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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
2018 Vol. 29, No. 6
Published: 2018-06-20
 
381 Diagnostic approach to childhood-onset cerebellar atrophy: retrospective study of 111 patients
ZHAO Fei1, XIAO Jiang-xi2, XIE Sheng3
Objective: To propose a neuroradiological diagnostic approach for childhood-onset cerebellar atrophy. Method: MR images of 111 patients with cerebellar atrophy were analyzed(62 males, 49 females). Hierarchical clustering of patients on the basis of their MRI item profile was performed. Result: Diagnosis was established in 76 patients. Mitochondrial diseases were the most common, followed by NCL and INAD. Hierarchical clustering result showed Cluster 1 mainly contained mitochondrial diseases, Cluster 2 mainly included INAD and NCL, Cluster 3 mainly included wilson disease, Cluster 4 mainly included Cockayne syndrome and Cluster 5 mainly includied ALD, MLD and Menks disease. Other diseases were comprised in  Cluster 6. Conclusion: The diagnostic approach to childhood-onset cerebellar atrophy requires integration of neuroimaging results with clinical information. The use of neuroimaging pattern recognition is extremely useful in differential diagnoses and in the selection of further investigations.
2018 Vol. 29 (6): 381-386 [Abstract] ( 579 ) HTML (1 KB)  PDF  (0 KB)  ( 146 )
387 Clinical value of quantitative evaluation of intracranial hemorrhage in neonates by three-dimensional ultrasonography
DUAN Miao, HE Qing, SU Li-jun
Objective: To study the feasibility and accuracy of brain three-dimensional ultrasonography in quantitative analysis of intracranial hemorrhage in neonates and its influence on prognosis. Methods: One hundred and eighty-seven neonates born in our hospital suspected of symptomatic intracranial hemorrhage from January 2015 to February 2017 were selected retrospectively. All of the neonates were screened by intracranial ultrasonography and confirmed of intracranial hemorrhage of different levels by brain CT examination. Quantitative analysis of neonatal intracranial hemorrhage was compared between the two examinations. Result: According to the result of CT and Papile grading standards, there were 51 cases of grade Ⅰ, 53 cases of grade Ⅱ, 62 cases of grade Ⅲ and 21 cases of grade Ⅳ. According to the result of three-dimensional ultrasonography, there were 54 cases of grade Ⅰ, 49 cases of grade Ⅱ, 65 cases of grade Ⅲ and 19 cases of grade Ⅳ. There was no significant difference between the results of CT and three-dimensional ultrasonography. The diagnosis accuracy of subependymal hemorrhage, intraventricular hemorrhage, subdural hemorrhage, subarachnoid hemorrhage and intraparenchymal hemorrhage were 47.33%, 31.24%, 94.62%, 91.73% and 91.35% by CT, and 98.74%, 96.37%, 91.51%, 90.41%, 97.64 by three-dimensional ultrasonography, with significant difference(P<0.05). Conclusion: Three-dimensional brain ultrasonography has a high feasibility and accuracy in quantitative analysis of intracranial hemorrhage in neonates, and it has a great significance for the prognosis.
2018 Vol. 29 (6): 387-390 [Abstract] ( 634 ) HTML (1 KB)  PDF  (0 KB)  ( 177 )
391 Analysis of misdiagnosis and missed diagnosis of papillary thyroid carcinoma without metastasis on CT
XU Fan-yong, ZHANG Li, XIA Jin-dong
Objective: To analyze the misdiagnosis and missed diagnosis of papillary thyroid carcinoma(PTC) without metastasis on CT, and to investigate the value and limitation of CT in diagnosis of PTC. Methods: Plain and enhanced CT scan of 16 cases of PTC(18 lesions in total) misdiagnosed or missed diagnosed proved by surgery and pathology was retrospectively analyzed. Reasons of CT misdiagnosis and missed diagnosis were analyzed. Results: There were a total of 18 PTC lesions(13 PTC lesions were shown on CT, 5 PTC micro-lesions were not shown on CT) in the 16 cases. In 9 cases, the thyroid lesion were multiple(7 cases were nodular goiter with 1 PTC lesion, while 2 cases had 2 PTC lesions). Thirteen cases were misdiagnosed, with an average diameter of 9.3 mm, among which 7 were misdiagnosed as nodular goiter, one was misdiagnosed as adenoma and five others were not definitely diagnosed. The average diameter of the 5 missed lesions was 2.4 mm. Conclusion: Multiple lesions, small diameter, lack of specific imaging character and lack of understanding of the typical signs are the main reasons of misdiagnosis of PTC. PTC lesions below 5 mm on CT are difficult to be shown, which may be the main cause of misdiagnosis.
