The radiologist-technologist integration (RTI)training program involves radiologists′ participation in technologists′ scan and examination training and technologists′ participation in physicians′preparation of reports during their residency training.Based on the investigations in the PLA General Hospital, West China Hospital of Sichuan University, The SecondXiangyaHospitalofCentralSouthUniversity, International Hospital of Peking University, and The First Hospital of Qinhuangdao, the author evaluated the methods of and practice in RTItraining as well as the potential value of RTI and itsfacilitation of work quality.RTItraining has effectively enhanced the basic skills training of the residents, deepened their understanding of the imaging process, and promoted scientific research and clinical work.The RTI training program can cultivate the technologists′ abilities to identify lesions, design individual protocols, and achieve the targeted scan for diagnosis.Meanwhile, itmay contribute to the improvement of human resource management inthe radiology department and overall quality of radiological examinations.

PurposeTo explore the correlation between apparent diffusion coefficient (ADC) value on MR diffusion-weighted imaging (DWI) and prognostic factors in breast invasive ductal carcinomas.Materials and Methods 103 patients with pathology-proven invasive breast ductal carcinomas underwent DWI MR scan using b=1000 s/mm2. The minimum ADC values of the lesions were determined. Histopathological specimens were analyzed for tumor size, lymph node metastasis, pathological grade (traditional prognostic factors) and the expression of prognostic factors including Ki-67, ToPo-IIα, P53 and CyclinD1. The correlations between ADC values and these prognostic factors were evaluated.Results In 103 breast invasive ductal carcinomas, there was no significant relationship between tumor size, lymph node metastasis, pathological grade and mean ADC values (P>0.05). The correlations between mean ADC values and the biological prognostic factors were not significant (P>0.05). However, positive correlations were observed between pathological grade and the expression of Ki-67 as well as ToPo-IIα(P<0.05).Conclusion ADC values cannot serve as a prognostic factor for invasive ductal breast carcinomas. However, the expression of Ki-67 and ToPo-IIα in breast invasive ductal carcinomas may be important in evaluating prognosis of the tumor and guiding clinical therapy.

Objective To investigate the application of proton magnetic resonance spectroscopy (1H-MRS) combined with magenetic resonance imaging (MRI) in detecting biochemical metabolism in children with epilepsy. Methods In 20 cases of epilepsy,6 were intractable epilepsy and 8 normal subjects exprienced MRI and single-voxel 1H-MRS exminations by locating in the amygdaloid-hippocampus The signal intensities of N-acetylaspartate(NAA),creatine+phosphocreatine(Cr),choline-containig compounds(Cho) and the ratios of NAA/Cho+cr,NAA/Cho,and NAA/Cr were set into comparison bilaterally between the patients and controls. Results 15 patients were abnormal in 1H-MRS examination The signal intensity of NAA in MRI abnormal area was obviously lower than that in the contralaterals of focus and the controls,the Cho was higher than in the contralaterals and controls;NAA/Cho+Cr (0 59?0 11) and NAA/Cho (1 08?0 36) were lower than those in contralaterals (0 75?0 17,1 40?0 38)and controls (0 77?0 12,1 29?0 48) NAA,Cho,Cr and ratios of NAA/Cho+Cr,NAA/Cho,NAA/Cr of the left and the right side of controls were not significantly different There are decreases of bilateral NAA and ratio NAA/Cho+Cr in 5 out of the 6 children with intractable epilepsy. Conclusions Signal intensity of NAA and ratio NAA/Cho+Cr,NAA/Cho in children with epilepsy were decreased by 1H-MRS detection These spectral abnormalities may reflect neuronal loss or dysfunction,there are bilateral diffuse abnormalities in the intractable epilepsy 1H-MRS may help understand the underlying pathophysiology in children with epilepsy

Objective To study the restraining capability mechanism of small calibre ileum conduit anastomosed directly to the bladder in pigs. Methods 15 pigs were randomized into 5 groups according to the length of the ileal loop to form the conduit: 4cm, 5cm, 6cm, 7cm, and 8cm. In each pig, two ileal segments of the same length were reduced in calibre by opening up longitudinally and closed around a catheter. They were then directly anastomosed to the bladder end to side and placed within rectus abdominis musche in each pig. Urodynamic test, radiological image analysis and histological study were carried out 8 weeks after the procedure. Results No stenosis and twisting of the ileal ileum conduit were observed in 5cm, 6cm, and 7cm groups, in which they could be catheterized with ease. When the bladder was filled with a mean volume of 400ml of saline, the maximum "urethral" pressure ranged from 5.15～12.19kPa and the maximum close pressure (MCP) ranged from 4.83～11.27kPa. The "urethral functional length" of the ileal conduit was longer than 2cm. Among 5cm, 6cm and 7cm groups, there were no significant differences in maximum closure pressure and the urethral functional length, except in maximum "urethral" pressure. In the 4cm group, there was incontinence. Failure was found in the 8cm group because of necrosis of the ileal loop embedded in the abdominal muscle. Conclusion Small calibre conduits formed with ileum in the length of 5cm to 7cm are able to restrain urinary leakage when anastomosed directly to the bladder and and embedded in the by rectus abdominis in pigs.

