Implantation of metallic stents is an important method in treatment of airway strictures,and it is applied in increasingly for treating benign tracheobronchial strictures. In this article, we comprehensively introduced the selection of characteristic stents, the current status and progress of stent application in benign tracheobronchial strictures.

Transcatheter arterial chemoembolization (TACE) has already been a mature and an effective treatment for advanced hepatocellular carcinoma (HCC).Clinically,it is very important to quickly and accurately evaluate the postoperative curative effect with minimally invasive technique so as to determine the next treatment options.At present,postoperative conventional CT and MRI are the main means to assess the curative effect of TACE,but it is a pity that after the treatment the functional changes of the tumor occur earlier than the morphological changes.In recent years,functional MRI techniques,such as diffusionweighted imaging (DWI),multi-b value DWI,dynamic contrast-enhanced (DCE) imaging,etc.have been more and more used for quantitative evaluation of the diffusion of water molecules and the blood microcirculation perfusion within the tumor tissue,and some progresses have been achieved in the evaluation of curative efficacy for tumor.This paper aims to make a comprehensive review about the research progress of the above mentioned functional imaging methods as well as their current application status in evaluation of the curative effect of TACE.

ObjectiveTo seek the optimal method in treating hemifacial spasm (HFS).MethodThirty HFS patients were selected and randomized into atreatment group and a control group. The treatment group was intervened by selecting cervical Jiaji (EX-B2) points plus conventional acupuncture, while the control group was by conventional acupuncture alone; 15 sessions were regarded as a treatment course, and the therapeutic efficacies were observed and compared after 2 successive treatment courses. ResultThe total effective rate was 86.7% in the treatment group, significantly higher than 66.7% in the control group (P<0.05). ConclusionElectroacupuncture at cervical Jiaji plus conventional acupuncture is significantly effective in treating HFS, and its total effective rate is higher than that of the conventional acupuncture alone.

Objective To investigate the safety and efficacy of placement of self expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56 3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. “Z” type stainless steel stents (7 5～10.0 cm in length and 2 5 cm in diameter) were selected for these patients. Part (1.0～3.0 cm in length ) of stent was placed in right atrium and the rest was in ICV. Results All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow up period (67～188 days). Conclusion Placement of self expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods.

Objective To investigate whether oral administration of probiotics can reduce complications induced by interventional therapy in patients with primary hepatic carcinoma and liver cirrosis.Methods Two hundred and sixty four patients with primary hepatic carcinoma and liver cirrhosis who underwent transarterial chemoembolization(TACE) were randomly divided into two groups.and patients in experimental group were given probiotics but not in control group.Shoa-term clinical manifestations.liver functions,blood routine and pain scores were compared between two groups.Results On the day 3 after therapy,the incidence of abdominal distension and constipation in experimental group were less than that in control group(x2=18.22 and 55.22,P=0.000);On the day 7 after therapy,the incidence of abdominal distension,constipation and infection in experimental group were less than that in control group(x2=5.35,13.5 and 19.14,P=0.021,0.000 and 0.000).There were no significant difference in other clinical manifestations,liver function,blood routine and pain scores between the two groups. Conclusion Oral administration of probiotics can reduce the incidence of some short-term complication induced by interventional therapy in patients with hepatic carcinoma and liver cirrhosis.

Objective To evaluate the CT and MR imaging findings of salivary duct carcinoma (SDC) in order to enhance the understanding of this rare disease.Methods A retrospective analysis of CT and MRI images was performed in 20 patients (14 males and 6 females,median age 56 years old) with pathologically proved SDC.CT and MR images were evaluated with respect to the following feature factors:location,size,morphology,margin,CT density/ MR signal intensity and enhancement pattern.Results Thirteen lesions were located in parotid gland,4 lesions in submandibular gland,1 lesion in sublingual gland and 2 lesions in the buccal spaces.The maximum diameter of SDC ranged from 1.5 to 7.0 cm,mean (3.5 ±0.9) cm.Five cases demonstrated round or oval round masses with well-defined margin,15 cases demonstrated irregular masses with ill-defined edge.Among them,the peritumoral fat tissues were infiltrated in 7 cases,the preauricular skin were invaded in 3 cases,the jaw muscles were invaded in 2 cases and the parapharyngeal space,pterygoid muscle,retromandibular vein was invaded in 1 case respectively.Lesions were homogeneous in 4 cases and heterogeneous in 16 cases.Seven lesions showed varied calcifications.Lesions were homogeneous iso-intense in 1 case and heterogeneous iso-intense in 2 cases on T1WI,heterogeneous hyperintense in all cases on T2WI.On post contrast images,lesions demonstrated remarkable enhancement in 17 cases,moderate enhancement in 3 cases.Enlarged cervical lymph nodes were found in 12 cases.Conclusions SDC has nonspecific imaging characteristics.CT and MR examinations can accurately demonstrate the extent of tumor involvement and are helpful to provide more comprehensive information for SDC management.

