1.A prospective study of 3D dynamic MRI on differential diagnosis of breast lesions
Yong GUO ; Zulong CAI ; Youquan CAI
Chinese Journal of Radiology 2001;0(09):-
Objective To prospectively evaluate the diagnostic ability of the lesions′ morphology, signal intensity time course, and early phase enhancement rate in dynamic MRI of the breast. Methods Forty cases with breast lesions were examined with a new Efgre 3D dynamic MR imaging series. Time signal intensity curves of the lesions were obtained and classified according to their shapes as monophasic, biphasic, or washout. Early phase enhancement rates of the lesions were calculated. The diagnostic indices were got by lesions′ morphology criterion, the time signal intensity curves criterion, and the enhancement rate criterion. Results There were 23 malignant and 18 benign lesions. The distribution of curve types for malignant lesions was monophasic (5%), biphasic (18%), and washout (77%). The distribution of curve types for benign lesions was monophasic (72%), biphasic (11%), and washout (17%). The distribution proved significantly difference (? 2=20.68, P
2.Endovascular repair of abdominal aortic aneurysms:value of postoperative follow up with helical CT
Shaohong ZHAO ; Zulong CAI ; Wei GUO
Chinese Journal of Radiology 2001;0(09):-
Objective To determine the value of helical CT for the follow up of patients with abdominal aortic aneurysms(AAAs) after graft implantation. Methods Twenty six patients with AAAs underwent helical CT within 3 days after graft placement. Additional follow up CT scans were obtained in 22 patients 3 months after placement. The diameter of the aneurysmal sac, complications of the procedure, position, shape, and patency of the device were recorded. Results CT scans obtained within 3 days after placement showed complete thrombosis of the aneurysm in 20 patients, and 6 patients with perigraft channels; 3 months later, of 17 thrombosed aneurysms, 9 decreased in diameter, 7 remained unchanged, and 1 increased in diameter; of 5 aneurysms with perigraft channels, 2 decreased in diameter, 2 were stable, and 1 became enlarged. 20 of 26 patients (76.92%) were successful with endovascular repaire. Conclusion Helical CT is a valuable means in follow up of the patients after endovascular repair.
3.Early lung cancer baseline screening: preliminary study with low-dose spiral CT
Yongkang NIE ; Zulong CAI ; Shaohong ZHAO
Chinese Journal of Radiology 2001;0(03):-
Objective To evaluate the prevalence rate of pulmonary malignant disease detected by low dose spiral CT in people at high risk of lung cancer. Methods Low dose spiral CT scans and chest radiographs in 300 symptom free volunteers from an on going screening study were prospectively evaluated. The study has enrolled 240 smokers, aged 45 years or older, with at least 10 pack years of cigarette smoking and 60 individuals with chronic obstructive pulmonary disease, and without previous cancer history, who were medically fit to undergo thoracic surgery. Low dose CT scans were performed with SR 7000 scanner using spiral mode, 120 kV, 50 mA, pitch 2, 5mm thickness reconstruction and Lightspeed Plus multi slice scanner using spiral mode, 120 kV, 50 mA, pitch 6 to produce 2.5 mm thick image at 2.5 mm increments. All images were assessed with cine display mode on workstation monitor. Results Non calcified nodules were detected in 56 (19%) participants by low dose CT, compared with 9 (3%) by chest radiography. Malignant disease was detected in 4 (1.3%) by CT and 3 (1%) by chest radiography. All 4 cancers were stage I. Lobar or segmental bronchial abnormalities were detected in 9 (3%) participants by CT. Among them, 3 (1%) proved to be early central lung cancer. No bronchial abnormality was detected by chest radiography. The sensitivity and specificity of cancer screening was 43% and 89%, respectively for chest radiograph, 100% and 80%, respectively for CT. The sensitivity of CT was significantly higher than that of radiograph, whereas the specificity showed no statistical difference. Conclusion Preliminary screening study indicates that low dose CT can greatly improve the likelihood of detection for small non calcified nodules and mild bronchial abnormalities, and thus of peripheral and central lung cancer at an earlier stage.
