肝癌的影像学评价:1.5T MRI与常规CT、US比较

目的：探讨三种非创伤性影像检查方法ＭＲＩ、ＣＴ和ＵＳ在肝癌诊断中的敏感性和准确性。方法：５２例经病理及临床证实的ＨＣＣ行ＭＲＩ,ＣＴ和ＵＳ检查。结果：ＭＲＩ常规序列与ＦＭＰＳＰＧＲ相比,敏感性以ＳＥＴ２Ｗ及ＦＭＰＳＰＧＲ序列为高。对ＨＣＣ检出总的敏感性依次为ＭＲＩ（ＳＥ＋ＦＭＰＳＰＧＲ）８５．８９％,ＣＴ７５．６４％,ＵＳ７１．７９％,＜３ｃｍＨＣＣ,ＭＲＩ检出的敏感性为７１．４２％明显高于ＣＴ（５１．４２％）和ＵＳ（４５．７１％）,对于＞３ｃｍＨＣＣ,三者敏感性相似。ＨＣＣ定性准确性依次为动态增强ＦＭＰＳＰＧＲ（９２．０６％）,常规ＳＥ序列（８５．９３％）,ＣＴ（８４．７４％）,ＵＳ（７５．００％）,ＳＥ序列结合动态增强ＦＭＰＳＰＧＲ对肝癌定性准确性可达９５％,明显优于ＣＴ和ＵＳ。结论：在ＨＣＣ的检出敏感性和定性诊断上,１．５ＴＭＲＩＳＥ序列结合动态增强ＦＭＰＳＰＧＲ明显优于常规ＣＴ和ＵＳ,为肝癌重要的影像学检查手段。     

Effects of Level Changes of 5-HT and Dopamine in Cerebral Microvasculature on Occurrence of Secondary Damages in Traumatic Brain Injury in Rats

ＥＦＦＥＣＴＳＯＦＬＥＶＥＬＣＨＡＮＧＥＳＯＦ５┐ＨＴＡＮＤＤＯＰＡＭＩＮＥＩＮＣＥＲＥ┐ＢＲＡＬＭＩＣＲＯＶＡＳＣＵＬＡＴＵＲＥＯＮＯＣＣＵＲＲＥＮＣＥＯＦＳＥＣＯＮＤＡＲＹＤＡＭＡＧＥＳＩＮＴＲＡＵＭＡＴＩＣＢＲＡＩＮＩＮＪＵＲＹＩＮＲＡＴＳＫＥ...     

OSTEOCLASTIC RESORPTION OF CANCELLOUS BONE TISSUES OF FEMORAL NECK IN HIP FRACTURE PATIENTS (A SCANNING ELECTRON MICROSCOPIC STUDY)

ＯＳＴＥＯＣＬＡＳＴＩＣＲＥＳＯＲＰＴＩＯＮＯＦＣＡＮＣＥＬＬＯＵＳＢＯＮＥＴＩＳＳＵＥＳＯＦＦＥＭＯＲＡＬＮＥＣＫＩＮＨＩＰＦＲＡＣＴＵＲＥＰＡＴＩＥＮＴＳ（ＡＳＣＡＮＮＩＮＧＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＩＣＳＴＵＤＹ）ＣＨＡＩＢｅｎ－ｆｕ（...     

多层块薄层重迭采集与移行预饱和法在颈部动脉MRA中的应用

目的：探讨多层块薄层重迭采集（ ＭＯＴＳＡ） 与移行预饱和组合序列（ＴＳＣ） 在颈部动脉ＭＲＡ 中的应用,以选择颈部ＭＲＡ 的优化序列组合。材料和方法：正常人组４０ 例,疾病组４ 例。均同时行ＭＯＴＳＡ、ＴＳＣＭＲＡ。结果：ＭＯＴＳＡ 技术空间分辨力高,血管／ 背景对比好,病变显示清晰,但检查时间长,层块间可见饱和伪影;ＴＳＣ ＭＲＡ 血流信号强度高,块间连接简便,无饱和伪影,缺点是对涡流敏感,空间分辨力较低。结论：以２Ｄ ＴＳＣ 观察血管全长,３Ｄ ＴＯＦ－ ＴＯＮＥ 观察血管局部是颈部动脉ＴＯＦ 法ＭＲＡ 较好的序列组合。     

HISTOLOGICAL CHARACTERISTICS OF HEALING OF INJURED AVASCULAR PORTION OF MENISCUS UNDER DIRECT MICROCUR-RENT STIMULATION

ＨＩＳＴＯＬＯＧＩＣＡＬＣＨＡＲＡＣＴＥＲＩＳＴＩＣＳＯＦＨＥＡＬＩＮＧＯＦＩＮＪＵＲＥＤＡＶＡＳＣＵＬＡＲＰＯＲＴＩＯＮＯＦＭＥＮＩＳＣＵＳＵＮＤＥＲＤＩＲＥＣＴＭＩＣＲＯＣＵＲ┐ＲＥＮＴＳＴＩＭＵＬＡＴＩＯＮＬＩＵＪｉｎ－ｃａｉ（刘晋才），ＨＵＡ...     

