Objective To explore the appearance of CT angiography(CTA)and magnetic resonance angiography (MRA)in persis-tent carotid-basilar artery anastomoses,and discuss its clinical significance.Methods 1 7 patients of persistent carotid-basilar artery anastomoses diagnosed by CT and MR angiography were retrospectively reviewed.10 patients were examined by craniocervical CTA, 7 patients were examined by cranial and cervical MRA,and 3 patients were examined by CTA and MRA.Results 10 patients had persistent trigeminal arteries (PTA).Based on Saltzman type:6 cases were Saltzman type Ⅰ,2 cases were Saltzman typeⅡ,and 2 cases were Saltzman type Ⅲ.1 case of 3 persistent hypoglossal arteries(PHA)originated from the right carotid artery,and 2 cases originated from the left external carotid artery.2 cases of 4 proatlantal intersegmental artery(PIA)were right ipsilateral,and 2 cases were left ipsilateral.1 case of PTA and 1 case of PHA associated with an aneurysm.6 cases of PTA,2 cases of PHA and 1 case of PIA complicated with ipsilateral vertebral arteries artopied or hypoplasia of the contralateral vertebral artery.Conclusion CTA and MRA can demonstrate clearly the course of persistent carotid-basilar artery anastomoses and its complicating intracranial coexisting abnormalities.Diagnosis of this anatomic variation may be helpful for providing reliable data to the guidance of surgery and interven-tional treatment.

Objective To analyze the relationship between the direct signs of invasive ductal carcinoma and the metastasis in the mammography.Methods 21 7 patients with invasive ductal carcinoma in the mammography were divided into four groups:mass with calcification group,mass without calcification group,calcification without mass group and the group without both mass and calcification. The correlation between metastasis and the size and shape of mass or calcification was studied.Results The rate of metastasis in the group with mass and calcification was 56.31%,and the percentage of the skin and nipple depressed in this group was 38.83%,both of whom were highest (P =0.004 and P =0.043)among four groups.The rate of metastasis in mass group was higher than that in the group without mass (46.27% vs 18.75%,P =0.033).Meanwhile,the edge burr and lobulation of the mass didn’t exert remarkable influence on the rate of metastasis (46.70% vs 25.00% and 43.37% vs 52.00%,P =0.389 and P =0.348).The probability of me-tastasis in the calcification group was higher than that in noncalcification group (53.57% vs 34.29%,P =0.001 ).However,in the calcification group,the different shapes of calcification did not result in significant difference in the rate of metastasis (51.19% vs 60.71%, P =0.382).In the 201 patients with breast cancer mass,the size of mass did not correlate with metastasis [(81.04±1 1 9.45)mm3 vs (70.06±208.30)mm3 ,P =0.654].The masses with lobulation were bigger than others [(7 6 .5 0 ± 1 7 4 .1 3 )mm 3 vs (8 .3 9 ± 1 0 .2 7 )mm 3 ,P =0.000],while the masses with edge burr were smaller than those with smooth edges [(52.10 ±85.90)mm3 vs (144.75±304.13)mm3 ,P =0.038].There was no significant correlation between the size of mass and the calcification [(80.39 ± 126.62)mm3 vs (69.63±209.12)mm3 ,P =0.660].However,the masses with point calcification were larger than those with both point and worm calcifications [(92.79±137.21)mm3 vs (41.71±94.58)mm3 ,P =0.041].Conclusion The mass and calcification in the mammography are valuable for judging the malignant degree of invasive ductal carcinoma.

