Objective To evaluate the clinical value of MSCT in the diagnosis of unexplained aseites.Methods 113 patients with unexplained ascites were retrospectively reviewed by CT、clinical data and continous observation.Results Large ascites in 50 cases(44.3%),moderate amount aseites in 10 cases(8.8%),small ascites in 53 cases(46.9%);Parietal peritoneum changed in 51 cases(45.1%);Mesentery changed in 44 cases(38.9%);Grerter omentum changed in 20 eases(17.7%);Enlargement of lymph nodes in 67 cases(59.3%).Conclusion Malignant tumor was the most common cause of unexplained ascites.MSCT could help in identifying tumors and the tumor lesion,forecast malignant ascites,and had great value in etiology and diagnosis of ascites.

Objective To investigate the MRI features of malignant mesothelioma(MM).Methods MRI data of 18 cases of MM confirmed by pathology were analyzed retrospectively.1 5 cases were malignant pleural mesothelioma,and 3 cases malignant peritone-um mesothelioma.MRI scans were performed in all cases,including MRI plain scan,MRI enhancement and diffusion weighted ima-ging(DWI).We evaluated the location,shape,size,signal,enhancement mode,dispersion characteristics,invasions of surrounding tissues and concomitant changes of MM.Results Among the 15 cases of malignant pleural mesothelioma,14 cases were diffuse type, 1 case was localized type,and 3 cases of malignant peritoneum mesothelioma were all diffuse types.10 of 14 diffuse malignant pleural mesothelioma had a thickening pleural of more than 3 cm,the average thickness was (5.3±3.8)cm,in which soft tissue mass was showed in 6 cases.2 of 3 diffuse malignant peritoneum mesotheliom had a thickening peritoneal of more than 3 cm with soft tissue mass.On T1 WI images,slightly low signal were showed in 7 cases,and equal signal in 1 1 cases.On T2 fat suppression sequence,low signal were showed in 4 cases,slightly high signal in 10 cases and high signal in 4 cases.On DWI,18 cases of MM lesions all showed high signal.On enhanced scan,continuous enhancement were showed in 1 8 cases of MM and the enhancement was the most obvious at 180 s.8 cases with lymph node enlargement (8/18).The diseased lateral thoracic profile was significantly narrowed in 11 cases with malignant pleural mesothelioma,of which 7 cases with chest wall invasion.Conclusion The MRI features of MM have certain char-acteristics,and MRI examination will help to make accurate diagnosis before treatment.

Objective To explore the function of the regional medical image network consultation system in propelling the quality control of regional medical image.Methods Based on the regional medical image network con-sultation system,the unified standard of quality control was implemented to reach the integrated management of the imaging quality control in region.The imaging specialists checked the quality of image and report in real time.In addi-tion,the specialists and inspectors monthly examined the quality of image and report.Subsequently,the unqualified causes were analyzed and the improvement measures were used.Finally,the quality of image and report were continu-ously improved.Results After the homogeneity management was applied for one year,the rates of remaking photos and returning the report were significantly decreased from 10% to 2%,and 12% to 4% respectively.Additionally,the rates of good image and report were significantly increased from 83% to 98%,and 89% to 100% respectively.The objective of good rate ≥90% was excellently achieved.Conclusion Based on the regional medical image network consultation system,the management in quality control of the networking hospitals has been uniform,and the technique of examination and the report format have been consistent.The standardability and accuracy of image examination have been realized.

Objective To explore the clinical value of magnetic resonance imaging( MRI) in the diagnosis and classification of perianal abscess and anal fistula.Methods Eighty patients with suspected perianal abscess and anal fistula were selected in Yuyao People＇s Hospital from May 2016 to December 2017.They were divided into general examination group and MRI group by random number table,with 40 cases in each group. The general examination group underwent ultrasound examination,and the MRI group underwent MRI examination.The detection rate of MRI examination for various types of perianal abscess and anal fistula was analyzed based on the results of operation. Results In the general examination group, the diagnostic accuracy of anal fistula supervisor, anal fistula internal orifice,perianal abscess and anal fistula branch were 65.0% (26/40),70.0% (28/40),57.5% (23/40) and 52.5% (21/40),respectively,which in the MRI group were 92.5% (37/40),77.5% (31/40),87.5% (35/40) and 95.0% (38/40),respectively.There were statistically significant differences in diagnostic accuracy of anal fistula supervisor, perianal abscess and anal fistula branch between the two groups ( χ2 =9.054,7.116,8.865, all P <0.05). The effective rate of operation in the MRI group was 67.5% (27/40),which was significantly higher than that in the general examination group [67.5% (27/40)],the difference was statistically significant(χ2 =9.935,P<0.01). Conclusion Using MRI to diagnose perianal abscess and anal fistula can accurately judge the number,involvement range,specific location and surrounding structure of the abscess and anal fistula,and has important value for clinical treatment and prognosis.

