ObjectiveTo investigate the CT and MR imaging features and distribution characteristics of lymphatic nodal involvement in patients with gallbladder carcinoma. MethodsThirtyseven histopathologically proven cases of gallbladder carcinoma with regional lymphatic nodal enlargement in upper abdomen were included into the study. The lymph nodal short diameter of equal to or larger than 10 mm was used as the criteria for positive lymphadenopathy. Thirtyone cases underwent contrastenhanced spiral CT scanning, 6 cases had MR imaging studies. CT and MR images were jointly evaluated by three radiologists with especial attention to the size and location of enlarged lymph nodes in upper abdomen.ResultsThe enlarged lymph nodes were observed in four anatomic locations in the upper abdominal region. ①The retroportal and retropancreatic group in which lymph nodes were located along the cystic duct and common bile duct, in the portocaval space and behind the pancreatic head. ②The celiac group in which enlarged nodes distributed along the common hepatic artery and surrounded the celiac trunk. ③The mesenteric group in which lymph nodes assembled at the mesenteric root and around the superior mesenteric vessels. ④The abdominal aorta group in which lymph nodes scattered at the left side of abdominal aorta and in the aortocaval space at the level of the left renal vein. The spiral CT visualization rates for the above 4 groups of lymphadenopathy were 89.1%(33/37), 78.3%(29/37), 29.8%(11/37) and 51.3%(19/37) respectively.ConclusionCT and MR can clearly depict the four location sites of lymphadenopathy in patients with gallbladder carcinoma, which closely reflects the three major lymphatic spreading pathways of gallbladder carcinoma, namely, the cholecystoretropancreatic, cholecystoceliac and cholecystomesenteric routes.
Objective To evaluate the role of contrastenhanced CT (CECT) scanning in the diagnosis and treatment planning of some rare liver tumors. MethodsWe retrospectively reviewed the CECT imaging features of 10 cases with rare tumors of the liver proved by surgical pathology in 8 cases or by liver biopsy in 2 cases, with correlation of relevant clinical manifestations, laboratory results and surgical findings. ResultsThree cases were histopathologically proved to be benign, and 7 cases were malignant. On CT images, the liver lesions were mixed cysticsolid in 5 cases, totally solid in the other 5. Eight cases demonstrated heterogeneous enhancement, while 2 cases of liver lymphoma had no enhancement. The anatomic relationship of tumors to intrahepatic vasculature, the compression and infiltration of neighboring abdominal structures were accurately delineated by CT as compared with findings at operation. Clinical manifestations and laboratory findings were not useful for the qualitative diagnosis of rare liver tumors, except for hepatocellular carcinoma. ConclusionCECT is very useful for the detection of rare liver tumors and the fine depiction of local extent of these tumors. When correlated with clinical and laboratory information, it helps to differentiate rare liver tumors from hepatocellular carcinoma. But its role in the characterization of rare liver tumors is limited.
Objective To investigate the CT manifestations of acute pancreatitis (AP) and its complications and to evaluate the imaging modalities for staging the severity of AP. Methods Literatures on CT manifestations of AP and its complications and severity staging of AP were reviewed.Results CT has shown an early overall detection rate of 90% for pancreatic necrosis with close to 100% sensitivity 4 days after episode. The CT severity index has shown a bly positive correlation with the development of local complications and mortality of AP.Conclusion Contrastenhanced CT is the imaging modality of choice to help detect pancreatic necrosis, stage the severity of the inflammatory processes, and depict local complications.
ObjectiveTo investigate the CT presenting rate and features of gastric bare area (GBA, including the area posterior to GBA and the adipose tissue in the gastrophrenic ligament) without pathologic changes.MethodsThirty cases with superior peritoneal ascites, but without pathological involvement of GBA were included into the study to show the normal condition of GBA, including the presenting rate and CT features. We selected some cases with GBA invasion by inflammation or neoplasm to observe their CT features. ResultsAll cases with superior peritoneal ascites showed the GBA against the contrast of ascites with the presenting rate of 100%. The GBA appeared at the level of gastricesophageal conjunction and completely disappeared at the level of hepatoduodenal ligament and Winslow’s foramen. The maximum scope of GBA presented at the level of the sagital part of the left portal vein with mean right to left distance of （4.39±0.08）cm (3.8~5.7 cm) (distance between the left and right layer of the gastrophrenic ligament). In acute pancreatitis, the width of GBA increased, in which local hypodensity area could be seen. In gastric leiomyosarcoma invading GBA, the mass could not separate from the crus of the diaphragm. In lymphoma and metastasis invading GBA, the thickness of GBA increased and the density was heterogeneous, in which lymph nodes presenting as small nodes or fused mass. ConclusionThe results of this study show that it is helpful to use contrast enhanced spiral CT scanning to observe the change of GBA and to diagnose retroperitoneal abnormalities that involving GBA comprehensively and accurately.
