The efficiency of Siemens E.CAM is evaluated by analyzing and practicing the technology of Siemens U-fly.Basic testing procedure is run.Standard source 99mTc and 57Co is used respectively and the operation is performed according to the instruction.The detecting head's uniformity can be corrected in this way with satisfactory results.It is suggested uniformity should be tested every day before study because it is the most important factor for the quality of clinical images.

Objective To study the complications related to and its management after retrieving temporary and retrievable IVC filters.Methods From Jul 2007 to Mar 2012,576 consecutive cases of deep venous thrombosis secondary to bone fractures confirmed by Duplex ultrasonography,received IVCF deployment to avoid fatal pulmonary embolism during perioperative period.There were 192 cases receiving temporary filters and 384 cases with retrievable filters.The temporary and retrievable filters were removed 2 to 4 weeks after implantation.Results The success rate of temporary filter removing was 100％.In 24 cases,the filters captured huge thrombi,and they were removed after thrombolysis using the Uni-fuse catheter.One patient received permanent filter deployment before removing the tempo-filter.Filters were successfully removed in 367 out of 384 cases with retrievable ones with a successful rate of 95.57％.In 7 cases the filters were removed with large thrombi.Double-snare-technique was used to retrieve 15 seriously tilted filters.After a mean 22 months follow-up,no pulmonary embolism occurred,but symptomatic DVT were revealed in 26 patients,and the conditions were improved after anticoagulation treatment.Conclusions The application of Uni-fuse thrombolysis catheter increases the success rate of filters retrieving,double-snare-technique helps retrieve seriously tilted filters and decrease long-term complications of permanent filters.

Objective To investigate the application of carotid artery resection and reconstruction in surgical management of thyroid carcinoma with carotid artery involvement.Methods We conducted a retrospective cohort study involving 10 patients whose common carotid arteries were invaded by thyroid carcinoma.All patients underwent tumor en bloc resection and carotid arteries reconstruction.Patients were evaluated by muhidisciplinary team and surgeries were cooperated by general surgeons,orthopedists and vascular surgeons.The perioperative complications and surgical outcomes were also recorded and analyzed.Results No patient had complications of central nervous system.One patient suffered Horner syndrome and one presented hoarseness postoperative.Two patients had wound infection,two patients presented carcinoma recurrence and two patients presented distant metastasis during the follow-up.Conclusion En bloc resection of tumor and carotid artery reconstruction is a feasible modality in treatment of thyroid carcinoma with carotid artery invasion.

Objective To investigate the clinical features, diagnosis and management of pancreatic lesions in patients with von Hippel-Lindau (VHL) disease, and improve the current understanding on pancreatic lesions in VHL disease.Methods The clinical data of three VHL disease patients with pancreatic lesions were analyzed retrospectively, including clinical features, laboratory findings, imaging, pathological features, operation method and follow-up.Results Two patients had a family history of hemangioblastoma in central neural system, and 1 patient had retinal multiple angioma and angioma in central neural system, who were diagnosed as VHL.One patient with pancreatic portal hypertension had splenectomy and biopsy of left renal tumor.During the surgery, pancreatic cystic lesions were observed and the transparent cysts were diffusively distributed on the surface.The other 2 patients were diagnosed as pancreatic multiple cysts and non functional pNETs, and pancreatic multiple cysts, respectively, based on the imaging.All the three patients had stable disease status, and followed up by outpatient visits.Conclusions VHL disease can manifest as simple pancreatic cyst, pancreatic serous cystadenoma and pNETs.The optimal individualized treatment should be determined by Multidisciplinary team (MDT) according to the general condition of patient.

