Objective To investigate retrospectively CT,MRI and DSA appearances of giant cell tumors(GCT) of bone in unusual sites,in order to improve the diagnosis of it.Methods CT,MRI and DSA features of GCT in 11 cases proved by surgery and pathology,were retrospectively analyzed.GCTs located in iliac bone in 4,sacral vertebrae in 3,ischial bone in 2, calcaneus and temporal bone in one respectively.Results (1) At CT,the tumors were mainly showed as expanding growth and osteolytic destruction,without periosteal reaction and calcification.(2)At MRI,the tumors were hypo-,isointensity on T_1WI and heterogeneously iso, hyperintensity on T_2WI.Low intensity curvilinear strips inside the tumor on T_1WI and T_2WI were found in 5 patients,and "bright patches sign" on T_2WI were also displayed in 2 cases.(3)At DSA,abundant blood supply to the tumors was demonstrated,the thickened and twisted feeding artery and,"tumor's stain sign" were also found.Conclusion To analyse imaging data synthetically,including CT,MR imaging and DSA,can improve the knowledge of GCT of bone in unusual sites.

Objective To study the method of treatment of esophageal stricture and ulcer in children caused by corrosive injury using esophageal stent.Methods The stent made of stainlees steel Z type covered with thin membrane or Ni-Ti shape memory wire mesh-like stent was used and placed through mouth by the transport of tracheal stent in 12 cases.Results Symptoms of the dysphagia in all 12 cases treated with 18 sets of Z stents were alleviated remarkably.Following up study from 6 month to 6 years,the stents were regulated or replaced one or more times in 9 cases,the stents were removed in 5 cases,and food-taking was normal following up from 6 to 36 months.Surgical operation was done in one case.The stents were retained in 6 cases,but ordinary and soft food could be taken without problem.One case was treated with 2 stes of Ni-Ti shape memory wire mesh-like stent,the esophageal stricture reappeared one month later and operation was done 6 years later.Conclusion Stent of the Z type is safe and effective in treating esophageal stricture and ulcer in children caused by corrosive injury.

Objective To study the influence of early intensive blood pressure (BP) lowering treatment on peri-he?matomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage. Methods A randomised con?trolled trial consisting of 36 consecutive patients within 6 h of intracerebral hemorrhage onset were randomly assigned to intensive BP lowering group and guideline BP lowering group. All patients underwent MR spectroscopy at 72 h and were followed up 90 days. N Acetyl Aspartate/Creatine (NAA/Cr) and lactic acid wave around peri-hematomal at 72 h, neuro?logic function at early stage, and death and/or disability at 90d were compared between these two group. Results Spec?trum lines were obtained from thirty-one patients:14 from intensive BP lowing group and 17 from guideline BP lowering group. There was no significant difference in the percentage declines of NAA/Cr at 72 h between the two groups (13.3%± 4.2% vs. 11.9%± 2.8%, P = 0.308). There was no statistical differences either in neurologic function at 7 d or in death and/or disability at 90 d (P>0.05). Conclusions Early intensive BP-lowering treatment had no role on peri-hematomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage. Further high-quality and large-scale ran?domised controlled trial are necessary to verify this result.

Objective To evaluate multi-slice spiral CT venography (MSCTV) and digital subtraction venography (DSV) in diagnosing iliac vein compression syndrome (IVCS) and secondary thrombosis. Methods The imaging materials, including MSCTV and DSV performed before and after the thrombolysis therapy, of 38 patients with clinically-suspected IVCS were collected. The inner diameters of the compressed iliac veins were measured on MSCTV images and the compression ratio was calculated. Usingχ2 test, the detection rates of IVCS by MSCTV and DSV were compared. Results Of 38 patients, IVCS was detected by MSCTV in 29, by pretreatment DSV in 20 and by post-treatment DSV in 29. The difference in the detection rate of IVCS between MSCTV and pre-treatment DSV was statistically significant (χ2=4.65, 0.010.05). Conclusion For the diagnosis of IVCS, MSCTV is superior to pre-treatment DSV in the diagnostic accuracy of iliac vein compression syndrome. Therefore, MSCTV should be used as the preferred method of examination.(J Intervent Radiol, 2015, 24:301-305)

