Over a 2 year period,53 transbrachial approachs were selectively performed in 42 cases.5～6F catheters were insertend directly over a guide-wire vie a puncture site 1～3cm over the antecubital fossa of left arm,where the artery would be less mobile.Selective cathetenization of the hepatic artery,superior mesenterie artery,infradiaphragmatic artery,renal artery,internalilliac artery,femoral artery and their branches were suessesfully achieved.No significant complications were encountered.This method proved to be a safe,reliable and well-tolerated ahernetive,though the exemination technique was more in demanding.The indications,techniques and complications of the method were discussed.

Objective To evaluate the value of the corticomedullary phase ( CMP ) of CT and MRI scan for the differentiation of the subtypes of renal cell carcinoma ( RCC ) .Methods Ninety six cases of RCC proved by surgery and pathology were performed CMP scan with multislice helical CT and/or 1.5T MRI . The enhancement patterns of CT/MRI were correlated with the subtypes of RCC.Results There were 1 case of sarcomatoid RCC , 78 cases of clear cell RCC , 5 cases of granular cell RCC , 8 cases of mixed cell RCC and 4 case of papillary RCC . The masses were 2 cm to 9 cm in diameter . Sarcomatoid RCC, mixed cell RCC , 97.4% ( 76/78 ) of clear cell RCC and 75.0%(3/4) of papillary RCC showed inhomogenous enhancdment, and granular cell RCC showed homogenous enhancdment. Comparing with renal cortex, 51.3%(40/78) of clear cell RCC and 37.5%(3/8) mixed cell RCC showed hyperdensity or hypertension, sarcomatoid RCC, 44.9%(35/78) of clear cell RCC and 50.0%(4/8) mixed cell RCC showed isodensity or isotension, and all the granular cell RCC and papillary RCC showed hypodensity or hypotension.Conclusion The enhancement pattern in CMP of CT and MRI scan is different among the subtypes of RCC, and could be used for differentiation.

Objective To state and analyze collateral vessels in patients with cirrhosis and portal hypertension with multislice spiral CT (MSCT).Methods 203 cases of cirrhosis and portal hypertension were included in the study and undergone upper abdomen examination with MSCT.Results 612 collateral vessels were demonstrated in this group: lower esophageal varices in 175, paraesophageal varices in 49, including greatly dilated azygos or hemiazygos veins and showing mediastinal pseudotumors in 13, gastric fundic varices in 119, left gastricvarices in 105, gastrorenal shunts in 34, splenorenal shunts in 15, paravertebral varices in 16, reopened umbilical vein in 48, reopenedparaumbilical vein in 22, reopened umbilical vein and paraumbilical vein in 4, abdominal wall varices and caput medusa sigh in 12, portalvein cavernous transformation in 8, greatly dilated right posterior portal vein connecting the inferior vena cava in 4 and left gastric veindirectly connected with the left portal branch in 1. Conclusion MSCT can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension. An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease, and may play a significant role in making a clinical treatment plan.

Objective:To evaluate the value of multi-slice computed tomography(CT) in differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma.Methods: The CT images of 47 patients with renal cell carcinoma(RCC) were reviewed.The RCC patients were divided into 2 groups pathologically,including 37 cases of clear cell RCC and 10 cases of papillary RCC.Plain scan and three phase(corticomedullary,nephrographic and excretory phases) CT were performed in all patients.Age and sex of patients,tumor size,enhancement degree and pattern(homogeneous,heterogeneous and predominantly peripheral),the presence of calcification or cystic degeneration(necrotic or hemorrhagic areas within the tumor) and tumor spreading(including perinephric change,venous invasion and lymphadenopathy) were compared between the 2 subtypes.Results: The degrees of enhancement were significantly different between the 2 subtypes in the corticomedullary,parenchymal and excretory phases(P

