Purpose To summarize the CT features and clinical characteristics of atypical primary fallopian tube cancer (PCFT) and ovarian cystadenocarcinoma (OCA), in order to improved the diagnosis. Materials and Methods CT findings and clinical data of 12 patients with atypical PCFT (PCFT group) and 20 patients with OCA (OCA group) were retrospectively studied. All patients were confirmed by pathology. Serum CA125 level, clinical characteristics and CT features of two groups were compared. Results Serum CA125 level of PCFT group and OCA group were (486.13±23.89) U/ml and (1606.94±62.86) U/ml, respectively. There was statistic difference between the two groups (P<0.01). There was significant differences on vaginal bleeding and vaginal discharge between the two groups (P<0.01). There were 4 cases with solid mass, 8 cases with cystic solid mass in PCFT group. And in OCA group, 16 cases with cystic solid mass and 4 cases with cystic mass were revealed, which showed statistic differences between the two groups (P<0.05). Some other findings also showed statistic differences including the diameter of ovarian vein on the affected side, the diameter of the round ligament of uterus on the affected side, tumor volume, and CT values of the mass in venous phase and delay phase (P<0.05 or P<0.01). However, there were no statistic significance in the size of metastatic lymph nodes, the mean CT value of the mass on plain scan and in the arterial phase (P>0.05). Conclusion Clinical findings of serum CA125 level, vaginal bleeding, and vaginal discharge combine with imaging findings of diameter of the ovarian vein in the affected side, diameter of ipsilateral round ligament of uterus, tumor volume, CT values of the mass in venous and delay phase would be the key points for differential diagnosis of PCFT and OCA.

Objective To observe the effect of piperine (PA) on experimental gallstone formation in the gallbladder of C57BL/6 mice. Methods 3 dietary groups of C57BL/6 with 10 mice each group were allocated as control (normal mice chow),lithogenic (1% cholesterol diet) and PA (1% cholesterol diet + PA 30 mg/kg body weight) group respectively for 4 weeks. The expression of Scp2 gene in liver tissue was measured by RT-PCR and the bile lipid contents was measured chemically,the cholesterol saturation index (CSI) was calculated by Carey’s method. Results Cholesterol crystals and stones were found in 10/10 and 9/10 gallbladders respectively in lithogenic group,but not found in control and PA groups. Comparing with the lithogenic group,the expression of Scp2 gene in liver tissue and CSI in the gallbladder bile were significantly decreased in PA group. Conclusions PA inhibit the experimental gallstone formation induced by high cholesterol feeding in C57BL/6 mice,with simultaneous decreasing of both the Scp2 gene expression in the liver tissue and the CSI value in the gallbladder bile. The further study of the preventive effect of gallstong formation of PA,whether or not related to the above results,is strongly suggested.

Objective To compare the iodine contrast agent dosage,radiation dose and image quality in CT pulmonary angiogra-phy (CTPA)with low tube voltage and high tube current in 64-slice spiral CT.Methods 60 patients with suspected pulmonary em-bolism in our hospital were randomly chosen and divided into three groups:Group Ⅰ:20 patients,using 120 kV,180 mA,contrast dose of 70 mL.Group Ⅱ:20 patients,using 100 kV,280 mA,contrast dose of 50 mL.Group Ⅲ:20 patients,using 80 kV,automat-ic tube current modulation techniques (300-500 mA),comparative dose of 30 mL.CT values and image noise of three pulmonary central areas and a segment branch were measured in each group.Objective indicators,subjective image quality assessment,CT dose index volume (CTDIvol),dose-length product (DLP)and effective absorbed dose (ED)were compared in three groups to evaluate the value of low kV,high mA with low-contrast dose in CTPA.Analysis of variance and t-test was used for data analysis.Results Compared with those of the standard method of CTPA,all pulmonary dry in two groups of low dose were well displayed.There was no statistical significance between each two groups in image quality score (P > 0.05),but was statistical significance in CT values, noise,SNR and CNR (P < 0.01).The CT radiation dose,CTDIvol and DLP of Group Ⅱ and Group Ⅲ were significantly lower than those of Group Ⅰ (P < 0.01).Conclusion Compared with traditional methods,low dose contrast agent injections under 80 kV could reduce the dose of contrast agent and the effect of hardening artifacts due to contrast agent in superior vena cava on right pul-monary artery.It is helpful to reduce the risk of contrast induced nephropathy and reduce patients’exposure to X-ray radiation.

