Objective To study the imagiological features of subtypes of osteosarcoma,and to improve the knowledge of these tumors.Methods X-ray findings of four subtypes of osteosarcoma in 8 cases proved clinically and pathologically were analysed retrospectively with review of literatare.Results 3 telangiectatic osteosarcomas localized in the upper end of femoral,the lower end of femoral and the lower end of humerus respectively,the fingings of X-ray were expansive and dissolved osseous destruction with soft tissue mass,aneurymal bone cyst-like in one case.3 parosteal osteosarcomas localized in the scapula,middler and lower end of femoral respectively,X-ray fingings appeared as condensans mass projected in soft tissue with radiolucent zone between cortiex of bone.One periosteal osteosarcoma localized in the lower end of femoral,CT showed osseous slight destruction with soft tissue mass.1 intrasseous well-differentiated osteosarcoma localized in the lower end of humerus,X-ray fingings included cystoid destruction,expansion in medullary cavity of bone and thin corter of bone.Conclusion Four subypes of osteosarcoma have ditinct roentgenographic features respectively,which is helpful for diagnosis.

Objective To investigate the characteristic clincal and X-ray findings of mycetoma and to enhance the undestanding of mycetoma. Methods The clinical and X-ray findings of mycetoma in 18 cases were analyzed with the review of literatures. There were 11 males and 7 females, the age ranged from 21-65 years, with the average of 41.5 year. The cases were all peasants, barefoot and with the history of trauma, which lasted for 4-17 years with the aveage of 9.8 year. Results Sixty-seven lesions of bone in 18 cases (30 metatarsal, 20 cuneiform, 7 cuboid, 5 phalanx, 3 tibia, 2 calcaneu) were presented, including 8 rodent, 3 osteolytic, 3 cystic, 2 rodent and sclerosis changes, 2 sclerosis, 9 irregular thickened bony cortex, 7 irregular deleted bony cortex, 12 periosteal reaction, 3 irregular crest of bone in lesion, 13 rarefaction of bone cortex, 11 swimmy of surface arthroses, 8 constriction of interval arthroses, 2 spot calcification in the soft tissue, 2 sequestrum, and 2 soft tissue mass. The mycelium had been discovered in grain in 18 cases and the colour of grain was from brown to black. Conclusion Mycetoma involves extensively and tends to involve multiple bones. The main X-ray findings are rodent and osteolytic changes.

Objective To investigate the clinical and X-ray characteristic findings of the cystic and expansive bone metastasis.Methods The clinical and X-ray findings of the cystic and expansive bone metastasis in 35 cases were analysed with the literaturereviewed.There were 21 males and 14 females,the age ranged from 35 to 70 years with average of 52 years.Results The bone metastasis was found 1~10 years after primary tumor diagnosed in 29 cases befor primary tumor diagnosed in 5 cases and the primary tumor did not know in one case.The primary neoplasmes included nasopharyngeal carcinoma in 10,lung carcinoma in 9,renal carcinoma in 5,breastcarcinoma in 4,thyroid carcinoma in 3,hepatic carcinoma,prostatic carcinoma,esophageal carcinoma and primary focus unknown in onerespectively.The metastatic lesions localized in the long bone in 20 cases,ribs in 4,pelvis in 4,vertebrae body in 2,scopula in 2,clavicle,metacarpal and skull in one respectively.There were 16 cystic destruction,9 expansive destruction,10 both cystic and expansive.The marginated lesions were in 27 and 8 unclear in outline of lesion was in 8.There were distruction in the bony cortex with soft tissue in 7,and sclerosis in outline of lesion in 11 and bone crest and spot clacification inside the lesions in 6.Conclusion The time of metastases occured of cystic and expansive bone metastases is depended on the differentiating degree of primary tumor cell its developmental speed.

Objective To study the CT appearances of solitary fibrous tumors of pleura,in order to improve the knowledge of this diseases.Methods CT findings of solitary fibrous tumors of the pleura proved by pathology in 6 cases were retrospectively analysed with literatures review.Results 6 cases of solitary fibrous tumors of the pleura were all seen in the right thoracic cavity.The tumor was about 3 cm in maximum diameter in one case,and the other 5 cases,the tumors were over 9 cm in maximum diameter.On plain CT scans,all tumors were smooth at edge and with wide base connected to the pleura,the density of tumors were homogeneous in 4 cases,the CT values were 28~39 HU,in the other 2 cases,the tumors were unhomogeneous slightly with low density inside the tumors,CT value of the tumors were 12~40 HU.On contrast-enhanced CT scans in 4 cases,3 tumors showed moderated enhancement and distort vessels could be seen,the CT value were 44~52 HU,the lesions enhanced increasing 12 HU,1 case was obviously unhomogeneous enhancement,the lesions enhanced increasing 22~50 HU and "Pseudo-capsules" were demonstrated in 3 cases.Conclusion Solitary fibrous tumors of the pleura has certain CT characteristics.

