Objective:In order to improve medical undergraduates' ability to interpret medical images and clinical application competencies, this study aimed to explore the effects of case-based learning (CBL) combined with seminars for integrated medical imaging teaching as well as its application value.Methods:We assigned 40 medical undergraduates of grade 2016 of Chongqing Medical University to learn imaging of liver diseases using either a traditional teaching model (control group, n=20) or the combined teaching model (experimental group, n=20), in the form of classroom teaching in our hospital. The teaching effects were evaluated through a theoretical assessment, image reading assessment, and questionnaire survey. SPSS 23.0 software was used for statistical analysis. Continuous data were compared using the t test, and categorical data were compared using the chi-square test. Results:The total theoretical score and total image reading score of the experimental group were (76.35±8.63) and (79.80±10.60), respectively, which were significantly higher than those of the control group ( P<0.05). Specifically, for the experimental group, the scores of theoretical analysis and comprehensive application were (22.85±3.63) and (22.15±2.92), respectively; the scores of image interpretation and report writing were (48.55±6.81) and (31.25±4.15), respectively; the scores for medium questions and hard questions in the image reading test were (24.85±3.12) and (22.50±2.91), respectively; and the pass rate and excellence rate for image reading were 100.00% and 50.00%, respectively, all significantly higher than those of the control group ( P<0.05). The degree of satisfaction with teaching in the experimental group was significantly higher than that of the control group ( P<0.05). In terms of improving learning desire, independent learning ability, innovation and expansion ability, literature search ability, communication and collaboration ability, and image interpretation ability, the experimental group showed significantly higher self-evaluated scores than the control group ( P<0.05). Conclusions:The CBL+seminar model can effectively improve students' academic performance in theoretical and image reading assessments, strengthen their ability to analyze and solve difficult problems, increase their enthusiasm and initiative in learning, and improve their comprehensive quality and image interpretation competency, which is worth promotion and application.

Based on the online course of Medical Imaging, the online and offline mixed teaching mode is an important reform against the traditional teaching mode. Combining the teaching reform experience of Chongqing Medical University, this paper introduces the resource construction of the online teaching platform of Medical Imaging, the construction of the online and offline mixed teaching mode (including the overall reconstruction design of the online and offline teaching content, and the organic integration of the online and offline teaching content before, during and after class), the details of teaching implementation (taking ischemic cerebral infarction as an example), the teaching efficiency, the existing problems and related improvement measures. The preliminary practice shows that it has great significance in enhancing the teaching quality since it can break through time and space constraints, expand teaching space, effectively stimulate students' learning autonomy, enhance their practical skills, increase the communication and interaction between teachers and students, and improve the teaching effect.

Objective:To study the application value of practical demonstration of actual X-ray film images in the experimental teaching of radiography technology courses in medical imaging undergraduates.Methods:A total of 63 medical imaging undergraduates of Grade 2015 were randomly divided into three groups to receive part of the experimental courses about chest and abdomen radiography examination. Their pre-class work and machine were the same. As the experimental group, group A and group B added demonstration with X ray film images, while group C (control group) did not. The different teaching effects of the two methods were evaluated by simulate practical assessment and quiz. The accepting degree of demonstration method was evaluated in accordance with questionnaire survey.Results:The scores of simulated practical assessment (7.36±1.39) and quiz (4.24±2.01) in experimental group were significantly higher than those of (6.05±1.28) and (3.10±1.48) in the control group, with a statistically significant difference ( P<0.01, P=0.024). Questionnaire survey showed that the experimental group were 100% accepted practical demonstration of X ray film images. Conclusion:The application of practical demonstration of X-ray film images in radiology technology experimental courses can help undergraduates to accept new knowledge, deepen impression on knowledge and improve teaching effect, which is worth developing and popularizing.