2018 Vol. 29 (6): 391-394 [Abstract] ( 682 ) HTML (1 KB)  PDF  (0 KB)  ( 162 )
395 The Logistic analysis of multimodal MRI technique in diagnosis of single benign and malignant breast nodules
ZENG Zhong-gang, LI Xue-xia, LI Gang, LI Zhi-juan, LU Huo-li, LI Yang-bin
Objective: To explore the significance of multimodal MRI in the identification of malignant breast lesions. Methods: We collected 51 cases of mammary gland patients with mammary gland nodules(diameter≤3 cm) from January 2013 to September 2016. The patient’s age, morphology of lesions, spiculation, boundary, ADC values and enhancement curve type were statistical analysis. Results: There was no statistically significant difference in the patient’s age(P=0.382). And there were statistical difference between the shape of the lesion, spiculation, boundary, ADC value, and enhancement curve type(P<0.05). In addition, the Logistic model was established to select two independent variables. The model was: Logit(P)=-0.503+0.387X5+0.257X6. And the sensitivity of its prediction ability was 91.9% and the specificity was 92.2%. Conclusion: Logistic regression model can be used to identify the most characteristic of benign malignant breast nodules, improve the ability of differential diagnosis of breast diseases, and provide more accurate imaging information for clinical diagnosis and treatment.
2018 Vol. 29 (6): 395-399 [Abstract] ( 776 ) HTML (1 KB)  PDF  (0 KB)  ( 172 )
400 Clinical significance of ADC in the diagnosis of ductal carcinoma in situ and invasive breast cancer
XIANG Xu1, YIN Jie1, LYU Guo-yi1, LI Jian-ling1, YOU Guo-qing1, ZENG Yue-can2
Objective: To explore the relationship between ADC parameters and the traditional diagnosis indexes of ductal carcinoma in situ(DCIS) and invasive breast cancer(IBC), and to evaluate the ADC for the diagnosis of DCIS and IBC. Methods: One hundred and eighteen female with breast mass were involved from May 2015 to April 2016 and their baseline information, ADC, elastography score, serum CA125, CA153 and CEA were recorded after admission. According to pathological findings, patients were divided into disease group and control group. Single factor analysis was used to show the factors affecting the diagnosis of DCIS and IBC, and then Logistic proportional hazard regression model analysis was applied to evaluate the influencing degree of those factors on the diagnosis of DCIS and IBC patients. Pearson analysis was used to study relationship between the ADC value and the traditional diagnostic index of elastography score. Meanwhile, the difference of the selected factors from multivariate analysis of two groups was analyzed and the sensitivity and specificity of the factors in diagnosis of DCIS and IBC were calculated by ROC curves. Results: The results of single factor analysis revealed that the diagnosis of DCIS and IBC was affected by ADC, elastography score, serum CA125, CA153, CEA level, and ADC parameters is the most influential(OR=2.273, 95%CI: 1.861～2.776, P=0.002). Pearson correlation analysis showed that the ADC and the traditional elastography score are positively correlated(r=0.475, P=0.000). The ROC analysis showed that the AUC of ADC parameters was 0.788(95%CI: 0.677～0.899) and the sensitivity and specificity were 0.784, 0.732, respectively. Conclusion: ADC parameters may be used as a good diagnostic tool for DCIS and IBC, which is hoped to be used as an early indicator.
