ObjectiveTo investigate the imaging features of insulinoma on multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) with correlation of pathology. MethodsAll images of 8 patients confirmed by surgery and pathology were retrospectively analyzed with correlation of pathology. MSCT scans were performed in 4 patients and MR scans in 6 patients, among which 2 patients accepted both MSCT and MRI examinations. ResultsInsulinoma in all patients manifested as solitary lesions with diameters of 0.5-3.5 cm. Four lesions demonstrated isodensity or hypodensity on plain MSCT, with significant enhancement on arterial phase, and relative isodensity or slight hyperdensity on portal phase and delay phase. On plain MRI, lesions demonstrated hyperintensity on T1WI, slight hyperintensity or hyperintensity on T2WI. The enhanced patterns of insulinoma were similar to the findings on MSCT. ConclusionsThe imaging characteristics of insulinoma reflect the pathological features. MSCT and MRI are effective in the diagnosis of inslinoma, and MRI can show more diagnostic information.
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。
目的:探讨MSCT对结肠癌诊断价值。方法:收集我院手术病理证实且经MSCT检查的结肠癌患者,对其CT表现进行分析,并与纤维结肠镜(FC),钡灌肠对比研究。结果:所有收集的结肠癌患者,MSCT均能多角度,多方法显示病变。结论: MSCT检查对结肠癌具有较高的诊断价值且对临床治疗有重大指导意义。
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.
ObjectiveTo investigate the radiological appearances of postoperative complications after living donor liver transplantation for patients with hepatocellular carcinoma under multi-detector row spiral computed tomography (MDCT) and magnetic resonance imaging (MRI) examination. MethodsThirty-nine imaging data in 20 patients with hepatocellular carcinoma after living donor liver transplantation from January 2008 to June 2010 in the West China Hospital were included and analyzed by two radiologists respectively. The relations between the types of complications and radiological appearances were especially recorded. ResultsAll the cases experienced complications to different extent. Common surgical complications occured in 20 cases, including pertitoneal fluid collection (14 cases), pneumoperitoneum (2 cases), swelling of peritoneum, omentum, and mesentery (1 case), abdominal wall swelling (2 cases), pleural effusion (9 cases), and pericardial fluid collection (2 cases). Hepatic vascular complications involved hepatic artery in 3 cases, portal vein in 5 cases. Biliary complications presented in 7 cases, including anastomotic stenosis of biliary duct (6 cases) and bile leak (1 case). Graft parenchymal complications included intrahepatic lymph retention (11 cases), infarction (3 cases), and infection (2 cases). Intrahepatic recurrence in 5 cases, intraperitoneal metastasis in 3 csses and pulmonary metastasis in 2 cases. ConclusionMDCT and MRI have important diagnostic values for postoperative complications after living donor liver transplantation for patients with hepatocellular carcinoma.
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。
ObjectiveTo analyze the CT features of parotid tuberculosis, in order to increase the cognition and diagnostic level of the disease. MethodsNine cases of parotid tuberculosis confirmed by pathology and laboratory examinations between August 2009 and December 2012 were collected retrospectively, and we analyzed their CT features which were then compared with pathological findings. ResultsAll the 9 cases involved unilateral parotid, among which 7 were on the left side and 2 on the right side. Eight cases were parotid lymph node tuberculosis located in parotid superficial lobe, including 3 cases of single lesion and 5 cases of multiple lesions. There were 30 lesions in total with diameters ranging from 0.5 cm to 4.5 cm, presenting slightly lower density on CT scan. Twenty-five lesions were moderate homogeneous enhancement; four lesions were ring-like enhancement; and one lesion was lace-like enhancement. Six cases of parotid lymph node tuberculosis had thickened platysma, and subcutaneous fat and skin were at different levels. Six cases in the group were accompanied with enlargement of cervical lymph nodes. One case of parotid gland essence tuberculosis involved its superficial and deep lobe diffusely presenting heterogeneous slightly low density, in which we could see some patchy low density and nodular calcification. All the parotid gland essence presented diffuse enhancement with irregular liquefactive necrosis, mildly swelling of adjacent platysma and fat, without enlargement of cervical lymph node. ConclusionCT signs of parotid tuberculosis are closely related to its pathologic changes. For the lesions in unilateral parotid superficial lobe, we should consider the diagnosis of parotid lymph node tuberculosis with the signs of homogeneous enhancement, thickness of close platysma, subcutaneous fat and skin, and enlargement of cervical lymph node.
目的 探讨胃肠道穿孔的多层螺旋CT（MSCT）表现及诊断价值。 方法 收集2010年3月－2011年3月18例经手术证实为胃肠道穿孔患者的临床及MSCT资料，回顾性分析了胃肠道穿孔及穿孔部位的MSCT表现。 结果 18例患者中，MSCT明确诊断穿孔17例，对穿孔部位准确定位11例。其中术后诊断胃穿孔4例、十二指肠球部穿孔9例、小肠穿孔3例、结肠穿孔1例、阑尾穿孔1例。MSCT表现有腹腔游离气体，肠壁周围局限性积气、腹腔积液及肠袢积液、肠壁增厚、肠腔周围脂肪间隙密度增高（条纹征）。 结论 MS CT有利于显示腹腔游离气体、胃肠道穿孔部位及其肠壁周围的变化情况，对胃肠道穿孔术前的定性及定位诊断有较明显的优势 ，可为临床提供更多有价值的诊断信息。
ObjectiveTo discuss the application value of the two kinds of three dimensional reformatting techniques of spiral CT: volume rendering (VR) and maximum intensity projection (MIP) in the evaluation of children's skeletal abnormality. MethodsEighteen children with skeletal abnormality in our hospital treated between March and June 2014 were recruited in this study, diagnosed by CT transversal images and images of multiplanar reformatting (MPR). VR and MIP were made with the raw data. All three dimensional images were independently evaluated by two doctors of the Radiology Department (a score of 1-4). Images with a score of 4 were excellent. Wilcoxon signed ranks test was done for all scores and Kappa values were calculated. ResultsImages score of VR was 3.28±0.96 and of MIP was 2.89±0.90, without statistically significant difference (Z=-1.732, P=0.125). Kappa value of VR was 0.730 and of MIP was 0.593, with good and moderate consistency. ConclusionWith the special superiority of displaying spatial configuration, VR and MIP can be used to help two dimensional CT images to evaluate children's skeletal abnormality more comprehensively.
目的 探讨多层螺旋CT血管造影（CTA）在主动脉夹层中的诊断价值及临床应用。 方法 回顾性分析2010年2月－2011年4月35例行CTA检查的主动脉夹层患者，所有患者原始数据在图像后处理工作站采用多平面重建、容积再重建、最大密度投影等方法进行主动脉成像。由2名有经验的放射科副主任医师进行诊断。 结果 35例均可明确显示主动脉夹层的真假腔、内膜片及破裂口部位。Ⅰ型12例，Ⅱ型3例，Ⅲ型20例；累及左锁骨下动脉5例，左颈总动脉2例，无名动脉2例，腹腔干3例，肠系膜上动脉4例，左肾动脉3例，右肾动脉2例，右髂总动脉受累6例，左髂总动脉受累8例，其中双侧髂总动脉均受累4例；合并动脉瘤3例；壁内血肿4例；所有患者均显示了单一或多发破口。 结论 CTA及图像后处理技术能快速、准确地诊断主动脉夹层，为临床治疗方案选择提供重要的影像学依据。