Picture archiving and communication system (PACS) was used to perform archiving and retrospective cases report presentation in resident radiologist standardized training, and the current conven-tional article reviewing case report presentation form was compared. The results showed the scores of quiz and questionnaire of using archiving and retrospective cases report based on PACS were higher than using the current conventional form (P<0.05). This type of case report presentation can improve overall capability of resident radiologist standardized training including imaging diagnose,research and educational skill.

At present,the graduate teaching of medical imaging and nuclear medicine is still facing many problems,such as paying more attention to the academic research while ignoring ideological and moral reconstruction,teaching arrangement being unreasonable,poor students' clinical practice ability,lack of scientific training system,and no mature evaluation system and so on.Therefore,in clinical teaching ideological and political education is needed as the guide,to enable students to understand the present medical environment,enhance their doctor-patient communication ability.Besides,in the clinical and scientific research ability cultivation,graduate students' learning enthusiasm should be fully mobilized to promote them to actively explore scientific problems.Furthermore the perfect clinical evaluation method and index system should be combined to assess the quality of training.

Objective To investigate the changes of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis (RRMS) and relapsing neuromyelitis optica (RNMO) using diffusion tensor imaging (DTI) and to analyze its correlations with clinical disability scores.Methods Thirty patients with MS (MS group),28 patients with NMO (NMO group) and 20 healthy volunteers were imaged using DTI on a 3.0 Tesla scanner.DTI indices of cervical spinal cord from all participants were measured,including mean diffusivity (MD) and fractional anisotropy (FA),and the correlations between the DTI metrics and the expanded disability status scale (EDSS) scores were assessed.One-way ANOVA,Dunnett-t test and Spearman correlation analysis were used for statistics.Results (1) The values of MD among three groups were different at C3 level for left lateral and dorsal columns,C4 level for the central gray substance and dorsal columns,and C5-C6 level for all structures.There were significant differences among them (F =4.006-36.814,P ＜ 0.05).The values of FA were significantly different at all levels (F =5.561-98.128,P ＜0.05).(2) Compared with the control group,the values of MD were increased and FA were decreased for both MS and NMO groups,there were significant differences among them (t =-0.320-3.138,P ＜0.05).In MS and NMO groups,there were no significant differences of MD (t =-1.183-0.069,P ＞0.05),while the FA at C4-C6 levels (including the central gray substance,dorsal columns,right lateral columns and left lateral columns) for NMO group were 0.57 ± 0.09,0.56 ± 0.11,0.54 ±0.10,0.57±0.09,0.55 ±0.11,0.52 ±0.13,0.55 ±0.11,0.54 ±0.13,0.54±0.10,0.54±0.11,0.53 ±0.13,0.52 ±0.11 ;and for MS group were 0.67 ±0.10,0.68 ±0.10,0.68 ±0.10,0.70 ±0.12,0.68 ±0.11,0.69±0.10,0.68 ±0.11,0.69 ±0.12,0.67 ±0.14,0.68 ±0.15,0.69 ±0.14,0.69 ±0.16,and there were significant differences between two groups (t =-0.011-0.169,P ＜ 0.05).(3)Univariate correlations between DTI measures and the average EDSS scores were assessed.The MD at all levels showed significant positive correlations with disability scores (r =0.324-0.541,P ＜ 0.05),and FA significant negative correlated with disability scores (r =-0.632--0.294,P ＜ 0.05),except C4 level for lateral columns and C2 level.Conclusions DTI metrics are sensitive to cervical spinal cord damage in demyelinating diseases,providing an important way of distinguishing MS from NMO,and can be potentially useful quantitative biomarkers for monitoring the evolution of demyelinating diseases.

