Objective To improve diagnosis accuracy of pineocytoma (PC) by joint analysis of CT,MRI imaging features and differential diagnosis with other lesions in pineal region.Methods Totally 6 pineocytoma patients confirmed surgically and pathologically had their clinical history,CT and MRI data collected and analyzed on lesion morphology,cystic solid changes,existence of necrosis,complications of hemorrhage and or calcification,MRI and enhanced scan of solid component,complications with hydrocephalus and etc.Results Plain scan found 1 case of solid nodule and 5 cases of cystic-solid nodules,2 cases with clearly-bordered lesions and 4 one not as well as 4 cases with significant hydrocephalus and 2 ones with light hydrocephalus.Enhanced scan showed 5 cases of moderate to marked enhancement and one case with no obvious enhancement.CT examination proved there were 1 case of calcification and 1 case of hemorrhage.Conclusion Pineocytoma has the characteristics of benign tumor,and has to be differentiated with other tumors frequently occurring in this region in case of obvious clinical signs due to crushing brain parenchyma or blocking aqueduct cerebri by oversized lesions.

Objective To establish the animal model of chronic thromboembolic pulmonary hypertension(CTEPH) and to compare the accuracy of dual-energy CT (DECT) pulmonary angiography and histopathology for detecting CTEPH. Methods Eighteen canines were included in the study. All canines underwent paracentesis, embolization, CT scanning, pressure measurement and tranexamic acid feeding. The procedures were repeated every two weeks, until systolic/diastolic pressure in canines was≥30/15 mmHg or mean pulmonary artery pressure ≥ 20 mmHg.And then canines were sacrificed for histopathology examination. For CT pulmonary angiography (CTPA)in DE mode and DECT lung perfused blood volume (Lung PBV) images, the presence or absence of PE or perfusion defects were recorded on a per-canineand aper-lobe basis. With histopathological results as reference standard, the sensitivity, specificity of CTPA and lung PBV to detect PE were computed for two readers. The pairedχ2 test (McNemar test) was used to analyze the difference in diagnostic accuracy between CTPA and Lung PBV. Inter-reader agreement was also calculated with kappa test. Results CTEPH was demonstrated in 13 canines. On a per-canine basis, both readers found uneven and peripheral perfusion defects with DECT in 11 canines (84.6%, 11/13); while 5 canines (38.5%, 5/13) had cutoff or sudden stenosis of pulmonary arteries with CTPA;on a per-lobe basis,
both readers had sensitivities of 14.3%(5/35), 83.3%(30/36), specificities of 100.0%(30/30), 100.0%(29/29), accuracies of 53.8%(35/65), 90.8%(59/65)for CTPA and DECT, respectively. DECT had a higher sensitivity(χ2=-4.690,P<0.01)and accuracy(χ2=8.284,P<0.01) in detecting CTEPH. Excellent and moderate inter-reader agreements were observed with CTPA and DECT (Kappa=0.938, 0.572, both P<0.001). Conclusions It is feasible to make a CTEPH animal model with autologous thrombus. DECT shows a higher accuracy than CTPA to detect CTEPH in this canine model study.

ObjectiveTo evaluate the feasibility of gadolinium-enhanced dual energy CT pulmonary angiography (CTPA) in detecting pulmonary embolism (PE).MethodsIn vitro dual energy CT of phantoms of gadolinium and iodinated contrast agents with different diluted ratio was performed,and CT values were measured at different tube voltages.Ten rabbits which were grouped into 3 ml/kg and 5 ml/kg groups underwent dual energy CT scan.CT values of pulmonary artery trunk and the first branch of pulmonary artery were measured.Sponge gelatin were injected into the femoral vein of 6 rabbits to make PE model next day,then lungs were re-imaged with dual energy CT 2 h after embolization.Creatinine was repeatedly measured before and one day after injection of gadolinium via ear marginal vein or femoral vein sampling.One-way ANOVA test and independent student t test were used to analyze the difference of pulmonary artery enhancement between different groups.Results ( 1 ) Compared with iodinated contrast agent,CT value of gadolinium-based contrast agent at 80 kV was higher than those at 140 kV and averageweighted 120 kV.(2) At 140,80,and average weighted 120 kV,CT values of pulmonary artery trunk [CT values were (463.1 ± 118.0),(664.2 ± 188.0),(522.9 ± 137.7) HU] and of the first branch of pulmonary artery [ CT values were (445.1 ± 82.3 ),(606.7 ± 207.2),(493.4 ± 117.3 ) HU ] were higher than those at 3 ml/kg [ CT value of pulmonary artery trunk was ( 258.1 ± 55.1 ),( 384.0 ± 92.3 ),(295.4 ± 73.6) HU,CT value of the first branch of pulmonary artery (245.0 ± 73.2 ),( 309.1 ± 94.2),(263.8 ±78.5) HU;all P ＜0.05].CT values of pulmonary artery trunk and the first branch of pulmonary artery at 80 kV were higher than those at 140 kV and average-weighted 120 kV ( pulmonary artery trunk:F =6.004,P =0.005 ; the first branch of pulmonary artery: F =4.374,P =0.018).In 6 rabbits,CTPA showed the enhancement cut-off of bilateral pulmonary arteries,gadolinium mapping showed decreased perfusion in the corresponding lung lobes,manifested as blue on color-coded map,while normal lung was color coded as red or yellow.Creatinine was higher by 6.7％ and 20.6％ for group 3 ml/kg and 5 ml/kg.ConclusionsWith similar X-ray attenuation characteristics as iodine,gadolinium-based contrast agent can be used to pulmonary contrast-enhanced dual energy CT imaging,simultaneously providing both CTPA and gadolinium maps to detect PE.