Objective To evaluate feasibility of flap fenestration in management of the condition that a stent-graft is wrongly deployed in false lumen of aortic dissection.Methods A retrospective analysis was conducted on a case of Stanford type B aortic dissection who was confirmed that the stent-graft had been wrongly deployed in false lumen of aortic dissection by CT angiography (CTA) after endovascular repair.Thereafter,an additional surgical management was carried out.At length,flap fenestration at 2 cm below pre-deployed stent-graft was performed using an Outback catheter so as to link false and true lumens.Successively,another stent-graft was placed via the access to draw blood flow from false lumen back to true lumen and then coil embolization was performed for distal breach of the dissection.Results Surgery was carried out under local anesthesia,with operation duration of 170 minutes and intraoperative blood loss of 350 ml.The chest and back pain disappeared after operation.The patient commenced to take food and take off-bed activity at the very day of operation in absence of paraplegia,visceral ischemia,or other complications.Aortic CTA at postoperative one week showed ideal positioning of stent-graft,fluent blood flow of aorta and major visceral artery,and vanishing of false lumen.Conclusions Flap fenestration at far-end of pre-deployed stent-graft so as to draw blood flow back to true lumen by connecting the new placed stent graft to pre-deployed stent-graft is an effective treatment for mis-deployment of stentgraft in false lumen of aortic dissection.Outback catheter for flap fenestration is characterized by accurate location and high safety.

ObjectiveTo discuss the central modulating mechanisms while acupuncturing the Stomach 36[ST36(Zusanli)]by brain functional imaging with positron emission tomography (PET).MethodsPET imaging of whole brain was performed in a group of six healthy subjects during two stimulation paradigms: pseudo acupuncture and real acupuncture at acupoint ST36(Zusanli). The data on cerebral glycometabolism,obtained by using PET,was analyzed by using statistical parametric mapping (SPM).ResultsThere was certain increase of glycometabolism in ipsilateral hypothalamus,back of medulla oblongata;bilateral insular lobe; contralateral paracentral lobule,superior part of precentral and postcentral gyrus,opercular part of frontal and temporal lobe,middle part of cingulate gyrus,head of caudate nucleus,middle part of the back of midbrain and pons,and deep part of cerebellum,whereas decrease in ipsilateral superior part of precentral and postcentral gyrus and lateral part of ipsilateral anterior cerebellar lobe,while acupuncturing at acupoint ST36(Zusanli on the right leg).ConclusionsThe central modulating mechanisms of acupuncturing ST36 are realized by neural and neuroendocrine network modulation mechanisms of vegetative nerve center in cortex and subcortex.

Objective　To investigate the relationship between tinnitus and glucose metabolism in auditory cortex and whether positron emission tomography (PET) can be an objective tool in measuring tinnitus. Methods　Eleven right-handed patients with severe tinnitus and ten right-handed control subjects participated in the 18　 F-FDG/PET study. Analysis with regions of interests was used to calculate asymmetry indices according to the formula: ［(L-R)×100/［(L+R)÷2］］. Results　Glucose metabolism in the auditory cortex of tinnitus patients was asymmetric between the left and right auditory cortices, with that of the left being much higher than that of the right. The asymmetry indices of tinnitus patients was significantly higher than that of the control group (unpaired t test, P<0.001). This revealed that the increased metabolic activity was present in the predominant left hemisphere with a significant focus on the superior and transverse temporal gyri (Brodmann areas 41 and 42, respectively corresponding to primary and secondary auditory cortex), and the results were independent of the subjective localization of the tinnitus sensation. Conclusion　It is suggested that the increased metabolism in the left auditory cortex is related to the tinnitus sensation. PET is capable of providing objective evidence for tinnitus and may be used as a potential tool in measuring tinnitus.

BACKGROUNDTo evaluate the diagnostic significance of FDG PET in preoperative mediastinal lymph node staging for NSCLC.

