Objective To evaluate the effect of different tube voltage and noise index (NI)on image quality and radiation dose during peripheral artery CTA with automatic tube current modulation(ATCM)technique.Methods Seventy-two patients were ran-domly divided into three groups with different scanning tube voltage and noise index as follows:group A with 100 kV and NI of 1 5, group B with 80 kV and NI of 1 5,group C with 100 kV and NI of 20.Image quality,segmental vascular enhancement,signal-to-noise ratio (SNR),contrast-to-noise (CNR)and effective dose (ED)were independently evaluated in 3 groups.The methods of sta-tistics analysis were ANOVA,and P <0.05 represented the significant difference.Results There was no significant difference of image quality of the peripheral artery among 3 groups.The CT value,SNR,CNR in group B (80 kV)was the highest,and there were statistical differences between A,B groups and B,C groups of arteries (P <0.05),and there was no satistiacal difference between A group and C group.Compared with group A and group B,the CTDlvol,DLP and ED of group C was reduced 50.45%,51.20%,51.21% and 35.03%,34.91%,34.92%,respectively,and the difference was statistical significance (P < 0.05 ),and there was no significant difference between group A and group B (P >0.05).Conclusion Using ATCM low-kV with high NI scanning can reduce radiation dose without interference on image quality for peripheral artery CTA.

ve To investigate the effects of acute normovolemic hemodilution on cardiac troponin I (CTnl) and myocardial enzyme. Methods Twenty-nine ASA I-II patients undergoing hepatectomy or bilateral hip replacement were randomly divided into two groups: hemodilution group (H , n=15) and control group (C, n=14) . The patients were premedicated with diazepam and scopolamine. Left radial artery was cannulated for intra-arterial pressure monitoring and the letting of blood. Right internal jugular vein was cannulated for fluid administration and CVP monitoring. Anesthesia was induced with midazolam 0.15-0.30mg?kg-1 , fentanyl 4?g?kg-1 and vecuronium 0.08-0.1mg?kg-1 and maintained with infusion of midazolam (0.03-0.10 mg?kg-1?h-1), fentanyl (0.15-2.0?g?kg-1?h-1) and vecuronium (0.5-1.0?g?kg-1?min-1). After tracheal intubation the patients were mechanically ventilated with 100% O2 and PETCO2 was maintained at 35-45 mmHg. 15 min after induction of anesthesia hemodilution was started. Blood was withdrawn from radial artery and collected until Hct was reduced to 25%-28% . Ringer's lactate solution and hydroxyethyl starch (HES 6%) were simultaneously infused to maintain blood volume. Blood samples were taken before anesthesia, before blood transfusion, 4h after surgery and on the 1st postoperative day for determination of blood CTnI, CK and CK-MB activities. Results The demographic data including age and body weight were not significantly different between the two groups. Prior to blood transfusion Hct was reduced to 20.33% ?1.91 % in group H and 29.64%?1.78% in group C. CK increased significantly at 4h after operation and on the 1st postoperative day; CK-MB increased significantly on the 1st postoperative day. The difference between the two groups was not significant. CTnI showed little change during and after operation in both groups.Conclusions Our study suggests that hemodilution to 20% Hct does not result in myocardial injury in patients without preexisting cardiopulmonary disease as long as normal blood volume is maintained and patient suffers nohypoxia.

Gastrointestinal duplication cyst is a rare congenital disease which can occur in any part of the digestive tract between the root of tongue and the anus,and it is commonly seen in the ileum.About 45％ of the gastrointestinal duplication cyst occurs in the ileocecus and the epityphlon.Multiple gastric duplication cyst is a rare type of the gastrointestinal duplication cyst,which accounted for 3.8％-5.0％.Gastric duplication cyst mostly occurs in the greater curvature of the stomach,and it connects with the stomach wall.Multiple gastric duplication cysts in the mediastina is rarely seen.In this article,the imaging presentations of 1 patient with multiple gastric duplication cysts inside the mediastina were analyzed.

