Objective To explore the diagnosis value of 320-row detector dynamic volume CT in complex congenital heart disease (CCHD)with double outlet right ventricle(DORV).Methods Seventy-eight patients who proveed DORV by surgery in Xinqiao Hospital of Third Military Medical University were reviewed.Thirty-six patients of group A performed 320-row detector dynamic volume CT by using segmental analysis,and were compared with the group B(42 Cases) performed conventional 64-slice CT respectively.Results In 36 cases of DORV confirmed by surgery in group A,MSCT provided accurate qualitative diagnosis in all cases.The accuracy rate of diagnosis of the group B was 90.7％.There was no significant differences compared with the group A (P＞0.05).There were ventricular septal defect in all the 78 cases,pulmonary stenosis in 56 cases,atrial septal defect in 34 cases,pulmonary hypertension in 21 cases,patent ductus arteriosus in 16 cases,coarctation of aorta in 9 cases.Conclusion The 320-row detector dynamic volume CT has important diagnostic value for DORV of the anatomical diagnosis.

This paper introduced the current situation of WeChat's official accounts of medical imaging.According to the operation agents,they can be divided into different categories,including professional societies,hospitals and departments,medical companies,academic journals,medical imaging websites and personal accounts.This paper also analyzed the advantages and disadvantages of WeChat's official accounts of medical imaging.Some measures were proposed to improve their application value in continue medical education (CME),such as establishing a platform of WeChat's official account with high approval and authority to award CME credit,integrating various kinds of network resources,strengthening the abundance,systematicness,chronergy and practicality of the resources,setting up and improving the evaluation mechanism of CME credit award,so as to provide a CME platform for the staff of medical imaging.

With the development of computer network technology,network teaching has become an important mode of continuing medical education.There are many kinds of medical imaging websites from both domestic and foreign.In general,they can be divided into three main categories,in terms of society official websites,academic journal websites,and educational resource websites.On the basis of the introduction of the representative domestic and international medical imaging websites,this paper analyzes the advantages and disadvantages of them,and emphasizes some measures to improve the application value of them in continuing medical education,including to establish an authoritative academic website to achieve continuing medical education credits,to strengthen the resources and function of various medical image sites,and to promote intelligent and personalized self-learning,etc.We hope the combination of medical imaging websites with continuing medical education will be much closer,so as to provide a good platform for imaging personnel to improve their professional level and scientific research ability.

Objective To analyze the clinical and CT characteristics of pancreatic metastasis to improve the correct diagnosis rate.Methods The clinical and CT data of 14 patients with pancreatic metastasis were reviewed retrospectively.Results Among the 14 patients,the primary malignancy was lung cancer in 6 cases,renal carcinoma in 3 cases,colon carcinoma in 2 cases,laryngeal cancer in 1 case,gastric cancer in 1 case and ovarian carcinoma in 1 case.Pancreatic metastases from renal carcinomas often developed a long period after initial nephrectomy and survived for a relatively long time.Abdominal CT plain scan and enhanced scan was performed in all cases.Four cases were of solitary type,9 cases were of multiple types and 1 was of diffuse type.Totally 28 lesions were found,which were usually located in the neck and body of the pancreas,the diameter of 28 pancreatic lesions was ranging from 0.5 cm to 11 cm,with a mean diameter of 2.3 cm.On CT plain scan,there were 19 hypodense lesions,7 slightly hyperdense lesions and 2 isodense lesions,5 necrotic lesions.On enhanced CT,the lesions showed moderate enhancement in 7 cases,circular enhancement in 6 cases,moderate and circular enhancement in 6 lesions,obvious enhancement in 8 lesions and no enhancement in 1 lesion.All patients had extra-pancreatic metastases,and 2 cases had peripheral vascular invasion.Conclusions Pancreatic metastases are rare,often accompanied with multiple lesions and extra-pancreatic metastases.The CT features of pancreatic metastases from renal carcinomas are slightly hyperdense and obvious enhancement; in other metastases,there are hypodense,morderate and/or circular enhancement lesions.Accurate diagnosis can be achieved by knowledge of patients' medical history.

Picture archiving and communication system ( PACS ) based on digital teaching platform of medical imaging consists of web teaching system and teaching resource library of medical imaging.The web teaching system includes four function modules of classroom management,work management,teaching management and test management.The teaching resource library includes script,pictures,and audio,video and animation materials of theoretical books,typical cases,examination techniques and medical imaging equipments.Utilized in theoretical and practical classes,the teaching characteristic of medical imaging is made prominent,and the subjective motility of the students is brought into play.