Objective To compare the difference of echocardiography and magnetic resonance imaging (MRI) in measurement of cardiac function in patients with dilated cardiomyopathy (DCM).Methods Totally 41 patients with DCM underwent echocardiography and MRI to measure cardiac function,the parameters included left ventricular end-diastolic volume (LVEDV),end systolic volume (LVESV),left ventricular ejection fraction (LVEF) and stroke volume (SV).The vertical long axis (VLA),horizontal long axis (HLA) and short axis (SA) of heart were measured by echocardiography.The differences of echocardiography and MRI were compared by linear regression and linear correlation.Results ①The value of LVEDV and LVESV obtained by the two methods:the value of LVEDV [(262.6 ± 117.0) ml] and LVESV [(196.4 ± 109.8) ml] obtained by MRI were higher than those of echocardiography [(211.4 ± 90.6),(216.5 ± 71.5),(219.1 ± 80.1) ml;(153.3 ± 76.1),(153.9 ± 54.1),(157.0 ± 61.1) ml,all P ＜ 0.05].②The value of SV and LVEF obtained by the two methods:the value of SV[(66.2 ± 21.3) ml] obtained by MRI was higher than that of echocardiography VLA [(58.1 ± 14.4) ml,P ＜ 0.05].The value of LVEF [(25.2 ±7.2)％] obtained by MRI was lower than those of echocardiography HLA and echocardiography SA [(28.9 ± 6.1)％,(28.3 ± 6.1)％,all P ＜ 0.05].③The value of LVEDV and LVESV obtained by echocardiography SA were associated with those obtained by MRI (r =0.785,0.653,all P ＜ 0.05).The value of LVEF obtained by echocardiography VLA was associated with it obtained by MRI (r =0.690,P ＜ 0.05).The value of SV obtained by echocardiography HLA and echocardiography SA were associated with those obtained by MRI (r =0.734,0.701,all P ＜ 0.05).Conclusion There are differences in accuracy and reliability using echocardiography and MRI when measuring dilated cardiomyopathy heart function,which must be treated differently.

Purpose A systematic analysis of the articles published in the Chinese Journal of Medical Imaging from year 2013 to 2015 was performed to investigate its features of acceptance and publication for future decision making.Methods The printed journal and retrieved data from the Chinese Hospital Knowledge Database was analyzed using biometrical index,including the number of the papers,subspecialties,publication types,medical imaging modalities,MeSH frequency,citation and download.Results From year 2013 to 2015,there were 770 papers published,21.4 articles per issue and 0.267 articles per page in average.The top three subspecialty were abdominal imaging,chest imaging and reviews/comments,accounting for 17.27％,9.61％,9.48％,respectively.The top three modalities were CT,ultrasound and MRI,accounting for 39.61％,38.31％,29.87％,respectively.The original research papers were 584,accounting for 75.84％.The frequent MeSH subjects were differential diagnosis,angiography,pathology,computer-assisted image processing and contrast agents.Totally,there were 2395 citations and averagely 3.11 citation for each paper.The top citation was 36.There were 71317 downloads and 92.62 for each paper in average,the top download was 499.Conclusions The publications and its density per page increased annually from 2013 to 2015.The subspecialty were fully covered,the papers focus on original researches and clinical applications.The publication theme could follow the tendency of the imaging technology and had good and steady effects in the field.

Objective To develop a localization strategy for magnetic resonance coronary angiography (MRCA). Methods In 89 subjects, the standard 4-chamber view and long-axis view of left and right ventricle were acquired using Fast-Imaging-Employing-Steady-State-Acquisition (FIESTA) sequence in CINE mode, and the trigger-delay time for mid-diastolic phase was determined. Coronary vessels including right coronary artery (RCA), left main (LM), left anterior descending (LAD), and left circumflex (LCX) were localized and imaged using 3-dimensional fat-suppressed FIESTA sequence during end-expiration. The reproducibility of the localization strategy was evaluated by taking the standard of coronary segmentation system recommended by American Heart Association. Results Eighty-six subjects completed the examination with full respiratory co-operation and the indication ratio was 96.63%. Nine planes were optimized as the standard to target the main branches of coronary arteries, and a comprehensive reproducibility reached 100% in demonstrating the proximal and middle segment of RCA (AHA-18, 19), LM (AHA-1, 2), proximal and middle segment of LAD (AHA-3, 5, 7), and proximal LCX (AHA-10). The reproducibility for the demonstration of distal segments of LAD, LCX, and RCA (AHA-9, 14, 21) was 94.19%, 72.09%, and 96.51%, respectively. Conclusion This is a simple and practical localization strategy for MRCA. It could image the proximal and middle segments of the coronary arteries with good reproducibility, which indicates the potential for clinical application.

