Objective To evaluate the cost-effectiveness of the aneurysm intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, and to give the instruction for the clinical practice. Methods A case control study (1 vs. 1) was developed to evaluate the cost in hospital, the cost for return visit and the Quality-adusted Life-Year (QALY) and lifetime costs of the intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, under the matching of the age, sex, living place, the size and place of the aneurysm, and the Hunt & Hess score. Clinically effectiveness dates were derived from the medical records. Cost dates were derived from follow-up by telephones or letters. The correlation analysis was done with the SPSS 13. 0. Results The cost in hospital in AC group was (54 945±16 946) RMBs,which washigher than the ones in AE group(63 768±12 665) RMBs, (t = 1.71, P <0. 05). The cost of missed working in AE group was 200 RMBs(the median), which was lower than the ones in AC group 650 RMBs (z =2. 57,P < 0. 01). The cost of return visit in AE group was 1200 RMBs, which was lower than the ones in AC group1950 RMBs (z = 1.82, P < 0. 05). The cost-effectiveness of the intra-artery GDC emhalization and the aneurysm clapping had no difference 3805 RMBs/year vs. 3028 RMBs/year(z =0. 42,P >0. 05). Conclusion The results suggest that the two therapies have no difference in cost effective rate. Considering the physical and mental loss, the aneurysm intra-artery GDC embolization was better than the aneurysm clapping for the patients with aneurysm that diameter less than 25 mm.

Objective To study CT findings of the giant mass in lesser peritoneal sac.Methods Thirty cases of the giant mass in lesser peritoneal sac proved by surgery and biopsy were examined by CT scan.Results There were four cases of gastrointestinal stromal tumor (three in stomach and one in duodenum) , two cases of pancreatic cancer , one case of pancreatic cyst-solid papilloma , three cases of non-function neuroendocrine carcinoma in pancreas , two cases of pancreatic peudocyst and one case of mesenterial lymphoma. Conclusion Based on the typical imaging findings ,CT can accurately diagnosis the giant mass in lesser peritoneal sac.

Objective To analyze the reliability of MRI malignant signs of soft tissue masses in extremities.Methods MRI features of soft tissue masses were analyzed retrospectively with emphasis on 30 cases with malignant MRI signs based on pathologic results,and these 30 cases were divided into two groups(benign lesions and malignant tumor group).The reliability of malignant signs for malignant tumor was evaluated.Results(1)The qualitative diagnostic accurate rate for benign and malignant masses was 89.7% and the histopathologic qualitative diagnostic accurate rate was 66.2% by MRI;(2)The findings of invasion and edema around the masses in diagnosis of malignant tumors had a remarkable statistical significance among five malignant signs(P0.05);(3)The sign of indefinite sturcture of muscular fibrosis had statistical significance between benign and malignant tumor diagnosis(P

Objective To study the efficiency of oral ferric ammonium citrate solution as a negative gastrointestinal contrast agent on magnetic resonance cholangiopancreatography (MRCP). Methods Sixty subjects were divided into two groups at random. Routine MRCP were performed directly for one group, and routine MRCP were performed after oral ferric ammonium citrate solution for another gruop. Contrast effect was evaluated on the basis of signal intensity in the stomach and duodenum at MRCP. Results The mean Raddit score of control group (without oral ferric ammonium citrate solution) was 0.275, and that of oral ferric ammonium citrate group was 0.725 (P

Objective To study CT findings of duodenal malignant tumor.Methods Plain and contrast-enhanced CT date of 20 patients with duodenal malignant tumor proved by pathology were retrospectively analysed.Results There were three adenocarcinomas, two lymphomas, three malignant gastrointestinal stromal tumors, three ampulla carcinomas, eight carcinomas of head of pancreas, one pancreatic nonfunction neuroendocrine cell carcinoma. Duodenal adenocarcinoma manifested as local irregular constriction of cavity accompanied with soft tissue mass. After enhancement, the mass manifested as moderate enhancement. Lymphoma manifested as extensive duodenal wall thickening or extracavity mass,after enhancement,the mass was manifested as mild enhancement. Malignant gastrointestinal stromal tumor manifested as massive mass with heterogeneous marked enhancement,ileus was not obvious. Ampulla carcinoma manifested as local soft tissues mass with mild and moderate enhancement in the media of duodenal descent part, intrahepatic and extrahepatic biliary duct dialated. Carcinoma of head of pancreas involving duodenum manifested as duodenal medial wall roug,mass in the head of pancreas with no enhancement, intrahepatic and extrahepatic biliary duct dilated. Pancreatic nonfunction neuroendocrine cell carcinoma involving duodenum manifested as massive mass with marked enhancement in the head of pancreas,there was indistinction between mass and duodenum, intrahepatic and extrahepatic biliary duct were non-dilation.Conclusion CT scan plays an important role in the diagnosis of duodenal malignant tumor.