Objective To explore the value of gemstone spectral imaging (GSI) in the detection and differential diagnosis of benign and malignant thyroid nodules.Methods The spectral CT images in 88 patients with thyroid nodules were analyzed retrospectively.All the patients underwent spectral CT scanning,including 33 patients undergoing biphase enhanced CT imaging.Nodules were divided into benign and malignant ones according to histopathologic results.The iodine concentration,slope of spectral curve,effective atomic number in non-enhanced and enhanced scanning were compared between benign and malignant group by the Wilcoxon rank sum test,respectively.The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic curve (ROC),sensitivity and specificity were achieved.Results A total of 106 nodules were detected,including 76 benign and 30 malignant nodules.In non-contrast CT imaging,the average iodine concentration,slope of spectral curve,effective atomic number of were 2.35 × 100 μg/ml,0.29 and 7.71 for benign group:-0.51 × 100 μg/ml,-0.06 and 7.52 for malignant group (Z value were-3.072,-3.107 and-3.055,respectively ; P ＜ 0.05).In the arterial phase,the average iodine concentration,slope of spectral curve,effective atomic number of the two group were 27.22 × 100 μg/ml,3.23 and 9.10 for benign group; 18.81 × 100 μg/ml,2.24 and 8.69 for malignant group (Z value were-2.582,-2.582 and-2.564,respectively; P ＜ 0.05).In venous phase,no significant difference was found for each parameter between the two groups (P ＞ 0.05).The optimal iodine concentration to predict malignancy was-0.35 × 100 μg/ml in non-enhanced phase with 56.7％ sensitivity and 73.7％ specificity.The optimal iodine concentration was 22.91 × 100 μg/ml in arterial phase,with 76.2％ sensitivity and 75.0％ specificity.Using iodine concentration to predict malignancy in both noncontrast phase and arterial phase,the sensitivity and specificity were 81.2％ and 73.3％,while the accuracy was 81.6％.Conclusion Gemstone spectral CT imaging can quantitatively evaluate the iodine content of thyroid nodules,having a potential value in differential diagnosis of thyroid nodules.

Objective To discuss the diagnostic value of monochromatic energy image spectral CT in active small bowel bleeding and to screen the optimal energy level that indicates active bleeding of the gastrointestinal tract.Methods The bleeding model was established using the small intestines of pigs in vitro.Seven blood flow rates were simulated:0.500,0.400,0.300,0.200,0.100,0.050,0.025 ml/min,respectively.For each rate,a GE Discovery HD750 CT scanner was used in GSI scan mode and 64 slice CT was performed,with a delay of 15 s and 40 s simulated the arterial phase and portal venous phase,respectively.Each out of the blood flow rate in the 2 modes was respectively scanned 5 times.The GSI reconstruction platform was employed to obtain 7 monochromatic energy images(40,50,60,70,80,90,100 keV).A set of polychromatic energy images was obtained from an ordinary scan.The detection rates of the contrast agent exudation regions using the two scanning methods were compared.The contrast to noise ratios(CNR) for the contrast agent exudation regions were measured.Randomized block analysis of Variance was performed to compare the differences in CNR between energy levels.The x2 test was used to compare the detection rates obtained from the 2 scanning methods.Results The detection rates for energy spectral CT and 64 slice CT in the arterial phase were 31/35 and 23/35,respectively; there was significant difference(x2=5.185,P=0.023).The total detection rates of portal venous phase were 35/35 and 32/35,respectively,there was no significant difference(x2=l.393,P=0.238).On the ordinary scan mode,the detection rates of arterial and portal venous phase difference was statistically significant(x2 =6.873,P =0.009);but on the GSI scan mode,there was no significant difference(x2=2.386,P=0.122). The CNR values at 8 group energy levels for arterial phase and portal venous phase were statistically different(respectively P＜ 0.05),the CNR value of the contrast agent exudation regions at 50 keV and 60 keV monochromatic energy images on the GSI scan mode higher than that of polychromatic energy images,the difference was statistically significant(respectively P＜0.05),the CNR in portal venous phase images were higher than that of arterial at all energy groups,differences were statistically significant(t=-3.996 to-2.380,respectively P＜ 0.05).Conclusions Monochromatic energy image spectral CT demonstrates superiority over polychromatic energy images in detecting active bleeding of the gastrointestinal tract.The optimal monochromatic energy value for detection was between 50 keV and 60 keV,and the detection was easier in the portal venous phase than in the arterial phase.