Objective To investigate the radiation dose differences of DTS,DR and CT in diagnostic imaging of the skeletal system and analyze the sensitivity and specificity of each modality in skeletal disease diagnosis.Methods 100 relevant patients with skeletal diseases were randomly selected,who were performed with DR,DTS and CT from Feb 2010 to Mar 2012.They were divided into three groups,respectively as the DR group,the DTS group and the CT group.The complete information including DR,DTS,CT data and the final clinical diagnosis were collected and the statistical analysis after comparing radiation dose of DR,DTS and CT examination.Two experienced experts evaluated the image of three examinations and made judgments.ROC curves of reader A and B were made by using the final clinical diagnosis as gold standard.Results The average absorbed dose and effective dose of DR,DTS,CT group were [(1.9±1.8)mGy,(0.03±0.03) mSv)],[(3.5±1.5)mGy,(0.05±0.02) mSv)],[(397.7 ± 106.0) mGy· cm、(5.60 ± 1.50) mSy] respectively.The difference among the three groups was analyzed by one-way ANOVA test(F =1377,P ＜ 0.05) and had statistically significant(P ＜ 0.05).ROC curve was drawn through analyzing lesion detection credibility of three groups.The Az values of reader A and B was (0.870 ± 0.035,0.966 ± 0.018,0.974 ± 0.015) and (0.852 ± 0.038,0.951 ± 0.021,0.959 ±0.019)respectively.Do the Z-test to these examinations' area under ROC curve of lesion detection credibility.Between DR and DTS or DR and CT,there was statistically significant(P ＜ 0.05).While for CT and DTS,there was not statistically significant.The two readers' sensitivity and specificity in diagnosing skeletal lesion with DR,DTS and CT were investigated using the x2 test:CT and DTS were no statistical significance,CT and DR were statistically significant (x2 =4.833,P ＜ 0.05).Conclusions Radiation dose of DTS only accounts for about 1％ of CT examination.While its sensitivity and specificity can meet the requirements for clinical diagnosis as CT.If the DR diagnosis is unclear or suspected,DTS should be the first recommended modality used for skeletal diagnosis with lower radiation dose.

Objective To evaluate the anatomical and developmental characteristics of inner ears and establish a normalized inner ear multi-slice computed tomography (MSCT)measurement standard.Methods The raw data of 81 normal head MSCT cases were amplified and reconstructed in inner ear areas and multi-plannar reformation (MPR)was used to measure diameters of the inner ears.-test was used to inspect the difference between sides and genders,one-way analysis of variance was adopted for different age groups. Significance level α=0.05,P <0.05 was considered statistically significant.Results There was no statistical significance in measured values of inner ears in different age groups,genders and sides.Not all the shapes of bony semicircular canals were completely circu-lar or elliptical.In lumen,posterior semicircular canal was maximal and superior semicircular canal was minimal.In height,posterior semicircular canal was maximal and lateral semicircular canal was minimal.In width,superior semicircular canal was maximal and lateral semicircular canal was minimal.Conclusion Measurement specifications of inner ear on MSCT are initial established,main structures of inner ear can be clearly displayed by post-processing of head MSCT raw data.

