Objective To analyze the X ray findings of enema unreduced (including 4 perforations ) intussusception so as to improve the knowledge about the difficulty of reduction by air enema or the risk of perforation. Methods Of the 552 cases, 506 cases were successfully reduced by air enema. The range of air pressure was 6.67 to 14.67 kPa(60～110 mm Hg). Forty six unreduced cases were cured by operation. The films were taken before and during the reduction period. X ray findings were analyzed compared with that of the operative pathology. Results (1)Abdominal plain films showed total obstruction in 26 cases and asctis in 4 cases; (2) Air enema showed big and lobular masses in 36 cases and the location of masses in distal part of colon in 22 cases; (3)Operation pathology: ileoilecolic intussusception in 35 cases, 15 cases with intestinal necrosis (including 4 perforation cases). In 3 cases, perforations were in the intussusceptum,the other in the intussuscipiens. Conclusion 92% of intussusceptions can be reducted by pressure of air enema. Complex intussusception, with intestinal necrosis and primary intussusceptum, are difficult to reduce, and these patients ought to be operated on time.

nal abnormalities of pediatric heart diseases.

Objective To determine the effects of dose reduction on multi-slice spiral CT(MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images.Methods Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans.Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool.A total of 855 image data sets were obtained for the 57 patients.Original and simulated dose-reduction scan images were analyzed.Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-peint scale and objective noise index.Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices.And the noise index and mean value was calculated.The degree of inter-observer concordance was determined by Kappa statistical analysis.The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed.Results On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively,the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20.2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively.The two radiologists had good intembserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoff ng (K=0.630, P=0.022).There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001).At 40% dose reduction to the standard protocol, the noise index was 2.44 and the image quality score was 3.21 which were considered clinically acceptable.Conclusion The study revealed that acceptable imagos could be obtained with mean noise index of 2.44 and 40% dose reduction.

Objective To evaluate the role of multi-slice computed tomography (MSCT) in the diagnosis of pulmonary sequestration.Methods MSCT scans of 18 cases of pulmonary sequestration proved by surgery and pathology were reviewed.All cases underwent plain and contrast enhanced CT scanning,and retrospective reconstruction was made.Various reconstruction techniques in displaying the pulmonary sequestration and associated malformation were evaluated.Results Anomalous systemic arterial supply was discovered by transverse CT images in 12 cases.The reconstructed images using multiple methods showed the aberrant artery more clearly in all cases,including 6 cases in which the abnormalities were not confirmed by transverse CT.Drainage vein was revealed in 13 cases and lung heteroplasia with other malformation was demonstrated in 14 cases.Volume rendering (VR) reconstruction is the optimal choice for displaying the abnormal vessels and airway.Conclusion Enhanced MSCT with image post-processing can show the abnormal artery and vein of the pulmonary sequestration and the associated malformation,so it is the first choice in diagnosing pulmonary sequestration in pediatric population.

Objective This research is one of the sub-researches of"The comparative study of the standards of interventional therapies and the evaluation of the long-term and middle-term effects for common malignant tumors",which is one of the National Key Technologies R&D Program in the eleventh five-year plan. Based on the project,the authors need to establish an international standard in order to set up the national tumor interventional therapy database and registration system.Methods By using the computing programs of downloading software,self-management and automatic integration,the program was written by the JAVA words.Results The database and registration system for the national tumor interventional therapy Wag successfully set up,and it could complete both the simple and complex inquiries.The software worked well through the initial debugging.Conclusion The national tumor interventional therapy database and registration system can not only precisely teU the popularizing rate of the interventional therapy nationwide,compare the results of different methods,provide the latest news concerning the interventional therapy,subsequently promote the academic exchanges between hospitals,but also help as get the information about the distribution of the interventional physicians,the consuming quantity and variety of the interventional materials,so the medical costs can be reduced.

Objective To explore the imaging features on chest radiograph and CT in children with Influenza A H1N1 pneumonia. Methods The imaging data of chest radiograph and CT in six children with Influenza A H1N1 pneumonia confirmed by real-time RT-PCR assay was retrospectively analysis. All patients had chest radiograph at first examination and 4 of them re-examed. One children took CT. Results All cases showed thick lung markings with varied degrees of pulmonary infiltration and interstitial changes on chest radiograph. Among them, 3 cases showed bilateral pulmonary infiltration and 3 cases showed infiltration in left lung; enlarged hilar was observed in 3 cases. The imaging findings of the pneumonia changed quickly during the follow-up accompanied with the improvement of clinical symptoms. The only one chest CT examination showed bilateral infiltration, multiple ground-glass opacities,small subpleural nodulars, right pleural effusion and lymphadenopathy of lung hila and mediastinum. Conclusions Chest radiograph and CT revealed certain typical imaging features in the children with influenza A H1N1 pneumonia. However, the final diagnosis of influenza A H1N1 pneumonia still should be made based on epidemiology and laboratory examination.

