The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.

Objective To evaluate the clinical value of dual-energy CT in the detection of monosodium urate crystals in patients with gout.Methods One hundred and eight patients who experienced unilateral arthrocele and (or) joint pain in the past two weeks were enrolled into our study.DECT were performed for the upper or lower extremity.Ninety-five patients were enrolled into the gout study group based on the American rheumatism association (ACR) classification standard;The 0.3 linear blended images group were regarded as conventional CT group,DE (80 kV and 140 kV) datasets were reconstructed via gout-recognition software,the pseudo-color images group as the postprocessed group.Imagings were reviewed independently by two senior radiologists.Chi-square test were used for statistical analysis with the SPSS 13.0software.Results In the conventional CT group,DECT scans revealed a total of 298 areas of urate deposition in 51 patients;The sensitivity,specificity,and accuracy were 53.7％,84.6％,and 57.4％.In the postprocessed group,401 areas of green urate deposition were detected in 69 patients,the sensitivity,specificity,and accuracy were 72.6％,100.0％,75.9％ respectively,the differences had statistical significance (x2 =7.329 and 8.333,P ＜ 0.05).Conclusions DECT gout recognition technology can detect smaller amount of monosodium urate in the other parts of the body,with a great potential in early diagnosis and treatment monitoring of patients with gout.

Objective To evaluate the CT features of the uncommon neoplasms of the paranasal sinuses and nasal cavity and related differentiate diagnosis.Methods CT manifestation of 26 cases with uncommon neoplasm of the paranasal sinuses and nasal cavity confirmed by histopathology were retrospectively analyzed and compared with 9 cases of common malignant neoplasm. Results All cases had soft-tissue mass with sinusitis in most cases (27/35).In benign group, 7 cases appeared as common benign tumor except for the hemangioma with marked enhancement and meningioma with calcification . In the malignant group, melanoma was small in volume and malignant granuloma was in infiltrative growth .The others had common appearances of malignancies.Conclusion CT signs are not characteristic in most cases compared with the common neoplasms. Surface configuration, bony change and circumstances are the main considerations in differentiate diagnosis and should be related to clinical and pathological materials..

Clinical data and manifestations on muhi-slice spiral CT (MSCT) of 11 patients with disseminated peritoneal adenomucinosis (DPAM) were retrospectively reviewed.The CT manifestations were also compared with surgical and histopathological findings.MSCT findings showed a large amount of gel-like ascites in 9 cases and local cystic masses in 2 cases.Among 9 cases with a large amount ascites,abdominal multiple cystic masses were shown in 5 case,and infiltration of the greater omentum and mesentery in 5 cases.Hepatic scalloping was found in 6 cases ; parenchymal invasion of the liver or spleen were showed in 5 cases; calcification of the cystic masses in 5 cases.Ovary mueinous cystadenoma was presented in 3 female patients.Enlarged lymph nodes and omental cake were not found in all cases.The results indicate that the characteristic MSCT manifestations of DPAM include diffuse gel-like ascites,multiple cystic masses with or without calcification,hepatic scalloping and parenchyma invasion.

Objective To evaluate the dose reduction technology using in CT-guided percutaneous lung biopsy of pulmonary lesions using automated core needle biopsies (ACNB).Methods 412 ACNB cases included 146 consecutive conventional patients (group A,120 kV/100 mA) and 266 consecutive patients (group B,120 kV/20 mA,low-dose scanning,reduce scanning width and scanning frequency).The quality of images was compared by grain homogeneity,fine structure,clearness of tissue interface and artifacts.The total diagnostic accuracy rate,the examination time and radiation dose between group A and group B were compared.Results The fine structure of group B was significantly lower (X~2 ＝7.0508,P ＜ 0.05).The total diagnostic accuracy rate was 95.9% vs 95.1% (X~2 ＝0.1296,P ＜ 0.05).The examination time for biopsy procedure was (16 ±2.2)min vs (15.9 ±2.0)min (t ＝ 1.3579,P ＜ 0.05) ,and the mean effective dose (E) was (1.74 ± 0.7) mSv vs (0.59 ± 0.14) mSv (t ＝ 19.3415 ,P ＜ 0.05) .The E of group B decreased by 66%.Conclusions ACNB is a feasible and accurate method for diagnosing pulmonary lesions,and the E can significantly reduce the dose received in low-dose scanning.

aused by pulmonary cryptococcus infection.Conclusions CT-gnided ACNB was a feasible, safe and accurate method for diagnosing pulmonary lesions, pulmonary malignant lesions less than 20 mm in diameter and complicated with pulmonary maybe affect accuracy.