ObjectiveTo evaluate the image quality of displaying the pulmonary artery and pulmonary emboli at different tube voltages and find the optimal tube voltage.MethodsSixty-six patients underwent contrast-enhanced dual energy CT pulmonary angiography (CTPA) from August 2007 to February 2010.Data obtained with 80 kVp,weighted average 120 kVp,and 140 kVp were divided into group Ⅰ,Ⅱ,and Ⅲ respectively.CT value of pulmonary artery ( grade 1—4),emboli,and muscles were measured.Corresponding signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated.One-way ANOVA analysis and Friedman test were used to analyze statistical significance among these values.Image quality of CTPA from these three groups was assessed.The inter-reader agreement of image quality was performed by kappa test.ResultsCT value of branch 1 to 4 of ptlmonary artery was (446 ± 140) HU,(433±130) HU,(411 ±138) HU,and (392±127) HU in group Ⅰ,(303±91) HU,(290±85) HU,(276±86) HU,and (263 ±85) HU in group Ⅱ,and (244 ±70) HU,(230 ±63) HU,(216 ±72) HU,and (205 ±68) HU in group Ⅲ.There was significant difference for CT values (P ＜0.01) among three groups.CT value of pulmonary artery in 80 kVp images was higher than 140 kyp and 120 Kvp.On quantitative analysis of 37 patients,CNR value of pulmonary clots was 8.3 ± 3.3,8.0 ± 2.9,and 5.6 ± 2.2 in group Ⅰ,Ⅱ,and ⅢⅢ,respectively.CNR values of pulmonary clots in 80 kVp images and 120 kVp images were higher than that in 140 kVp (P ＜0.01 ).There was no statistical difference for image quality of CTPA among the three groups ( P ＞ 0.05 ).Agreement of image quality of CTPA derived from 80 kVp (kappa value =0.789,P ＜0.01 ) was superior to that of 120 kVp (kappa value =0.652,P ＜0.01 ) and 140 kVp ( kappa value = 0.509,P ＜ 0.01 ).Conclusions CT value of pulmonary artery in 80 kVp images was higher than that of weighted average 120 kVp and 140 kVp,and the image quality and CNR was comparable with that of weighted average 120 kVp images.This tube voltage ( 80 kVp) is optimal for CT pulmonary angiography in the evaluation of patients with suspected pulmonary embolism.

Objective To evaluate monoenergetic imaging of dual energy CT in the visualization of metal fixation of factures. Methods In total, 29 patients with factures underwent 36 metal fixations,including 11 external fixations implanting in tibiofibula (n = 11 ) and 25 internal fixations (cervical spine,n=10; lumbar spine, n=4; tibiofibula, n=8; radial bone, n=3). They were recruited into this study.After dual energy CT scan, monoenergetic software was used to post-process with the following 6 photon energies: 40, 70, 100, 130, 160, 190 keV. Two radiologists evaluated and rated the reformatted images with 6 different photon energies and average weighted 120 kV images according to the following 4-score scale. Score 1: nonassessable, with marked artifact; score 2: assessable, moderate artifact; score 3: good,mild artifact, good visualization of bony structures; score 4: excellent, no artifact. Kruskal-Wallis was used to perform statistical analysis of image quality for total fixations, external and internal fixations with various selective kev settings and average weighted 120 kV. Results For total fixations, monoenergetic imaging of dual energy CT has 25 fixations with score 3 and 4, but 120 kV has only 4 fixations with score 3 and 4.Monoenergetic imaging of dual energy CT improved image quality of fractures with metal fixation compared to average weighted 120 kV images ( F = 116. 487, P ＜0. 01 ). Images of 130 kev had the best image quality for external metal fixation (9 fixations with score 3 and 4, F = 60. 902, P ＜ 0. 01), while 70 kev was best for internal metal fixation ( F = 122. 149, P ＜ 0. 01). Conclusions Monoenergetic imaging of dual energy CT improves image quality of fractures with metal fixation. Reformatted images at 70 keV and 130 keV havethe optimal image quality for internal and external metal fixation, respectively.

