Objective To review the examination techniques and the current research progress of the magnetic resonance diffusion weighted-imaging (DWI) used in liver. Methods The recent and relevant literatures about the principles and the current study situation of liver DWI were scrutinized and analyzed retrospectively. In addition, the existing problems of liver DWI were discussed. Results DWI could demonstrate the normal and abnormal structure and function through measuring the diffusion motions of water molecule in the liver. With the improving technology and better understanding of diffusion dynamics, DWI has been used for the diagnosis and differential diagnosis for hepatic diseases. Conclusion DWI as a non-invasive examine method, may provide valuable functional information for clinical diagnosis and treatment.
Objective To evaluate the value of MRI and MDCT in detecting both inferior vena cava tumor thrombus and vena cava wall invasion in renal cell carcinoma. Methods Databases including PubMed, EMbase, The Cochrane Library, MEDLINE (Ovid), CBM, CNKI, VIP and WanFang Data were searched from January 2000 to February 2012. Relevant studies were screened on the basis of the inclusion and exclusion criteria, and then quality assessment and data extraction were conducted. Then heterogeneity test and meta-analysis were conducted using RevMan 5 and Meta-disc 1.4. Results A total of 6 trials involving 244 patients and 246 cases of renal cell carcinoma were included. The results of meta-analysis showed that, for the MRI group and the MDCT group, the sensitivity was 0.963 and 0.952, the specificity was 0.969 and 0.979, the value of +LR was 9.759 and 15.57, the value of −LR was 0.091 and 0.108, and the dOR was 198.71 and 251.54, respectively. There were no significant differences in pooled effect-size among groups (Pgt;0.05). The area under curve (AUC) of summary ROC curve analysis as well as Q index of the MDCT group were 0.981 8 and 0.940 7, respectively. Conclusion There is no significant difference in the value of MRI and MDCT in detecting inferior vena cava tumor thrombus induced by renal cell carcinoma. More original studies on vena cava wall invasion by tumor thrombus should be conducted in the future due to the limitation of current materials.
Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.
【摘要】 目的 探讨闭孔疝的CT表现，以提高对其疾病的诊断水平。 方法 回顾性分析2009年10月-2010年9月收治的经手术或临床资料证实的3例闭孔疝患者的CT影像学表现，观察闭孔疝发生的位置、密度、形态、强化特征及继发征象。 结果 3例闭孔疝均为老年消瘦患者，CT检查发现疝囊位于闭孔外肌与耻骨肌间疝出1例，闭孔外肌上、中束间疝出2例，所有疝出物均为肠管，表现为疝出部位囊性密度影，1例肠壁可见增厚、水肿，诊断为肠壁血运障碍，及时行手术治疗后预后良好。 结论 CT检查是闭孔疝有效的检测手段，特别是对于不明原因腹痛合并肠梗阻的老年消瘦患者，CT检查将有助于临床确诊。【Abstract】 Objective To observe the manifestations of CT images of obturator hernia to improve the diagnosis of obturator hernia. Methods The CT images of three patients with obturator hernia confirmed by surgery or clinical data from October 2009 to September 2010 were retrospectively analyzed. The location, density, morphology, enhancement patterns and secondary signs were observed. Results Three patients with obturator hernia were elder and emaciated. The hernia sac located between the pectineus and obturator externus muscles in two patients, between the superior and medial fasciculi of the obturator externus muscle in one patient. All contents were small intestine, performed as a low-density mass in the location. One patient with thick and hydropic intestinal wall diagnosed as strangulated obturator hernia had a good prognosis after immediately laparotomy. Conclusion CT examine is an effective measure for obturator hernia, especially for elder and emaciated patients with intestine obstruction due to unknown reason. CT examine is helpful for the diagnosis.
