Objectives:To evaluate the efficacy and safety of drug-coated balloon in the treatment of de novo coronary chronic occlusive lesions. Methods:Consecutive patients with de novo coronary chronic occlusive lesions treated with drug-coated balloons only were included in this study.The general information,medical history,and surgical information of the patients were recorded,and major adverse cardiovascular events(MACE,including cardiac death,myocardial infarction,and target vessel revascularization)were recorded by telephone or outpatient follow-up. Results:A total of 160 patients were included.There were 26 ostial lesions(16.3%),42 bifurcated lesions(26.3%),117 diffuse lesions(73.1%),and 87 calcified lesions(54.4%).The reference vessel diameter was(2.3±0.4)mm.During hospitalization,there were no acute myocardial infarction,cardiac death,target lesion revascularization,or acute coronary thrombosis.Cardiac death occurred in 1 case and target vessel revascularization occurred in 6 cases during follow-up.The MACE rate is 4.4%. Conclusions:Drug balloon therapy for de novo coronary chronic occlusive lesions is safe and effective,and the prognosis is satisfactory.

Objective To investigate the clinical and MRI features of primary non-urachal adenocarcinoma of the bladder.Methods The clinical and MRI data of 9 patients with histopathologically confirmed primary non-urachal adenocarcinoma of the bladder were analyzed retrospectively.Results Clinical symptoms of hematuria were present in 7 cases and urinary irritation symptoms in 5 cases among all patients.On MRI,1 case showed diffuse thickening of the bladder wall,8 cases showed a solitary nodular/cauliflower-like mass in the bladder with iso-hypointensity on T1WI and slight hyperintensity on T2WI,and patchy areas of hyperintensity on T2WI were seen in some patients.The apparent diffusion coefficient(ADC)ranging from 0.83× 10 3 mm2/s to 1.85× 10 3 mm2/s,mean ADC was approximately 1.23×10-3 mm2/s.Dynamic enhancement showed mild to marked enhancement,with some rim or compartmentalized enhancement,and patchy or diffusely distributed areas of no enhancement can be seen.No cystic changes and necrosis were seen in all patients,invasion of the muscularis propria and above were seen in 7 cases,lymph node metastasis was seen in 3 cases,and distant metastasis was seen in 2 cases.Conclusion Primary non-urachal adenocarcinoma of the bladder has certain clinical and MRI features.Patients often present with hematuria and urinary irritation symptoms,and some may present with blennuria.MRI shows that the lesion is solitary and more aggressive,with some hyperintensity on T2 WI,cystic changes and necrosis are rare.These features help to improve the accuracy of preoperative diagnosis to some extent,and the final diagnosis still relies on pathology.

Objectives:To analyze the efficacy and safety of drug coated balloon for coronary de novo lesions in real world. Methods:We enrolled consecutive patients with coronary de novo lesions treated with drug coated balloons from January 2020 to June 2021 in Fuwai Hospital.The baseline data,procedure data and in-hospital cardiac events were collected through case query.All patients were followed up by clinical visit or telephone call.Major adverse cardiac events(MACE)were defined as the composite of the cardiac death,acute myocardial infarction,target lesion revascularization.According to the diameter of the blood vessels,the patients are divided into the large vessel lesion group(vessel diameter≥2.75 mm,n=337),and the small vessel lesion group(vessel diameter<2.75 mm,n=575). Results:There were 940 coronary de novo lesions in 912 patients.A total of 974 drug balloons were used,average diameter was(2.6±0.8)mm,average length was(21.0±6.0)mm,average pressure was(10.0±3.8)atm.Among the 940 primary coronary artery lesions,343 lesions had a diameter≥2.75 mm,and 597 lesions had a diameter<2.75 mm.During hospitalization,two patients with acute ST-segment elevation myocardial infarction died of cardiac rupture after emergency coronary interventional treatment,acute vessel closure because of coronary hematoma occurred in 1 patient and bailout drug-eluting stent was used in this patient,five patients received salvage stent treatment due to type C dissection immediately after drug coated balloon treatment.During follow-up,Target lesion revascularization(TLR)occurred in 15(1.6%)patients(including coronary artery bypass grafting in 1 patient).Nonfatal acute myocardial infarction occurred in 1 patient,cardiac death occurred in 1 patient,2 patients died of cerebral hemorrhage,1 patient died of cerebral infarction,MACE rate was 1.9%(17/912).MACE rate during follow-up was similar between large vessels group and small vessels group(1.8%vs.1.9%,P>0.05). Conclusions:Our study indicates that drug coated balloon for coronary de novo lesion is safe and effective.There is no difference of MACE rate between large vessel group and small vessel group.

Objective To discuss the imaging features of germ cell tumors on CT and MRI.Methods Preoperative CT and MRI data of 11 pathologically proved germ cell tumors were analyzed retrospectively.A total of 11 cases were enrolled in the study,4 cases received plain and contrast-enhanced CT scan,1 received plain and contrast-enhanced MRI scan,and 6 received both CT and MRI scan.Results Histological examinations revealed 11 testicular neoplasms,among which 4 cases were seminoma,1 was embryonal carcinoma,1 was immature teratoma,3 were mixed germ cell tumors,1 was spindle cell rhabdomyosarcoma and 1 was carcinoid.Most germ cell tumors were iso density or low density with or without clear boundary,mild to moderate enhancement on CT scan.On MRI scan,most germ cell tumors showed iso-hyper intensity on T1WI,hypointensity,isointensity or hyperintensity on T2 WI,heterogeneous mild to moderate enhancement,high signal intensity on DWI,and low or high signal intensity on ADC.Conclusion Typical testicular germ cell tumor imaging performance has a certain specificity,but the atypical germ cell tumor lacks specificity.So the final diagnosis still depends on the pathology.