Objective To investigate the application of respiratory navigator echo triggered black blood contrast FSE in cardiac MRI. Methods The respiratory navigator echo trigger technique combining with black blood FSE (NAV-FSE) was tested on 11 volunteers and 5 patients in free breathing,using breath-hold FSE (BH-FSE) with the same imaging protocals as control. The imaging efficiency and the image sharpness were compared between NAV-FSE and BH-FSE and t-test was used for the statistics. Results All NAV-FSE acquisitions were completed in sixteen subjects while 4 BH-FSE acquisitions failed because of poor breath holding. The efficiencies of NAV-FSE were (42. 95±11.50)%, (56. 14±11.40)% and (55.25± 14. 70)% when echo train length (ETL) were 24, 16 and 8, respectively. When ETL were 16 and 24, the sharpness of NAV-FSE ( 0. 43±0. 02 vs 0. 36±0. 02 ) and BH-FSE ( 0. 36±0. 03 vs 0. 35±0. 02 ) were statistically different (t =4. 26, 5. 53 ,respectively; P <0. 05). NAV-FSE could have a shorter ETL setting without consideration of breath holding. Conclusion The navigator echo trigger technique could be compatible with black blood contrast FSE to image the heart without the restriction of breath holding and it allows to optimize the parameters to improve the image quality.

PurposeTo investigate a multi-parametric protocol for breast MRI examination and lesions assessment correlated to the American College of Radiology (ACR) breast imaging reporting and data system (BI-RADS) categorization, and to improve the management of the breast lesions.Materials and Methods 301 pathologically confirmed lesions on 278 patients were retrospectively included. The scan protocol used a dynamic contrast enhancement sequence (DCE) of 1 mm×1 mm×1 mm spatial resolution, 120 temporal resolution and a diffusion weighted imaging (DWI) of b=1000 s/mm2. The malignant morphological features on the early-enhanced images, type II or III time intensity curve and the apparent diffusion coefficient (ADC) value less than benign/malignant threshold was equally weighted. Each was given 1 point when present malignant features and treated different on mass and non-mass-like enhancement lesions. When the sum of score was ≥2 points, the lesion was categorized as BI-RADS 5. When the sum of score was 1 point, the lesion was categorized as BI-RADS 4. When the sum of score was <1 point, the lesion was categorized as BI-RADS 3. The other specific benign findings were categorized as BI-RADS 2. No abnormality on DWI, DCE, T2WI and T1WI was categorized as BI-RADS 1. The final categories were correlated to the pathological grades as benign (B), high risk (HR) and malignant (M).Results When grouped HR as malignant (M+HR), the area under curve (AUC) of the ROC was 0.860. When grouped HR as benign (B+HR), the AUC of the ROC was 0.876, and the optimized sensitivity, specificity and accuracy was 85.3%, 86.8% and 85.1%, respectively, which were better than the other grouping. If the management of HR lesions could be lumptoectomy or short-term follow-up, the positive predictive value (PPV) of BI-RADS 5 for excisable lesions (M+HR) was 93.2%, the PPV of BI-RADS 4 for excisable lesions (M+HR) was 46.9% and the biopsy was essential. The PPV of BI-RADS 3 and below for follow-up lesions (B+HR) was 90.4%.Conclusion A simple diagnosis algorithm was established, which equally weighted the DCE morphological feature, DCE-TIC and DWI-ADC. The diagnosis protocol was well consistent with BI-RADS categorization and could predict the benign, high risk and malignant lesions in pathology as well as the proper management.

Objective To evaluate the efficiency of coronary magnetic resonance angiography (CMRA) for stenoses detection by using breath-hold three-dimensional fast imaging employing steady state acquisition (FIESTA) sequence with the reference of conventional coronary catheter angiography. Methods~Consecutive 33 patients accepted CMRA examination within 3 weeks after the catheter angiography. Coronary stenoses was graded in 5 levels as 0%, 0%-25%, 25%-50%, 50%-75%, and 75%-100%, respectively, and CMRA and catheter angiogram were compared segment by segment. Results For the differentiation of the stenoses 50%, the accuracy, sensitivity, and specificity of CMRA was 84.3%, 84.8%, and 84.1%, respectively, and the negative prediction value was 92.3%. The accuracy, sensitivity, and specificity for the differentiation of stenoses between 50%-75% and 75%-100% were all 61.5%. Conclusion The breath-holding three-dimensional FIESTA sequence for CMRA was practical to exclude hemodynamic significant coronary stenoses but limited in detail grading.