Objective To investigate the effects of source to image receptor distance (SID) on the image quality and entrance surface dose (ESD) in the chest digital radiography (DR) for infants.Methods Anthropomorphic chest phantoms were exposed to 60 kVp and different values of SID ( 150 -80 cm with the interval of 10 cm,totally 8 groups) so as to record the values of mAs and ESD.The SID values of 110 cm and 90 cm with the moderate and low ESD values were selected for clinical test.Forty-two hospitalized infants,aged 12 months (8 months to 2 years) underwent chest DR with the SID of 110 cm before admission and 90 cm before discharge respectively.The values of ESD were recorded and compared.Three experienced experts assessed the quality of 84 pieces of images.Results The values of mAs and ESD decreased gradually along with the decrease of the SID from 150 cm to 80 cm.All the 84 images from the 42 infants met the demands for diagnosis.There was no significant difference in the score of image quality of the group with the SID of 110 cm (4.4±0.3) and 90 cm(4.2±0.4) (t=0.453,P＞0.05).The value of ESD of the group with the SID of 90 cm was significantly lower than that of the group of SID of 110 cm by 0.003 4 mGy ( t =12.001,P ＜ 0.05 ).Conclusions The image quality of chest DR could meet the demands for diagnosis in spite of the value of SID,however,the SID value in chest DR significantly might influence the ESD.The SID value of 90 cm shoud be recommended in chest DR for infants.

Objective To investigate the MRI features of cardiac myxoma by correlated with its pathological findings. Methods MRI features of 22 cases of pathologically confirmed cardiac myxomas were retrospectively reviewed. Results Of 22 cases, 21 are solitary, 12 located in left atrium, 6 located in right atrium, 2 located in left ventricle and 1 located in right ventricle. The other one occupied multiple chambers. MRI: 19 are heterogeneous and 3 are homogeneous. Cine-MRI: 18 attach to the endocardium with a pedunculated stalk and 4 are sessile and with a broad attachment. Thirteen cases had secondary valve insufficience or stenosis. Nine have compromised cardiac function. Nineteen cases demonstrated mild to moderate heterogeneous enhancement after Gd-DTPA administration and 3 ease showed no enhancement. Four cases had gadolinium first-pass perfusion study and showed a slow and continuous increasing time-intensity, lower than normal myocardium. The pedicles and wall showed delay enhancement. Pathologic findings: 21 are oval and lobalar configuration, 1 is grape-like. Ten cases had fresh hemorrhage and 5 had chronic hemorrhage. Fourteen had necrosis , 2 had cystic change and 4 had calcification. Blood vessels or inflanmmtory cells could be detected in 19 cases. Conclusions MRI can evaluate the size, location, morphology, especially the vascularity, histologic features and cardiac function of cardiac myxomas.

OBJECTIVE: To evaluate the distribution and characteristics of peripheral nerve abnormalities in chronic inflammatory demyelinating polyneuropathy (CIDP) using magnetic resonance neurography (MRN) and to examine the diagnostic efficiency.MATERIALS AND METHODS: Thirty-one CIDP patients and 21 controls underwent MR scans. Three-dimensional sampling perfections with application-optimized contrasts using different flip-angle evolutions and T1-/T2- weighted turbo spin-echo sequences were performed for neurography of the brachial and lumbosacral (LS) plexus and cauda equina, respectively. Clinical data and scores of the inflammatory Rasch-built overall disability scale (I-RODS) in CIDP were obtained.RESULTS: The bilateral extracranial vagus (n = 11), trigeminal (n = 12), and intercostal nerves (n = 10) were hypertrophic. Plexus hypertrophies were observed in the brachial plexus of 19 patients (61.3%) and in the LS plexus of 25 patients (80.6%). Patterns of hypertrophy included uniform hypertrophy (17 [54.8%] brachial plexuses and 21 [67.7%] LS plexuses), and multifocal fusiform hypertrophy (2 [6.5%] brachial plexuses and 4 [12.9%] LS plexuses) was present. Enlarged and/or contrast-enhanced cauda equina was found in 3 (9.7%) and 13 (41.9%) patients, respectively. Diameters of the brachial and LS nerve roots were significantly larger in CIDP than in controls (p < 0.001). The largest AUC was obtained for the L5 nerve. There were no significant differences in the course duration, I-RODS score, or diameter between patients with and without hypertrophy.CONCLUSION: MRN is useful for the assessment of distribution and characteristics of the peripheral nerves in CIDP. Compared to other regions, LS plexus neurography is more sensitive for CIDP.