Objective To test the expression of serine/arginine rich splicing factor 1(SRSF1)and apoptosis inhibiting factor(Survivin) in prostate cancer,and study their correlation with the pathological features of prostate cancer,so as to put forward the new targets in the treatment of prostate cancer. Methods SRSF1 and Survivin protein was determined in 20 prostate tissue samples including prostate cancer(n=12)and benign prostat?ic hyperplasia(n=8)by immunohistochemical SP method. SRSF1 and Survivin was correlated to pathological features,and both the relevance was analyzed(no related reports at home and abroad). Results The positive expression rate of SRSF1 protein in prostate cancer tissue cells was 76.37± 5.06%,which was significantly higher than that of benign prostatic hyperplasia(11.30%±1.09%,P<0.05);the positive expression rate of Survivin protein in prostate cancer tissue cells was 86.93%±3.21%,which was significantly higher than that of benign prostatic hyperplasia(17.67%±1.99%, P<0.05);SRSF1 and Survivin protein expressed in prostate cancer organizations and were positively correlated to pathological Gleason grading, and there was significant correlation(P<0.05). Conclusion SRSF1 and Survivin protein were highly expressed in adenocarcinoma tissue,which were significantly increased than that of benign hyperplasia of prostate tissue. The positive expression SRSF1 and Survivin protein were positively cor?related to pathological Gleason grading.The expression of Survivin protein was elevated with the expression of SRSF1 protein in prostate cancer. These preliminary evidence indicated that SRSF1 may up?regulate the expression of Survivin,and thus promote the occurrence and development of prostate cancer.

Objective To evaluate the techniques and application of 64-slice helical CT colonography in colonic lesions. Methods Thirty-eight patients (including 12 colonic carcinomas,10 polypi, 9 colon multiple scrobiculus, 2 multiple diverticula, 2 negative, 1 congenital bowel malrotaion,1 ulcerative colitis and tunica mucosa glandular organ hyperplasy,1 colocolic anastomosis of terminal ileum and sigmoid colon) underwent volume scanning using 64-slice helical CT after cleaning colon. Six types of reconstruction including CT virtual colonoscopy(CTVC), volume rendering(VR), multiple planar reconstruction(MPR), 360?sectional view, RaySum,and navigation were gained.CTVC appearances were compared with that of conventional colonoscopy(CC).Results In 12 colonic carcinomas and 10 polypi,the lesions’ morphology,number,size, were satisfactorily shown by CTVC. The lesions’ location,range,and 1 intestinal canal obviously stenosis were also exactly shown by RaySum.The relationship between tumor and environment, 3 liver or retroperitoneal lymph node metastasis were satisfactorily shown by MPR and 2D transection image. On 360?sectional view,the distance between tumor and anus was exactly measured and the result was in conformity to that of CC. Of the CTVC appearances,1 sigmoid carcinoma and 1 transverse colon polyp was in unconformity to that of CC;1 ulcerative colitis and descending colon carcinoma was diagnosed as ulcerative colitis and tunica mucosa glandular organ hyperplasy by pathology.Conclusion 64-slice helical CT is a valuable imaging technique for detecting colon diseases. CTVC can obtain more clinical information than CC combining MPR,RaySum and VR.

