The dual source computed tomography is equipped with two X-ray tubes and two corresponding detectors.With its 83 ms-temporal resolution of single segment reconstruction,high quality coronary artery CT angiography can be acquired without heart rate control.Dual energy output by two x-ray tubes improves the differentiation of body tissues,clinical application and lesion diagnostic accuracy of CT.

Objective To discuss the construction and principal of dual-source CT,as well as its superiorities in imaging of heart coronary artery and the clinical application of dual energy technique.Methods The structure of Siemens 64-slice CT was analyzed.The superiorities of dual-source CT in imaging of heart coronary artery were compared with conventional multi-slice CT,and the clinical value of dual energy technique was discussed.Results The dual-source computed tomography had high temporal resolution superiority,and high quality coronary artery CT angiography could be acquired without heart rate control.Dual energy technique could be applied to differentiate tissue component,display given tissue,evaluate the content of iodine in tissue.Conclusion Dual-source CT can not only enhance the diagnosis veracity of pathological changes of heart coronary artery but improve the ability of CT in tissue differentiation.

Different from conventional MRI, Diffusion-weighted(DW) magnetic resonance(MR)imaging is dependent on the molecular motion of water, and provides information on the physiologic state of the brain. In the diagnosis of acute cerebral infarction,the sensitivity is 94% and specificity is 100%. On MRDW imaging, the epidermoid tumors and cerebrospinal fluid or arachnoid cysts, subdura effusions and subdural empyemas,abscess cavities or empyemas and necrotic tumors could be differentiated accurately. MRDW imaging also provides adjunctive information for the diagnosis and evaluation of other cerebral diseases including neoplasms, intracranial infections, traumatic brain injury, and demyelinating processes. As a valuable technique, diffusion-weighted MR imaging should be considered an essential sequence on the diagnosis of brain stroke, and its use in most brain MR studies is recommended.

Atypical teratoid/rhabdoid tumor of the central nervous system has aggressive growth with high potential CSF dissemination and frequently affects very young children.The tumor contains rhabdoid cells and primitive neuroectodermal,malignant mesenchymal and epithelial elements.Immunohistochemistry is helpful in differentiating atypical teratoid/rhabdoid tumor from primitive neuroectodermal tumor/medulloblastoma.Atypical teratoid/rhabdoid tumor is cytogenetically characterized by monosomy 22 or deletion of chromosome band 22q11.2.Intensified therapy combined with surgical resection has been suggested for its treatment.Due to the secondary cystic/necrotic changes and hemorrhage,the imaging features of the tumor are variable.

Objective To study the clinical effect of early rehabilitation nursing intervention in the patients who underwent lum-bar intervertebral disc operation .Methods 80 patients with lumbar disc herniation were selected and divided them into observation group and control group randomly ,each group contains 40 patients .The control group received conventional nursing while the ob-servation group underwent early rehabilitation nursing intervention after operation .Comparison was made in respects of pain ,func-tion rebuild and clinical effect after operation between two groups .Results There was no significant difference in the preoperative Japanese Orthopaedic Association(JOA) score between two groups .The differences in postoperative JOA scores were significant from 2 weeks after operation to 1 year .The observation group has better clinical effect than that of control group .And the percent-age of back pain or leg pain ,the positive rate of straight leg raising in observation group was less than the control group in 12 months after operation .Conclusion The early rehabilitation nursing intervention can help lumbar disc operation patients recover faster ,maintain the clinical effect and prevent the postoperative complications .

Objective To investigate the alteration of the default-mode network (DMN) in the patients with minimal hepatic encephalopathy (MHE) using resting functional MRI, and to explore its underlying clinical significance. Methods Fourteen MHE patients and 14 age-matched normal controls underwent standard resting state functional MRI scan. The components representing DMN were picked out after separation of independent component analysis. One and two sample t-tests were used to observe the changes of DMN in the patients in contrast to the controls. Results Typically spatial distributions of the DMN were found in both MHE patients and controls. Comparison results revealed that there was significantly reduced functional connectivity in the left posterior cingulate cortex, bilateral anterior cingulate cortex, bilateral medial prefrontal cortex, left parahippocampal cortex in MHE patients, while functional connectivity increased in the right precuneus. Conclusion Resting state functional MRI can be used to observe DMN changes in MHE patients. In MHE patients, there is reduced DMN activation in the widespread regions, while the activation of right precuneus increases.

