Objective To compare the bronchial arteriography through multidetector-row CT (MDCT) with the digital subtraction angiography (DSA) via femoral artery, and evaluate the application value of bronchial arteriography through MDCT in the diagnosis and treatment of hemoptysis. Methods 133 cases complained of hemoptysis were examined by MDCT and DSA via femoral artery respectively to perform bronchial arteriography, and the differences of image results by two methods were compared. Results 129 cases with abnormal bronchial arteries were confirmed by DSA via femoral artery, 117 cases were checked by MDCT [ the positive rate was 90.7% (117/129 ) ] . 117 cases with abnormal bronchial arteries were confirmed by both MDCT and DSA via femoral artery and 4 cases did not detected any abnormal arteries by both methods. The coincidence rate of two methods was 91.0% (121 /133) . MDCT and DSA via femoral artery showed the similar origins of abnormal bronchial arteries. The coincidence rate of two methods was 100% . Conclusions There is a high coincidence rate betweenMDCT and DSA in detecting bronchial artery abnormalities. MDCT shows the origins of abnormal vessels clearly which could be a fist-choice of routine imagination for interventive operation.
ObjectiveTo investigate value of MSCT imaging on differentiating low grade pancreatic neuroendo-crine neoplasms (pNENs) from non-low grade pNENs. MethodThe clinical and CT data of 32 patients with pNENs,who were confirmed by pathological diagnosis from January 2014 to August 2015,were collected and analyzed retrospec-tively. ResultsThere were 15 patients with grade 1 in the low grade pNENs group,there were 11 patients with grade 2 and 6 patients with grade 3 in the non-low grade pNENs group.Compared with the low grade pNENs,the non-low grade pNENs had the larger diameter of the tumor (P=0.007),irregular tumor shape (P=0.006),obscure tumor margin (P=0.003),peripancreatic tissue or vascular invasion (P=0.036),lymphadenopathy (P=0.003),distant metastasis (P=0.019),lower absolute enhancement of tumor at the arterial (P=0.003) and the relative enhancement of tumor at the arterial (P=0.013). ConclusionThe analysis of MSCT features might help for differentiating low grade pNENs from non-low grade pNENs,so that more timely selection of appropriate treatment strategies would be made.
ObjectiveTo explore the value of multi-slice CT angiography (MSCTA) in peripancreatic vascular invasion of pancreatic carcinoma. MethodsThirty-eight patients with pancreatic carcinoma were detected by MSCTA technology before operation. The peripancreatic vascular invasion of pancreatic carcinoma was evaluated by multi-planar reconstruction (MPR) and maximum intensity projection (MIP) combined with axial image, and compared with the surgical results. ResultsThe MSCTA results showed that there were 12 patients (31.6%) with vascular invasion in 38 patients with pancreatic carcinoma, and the surgical results showed that there were 16 patients (42.1%) with vascular invasion. There was a b fit goodness of two results (kappa=0.665, P=0.000). The sensibility and specificity of MSCTA was 68.8% (11/16) and 95.5% (21/22), respectively. ConclusionsMSCTA technology has a high correct rate in evaluation of peripancreatic vessel encroached by pancreatic carcinoma, the MSCTA result has a b consistency to the surgical result. It has a value of clinical application in evaluation of peripancreatic vessel encroached by pancreatic carcinoma.
摘要:目的:评价64层螺旋CT对冠心病的诊断价值。方法:对25例典型病例的CT图片进行分析、总结,观察64层螺旋CT对冠状动脉的管腔狭窄程度及冠脉内斑块性质的显示能力,并对桥血管和支架通畅性进行观察。结果:近端冠脉中度以上狭窄的敏感度、准确度、阳性预测值分别为93.5%,90.3%,88.5%,对左主干及前降支病变诊断价值较高;对冠状动脉内软斑块显示较佳;对桥血管及支架通畅和有无再狭窄显示良好。结论:MSCT冠状动脉成像在冠心病筛查及冠状动脉支架术后和搭桥术后的随访发挥重要作用。Abstract: Objective: To study the diagnose value of 64slice spiral CT for coronary heart disease. Methods:The CT pictures of 25 typical cases of coronary heart disease were analyzed so as to survey the displaying ability coronal arterial stenosis, its degree and the character plaques, the patency of bypass graft and stents by 64slice spiral CT. Results:The sensitivity, accuracy, positive predictive value for RCA1 narrow above moderate was 93.5%, 90.3%, 88.5% respectively. For LM and LAD, its diagnose value was high. The coronary soft or fibrous plaque, stent and bypass graft were displayed well. Conclusion:MSCT plays an important role in filtering coronary heart disease and reexamination after stents and bypass.
