Objective To evaluate Meta-analysis in assessing the overall diagnostic value of adenosine stress echocardiography (ASE) in patients with coronary heart disease (CHD). Methods Relevant English and Chinese articles about ASE for assessing diagnostic accuracy of CHD were collected from the literatures published from 1994 to 2007 in China and abroad. Meta-analysis was conducted with the method recommended by the Cochrane Collaboration. Results Twelve papers were included. The reported sensitivity of ASE for the diagnosis of CHD ranged from 0.69 to 0.94, and the specificity ranged from 0.71 to 1.00. The pooled weighted sensitivity and specificity was 0.81 (95%CI 0.77-0.85) and 0.83 (95%CI 0.78-0.87), respectively;and the pooled positive and negative likelihood ratio was 4.81 (95%CI 3.65-6.33) and 0.22 (95%CI 0.18-0.28), respectively. The area under the curve of the summary receiver operating characteristic was 0.8968±0.0151. Conclusion ASE is medium to highly accurate in the diagnosis of CHD.

Objective To analyze scanned image optimization based on the multifractal soectrum and image fractal algorithm of 64-slice spiral CT in brain of infant. Methods The image data of Toshiba Aquilion 64-slice CT scanning using 10 mAs were imported to image processing toolboxs of Matlab 7.1. The evaluation of muhifractal spectrum and image denosing were performed, and compared with image quality of conventional low-dose CT using 50 mAs. Results The low-contrast scanned image used 10 mAs is the valueless medical image because of serious noise. Image denoise based on the fractal model had superior characteristic of image detail preserving and better contrast-to-noise ratio(CNR). There existed a group difference in the score of image quality between the rude imaging noise and optimized image based on the muhffraetal spectrum algorithm, though the score was still significantly lower than the normal dosage scanned image(F = 38.85, P < 0.01). The group difference was also manifested the image quality of infants can achieve basieaUy the request of clinical diagnosis by suitable model denoising algorithm. Conclusions Image denoising based on the multifraetal spectrum model can be used on the low-dose and low-contrast CT image optimization. It improved the CNR of the pathological region. The radiation dose of CT scanning in infants would be declined significantly by its further application in the future.

Objective To explore the role of MR imaging (MRI) in the differential diagnosis of pleural tumor. Methods Forty five cases of pleural tumor (8 benign and 37 malignant) were examined with both CT and MRI. The morphologic features of pleural lesions and MR signal intensity on T 1 weighted, T 2 weighted, and contrast enhanced T 1 weighted images were evaluated. Results On CT images, it was found that 30 cases were with diffuse pleural thickening (29 malignant and 1 benign), 28 with mediastinal pleural involvement (27 malignant and 1 benign), 23 with circumferential or irregular pleural thickening (22 malignant and 1 benign), and 9 with infiltration of the chest wall or diaphragm (only in malignant patients). On MR images, it was found that 32 cases were with diffuse pleural thickening (31 malignant and 1 benign), 29 with mediastinal pleural involvement (27 malignant and 2 benign), 24 with circumferential or irregular pleural thickening (23 malignant and 1 benign), and 11 with infiltration of the chest wall or diaphragm (only in malignant patients). According to the above mentioned morphologic features, CT had a sensitivity of 83.8% and a specificity of 62.5% in the detection of pleural malignancy, as compared to 86.5% and 62.5% by MRI, respectively. In combination with signal intensity and morphologic features, MRI had a sensitivity of 97.3% and aspecificity of 100% in the detection of pleural malignancy. Conclusion According to the morphological features only, MRI allowed a similar value in the detection and diagnosis of pleural tumor compare with CT. In combination with signal intensity and morphologic features, MRI is more useful and, therefore, superior to CT in differentiation of malignant from benign pleural tumor.

