PurposeTo explore CT and MRI findings of pigmented villonodular synovitis (PVNS) of spine, and to improve the preoperative diagnosis.Materials and MethodsCT and MRI findings of 7 cases of PVNS of spine confirmed by surgery and pathology were retrospectively analyzed. Seven cases underwent CT scan and 5 of them underwent MRI scan. The location of the lesions, tumor size, shape, density (signal), bone destruction and enhanced features were analyzed.ResultsExcept one case with small lesion, the remaining 6 cases showed lobulated soft tissue masses centering at the facet joint area, with lytic, expansive bone destruction. On CT images (n=7), 3 cases showed the masses density similar to that of the surrounding muscles, and 4 cases showed the tumor density slightly lower than that of the surrounding muscles. On MRI images (n=5), 1 small lesion demonstrated low signal at the peripheral, 1 lesion was isointensity without obvious low-density in it, 3 cases showed characteristic multiple visible low signal nodules in the lesions.ConclusionThe possibility diagnosis of the PVNS should be considered when spinal lesions are characterized by osteolytic bone destruction centering at facet joints and soft tissue masses with distinctive MR signals.

Objective To explore the effective approaches in information recognition rate improving for picture archiving and communication system (PACS) centralized printing system.Methods Possible factors that impact information recognition rate wereanalyzed,and then proposed the relevant optimizing solutions respectively by configuring the modality printing parameters and adjusting the radiology information system accession number (RIS ACCESSION NUMBER) matching rules.Results Effectiveness and accuracy were enhanced significantly through testing at Central Printing System by using these approaches.Conclusion These methods improve effectively the film information recognition rate and provide important technical support for digital imaging and communications in medicine (DICOM) centralized printing system.

Objective To compare the applications of half-Fourier acquisition single-shot turbo spin-echo(HASTE)sequence and true fast imaging with steady state precession(True FISP)sequence for the delineation of structures and diseases in several twin pregnancy with comorbidities and to explore the clinical value of two series of fast imaging for MRI of fetus.Methods 27 twin preg-nancy women with comorbidities were imaged with HASTE and True FISP sequences.All images were statistically analyzed in re-spect of imaging qualities and artifacts.MR signs of fetal brain were analysized.Results There were abnormal changes in brains in 7 of 27 cases.Both sequences could demonstrate the structures and lesions of the fatus.Imaging quality scores of HASTE were higher than that of True FISP,but with more respiratory blurring.Conclusion There might be varying abnormalities in central nervous system in twin pregnancy with comorbidities.Combining the demonstration abilities of HASTE and True FISP is needed when de-tecting fetus lesions,especially the brain.

Objective To present the CT and MRI findings of the fibrous dysplasia(FD) of the spine.Methods CT and MRI findings were retrospectively evaluated in 19 cases of FD of spine,all of which were confirmed pathologically.Nineteen patients underwent CT plain scanning(19/19) and 5 had enhanced CT scanning(5/19).Patients were also examined by MRI plain scan(11/11) or MRI enhanced scan (6/11).The location of tumors,the type of bone destruction,the boundary of lesions,internal intensity or signal,the enhancement pattern of lesions,and presence of compression fractures,spinal deformity were observed.Result Nine cases had monostotic FD,while 10 had polyostotic FD.In all the 49 lesions of 19 cases,13 lesions were located in the cervical vertebrae,23 lesions in the thoracic vertebrae,11 lesions in lumbar vertebrae,and 2 lesions in sacral vertebrae.Thirty-three lesions involved both vertebral body and appendix.Pure osteolysis were found in 26 lesions on CT examinations.Peripheral osteosclerosis rims (41/49) and expansive lesions(32/49) were seen.Residual bone crest(28/49) and ground-glass opacity(23/49)were noted.Different degrees of vertebral compression were found in 19 lesions.Five patients had spinal deformity.On T1WI,14 lesions showed intermediate or low signal,and 10 lesions presented as heterogeneous signal.On T2WI,6 lesions had low signal intensity,4 lesions were noted as hyperintensive,and 14 lesions presented as heterogeneous signal.Multiple fluid-fluid levels were found in 1 lesion.Low signal rims were seen in 14 lesions.Twenty lesions of 11 patients had significant enhancement.Conclusion Expansive pattern,ground-glass opacity,peripheral osteosclerosis rims and significant enhancement were helpful findings for the diagnosis of spinal FD.

