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Clinical Application of Wireless Flat-panel Detector in X-ray Photography in the Small Joints of the Limbs

Chinese Journal of Medical Imaging.2013;(6):411-413,416. doi:10.3969/j.issn.1005-5185.2013.06.003

Purpose To compare the wireless flat-panel detector with gadolinium oxide coating in X-ray photography in the small joints of the limbs compared with conventional flat panel detector with cesium iodide coating. Materials and Methods Comparison was randomly performed between gadolinium oxide coated sulfur wireless flat-panel detector and cesium iodide coated conventional flat-panel detector for 80 patients who received routine X-ray photography, and scoring data were applied with statistical analysis. Results There was no significant difference between the scoring data from two film-reading people (P>0.05). The resolution of anatomical structure of small joint of limbs and tube current showed no significant difference for two types of imaging systems (P>0.05). Conclusion Wireless flat panel detector sulfur with gadolinium oxide coatings can obtain satisfactory image quality at a reasonable inspection doses in the X-ray photography of small joint of limbs. The imaging quality and inspection doses are similar to conventional flat panel detector device with cesium iodide coating, but the posture is more convenient.

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CT Manifestations and Drainage Characteristics of Klebsiella Pneumoniae Induced Liver Abscess

Zhihui CHANG ; Jian ZHAO ; Jiahe ZHENG ; Zhaoyu LIU

Chinese Journal of Medical Imaging.2013;(6):436-438,442. doi:10.3969/j.issn.1005-5185.2013.06.010

Purpose To analyze the differences of CT manifestations, and to explore the disparity of drainage volume in early drainage between Klebsiella pneumoniae induced liver abscess and non-Klebsiella pneumoniae induced liver abscess. Materials and Methods 337 cases of patients whose blood culture or drainage fluid culture results were positive were divided into Klebsiella pneumoniae group (219 cases) and non-Klebsiella pneumoniae group (118 cases). CT characteristics of the two groups were analyzed, including lesion distribution, quantity, structure, texture, abscess wall thickness, enhancement character around the lesion, whether or not concurrent with thrombophlebitis or migratory infection and so on. Early drainage volume in interventional puncture drainage was observed in both groups. Results Chest CT showed that solitary, multi-room, solid, thin-walled abscesses with concurrent thrombophlebitis, migratory infection and no enhancement around tend to occur in Klebsiella pneumoniae group (χ2=4.065, 3.834, 4.682, 5.689, 5.215, 8.362, 8.407, P<0.01). Early drainage volume of Klebsiella pneumoniae group was significantly lower than that of non-Klebsiella pneumoniae group (χ2=5.863, P<0.01). Conclusion CT manifestations of Klebsiella pneumoniae induced liver abscess are solitary, multi-room, solid, thin-walled abscesses without enhancement around them, thrombophlebitis and migratory infection are common seen and drainage volume is less in early stage after interventional operation.

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Whole Body Diffusion-weighted MR Imaging Study of Bone Marrow in Healthy Adults

Xian XU ; Lin MA ; Ningyu AN ; Youquan CAI ; Xinqiu LIU

Chinese Journal of Medical Imaging.2013;(6):401-405,410. doi:10.3969/j.issn.1005-5185.2013.06.001

Purpose To explore the correlation between whole body magnetic resonance diffusion-weighted imaging (WB-DWI) quantitative parameters of healthy adults' bone marrow with gender, age, height, weight, body mass index, and sex hormone levels. Materials and Methods 108 healthy adult subjects in different age groups underwent WB-DWI scan using GE 1.5T MR scanner, among them estradiol and progesterone levels were measured in 60 subjects within 48 hours before or after the scan. Apparent diffusion coefficient (ADC) values of bone marrow and the signal to noise ratio (SNR) were compared among different gender and age groups. Partial correlation analysis was used to evaluate the correlation of skeletal system ADC values and SNR with sex, age, height, weight, body mass index, estradiol and progesterone levels in 60 subjects. Results ADC values and SNR of the female subjects were significantly higher than males (P<0.01);there were significantly differences for skeletal system ADC values and SNR in different age groups (P<0.01). Skeletal system ADC values was significantly negatively correlated (r=-0.642, P<0.01) with age, and were mildly positively correlated (r=0.278, 0.271, P<0.05) with estradiol and progesterone levels;SNR was significantly negatively correlated (r=-0.709, P<0.01) with age, and was mildly positively correlated (r=0.293, P<0.05) with estradiol levels;ADC values and SNR had no significant correlation with height, weight and body mass index. Conclusion Skeletal system ADC values are effected by gender, age and sex hormone levels, the skeletal system WB-DWI manifestations are different in different gender and age groups.

