Objective To assess the value of susceptibility weighted imaging(SWI) in the diagnosis of intracranial hemorrhage. Methods Forty patients with intracranial hemorrhage underwent MRI scanning (GE Signa HDe 1.5 T), which included T2WI, T1WI, T2 * WI and SWI. Of them, DWI was conducted in 37 cases and enhanced MRI was conducted in 10 cases additionally. After post processing on the workstation, both magnitude and phase images of SWI were acquired for further analysis. The images of all sequences were scored from 1 to 3, according to their ability of depicting the lesions. Statistical analysis was conducted to compare the scores among these sequences. Results On SWI, the scores in detecting the lesions, their margin and adjacent veins were 2. 8, 2. 8, and 2. 8 respectively. The scores of those were 1.8, 1.7,and 0.0 on T1WI, 2.3, 2.0 and 0.0 on T2WI, 2.0, 2.1 and 0.2 on T2* WI, respectively. There was statistical difference between the scores on SWI and those on T1WI, T2 WI and T2 * WI ( P < 0. 01 ). The numbers of micro hemorrhagic lesions that could be observed on SWI, T1WI, T2WI, DWI and T2 *WI were 402, 55, 61, 84 and 188 respectively. There was statistical difference in showing micro hemorrhagic lesions between SWI and T1WI, T2WI, DWI, T2 * WI (P < 0. 01 ). Conclusion SWI is sensitive to visualize the hemorrhagic region, and has predominant advantage over conventional MR sequences including T2 * WI in detecting intracranial hemorrhage, especially cerebral microbleeding. According to the features of the paramagnetic and diamagnetic lesions, radiologists can differentiate hemorrhage and calcification with phase images.

Objective To investigate the levels and distribution of radon in dwellings in Shenzhen cities of China.Methods A total of 108 low-,multi-,middle-and high-rise buildings were selected.Indoor radon concentrations were measured by using solid track detector.Results The arithmetic mean of indoor radon concentrations in Shenzhen was 64 Bq/m3,and geometric mean was 58 Bq/m3,in range of 15 to 155 Bq/m3.The average indoor radon concentration in Bao'an district was 50 Bq/m3 with the lowest value,and that in Pingshan new district was 87 Bq/m3 with the highest value.There were 12 measuring points where indoor radon concentrations were higher than 100 Bq/m3 in Shenzhen,accounting for 11.1％ of the total number.Shapiro-Wilk test showed that the frequency distribution of indoor radon concentration in Shenzhen follows lognormal distribution (P ＞ 0.05).The indoor radon concentrations showed a downward trend from 1990 to 2015.The indoor radon concentration decreases with the elevated floors except 10th and above floors.Conclusions The indoor radon concentrations in Shenzhen increased by 35％,compared to the previous investigations.It is recommended that efforts continue to improve radioactive materials standards about building material and to enhance the natural ventilation in high-rise buildings in order to lower the radiation hazards from radon.

Objective To compare the imaging quality of articular cartilage of the knee with 3D-sampling perfection with applica-tion optimized contrast using different flip angle evolutions (3D-SPACE),3D-true fast imaging with steady-state precession (3D-True FISP)and 2D-fast-spin-echo-proto-density(2D-FSE-PD)sequences.Methods 40 healthy volunteers and 20 patients of knee joints were examined with 3D-SPACE,3D-True FISP and 2D-FSE-PD sequences at 1.5T MRI.Signal-noise ratio (SNR),contrast-to-noise ratio (CNR)and lesion visualization of articular cartilage were compared.Results 3D-SPACE showed the highest SNR of cartilage and CNR of fluid/cartilage among the three sequences (P <0.05).3D-SPACE had the better capability for showing the lev-el I 、level Ⅱcartilage injury comparing with 3D-True FISP,but no significant difference between the cartilage injury at level Ⅲ and level Ⅳ.For all levels of cartilage injury,3D sequence was better than the 2D sequence.Conclusion Compared with the 3D-True FISP sequence and 2D-FSE-PD sequence,3D-SPACE sequence can show the structure of knee and knee cartilage injury better.