Objective To study the value of chest radiograph and thin-section computed tomography (CT) in diagnosis bronchiolitis obliterans in children, and to determine clinical view of obliterative bronchilitis in children. Methods We identified 12 infants, 10 boys, and 2 girls (age range, 5 month to 11 years) with clinical confirmation of bronchiolitis obliterans. Three cases were after Steven-Johnson syndrome, 8 were post-infection(2 adenovirus, 2 measles and 1 Pseudomonas aeruginosa infection, 3 cases were unknown etiology infection) ; The symptoms lasted for at least 6 weeks. One case had lung ventilation nuclear scan. We evaluated individual bronchscopy, pulmonary function test, chest radiograph and thin-section CT features and their characteristic appearance. Results All cases had typical clinical characteristics and pulmonary function testing results that were consistent with nonreversible small airways obstruction. One case had lung ventilation nuclear scan illustrated absent and reduced ventilation of the right lower lobe. Nine cases who underwent bronchoscopy were chronic endobronchial inflammation. Three children had transbronchial biopsy and 1 patient who underwent open pulmonary biopsies were uncertain of histological diagnosis. Chest radiography showed hyperinflation in 8 cases; peribronchial thickening in 6 cases; consolidation/atelectasia in 6 cases; unilateral hyperlucency of a small/normal-sized lung in 4 cases. Thin-section CT/HRCT features included: mosaic perfusion pattern, decreased lung attenuation in 11 cases, pulmonary vascular attenuation in 10 cases; bronchial dilatation in 7 cases; bronchial wall thickening in 9 cases; unilateral hyperlucency of a small/normal-sized lung in 5 cases; consolidation in 6 cases; nodular in 3 cases; mucoid impaction in 5 cases. Conclusions In our study, correct diagnoses of bronchiolitis obliterans in children were made more special with thin-section CT than with chest radiographs. The diagnosis of BO in children can be based on the characteristic clinical situation, pulmonary function, indicating minimally reversible airways obstruction and characteristic thin-section CT findings.

Objective To study the clinical manifestation,diagnosis,differential diagnosis and the essentials of management and treatment of fibrodysplasia ossificans progressiva (FOP).Methods Three cases of FOP were reported.The features of clinical manifestation and radiography were studied.The literature related to FOP was reviewed.Results FOP affected young children′s age of onset was between 10 days and 2 years (mean age 1 3 years).Mean disease duration was 5 3 years (range 2～11 years),and mean age 5 3 years (range 2～11 years) with sex ratio 1∶2 (boy∶girl).Soft tissue swelling in cervical and dorsal regions with or without local pain and warmth,and low fever were the early clinical manifestations.These nodules usually disappeared spontaneously,but some of nodules gradually developed ossification.The X ray features included ectopiac ossification most frequently in the soft tissue of the upper back and neck,next,the loin,chest and extremities.Two cases showed short hallux and hallux valgus.Exacerbation of the two cases was precipitated after muscle biopsy and careless venepuncture.All patients showed progressive extra articular bony ankylosis of most joints of axial and/or appendicular skeleton with severe movement restriction.Conclusion FOP is a rare and disabling genetic disorder of connective tissue.FOP should be diagnosed as early as possible and non invasively,based upon history,clinical and radiological findings.The finding of abnormalities of the great toe is helpful to diagnose FOP so that management can be early and adequate.Manogement principle includes avoiding conditions potentially provocative of abnormal ossification.The disease should be familiar to pediatricians.

Objective　To introduce the technique of mitral v alve replacements in beating heart, and review the clinical experience in 234 ca ses of operation. Methods　A total of 234 patients of mitral val ve replacement in beating heart with mild hypothermic extracorporeal circulation (30～32 ℃) were reviewed. Results　 The procedures underwe nt fluently and only 2(0.85%) died early postoperatively. No low cardiac output , arrhythmia and cer ebral embolism complications was found. Conclusion　Results sugg ested that mitral valve replacement in beating heart is a safe and available method and is good in extenuating myocardial and pulmonary i njury from ischemia-reperfusion and deep hypothermia.

Objective　To compare the clinical efficiency of intracardiac procedures on traditional cardioplegic arrested-heart and on-pu mp beating-heart for congenital heart disease (CHD) with severe pulmonary hyper tension. Methods　Among all 153 cases, 95 cases underwent operat ions on cardioplegic arrested-heart, while 58 on-pump beating-heart. In arres ted-heart group, 79 cases with ventricular septal defect (VSD), 13 with atria l septal defect (ASD) and 3 with patent ductus arteriosus (PDA) were examined whi le in beating-heart group, 43 cases with VSD, 10 with ASD, and 5 with PDA were examined. Results　There were 12 cases of operative death (12.6%) and 8 of tracheotomy (8.4%) in heart arrested group. No operative death and tracheotomy in beating-heart group. 141 patients were followed up for 3 months to 10 year s with good recovery. There were 2 cases of right heart function failure six yea rs later in arrested-heart group. Conclusion　Results sugges t that on-pump beating-heart technique is superior to traditional cardiopl egic arrested-heart for CHD with severe pulmonary hypertesion. The cause might be t hat on-pump beating-heart intracardiac operation is more effective in cardio pulmon ary protection.