Objective To explore the clinical value of whole-brain CT perfusion imaging with 320-detector row CT in early acute cerebral infarction.Methods The CTP parameters(CBF,CBV,MTT,TTP)and its pseudo color map of 25 patients with early acute cerebral infarction were retrospectively analysed and compared between infarction area,ischemic penumbra (IP)and the con-tralateral normal region.Results The abnormal perfusion area were found on CTP in 25 patients with early acute cerebral infarction. CTP showed cerebral blood flow (CBF)and cerebral blood volume (CBV)decreased significantly,mean transit time (MTT)short-ened significantly,time to peak (TTP)was significantly longer than those of the contralateral normal region in 7 cases of acute cere-bral infarct core.18 cases of IP lesions showed CBF decreased slightly,CBV increased slightly or maintain normal,MTT and TTP extension compared with contralateral.CBF,CBV,MTT,TTP values had significantly differences between infarct region and the contralateral corresponding normal region,between the infarct core area and IP of acute cerebral infarction (P <0.01).CBF,MTT, TTP values had statistically significant(P <0.05),and CBV values was not statistically significant (P >0.05)between IP region and the contralateral corresponding normal region,but showed a downward trend in blood flow.Parameter color maps of CTP could di-rectly,clearly and sensitively show abnormal changes region about cerebral blood flow.In particular,MTT and TTP maps shows ab-normal region clearer and sensitively.Follow-up 18 cases of IP,active lesions deduced in 6 cases,the lesions disappeared in 5 pa-tients (CT/ MRI showed no abnormal,and the clinical symptoms disappeared)after thrombolytic therapy,7 cases of MRI and CT scans confirmed infarction stove.Conclusion Whole-brain CTP with 320-detector row CT can early show the acute cerebral infarc-tion and its ischemic penumbra,it has significant important clinical value for early acute cerebral infarction.

Objective To study the value of CT and MRI in the diagnosis of hepatocellular adenoma(HCA).Methods The comprehensive imaging features of HCA in 11 patients confirmed by pathology were analyzed retrospectively in our hospital.Results 11 patients presented with a total of 18 lesions, and plain CT showed low or slightly low density in all lesions, with irregular high density area in two lesions.The CT values of the lesions were significantly higher than in adjacent normal liver in the arterial phases(P<0.05).On T1WI, two lesions showed low or slightly low signal intensity, and 16 lesions showed slight hyperintensity.On T2WI, 14 lesions showed hyperintensity, and 4 lesions showed hypointensity.All lesions showed significant enhancement in arterial phase of dynamic enhanced scanning.Pseudocapsule enhancement was revealed in 17 lesions.For 18 lesions, ADC values were measured on DWI, and the ADC values of the lesions were higher than the value of surrounding normal liver parenchyma.Conclusion Dynamic contrast-enhanced CT combined with MRI and ADC value measurement can provide valuable information in diagnosis of HCA.

Objective To investigate the image characteristics of Synovial Sarcoma, and improve the diagnostic accuracy. Methods The clinical materials and image findings of synovial sarcomas proved by pathology and were retrospectively analyzed in 13 cases.Results ①Most synovial sarcomas located in close proximity to joints, especially large joints of lower limbs . ②The mass diameter was usually more than 5cm ,and most masses presented moderate density, and some with calcification inside it on X-ray films. ③Most masses density was not homogeneous and lower than that of the muscle on CT, the demarcation was clear or not. ④On T2WI /STIR of MRI, most tumours presented slightly hyperintense "cobble" nodules , with hypointense septa among the nodules. After contrast, the nodules were unenhanced or enhanced slightly,the septa were markedly enhanced. Conclusion Some image features of synovial sarcoma ,especially on MRI, are helpful for the diagnosis of it.

With more and more non-affiliated hospitals of universities joining the clinical teaching of infectious diseases,there have been some dilemmas on clinical teaching,such as the shortage of staff,teaching experience,poor lecture art and teaching enthusiasm,textbook lag,the shortage of case teaching abd students'fear of infectious disease etc. Countermeasures such as perfecting the organizational structure,formulating preferential policy,clearing historical mission,increasing students' interest in learning,adding new academic progress,enriching teaching methods,setting up experts'supervision will ensure the effective teaching quality.

The significance for specialized hospital's resident physicians participating in the standardized clinical resident training in general hospital is expounded and its existing prob-lems are pointed out.It is suggested that the administration division should give full play to subjective initiative,coordinate problem solving and improve training quality,and meanwhile speciality hospitals should make an active effort in the application for national subspeciality physician training base.

