To establish a medical imaging teacher competency model and evaluate its application value in group teaching for undergraduates.

The competency-based medical education has formed a global trend, and puts forward a greater challenge for educational design of resident training. The traditional curriculum cannot meet the goal of competency-based education as the curriculum design is lack of theoretical support. Curriculum design is the core of training content, and serves as a significant contributing factor of training outcome. Based on the six-step approach curriculum design, the theory and practice are integrated to form a curriculum design based on theoretical guidance. Through feedback evaluation, the current curriculum design is continuously improved in order to achieve a higher competency-based training quality. With the 5-year experiences and practice, preliminary reform demonstrates effectiveness. The current study hopes to share the teaching reform experiences of residency training base and provide references for colleagues of medical education.

Objective: To explore the application value of 3.0 T MultiVane XD (MVXD) technique in female patients with uterine adenomyosis and fibroids. Methods: Patients diagnosed with uterine fibroids with ultrasound and suspected of adenomyosis were involved prospectively from March to May 2018, 3.0 T pelvic MRI examinations were performed during peri-ovulatory period. Axialconventional turbo spin echo (TSE) T₂WI, axial MVXD T₂WI, sagittal conventional TSE T₂WI and MVXD sagittal T₂WI were acquired. Two observers rated those 4 series in the aspects of sharpness of uterine border, motion artifacts, identification capability of lesions, confidence of diagnosis and overall image quality. Cohen Kappa analysis was used to evaluate the consistency of scores between 2 observers. Scores of TSE T₂WI and MVXD T₂WI qualities were compared using Wilcoxon matched-pairs signed-ranks test. Results: Twenty patients were enrolled. Axial conventional TSE T₂WI, axial MVXD T₂WI were aquired on all of them. Sagittal conventional TSE T₂WI, sagittal MVXD T₂WI were aquired on 19 among them. Nine patients had only obvious adenomyosis, 6 had only uterinefibroids, and 5 had adenomyosis and uterine fibroids. Compared to conventional TSE technique, scores of two observers in the sharpness of uterine border, motion artifacts, and overall image quality is higher by MVXD with significant difference (P<0.05). The Kappa values for image quality scores of two observers ranged from 0.615 to 0.971, the agreement was good or very good. Conclusion Applying MVXD T₂WI technique to patients with uterine fibroids and adenomyosiscould improve image quality, without sacrificing the ability to recognize and diagnose lesions, compared to conventional TSE T₂WI technique.

Objective To investigate the feasibility of using CT texture analysis to differentiate among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.Methods 66 lipid-poor adrenal adenoma,98 pheochromocytoma and 101 adrenal metastases lesions were analyzed retrospectively.All the patients had abdominal non-enhanced CT and adrenal enhanced CT scans.We used TexRAD software to analyze the textural features of CT images and compared the differences in each texture parameter among three adrenal lesions.Results On non-enhanced CT images,there were significant differences in Mean and Kurtosis at all the texture scales(SSF 0-6) among the three types of adrenal lesions (P<0.05),as well as SD at fine and coarse texture scale (SSF 2,6)(P<0.05).Entropy (SSF 0-3, 5-6) and MPP (SSF 0-2, 4-6) were significantly lower in lipid-poor adrenal adenoma and adrenal metastases than that in pheochromocytoma (P<0.05).There were significant differences in Skewness (SSF 0-3) among three types of lesions, which was lowest in pheochromocytoma and highest in adrenal metastases.On enhanced CT images, Mean, SD, Entrophy and MPP showed significantly differences among the three types of adrenal lesions at all the texture scales (SSF 0-6) (P<0.05), which were all highest in pheochromocytoma and lowest in adrenal metastases.Skewness (SSF 0) and Kurtosis (SSF 0, 2) were significantly lower in adrenal metastases than that in lipid-poor adrenal adenoma and pheochromocytoma (P<0.05).Conclusion There are significant differences in CT texture analysis parameters among lipid-poor adrenal adenoma,pheochromocytoma and adrenal metastases.CT texture analysis has potential clinical application values in differentiating these three adrenal lesions.

