目的:评价先天性心脏病（CHD）不同病变类型在64层螺旋CT（64-MDCT）三维重建图像上的表现及显示效果。方法:回顾性分析36例CHD患者的64-MDCT资料,分别在轴位、冠状、矢状位及容积再现（VR）重组图像上观察病变,统计分析不同重组图像显示总体病变及房、室间隔缺损效果有无差异。结果:36例患者共有病变59处,轴位、冠状及矢状位图像在发现病变（59处,100.0%；57处,96.6%；53处,89.8%）及室间隔缺损显示（显示效果评分:41、38及39分）方面无明显差异（P＞0.05）,但轴位图像显示房间隔缺损明显优于冠、矢状位图像（显示效果评分:19、13及12分）（P＜0.05）。VR图像与轴位及冠、矢状位图像显示心外大血管病变效果无差异P＞0.05）。不同类型病变在轴位,冠、矢状位及VR图像上表现特征不尽相同,而不同重组图像有各自优势显示的病变类型。结论:64-DCT三维重建图像能够很好地显示先心病各种类型病变,了解不同重建图像上病变表现特征及显示效果有利于做出准确、全面的诊断。
目的:探讨腰椎峡部裂性滑脱的多层螺旋CT特征及其价值。方法 收集经临床诊治的腰椎峡部裂性滑脱30例CT资料进行回顾性分析。结果 多层螺旋CT能清晰显示腰椎峡部裂性滑脱的椎弓峡部裂、椎体滑脱程度、椎间盘及椎管等CT特征。结论 多层螺旋CT是腰椎峡部裂性滑脱的优良影像学检查方法。
目的:利用低剂量多层螺旋CT儿童序列及多平面重组(MPR)技术探索儿童鼻咽部气道大小及形态。资料及方法:回顾性性分析2005.05～2008.08来我院检查鼻及鼻咽部儿童的CT扫描图像,选择符合条件的3～14岁患儿73例,根据儿童鼻咽部腺样体生理特点分两组,一组3～7岁,二组8～14岁,分析儿童鼻咽部A值、N值及A/N值,总结鼻咽腔形态学特点。结果:3～14岁(两组)儿童正常鼻咽部气道失状位均呈镰刀形,周围脂肪间隙清晰,后缘光整连续;一组及二组A值均数分别为9.23±4.85 mm、9.56±4.74 mm;N值均数分别为19.23±3.5 mm、21.5±4.9 mm;两组A值及N值均数间没有统计学差异;A/N值范围一组为0.2～0.58,二组0.21～0.6。结论:3～14岁健康儿童鼻咽腔失状位呈弓向上的镰刀形,边缘光整,周围脂肪间隙清晰,A/N≤0.6。
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 应用128层螺旋CT冠状动脉成像，探讨冠状动脉不同成分斑块与狭窄程度的诊断价值。 方法 对2010年3月－2012年10月150例临床拟诊冠心病及确诊冠心病患者的128层螺旋CT冠状动脉成像检查，冠状动脉影像表现由两位心血管CT诊断医师独立判断冠状动脉斑块成分及测量冠状动脉狭窄程度。应用Circulation血管分析软件，分析冠状动脉斑块成分与狭窄程度之间的相关性。 结果 150例患者中，共发现319处斑块，其中软斑块104处，纤维、混合斑块103处，钙化斑块112处。冠状动脉轻度狭窄114处中，钙化斑块86处 （75.4%）；冠状动脉中度狭窄113处中，纤维、混合斑块75处（66.3%）；冠状动脉重度狭窄92处中，软斑块68处（73.9%）。 结论 128层螺旋CT冠状动脉成像能够有效检测患者冠状动脉斑块的成分及准确判断冠状动脉狭窄程度。
【Abstract】Objective To investigate the imaging features of malignant invasion of major intrahepatic ductal structures (the portal and hepatic venous vasculature, the bilie duct) by primary hepatocellular carcinoma (HCC) using multidetector-row spiral CT (MDCT). Methods We retrospectively analyzed 68 documented HCC patients with tumorous invasion of the major intrahepatic ductal structures who had undergone contrast-enhanced dual-phase MDCT scanning of the upper abdomen.The morphological changes of the portal and hepatic venous vasculature, the bile duct, and the liver parenchyma at both the hepatic arterial phase and portal venous phase images were carefully observed and recorded. Results Among the 68 patients, 47 patients had malignant invasion of the intrahepatic portal venous vessels with secondary tumor thrombus formation; 12 patients had tumor involvement of the hepatic veins and intraheptic segment of the inferior vena cava; Tumor invasion of the bile duct was seen in 9 patents. The direct CT signs of tumor invasion of intrahepatic venous vessels included: ①dilatation or enlargement of the involved vein with intraluminal softtissue “filling defect”； ②enhancement of the tumor thrombus at hepatic arterial phase, the so-called “venous arterialization” phenomenon. The indirect CT signs included: ①arterial-venous shunt, ②early and heterogeneous enhancement of the hepatic parenchyma adjacent to HCC focus, ③cavernous transformation of the portal vein. The CT signs suggesting tumor invasion of the bile duct included: ①dilation of the bile ducts near or proximal to HCC lesion, ②soft-tissue nodule or mass inside the bile ducts. Conclusion Invasion of major intrahepatic ductal structures by HCC will present corresponding CT imaging features. Contrast-enhanced MDCT dualphase scanning combined with appropriate image postprocessing techniques can better evaluate the malignant invasion of major intrahepatic ductal structures.
Objective?To evaluate the value of various CT features in differentiating renal angiomyolipoma (RAML) with minimal fat and renal cell carcinoma (RCC). Methods?The Cochrane Library, PubMed, MEDLINE (OVID), EMBase, and the Chinese Periodical Wed (CNKI, CBM, VIP) were searched. They were searched from Jan 2001 to Nov 2008. Trials screening, quality assessment, and data extraction was conducted according to the inclusion criteria recommended by the Cochrane Collaboration. The SROC curve and meta-analyses were performed by Meta-disc 1.4. Results?Seven trials, involving 482 patients and 513 tumors, were included. The studies were highly homogonous. It was considered that 8 features including single or multiple lesions, scanning density, calcification, angle with cortex, levering-cortex-up sign, lesions pro-trusion, homogeneous enhancement, and prolonged enhancement, played certain roles in differentiating RAML with minimal fat and RCC. Among these features, interface with the cortex was the most important, and the features of homogeneous enhancement and prolonged enhancement were the second most important. Conclusion?Besides measuring lipoid tissue in the tumor, there are another 8 features which are valuable to the differentiation of RAML with minimal fat and RCC.