Objective: To quantitatively study the incidental extra-cardiac ifndings (ECFs) by coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) in order to better recognize those lesions in clinical practice.
Methods: A total of 1169 suspected CAD patients received CCTA in our hospital from 2011-06 to 2013-03 and 1030 patients were enrolled in this study. There were 589 in-patients, 441 out-patients and 549 patients≥60 years of age,481 patients < 60 years of age. 3 physicians evaluated the incidental ECFs in the full ifeld of view (FOV) in different window level and window width for lung, mediastinum, thorax and upper abdominal areas. Clinical relevance of ECFs were classiifed by corresponding scores. Score 1, the patients with severe lesion need immediate treatment, score 2, the lesion with clinical and prognostic signiifcance and score 3, the ifnding without clinical signiifcance.
Results: There were 197/1030 (19.1%) patients having 224 ECFs and 27 (2.6%) patients having 2 ECFs; 90/1030 (8.7%) patients having 106 signiifcant lesions including 3 (0.3%) of lung cancer and 8 (0.8%) of pulmonary embolism; 107 patients with 118 lesions without signiifcance. ECFs were found in 114/589 (19.4%) in-patients and in 83/441 (18.8%) out-patients, P>0.05; 76/481 (15.8%) of patients < 60 years of age and 121/549 (22.0%) of patients≥60 years,P<0.05.
Conclusion: Unexpected ECFs detection rate was 19.1% in patients undergoing CCTA without further radiation exposure by reconstruction with the full FOV setting, and 8.7% of ECFs had clinical signiifcance. Radiologists should routinely analyze the extra-cardiac organs in CCTA.

Objective: To explore the features of ascending aortic distensibility (AAD) and risk factors in pre-hypertension (PHT) patients. Methods: A total of 206 participants who received retrospective ECG-triggered coronary CTA by physical check-up or by clinically suspected coronary artery disease (CTA) were enrolled. The participants were divided into 2 groups: Control group, the subjects with normal blood pressure,n=85 and Pre-hypertension group,n=121. A 128 slice dual-source CT scanner was used and the image was automatically reconstructed at every 5% absolute phases in entire R-R interval. The beginning of left coronary artery plane was deifned as the reference and 25 mm above the reference plane was deifned as interested region. ADD value was calculated. Results: Compared with Control group, Pre-hypertension group had decreased AAD,P<0.01 and similar normalized cross-sectional area (Ss),P>0.05; ADD value was similar among different gender and blood lipid levels. Correlation analysis presented that AAD was negatively related to age (r=-0.69,P=0.001), systolic blood pressure (r=-0.37,P=0.001), pulse pressure(r=-0.43,P=0.001) and glycosylated hemoglobin (r=-0.43,P<0.05). Age and systolic blood pressure were the independent risk factors for AAD decline (standardized β=-0.66,P=0.001) and (standardized β=-0.44,P=0.001). Conclusion: Without additional contrast media consumption and radiation dosage, retrospective ECG-triggered coronary CTA may detect AAD changes with risk factors at the early stage in pre-hypertension patients which is helpful to distinguish the high risk individuals.

Objective: To assess the renal cortical perfusion parameters by the imaging of computed tomography (CT) in patients of essential hypertension (EH) with target organ damage.
Methods: A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups: EH + target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow (BF), blood volume (BV), time to peak (TTP) and the mean transit time (MTT) were examined and compared among different groups.
Results: There were 90/97 (92.8%) participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P>0.05. While EH + target organ damage group had decreased BF (214.6 ± 36.1) ml/(min?100 ml ) than Control group (262.1 ± 26.6) ml/(min?100 ml ),P<0.01, and BV, TTP, MTT were similar to Control group,P>0.05. Compared to EH without target organ damage group, the EH + target organ damage group presented decreased BF (214.6 ±3 6.1) ml/(min?100 ml ) vs (268.9 ± 33.1) ml/(min?100 ml ), P<0.01 and prolonged MTT, TTP,P< 0.05.
Conclusion: CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the renal perfusion more sensitively than other parameters in EH + target organ damage patients.

Objective:To analyze the clinical characteristics and diagnosis and treatment experiences of Langerhans cell histocytosis (LCH) in skull.Methods:Sixteen patients with cranial LCH admitted to our hospital from January 2015 to December 2019 were chosen in our study. Their clinical data, diagnosis and treatment procedures and prognoses were retrospectively analyzed.Results:Among the 16 patients, there were 13 males and 3 females, aged from 1 to 31 years. The clinical manifestations included space-occupying lesions of the skull; and imaging showed bone destruction of the skull, with or without involvement of other bones or organs. All patients were pathologically confirmed to have LCH after surgical total resection of the lesions. Routine whole-body bone scanning was performed after surgery: one was found to have local abnormal metabolic activity and received local radiotherapy; 8 were combined with other bone or organ involvement, and received chemotherapy. All the patients were followed up for 1-5 years, and no recurrence was found, and no one died.Conclusion:Good prognosis can be achieved in cranial LCH patients accepted resection by giving additional treatment according to the results of postoperative reexamination and combination use of standardized radiotherapy and chemotherapy.

Objective:To compare the simplicity, safety, efficacy, prognoses and economic burden of CAS-R-2 frameless stereotactic device and Leksell frame stereotactic device in assisting surgery for patients with hypertensive cerebral hemorrhage (ICH, hematoma volume: 20-40 mL).Methods:The clinical data of 120 patients with supratentorial ICH, admitted to our hospital from December 2012 to December 2019, were retrospectively analyzed; trepanation and drainage assisted by CAS-R-2 frameless stereotactic device was performed in 65 patients (frameless group), and trepanation and drainage assisted by Leksell frame stereotactic device was performed in 55 patients (frame group). The differences of surgery time, hematoma evacuation rate 7 d after surgery, incidences of recurrent hemorrhage and intracranial infection during hospitalization, length and expense of hospitalization, and modified Rankin scale (mRs) scores 6 months after surgery were compared between the two groups.Results:As compared with those in the frame group, patients from the frameless group had significantly shorter surgery time ([0.5±0.1] h vs. [2.2±0.5] h), significantly lower incidence of recurrent hemorrhage (0% vs. 9.1%) and significantly lower incidence of intracranial infection (1.5% vs. 9.1%) during hospitalization ( P<0.05). The hospitalization expense of patients from the frame group was significantly lower than that in the frameless group ( P<0.05). There were no significant differences in hematoma evacuation rate 7 d after surgery, length of hospital stays, and mortality and mRs scores 6 months after treatment between the two groups ( P>0.05). Conclusion:For patients with supratentorial ICH, trepanation and drainage assisted by CAS-R-2 frameless stereotactic device has the same curative effect and prognoses as Leksell frame stereotactic one; the former has higher simplicity and clinical safety, and the latter has lower economic burden.