Objective To study the clinical value of colorectal carcinoma exa mination by comparison of different postprocessing techniques such as multiplana r reformation(MPR),CT virtual colonoscopy(CTVC), shaded surface display(SSD) a nd Raysum. Methods 64 patients with colorectal carcinoma s underwent volu me scanning using spiral CT. MPR, CTVC, SSD and Raysum images were obtained by u sing 4 different softwares in workstation. All cases were proved by surgical or CC bioptic histology. The results were compared and analyzed according to the circumferential extension, length and pathologic patterns of colorectal carcinoma with MPR, CTVC, SSD and Raysum. Results The correct ion rate of dete rmination the circumferential extension of colorectal carcinoma with MPR, CTVC, SSD and Raysum were 1000%, 828%, 797% and 797%, respectively There wa s signi ficant statistical difference between MPR and CTVC; The accuracy of judging the leng th of carcinoma were 891%, 766%, 953% and 1000%, respectively. There wa s stat istical difference between CTVC and SSD; The accuracy of showing carcinoma patho logi c patterns were 813%, 922%, 719% and 719%, respectively. There was stati stica l difference between CTVC and SSD, too. MPR could correctly determine the circum ferential extension of colorectal carcinoma. In determination the length of carc inoma, Raysum was more accurate than SSD. CTVC could be more helpful in showing carcinoma pathologic patterns. Conclusion There were advantag es and disadvant ages in colorectal carcinoma examination with MPR, CTVC, SSD and Raysum, and the combination could display colorectal carcinoma more completely and comprehensiv ely.

Background: CT scan of hepatic carcinoma after transarterial embolization with Lipiodol (LP-TAE) will be influenced. A comparative study was made between CT scan and hepatoarteriography in hepatic carcinomas fully filled with Lipiodol after TAE for the purpose of demonstrating the difference. Materials and Methods: 20 cases of hepatic carcinoma fully filled with Lipiodol after TAE 1 to 8 months, confirmed by CT scans. Hepatoarteriography were then done 1 to 14 days afterwards. The demonstration of the original and new foci were thus be compared respec- tively by these methods. Results: The original tumor lesions were all stable on CT scans and new tumor lesions were found in 5 cases. Three features were found in arteriographies of the original tumor lesions: (1) stable, no obvious tumor vessels and stain; (2) tumor vessels and stains confined within the LP accumulated areas; (3) largely increased lesions exceeding the LP accumulated areas; (3)largely increased lesions exceeding the LP accumulated areas. Also other three features were found in new tumor lesion: (1) multiple intrahepatic daughter nodules; (2)small arterioportal shunts; (3) new masses. Conclusion: (1) Although good results had been archieved, but the lesions were not stabe in many of them. Long interval follow-up and TAE were not suitable. (2) Stage-Ⅱ surgical resection should be taken cautiously. (3) New techniques of CT scan and superselective he- patic arteriography with high flow rate should be adopted to improve the accuracy rate of de- monstrating tumor lesion.

Objective To analyze the time-density curve of the small HCCs in the arterial phase and to find out its unique features.Methods All lesions were imaged with single-level serial SCT.The attenuations of the lesion,hepatic artery and hepatic parenchyma were measured.The time-density curve was built with these CT values and their corresponding times.Results The time-density curves of the lesion and liver parenchyma were divided into three kinds:the first kind had two intersects(73%).The first one was seen at the time when the curve of the lesion went up over the one of the parenchyma and the second was seen at the point the curve came down below the parenchyma's.There was no second intersecting point in the second type(19.2%) and the curve of the lesion was below that of the parenchyma in the third (7.7%). Conclusion The initial time of the enhancement of small SHCC is (21.6?6) s.The optimal time of the enhancement of SHCC is (36?8) s.

Objective To improve the diagnostic accuracy of ovarian endometrioma and to discriminate it from other adnexal masses by analyzing its CT manifestations. Methods The CT images of 57 patients with 77 ovarian endometriomas proved by surgery and pathology were studied retrospectively.Results The cysts ranged in diameter from 2 to 14 cm with the mean size of 6.2 cm?5.1 cm. The margins of the cyst were sharp in 39 and ill defined in 38 endometriomas. Thin and thickened walls were found respectively in 40 and 37 of 77 endometriomas. Unilocular, bilocular and multilocular forms were seen respectively in 29(37.7%), 23(29.9%) and 25(32.5%) of 77 endometriomas. Gourd and sister forms were present respectively in 15 and 8 of 23 bilocular cysts, and sister loculi, outer son loculi, inner son loculi, and mixed forms in 10, 9, 1 and 5 of 25 multilocular endometriomas. The density of the cyst fluid varied from 11～65 HU with the mean of 28.5 HU. New hemorrhage inside cyst was found in 6 cysts. Slight or intermediate enhancement of the cyst wall of endometriomas in 42, and significant enhancement in 35 were demonstrated. 54 cysts, 13 cystadenomas with 18 lesions and 4 malignant tumors with 5 lesions were diagnosed by preoperatively by CT. The accurate rate of CT characterization was 71.4%. Conclusion The certain morphologic characteristics of the ovarian endometrioma can be showed by CT in higher extent. It is critical to familiar with these characteristics to improve the diagnostic accuracy, and to avoid misdiagnosis.