Objective To analyze the atypical CT and MRI findings of renal cell carcinoma (RCC) and to discuss how to improve the diagnostic accuracy of RCC using CT and MRI. Methods The data of 100 cases of RCC (71 males and 29 females;age range from 29 to 75 years with a mean of 55 years) were reviewed.The surgical and pathological findings showed clear cell carcinoma in 82 cases,mixed cell carcinoma in 8,granular cell carcinoma in 5,papillary RCC in 4 and sarcomatoid RCC in 1.A total of 101 masses were found.The masses were 0.8 to 9.0 cm (mean,4.3 cm) in greatest dimension. According to the CT and MRI findings of most cases in this group and the relevant information in literature,the typical CT and MRI findings of RCC were summarized. The atypical CT and MRI findings of RCC were analyzed,and correlated with surgical and pathological findings. Results There were 17 cases presenting with atypical CT and MRI findings.The atypical CT and MRI findings of RCC were divided into 4 types:① hypovascular RCC (12 cases,including 3 of clear cell carcinoma, 1 of mixed cell carcinoma, 5 of granular cell carcinoma and 3 of papillary RCC);②cystic RCC (3 cases of clear cell carcinoma);③RCC with volumes of hemorrhage (1 case of papillary RCC);④tumor's diameter less than 1㎝ (1 case of clear cell carcinoma). Conclusions Correct evaluation of the CT/MRI findings of hypovascular and cystic RCC,application of adequate scanning methods and careful interpretation of the imaging films are helpful for improving diagnostic accuracy of RCC.

Objective To study CT findings of gastrointestinal lymphoma.Methods Conventional and enhanced CT data of 25 gastrointestinal lymphoma patients proved pathologically by gastroscope(8 cases),enteroscope(3),operation(5)and lymph node of neck puncture(9) were retrospectively analysed.Results All cases were secondary gastrointestinal lymphoma except one primary located in cardia.CT manifestations of gastric lymphoma included three kinds:(1)Widespread infiltration or multiple type (9 cases);(2)Limited type(3 cases);(3)polypus type(1 case):which had not been found by gastroscope.The CT value range of tumor was 20～42 HU with average of 31.3 HU.Most tumours showed homogeneous contrast enhancement.Enhanced value range of tumor was 15～33 HU with average of 23.5 HU.CT manifestations of intestinal lymphoma included:(1)Multiple nodus type(4 cases);(2)infiltration type(5 cases);(3)mesentery involved type(3 cases);(4)lump type(3 cases).Thickening mural were homogeneous except one showed low attenuation in the center of one extremely thickening wall.Conclusion Gastrointestinal lymphomas have slight to medium enhancement on comtrast-enhanced CT,while the medium enhancement is characteristic finding of this lesion.

Objective To study imaging findings of solitary hepatic biliary hamartoma in adult in order to improve the understanding of this disease.Methods The imaging findings of solitary hepatic biliary hamartoma proved by surgery and pathology in 3 cases were retrospectively analyzed.There were one male and two female,the age was 28,43 and 76 years old respectively.B-ultrasound and CT were performed in three cases and MRI was done in one case.Results The masses ranged in diameter from 2 cm to 4 cm.The lesions were inhomogeneous slightly hypoecho or slightly hyperecho on B-ultrasound,slightly homogeneous or inhomogeneous hypodensity on plain CT scan,slight or medium homogeneous or inhomogeneous enhancement and delayed enhancement on contrast-enhanced CT scan,slight low signal intensity on T1WI and slight high signal intensity on T2WI,and rim enhancement on post-gadolinium images.Conclusion The findings of solitary hepatic biliary hamartoma in the adult are not of characteristics.It may be similar to common hepatic mass,such as metastasis,hepatic abscess and hepatic cavernous hemangioma.

Objective To assess the CT manifestation an d its diagnostic value for renal milk of calcium (RMC). Methods Conventional CT examination was made for 14 patients of RMC and the imag es obtained were analyzed. Results CT clearly displayed the whole view of milky calcium cyst and its "half-moon sign". In 4 cases,th e half-moon high density formed by milk of calcium always located in the lowest part of the lesion with change of the body's position. All the lesions are unil ateral and their average diameter is 2.4 cm. Out of 14 patients, 13 are renal cy st type and 1 hydronephrosis type. Conclusions CT can di splay characteristic changes of RMC more clearly and distinguish it with other d iseases more reliably. CT can definitely discriminate types of RMC and provide more reliable pathologic and anatomic data.