Objective:To assess the clinical application of bedside X-ray photography assistor (Patent No. 202 023 219 898.1) in neonatal bedside photography.Methods:From April 2021 to February 2022, a total of 180 pediatric patients were selected who underwent bedside chest X-ray photography in neonatal intensive care unit (NICU) of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology. These patients were divided into contrpol group, consisting of 48 males and 42 females aged at (3.3 ± 2.0) d (0-10 d), and experimental group, including 50 males and 40 females aged (3.1±2.2) d (0-12 d). For chest photography, routine workflow was followed in the control group while in experimental group bedside photography protection and body position fixing device was used. The examination time, reshoot rate and image quality were compared between the two groups.Results:The diagnostic physician score and patient comfort score in the experimental group were higher than those in the control group, with statistically significant differences ( t = 3.98, 3.82, P < 0.001). The success rate in the experimental group was higher than that in the control group, with statistically significant difference ( χ2= 7.84, P < 0.05). The average time of examination in the experimental group was not significantly different from in the control group ( P>0.05 ). Conclusions:The application of bedside X-ray photography assistor in neonatal bedside photography can significantly improve the success rate and image quality and reduce the radiation dose to pediatric patients without significantly increased examination time, which is worthy of clinical application and promotion.

Objective:To compare the image quality of turbo gradient and spin echo-BLADE diffusion weighted imaging (TGSE-BLADE-DWI) with that of readout segmentation of long variable echo-trains (RESOLVE) at the sellar region.Methods:From September 15 th, 2019 to February 15 th, 2020, 38 patients with suspected sellar abnormalities were enrolled prospectively to perform RESOLVE and TGSE-BLADE-DWI at a 3.0 T MR scanner in Department of Radiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Totally, 32 patients were identified with sellar lesions. The DWI images were evaluated subjectively and objectively. Two experienced radiologists scored images of the two DWI methods for anatomical structures (including the internal carotid arteries, optic chiasm, pituitary stalk and pituitary gland), lesion conspicuity, susceptibility artifacts, geometric distortions and overall image quality using a five-point scale respectively. Objective parameters on the images of the two DWI methods were analyzed, including lesion size, signal to noise ratio (SNR) and apparent diffusion coefficient (ADC). The consistency of subjective scores of two radiologists was tested by Kappa test. Paired t-test, Wilcoxon signed rank test, Kappa statistics were used for statistical evaluation. Results:TGSE-BLADE-DWI performed significantly better than RESOLVE in depicting the sellar anatomical structures, lesion conspicuity, geometric distortion and overall image quality (all P<0.05). There were no significant differences in SNR, maximum longitudinal diameter of lesions and ADC of lesions between the two DWI methods(all P>0.05). The maximum transverse diameter measured by TGSE-BLADE-DWI was significantly smaller than that of RESOLVE ( Z=3.31, P=0.001). Conclusions:Compared with RESOLVE, TGSE-BLADE-DWI is superior in depicting the anatomical structures, decreasing susceptibility artifacts and geometric distortions at the sellar region and effectively improves the image quality of DWI, which has great value in clinical applications.

