If the DR diagnosis is unclear or suspected,DTS should be the first recommended modality used for skeletal diagnosis with lower radiation dose.

Objective To compare the iodine contrast agent dosage,radiation dose and image quality in CT pulmonary angiogra-phy (CTPA)with low tube voltage and high tube current in 64-slice spiral CT.Methods 60 patients with suspected pulmonary em-bolism in our hospital were randomly chosen and divided into three groups:Group Ⅰ:20 patients,using 120 kV,180 mA,contrast dose of 70 mL.Group Ⅱ:20 patients,using 100 kV,280 mA,contrast dose of 50 mL.Group Ⅲ:20 patients,using 80 kV,automat-ic tube current modulation techniques (300-500 mA),comparative dose of 30 mL.CT values and image noise of three pulmonary central areas and a segment branch were measured in each group.Objective indicators,subjective image quality assessment,CT dose index volume (CTDIvol),dose-length product (DLP)and effective absorbed dose (ED)were compared in three groups to evaluate the value of low kV,high mA with low-contrast dose in CTPA.Analysis of variance and t-test was used for data analysis.Results Compared with those of the standard method of CTPA,all pulmonary dry in two groups of low dose were well displayed.There was no statistical significance between each two groups in image quality score (P > 0.05),but was statistical significance in CT values, noise,SNR and CNR (P < 0.01).The CT radiation dose,CTDIvol and DLP of Group Ⅱ and Group Ⅲ were significantly lower than those of Group Ⅰ (P < 0.01).Conclusion Compared with traditional methods,low dose contrast agent injections under 80 kV could reduce the dose of contrast agent and the effect of hardening artifacts due to contrast agent in superior vena cava on right pul-monary artery.It is helpful to reduce the risk of contrast induced nephropathy and reduce patients’exposure to X-ray radiation.

Objective To study the X-ray imaging characteristics of gouty arthritis. Methods The X-ray plates from gouty arthritis were analyzed. Results The gouty arthritis usually occurred in the first metatarsophalangeal joint. The X-ray findings were dissymmetric swellings of soft tissue,bony erosion defect with sharp and hard edge,narrowed joint space and irregular articular surface,emergence of fiber stiffness,even joint malformations and sublimation or dislocation, associated with hyperosteogeny and nearby osteoporosis. Conclusion Diversification was presented in X-ray findings of gouty arthritis, which could be easily confused with other single or multiple bone joint diseases. As a result, accurate diagnosis should be based on careful analysis about X-ray findings.

Pancreatic sarcomatoid carcinoma is an extremely rare malignant tumor.The clinical data and computed tomography images of 8 patients with pancreatic sarcomatoid carcinoma who were admitted to the Subei People's Hospital from March 2001 to January 2013 were retrospectively analyzed.The results of computed tomography showed that 8 tumors were cystic and solid,showing exophytic growth.Two tumors were located in the pancreatic head,1 in the pancratic neck,3 in the body of pancreas,and 2 in the tail of the pancreas.The shape of the tumors were round or ellipse,and the mean tumor diameter was (7.2 ± 1.8)cm (range,6.3-9.6 cm).The plain scan of computed tomography showed that the attenuation of the tumors was mild hyperdense (7 cases) or equal to pancreatic tissue (1 case).Tumors were solid with cystic components,and no hemorrhage within the tumor was detected.Small calcification nodule wasdetected in 1 case.The enhanced scan of computed tomography showed that the enhancement of the tumor was moderate; the enhancement of the tumor was higher than that of normal pancreatic parenchyma during venous phase and delayed phase,while lower than that of normal pancreatic parenchyma on arterial phase; the enhancement of tumors was significantly lower than that of aorta during all the enhanced phases.All the tumors had complete capsule,and abnormal enhancement of the capsule was not detected.Three tumors had peripancreatic lymphadenectasis,2 had infiltration of splenic artery,2 had infiltration of splenic flexure of colon and 1 had infiltration of duodenal serosa or muscle.Familiarity with the imaging features of the pancreatic sarcomatoid carcinoma can help surgeons to make a suggestive diagnosis.

Objective To investigate the diagnostic value of computed tomography,X ray enterography and digestive endoscopy for intestinal Crohn's disease in active and chronic phase.Methods The clinical data of 39 patients with Crohn's disease who were admitted to the Subei People's Hospital from June 2008 to August 2011 were retrospectively analyzed.All patients were divided into the active phase group (28 patients) and the chronic phase group (11 patients).The results of computed tomography,X ray enterography and digestive endoscopy of the 2 groups were compared.The accuracy of the 3 diagnostic methods was assessed by consulting the operative findings.The enumeration data were analyzed using the chi-square test.Results The incidences of intestinal wall stratification,intesitnal edema strap,severe enhancement,ulcers,intestinal stenosis,intestinal fistula,phlegmon,swollen lymph nodes and comb sign in patients with active phase of Crohn's disease were significantly higher than those with chronic phase of Crohn's disease (x2 =10.700,3.954,22.025,7.661,10.700,7.661,6.810,7.661,4.592,P＜0.05).The incidences of intestinal wall thickening,intramural fat,mild enhancement,unenhancement,inflammatory polyps,abscesses and inflammatory masses in patients with chronic phase of Crohn's disease were significantly higher than those with active phase of Chrohn's disease (x2=17.475,11.345,18.050,5.366,22.856,12.662,5.846,P ＜ 0.05).Computed tomography was effective in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease,but it was difficult in demonstrating ulcers and inflammatory polyps.X ray enterography and digestive endoscopy were effective in detecting ulcers and inflammatory polyps,but they were difficult in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease.Conclusion Computed tomography combined with X ray enterography and digestive endoscopy is helpful in demonstrating the presentations of Crohn's disease in active and chronic phase.

