Objective: To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods: Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results: A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78.57%, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P = 0.204), but greater than that of residents (P<0.001). Conclusion: Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.

Objective: To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods: Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results: A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78.57%, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P = 0.204), but greater than that of residents (P<0.001). Conclusion: Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.

Objective To explore the characteristics and applied value of diffusion-weighted MR imaging of kidney in healthy people.Methods Using Philips Gyroscan Intera 1.5T MR System,DWI of kidney was performed in 40 healthy adult volunteers,the ADCs of renal cortex and medulla were measured.Results The cortex and medulla of the normal kidney could be clearly showed by DWI.The ADCs of the cortex medulla and average were 3.08?0.52,2.74?0.68 and 2.91?0.58;2.79?0.51,2.53?0.65 and 2.63?0.62;2.64?0.43,2.32?0.47 and 2.48?0.44 when the b values were 300,500 and 800 s/mm2,respectively.The ADC was higher in the cortex than that in the medulla.Conclusion DWI can be used in kidney,it may be helpful for the diagnosis of renal diseases.

Objective To explore CT diagnostic values of cardiac carcinoma.Methods CT findings of cardiac cancer comfired pathologically in 50 cases were analysed.All case were examined with spiral CT.Results The thickness of gastric cardia wall was found in all 50 cases,soft tissue masses was found in 25 cases,adjacent tissue invasion was found in 18 cases and metastasis of lymph nodes was found in 33 cases.Conclusion CT is a valuable method in demonstrating the size of cardiac carcinoma,its adjacent tissue infiltration and lymph node metastasis.It plays important role in the planning of treatment in clinical practice.

Objective To explore CT and MR manifestations and its diagnostic value of liver cystic lesions.Methods The clinical and imaging data of 78 cases with liver cystic lesions were collected,including 21 cases of inflammatory cystic lesions,30 cases of tumor cystic degeneration and 27 cass of congenital growth cysts.Results The detected rate of liver cystic lesions with CT and MRI was all 100%.For inflammatory cystic lesions,tumor cystic degeneration and growth cyst,CT diagnostic accurate rate was 76%,90% and 93%,respectively,and MR was 83%,93% and 100% respectively.CT and MR manifestations:Of all inflammatory cystic lesions,hepatic abscess and liver echinococcosis cyst appeared as cystic occupying lesion,the cysts were of tension,low-density band on CT or water-like signal intensity on MR around the lesions in hepatic abscesses.Liver echinococcosis cysts were of big cyst with small cyst sign and enhanced moderately in cystic wall post contrast-enhanced scan.The metastasis cystic tumors showed single or multiple cystic lesions and mild or moderate circular enhancement.The primary liver tumor's cystc degenerative lesions showed cyst-solid lesions on CT and MR,and were of enhanced manifestations of the primary tumors.Growth cysts were single or multiple low-density or water-like signal intensity,generally there was not enhanced.Conclusion CT and MR have great diagnostic value for the location and nature of cystic lesions.

Objective To study the procedure of imaging examination for the patients with colon cancer.Methods The comparative study on ultrosonograph, pneumobarium double contrast examination, colonscopy and CT in 82 cases with colon carcinoma comfired by operation and pathalogy were carried out.Results The detective rate of colon cancer was 90.1%,89.5%,53.8% and 53.3% by pneumobarium double contrast examination,colonscopy ultrosonography and CT respectively.The detective rate of metastasis in liver was 100% by ultrosonograph and CT.Conclusion Pneumobarium double contrast examination and colonoscopy are the main methods for diagnosis of colon cancer. Ultrosonography and CT are the important methods in evaluating the stage of colon carcinoma before operation.

Objective To investigate the imaging manifestations, clinical features and treatment of primary aggressive osteoblastoma (PAO)of the calcaneus.Methods The clinical data,imaging findings and treatment of PAO of the calcaneus in a young man retrospectively analyzed with literature review.The lesion was confirmed by pathology one and half years ago,and recurred after operation 10 months follow-up.Results X-ray and CT revealed expansive destruction of right calcaneus with little calcification or ossification,the bone destruction in the medial part of the calcaneus was obvious,the bone cortex was thin and incontinuous,there was no soft tissue mass or periosteal reaction.The talocalcaneal joint was not involved by the tumor.Neither other bones nor the root of Achilles' tendon showed direct tumor invasion or metastasis but neighboring swelling existed.Conclusion There are no significant differences about imaging manifestations, clinical features and laboratory analyses between primary aggressive and benign osteoblastoma of the calcaneus.The accurate diagnosis of PAO is only depending on pathology.The therapeutic effect with pure curettage and bone grafting for the lesion is not fine and tends to recur and malignant change.

