【摘要】 目的 探讨结核性腹膜炎的CT诊断价值。 方法 回顾性分析2009年10月-2010年7月22例经手术、病理或抗结核治疗确诊的结核性腹膜炎CT完整资料。主要观察:淋巴结、腹水、腹膜、系膜、网膜改变。 结果 淋巴结肿大12例，增强后呈“环状”强化改变。腹腔积液15例，少～中量12例，聚集在肠系膜根部、结肠旁沟及盆腔较多，CT值20～28HU。腹膜增厚16例，其中14例均匀光滑增厚，10例明显强化；大网膜增厚15例，其中饼状增厚2例、污垢样增厚9例、结节样4例。肠系膜增厚18例，3例肠袢聚集、粘连。伴有其他脏器结核13例。 结论 CT对诊断和鉴别诊断结核性腹膜炎具有较大的临床价值，结合临床多数结核性腹膜炎可作出正确诊断。【Abstract】 Objective To evaluate the diagnostic value of CT scan for tuberculotic peritonitis. Methods The complete CT image data of 22 patients with tuberculotic peritonitis confirmed by surgical, pathologically, or therapeutic procedures from October 2009 to July 2010 were retrospectively analyzed. The changes of lymph nodes, ascites, thickened peritoneum, mesentery and greater omentum were observed. Results In 22 patients, enlargement and rim enhancement of lymph nodes were found in 12; ascites with CT value of 20-28 HU was in 15, of whom 12 had small or middle amount of effusion which located in mesentery or abdominal cavity; thickened parietal peritoneum was in 16, including smooth peritoneum in 14 and evident enhancement in 10; thickened greater omeutum was in 15, including cake-like thickening in 2, filth-like thickening in 9 and tuber-like thickening in 4; thickened mesentery was in 18, including intestinal loop adhesion in 3.A total of 13 patients were combined with other tuberculosis. Conclusion CT scan is very important in diagnosing and differentially diagnosing tuberculous perinitis.
目的 探讨螺旋CT增强扫描在子宫内膜癌的表现和分期价值。 方法 2004年3月－2010年2月对40例子宫内膜癌术前均行CT平扫和增强扫描，并按世界妇产科联合会（FIGO）标准进行术前CT分期，且均经手术和病理证实。 结果 子宫内膜癌增强CT主要表现为：子宫前后径增大，子宫内膜增厚，宫腔扩大，其内可见强化程度低于子宫肌壁的乳头状、息肉状或不规则状软组织影，部份可见宫腔积液、积血或积脓；或子宫肌壁变薄、厚薄不均或不规则，宫颈增大、密度变低或不均；子宫外播散等相关表现。FIGO分期：Ⅰa期6例，Ⅰb期8例，Ⅰc期8例，Ⅱ期8例，Ⅲ期4例，Ⅳ期6例。其中2例Ⅰa期高估为Ⅰb期，3例Ⅱa期高估为Ⅱb期，2例Ⅱ期低估为Ⅰ期。Ⅰ、Ⅱ期CT分期准确率分别为81.82％、37.5%，Ⅲ、Ⅳ期诊断均正确，总准确率为82.5%。 结论 螺旋CT增强扫描对子宫内膜癌的诊断和分期均有价值。
【摘要】 目的 利用首过时间技术进行全胰腺CT灌注扫描，了解正常胰腺CT灌注的特点。 方法 2006年6月-2007年3月， 64例正常胰腺患者行64排螺旋CT灌注扫描，测量胰头、胰体及胰尾的灌注值、强化峰值、达峰时间和血容量。分别按患者的性别、年龄及胰腺测量的部位分组，将灌注参数进行统计分析。 结果 ①男性胰腺的血容量高于女性（Plt;0.05），其余灌注参数在两性间差异无统计学意义（Pgt;0.05）。②41~60岁组的灌注值低于lt;40岁组和gt;60岁组；gt;60岁组的强化峰值高于41~60岁组；41~60岁组的达峰时间长于lt;40岁组；gt;60岁组的血容量高于41~60岁组（Plt;0.05）。③胰体和胰尾的灌注值高于胰头（Plt;0.05），其余灌注参数在胰腺不同部位差异无统计学意义。 结论 正常胰腺血流状况在不同性别、不同年龄段及不同部位存在差异，首过时间技术应用于正常胰腺能反映这些特征。【Abstract】 Objective To investigate the CT perfusion features of normal pancreas with first-pass technique with 64-MDCT. Methods Perfusion CT was performed on 64 patients with normal pancreas from June 2006 to March 2007. Four perfusion parameters, including perfusion, peak enhancement, time to peak, and blood volume, were obtained at the head, body and tail of the pancreas. Perfusion parameters were compared between different sexes, among different age groups and among different sites. Results ① Blood volume of male was significantly higher than that of female (Plt;0.05). ② The perfusion value in the age group of 41-60 was significantly lower than that in the age group of lt;40 and gt;60 (Plt;0.05). The peak enhancement in the age group of gt;60 was significantly higher than that in the age group of 41-60 (Plt;0.05). The time to peak in the age group of 41-60 was significantly longer than that in the age group of lt;40 (Plt;0.05). The blood volume in the age group of gt;60 was significantly higher than that in the age group of 41-60 (Plt;0.05). ③The perfusion values of the body and the tail were significantly higher than that of the head (Plt;0.05). Conclusion There are significant differences in the perfusion parameters between different sexes and among several age groups and sites. The first-pass technique of perfusion applied in normal pancreas can reflect these features.
