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期刊信息
创刊日期:1990年
主管单位:中国人民共和国卫生部
主办单位:中国医学影像技术研究会
中国医科大学
承办单位:中国医科大学附属盛京医院
辽宁省医学影像学会
编辑出版:《中国临床医学影像杂志》
编辑部
刊 期:月刊
2016 Vol. 27, No. 1
Published: 2016-01-20
3
MRI T2WI features of vestibular aqueduct area with large vestibular aqueduct syndrome
SHAO Yong-liang, ZHOU Yong-qing, LI Xiao-ming, DU Yu-ping, ZHANG Yan-xu, GAO Chun-mei
Objective: Analyze vestibular aqueduct MRI T2WI features of a group of patients affected with large vestibular aqueduct syndrome(LVAS). Methods: From Jan. 2011 to Dec. 2013, 150 patients affected LVAS had been diagnosed by means of temporal bone CT and brain MRI in our hospital. We analyzed MRI T2WI features of vestibular aqueduct area in all 297 ears. Results: Based on vestibular aqueduct T2WI features, endolymphatic duct and endolymphatic sac were divided into 2 types. Among all endolymphatic ducts and endolymphatic sacs, 10.8% were type Ⅰ with only hypointensity, while the rest 89.2% were type Ⅱ with both hypointensity and hyperintensity. Conclusion: There are different imaging features in vestibular aqueduct on MRI T2WI for LVAS.
2016 Vol. 27 (1): 3-5 [
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949
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6
Clinical values of CT scan with oral contrast agent for displaying the anatomical structure in hypopharynx
ZHANG Ji-yang, WAN Ye-da, ZHANG Lin, HE Zhen, LIU Jing-yan, HU Peng, HE An-wei,
Objective: To investigate the clinical value of spiral CT scan with oral contrast agent for displaying the anatomical structure of postcricoarytenoid region and piriform sinus region. Methods: The CT images of 60 patients after conventional spiral CT scan were reviewed and the CT images of 60 patients after spiral CT scan with oral contrast agent were analyzed. The anatomical structures of postcricoarytenoid region and piriform sinus region were observed. The demonstration rate was calculated and the image rating was evaluated by two radiologists and two otolaryngology doctors with a double-blind method. Chi-square test was adopted in statistical analysis. Results: In conventional spiral CT scan, the air occurrence rates were 65% and 70% in the right and left sinuses respectively. The detection rate of hypopharyngeal cavity was 43.3% in the arytenoid cartilage level and was 28.3% in the cricoid cartilage level. After orally contrasted spiral CT scanning, the left and right piriform sinus occurrence rates were 91.7%(55/60) and 90%(54/60). The detection rates of hypopharyngeal cavity in the arytenoid and cricoid cartilage level were 93.3%(56/60) and 96.7%(58/60) respectively. P<0.05 was considered statistically different. Conclusion: CT scans with oral contrast agent can contour the profile of hypopharynx and clearly display the anatomical structure of the postcricoarytenoid region and piriform sinus region in closed state. It can cover the shortage of clinical laryngoscope and provide objective images for detecting early diseases and confirming the surgical staging.
2016 Vol. 27 (1): 6-9 [
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850
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10
The combination of superb microvascular imaging and BI-RADS in distinguishing breast benign lesions from malignant lesions
MA Yan, GUO Song, LI Jing, REN Wei-dong, DENG Li-jun
Objective: To explicate the diagnostic performance of the combination of superb microvascular imaging(SMI) and BI-RADS in distinguishing breast benign lesions from malignant lesions. Methods: One hundred and thirty-eight breast lesions were detected by ultrasonography and pathologic types were confirmed by histopathology. Both SMI and CDFI were used to detect blood flows of breast masses according to Adler’s grading criteria, respectively. The optimal threshold drawing from ROC curve and diagnostic efficacy of single and combinative modality were calculated. Results: The inter-observer agreement of SMI and CDFI were favorable(CDFI: κ=0.82; SMI: κ=0.76). There was a significant difference between SMI and CDFI for detecting blood flows in all lesions(κ=0.38), which was more significant in malignant group(κ=0.028) but not significant in benign lesions(κ=0.61). The areas under ROC curves were 0.867(BI-RADS), 0.669(CDFI), 0.871(SMI), 0.710(BI-RADS+CDFI) and 0.899(BI-RADS+SMI) respectively. The sensitivities and specificities were 0.950 and 0.692(BI-RADS), 0.821 and 0.900(SMI), 0.600 and 0.821(CDFI), respectively. There was no significant difference between combinative modality(BI-RADS and SMI) and SMI(0.900 vs 0.950, P>0.05) for the sensitivity; but the specficity of combinative modality(BI-RADS and SMI) was significantly higher than that of SMI(0.897 vs 0.692, P<0.01). Conclusion: Comparing with CDFI, SMI provides better microvascular information in breast lesions. The combination modality of BI-RADS and SMI can improve diagnostic performance of breast malignancy.