INTRADURAL HERNIATION OF LUMBAR INTERVERTEBRAL DISC：ARE－PORTOFSEVENCASESANDDISCUSSIONOFTHEPATHOLOGICALMEC

ＩＮＴＲＡＤＵＲＡＬＨＥＲＮＩＡＴＩＯＮＯＦＬＵＭＢＡＲＩＮＴＥＲＶＥＲＴＥＢＲＡＬＤＩＳＣ：ＡＲＥ－ＰＯＲＴＯＦＳＥＶＥＮＣＡＳＥＳＡＮＤＤＩＳＣＵＳＳＩＯＮＯＦＴＨＥＰＡＴＨＯＬＯＧＩＣＡＬＭＥＣＨ－ＡＮＩＳＭＬｉａｎＰｉｎｇ连平ＳｕｎＲｏｎｇ－...     

CHANGES OF BETA-ADRENERGIC RECEPTORS OF PERIPHERAL BLOOD LYMPHOCYTE IN PATIENTS WITH ACUTE CEREBRAL TRAUMA AND THEIR CLINICAL SIGNIFICANCE

ＣＨＡＮＧＥＳＯＦＢＥＴＡ┐ＡＤＲＥＮＥＲＧＩＣＲＥＣＥＰＴＯＲＳＯＦＰＥＲＩＰＨＥＲＡＬＢＬＯＯＤＬＹＭＰＨＯＣＹＴＥＩＮＰＡＴＩＥＮＴＳＷＩＴＨＡＣＵＴＥＣＥＲＥＢＲＡＬＴＲＡＵＭＡＡＮＤＴＨＥＩＲＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＨＵＸｉ...     

X线照片斑点的自相关函数的测试探讨

目的：测试Ｘ线照片斑点的自相关函数（ａｕｔｏ－ｃｏｒｅｌａｔｉｏｎｆｕｎｃｔｉｏｎ，ＡＣＦ）。材料与方法：对Ｆｕｊｉ（ＣａＷＯ４），Ｆｕｊｉ（ＢａＦＣｌＥｕ），天津Ｘ线胶片（ＣａＷＯ４）和天津Ｘ线胶片（ＢａＦＣｌＥｕ）４种屏－片组合系统，在同一摄影条件下获得Ｘ线照片，用显微密度计对其进行扫描取得Ｘ线照片的密度分布曲线Ｄ（Ｘ），作为离散型随机信号来处理，计算出４种屏－片系统的Ｘ线照片斑点的ＡＣＦ值。结果：与ＢａＦＣｌＥｕ组合的Ｘ线照片斑点的ＡＣＦ值比与ＣａＷＯ４组合的屏片系统的大。结论：ＢａＦＣｌＥｕ增感屏因结构颗粒大，对Ｘ线照片影响大（或相关性强），控制Ｘ线照片斑点ＡＣＦ值的主要措施是，使增感屏的颗粒不宜过大。     

快速动态增强MR多期扫描技术在小肝癌诊断中的应用

研究动态增强ＧＤ－ＦＭＰＳＰＧＲ多期扫描在肝癌诊断中的价值小肝癌的ＭＲＩ表现,材料与方法：３５例ＳＨＣＣ患者进行了前瞻性ＭＲＩ研究,所有病例均行ＳＥ序列及动态增强的ＦＭＰＳＰＧＲ序列多期扫描,并经手术病理证实。     

EFFECTS OF NIMODIPINE ON CALCIUM CURRENTS IN CORTICAL NEURONS AFTER IMPACTING BRAIN INJURY

ＥＦＦＥＣＴＳＯＦＮＩＭＯＤＩＰＩＮＥＯＮＣＡＬＣＩＵＭＣＵＲＲＥＮＴＳＩＮＣＯＲＴＩＣＡＬＮＥＵＲＯＮＳＡＦＴＥＲＩＭＰＡＣＴＩＮＧＢＲＡＩＮＩＮＪＵＲＹＮＩＮＧＫｅ（宁可），ＷＡＮＧＺｈｅｎｇ－ｇｕｏ（王正国），ＣＨＥＮＣｈａｎｇ－ｃａｉ（陈长才...     

