Objective To discuss the MRI features and its clinical significance of bone contusion in knee joint.Methods MR images of injuries of knee in 40 cases were retrospectively analyzed,the complications were reviewed simultaneously.Results 69 lesions of bone contusion in 40 cases were discovered,of them,Ⅰ type was in 38 and Ⅱ type was in 31, in company with fractures were 24 in 22 cases and ligament injury was in 33 cases.Conclusion The present of bone contusion is prompt to the bone injuries,MRI is of significant value in showing bone contusion and its complications in knee.

Objective To optimize the parameters for the diffusion tensor imaging (DTI)of the ulnar nerve in elbow.Methods 5 groups of DTI sequences with different b values and numbers of diffusion gradient directions (NDGDs)were used to collect ulnar nerve images from 13 volunteers,and then the diffusion tensor tractography (DTT)was established.The fractional anisotropy (FA),apparent diffusion coefficient (ADC),length of ulnar nerve fiber and DTI image quality were compared under different imaging parameters. Results DTI results for 18 normal ulnar nerves were included in the study.Under different imaging conditions,FAs showed no significant differences.With constant NDGDs,increasing b value decreased both image quality and ADCs of the ulnar nerve.NDGDs had no significant effects on ADCs or image quality.When b=1 000 s/mm2 and NDGDs=20,the length of the ulnar nerve fiber was the longest and DTT had the best subjective scoring in image quality.Conclusion b=1 000 s/mm2 and NDGDs=20 is recommended for DTI of elbow ulnar nerve,so as to obtain high image quality and stable observing targets.

The current situation of large-scale medical imaging equipment in Zhenjiang region is briefly summarized.Investigation and study are made on DSA,CT and MR of 19 hospitals in Zhenjiang.Data are treated statistically.Suggestions on management and disposition of large scale medical imaging equipment are put forward at last.

Objective To evaluate the value of low-dose computed tomographic colonography (CTC) performed with 64-slice CT in the diagnosis of incidental extracolonic lesions and its clinical significance .Methods The image data in 158 CTC examinations with two positions were retrospectively analyzed .All abdominal extracolonic lesions were recorded .According to the age ,the pa-tients were divided into two groups :elderly and non-elderly groups .The extracolonic lesions were divided into 4 groups(E1- E4) according to the clinical importance .The incidence rates in two groups were calculated respectively .Results The incidence rate of the E2-E4 level extracolonic lesions in the elderly group was higher than that in the non -elderly group ,the difference between them had statistical signficance (P< 0 .05) .Conclusion Low-dose CTC has the high diagnostic value in finding extracolonic le-sions ,and the incidence rate of extracolonic lesions with important clinical significance is increased with the age increase ,especially for the elder patients over the age of 60 years .

Objective To evaluate the diagnostic ability of fusion images of SWI and DWI in ischemic penumbra(IP)of patients with acute ischemic stroke(AIS).Methods 47 AIS patients were retrospective analyzed.Two neuroradiologists analyzed the fusion images of SWI and DWI respectively.SDM was defined as that the hypo-intensity signals of intramedullary or sulcal veins were dilated or increased on fusion images compared with contralateral areas.The results compared with the PDM,which was considered as the“gold standard”.Areas under the receiver operating characteristic curve(AUC)were used to assess the efficacy of SDM which determined by fusion images and compared to PDM.Chi-square test was used to analyze the consistency between the two neuroradiologists and also the consistency between SDM and PDM in IP assessment Results The fusion images of SWI and DWI had a high diagnostic efficacy compared to PDM, AUC of the two radiologists were 0.885,0.877,the diagnostic sensitivity were 84.2%,78.9% and specificity were 92.9%,96.4%respectively.There was also a high consistency in SDM assessment through fusion images between the two neuroradiologists (Kappa=0.908,P >0.05). Conclusion Fusion images of SWI and DWI have a high diagnostic efficacy in IP assessment,which may be considered as a simple approach for IP assessment in patients with AIS.

