Objective To assess the value of CT in the detection of spontaneous rupture of hepatocarcinoma as well as to assess CT finging of hepatocarcinoma rupture.Methods Clinical manifestation and CT findings of spontaneous rupture of hepatocarcinoma in 22 cases proved surgically and pathologically were reviewed. CT characters of variable pathological changes of ruptured hepatocarcinoma and its relationship to the rupture of hepatocarcinoma were also analyzed. The analysis involved the status of liver cirrhosis, ascites, intrahepatic locations of the tumor, extent of extrahepatic protrusion and central necrosis of the tumor.Results All ruptured tumours were located at the periphery of the liver, 12 cases had a protruding contour. The maximum diameter of tumours ranged from 2 to 16 cm. Discontinuity of the hepatic surface was seen in 16 cases,necrosis of core was seen in 12 cases. 3 cases with non-ruptured masses also showed contrast medium flow over the perihepatic border during the arterial phase. 2 cases showed a haematoma with attenuated rim inside the mass, but rupture was found during surgery. 1 case show detached broken bits drifting in mass ascites. In 5 cases, CT images during the arterial phase showed a non-enhancing low attenuating lesion with focal discontinuity and peripheral rim enhancement. Conclusion The accuracy of CT diagnosis of spontaneous rupture of hepatocarcinoma is very high. Moreover, CT is a necessary imaging modality in diagnosis of ruptured hepatocarcinoma suspected by clinical findings.

BACKGROUND: An effective method to enhance the accuracy and sensitivity of magnetic resonance imaging (MRI) is to select a targeted contrast agent. OBJECTIVE: To prepare gadopentetic acid -polybutylcyanoacrylate nanoparticle (Gd-PBCA-NP) and to investigate its liver-targeted values in animal experiments.DESIGN, TIME AND SETTING: A comparative observation was performed at the Laboratory of Department of RadiologicelCenter, Nanfang Hospital between September 2004 and January 2005. MATERIALS: Gd-PBCA-NPs were prepared by anionic emulsion polymerization. METHODS: A total of 18 Wistar rats were randomly divided into 3 groups, with 6 rats per group: Gd-DTPA, PBCA-NP, and Gd-PBCA-NP. Following caudal venepuncture (catheter remained), rats received 0.1 mmol/kg Gd-DTPA, 10 mL/kg PBCA-NP, or 10 mL/kg Gd-PBCA-NP. MRI scans (coronal and transverse) were performed prior to and after different enhancement protocols using a head coil for transmission and reception of the signal. Immediately after contrast medium injection, dynamic data of each group were acquired at 5, 15, 30, 60, and 120 minutes using imaging parameters the same as for the pre-contrast images. MAIN OUTCOME MEASURES: The morphology of Gd-PBCA-NPs was observed using transmission electron microscope. The size and the index of size distribution were measured through the use of laser granulometer (Malvern-3000HS). The Gd ion concentration in the dialysate was determined by inductively coupled plasma atomic emission spectroscopy for calculation ofencapsulation efficiency and loading capacity of Gd-PBCA-NP. The enhanced rate of the liver at each time point was calculated. RESULTS: The morphology of Gd-PBCA-NPs was spherical shape with core-shell structure and without adherence between particles. The average size of Gd-PBCA-NPs was 65.7 nm, and the index of size distribution was 0.09 measured by dynamic light scattering. The average encapsulation efficiency and loading capacity of Gd-PBCA-NPs were 81.97% and 51.23%, respectively. After intravenous injection of Gd-DTPA, the enhanced rate of the liver was 35.2% and 48.6% at 5 and 15 minutes respectively and the kidney was obviously enhanced; at 30 minutes, the enhancement of the liver recovered to normal level. After intravenous injection of Gd-PBCA-NPs, the average enhanced rate of the liver was 3.4%, 22.7%, 36.1%, 56.4%, and 24.8% at 5, 15, 30, 60, and 120 minutes accordingly. After intravenous injection of PBCA-NP, the enhancement of the liver was not found. CONCLUSION: Gd-PBCA-NPs can be taken as liver-targeted MRI contrast agents and have potential application value in MRI.

Objective To study the CT characteristics of inflammatory pseudotumor of the liver(IPL).Methods 16-slice spiral CT findings of IPL in 16 cases were analysed retrospectively.The CT values of IPLs and the liver tissue surrounding the lesions were measured on plain and contrast-enhanced CT scans.Results Totally 18 lesions in 16 cases were detected by CT,most of them(16 lesions) located in the right lobes of liver.The lesions appeared as low-density,round or round-like,or irregularity in sharp.Dynamic enhanced CT scan showed the lesions no or slight enhancement in arterial phase,slight to moderate enhancement in portal vein phase.A part of the lesions showed ring enhancement surrounding the lesions,nodular or fiber stripped enhancement in the center of lesions,and the branches of the portal vein passesed through the lesions.In enhanced degree of the lesions,there was not statistical difference in arterial phase compared with plain CT scans,but there were statistical differences in portal-venous phase compared with plain scan and arterial phase.In the liver around the lesion,the enhanced degree had statistical difference in artery phase and portal-vein phase compared with plain CT scans.Conclusion Dynamic enhanced CT scan shows that IPL is of hypovascularity,it's of characteristic in the portal-venous phase and delayed phase.

