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.
摘要:目的: 探讨64排多层螺旋CT(MSCT)和血清淀粉样蛋白A(serum amyloid A protein, SAA)联合术前评估直肠癌在肿瘤分期诊断中的作用。 方法 :纳入经根治术治疗的直肠癌患者通过MSCT扫描进行评估,同时取患者静脉血测量术前SAA水平,行MSCT分期与MSCT和SAA联合分期以比较二者的诊断价值。 结果 :本研究纳入患者121例。MSCT检测T分期的准确度为851%。在评估淋巴结转移方面,MSCT和SAA联合分期的准确度为760%,明显高于MSCT分期(595%, 〖WTBX〗P lt;0001)。MSCT正确判断所有远处转移。同单一的MSCT检测相比,MSCT和SAA联合评估能显著的提高术前TNM分期的准确率(785% vs. 636%,〖WTBX〗P =0011)。 结论 :MSCT联合SAA检测比单一的MSCT检测显著提高了直肠癌术前肿瘤分期和淋巴结转移方面的准确度。这种新的术前评估方法的为肿瘤进展评估和术前治疗决策提供了更加可靠的信息。Abstract: Objective: To determine the role of combinative assessment of 64 multislice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) in preoperative rectal cancer staging. Methods : Enrolled consecutive rectal cancer patients undergoing curative surgery were evaluated by MSCT scan. Meanwhile venous blood specimens were taken to measure preoperative SAA concentration. Both MSCT staging and MSCT plus SAA staging were performed to compare with each other. Results : The study population consisted of 121 patients. The accuracy of T staging was 851% for MSCT. The accuracy in evaluating lymph nodes metastases was 760% for MSCT plus SAA compared with 595% for MSCT alone (〖WTBX〗P lt;0001). All the distant metastases were correctly detected by MSCT. The method combining MSCT with SAA led to significant improvement on preoperative TNM staging compared with MSCT alone (785% vs. 636%, 〖WTBX〗P =0011). Conclusion : MSCT plus SAA showed greater accuracy than MSCT alone in rectal cancer staging and lymph node metastases. This novel strategy of preoperative evaluation appears to provide more accurate information on tumor progression and preoperative therapy decisionmaking.
In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly presented as a large solid, well-defined and hypervascular mass with necrosis or cystic changes at some extents together with the displacement of adjacent structures. The radial area with hypointensity on T2-weighted image and with progressive enhancement on enhanced magnetic resonance imaging is an important feature of SFT, which can be helpful for the diagnosis of this mass.
ObjectiveTo explore the correlation between coronary artery plaque composition and the gender via 128-slice spiral CT coronary angiography (128-SCTCA). MethodsBetween January and December 2012, 143 patients with coronary artery plaque diagnosed by 128-SCTCA were selected. The patients were divided into group A (no more than 50 years old, n=37) and group B (over 50 years old, n=106). ResultsThere were 29 male patients in group A, with 70 plaques including 30 fibrous plaques, 17 mixed plaques, 11 soft plaques, 12 calcified plaques; and the other 8 female patients had 13 plaques including 7 fibrous plaques, 2 mixed plaques, 2 soft plaques, and 2 calcified plaques. In group B, 56 male patients had 116 plaques, including 48 mixed plaques, 40 fibrous plaques, 14 soft plaques and 14 calcified plaques; the other 50 female patients had 90 plaques, including 36 mixed plaques, 22 fibrous plaques, and 16 soft plaques and calcified plaques. The differences of the plaque composition between males and females were not significant both in group A (χ2=0.664, P>0.05) and group B (χ2=3.708, P>0.05). ConclusionThere is no obvious correlation between gender and coronary plaque composition.