Objective To evaluate the CT features of primary adrenal lymphoma and its relationship with pathology.Methods Pathologically proven primary adrenal lymphoma 6 cases were reviewed.There were 4 males and 2 females.The age was 18-62 years,average age was 51 years.5 cases was single tomur in unilateral,1 case was bilateral disease.The main clinical manifestations were abdominal pain,abdominal discomfort.All patients had CT scan and were treated surgically.Results CT scan showed the characters of adrenal little low-density soft tissue mass:the maximum diameter of 3-11 cm,irregularly shaped or ovalshaped,multi-state a clear,homogeneous or slightly inhomogeneous density,CT value was 30-40 HU.Lesions could be embedded or close to blood vessels and the ipsilateral kidney.The lesions were not enhanced arterial phase enhancement,CT value was 39-50 HU.The lesions showed vein phase of mild to moderate enhancement,CT value was 47-66 HU.At the delay of continuing to strengthen phase,CT value was 60-78 HU.The pathology charaters showed that:Diffuse of tumor cells under light microscope dense,more uniform size,and a large,granular chromatin,tumor stromal components was relatively small.There was no significant bleeding,necrosis and calcification.one lesion showed sheet,tumor cell necrosis.Conclusions CT scan characteristics and pathological features of primary adrenal lymphoma might have a certain correlation.

Objective To evaluate the CT image features of urinary tract inflammatory myofibroblastic tumor (IMT) for use in clinical and differential diagnosis.Methods Eight pathologically proven IMT cases were retrospectively analyzed in this study.There were six female patients and two male patients.Patient average age was 35 (13-62) years.The main clinical manifestations were hematuria and urination pain.Tumors were found in the bladder in 5 cases,in ureter in 2 cases and in urethra in 1 case.All the 8 cases accepted CT scan five of which had contrast enhanced CT scan.The imaging features were then analyzed.Results Of the IMT in bladder,CT scan showed a cauliflower like bladder tumor or round soft tissue mass with even or uneven density of 11.5-36.0 HU.Three tunors were accompanied with necrosis.Four cases had associated adjacent bladder wall thickening and two cases were found with fuzzy surrounding fat space.Ureteral lesions in two cases showed a solid mass with smooth edges and even density of 40.3 HU compared to the surrounding muscle.The urethral lesions had clear mass realm of 17.5-22.6 HU accompanied with calcification.Enhanced CT scan showed that homogeneous or heterogeneous mild to moderate enhancement was found in the tumor.Delayed phase showed consistant enhancement of 102.7-118.6 HU.Conclusion Tumor CT imaging features,particularly the significant and consistant enhancement in delayed phase,provide important information for diagnosis and differential diagnosis of the urinary tract IMT.

Objective To investigate clinical,endoscopic and CT characteristics in Crohn's disease (CD),intestinal tuberculosis(ITB) and primary small intestinal lymphoma (PSIL).Methods In this study,39 cases of CD,24 cases of ITB and 23 cases of PSIL were retrospectively analyzed.Clinical and CT data were collected in all patients,23 CD cases,20 ITB cases and 20 PSIL cases underwent endoscopic exam.Chi-square tests or analysis of variance were used to evaluate and differentiate characteristics.Results Diarrhea,perianal disease,intestinal obstruction occurred significantly more in CD than in ITB and PSIL (x2 =10.134,6.769,8.000,P ＜ 0.05).Febrility,night sweating,pulmonary tuberculosis and ascites occurred more in ITB than in CD and PSIL (x2 =25.696,19.194,35.133,P ＜0.05).Abdominal mass,hematochezia and enterobrosis occurred more in PSIL than in CD and ITB (x2 =19.562,17.708,12.647,P＜0.05).Longitudinal ulcer,cobblestone sign were found more in CD than in ITB and PSIL(x2 =6.283,11.592,P ＜ 0.05).Transverse ulcer and rodent ulcer were found more in ITB than in CD and PSIL(x2 =15.633,19.686,P ＜ 0.05),but lump eminentia were found more in PSIL than in CD and ITB(x2 =26.120,P ＜0.05).Layering thickening,mural gas,fat,edema,enteric cavity stenosis,abscess were discovered more in CD than in ITB and PSIL (x2 =17.472,10.346,7.773,6.867,16.325,10.994,P＜0.05),single layer thickening and hollow lymph nodes were discovered more in ITB than in CD and PSIL(x2 =17.997,12.475,P ＜ 0.05).Multi segmental lesions was discovered more in CD and ITB than in PSIL (x2 =28.460,P ＜ 0.05),while single segmental lesions,mural single eccentric layer thickening and intussusceptions were discovered more in PSIL than in CD and PSIL (x2 =28.460,P ＜0.05).The intestinal wall thickening and lymph nodes enlargement in ITB and PSIL were higher than the CD (F =8.661,7.166,P ＜ 0.05),while the intestinal wall enhancement at CT imaging in PSIL was lower than CD and ITB (F =10.179,P ＜ 0.05).Conclusions Comprehensive analysis made on clinical,endoscopic and CT features of CD,ITB and PSIL may facilitate correct diagnosis.