METHODSWhole-body FDG PET imaging was performed in 70 patients with NSCLC. All patients received thoracic CT examination 2 weeks before PET scan or 1 week after PET scan, and then were given thoracotomy with hilar and mediastinal lymph nodes dissection. After intravenous administration of 18F-FDG (150μCi/kg), PET scan was performed in 3-7 bed positions with 2D acquisition and OSEM reconstruction. For quantitative evaluation, a region of interest (ROI) was placed over the mediastinal lymph node which had abnormal uptake of radiation activity, then the standardized uptake value (SUV) were calculated. If SUV≥2.5 or uptake activity was higher than the blood pool of mediastinal on the basis of visual inspection, it was considered to be positive.

RESULTSThe sensitivity, specificity and accuracy of PET were 100%, 93% and 94%, respectively. The positive lymph nodes diagnosed by PET correctly corresponded to pathological results. PET changed the clinical staging of 12 patients. The sensitivity, specificity and accuracy of CT were 70%, 77% and 76%, respectively.

CONCLUSIONSPET is an effective modality for accurate mediastinal lymph node staging in patients with NSCLC. It is valuable for determining clinical treatment.

Objective:To explore the CT features of inflammatory pseudotumor like follicular dendritic cell sarcoma (FDCS) of the spleen.Methods:The clinical data of 12 patients with splenic inflammatory pseudotumor like FDCS admitted to 3 central hospitals including Yongjia People's Hospital in Zhejiang Province from January 2015 to December 2022 were retrospectively analyzed, including 4 males and 8 females, with a median age of 60 years old. The number, shape, size and CT features of the lesions were analyzed based on patient's CT image data.Results:CT scans of 12 patients showed 15 lesions, including 10 single lesions and 2 multiple lesions. The lesions were circular in 5 cases, elliptical in 4 cases, and irregular in 3 cases. The median maximum diameter of the mass is 6.5 cm. On plain scan, all 12 tumors showed low density or slightly low density. The CT value is (41.3±7.2) HU; 8 cases had uneven density and 4 cases had uniform density. There were 8 cases with clear tumor boundaries and 4 cases with unclear boundaries. There were 8 cases with tumor necrosis and cystic transformation, and 5 cases showed patchy bleeding lesions in the center of the tumor. Enhancement: the arterial phase shows small patches or flocculent enhancement at the edges or parenchymal parts of the tumor, with CT value of (56.0±3.8) HU. Among them, there were 7 cases of mild enhancement, 4 cases of moderate enhancement, and 1 case of significant enhancement. During the portal phase, there was mild to moderate persistent small patchy uneven enhancement, with CT value of (62.0±4.3) HU. Among them, there were 8 cases of mild enhancement and 4 cases of moderate enhancement. The delayed phase showed a slow withdrawal of enhancement, with CT value of (45.0±8.2) HU. All 12 cases underwent complete resection and were diagnosed with FDCS through pathological examination.Conclusion:FDCS plain scan shows circular or elliptical uneven low-density masses, with small patches or flocculent light to moderate uneven enhancement in the arterial phase, continuous enhancement in the portal phase, and slow withdrawal in the delayed phase as the main characteristics.

OBJECTIVETo explore the experimental method of obtaining position emission tonogiaphy (PET) imaging evidence of changes in cerebral function by puncturing the Stomach 36 (ST36, Zusanli) acupoint.

METHODSData on changes of cerebral glycometabolism were obtained from six healthy male volunteers with positron emission tomography. Visual experimental evidence, as well as statistical parametric mapping (SPM), was gathered while puncturing the ST36 (Zusanli, right leg) acupoint.

RESULTSThere was increased glycometabolism in the hypothalamus, head of the caudate nucleus, temporal lobe, the sinistral cerebellum, postcentral gyrus, and brain stem while the acupoint ST36 was being punctured.

CONCLUSIONSAcupuncture on ST36 can lead to increase in glycometabolism in the vegetative nerve centers, which is correlated with gastric function. Visual experimental evidence of ST36 acupuncturing on functional gastrointestinal disorder was obtained in our study.

Acupuncture ; Acupuncture Points ; Adult ; Brain ; diagnostic imaging ; physiology ; Glucose ; metabolism ; Humans ; Male ; Tomography, Emission-Computed