Objective To review the examination techniques and the current research progress of the magnetic resonance diffusion weighted-imaging (DWI) used in liver. Methods The recent and relevant literatures about the principles and the current study situation of liver DWI were scrutinized and analyzed retrospectively. In addition, the existing problems of liver DWI were discussed. Results DWI could demonstrate the normal and abnormal structure and function through measuring the diffusion motions of water molecule in the liver. With the improving technology and better understanding of diffusion dynamics, DWI has been used for the diagnosis and differential diagnosis for hepatic diseases. Conclusion DWI as a non-invasive examine method, may provide valuable functional information for clinical diagnosis and treatment.

Objective To analyze the status quo of applying diagnosis test in imaging scientific study in China, and to see whether reliable diagnosis can be provided to clinicians for accurate guidance of clinical management. Method We manually looked up diagnosis tests published in 1979～1999 "Chinese Journal of Radiology" that is quite influential in our country. Then we evaluated each of these diagnosis tests according to the International Standards. Results We totally searched 2 888 articles in which only 9% were diagnosis tests. Of these diagnosis tests, only 8.9% applied blind comparison with Gold Standard, 24% calculated sensitivity, specificity and accuracy in the same time. And only 0.5%?6% and 5.7% respectively calculated likelihood ratios, negative predictive value and positive predictive value. Conclusion In China, the quality and quantity of the diagnosis tests applied in the specialty of imaging scientific study is far from meeting the clinical demand. Improving methods of scientific study and carrying on more diagnosis tests of high quality are of important significance to improving the diagnostic level of imaging.

Objective: To investigate the combined examination of plasma levels of troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for predicting the risk of peri-operative cardiovascular events in elder coronary artery disease (CAD) patients with non-cardiac surgery. Methods: A total of 200 patients from (60-82) years of age with elective non-cardiac surgery were enrolled. The patients were divided into 2 groups: CAD group,n=118 and Non-CAD group,n=82. Plasma levels of TnT and NT-proBNP were examined at 1 day before and 2 days after the operation respectively. The cardiovascular events were recorded in both groups and the best cut-off values for TnT and NT-proBNP in risk prediction were evaluated by receiver operating characteristic (ROC) analysis. Results:①CAD group had the higher levels of post-operative TnT and NT-proBNP than pre-operative; both TnT and NT-proBNP levels were higher in CAD group than those in Non-CAD group at the same time points, allP<0.05.②The total cardiovascular events in CAD group was higher than those in non-CAD group (χ2=5.85,P=0.016) and the individual event was similar between 2 groups.③In CAD group, the best cut-off value for pre-operative TnT in predicting peri-operative cardiovascular events was 18.5 ng/L with the sensitivity at 72% and speciifcity at 69.6%; for NT-proBNP was 98.0 pg/ml with the sensitivity at 90.8% and speciifcity at 74.6%.④The patients with the higher level of pre-operative TnT had the increased risk of total cardiovascular events than those with normal TnT (χ2=4.56,P=0.043), and the same as NT-proBNP (χ2=4.08, P=0.036). Likewise, the patients with higher levels of both pre-operative TnT and NT-proBNP had the increased risk of total cardiovascular events than those with normal TnT and NT-proBNP (χ2=13.32,P=0.000). Conclusion:Either plasma levels of TnT or NT-proBNP could be used as the biomarker for predicting the risk of peri-operative cardiovascular events in elder CAD patients with non-cardiac surgery, the combined examination would have the better predictive value.

Carcinosarcoma(CS)of the uterus is a rare class of malignant female pelvic neoplasms.The primary modality of therapy for uterine CS is surgery.Postoperative adjuvant radiation therapy may only improve loco-regional control.Standard adiuvant treatment of uterine CS has shifted from primarily loco-regional radiotherapy to chemotherapy.Potentially more effective adjuvant chemotherapy regimens will be investigated.Chemotherapy can extend life for patients with advanced,persistent,or recurrent uterine CS.However,effect of chemotherapy remains to be further enhanced.