Objective To investigate the prevalence of cognitive and motor disorders as well as emotional and sleep abnormality in the veterans from military communities in Beijing. Methods The participants underwent a comprehensive in-person evaluation including detailed neuropsychological testing,Hospital Anxiety and Depression Scale and special questionnaires for movement and sleep disorders. Results The overall prevalence of cognitive impairment, extrapyramidal diseases was 32.7%, 8.8% . The prevalence of mild cognitive impairment, dementia, Parkinson disease, essential tremor, anxiety and depression was 26.2% , 6.5% , 2.0% , 6.1 % , 1.4% and 4.1% respectively. Prevalence of all kinds of sleep disorders ranged from 10. 3% to 53. 9%. The prevalence of cognitive impairment had no significant difference of sex, but were correlated to age and education, the correlation coefficient was 0. 326 and -0.221 ( P<0.01) . Conclusion Veterans from military communities had higher prevalence of cognitive impairment, extrapyramidal diseases and sleep disorders and lower that of anxiety and depression relatively.

Objective To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as "gold standard", the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X~2=4.35, P<0.05, respectively. Conclusion Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography.

Objective To explore the clinical value of dual-energy CT lung perfusion imaging and perfusion scintigraphy in acute pulmonary embolism (PE) rabbit models. Methods Acute PE models were established in 20 rabbits with femoral vein injection of sponge as embolus materials, and 4 rabbits were injected saline as control group. Two hours after embolization, dual-energy CT and perfusion scintigraphy imaging were performed respectively. Taking the pathologicall findings as the reference standards, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both imaging methods were compared. CT values and enhancement degree (overlay value) of the embolic areas and normal pulmonary parenchyma were measured in DEPI image after embolization. Results Normal lung was color-coded as homogeneously yellowish red, perfusion scintigraphy displayed rarefaction or absence. The sensitivity, specificity, PPV, NPV of DEPI was 100%, 97.50%, 95.24%, 100%, and of perfusion scintigraphy was 67.50%, 81.25%, 64.29%, 83.33%, respectively. Increased CT values and overlay values of embolism areas in DEPI images were lower than those of normal pulmonary parenchyma (P<0.05). Conclusion DEPI has higher sensitivity and specificity than perfusion scintigraphy for detection of pulmonary emboli in an acute PE rabbit models.

clues for interpretation of myocardial ischemia.

Objective To evaluate the feasibility and value of dual-energy perfusion imaging (DEPI) of dual-source CT(DSCT) in the diagnosis of acute experimental pulmonary embolism. Methods Acute pulmonary embolism ( PE ) model was made in 8 New Zealand rabbits, and non-enhanced and enhanced DSCT scans were performed before and after embelization. Postprocessing of image data was made on the workstation, and CT pulmonary angiography ( CTPA ), DEal and fusion images were obtained. The location and number of the emboli were recorded. The rabbits were killed immediately after DSCT scan, the location and number of the lung lobes with pulmonary emboli were evaluated pathologically. Based on the pathological results, the sensitivity, specificity, positive predictive value ( PPV), and negative predictive value (NPV) of CTA, DEal and fusion images for the diagnosis of PE were calculated. Weighted Kappa values were calculated to evaluate the consistency between CTPA and DEal. Results PE model was made successfully in 7 rabbits. Six rabbits with 30 lobes were evaluated with one exception because of the catheter affecting the quality of lung peffusian image. PE was found pathologically in 18 lobar arteries. On DEPI, the region with PE showed low peffusion area comparing with the normal parenchyma and CTPA showed the filling defect within corresponding pulmonary artery or interruption of the artery. The sensitivity, specificity, PPVand NPV of CTPA were 66. 7% (12/18), 100.0% (12/12), 100.0% (12/12) and 66. 7% (12/18), respectively. The Kappa value was 0. 651 indicating moderate correlation with pathology. The sensitivity, specificity, aPv, and NPV of DEal were 88. 9% ( 16/18), 91.7% ( 11/12, 94. 1% (16/17) and 84. 6% ( 11/13 ), respectively. The Kappa value was 0. 795 indicating excellent correlation with pathology. Conclusion Dual-energy lung perfusion imaging of DSCT can display the blood distribution of rabbit's lung and has a high sensitivity for the diagnosis of acute pulmonary embolism.