4.Diagnosis of early central lung cancer with CT: correlation with bronchoscopic and histopathologic findings
Yongkang NIE ; Zulong CAI ; Shaohong ZHAO
Chinese Journal of Radiology 2001;0(07):-
Objective To study the CT findings of early central lung cancer and correlative pathologic basis, and to evaluate the role of CT in the differential diagnosis of central lung cancer Methods Seventeen patients with early central lung cancer and 10 patients with benign lesions resembling the central lung cancer were analyzed Thin section CT was performed with a section thickness of 3 mm or 1 5 mm at Philips SR 7000 or GE Lightspeed Plus scanner The visibility of the lesions was correlated with bronchoscopic and histopathologic findings Results All 17 lesions were visualized at CT Three lesions showed focal bronchial wall thickening and internal bronchial wall irregularity, bronchial mucous coarsening, redness and swollening at bronchoscopy Fourteen lesions showed focal narrowing or obliteration of the bronchial lumen, 4 complicated with subsegmental bronchial mucoid impaction, 10 with obstructive pneumonia or atelectasis Corresponding bronchoscopic view disclosed intraluminal polypoid protrusions The epithelia were involved in 1 case, subepithelia in 5, and cartilaginous involvement in 11 according to the depth of invasion of the bronchial wall at histopathology Among 10 patients with benign lesions, 6 cases were suspected as bronchogenic carcinoma and the possibility of bronchogenic carcinoma was not excluded at CT in 4 cases There were 5 patients with uneven thickening of internal bronchial wall, 2 with lumen blood clots, 1 with lumen nodule, and no abnormalities in 2 patients at bronchoscopy Conclusion Thin section CT has been proved to be a reliable method for demonstrating the mild changes of the bronchi and to be a valuable tool for the diagnosis of early central lung cancer
5.Rationality of 16 or more multi-slice helical CT utilization for solitary pulmonary nodule
Shaohong ZHAO ; Yongkang NIE ; Zulong CAI ; Ning XING
Chinese Journal of Radiology 2010;44(1):8-11
Objective To analyze the rationality of 16 or more multi-slice helical CT (MSCT) utilization for solitary pulmonary nodule (SPN) (<3 cm). Methods One hundred and fifty consultant cases with SPN from 133 different hospitals, examined with 16 or more MSCT, were selected in this study. The reconstructed slice thickness of routine CT scan, thin slice reconstruction thickness, 2D or 3D reconstruction, window wide and level setting, contrast enhancement effect were recorded from consultant films. Thoracic CT scan criteria for SPN were proposed according to the scan guidelines at Stanford University and PubMed articles. The rationality of 16 or more MSCT utilization in other hospitals for SPN was analyzed by two radiologists compared with scan criteria. The diagnostic accuracy in other hospitals was evaluated according to the pathologic and treatment results in our hospital. Results Sixteen-MSCT was performed in 92 cases, 64-MSCT in 54 cases and 40-MSCT in 4 cases. In routine thoracic CT scan, 9--10 mm reconstructed slice thickness was selected in 59 cases, 7--8 mm thickness in 12 cases and 5 mmthickness in 79 cases. Consecutive thin slice thickness (<3 mm) was used for SPN only in 46 cases. OnlyMPR and VR were filmed in 9 cases without thin slice reconstructed axial images. :53 cases (35.3%) were rescanned in our hospital due to the unsatisfied image quality. Of 150 cases, 78 cases had pathologic or treatment results in our hospital and 22 cases (14.7%) were proved to be misdiagnosed in other hospitals, and only 2 cases were misdiagnosed in our hospital. Conclusion There are many irrationalities of 16 or more MSCT utilization in our country which influence the diagnostic accuracy of SPN, Unified thoracic CT scan criteria in our country are needed.
6.Application of CT perfusionimaging in assessing the physiological state of solitary pulmonary nodules
Ning XING ; Zulong CAI ; Shaohong ZHAO ; Li YANG
Chinese Journal of Tissue Engineering Research 2007;0(09):-
0.05); mean transit time was significantly lower but permeability surface area product higher than benign nodules (P 0.05). ③If the mean transit time ≤ 7 s was selected as cut-off value for malignant lesion, the sensitivity was 68.97%, specificity was 66.67%, accuracy was 68.49%, positive predict value was 88.89%, and negative predict value was 35.71%. When permeability surface area product ≥ 0.20 was selected as the cut-off value for malignant lesion, the sensitivity, specificity, accuracy, positive predict value, and negative predict value were 86.21%, 53.33%, 79.45%, 87.72%, and 50.0%, respectively. CONCLUSION: CT perfusion imaging is a valuable method for assessing the physiological state of solitary pulmonary nodules.
