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 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 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 study radiological characteristics of hand-foot-mouth disease(HFMD) in children. Methods The chest X-ray films of 1295 children patients of HFMD were analyzed,for the general X-ray manifestations and the evolution. Results A total of 1427 films was obtained from all patients, in which 1203 cases were normal and 224 cases were abnormal. The interstitial changes characterized the abnormal group, mainly as increased and vague lung markings, increased hilar shadows (137 cases).The parenchyma changes appeared as patchy exudative shadows(49 cases). Short-term dynamic observation was applied in 62 cases, 38 cases pulmonary disease progression manifested as normal and the interstitial type changing into the parenchyma type and the mixed type, the localized type changing into the diffuse type. Conclusions Most children patients of HFMD showed normal chest films, while the abnormal patients were characterized by interstitial and parenchyma pulmonary edema. Serial chest X-ray examination and short-term dynamic observation were important to identify the severe cases and assess patients' condition.

Objective To study the value of MR diffusion tensor imaging (MR-DTI)using a 3.0 T scanner in anterior ischemic optic neuropathy(AION).Methods A total of 26 patients suffering from unilateral subacute AION were examined using DTI and pattern visual evoked potential(P-VEP).The parameters values of optic nerves including fractional anisotropy (FA),ADC,vertical diffusivity (λ⊥),paralleldiffusion (λ//),P100 value and amplitude were obtained.Paired t-tests were used for comparing the FA,ADC,λ⊥,and λ// values of the two groups.Correlations of DTI parameters and P-VEP parameters were analysed by using the Pearson rank correlation analysis.Results The values of FA,ADC,λ//,and λ_ in the affected nerve were 0.28±0.07,(1.43±0.20) ×103 mm2/s,(1.79±0.16) ×10-3 mm2/s,and (1.25±0.17) ×10-3 mm2/s respectively,and the corresponding values of unaffected nerve were 0.57±0.05,(1.04±0.17) ×10-3 mm2/s,(1.71 ±0.19) × 10-3 mm2/s,and (0.75±0.08) × 10-3 mm2/s respectively.Compared to unaffected contralateral nerves,the mean FA was reduced,the mean ADC,λ⊥ were increased in the affected nerves(t=-19.269,10.537,15.301,P＜0.01).However,there were no significant difference of the λ//(t=l.632,P＞0.05).There was significant negative correlation between ADC and P-VEP amplitude in affected optic nerves (r=-0.722,P＜0.01).There was moderate negative correlation between λ⊥ and P-VEP amplitude in affected optic nerves (r=-0.634,P＜0.01).There was moderate correlation between FA and P-VEP amplitude (r=0.539,P＜0.01).There was no correlation between λ// and P-VEP amplitude.There was moderate negative correlation between FA and P-VEP P100 latency(r =-0.619,P＜0.01).Conclusions DTI can sensitively detect diffusional abnormality of anterior ischemic optic neuropathy.DTI could be used as a supplemental way in the assessment of AION.

Objective To assess the dose reduction potential of adaptive statistical iterative reconstruction(ASiR)and model-based iterative reconstruction(MBIR)in pelvic CT with a standard male phantom.Methods A Fluke Biomedical RANDO standard male phantom was scanned with discovery CT750 HD using different tube currents.CT images were reconstructed with FBP,50％ASiR and MBIR.The CT value,the image noise and the contrast-to-noise ratio(CNR)for the sacral vertebra relative to muscle were measured.The volume CT dose indexes(CTDIvo1)and dose-length product(DLP)were recorded.Results Compared with FBP,using 50％ASiR and MBIR had significant reduced image noise and greater CNR.The effective minimal tube currents for displaying sacral vertebra were 250 mA(FBP),180 mA(50％ASiR),and 100 mA(MBIR).With the similar image quality using FBP,the dose was reduced by 28.0％ and 59.9％ using 50％ASiR and MBIR,respectively.Conclusions Using advanced iterative algorithms can reduce image noise,improve CNR,and reduce the radiation dose in pelvic CT examination.

Objective To explore the feasibility of in-flow inversion recovery (IFIR)sequence of magnetic resonance imaging (MRI)at 1.5T in diagnosis of Budd-Chiari syndrome (BCS).Methods A total of 45 patients with Budd-Chiari syndrome diagnosed by surgery or interventional surgery in our institution were enrolled.The prerequisite of the study was that all medical imaging data including MRI and digital subtraction angiography (DSA)should be integrated.Then,the diagnostic accuracy rates between IFIR sequence and DSA were analyzed and compared.Results Of all 45 patients with BCS,40 (88.9%)were diagnosed accurately by IF-IR sequence,including typeⅠa in 10,typeⅠb in 14,typeⅡ in 10 and type Ⅲ in 6.Meanwhile,41 (91.1%)were diagnosed accu-rately by DSA,including typeⅠa in 8,typeⅠb in 14,typeⅡ in 13 and type Ⅲ in 6.No significant difference was showed in diag-nostic accuracy between two imaging methods (P >0.05).Spearman rank correlation analysis revealed that the diagnostic accuracy of IFIR sequence was highly consistent with that of DSA(r =0.853,P <0.001 ).However,there existed significant difference be-tween two methods in accurate diagnosis of typeⅠa and typeⅡ BCS (P <0.05).Conclusion MRI IFIR sequence at 1.5T is highly consistent with DSA in diagnosis and classification of BCS,which can be used as a reliable method of preoperative screening for BCS diagnosis.

BACKGROUND:Pedicle screw implantation is a common method to repair many kinds of diseases of the lower cervical spine. Three-dimensional (3D) reconstruction visualization system can be used in order to improve the accuracy of the implant and improve the prognosis.
OBJECTIVE:To investigate the effect of 3D reconstruction visualization system on the accuracy of cervical pedicle screw implantation.
METHODS: The clinical data of 89 patients with cervical spine dislocation, who underwent cervical pedicle screw implantation, were analyzed retrospectively. Patients were divided into control group (46 cases) and observation group (43 cases) according to the navigation method. Patients in the control group underwent C arm X ray two dimensional navigation. Patients in the observation group underwent three-dimensional reconstruction visualization system navigation. Intraoperative placement time was observed, and the accuracy of screw placement was assessed in both groups. The cases were folowed up for 12 months, and the adverse events were recorded and compared.
RESULTS AND CONCLUSION: (1) Intraoperative implantation time was shorter in the observation group than in the control group, but no significant difference was found (P> 0.05). (2) Accuracy rate: There were no three types of nail cases in the observation group, and the accuracy rate was 93% (40/43). In the control group, two cases affected three types of nailing, and the accuracy rate was 81% (37/46). The accuracy rate was significantly higher in the observation group than in the control group (P < 0.05). (3) Postoperative folow-up: None suffered from nerve tissue injury to vertebral artery, blood vessel and spinal cord. The screws of the two groups were in stable condition, without screw breakage or loosening. (4) Results suggested that in lower cervical pedicle nail implantation, 3D reconstruction navigation system can effectively improve the accuracy of screw placement, and does not increase nailing time or lead to adverse events. It is a safe and effective navigation mode.