Objective To investigate the diagnostic value of MR cholangiopancreatography(MRCP) and volume imaging body exam(VIBE) in the obstructive jaundice.Methods 119 patients with obstructive jaundice underwent MRI examination of upper abdomen using the special sequences of MRCP and VIBE.The qualitative diagnosis of obstructive jaundice was evaluated with MRCP and VIBE in comparison with that of percutaneous transhepatic cholangiography(PTC),endoscopic retrograde cholangiopancreatography(ERCP) and operation.Results The corresponding diagnostic rate was 94.1% for obstructive jaundice with MRCP and VIBE,of that the corresponding rate in calculus obstruction,malignant obstruction,and the benign obstruction except calculus obstruction was 100%,94.3% and 83.9% respectively.There was significant difference between malignant obstruction and benign obstructive(P

Objective To study the correlation between multi-slice CT perfusion imaging and angiogenesis in hepatocellular carcinoma(HCC) induced by hypoxia inducible factor-1?(HIF-1?).Methods Multi-slice CT perfusion data were obtained in 34 cases of HCC and 11 cases of hepatic hemangioma identified by operation and pathology.Positive expression of HIF-1? and vascular endothelial growth factor(VEGF) protein of the lesions in all cases and surrounding normal hepatic tissue were investigated with SP immunohistochemistry.Microvessel density(MVD) was determined by anti-CD34 immunostaining.The correlation between multi-slice CT perfusion data and positive expression of HIF-1?,VEGF and CD34 was investigated simultaneously.Results Hepatic arterial perfusion(HAP) and hepatic arterial perfusion index(HAI) in HCC were higher than that of hepatic hemangioma and surrounding normal hepatic tissue(P

Objective To explore clinical application of the combined therapy of manual small incision cataract surgery (MSICS) with intraocular lens (IOL) implantation and trabeculectomy for patients with refractory glaucoma and coexisting cataract.Methods In our hospital,68 patients (76 eyes) with angle-closure glaucoma of continuously high intraocular pressure (lOP) and coexisting cataract were included in this study from April 2008 to October 2011.All of them were treated with the combination of MSICS with IOL implantation and trabeculectomy.Postoperative visual acuity,IOP,anterior chamber depth (ACD),filtering bleb,ocular fundus and complications were observed.Results Each operation was successfully completed.Postoperative visual acuity and IOP were significantly improved and decreased,respectively,compared to the preoperative.ACD was deepen and filtering bleb was effectively established in the postoperative eyes without significant complications.Conclusion The combined surgery of MSICS with IOL implantation and trabeculectomy might effectively increase visual acuity and decrease IOP,which was a safe and effective approach for patients with refractory glaucoma and coexisting cataract.

Objective To investigate the value of magnetic resonance (MR) imaging for diagnosing typeⅠ congenital choledochocele and its complications. Methods The MR imaging data of 13 cases with proved typeⅠ congenital choledochocele associated with complications were retrospectively reviewed and compared with operative findings. MR imaging sequences included axial T2W and T1W plain scan, true-FISP coronal images, 2D-MRCP, and Gd-enhanced T1W images. Results All patients had cystic dilatation of the common bile ducts to various degrees. In 6 patients complicated with stone and infection, the bile duct showed uniform wall thickening with marked enhancement, and calculus were depicted within the duct lumen with dilatation of the proximal biliary duct. In 7 cases complicated with carcinoma of biliary duct, a polypoid soft tissue mass or nodule was seen inside the ductal lumen in 3 cases, or the duct wall was irregularly thickened in 4 patients. Six cases received curative operation, but one patient with extensive local infiltration, vascular encasement and lymphadenopathy had only palliative treatment. MR imaging observations were verified by surgery findings in all 13 patients. Conclusion MR imaging is very valuable not only in diagnosing typeⅠ congenital choledochocele, but also in revealing its complications.

Objective To study the imaging features regarding perineural spread of tumor along the trigeminal nerve in malignant head and neck tumors, investigate its usefulness in improving diagnostic accuracy and palnning for clinical treatment. Methods Images in 9 patients with clinical or radiological findings suggestive of perineural spread along trigeminal nerve were retrospectively studied. Results Among the 9 patients, 6 were adenoid cystic carcinoma of the hard palate (n=3), maxillary sinus (n=1), parotid gland (n=1) and buccal space (n=1), respectively. Two were nasopharyngeal carcinoma and 1 was squamous carcinoma of the maxillary sinus. Enlargement and fat effacement of greater palatine foramen and pterygopalatine fossa distant from primary diseases were seen in all the 3 patients with adenoid cystic carcinoma of the hard palate and 1 with squamous carcinoma of maxillary sinus, furthermore, enlargement of foramen ovale and invasion of meckal cave was seen in 1 case. Erosion of infraorbital foramen and enlargement of the pterygopalatine fossa was seen in 1 patient with adenoid cystic carcinoma of maxillary sinus. Enlargement of pterygopalsatine fossa and foramen rotundum and invasion of the Meckal cave were seen in 1 patient with adenoid cystic carcinoma of buccal space. Perineural spread along auriculotemporal nerve and intracranial invasion through foramen ovale were seen in 1 patient with adenoid cystic carcinoma of parotid gland. Enhancement of mandibular nerve was seen in 2 patients with nasopharyngeal carcinoma. Conclusion Perineural tumor spread along trigeminal nerve can be seen in malignant head and neck tumors, and knowledge of the anatomy of trigeminal nerve and its surrounding structures is important for correct diagnosis.