Objective To investigate the value of mesenteric vascular CTA in the diagnosis of small intestinal neoplasms.Methods A retrospective analysis of mesenteric CTA from January 2008 to April 2013 was conducted in 51 patients with pathologically proven small intestinal neoplasms.Features of intestinal neoplasms CTA signs including neoplasm feeding artery,draining vein,mesangial side vasa recta and the formed neoplasm vessels,were observed.Two radiologists individually used two methods,namely intestinal tumor feeding artery positioning method and Cole fractionation method,for diagnosis and localization diagnosis of tumor,and also for comparing the results with those of surgical pathology.McNemar Chi-square test was adopted to evaluate the diagnosis differences between the two physicians and between the two methods by the same physician.Kappa value was used to assess the consistency of the results.Results Features of intestinal tumors CTA signs:12 cases of enlarged neoplasm feeding artery,9 cases of early displayed draining vein,22 cases of enlarged mesangial side vasa recta,and 11 cases of vessels formed inside and around the neoplasm,single lesion for all and the largest lesion diameter≥ 5 cm for 37 cases.The accuracy of Cole fractionation method positioning and the feeding artery positioning were 84.31％(43/51) and 98.03％(50/51) respectively.Moderate consistency(Kappa=0.49,P＜0.01) was seen with Cole fractionation method by the two physicians and high consistency(Kappa=1.00,P＜0.01) with feeding artery positioning method.McNemar Chi-square test showed no significant difference between the two methods by the same physician and the consistency of the results from the two methods was passable(P were 0.062 and 0.125).Conclusion Mesenteric CTA can display the intestinal tumor feeding arteries and draining veins,and is helpful in identification of the relationship between the tumor and its surrounding blood vessels,which can improve the accuracy of pre-operative localization and qualitative diagnosis for small intestinal tumor.

Objective To evaluate the diagnostic value of intra-arterial thrombi under went susceptibility weighted imaging(SWI) in patients with acute ischemic stroke(AIS).Methods The MRI images of 133 patients with AIS was analyzed,included time of flight MR angiography(TOF-MRA )and SWI.The patients were divided into two groups according to the time between onset of symptoms and MR imaging (group A,interval time<24 h;group B,interval time 24-72 h).Two neuroradiologists who were blin-ded to the patients clinical information,documented the number and location of susceptibility vessel sign (SVS)in SWI and embolic occlusion or stenosis on TOF-MRA in AIS patients.Results The thrombus detection rate in group A was higher than that in group B.There was no significant difference in the overall detection rate of thrombi between SWI and TOF-MRA in all AIS patients,but the thrombi detection rate in M3 segement of middle cerebral artery(MCA)with SWI was higher than that with TOF-MRA in group A(P <0.05).Conclusion SWI performs a high diagnostic value for thrombus detection in AIS patients,especially for the thrombus detection of M3 segement in early period of AIS.

Objective To investigate the value of early?phase enhancement ratio combined with peripheral vascular diameter in the differential diagnosis of benign and malignant breast lesions using 3.0 T dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI). Methods Sixty seven cases of patients (35 with malignant lesions and 32 with benign lesions in the breasts) were retrospectively analyzed. Their diagnoses were confirmed by surgery and pathology and all the patients underwent breast MRI plain scan and DCE?MRI in the two weeks before surgery. Lesion ROIs were drawn and time?signal intensity curves in the DCE?MRI were generated. Early?phase enhancement rate, time to peak, early?phase enhancement ratio, numbers of tumor vessel within 3 cm of the lesion and diameter of the largest vessel were recorded. Mann?Whitney U test was used to compare the difference of DCE?MRI between benign and malignant lesions, and the ROC curve was used to evaluate the efficiency of early?phase enhancement rate, early?phase enhancement ratio and vascular diameter in differentiating benign and malignant lesions. Results With breast malignant lesions, the medians of time to peak, early?phase enhancement rate, early?phase enhancement ratio, numbers of tumor vessel and vascular diameter were 2.2 s, 176.0%, 100.0%, 4 and 2.96 mm respectively, while with benign lesions of these parameters were 4.7 s, 113.3%, 81.9%, 0 and 0.00 mm respectively, and the differences were statistically significant (all P<0.05).When early?phase enhancement rate was used for differential diagnosis of breast benign and malignant lesions, the area under the ROC curve was 0.702 and the sensitivity and specificity were 82.86%and 56.25%with a threshold of 120.0%. When early?phase enhancement ratio was used, the area under the ROC curve was 0.854 and the sensitivity and specificity were 94.29% and 68.75% with a threshold of 86.0%. When peripheral vascular diameter was used, the area under the ROC curve was 0.896 and the sensitivity and specificity were 74.29%and 84.38% with a threshold of 2.78 mm. When early?phase enhancement ratio was combined with peripheral vascular diameter, the area was 0.925 and the sensitivity and specificity were 97.14% and 62.50%. Conclusion In the differential diagnosis of benign and malignant breast lesions under DCE?MRI, early?phase enhancement ratio combining with peripheral vascular diameter has improved sensitivity.