2018 Vol. 29 (6): 400-403 [Abstract] ( 634 ) HTML (1 KB)  PDF  (0 KB)  ( 155 )
404 Evaluation of left ventricular function by cardiac magnetic imaging in dilated cardiomyopathy and #br# the relationship with plasma NT-proBNP levels
ZHANG Ying-xue1, ZHAO Xin-xiang2
Objective: Dilated cardiomyopathy(DCM) is characterized with left ventricular dilatation and dysfunction, which has a high morbidity and mortality. Our study is to investigate relationship between the left ventricular function by cardiac magenetic imaging(CMR) and plasma NT-proBNP levels in DCM. Methods: Twenty-two cases of DCM were enrolled. All patients received CMR examination and NT-proBNP level test. The imaging data of CMR were transferred to cardiac explorer workstation and the parameters of left ventricular structure and function were calculated. The parameters included LVEDV, LVESV, LVEF, SV, CO, CI, LVMM, FS, LVEDD, and SI. The correlation between all the parameters and plasma NT-proBNP levels was analyzed. Result: The plasma NT-proBNP levels in patients with DCM had a linear correlation with LVEDV, LVESV, LVEF, LVMM, FS, LVEDD and SI. The plasma NT-proBNP levels showed a positive correlation with LVEDV(r＝0.596, P＝0.003), LVESV(r＝0.742, P＝0.000), LVMM(r＝0.763, P＝0.000) and LVEDD(r＝0.629, P＝0.002) and negative correlation with LVEF(r＝-0.829, P＝0.000), FS(r＝-0.623, P＝0.002) and SI(r＝-0.539, P＝0.010). The coefficient of correlation between plasma NT-proBNP levels and LVEF was the highest. Conclusion: CMR can provide more valuable information for left ventricular remodeling and function in DCM patients. The more dilatation of the left ventricular chamber, the worse the cardiac function, the heavier the myocardial burden, and the higher the plasma NT-proBNP levels are. It demonstrates that the plasma NT-proBNP levels can reflect the severity of cardiac structure and function, and further reflect the severity of ventricular remodeling.
2018 Vol. 29 (6): 404-408 [Abstract] ( 674 ) HTML (1 KB)  PDF  (0 KB)  ( 282 )
409 Value of transesophageal echocardiography and myocardial contrast echocardiography in diagnosis of cardiac myxoma
GAN Ling1, GAO Yun-hua2, LIU Wei-chao1, LIU Shan-jun1, YIN Jia-bao1
Objective: To evaluate the clinic value of transesophageal echocardiography(TEE) and myocardial contrast echocardiography(MCE) in the diagnosis of cardiac myxoma. Methods: Imaging features of transthoracic echocardiography(TTE), TEE and MCE in 29 patients with cardiac myxoma were summarized and compared with histological results. Results: The diagnostic rate of tumor pedicle by TTE was significantly lower than by TEE(P＜0.05). Twenty-nine cases showed low enhancement. Nine cases showed smooth boundary and 20 cases showed unsmooth boundary. Ten cases were homogeneously enhanced while the other 19 cases were inhomogeneously enhanced. The MCE of cardiac myxoma was consistent with histological results. Conclusion: TEE and MCE can evaluate the pedicle, location, affect on atrioventricular valve, blood perfusion, shape and echo of myxomas. It can provide dependable information for operator.
