Objective To evaluate the large field diffusion weighted imaging (DWI) (from head vertex to lower leg) in detection of bone metastases from prostate cancer. Methods One hundred and sixty-six consecutive patients who were suspected of prostate cancer received pelvic MRI and large field diffusion weighted imaging examination. Forty-nine of them underwent bone scintigraphy within one month of the examination of large field DWI. The images were double-blindly evaluated without the knowledge of the pathology result. Conventional MR T1 and fat saturation T2 weighted images were taken as standard for the diagnosis of bone metastasis. The sensitivity, specificity, and area under curve between large field DWI and bone scintigraphy were compared with McNemar test. Five patients with bone metastases exceeding 10 per patient were excluded in the lesion-by-lesion analysis. Results Ten of the 49 patients were diagnosed as bone metastases. The diagnosis of bone metastasis were made in 15 patients by large field DWI and in 17 patients by bone scintigraphy. With patient number as study units (n =49) , the diagnostic sensitivity of bone metastases with large field DWI and bone metastases were both 100% (10/10), and specificity were 87. 2% (34/39) vs. 82. 1% (32/39), respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 0. 936 vs. 0. 910, respectively. Totally 68 abnormal foci were identified from large field DWI and/or bone scintigraphy in 44 patients (while 5 patients with bone metastases exceeding 10 foci per patient were excluded ), 20 of them were diagnosed as foci of bone metastasis. The diagnosis of bone metastases was made in 23 foci by large field DWI and in 34 by bone seintigraphy. With lesion numbers as study units ( n = 68), the diagnostic sensitivity of large field DWI and bone scintigraphy were both 90. 0% ( 18/20), and specificity were 89.6% (43/48) vs. 66. 7% (32/48) , respectively. ROC study showed the area under curve of large field DWI and bone scintigraphy were 0. 898 vs. 0. 783, respectively. The difference of specificity between large field DWI and bone scintigraphy showed statistical significant difference (P < 0. 01 ). The AUC between large field DWI and bone scintigraphy showed statistical significant difference (P < 0. 05). Conclusion Large field DWI may allow us to screen for bone metastasis in patients with prostate cancer, and its diagnostic specificity and accuracy may be higher than that of bone scintigraphy.

Objective To investigate the incidence of contrast induced nephropathy (CIN) among different patient groups after contrast agent injection.Methods A total of 1243 patients were included in this study (male =694,female =549).The SCr level one week before and 72 hours after the CT examination and the incidence of CIN were recorded and comparison was made among groups according to sex,age,body mass index (BMI),the history of high blood pressure (HBP),diabetes mellitus (DM),chronic kidney disease (CKD),chronic heart failure (CHF),tumor,nephrotoxicity drug (NTD) usage.The frequency,type,dose and injection velocity of the contrast media(CM)were also recorded.Multivariate predictors of CIN were identified by Logistic regression using step-wise selection with entry and exit criteria of P ＜0.10,results were tabulated as odds ratios (OR) with 95％ confidence intervals (CI).Results Among 1243 consecutive patients,the incidence of CIN was 5.5％ (68/1243).Patients with a history of HBP,DM,CHF,CKD or tumor presented with higher incidence of CIN than that of controls (5.9％,51/868 vs.4.5％,17/375).CIN developed in 9 of 203 patients (4.4％,9/203) with CKD and in 59 of 1040 patients (5.7％,59/1040)without CKD.There was no significant difference between the two groups(x2 =0.51,P =0.30).In CKD (-) group,the incidence of CIN was higher in females,patients with DM and patients using LOCM than those of males,DM (-) and using low osmolality contrast medium (IOCM) (P ＜ 0.05),but there was no statistical significance in CKD (+) group.Logistic regression analysis showed that women,age ≥ 75 years,DM,LOCM,NTD,tumor,the time of using CM more than once per month were the most significant predictors of CIN (OR ＞ 1).Conclusion Women,age ≥ 75 years,LOCM,NTD,tumor,and the frequency of using CM more than once per month were more likely to develop CIN.