增感屏-胶片组合体系的威纳频谱测试探讨

目的　通过实验测试增感屏-胶片组合体系的威纳频谱(Wienerspectrum,WS),评价X线照片的粒状性。方法　制作CaWO4屏-Kodak片、BaFClEu屏-Kodak片、T颗粒技术3种增感屏-胶片组合体系的10cm×10cm粒状性抽样照片,用显微密度计扫描,获得10万个密度值,作为离散随机信号来处理,用快速傅立叶变换（fastFouriertransform,FFT）计算WS。结果　（1）BaFClEu屏-Kodak片的WS值当空间频率为0.1LP/mm时,WS值为8.26×10     

X线照片影像颗粒度及其相关影响因素的探讨

目的评价不同屏片组合下Ｘ线照片影像的颗粒性，以期掌握照片颗粒性的客观评价方法，并获得影响影像颗粒度的相关因素。方法利用显微密度计对测试样本进行扫描，通过均方根（ｒｏｏｔｍｅａｎｓｑｕａｒｅ，ＲＭＳ）值的计算，对不同屏片组合的Ｘ线影像进行颗粒度的物理评价。结果通过测试和数据整理，得出颗粒度与管电压、密度、对比度及清晰度的关系。结论Ｘ线照片影像颗粒度随着管电压、清晰度和对比度的升高而升高，随密度的升高而降低     

Multi-detector row spiral CT angiography of the thoracic outlet: dose reduction with anatomically adapted online tube current modulation and preset dose savings

PURPOSE: To evaluate image quality obtained with anatomically adapted online tube current modulation and preset minimum dose savings at multi-detector row spiral computed tomographic (CT) angiography of the thoracic outlet. MATERIALS AND METHODS: A total of 100 patients were evaluated for thoracic outlet arterial syndrome with spiral CT angiography (collimation, 4 x 1 mm; pitch, 1.75) both with and without dose reduction by means of anatomically adapted online tube current modulation and preset minimum dose savings. Preset minimum savings of 20% and of 32% were applied in two groups of 50 patients (groups 1 and 2). In each group, low-dose scanning was performed in 25 patients in the neutral position and in 25 patients after postural maneuver. Tube current-time product, noise, presence and quality of graininess and of linear streak artifacts on transverse CT scans, and diagnostic value of sagittal reformations and volume-rendered images were evaluated and recorded for each data set. chi2 test was used to compare frequencies; paired Wilcoxon rank test, to compare subjective and objective image quality scores. P <.05 indicated a significant difference. RESULTS: In group 1, mean tube current-time product was 3225 mAs for reference scans and 2101 mAs for low-dose scans (mean reduction, 35%; range, 27%-47%). In group 2, mean was 3070 mAs for reference scans and 2068 mAs for low-dose scans (mean reduction, 33%; range, 17%-38%). In group 1, no differences in frequencies of graininess and linear streaking or in noise level were found between images acquired with or without dose reduction. In group 2, no difference was found in noise level between low-dose and reference scans. On low-dose scans, moderate linear streaking was observed with lower frequency and moderate graininess was observed with higher frequency, but artifacts did not compromise image quality or prevent confident assessment of arterial diameter in the three compartments of the thoracic outlet. CONCLUSION: Online tube current modulation with a preset minimum dose saving of 20% allowed 35% reduction in mean tube current-time product, with no loss in image quality.     

A study of optimum radiographic conditions on chest examinations with computed radiology (CR) in conjunction with the offset balance of patient dose and image quality]

In a report of a nationwide survey on radiographic conditions of chest radiography in Japan, it was pointed out that the average entrance surface dose (ESD) of the computed radiography (CR) system was higher than that of the film-screen system. It seemed important that an objective index and criteria be established for dose reduction without a loss of image quality that would interfere with diagnostic observation. For this purpose, we investigated the properties of root of mean square (RMS) granularity, since it is a dominant factor in CR image quality and strongly depends on dose. The results indicated that RMS granularity showed little dependence on tube voltage when relative exposure was kept constant and that it decreased with the increment of exposure and approached a finite minimum value in a very high exposure region. For the most frequently used radiographic conditions in Japan (120 kV, 2.5 mmAl, 200 cm SID, 10: 1 grid), the decrement in RMS granularity from 6 to 16 mAs was 0.0276 to 0.0253 (9.1%). This finding suggested that exposure exceeding 6 mAs did not improve image quality, i.e., exposure reduction down to 6 mAs would not cause a significant loss of image quality. It was therefore concluded that RMS granularity was a useful objective index by which to determine the upper limit of exposure. Use of the most frequent conditions with 6 mAs seemed to be recommendable as an initial condition for the technical optimization of CR chest radiography, since ESD under this condition was 0.265 mGy, which was approximately equal to the value of the ESD distribution of a total chest radiogram in Japan.     