Purpose:To evaluate the role of CT in diagnosing local recurrence after surgery of gastric carcinoma. Methods:Two groups of 51 patients after surgery of gastric carcinoma were prospectively studied by means of CT performed with the water as oral contrast,hypotonic agent and dynamic or spiral CT technique. 15 patients proved to be without local recurrence measured the thickness and observed the CT findings of anastomosis stoma ,36 patients proved to have local recurrence ,those patients included male 21 and female 15.Results:90.19%(46/51)anastomosis stoma was clearly demonstrated ,and 32 lesions was detected and confirmed the diagnosis in 29 of 32 cases . The CT findings of local recurrence after gastric resection for gastric cancer were irregular gastric wall thickening ( n =14),local mass ( n =6) and mixed lesions ( n =9).Conclusions:Using the optimal technique can improve the detectability and accuracy of CT for diagnosing the local recurrence after surgery for gastric carcinoma.

Objective To define the CT imaging characteristic of menetrier disease. Methods Four patients with proved Menetrier disease were retrospectively studied by means of CT performed with the water as oral contrast, hypotonic agent and dynamic or spiral CT technique. Results All cases showed that the enlarged rugae were seen projecting into the gastric lumen, but the gastric wall was otherwise normal. CT detected all lesions and made a confirmed diagnosis before pathology biopsy. Conclusion Our primary result revealed that the CT appearance of Menetrier disease was quite characteristic, CT is a very valuable tool for the diagnosis of Menetrier disease.

Objective To evaluate the usefulness of three dimensional dynamic contrast enhanced magnetic resonance angiography(3D DCE MRA) in the diagnosis of vena caval abnormalities. Methods 3D DCE MRA was performed on fifty two patients with suspected vena caval anomaly, thrombosis, stenosis, occlusion, or compression. Image quality and the presence of venous abnormalities and collaterals were evaluated. Comparison with conventional venacavography( n =15) and surgical findings( n =18) was made. Results 3D DCE MRA images were of diagnostic quality without artifact for all 52 patients. 3D DCE MRA clearly showed vascular anatomy, anomaly and various disorders. The site, extent, cause of venous obstruction, and collateral pathways were well depicted. According to venography or surgery, the sensitivity and specificity of 3D DCE MRA in the diagnosis of abnormalities of vena cava were both 100%. In addition, it had advantages regarding demonstration of extravascular lesions and multiplanar capabilities. Conclusion 3D DCE MRA is simple to perform and accurate in detecting various vena caval abnormalities.

Objective To investigate the curative effect and influential factors of small hepatocellular carcinoma (SHCC) treated by interventional therapy. Methods 42 patients with SHCC were treated by interventional therapy. Some possible prognostic factors were analysed with COX proportional hazard regression model. Results (1)Hepatic arteriographic manifestations: 26 of 42 cases SHCC revealed rich tumor vessels, 37 had tumor stain including 34 with nodular stain. (2)The overall 1 , 3 , 5 year survival rates of SHCC using Kaplan Meier method were 88%(37/42),74%(31/42),51%(21/42), respectively. (3)Clinical staging and typing of the patients,and accumulation of Lipiodol within the tumor obviously influenced interventional effects of SHCC. Conclusion (1) The most important diagnostic angiographic sign of SHCC is tumor staining, besides tumor vessels. (2) Interventional therapy of SHCC has an ideal effect and should be an important nonoperable curative method.

Objective To investigate the safety and efficacy of placement of self expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56 3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. “Z” type stainless steel stents (7 5～10.0 cm in length and 2 5 cm in diameter) were selected for these patients. Part (1.0～3.0 cm in length ) of stent was placed in right atrium and the rest was in ICV. Results All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow up period (67～188 days). Conclusion Placement of self expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods.

Objective To investigate the MR features of uterine leiomyomas and evaluate its diagnostic value. Methods Twenty six patients with probable uterine leiomyomas underwent preoperative ultrasound, T 1 weighted spin echo and T 2 weighted fast spin echo MR examinations. Among them, 11 cases were performed with dynamic contrast enhancement. Comparative analysis between MRI findings and pathologic results was done. Results MRI diagnosis in all cases was consistent with the results given by surgery and pathology, except 2 being pathologically proven as endometrial polyp or inflammatory pseudoplasma. The diagnostic accuracy of MRI was 92%, while the accuracy of ultrasound was 85%. The difference between the number of lesions detected by two modalities had statistical significance (89% for MRI vs 69% for ultrasound, ? 2=17.86, P