Objective To investigate the value of MR enteroclysis with air infusion in the diagnosis of small bowel disease.Methods Sixteen patients with suspected small bowel disease, but without acute inflammatory disease or bowel obstruction, received MR enteroclysis with air infusion.There were 12 males and 4 females, and their age ranged from 17 to 75 years.10 patients had abdominal pain, 4 with melena or blood stool, and 2 with diarrhea.The longest course was 7 years, and the shortest 1 week.Before MR imaging, a nasoenteric catheter was inserted into the distal part of duodenum, and about 1000 ml of air was infused through the tube to distend the small bowel.20 mg of IV anisodamine was given to reduce small-bowel peristalsis.All patients were imaged with fat-saturated Gd-DTPA enhanced coronal and axial T 1-weighted spin-echo (SE) sequence and fast spoiled gradient echo (FSPGR) sequence.Comparison between the diagnosis of MRI and the results of surgery, pathology or clinic was performed to assess the sensitivity and specificity of MRI.Results 5 cases were normal, 6 with Crohn disease, 2 with gastric intestinal stromal tumor (GIST), and 1 each of lymphoma, tuberculosis and irritable bowel syndrome.The lumen of normal small bowel in MR enteroclysis was no signal, the wall was outlined as middle signal by intraluminal air and surrounding air-distended bowel and was between 1-3 mm thick, and the diameter of the lumen was between 17-28 mm.Crohn disease showed segmental mural thickening, increased enhancement, luminal stricture, and even extraluminal inflammatory mass or fistula.Intestinal tuberculosis invaded the distal section of ileum, cecum, and the proximal ascending colon, the wall thickened and enhanced apparently, and cecum and proximal ascending colon shortened.GIST showed a mass that was iso-signal on T 1WI, high signal on T 2WI, and enhanced significantly after IV Gd-DTPA.1 recurrent lymphoma of ileum showed mural thickening and increased enhancement but no stenosis.1 irritable bowel syndrome is disfunction, so its shape and signal is normal.Except 1 Crohn disease, which showed a large mass, was misdiagnosed as lymphoma and no abnormality was found in 1 irritable bowel syndrome, the other diagnosis of MRI was correct.The sensitivity in diagnosing small intestinal disease was 100%, and the specificity was 83%.Conclusion MR enteroclysis with air infusion is a sensitive method in diagnosing the small bowel disease, especially in Crohn disease and tumor.It can clearly display the mural thickening and the extraluminal inflammatory mass.

Objective To describe CT and MR apearance of retroperitoneal ganglioneuroma .Methods CT and MR findings ofretroperitoneal tumor in a patient with ganglioneuroma biopsy-proved were retrospectively analyzed,and a literature review was conducted. Results The mass was well-circumscribed,non-enhanced CT showed homogeneous low atenuation, and a punctate calcification was seeninside tumor.Contrast uptake was delayed.Progressive but incomplete enhancement was observed.On MRI,T_2WI showed a high signalintensity and T_1WI show a low signal intensity.Enhanced MR depicted the mild enhancment.Conclusion Retroperitoneal ganglioneuroma is a rare tumor which should nevertheless be included in differential diagnosis of retroperitoneal masses when presenting as a well-delimitedtumor with possible tendency to surroud or displace major blood vessels.Low density on non-enhanced CT,and delayed progressiveenhancement on CT and MRI.