Objective To summarize MRI features of anterior cruciate ligament graft tear and to explore the differences of MRI findings between acute tear and chronic tear, and compare the diagnostic ability of MRI and clinical examinations for graft tear. Methods MR images of 43 patients (44 knees) with anterior cruciate ligament graft tear(40 complete tear, 4 partial tear)confirmed by secondary arthroscopy were retrospectively analyzed. There were 18 acute tear and 26 chronic tear. Primary and secondary signs reported with conventional anterior cruciate ligament tear were adopted to evaluate graft tear. The exact probability method was used to compare the prevalence difference between various direct and indirect signs and the χ2 test was used to compare the accuracy between MRI and physical examination. Results The primary signs in MR images of anterior cruciate ligament graft tear included graft discontinuity in 13 kness, graft thickening with edematous high signal intensity in 12 knees, decreased slope of graft fibers in 6 kness, graft disappearing in 5 knees, and distinct graft atrophy in 3 knees. The secondary signs included kissing bone contusion in 4 knees, posteriorcruciate ligament buckling in 3 knees, increased anterior tibial displacement in 2 knees, bone contusion of the lateral condyle of femur, and bone contusion of thetibia condyle in 1 knee, respectively. There were no significant differences regarding the proportion of each sign between acute and chronic graft tear. Accuracy of MRI, Lachman test, and anterior drawer test were 87.5%(35/40), 95.0%(38/40)and 95.0%(38/40), respectively, which were all significantly higher than that of pivot shift test(42.5%,17/40) with significant differences(χ2=17.80, P<0.0083). Conclusions MRI is sensitive for diagnosing anterior cruciate ligament graft tear, the primary signs is the main evidence for the diagnosis of ACL graft tear, but it is hard to distinguish acute and chronic graft tear based on MR findings. The diagnostic accuracy has no statistically significant differences among MRI, Lachman test, and anterior drawer test, but they are all higher than pivot shift test.

Objective To discuss the selection of approaches for CT-guided percutaneous biopsy of thoracic and lumbar spine. Methods One hundred and forty-one cases of thoracic (70 cases) or lumbar (71 cases) vertebral undiagnosed lesions underwent CT-guided percutaneous biopsy. Appropriate needle approaches were designed according to different locations of lesions in the vertebra, including 63 cases of paravertebral path, 45 cases of transpedicular path, 11 cases of transcostovertebral path, and 22 cases of other paths. Results Out of the 141 cases, a definite diagnosis was obtained in 128 cases. The diagnostic accuracy of biopsy was 90.8%. No complications occurred. Conclusions The needle approach for CT-guided percutaneous biopsy of the thoracic and lumbar spine should be selected according to different locations of lesions, which should be based on principles of safety, enough specimen, and minimally invasive to patients.

