Objective To evaluate the value of 64-slice spiral computed tomography angiography(CTA) in diagnosis of acute severe chest pain caused by vascular diseases.Methods 34 cases with acute severe chest pain caused by vascular lesions confirmed clinically underwent CTA examinations.The images were processed with multi-planar reconstruction,maximal intensity projection,curved planar reconstruction and volume rendering,then the imaging features were analysed.Results CTA showed acute aortic dissection in 13 cases,acute pulmonary embolism in 9 cases and acute coronary syndrome in 12 cases,all cases were confirmed by clinic.Conclusion 64-slice CTA has very important practical value in diagnosis of acute severe chest pain.

Objective To investigate the diagnostic value of using magnetic resonance imaging (MRI) and transabdominal sonography in antenatal placental adhesive disorders,to provide a theoretical basis for choosing different delivery ways.Methods 75 patients were assessed the placenta structure with MRI and transabdominal sonography.The patients were divided into two groups according placenta in the anterior and posterior uterus(41 cases in anterior group,34 cases in posterior group).Observed relationship between placenta and myometrium,compared imaging finding with pathological or clinical results.Results The sensitivity in diagnosis of placenta in the anterior uterine group was 75.0％ with MRI and 95.0％ for transabdominal Sonography (P＜ 0.05).The specificity was 90.1 ％ with MRI and 80.9 ％ for transabdominal sonography (P＞0.05).The sensitivity in diagnosis of placenta in the posterior uterine group was 95.8％ with MRI and 66.7 ％ for transabdominal Sonography(P＜0.05).The specificity was 90.0％ with MRI and 70.0％ for sonography (P＜0.05).There were significantly difference the imaging feature of uterine bulging,increased subplacental vascularity and dark intraplacental bands on T2-weighted images in placenta accrete group and nonplacenta accretegroup (P＞0.05).Conclusion Both sonography and MRI have fairly good sensitivity and imaging features for prenatal diagnosis of placenta accrete.Especially,MRI is an excellent tool for diagnosis of placenta accrete in the posterior uterine.

Objective To study the value of diffusion weighted imaging (DWI)in Marchiafava-Bignami disease.Methods (1)12 cases of Marchiafava-Bignami disease (MBD)patients with 6 month follow-up and 12 hedthy adults were clone MRI DWI;(2)MR imaging characteristics of 12 patients were observed on the corpus callosum and the other gray-white matters;(3)The ADC values of the central part and marginal area of the corpus callosum and the other gray-white matters were measured,data analysis were carried out completely by random design.Results Hyperintensity on the corpus callosum were showed in 12 patients on DWI,typical“sandwich sign”was seen on the sagittal T2 WI in 1 1 cases,and gray-white matters beside the corpus callosum were involved other in 6 cases;The ADC values of central and marginal area of the corpus callosum and the other gray-white matters had significant differ-ence between the improved clinical symptom group and,unimproved clinical symptom group and the control group (P < 0.05 ). There were no significant differences in the ADC values for the other white matters.Conclusion DWI can be used to reflect the change of MBD.Low ADC values in the corpus callosum and cortex are associated with a poor prognosis.

Objective To study the value of the application of 320-row detector dynamic volume CT in diagnosis of complicated congenital heart diseases(CCHD).Methods Datas of 43 cases with CCHD,who examined by ECC-gated 320-row CT angiography (CTA)as preoperative examinations were collected.All the CT data were processed by combined application of multi-imaging post-processing technique to show the anatomic malformation based on segmental analysis,and were compared with the transthoracic ech-ocardiography (TTE )and surgical results .Results 1 97 various malformations were found in 43 cases and proved by operation, among which there were 87 intracardiac malformations,the diagnostic accuracy with CTA and TTE were 86.2%,89.7%,and there was no obvious difference between them(P >0.05 ).1 10 extracardiac malformations (including connection malformations between heart and vessels,extracardiovascular malformation,bronchial or other nonvascular structure malformation)were found ,the accura-cy with CTA and TTE were 91.8% and 76.4%,the former was superior to latter (P <0.05)Conclusion 320-row detector dynamic volume CT in diagnosis of CCHD has very important meaning and practical application value,should be used as the significant choice for clinical diagnosis of CCHD.

Objective To observe clinical significance、anatomy and variation of normal internal cerebral veins and their tributa-ries.Methods The studies included 284 sides in 142 patients.The patients were performed with 320-detector Row CT One-stop Scanning.Then,the anatomical features of internal cerebral veins and their tributaries were evaluated.Results The detection rate of internal cerebral veins(ICA)、thalamostriate veins(TSV)、septal veins(SV)、anterior caudate nucleus veins、posterior caudate nucleus veins and lateral direct veins was 100%、100%、98.9%、95.4%、93.7%、48.6%.Type of IA was seen frequently in four types of ICA,the parts of ICV and their tributaries were mirror symmetry,the majorities of ICA were located the same plane.Anterior cau-date nucleus veins were classified four types on basis of these different draining patterns,they were drained to TSV commonly.There was no significant difference between venous angle or false venous angle and type of their draining(P>0.05).There was significant difference between detection rate of lateral direct veins and development of posterior caudate nucleus veins(P<0.05).Conclusion 320-detector Row CT One-stop Scanning was an important method that internal cerebral veins were detected effectively and non-inva-sively,observed anatomy,course and morphological change of ICV.

Objective To study the effects of the different phases of breast dynamic contrast enhanced MR with 3D MIP in reconstruction of breast vascular.To explore the reconstruction parameters of breast vascular in benign and malignant breast lesions.Methods All of 132 female patients with pathologically confirmed breast disease were enrolled,including 50 cases of benign lesions and 82 malignant cases.All of them underwent high temporal resolution dynamic enhanced MR scanning,with each phase of 20 s.All of the images were reconstructed by 3D MIP and analyzed.Results In both of benign and malignant lesions,the display rate of the internal thoracic artery was higher than that of the lateral thoracic artery and intercostal artery.The display rate of grade Ⅱ vessels of internal thoracic artery and intercostal artery were higher in malignant lesion(P=0.035,0.000).The grade Ⅰ and Ⅱ vessels of the internal thoracic artery and the lateral thoracic artery increased gradually with time delay.The vascular branches were showed in malignant lesions earlier than those in benign lesions,in the 20th seconds in which grade Ⅰ vessels could be displayed,and in the 60th seconds,internal thoracic artery in malignant lesions(96.3%)can be clearly displayed.For benign lesions,grade Ⅰ branch of the internal thoracic artery in patients(80%)could be displayed in the 120th seconds.Conclusion Breast dynamic contrast enhanced MR with 3D MIP can be used to display the blood vessels of the breast,which is of great value in the diagnosis of breast diseases.To achieve the best display effect,different enhanced phases should be selected to reconstruct the blood vessels based on the different enhancement patterns in benign and malignant lesions.

Objective To evaluate the value of MRI in the diagnosis of secondary dysmenorrhea.Methods 96 cases of secondary dysmenorrhea confirmed by clinic were analyzed retrospectively.Organic diseases contributed to secondary dysmenorrhea were classified and the characteristics of MRI were analyzed.Results There were 53 cases of endometriosis(EM),22 cases of adenomyosis (AM),14 cases of genital malformations,5 cases of chronic pelvic inflammation and 2 cases of uterine leiomyoma.Conclusion MRI can search the etiology of secondary dysmenorrhea,which can be used as effective means of inspection for secondary dysmenorrhe.