Objective:To investigate the application value of third-generation dual-source CT(3-G DSCT) low-dose scan mode combined with iterative reconstruction technology in the screening of COVID-19 and to evaluate the radiation dose.Methods:One hundred and twenty patients suspected of COVID-19 from December 2019 to February 2020 were retrospectively analysed and randomly divided into two groups (test group and conventional group, 60 patients in each). The parameters for test group included 3-G DSCT, Turbo Flash scan mode, CARE kV, with reference 90 kV, pitch 2.0, and ADMIRE algorithm, while those parameters for conventional group included the 128-slice CT, conventional spiral scan mode, 120 kV, pitch 1.2, and FBP algorithm. The CT values of aorta, spinal posterior muscle, and subcutaneous fat, the aortic noise, signal-to-noise ratio (SNR), and contrast noise ratio (CNR) were compared to evaluate the image quality between two groups. Two experienced doctors scored the image quality using a double-blind method, and compared the CT dose index volume (CTDI vol), dose-length product (DLP), and effective dose ( E) of the two groups. Results:The CT value of the aorta and spinal posterior muscle and the aortic SNR in the test group were (45.38±4.77), (53.41±8.44) HU, and 2.82±0.59, and significantly higher than those in the conventional group [(39.68±6.26), (42.66±6.32) HU, 2.58±0.61, t=5.608, 7.897, 2.162, P<0.05]. The aortic noise, CNR and subjective scores between the two groups had no significant difference( P>0.05). The CTDI vol, DLP, and E in the test group were (3.09±1.02) mGy, (107.57±32.81) mGy·cm, (1.51±0.46) mSv, significantly lower than those in the conventional group [(7.00±1.80) mGy, (261.65±73.93) mGy·cm, (3.66±1.03) mSv; t=-14.680, -14.756, -14.756, P<0.05]. Conclusions:In the screening of COVID-19, using low-dose scanning mode of 3-G DSCT combined with iterative reconstruction technology would provide diagnostic quality images and meanwhile effectively reduce the radiation dose and improve the SNR of the image.

Objective:To investigate the value of the size-specific dose estimate (SSDE) on dose estimations of children's head CT scans.Methods:A retrospective study was conducted on plain head CT scans of 252 patients with the 64-row detector CT device of Discovery 750HD in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to September in 2019. The volume CT dose index (CTDI vol)values were recorded. The head circumference (HC), area, and CT value were measured using a self-developed computer program, and the water equivalent diameter (WED), size-specific conversion factors ( f293 and f220), and absorbed dose (SSDE 293 and SSDE 220) were calculated according to the AAPM reports 293 and 220.The patients were divided into three groups by the quartering meth odaccording to their HC(<47.8 cm, 47.8-52.7 cm, >52.7 cm)and four groups based on their ages(0-2, 3-6, 7-10 and 11-14 years old). The difference between parameters ( f220 and f293, SSDE 220 and SSDE 293、SSDE 293 and CTDI vol) were compared for different groups, and the correlation of HC with f293 and SSDE 293 was analyzed. Results:There was an overestimation of f220 by 11.11% ( t=252.61, P<0.05) compared with f293. SSDE 220 was overestimated by 10.31% ( t=228.21, P<0.05) compared with SSDE 293, and SSDE 293 was underestimated by 9.60% ( t=-31.34, P<0.05)compared with CTDI vol. For the three HC groups, SSDE 220 was overestimated by 8.54%, 10.37%, and 11.57% ( t=73.73, 438.58, 275.52, P<0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.30%, 9.79%, and 14.61% ( t=-1.91, -60.95, -47.64, P<0.05)compared with CTDI vol. For the four age groups SSDE 220 was overestimated by 8.45%, 10.00%, 10.57%, and 11.36% ( t=63.58, 232.29, 247.84, 302.95, P< 0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.49%, 8.27%, 10.63%, and 13.78% ( t=-1.83, -28.27, -37.30, -49.80, P< 0.05)compared with CTDI vol. Furthermore, HC was highly correlated with f293 and SSDE 293 ( r2=0.88 and 0.76, respectively, P< 0.05). Conclusions:The radiation dose in children′s head CT scanning can be more accurately estimated according to the AAPM Report 293, while it can be overestimated by CTDI vol. Meanwhile, the CT radiation dose can be patently overestimated with the AAPM Report 220 compared with Report 293.HC is closely correlated with f293 and SSDE 293 and it can be used to estimatee more accurately for SSDE and the radiation dose received by children during head CT scanning.