2016 Vol. 27 (1): 10-13 [
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794
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14
Multimodality ultrasonic observation in the marginal zone of breast lesions with BI-RADS grade 4 or above
LENG Xiao-ling1, HUANG Guo-fu2, MA Fu-cheng1
Objective: To evaluate their application value in observing the marginal zone of breast lesions with BI-RADS grade 4 or above by 2D-CEUS, 3D-CPA and 3D-CEUS. Method: One hundred and eighty-two pathologically proved benign and malignant breast lesions with BI-RADS grade 4 or above received examinations in the order of 2D-CEUS, 3D-CPA and 3D-CEUS. The marginal zone, the central region and the adjacent gland tissue for all lesions were analyzed and compared by time-intensity curve using QLab software. Three dimensional reconstruction of power Doppler and contrast-enhanced images were performed in the marginal zone and 4 levels were divided according to the blood supply. The abilities to display the vascular structure of breast lesions by 3D-CEUS and 3D-CPA were compared. Results: For cancers, the marginal zone had different ultrasonic perfusion parameters from the central region and adjacent normal gland tissue(F=7.782 7, P<0.000 1). Compared with the adjacent tissue, the marginal and central regions showed obvious enhancement with quick access and slow retreat. Compared with the central region, the marginal zone showed medium enhancement with quick access and slow retreat(P<0.05). For benign lesions, the marginal and central zones showed obvious enhancement with quick access and quick retreat in comparison to adjacent normal tissue. Compared with the central region, the marginal zone showed medium enhancement with quick access and quick retreat(P<0.05). 3D-CPA and 3D-CEUS in the periphery of breast cancers were characterized by more blood supply of grade Ⅲ or Ⅳ compared to benign breast lesions(P<0.05). Blood supply levels were higher by 3D-CEUS than by 3D-CPA(P<0.05). Conclusion: The marginal zone contributed more to the malignant imaging features than the central region for contrast-enhanced ultrasound in breast cancer. 3D-CEUS was superior to 3D-CPA in manifesting the blood vascular structure in the marginal zone of breast lesions of BI-RADS grade 4 or above. 2D-CEUS combined with 3D-CPA and 3D-CEUS can better display blood perfusion in the marginal zone of breast cancers.
2016 Vol. 27 (1): 14-18 [
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785
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19
CT and MR diagnosis of extrapleural solitary fibrous tumor
JIANG Wei-li, PENG Hong-fen, ZHANG Dong-you
Objective: To investigate CT and MR findings of extrapleural solitary fibrous tumor(ESFT) for imaging diagnosis. Methods: The CT and MR findings of 7 cases with ESFT proved by pathology were retrospectively analyzed. Results: In 7 cases, 3 cases were located in the abdomen(intraabdominal, retroperitoneal and peritoneal respectively), and 1 in nasal cavity and sinuses, 1 in parotid gland, 1 in inguinal region and 1 in bladder respectively. All masses were solitary, four were round or oval, while 3 were irregular. Margins of 5 cases were well defined, while 2 were partly unclear. Diameters of the tumors ranged from 2.0~9.1 cm, and the average tumor size was 6.5 cm. The CT density was homogeneous in 2 cases and heterogeneous in 4 cases. Contrast enhanced CT showed early mild enhancement in 1 case, and obvious enhancement in the arterial and delay phases in 3 cases. On MR, one was hypointense on T1WI and slightly hypointense on T2WI. One was isointense on T1WI and slightly hyperintense on T2WI with strip hypointensity. Conclusion: ESFT can be found in any part of the body. CT and MR findings of ESFT were sometimes characteristic and multiphase contrast enhanced scan can improve the diagnostic accuracy.
