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。
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。
Objective To evaluate the accuracy of pedicle guide device for the placement of the pedicle screws. Methods Pedicle guide device was designed and made for the anatomical trait of pedicle. The 3-Danatomical data of the thoracic pedicles were measured by multislice spiral CT in two embalmed human cadaveric thoracic pedicles spine(T1 -T10). Depending on transverse section angle(TSA) and sagittal section angle(SSA) of pedicle axis, the degree of horizontal dial and sagittal dial were adjusted in the guide device. The screws wereinserted bilaterally in the thoracic pedicles by using the device. After pulling the screws out, the pathways were filled with contrast media. The TSA and SSA of developed pathways were measured. Results Analysis of the difference between pedicle axis and developed pathway was of no statistical significance(P＞0.05). Conclusion The guide device could be easilyoperated and guarantee high accuracy of the pathways of screws and the incidence of pedicle penetration could be significantly reduced.
Objective To introduce the current value of multi-detector row CT (MDCT) and magnetic resonance imaging (MRI) techniques on evaluation of diffuse hepatic parenchymal diseases.Methods By literature review, the application and recent advances of various kinds of MDCT and MR imaging techniques in evaluating diffuse hepatic parenchymal diseases were summarized. Results There were three kinds of diffuse liver parenchyma diseases, which were the diseases of storage, vascular and inflammatory. The morphology changes of diffuse liver parenchyma diseases could be demonstrated well by MDCT. MRI, especially MR functional imaging could reflect the morphology changes, and cellular metabolic activity of the liver, which provided qualitative and quantitative information for the diagnosis and evaluation of therapeutic effect on diffuse liver parenchyma diseases. Conclusion MR imaging techniques, especially those functional techniques, developed rapidly and had practical value in both the diagnosis and severity assessment of hepatic fibrosis.
目的:研究距骨骨折螺旋CT轴扫、多平面(MPR)和三维(3D)重建图像的特点及其临床意义。方法:收集距骨骨折患者术前螺旋CT资料12例,同时进行了MPR和3D重建图像。着重分析距骨骨折线的走行、与关节面的关系、关节面塌陷程度等,并评价轴扫、MPR和3D重建图像的优势。结果:在12例距骨骨折者骨踝关节受累7例。MPR和3D重建图像可直观显示骨折详细情况。结论:螺旋CT轴扫、多平面和三维重建图像相结合,可更好显示距骨骨折的情况,能为临床术前诊断和治疗提供有价值的影像信息。
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.
目的:研究多层螺旋CT多平面图像重组技术(multiplanar reformation,MPR)对肺部病变定位诊断的价值。方法:398例患者行胸部多层螺旋CT薄层扫描后,采用MPR技术将横断面图像重组,分别获得矢状和冠状位的MPR图像。三位高年资医师分别在横断和矢冠状重组图像上确定病变部位,两位或两位以上均诊断为同一位置者确定为病变部位,纳入统计分析。所有资料用χ2检验。结果:398例中,矢冠状重组图像组无定位诊断错误,横断图像组有22例定位诊断错误。两者间差异无统计学意义(Pgt;005)。结论:多层螺旋CT MPR图像定位准确性较高,对少数横断图像难以定位的病变可加作MPR重组图像。
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.
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.