Objective To discuss the diagnosis and clinical value of spiral CT(SCT) in orbital blowout fracture.Methods The SCT MPR findings in conjunction with transaxia images in 120 cases of orbital blowout fracture were retrospectively analyzed. According to the this analysis,108 patients were treated conservatively only 12 were under the opereation.Results Interruption of bone continuity, fragments, depression and displacement of orbital bone wall were direct signs of orbital blowout fracture." Tear drop"sign in the maxillary or ethmoid sinus was a characteristic indirect sign of inferior or medial orbital wall fracture. Enophthalmos obviously compacting of extraocular muscler and distraction test male were operation signs.Conclusion Orbital blowout fracture can be diagnosed by SCT volume scanning findings of the MPR comprehensively and accurately, that is very important in choosing the treatment methods for orbital blowout fracture.

Objective To assess the diagnostic value of susceptibility weighted imaging in intracranial capillary telangiectasia. Methods Clinical and imaging data of 1 3 cases with pathologically proved intracranial telangiectasia were collected.All 1 3 patients were examined with conventional MRI and SWI scanning,five patients were checked with MRA while other six cases were examined by CT scanner,and the results were compared.Results All 13 patients had multiple lesions and a total of 176 lesions were detected by SWI,exhibiting hypointense with possiblely punctate hyperintense in the center .Fifty-two lesions were detected by T1 weighted imaging;105 lesions were detected by T2 weighted imaging;112 lesions were detected by fluid attenuated inversion recovery;69 lesions were detected by diffusion weighted imaging;6 9 lesions were detected by apparent diffusion coefficient.Six cases underwent CT scanning, and one showed multiple low density while the remaining five cases did not find any abnormalities.No cerebral vascular malformation was found in five cases scanned by MRA.The lesions showed round or oval shape,ranging from 3 mm to 17mm in diameter.Among them,98 lesions were located in the pons,39 in cerebellum,23 in cortex,10 in basal ganglia,6 in thalamus.Conclusion SWI is the sensitive sequence to detect intracranial capillary telangiectasia.SWI could be used as the preferred imaging method for intracranial capillary telangiectasia.

Objective To investigate the clinical applied value of the early slope value of MR contrast-enhancement in differentitating benign from malignant musculoskeletal neoplasms.Methods 48 patients with benign or malignant musculoskeletal masses(26 benign,22 malignant) confirmed by pathology underwent dynamic contrast-enhanced scanning.The largest slope of dynamic enhancement in early stage and SI-Time curve type were gained and the difference of them in benign and malignant musculoskeletal tumours were analysed.Spearman rank correlation analysis was used to determine the relation between slope and microvessel density of tumor tissues.Results There were 3 SI-Time curve types in all cases with typeⅠ(precipitous rise) in 22 cases,type Ⅱ(slow rise) in 21 cases and type Ⅲ(slight rise) in 5 cases.The average early slope value of enhancement was(4.23?2.68)% per second(range 0.96%~10.53%)in malignant tumors,and(1.44?0.99)% per second(range 0.36%~3.76%)in benign tumors.There was an apparent statistical significance between benign and malignant tumors(P

Objective To study the diagnostic value of achilles tendon injury(ATJ) and the diagnostic standards for different severities of the injury by MRI.Methods Twenty-six cases of traumatic ATJ proved both clinically and surgically and had complete MRI materials were selected.The characteristic MRI appearances were summed up and retrospectively compared with that of 10 normal achilles tendons.Results The results were as follows :(1) MRI appearances of 10 normal achilles tendons : regular course,smooth margin,homogenous hypointensity on T_1WI and T_2WI;(2) MRI appearances of 17 partial ATJs:tendon thickening,decreased ratio of wide/vertical diameter,localized hyperintensity in tendon on T_1WI and T_2WI,crude and irregular fibrous bundles but at least keeping one continuous layer on sagital view;(3) MRI appearances of 9 total ATJs: tendon thickened and irregular appearance,totally discontinuous fibrous bundles,"brush" or "pestle" change and mixed hyperintensity on T_1WI and T_2WI;(4) 7 cases with bone contrusion and soft tissue injury,2 cases with ligament injury,2 cases with bone and cartilage injury and 11 cases with fluid collected around tendon.Conclusion MRI can accurately judge thenature,range,degree and complications of ATJ and is of great value for preoperative plan of the treatment program and the postoperativeanalysis of the therapeutic effect.

