2014年 · 第94卷第43期

With the rapid improvement of China's economic strength, medical and health undertakings have developed rapidly, and all kinds of high-precision medical imaging equipment have been rapidly popularized. At present, in China's large medical institutions, the new CT models have been updated in synchronization with the world's advanced level; The localization of CT equipment has promoted the popularization of CT in small and medium-sized medical institutions. In clinical medical work, CT scan is widely used in the detection, characterization and evaluation of therapeutic efficacy of diseases, and plays an important role in the construction of health undertakings in China. However, the widespread use of CT is accompanied by a serious public health problem: that is, the number of CT examinations is climbing rapidly, resulting in a large increase in the dose of CT radiation to the exposed population. Although the radiation dose level per CT examination is low (much lower than the fatal biological effect dose that leads to cell death), more and more people at home and abroad are beginning to pay attention to the random effect that low radiation dose may lead to cancer development. At present, there is no direct evidence that CT scan is one of the direct causative factors of cancer. The results of long-term follow-up surveys of radiation-exposed survivors of Hiroshima and Nagasaki atomic bombings and 400,000 nuclear industry practitioners in 15 countries show that X-ray radiation exposure is one of the high-risk causative factors of tumors. Therefore, it is necessary to take effective measures to reduce the radiation dose of CT scan^{[1,2,3,4,5,6,7,8,9]}。

The patient was a 27-year-old female. Lower back pain for 2 months, aggravated with radiating pain in the left lower limb for 1 month. Physical examination: Obvious tenderness and percussion pain in the left spinous process and paravertebral, and slight tension in the paravertebral muscles. Skin pain on the anterior and posterior side of the left thigh was significantly reduced. Imaging examination: CT plain scan showed the soft tissue density shadow in the spinal canal of L2~3 intervertebral discs, and nodular calcification was found inside (FIG. 1A)。 MRI plain scan showed an oval short T running up and down in the spinal canal at the level of L2/3 intervertebral disc₁Long T₂Signal, T₂WI lipid pressure showed high signal, the size was 16.1 mm ×12.2 mm ×21.0 mm, with clear boundary and spotty long T₁Short T₂Signals. Nodular short T was seen in the upper part of the lesion₁Short T₂Signal shadow, clear boundary, T₂Pressure lipid showed low signal (FIG. 1B，Figure 1C，Figure 1D)。 The enhanced MRI scan showed obvious uniform enhancement in the main body of the lesion, and the nodular signal shadow in the upper part of the lesion showed annular enhancement (Figure 1E)。 Imaging diagnosis: teratoma is likely. During the operation, the mass in the dural sac was explored, which was hard, gray-black in color, and the capsule was intact. A hard white mass was seen in the upper part, which was mobile, 12.2 mm ×16.1 mm ×21.0 mm in size, and slightly adhered to the nerve root. The results of pathological examination of the tumor showed that the cyst wall-like tissue was gray-white and gray-red, with a size of 20 mm ×10 mm ×10 mm and a cyst wall thickness of 1.0 cm. Pathological diagnosis: cystic mature teratoma (in lumbar spinal canal) (Figure 1F)。

Members of the working group:Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong People's Hospital (Liang Changhong); Department of Radiology, Huashan Hospital, Fudan University (Feng Xiaoyuan); Department of Radiology, Shengjing Hospital affiliated to China Medical University (Guo Qiyong, Liu Zhaoyu); Department of Radiology, First Affiliated Hospital of China Medical University (Xu Ke, Ren Ke, Dai Xu); Department of Radiology, Beijing Hospital (Zhou Cheng); Editorial Department of Chinese Journal of Radiology (Gao Hong); Department of Radiology, West China Hospital, Sichuan University (Chen Weixia); Department of Radiology, Nanfang Hospital, Southern Medical University (Xu Yikai); Department of Radiology, Hainan Provincial People's Hospital (Chen Feng); Department of Radiology, Panyu Central Hospital, Guangzhou (Chen Hanwei); Department of Radiology, Zhongda Hospital, Southeast University (Deng Gang); Department of Radiology, Second Hospital of Hebei Medical University (Li Caiying); Department of Radiology, First Hospital of Dalian Medical University (Liu Ailian); Department of Interventional Oncology, PLA General Hospital (Liu Fengyong); Department of Radiology, Hubei Cancer Hospital (Liu Yulin); Department of Radiology, Third Hospital of Sun Yat-sen University (Meng Xiaochun); Department of Radiology, Peking University Cancer Hospital and Beijing Institute of Cancer Prevention and Treatment (Sun Yingshi); Department of Radiology, Second Hospital of Xinjiang Medical University (Wang Hong); Department of Radiology, Tongji Hospital, Tongji University, Shanghai (Wang Peijun); Department of Radiology, Guizhou Provincial People's Hospital (Wang Rongpin); Department of Radiology, Shandong Institute of Medical Imaging (Xu Zhuodong); Department of Radiology, Peking Union Medical College Hospital (Xue Huadan); Department of Radiology, Union Hospital affiliated to Fujian Medical University (Xue Yunjing); Department of Radiology, First Hospital of Xi'an Jiaotong University (Jian Yang); Department of Radiology, Third Hospital of Central South University (Ye Bin); Department of Radiology, Second Hospital of Zhejiang University (Yu Risheng); Department of Interventional Therapy, Second Hospital of Shanxi Medical University (Yu Shiping); Department of Radiology, Beijing Chaoyang Hospital (Zhai Renyou); Department of Radiology, First Affiliated Hospital of Shanxi Medical University (Zhang Ruiping); Department of Radiology, Hospital of Inner Mongolia Autonomous Region (Zhang Xiaoqin); Department of Radiology, Daping Hospital, Third Military Medical University (Zhang Weiguo); Department of Radiology, First Hospital of Zhengzhou University (Zhang Yong); Department of Radiology, First Hospital of Kunming Medical College (Zhao Wei); Department of Radiology, Xiangya Second Hospital, Central South University (Zhou Shunke); People's Liberation Army First ○ Department of Radiology, Fifth Hospital [Zhu Youzhi]