Objective To compare the accuracy rate of talar osteochondral lesions between the small field of view (FOV) surface coil MR imaging and 2D FSE proton density weighted imaging (2D-FSE-PD),3D-SPACE sequences MR imaging with boot-shaped coil.Methods Totally 43 patients (45 ankles) underwent 3D-SPACE sequence after 2D-FSE-PD sequence scanning using the boot-shaped coil,then the PDWI sequence was scanning after the boot-shaped coil was replaced by the small FOV surface coil at 1.5T MRI.The results of the arthroscopic examinations was regarded as the standard for assessing the accuracy rate of the three methods.Results The accuracy rate of 2D-FSE-PD sequence with small FOV surface coil was 86.67％ (39/45),the accuracy rate of 2D-FSE-PD sequence with boot coil was 60.00％ (27/45),the accuracy rate of 3D-SPACE sequence with boot coil was 68.89％ (31/45).The accuracy rate of small FOV surface coil was higher than those of boot coil used 3D-SPACE sequence (x2 =4.114,P =0.002) and boot coil used 2D-FSE-PD sequence (x2 =8.182,P＜0.001).There was not significant difference between 3D-SPACE sequence using boot coil and 2D-FSE-PD sequence using boot coil (x2 =0.776,P=0.125).Conclusion Compared with the 2D-FSE-PD and 3D-SPACE sequences with boot-shaped coil,the small surface coil scanning with routine sequence can show talar osteochondral lesions better.

ABSTRACT:Objective To investigate the clinical features of seronegative rheumatoid arthritis (RA)in western China and its outcomes after one-year treatment with disease modifying anti-rheumatoid drugs (DMARDs) so as to provide evidence for effective therapy.Methods We made a retrospective analysis of 240 RA patients treated in our department from May 2013 to June 2014.We compared the 47 seropositive and 25 seronegative RA patients in clinical features,laboratory parameters and outcomes after one-year DMARDs medication.Results The percentage of seronegative RA was 10.4% (25/240).The number of swollen small joints was significantly smaller in seronegative RA group (P<0 .0 1 ).Compared with those in seropositive RA,the level of hemoglobin was lower,the level of platelets was higher,and the level of alkaline phosphatase was lower in seronegative RA (P<0 .0 5 ).The remission rate was higher in seronegative RA group than in seropositive RA group after one-year DMARDs administration (P<0.05).Conclusion Seronegative RA is not rare in clinic.Even though seronegative RA patients often present fewer swollen small joints, it is difficult to distinguish between seronegative and seropositve RA just based on the clinical features.Besides,hematological damage is more severe in some patients with seronegative RA.Only after one-year treatment with DMARDs,the remission rate is higher in seronegative RA patients than in seropositve RA ones.

Objective:To evaluate the application values of small FOV surface coil and BLADE sequence in MR imaging on assessment of talar cartilage injury of ankle joint under traction.Methods:The clinical and imaging data of 53 patients with ankle cartilage injury in the Affiliated Suzhou Hospital of Nanjing Medical University from December 2018 to July 2020 were prospectively analyzed. All patients underwent the following MR sequences: sequence Ⅰ was fast spin echo proton density weighted (FSE-PD) BLADE sequence with surface coil small FOV, and sequence Ⅱ was FSE-PD-BLADE imaging of small FOV under horizontal load traction of ankle joint. Paired sample Wilcoxon rank sum test was used to compare the thickness of talus dome cartilage, cartilage space and subjective assessment score of image quality (including the outline of the upper surface of the cartilage at the injury, the thickness of the cartilage layer at the injury, the rupture of the cartilage at the injury, the relationship between cartilage and subchondral bone, subchondral bone collapse or trabecular fracture line) between sequence I and sequence Ⅱ.Results:There was significant difference in the thickness of central cartilage of talus between sequence Ⅰ and sequence Ⅱ [0.70 (0.60, 0.90) mm and 0.80 (0.70, 0.90) mm, Z=-2.900, P=0.004, respectively]. There was no significant difference in the thickness of medial and lateral talus cartilage between sequence Ⅰ and sequence Ⅱ (P>0.05). There were significant differences between sequence Ⅰ and sequence Ⅱ in the center [0.10 (0, 0.15), 0.89(0.63, 1.00) mm], medial [0.10(0, 0.31), 1.20(0.70, 1.25) mm] and lateral cartilage space [0.18(0.08, 0.23), 0.90(0.76, 0.94)mm] (all P<0.001). As for the subjective assessment score of talus cartilage injury, except for score in subchondral bone collapse or bone trabecular fracture line between sequence Ⅱ and sequence Ⅰ ( Z=-1.480, P=0.139), significant differences were found in all other scores ( P<0.05). Conclusion:MRI of the ankle under traction is safe and feasible. Under the condition of horizontal traction, small FOV surface coil combined with BLADE sequence can better display talus cartilage injury.

Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced (VNE) dual-energy computed tomography (CT), and to evaluate the possibility of VNE images in diagnosis for those lesions.Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced (TNE) phase and arterial phase were performed with single-energy CT (120 kVp) and portal venous phase was performed with dual-energy CT (100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio (CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate (SSDE) were also calculated.Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images (164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR (10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR (17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images (0.69±0.88 vs. 0.72±0.85 cm, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30 (23.4%) lesions, lighter density in 88 (68.8%) lesions, while failed to show 10 (7.8%) lesions, and showed the same size in 61 (47.7%) lesions and smaller size in 57 (44.5%) lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mSv, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 mSv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively.Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cmcould be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.

OBJECTIVETo investigate the perfusion characteristics of renal mass parenchyma on 64-slice spiral computed tomography (CT).

METHODSTotally 91 patients with renal mass were enrolled. Sixty-four slice spiral CT was used for renal perfusion scan that began with a contrast bolus injection of 50 ml (370 mgI/ml) at a rate of 5 ml/s. Perfusion characteristics, including blood flow (BF), blood volume (BV), and permeability (PM) of renal mass parenchyma and renal cortex in affected and normal kidneys were calculated from Siemens Body PCT (VB20B) software, and the perfusion characteristics among renal mass parenchyma and renal cortex in affected and normal kidneys were compared.

RESULTSRenal clear cell carcinoma (RC-CC), renal pelvic transitional cell carcinoma (RPTCC), and renal angiomyolipoma (RAML) was pathologically confirmed in 40, 21, and 16 patients, respectively, while the remaining 14 patients were diagnosed as with renal simple cyst (RSC). Technical failure was experienced in 1 (1.1% ) patient. Perfusion parameters of tumor parenchyma were measured as follow: RCCC, BF (93.7 +/- 20.2) ml x (100 ml)(-1) x min(-1), BV (182.0 +/- 46.6) 1000:1, PM (115.7 +/-30.2) 0.5 ml x (100 ml)(01) x min(-1); RPTCC, BF (48.0 +/- 21.2) ml x (100 ml)(-1) x min(-1), BV (82.4 +/- 29.7) 1000:1, PM (65.7 +/- 17.2) 0.5 ml (100 ml)(-1) x min(-1); RAML, BF (52.6 +/- 18.5) ml x (100 ml)(-1) x min(-1), BV (110.1 +/- 45.9) 1000:1, PM (60.1 +/- 23.0) 0.5 ml x (100 ml)(-1) x min-1; RSC, BF (7.0 +/- 6.5) ml x (100 ml)(-1) min(-1), BV (16.2 +/- 9.7) 1000:1, PM (12.0 +/- 7.2) 0.5 ml x (100 ml) (-1) x min(-1). In all pathological groups, perfusion pa- rameters showed significant differences (P <0 . 1) between mass parenchyma and renal cortex in affected kidney, while there were no significant differences (P > 0. 5) in perfusion characteristics between renal cortex in affected and normal kidneys. Aslo, the perfusion characteristics were significantly different between parenchyma D in any two kinds of renal masses (P <0 . 5) except for RPTCC and RAML (P > 0. 5). C ONCLUSIONS: fDif-rent pathological types of renal mass have different perfusion characteristics. Perfusion imaging with multislice CT is potentially useful in the differential diagnosis of renal mass.