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Application of Contrast-enhanced Ultrasound in Detection Non-vascular Channel

Yanpeng KONG ; Lei FENG ; Yaoyou XIA ; Yan SUN ; Kun CHEN ; Cuiyun LIN

Chinese Journal of Medical Imaging.2014;(9):704-707. doi:10.3969/j.issn.1005-5185.2014.09.017

Purpose To explore the application value of contrast agent in non-vascular channel. Material and Methods Totally 68 patients with drainage tube/stoma were collected in the pattern of real-time contrast enhanced ultrasound. Position, scope and moving of contrast agent in non-vascular channel were observed. Results It was accurately revealed enhanced areas in 68 cases of drainage tube and stoma, including 9 abnormal cases. CEUS implied 3 cases of failed drainage ifrstly, 5 cases of bleeding and 1 case gallbladder stone. It judged the degree and location in 25 PTBD cases and 22 PCN cases. The distance with renal hilum of one parapelvic cyst was measured accurately. Conclusion It is very important in diagnosis and treatment of interventional ultrasound to CEUS, therefore is worthy of wide application.

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Differentiation of Two Contrast Media Using Dual-energy CT

Qi WANG ; Mengyue SUN ; Gaofeng SHI ; Zhihui TIAN

Chinese Journal of Medical Imaging.2014;(9):701-703. doi:10.3969/j.issn.1005-5185.2014.09.016

Purpose To evaluate the feasibility of using dual-energy CT scanner to differentiate two contrast media bismuth and gadolinium. Materials and Methods Two phantoms containing contrast media of different ratio were scanned on dual-energy CT. Group 1 was mixture of iodine and gadolinium solution with volume ratio of 0∶1, 1∶6, 1∶1, 6∶1 and 1∶0. Group 2 was mixture of iodine and bismuth solution with mass ratio of 0∶1, 1∶6, 1∶1, 6∶1, 1∶0. Monoenergetic image reconstruction was performed at 80 keV. Liver VNC software was used for virtual scanning and iodine concentration analysis. Results Under 80 keV reconstruction, the measured CT attenuation of Group 1 was 379-383 HU, and 170-173 HU in group 2. The iodine concentration of two groups was not signiifcantly different between the calculated and actual iodine concentration (P>0.05). The dual-energy CT can distinguish two contrast media. Iodine and gadolinium contrast media were not statistically different, while iodine and bismuth contrast media agent could be easily differentiated. Conclusion Dual-energy CT can distinguish two contrast media with different attenuation.

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Factors Inlfuencing Shear Wave Velocity by Using Elasiticity Imaging Technique

Long YANG ; Jianjun YUAN ; Qi WANG ; Gang WU ; Wenqing GUO ; Wenwei WANG ; Bing ZHAO

Chinese Journal of Medical Imaging.2014;(9):697-700. doi:10.3969/j.issn.1005-5185.2014.09.015