Effects of dehydration and rehydration on EMG changes during fatiguing contractions

PURPOSE: This study measured the effects of sauna-induced dehydration (Dhy) and the effectiveness of rapid rehydration on muscle performance and EMG frequency spectrum changes associated with fatigue during isometric contractions. METHODS: Knee extensor muscle strength during isometric maximal voluntary contraction (MVC) and endurance time at 25% and 70% of MVC (ET25 and ET70, respectively) were measured three times in 11 healthy male subjects, under euhydration conditions (Eu), after Dhy, and after rehydration following Dhy (Rhy). RESULTS: Dhy led to a decrease in body weight by 2.95 +/- 0.05%. No significant effect of the hydration status was shown on MVC values. A 23% decrease in ET25 was recorded during Dhy (P < 0.01), whereas ET70 only tended to decrease (-13%, P = 0.06). ET25 was higher during Rhy than Dhy (8%, P < 0.05) but remained lower than during Eu (-17%, P < 0.05). The EMG root mean square (RMS) increased earlier during Dhy than Eu. Opposite changes were shown for the mean power frequency (MPF) of EMG, and Dhy resulted in an accelerated fall in MPF. However, because ET25 decreased with dehydration, RMS and MPF changes were similar during Eu and Dhy when reported to normalized contraction time, exhaustion was thus associated with similar values of RMS and MPF for all conditions. RMS and MPF changes during Rhy showed an intermediate pattern between Eu and Dhy. CONCLUSIONS: Dhy induced an increase in muscle fatigue, associated with early changes in EMG spectral parameters. It is not clear whether these alterations could be attributed to biochemical modifications, and the role of increased perception of effort when subjects were dehydrated should be clarified.     

Diagnostic accuracy of in vitro panoramic radiographs depending on the exposure

OBJECTIVES: The aim was to evaluate the effect of dose reduction on diagnostic accuracy in panoramic radiographs with increased tube potential and reduced milliampere settings. METHODS: Panoramic radiographs of 12 dried human skulls prepared with lesions in the bone, teeth and peri-implant bone in ascending size were taken. Medium and regular film--screen combinations and a storage phosphor system were used for imaging. All systems were exposed at a low and a high tube potential level. To compare the dose at different tube potential settings, dose length product was measured at the secondary collimator. Five observers assessed the presence (response: 1) or absence (response: 0) of lesions. Sensitivity, specificity and diagnostic accuracy were evaluated and 36 000 ratings were made in all. All settings were repeated once. Intrarater agreement was expressed by Cohen's kappa coefficient. RESULTS: There was no significant difference in diagnostic accuracy between a medium and a regular film--screen combination at a low tube potential level (70 kV; 0.935 and 0.930) and the medium film--screen system at a high tube potential level (85 kV; 0.926). Compared with this group, the regular film-screen combinations at high tube potential level (85 kV, 0.906) and all digital radiographs were significantly different (0.886 and 0.866), irrespective of the tube potential level. The digital panoramic radiograph was only comparable with the best film--screen combinations with an exposure for a medium film-screen system and at a low tube potential level. Sensitivity was 89.9% and specificity 93.7%. The kappa coefficient for intrarater agreement was high (0.81). CONCLUSIONS: The medium intensifying screen can be used at high tube potential settings instead of low tube potential settings, or the regular intensifying screen can be used at low tube potential settings with the same diagnostic value. A dose reduction of about 40% is possible. The storage phosphor plates should be exposed at least like a regular film-screen system and at a low tube potential level.     

Screening for tracheobronchial diseases with digital storage phosphor radiography]

Digital storage phosphor radiography (FCR: Fuji computed radiography) has a wide dynamic range and unique postprocessing capabilities. This study was designed to test whether chest imaging with FCR and its image processing would increase the accuracy of and confidence in the diagnosis of tracheobronchial abnormalities. In a phantom study, the performance of digital images having the appearance of a conventional chest radiograph was compared with that of a conventional system in detecting simulated tracheobronchial nodules. The digital images of lower kilovoltage (ROC area = 0.647 +/- 0.035) were equivalent to the conventional radiographs (ROC area = 0.620 +/- 0.028). On the other hand, nodule detectability was significantly improved in the digital images of higher kilovoltage (ROC area = 0.826 +/- 0.020). The author also compared the impact of five postprocessing algorithms (standard image, wide latitude image, enhanced image, reversed image, and subtraction image). ROC analysis indicated that the default standard image (ROC area = 0.826 +/- 0.020) was as good as an image with a linear rather than a sigmoid gradation curve (ROC area = 0.843 +/- 0.020), an image with strong enhancement of high frequencies (ROC area = 0.804 +/- 0.020), and an image with reversed gray scale polarity (ROC area = 0.775 +/- 0.015). Therefore these specific algorithms had no effect on the detection of tracheobronchial nodules. However, digital subtraction soft tissue images (ROC area = 0.961 +/- 0.030) were significantly better than the control images. Clinical study also indicated that subtraction images improve diagnostic accuracy in tracheobronchial diseases.     