Objective To explore the improvement of traditional incision in thoracotomy and the application of subaxillary vertical small incision in lung operations. Methods We carried out a retrospective analysis on documents of 680 cases of subaxillary vertical small incision pneumonectomy conducted in this hospital between December 1996 and June 2003. Results The length of incision was 8~13 cm (mean, 11 2 cm). The time for thoracotomy was 4 5~10 min (mean, 6 min) and the operation time was 50~ 170 min (mean, 135 min). The intraoperative blood loss was 100~1200 ml (mean, 350 ml), the postoperative drainage volume was 120~800 ml (mean, 300 ml), and the perioperative blood transfusion, 0~1400 ml (mean, 300 ml). Postoperative pain classification results revealed that 585 cases of grade 1, 60 cases of grade 2 and 35 cases of grade 3 severity were observed. The postoperative hospital stay was 10~21 days (mean, 14 days). No surgical death occurred. Conclusions Subaxillary vertical small incision can be simply made. It offers minimal invasion, less blood loss, mild postoperative pain, quick recovery and good cosmetic results, being a viable option in most operations of pneumonectomy.

Objective To discuss the diagnosis and surgical management of pulmonary sclerosing hemangioma(PSH).Methods Clinical records of 33 cases of PSH(34 lesions) in this hospital from 1987 to 2002 were reviewed.There were 6 male cases and 27 female cases,with a mean age of 41.3 years(range,24~57 years).Twenty-three cases had an initial symptom of bloody sputum,while 10 cases were disclosed by physical examinations.Image findings revealed solitary mass of the lung in all the cases,in 5 of which a "crescent sign" was presented.Results Preoperatively,28 cases were diagnosed as having pulmonary benign tumors(including 5 cases of suspected sclerosing hemangioma),1 case was clarified as having PSH by percutaneous needle aspiration cytology,and 4 cases were misdiagnosed as having lung cancer. All the patients received surgical treatment,including 21 cases of unilateral pulmonary lobectomy,1 case of bilateral lobectomy,5 cases of segmentectomy,4 cases of wedge resection(including 1 case of bilateral thoracoscopic wedge resection),and 2 cases of tumor excision.The operation time was 45~210 min(mean,90 min),and the blood loss was 100~600 ml(mean,230 ml).No peri-operative deaths were encountered.Follow-up surveys in 33 cases for(3~)10 years(mean,5.5 years) found no recurrence.Conclusions In middle-aged women,if the sign of bloody sputum develops,and image findings indicate the solitary mass of the lung,especially with a "crescent sign",a diagnosis of PSH is possible.Percutaneous needle aspiration cytology is helpful to make a confirmative diagnosis in some patients.It is advisable to manage the disease surgically.

Objective To investigate the correlation between middle cerebral artery (MCA) atherosclerotic plaques and single subcortical infarction (SSI) using high-resolution magnetic resonance imaging (HR-MRI).Methods The patients with SSI received HR-MRI examinations at the ipsilateral MCA horizontal segment stenosis from January 2012 to November 2014 were analyzed prospectively.They were divided into proximal SSI (pSSI) and distal SSI (dSSI).The longitudinal and transverse diameters and volume of different types of infarction pattern as well as the degree of luminal stenosis of MCA deep perforating parent artery,plaque distribution,plaque enhancement or not,white matter lesions,and general information of both groups were documented respectively.Results A total of 78 patients with SSI were enrolled,including 40 (51％) in the pSSI group and 38 (49％) in the dSSI group.The proportions of Fazekas scale grade 3 white matter lesions (63.5％vs.40.0％;x2 =4.183,P=0.041) and deep white matter lesions (50.0％ vs.15.0％;x2 =10.961,P =0.001) in the dSSI group were significantly higher than those in the pSSI group.The proportions of MCA plaque in the opening (35.0％ vs.13.2％;x2=3.930,P=0.047),plaque enhancement (87.5％ vs.30.0％;x2 =25.447,P ＜ 0.001) and posterosuperior wall plaques (42.5％ vs.21.4％;x2 =9.491,P ＜ 0.001) and the degree of luminal stenosis (60.38％ ± 10.20％ vs.45.00％ ±6.44％;t =3.625,P =0.031) in the pSSI group were all significantly higher than those in the dSSI group.In addition,the longitudinal and transverse diameters and volume of the infarcts in the pSSI group were significantly larger than those in the dSSI group (all P ＜ 0.001).Multivariate logistic regression analysis showed that MCA enhanced plaques on the lesionipsilateral sides (odds ratio[OR] 11.764,95％ confidence interval[CI] 2.081-66.511;P =0.005) and posterosuperior wall plaques (OR 6.131,95％ CI 1.012-23.339;P =0.037) were independently associated with pSSI,while deep white matter lesions (OR 0.280,95％ CI 0.203-0.648;P=0.012) was independently associated with dSSI.Conclusions The atherosclerotic plaques of MCA deep perforating parent artery are common in both the pSSI group and the dSSI group.pSSI is mainly associated with the location of atherosclerotic plaques of deep perforating parent artery and enhanced plaques,while dSSI is mainly associated with deep perforating artery vasculopathy.