Objective To study the clinical value of 64-slice spiral computed tomography(64SCT) contrast-enhanced scan and three-dimensional reconstructed techniques in the diagnosis of complex congenital heart disease(CCHD). Methods 39 patients with CCHD underwent CT angiography and transthoracic echocardiograms (TTE). Of them, the electrocardiographic-gating technique was used in 8 cases. The accurate rates in diagnosing CCHD with CT, TTE and CT with or without electrocardiographic-gating were analysed compared with that of operation and χ~2 test using SPSS13.0 tool. Results A total of 102 cardiac deformities con-firmed by operations,those included 47 intracardiac deformities,the diagnostic accuracys with CT and TTE were 85.1% and 95.7%, respectively, and there was no obvious difference among them (χ~2=2.68, P>0.05). 55 extracardiac deformities, the definite diagnos-tic rates with CT and TTE were 98.2% and 78.2%, respectively. CT was superior to TTE in the indentification of extracardiac de-formities(χ~2= 14.64 ,P<0.01). There was no obvious difference between with and without electrocardiographic-gating technique during CT scanning in diagnosis of cardiac deformities(χ~2=1.84, P>0.05). Conclusion 64SCT has significant value in diagnosis of CCHD,and there was no obvious difference in diagnosis of cardiac deformities by 64SCT between with and without electrocardio-graphic-gating technic.

Objective To summarize the experience of diagnosis and treatment of solid-pseudopapillary tumor of pancreas (SPTP).Methods The clinical data of 15 patients with SPTP who were treated in our hospital from March,2003 to March,2006 were analyzed retrospectively.Results The 15 cases were all women, and the average age was 29.4 years.The chief manifestations were abdominal mass, abdominal pain or other abdominal discomfort. None of the 15 cases had history of pancreatitis or abdominal trauma, and no long history of drinking or smoking. Six cases were negative for CEA,CA50,CA199,CA125 and other tumor markers.Solid and solid-cystic masses in pancreas or solid and solid-cystic tumors in retroperitoneum were found both by B-mode ultrasonography and CT examinations. Preoperative fasting blood sugar was within normal limits. The tumor in 8 cases was located in the pancreatic head, in 6 cases was in the body and tail of pancreas, and in 1 case was in the neck of pancreas. The diameter of the tumors was 2.5-10 cm. No metastasis was found in the abdominal cavity or liver. Local excision was performed in 6 cases, distal pancreatectomy was performed in 5 cases, including 2 cases combined with splenectomy, and pancreaticoduodenectomy was performed in 3 cases, segmental pancreatectomy was performed in one patient with tumor in the neck of pancreas. The 15 cases showed typical pathologic manifestation of SPTP by microscopy. At followed up for 16-52 months, no evidence of recurrence or metastasis in these cases was found.Conclusions Solid-pseudopapillary tumor of pancreas primarily affects young women, and it may be located in any part of pancreas. Surgical resection is recommended as the treatment of choice, and the prognosis is good.

Objective To evaluate the value of multi-slice CT enterography(MSCTE),capsule endoscopy(CE) and contrast-enhanced ultrasound(CEUS) findings score in the assessment of Crohn disease activity,prospectively.Methods One hundred and eight patients were diagnosed with CD by endoscopy combined with clinical or pathological results,and all of the patients' Crohn disease activity index(CDAI) were greater than or equal to 150.MSCTE were performed in all the patients.At the same time,48 and 60 patients of them were voluntary to accept CEUS and CE examination,respectively.The imaging score of the three different techniques was calculated.Patients' CDAI were calculated combined with the C-reactive protein(CRP) content and clinical feature.To analyze the correlation among the imaging score patients' CDAI,and CRP content,respectively using the Pearson method.Results The mean score of MSCTE,CEUS and CE were(7.6±2.7),(11.5 ±4.3) and(12.8±8.2),respectively.The patients' mean CDAI and CRP content were(296.1±93.5) and(23.7±5.2) mg/L,respectively.It was high correlation between MSCTE score and CDAI (r=0.916,P＜0.01),but it was moderate between CEUS(r=0.752,P＜0.01),CE(r=0.707,P＜0.01) score and CDAI.There was no evident correlation between MSCTE(r=0.167,P＞0.05),CEUS(r=0.200,P＞0.05) score and CRP content excepting the CE result(r=0.467,P＜0.01).Conclusions There was a good correlation between the MSCTE score and CDAI.We could use MSCTE findings score to assess the activity of CD patients prospectively.