Objective To investigate the value of 64-slice spiral computed tomography(CT)angiography in preoperative evaluation of spinal vascular intervention.Methods Seventeen patients with segmental injury of the spinal cord underwent the enhanced 64-slice CT scan of the spine.Thin-slice reconstruction was done,with the slice thickness of 0.625 mm and interval of 0.625 mm.The data were transferred to the work station ADW4.2 in DICM format.Image postprocessing technologies such as volume rendering(VR),maximum intensity projection(MIP)and multi-planar reformat(MPR)were used to conduct three-dimensional reconstruction and analyze the anatomical characteristics of radiculomedullary artery.Results Radiculomedullary artery could be found in the thoracolumbar segment of 16 patients(16/17,94%).Among them,one artery(1/17,6%)went into the vertebral canal through the left intervertebral foramen of T4/5,two(2/17,12%)through the left intervertebral foramen of T10/11,one (1/17,6%)through the left intervertebral foramen of T11/12,four(4/17,24%)through the left intervertebral foramen of L1/2,two(2/17,12%)through the left intervertebral foramen of L2/3,two (2/17,12%)through the right intervertebral foramen of T11/12,two(2/17,12%)through the right intervertebral foramen of T12/L1,two(2/17,12%)through the right foramen of L2/3 andl0(10/17,59%)through the left intervertebral foramen.Either CT scan or DSA examination found no radiculomedullary artery in one patient.All the above findings were in accordance with the results of DSA examination.Conclusions Spiral 64-slice CT scan can provide significant preoperative evaluation information for spinal vascular intervention,for it can accurately and visually show the anatomical features of the radiculomedullary artery such as open position,flow tendency,caliber size and spatial relationship with the surrounding vessels.

ObjectiveTo explore the values of 3D enhanced T2-star weighted angiography (ESWAN) in detecting iron deposition of the brain in patients with multiple sclerosis ( MS).Methods Conventional MRI and 3D ESWAN were performed in 22 patients with released-remitting MS(RR-MS) and in 22 age- and gender-matched normal controls.Both the magnitude images and phase images were available after post processing of the original ESWAN data post processing.The expanded disability status scale (EDSS) scores of the patients were from 0 to 8.5,and the course of disease were between 0.5 year and 15 years.The manifestation of MS lesions was evaluated on conventional MR images and ESWAN images by two experienced radiologists with blind methods.The phase values were measured for MS lesions between the semioval center and periventricular white matter and the corresponding regions in the normal control group were measured as well The Wilcoxon rank test was used to compare the differences of phase values between MS patients and normal controls,and the Spearman rank correlation analysis were used to analyze the correlations among the phase values of MS lesions,EDSS scores and course of disease of MS patients.Results( 1 ) MS lesions were observed on magnitude images and phase images,respectively and together.Two hundred and thirteen(32.8％ )lesions were detected on both the magnitude images and phase images,164 (25.2％)lesions were detected on the magnitude images only,and 273 (42.0％) lesions were detected on the phase images only.A total of 650 lesions were observed on the ESWAN,which showed more 42 lesions than conventional images(608).Among 486(273 + 213 )lesions observed on the phase images,205 (31.5％) lesions were homogeneously hypointense,45 (6.9％ ) lesions showed hypointense ring,and 236 (36.4％ ) lesions were inhomogeneously hypointense.(2) “ Penetrating veins” were showed in 424 (65.2％ ) periventricular lesions.The “penetrating veins” showed dilated and prolonged in 198 (30.5％ ) acute lesions,thin and short in 208 (32.9％ ) chronic lesions.However,the “penetrating veins” of 12 ( 1.8％ ) chronic lesions in 5 stable MS patients were expanded and prolonged slightly.( 3 ) The average phase value of the lesions ( - 0.05 ± 0.08) in patients with RR-MS was significantly lower than that of corresponding to regions (0.06 ± 0.05 ) in the normal control group( Z = 22.30,P ＜ 0.01 ).(4) The phase values of MS lesions were significantly correlated to the EDSS and course of disease of patients with RR-MS (r = -0.98,0.99 respectively,P ＜ 0.01 ).ConclusionESWAN can be helpful in the evaluation and quantification of abnormal iron deposition in MS lesions,which provides important values for the pathogenesis and pathological study for MS patients.

