Objective To analyze the imaging features of solitary focal ground-glass opacity nodules (fGGO)by multi-slice spiral CT(MSCT)reconstruction technique in order to improve the differential diagnosis between benign and malignant fGGO and the diag-nosis of early-stage lung cancer.Methods 50 lesions confirmed by pathology were divided into three groups including preinvasive nodules in 19,invasive adenocarcinoma in 10 and benign ones in 21.All CT images were processed by coronal and sagittal recon-struction,maximum and minimum intensity projection (MIP & minIP)and VR.The relationships between fGGO and bronchus were divided into four types:Type Ⅰ with abruptly obstructed bronchus by the fGGO;Type Ⅱ with penetrated and conical inter-rupted bronchus by the fGGO;Type Ⅲ with normal bronchus;and Type Ⅳ with fGGO neighboring the bronchus.In addition,the relationships between fGGO and vessel were divided into three types:Type Ⅰ with normal vessel in or near the fGGO;Type Ⅱ with taper-like narrowed or interrupted one in fGGO;and Type Ⅲ with obstructed one by the fGGO.The clinical data,lesion type,mar-gin,internal structure (air bronchograms/vacuole sign),adjacent structures (vascular convergence/pleural retraction)and the rela-tionships between lesion and adjacent bronchus or vessel were statistically analyzed.Results No statistical differences between three groups were found in the sex of patient and lesion type.A significant difference was found in the age of patients (P=0.005)with less age in benign group than that in preinvasive or invasive adenocarcinoma group.The margin,internal and adjacent structures of the lesions were significantly different (P<0.05).Among the different types of relationship between fGGO and brochus,type Ⅱand Ⅲ were often seen in the preinvasive and the invasive adenocarcinoma groups (the invasive adenocarcinoma often with type Ⅱ), and the type Ⅲ and Ⅳ were in the benign group (benign nodules only with the type Ⅳ).Among the types of relationship between fGGO and vessel,type Ⅱ was seen commonly in the preinvasive group, type Ⅲ often in the invasive adenocarcinoma group,and type Ⅰ only in the benign group.Conclusion The suggested signs with malignant possibility may include the older age,the lesions with lobulated and/or speculated margin,air bronchograms,vacuole sign,pleural retraction around the lesion,vascular convergence sign,and obstructed or cone-shaped narrowed bronchi or vessels in or near the nodules.Thin-section imaging reconstruction techniques help to fully display these signs.

Minimally invasive treatment with lung volume reduction is the promising future for severe pulmonary emphysema patients. With emerging and improving of new techniques and instruments, it would become an important choice for managing severe emphysema. A comprehensive review is here documented through the corvelative techniques, instruments, new achievements and latest research work.(J Intervent Radiol, 2006,15:53-56)

Objective To investigate the methods of the design of multimedia didactic courseware of network on image diagnosis and its characteristic. Methods Based on the teaching material of “image diagnosis”, the images were collected with computers and scanners, and processed with graphic software, and then the multimedia didactic courseware was designed with Frontpage. Results The design of multimedia didactic courseware of network has been completed. Domain name has been applied. Part of the courseware has been passed to the website. Conclusion Multimedia didactic courseware of network, with bright prospects, is superior in agility of didactic style, in abundance of content, and in timeliness of information.

Objective To discuss the clinical value of three dimensional proton MR spectroscopic imaging( 3D 1HMRSI) in the detection of transition zone(TZ) prorate cancer and evaluate the feasibility of 3D 1HMRSI for determining the aggressiveness of TZ cancer by analyzing its metabolic characteristics.Methods The 3D 1HMRSI data of sixty patients suspected TZ cancer in conventional MR examinations were retrospectively analyzed.The values of (Cho + Cre)/Cit of TZ cancer and benign prostatic hyperplasia (BPH) voxels were recorded and compared using independent sample t' test,and the area under the ROC curve was used to evaluate the diagnostic accuracy.Based on Gleason scores,TZ cancer voxels were divided into three groups,including low-risk ( Gleason score ＜ 7 ),intermediate-risk ( Gleason score =7 ) and highrisk (Gleason score ＞ 7).The values of (Cho + Cre)/Cit were compared among the three groups using Kruskal-Wallis test.The correlation of the value of (Cho + Cre)/Cit and Gleason score was analyzed using rank correlation analysis.Results Among the 60 patients,histopathology confirmed TZ cancer in 25 patients and BPH in 35 patients.The inversion of Cho and Cit peak value with increased ( Cho + Cre)/Cit was detected in 160 out of 177 TZ cancer voxels.Most spectral curves of the 517 BPH voxels were similar with that of normal peripheral zone on 1HMRSI.The mean values of ( Cho + Cre)/Cit of TZ cancer and BPH voxels were 2.17 ± 1.29 and 0.77 ± 0.20,respectively,with significant difference between them( t' =14.38,P ＜ 0.01).Using (Cho + Cre)/Cit for distinguishing TZ cancer,the area under ROC curve was 0.985 (P ＜ 0.01).With the cut-off point 1.08,the sensitivity,specificity and accuracy of TZ cancer diagnosis was 92.7％,94.2％ and 93.8％,respectively.The number of low-risk,intermediate-risk and high-risk TZ cancer voxels were 57,64 and 56 respectively,and the mean values of ( Cho + Cre)/Cit of the three groups were 1.43 ( 1.16-1.87 ),1.66 ( 1.43-2.36 ) and 2.32 ( 1.86-3.30 ) respectively,with significant difference among them ( x2 =36.282,P ＜ 0.01).The value of ( Cho + Cre )/Cit of TZ cancer increased with the increasing of Gleason score with positive correlation ( r =0.555,P ＜ 0.01).Conclusions TZ caner has a different metabolic profile from BPH.The value of ( Cho + Cre)/Cit on 3D 1HMRSI could provide useful information for early detection and differentiation TZ cancer from BPH.Besides these,( Cho +Cre)/Cit is also a valuable imaging marker to evaluate the aggressiveness of TZ cancer.