Objective To investigate the clinical value of 256-slice CT angiography (CTA) in diagnosing coronary artery fistula(CAF).Methods A total of 18 patients with CAF were analyzed retrospectively.The raw data were transferred to the work station.Image reconstruction techniques were employed, including multiplanar reconstruction (MPR),curved planar reconstruction (CPR),maximum intensity projection (MIP) and volume render (VR).Results Coronary artery angiography showed fistula affluxed to the pulmonary artery in 5 cases,affluxed to the coronary sinus in 5 cases,affluxed to the right atrium in 3 cases,affluxed to the left atrium in 3 cases, affluxed to the right ventricle in 2 cases.The blood flow from abnormal vessels to pulmonary arteries was demonstrated in 5 patients,and injection sign or hyper-density of contrast material in the main pulmonary artery was seen.The tortuous vascular networks on the surface of the main pulmonary artery trunk were seen in 2 cases.Formation of aneurysm was seen in 3 cases.Conclusion 256-slice CTA can precisely show the detailed anatomy variations and heomodynamic information of CAF, and directly display the abnormal vessels with multiple image reconstruction techniques.

Objective To explore the value of dynamic contrast-enhanced MRI (DCE-MRI)and diffusion tensor imaging(DTI)in grading of glioma.Methods 3.0T DCE-MRI and DTI scans were performed in 31 patients with glioma confirmed by pathology.Capacity volume transfer constant (Ktrans ),extravascular extracellular volume fraction (Ve ),exchange rate constant (Kep ),initial area under the gadolinium concentration-time curve (iAUC),and relative fractional anisotropy (rFA)were measured in the low grade glioma (LGG)and the high grade glioma (HGG).The correlation between parameters of DCE-MRI and rFA with microvessel denisity (MVD)and microvessel structure (MVS)were performed by Spearman rank correlation analysis.Results The MVD and MVS were positive correlation with the grading of glioma.Ktrans ,Kep ,Ve ,iAUC and rFA values of the LGG were (0.02±0.01)min-1 ,1.82 (0.18-8.54)min-1 ,0.05±0.03, 2.47±1.66 and 0.55±0.22,respectively.Ktrans ,Kep ,Ve ,iAUC and rFA values of the HGG were (0.1 1±0.02)min-1 ,1.31 (0.12-7.58)min-1 ,0.28±0.10,10.84 ±6.46 and 0.28 ±0.08,respectively.The differences of all parameters between the LGG and the HGG were statistically significant,except for Kep (P <0.05 ).Ktrans ,Ve and iAUC values were positive correlation with MVD and MVS (P <0.05),and rFA values were negative correlation with MVD and MVS (P <0.01).Conclusion The quantitative parameters of DCE-MRI and DTI have important values in grading of glioma and evaluating tumor angiogenesis and microvessel structure.

Objective To summarize the imaging features of intracranial solitary fibrous tumors (ISFT).Methods Ten patients with ISFT proven histopathologically were collected.Four cases had CT data and all cases had MR data.The imaging features and pathological results were retrospectively analyzed.Results All cases were misdiagnosed as meningioma at pre-operation.All lesions arose from intracranial meninges including 5 lesions above the tentorium,4 lesions beneath the tentorium and 1lesion growing around the tentorium.The margins of all the masses were well defined,and 8 lesions presented multilobular shape.CT demonstrated hyerattenuated masses in all 4 lesions,smooth erosion of the basicranial skull in 1lesion,and punctiform calcification of the capsule in 1lesion.T1WI showed most lesions with isointense or slight hyperintense signals including homogeneous in 4 lesions and heterogeneous in 6 lesions.T2WI demonstrated isointense or slight hyperintense in 2 lesions,mixed hypointense and hyperintense signals in 4,cystic portion in 2,and two distinct portion of hyperintense and hypointense signal,so called “yin-yang”pattern,in 2.Strong enhanced was found in all lesions,especially in 8 lesion with heterogeneous with the low T2 signal.“Dural tail” was found in 4 lesions.Conclusions ISFI has some specific CT and MR features including heterogeneous signal intensity on T2WI,strong enhancement of areas with low T2 signal intensity,slight or no “dural tail”,without skull thickening,and the typical “yin-yang” pattern.