Objective To explore the effect factors on the related measurement guidelines of renal area and renal cortex thickness by measurement of CT/MRI radiography in vivo kidney in adults. Methods Thickness of renal cortex (TC), cortical area (CA), parenchymal area (PA), as well as cortical faction (CF, cortical/parenchymal area) of 164 cases (106 cases with enhanced CT abdomen and 58 cases with MRI abdomen scanning) without renal disease was calculated bilaterally. All data were analyzed by SPSS 11.5 (the mean of two groups and multi-groups was compared by t test and analysis of variance, respectively).Results ① In CT scan, the mean value and 95% confidence interval of TC，CA，PA and CF were 0.62 (0.44 to 0.80) cm, 7.2 (4.1 to 10.2) cm2, 18.2 (10.7 to 25.7) cm2, 39.3 (30.3 to 48.3) % on the left, and 0.63 (0.43 to 0.83) cm, 7.3 (4 to 11) cm2, 18.1 (11 to 25.3) cm2, 39.9 (32 to 48) % on the right, respectively. Likewise, in MRI, those were 0.58 (0.33 to 0.83) cm, 7.5 (3.5 to 11.3) cm2, 14.8 (8.5 to 21.1) cm2, 50.2 (32.8 to 67.6) % on the left, and 0.55 (0.31 to 0.79) cm, 7.3 (4.4 to 10.3) cm2, 15.6 (10.1 to 21.1) cm2, 47.3 (30 to 65) % on the right. ② There was a significant difference in the value of TC, CA, PA between different gender and age groups, and were decreased with the age increaseing. ③ Most of the values measured by MRI were less than those by CT. Conclusions The study suggests that the values of TC, CA, PA and CF can well represent the renal size and function, and may offer a practical and significant normal standard in the radiological diagnosis.
目的 探讨结核性腹膜炎（TBP）及癌性腹膜炎（CP）的螺旋CT表现，提高其诊断及鉴别诊断水平。 方法 回顾分析2009年9月－2010年9月经手术病理、穿刺活检或综合手段证实的22例TBP和45例CP患者的CT影像资料，采用χ2检验比较各种CT征象在两种病变中的发生率，结合病理、临床结果进行分析。 结果 TBP组及CP组患者大量腹水所占比例差异有统计学意义（36.4%、75.6%，χ2=9.703，P=0.002）；两组壁腹膜、肠系膜增厚构成比差异有统计学意义，TBP组以壁层腹膜均匀增厚、肠系膜污迹样改变为主，CP组壁层腹膜以结节、块样增厚为主；两组大网膜厚度差异有统计学意义。 结论 以壁层腹膜改变为基础，综合大网膜、肠系膜及腹水改变CT征象对两种病变的诊断及鉴别诊断具有重要意义。
【摘要】 目的 探讨肝脏血管平滑肌脂肪瘤（hepatic angiomyolipoma，HAML）的多层螺旋CT影像学表现特征及其与病理学基础的相关性，以进一步提高CT诊断的准确性。 方法 收集2008年11月-2010年12月经手术病理证实的16例HAML患者。所有患者均行螺旋CT平扫及动脉期、门脉期增强检查，重点观察HAML的分型及其相应CT表现及影像-病理的相关性。 结果 16例患者共20个病灶，19个为稍低密度病灶，其中11个病灶内可见明显的脂肪密度影；1个为稍高密度病灶。动脉期所有病灶均有不同程度的强化表现，15个病灶内可见到较明显条状及扭曲的血管影。门脉期15个病灶有持续强化。 结论 多层螺旋CT能准确反映HAML的分型及其病理特征，对临床表现不典型患者的诊断和鉴别诊断有较大诊断价值。【Abstract】 Objective To discuss the correlation between the features of multislice spiral CT results for hepatic angiomyolipoma (HAML) and their pathological basis, and to further improve the diagnostic accuracy through CT examination. Methods Sixteen HAML patients diagnosed pathologically between November 2008 and December 2010 in our hospital were enrolled in our study. All patients underwent multi-slice spiral CT scanning of pre-and post-contrast arterial phase, and portal venous phase. Focus was put on observation of HAML types and their corresponding manifestations, and the correlation between CT imaging and the pathologic basis. Results There were 20 lesions in the 16 patients. Among the 19 hypodense lesions, 11 were clearly seen with fat density shadow. One out of the 20 lesions showed as slightly hyperdense. On the arterial phase scanning, all lesions showed enhancement, and obvious vascular shadow could be seen in15 lesions. On the portal venous phase, 15 lesions continued to strengthen. Conclusions Multi-slice spiral CT can accurately reflect the classification of HAML and its pathological features. It has a great value in the diagnosis and differential diagnosis of patients without typical clinical manifestations.
