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。
ObjectiveTo assess the value of multi-slice spiral CT (MSCT) in the diagnosis and resectability judgement of hepatic alveolar echinococcosis (HAE). MethodsThe CT findings of 28 patients who were confirmed HAE by surgical pathological examination were retrospectively analyzed. Comparative analysis were made between the CT findings and surgical pathology. ResultsAltogether 45 lesions in hepatic were detected. Lesions mainly revealed an infiltrating tumor-like hepatic mass with irregular margins and heterogeneous contents with varied attenuation, including scattered hyper-attenuating calcifications and hypo-attenuating areas corresponding to necrosis, no substantial enhancement, however, the fibro-inflammatory component surrounding the parasitic tissue was enhanced faintly in the delayed phase, and clearly demarcated from surrounding parenchyma. MSCT angiography (CTA) depicted signs of infiltration of hepatic vessels such as pushed, compression, displacement, stenosis, encasement and interruption. Compared with findings of operation, the sensitivity and specificity value of MSCT for evaluating the hepatic artery system disorders were 67%, 97%; and for portal venous system were 83%, 93%; and for hepatic venous system were 84%, 91%; while for inferior vena cava were 85%, 100%. Twelve cases which were evaluated as resectable by MSCT were in accordance with surgical findings. In the rest 16 patients which were judged as non-resectable by MSCT, only 2 patients were radical treatment through partial excision, repair and reconstruction for the involvement of large vessels and bile ducts. ConclusionMSCT is accuracy in the diagnosis and assessment of vessels complication of HAE. It has an important value to evaluate the resectability of HAE and the planning of treatment.
目的 探讨强直性脊柱炎（AS）受累骶髂关节、腰椎小关节及髋关节的病变CT表现特点，以提高诊断与鉴别诊断水平。 方法 2011年1月－10月对临床确诊的强直性脊柱炎患者44例骶髂关节、28例腰椎及14例髋关节行CT扫描，回顾性分析骶髂关节、腰椎小关节及髋关节的CT表现。 结果 AS患者的CT表现特点为病变主要累及骶髂关节滑膜部的髂骨侧，腰椎小关节及髋关节则表现为关节间隙改变、关节面毛糙及囊状破坏、面下骨硬化或吸收等改变。 结论 AS骶髂关节、腰椎小关节及髋关节的CT表现具有一定特征，CT具有重要的诊断及鉴别诊断价值。
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：探讨多层螺旋CT（MSCT）在急性主动脉综合征（AAS）的临床应用价值。方法：采用西门子Sensation 16层螺旋CT扫描机，对59例主诉急性胸背痛患者进行MSCT检查。结果：59例患者中主动脉夹层（AD）40例，主动脉壁内血肿（IMH）11例，穿透性粥样硬化性溃疡（PAU）8例。MSCT能够显示三种疾病的特征性征象：AD可见内膜片和双腔征；IMH主动脉壁呈新月形或环形增厚≥5 mm；PAU为凸出于主动脉管腔外的造影剂充盈的龛影。结论：MSCT是一种快速、无创的检查方法，能为AAS的诊断提供重要信息。
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。
ObjectiveTo explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. MethodsThirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. ResultsIn the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). ConclusionCTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.
目的 探讨螺旋CT增强扫描在子宫内膜癌的表现和分期价值。 方法 2004年3月－2010年2月对40例子宫内膜癌术前均行CT平扫和增强扫描，并按世界妇产科联合会（FIGO）标准进行术前CT分期，且均经手术和病理证实。 结果 子宫内膜癌增强CT主要表现为：子宫前后径增大，子宫内膜增厚，宫腔扩大，其内可见强化程度低于子宫肌壁的乳头状、息肉状或不规则状软组织影，部份可见宫腔积液、积血或积脓；或子宫肌壁变薄、厚薄不均或不规则，宫颈增大、密度变低或不均；子宫外播散等相关表现。FIGO分期：Ⅰa期6例，Ⅰb期8例，Ⅰc期8例，Ⅱ期8例，Ⅲ期4例，Ⅳ期6例。其中2例Ⅰa期高估为Ⅰb期，3例Ⅱa期高估为Ⅱb期，2例Ⅱ期低估为Ⅰ期。Ⅰ、Ⅱ期CT分期准确率分别为81.82％、37.5%，Ⅲ、Ⅳ期诊断均正确，总准确率为82.5%。 结论 螺旋CT增强扫描对子宫内膜癌的诊断和分期均有价值。