2016 Vol. 27 (1): 19-21 [
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959
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22
The diagnostic value of PET/CT in pediatric hepatoblastoma
LIU Ya-chao, SHEN Zhi-hui, DANG Hao-dan, LI Can, LIU Jia-jin, XU Bai-xuan
Objective: To investigate the diagnostic value of 18F-FDG PET/CT in pediatric hepatoblastoma(HB). Methods: We retrospectively analyzed the PET/CT images and clinical data of 15 pediatric HB patients proved by biopsy or/and histopathology after operation, and summarized the PET/CT features of HB and the key points of its differential diagnosis. Results: Tumors showed low or mixed density with high metabolism. Calcifications were found in 8 of the 15 patients. Four patients were found with pulmonary metastases and one patient was found with both pulmonary and bone metastases by whole body PET/CT scan. Conclusion: PET/CT scan can be safely and noninvasively used in children(including infants). HB has certain characteristic findings on PET/CT, whicn is very helpful to the diagnosis and clinical staging of HB.
2016 Vol. 27 (1): 22-24 [
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881
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25
A correlation study of CEUS quantitative analysis and the expression of P53 in hepatocellular carcinoma
MA Zhen1, YANG Hong2, HE Yun2, LU Jing-ning2, PENG Jin-bo2, WU Yu-quan2
Objective: To investigate the expression of mutant P53 protein and their correlation with contrast-enhanced ultrasound quantitative parameters in hepatocellular carcinoma(HCC). Methods: Fifty-seven cases of HCC were enrolled. A retrospective analysis of the contrast-enhanced ultrasound quantitative parameters was performed, and then their correlation with P53 protein by immunohistochemistry staining method was done. Results:①P53 positive expression rate was 54.3%(31/57). ②In P53 positive and negative groups, the peak strength, the mean transit time and time to peak showed no significant difference(P>0.05). There was significant difference in the rising slope and washout time(P<0.05). ③There was no correlation between the expression of P53 and maximum intensity, mean transit time or time to peak(P>0.05). The positive expression of P53 was positively correlated with the rising slope with r=0.377(P<0.05), and negatively correlated with washout time with r=-0.410(P<0.05). Conclusion: For HCC contrast-enhanced ultrasound parameters, there is a certain correlation between rising slope, washout time and mutant P53 protein expression. The time-intensity curve might noninvasively assess the expression of P53.
2016 Vol. 27 (1): 25-28 [
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788
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29
Diagnosis and differential diagnosis of Castleman disease in children
YIN Chun-hong1, ZHU Ming2, DONG Su-zhen1
Objective: To analyze the imaging characteristics of ultrasound, CT and MRI and pathology of Castleman disease in children. Method: Five cases of Castleman disease proved by pathology were included in the study. Four were male and one was female, aged from 9 to 16, (11.4±2.3) years on average. The imaging characteristics of ultrasound, enhanced CT or MR were analysed. Results: Two cases were in the neck and 3 were in the abdomen. Ultrasound findings were hypoechoic nodules of internal blood flow signals or rich blood supply. CT showed low density nodules of uniform density and obvious enhancement. MR showed hypointensity on T1WI and hyperintensity on T2WI, which were homogeneously enhanced nodules with clear borders. On pathology, all cases were single-centered vascular transparent type. Conclusion: As a rare disease in children, Castleman disease can easily be misdiagnosed before operation, but better understanding can be achieved according to the specific imaging characteristics of this disease.