Objective To study the clinical significance of routine MRI and 3 dimensional time of flight magnetic resonance angiography (3D-TOF-MRA) for the pathogenesis of Trigeminal neuralgia (TN) Methods 32 patients with TN and 32 controls were observed by MRI and 3D-TOF-MRA by the enhancement of DTPA Diagnosis of the presence of compressions in the root exit zone (REZ) of the Trigeminal nerves were carried out by two radiologist on an independent console Results (1) In patients studied, compressions of the REZ of the nerves were detected with 29 on symptomatic sides (90 63%), neurovascular on 25 sides and tumor on 4 sides, and 2 on the asymptomatic sides(6 25%, all neurovascular) In the controls, 3 sides (4 26%, all neurovascular) were involved in the compressions of the REZ of the Trigeminal nerves (2) In 25 cases with TN of neurovascular etiology, the offending vessels were the superior cerebellar arteries in 17 cases (68%), anterior inferior cerebellar arteries in 2 cases, vertebral artery (VA) in 1 cases, difficultly identified vessels in 2 cases, vein in 2 cases, vascular malformation in 1 case (3) The RR of microvascular and tumor compressions which cause TN were 36 74 (4) The real microvascular compression and entrapping were only detected on the symptomatic sides of TN in 13 patients (52%) Conclusion MRI and 3D-TOF-MRA appeared to be the best imaging test for the pathogenesis of TN now The major causes of TN might be different neurovascular and tumor compressions in the REZ of the fifth cranial nerve, with real compression, entrapping or tight contact

Objective To detect the value of dynamic spiral CT on the prostatic cancer and benign prostate hyperplasia(BPH).Methods Plain and dynamic spiral CT scans were obtained in 88 male patients with various ages due to prostate or other pelvis diseases.Out of these detailed data in 5 cases of prostate cancer and 11 cases of BPH which were confirmed by operation and pathology were available.Contrast enhancement pattern and degree were correlated with the pathological and operational findings.Results Prostate was enlarged in all cases except one prostate cancer and 3 cases of BPH within normal limits in size.The contour of the prostate was irregular in all cancer cases and one BPH.On dynamic CT scans,prostatic malignant lesions appeared iso-hypodensity with the rest of the prostate gland at the arterial stage and low density at the veinous stage.Diffuse heterogeneous central enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found at the middle stage.There was little enhancement in the peripheral part at the arterial and veinous stages in BPH.The ratio of the central and the peripheral decreased.One case of BPH within normal size had spotty enhancement in the central part.On delayed CT scans 8 cases of BPH showed homogeneous enhancement in the total prostate gland.Conclusion Prostate cancer and BPH have their own characteristic enhancement patterns and degress,therefore dynamic spiral CT scan could help make differentiation between the two disease.

Objective To investigate the changes of the serum levels of matrix metalloproteinase- 2 (MMP-2) and peripheral blood leukocytes content and its relationship with the severity of cerebral infarction in acute cerebral in-farction(ACI)patients at different altitudes (high, middle and low). Methods One hundred thirty-nine cases and 150 healthy controls were included in the present study. Enzyme linked immunosorbent method was used to detect MMP-2 and WBC levels. Results MMP-2 levels increased as the altitude increased in controls. The MMP-2 in a descending or-der was 1.41±0.39 in Haixi (high altitude), 1.37±0.27 in Xining (middle altitude) and 1.28±0.21 in Sichuan (low altitude) (P<0.05). The serum levels of MMP-2 were significantly increased at 7 d at different altitudes (5.75±1.19, 5.23±1.12 and 4.15 ± 0.97 in low, middle and high altitudes, respectively). The WBC were significantly increased at different alti-tudes (12.93±2.11, 12.11±1.74 and 11.15±1.68 in low, middle and high altitudes, respectively) within 48 h in severe ACI group (P<0.05). MMP-2 levels in different altitudes were positively associated with the infarction size and the degree of neurological deficit, while were negatively correlated with the prognosis. The WBC in large infarction group were positive-ly correlated with the infarct size. Conclusions The levels of MMP-2 and WBC in different altitudes may be helpful in determining the ACI lesion size and the severity of the illness as well as estimating the prognosis.