Objective To evaluate the differences in image quality and radiation dose in the neck CTA between low tube voltage scanning method combined with exact calculation of contrast dosage and conventional scanning methods.Methods Ninety patients who had undergone neck CTA examination from October 2012 to June 2013 were prospectively selected to perform study.Patients were randomly divided into Group A,B and C,each with 30 cases.Tube voltage and contrast amount were,respectively,120 kV and 70-80 ml for Group A (conventional group),100 kV and exact calculation for Group B,80 kV and exact calculation for Group C.Using ANOVA test,radiation dose,contrast amount,CNR were statistically analyzed among three groups.Subjective evaluations were made of image quality by two experienced radiologists based on a 5-point system.Results The effective doses in Group B and C were (4.5 ± 0.7) mSv and (2.1 ± 0.4) mSv,respectively,significantly lower than (6.6 ± 0.9) mSv in Group A,with statistically significant difference(F =72.4,P ＜ 0.05).The amounts of contrast were significantly lower in Group B and C than that in Group A,which respectively were (73.2 ± 8.2) ml for Group A and (48.2 ± 5.1) for Group B and (48.6 ± 5.4) ml for Group C,with statistically significant difference (F =56.8,P ＜ 0.05).CNRs increased respectively by 42.2％ in Group B and by 42.2％ in Group C compared with Group A,with statistically significant difference (F =72.6,P ＜ 0.05).Venous artifact images were found in 10 patients of Group A,having different effects on image quality,whereas in Group B and C,there were not vein artifacts to found.Conclusions The low tube voltage (80 kV) scanning method combined with exact calculation of contrast features not only significantly lower radiation dose and lower contrast amount used,but also improved image quality in comparison with conventional method.

Objective To evaluate the feasibility of a low-dose contrast medium protocol for 64-slice CT angiography (CTA) of head using a low-tube-voltage setting.Methods ① Phantom study:64-slice spiral CT respectively sets 80,100,120,140 kV and 100,200,300,400,500 and 600 mA as scanning parameter lines.Analysis of the best Signal-to-noise ratios (SNR) and contrast to noise ratios (CNR).②Clinical study:to prospectively continuous select sixty-six patients with suspected intracranial aneurysm and arteriovenous malformation and so on from April to October of 2012 to perform hand CTA inspection.The random number table method for A,B two groups,33 patients in each group.Group A (conventional group)scanning parameters:120 kV,400 mA and amount of contrast agent:1 ml/kg; Group B(test group) scanning parameters:80 kV,600 mA,amount of contrast agent 0.5 ml/kg.Using independent samples t test for each group radiation dose,SNR,CNR were statistically analyzed.By two experienced radiologists to 5 points on two groups of image quality subjective evaluation.Mann-Whitney U test was used for statistical analysis of subjective evaluation.Results Group A and B group CTDIvol respectively is 59.1,27.5 mGy.Group B than in group A,CTDIvol decreased by 53.5％.A,B groups of the SNR,CNR were 71.5 ± 10.7,92.0 ± 7.4; 58.5 ± 10.5,79.6 ± 7.7,Group B than in group A SNR,CNR were enhanced by 22.3％,26.4％,differences were statistics significance (t =584.0,388.6,P ＜ 0.01).The subjective image evaluation of group B was bigher than group A (Z =31.2,23.4,P ＜ 0.05),differences were statistics significance.Two physicians on CTA images to assess the consistency of uniform height(Kappa =0.904,P ＜0.05).Conclusion In the head CTA examination,use of low tube voltage combined with low contrast dose not only can improve the image quality but also radiation dose were significantly lower.