2016 Vol. 27 (1): 29-31 [
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919
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32
A longitudinal study of maternal left cardiac morphology, function and uterine artery resistances in#br# normal twin pregnancy
LI Xiao-fei, WU Qing-qing
Objective: To longitudinally investigate maternal left cardiac morphology, function and uterine artery resistances in uncomplicated twin gestations. Methods: Women with twin pregnancies, who were examined and delivered in Beijing Obstetrics and Gynecology Hospital between January 2013 to October 2014, were enrolled prospectively and underwent serial fetal ultrasound examination and maternal echocardiography at 11~14 weeks, 21~26 weeks and 28~34 weeks of gestation. Those with any complications were excluded. Left cardiac morphology, function and uterine artery resistances were assessed longitudinally and compared with those obtained at the same gestational age periods in a group of singleton gestations. Results: There were 50 normal twin pregnancies and 35 singleton pregnancies as controls. In twin pregnancies, left atrial end-diastolic dimensions, left ventricular end-diastolic and end-systolic dimensions showed significant increase throughout the pregnancy period, especially between 11~14 weeks and 21~26 weeks, but the difference was not statistically significant between twin pregnancies and control group. Total vascular resistance(TVR), cardiac output(CO) and heart rate(HR) changed throughout the pregnancy period, especially between 11~14 weeks and 21~26 weeks. E/E' increased throughout the pregnancy period and grew rapidly between 21~26 weeks and 28~34 weeks. Compared with singletons, HR and CO were significantly higher at 21~26 week and diastolic blood pressure(dBp) was significantly higher at 28~34 weeks in twins. Bilateral uterine artery mean pulse index(PI), resistance index(RI) and ratio of peak-systolic to end-diastolic blood flow velocities(S/D) decreased significantly in twins throughout the pregnancy period. The existence of early-diastolic notch decreased significantly especially between 11~14 weeks and 21~26 weeks. Bilateral uterine artery mean PI, RI and S/D at each period and the existence of early-diastolic notch at 11~14 weeks were significantly lower in twins than in singletons(P<0.05). Conclusions: In twin pregnancies, left cardiac dimensions, CO and HR showed significant increase. TVR and uterine artery resistances decreased throughout the pregnancy period, especially between the first and second trimester. Left ventricular filling pressure was growing fast between the second and third trimester.Compared with singletons, HR and CO were significantly higher at the second trimester, dBp was significantly higher at the third trimester in twins, and uterine artery resistance was lower at each time period. The existence of early-diastolic notch was lower at the first trimester.
2016 Vol. 27 (1): 32-37 [
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892
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38
Ultrasound soft markers of prenatal diagnosis and maternal serological detection in#br# screening fetal chromosomal abnormalities
ZHU Ji-hong
Objective: To explore the significanc of ultrasound soft markers(USM) in the first and second trimester combined with maternal serological detection of alpha-fetoprotein(AFP) and β-human chorionic gonadotropin(free-β-HCG) during the second trimester of pregnancy in screening fetal chromosomal abnormalities. Methods: A total of 2 502 pregnant female outpatients and inpatients from December 2010 to December 2014 were enrolled. The USM was detected during the 11th~28th gestational week by ultrasound, and multiple ultrasound soft markers(≥2) were taken as high risk. The levels of maternal serum AFP and free-β-HCG were detected during the 15th~21st gestational week. The risk of Down’s syndrome(DS) was assessed by the software named analysis system of DS prenatal screening, and the risk rate ≥1/270 was taken as high risk. Pregnant women of multiple ultrasound soft markers(≥2) and/or serological test in the high-risk level received genetic consultations, and the invasive amniocentesis and chromosomal examination were performed with consent. The screening results of multiple ultrasound soft markers or serological detection were compared with combined detection. Results: There was no statistically significant difference in detection results between USM screening and serological test. There was statistically significant difference in detection results between USM screening/serological test and combined screening. The specificity and the false negative rate were increased by combined detection. Conclusion: USM screening and serological test can't replace each other. Combined detection can enhance the exclusive ability of negative patients, and improve the reliability of prenatal screening for fetal chromosomal abnormalities.
2016 Vol. 27 (1): 38-41 [
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905
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42
The diagnostic value of transabdominal and transvaginal color Doppler ultrasound in caesarean scar pregnancy
LIAO Cai-hua, CHEN Lu-ying, LIN Li
Objective: To evaluate the diagnostic value of transabdominal color Doppler ultrasound(TAS) and transvaginal color Doppler ultrasound(TVS) in caesarean scar pregnancy(CSP). Methods: Twenty-eight cases diagnosed as CSP from May 2012 to December 2014 in our hospital were selected. Their TAS and TVS diagnostic images were analyzed. Results: CSP rates showed by TAS and TVS ultrasound were 67.9%(19/28) and 96.4%(27/28) with statistically significant difference(P<0.05). In all 28 patients, there were simple gestational sacs in 15 cases(53.6%), mixed masses in 9 cases(32.1%) and partly in the uterine cavity in 4 cases(14.3%). Conclusion: TVS can be complementary for TAS in diagnosing CSP by significantly improving the detection rate. CSP ultrasonic images can clearly show the location, extent, thickness of myometrium and blood supply, which has an important clinical value.
