Extracranial carotid athcrosclcrosis is the major cause of ischcmic stroke.The intumescence of carotid atherosclerotic plaque in meries results in lumen stenosis or detachment of plaque organisms.causing the distal vascular embolization,and thus resulting in a reduced cerebral blood supply and cerebral ischemic event.The volume data acquisition of multislice spiral CT angiography can provide high-quality two-dimensional and three-dimensional images,its imaging technique has become a very effective detection tool for carotid atherosclerosis.This article reviews the diagnosis application of multislice spiral CT angiograohy of carotid atherosclerosis and its pitfalls.

Objective: To evaluate the application value and potential faults of Dual-source CT in carotid arterial angiography.Methods: We retrospectively analyzed the images of 477 patients with symptomatic carotid atherosclerosis detected by dual-source CT angiography(CTA) from February 2007 to January 2008,and evaluated the quality of the images,which were classified into 3 quality grades: excellent(with clear display of the lesion and no noticeable motion artifacts,good(with a few motion artifacts but still diagnostically applicable),and poor(with heavy motion artifacts,unclear display and no diagnostic value).Results: Of the 477 images,420(88.1%) were of excellent quality,44(9.2%) of good quality and 13(2.7%) of poor quality.Among the total number of cases,134(28.1%) were shown to be normal and 34(7.1%) abnormal in anatomic structure.Atheromatous plaques were detected in 295 cases(61.8%),carotid artery stenting in 11(2.3%),internal carotid artery occlusion in 1,common carotid artery occlusion in 1,and cervical tumor in 3.Conclusion: Dual-source CT,faster,effective and minimally invasive,is particularly valuable in the diagnosis of carotid arterial lesion and stenosis.

The structure and working principle of dual-source CT(DSCT) and its clinic application are expatiated.Many advantages are proved after the analysis and discussion and also after the validation of clinic application,such as higher temporal resolution for the imaging of cardiac and coronary artery to be finished without the influence of any heart rate,lower X-ray absorbing dose to offer more safe surrounding for the patients,higher special resolution and higher signal to noise of images to offer more reliable diagnostic tool,the technology of dual-energy is special in the examination and research of function and metabolize of human being.

Objective To discuss the application of DWI and DTI in diagnosis and evaluation of brain tumor. Methods Combining with literatures, the application of DWI and DTI in brain tumor diagnosis, differential diagnosis, tumors classi- fication, preoperative evaluation, operation plan establishment, follow-up role of treatment were reviewed and evaluated. Results The DWI and DTI were available to brain tumor diagnosis, differential diagnosis and tumor grade. The DTI could be clearly shown the influence of tumor with white matter quality, it was important in operation plan establishment. The combination of intra-operative MRI, functional MRI and DTI was valuable for brain tumor resection. In the meantime, the treatment response of tumor and the changes of treatment-induced white matter were accurately assessed by DTI. Conclu- sion With the MRI hardware and software technology development, the DWI and DTI imaging information can be provided important value in brain tumor pathological changes diagnosis, evaluation, therapeutic planning and post treatment assess- ment.

A grand view of hospital propaganda should be built in the new era to manifest the characters of healthcare services,transmit health and medical information to the general public,promote mutual communication between society and hospitals,and construct a harmonious circumstance between hospital staff and patients.We should aim to optimize the image of the whole medical industry and change the parochialism in current hospital propaganda.We should innovate the operational ways and means of hospital propaganda to strengthen the working quality and effect,aiming to advance both the social and economic benefit of hospitals.

This article analyses the situation, task, chance and challenge of ideological and political work in the medical and health circles in the new period through a widespread and profound investigation and study, further analyses the contradictions and problems of professional ideological and political work, discusses the way and method of strengthening and improving ideological and political work of medical and health circles, tries to create a new situation in the ideological and political work and promotes the health, coordinated and continuous growth of medical and health undertakings.

