Objective To investigate CT features of adrenal neoplasms.Methods 9 cases of rare adrenal neoplasms were verified with operation and histology.3 cases were ganglioneuroma,2 cases were neuroblastoma and the remaining four were cyst,neurofibroma,lipoma and mesenchymoma.Results Adrenal cyst,neuroblastoma and lipoma had their obvious CT features.All adrenal ganglioneuroma,neurofibroma and mesenchymoma had low or equivalent density.Ganglioneuroma and neurofibroma had no enhancement but mesenchymoma had slight or moderate enhancement.Conclusion It is difficult or impossible to distinguish these tumors,except cyst,neuroblastoma and lipoma,from non-function adenoma or pheochromocytoma.

Objective To investigate CT findings of atypical pheochromocytoma.Methods 18 cases of atypical pheochromocytoma were verified with operation and pathology.2 cases were extra-adrenal pheochromocytoma,3 cases were bilateral or multiple pheochromocytoma,7 cases were non-function pheochromocytoma and malignant pheochromocytoma were 6 cases.Results All atypical pheochromocytoma showed equivalent density mass with necrosis in CT scanning,calcification was rare.Most of them had strong enhancement in parenchyma.Conclusion (1)Atypical pheochromocytoma has high tendency to malignance.(2)CT has high locational and qualitative rate in diagnosing atypical pheochromocytoma but can not different malignance from benign pheochromocytoma,except the mass has metastatic signs.The diagnosis of non-function pheochromocytoma has to consider biochemical and other examination.

Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) pathway in the protective effect of remifentanil or ischemic preconditioning (IPC) against hepatic ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four male SD rats,weighing 200-250 g,were randomly assigned into 6 group ( n =24 each):sham operation group (group S),I/R group,remifentanil group (group R),IPC group,SB203580 (a specific p38MAPK inhibitor) + remifentanil group (group SB + R),and SB + IPC group.The animals were anesthetized with intraperitoneal 20％ urethane 1 mg/kg.Partial liver ischemia was produced by clamping the hepatic pedicle supplying left lobe and middle lobe for 30 min,followed by 120 min reperfusion.In group R,remifentanil was infused intravenously at 2μg· kg- 1 · min- 1 starting from 30 min before ischemia until the end of reperfusion.In IPC group,the rats were subjected to 3 episodes of 5 min ischemia at 5 min intervals before I/R.SB203580 0.2 mg/kg was injected intravenously at 5 min before remifentanil infusion or IPC in groups SB + R and SB + IPC,and the equal volume of normal saline was given in the other groups.Six rats in each group were selected at 30,60,90 and 120 min of reperfusion and venous blood samples were taken from inferior vena cava for measurement of serum ALT and AST activities and concentrations of TNF-a and 1L-1β.The rats were then sacrificed and liver tissues were taken for microscopic examination and determination of phosphor-p38MAPK expression by Western blot.Results Compared with group S,serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased at each time point (P ＜ 0.05) and pathological injury was aggravated in group I/R.Compared with group I/R,serum AST and ALT activities and serum levels of TNF-a and IL-lβ were significantly decreased and phosphor-p38MAPK expression was up-regulated at 90 min of reperfusion in groups R and IPC ( P ＜ 0.05).The serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased,phosphor-p38MAPK expression was down-regulated at 90 min of reperfusion ( P ＜ 0.05),and pathological injury was aggravated in group SB + R compared with group R,and in group SB + IPC compared with group IPC.Conclusion Activation of p38MAPK pathway and inhibition of inflammatory response may be involved in the mechanism by which remifentanil or IPC reduces the hepatic I/R injury in rats.

Objective To study the clinical applications of SIVP detecting hepatocarcinoma in cirrhosis.Methods 40 cases of cirrhosis combined with hepatocarcinoma diagnosed by operation and pathology were collected.Control group were scaned with conventional technique,experimental group were scaned with SIVP.Results Only 5 cases catched the optimal scan timing in control group,the accuracy of diagnosis in hepatocarcinoma was 70%;All the cases found the optimal scan timing in experimental group,the detectable rate of hepatocarcinoma was 95%.Conclusion SIVP can find out the optimal timing,which greatly improved accuracy of diagnosing hepatocarcinoma in cirrhosis.