Objective To evaluate large field diffusion-weighted imaging (DWI) in detection of bone metastases of malignant tumors. Methods Eighteen patients with various malignant tumors were enrolled in this study. All the patients underwent large field DWI and 99mTc-MDP bone scintigraphy within one month. Results Fifteen of 18 patients were diagnosed as bone metastases with conventional MRI; 7 of them were found more than 10 bone metastases, and 23 bone metastases were confirmed in the other 8 patients. When seven patients with multiple bone metastases (>10) were excluded, and lesions in the residual 11 patients with or without bone metastases were counted, the diagnostic sensitivity of bone metastases with large field DWI and bone scintigraphy was both 100%, and specificity were 100% and 33.33%, respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 1.00 and 0.67, respectively (P=0.04). With lesion numbers as study unit, the diagnostic sensitivity of large field DWI and bone scintigraphy were 86.96% and 78.26%, and the specificity was both 60.00%. ROC study showed the AUC of large field DWI and bone scintigraphy was 0.74, 0.69, respectively; and no statistical difference was found. Conclusion Large field DWI can be used in screening the bone metastases of malignant tumors.

Objective To compare the techniques of bolus chasing angiography(BCA)and static digital subtraction angiography(DSA).Methods The parameters of BCA and DSA including time of examination,dose of contrast medium,image quality and dose-area product(DAP)were comparatively analysed in 61 patients with symptomatic atherosclerotic peripheral disease.Results DSA in comparison with BCA was of better image quality in showing fibiofibular vessel,but DAP value was high,more contrast medium dose and examined time was long.There was statistically significant difference between both DSA and BCA(P

Objective To kown X-ray and clinic feature of thoracic metastasis of primary malignant tumor of female genital organs,so that to improve diagnostic accuracy.Methods All 204 cases of female genital tumor were confirmed by operation and pathology.The thoracic films of postero-anterior and lateral projections were performed before and after operation and chemotherapy in all patients, CT scan was performed in 30 cases CA-125 in 48 cases and HCG in 23 cases were done.All data of patients were reviewed and analysed by 3 doctors.Results 25 cases presented pleural fluid,CA-125 rised to 125-3765 u/ml;12 cases presented pulmonal shadow,hCG rised to 92-200000 mIU/ml.One of Choriocarcinoma had appeared pulmonal metastasis in normal pregnancy.Conclusion The metastasis of pleural fluid is most seen in ovary carcinoma,pulmonary metastatic tubercle is most manifestion in choriocarcinoma.Pulmonary metastasis of choriocarcinoma can't be ignored in normal pregnancy.

Objective To study the effectiveness of comprehensive control measures based on systematic ecological system construction to interrupt the transmission of schistosomiasis in hilly endemic regions in Sichuan Province ,so as to provide the ev?idence for adjustment of schistosomiasis prevention and control strategies. Methods A high endemic area of schistosomiasis, Panao Township of Dongpo District in Meishan City,was selected as a demonstration area. The comprehensive measures for schistosomiasis control with focus on systematic ecological management were implemented,and the income of residents,index?es of schistosomiasis control effect and so on were investigated before and after the intervention and the results were compared. Results The project based on systematic ecological system construction started in 2009 and 317.351 million Yuan was put into the construction. The construction included economic forest plant base(1 866.68 hm2,72.66%of the total farmland areas),eco?logical protection gardens(585.35 hm2)and so on. Totally 97.04% of historical areas with Oncomelania hupensis snails were comprehensively improved. In 2015,the peasants' pure income per capita increased 4 938 Yuan,with the average annual growth rate of 14.69%. All the farm cattle were replaced by the machine. The benefit rate of water improvement was increased by 52.84%and the coverage rate of harmless toilets increased by 18.30%. The positive rate of serological tests for schistosomiasis decreased from 7.69%to 3.50%,and the positive rate of parasitological tests decreased from 1.18%to 0. The area with snails was decreased from 23.33 hm2 to 0. The awareness rate of schistosomiasis control knowledge and correct behavior rate of the resi? dents increased from 85.50%and 82.60%to 95.70%and 93.90%respectively. Conclusions The comprehensive schistosomia?sis control measures based on systematic ecological management are conform to the currently actual schistosomiasis prevention and control work in hilly endemic regions,and have good ecological economic benefit and schistosomiasis control effectiveness, which provide an effectively new model of prevention and control for advancing process,consolidating the effect,finally realiz?ing goal of interruption and elimination of schistosomiasis in hilly endemic regions.