2018 Vol. 29 (6): 409-412 [Abstract] ( 627 ) HTML (1 KB)  PDF  (0 KB)  ( 156 )
413 Evaluation of diagnostic effect of CTA on the internal carotid artery occlusion of different parts
MENG Shu-chun1, HUANG Xian-hui1, HAN Xing-jun1, XIAO Jian-guo1, ZHU Li-na2
Objective: To evaluate the diagnostic effect of characteristic CT angiography(CTA) patterns on the internal carotid artery(ICA) occlusion in different parts. Methods: The clinical characteristics and imaging characteristics of patients with acute ICA occlusion were analyzed retrospectively from January 2012 to December 2016 in our hospital. Diagnostic effect of characteristic CTA patterns on the ICA occlusion in different parts was evaluated using receiver operating characteristic(ROC) curve. The five diagnostic methods were: ①The carotid occlusion stump shape based on CTA; ②Carotid artery calcification based on CTA; ③The occlusion shape of Willis ring based on CTA; ④The leptomeningeal collaterals(LMC) based on CTA; ⑤The combined diagnosis of the above four diagnostic methods. Multivariate Logistic regression analysis of risk factors was also performed in patients with acute ICA occlusion with short-term poor prognosis. Results: A total of 161 patients were enrolled in this study, which were divided into three groups: 56 patients with C1 cervical segment occlusion, 72 patients with C4 cavernous segment occlusion, and 33 patients with C6 ophthalmic segment or C7 communicating segment occlusion. In the three groups of patients, the more distant the occlusion site was, the greater the degree of neurological deficit and the infarct volume were(P<0.05). The etiology of cerebral infarction, post-infarction complications and the prognosis of patients were related with the occlusion site(P<0.05). The imaging characteristics of CTA in patients with various parts of ICA occlusion were also different(P<0.05). ROC curve showed that the combined diagnosis of carotid artery occlusion stump shape, carotid artery calcification, the occlusion shape of Willis ring and LMC status was the best. The area under curve(AUC) for C1 cervical segment occlusion, C4 cavernous segment occlusion, C6 ophthalmic segment or C7 communicating segment occlusion were 0.966, 0.878, and 0.902, respectively. Older age and ICA distal occlusion were risk factors for poor prognosis. Conclusion: The clinical manifestations and CTA imaging findings of ICA occlusion are associated with occlusion location. The CTA-based combined diagnostic method can effectively differentiate the part of acute ICA occlusion, which is worthy to be widely promoted in the clinic.
2018 Vol. 29 (6): 413-418 [Abstract] ( 590 ) HTML (1 KB)  PDF  (0 KB)  ( 171 )
419 Study of correlation between carotid atherosclerotic plaque and stroke by virtual touch tissue quantification
YANG Huan-yu, YANG Yang, REN Jian-li, WANG Zhi-gang
Objective: To explore the relationship between the carotid plaque SWV value and the risk of initial stroke. Methods: A total of 98 patients with carotid atherosclerotic plaque and without stroke before in our hospital from January to June 2017 were investigated. Based on the Framingham stroke scale score, the patients were divided into high-risk group(n=53) and non high-risk group(n=45), and the stroke risk factors between groups were compared. Results: Multivariate unconditional Logistic regression analysis showed that SWV, Cr and BMI were the independent risk factors for high risk of stroke (B=-1.974, 0.414, 0.102; 95%CI: 0.026~0.736, 1.086~2.105, 1.006~1.219; P=0.020, 0.014, 0.026, respectively). Multivariate linear regression analysis indicated that SWV, Cr and LDL were related to the severity of stroke risk(B=-1.946, 0.075, -2.157; P=0.023, 0.000, 0.003 respectively). Compared with high-risk group, non high-risk group presented the higher SWV value(P<0.01). Conclusion: The SWV value can reveal the stability of carotid plaque, and it can be used as an effective indicator for prediction and assessment of stroke risk.
2018 Vol. 29 (6): 419-422 [Abstract] ( 651 ) HTML (1 KB)  PDF  (0 KB)  ( 162 )
423 Application of high-definition flow imaging with spatiotemporal image correlation in evaluation on normal fetal ductus venosus
WANG Lei, ZHANG Ying, CAI Ai-lu
Objective: To investigate the application value of high-definition flow imaging(HDFI) and spatiotemporal image correlation(STIC) technology to identify normal fetal ductus venosus(DV). Methods: From March 2015 to September 2016, DV was detected in 155 normal fetuses at 18～37 weeks of gestation using color Doppler echocardiography and HDFI-STIC imaging. Color Doppler echocardiography was performed with an oblique transverse plane of the fetal abdomen and scanning around the midsagittal plan. HDFI pattern was used to obtain a clear fetal aortic arch or a long axial section of the ductal arch, and then the STIC program was used to collect volume data, and the 3D images of the fetal DV were obtained by the post processing software. Comparisons were made between the three methods for visualization of the normal fetal DV. Results: HDFI-STIC showed a visualization rate >90% of DV at 18～29 weeks of gestation, while the color Doppler echocardiography method did a better work than HDFI-STIC imaging in 30 weeks of pregnancy. Conclusion: HDFI-STIC technology is a new method for evaluating the DV of fetal before 30 weeks of gestation, as it can show the shape of the fetal DV and its spatial relationship with the surrounding vascular. It is possible to observe the three-dimensional morphology of fetal DV.