Objective To analyse CT features of cystic expansile lesions of the jaw.Methods CT features of 23 cystic expansile lesions of the jaw in 22 patients were retrospectively studied,the configuration and structure of the lesions were observed.Results There were ondontogenic cysts(n=11)including radicular cyst(n=3),dentigerous cyst(n=4)and keratotic cyst(n=5),ameloblastomas(n=6),ondontogenic adenomatoid tumor(n=1),cemento-ossifying fibroma(n=2)and firbrous dysplasia(n=2).The ondontogenic cysts were mainly unilocular in shape with distinct sclerosing margin,most of them contained teeth.Ameloblastomas mainly appeared as multilocular or lobulated in shape and markedly expanded growth with disruption of the adjacent cortex;cemento-ossifying fibroma and fibrous dysplasia were mainly solid tumors,ossifying fibromas often associated with calcification.Conclusion Plain CT scan is of important value in diagnosing cystic expansile lesions of the jaw preoperatively.

Objective To study the CT features of the sero-hepatic type of hepatic tuberculosis.Methods This is a retrospective,multi-center and cross-sectional study.17 patients with the sero-hepatic type of hepatic tuberculosis from the Yueqing People' s Hospital (n =5),Second Affiliated Hospital of Wenzhou Medical College (n =5),and Wenzhou People's Hospital (n =7) were studied.All these patients were fasted for 8 h prior to CT scanning.They underwent enhanced after conventional CT breathless scanning with no abdominal pressure.Results The CT scans displayed 41 lesions in these 17 patients with the sero-hepatic type of hepatic tuberculosis,including a solitary lesion in 13 patients and multiple lesions in 4 patients.The diameter of the lesions varied from 0.8 to 4.7 cm,with a mean ± S.D.of 2.38 ± 4.82 cm.The CT features showed a localized spindle-shaped focal lesion just underneath the liver capsule with resultant concave compression of the adjacent liver tissue (n =22),spotted calcifications in the center of the focal nodules (n =1);and aggregation of multiple low density nodular foci (n =19).Additional CT features included focal nodules surrounded by a small amount of liquid (n =15),compression of adjacent liver tissue (n =22),a small amount of ascites (n =8),and retroperitoneal lymph nodes enlargement (n =2).These nodules showed moderate (n =5) and slight enhancement in the arterial phase (n =36);moderate (n =32) and mild enhancement in the portal venous phase (n =9);and moderate (n =32) and mild enhancement in the parenchymal phase (n =9),respectively.The nodules showed ring-shaped (n =26),honeycomb or multiple ring-shaped enhancement (n =15).The enhanced ring-shaped wall thickness varied from 0.2 to 0.9 cm,with a thin wall (n =30) and a thick wall (n =11).The center of the focal nodule was a low density sac-shaped area,with no obvious contrast enhancement.The CT value was 21 to 39 hu.The infiltrative liver tissues which surrounded the focal nodules were shown as lamellar areas of obvious arterial enhancement,with equidensity in the portal vein phase and equilibrium phase.Conclusions CT showed characteristic features of the sero-hepatic type of hepatic tuberculosis.Clinical and laboratory findings could provide important supplementary information to make the diagnosis.

Objective To study the CT findings of traumatic bone cyst and to improve the knowledge of that disease.Methods CT features of 8 cases of traumatic bone cyst confirmed by clinical and pathology were reviewed retrospectively.There were 4 females and 4 males,from 26 to 76 years (the median age was 53 years old)of age.Three patients had traffic accidents,2 patients had trauma unrelated,1 patient had boulder crushing,1 had patient stick wounded and 1 patient had high jump wounding.The bone cyst occurred from 18 to 36 months after trauma(2 at 18 months,4 at 24 months,1 at 30 months and 1 case at 36 months).Results There were 6 fractures,1 joint dislocation and 1 frontal soft tissue hematoma in trauma.The cyst located in the ilium of 3 cases,in the calcaneus of 2 cases,in the frontal bone of 1 case,in the hooked bone of 1 case,in the lunate bone of 1 case.The cyst size was 2.0 cm × 2.6 cm to 3.0 cm × 6.0 cm (average 2.7 cm × 4.0 cm).8 cases all single capsule change,all clear boundaries.6 cystic destruction and 2 cystic expansion destruction of bone.Two see separated and 6 no divider of the cyst region.Five bone sclerosis and 3 no hardening of the cyst edge.Three sclerosis and Five no sclerosis of the adjacent bone.Four osteoporosis decalcification and 4 no osteoporosis decalcification of he adjacent bone.Conclusion The traumatic bone cyst is closely related to trauma,CT manifestations with certain characteristics,combined with a history of trauma can make a definite diagnosis.