Objective To investigate the application value of spiral CT imaging in diagnosing costal cartilage diseases. Methods CT volume scan with 1～7mm layer thinkness and 1～2.5mm layer distance was performed in 28 cases of costal cartilage diseases and 200 cases of controls. All of the original images were processed to form the thin layer reconstruction of low contrast and high contrast, and then the reconstructed images were transmitted to CT 3D work-station to perform the image reconstruction by MPR, MIP and SSD methods. The ability of different image techniques in displaying costal cartilage was compared, and costal cartilage pathological changes were analyzed. Results The CT scanning images of 228 cases could display the costal cartilage after the management of MPR, MIP and SSD, and the images managed with MIP and SSD were better. Among 28 patients with costal cartilage diseases, 13 cases of costal cartilage damage,9 cases of costal cartilage inflammation and 6 cases of costal cartilage malformation were found. Conclusion Spiral CT image could display the costal cartilage perfectly, was a new means of researching costal cartilage morphology in living body, and was the best imaging technique of researching costal cartilage disease without trauma.

Objective To detect apoptosis of transplanted lung adenocarcinoma cells in nude mice after 125I brachytherapy by 99Tcm-Annexin V combined with diffusion weighted MRI (MR-DWI).Methods Twenty-five BALB/c-nu nude mice models subcutaneously transplanted with A549 cells were divided into experimental group (EG,n=13) and control group (CG,n=12) by random number table method.One 125I seed with apparent activity of (24.8±6.3) MBq was implanted into each mouse in EG,while CG underwent cold seed implantation.Both of 99Tcm-Annexin V imaging and MR-DWI were performed within 7-10 d after brachytherapy,then all mice were sacrificed and tumor cell apoptosis was detected by terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) immunofluorescence,Survivin expression was assayed by SP.Two-sample t test,x2 test and Pearson correlation analysis were used for data analysis.Results Positive rate of cell apoptosis by 99Tcm-Annexin V imaging was 69.2％(9/13) and 8.3％(1/12) respectively in EG and CG (x2 =12.73,P＜0.01).The uptake ratio of 99Tcm-Annexin V,apparent diffusion coefficient(ADC) value and apoptosis index(M) of the tumor in EG were 2.91±0.85,(2.03±0.44)×10-3 mm2/s and (49± 18) ％,respectively,which were significantly higher than those of CG (1.26 ± 0.37,(1.29 ± 0.21) ×10-3 mm2/s and (11±4)％ respectively,t=5.930,5.452,7.606,all P＜0.05).Survivin expression in EG and CG was (46± 13) ％ and (15±7) ％ respectively (t =5.158,P＜0.05).The value of ADC was correlated with AI and uptake ratio(r=0.756,0.788,both P＜0.05).Uptake ratio was correlated with AI (r=0.754,P＜0.05),while Survivin expression was negatively correlated with AI (r =-0.772,P＜0.05).Conclusions Down-regulation of Survivin expression may play an important role in apoptosis induced by 125I brachytherapy.99Tcm-Annexin V combined with MR-DWI could effectively evaluate apoptosis of lung adenocarcinoma cells in a non-invasive way,thus it might be helpful in evaluation of early efficacy of 125I brachytherapy.

Objective To observe the relationship between CT signs, prognosis and the expression of CD44v3 and CD44v6 in peripheral non-small-cell lung cancer (NSCLC). Methods The expression of CD44v3 and CD44v6 was detected with immunohistochemistry (SP method) in 46 patients with peripheral NSCLC confirmed by surgery and pathology. The expression, CT signs and prognosis of NSCLC were analyzed respectively. Results The expression of CD44v3 and CD44v6 correlated with deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum (P<0.05), but not with the tumor size, vacuole sign, vessel convergence sign and pleural indentation in CT images of peripheral NSCLC (P＞0.05). The expression of CD44v3 and CD44v6 correlated with the three-year survival rate in peripheral NSCLC patients (P<0.05). Conclusion Deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum may indicate strong potential invasion and metastasis in peripheral NSCLC. The positive expression of CD44v3 and CD44v6 may suggest shorter survival time and poorer prognosis in peripheral NSCLC patients.