Objective To analyze CT morphologic features and pathologic changes of pulmonary sclerosing pneumocytoma (PSP) and to improve preoperative diagnostic accuracy of PSP.Methods The clinical and CT data of 12 cases with PSP (with total 13 lesions)confirmed by surgery and pathology were collected and analyzed retrospectively.All cases performed CT plain scan,9 cases had contrast CT scan.Results 1 1 cases had isolated lesions,and 1 case multiple lesions.The long-axis diameter ranged from 1.10 cm to 8.03 cm, with an average of (3.53±0.78)cm.Of 13 lesions,3 located in left lung (23.1%,1 in the upper lobes,2 in lower lobe),and 10 in right lung (76.9%,2 in upper lobe,2 in the middle lobe and 6 in lower lobe);8 lesions located in the lower lobe (61.5%),and 5 in upper and middle lobe (38.5%).There were center type of 4 lesions (30.8%),and peripheral type of 9 lesions (69.2%);The shapes of 8 lesions wereovoid or similar round (61.5%),irregular type of 1 case (7.7%),shallow lobe of 4 cases (30.8%);Smooth edge of 10 cases (76.9%), burr edge in 3 cases (23.1%).With contrast CT scan,7 cases (53.8%)had vascular welt sign,6 cases (46.2%)had air crescent sign,6 cases (46.2%)had halo sign,and 6 cases (46.2%)had tail sign.3 lesions (23.1%)had scattered spot calcification,and the other lesions had uniform density.The CT value ranged from 28 HU to 47 HU,with the average of 35 HU;Of 9 cases (with 10 lesions)with contrast CT scan,2 lesions had mild enhancement,5 cases had obvious enhancement,and 3 case had non-uniform enhancement.Enhanced CT value was 60-1 10 HU,with the average of 77.2 HU,and with the maximum of 75 HU.Conclusion If the pulmonary nodules or masses in middle-aged females had single round or ovoid shape,with about 3 cm diameters,soft-tissue density,smooth edge,and with obvious enhancement after contrast CT scan,and accompanied by vascular welt sign,air crescent sign,halo sign,or tail sign, the diagnosis of PSP should be considered.

Objective To explore the value of MSCT in diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH). Methods 24 patients with CTEPH and 8 patients with pulmonary hypertension by other causes were collected retrospectively.To analyzed the characteristics of CTPA images in patients with CTEPH,summarized the direct and indirect signs,and to compared with non-CTEPH.Statistical analysis was performed with SPSS1 7.0 software.Results According to the CTPA images,744 arteries of 24 patients with CTEPH were evaluated.The direct sign of CTEPH was mural thrombus firstly,accounted for 55.35% of the involved arteries,and then was followed by holo-obstruction,partial filling defect,central filling defect,irregular vessel wall thickening and eccentricity filling defect.There were narrowed lumens in 35.01%,dilated ones in 0.89% and no changes in 45.24%.The common indirect signs of CTEPH were pulmonary broadening (100%),enlargement of right heart (95.83%),mosaic attenuation,pericardial or pleural effusion,ground-glass opacity,infarction and atelectasis or consolidation in order.All patients had different degrees of pulmonary hypertension,and the most common findings of CTPA were widened pulmonary artery and enlarged right ventricle,and then were followed by enhancement of the inferior vena cava and hepatic vein,the expansion of bronchial artery and abnormal septal position.Conclusion CTPA can show the types and direct or indirect signs of CTEPH clearly.The morphological changes of the heart in CT are not enough to differentiate the CTEPH and non-CTEPH,and the severity of CTEPH is not alone decided by the degree of chronic pulmonary embolism.

Objective To investigate the value of mammography (MAM),ultrasound (US)and MRI in the diagnosis of breast tumors using a Meta-analysis.Methods A systematic search of relevant literatures was done from CNKI,CBM,VIP,EMBASE OvidSP,PubMed and The Cochrane Library databases.Some related literatures about MAM,US and MRI in the diagnosis of breast tumors and the quality was evaluated,and the available information was extracted.The Meta-analysis was then performed by a Meta-disc 1.4 software,and a Review Manager 5.3 software was used to calculate the summary receiver operating characteristic curves and the area under the curve.Results The diagnostic effect of the MAM+US+MRI was significantly higher than that of mammography or ultrasound (P <0.05).The MAM study heterogeneity among sources was affected by whether it based on BI-RADS diagnostic criteria,and US study heterogeneity was affected by average age of patients.However,the MRI heterogeneity between studies displayed by regression analysis was not affected by each covariate.The diagnostic sensitivity and specificity were 76% (95%CI:0.73-0.79)and 72% (95%CI:0.69-0.75)for MAM,85% (95%CI:0.82-0.87)and 70% (95%CI:0.67-0.73)for US,and 95% (95%CI:0.93-0.96)and 72% (95%CI:0.69-0.75)for MRI,respectively.And the area under curve (AUC)of summary receiver operating characteristic (SROC)curve was 82.0%,88.5% or 97.4%, respectively.Moreover,the AUC of combined three methods together was 98.3%.Conclusion The value of MAM,US and MRI in diagnosis of breast tumor is higher,and the highest one exists when the combined three methods together are used.