ObjectiveTo investigate the vaules of multi-slice spiral CT (MSCT) in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer. MethodsFifty-nine patients with gastric cancer performed preoperative MSCT plain scan and triple enhanced scans from February 2019 to March 2021 in the First People’s Hospital of Wuhu City were collected. The results of postoperative pathology were taken as the gold standard, the short diameter, long diameter, short to long diameter ratio, CT values of triple enhanced scans and lymphatic hilar blur were compared between the metastatic lymph nodes and the non-metastatic lymph nodes. ResultsThe preoperative MSCT showed that there were 50 cases of metastatic lymph nodes and 9 cases of non-metastatic lymph nodes in 59 patients with gastric cancer. A total of 1 467 lymph nodes were harvested, including 562 metastatic lymph nodes and 905 non-metastatic lymph nodes. The short diameter, long diameter, short to long diameter ratio, and the CT values of plain scan, arterial phase, portal vein phase, and delayed phase of metastatic lymph nodes were higher than those of non-metastatic lymph nodes (P<0.05), and the incidence of lymphatic hilar blur was also higher than that of non-metastatic lymph nodes (P<0.05). Referring to the results of postoperative pathological examination, the accuracies of MSCT in judging of N0, N1, N2, N3a, and N3b stages were 88.9% (8/9), 83.3% (5/6), 85.7% (12/14), 92.3% (12/13), 88.2% (15/17), respectively, and the total accuracy was 88.1% (52/59), the specificity was 96.6% (57/59), and the sensitivity was 91.2% (52/57). ConclusionAccording to this study results, preoperative MSCT has higher specificity, sensitivity, and accuracy in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer.
目的 探讨多层螺旋CT对下颌骨骨折的诊断价值。 方法 对2007年4月-2009年10月下颌骨不同部位骨折的45例患者进行多层螺旋CT轴位扫描，并行多平面、表面遮盖法等三维重建，对下颌骨骨折CT表现特征作回顾性分析。 结果 45例下颌骨骨折中，位于下颌体骨折24例，下颌角骨折5例，下颌升支骨折6例，髁部骨折13例，冠突骨折2例；颞下颌关节脱位中，单侧脱位3例，双侧脱位5例。 结论 多层螺旋CT能准确诊断下颌骨各部位骨折，对诊治方案具有重要价值。
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.
目的:探讨肾上腺节细胞神经瘤的CT表现特征，以提高此病CT诊断的准确性。方法:回顾性分析8例经病理确诊为节细胞神经瘤的CT表现，并与病理结果对照研究。结果:8例肿瘤边界均清晰，无周围组织和血管侵犯征象。CT平扫呈均匀稍低密度，CT值约18～35 HU，其中内有点状钙化者3例（37.5%）。CT增强扫描有轻度强化，CT值约30～45 HU。CT征象符合病理表现。结论:肾上腺节细胞神经瘤有一定的CT表现特点，多层螺旋CT扫描有助于提高肾上腺节细胞神经瘤诊断的准确性。
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 analyze the relationship between image development types and delay time in computed tomography urography (CTU) examination and to investigate the value of choosing reasonable delay time to get the best images. MethodWe collected the data of 62 patients who underwent multi-slice CTU examination without fully developed images within 8 minutes from January 2010 to May 2014. There were 35 unilateral and 27 bilateral delayed imaging patients with a total of 89 cases. According to the degree of imaging development after the delayed 8 minutes, we divided it into 4 levels as follows:level 0 (no development), levelⅠ (light development), levelⅡ (partial development) and levelⅢ (full development). LevelⅢ was not included in this study. For level 0 to levelⅡ, we delayed scan for 15 to 1 440 minutes. ResultsAs the imaging development degree decreased, the delay time obviously extended. LevelⅡ could be fully displayed after 15 to 150 minutes of delayed scan. LevelⅠ could be fully displayed after 150 to 720 minutes. Level 0 still had no imaging development after 120 minutes, so there was no need to continue scanning. ConclusionsSelecting appropriate delay time of CTU based on the type of delayed imaging development can avoid unnecessary repeated delay scans, get the best development images, and estimate the kidney secretion functions, which is most helpful for accurate diagnosis of urinary system related diseases.
ObjectiveTo summarize the clinical features and imaging features of CT in the omental torsion, and in order to reduce the misdiagnosis and missed diagnosis rate of imaging features. MethodsThe data of 16 cases of omental torsion (secondary 15 cases, primary 1 case) and 286 cases of acute appendicitis (eliminated the subhepatic and retroperitoneal ectopic appendix) in our hospital from 1998 to 2014 were retrospectively analyzed. ResultsEleven cases of omental torsion suffered from the shifting pain in right lower quadrant. No obvious shifting abdominal pain was observed in other 4 cases whose main manifestations were abdominal tenderness and rebound tenderness around umbilicus. The patient of the remaining 1 case had enclosed mass in the area of left groin with pain and suffered from continuous periumbilical pain. Abdominal spiral CT examination was performed in 16 patients before operation. Increased signal intensity of globular soft tissue, which deviating from McBurney's point, was found at level of distal umbilicus by preoperative spiral CT in 13 cases. One case of omental torsion associated with ncarcerated inguinal hernia was missed. ConclusionsOmental torsion manifests chiefly shifting pain in right lower quadrant, abdominal tenderness, and rebound tenderness around umbilicus. It is easily confused with appendicitis. Abdominal spiral CT should be chosen as a preferred means in preoperative diagnosis of omental torsion.