BACKGROUND: Clinical researches found that portal vein occlusion was beneficial to inhibit growth of hepatocarcinoma, promote compensatory hyperplasia of un-blocking hepatic tissue and decrease metastasis of portal vein occlusion; however, it should be fu~her proved by animal experiments.OBJECTIVE: To investigate models of portal vein occlusion of hepatic VX2 tumor in rabbits and evaluate value of multi-slice CT.DESIGN: Randomized grouping design and animal study.SETTING: Department of Radiology, Xinqiao Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Imaging Department of Xinqiao Hospital of the Third Military Medical University of Chinese PLA from July 2002 to January 2005. Forty New Zealand rabbits were divided according to digital table into 4 groups: immediate group (transplantation of tumor after immediate portal vein occlusion), 3-week group (transplantation of tumor at 3 weeks after portal vein occlusion), negative control group and positive control group, 10 in each group.METHODS: Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation at immediate portal vein occlusion and 3 weeks after portal vein occlusion. Meanwhile, they were divided into negative control group (Left external branch of portal vein was done sham-operative block,and left exite was embedded and inoculated pseudoly) and positive control group (Transplanted tumor did not suffer from portal vein occlusion). All rabbits were scanned with multi-slice CT.MAIN OUTCOME MEASURES: General changes of liver, changes of tumor, metastasis of tumor, vascular-imaging displaying rate of multi-slice CT of hepatic artery and portal vein, blood flow of liver, blood volume,mean transit time, permeability of vascular surface and fraction of hepatic arterial infusion (HAI).RESULTS: All 40 animals were involved in the final analysis. ① Tumor did not grow in both immediate group and 3-week group. In 3-week group,left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was smaller than that in positive control group [(2.55 ±0.46), (3.59±0.37) cm, t=5.57, P ＜ 0.001]. Incidences of metastasis in liver and lung were lower in 3-week group than those in positive control group (10%, 40%; 100%, 90%); however, there was no significant difference. ② Scanning with multi-slice CT, displaying rate of branches hepatic artery was lower in grade Ⅲ than that in grade Ⅰ and Ⅱ (40%, 70%,100%, P ＜ 0.05); but there was no significant difference of displaying rate of portal vein at various grades (P ＞ 0.05). ③ Values of blood flow of liver,blood volume, mean transit time and permeability of vascular surface were lower in immediate group and 3-week group than those in control groups,but values of HAI were increased.CONCLUSION: Ligating left external branch of portal vein is an ideal way to establish models of portal vein occlusion of hepatic VX2 tumor in rabbits; furthermore, multi-slice CT plays a key role in evaluating effect of portal vein occlusion.

OBJECTIVE To make a further understanding of the imaging findings of the carotid artery pseudoaneurysm (CAPA) in head and neck and to explore the clinical value of imaging in diagnosis of it, especially the angiographic diagnosis. METHODS The clinical and imaging data of 36 patients with CAPA were analyzed retrospectively. The imaging appearances in all of the patients were observed by two experienced radiologists together and formed a consensus interpretation. RESULTS Imaging examination can establish definitive diagnosis in all cases. The parent arteries included the common carotid artery (2 case), common carotid artery bifurcation (18 cases), internal carotid artery (10 cases) and external carotid artery (2 cases). The imaging features of the CAPA were:the contrast media retained in the aneuysm in all cases;the aneuysm lumen with turbulent flow in 18 cases;the"jetting sign"at the leak of the parent artery in 14 cases;increase of bifurcation angles of internal and external carotid arteries in 24 cases. CONCLUSION Imaging examination is the most valuable examination method in diagnosis of CAPA, and it can not only make definitive diagnosis, but also play an important role in selection of therapeutic planning.

BACKGROUNDTo analyze the causes of computed tomographic misdiagnosis of pulmonary carcinoma.

METHODSFrom September 1991 to January 2002, 45 cases of pulmonary carcinoma misdiagnosed by CT were analyzed retrospectively. Twenty-six cases of pulmonary tuberculosis and 15 cases of pulmonary pneumonia misdiagnosed as pulmonary carcinoma by CT were studied as control subjects. All of these cases were confirmed by surgery and clinical course. The CT appearances of these cases were independently reviewed in a double blind method by three experienced radiologists. Then they discussed together in order to search for the factors of CT misdiagnosis and formed a consensus interpretation.

RESULTSForty-five cases of pulmonary carcinoma were misdiagnosed as pulmonary tuberculosis in 19 cases, pneumonia in 14 cases, abscess in 4 cases, pleural mesothelioma in 2 cases, normal in 2 cases, and others in 4 cases. The fundamental manifestations of misdiagnosed cases were lobar or segmental shadows (26 cases), solitary mass or nodule (19 cases).The reasons of CT misdiagnosis were very confusing. The main factors were:(i) Missed diagnosis (2 cases, 4.5%). One case had an endobronchial mass and another had the erosion of rib. (ii) Twenty-four cases (53.3%) due to mis interpretation and lack of experience. (iii) The manifestations in CT were atypical (19 cases,42.2%).

CONCLUSIONSNot identifying accurately the CT appearances and excessively emphasizing the specificity of some signs are the main causes of the misdiagnosis. A reasonable and careful CT examination, summarizing analysis combined with clinical findings, and the accumulation of diagnostic experience will help to reduce the CT misdiagnostic rate of pulmonary carcinomas.

This paper discusses the conception of multimedia courseware in the teaching of medical imaging technology, and meaning, features and requirements. It is concluded multimedia courseware can play an important role in the teaching of medical imaging technology. Also, some problems existing in the application are analysed in this article.

Objective To study the method and efficacy of double chemoembolization of hepatic carcinoma by transcatheter arterial cheomembolization (TACE) and portal vein port catheter system (PCS). Methods PCS was implanted in portal vein in 17 cases of irresectable primary hepatocellular cancer (HCC) during operation. One month later, chemoembolization of portal vein via PCS was performed, meanwhile TACE was also done (hepatic arterial portable vein chemoembolization, HA PVCE). A total of 120 cases of HCC treated simply with TACE were served as the control. Results The technical success rate was 100% in both TACE and portal vein PCS. Hepatic arteriography showed rich or moderate blood supply of HCC in 134 cases and PCS portography showed tumor staining in 6 cases. In groups of HA PVCE and TACE, the positive alpha fetoprotein (AFP) level decreased in 80% and 71.6% cases; half a year survival rate was 85.7% and 74.4%, and one year survival rate was 71.4% and 52.4%, respectively. Conclusion Double chemoembolization by TACE and portal vein PCS is a safe procedure with high technique success rate and therapeutic efficacy for irresectable hepatic carcinoma.