Assessing the stage of live fibrosis and cirrhosis has direct clinical implications for patient treatment options.Liver biopsy is typically considered as the gold standard, but it has limited clinical utility due to its invasiveness.In recent years, with the rapid development of CT hardware and software, CT has made important progress in the non-invasive evaluation of liver fibrosis and cir-rhosis at home and abroad.This review focuses on clinical application of of contrast-enhanced CT, CT perfusion imaging, dual-energy CT and CT molecular imaging for liver fibrosis and cirrhosis.

Objective To compare the advantages and disadvantages of 3D BRAVO and TRICKS for detecting cerebral venous sinus thrombosis (CVST) and to explore the MR scanning methods on CVST.Methods A retrospective analysis was conducted on 40 patients who were diagnosed with CVST in the Fourth Affiliated Hospital of Kunming Medical University from January 2011 to June,2014.All the patients underwent TRICKS scan and 3D BRAVO examination and were classified into 3 groups based on dural venous sinuses,deep cerebral vein and superficial cerebral vein.Detection rates of TRICKS and BRAVO were evaluated and the results were analyzed.Result Detection rates of dural venous sinuses by TRICKS and BRAVO were 98.0％ and 100％ respectively.Detection rates of deep cerebral vein were 92.9％ and 100％ respectively.No significant difference was found (P＞0.05).Detection rates of superficial cerebral vein were 66.7％ and 100％ respectively.Significant difference was found between the two (P＜0.05) Conclusion BRAVO technology can clearly demonstrate the details of CVST,especially in superficial cerebral vein.With the combination use of TRICKS sequences,it will be of higher diagnostic value.

Objective To discuss the technical points and the clinical application of single wire-guided inverted Y-shaped tracheal stent implantation under general anesthesia in treating complex tracheal diseases. Methods During the period from January 2014 to October 2014 at authors’ hospital, a total of 6 patients with complex tracheal diseases received inverted Y-shaped tracheal stent implantation. The diseases included trachea-pleural fistula(n=1), trachea-esophageal fistula(n=2) and complex tracheal stenosis(n=3). Under general anesthesia and guided by DSA, inverted Y-shaped tracheal stent implantation was carried out in all the 6 patients. The results were analyzed. Results A total of 6 Y-shaped tracheal stents were used in the 6 patients, and single wire-guided implantation technique was employed in all procedures. In one case , the right branch of the Y-shaped tracheal stent was placed in the right upper lobe bronchus by mistake , and in the remaining 5 cases the stent implantation was successfully accomplished with single manipulation. Conclusion Under general anesthesia, Y-shaped tracheal stent implantation can effectively obstruct the trachea-pleural fistula and left main bronchus-esophageal fistula, and it can also quickly and significantly relieve the complex airway stenosis located at the tracheal carina region. This treatment is safe and reliable with satisfactory short-term effect. Moreover, single wire-guided manipulation is technically simpler, easier and faster than dual wire-guided manipulation. Therefore, this technique should be recommended in the clinical practice.

Purpose To investigate the value of quantitative evaluation of upper urinary tract pump function after unilateral lower urinary tract obstruction using 640-slice dynamic volumetric CT. Materials and Methods Twenty-six healthy subjects (control group), thirty cases of acute upper urinary tract obstruction caused by unilateral ureteral calculi and thirty cases of chronic upper urinary tract obstruction were selected, all receiving dynamic volume scan of 640-slice dynamic volumetric CT during renal excretion. The value of contrast agent volume, volumetric difference, time difference correspondent to the difference, volumetric change rate, and flow rate in ureteropelvic and partial upper ureter were calculated and analyzed. Results Volumetric change rate of obstruction side of upper urinary tract in acute obstruction group was higher than that of contralateral upper urinary tract. Volumetric average value, volumetric difference and flow rate were increased with time difference value decreased, the difference of which were all statistically significant (P<0.001). Volumetric change rate, volumetric difference and flow rate of obstruction side of upper urinary tract in acute obstruction group was lower compared with those of contralateral upper urinary tract, while volumetric average value and time difference raised, the difference was statistically significant (P<0.001). The difference of five pump function values among acute obstruction group, obstruction side of chronic obstruction group and control group were statistically significant (P<0.001). Conclusion 640-slice dynamic volumetric CT can be used to quantitatively evaluate changes of urinary tract pump function in physiological and obstructive status.

BACKGROUNDTo explore the therapeutic effect of bronchial artery infusion chemotherapy combined with immunotherapy for lung cancer with malignant hydrothorax.

METHODSSeventy-five lung cancer patients with malignant hydrothorax were randomly divided into the two groups: 38 patients were given intrathoracic chemotherapy and bronchial artery infusion chemotherapy combined with immunotherapy as observing group; 37cases only received intrathoracic chemotherapy as control group. Chi-square assay was performed to analyze the efficacy (responses for lung cancer and hydrothorax control) after the first course of treatment and the 1-, 2-year survival rates in the two groups.

RESULTSAfter the first course of treatment, the total responses for lung cancer were 31.58% (12/38) and 5.41% (2/37) in the observing group and control group (Chi-square=8.46, P < 0.01) respectively ; and responses for hydrothorax control were 86.84% and 64.86% respectively (Chi-square= 4.96, P <0.05). The 1- and 2-year survival rates in the observing group were 65.79% (25/38) and 26.32% (10/38) respectively, which were significantly higher than those of the control group (40.54% and 5.41%) respectively (Chi-square=4.80, P <0.05; Chi-square=6.10, P <0.05).

CONCLUSIONSThe intrathoracic chemotherapy combined with bronchial artery infusion chemotherapy and immunotherapy is quite effective in the treatment of lung cancer with malignant hydrothorax.