Objective To sum up the imaging features of tuberous sclerosis.Methods CT and MRI findings of brain in 20 patients with tuberous sclerosis proved by clinic,imaging or pathology were retrospectively studied. Results Among 20 cases,on CT,the lesions appeared as subependymal calcified noduli in 16 cases (multiple noduli in 14 cases and single nodule in 2) and subependymal uncalcified noduli in 2,the noduli were 2~12 mm in diameter,2 cases were normal.On MRI,the subependymal noduli were multiple in 19 cases and single in one case,the noduli were iso-or hypointensity on T1WI and iso-,hypo or hyperintensity on T2WI.In addition,the lesions within cortical or sub-cortical matter were demonstrated by MRI in 19 cases,and the abnormal signals were showed in local patterns of cortical tubers.The abnormal findings of white matter were radial linear or wedge-shaped or irregular type in 7 cases.The subependymal noduli were enhanced,and the most of cortical lesions were not enhanced after contrast-enhanced MR scans in 9 cases.Conclusion There are characteristic findings of tuberous sclerosis both on CT and MRI.

Objective To analyze the CT features of orbital bone benign tumor and tumor mimics,so that to improve the diagnostic accuracy of these diseases.Methods CT appearances of orbital bone benign tumor and tumor-like lesion in 32cases proved by surgery,pathology and clinical features were reviewed.The lesions included orbital bone benign tumor(n=17)and tumor-like lesions(n=15).Results On CT,orbital osteomas in 9 cases showed homogeneous high density and cavernous bone-like density or ground glass-like density;ossifying fibroma in 5 cases were well-defined expansion of bone with ossification,cystic areas within the lesions;epidermal cyst in 2 displayed cystic density ;calcification and ossification could be seen in 1 case of chondroma ;10 cases of fibrous dysplasia showed ground glass-like density with cystic areas in poor-defined expansion of bone;the osteolytic destruction with well-defined margin were founded in 3 cases of orbital Langerhans' cell histiocytosis;1 case of aneurismal bone cyst appeared as cystic and expansive lesion with thin bone shell;1 case of osteopetrosis showed homogeneous high density in orbital wall.Conclusion Various orbital bone benign tumor and tumor-like lesions have different CT features.CT scan can clearly demonstrate the extent,density,border and the relationship with adjacent tissue of these lesions.

Objective To investigate the characteristics of imaging appearances and diagnostic value of ciliochoroidal detachment.Methods Ultrasound,MRI and CT appearances of 19 cases of ciliochoroidal detachment were reviewed,which included 9 cases of serous ciliochoroidal detachment,7 cases of choroid hematoma,and 3 cases of ciliary body detachment.All cases were examined by both B ultrasound and MRI at the same time,11 of them were examined by CT.Results UItrasound showed membrane bulge of the eyeball wall with different extent in 9 cases of serous ciliochoroidal detachment.Its postzone connected the equator or close to optic disc and its prozone could not been detected by ultrasound.There was echofree fluid darkspace under detached membrane.MRI showed membrane detachment at both nasal side and temporal side of ocular annulation in 9 cases of ciliochoroidal detachment.The detached membrane was approximately symmetry,its anterior margin did not exceed ciliary body adhesion of ocular annnlation and its posterior margin stopped at posterior part of ocular annulafion.There was long T1 and long T2 signal under detached membrane.CT showed slight thickening of ocular annulafion and slightly increased density of eyeball in 5 cases of serous cilioehoroidal detachment.Ultrasound showed hemispheroid or curve bulge of eyeball wall,projected toward the vitreous cavity in 7 cases of choroid hematoma,and there was an amount of low echo light spot under the detached membrane.Both MRI (7 cases)and CT (5 cases) showed hemispheroid,fusfform or curve bulge on the nasal side,temporal side and posterior part of ocular annulation.They appeared as isodensity or slight high density on CT,iso- or high signal on T1 WI and T2WI.Stratification was seen on T2WI in I case of choroid hematoma.Ciliary body detachment could not been detected by either MBI (3 cases) or CT (1 case) except ultrasound.Conclusion Imaging examination may provide reliable diagnostic evidence for ciliochoroidal detachment.