2018 Vol. 29 (6): 423-426 [Abstract] ( 502 ) HTML (1 KB)  PDF  (0 KB)  ( 148 )
426 Ultrasonic diagnosis of complete cystic change of huge hysteromyoma: report of one case
LIU Fang-xin, WANG Zhou
2018 Vol. 29 (6): 426-426 [Abstract] ( 657 ) HTML (1 KB)  PDF  (0 KB)  ( 169 )
427 Imaging of SAPHO involvement in spine
ZHANG Li-hua, YUAN Hui-shu, DENG Xiao-li, GAO Shuang, SONG Le
Objective: To explore imaging features of synovitis, acne, pustulosis, hyperostosis, and osteitis(SAPHO) syndrome with vertebral involvement. Methods: Clinical and imaging data of 26 cases(16 male and 10 female; age between 26 to 73 years old, mean age (48.5±12.5) years) clinically confirmed as SAPHO syndrome were analyzed retrospectively. Imaging features of CT and MRI were described. Results: The number of thoracic, lumbar and cervical spine involved was 13, 10 and 6 respectively. Five cases had cervical-thoracic or thoracic-lumbar involvement. The number of spine involvement was between 2 to 10 and mean value was 3.4±0.8. Contiguous involvement of 2 vertebral bodies or more was found in 9 cases. Edema of vertebra body was found in 11 cases and bone erosion and bone sclerosis were present in 8 and 9 cases, respectively. Endplate irregularity was found in 10 cases. Six cases showed T2 hyperintensity in intervertebral discs and three cases showed narrowed intervertebral space. Thickened paraspinal soft-tissue was present in 4 cases and calcification of ligament was present in 2 cases. Other involvement locations included sternoclavicular, sternocostal joint, rib and sacroiliac joint and these are commonly seen SAPHO. Conclusion: SAPHO with spine involvement is not rare and thoracic is the most commonly involved segment, with lumbar and cervical segment following. Contiguous involvement of two or more segments is commonly seen and other commonly involvement location is sternoclavicular joint. Imaging appearance is diverse and several methods are needed to detect all of these lesions.
2018 Vol. 29 (6): 427-430 [Abstract] ( 657 ) HTML (1 KB)  PDF  (0 KB)  ( 174 )
431 Effect on CT value of peripheral tissue with different concentrations of #br# contrast media using simulated vascular enhancement
LI Wei-wei

Objective: To study the influence of contrast agent on CT value of tissue around syringe with different concentrations of contrast agent in the paraffin mold. Methods: Paraffin phantom of syringe with 11 different concentrations of contrast agent and saline as control was scanned with the same condition, and the CT value of the study area was measured in pixels and analyzed. Results: Contrast concentration had impact on CT value of different areas. CT beam hardening effect decreased the CT value of the small area around blood vessels with the increase of contrast agent concentration. Volume effect increased the CT value of area outside the beam hardening effect around blood vessels with the increase of contrast agent concentration. Conclusion:　CT values of surrounding tissue increase because of volume effect. There is significant difference between each experimental group and control group(P<0.004). Decreases of CT value of peripheral tissue due to pixel tube beam hardening effect is not significant between each experimental group and control group(P>0.004).
2018 Vol. 29 (6): 431-434 [Abstract] ( 609 ) HTML (1 KB)  PDF  (0 KB)  ( 272 )
435 The value of PET/CT in early diagnosis of Parkinson’s disease
CUI Li-li, CHENG Gang
Parkinson’s disease(PD) is a common disease of movement disorder in the elderly. It is chronic and progressive. Early clinical manifestations are not typical and it is easy to be misdiagnosed. But L-dopa is effective and early treatment can significantly improve the prognosis and living quality of the patients. So early diagnosis of the disease is very important. PET/CT has a high clinical value in the diagnosis of PD, especially in early diagnosis.