The patient, a 23-year-old female, began to develop palpitations and chest discomfort without obvious triggers 3 years ago, but improved after a few minutes. She had no dizziness, no fear of cold and fever, and did not see a doctor at first. After that, palpitations recurred without obvious inducement, loss of consciousness, fall, and incontinence. After about 3 minutes, he woke up without limb twitching, closed teeth, and no foaming at the mouth. He went to the local hospital for treatment and got better after symptomatic treatment. After that, there were still repeated palpitations with loss of consciousness, and many dynamic electrocardiograms (DCG) showed "sinus rhythm, frequent multi-source ventricular premature, and short ventricular tachycardia".

leukoaraiosis (LA) is an imaging diagnostic term proposed by Canadian neurologist Hachinski et al. in 1987. It refers to spotty or patchy changes in periventricular or subcortical white matter. At present, most scholars believe that LA is closely related to ischemic injury and belongs to a type of cerebral small vessel disease. With the popularization of imaging examination, the detection rate of cerebral small vessel disease has increased significantly, which is closely related to stroke, cognitive impairment and aging^[1]Therefore, it has attracted much attention. Fundus artery belongs to a small branch of cerebral artery, and retinal arteriosclerosis seen by ophthalmoscopy can directly reflect the arterial vascular disease of the brain and even the whole body to a certain extent. Clinical trials have confirmed that fundus arteriopathy is associated with cerebral small vessel disease, suggesting that fundus arteriosclerosis and LA may have common risk factors and the same pathogenesis. Therefore, by studying the correlation between fundus arteriosclerosis and cerebral small vessel disease, it is speculated whether fundus arteriosclerosis can be used as an index for early assessment of LA.

Osteopenia/osteoporosis is one of the most common complications in patients with chronic liver disease^[1,2,3]。 In China, chronic liver disease is mainly caused by chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infection. The factors that cause osteopenia/osteoporosis in this population include the influence of the disease itself and the common risk factors of the general population. Osteopenia/osteoporosis will increase the risk of fracture, seriously affect the quality of life and even long-term prognosis of patients^[4]。 Clarifying the risk factors of disease, carrying out targeted screening, early diagnosis and early treatment are reasonable strategies to prevent fractures. At present, there are few studies on osteopenia/osteoporosis in patients with viral hepatitis in China. This article intends to introduce the relevant progress in order to attract attention.

A 46-year-old woman with a pelvic mass found on physical examination for 14 d. The patient usually has regular menstruation, without abdominal pain, abdominal distension and other discomfort. Gynecological examination: a huge mass can be accessed in the right adnexal area, with medium quality and average mobility. After admission, ultrasound showed a hypoechoic mass in the right pelvic cavity with irregular shape and uneven internal echo. Color Doppler imaging (CDFI) showed abundant internal blood supply, considering right broad ligament leiomyoma. MRI showed irregular mass and intestinal loop-like abnormal signals in the right pelvic cavity, with a size of 10.8 cm ×7.0 cm ×11.0 cm.₁isosignal on WI, and at T₂There was a mixed slightly high signal on WI lipid pressure, with multiple tortuous, thickened and empty blood vessel shadows, high signal on diffusion weighted imaging (DWI), and progressive enhancement on GD – DTPA enhanced scan, considering broad ligament leiomyoma (FIG. 1A，FIG. 1B，Figure 1C)。 One week later, total hysterectomy and double adnexal were performed. During the operation, multiple tumor protrusions were found in the right broad ligament and right pelvic vessels, the largest of which was about 8.0 cm in diameter. Postoperative pathology: leiomyoma of right broad ligament, intravascular leiomyomatosis around uterus (Figure 1D)。