2017年 · 第51卷第09期

The imaging examination report of the medical imaging department is not only the result of the patient's imaging examination, but also the diagnostic opinion provided by the imaging diagnostician to the relevant clinician. It is a bridge connecting diagnosis and treatment, and it is the final product produced by the imaging department. In particular, the examination reports of CT and MRI involve almost all disciplines of clinical medicine, and play an indispensable role in the whole clinical medical practice. International imaging professional organizations have issued some imaging reporting specifications, such as prostate imaging reporting and data system (PI-RADS), breast imaging reporting and data system (BI-RADS) and liver imaging reporting data system (LI-RADS). However, due to various reasons, the methods, writing contents and standardized language of imaging examination reports in various medical units (especially primary hospitals) in China are hugely different, and there are many problems, such as writing reports in tables, replacing descriptions with diagnosis or only describing without diagnosis, etc., thus reducing the significance of imaging examination reports.

Ocular diseases are more common clinically. The incidence of visual disability in China is 0.9%, and the patients who see the doctor due to ocular symptoms account for 3.0% of all patients^[1]It is essential to identify the cause and carry out early and rational intervention for patient recovery. Imaging examination is one of the key techniques in the diagnosis and treatment of ocular diseases. Optimizing examination technology and process, standardizing eye scanning and post-processing, report content and diagnostic points will further enhance the application value of eye imaging. The Head and Neck Group of Radiology Branch of Chinese Medical Association organized experts to reach the following consensus after many discussions on the above contents.

The clinical incidence of ear diseases is high. The incidence of hearing loss in China is about 13%, hearing disability is about 8%, and tinnitus is about 17%^[1]It is essential to identify the cause and carry out early and rational intervention for patient recovery. Imaging examination is one of the key technologies in the diagnosis and treatment of ear diseases. Optimizing examination technology and process, standardizing ear scanning and post-processing, report content and diagnostic points will further enhance the application value of ear imaging. Experts from the Head and Neck Group of Radiology Branch of Chinese Medical Association have reached a consensus after many discussions for your reference.

The prevalence of nasal diseases in China is as high as 30.8%^[1]Identifying the lesions and carrying out early and rational intervention is crucial for patient rehabilitation. Imaging examination is one of the key techniques in the diagnosis and treatment of nasal diseases. At present, the technical process, image processing and image evaluation of nasal diseases are lack of unified standards, which restricts the development of nasal imaging. After many discussions, experts from the Head and Neck Group of Radiology Branch of Chinese Medical Association reached a consensus on the imaging examination path, scanning and post-processing plan, report content and diagnosis points of nasal diseases.

Male, 1 year old. Two months ago, the family members found that the child's anterior fontanel was bulged, and then found that the child's balance ability was decreased, his motor ability was poorly developed, and he could only stand. The local hospital examination found multiple intracranial occupancy, so he went to our hospital on March 24, 2014.

Female, 18 years old. A left vulvar mass was found for 6 months and was admitted on 16 January 2017. Physical examination: The vulva developed normally, unmarried and unchildbearing, the lower edge of the labia majora of the left vulva was slightly raised, and a hard mass of 4.0 cm ×3.0 cm ×3.0 cm was palpable, with clear boundaries, good mobility and no tenderness. Ultrasound of the vulva showed that a hypoechoic mass of 4.2 cm ×3.8 cm ×4.0 cm was detected subcutaneously on the left labia majora, with clear edges and uneven internal echoes, and blood flow signals could be detected. Abdominal ultrasound and gastrointestinal angiography showed no obvious abnormalities.

Female, 80 years old, was seen on January 16, 2016 due to weakness of both lower limbs for more than 10 days. More than 10 days ago, the patient developed weakness of both lower limbs and could not walk without obvious trigger in quiet state; 4 days ago, he had unclear speech, choking and coughing after drinking water, accompanied by paroxysmal dizziness, rotation of vision, nausea and vomiting. Previous history of pelvic inflammatory disease for 1 year, long-term metronidazole (0.2~0.4 g/time, 3 times/d). Nervous system examination: clear mind, lack of spirit, unclear and fluent speech, poor cooperation in memory, computing power and orientation examination. Muscle strength of both upper limbs 5^-Grade, left lower limb muscle strength grade 3, right lower limb muscle strength grade 4, normal muscle tone, no involuntary movement. Poor coordination of bilateral finger-nose test, rapid rotation movement, heel-knee-tibia test, hypoalgesia on the ulnar side of both upper limbs and hypoalgesia on the left lower limb. Bilateral brachii biceps and triceps tendon and radial periosteum reflexes (+), bilateral knee tendon reflexes and ankle reflexes (+ ~ + +). Bilateral Babinsky sign (+), bilateral Shaddock sign undrawn. Neck no resistance, Kernig sign negative.

A 13-year-old male was admitted to hospital on September 17, 2012 with blunt pain in his left upper limb with slight back pain without obvious trigger 2 months ago. There was no dysphagia and eating discomfort during the course of the disease. Deny past history of trauma and infection. Physical examination: No abnormalities were found in cardiopulmonary examinations. The left supraclavicular fossa was full and touched a tough mass about 3 cm ×3 cm in size, with a smooth surface with tenderness and insignificant mobility. There were no abnormalities in routine hematuria, liver biochemical examination and tumor marker detection. CT plain scan showed a soft tissue mass of uneven density on the left side of the trachea at the thoracic entrance, immediately adjacent to the spine, and a suspected neurogenic tumor (Figure 1）。 CT enhancement showed that the medial segment of the left subclavian artery was compressed and displaced inward and downward, and the lumen became locally thinner and narrower. The initiation of the left vertebral artery is near-spherical dilation, about 3.7 cm in diameter. The periphery of the contrast agent is irregular and stripe-shaped low-density shadow is seen, and the upper side of the vertebral artery is seen as a finger-like protrusion enters the intervertebral foramen and continues into the vertebral artery (Figure 2，Figure 3), the distal end of the tumor was approximately 6.0 mm from the transverse process foramen and the proximal end was approximately 5.0 mm from the initiation of the subclavian artery. Proximal vertebral artery aneurysm with mural thrombosis was diagnosed. After a multidisciplinary consultation, it was decided to perform endovascular isolation of the left subclavian artery for vertebral aneurysm. The right femoral artery was punctured under the right inguinal ligament using Seldinger technique, a catheter sheath was placed, and a 5 F contrast catheter was sent to the initiation of the left subclavian artery under the guidance of a guidewire. The contrast showed a huge fusiform aneurysm at the initiation of the left vertebral artery with uneven filling of contrast agent (Figure 4）； Right vertebral artery angiography showed balanced blood supply to bilateral vertebral arteries, which was suitable for left vertebral artery closure. Then, FVL06060 covered stent was used to isolate the vertebral artery opening of subclavian artery. After stent placement, re-angiography showed that the vertebral aneurysm was successfully endovascularly isolated, the tumor disappeared, and the left subclavian artery was patent and good (Figure 5）。