Objective To discuss the 3D reconstruction dual-source CT angiography (DSCT) in diagnosing nutcracker syn- drome. Methods 24 cases with known or suspected "nutcracker" syndrome were underwent with DSCTA and 3D recon- struction, left renal vein (LRV) were demonstrated and measured. Results Among 24 cases, 16 cases were diagnosed with " nutcracker" syndrome; the imaging demonstrated LRV were compressed. The angle between SMA and AO of 24 cases with "nutcracker" syndrome was abnormally acute(

Objective To discuss the 3D reconstruction dual-source CT angiography (DSCT) in diagnosing nutcracker syn-drome,Methods 24 cases with known or suspected "nutcracker" syndrome were underwent with DSCTA and 3D recon-struction, left renal vein (LRV) were demonstrated and measured. Results Among 24 cases, 16 cases were diagnosed with "nutcracker" syndrome; the imaging demonstrated LRV were compressed. The angle between SMA and AO of 24 cases with "nutcracker" syndrome was abnormally acute(<45°). The angle A was 14°～38°, the average angle was 28.12°±7.92°. The angle A' was 11°～21°, the average angle was 16.46°±3.42°. Conclusion The 3D reconstruction DSCTA may be the most useful tool in diagnosing nutcracker phenomenon.

Objective To reassess the treatment of Bosniak category Ⅱ-Ⅲ renal cyst.Methods Sixty-eight cases of Bosniak category Ⅱ-Ⅲ renal cyst were operated from 2005 to 2008 in our institute.The average patient age was 40 years with the average renal cyst diameter of 5.1 cm.There were 37 left lesions and 31 right lesions with 31 cases of category Ⅱ (including 13 cases of category Ⅱ F) and 37 cases of category Ⅲ.Renal unroofing were performed in 49 cases with 9 cases found malignant and followed by radical nephrectomy,19 cases were diagnosed as malignancy preoperatively and nephron sparing surgery or radical nephrectomy were performed in these cases.Results Malignant lesions were found in 21 cases and benign lesions were found in 47 cases.The malignant rate was 9.7％ in category Ⅱ (15.4％ in category Ⅱ F),48.6％ in category Ⅲ.Nine cases were diagnosed benign preoperatively but confirmed malignancy after operation; 7 cases were diagnosed malignancy preoperatively but confirmed benign after operation.Forty-two cases were followed up for 8-65 months with 15 cases of malignancy and 27 cases of benign lesions.The recurrence of renal cyst occurred in 6 cases of benign lesions and recurrence and metastasis occurred in 3 cases of malignancy in 1-5 years.Conclusions It is difficult to draw a therapeutic principle for Bosniak category Ⅱ-Ⅲ renal cyst because of the uncertainty of the lesion.Partial nephrectomy or renal cystectomy is a good choice in the treatment of Bosniak category Ⅱ-Ⅲ renal cysts.

Objective To investigate the safety and efficacy of radical nephrectomy plus inferior vena cava thrombectomy,and to evaluate the efficacy of preoperative temporary inferior vena cava filter placement and intraoperative application of liver transplantation techniques to reveal the inferior vena cava in order to avoid tumor thrombosis shedding and embolism.Methods The data of 42 cases (January 2004 to December 2010) of renal cell carcinoma with subdiaphragmatic thrombus were analyzed retrospectively.All these patients underwent radical nephrectomy plus inferior vena cava thrombectomy.Patients were implanted temporary inferior vena cava filter as preoperative routine.Patients with the tumor thrombi behind the liver were applied liver transplant techniques to free and turn liver to the left in order to reveal inferior vena cava,block blood flow according to priority and then finish the inferior vena cava thrombectomy.The filter was removed postoperatively on the same day,and the patients were followed up as routine.Results The operation of the 42 cases was successful without symptomatic tumor thrombus embolism perioperatively,while 1 case died of severe postoperative lung infection.The average operation time was 220 min (130-320 min),blood loss was 750 ml (200-2500 ml),and 12 cases had blood transfusion with an average of 800 ml (400-2000 ml).Forty-one cases were followed up with an average period of 36 months (6-60 months).Among the 37 cases without preoperative tumor metastasis,15 cases had metastases and 22 cases had disease-free survival.Conclusions Nephrectomy and inferior vena cava thrombectomy could be safe and effective for renal cell carcinoma with subdiaphragmatic thrombosis.Preoperative temporary inferior vena cava filter placement and intraoperative application of liver transplantation techniques to reveal the inferior vena cava can be effective to prevent tumor thrombosis shedding and embolism and improve surgical safety.