5) receiving cardiopulmonary coronary artery bypass grafting(CCAB) during the same period was reviewed as control group(CCAB Group).The preoperative risk factors,operation parameters,and postoperative outcomes between the two groups were compared for statistical analysis.Results The EuroSCORE value of the OPCAB Group and the CCAB Group was 9.0?2.6 and 8.3?2.1,respectively(t=2.016,P=0.045). The number of grafts in the OPCAB Group was less than that in the CCAB Group(3.2?0.9 vs 3.8?0.9;t=-4.267,P=0.000).The postoperative levels of creatine kinase(CK) and creatine kinase myocardial band(CK-MB) were significantly lower in the OPCAB Group [570(61～8246) U/L and 20(1～282) U/L] than the CCAB Group [870(246～8155) U/L and 55(12～300) U/L](Z=-3.648 and-5.767,P=0.000).The blood transfusion in the OPCAB Group was significantly less than that in the CCAB Group(775?693 ml vs 1088?712 ml;t=-2.887,P=0.004).There was no statistical difference in postoperative complications between the two groups.The mortality is 3.5%(4/113) in the OPCAB Group and 6.6%(5/76) in the CCAB Group,without statistical difference(?2=0.925,P=0.336).Conclusions OPCAB is safe and effective in high risk patients.Different operation methods should be used for patients with different risks.

Objective To study the facial nerve canal (FNC) abnormalities of the congenital external auditory canal (EAC) atresia by MSCT curved planar reformation (CPR).Methods 15 cases(17 ears) of congenital EAC atresia were scanned by MSCT. Post-processing images were completed by Philips Mx8000 workstation.Results In 17 ears, there were 2 ears with stenosis of EAC, 2 ears with membranous atresia of EAC and 13 ears with bony atresia of EAC.There were 1 ear with congenital cholesteatoma, 3 ears with malformation of tympanum, 7 ears with malformation of the ossicular chain and 1ear with malformation of inner ear. In 17 ears with abnormalities of FNC, included 11 ears with the shortness of FNC general length, 5 ears with the anomalous course of FNC, 9 ears with the displacement of FNC, 1 ear with the narrowing of FNC and 1 ear with the branch of FNC.Conclusion MSCT CPR of FNC, combined with HRCT axial scan, can clearly show the FNC abnormalities of the congenital EAC atresia and provide valuable information for surgery.

Objective Using curved planar reformation(CPR)to delineate the ossicular chain(OC)in one image and evaluate its clinical application. Methods HRCT of temporal bone was performed in 122 cases(165 ears).The CPR of OC was then performed.The main parameters were as follow:collimation 0.5mm,pitch 0.875,reformation interval 0.2～0.3mm,reformation matrix 1024?1024.Results (1)CPR of normal OC were performed on 80 ears,the three ossicles and its joints could be showed on one image clearly.(2)Clincal application(72cases):in 39 cases of temporal bone trauma,OCs were normal in 21 cases and abnormal in 18 cases.Subluxation or dislocation of malleoincudal joint(MIJ)(5,5) and incudostapedial joint(ISJ)(5,6),dislocation of MIJ and ISJ with rotation of incus(1 case),fracture of manubrium of malleus(1 case) were found respectively.In 16 cases of external auditory canal dysplasia(EACD),the most commonly associated type of OC deformity was absence of manubrium of malleus(10 cases)。Absence of OC associated with coarctation of middle ear cavity(3 cases) and fusion of the malleus and incus associated with absence of long process of incus represented in 1 case.Congenital ossicular anomalies without associated EACD were found in 2 cases.The long processes of the incus of both side were absent in 1 case.Incudostapedial disconnection was demonstrated in 1 case due to improper development of the long process of the incus.In 15 cases of chronic otitis media(COM),6 cases were complicated cholesteatoma.Destruction of OC was demonstrated in 6 cases.Conclusion CPR of OC with multislice spiral CT is an effective method in the diagnosis of conductive hearing loss.

Objective To explore the high-resolution CT manifestation of chronic otitis media with cholesteatoma. Methods clinical and high-resolution CT manifestation of 31 cases of chronic otitis media with cholesteatoma were analyzed. All the cases were confirmed by operation and pathology. Results High-resolution CT can accurately show the signs of soft-tissue occupancy and bony-erosion of cholestcatoma in middle ear which originate from various sites and of various sizes.confirmed by operation, accuracy were as high as 93.5%-100% . Conclusion high-resolution CT is extremely accurate in diagnosis of chronic otitis media with cholesteatoma.

Objective To explore the applied value of multi-slice spiral CT(MSCT) scan in the traumatic facial palsy.Methods 41 cases of traumatic facial palsy were scanned using MSCT,the MPR of interseted region of temporal bone and curved planar reconstruction(CPR) images were performed on Philips Mx8000 MSCT work station.The types,locations and course of the temporal bone fracture and the involving features of the external auditory canal,middle ear,inner ear were observed.Results 39 cases of the 41 patients had temporal fracture in different location.34 cases were longitudinal fracture,2 were transverse fracture and 2 were mixed fracture.The facial nerve canals were involved in 21 cases.Conclusion MSCT and the reformation images can help to study the facial nerve canal in the traumatic patients.It is important to use the MPR and CPR in the traumatic facial palsy.