Objective To evaluate the microstructural integrity of white matter (WM) in mild cognitive impairment ( MCI ) and Alzheimer disease (AD) using DTI technique, and to explore the relationship between WM abnormalities and cognitive dysfunction. Methods Nine cases of amnestic MCI, 15 cases of mild probable AD and 11 cases of normal controls (NC) with normal-appearing WM (NAWM) were studied using 3. 0 T MR system. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in different WM areas. One-way analysis of variance was used to test the difference among the three groups for DTI indices. Spearman Correlation analysis was applied to reveal the correlation between the DTI indices and the MMSE and CASI scores. Results The FA value in parietal, centrum semiovale, posterior cingulate gyrus, parahippocampus, temporal and frontal WM in MCI was 0. 31 ± 0.03,0. 39 ± 0. 03,0. 62 ± 0. 05,0. 59 ± 0. 05,0. 47 ± 0. 08,0. 32 ± 0. 04, respectely, and MD value was ( 899 ± 30 ) × 10-6,(782±53) × 10-6, (732±45) × 10-6, (806±38) × 10-6, (772 ± 55) × 10-6, (792 ± 35) × 10-6 mm2/s. The FA value of these regions in AD was 0. 28 ± 0. 04, 0. 37 ± 0. 03,0. 55 ± 0. 06,0. 52 ± 0.05,0.40±0. 05,0. 27 ± 0. 04,and MD value was (912±37) × 10-6,(800 ± 67) × 10-6, (762 ± 46) × 10-6, (874±57)×10-6,(822±55)×10-6, (822±39)×10-6 mm2/s. The FA value in NC was 0.36±0.03,0.43±0.05,0.64±0.05, 0.60±0.05, 0.52±0.05,0.33±0.03, and MD value was (866±37)×10-6,(754±54)×10-6,(718±32)×10-6,(810±39)×10-6,(755±48) × 10-6, (785±23)×10-6 mm2/s. Compared with NC, the FA value in parietal WM was significantly decreased in MCI(P<0. 01 ), The significantly reduced FA values in parietal, centrum semiovale, posterior cingulate gyrus, parahippocampus, temporal and frontal WM , as well as significantly elevated MD values were found in AD(P <0. 05). There was significant correlation between these DTI indices and MMSE and CASI scores (P<0.05). Conclusions MR DTI can detect WM abnormalities in AD and MCI. The parietal WM abnormalities and the disconnection of WM circuitry may play an important role in the development of dementia.

ObjecfiveTo investigate clinical features and imaging manifestation in patients with posterior reversible eneephalopathy syndrome (PRES) to improve its recognition.MethodsSix patients with PRES were enrolled,four women with history of end-stage renal disease,kidney transplantation,eclampsia,or systemic lupus erythematosus (SLE) and two men with history of chemotherapy or hypertension.All of them underwent multi-serial MR imaging (T1 WI,T2 WI,FLAIR) and post-contrast T1 WI.Three cases also underwent CT scan and gadolinium enhancement. ResultsAll the six cases of PRES had different inducing causes such as acute hypertension,preeclampsia or eclampsia, taking immunosuppressive agents or steroids.and their clinical symptoms were characterized by sudden occurrence of headache,eclampsia or seizure of epilepsy,altered melltal status,visual disturbances.Clinical symptoms were died out in about one week after prompt and appropriate treatments for high blood pressure.or removal of precipitating factors,or treatment for epileptic seizures or status epilepticus.MRI and CT scanning demonstrated multifocal subcortical white lesions in bilateral parieto-occipital lobes (six cases), bilateralfrontal lobes (two cases),bilateral post temporal lobes (two cases) and left cerebellum (one cases).and cortical involvement (two cases).All lesions appeared unenhanced with gadolinium enhancement. FoHow-up by MRI showed decreased abnormal signs and small infarct foci were left in the cortex-subeortex of one case.ConclusionsPRES is a clinico-neuroradiologieal transient condition, usually benign and reversible in nature.Completely clinical and radiographic recovery Can be achieved with prompt antihypertensive treatment or removal of precipitating factors and supportive care,but delayed diagnosis and therapy Can result in cerebral infarct with neurological sequelae.

Objective To investigate the association of multi-modality neuroimaging features and cognitive function in mild cognitive impairment (MCI) and Alzheimer's disease (AD).Methods Nine individuals with amnestic MCI (aMCI), fifteen patients with mild probable AD, and eleven age-controlled cognitively normal controls (NC) were recruited.All participants were administered with mini-mental status examination (MMSE) and Cognitive assessment screening instrument (CASI) to assess general cognitive function.Optimized voxel-based morphometry ( VBM ) was used for the analysis with 3-D high resolution anatomical images.Values of fractional anisotropy (FA) and mean apparent diffusivity coefficient (ADC) were measured from different brain regions on diffusion-tensor images ( DTI) .The relationship between structural atrophy and DTI-based measurements in the selected brain regions was examined.Results The scores of MMSE and CASI were correlated with the volumetric changes in such areas as temporal, frontal and parietal lobes, and cingulate gyrus and hippocampal gyrus (P <0.001).The scores of MMSE and CASI were positively correlated with FA values, and negatively with ADC values in the white-matter-affected regions including temporal, frontal, parietal lobes, cingulate gyrus, and parahippocampal gyrus (P < 0.05).Conclusions Cognitive decline was associated with atrophy and white matter microstructural alterations in temporal, frontal, parietal lobes, cingulate gyrus, and parahippocampal gyrus in MCI and AD. Multi-modality imaging technique may be important in elucidating the brain mechanism of cognitive impairment.

Objective To study the relationship between obstructive sleep apnea syndrome(OSAS) in the elderly and the occurrence and development of arrhythmia. Methods A total of 120 OSAS patients and 40 normal controls were selected and their polysomnography(PSG) or dynamic blood oxygen and analyzed holter were monitored. Results The total number of the reduction in apnta hypopnea index (AHI) and arterial orygen saturation (SaO 2) over 0.04 and the lasted period during SaO 20.05), while the incidences of the intermediate and serious groups significantly increased(P