Objective: To evaluate the clinical value of 16-slice spiral CT low dose chest scanning in the diagnosis of pulmonary tuberculosis. Methods: From June 13, 2014 to June 20, 2017, 80 patients with pulmonary tuberculosis in Yuyao People's Hospital were selected in the study.The conventional chest dose(control group) and low dose(observation group) of 16-slice spiral CT were used.The diagnostic accuracy, radiation dose of the two methods, lymph node or vascular space display and image features were observed. Results: The diagnostic accuracy of the two methods had no statistically significant difference (P>0.05). The dose product length, the CT dose index in the observation group were (32.98±2.57) mGycm, (44.29±3.47), respectively, which were significantly lower than those in the control group[(127.66±5.03)mGycm, (44.29±3.47)](t=106.01, 21.05, all P<0.05). The display clarity of lymph nodes or vascular space of the observation group was 90.00%, which of the control group was 92.50%, there was no statistically significant difference between the two groups (P>0.05). The rates of ground glass shadow, burr of the observation group were 29.32%, 31.58%, respectively, which were significantly lower than those of the control group(41.35%, 47.37%), the differences were statistically significant (χ²=4.21, 6.94, all P<0.05). Other signs detection probability are similar between the two groups and had no statistically significant differences (all P>0.05). Conclusion The low dose chest CT scan with 16 rows spiral CT has high clinical value, low radiation dose and high diagnostic accuracy in the diagnosis of pulmonary tuberculosis.

Objective:To compare the clinical value of ultrasonography, multi-slice spiral computed tomography(MSCT) and magnetic resonance cholangiopancreatography(MRCP) in the early diagnosis of cholelithiasis.Methods:The clinical data of 140 patients with suspected cholelithiasis treated in Yuyao People's Hospital from January 2017 to March 2019 were reviewed.All the patients were examined by ultrasonography, MSCT and MRCP.Based on the results of operation, the diagnostic results of ultrasonography, MSCT and MRCP were compared, and the consistency between the diagnostic results was analyzed.Results:Of 140 patients with suspected cholelithiasis, 100 cases were confirmed to be cholelithiasis by operation.The sensitivity, specificity and accuracy of MRCP were 97.00%(97/100), 95.00%(38/40) and 96.43%(135/140), which were higher than those of ultrasonography[87.00% (87/100), 80.00%(32/40), 85.00%(119/140)] and MSCT[89.00%(89/100), 77.50%(31/40) and 85.71%(120/140)](χ 2=6.794, 4.114, 10.854, χ 2=4.916, 5.165, 9.882, all P<0.05). The consistency between MRCP and surgical diagnosis was good, but the consistency between ultrasound, MSCT and surgical diagnosis was moderate. Conclusion:The accuracy of MRCP is better than ultrasound and MSCT in the diagnosis of cholelithiasis, which has good diagnostic value and can reduce the missed diagnosis and misdiagnosis of cholelithiasis.

Objective:To investigate the efficacy of digital subtraction angiography combined with wire guidance versus gastroscopy in enteral nutrition catheterization in patients with special diseases of the upper gastrointestinal tract. Methods:We recruited 120 patients with special diseases of the upper gastrointestinal tract who underwent enteral nutrition catheterization in Yuyao People's Hospital from January 2016 to July 2020. These patients had gastric outlet obstruction ( n = 40), esophageal obstruction ( n = 39), tracheoesophageal fistula and mediastinal-esophageal fistula ( n = 26), or anastomotic fistula or anastomotic stenosis ( n = 15) after esophageal and gastric surgery. They were randomly allocated into the control and study groups ( n = 60/group). The control group was subject to enteral nutrition catheterization under the guidance of gastroscopy. The study group was subject to enteral nutrition catheterization using digital subtraction angiography combined with wire guidance. We compared the success rate of enteral nutrition catheterization, the time to successful enteral nutrition catheterization, changes in vital signs (such as heart rate, respiratory rate, mean arterial pressure, and blood oxygen saturation) after catheterization relative to before catheterization, and the incidence of adverse reactions between the two groups. Results:The success rate of enteral nutrition catheterization was significantly higher in the study group than in the control group (86.67% vs. 65.00%, χ2 = 7.68, P = 0.006). The time to successful enteral nutrition catheterization in the study group was significantly shorter than that in the control group [(28.61 ± 3.37) minutes vs. (39.75 ± 4.61) minutes, t = -8.92, P < 0.001]. During enteral nutrition catheterization, heart rate, respiratory rate, and mean arterial pressure in the control group were significantly increased compared with before enteral nutrition catheterization ( t = 5.07, 6.85, 4.96, all P < 0.001). During enteral nutrition catheterization, the heart rate and respiratory rate were significantly higher in the control group than in the study group ( t = 3.45, 3.29, both P < 0.001). After enteral nutrition catheterization, the incidence of adverse reactions was significantly lower in the study group than in the control group (13.33% vs. 33.33%, χ2 = 6.70, P = 0.010). Conclusion:Digital subtraction angiography combined with wire guidance can increase the success rate of enteral nutrition catheterization in patients with special diseases of the upper gastrointestinal tract, shorten the time to successful enteral nutrition catheterization, increase patient tolerance to catheterization, and reduce adverse reactions.