Objective To study imaging findings of Sturge-Weber syndrome. Methods The clinical manifestations and imaging findings of 11 cases suffered from Sturge-Weber syndrome were analysed. 10 cases had facial vascular nerves angioma in the trigeminal nerve distribation. Routine CT examination was performed in all 11 cases, 2 cases had head radiography and 8 cases had MRI, 5 cases had enhanced CT and 3 cases had enhanced MRI.Results Imaging finding included:on the affected hemisphere, cortical calcifications (n=11), brain atrophy (n=9), the interfaces between gray matter and white matter blured, dilated subependymal veins,enlargeel choroids plexus (n=7) and increasing thickness of cranial diploe (n=8). The choroids plexus of lateral ventricle was prominent enhanced in 5 cases. Enhancement of cortical areas and vessels on the surface of brain were noted in 6 cases. Conclusion Head radiography has finite effects in the diagnosis of Sturge-Weber syndrome, MRI combined with CT plays an important role in the diagnosis of this syndrome.

Objective To explore the imaging characteristics of seminomas and nonseminomatous germ cell tumors (NSGCT) and its pathological foundation. Methods CT and MR imaging manifestations in 25 cases of testicular germ cell tumors proved by pathological examinations were analyzed retrospectively. All tumors were divided into seminomas group (12 cases) and NSGCT group (13 cases). In the seminomas group, 5 cases were examined by CT and 4 of those also had contrast enhanced CT. Seven cases had MRI and 4 of those had dynamic enhanced MRI. In the NSGCT group, 5 were examined by plain CT in which two were by contrast enhanced CT, eight were by MRI in which 4 were by dynamic enhanced MRI. CT or MRI characteristics (morphology, density or intensity, enhancement) in both groups were analyzed by Fisher test. Results Histological examination revealed 25 intratesticular lesions. In 12 seminomas, 10 showed a nodular/lobulated shape, 5 showed a mixed density or intensity. In 13 NSGCT, only one lesion showed a lobular shape, 11 showed a mixed density or intensity. Seven seminomas showed a low signal on T2WI on MRI while only two NSGCT showed this sign. In four lesions underwent dynamic MRI scanning, 3 showed fibrous septum enhancement while no lesions in NSGCT showed this sign. The occurrence rate of the above imaging characteristics in both group was significantly different (P<0.05). Conclusion Seminomas and NSGCT may have their own CT and MRI characteristics, which may be of great value for differential diagnosis .

Objective To investigate the correlation of spiral CT features with expression of E-cadherin(E-cad) in peripheral lung cancer.Methods Spiral CT scans were performed in 58 patients with peripheral lung cancer confirmed by pathology.Expression of E-cad in 58 cases were detected with SP immunohistochemical techniques.Spiral CT findings were compared with expression of E-cad.Results The abnormal expression of E-cad was showed in 32 cases(55.17%).The positive rates of E-cad expression were 40.63% in I-II cell differentiation group and 73.08% in III-IV cell differentiation group,and the difference was significant(P＜0.05).The abnormal expression of E-cad was associated with the CT features,such as lymph node metastasis,pleural invasion and the size of tumor(P＜0.05),but not the cavity sign,spicular sign and vessel convergence sign(P＞0.05).Conclusion E-cad gene over expression may play an important role in the pathogenesis and CT appearances of lung cancer.

