This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
目的 探討多層螺旋CT在評價頸動脈斑塊特征中的價值。 方法 回顧性分析2011年7月－10月132例行CT頸部血管造影患者的影像資料。對頸動脈斑塊特征進行評價，重建方法包括多層面重建、容積再現技術、最大密度投影及曲面重建。 結果 132例患者中，80例檢出頸動脈斑塊，最常出現鈣化斑塊的部位為海綿竇段和床突上段，右側海綿竇段52例（65.0%）、左側海綿竇段49例（61.3%），右床突上段37例（46.3%）、左側床突上段30例（37.5%）。最常出現軟斑塊的部位為雙側頸總動脈，均為12例（15.0%）。最常出現混合斑塊的部位為頸總動脈，右側頸總動脈9例（11.3%）、左側頸總動脈12例（15.0%）。頸動脈最容易輕度狹窄294處（294/1 440，20.4%），中、重度狹窄少見，分別為8處（8/1 440，0.5%）和6處（6/1 440，0.4%）。頸部動脈血管斑塊最易出現鈣化，總計249處（249/1 440，17.3%），其次是軟斑塊和混合斑塊，均為39處（39/1 440，2.7%）。 結論 多層螺旋CT可準確評價頸動脈斑塊特征。
目的 探討常規注射速率下單倍劑量對比劑在頸部三維對比增強磁共振血管成像（3D-CEMRA）中的可行性及臨床應用價值。 方法 2011年8月－11月，連續納入30例臨床懷疑頸動脈或椎動脈狹窄并要求頸部磁共振血管成像檢查的患者，隨機分成A、B兩組（每組各15例）。使用西門子Magnetom Avanto 1.5 T磁共振成像儀及其配備的頸部線圈和頭部線圈進行CEMRA成像。A組使用雙倍劑量對比劑（0.2 mmol/kg），B組使用單倍劑量對比劑（0.1 mmol/kg）。用三維快速小角度激發序列進行頸部血管成像。由2位有豐富經驗的高年資醫生對兩組原始圖像的信噪比以及最大密度投影（MIP）圖像的質量進行評價，并對結果進行統計學分析和處理。 結果 A、B兩組的所頸動脈信噪比分別為189.95 ± 71.31、175.07 ± 68.61，差異無統計學意義（t=?0.566，P=0.576）；所得的MIP圖像質量均達到優良，差異無統計意義（χ2=0.180，P=0.671）。 結論 與雙倍劑量相比，單倍劑量對比劑獲得頸部血管的圖像清晰，能夠滿足臨床診斷要求。
【摘要】 目的 評價64層螺旋CT低劑量冠狀動脈血管成像的價值。 方法 2009年1-6月157例患者隨機分為3組，常規劑量組（A組）管電流量采用1 000 mAs，兩個低劑量組（B、C組）分別采用800、600 mAs。對3組的圖像質量、噪聲、CT劑量指數（CTDI）、劑量長度乘積（DLP）和有效劑量（ED）進行評估。 結果 A、B、C組圖像噪聲分別為20.50±3.23、23.02±3.05和26.28±2.58，組間差異均無統計學意義（Pgt;0.05）；A、B、C組的CTDI分別為（58.7±0.23）、（46.98±2.27）、（35.28±3.56） mGy，DLP分別為（1 050.88±89.63）、（846.21±57.86）、（641.13±32.15） mGy?cm，ED分別為（14.78±2.56）、（11.85±1.87）、（8.98±1.15） mSv，B、C組的CTDI、DLP、ED均明顯低于常規劑量A組（Plt;0.05），C組的CTDI、DLP、ED均為3組中最低值。 結論 64層螺旋CT冠狀動脈血管檢查，采用600 mAs管電流量獲得的冠脈圖像既可滿足診斷需要，又可使患者接受的輻射劑量降低。【Abstract】 Objective To evaluate the best tube current for low-dose radiation CT in coronary artery imaging by 64-slices multi-detector CT. Methods From January to June 2009, a total of 157 consecutive patients were randomly divided into 3 groups: group A (conventional group): 1 000 mAs; group B: 800 mAs; group C: 600 mAs. The image quality, noise, CT dose index (CTDI), dose length product (DLP) and effective dose (ED) in each group were measured and compared respectively. Results The image noise scores in group A, B, and C were (20.50±3.23), (23.02±3.05) and (26.28±2.58), respectively. There was no statistically significant difference among the three groups in the two indexes (Pgt;0.05). The CTDI in group A, B and C were (58.7±0.23), (46.98±2.27), and (35.28±3.56) mGy, respectively; the DLP in each were (1 050.88±89.63), (846.21±57.86), and (641.13±32.15) mGy?cm, respectively; the Ed were (14.78±2.56), (11.85±1.87), and (8.98±1.15) mSv, respectively. All of the differences among the three groups in CTDI, DLP and ED were statistically significant (Plt;0.05). Conclusion The image with 600 mAs as tube current in the coronary artery imaging of 64-slices multi-detector CT could fulfill the need of the diagnosis, and the radiation dose is apparently lower than the conventional scan.
ObjectiveTo summarize the methods and research progress of imaging evaluation of liver iron concentration.MethodsThe current status and progress of different imaging techniques in liver iron overload research were reviewed by studying the relevant literatures at home and abroad. The methods for determining liver iron concentration and their advantages and disadvantages were summarized.ResultsThe imaging methods for determining liver iron concentration mainly included traditional non-enhanced CT and dual energy CT examination, magnetic resonance signal intensity ratio, relative signal intensity index, T2 and R2 values, magnetic resonance spectroscopy, T2* and R2* values, susceptibility weighted imaging, and quantitative susceptibility mapping.ConclusionLiver iron quantification imaging method, including dual-energy CT and magnetic resonance imaging could non-invasively and accurately assess the liver iron overload.
目的：采用高分辨多排螺旋CT研究鼻中隔和中鼻甲解剖變異，并評價它們對前組鼻副竇引流通道的影響。方法：回顧分析60例行鼻腔和副鼻竇高分辨多排螺旋CT檢查患者的圖像資料。 其中男35例，女25例，平均年齡42歲。所有受試者均采用16排螺旋CT機行高分辨容積掃描，層面從硬腭至額竇上緣，準直0.75~1 mm，橫斷、冠狀和矢狀重建，層厚及層距均為1 mm。分別觀察和統計鼻中隔和中鼻甲解剖變異的類型和發生率，并評價其與前組鼻副竇引流通道的關系。結果：60例中，共發現鼻中隔變異45例(75%)，其中鼻隔偏曲45例(單向偏曲31例，雙向偏曲14例)；犁骨軟骨結合部畸形5例(肥大2例，脫位3例)；鼻隔刺16例。中鼻甲變異共43例(71.7%)，其中反曲15例；氣化9例；雙側不對稱20例(46.5%)。不對稱中鼻甲中，增大一側多見于鼻隔偏移方向的對側，多數伴有不同程度的鉤突移位和篩漏斗或鼻道狹窄。結論：鼻腔和中鼻甲不對稱與鼻中隔偏曲關系密切，后者是導致前組鼻副竇引流通道中的關鍵部位--中鼻道和篩漏斗狹窄的重要原因。