Objective To study the etiology and clinics as well as CT diagnostic value of periventricular leukomalacia(PVL)in children.Methods Clinical and CT findings in 130 cases of PVL were retrospectively analyzed.Results 85 cases were premature newborn babies(65.4%) and 45 cases were fullmature newborn(34.6%) with hypoxic ischemic encephalopathy.CT showed the lateralventricle enlarge in different degrees and the white matter of periventricle decreased.Conclusion CT scan is of important value indiagnosis of PVL.

Objective To study the X-ray findings and clinical factors of the neonatal necrotizing enterocolitis (NEC)and to im-prove the detection rate of neonatal NEC-especially early lesions.Methods To retrospectively analyzed the plain abdominal radio-graphy images and clinical data of the 21 cases with confirmed neonatal NEC by clinical and surgical diagnosis.Results The X-ray findings of neonatal NEC:stageⅠ:10 cases showed the changes in intestinal motility and the interval thickness between the intestine≤2 mm;stageⅡ:① 4 cases showed the interval thickness between the intestine > 2 mm;② 4 cases showed the pneumatosis of the intestinal wall;③ the pneumatosis of the portal vein were three cases;stage Ⅲ:① 3 cases showed seroperitoneum;② pneumoper-itoneum were three cases.18 cases (85%)were the premature infan;1 6 of 21 cases NEC were the low birth weight;neonatal re-spiratory distress syndrome,infection,pneumonia,sepsis,and mechanical ventilation therapy are important risk factors of NEC. Conclusion X-ray findings has characteristic signs in the neonatal NEC.At the early of NEC,it is very important to make the correct diagnosis need combine X-ray performance with the clinical manifestations and risk factors for,with the necessary dynamic follow-up review in the clinical treatment and prognosis.

Objective To evaluate if high energy spectral CT images of contrast-enhanced phase could replace the plain scan for radiation dose reduction in children with solid tumor in abdomen.Methods Thirty children with solid tumor in the abdomen underwent CT scan.Plain CT scan was performed as usual,and the contrast-enhanced scan was performed with spectral CT imaging mode.Eleven sets of monochromatic images were reconstructed from the enhanced spectral CT with energies from 40 to 140 keV with 10 keVinterval.CT values for liver,spleen,kidney,pancreas,muscle,vessel and tumors were measured on both the plain and contrast-enhanced spectral images and were statistically compared.Two board-certified radiologists reviewed both plain and contrast-enhanced spectral images for image quality,calcification and tumor characterization.Radiation dose was recorded(CTDIvol,DLP).Pair t test was used to analyze the difference.Results At 140 keV,CT values of the contrast-enhanced spectral images had good correlations with those of plain scan for various organs.The paired CT values between the 140 keV and plain phaseimages were (62.8± 1.1 vs.59.8±4.0),(69.4±2.6vs.63.1 ±5.6),(52.7 ±5.1 vs.51.4±4.0),(35.4± 5.9 vs.35.7 ±5.3),(51.4±8.6vs.50.0±5.7),(55.5±6.6vs.54.7±5.7) and (33.2± 10.4vs.35.4± 12.1) HU for vessel,liver,spleen,kidney,pancreas,muscleand tumor,respectively.There was no significant difference between two groups(t=0.335 to 2.127,P＞0.05).140 keV images of the contrast-enhanced spectral scan in pediatric tumor patients provided adequate image quality (4.4±0.8 points and 3.7±0.5 points)for describing solid tumor features and calcification.The radiation dose of plain phase and contrast-enhanced phase were [CTDIvol (1.6±0.8) mGy,DLP(46.4±36.8)mGy·cm and CTDIvol(12.7±0.1)mGy,DLP(378.6±91.4)mGy·cm.Conclusion It isfeasible to replace plain CT with 140 keV contrast-enhanced spectral images to reduce 10％ radiation dose.

Objective To investigate the clinical effect of operation of superficial temporal artery-middle cerebral artery(STA -MCA)bypass combined with temporal muscle sticking in the treatment of adult moyamoya disease.Methods A retrospective analysis was the data of operation,including preoperative evaluation,operation method,postoperative follow -up.Results Postoperative complications occurred in 5 cases,including 3 cases of intracranial hemorrhage,2 cases of cerebral infarction.During the follow -up of 6 -35 months,no recurrent hemor-rhage cases,1 cases of cerebral infarction,TIA remission rate was 93.5%.Postoperative cerebral blood flow of 38 cases significantly improved compared with preoperative by SPET,accounted for 86.3%.Cerebral blood flow of 41 cases was well compensated by vascular bridge,accounted for 91%.Conclusion Operation of STA -MCA bypass combined with temporal muscle sticking can significantly reduce the incidence of stroke,fewer complications,which is an ideal method in the treatment of adult moyamoya disease.