Objective To study the correlation between the CT features of tumor blood supplies and the pathological changes in primary hepatocellular carcinoma (PHCC). Methods Fifty cases with surgically and pathologically proved PHCC underwent spiral CT scanning (plain+dual phase). One research group blindly evaluated the CT films obtained. According to tumor contrast enhancement and signals showed on CT, the patterns of PHCC was divided into 4 types: arterial blood supplying, portal blood supplying, arterial combining with portal blood supplying, and poorly blood supplying. Microscopically, PHCC was respectively classified into grade I to Ⅳ with Edmonson′s standard, and into 4 types (trabecular, pseudoglandular, compact, scirrhous) with WHO histological grading standard. At last, the CT features of tumor blood supplies were correlated with pathologic changes. Results 36(72%) cases were supplied by hepatic arterial blood, 6(12%) by arterial combining with portal blood supplying, 4(8%) by portal, and 4(8%) were poorly blood supplying. The patterns of tumor blood supplies in PHCC correlated with tumor cells differentiation ( P

This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
Abdominal Cavity ; anatomy & histology ; Adult ; Contrast Media ; Fascia ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Kidney ; anatomy & histology ; Multidetector Computed Tomography ; Pancreatitis ; pathology ; Pelvis ; anatomy & histology ; Tomography, X-Ray Computed

Objective To make a further recongnizing of the manifestations of diffuse axonal injury (DAI)on CT images for the early accurate clinical diagnosis.Methods The CT image data and its correlated clinic features of 56 cases with diffuse axonal injury(44 male,12 female)were analyzed retrospectively.In this series,43 cases were caused by traffic accident,13 by falling from high place.Results 1. 44 cases had haemorrhage lesions(less than 2 cm in diameter)in brain parenchyma which were at the corticomedullary junction,corpus callosum,brain stem,basal ganglia,internal capsule.2. 41 cases had subarachnoid and/or intraventricular hemorrhage 3. 9 cases had acute generalized brain swelling 4. 5 cases were associated with epidural hematoma and 16 with subdural hematoma.Conclusion CT manifestation of DAI have some featrues,and can provide reliable evidence for accurate clinic diagnosis of DAI.

Objective To analyse the normal helical CT appearances of the bronchial stump or anastomosis after pulmonectomy for central bronchial carcinoma.Methods The available 110 contrast-enhanced spiral CT images in 55 patients undergone different surgical procedures for central bronchial carcinoma were evaluated retrospectively.Results The CT findings of bronchial anastomosis in shape appeared as smooth,concave and convex,sharp angle,obtuse angle,spininess,irregulated or short tube.The thickness of anastomosis was (3.26?1.46) mm.Conclusion Spiral CT can display the bronchial anastomosis clearly after pulmonectomy for central bronchial carcinoma.

Objective To investigate the features of gallbladder carcinoma in two-phase spiral CT, and to analysis the values of two-phase spiral CT for the differential diagnosis between gallbladder carcinoma and chronic cholecystitis. Methods The two-phase spiral CT manifestations of 30 cases of gallbladder carcinoma, proved by surgery and pathology, and 30 cases of chronic cholecystitis were analyzed. Results According to the CT findings, the gallbladder carcinoma was categorized into 3 types: intraluminal mass of gallbladder in 6 out of 30 (20.0%), thickening of the gallbladder wall in 11 (33.7%), and mass replacing the normal gallbladder in 13(43.4%). The most common enhancement patterns of the wall in gallbladder carcinoma were hyperattenuation during the arterial phase, while isoattenuation with the adjacent hepatic parenchyma during the venous phase; or hyperattenuation during both phases. The most common enhancement pattern of the wall in chronic cholecystitis was isoattenuation during both phases, with clear hypoattenuation linear shadow in the gallbladder fossa. Other ancillary features of gallbladder carcinomas included: infiltration of the adjacent parenchyma, local lymphadenopathy and intrahepatic metastasis. Conclusion Two-phase spiral CT scan can identify the features of the gallbladder carcinoma and is helpful for the differential diagnosis of these two different disease entities.