Chronic pancreatitis is a chronic inflammatory disease of the pancreas,whichcan lead to irreversible damage to the morphology and function of the pancreas ultimately.So the early diagnosis and treatment for chronic pancreatitis are very important.And the differentiation between mass-forming chronic pancreatitis and pancreatic cancer is also a difficult problem in clinic.MRI as a noninvasive and nonradiative examination with excellent soft tissue resolution,is very valuable for the diagnosis of chronic pancreatitis.And the combination of functional MRI and conventional MRI is very helpful for the differentiation between pancreatic carcinoma and mass-forming chronic pancreatitis,which is of great significance to the clinical management.The application and progresses of function MRI in the diagnosis and identification of chronic pancrea titis were reviewed in this article.

Objective To explore the feasibility of dual-source CT virtual scan replace conventional scan in the CT peritoneography. Methods Prospective enrolled 29 cases who accepted peritoneal dialysis (PD) treatment and were highly suspected with PD-related complications. The patients were firstly underwent CT conventional in the fasting state by applied the dual-source CT (single energy pattern), and then 2 L dialysate which mixed with contrast medium was infused into peritoneal cavity, and the CT scan was performed again after 30 min (dual-energy pattern). Scaning data were processed by virtual post-processing software to obtain virtual CT scan imaging. Subjective evaluation (including lesions and image quality score) and objective evaluation (including the CT value, noise and signal to noise ratio) were performed on the conventional scan and virtual scan, and recorded the radiation dose. Wilcoxon test was used to analyse the differences of lesions revealing and image quality score of conventional scan imaging and virtual scan imaging, and paired t test was applied to compare the differences of radiation dose and the other quality objective evaluation index. Results There was no significant difference between conventional CT scan and virtual CT scan in the cyst, calcification, calculus, hematoma and catheterization (P>0.05). The image quality score of conventional CT scan and virtual CT scan was 5.0±0.0 and 4.9±0.4, and there was no significant difference (Z=-1.6,P=0.10). There was no statistically significant difference in CT value of muscle, kidney, subcutaneous fat, urine in bladder and intraperitoneal fluid between the two groups (P>0.05), and the CT value of liver in the virtual CT scan was higher than that in the conventional CT scan (P<0.05), but the value of bone in the virtual CT scan was lower than that in the conventional CT (P<0.05). The noise of conventional CT was significant higher than that of invirtual CT, but the SNR was significant lower than virtual CT scan (P<0.05). The effective radiation dose in the conventional CT scan and virtual CT scan were(9.6±1.4)and(15.9±4.9)mSv, and showed significant difference. Furthermore, the effective radiation dose decreased by 39.6%(6.3/15.9). Conclusion Dual-energy CT scan can replace conventional CT scan in the CT peritoneography, which can guarantee the accuracy of diagnosis and reduce radiation dose.

Objective To study the correlation between the CT features of tumor blood supplies and the pathological changes in primary hepatocellular carcinoma (PHCC). Methods Fifty cases with surgically and pathologically proved PHCC underwent spiral CT scanning (plain+dual phase). One research group blindly evaluated the CT films obtained. According to tumor contrast enhancement and signals showed on CT, the patterns of PHCC was divided into 4 types: arterial blood supplying, portal blood supplying, arterial combining with portal blood supplying, and poorly blood supplying. Microscopically, PHCC was respectively classified into grade I to Ⅳ with Edmonson′s standard, and into 4 types (trabecular, pseudoglandular, compact, scirrhous) with WHO histological grading standard. At last, the CT features of tumor blood supplies were correlated with pathologic changes. Results 36(72%) cases were supplied by hepatic arterial blood, 6(12%) by arterial combining with portal blood supplying, 4(8%) by portal, and 4(8%) were poorly blood supplying. The patterns of tumor blood supplies in PHCC correlated with tumor cells differentiation ( P