ObjectiveTo explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. MethodsThirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. ResultsIn the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). ConclusionCTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.
目的 探讨镰状韧带引起假性病灶的影像学表现，以提高对其的认识，减少误诊。 方法 对2010年1月－2012年1月收入的817例患者进行上腹部64排CT平扫加增强扫描，筛选出肝镰状韧带附近假病灶，详细记录其部位、大小、形状以及扫描各期图像的密度变化情况。 结果 有72例存在镰状韧带假病灶，绝大多数位于肝左叶内侧段（69例），并呈单发病灶（70例）。假病灶最大直径约5.1～22.0 mm，平均约13.1 mm，假病灶分别呈三角形43例、类圆形19例、结节状10例。CT扫描：平扫显示10例，动脉期显示63例，门脉期几乎全部显示清晰。 结论 镰状韧带形成假病灶比较少见，其发生部位特殊，在门脉期易于显示，可与肝内真性病灶鉴别，以免误诊。
目的 探讨小肠扭转的CT影像学表现及多层螺旋CT的诊断价值。 方法 回顾性分析2006年2月－2011年8月14例经手术证实肠扭转患者的临床及影像资料。 结果 14例小肠扭转患者中有9例出现“U形征”，13例有肠管和血管的“漩涡征”，4例有“鸟喙征”，2例可见“靶环征”，1例可见空回肠“转位征”。 结论 肠管及血管的“漩涡征”是诊断小肠扭转的特异性征象，“鸟喙征”、“靶环征”等其他CT征象为小肠扭转的正确诊断提供可靠依据。多层螺旋CT扫描及三维重组对小肠扭转的诊断具有重要价值。
目的 探讨结核性腹膜炎（TBP）及癌性腹膜炎（CP）的螺旋CT表现，提高其诊断及鉴别诊断水平。 方法 回顾分析2009年9月－2010年9月经手术病理、穿刺活检或综合手段证实的22例TBP和45例CP患者的CT影像资料，采用χ2检验比较各种CT征象在两种病变中的发生率，结合病理、临床结果进行分析。 结果 TBP组及CP组患者大量腹水所占比例差异有统计学意义（36.4%、75.6%，χ2=9.703，P=0.002）；两组壁腹膜、肠系膜增厚构成比差异有统计学意义，TBP组以壁层腹膜均匀增厚、肠系膜污迹样改变为主，CP组壁层腹膜以结节、块样增厚为主；两组大网膜厚度差异有统计学意义。 结论 以壁层腹膜改变为基础，综合大网膜、肠系膜及腹水改变CT征象对两种病变的诊断及鉴别诊断具有重要意义。
ObjectiveTo evaluate the value of computed tomography examination in the clinical diagnosis guidance and therapeutic effect assessment for patients with uremic pneumonia. MethodsWe reviewed the clinical situation and pathogenesis turnover of 64 cases of uremic pneumonia from February 2011 to January 2013,and analyzed the correlation between image modification and treatment effectiveness. ResultsSixty-four cases of uremic pneumonia had different image manifestations in each phase of the disease course,including 27 cases of pulmonary venous pleonaemia,51 of lung interstitial edema,8 of pulmonary alveoli effusion,and 15 of pulmonary interstitial fibrosis.Dropsy of serous cavity and the heart shape could be viewed by CT scanning.CT rechecking was carried out after hemodialysis and symptom-targeted treatment.The results showed that CT results of 27 cases of pulmonary venous pleonaemia,51 cases of edema in the interstitial tissue and 41 cases of pleural effusion changed significantly after treatment (P<0.001);the image manifestations of 8 cases of pulmonary alveoli edema also changed significantly (P<0.05);the CT result of 15 cases of pulmonary interstitial fibrosis had no change;six cases among the fourteen cases of pericardial effusion were not absorbed by treatment (P>0.05). ConclusionThe diagnosis of uremic pneumonia mainly depends on imaging results.CT scanning plays an important role on the determination of clinical stage,the choice of therapeutic method,and evaluation of curative effect for uremic pneumonia.