Objective To investigate the imaging methods of multi-slice CT(MSCT) in costicartilage and the diagnostic value in the costicartilage injuries. Methods There were 100 cases in normal group and 36 cases in group of chest injuries. All cases were performed in volume scan according to conventional chest scan by SIEMENS Sensation 4 MSCT, then performed in thin slice low and high contrast image reconstructions. After that, all the source images were input into CT 3D workstations,costicartilage were imaged by postprocessing software such as multiplanar reconstructions(MPR), maximum intensity projection(MIP), surface shade display(SSD) and volume rendering technique(VRT). All the pictures were observed and analyzed by two radiologists. Results All postprocessed images that obtained from the MSCT could show the costicartilage clearly. Normal costicartilage displayed uniform density,regular shape and smooth surface;there were 6 injuries in 10 cases with costicartilage injuries,which displayed no uniformity density or cranny in costicartilage and showed cranny in 2 cases. No significant difference of image quality was found among the three imaging modes of MIP、SSD、VRT(?2=1.356, P=0.716). [JP2]Significant differences were found between MPR and other three imaging modes(U_ MIP:MPR=[JP]12.981,U_ SSD:MPR=12.652, U_ VRT:MPR=12.937, P=0.000). Conclusion So far, the MSCT is the best noninvasive imaging method to show the shape of costicartilage, it may be considered as a clinical “gold standard” in the diagnosis of costicartilage injury.

0.05).(2)In 67 cases with pre-and post-image selection and reconstruction in single-slice or twin-slice helical CT,the slice concordance rate in measurement was 20.98% and 97.01%,respectively(?2=80.22,P=0.00).The slice concordance was all accomplished with the same method in multi-slice helical CT in 5 cases.(3)Peak heights and SPN-to-aorta ratios of malignant [(38.48?14.32)HU,(19.64?9.52)% ] and inflammatory SPN [(42.48?11.55)HU,(21.14?7.77)%] were significantly higher than that of benign SPN [(9.52?3.78)HU,(3.41?1.86)%,P0.05).Slice optimization of dynamic contrast-enhanced CT scan improved the diagnostic accuracy of SPN from 78% to 80%.Conclusion No significant efficacy was found in the attenuation between primitive images and reconstructive images with the same slice thickness of homogenous material.Slice concordance of dynamic contrast enhanced spiral CT could reflect objectively the morphological appearance and CT value changes of solitary pulmonary nodules,and may improve the veracity of diagnosis.

Objective: To study the efficiency of silencing small ubiquitin-like modifier-1(SUMO-1) induced by siRNA in hepatocellular carcinoma cell line SMMC-7721 and the growth inhibition of SMMC-7721 thereof. Methods: The SUMO-1 siRNA was transfected into SMMC-7721 by means of lipofectamine~(TM) 2000. The silencing efficiency of SUMO-1 was examined by RT-PCR and western blot. The cell growth and cell cycle were examined by MTT and flow cytometry(FCM). The cell apoptosis was detected by DeadEnd~(TM) Colorimetric TUNEL System. Results: The siRNA could significantly silence the expression of SUMO-1 in SMMC-7721.The maximal silencing rate was utmost 73.43% at 48 hours after being transfected SUMO-1 siRNA. MTT assay revealed that the cell line grew more slowly. FCM result showed that the number of G_2 stage cells was increased significantly. But apoptosis cells were not found by TUNNEL assay. Conclusion: SiRNA is a good manner to silence the expression of SUMO-1 in SMMC-7721 in vitro. Owing to the growth inhibition induced by SUMO-1 siRNA, SUMO-1 plays an important role in development of SMMC-7721.

Objective To analyze effect of balloon embolization therapy for traumatic carotid cavernous fistula (TCCF),so as to provide references for treatment of this disease.Methods A total of 21 patients with TCCF managed with balloon embolization from April 2006 to March 2012 were collected in the study.There were 17 males aged (32.3 ±5.4) years and 4 females aged (40.6 ±5.8)years.Perioperative clinical presentations and imageologic changes were observed as well as operative outcome was evaluated.Results After 3 months of follow-up,20 patients experienced successful detachable balloon embolization,but the other one patient had to have stent angioplasty due to the failure of the procedure.All patients had some improvements on clinical presentations after operation (P ＜ 0.05).Imageologic examination revealed that all patients had complete occlusion of TCCF following operation.In follow-up,one patient had a relapse,with total curative ratio of 95％.Conclusions Detachable balloon embolization is effective in treatment of TCCF.Presently,the technique is an optimal method for such kind of disease and is worthy of wide clinical use.