ObjectiveTo discuss the diagnostic value of multi-slice spiral CT for bronchial mucoid impaction in early central-type carcinoma of lung. MethodsWe used multi-planar reformat, maximum intensity projection and minimum intensity projection to observe the characteristics of 15 patients with bronchial mucoid impaction in early central-type carcinoma of lung treated between March 2010 and October 2013. The characteristics included location, shape and enhanced performance of the tumor and the bronchial mucoid impaction. All the cases were confi rmed by operation or pathology. ResultsAmong the 15 cases, 12 were squamous cell carcinoma and 3 adenocarcinoma; 8 occurred on the right and 7 on the left. All the tumors showed equal density and were enhanced moderately. Bronchial mucoid impaction showed low density, no enhancement, accompanied bronchiectasis and occurred in bronchi which were far from the tumor, and there were 9 cases of strip, 5 of fabrication, and 1 of nodositas or cystic carcinoma. ConclusionThe location and shape of tumor and bronchial mucoid impaction are displayed clearly by multi-slice spiral CT and enhancement scanning can differentiate tumor from bronchial mucoid impaction. Multi-slice spiral CT has important diagnostic value in bronchial mucoid impaction of primary lung cancer in its early stage.
目的:研究多层螺旋CT(MDCT)增强扫描对慢性肾盂肾炎的诊断价值。方法:病例组:2008年3月至2009年3月经我院诊治的慢性肾盂肾炎患者30例,均行MDCT增强扫描及静脉肾盂造影(IVP)检查,两者间隔时间不超过1周;对照组:同期无肾脏疾患,无尿路感染史,因其他原因来做腹部CT增强扫描的患者25例。由两名不同年资的腹部影像医师对拟定的征象进行观察、评价。结果:两医师对本组病例的诊断一致性极佳K=0.812,Plt;0.05)。病例组30例,双肾病变14例,单肾病变16例。单肾病变中,左肾12例,右肾4例。MDCT增强扫描显示肾盏轻度变形2例(6.7%),肾盏裸露18例(60.0%),实质凹陷征23例(76.7%),肾盂轻度扩张积水21例(70.0%),肾盂壁增厚、强化21例(70.0%),肾功能减退15例(50.0%)。5例(16.7%)仅表现为肾盂壁增厚、强化。MDCT增强扫描与IVP对肾实质凹陷征,肾盂壁增厚、强化及肾盏轻度变形的显示率有统计学差异(Plt;0.05)。结论:MDCT增强扫描能清晰地显示慢性肾盂肾炎的病理变化。与IVP比较,它能提供更多肾实质的信息,对判定慢性肾盂肾炎所造成的肾脏损害程度及疾病预后具有很高的价值,不过对肾盏轻度变形的显示有赖于延迟扫描。
Objective To study the feasibil ity and rel iabil ity of the multi-plannar reformation (MPR) of multispiral CT (MSCT) in measuring the kyphosis angle (KA) after thoracolumbar fracture. Methods From December 2007 to December 2009, 45 thoracolumbar fracture patients who underwent computed radiology (CR) and MSCT were recruited. There were 32 males and 13 females with a mean age of 48 years (range, 24-63 years), including 36 simple compression fractures and 9 burst fractures. The fracture locations were T11 in 6 cases , T12 in 11 cases, L1 in 20 cases, and L2 in 8 cases. Fracture was caused by trafffic accident in 25 cases, by fall ing from height in 12 cases, and by others in 8 cases. The imaging examination was performed after 2 hours to 7 days of injury in 22 cases and after more than 7 days in 23 cases. The KA was measured on the lateral X-ray films of CR and MPR by two observers, then the measurements were done again after three weeks. The data were statistically analyzed. Results The average KA values on CR by two observers were (20.75 ± 8.31)° and (22.49 ± 9.07)°, respectively; showing significant difference (P lt; 0.05), and the correlation was good (r=0.882, P lt; 0.05). The average KA values on MPR by two observers were (16.65 ± 8.62)° and (17.08 ± 7.88)°, respectively, showing no significant difference (P gt; 0.05), the correlation was excellent (r=0.976, P lt; 0.05). The average KA values on CR and MPR were (21.61 ± 8.43)° and (16.87 ± 8.20)°, respectively; showing significant difference (P lt; 0.05), the correlation was good (r=0.852, P lt; 0.05). Conclusion It is more feasible and rel iable in measuring the KA on MRP of MSCT than CR, but the value is larger on CR.