Purpose To investigate the influence on shear wave velocity (SWV) by different probe frequency, scanline angle and ROI depth. Materials and Methods The elasticity QA Phantoms was used in the study. First the SWV was measured by curve probe at depths of 1 cm, 2 cm, 3 cm, 4 cm, 5 cm, 6 cm, 7 cm and 8 cm. The scanline angle changed from 0°from midline, 1°-15°, 16°-30°and 31°-45°. Then the SWV was measured again by using line probe at depths of 1 cm, 2 cm, 3 cm and 4 cm. The measured data were analyzed statistically. Results The SWV showed difference by using the two probes (P<0.05). As depth increased, the measurement by curve probe changed from overestimate to underestimate, while the measurement by line probe always showed underestimate from standard value. When the curve probe was used, the angle and depth affected SWV interactively (F=85.87 and 35.96, P<0.01), and had interactive effects (F=17.63, P<0.01). When the scanline angle was within 15°, the angle had little inlfuence upon the measurement. When the scanline angle was 0 °, the measurement was the closest to the standard value at the depth of 4 cm, and the maximum deviation occurred at the depth of 5 cm. The inlfuence of depth upon measurement had signiifcant difference when the line probe was used (P<0.05). The measurement was the closest to the standard value at the depth of 1 cm, and the maximum deviation occurred at the depth of 4 cm. Conclusion Factors like probe frequency, scanline angle and ROI depth can affect the SWV. When the curve probe is used, the accurate measurement occurs at the depth of 4 cm when the scanline angle is within 15°. When the line probe is used, the accurate measurement occurs at the depth of 1 cm.

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Change of Space Anterior to the Right Portal Vein in Liver Fibrosis and Cirrhosis:CT Analysis

Julin HU ; Xiaoping DAI ; Jianbo ZHOU ; Jinming LI ; Qing LIANG ; Yingqun XIAO ; Qiuhua DENG ; Kehuang TIAN

Chinese Journal of Medical Imaging.2014;(9):674-677. doi:10.3969/j.issn.1005-5185.2014.09.008

Purpose To explore the relationship between the change of space anterior to right portal vein and the pathological staging in liver ifbrosis/cirrhosis. Materials and Methods Plain and contrast enhanced CT scan were performed in patients with biopsy proven liver ifbrosis/cirrhosis including S1 in 17 patients, S2 in 13 patients, S3 in 15 patients, S4 in 21 patients and cirrhosis in 22 patients. Twenty subjects were included as control group. The width of anterior space of right portal vein was measured on contrast enhanced CT and correlated with ifbrosis staging. The receiver operating characteristic curve was created for cirrhosis diagnosis. Results The width of anterior space of right portal vein enlarged in patients with S3 ifbrosis to cirrhosis (P<0.05 or P<0.01). It was signiifcantly bigger in group S4 compared to other groups (P<0.01). Spearman rank correlation analysis showed significant positive correlation between the width of anterior space and liver fibrosis staging (r=0.704, P<0.01). ROC curve analysis showed the area under curve (AUC) of 0.897 with the optimum width of ≥10 mm. Conclusion The change in the space anterior to the right portal vein is positively correlated with live ifbrosis staging. CT measurement helps early diagnose and assess the severity of liver ifbrosis and cirrhosis.

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Effect of Levothyroxine on Spatial Working Memory Impairments in Patients with Subclinical Hypothyroidism:Functional MRI Observation

Ranran HUANG ; Shuhua MA ; Rufeng BAI ; Jingjing YIN ; Lei XIE ; Zongbo SUN

Chinese Journal of Medical Imaging.2014;(9):664-669. doi:10.3969/j.issn.1005-5185.2014.09.006

Purpose To explore the effect of Levothyroxine on spatial working memory in patients with subclinical hypothyroidism (SCH) using blood oxygenation level dependent-functional MRI (BOLD-fMRI). Materials and Methods Sixteen patients with SCH before and after 6 months levothyroxine (LT4) treatment and 16 matched euthyroid volunteers underwent n-back task fMRI scanning. AFNI software was used for localization and quantification. Results All the subjects demonstrated activated areas including bilateral dorsolateral prefrontal cortex (DLPFC), bilateral premotor area (PreMA), supplementary motor area/anterior cingulate cortex, bilateral parietal area (PA) and right caudate nucleus/thalamus, with right hemisphere dominance. Quantitative analysis of regions of interests showed that all these regions had load effect related to memory load in the control group (P<0.001), whereas only left DLPFC, left PA, bilateral PreMA and right caudate nucleus/thalamus showed the same effect in SCH group. After 6-month treatment with LT4, BOLD signal change was observed in SCH patients within the right DLPFC, right PA and anterior cingulate/supplementary motor cortex (P<0.001). The activation intensity of working memory related brain regions was lower in SCH group compared with that of the control group. Conclusion Spatial working memory impairments in SCH patients are likely related to decreased right DLPFC and right posterior parietal function. LT4 replacement therapy is important to improve and reverse the memory impairment.