Objective To analysis the CT features and differential points of adrenal myelolipoma.Methods The CT and clinical information of 9 adrenal myelolipomas were collected.Results CT diagnosed 8 cases of adrenal myelolipoma except 1 case misdiagnosing as adenoma.All mass measuring 2.8～10.5 cm in diameter with clear edge,low attenuation value of fat and irregular linear shadow of soft tissure might be seen in mass.Conclusion CT is the best examination of diagnosing,which could show the position,component of the mass and organs around it.

Objective To evaluate the clinical efficacy of MRA in the arteries of the pelvis and lower extremity with automatic table movement (MobiTrak).Methods 12 cases suspected of pelvis and lower extremity artery diseases underwent dynamic 3D contrast enhanced MRA and automatic table movement at the same time.Three cases underwent artery angiography,four cases were detected by operation.Results All diseased arteries were well demonstrated.Among them,lower extremity artery occlusion 8,failing vascular grafts 2,artery aneurysms 2.Conclusion Automatic table movement is of value in assessing pelvis and lower extremity artery diseases accurately.And it is a reliable and potential new technique.

Objective To analysis diagnostic CT findings of adrenocortical carcinoma.Methods To collect 13 adrenocortical carcinomas verified by operation and pathology from 1990 to 1999.Results 8 cases were functional tumor and 5 were non-function mass.The diameter of 10 cases was more than 5 centimeters.The density of carcinoma was not equality and necrosis was often be found.The edge of 6 cases were clear and 7 were not clear,3 cases had local invade and metastasis.Conclusion CT can diagnose most of functional adrenocortical carcinoma with clinic syndrome but can not differentiate non-function adrenocortical carcinoma from pheochromocytoma.

Objective To investigate the clinical value of MRI in evaluating the cardiac structures and function of congenital heart diseases.Methods Fifteen cases with surgically proved different types of CHD were examined by the techniques of magnetic resonance imaging ( MRI) and echocardiography (ECG).The results were compared to determine their values in showing the abnormalities of cardiac structures and function.Results In 15 cases,20 malformations were diagnosed correctly by MRI within 24 abnormalities confirmed by operation(20/24),21 by ECG (21/24).MRI was better than ECG in displaying great vascular diseases, while ECG was better in valvular diseases.There was no significant difference between MRI and ECG in examining cardiac function.Conclusion MRI can clearly show the abnormalities of cardiac anatomy and function.

Objective To analysis the CT features in 7cases of rare adrenal interstitial tissue tumors.Methods 7 cases of rare adrenal interstitial tissue tumors were verified with operation and histology.2 cases were cyst and 2 were lipoma,neurofibroma,neurilemoma and mesenchymoma was 1 case,respctively.Results Adrenal cyst and lipoma appered the density of water and fat.neurofibroma and neuriemoma were slightly low density mass,without enhancement.There were cystic lesion in neurilemoma.Mesenchymoma had slight or moderate enhancement.Conclusion It is difficult or impossible to distinguish nuerofibroma,neurilemoma or mesenchymoma from non-function adenoma or pheochromocytoma except adrenal cyst and lipoma.

Objective To evaluate the clinical efficacy of 3D DCE MRA(three dimensional dynamic contrast-enhanced MR angiography)in patients of preoperation of liver transplantion.Methods 8 cases of potential liver transplant recipients suffering from severe liver disease underwent MRI and 3D DCE MRA, accessed the images synthetically. All of them had DUS examination, 4 cases received liver transplantation successfully.Results Satisfactory angiography images were obtained in all cases, the grade Ⅱ～Ⅲ branches of the hepatic artery, the grade Ⅱ～Ⅴ branches of the portal vein and gradeⅡ branches of the hepatic vein could clearly be visualized. Gastric-oesophageal varices were found in 3 cases of cirrhosis, compression and displacment of hepatic artery and portal vein were shown in one case of polycystic liver.Conclusion 3D DCE MRA is an efficiency, noninvasive technique, it offers great help in evaluating pre-operative vasculature of liver transplantation.