BACKGROUND: Chronic myeloid leukemia (CML) is characterized by the clonal expansion of hematopoietic stem cells. Without effective treat ment, individuals in the indolent, chronic phase (CP) of CML will undergo blast crisis (BC), the prognosis for which is poor. Therefore, it is important to clarify the mechanism underlying CML from a whole-genome perspec tive. OBJECTIVE: To investigate the gene expression profile of bone marrow mononuclear cells from CML with Applied Biosystems Expression Array System.DESIGN: Observation and controlled analysis.SETTING: Institute of Gene Engineering, Southern Medical University PARTICIPANTS: Samples of two cases of bone marrow (a chronic myeloid leukemia patient and a healthy person).METHODS: This experiment was conducted at the Institute of Gene Engineering, Southern Medical University from October 2004 to September 2005.The total RNAs were extracted and purified from bone marrow mononuclear cells derived from a CML patient and a healthy person. mRNAs were purified using an oligo (dT)-cellulose mRNA purification kits and labeled using reverse transcription, in vitro transcription (RT-IVT), then hybridized with microarray. Gene expression differentiation of the bone marrow mononuclear cells were examined by ABI 1700 Chemiluminescent Microarray Analyzer. Reproducibility of microarray results was assessed by comparing data sets obtained from the same sample and analyzed by two different arrays.MAIN OUTCOME MEASURES: ①Assessment of quality of total RNA and labled cRNA. ②Reproducibility of microarray. ③ Hybridization of array.④Results of semi-quantitative reverse transcription-polymerase chain reaction RESULTS: ①Using statistical data analysis tools, we identified 6 706 genes that were up- or down-regulated in CML patient compared with the healthy person. In these genes, we found that 17 genes were up-regulated while 51 genes were down-regulated among 68 genes closely related to CML. ②most differentially expressed genes in C/EBPalpha mediated path way and CD40L signaling pathway had reduced expression. ③Good repro ducibility of microarray was confirmed by analysis of correlation and detection concordance in technical replicates. The correlation coefficient of the detectable probe in technical replicates was 0.991 for the CML patient and 0.988 for the healthy person. ④The results of semi-quantitative RT-PCR experiments supported the reliability of our microarray analysis.CONCLUSION: By comparing expression patterns of CML with those of the healthy person, we identified a large number of genes that, were up- or down-regulated in CML patients. These data should provide useful information for finding candidate genes whose products might serve as molecular targets for treatment of CML patients.

ObjectiveTo evaluate the role of perfusion weighted magnetic resonance imaging ( PWMRI ) in distinguishing brain glioma recurrence for postoperative radiotherapy patients.Methods Thirty-five patients with suggested recurrent brain glioma (20 true,15 false) were examined by conventional MRI and PWMRI.Regions of interests (ROI) were manually drawn in contrast-enhancing lesion,surround edema region and normal white matter of contra-lateral brain on regional cerebral blood volume (rCBV) images.rCBV values of ROI and rCBVmax were measured,the standardized rCBV ratios were calculated,The mean rCBVmax ratio were compared between two lesion types with group t-test.The rCBVmax ratios of contrastenhancing regions was analyzed by the receiver operating characteristic curve.ResultsThe mean rCBVmax ratio of contrast-enhancing lesion in tumor recurrence was higher than those in non tumor recurrence (4.36vs 1.28,t =3.00,P =0.005 ).The mean rCBVmax of edema regions in tumor recurrence was also higher than those in non tumor recurrence ( 1.79 vs 0.85,t =2.41,P =0.026).Four patients with recurrent tumor and three with non tumor recurrence were wrong diagnosed when set the recurrent tumor rCBVmax ratio ＞2.15.The diagnostic sensitivity,specificity and accuracy for recurrent tumor by PWMRI were 80％respectively.Conclusion PWMRI examination is a useful method for distinguishing brain glioma recurrence.