Objective To investigate the effects of hyperbaric oxygen (HBO) therapy on serum matrix met-alloproteinase-9 (MMP-9) and intercellular adhesion molecule-1 (ICAM-1) levels, and on brain edema in patients with intracerebral hemorrhage. Methods Seventy-six subjects with intracerebral hemorrhage were divided into a routine treatment group (40 cases) and a.HBO treatment group (36 cases). 30 healthy persons served as a control group. Serum MMP-9 and ICAM-1 levels were measured before and after treatment. MRI images of the subjects' brains were prepared at the 5 ～ 7 th and 25th days. Absolute edema volumes and relative edema volumes were meas-ured on T2-weighted images. Results (1)The serum MMP-9 and ICAM-1 levels in the routine therapy and HBO groups were higher than those in the control group at the outset ( P≤0. 01 ). Both indices peaked on the 5th day, but there was no significant difference between the two treated groups. At the 15th and 25th day (after 10 and 20 HBO treatments) , the serum MMP-9 and ICAM-1 levels in the HBO group had decreased remarkably and were significant-ly lower than those in the routine therapy group (P≤0. 01 ). (2)At the 5 -7th and 25th days, both absolute edema volumes and relative edema volumes in the HBO group were significantly smaller than those in the routine therapy group ( P≤0. 05, P≤0. 01 ). (3) Serum MMP-9 and ICAM-1 levels were positively correlated with the brain edema volumes, and negatively correlated with decreased NIHSS scores (between pre- and post-treatment). Conclusions HBO therapy may reduce serum MMP-9 and ICAM-1 levels in patients with intracerebral hemorrhage, and lessen the severity and range of brain edema. HBO is helpful for restoring nerve function. Early and repeated multiple HBO treatments are beneficial for patients.

Objective To study the effect of hyperbaric oxygen (HBO) therapy on perihematomal edema in acute spontaneous intracerebral hemorrhage. Methods Sixty-three consecutive hospitalized patients with supraten-torial intracerebral hemorrhage were allocated to an HBO group (n = 30) or a control group (n = 33) at random. Routine therapies were used with both groups. The treatment group received in addition twenty consecutive daily ses-sions of HBO therapy beginning 3～5 d after onset. MRI brain scans were performed on the 5～7th and 25th day. Absolute edema volumes and relative edema volumes were measured from T2-weighted images. Apparent diffusion co-efficients (ADCs) of the edematous regions were calculated on diffusion-weighted images (DWI). Results There were no statistical differences between the two groups in terms of age, sex, blood pressure, NIHSS, hematoma posi-tion or volume. At the 5th～7th d, both absolute and relative edema volumes in the HBO group were smaller than in the controls (P≤0.05). Brain edema was still prominent at the 25th d. Absolute edema volumes, relative edema volumes and ADC values were all smaller in the HBO group at the 25th day compared with the controls (P≤0.05). Conclusion HBO therapy soon after intracerebral hemorrhage can lessen the severity and range of brain edema. E-dema persists after the onset of the disease, and HBO can reduce such delayed brain edema. HBO may benefit func-tional recovery from intracerebral hemorrhage by reducing perihematomal edema.