Objective To introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.Methods Ultrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.Results Many of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, low grade dysplastic nodule, high grade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.Conclusion Modern state of the art medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.

Objective To introduce the technique of three dimensional portal venography of multi detector row spiral CT and its clinical application in the evaluation of the portosystemic collateral shunts of liver cirrhosis. Methods All relevant literatures were retrospectively reviewed on the application of two dimensional and three dimensional reconstruction techniques such as MIP, SSD, VRT of multi detector row spiral CT to demonstrate the collateral vessels of liver cirrhosis.Results The distribution, pathway and anatomy of portosystemic collateral vessels were well shown by multi detector row spiral CT portal venography. Conclusion Multi detector row spiral CT portal venography provides excellent depiction of the anatomic characteristics of the collateral shunts and enables the continuous tracing of vascular structures, thus it is very helpful in the imaging evaluation of the collateral vessels of liver cirrhosis.

Objective: To investigate the feasibility of culturing and identifying the cementoblasts in vitro and to study the biological characteristics of rat cementoblasts.Methods: Osteoblasts, PDL fibroblasts and cementoblasts were obtained from alveolar bone and the root surface of rat first molars and cultured with a 2-step method of enzyme digestion/explant technique. Bone osteocalcin(OCN) and alkaline phosphatase(ALP) were detected by quantitative immunohistochemical examination. Alizarin Red S was used to examine the formation of calcified nodules under conditional culture. Results: Primarily cultured cells could be subcultured. Osteoblasts were identified by the expression of OCN and ALP at heigh level, cementoblasts by OCN , PDL fibroblasts by ALP at moderate level, cell clusters/nodules of cementoblasts were observed as the cells approached confluence.Conclusion: Cementoblast-like cells may be cultured in vitro.

This paper reviews the basic principles and calculation methods of MR specific absorption rate, discusses the clinical application of MR specific absorption rate.
Humans ; Magnetic Resonance Imaging ; Radio Waves

Objective To investigate the relationship of magnetic resonance diffusion-weighted imaging (DWI) to histology in the patients of chronic viral hepatitis. Methods Thirty-five patients of chronic viral hepatitis who received liver biopsy and 10 healthy volunteers were included in this study. All of them underwent DWI on a 3.0T MRI device. Apparent diffusion coefficient (ADC) of the liver were measured respectively when b value were set as 100, 400, 600 and 800 s/mm~2. Biopsy specimens were scored for fibrosis and necroinflammation according to the Knodell histology activity index (HAI). Results When b value was set as 800 s/mm~2, statistical difference was showed between the fibrosis group and the non-fibrosis group, statistical difference was also shown among the different degrees of necroinflammation and fibrosis. Conclusion DWI is a valuable method for grading and staging of chronic viral hepatitis.

Objective To summarize the principle and application of functional MR imaging of pancreatic carcinoma and chronic mass-forming type pancreatitis.Methods Articles about diffusion-weighted imaging(DWI),magnetic resonance spectrum imaging(MRSI) and dynamic contrast-enhanced MR imaging of pancreatic carcinoma and chronic pancreatitis were reviewed and analyzed.Results Functional MR imaging could reflected the differences in molecules diffusion,metabolism and tissue perfusion between pancreatic carcinoma and chronic pancreatitis.Conclusion As a non-invasive protocol,functional MR imaging can provide useful information in differential diagnosis between chronic mass-forming type pancreatitis and pancreatic carcinoma.

Objective To investigate the value of MR diffusion-weighted imaging (DWI) in differentiating pancreatic carcinoma from chronic focal pancreatitis on 3.0 T MR system. Methods Thirteen patients with proved pancreatic carcinoma, 7 patients with confirmed chronic focal pancreatitis, and 14 healthy volunteers, were included in this study. MR examination including the routine abdomen scanning protocol and DWI was performed for both patients and volunteers. The SE-EPI sequence and ASSET technique were used for DWI. The b values of 400, 600, 800 and 1 000 s/mm2 were selected to acquire the DWI. The corresponding apparent diffusion coefficient (ADC) values were measured in each designated region of interest and statistically analyzed. Results ①DWI of the healthy volunteers showed intermediate signals of pancreas. ②DWI of pancreatic tumor masses showed homogenous high signal intensity relative to the surrounding pancreatic tissue with clear boundary. Under different b values, the tumor ADC values were (1.63?0.235)?10-3 mm2/s, (1.42?0.126)?10-3 mm2/s, (1.36?0.170)?10-3 mm2/s and (1.26?0.178)?10-3 mm2/s respectively, which were significantly lower than those of non-tumor region (2.11?0.444)?10-3 mm2/s, (1.83?0.230)?10-3 mm2/s, (1.81?0.426)?10-3 mm2/s, (1.60?0.230)?10-3 mm2/s and of the normal pancreas (1.85?0.350)?10-3 mm2/s, (1.69?0.290)?10-3 mm2/s, (1.67?0.268)?10-3 mm2/s, (1.42?0.221)?10-3 mm2/s, P