目的 探讨多层螺旋CT在评价颈动脉斑块特征中的价值。 方法 回顾性分析2011年7月－10月132例行CT颈部血管造影患者的影像资料。对颈动脉斑块特征进行评价，重建方法包括多层面重建、容积再现技术、最大密度投影及曲面重建。 结果 132例患者中，80例检出颈动脉斑块，最常出现钙化斑块的部位为海绵窦段和床突上段，右侧海绵窦段52例（65.0%）、左侧海绵窦段49例（61.3%），右床突上段37例（46.3%）、左侧床突上段30例（37.5%）。最常出现软斑块的部位为双侧颈总动脉，均为12例（15.0%）。最常出现混合斑块的部位为颈总动脉，右侧颈总动脉9例（11.3%）、左侧颈总动脉12例（15.0%）。颈动脉最容易轻度狭窄294处（294/1 440，20.4%），中、重度狭窄少见，分别为8处（8/1 440，0.5%）和6处（6/1 440，0.4%）。颈部动脉血管斑块最易出现钙化，总计249处（249/1 440，17.3%），其次是软斑块和混合斑块，均为39处（39/1 440，2.7%）。 结论 多层螺旋CT可准确评价颈动脉斑块特征。
【Abstract】 Objective Using 16-slice multi-detector row helical CT (16-slice MDCT) to investigate the value of multiplanar reformation technique (MPR) in the diagnosis of bowel obstruction. Methods Thirty patients with surgically (27 cases) or clinically (3 cases) proofed diagnosis of bowel obstruction underwent 16-slice MDCT examination of the entire abdomen. All cases had plain CT scan, while 20 cases had additional contrast-enhanced CT scan at portal venous phase. In addition to the conventional axial images, the original CT raw data were then reconstructed into both coronal and sagittal images using MPR technique. Imaging findings were analyzed on axial, MPR coronal and sagittal images. Results Among the 30 patients with bowel obstruction, there were 8 cases caused by adhesion, 7 by simple intestinal tumor, 5 by intussusception (including caused by instestinal tumor), 4 by abdominal hernia, 2 by volvulus, 1 by ileocecal abscess, 1 by stenosis of mesenteric artery，1 by retroperitoneal cyst, and 1 by carcinoma in pancreatic tail. Six patients developed intestinal ischemia or strangulation. Both axial and MPR images correctly depicted the presence of bowel obstruction. Based on CT axial view （AV）, the site and the underlying etiology of bowel obstruction were determined in 26 (86.7%) and 22 (73.3%) patients respectively, while the combination with MPR coronal and sagittal images improved the diagnostic performance to 29 (96.7%) and 27 (90.0%) patients respectively. Both axial and MPR images correctly revealed the presence of intestinal ischemia or strangulation in 5 （83.3%）patients. Conclusion MPR technique of MDCT is very useful for evaluating the site and etiology of bowel obstruction, as well as the circulation status of involved bowel loop.
目的 分析多层螺旋CT在评价上腔静脉综合征侧支循环中的作用。 方法 报道2012年2月收治的1例上腔静脉综合征患者，并以多层螺旋CT评价侧支循环建立情况。 结果 通过多层螺旋CT的多维成像技术，可清楚发现患者典型的以及2支少见的侧支循环。 结论 多层螺旋CT在评价上腔静脉综合征侧支循环中有其重要意义。