Objective To investigate the application of multi-detector row spiral CT （MDCT） and multi-planer reconstruction （MPR） in identify the anatomy detail of normal adult groin region. Methods We retrospectively collected the CT images of 50 adult subjects with normal groin anatomic structure underwent groin region thin-slice MDCT scans between July and December 2009, 30 males and 20 females, obtained the coronal and sagittal views by MPR, investigated the value of different plans in identifying anatomic detail. Results Bilateral inferior epigastric artery (100/100, 100%), spermatic cord (60/60, 100%), and round ligament of uterus (40/40, 100%) were well identified on all plans in all subjects. The bilateral “radiological femoral triangle” could be demonstrated on coronal views in all subjects (100/100, 100%). The bilateral inguinal ligament were visible on coronal view in all subjects (100/100, 100%) and on sagittal views in 34 subjects (68/100, 68%), but on axial views was identified in 3 male subjects (6/100, 6%). The bilateral inguinal canal and deep inguinal ring were reliably visible on coronal views in all subjects (100/100, 100%), and on sagittal views in 46 subjects (92/100, 92%). On coronal views, the widths of inguinal canal was (0.97±0.35) cm in left, (0.89±0.23) cm in right for males, and (0.62±0.11) cm in left, (0.71±0.11) cm in right for females. No significant difference was found between two sides (P=0.059 in males， P=0.067 in females), but there were significant differences between males and females (P=0.007 in left， P=0.009 in right). Transverse diameter of deep inguinal ring was (1.32±0.31) cm in left, (1.31±0.36) cm in right for males, and (1.07±0.35) cm in left, (1.07±0.30) cm in right for females. No significant difference was found between two sides (P=0.344 in males， P=0.638 in females), but there were significant differences between males and females (P=0.001 in left， P=0.002 in right). Conclusion MDCT with different plans plays an important role in identify the anatomic details of groin region, the coronal views especially.
Objective To evaluate the diagnosis value of temporal Done high-resolution computed tornography (HRCT) in cholesteatoma. Methods There were 30 causes that had received the mastoid surgery because of cholesteatoma. Each patient’s mastoid plain films (Schuller’s and Mayer’s ) and HRCT had been taken and compared with each other and surgical findings and evaluated with health economic evaluation methods. Results The sensitivity rate in diagnosing cholesteatoma with HRCF was much higher than that with mastoid film (Plt;0.005). The more important benefit with HRCT was that it can afford the detail information in ear such as the ossicular chain, facial nerve canal, tympanic sinus, etc. which were basis for otologist in surgery to remove the focus thoroughly and reconstruct the middle ear function at the same time. In the view of health economic evaluation, HRCT is also much better than mastoid X-ray film. Conclusion HRCT should replace masloid Schuller’s and Mayer’s film in diagnosis cholesteatoma and HRCT should use as ordinary examination in chronic otitis media.
ObjectiveTo investigate the value of magnetic resonance (MR) imaging in the assessment of bile duct complications after cholecystectomy. MethodsFifty patients of having bile duct complications after cholecystectomy underwent MR imaging and had some positive manifestations. The indication for cholecystectomy was symptometic cholelithiasis in all cases. MR imaging was performed with a 1.5T clinical imager including all of the sequences of: ①T1 weighted imaging (T1WI) was performed in transverse and coronal plane before and after gadolinium-enhanced. ②T2 weighted imaging (T2WI) was performed in transverse plane. ③A true fast imaging with steadystate precession sequence (True fisp) was performed in coronal plane. ④MR cholangiopancreatography was also obtained. ResultsThe bile duct complications after cholecystectomy including: 22 cases of cholelithiasis, 15 cases of chronic cholangitis with or without bile duct abscess. Bile duct strictures or abruption at the confluence of hepatic and common bile duct in 6 and 3 cases respectively. Tumors of bile duct or pancreas in 9 cases. The other complications after cholecystectomy including bile leak with choleperitonitis and/or biloma and acute pancreatitis.ConclusionMR imaging was a valuable method for the assessment of bile duct complications after cholecystectomy. MR imaging could assess the etiology of bile duct complications. If there were bile duct obstruction, MR imaging could assess the location and the severe of obstruction. For bile duct or pancreatic tumors, MR imaging could assess the areas of tumor infiltration and resection and was helpful to select treatment methods. Before lapatoscopic cholecystectomy, the overall and careful imaging assessment for bile duct and gallbladder and its adjacent hepatic tissue and pancreas so to avoid missing the relative tumors.