Objective To analyze the clinical characteristics of IgG4-related disease (IgG4-RD)so as to improve the understanding of IgG4-RD in China.Methods IgG4-RD patients were recruited from Peking Union Medical College Hospital between January 2011 and January 2016.All patients were followedup for more than 6 months.The demographic characteristics,symptoms,organ involvements,laboratory examinations and treatment efficacy were evaluated and analyzed.Results A total of 346 patients were finally enrolled,including 230 males (66.5％) and 116 females (33.5％).The mean age of disease onset was (53.8 ± 14.2) years old.The mostly common involved organs were lymph nodes (56.4％) and submandibular glands (52.6％).Other affected organs and manifestations included:swelling of the lacrimal glands (46.5％),autoimmune pancreatitis (38.4％),pulmonary involvement (28.0％),sclerosing cholangitis (25.4％),naso-sinusitis (23.4％),parotid gland swelling (21.7％),retroperitoneal fibrosis (19.9％),large arteries involvement (9.5％),kidney involvement (obstructive nephropathy caused by retroperitoneal fibrosis was excluded) (6.9％),skin lesions (6.4％).Rare features consisted of thyroid glands,pituitary glands,gastrointestinal tract,pachymeningitis,pericardium,sclerosing mediastinitis and orchitis.The majority of patients had multi-organ involvement,such as 74.3％ patients with 3 and more,18.2％ and 7.5％ patients with 2 and single organ involvement respectively.The average IgG4-RD responder index (IgG4-RD RI) was 13.21 ±5.70.History of allergy was found in 172 (49.7％) patients.As to the laboratory tests,elevated serum IgG4 levels were confirmed in 285 (94.1％) patients,which was positively correlated with IgG4-RD RI.There were 33.5％ patients receiving monotherapy of glucocorticoid,52.6％ treated with glucocorticoids combined with immunosuppressive agents,4.9％ patients with immunosuppressant only,and 9.0％ patients with mild disease not receiving medication.The majority (336,97.1％) patients improved the above regimens.Conclusion IgG4-RD is a systemic fibro-inflammatory disease with multiple organ involvement.The mostly common involved organs include lymph node,submandibular glands,and pancreas.Glucocorticoids and immunosuppressive agents were effective for IgG4-RD.

