2015年 · 第49卷第03期

As X-ray is widely used in clinical practice, the types of equipment and medical imaging technology are diversified and complex. The responsibilities of radiodiagnostic practitioners are further subdivided and specialized. Radiodiagnostic physicians and radiodiagnostic technicians, as two occupational categories in the field of radiodiagnosis, have their own practice scopes and requirements. With the rapid improvement of imaging equipment performance and technology, the comprehensive digitalization of medical imaging has been basically realized at present, and the development trend of digitalization, fusion, networking and standardization of medical imaging is presented, which also puts forward higher requirements for the work of radiological diagnostic technicians. China has not yet established a medical physicist system, and there are still serious deficiencies in the stability testing and quality control of radiological diagnostic X-ray equipment in clinical practice. Radiological diagnostic technicians still have great room for improvement in the standardization of medical imaging technology, the optimization of radiation dose of subjects, the expansion of imaging methodology, the networking of adapting to digital imaging, the evaluation of imaging performance and quality control, etc. The author discusses the problems existing in clinical practice and scientific research of radiographic diagnostic technicians, and hopes to put forward solutions to improve the scientific research and practice level of radiographic diagnostic technicians in China.

transjugular intrahepatic portosystemic shunt (TIPS) can effectively control the symptoms of acute and chronic esophageal and gastric varices rupture and bleeding, refractory ascites and other symptoms caused by portal hypertension^{[1,2,3,4,5,6]}。 Abdominal hemorrhage caused by extrahepatic portal vein puncture is one of the most critical complications in TIPS, with a reported incidence of 1% ~2%^[7]。 In the past, TIPS surgery with bare stent was performed. If there was bleeding caused by extrahepatic portal vein puncture, the amount of bleeding during the operation was huge, and the patient could quickly develop hemorrhagic shock. The treatment was mostly balloon compression and surgical open repair. The appearance of covered stents can better deal with this situation. Since 2005, the author has attempted to perform TIPS surgery with a stent covered with film (Fluency stent, Bard, Germany) as an alternative product, and achieved satisfactory results^[8]At the same time, it was found that the use of Fluency covered stent can also obtain satisfactory results for abdominal hemorrhage caused by extrahepatic portal vein puncture during TIPS operation. The preliminary experience is reported below.

The anterior cruciate ligament is an important structure to assist in stabilizing the knee joint. Its injury is one of the most common sports injuries, which can lead to knee instability and then osteoarthritis. Arthroscopic reconstruction of the injured ligament is helpful to restore the stability and biomechanical properties of the knee joint, and has become the main treatment for ACL injury^[1]。 Observation of graft is an important part of postoperative evaluation. Conventional MRI can show the two-dimensional morphology and internal structure of graft well, which is an effective method for diagnosing anterior cruciate ligament injury and evaluating postoperative graft^[2]However, at present, there are few reports on graft morphology displayed by three-dimensional images, and there are relatively few quantitative evaluation methods for ligaments and grafts, especially the lack of objective evaluation methods for postoperative follow-up of grafts.

Male, 3 months old, came to our hospital on March 19, 2014 due to refusal of breast for 15 h with repeated convulsions for 7 h. The child was born prematurely (36⁺⁴Weeks), with a birth weight of 2.55 kg. Physical examination: Hair color is light and sparse, twisted and easy to break. Poor mental response, unable to raise your head in prone position, unable to erect your neck, responsive to sound and light stimulation, and not accompanied by fever and vomiting when convulsing. Laboratory examination: Serum ceruloplasmin (sCEP) content was determined for the first time at 2.35 mg/L, and remeasured at 0.06 mg/L (normal reference value 150-300 mg/L) after 6 days. Blood copper content was 8.0 μ mol/L (normal reference value 11.8-39.3 μ mol/L), blood calcium content was 1.91 mmol/L (normal reference value 1.55-2.10 mmol/L). Microscopic observation of hair showed localized bulge of single hair. Ultrasound examination: bilateral pelvic dilation.

Female, 39 years old, was seen on 13 September 2013 due to menopause for 2 months. Physical examination: bilateral pupil diameter 3.0 mm, poor visual field cooperation of both eyes, dark spots on the arm side of the right eye, dark spots on the subtemporal and upper side of the left eye, and all other ophthalmic examinations were normal. No neurological positive signs were found elsewhere throughout the body. Hormone examination: thyroid stimulating hormone (TSH) 0.03 mU/L (normal reference value 0.27-4.20 mU/L), serum prolactin (PRL) 910.95 mU/L (normal reference value 70.81-566.50 mU/L), free thyroxine (FT4) 13.8 nmol/L (normal reference value 15.6-28.6 nmol/L), 24 h urine free cortisol 28.74 nmol/24 h (normal reference value 108.00-961.00 nmol/24 h).

Malignant tumors have always threatened human life and health. Existing imaging methods (such as CT, MRI and PET) play an important role in preoperative diagnosis and postoperative efficacy evaluation. However, clinical diagnosis of tumors largely depends on surgeon's observation and palpation^[1]。 How to diagnose tumor early, verify intraoperative pathological classification, accurately obtain tumor boundary and perform surgical navigation resection guided by accurate images are challenging problems in clinical practice at present. With the development of medical imaging technology, optical molecular imaging surgical navigation system provides a method to solve this problem^[2]。

Prostate cancer is the most common malignant tumor of male urinary system, and its prevalence is on the rise in China. MRI is the most important imaging examination method for the diagnosis of prostate cancer. MRI multi-parameter functional imaging is of great value in non-invasive diagnosis of prostate cancer. DWI can qualitatively and quantitatively analyze the tissue structure and cell characteristics of prostate cancer, and improve the accuracy of diagnosis. The author reviews the research progress of DWI in the diagnosis of prostate cancer.

nontuberculous mycobacterium (NTM) refers to mycobacteria other than mycobacterium tuberculosis complex and mycobacterium leprae, which are widely found in water and soil. To date, a total of 154 species of NTM have been found, but only a few can cause disease, and the lung is the organ most commonly affected by NTM^[1]Its imaging manifestations and clinical symptoms are difficult to distinguish from pulmonary tuberculosis. In recent years, the prevalence of NTM in the world has shown a rapid growth trend^[2,3]mycobacterium avium-intracellare complex (MAC) and rapidly growing mycobacteria (RGM) are the most common species in respiratory NTM infections in East Asia^[3]Chest plain radiograph and CT examination play a very important role in the diagnosis of NTM. The author summarized the imaging manifestations of common NTM lung infection in people with normal immunity, in order to help imaging physicians to understand the imaging of NTM lung infection and improve the ability of differential diagnosis.