Objective:To investigate the value of diffusion-weighted imaging (DWI) quantitative parameters with different b values in the diagnosis of prostate cancer and its correlation with prostate cancer diagnosis to determine the optimal b values.Methods:Forty-one patients with pathologically confirmed prostate cancer who were admitted by Yuyao People's Hospital from May 2019 to April 2021 were included in this study. Forty-seven foci were selected to undergo 1.5T MR high-resolution T 2-weighted imaging (T 2WI) and DWI. Four different b values (800, 1 000, 1 500, 2 000 s/mm 2) were applied to DWI. The apparent diffusion coefficient (ADC) values and areas of tumor region were measured on different b-value ADC maps. Tumor signal intensity and area were measured on DWI. The same area in the same layer was selected as the reference area to calculate and analyze the signal intensity. Results:The ADC values of tumor area were 0.93 ± 0.21, 0.87 ± 0.19, 0.76 ± 0.17 and 0.68 ± 0.14 when b values were 800, 1 000, 1 500 and 2 000 s/mm 2, respectively, which were significantly different from the ADC values of the reference area (1.59 ± 0.26, 1.50 ± 0.27, 1.28 ± 0.25, and 1.08 ± 1.84, t = 13.53, 13.08, 11.79, 7.30, all P < 0.01). However, there was no significant difference in the signal intensity ratio (-0.26, -0.27, -0.25, -0.22) on the ADC maps of tumor area under different b values ( P = 0.52). The DWI signal intensities of tumor region were 68.2 ± 19.1, 59.5 ± 18.8, 47.9 ± 17.7, and 50.1 ± 11.5, respectively when b values were 800, 1 000, 1 500, and 2 000 s/mm 2, respectively, which were significantly different from the DWI signal intensities of reference area (49.1 ± 17.7, 38.7 ± 11.3, 25.3 ± 6.9, 19.6 ± 4.5, t = 5.02, 6.50, 9.43, 16.93, all P < 0.01). DWI signal intensity ratio of tumor region at the b value of 800 s/mm 2 was significantly different from that at the b value of 1 000, 1 500 and 2 000 s/mm 2 (0.16 vs. 0.21, 0.30, 0.33, t = 10.84, 23.27, 22.85, all P < 0.01). DWI signal intensity ratio at the b value of 1 000 s/mm 2 was significantly different from that at the b value of 1 500 and 2 000 s/mm 2 ( t = 12.34, 14.10, both P < 0.01). Conclusion:High b-value DWI ( b ≥ 1 500 s/mm 2) has a remarkable advantage in the diagnosis of prostate cancer over low b-value DWI.

Objective To discuss the radiation quality control in county based on regional medical imaging platform. Methods Based on regional medical imaging platform with the combination of PACS technology and telecommunication broadband network, we established the database, unified the radiological image quality standards and the regional medical imaging platform templates of the radiological examination report, built the evaluation standards, objectives, methods and processes of radiological quality, and observed the good rate of image quality and diagnostic report quality, in order to build a county-based radiation quality control system based on regional medical imaging platform. Results The good rate of the image quality and the diagnostic report quality increased and reached the target of examination(≥ 90％). Conclusion Through the regional medical imaging platform, changing the quality control mode of traditional radiation can improve the quality of radiation examination in the region and increase management efficiency and time efficiency.

Objective To investigate the application value of MR SWI and DWI in the diagnosis of liver lesions.Methods 1 300 patients underwent 1.5T MRI scan of liver,no pathology or follow-up examination results of patients with focal liver lesions were excluded,147 patients were included and underwent conventional magnetic resonance(MRI),DWI and SWI.By 2 senior radiologists with double blind method of conventional MRI and MRI combined with DWI and SWI image reading,the feature and enhancement pattern of signal intensity were evaluated.Kappa test was used to evaluate the consistency of the diagnosis of 2 physicians.The pathological examination and comprehensive follow-up results were used as the gold standard.The diagnostic accuracy of the two groups was compared.Results 2 doctors had good consistency in the image diagnosis of the two groups.The Kappa values of conventional MRI and conventional MRI combined with DWI and SWI images were 0.912 and 0.936,respectively.The conventional MRI diagnosed primary hepatocellular carcinoma(HCC) in 40 cases,bile duct cancer cells (ICC) in 13 cases,liver metastasis (HMs) in 14 cases,cavernous hemangioma of the liver (CHL) in 17 cases.The conventional MRI combined with DWI and SWI diagnosed HCC in 50 cases,ICC in 20 cases,HMs in 20 cases,CHL in 24 cases,the differences were statistically significant (x2 =5.660,5.250,5.560,6.640,all P ＜ 0.05).Conclusion Conventional MRI combined with DWI and SWI can provide additional valuable information and improve diagnostic performance for liver lesions.