Objective To study the radiological features of dynamic enhanced multi-slice spiral CT (MSCT) and CTA in pure hepatic arterio-venous fistula (AVF).Methods The radiological features of MSCT imaging and CTA of 100 patients with pure hepatic AVF were retrospectively analyzed.Results Positive signs on the arterial phase were detected in 100 patients with pure hepatic AVF.In 89 patients,they were the peripheral type and in 11 patients they were the central type.There were 128 lesions in the 100 patients.In the peripheral type,the features were (1) in the arterial phase,the lesions appeared as a wedged or a patchy enhancement area at the edge of the liver,showing a halo sign in 68 patients.In 56 patients,the PV was shown also in the early arterial phase;(2) in the arterial phase,arailway track sign was shown in 21 patients as a result of a portal vein branch showing right next to a hepatic arterial branch.In the central type and in the arterial phase,the main portal vein (or the hepatic vein) and the left/right branches of the PV (or the HV) were shown.Conclusion MSCT and CTA were useful in the diagnosis of pure hepatic AVF.

Objective To investigate the CT features of primary hepatic neuroendocrine carcinoma (PHNEC).Methods The CT findings of 8 patients with PHNEC which was confirmed by surgery and histopathology were analyzed retrospectively.Tumor location,size,shape,margin,density,enhancement patterns and degree,portal vein tumor thrombus,hilar and retroperitoneal lymph node enlargement were studied retrospectively.Results Of 8 patients,there were 5 tumors which were located in the right liver,1 in the left liver,and the remaining 2 in both the left and right livers.The CT value of the mass on plain scanning ranged from 20 to 35 HU.The mean value of CT was (29.6 ± 8.4) HU.Tumors showed low density in 5 patients and slightly lower density in 3.In 5 tumors the boundary was clear and in 3 it was not clear.Uneven mass density and different sizes of necrotic cysts were found in 8 tumors.In one of these tumors,the inside showed honey-comb appearance while small areas of haemorrhage were found in the tumor of another 2 patients.For all the eight patients,there were dilatation of peripheral bile ducts,portal vein tumor thrombus,enlarged lymph nodes or peritoneal effusion in hepatic portal area and peritoneal cavity.In the arterial phase,there was mild to moderate enhancement of the mass with CT value of 38 ～ 65 HU.The average value of CT was (54.8 ± 6.9) HU.In the venous phase,there was mild to moderate continuous enhancement of liver parenchyma,with CT value of 40 ～67 HU.The average value of CT was (61.4 ± 11.6) HU.In the delay phase,a substantial part of the mass was continuously enhanced in 2 patients while there was slow fading of enhancement in 6 patients.The CT value were 36 ～ 57 HU,the average value of CT was (46.6 ± 9.2) HU.In 3 patients,the separations inside the tumor showed enhancement.Conclusion CT features combined with clinical findings might give a hint to the diagnosis of primary neuroendocrine carcinoma of liver.

Objective To investigate the MRI characteristics of low grade fibromyxoid sarcoma (LGFMS).Methods The MRI imaging of 13 cases with operation and pathology proven low grade fibromyxoid sarcoma were retrospectively analyzed.Comparative study of the relationship between the signal,boundary,cystic,and the enhancement degree with tumor tissue components was performed.Results The tumors were located in thigh (n=7),lower leg (n=3),elbow,shoulder and upper arm (n=l for each).The average diameter of tumor was (7.01 ±2.89) cm (range from 2.5 to 12.0 cm).The tumors with maximal diameter larger than 5 cm were seen in 11 patients.All tumors had well-defined margin.Necrosis and cystic change was seen in 5 tumors,tumor compartment in 3 cases,intratumoral fluid fluid level in 2 cases,and peritumoral edema in 3 cases.T1WI showed hypointensity in 6 cases,iso-,hopointensity in 4 cases,isointensity with slightly hyperintensity in tumor center in 4 cases,heterogeneous intensity in 1 case.T2WI showed hyperintensity in 6 cases,central higher intensity in 4 cases,hyper-,iso-,hypo-intensity in 4 cases,and hyper-,hypo-intensity in 3 cases.T2WI with fat suppression sequence showed hyper-,iso-,hypo-intensity in 8 cases and high intensity solid part and much higher intensity in tumor center in 5 cases.Heterogeneous enhancement of the tumors was noted,including mild enhancement in 8 cases,moderate enhancement in 4 cases,and marked enhancement in one case.Pathological results showed that the tumors were gray and white or yellow,well-defined,and hard texture,in which 5 cases cystic degeneration with tremelloid material can be seen in 5 cases.Microscopy results showed alternating distribution of fibrous and myxoid areas.Nine cases had rosettes formation and characteristic arcuate vessels were seen in 2 tumors.Immunohistochemical results showed negative Vimentin,Desmin,and S-100 in 5 patients,while 3 patients were positive for SMA and CD34.Conclusions LGFMS has some characteristic MRI finding.Combination of MRI and the clinical findings can suggest the diagnosis of LGFMS,however,the final diagnosis depends on pathological examination.