Objective To explore MRI features of incontinentia pigmenti(IP) in central nervous system (CNS) in newborn infants.Methods MRI and clinical data of 17 cases of IP which confirmed by clinic,skin biopsy or NEMO gene test were analyzed retrospectively.Results There were 17 cases with IP in this study.MRI abnormalities were found in 12 cases, among which 3 cases showed high signal intensity on T2WI and a reduced signal intensity on T1WI,and 9 cases showed normal signal intensity on traditional MRI.Multiple areas of restricted diffusion were found in 12 cases which showed asymmetric high signal intensity in bilateral cerebral cortex and subcortical area, basal ganglia,centrum semiovale and periventricular area on DWI.In addition,basal ganglia was involved in 4 cases,corpus callosum was involved in 5 cases, and thalamus was involved in 2 cases.Conclusion MRI of IP in CNS shows certain specific characteristics.DWI plays an important role in the early detection and prognosis of the disease.

Objective To explore the clinical characteristics of B cell prolymphocytic leukemia (B-PLL).Methods The clinical manifestation,treatment and outcome of a 33-year-old man with B-PLL were reported.Results The young patient had thrombocytopenia and systemic B-symptoms,markedly raised lymphocyte'count,bulky splenomegaly and lymphadenopathy.He refused stem cell transplant,so RFC regimen (fludarabine,cyclophosphomide and rituximab) therapy were administered.After 4 cycles of RFC therapy,the patient achieved a complete immunophenotypical and hematological remission response.Conclusion RFC therapy might be a feasible and useful treatment option for B-PLL.

Objective To analyze the CT appearances and the classification of gray matter heterotopia.Methods The clinical and CT data of 26 cases with gray matter heterotopia were retrospectively reviewed,11 were males and 15 were females,ranged in age from 2 days to 9 years with a mean of 2.6 years.Results The classification of heterotopia included:(1)Subependymal heterotopia in 14,5 cases with encephaloceles,1 case with Dandy-Walker malformation and 1 case with arachnoid cyst of cisterna megna.(2)Subcortical heterotopia in 7,4 cases with callosal agenesis were accompanied.(3)Band heterotopia in 5.Conclusion CT scan can not only reveal the appearances of the subependymal,subcortical and band types heterotopia,but also show other associated abnormalities.

Objective To investigate CT features and its diagnostic value of traumatic cerebral lacunar infarction. Methods Axial CT scan was performed in 26 cases of brain injury with clinical manifestation of different degree of hemiplega.Results The infarction appeared as small lacunar focuses which were located mainly in the regions of lenticular nucleus,caudate nucleus and internal capsule.Conclusion CT scan is of significant value in diagnosing the traumatic cerebral lacunar infarction and assessing its prognosis.

OBJECTIVE:To screen the method for extracting total flavonoids in persimmon leaves and optimize extraction tech-nology. METHODS:Using extract quality and flavonoids content as indexes,the effects of extracting total flavonoids in persim-mon leaves by ethanol refluxing method,enzyme method(cellulase,β-glucanase and complex enzyme mixed by equal amounts of both),semi-bionic method and semi-bionic-enzyme method (the same enzymes) were compared. Using flavonoids content as in-dex,solid-liquid radio,reflux temperature,reflux time as factors,orthogonal test was designed to optimize the extraction technolo-gy conditions of flavonoids in persimmon leaves by semi-bionic-enzyme method,and the verification test was conducted. RE-SULTS:The extract quantity and flavonoids content by semi-bionic-enzyme method was the highest among the 4 extraction meth-ods,and the complex enzyme was the most suitable;the optimized extracting condition of semi-bionic-enzyme method were as fol-lows as solid-liquid radio of 1:14,reflux temperature of 50 ℃,reflux time of 2.0 h;extraction rates of flavonoids in 3 verification tests were 5.9%,5.8%,5.9%(RSD=0.98%,n=3). CONCLUSIONS:The optimized semi-bionic-enzyme method is efficient and stable in extracting flavonoids in persimmon leaves.

Objective To study the appearances of split cord malformation(SCM)and evaluate the diagnostic value of CT for SCM.Methods Clinical and CT data of 48 cases with SCM were analyzed retrospectively ,21 were males and 27 were females,ranged from 1 day to 8 years with a mean of 11.6 months. All cases evaluated by plain CT with coronal and sagittal reconstructions.Results Type I accounted 75%, consisted of two hemicords, each contained in its dural tube and separated by a rigid median septum .TypeⅡaccounted 25%, consisted two hemicords contained in a single dural sac separated by a non-rigid, fibrous median septum. Associated abnormalities: tethered cord syndrome(n=38), syringomyelia(n=9), intradural lipomas(n=10), meningocele(n=18).Conclusion CT can clearly demostrate the position, the septum and the shape of the SCM, as well as associated abnormalities.