Objective Aprotinin, a serine proteinase inhibitor, has been reported to reduce blood loss significantly in patients undergoing cardiac surgery with CPB, heart and liver transplantation. The aim of this study was to evaluate the effect of aprotinin on intraoperative blood loss, transfusion requirement and blood coagulation during liver cancer resection.Methods Eighty-two ASA Ⅰ -Ⅲ patients ( 51 male, 31 female ) aged 33-65 yr undergoing liver cancer resection ( 61 partial hepatectomy, 21 extirpation of liver cancer) were studied. The patients were randomly divided into 2 groups : aprotinin group received a bolus of aprotinin 1 112 EPU after induction of anesthesia, followed by continuous aprotinin infusion at 278 EPU?h-1 until 2 h after operation ( n = 40); control group received normal saline instead of aprotinin ( n = 42) . The patients were premedicated with sodium luminal, droperidol-fentanyl and atropine. Anesthesia was induced with midazolam 2 mg, thiopental 5 mg?kg-1 and succinylcholine 1.5 mg? kg-1 . After tracheal intubation the patient was mechanically ventilated (VT = 8-12 ml?kg-1 ) and PaCO2 was maintained at about 35 mm Hg, Anesthesia was maintained with N2O/O2 , fentanyl and vecuroniurn. Venous blood samples were taken before induction of anesthesia (baseline) , 0.5 h, 2 h and 4 h after skin incision and 6 h and 12 h after operation for routine blood tests, thromboelastography ( TEG), and determination of activated partial thromboplastin time (APTT), thromboplastin time (TT) prothrombin time (PT) and plasma fibrinogen concentration (Fig) . Intraoperative blood loss and amount of blood transfused were recorded. Results The preoperative hypercoagulable state was ameliorated and coagulation was maintained within the normal range in aprotinin group; while in control group the hypercoagulable state was aggravated during operation and at the end of operation it changed to hypocoagulable state. The intraoperative blood loss and amount of blood infused were significantly less in aprotinin group than in control group. Conclusion The use of aprotinin during liver cancer resection results in reduction in intraoperative blood loss and less transfusion requirement.

Objective To investigate the spectrum of spiral CT imaging findings of blunt liver trauma.Methods Clinical data of 17 patients with blunt liver trauma were retrospectively collected. All patients underwent standardized spiral CT examination of the upper abdomen, which include plain scan, arterial phase and portal venous phase acquisition. The morphology, density and integrity of liver parenchyma and intrahepatic venous structures were carefully observed, as well as regions of porta hepatis, peritoneal cavity and retroperitoneal space.Results Twelve cases (70.6%) developed hepatic parenchymal laceration. There were 9 cases (52.9%) of traumatic hematoma, among which 5 were intraparenchymal and 4 were subcapsular. One case (5.9%) showed active bleeding within an intrahepatic hematoma, while two cases (11.8%) had injury (laceration) of hepatic veins. There were 7 patients (41.2%) who demonstrated the so-called “halo sign” around the intrahepatic portal branches. Thirteen patients were associated with peritoneal fluid (blood) collection, 3 with hematoma or hemorrhage of the right adrenal gland, 8 with plural effusion and 3 cases with rib fractures of right lower chest. Conclusion CT imaging findings of blunt liver trauma include parenchymal laceration, intraparenchymal and /or subcapsular hematomas, active hemorrhage, and tear of hepatic veins. Plain CT scan and contrast-enhanced dual-phase acquisition is very important for the comprehensive evaluation of patients with blunt liver trauma.

Objective To summarize the principle and clinical applications of ~(31)phosphorus MR spectroscopy(~(31)p-MRS).Methods Literatures about ~(31)P-MRS in liver were reviewed and analyzed.Results Abnormalities of ~(31)P-MRS were found in patients of hepatitis,liver cirrhosis,liver tumor,obstructive jaundice and patients after liver transplantation.Evaluation of ~(31)P-MRS is important in diagnosis and treatment of many hepatic diseases.(Conclusion As a) non-invasive protocol for analyzing the energetic metabolism and biomedical changes in cellular level of living liver,~(31)P-MRS has a wide clinical application.