BACKGROUND:Radiation-induced brain injury has recently become an increasing area of research, in particular in animal experimental studies. Domestic and international researches show that there have been no uniform scanning parameters used for examination of animal models of radiation-induced brain injury by magnetic resonance imaging. In this study, we performed magnetic resonance imaging in rabbits to determine related sequence parameters. OBJECTIVE:To establish the New Zealand rabbit models of radiation-induced brain injury, and obtain the brain magnetic resonance images of rabbits using LOOP7 coil, so as to provide experimental evidence for diagnosis of radiation-induced brain injury by magenetic resonance imaging. METHODS:Each of T2-weighted imaging, diffusion tensor imaging, magnetic resonance spectroscopy and magnetic susceptibility-weighted imaging were performed several times through the use of LOOP7 coil, to determine the optimal scanning parameters for each sequence. Rabbit models of radiation-induced brain injury were established and then their right hemispheres were irradiated using 6 MV X-rays at a single dose of 40, 80 and 120 Gy. The daily performance and dynamic magnetic resonance signs of rabbits were observed. The brain tissue was taken for pathological examination once abnormal magnetic resonance findings were observed or after 20 weeks of folow-up. RESULTS AND CONCLUSION:Only one rabbit model in the 40 Gy group had subdural hemorrhage. In the 80 Gy group, abnormal T2-weight imaging signals were observed in al rabbit models, which were pathologicaly confirmed as scattered degenerated neurons and infiltrated neutrophils. The abnormal signals that gradualy expanded over time were seen in rabbits from the 120 Gy group by magnetic resonance imaging and were pathologicaly confirmed as radiation-induced brain injury loci. The results confirm that establishing rat models of radiation-induced brain injury using radiation therapy system can better simulate the pathological process of radiation-induced brain injury; moreover, this model can be applied to receive routine magnetic resonance examination with LOOP7 coil.

Objective To evaluate the nasointestinal decompression intubation in acute small intestinal obstruction. Methods Ten patients with acute small bowel obstruction received nasointestinal decompression intubation under x-ray guidance. The nasointestinal decompression tube passing over a guidewire was inserted into small intestine near Tres ligament or further down distally with assistance of patients adopting in multi-physical positions. Results The intubation of nasointestinal decompression tubes into small intestine was technically successful in all patients with average procedural time of 16 min.(10 ～ 35 min). After placement of the tube, all patients obtained various degrees of symptoms relief including abdominal pain, distention, vomiting, etc. Four patients with simple adhesive obstruction recovered completely and the tube was removed 2 weeks later. Three patients were refered to surgical operation, and 3 others gave up for further treatment. There were no complications such as bleeding or perforation related to intubation. Conclusion Nasointestinal decompression intubation under guidance of X-ray is rather simple, less time consuming, especially with high efficiency for preoperative gastrointestinal decompression and treating simple adhesive bowel obstruction; ought to be recommended. [

Objective To evaluate the efficacy of percutaneous CT guided interstitial 125Ⅰ seeds implantation treatment for refractory pelvic malignant tumors and discuss the procedure of technique.Methods Twenty-three patients with refractory pelvic malignant tumors(25 lesions,diameter 3.5-7.0 cm,mean 4.5 cm) showing failure response to full chemotherapy and/or radical radiotherapy after tumors resection were undergone percutaneous CT guided intratumoral 125Ⅰseed implantation.Treatment plan system(TPS)was used to design the distribution and number of 125Ⅰ seeds according to matched peripheral dose(MPD)1-3 days before the procedure.Of which 6 cases received combined internal iliac arterial infusion chemotherapy before or after the 125Ⅰ seed implantation procedure.Results 9 ～ 75(mean 27)125Ⅰ seeds were implanted into a single tumor at first time including 6 patients with intraarterial chemotherapy for 14 cycles(mean 2.3 cycles),showed relief of clinical pain symptoms in 16 of 23 cases,72 h ～ 4 w after the seeds implantation;with the an effective rate of 69.6%.Follow up for 2-34 months(median,21 months),CT or MRI performed 2 months after the seeds implantation showed no CR,but PR in 18 cases,SD in 4 cases,and PD in 1 case,with overall response rate of 78%(18/23),and no serious complication.In addition,20 cases survived,with the longest one of 34 months and the other 3 died.Conclusions Intratumoral 125Ⅰ seeds implantation under CT guidance for pelvic refractory malignant tumors is safe,minimally invasive,and effective.

Objective To study the value and clinical significance of diffusion tensor imaging(DTI)in differentiating high-grade astrocytomas and solitary metastatic tumors of brain.Methods 16 patients with intracranial solitary metastasis and 25 patients with high-grade astrocytoma confirmed pathologically were examined with MR DTI.Mean diffusivity(MD)and fractional anisotropy(FA)were measured in the regions of interest(ROI)of peritumor and cerebral parenchyma of the normal side on DTL Fiber tractography was reconstructed and the encountered patterns of tumor-related alteration to cerebral white matter were observed.Results The peritumor were all depicted as hyperintense or isointense signals on DTI.The FA values were 0.227±0.05 and 0.169±0.07 in the peritumor of high-grade astrocytoma and metastasis respectively,which was of significant difference(P＜0.05).Furthermore,fiber tractography could display the course of white matter tracts in three-dimensional space.Conclusion DTI may be help to differential diagnosis of solitary metastasis and high-grade astrocytoma in clinical practice.