Objective To investigate the diagnostic value of computed tomography,X ray enterography and digestive endoscopy for intestinal Crohn's disease in active and chronic phase.Methods The clinical data of 39 patients with Crohn's disease who were admitted to the Subei People's Hospital from June 2008 to August 2011 were retrospectively analyzed.All patients were divided into the active phase group (28 patients) and the chronic phase group (11 patients).The results of computed tomography,X ray enterography and digestive endoscopy of the 2 groups were compared.The accuracy of the 3 diagnostic methods was assessed by consulting the operative findings.The enumeration data were analyzed using the chi-square test.Results The incidences of intestinal wall stratification,intesitnal edema strap,severe enhancement,ulcers,intestinal stenosis,intestinal fistula,phlegmon,swollen lymph nodes and comb sign in patients with active phase of Crohn's disease were significantly higher than those with chronic phase of Crohn's disease (x2 =10.700,3.954,22.025,7.661,10.700,7.661,6.810,7.661,4.592,P＜0.05).The incidences of intestinal wall thickening,intramural fat,mild enhancement,unenhancement,inflammatory polyps,abscesses and inflammatory masses in patients with chronic phase of Crohn's disease were significantly higher than those with active phase of Chrohn's disease (x2=17.475,11.345,18.050,5.366,22.856,12.662,5.846,P ＜ 0.05).Computed tomography was effective in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease,but it was difficult in demonstrating ulcers and inflammatory polyps.X ray enterography and digestive endoscopy were effective in detecting ulcers and inflammatory polyps,but they were difficult in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease.Conclusion Computed tomography combined with X ray enterography and digestive endoscopy is helpful in demonstrating the presentations of Crohn's disease in active and chronic phase.

Objective To evaluate the CT features of primary adrenal lymphoma and its relationship with pathology.Methods Pathologically proven primary adrenal lymphoma 6 cases were reviewed.There were 4 males and 2 females.The age was 18-62 years,average age was 51 years.5 cases was single tomur in unilateral,1 case was bilateral disease.The main clinical manifestations were abdominal pain,abdominal discomfort.All patients had CT scan and were treated surgically.Results CT scan showed the characters of adrenal little low-density soft tissue mass:the maximum diameter of 3-11 cm,irregularly shaped or ovalshaped,multi-state a clear,homogeneous or slightly inhomogeneous density,CT value was 30-40 HU.Lesions could be embedded or close to blood vessels and the ipsilateral kidney.The lesions were not enhanced arterial phase enhancement,CT value was 39-50 HU.The lesions showed vein phase of mild to moderate enhancement,CT value was 47-66 HU.At the delay of continuing to strengthen phase,CT value was 60-78 HU.The pathology charaters showed that:Diffuse of tumor cells under light microscope dense,more uniform size,and a large,granular chromatin,tumor stromal components was relatively small.There was no significant bleeding,necrosis and calcification.one lesion showed sheet,tumor cell necrosis.Conclusions CT scan characteristics and pathological features of primary adrenal lymphoma might have a certain correlation.

Objective To compare the efficacy of spectral CT imaging and 64 slice CT in assessment of carotid artery atherosclerotic plaque.Methods Thirty-eight patients with carotid plaque were detected retrospectively in this study (plaque,n=46) by using spectral CT.The composition of atherosclerotic plaque was measured by iodine-based images,lipid-based images with spectral CT imaging.Intraplaque hemorrhae,lipid components were also evaluated on spectral CT imaging and compared with pathology and specimen.Statistical comparison was performed with the Kappa value,independent-sample t test and exact test.Results The degree of carotid artery stenosis was (63.3 ±3.1)％ on spectral CT imaging whereas (61.6 ± 3.8) ％ on 64 slice CT.Two imaging modalities were in good consistency in evaluation of the degree of stenosis (Kappa=0.993,P＜0.01).There was no statistical difference in detecting fibrous cap rupture on spectral CT imaging and 64 slice CT (12 plaques vs 11 plaques,respectively,P＞0.05).Furthermore,spectral CT imaging showed 11 plaques within intraplaque hemorrhage,however,no case was found on 64 slice CT (P＜0.05).The plaque iodine concentration were (6.365 ± 1.937) and (1.573 ±0.776) mg/cm3 with or without internal hemorrhage(t=16.39,P＜0.05).Spectral CT imaging showed 9 plaques within intraplaque liquid whereas only 2 plaques showed intraplaque liquid on 64 slice CT (P＜0.05).Twenty-eight plaques within calcification in the plaque were found on spectrl CT imaging and 27 on 64 slice CT(P＞0.05).Conclusion Spectral CT imaging is a reliable tool in detecting intraplaque hemor-rhage and liquid component.