Objective To analyze the selection of puncture needles in CT-guided percutaneous biopsy in musculoskeletal system diseases.Methods Three hundred and sixty-four undiagnosed lesions of musculoskeletal system underwent CT-guided percutaneous biopsy from January 1996 to March 2005.Proper selection of different puncture needles,including biopsy gun,bone biopsy needle,or both,was made according to different locations and characteristics of the lesions.Results Among 255 lytic lesions,the biopsy gun alone was used in 47 cases and both biopsy gun and bone biopsy needle were used in 208 cases.Among 73 mixed lesions,the bone biopsy needle alone was used in 49 cases,biopsy gun alone in 14 cases,and both in 10 cases.The bone biopsy needle was used in all 36 sclerotic lesions.Enough specimens were obtained in all the cases,and no complications occurred.A correct biopsy diagnosis was made in 334 cases,the diagnostic accuracy of biopsy being 91.8%(334/364). Conclusions The puncture needles for CT-guided percutaneous biopsy of the musculoskeletal system lesions should be selected according to different locations and characteristics of lesions.For sclerotic lesions or lesions containing relatively more sclerotic contents,the bone biopsy needle should be used.For lytic lesions,the biopsy gun should be used.And the combined use of both bone needle and biopsy gun should be utilized for mixed lesions.

2 months) was 93%(14/15); both 1- and 2-year local control rates were 83%; and 1- and 2-year survival rates were 72.9% and 62.5%, respectively. The median survival time was 32 months. Three patients had distant metastasis. Five patients died of lung metastasis (1 case) or multiple organ failure (4 cases). No complication or side-effect was observed in the patients, except skin ulceration in one patient. Conclusions Interstitial implantation of ~(125)I seed combined with or without external beam radiation therapy is convenient, effective, safe, and minimally invasive for soft tissue tumor, especially for metastatic or recurrent tumors.

Objective To investigate the CT and MRI features of Langerhans cell histiocytosis (LCH) with multiple spinal involvement.Methods The CT and MRI data of 13 patients with multiple LCH lesions in spine confirmed by pathology were retrospectively analyzed.All of 13 cases underwent CT examination (1 case underwent enhanced scanning) and 12 cases underwent MR examination (6 cases underwent enhanced scanning).Results In 13 cases,there were 8 cases of single central lesions invading the adjacent vertebrae and 5 cases of multiple central lesions.There were 19 core spinal lesions and 15 adjacent invading lesions in a total of 34 vertebrae lesions.Eighteen core lesions (18/19,94.74 ％) had different degrees and shape of vertebral compression.A total of 34 abnormal vertebrae were found in 13 cases by CT,which were manifested as osteolytic bone destruction.Eighteen cortical bones of 19 core vertebrae were incomplete,and a paravertebral soft-tissue masses were observed.There were 33 vertebrae lesions in 12 patients who underwent MR examination,including 18 core spinal lesions and 15 adjacent invading lesions.The lesions displayed equal,slightly lower or low signal on T1WI,slightly higher or high signal on T2WI and high signals on fat suppression sequences.A paravertebral soft-tissue masses were observed in 17 core spinal lesions (17/18,94.44％).Conclusion CT and MRI manifestations of spinal multiple LCH have certain characteristics.The level of diagnosis and differential diagnosis should be improved by deepen understanding of the disease image performance,but the diagnosis still depends on the pathology.

Objective To detect the application value of the apparent diffusion coefficient (ADC) values using diffusion weighted imaging (DWI) in detection of fetus with enlargement of cisterna magna.Methods Sixteen fetuses with enlargement of cisterna magna (group 1) and other sixteen healthy controls (group 2) were scanned by DWI.The ADC values were measured and compared between two groups at the same regions, and between left and right brain in group 1.The correlations between ADC values,the enlarged degree of cisterna magna and gestational age were calculated respectively.Results The ADC values were lower in the white matters of bilateral frontal lobes and parietal lobes, bilateral thalami and cerebellum in group 1 than those in group 2.There were no significant differences in ADC values between left areas and right areas in group 1 (P>0.05).The ADC values in bilateral basal ganglia and thalami were negatively correlated with the gestational age (P<0.05).There was no correlation between the enlarged degree of cisterna magna and gestational age (P>0.05).Conclusion The ADC values were decreased in certain regions in fetuses with enlargement of cisterna magna, which suggested that ADC value might be more sensitive for detecting potential damage of brain.Combined with conventional MRI, DWI and ADC values could be regarded as accurate protocols for the detection of fetus abnormalities.