2018 Vol. 29 (6): 435-438 [Abstract] ( 755 ) HTML (1 KB)  PDF  (0 KB)  ( 159 )
439 Application of molecular imaging in paraganglioma of head and neck
HU Yue, MA Xiu-lan
Paragangliomas of head and neck are usually slow-growing tumors that are benign in most cases. Metastasis may also occur. Paragangliomas in head and neck usually do not produce catecholamines and related substances. They almost all have succinate dehydrogenase gene germline mutations and overexpression of somatostatin receptor. Conventional anatomical imaging has low sensitivity and specificity for detecting head and neck paragangliomas. Molecular imaging is gradually used in clinical diagnosis, which can significantly improve the sensitivity and specificity of the diagnosis of head and neck paragangliomas. Molecular imaging is useful for detection and characterization of head and neck paragangliomas and to demonstrate synchronous paragangliomas at other sites and distant metastases, which is critical because it can significantly affect treatment plan of patients.
2018 Vol. 29 (6): 439-442 [Abstract] ( 582 ) HTML (1 KB)  PDF  (0 KB)  ( 166 )
443 Ultrasonographic analysis of follicular variant of thyroid papillary carcinoma#br#
XIE Li-ling1, TANG Qing2, ZHOU Da-zhi2, ZHOU Xing-hua2
2018 Vol. 29 (6): 443-444 [Abstract] ( 727 ) HTML (1 KB)  PDF  (0 KB)  ( 158 )
445 Evaluation of liver fibrosis in schistosomiasis by ultrasound elastography
XIAO Jun-fei, ZHANG Qiang, CAO Le, LIAO Hua-wei
2018 Vol. 29 (6): 445-447 [Abstract] ( 613 ) HTML (1 KB)  PDF  (0 KB)  ( 177 )
447 Preoperative diagnosis of presacral cyst by transperineal sonography
HE Xiu-hong1, HE Yu1, ZHOU Li-xia2
2018 Vol. 29 (6): 447-448 [Abstract] ( 603 ) HTML (1 KB)  PDF  (0 KB)  ( 186 )
449 MRI of knee cruciate ligament cyst
BAI Hong-jun, ZHOU Ding-jun, WANG Guang-ping, LIU Ming, REN Wei, XU Meng
2018 Vol. 29 (6): 449-451 [Abstract] ( 734 ) HTML (1 KB)  PDF  (0 KB)  ( 185 )
452 Intrahepatic cholangiocarcinoma complicated with hepatic artery pseudoaneurysm hemorrhage: report of one case
YAN Tang-zhong, HOU Lu-qiang, CHI Qiang, WEI Si-rong
2018 Vol. 29 (6): 452-453 [Abstract] ( 630 ) HTML (1 KB)  PDF  (0 KB)  ( 145 )
453 Massive hepatic lymphoma: report of one case
LI Xing-zhe, LIU Yan-jun, WANG Xue-mei
2018 Vol. 29 (6): 453-454 [Abstract] ( 660 ) HTML (1 KB)  PDF  (0 KB)  ( 181 )
455 Ultrasonic diagnosis of incarcerated inguinal hernia of adnexa uteri in female infants: report of two cases#br#
SONG Jian1, ZHANG Wen-jun2, LEI Lin2
2018 Vol. 29 (6): 455-455 [Abstract] ( 520 ) HTML (1 KB)  PDF  (0 KB)  ( 162 )
456 Complete androgen insensitivity syndrome combined with spermatocytoma: report of one case
ZHANG Bing-yi, PING Jie, ZHANG Ling, DU Zhi-yong, GAO Yang
2018 Vol. 29 (6): 456-456 [Abstract] ( 546 ) HTML (1 KB)  PDF  (0 KB)  ( 154 )
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