Objective To evalute the value of spiral CT in diagnosis and treatment of chronic suppurative otitis media.Methods Sixty-five cases including seventy-nine ears underwent the direct axial plane and coronal multiplanar reformation and three-dimensional reconstruction of auditory ossicular chain in chronic suppurative otitis media spiral CT imaging of temporal bone. Results The direct axial plane and coronal multiplanar reformation in diagnosing of the chronic suppurativeotitis media were correspondent,but in showing of the most middle ear structure were difference. Three-dimensional images was superior to axial and coronal MPR images in showing of the change of malleus and incus,the contrary situation in showing stapes. Only 3D image may not select application for definition.The rate of agreement between spiral CT diagnosis by combination of three different imaging methods and definition of chronic suppurative otitis media and operative findings(89.9%～97.5%) were higher, false positive rate(2.9%～6.0%) and false negative rate(0～14.6%) of the CT diagnosis were lower.Conclusion Combination of three different imaging methods(axial images, coronal MPR images and three-dimensional images of the ossicular chain) can improve the value of the spiral CT diagnosis and therapy of chronic otitis media.

Objective To explore a reasonable,accuracy and effectual proposition model for medical imaging examination.Methods Mean scores and their standard deviation and distribution as well as the difficulty,discrimination,reliability and validity of the test paper were analyzed for the 2005 grade 7-year program students by using SPSS 13.0 statistic software.Results The scores of the 67 copies of test paper displayed a normal distribution,with the mean score of 73.76 and standard deviation of 11.88.The difficulty,reliability and validity indexes of the test paper were 0.74,0.78 and 0.25 respectively.The difficulty,discrimination,reliability and validity indexes of subjective items were higher than those of objective items(0.76 vs.0.73,0.94 vs.0.90,0.71 vs.0.68,0.32 vs.0.22,respectively).Conclusions We should keep quite high proportion of subjective items and make detailed scoring standard in medical imaging examination.Furthermore,as a supplement,objectively items such as multiple choice questions can expand the scope of knowledge examined.

Objective To analyze the mammographic features of invasive lobular carcinoma (ILC)compared to those of invasive ductal carcinoma (IDC).Methods Twenty cases with ILC and 95 cases with IDC were retrospectively evaluated by two breast radi-ologists according to the Breast Imaging Reporting and Data System (BI-RADS)lexicon.The mammographic findings were com-pared between ILC and IDC with the independent samples chi-square test or Fisher’s exact test,as appropriate.Results Mass was the most common finding in both ILCs and IDCs,but less frequent in ILCs (36.4% vs 63.9%,P =0.008).Mass in ILCs was more frequently lobular or irregular shape with spiculated margin.Architectural distortion and focal asymmetry were more frequent in ILCs than in IDCs,however,the differences were no significant.The frequency of calcifications was not significantly different between the two groups.The distributions of calcifications were more regional in ILCs,and more segmental or linear in IDCs (P =0.01).Conclu-sion ILCs are more usually shown as non-mass appearances on mammography.ILCs that appeared as mass are more frequently ir-regular in shape with spiculated margins.

Objective To evaluate the value of diffusion.weighted imaging(DWI)in the differential diagnosis of benign and malignant breast lesions with Meta.analysis.Methods English and Chinese articles published from 1997 to 2007 were searched in Cochrane library,Pubmed,Ovid.Elsevier.Springer databases and Chinese National Knowledge Infrastructure(CNKI),and selected according to the criteria for diagnostic research recommended by Cochrane Method Group.The characteristics of selected articles including the study background,design,results and diagnostic indicators were analyzed.Statistical analysis was performed with Meta-test version 0.9.Results Six articles were included with a total of 479 lesions.The sensitivity and specificity of DWI for breast 1esions ranged from 64.0% to 92.8% and from 45.8% to 96.7% respectively. All groups had homogeneity.and a fixation effects regression Was developed.The pooled weighted sensitivity and specificity with 95% CI and Az Was 86%(76%-92%).80%(61%-91%)and 92.19% respectively.Sensitivity analysis demonstrated no remarkable change on heterogeneity.Condnsion The value of ADC in DWI can help to differentiate the benign breast lesions from the malignant with good sensitivity and specificity.The further study is needed to assess the clinical aplication of the b-value and diagnostic threshold.