小儿盆腔及泌尿生殖系横纹肌肉瘤的超声诊断

目的:探讨小儿盆腔及泌尿生殖系横纹肌肉瘤(RMS)的超声表现及其诊断价值。方法:回顾性分析36例经手术及病理证实的原发于盆腔及泌尿系RMS的临床及超声资料。患儿采取相应憋尿的形式经腹探查。结果:36例患者主要临床表现为尿频、排尿困难、血尿、排便困难、腹部疼痛或发现包块、阴道或尿道口脱出肿物。膀胱RMS14例,多发生于膀胱颈三角区呈形态不规则的菜花状的实性低回声块。盆腔RMS12例起自盆腔,为实性不均匀的低回声包块,形态不规则,边界清晰,常包绕或与盆腔大血管关系密切,并可发生早期转移。前列腺RMS7例,为前列腺区的较大的不均匀的实性低回声肿物,将膀胱顶起位置抬高,环绕尿道,内伴有不同程度的坏死无回声区。阴道RMS2例表现为阴道处实性低回声块,子宫有不同程度的受累。尿道RMS1例示尿道内实性低回声块,致尿路梗阻。结论:超声能够明确小儿横纹肌肉瘤的位置、起源、形态、内部结构以及与周围组织的关系,揭示继发的上尿路病变,且无创伤无射线伤害。     

Individualized periapical radiography determined by clinical and panoramic examination.

The efficiency of panoramic radiography compared with full-mouth periapical examination is an unresolved problem. The diagnostic yield of periapical lesions when the clinical signs and symptoms and the findings from a panoramic radiograph served as the basis for an individualized periapical radiographic examination was studied. Two hundred patients were examined clinically and radiographically. The periapical status was assessed step by step with access to increasing numbers of radiographs. For the clinical examination, the sensitivity was 0.24, the positive predictive value 0.62, the specificity 0.98, the negative predictive value 0.90 and the likelihood ratio for the positive test result 12. For radiographs indicated by the clinical examination plus the panoramic radiograph and selected periapical radiographs, both the sensitivity and the positive predictive value were 0.91, the specificity and the negative predictive value 0.99 each and the likelihood ratio was 91. False findings were twice as frequent in the upper as in the lower arch and particularly found in the incisor and premolar regions. In 30% of the patients no periapical radiograph was needed to supplement the panoramic radiograph. In the other patients, two supplementary periapical radiographs were needed on average. We conclude that the information obtained from the clinical and panoramic examinations supplemented with no more than two periapical radiographs will result in a high diagnostic yield on the periapical status.     

Computer-aided diagnosis in full digital mammography

RATIONALE AND OBJECTIVES: The authors clarify the detection rates for breast cancerous tumors and clustered microcalcifications with computer-aided diagnosis (CAD) based on Fuji Computed Radiography. The authors also determine whether mammographic reading with CAD contributes to the discovery of breast cancer. METHODS: Data acquired by Fuji Computed Radiography 9000, which consisted of 4148 digital mammograms including 267 cases of breast cancer, was transferred directly to an analysis workstation where an original software program determined extraction rates for breast tumors and clustered microcalcifications. Furthermore, using another 344 mammograms from 86 women, observer performance studies were conducted on five doctors for receiver operating characteristic (ROC) analysis. RESULTS: Sensitivity to breast cancerous tumors and clustered microcalcifications were 89.9% and 92.8%, respectively false-positive rates were 1.35 and 0.40 per image, respectively. The observer performance studies indicate that an average Az value for the five doctors was greater with the CAD system than with a film-only reading without CAD, and that a reading with CAD was significantly superior at P < 0.022. CONCLUSIONS: It has been shown that CAD based on Fuji Computed Radiography offers good detection rates for both breast cancerous tumors and clustered microcalcifications, and that the reading of mammograms with this CAD system would provide potential improvement in diagnostic accuracy for breast cancer.