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Relationship Between CT Perfusion Parameters and Vascular Endothelial Growth Factor Expression in Rabbits Portal Vein VX2 Implanting Tumor Emboli

Qiang WEI ; Zhen LEI ; Guoquan FENG ; Xu YANG

Chinese Journal of Medical Imaging.2014;(9):650-654. doi:10.3969/j.issn.1005-5185.2014.09.003

Purpose To establish rabbit VX2 tumor model and to explore the relation between perfusion parameters and the expression of the VEGF in the portal vein VX2 implanting tumor emboli. Materials and Methods VX2 tumor was implanted in the portal vein of eight experimental rabbits. Multi-slice CT (MSCT) perfusion scan was performed after tumor formation to measure and compare portal vein tumor thrombus, hepatic blood lfow (HBF) near tumor foci and far away from tumor foci, hepatic blood volume (HBV), probability of surface area product (PS) and mean transit time (MTT). The VX2 tumor emboli were then resected to analyze the relationship between the liver perfusion parameters and VEGF expression using immunohistochemical method. Results MSCT liver perfusion parameters were not statistically signiifcant between foci close to or far away from the tumor (P>0.05). The HBF, HBV and PS within the tumor emboli were higher than that in hepatic parenchyma (P<0.05) and the MTT was higher (P<0.05). There was positive correlation (r=0.711, 0.646 and 0.626, P<0.05) between the HBF, HBV and PS of portal vein VX2 tumor emboli and VEGF expression, and there was negative correlation between MTT and VEGF expression (r=-0.565, P<0.05). Conclusion MSCT perfusion parameters in the portal vein VX2 implanting tumor emboli and the expression of VEGF are positively related. MSCT can evaluate the angiogenesis of portal vein VX2 implanting tumor emboli.

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1H-MR Spectroscopy of Traumatic Brain Injury in Rabbits

Yong XIAO ; Jianguo XIA ; Yi ZHOU

Chinese Journal of Medical Imaging.2014;(9):645-649. doi:10.3969/j.issn.1005-5185.2014.09.002

Purpose To evaluate 1H proton magnetic resonance spectroscopy (1H-MRS) in detecting traumatic brain injury (TBI) and its metabolic changes during the initial two weeks after trauma using rabbit modes. Materials and Methods Fifteen Chinese rabbits were randomly divided into sham control group (n=5) and TBI group (n=10), 1H-MRS was performed 1 hour, 6 hours, 24 hours and 2 days, 7 days, 14 days after trauma, the concentration of N-acetylaspartate (NAA), creatine (Cr), choline-compound (Cho), NAA/Cr and Cho/Cr in each group was evaluated. At 6 hours, 24 hours and 168 hours after injury, 1 rabbit was slaughtered after abdominal anesthesia at each time point, the sample was ifxed with left heart catheterization perfusion after death, brain tissue was obtained, blocked, dehydrated into frozen section, HE staining was used for observation. Results Compared with the control group, NAA/Cr ratio in the trauma region decreased by 29%1 hour after trauma, with maximal reduction of 40% (at 24 hours) before increasing slightly, the NAA/Cr ratio returned to control level gradually until 168 hours later. The Cho/Cr ratio decreased by 16% 1 hour after trauma, with maximal reduction of 30%(at 6 hours) and increased gradually until finally su rpassed control level (168 hours) for 20% and then became stable. NAA/Cr ratio and Cho/Cr ratio showed statistically significant changes between each observing time point (P<0.05). Conclusion 1H-MRS can be used for dynamic detection of cerebral metabolism without injury, and is superior to MRI in detecting early abnormality of the brain, with NAA/Cr as the most sensitive parameter. Detecting the changes of NAA/Cr, Cho/Cr ratios in the trauma region can be used as a guide for assessment of the clinical treatment effectiveness of TBI.

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