Objective To investigate the diagnostic value of MR fast scanning techniques in fetal congenital diaphragmatic hernia. Methods 12 cases diagnosed or suspected fetal congenital diaphragmatic hernia by ultrasound with gestational age (>20 weeks) were underwent MR examination.The fast scan sequences were as follows:Half-Fourier acquisition single-shot fast spinecho se-quence(HASTE)、True fast imaging steady-state precession sequence (True FISP)、Turbo FLASH T1 WI sequence.The axial,co-ronal and sagittal scanning were focused on fetal head and body.The results of prenatal MR examination was compared with neonatal surgical findings or autopsy results after inducing labor.Results All of 12 cases,9 cases were left diaphragmatic hernia,2 cases were right diaphragmatic hernia and 1 case was hiatal hernia.2 cases of them were complicated with other congenital malformations. The features of MRI were as follows:Some portions of bowels and stomach crossed into the thorax were visible in the HASTE and TRUE FISP sequence.The herniated stomach and bowels showed high or scattered high signals.The intestinal types were visible as well.The lung tissue intruded at the apex of the lung and the heart deviated to the opposite side were demonstrated.T1 weighted im-ages obtained from ultra-fast FLASH (Turbo FLASH)T1WI sequence showed characteristic high signals in the meconium,which delineated clearly the shape of the colon and small intestine.The prenatal MRI results of all cases were consistent with surgical (10 cases)and autopsy (2 cases)findings.Conclusion MR fast scanning techniques can clearly show fetal congenital diaphragmatic her-nia.Multiple sequences scanning can comprehensively map the organizational structure and anatomical relationship of fetal congenital diaphragmatic hernia with the surrounding tissues.MR fast scanning techniques play an important role in the diagnosis of fetal con-genital diaphragmatic hernia.

Objective Magnetic resonance diffusion tensor imaging (DTI) was applied to study the cantral auditong pathway in patients with .Methods A total of 30 cases of acquired hearing loss patients were divided into 2 groups ,group 1 (15 ,sudden deafness) and group 2 (15 ,with duration up to 2 years SNHL group from the time of onset) .A total of 15 cases of normal-hearing patients on MRI examination were selected as the control group for the same period .All subjects received DTI of whole brain .The values of the whole brain DTI were obtained from the inferior colliculus and lateral lemniscus ,consisting of the fractional anisotropy (FA) ,radial diffusion (RD) ,axi‐al dispersion (AD) and mean diffusivity .Results There were significant differences(P<0 .05) in FA of bilateral in‐ferior colliculus among sudden deafness group ,SNHL of 2 -year -history group and the control group by ANO‐VA .FA of inferior colliculus in the control group was higher than that of in the SNHL group ,but lower than that of in the sudden deafness group .RD of lateral lemniscus in the SNHL group was higher than that of in the sudden deafness group(P<0 .05) ,MD of lateral lemniscus in the sudden deafness group was higher among the other 2 groups ,and there were signigicant(P<0 .05) .For AD of the inferior colliculug and lateral lemniscus ,there were no differ‐ences among the 3 groups (P>0 .05) .Conclusion There was no obviously abnormal change on the central auditory processing in sudden deafness group ,but significant destruction was found on 2 years SNHL group .It indicated that central auditory processing of the history of sensorineural deafness affected the structural changes of the central au‐ditory pathway .

Objective To increase the ability to recognize the characteristic MRI features of multiple sclerosis (MS) in the spinal cord. Methods Fifteen patients with MS underwent MR examination of the cervical spine. The MS plaques were evaluated for lesion location, length,size on cross-section and lesion enhancement. MRI features of intraspinal tumor of spinal cord, cervical spondylopathy of myeloid form and transverse myelitis were analyzed and compared. Results The lesion mainly developed in cervical cord in the 15 patients. The lesions were less than five vertebra body in length. MRI features showed that involved cord segment was mild swollen with smooth periphery in sagittal section;the plaques showed iso-mild hypointense on T 1WI and hyperintense on T 2WI; the plaques were located peripherally and occupied less than 50%of the cross-sectional area of the cord; the lesions in active stage were enhanced by Gd-DTPA or no enhancement, the enhanced size of plaque was smaller than the extent showing hyperintense on T 2WI. The case of several onset showed various enhancement. Conclusion MS of spinal cord has characteristic feature on MRI, this can provide reliable proof for clinical diagnosis.