Objective To evaluate the correlation between low choledochal joint and common bile duct stones(CBDS)by magnetic resonance cholangiopancreatography(MRCP).Methods The clinical data of 129 patients without intrahepatic calculus after cholecystectomy receiving MRCP from March 2008 to August 2009 were retrospectively analyzed.MRCP images and T2WIs were analyzed independently by 2 doctors to classify anatomic variants of cystic duct and calculus.Results CBDS was found in 49 and low insertion of the cystic duct in 31 of the 129 patients(38% vs.24%).For the latter 31 patients, low insertion of the cystic duct with CBDS was found in 17.The analysis showed that low choledochal joint were associated with CBDS(x2 =4.921, P=0.027).Conclusion There is a certain correlation between low insertion of the cystic duct and CBDS.The low insertion of the cystic duct is one of the risk factors for calculus of the common bile duct.

Objective To evaluate the feasibility and clinical significance of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of anatomic variants of the extrahepatic biliary tract. Methods The MRCP images of 535 patients who were admitted to The Second Affiliated Hospital of Suzhou University from March 2008 to March 2009 were retrospectively analyzed by two reviewers independently. The anatomic variants of the extrahepatic biliary tract were evaluated by studying the T2-weighted magnetic resonance images. Results The consistency between the two reviewers in the diagnosis of low choledochal joint, medial cystic duct insertion, aberrant hepatic duct, accessory hepatic duct and other anatomic variants was 98% , 99% , 89% , 90% and 100%, respectively (K = 0.86, 0.93, 0.81, 0.82, 1.00). The extrahepatic biliary system was clearly displayed by MRCP in 500 patients, and anatomic variants were observed in 240 patients, including low choledochal joint in 85, parallel cystic duct in 37, medial cystic duct insertion in 82, aberrant hepatic duct in nine, accessory hepatic duct in 10, choledochal cyst in three and high cystic duct in seven. A total of 259 patients underwent operation, and 168 patients had anatomic variants of the extrahepatic biliary tract. Conclusion MRCP imaging enables the accurate assessment of anatomic variants of the extrahepatic biliary system and avoids bile duct injury.

Objective To study the clinial application value of MR dispersion arthrography in meniscus tear of knee.Methods The conventional MR scans of 24 knee joints in 24 patients who were considered to have meniscus tear were performed and followed by MR dispersion arthrography.All cases were approved by arthroscope or operation.The results of both convention MR scan and MR arthrography were compared with arthroscope and operation.The sensitivity and the specificity of plain MR scan and MR dispersion scan were evaluated respectively.Results The signal intensity in the area of meniscus tear was obiously highen on MR dispersion scan than that of MR plain scan.The sensitivity was improved from 74.2% to 94.3% ,and the specificity improved from 88% to 94.3%.Conclusion MR dispersion scan is superior to convention MR scan in image quality and sensitivity in detecting meniscus tear.

Objective To investigate the MR features of adenomyosis and its diagnostic value.Methods Forty-six patients with suspicious adenomyosis underwent preoperative ultrasound and MR exam.Inversion recovery sequence(IR)T 1-weighted images and turbo spin echo sequence(TSE)including T 1-weighted and T 2-weighted images were adopted.All patients were performed with contrast enhancement.Comparative analysis between MRI findings and pathology results was done. Results The diagnostic specificity,sensitivity and accuracy of MRI was 100%,94.74% and 97.14% respectively.The effect of MRI for diagnosis of adenomyosis was better than that of US significantly.All cases showed enlargement of uterus with regular contour.Diffuse and local thickening of junctional zone or low signal intensity lesion in outer myometrial layer was found on T 2-weighted images,sometimes bright foci observed in lesion on T 2-weighted images or on T 1-weighted images.Conclusion MRI has high value in gualitative diagnosis and localization of adenomyosis.It can be used as an important complementary method to ultrasound.

Objective To analyze the MRI manifestations of meningeal carcinomatosis, and to investigate the value of MRI in diagnosis of meningeal carcinomatosis.Methods The MRI data of 28 cases with proven meningeal carcinomatosis were reviewed retrospectively.Results 11, 8 and 25 cases were detected respectively on pre-contrast T 2WI and T 1WI of SE sequence , and post-contrast T 1WI.According to the manifestations of post-contrast MRI, meningeal carcinomatosis were divided into two types: dura-arachnoid enhancement(7 cases) and pia-subarachnoid space enhancement(18 cases) in accordance with the standard of Meltzer.Conclusion MRI, especially the post-contrast MRI is a reliable modality in diagnosis of meningeal carcinomatosis. Double dosage of contrast medium and thin slice thickness can provide more informations.

Objective To discuss the imaging diagnostic value using seven division for dystopic thymomas in mediastinum. Methods 11 cases of dystopic thymomas proved by biopsy and histopathology were analyzed based on chest radiography, computed tomography (CT) and magnetic resonance imaging (MRI) .Results According to nine division, 3 cases located in left mid-middle and mid-inferior mediastinum, 4 cases in right mid-middle and mid-inferior mediastinum, 4 cases in right ante-middle and ante-inferior mediastinum.While according to seven division,all cases (11) located in ante-inferior mediastinum. Conclusion Seven division of mediastinum is of great value in diagnosing dystopic thymomas and in guiding clinical management.