Purpose To describe the normal appearances of skull on 3D-reconstruction of Multi-slice CT in adult.Materials and Methods 130 patient data of Volume CT digital subtraction angiography (VCTDSA) with cephalocervical and cephalic vessel that were checked at our hospital from May to July 2009 were analyzed.All of them were subjected to 3D reconstruction of the skull by volume render (VR) and maximum intensity projection (MIP).The anatomy of skull,vascular grooves,pacchionian impressions,the types and closure status of cranial sutures were observed.Results 27 pacchionian impressions (20.77%,27/130) and 51 vascular grooves (39.23%,51/130) were detected.There were three types of the general shapes of cranial sutures:Ⅰconventional type(86.15%,112/130),Ⅱfontanelle ossification type(5.38%,7/130) and Ⅲcranial suture within a cranium (8.46%,11/130).Furthermore,Status of each suture closure were divided into five types:typeⅠcomplete closure(3.0%,16/531);typeⅡgomphosis(78.3%,416/531);typeⅢ sutural bone (7.0%,37/531);typeⅣincomplete closure(3.6%,19/531),the average width of non-closed suture was 1.41mm±0.70mm;typeⅤmixed type (8.1%,43/531).Conclusion 3D reconstruction of multi-slice computed tomography is proved to be a reliable technique capable of defining anatomy of skull.Better than MIP to displays three-dimensional structure VR,but to display cranial sutures,vascular grooves,pacchionian impressions MIP is more definite and hypersensitive.Status of each suture closure may be divided into five types,and the general shapes of cranial sutures may be divided into three types.

BACKGROUND: At present, traditional modalities of neuroimaging, such as CT and MRI, is very limited in the diagnosis and severity estimation of diffuse axonal injury (DAI).OBJECTIVE: To investigate the value of proton magnetic resonance spectroscopy (1HMRS) in the diagnosis and prognosis of DAI.DESIGN, TIME AND SETTING: Prospective clinical controlled observation. The study was performed at the Department of Neurosurgery, and Department of Radiology, First Affiliated Hospital of Chongqing Medical University between October 2002 and September 2007.PARTICIPANTS: A total of 63 subjects with traumatic brain injury were enrolled and divided into DAI group (n=27) and non-DAI group (n=36) according to the result of MRI. In addition, 20 healthy persons were served as control group.METHODS: Demographic and clinical data were recorded on admission and neuroimaging examinations including fluid attenuated inversion recovery were carried on according to carefully designed procedures, in addition, 1HMRS was performed and the data were analyzed in combination with clinical condition.MAIN OUTCOME MEASURES: The ratios of N-acetyl aspartate (NAA)/creatine (Cr) and creatine phosphate (Cr), Choline compound (Cho)/Cr, myoinositol (mlNs)/Cr, and glutamic acid (GIx)/Cr at genu and splenium of corpus cellosum, and basal ganglia were quantified using 1HMRS.RESULTS: Compared with control and non-DAI groups, DAI group had decreased NAA/Cr and increased Cho/Cr at genu and splenium of corpus callosum, and basal ganglia (P < 0.05- 0.01), as well as increased mlNs/Cr and Glx/Cr at genu and splenium of corpus cellosum (P < 0.05). Non-DAI group also showed decreased NAA/Cr at splenium and increased Cho/Cr at genu of corpus callosum compared with control group (P < 0.01), but the change degree was less than DAI group. A positive correlation between Cho/Cr at genu of corpus callosum and the peded of primary unconsciousness was identified in DAI group (r=0.824, P < 0.01). CONCLUSION: The 1HMRS indexes at genu and splenium of corpus callosum, and basal ganglia could serve as effective indexes for the diagnosis of DAI. The Cho/Cr could well reflect histological changes following injury and act as sensitive index to predict clinical injury.