探讨64层螺旋CT在诊断冠状动脉起源、走行异常中的价值。 方法: 回顾性分析2007年8月8日至2009年2月1日行冠状动脉64层螺旋CT血管造影检查患者的结果,共635例。对每位患者图像行容积重现(VR)、多平面重建(MPR)、曲面重建(CPR)心脏及冠状动脉,分别观察冠状动脉起始部位、走行情况。结果:635例冠状动脉各段清楚显示,发现冠状动脉起源异常共23例(23/635,3.6%),以起源于主动脉窦上方为主;发现心肌桥共132例(132/635,20.8%),以左冠状动脉前降支(LAD)心肌桥为多,共127例(127/132,96.2%)。结论:64层螺旋CT显示冠状动脉与心脏关系直观、准确,在诊断冠状动脉起源、走行中有重要价值。
目的：探讨胆囊癌肝侵犯的CT诊断及临床价值。方法：回顾性分析经手术、病理证实的17例胆囊癌肝侵犯CT资料。结果：肿块型11例，腔内型2例，厚壁型4例。侵犯肝左内叶5例，肝右叶前段3例，同时侵犯肝左内叶及右叶前段9例。5例侵犯深度＜2 cm，12例侵犯深度＞2 cm。CT表现为胆囊窝脂肪间隙消失，邻近胆囊窝的肝脏组织内出现不规则形低密度影，边界模糊，胆囊癌肿与肝脏组织分界不清，增强后肝内病灶不规则强化。结论：CT对胆囊癌肝侵犯的诊断及临床分期、治疗方案的选择具有重要价值。
目的 探讨小肠扭转的CT影像学表现及多层螺旋CT的诊断价值。 方法 回顾性分析2006年2月－2011年8月14例经手术证实肠扭转患者的临床及影像资料。 结果 14例小肠扭转患者中有9例出现“U形征”，13例有肠管和血管的“漩涡征”，4例有“鸟喙征”，2例可见“靶环征”，1例可见空回肠“转位征”。 结论 肠管及血管的“漩涡征”是诊断小肠扭转的特异性征象，“鸟喙征”、“靶环征”等其他CT征象为小肠扭转的正确诊断提供可靠依据。多层螺旋CT扫描及三维重组对小肠扭转的诊断具有重要价值。
With the development of radiologic intervention, the treatments of aortic dissection are getting more and more diversified. In recent years, Debakey Ⅲ and DebakeyⅠaortic dissection has been usually treated with endovascular graft exclusion, or combined surgical and endovascular treatment. It is therefore more important to evaluate the aorta and its complications after interventional treatments. Because multidetector-row computed tomography (MDCT) has advantages, such as short examination time, high spatial resolution, and simple operation, this modality has become a first choice of non-invasive methods for the follow-up of aortic diseases after the intervention. Now the MDCT presentations and their anatomic-pathologic features of aortic dissection after endovascular graft exclusion or combined surgical and endovascular treatment are reviewed in this article.
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.
Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.
ObjectiveTo evaluate the CT features of coronary artery aneurysm by coronary artery imaging on 128 slice CT and dual source CT (CTCA). MethodsA total of 1 108 cases were prospectively examined using CTCA between March 2011 and April 2014. With volume rendering, maximum intensity projection, multiplanar reconstruction and surface reconstruction, we observed the coronary artery morphology and vascular wall condition. ResultsThree cases of coronary artery aneurysm were found. In case one, the anterior descending branch (LAD) had grape-like prominency segmentally; in case two, LAD and left coronary circumflex branch (LCX) and right coronary artery (RCA) had diffuse dilation with local shuttle expansion; in case three, left main, LAD and LCX and RCA had diffuse expansion. ConclusionCTCA is a noninvasive, simple and effective method for the diagnosis of coronary artery aneurysm, and it can be the first choice for the high risk population with coronary artery aneurysm.
目的探讨多排螺旋CT（MSCT）诊断胡桃夹现象的价值及临床意义。 方法对40例正常者（对照组）和12例胡桃夹现象患者（病例组）的腹部MSCT动脉期及延迟期图像进行后处理，测量腹主动脉与肠系膜上动脉（SMA）的夹角、左肾静脉层面腹主动脉前壁与SMA后壁的距离以及左肾静脉最小前后径，并观测左侧精索或卵巢静脉或左侧腰静脉是否扩张。 结果对照组及病例组所有观察对象MSCT均清晰显示左肾静脉、SMA及腹主动脉之间的立体解剖关系。对照组中无一例出现左肾静脉近段及左侧精索静脉或卵巢静脉或左侧腰静脉扩张；腹主动脉与SMA的平均夹角为71.4°，左肾静脉层面腹主动脉前壁与SMA后壁的平均距离为13.7 mm，左肾静脉平均最小前后径为6.9 mm。病例组中左肾静脉近段及左侧精索静脉或卵巢静脉扩张12例，左侧腰静脉扩张5例；腹主动脉与SMA的平均夹角为27.4°，左肾静脉层面腹主动脉前壁与SMA后壁的平均距离为3.8 mm，左肾静脉平均最小前后径为2.7 mm，近端肾静脉扩张。经两独立样本均数t检验，病例组腹主动脉与SMA的夹角、左肾静脉层面腹主动脉前壁与SMA后壁的距离及左肾静脉最小前后径均明显小于对照组（P＜0.05）。 结论MSCT可清晰显示SMA、腹主动脉和左肾静脉之间的解剖关系，对诊断胡桃夹现象具有很高的价值。