OBJECTIVETo investigate whether DTI abnormalities in patients with nondemented subcortical ischemic vascular disease (SIVD) are correlated to general cognitive function and executive function independent of conventional MRI parameters.

METHODSSixty-six SIVD patients including 30 with cognitive impairment without dementia (VCIND) and 36 with normal cognition (NCI) underwent DTI and cognitive assessment of the general cognitive function and executive function. Conventional MRI parameters and DTI parameters were measured within the white matter lesions (WMLs), normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM). The independent predictors of general cognitive function and executive function in SIVD patients was analyzed.

RESULTSNCI and VCIND patients showed significant differences in the periventricular WMLs, ADC valus in NAWM and WMLs of the centrum semiovale, and FA values in NAWM of the anterior periventricular. Except for ADC values of the caudate nucleus, ADC and FA values in the subcortical NAGM showed significant difference between the two groups. After controlling for age and education, PVLs and ADC values in the WMLs and NAWM of the centrum semiovale and putamen, and FA values in the anterior periventricular NAWM, WMLs and putamen showed significant correlations to MMSE; the number of lacunar infarcts, ADC values in posterior periventricular NAWM and caudate nucleus, and FA values in anterior periventricular NAWM and thalamus showed significant correlations to CDT. Multivariate analysis showed independent correlations of the ADC values in WMLs and NAWM of the centrum semiovale to MMSE, and demonstarted correlations of the ADC values of the caudate nucleus and number of lacunar infarcts to CDT.

CONCLUSIONIn nondemented SIVD subjects, the integrity of the white matter in the centrum semiovale strongly correlates to the general cognition, and the microstructural damage of the caudate nucleus head predicts executive function impairment independent of other MRI variables.

Brain Ischemia ; pathology ; physiopathology ; psychology ; Case-Control Studies ; Caudate Nucleus ; pathology ; Cerebral Cortex ; pathology ; Cognition ; physiology ; Cognition Disorders ; pathology ; physiopathology ; Diffusion Tensor Imaging ; Humans ; Magnetic Resonance Imaging

Objective:To investigate the safety and effectiveness of endoscopic cold snare resection of small colorectal polyps and prophylactic hemostatic clip.Methods:A total of 260 patients diagnosed as having small colorectal polyps in Qinghai Provincial People's Hospital from January 2021 to March 2022 were randomly assigned to cold snare polypectomy (CSP) group (receiving CSP), CSP+hemostatic clip group (receiving CSP+prophylactic hemostatic clip), hot snare polypectomy (HSP) group, and HSP +hemostatic clip group (receiving HSP+prophylactic hemostatic clip). Each group had 65 cases. The treatment, incidence of bleeding, and other complications were compared.Results:There was no significant difference in the basic characteristics of patients or polyps among the four groups ( P>0.05). Immediate intraoperative bleeding occurred in 5 cases (7.69%), 4 cases (6.15%), 3 cases (4.62%), and 3 cases (4.62%) in the four groups respectively with no significant difference ( χ2=0.778, P=0.855), while only 1 delayed postoperative bleeding was observed in HSP group with no significant difference among the four groups ( χ2=3.012, P=0.390). The incidence of postoperative abdominal pain was the highest in the HSP group ( n=7, 10.77%) significantly different from those of the CSP group ( n=1, 1.54%) and the CSP+hemostatic clip group ( n=1, 1.54%) ( P<0.05). Polypectomy time of single polyp in CSP group was the shortest (2.18±1.07 min) , followed by HSP group (2.83±0.82 min), then CSP+hemostatic clip group (3.15±1.16 min), with HSP+hemostatic clip group (4.88±1.85 min) being the longest ( F=50.397, P<0.001). Conclusion:It is suggested to use CSP for small colorectal polyps. If there is no risk of bleeding or perforation during the operation, it is not necessary to use prophylactic hemostatic clips.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.