Purpose To explore the value of 128-slice dual source CT (DSCT) three-dimensional post-processing techniques in the diagnosis of acute aortic dissection (AAD). Materials and Methods All image data of 116 patients with AAD who underwent conventional and enhanced DSCT scan by dual-energy scanning technology were retrospectively analyzed, and the multi-planar reconstruction (MPR), volume rendering (VR) and maximum intensity projection (MIP) were conducted in the workstation. Taking digital subtraction angiography (DSA) as the diagnostic gold standard, we analyzed the imaging manifestation of the original and 3D-reconstruction images and evaluated the specificity and the sensitivity of diagnostic accuracy and the image quality. Results The diagnostic accuracy of conventional scan was 37.1%(43/116). The display rates of MPR for initial break, intimal flap and true and false lumen were 93.1%, 100.0%and 100.0%, respectively. The display rates of VR and MIP for the initial break were 33.62%and 6.90%, respectively, which was both lower than that of MPR. The display rate of MIP for the true and false lumen was 23.28%. The overall display capability of MPR was significantly better than that of VR and MIP (P<0.01), and the display capability of VR was better than that of MIP (P<0.01). The sensitivity and specificity of enhanced DSCT in the diagnosis of AAD were both 100.0%. Conclusion DSCT has a fast and reliable diagnostic value on AAD. Conventional CT signs should be highly valued in the evaluation of chest or abdominal pain; and a thin layer of MPR and VR should be chosen in the three-dimensional reconstruction;whilst MIP reconstruction may be unnecessary for AAD.

Objective To evaluate the clinical value of MSCTA in displaying the right gastroepiploic artery(RGEA).Methods 16-slice spiral CT enhanced images of abdomen in 80 cases were retrospectively reviewed.The course and the length of RGEA were observed and the diameters of RGEA at the origin and the end were also measured on maximum intensity projection(MIP),thin slice maximum intensity projection(TSMIP) and volume rendering(VR) images.Results The displaying rate of RGEA by MSCTA was 100% including long type in 22 cases(27.50%),moderate type in 53 cases(66.25%) and short type in 5 cases(6.25%).The average length of RGEAs was (19.5±4.5) cm.The average diameters of RGEAs at the origin in long,moderate and short type respectively were (2.69±0.26) mm,(2.70±0.18) mm,(2.68±0.12) mm respectively.The average diameters of RGEAs at the end in these three types were (1.76±0.17) mm,(1.75±0.18) mm and (1.74±0.05) mm respectively.The average diameters of RGEA in different length were no of statistical significance(P＞0.05).Conclusion RGEA can be evaluated with MSCTA before coronary artery bypass grafting.

Objective To assess the value of multi-slice spiral CTA in the diagnosis of iliac vein compression syndrome(IVCS)and secondary thrombosis.Methods The CTA data of 80 controls and 31 patients with IVCS conformed by DSA were retrospectively studied.The inner diameters of the compressed iliac vein in two groups were measured and compression ratios were calculated.The data were compared using t test and Wilcoxon test.The findings of CTA were compared with that of DSA and the accuracy of CTA was analyzed.Results For the control group,the inner diameters of left iliac vein in female group(7.0±2.5)mm were significantly less than that in male group(8.1±2.5)mm(t=2.42,P＜0.05).For the control group,the inner diameters of left iliac vein was(7.6±2.0)mm,and the compression ratios were 0 to 65.41%(median 27.65%).The compression ratios were no statistical differences between male group(0 to 61.36%,median 26.82%)and female group(0 to 65.41%,median 28.75%)(Z=-0.59,P＞0.05).For the patients group,the inner diameters of compression iliac vein was(2.7±1.1)mm.The compression ratios were 55.18% to 100%(median 76.12%).Both inner diameters and compression ratios were statistically different between the control and patients group(t=12.78,P＜0.05;Z=-8.18,P＜0.05).Fifteen of 31 cases with IVCS were accompanied with deep vein thrombosis.The left iliac veins were compress in 28 cases,while right iliac veins were compressed in 2 cases.The left and right iliac common veins were compressed by the left and right jliac common arteries in one case.The results of CTA were consistent with that of DSA in all cases.Conclusions CTA can not only measure the inner diameters of iliae vein compression and calculate compression ratios,but also demonstrate secondary thrombosis clearly.CTA is an effective examination in diagnosis of IVCS and secondary thrombosis.