Objectives The study aims were to analyze the clinical features and to explore the management of intrapancreatic pseudocysts after acute pancreatitis.Methods A retrospective study was conducted on 151 patients who received surgical treatment from Dec,2008 to Feb,2012 after acute pancreatitis.Based on CT/MRI findings and clinical data,there were 17 patients with intrapancreatic pseudocysts (11.3％).The clinical manifestations,diagnoses and treatments for these 17 patients were retrospectively analyzed,and the outcome after operations were followed.Results For the 17 patients,obstructive jaundice was present in 3 patients,pancreatic portal hypertension (PPH) in 7,pseudoaneurysm in 2.All 17 patients underwent operation.The surgical procedures included internal drainage (n=8),external drainage (n=5),distal pancreatic resection with splenectomy (n=3),and local resection (n=1).All patients recovered after the operations.Conclusions Intrapancreatic pseudocysts after acute pancreatitis had a high incidence of local complication.The diagnosis of these pseudocysts was difficult.The treatment should be performed early for those patients who had developed complications.

Objective To probe the value of varied magnetic resonance imaging(MRI) techniques applied in differential diagnosis of tuberculous pyonephrosis from hydronephrosis.Methods Features of MRI,including in T_1WI with/without enhancement,T_2WI,urology MRI and diffusion weighted image(DWI),in seven cases with tuberculous pyonephrosis and 10 cases with hydronephrosis pathologically confirmed were retrospectively analyzed.Results Regular T_1WI and T_2WI could show morphology of the whole kidney,destruction of renal parenchyma and empyema.T_1WI with enhancement could manifest abnormally reinforced walls of pyoid cavity,renal pelvis and calyx and ureter.Urology MRI could show morphology of the whole urinary passage with pathological changes more clearly.Accuracy of these techniques was 84.7%.DWI had the advantage of analyzing diffusion image and ADC map to understand diffusion features of water molecule,and of quantitating ADC value to differentiate tuberculous pyonephrosis from hydronephrosis,with an accuracy of 91.2% combining with DWI and other methods.Conclusion Combined application of varied MRI techniques should be highlighted in differentiation of tuberculous pyonephrosis and hydronephrosis with a higher accuracy of diagnosis.

Objective To investigate the value of magnetic resonance (MR) imaging in the assessment of bile duct complications after cholecystectomy. Methods Fifty patients of having bile duct complications after cholecystectomy underwent MR imaging and had some positive manifestations. The indication for cholecystectomy was symptometic cholelithiasis in all cases. MR imaging was performed with a 1.5 T clinical imager including all of the sequences of: ①T1 weighted imaging (T1WI) was performed in transverse and coronal plane before and after gadolinium enhanced. ②T2 weighted imaging (T2WI) was performed in transverse plane. ③A true fast imaging with steady state precession sequence (True fisp) was performed in coronal plane. ④MR cholangiopancreatography was also obtained. Results The bile duct complications after cholecystectomy including: 22 cases of cholelithiasis, 15 cases of chronic cholangitis with or without bile duct abscess. Bile duct strictures or abruption at the confluence of hepatic and common bile duct in 6 and 3 cases respectively. Tumors of bile duct or pancreas in 9 cases. The other complications after cholecystectomy including bile leak with choleperitonitis and/or biloma and acute pancreatitis.Conclusion MR imaging was a valuable method for the assessment of bile duct complications after cholecystectomy. MR imaging could assess the etiology of bile duct complications. If there were bile duct obstruction, MR imaging could assess the location and the severe of obstruction. For bile duct or pancreatic tumors, MR imaging could assess the areas of tumor infiltration and resection and was helpful to select treatment methods. Before lapatoscopic cholecystectomy, the overall and careful imaging assessment for bile duct and gallbladder and its adjacent hepatic tissue and pancreas so to avoid missing the relative tumors.