7.Multislice helical CT and chest radiographic findings in congenital bronchial atresia
Shaohong ZHAO ; Hong ZHAO ; Zulong CAI ; Li YANG
Chinese Journal of Radiology 2001;0(01):-
Objective To present the multislice helical CT (MSCT) and chest radiographic findings of congenital bronchial atresia (CBA) in order to improve the diagnosis of CBA.Methods Eleven patients with CBA, who had histological results in 3 cases, bronchoscopy in 6 cases and more than 1 year follow-up in 2 cases, underwent MSCT with 10 mm slice thickness. 1.25 mm thickness images with 1 mm reconstruction interval were performed on 16-slice helical CT, and multiplanar reconstruction (MPR), maximum intensity projection (MIP) and minimum intensity projection (MinIP) were made at a dedicated workstation. The involved segment of lung, shape of bronchocele and hyperinflation around bronchocele were recorded. Results On CT findings, all 11 patients demonstrated bronchocele and peripheral emphysematous changes which were shown in 8 cases on chest radiographs. An air-fluid level within the bronchocele was seen in 3 cases by MSCT and 2 by chest radiographs. The segmental bronchus was affected in 10 cases and the subsegmental in 1 case. 3 CBAs were in the left and 8 in the right. 6 patients with CBA presented a rounded, branching opacity emanating from the hilum and 5 were seen as a peripheral nodule. Conclusion The presence of a bronchocele and surrouding emphysematous change is the typical radiologic finding of CBA. MSCT can provide more information than X-ray chest radiograph for the diagnosis of CBA.
8.Demonstration of the right inferior phrenic artery by using multislice helical CT
Shaohong ZHAO ; Xin LIU ; Zulong CAI ; Hong ZHAO ; Li YANG
Chinese Journal of Radiology 2001;0(04):-
Objective To demonstrate the origin of the right inferior phrenic artery(RIPA) in normal and hepatocellular carcinoma(HCC) patients and provide valuable anatomical information for angiographers before and after transcatheter arterial chemoembolization(TACE).Methods Four hundred and forty consecutive patients including 133 HCC cases who had biphase abdominal CT were assessed in this study.The routine abdominal enhanced CT scan(GE,LightSpeed16) was performed with 120 kV,200—240 mAs,10 mm collimation,1.375 pitch,and 10 mm reconstruction interval at 22—25 seconds for arterial phase triggered by timing bolus,60 seconds for portal venous phase after injection of 100 ml contrast material(300 mg I/ml) at a rate of 3.5 ml/s.Multiplanar reconstruction(MPR) and maximum intensity projection(MIP) images were generated using 1.25 mm images reconstructed with 1 mm interval in arterial phase and reviewed by two radiologists.An enhanced artery medial-posterior to the IVC,originated from aorta or its branches to the diaphragmatic dome was interpreted as the RIPA.Results The RIPA was showed in all(440 patients)(100%).Among 218(49.5%) RIPAs originated from the aorta,140 were from the right side of the aorta,22 from the left side of the aorta,56 from the anterior wall of the aorta,36 RIPAs had the same origin with the left inferior phrenic artery.Among 138(31.4%) RIPAs from the celiac artery,10 RIPAs had the same origin with the left gastric artery,and 33 RIPAs had the same origin with the left inferior phrenic artery.78(17.7%) were from the right renal artery,6(1.4%) were from the left gastric artery(the left gastric artery from aorta).The dilatation of the RIPA was demonstrated in 16 of(133 hepatocellular) carcinoma patients.Conclusion Multislice helical CT could demonstrate the origin of the RIPA in arterial phase and provide useful anatomical information for angiographer before and after TACE.
9.Multislice helical CT findings of mesenteric panniculitis
Shaohong ZHAO ; Hong ZHAO ; Zulong CAI ; Li YANG
Chinese Journal of Radiology 2001;0(05):-
0.05) and CT values of mesenteric panniculitis on unenhanced scan were significantly higher than those of the same patients′retroperitoneal fat(-91——115 HU)(P
10.Multislice helical CT imaging of coronary artery disease:primary experience
Shaohong ZHAO ; Yongkang NIE ; Zulong CAI ; Hong ZHAO ; Li YANG
Chinese Journal of Radiology 2001;0(08):-
Objective To evaluate the efficacy of multislice helical CT(MSCT) in the diagnosis of coronary artery disease Methods 30 patients were studied with MSCT CT data were reconstructed to demonstrate the abnormalities of coronary artery and the results were compared with that of angiography Results In patients with heart rate less than 60 BPM, there was no difference to show the main branch of left coronary artery and left descending artery compared with more than 60 BPM( P =0 197 and 0 128,Fisher′exact);and obvious differences in showing left circumflex artery (? 2=5 88, P