2016 Vol. 27 (1): 42-44 [
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703
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45
Prediction of poor prognosis of fetus by the elastic value of placenta and#br# umbilical artery S/D and their correlation analysis
ZHANG Wei-wei1, HAN Xiu-mei2, ZHANG Zhen1
Objective: To investigate whether the elastic value of placenta and umbilical artery S/D can predict poor prognosis of fetus, and analyze the relationship between them. Methods: One hundred and fifty cases of pregnant women were selected with gestation weeks of 37~40. By SuperSonic Imagine Aix Plorer real-time shear wave elastography ultrasound diagnostic apparatus, the elastic value of placenta and umbilical artery S/D were measured before childbirth and poor prognosis of fetus was observed. Finally, the elastic value of placenta was analyzed by ROC curve, to find the optimal critical value which can predict poor prognosis of fetus. Two groups were divided by the critical value, then comparison was made between the difference of umbilical artery S/D and the elastic value. Results: On ROC curve, the area under the curve(AUC) of the elastic value of placenta was 0.86 and the threshold of diagnosing poor prognosis of fetus was 26.5 kPa with a sensitivity of 82.4% and a specificity of 80.7%. There was a significant difference(P<0.05) of umbilical artery S/D between two groups(≥26.5 kPa and <26.5 kPa). The elastic value of placenta was positively correlated with umbilical artery S/D(r=0.822, P<0.05). Conclusion: It will help to predict the prognosis of fetus by combining the elastic value of placenta with umbilical artery S/D.
2016 Vol. 27 (1): 45-47 [
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666
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48
Prenatal diagnosis of congenital high airway obstruction syndrome by ultrasound
PANG Dong-jing, HU Bo, XU Zhi-hua
Objective: To investigate the prenatal ultrasonic manifestation and diagnosis of congenital high airway obstruction syndrome(CHAOS). Methods: Five cases of CHAOS were diagnosed by prenatal ultrasonography. The prenatal ultrasonic manifestations and key points for diagnosis of CHAOS were analysed and concluded. Results: Three cases were comfirmed by autopsy, one was comfirmed by local exploration after termination of pregnancy, and one was lost during follow up. The characteristic prenatal ultrasonic manifestations of CHAOS were hyper-echogenic and symmetrical enlarged lung fields, flattened or inverted diaphragm and dilated trachea, as well as small and compressed heart. Conclusions: The prenatal ultrasonic manifestations of CHAOS were characteristic. CHAOS can be prenatally diagnosed.
2016 Vol. 27 (1): 48-50 [
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1002
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51
Evaluation of a standardized procedure for 13N-ammonia dynamic myocardial perfusion imaging
LIANG Jia-wei, WANG Shu-xia, LI Dong-jiang, HU Zhi-hui, ZHANG Qing
Objective: To establish and analyze its feasibility of a standardized procedure for 13N-ammonia dynamic myocardial perfusion imaging for PET/CT centers. Methods: 13N-ammonia dynamic myocardial perfusion imaging was performed on 53 patients based on the operational procedure from October 2013 to March 2015. Results: From October 2013 to September 2014, termed as primary stage, 43 samples were collected with their original dosage of(31.20±6.53)mCi and calibrated dosage of (23.37±5.22) mCi. The interval was set (4'05"±1'50") and the initial collecting counts(106) were 45.84±10.77. From October 2014 to March 2015, termed as optimizing stage, 10 samples were collected with their original dosage of (26.68±7.37) mCi and calibrated dosage of (20.39±5.41) mCi. The interval was set (3'47"±0'56") and the initial collection counts(106) were 35.08±11.55. Consequently, the images of the 53 samples were clear, indicating the excellent feasibility of this operational procedure. Conclusions: We build up a standardized procedure for 13N-ammonia dynamic myocardial perfusion imaging for PET/CT centers with good feasibility and repeatability and its promotion is recommended.