Objective To explore the diagnostic value of the CT angiography (CTA) in the detection of mechanical obstructive cause of deep venous thrombosis of lower extremity. Methods Forty-seven cases of CTA and DSA image data of DVT in lower extremity with mechanical obstruction were retrospectively analyzed. The CTA three-dimensional reconstruction images were compared with DSA results, and the position and size of thrombus, collateral circulation of blood vessels, vascular compression area and the corresponding outside vascular lesions were evaluated. The causes of venous occlusion were analyzed. Diagnostic agreement of CTA and DSA was assessed by Kappa statistics. The difference of the accuracy between CTA and DSA in the diagnosis of the left and right iliac femoral vein, inferior vena cava, internal iliac vein thrombosis were analyzed with χ2 test. Results There were 47 patients with lower extremity DVT. Of them, DVT was detected in the left leg in 28 patients, in the right leg in 14 patients and in both lower extremities in 5 patients. Mechanical obstruction caused DVT in all of them. There were 27 patients of iliac vein compression syndrome(IVCS)complicated with lower limb DVT. The left iliac vein was oppressed by the right common iliac artery with compression degree from 55.41%to 100.00%,and mean of(77.1 ± 16.8)%. There was congenital stenosis or occlusion of inferior vena cava in 3 patients. There was Budd-Chiari syndrome in 2 patients. There was pelvic mass pressing the common iliac vein in 4 patients. Enlarged right inguinal lymph nodes oppressed the right femoral vein in 3 patients and enlarged left inguinal lymph nodes oppressed the left femoral vein in 2 patients. Other mechanical obstruction factors caused DVT in 6 patients, including right iliac artery aneurysms,spontaneous hematoma, etc. The agreement of CTA and DSA on the diagnosis of the iliac femoral thrombosis was good (Kappa=0.978), the diagnosis agreement on the inferior vena cava thrombus was good (Kappa = 0.737), while the diagnosis agreement on the internal iliac vein thrombosis was poor (Kappa=0.189). The difference of CTA and DSA in the diagnosis of left and right iliac femoral venous thrombosis was not statistically significant (52,51 case;χ2=0.00, P>0.05), neither was the diagnostic difference of inferior vena cava thrombus (21,17 cases;χ2=1.50, P>1.50). However, the difference of the diagnosis of the iliac vein thrombosis was statistically significant (14,2 cases;χ2=8.33, P<0.05) . Conclusions CTA can clearly show the location and scope of the thrombus. Compared with conventional DSA, CTA shows higher diagnostic coincidence rate, and can accurately determine the mechanical obstruction causes of lower extremity DVT.

Objective To assess the diagnostic value of magnetization transfer contrast (MTC) gradient echo (GRE) T2WI sequence in bone injury of knee joint. Methods MRI data of 56 patients with knee injury were analyzed retrospectively. All patients underwent SE sequence (sagittal T1WI, T2WI) and sagittal MTC-GRE T2WI sequence. The size, signal intensity and margin of bone contusion with different MRI sequence were analyzed and compared. Results Among 56 patients, 43 and 45 cases were demonstrated on SE T1WI and T2WI, respectively; 50 cases were displayed on MTC-GRE T2WI sequence. The size, border of bone contusions and sensitivity displayed on MTC-GRE T2WI sequence were statistically higher than those on SE sequence (P<0.05). Conclusion MTC-GRE T2WI sequence has great diagnostic value in contusion of knee joint, which is superior to FSE sequence.

Objective To assess the clinical value of dual-energy CT (DECT) Volume software in quantitative analysis of urate crystals.Methods The DECT data of 60 gout patients based on the American College of Rheumatology diagnostic criteria were analyzed retrospectively.The volumes of urate crystals were quantitatively analyzed by using Volume software with two senior radiologists.The results were statistically analyzed.Results Seventy-two joints of 60 gout patients were scanned by DECT.40 of 43 joints had urate crystals in foot and ankle with the average volume of (0.621±0.742) cm3;18 of 19 joints had urate crystals in knee with the average volume of (0.842±1.086) cm3;10 of 10 joints had urate crystals in hand and wrist with the average volume of (0.796±0.583) cm3.There was no statistical difference for volume measurement between two doctors (P>0.05).The volumes of urate crystals in 4 patients with regular medication were reduced.Conclusion Volume software of DECT can quantitatively analyze urate crystals with a good repeatability, which has high application value in clinical diagnosis and treatment monitoring of gout.