Objective To evaluate the value of bone marrow imaging by third-generation dual-source dual-energy CT(DSDECT) using virtual noncalcium(VNCa) technique for the assessment of diffuse infiltrative lesions of multiple myeloma(MM). Methods From December 2015 to June 2016,31 patients with plasma disorders at our center were prospectively recruited and received whole-body imaging with third-generation DSDECT and MRI. CT numbers of vertebrae were measured on VNCa images as well as regular CT images. Correlation between VNCa CT numbers and MRI signal intensities of the vertebrae was evaluated. The diagnostic ability of VNCa for MM infiltrative lesions was assessed by ROC analysis,using MRI as the reference standard. Results The mean VNCa CT numbers of vertebrae with MM diffuse infiltration (n=62) were (-13.27±18.96)HU,which were significantly higher than those of non-infiltrated vertebrae[(-63.31±26.75)HU,(n=117)] (Z=-9.731,P=0.000). VNCa CT numbers of vertebrae were negatively correlated with T1WI signal intensity normalized by non-degenerative vertebral discs (r=-0.592,P=0.000). ROC analysis showed the area under the curve of VNCa for the diagnosis of infiltrative lesions was 0.943. With the cut-off value of-37 HU,the sensitivity and specificity of VNCa were 90.32% and 87.18%,respectively. Conclusion Bone marrow imaging by third-generation DSDECT using VNCa technique is a valuable tool for assessing diffuse infiltrative lesions of MM.
Bone Marrow ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Multiple Myeloma ; diagnostic imaging ; ROC Curve ; Sensitivity and Specificity ; Spine ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To evaluate the feasibility of peripheral artery CT angiography (CTA)under 70 kV with 50 ml contrast medium on the third-generation dual-source CT. Methods Totally 82 patients who were equally randomized into two groups:70 kV group:the scan was performed under 70 kV tube voltage+50 ml iopromide on the third-generation dual-source CT;and 100 kV group:the scan was performed under 100 kV tube voltage+90 ml iopromide on the second-generation dual-source CT. The CT number of abdominal aorta,bilateral common iliac arteries,common femoral arteries,superficial femoral arteries,popliteal arteries and arteries of the calf were measured and contrast to noise ratio(CNR),signal to noise ratio(SNR)were calculated. The image quality was compared between these two groups. Results The dose-length product was (195.8±46.9)mGy·cm in 70 kV group,which was significantly lower than that in 100 kV group (461.6±57.9)mGy·cm,and was decreased by 57% (t=-22.848,P=0.000). Compared with the 100 kV group,the CT number of the proximal abdominal aorta in 70 kV group was significantly lower(t=-2.502,P=0.014),while the CT number of superficial femoral arteries (t=3.053,P=0.003)and popliteal arteries (t=4.013,P=0.000)was much higher in 70 kV group. SNR and CNR of proximal abdominal aorta,distal abdominal aorta,bilateral common iliac arteries,common femoral arteries,superficial femoral arteries,popliteal arteries and arteries of the calf were significantly lower in 70 kV group than those in 100 kV group (all P<0.05). The artifacts in abdominal aorta (t=2.893,P=0.000)and feet arteries (t=3.776,P=0.000)were higher in 70 kV group than those in 100 kV group,the enhancement of abdominal aorta (t=-1.000,P=0.002)and feet arteries (t=2.893,P=0.010)were lower in 70 kV group,the enhancement of femoral-popliteal arteries (t=-1.000,P=0.000)and arteries of calf (t=4.261,P=0.000)were higher in 70 kV group. Compared with the 100 kV group,the image noise in aorta (t=2.048,P=0.044),femoral-popliteal arteries (t=8.370,P=0.000),arteries of the calf (t=8.315,P=0.000)and feet arteries (t=7.202,P=0.000)were higher in 70 kV group. Conclusion Compared to conventional scan protocol,using 70 kV tube voltage with 50 ml contrast medium to perform peripheral artery CTA can assure the image quality and meanwhile remarkably reduce the radiation dose and the use of contrast medium.
Aorta, Abdominal ; diagnostic imaging ; Arteries ; diagnostic imaging ; Artifacts ; Computed Tomography Angiography ; Contrast Media ; Humans ; Iohexol ; analogs & derivatives ; Leg ; blood supply ; Radiation Dosage ; Signal-To-Noise Ratio ; Tomography, X-Ray Computed