Objective To investigate MRI manifestations of temporomandibular joint trauma,emphasized on the displacement and deformation of the meniscus.Methods Thirteen patients with TMJ trauma were examined by MRI with 3-inch dual surface coils.T1WI and T2WI images in oblique sagittal and coronal plane were acquired in both closed-and open-mouth positions.Results Twenty(20/26,76.9%) joints had condylar fractures.Nineteen(19/20,95%) discs in 12 patients displaced anteromedially with the condylar fragments,six(6/20,30%) discs showed distortion and deformation.The other one patient had unilateral condylar fracture companied with avulsion and lateral dislocation of ipsilateral disc(1/20,5%),and the opposite disc also showed slight anterior displacement.Effusion was observed in 12(12/20,60%) joints with condylar fractures.The location of the discs didn't show obvious change between closed-and open-mouth positions.Conclusion MRI is an effective method for demonstrating TMJ injuries,and is useful for detecting the changes of morphology and position of the discs.

Objective To evaluate the stability and repeatability of gradient-echo sampling of spinecho (GESSE) sequence in measuring the R2'value in volunteers, by comparison with traditional GRE sequence (T2* map and T2 map). Methods Eight normal healthy volunteers were enrolled in this study and written informed consents were obtained from all subjects. MR scanning including sequences of GESSE,T2 map and T2 * map were performed in these subjects at resting status. The same protocol was repeated one day later. Raw data from GESSE sequence were transferred to PC to conduct postprocessing with the software built in house. R2'map and OEF map were got consequently. To obtain quantitative R2'and OEF values in the brain parenchyma, six ROIs were equally placed in the anterior, middle and posterior part of bilateral hemispheres. Both mean and standard deviation of R2 'and OEF were recorded. All images from T2 * map and T2 map were transferred to the Workstation for postprocessing. The ROIs were put at the same areas as those for GESSE sequence. R2'is defined as R2' = R2 * -R2,R2* = 1/T2*. The R2'value of GESSE sequence were compared with that of GRE sequence. Results The mean R2 'values of GESSE at the first and second scan and those of the GRE were (4.21 ±0.92),(4.45 ±0. 94) Hz and (7.37 ±1.47), (6. 42 ±2. 33) Hz 0. 035 respectively. The R2'value and OEF value obtained from GESSE were not significantly different between the first and second scan ( t = - 0. 83, - 1.48, P ＞ 0. 05 ). The R2' value of first GRE imaging had significantly statistical difference from that of second GRE inaging ( t = 1.80, P ＜ 0. 05 ). The R2' value of GESSE sequence was less than that of GRE sequence, and there was significantly statistical difference between them(t = 1.71 ,P＜0. 05). Conclusion The GESSE sequence has good stability and repeatability with promising clinical practicability.

Objective To detect the differences of grey matter volume between the patients with mental retardation (MR) presented clinically as operation deficit (OD) or as language deficit (LD) and the children with typical normal development using optimal VBM.The developmental connections between brain gray matter and language or operation skills were examined.Methods Magnetic resonance imaging was obtained from 9 children with mental retardation presented as OD predominantly and 11 children with mental retardation presented as LD mainly,as well as the age-matched control group (11 and 14 normal children,respectively) on a 1.5 T scanner.Voxel-based morphometry analysis with an optimization of spatial segmentation and normalization procedures was applied to compare the volume of grey matter between the two groups (OD VS.control; LD VS.control).Statistically,the total and local gray matter volumes were compared between the two groups with t test.Results The total gray matter volume of OD group was [(1.030 ± 0.078) × 106 mm3].Compared to that of controls [(0.984 ± 0.058) × 106 mm3],it was increased significantly (t =-2.6,P ＜ 0.05).And the gray matter volume in the posterior cingulated gyrus,left superior prefrontal gyrus,left cuneus,left middle prefrontal gyrus and the body of left caudate nucleus showed significantly increased.Meanwhile,the total gray matter volume of the MR children presented as LD [(1.002 ± 0.068) × 106 mm3] showed significantly increased(t =-3.0,P ＜ 0.05) compared with that of control group [(0.957 ±0.057) × 106 mm3].The gray matter volume in bilateral thalami,the left inferior temporal gyrus,the left inferior frontal gyrus,and the left cerebellum of the LD group was more than that of normal children.Conclusion As revealed by VBM,there are differences in alterations of gray matter volume between MR children presented with OD and with LD relative to control.

Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.