Objective To evaluate the appropriate timing of coronary artery bypass grafting(CABG) with acute myocardial in- farction(AMI) and to discuss the influence of postoperative mortality on 30 days.Methods 233 patients after CABG were divided into 2 groups,AM/group and unstable angina (UA) group.There were 176 males (75.4%) and 57 females (24.5%).The mean age was (65.6?9.2) years(range 34～86 years).The mean grafts were 3.46?0.89.The complex risk elements between the 2 groups were analyzed to evaluate the independent risk element of death.Results Internal mammary arteries were used in 137 patients (58.8%).The postoperative mortality rate was 4.3 % (10/233).The operative mortality rates(OMR) were closely related to the in- creasing time intervals between AMI and CABG,for less than 3 days was 14.6% (6/41 cases),for 4 to 10 days was 2.7 % (1/37) and for 11 to 30 days was 0.The OMR of AMI less than 3 days has significant difference (P=0.033) comparing with that of unstable an- gina pectoris [2.3% (3/130) ].Conclusion Proper timing of CABG should be done in 3 days after AMI.

Objective To study the relationship of X-ray and MRI features of breast benign lesions with histopathology.Methods The X-ray and MRI features of breast benign lesions in 48 cases were analyzed retrospectively and compared to the histopathogic results.Results There were 18 cases with fibroadenoma and 12 cases with mammoplasia,8 cases with breast galactocele,8 cases with adenosis of breast accompanied by chronic inflammation and 2 cases with lipoma.The structure and vessels of breast were normal mostly in breast benign lesions.The margins of the lesions were clear and the density of lesions was uniformity.The calcifications inside the lesions appeared as granular with definite and smooth margins,less in amounts,growth as plexus-like or diffusive.The lesions were circular,oval or patchy shadows and homogeneous iso-or hypo-intensity on T1WI,iso-or slight hyperintensity on T2WI,and obviously homogeneous enhanced in 4 cases after administration of contrast medium.Conclusion Mammography is the first choice for the breast benign lesions,while MRI can improve the diagnostic accurate rate.

Objective To evaluate MR diagnostic value of neurovascular compression in patients with hemifacial spasm(HFS). Methods MRI and MRA manifestations and operative results of eighteen patients with HFS were reviewed retrospectively.Results (1)The roots of the facial nerve involved sides were compressed by vessel in all cases.(2)There was statistical correlation between the vascular compression of the root exit zone(REZ)of facial nerves and the symptoms of HFS(P

Objective To study the curved planar reformation (CPR) imagings of bony canals in craniofacial region with multislice spiral CT.Methods CPR of the bony canals in craniofacial regions were performed in 267 cases by using Philips Mx8000 multislice spiral CT,including facial nerve canal (FNC) in 217 cases,optic nerve canal (ONC) in 28 cases,mandibular canal in 9 cases,carotid canal in 7 cases, jugular foramen in 4 cases and hypoglossal canal in 2 . Scanning parameters were as followed : 120 kV , 200~250 mAs , collimation 0.5mm, pitch 0.625 or 0.875,scan time 0.75s/ring, matrix 512?512.Collimation and reformation interval were 0.5~1.0 mm and 0.2~0.5 mm separately, except for FNC,in which were 0.5 mm and 0.2 mm separately.Reformation matrix was all 1024?1024.Results Of all cases , the images of CPR in 11 were unsatisfied because of the head shaking during the scanning, in other 256 cases , images could show the whole length of canals clearly. In FNC,178 cases were normal , 18 cases had congenital abnormal in the external , middle or inner ear accompanied with changes of length , course and position. 8 cases of otomastoiditis accompanied with cholesteatoma involving facial canal. In 21 cases of temporal bone trauma accompanied with traumatic facial palsy, fracture lines or bony fragments of the FNC were found in 9 cases. 2 cases of facial nerve tumor and 2 cases of jugular foramen schwannoma accompanied with facial canal destruction.24 cases of ONCs were normal. Fracture lines or bony fragments of ONCs were found in 3 cases. Narrowing of ONC was found in 1 cases of fibrous dysplasia.Normal carotid canal was seen in 2 cases, there were 2 cases of carotid canal fracture.1 cases of bony destruction of carotid canal caused by cholesteatoma of petrous apex. Jugular foramen was normal in 2 cases. Destruction and enlargement of jugular foramen were found in 2 cases of schwannoma. In 1 cases, hypoglossal nerve canal was normal. Destruction and enlargement of hypoglossal nerve canal were found in the other cases of schwannoma. Mandibular canal were normal in 4 cases and was involved in 2 cases by mandibular osteomyelitis and mandibular fracture,respectively, and 1 case by mandibular tumor. Conclusion The bony canals in craniofacial regions can be shown clearly by CPR with multislice spiral CT . It can provide more valuable informations than that of the axial scan and multiplanar reformation in the diagnosis of diseases of craniofacial region and was the important supplement of routine CT scan.

Objective To measure the dimension and area of the brainstem on MR images in healthy adults and to study the relationship between age, sex and the size of the brainstem.Methods The dimensions and areas of the brainstem in 360 healthy volunteers on midsagittal MR images were measured. There were 180 males and 180 females, ranged in age from 20～87 years old. Results The average antero-posterior(AP) distances and areas of the midbrain were the largest at the 20～29 years old, and decreased slightly over 60 years. The average AP distance, vertical distance and area of the frontal pontine and pontine were no significant difference between different age groups, but there were significant difference in sex. The average upper diameter and area of the medulla oblongata were significant difference in partial age groups, and there was difference in sex (?