ObjectiveTo study the application value of multi-slice CT portography (MSCTP) in the diagnosis and evaluation of esophageal and gastric varices (EGV) caused by cirrhosis. MethodsPatients with cirrhosis diagnosed between September 2009 and December 2012 were screened in this study. And the consistency of MSCTP and digestive endoscopy in the diagnosis, classification and grading of EGV in cirrhosis were evaluated. ResultsA total of 78 patients were included in this study, and there were 55 patients with EGV diagnosed by endoscopy, including 35, 16 and 4 patients with GOV1, GOV2 and IGV1 respectively by Satin type standards; and the number of patients with mild, moderate and severe EGV by general grading standards was 2, 15, and 37, respectively. In this cohort, the findings of MSCTP examination also showed that 58 patients had EGV, including 36, 17, 4 and 1 patients with GOV1, GOV2, IGV1 and IGV2 by Satin type standards; and the number of patients with grade I,Ⅱ andⅢ EGV by Kim grading standards was 5, 16 and 37, respectively. Statistical analysis showed that there was a high consistency between endoscopy and MSCTP in the diagnosis (Kappa=0.712, P=0.000), typing (Kappa=0.732, P=0.000) or grading (Kappa=0.863, P=0.000) of EGV. ConclusionMSCTP has a high application value in the diagnosis and severity evaluation of EGV in patients with cirrhosis.
Objective To evaluate the accuracy of preoperative 64 multidetector spiral computed tomography (MDCT) in the diagnosis of stage Ⅳ gastric cancer. Methods The data of patients with stage Ⅳ gastric cancer between July 2007 and April 2008 were collected. Twenty-nine patients underwent preoperative 64 MDCT were retrospectively analyzed. All computed tomography scans were prospectly analyzed by 2 abdominal radiologists separately. Pathological tumor stage was based on TNM stage according to the revised Japanese Classification of Gastric Carcinoma from the Japanese Gastric Cancer Association. All CT results were compared with clinical, surgical and histopathologic results. Results The 65.2% (15/23), 47.8% (11/23) and 70.8% (17/24) of the stage Ⅳ patients were accurately predicted of T, N and M stage, respectively. Moreover, 58.6% (17/29) of the stage Ⅳ patients were accurately predicted of TNM stage. But 6/9 cases with peritoneal metastases were not detected by preoperative 64 MDCT. Conclusion The 64 MDCT is a promising technique for detection and preoperative staging of stage Ⅳ gastric cancer. It was difficult to detect peritoneal metastases, but it may not increase the rate of exploratory laparotomy.
【摘要】 目的 探討汶川大地震傷員胸部外傷的影像學表現特點。 方法 對2008年5月12日-6月21日因地震胸部外傷在我院放射科檢查的687例患者（年齡1～96歲）的臨床資料進行回顧性分析。將患者按10歲為一個年齡組劃分。所有患者均行胸部X線片檢查，38例行CT檢查。 結果 687例患者中，256例檢查結果為陽性，陽性率為37.26%。年齡以30~79歲年齡組為主。在陽性傷員中，98例（38.28%）為多系統多發傷，159例（62.11%）為多種類型胸部傷同時存在，肋骨骨折198例（約77.34%），肺挫裂傷49例(約19.14%)。 結論 本組地震傷員多系統多發傷、多類型胸部傷常見，肋骨骨折及肺挫裂傷為主要損傷表現。影像學檢查有助于胸部外傷的及時和準確診斷。【Abstract】 Objective To explore the imaging features of thoracic trauma in patients injured in Wenchuan earthquake. Methods The radiological data of 687 patients (aged from 1 to 96 years) with thoracic trauma who underwent radiological examinations between 12 May and 21 June 2008 were retrospectively analyzed. The patients were divided into subgroups according to the age. All patients underwent X-ray plain film examination, in whom 38 underwent CT examination. Results In 687 patients, the results of the examination were positive in 256 with a positive rate of 37.26%; the major injured patients were in the 30-79 years old group. In the patients with positive findings, 98 (38.28%) were accompanied by multi-system injuries, 159 (62.11%) were comprised of several types of thoracic trauma. There were 198 patients (about 77.34%) with rib fracture and 49 patients (19.14%) with lung contusion. Conclusions Multi-system injuries and several types of thoracic trauma are common in the patients injured in the earchquake. The main traumatic manifestations are rib facture and lung contusion. Imaging examination is very helpful in the diagnosis of thoracic trauma.
摘要:目的:評價64層螺旋CT對冠心病的診斷價值。方法:對25例典型病例的CT圖片進行分析、總結,觀察64層螺旋CT對冠狀動脈的管腔狹窄程度及冠脈內斑塊性質的顯示能力,并對橋血管和支架通暢性進行觀察。結果:近端冠脈中度以上狹窄的敏感度、準確度、陽性預測值分別為93.5%,90.3%,88.5%,對左主干及前降支病變診斷價值較高;對冠狀動脈內軟斑塊顯示較佳;對橋血管及支架通暢和有無再狹窄顯示良好。結論:MSCT冠狀動脈成像在冠心病篩查及冠狀動脈支架術后和搭橋術后的隨訪發揮重要作用。Abstract: Objective: To study the diagnose value of 64slice spiral CT for coronary heart disease. Methods:The CT pictures of 25 typical cases of coronary heart disease were analyzed so as to survey the displaying ability coronal arterial stenosis, its degree and the character plaques, the patency of bypass graft and stents by 64slice spiral CT. Results:The sensitivity, accuracy, positive predictive value for RCA1 narrow above moderate was 93.5%, 90.3%, 88.5% respectively. For LM and LAD, its diagnose value was high. The coronary soft or fibrous plaque, stent and bypass graft were displayed well. Conclusion:MSCT plays an important role in filtering coronary heart disease and reexamination after stents and bypass.
目的:研究多層螺旋CT多平面圖像重組技術(multiplanar reformation,MPR)對肺部病變定位診斷的價值。方法:398例患者行胸部多層螺旋CT薄層掃描后,采用MPR技術將橫斷面圖像重組,分別獲得矢狀和冠狀位的MPR圖像。三位高年資醫師分別在橫斷和矢冠狀重組圖像上確定病變部位,兩位或兩位以上均診斷為同一位置者確定為病變部位,納入統計分析。所有資料用χ2檢驗。結果:398例中,矢冠狀重組圖像組無定位診斷錯誤,橫斷圖像組有22例定位診斷錯誤。兩者間差異無統計學意義(Pgt;005)。結論:多層螺旋CT MPR圖像定位準確性較高,對少數橫斷圖像難以定位的病變可加作MPR重組圖像。
目的 分析多層螺旋CT在評價上腔靜脈綜合征側支循環中的作用。 方法 報道2012年2月收治的1例上腔靜脈綜合征患者，并以多層螺旋CT評價側支循環建立情況。 結果 通過多層螺旋CT的多維成像技術，可清楚發現患者典型的以及2支少見的側支循環。 結論 多層螺旋CT在評價上腔靜脈綜合征側支循環中有其重要意義。
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.