ObjectiveTo evaluate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with multislice computed tomography (MSCT) in the evaluation of neoadjuvant chemotherapy (NACT) for breast cancer. MethodsThe clinical, imaging, and pathological data of breast cancer patients who received NACT in the Affiliated Hospital of Southwest Medical University from February 2019 to August 2021 were retrospectively collected. Based on the results of postoperative pathological examination, the patients were assigned into significant remission (Miller-Payne grade Ⅰ–Ⅲ) and non-significant remission (Miller-Payne grade Ⅳ–Ⅴ). The variables with statistical significance by univariate analysis or factors with clinical significance judged based on professional knowledge were included to conduct the logistic regression multivariate analysis to screen the risk factors affecting the degree of pathological remission after NACT. Then, the screened risk factors were used to establish a prediction model for the degree of pathological remission of breast cancer after NACT, and the efficacy of this model was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) curve. ResultsAccording to the inclusion and exclusion criteria, a total of 211 breast cancer patients who received NACT were collected, including 116 patients with significant remission and 95 patients with non-significant remission. Logistic regression multivariate analysis results showed that the human epidermal growth factor receptor 2 positive, lower early enhancement rate after NACT, lower arterial stage net increment after NACT, and lower CT value of arterial phase of lesions would increase the probability of significant remission in patients with breast cancer after NACT (P<0.05). The area under the ROC curve of the model for predicting the degree of pathological remission of breast cancer after NACT was 0.984, the specificity was 93.7%, and the sensitivity was 95.7%. The calibration curve showed that the model result fit well with the actual result, and the DCA result showed that it had a high clinical net benefit value. ConclusionFrom the results of this study, DCE-MRI combined with MSCT enhanced scanning has a good predictive value for pathological remission degree after NACT for breast cancer, which can provide clinical guidance for further treatment.
ObjectiveTo explore the evaluation value of preoperative multislice spiral computed tomography angiography (MSCTA) for normative radical gastrectomy. MethodsThe anatomic distributions of celiac trunk and its three branches and their tributaries (common hepatic artery, right hepatic artery, left hepatic artery, splenic artery, and left gastric artery) of 86 patients with gastric cancer were comprehended by preoperative MSCTA, which were verified during the surgery. Simultaneously preoperative TNM staging was evaluated by MSCTA, which compared with postoperative pathological results. ResultsThe accuracy rate of preoperative MSCTA evaluating the distribution of celiac trunk and its three branches and their tributaries was 100%. Abnormal hepatic arteries were found in 22 cases by MSCTA, the mutation rate was 25.58%. Abnormal right hepatic arteries were found in 11 cases (12.79%), abnormal left hepatic arteries in 7 cases (8.14%), both abnormal right and left hepatic arteries in 1 case (1.16%), and abnormal common hepatic arteries in 3 cases (3.49%). Straight splenic arteries were found in 24 cases (27.91%), slightly curved splenic arteries in 44 cases (51.16%), and significantly curved splenic arteries in 18 cases (20.93%). Compared with postoperative pathological results, the accuracy rates of preoperative MSCTA evaluating gastric cancer T, N, and M staging were 75.58%（65/86）, 74.42%(64/86), and 91.86%(79/86), respectively. ConclusionsPreoperative MSCTA is an objective way to assess the distributions of celiac artery trunk and related tributaries of patients with gastric cancer. Also, it is an accurate method to evaluate the preoperative TNM stage of gastric cancer, which can help to make an individual operative plan and avoid the intraoperative injury of the artery.
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。
Objective To evaluate the clinical value of multi-detector row helical CT (MDCT) in Diagnosing the TN staging and typing of adenocarcinoma of esophagogastric junction. Methods From January 2008 to June 2011，149 consecutive cases with AEG confirmed surgery were examined by using MDCT scanner before surgery in West China Hospital，pathologic and operative finding diagnosis were correlated with that results of MDCT . Results The accuracies of MDCT for the T1, T2, T3, and T4 staging was 97.3%，91.3%，84.5%， and 89.3%，respectively， and for the typing of Ⅰ,Ⅱ, andⅢwas 84.6%, 63.8%, and 79.2%，respectively. The accuracies of MDCT to judge the metastasis of lymph node was 88.6%（132/149）. The feature of metastasis of lymph node with circular and fusion，significantly and obviously enhanced，ring and heterogeneous enhanced, which the positive rate of pathological metastasis was higher (P=0.000). Conclusions MDCT is an excellent diagnostic tool for the diagnosis of the TN staging and typing of AEG, which is useful for the selection of the surgical procedure and decision operation path.