Objective To discuss the applied research of CT perfusion imaging on the diagnosis of splenic diseases. Methods 20 patients with splenic diseases which accepted treatment in our hospital from January 2012 to December 2014 were assigned into group A,including 7 cases of splenic lymphoma patients(group A1),8 cases of leukemia patients with spleen infiltration(group A2)and 5 cases of splenic metastasis(group A3). At the same time,20 healthy persons were selected as the control(group B). Results The result of CT scan was normal in group B,but that showed a variety of lesions in the spleen in group A. The spleen perfusion volume in the group A was significantly higher than that in the control group(P<0.05). The detection rate of CT perfusion imaging was significantly higher than that of CT scan(P<0.05). TIP and MTT in group A were significantly higher than those in group B,while BF,PEI and BV were significantly lower(P<0.05). Conclusion CT perfusion imaging has advantage of simple,short imaging time,less trauma,and a high diagnostic value for the spleen disease,which is an ideal detection means and can be used in clinic.

Objective To explore the value of DWI (diffusion weighted imaging,DWI) in diagnosis of bladder cancer in clinical T stage by comparing DWI and CT.Methods Seventy-five patients with bladder cancer underwent MRI plain scan,enhanced diffusion-weighted imaging and CT scan,to make a diagnosis preoperative clinical T stage according to their image.Then we compared the diffusion-weighted imaging and CT results with pathological staging results to assess the value of DWI in bladder tumor staging.Results For clinical T staging bladder cancer,the diagnostic accuracy rate was 83.5％ and 72％ for DWI and CT,resectively,statistical analysis showed a significant difference (P ＜0.05).Conclusion Magnetic resonance diffusion weighted imaging can accurately diagose the clinical T stage of bladder cancer,and has a higher value than CT.

Objective: To assess the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on mid- to long-term left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy (HOCM) by real-time three-dimensional echocardiography (RT-3DE). Methods: A total of 46 HOCM patients who received 2DE and RT-3DE examination before and after (with the mean of 18.8 months) PTSMA were studied. The ratios of E/A and E/Ea were analyzed, RT-3DE was conducted to collect the images, to obtain 17-segmant volume-time curve and to calculate the parameters of rEDV, rESV, rSV and rPFR respectively. Results: The follow-up echocardiography in all 46 patients indicated that the ratio of E/Ea decreased after the operation (12.04 ± 3.29) vs (15.70 ± 5.68),P<0.001, the rSV of left ventricular anterior wall middle segment and anterior septal middle segment decreased after the operation,P<0.05, while the rPFR of anterior septal middle segment, rear septal middle segment and apical segment increased,P<0.05. Conclusion: PTSMA may improve local left ventricular diastolic function in HOCM patients, RT-3DE provides a new method and viewing angle for HOCM evaluation.

Objective To observe the characteristics of different level of normal abdominal aorta’s time-flow,time-velocity curve and to investigate the hemodynamic factors in role of the occurrence and development of abdominal aorta’s disease.Methods PC-MRI scanning was performed on 60 normal volunteers T12/L1-L4/5 disc at the level of abdominal aorta,time-flow and time-veloci-ty curve were generated respectively.The characteristics of blood flow curves at different levels of abdominal aorta were observed. Results The time-flow,time-velocity curve of the normal abdominal aorta in different levels have 2nd phase (no diastolic reflux) and 3rd phase (diastolic reflux).Conclusion The characteristics of blood flow curves of different levels of abdominal aorta are dif-ferent.

Objective:To evaluate the value of multilayer dynamic CT scan in the preoperative diagnosis and staging of rectal carcinoma.Methods: CT findings of a retrospective analysis of 38 cases with pathologically confirmed cancer, study characteristics of partial image, Adjacent tissue invasion and distant organ metastasis, And compared with postoperative pathology.Results:Intraluminal mass 15 cases, Intraluminal mass associated with of bowel wall thickening 12 cases, The a tumor breakthrough serosa layer and surrounding tissue invasion 7 cases; Tumor invasion of adjacent organs or with distant metastasis 4 cases; consistent rate compared with pathological was 81.5%(31/38).Conclusion: Multilayer enhanced CT scan is well consistent rate in the diagnosis and staging of rectal cancer compared with pathologic staging, Preoperative contrast enhanced CT scanning have guiding significance for clinical choice of surgical approach, With higher value of clinical application.

Objective To evaluate the diagnostic value and limitation of MRI for chromophobe renal cell carcinoma.Methods MRI features of 5 cases with pathology proved chromophobe renal cell carcinoma were analyzed retrospectively.Results All tumors showed homogenous isoin-tensity or slightly hypointensity on T1 weighted images and isointensity or slightly hyperintensity on T2 weighted images.Slightly hyperintensity were showed on DWI images,the mean ADC value of tumors was 1.42×10-3 mm2/s.On the contrast enhanced images,all the mass showed slight to moderate enhancement ,1 case had spoke-wheel-like enhancement,1 case showed flowed out blood vessels in the tumor.Conclusion The preoperative diagnosis is difficult for chromophobe renal cell carcinoma,MRI is a valuable method which could provide useful information for qualitative diagnosis.