ObjectiveTo introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.MethodsUltrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.ResultsMany of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, lowgrade dysplastic nodule, highgrade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.ConclusionModern stateoftheart medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.
摘要:目的:研究胸腺瘤与前纵隔(血管前间隙)淋巴瘤的MSCT表现,提高对二者的诊断与鉴别诊断能力。方法:回顾性分析经手术病理证实的30例胸腺瘤与18例血管前间隙淋巴瘤MSCT表现,着重观察肿瘤的密度、形态及其与周围结构的关系。结果:30例胸腺瘤中,24例良性胸腺瘤与邻近大血管分界清晰,肿块表现 “D”字或反“D”字状,平扫CT值16~59 Hu,增强CT值20~110 Hu;6例侵袭性胸腺瘤边界不清,呈分叶状、不规则形,密度不均,平扫CT值23~42 Hu,增强CT值23~60 Hu。18例淋巴瘤中,单发于前上纵隔者6例,其余12例呈多结节、肿块状,侵入血管间隙生长,致大血管受压,增强扫描呈轻度强化,常伴有其它部位淋巴结增大。结论:MSCT能清晰显示胸腺瘤与前纵隔淋巴瘤的影像学表现特征,并能有效提高对二者的鉴别诊断。Abstract: Objective: To diagnosis and differentiate thymoma and malignant lymphoma in the anterior mediastinum on the basis of multislice CT (MSCT) imaging features. Methods:We retrospectively reviewed 30 cases with thymoma and 18 cases with malignant lymphoma proven by surgery and pathology.More attention was put on the density, morphology and relation with the surrounding structures of the tumors. Results: The CT manifestations of 30 cases of thymoma were shown as: For 24 cases of benign thymoma, the boundaries were clear, the shapes were “D” signs or contra“D” signs, CT attenuation value were 1659Hu and 20110Hu on unenhanced and contrastenhanced scanning. For 6 cases of malignant thymoma, the boundaries were unclear, the shapes were lobulated or irregular, the density was heterogeneous, CT attenuation value were 2342Hu and 2360Hu on unenhanced and contrastenhanced scanning. For 18 cases of malignant lymphoma, 6 cases were located at anterior mediastinum, 12 cases were nodes or multiple mass, enveloped the neighboring vessel structures, mildly enhanced on contrastenhanced scanning, and associated with enlargement of lymph nodes in other place. Conclusion: MSCT can display the imaging features of thymoma and anterior mediastinal lymphoma, and effectively differentiate thymoma and mediastinal lymphoma.
摘要:目的:研究一种能够显示颈椎关节突关节及关节间隙的最佳投照摄影位置的方法。方法:观察50例非脊柱疾病患者,在透视下利用传统颈椎斜位的基础上,继续增大角度20°～25°,使人体冠状面与床面的夹角逐渐增大至65°～70°角的范围,此时颈椎(C3～C7)关节突关节在电视上显示最佳时,然后进行点片获取C3~C7关节突关节X线照片。结果: 经透视点片获取422个关节突关节,其中C3显示48个,C4 为96个,C5 为98个,C6 为98个,C7为82个;经统计学χ2检验,颈C3~C7关节突关节在同一椎体的不同侧面及性别间显示率无差异(Pgt;0.05)。在摄影时,笔者设计将躯干冠状面与胶片成65°～70°角的范围,颈椎略呈屈曲位,头部略向对侧外旋,使头部冠状面与胶片成45°角,中心线下移至第五椎体下缘平行射入,经透视确定位置后点片,可得到清晰的关节突关节影像,此摄影位置称可视颈椎关节突关节投照位。结论:可视的颈椎节突关节投照位置能清晰显示颈椎关节突关节及关节间隙。Abstract: Objective: To study the best projection position of cervical articular facet. Methods:The cervical facet angle which was the join angle between sagittal plane of body and the continual line of cervical facet was measured on cervical Xrayed images showed and to the film in 50 healthy people. Results: The facet angle was 65°70°,during projection, the coronal plane of body in the form of 65°70° to the film, this projection position was called cervical facet position. Conclusion: seeingredients cervical facet and its interspaces of join can be showed clearly in the cervical facet position of projection.