Objective To investigate the clinical value of 64-slice spiral computed tomography(64-MSCT)triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters de-termined metastatic perigastric lymph node as follows:①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters (①+②)in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters (①+②+③)were 98.2% and 1 9.4%,respec-tively.The sensitivity and specificity of combining four parameters (①+②+③+④)were 99.7% and 13.2%,respectively.In ad-dition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.

Objective To investigate the correlation between the feature of lobulation, degree of lobulation on CT images and epidermal growth factor receptor gene (EGFR) mutations in advanced pulmonary adenocarcinoma. Methods Two hundred and one patients who were diagnosed with advanced pulmonary adenocarcinoma between January and December 2017 and had undergone a chest CT and EGFR mutation testing at Shanghai Pulmonary Hospital were enrolled in this retrospective study. The clinical and imaging data of the patients were analyzed. The patients were classified into EGFR mutations group (107 cases) and wild type group (94 cases) according to whether EGFR gene mutation occurred. The feature of lobulation (described as presence of lobulation, absence of lobulation, or obscured margin), degree of lobulation (including deep lobulation, shallow lobulation, no lobulation, and obscured) on CT images were statistically compared between the two groups. Results Based on the presence or absence of lobulation sign, there were 99, 0, 8 cases with lobulation, no lobulation, obscured margin in the EGFR mutations group and 80, 1, 13 cases in the wild type group, respectively. There was no significant difference in lobulation sign between the EGFR mutations group and wild type group (P=0.152). According to the degree of lobulation, there were 32, 67, 0, 8 cases of deep lobulation, shallow lobulation, no lobulation, obscured margin in EGFR mutations group and 60, 20, 1, 13 cases in wild type group. Significant differences of frequency were found regarding deep lobulation and shallow lobulation between the two groups (P<0.001). However, there was no significant difference between the two groups in the presence of no lobulation, and obscured margin (P>0.05). Conclusions EGFR mutations are significantly associated with shallow lobulation in advanced pulmonary adenocarcinoma. Conversely, deep lobulation is more likely to appear in advanced pulmonary adenocarcinoma with wild?type EGFR. However, there is no association between EGFR mutation status and the presence of lobulation.

Objective: To investigate the correlation between the feature of lobulation, degree of lobulation on CT images and epidermal growth factor receptor gene (EGFR) mutations in advanced pulmonary adenocarcinoma. Methods: Two hundred and one patients who were diagnosed with advanced pulmonary adenocarcinoma between January and December 2017 and had undergone a chest CT and EGFR mutation testing at Shanghai Pulmonary Hospital were enrolled in this retrospective study. The clinical and imaging data of the patients were analyzed. The patients were classified into EGFR mutations group (107 cases) and wild type group (94 cases) according to whether EGFR gene mutation occurred. The feature of lobulation (described as presence of lobulation, absence of lobulation, or obscured margin), degree of lobulation (including deep lobulation, shallow lobulation, no lobulation, and obscured) on CT images were statistically compared between the two groups. Results: Based on the presence or absence of lobulation sign, there were 99, 0, 8 cases with lobulation, no lobulation, obscured margin in the EGFR mutations group and 80, 1, 13 cases in the wild type group, respectively. There was no significant difference in lobulation sign between the EGFR mutations group and wild type group (P=0.152). According to the degree of lobulation, there were 32, 67, 0, 8 cases of deep lobulation, shallow lobulation, no lobulation, obscured margin in EGFR mutations group and 60, 20, 1, 13 cases in wild type group. Significant differences of frequency were found regarding deep lobulation and shallow lobulation between the two groups (P<0.001). However, there was no significant difference between the two groups in the presence of no lobulation, and obscured margin (P>0.05). Conclusions EGFR mutations are significantly associated with shallow lobulation in advanced pulmonary adenocarcinoma. Conversely, deep lobulation is more likely to appear in advanced pulmonary adenocarcinoma with wild-type EGFR. However, there is no association between EGFR mutation status and the presence of lobulation.