Objective:To analyze the clinical reliability of neonatal bedside photography protection and body position fixing device during neonatal bedside X-ray photography.Methods:A mobile X-ray diagnostic machine was used to project the phantom of children. The samples were divided into group A with conventional bedside photography mode, and group B using neonatal bedside X-ray photography protection device. X-ray diagnostic level dosimeters were placed at the projection and radiation sensitive sites, respectively. The three parts of the chest, pelvis and skull were used as the projection center, and the radiation dose to the projection site and the radiation sensitive site were collected and recorded, and the statistical analysis was carried out.Results:When the chest was taken as the center of the projection, the radiation doses to the lens of the eye, thyroid and gonad in the body model group B of children were 94.4%, 96.9% and 96.7% lower than those in the non-injected part of group A, respectively ( t=-152.55, -445.16, -129.07, P<0.05). When the pelvis was taken as the projection center, the radiation doses to the lens, thyroid and thymus in the body model group B were 85.5%, 87.1% and 94.9% lower than those in the non-projection part of group A, respectively ( t=-50.68, -194.18, -535.94, P<0.05). When the head was taken as the projection center, the radiation doses to thyroid, thymus and gonad in the body model group B were 99.3 %, 97.4 % and 94.3 % lower than those in the non-projection position of group A, respectively ( t=-1 859.97, -542.08, -66.26, P< 0.05). Conclusions:The use of neonatal bedside photography protection and position fixing device during neonatal bedside X-ray photography can significantly reduce the radiation dose to children in non-projected areas under the premise of ensuring image quality. At the same time, it can fix and protect the children, improve the success rate of examination, being worthy of clinical promotion.

Objective: To explore the feasibility of constructing a machine learning classification model for unilateral sudden sensorineural hearing loss (SSHL) patients and normal controls based on diffusion tensor imaging. Methods: Prospective collection of 84 patients with untreated SSHL were recruited from the otolaryngology department of the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology between June 2013 to May 2015 as the SSHL group. Meanwhile, a total of 63 healthy volunteers who were no any ear disease history, and the hearing function were confirmed with pure tone audiometry, were collected as the control group. All subjects underwent a brain DTI scan. The data were divided into the training set and validation set according to the ratio of 7 to 3, that was, the training set contained 58 cases of SSHL patients and 44 control groups, and the validation set included 26 cases of SSHL patients and 19 control groups. A vector which included the DTI parameters such as fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity was constructed with the software R. The LASSO regression of machine learning method was used to perform feature dimensionality reduction and construct a classification model. The training set samples were used to map the nomogram based on the multivariate logistic analysis method, the validation set and the AUC were used to evaluate the prediction ability of the nomogram, and the calibration curve was used to evaluate the model. Results: From the 200 feature vectors including the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values of each brain region, after each dimension reduction process, a total of six features were retained, which were the MD of left superior corona radiate and right superior fronto-occipital fasciculus, the AD of the body of corpus callosum, and the RD of left inferior cerebellar peduncle, left superior corona radiate and right posterior limb of internal capsule. The six features of patients with unilateral SSHL were higher than the control group, and the difference was statistically significant (P<0.05). Based on this, a two-class model is constructed and a nomogram is drawn. The sensitivity, specificity, accuracy and AUC of the training set were 93.1% (54/58), 72.7% (32/44), 84.3% (86/102) and 0.854, respectively; the sensitivity, specificity, accuracy and AUC of validation set were 80.8% (21/26), 84.2% (16/19), 82.2% (37/45), 0.870, respectively. Nomogram could significantly improve the classification efficiency of the control group and patients, and the model with the LASSO method showed a higher prediction curve than other models. Conclusions The machine learning classification model based on DTI metrics can effectively distinguish patients with unilateral sudden sensorineural deafness from healthy control people.