Objective To evaluate the dynamic imaging alteration of radiation-induced hepatic injuries after stereotactic radiotherapy (SRT) in hepatocellular carcinoma.Methods 18 healthy New Zealand white rabbits inoculated VX_2 carcinoma underwent 40 Gy SRT and divided into three groups randomly.The rabbits underwent identical plain and enhanced MR imaging after SRT 3 weeks,9 weeks and 20 weeks respectively. The signal-to-noise ratios of irradiation area and the surrounding normal liver on T_1WI and T_2WI imaging were calculated;The percentage enhancement of the hepatic injuried areas and the surrouding livers after Gd-DTPA enhanced was also calculated.Results After radiotherapy three weeks, the signal-to-noise ratios of irradiation areas on T_1WI and T_2WI were no difference between normal liver tissue and irradiation area; there were significant difference between normal liver tissues in radiotherapy nine weeks and twenty weeks; The difference in the signal-to-noise ratios of irradiation area were significant between after three weeks and nine weeks, twenty weeks. There were no difference in the signal-to-noise ratios of irradiation area between nine weeks and twenty weeks.The percentage enhancement of the hepatic injuries area have significant difference in arterial phase between three weeks and twenty weeks and between nine weeks and twenty weeks;The difference in portal and delay phase were significant between three weeks and nine weeks, twenty weeks, there were no difference between nine weeks and twenty weeks.Conclusion Dynamic enhanced and unenhanced MR imaging can reflect the pathological background of radiation-induced hepatic injuries in different phases.

Objective To explore the value of CT in diagnosing abdominal leiomyosarcoma.Methods CT findings of abdominal leiomyosarcomas conformed pathologically in 9 patients were analyzed.Results The tumors localized in peritoneum in 3 cases,in stomach in 3 cases,in rectum,colon and uterus in 1 case respectively.On plain CT scan,the tumors appeared as unhomogeneous dense masses with mecrosis at the centre,the periphery of tumors was flocculation or ringlike,and having fluid-fluid level in 1 case.The delayed peripheral enhancement on contrast CT could be seen.Conclusion CT imaging can help to diagnosis the abdominal leiomyosarcoma.

Objective Estimating the treatment to respiratory failure in acute exacerbation of chronic obstructive pulmonary disease by scores in the form of quantitative assessment.Methods 156 patients with chronic obstructive pulmonary disease with acute exacerbation of respiratory failure in patients in the medical intensive care unit based on the worst value of the calculated APACHEⅡ score were grouped,divided into groups and pairs of oxygen the level of non-invasive positive pressure ventilation group.Based on the worst values calculated by the APACHEⅡ and TISS-28 score within 24 h after admission into MICU selected cases is re-grouped into an effective group of oxygen,BiPAP effective group and invasive ventilation group.Statistics separately for each group of patients with APACHEⅡ score and TISS-28 score range,length of stay.Results The invasive ventilation group APACHEⅡ score(27.44?6.79)and TISS-28 score(28.22?7.90)was significantly higher than the other groups(P0.05),invasive ventilation group and effective group MICU hours of BiPAP have significant difference(P

Objective To investigate the value of superparamagnetic iron oxide particles(SPIO) in MR imaging for differentiation of metastatic lymph nodes from normal or reactively hyperplastic lymph nodes. Methods For the time course study,10 ?mol Fe of SPIO per extremity was administered to 6 animals, and images were obtained before and 1 h to 48 h after administration. Reactively hyperplastic lymph node model was established in 6 animals by injection of egg yolk emulsion, and tumor bearing lymph node model was established in another 6 rabbits. MR images of the popliteal lymph nodes were obtained before and 12 h after subcutaneous administration of SPIO. Imaging results were analyzed and correlated with pathological findings. Results In unenhanced images, the signal intensity of tumor free and metastatic lymph nodes did not differ significantly. After administration of SPIO, a significant signal intensity loss occurred in the tumor free lymph node, and the maximal loss occurred at 12 h, and the signal intensity reduced by 49%,28%,59%, and 89% on T 1WI, T 2WI, PDWI, and T  2WI, respectively at 48 h( P =0.000). However, the signal intensity of the metastatic lymph nodes remained unchanged. Conclusion MR imaging after subcutaneous administration of SPIO help to differentiate metastatic from normal or reactively hyperplastic lymph nodes.

0 05),but arterial oxygen tension and FEV 1 were elevated obviously (P

0.05). Conclusion DSA is highly valuable for the evaluation of collateral pathways of ICA stenosis or occlusion, and it is necessary for preoperative examination. MRA is a non-invasive angiographic method and can evaluate collateral circulation in both morphology and function, and can be the preferred method for the disease.

Objective To evluate Feridex-enhanced MRI in the diagnosis of focal hepatic lesions. Methods Conventional plain and Feridex-enhanced MR scanning was performed in 20 cases with suspected hepatic neoplasm.The number of lesions on T 2WI ,and the signal intensity of liver and lesions demonstrated on plain and enhanced scans were observed and analyzed.Results After the injection of Feridex,the signal intensity of normal liver tissue reduced significantly,while the signal intensity of lesions showed no marked changes,Feridex-enhanced MRI clearly displayed more lesions on T 2WI than plain scanning did.Conclusion Feridex-enhanced MRI is very sensitive in detecting focal hepatic lesions.