Objective To assess the anatomic morphology of the connective structures among brain ventricles and cerebrospinal fluid (CSF) movement in them by CSF spin-labeling MR imaging. Methods According to the order of registration, 50 healthy volunteers were randomly selected and received cerebrospinal fluid spin-labeling MR scan with time-spatial labeling inversion recovery single-shot fast spin echo sequence (SLIR-SSFSE). The tagged CSF was used as an endogenous tracer. The anatomic morphology of the connective structures of brain ventricles and the flow direction of CSF were observed. The longitudinal diameter and transverse diameter of bilateral foramina of monro, midbrain aqueduct, and the central and bilateral lateral apertures of the fourth ventricle of each subject were measured and calculated based on multiple measurements. The flow rate of CSF was calculated based on the flow distance of CSF in the connective structures between brain ventricles during different TI time. The mean value of each indicator was acquired. Results Two-way flow state of CSF was observed in all connective structures, including bilateral foramina of monro, midbrain aqueduct, and the central and bilateral lateral apertures of the fourth ventricle. On the coronal planes, foramen of monro appears as a "Y"-type tubular structure locating among the both sides of the anteriomedial thalamus and fornix, which connect upward with bilateral lateral ventricles and downward with the third ventricle. The longitudinal diameter and transverse diameter of the left side of foramen of monro were 3.50-5.50 mm[mean (4.37 ±0.47)mm]and 1.00-1.40 mm[mean(1.21 ±0. 13) mm], respectively. The longitudinal diameter and transverse diameter of the right side of foramen of monro were 4. 20-4. 80 mm[mean(4.42 ± 0.20) mm]and 1.00-1.60 mm[mean (1.21 ±0. 19) mm], respectively. On the sagittal planes, foramen of monro appeared as an oblique fine tubular structure with the angle of 55°-58° between the both sides. CSF flow velocity towards the foot was 1.61-2. 52 mm/s[mean (2. 00 ± 0. 17) mm/s]in the left side of foramen of monro and 1.93-2. 20 mm/s [mean (2.03 ±0.09) mm/s]in the right side of foramen of monro. On the sagittal planes, midbrain aqueduct appeared as a curved tubular structure through diencephalon, with the longitudinal diameter of 9.90-17.30 mm[mean(15.51 ± 1.70) mm]and the transverse diameter of 1.70-2.30 mm[mean (1.92 ± 0. 17)mm]. In midbrain aqueduct, CSF flow velocity towards the foot was about 5.00-8.74 mm/s[mean (7.84 ±0.86) mm/s]and towards the head was about 3.84-6.71 mm/s[mean (6. 01 ±0. 66) mm/s]. On the sagittal plane, the central apertures of the fourth ventricle appeared as a fork-like tubular structure, with a small bifurcation forward to the central canal of the medulla oblongata and a posterior branch downward to cerebellomedullary cistern. On the coronal plane, lateral apertures of the fourth ventricle appeaed as curved tubular structures connecting the lateral horn of the fourth ventricle and cerebellomedullary cistern. The longitudinal diameter and transverse diameter of the left lateral aperture were 6.30-14. 60 mm[mean (10.42 ±2.88) mm]and 1.00-1.50 mm[mean (1.24 ±0.18) mm],respectively; of the right lateral aperture, they were 6. 20-15.50 mm[mean (12. 13 ± 3.05) mm]and 1.00-1.40 mm[mean(1.19 ±0. 13) mm], respectively. The angle range between the left and right lateral aperture was from 87° to 114°. CSF flow velocity towards the foot was about 2. 89-6. 70 mm/s[mean (4. 78 ± 1.32) mm/s]in the left lateral aperture and 2. 84-7.11 mm/s[mean (5.56 ±1.40) mm/s]in the right lateral aperture. Conclusions CSF spin-labeling MR imaging could display the anatomic morphology of the connective structure among brain ventricles and could be used for noninvasively assessing CSF movement.

Objective To investigate radiation dose diffent type of anesthesia affected radiation dose when we do interventional therapy for child patent ductus arteriosus (PDA).Methods From 201 1 to 2014,we collected 50 children(3-6 years old)with PDA which received interventional therapy were included in the study.They were divided into two groups:group A (25 cases,male/fe-male=7/18,mean weight=1 5.32 kg±2.41 5 kg)underwent interventional therapy of PDA under general anesthesia,and group B (25 cases,male/female=13/12,mean weight=1 6.40 kg±2.056 kg)using local anesthesia.The surgery were operated by the same doctor,we used DSA children cardiovascular film AE mode (ped CARD)to monitor the surgery,image frames 1 5-30 f/s,used the non-ionic contrast agent (Iodixanol 320 mg I/mL)and recorded the child cumulative incidence of skin surface dose (AK),dose area product(DAP),and time of fluoroscopy,and do statistical analysis.Results All 50 cases were performed the surgery successfully. There were no significant difference of age,weight and gender between groups (age:t=1.924,P =0.06;weight:t =1.703,P =0.095;gender:χ2 =3.00,P =0.083).The cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy were (0.061±0.025)Gy,(5.08±2.19)Gy·cm2 and (3.15±1.16)min in A group,and (0.094±0.046)Gy,(8.41±3.587)Gy·cm2 , (6.86±3.27)min in B group.The sequence and image number of two groups were same.There were significantly differences of cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy between two groups (AK:t =3.152,P =0.003;DAP:t =3.957,P =0.000;time of fluoroscopy:t =5.346,P =0.000).The radiation doses of A group significantly lower than B group,compared with B group,the radiation dose were 40 percent [(1-5.08/8.41)%]lower in A group,the 1.1 7 times discrepancy of time of fluoroscopy between two group [(3.1 5-6.86)/3.1 5].Conclusion Radiation dose is associated with type of anesthesia. Compared with local anesthesia,radiation dose reduced 40% using general anesthesia during interventional therapy for PDA.