Objective To investigate the feasibility of using low-dose prostate CT perfusion (pCTP)on a third-generation dual-source CT. Methods Nine patients with elevated prostate-specific antigen underwent pCTP before having prostate biopsy. We measured the blood flow (BF),blood volume (BV),mean transit time (MTT),permeability surface (PS),and time to peak(TTP)of both lesions and normal prostate tissue. The effective dose (ED)was calculated. Results Of the 9 cases,6 were prostate cancers and 3 were prostate hyperplasia with chronic inflammation. The average ED of the 9 pCTPs was (3.5±0.3)mSv. The BF (t=4.64,P<0.001),BV (t=3.27,P<0.001),and PS (t=3.58,P=0.004)of prostate cancer were significantly higher than those of normal prostate tissue and TTP (t=-1.26,P<0.001)of prostate cancer was significantly lower than that of normal prostate tissue. BF (t=3.96,P=0.001)and PS (t=2.91,P=0.021)of prostate hyperplasia with chronic inflammation were also significantly higher and TTP (t=-1.19,P<0.001)was significantly lower than those of normal prostate tissue. TTP of prostate cancer was significantly lower than that of prostate hyperplasia with chronic inflammation (t=-2.56,P=0.049). Conclusion sLow-dose pCTP is feasible on third-generation dual-source CT. The BF,PS,and TTP differ among prostate cancer,prostate hyperplasia with chronic inflammation,and normal prostate tissue.
Blood Volume ; Feasibility Studies ; Humans ; Male ; Prostatic Neoplasms ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To evaluate the value of third-generation dual-source CT scanner in application of high-pitch aorta CT angiography(CTA). Methods Totally 59 patients clinically indicated for whole aorta angiography were divided into 2 groups using a simple random method:in group 1 there were 28 patients who underwent the examination on a third-generation dual-source CT device,with a collimation of 2×192×0.6 mm and a rotation time of 0.25 s;in group 2 there were 31 patients who underwent the examination on a second generation dual-source CT device,with a collimation of 2×128×0.6 mm and a rotation time of 0.28 s. Both groups were given the examination operated in dual-source high-pitch ECG-gating mode with a pitch of 3.0,a tube voltage of 100 kV,and automated tube current modulation using a reference tube current of 288 mA. A contrast material bolus of 45 ml with a flow of 4.5 ml/s followed by a 50 ml saline chaser in 5.0 ml/s was used. CTA scan was automatically started using a bolus tracking technique at the level of the original part of aorta after a trigger threshold of 100 HU was reached. The start delay was set to 6 s in both groups. Effective dose(ED),signal to noise ratio (SNR),contrast to noise ratio (CNR),and subjective diagnostic quality of both groups were evaluated. Results The mean ED were 19.44% lower (t=-3.989,P=0.000) in group 1 [(3.15±0.86)mSv] than in group 2 [(3.91±0.60)mSv]. These two groups showed no significant differences in SNR or CNR (all P >0.05). The subjective diagnostic quality values also showed no significant difference between two groups [(1.39±0.50)scores vs. (1.45±0.51)scores;W=814.5,P=0.651].Conclusion Compared with the second-generation dual-source CT scanner,the third-generation dual-source CT scanner in whole aorta CTA can remarkably reduce the radiation dose without affecting image quality.
Aorta ; diagnostic imaging ; Computed Tomography Angiography ; methods ; Humans ; Radiation Dosage ; Retrospective Studies ; Signal-To-Noise Ratio

Objective To evaluate the application of automated tube potential selection technique in high-pitch dual-source CT aortic angiography on a third-generation dual-source CT scanner. Methods Whole aorta angiography were indiated in 59 patients,who were divided into 2 groups using a simple random method:in group 1 there were 31 patients who underwent the examination with automated tube potential selection using a vascular setting with a preferred image quality of 288 mA/100 kV;in group 2 there were 28 patients who underwent the examination with a tube voltage of 100 kV and automated tube current modulation using a reference tube current of 288 mA. Both groups were scanned on a third generation dual-source CT device operated in dual-source high-pitch ECG-gating mode with a pitch of 3.0,collimation of 2×192×0.6 mm,and a rotation time of 0.25 s. Iterative reconstruction algorithm was used. For group 1,the volume and flow of contrast medium and chasing saline were adapted to the tube voltage. For group 2,a contrast material bolus of 45 ml with a flow of 4.5 ml/s followed by a 50 ml saline chaser at 5 ml/s was used. CTA scan was automatically started using a bolus tracking technique at the level of the original part of aorta after a trigger threshold of 100 HU was reached. The start delay was set to 6 s in both groups. Effective dose (ED),signal to noise ratio (SNR),contrast to noise ratio (CNR),and subjective diagnostic quality of both groups were evaluated. Results The mean ED were 21.3% lower (t=-3.099,P=0.000) in group 1 [(2.48±0.80) mSv] than in group 2 [(3.15±0.86) mSv]. Two groups showed no significant difference in attenuation,SD,SNR,or CNR at all evaluational parts of aorta (ascending aorta,aortic arch,diaphragmatic aorta,or iliac bifurcation)(all P>0.05). There was no significant difference in subjective diagnostic quality values of two groups [(1.41±0.50) scores vs. (1.39±0.50) scores;W=828.5,P=0.837]. Conclusion Compared with automated tube current modulation,the automated tube potential selection technique in aorta CT angiography on a third-generation dual-source CT can dramatically reduce radiation dose without affecting image quality.
Algorithms ; Aorta ; diagnostic imaging ; Computed Tomography Angiography ; methods ; Humans ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted ; Signal-To-Noise Ratio