Adult ; Aged ; Blood Volume ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Perfusion Imaging ; Regional Blood Flow ; Tomography, Spiral Computed ; Young Adult

OBJECTIVETo investigate the image quality and radiation dose of dual-energy (DE) computed tomographic angiography (CTA) of head and neck.

METHODSWe retrospectively analyzed two groups of patients (both n=30) undergoing 64-slice spiral CTA of cervical and cranial regions with different scan protocols. The DE group was obtained with 140/80 kVp, 64/272 mAs, 0.6 pitch, 80 ml of contrast medium, and caudal-cranial scan orientation. The single-energy (SE) group was obtained with 120 kVp, 220 mAs, 1.2 pitch, 60 ml of contrast medium and cranial-caudal scan orientation. The image quality and radiation dose were compared. The attenuation values and noises were measured on transverse images at 4 different vessels (the distal part of common carotid artery and adjacent vein in same axial image; the M1 segment of middle cerebral artery and sigmoid sinus or confluence of sinus in same image) and two muscles: erector spinae presenting average soft tissue enhancement and supraspinatus muscle presenting regions of great artifact.

RESULTSIn cranial region the arterial enhancement and venous contamination were similar (P=0.1427,P=0.1116) . In cervical region the arterial enhancement was similar (P=0.9414) . DE group had significantly greater venous contamination (P<0.0001) , while the mean attenuation value of common carotid artery was still 127 Hu higher than that of jugular vein. No matter artifact of soft tissue was obvious or not, the noise of DE group was significantly less than that of SE group (both P<0.0001) , and the soft tissue enhancement was similar (P=0.0760,P=0.0793) . The radiation dose required for bone-subtraction angiography was significantly less in DE group than in SE group (P<0.0001) .

CONCLUSIONSDE group has comparable image quality to SE group and less scan dose for bone-subtraction. DE-CTA has great potential in clinical application. "

Adult ; Aged ; Angiography ; methods ; Female ; Head ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Neck ; diagnostic imaging ; Radiation Dosage ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods

OBJECTIVETo explore the impacts of physiological factors on liver volume in patients with or without cirrhosis and to investigate its correlation with two different hepatic function scoring systems.

METHODSTotally 44 consecutive patients without any suspicious hepatic disease and 17 contemporaneous patients who had been diagnosed as cirrhosis by natural history, clinical performance, past-imaging examination (ultrasound or CT), and serum tests were enrolled. Contrast enhanced abdomen CT scan was performed with 64-slice CT (target study phase: portal phase; reconstruction slice thickness: 2mm; slice interval: 2mm; Kernel value: B30s Smooth). We defined the concept of liver body index (LBI) = total liver volume (TLV) (cm3)/[1000 x body surface areal (BSA) (m2)]. The correlations between liver volume and individual physiological factors were analyzed, and the relationships between volume parameters and two hepatic scoring systems of cirrhosis group were explored.

RESULTSThe average TLV was (1249 +/- 248) cm3 in control group. TLV correlated well with patient's height, weight, and BSA (r = 0.5285, r = 0.5754, r = 0.6210 ; P < 0.01), and weakly correlated with body mass index (r = 0.3074, P < 0.05). TLV weakly negatively correlated with age (rs = -0.3342, P < 0.05). There was no significant difference of TLV grouping by sex when setting weight as covariant factor. In cirrhosis group the liver volume was not correlated with the patients' weight or BSA. The average liver volume was decreased to (1044 +/- 300) cm3, which was significantly different from that in control group (P < 0.01). While Child-Pugh was not correlated with volume parameters in cirrhosis group, model for end-stage liver disease (MELD) score was significantly correlated with LBI (r = -0.6937, P < 0.05).

CONCLUSIONTLV relates to several physiological factors in general population. MELD score, rather than Child-Pugh score, correlates with TLV and LBI in patients with cirrhosis.

Adult ; Aged ; Female ; Humans ; Liver ; anatomy & histology ; diagnostic imaging ; physiology ; Liver Cirrhosis ; diagnostic imaging ; pathology ; physiopathology ; Liver Function Tests ; methods ; standards ; Male ; Middle Aged ; Organ Size ; Radiography ; Severity of Illness Index ; Young Adult