Objective To investigate the differences of X-ray findings of skeletal fluorosis between coal-burning type endemic fluo-rosis and industrial fluorosis.Methods The patients were randomly selected as research objects including 60 cases of coal-burning type endemic osteofluorosis and 60 cases of industrial osteofluorosis.The X-ray findings on the left forearm,crus and pelvic radio-graphs of these patients were analyzed retrospectively to find out the differences between skeletal fluorosis of coal-burning type endemic fluorosis and industrial fluorosis.Results X-ray features are no significant statistical differences between coal-burning type endemic fluorosis and industrial fluorosis,except these of interosseous membrane ossification of forearm and crus (forearmχ2=10.909,P<0.05;crusχ2=8.547,P<0.05),obturator membrane ossification of pelvis (χ2=36.554,P<0.05),periosteal proliferation outside bone of crus (χ2=4.937,P<0.05),and ossification of soleus (χ2=4.904,P<0.05).Conclusion The X-ray signs of endemic osteofluorosis and industrial skeletal fluorosis are almost similar,but there are some differences between them.

Objective This study used resting-state functional magnetic resonance imaging(rs-fMRI)to investigate the changes of local brain regional homogeneity in patients with depression and childhood maltreatment,and we calculated the relationship between altered ReHo values and the severity of childhood maltreatment.Methods 25 patients with depression and childhood maltreatment,25 patients with depression without childhood maltreatment,and 25 age,gender,and education-matched healthy controls were prospectively enrolled.All subjects underwent resting-state functional magnetic resonance imaging and ReHo analysis.One-way analysis of variance was used to compare the group differences,along with multiple comparison correction.Pearson correlation analysis was used to explore the relationship between region ReHo values with clinical scales.Results Compared with the group of depression without childhood maltreatment,the abnormal brain regions of depression with childhood maltreatment are mainly located in the dorsolateral prefrontal cortex,cerebellum,parietal gyrus,and precentral gyrus.The ReHo values of depression with childhood maltreatment in the left cerebellum and the left dorsolateral prefrontal cortex are correlated with the severity of childhood maltreatment.Conclusions Depression with childhood mal-treatment is associated with changes in local spontaneous brain activity,which are correlated with the severity of childhood maltreatment.The brain changes in the dorsolateral prefrontal cortex and cerebellum may explain the neurobiological mechanisms of depression with childhood maltreatment.

Objective To investigate the feasibility and value of the four-low scanning scheme of dual-source computed tomography(DSCT)on triple-rule-out computed tomography angiography(CTA)examination in acute chest pain.Methods Triple-rule-out CTA examination was performed on 150 patients with prospective electrocardiogram gating.They were divided into two groups:group A(100 kV)and group B(70 kV).According to different body mass index(BMI),group A were divided into Anon-overweight and Aoverweight,while group B were divided into Bnon-overweight and Boverweight.Subjective and objective evaluations[signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),standard deviation(SD)]of the two groups were analyzed,and radiation-related parameters were recorded.Results There was no significant difference in subjective scores between the two groups(Kappa value=0.372,P＞0.05).CT value,SD,CNR and SNR were significantly different among the four subgroups(P＜0.05).SNR and CNR of A(B)non-overweight were higher than those of A(B)overweight(P＜0.05).Effective dose(ED)of group B decreased by 74.5％.Conclusion ADMIRE-3 and iterative beam-hardening correction(iBHC)combined with four-low scanning scheme of DSCT could improve the images quality of vascular,and reduce the radiation dose,contrast agent dosage and flow rate,which is worthy of promotion and application in patients with BMI≤30 kg/m2 acute chest pain triple-rule-out.

Objective To investigate the value of radiomics model based on multiple sequences MR in predicting the efficacy of neoadjuvant chemotherapy(NAC)among different breast cancer subtypes.Methods Two hundred breast cancer patients undergoing NAC treatment were retrospectively selected,and then randomly divided into training group and validation group at a ratio of 7:3,as well as divided into responsive and non-responsive according to the therapeutic response.Radiomics features were selected and filtered from multiple sequences MR.The model was established by using machine learning,and validated in the validation group.The predictive performance of the model was evaluated by using receiver operating characteristic(ROC)curve,and the clinical application value of the model was assessed by clinical decision curve analysis(DCA).Results The area under the curve(AUC)of hormone receptor(HR)-positive with human epidermal growth factor receptor-2(HER-2)-negative breast cancer patients in training and validation groups were 0.881 and 0.682,respectively,while the AUC of HER-2-positive breast cancer patients were 0.831 and 0.636,respectively.The AUC of triple-negative breast cancer patients were 0.969 and 0.708,respectively.The clinical DCA showed significant clinical benefits.Conclusion The MR radiomics model can predict the efficacy of NAC among different breast cancer subtypes.

The clinical characteristics of the pneumonia includes hyperthermia, cough and pectoralgia, etc with simultaneous mixed signs of inflammatory infiltration, consolidation, cavity/air sac and abscess in pulmonary CT scan, and these signs change rapidly. Respiratory failure and septic shock frequently occur in severe such patients, resulting in refractory management and relatively long therapeutic course. The timely diagnosis, use of sensitive antibiotics, respiratory and nutritional support, etc comprehensive effective measures can elevate the rescue success rate with severe hematogenous staphylococcus aureus pneumonia.