Objective To study the radiographic features of the chordoid glioma and its differential diagnosis,and increase neuroradiologists'awareness of this newly described tumor,facilitating prospective diagnosis.Methods Three patients with chordoid glioma were reviewed retrospectively to determine whether any characteristic radiographic findings and clinical-pathologic findings would emerge,and the relevant literatures were reviewed.Routine CT(2 cases)and MR(3 cases),contrast-enhanced MR(3 cases)were performed.Results The masses were well circumscribed and located in the region of the hypothalamus/third ventricle-suprasellar region(2 cases)and intrasuprasellar region(1 case).Tumors were isointense to gray matter on CT scans and were isointense or hypointense on T_1WI and hyperintense on T_2WI.In two patients,vasogenic edema extended into the optic tracts and cystic or necrotic area was seen.All cases were remarkably enhanced following contrast administration.Conclusions Radiologic findings of the chordoid glioma has some unique features.Tumor,in the region of the hypothalamus-third ventricle-suprasellar region,if it is well circumscribed and remarkably enhancing following contrast administration,should be included in the differential diagnosis.

Objective Different grades of glioma lead to different clinical course,treatments and prognosis,thus it is important to predict histological grades of glioma preoperatively.18F-FDG PET/CT imaging and MR perfusion imaging is considered a promising method to evaluate glioma,and the present study was to evaluated the contribution of 18F-FDG PET/CT imaging and MR perfusion imaging in grading intracranial glioma.Methods Eighteen consecutive patients with suspected primary brain glioma underwent 18F-FDG PET/CT scanning and MR perfusion scanning in our hospital.To evaluate the relative sensitivity among standardized uptake value (SUV),L/W,and rCBV,the PET/CT imaging were analyzed,and the SUV and Lesion-to-white matter ratio (L/W) were calculated.The rCBV ratios of lesions were calculated relative to the region of interest (ROI) values in contra lateral normal white matter.Results Eighteen brain gliomas were confirmed by pathologic diagnosis,including 7 WHOⅡ tumors,6 WHOⅢ tumors,and 5 WHOⅣ tumors.SUV and rCBV could not differentiate between WHOⅡ tumor and WHOⅢ tumor,however significant difference could be found among the three using L/W.Conclusion 18F-FDG PET/CT imaging and MR perfusion imaging could offer more diagnostic information than conventional MRI.All of the three semiquantitative data offer some contribution in grading intracranial gliomas,and L/W might be the best one.

Objective To investigate the relationship between the carotid calcification and the prognosis in patients with ischemic stroke. Methods A total of 522 patients with non-cardiac ischemic stroke registered in the Nanjing Stroke Registry Program (NSRP )from December 2009 to October 2012 were enrolled. All patients underwent head and neck CT angiography (CTA). The original data of CT scan were transmitted into the Siemens workstation. Calcium score measurement was performed using the same reconstruction conditions and Agatston calcium score to measure calcification score. The patients were divided into no (0),mild (0

Objective    To evaluate the prognostic value of preoperative inflammatory indexes in patients with local-advanced esophageal squamous cell carcinoma. Methods    We retrospectively analyzed the clinical and prognostic data of 150 local-advanced esophageal squamous cell carcinoma patients who were treated by esophagectomy in Guangyuan Central Hospital from July 2014 to July 2015. There were 128 males and 22 females with average age of 62.23±8.48 years. The optimal cutoff value was determined by receiver operation characteristics (ROC) curve analysis. Patients were grouped according to the optimal cutoff values (NLR=3.49, PLR=152.28, MLR=0.36). Log-rank test, and multivariate Cox logistic regression modelling were used to assess the simultaneous influences of prognostic factors for survival outcomes after esophagectomy. Results    The patients with higher ratio (NLR>3.49, PLR>152.28, MLR>0.36) had significantly shorter median progression free survival (PFS) and lower postoperative recurrent rate than those of the patients with lower ratio. The stratified analyses found that thelymph node staging and postoperative recurrent rate were positively correlated with the higher ratio. However, the tumor differentiation was negatively correlated with it. In univariate analyses, patients with preoperative NLR>3.49, PLR>152.28 and MLR>0.36 had a poorer prognosis. Furthermore, in multivariate analyses we found MLR>0.36 was also significantly associated with a decreased postoperative recurrent rate (HR=12.945, 95%CI 2.31 to 72.548, P=0.00). Conclusions    The preoperative NLR, PLR and MLR are useful prognostic markers in patients with stage ⅢA-ⅣA esophageal squamous cell carcinoma who conducted esophagectomy.