2016 Vol. 27 (1): 51-54 [
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1131
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The clinical application of radiofrequency ablation in colorectal cancer liver metastases
ZHANG Guo-ning, LIU Zhao-yu
Distant metastasis is common in advanced colorectal cancer(CRC). The most common site of metastases is the liver. According to incomplete statistics, more than half patients with CRC will have liver metastases before or after surgery. For such patients, treatment is usually limited and their survival life is usually short. This is a main reason for the poor prognosis of colorectal cancer. As a new treatment method, radiofrequency ablation(RFA) can inactivate the tumor locally in situ by ablation, which has become an important means of comprehensive treatment of patients with colorectal cancer liver metastases(CRLM). With the expansion of medical indications, more and more CRLM patients choose radiofrequency ablation. The article reviewed current clinical applications of RFA therapy in CRLM, aiming to provide evidence for CRLM through RFA.
2016 Vol. 27 (1): 59-61 [
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730
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62
The clinical application of contrast-enhanced ultrasound in ovarian tumors
LI Zai-hong, JING Xiang-xiang
Ovarian cancer is one of the most common gynecological tumor which can be classified into different histological types. In recent years the incidence rate of ovarian cancer increased year by year. To characterize ovarian masses enables patients with malignancy to be appropriately triaged for treatment, which has been shown to further optimized care and improved survival. There are many kinds of imaging methods applied in the clinical diagnosis of ovarian cancer, such as transabdominal or transvaginal two-dimensional ultrasound, three-dimensional ultrasound, color and power Doppler ultrasound, computed tomography, magnetic resonance imaging and contrast-enhanced ultrasound. Contrast-enhanced ultrasound is a new technology which can detect the neovascularization in and around the ovarian cancer sensitively, and the time-intensity curve can be drawn by analysis software to help distinguish benign from malignant tumors. Contrast-enhanced ultrasound is a reliable and convenient imaging method and is now more and more widely applied in clinical diagnosis.
2016 Vol. 27 (1): 62-65 [
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788
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Advances of dual-energy CT virtual non-calcium technique in the diagnosis of occult fracture
CHEN Ting-ting, LIU Bai-lu
The dual-energy CT virtual non-calcium technology can analyze abnormal attenuation of marrow edema caused by occult fracture visually and quantitatively, which has a high negative predictive value in the detection of bone marrow abnormalities. Therefore, dual-energy CT might be a fast and available screening tool to rule out occult fracture. Advances of dual-energy CT virtual non-calcium technique in the diagnosis of occult fracture were reviewed in this article.
2016 Vol. 27 (1): 66-68 [
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606
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69
Clinical value of ultrasonic diagnosis for gossypiboma in abdominopelvic cavity
LIU Xue, DU Ying, YAO Yan-feng, ZHANG Dong-zhu
2016 Vol. 27 (1): 69-70 [
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756
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Value of pelvic 99mTc-MDP SPECT/CT imaging in patients with urinary retention
ZHOU Qing1, GUO Rui2, LI Zhi-yong1, HOU Xian-cun1, ZHANG Yan-ju1, ZHU Hui1, LIU Li1, LIU Zhao1
2016 Vol. 27 (1): 71-72 [
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659
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225
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Nasal glomangiopericytoma: report of one case
HU Sha-sha, LI Jin-kui, LEI Jun-qiang
2016 Vol. 27 (1): 73-73 [
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703
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218
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74
Congenital supravalvar mitral ring with atrial septal defect diagnosed by#br# three-dimensional echocardiography: report of one case
LIU Kai-wei, REN Wei-dong, XU Min, SUN Lu
2016 Vol. 27 (1): 74-74 [
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600
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75
Primary pancreatic lymphoma: report of one case
ZHUANG Ying-ying, SHI Yun-tao
2016 Vol. 27 (1): 75-75 [
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731
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Varicose veins of the uterine round ligament: report of one case
ZENG Gui
2016 Vol. 27 (1): 76-76 [
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788
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197
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