Objective To explore the value of three-dimensional constructive inference in steady state sequence (3D-CISS se-quence)in case of midbrain aqueduct obstruction.Methods 46 cases with midbrain aqueduct obstruction were scanned with FLASH T1 WI、TSE T2 WI and 3D-CISS sequence at 3.0T superconductive MR scanner.The original images of the 3D-CISS sequence were reconstructed.The images of three sequences showing midbrain aqueduct obstruction were observed and analyzed.Results The de-tection rate of the midbrain aqueduct obstruction was 13% 、71.7% and 100% in FLASH T1 WI、TSE T2 WI and 3D-CISS sequence, respectively.The difference between the three sequences were significant (P <0.01 67).Conclusion 3D-CISS sequence shows mid-brain aqueduct obstruction more accurately.

Objective To investigate the imaging findings with pathologic correlation in patients with acquired immune deficiency syndrome(AIDS).Methods Imaging findings,autopsy and pathological data were retrospectively analyzed in eight patients with AIDS.Routine CT scanning of different body parts was performed during their hospitalization.CT scanning was performed from the skull to the pelvis immediately following their death.After routine formalin fixing,7 cardevers were cross sectioned for autopsy in freezing state and 1 for gross autopsy.Tissues were obtained from each sections and organs for pathological examinations.Results The autopsy data showed parasitic infections(5 cases),bacterial infections (3 cases),fungal infections(2 cases),virus infections(2 cases),lymphoma(1 case)and cerebrovascular diseases(1 case)in eight patients with AIDS.The CT scanning demonstrated symmetrical ground glass liked shadows with pulmonary hilus as the center in 5 cases of pulmonary PCP infection; pulmonary patchy shadows,scattering distribution of nodular shadows,extensive military nodular shadows with even distribution and tuberculous pleurisy; cloudy shadows for 2 cases of fungi infection with multiple foci of chronic inflammation;pulmonary net-like parenchymal changes for 2 cases of pulmonary CMV infection;thickened intestinal wall and narrowed intestinal lumen for 1 case of intestinal tumor; low density shadows of brain tissue for 1 case of CMV encephalitis and MRI findings of high T_1 and high T_2 signals as well as MRA findings of broken vascular channels in liquefied areas of brain tissues; patchy low density areas inside a cyst of brain for one case of brain toxoplasmosis infection:multiple small patchy low density areas in cerebral basal ganglia for one case of brain cryptococcus infection.Conclusions In AIDS patients,infection and tumor may occur in various organs resulting in complex symptoms,which makes it more complicated and difficult to make accurate diagnosis.A correlative study of imaging findings and pathological manifestation of AIDS patients at autopsy could be helpful for clinical diagnosis.

Objective:To evaluate the precision of quantitative CT (QCT) in measuring fat content of goose liver and to explore the influence of tube voltage on liver fat measurement.Methods:From January to March 2017, 22 Landes geese were selected to establish fatty liver models with overfeeding. The QCT was performed under 2 different tube voltages, 80 and 120 kV. In addition to the voltage, the other scanning parameters were the same. Three ROI were placed in the centre part of the left lobe, upper and lower half of the right lobe on the 3D reconstructed images. The volume percentage of goose liver fat (Fat% QCT) was calculated according to the formula provided by Mindways. Immediately after the QCT examinations, each goose was dissected, and the whole liver was removed. Then samples were taken in the corresponding areas of the ROI by QCT. The fat (triglyceride) content of the samples was measured by the biochemical extraction method. The Spearman correlation tests were used to determine the correlation between the QCT measurements of 80 kV and 120 kV groups and the results of biochemical extraction method. The Wilcoxon signed-rank test was performed to compare Fat% QCT between 80 kV and 120 kV groups. Bland-Altman plots were used to assess agreement between the two groups′ measurements. Results:The Fat% QCT of both 80 kV and 120 kV group positively correlated highly with biochemical extraction ( r s=0.936, P<0.001, r s=0.927, P<0.001) respectively. No statistically significant difference of Fat% QCT was detected between 80 kV and 120 kV group ( Z=-0.141, P=0.888). Bland-Altman analysis showed a small difference of Fat% QCT between the 80 kV and 120 kV group, in which mean values were 0.20%. Conclusions:Using biochemical extracted triglyceride as the reference, under the conditions of low-dose 80 kV and standard 120 kV tube voltages, QCT measurement of fat content is accurate and reliable in goose liver.