目的:评价先天性心脏病（CHD）不同病变类型在64层螺旋CT（64-MDCT）三维重建图像上的表现及显示效果。方法:回顾性分析36例CHD患者的64-MDCT资料,分别在轴位、冠状、矢状位及容积再现（VR）重组图像上观察病变,统计分析不同重组图像显示总体病变及房、室间隔缺损效果有无差异。结果:36例患者共有病变59处,轴位、冠状及矢状位图像在发现病变（59处,100.0%；57处,96.6%；53处,89.8%）及室间隔缺损显示（显示效果评分:41、38及39分）方面无明显差异（P＞0.05）,但轴位图像显示房间隔缺损明显优于冠、矢状位图像（显示效果评分:19、13及12分）（P＜0.05）。VR图像与轴位及冠、矢状位图像显示心外大血管病变效果无差异P＞0.05）。不同类型病变在轴位,冠、矢状位及VR图像上表现特征不尽相同,而不同重组图像有各自优势显示的病变类型。结论:64-DCT三维重建图像能够很好地显示先心病各种类型病变,了解不同重建图像上病变表现特征及显示效果有利于做出准确、全面的诊断。
Objective To evaluate CT and ultrasonic imaging as a diagnostic means of acute intestinal obstruction. Methods Acute intestinal obstruction of 30 patients diagnosed by preoperative CT scanning and ultrasonic imaging was retrospectively viewed, compaired with intraoperative and pathologic findings.Results The overall accuracy of CT for detection of obstruction was 86.7% (26/30),CT and ultrasonic imaging was 93.3% (28/30). Conclusion CT with ultrasonic imaging is of great advantages for senile patients especially having malignant tumors and for patients with intestinal intussuception. CT with ultrasonic imaging is found to be reliable for diagnosing ileolithiasis and abdominal abscess and mesentery vein thrombosis, but is less sensitive in cases of bowel torsion.
【Abstract】Objective To investigate the imaging features of malignant invasion of major intrahepatic ductal structures (the portal and hepatic venous vasculature, the bilie duct) by primary hepatocellular carcinoma (HCC) using multidetector-row spiral CT (MDCT). Methods We retrospectively analyzed 68 documented HCC patients with tumorous invasion of the major intrahepatic ductal structures who had undergone contrast-enhanced dual-phase MDCT scanning of the upper abdomen.The morphological changes of the portal and hepatic venous vasculature, the bile duct, and the liver parenchyma at both the hepatic arterial phase and portal venous phase images were carefully observed and recorded. Results Among the 68 patients, 47 patients had malignant invasion of the intrahepatic portal venous vessels with secondary tumor thrombus formation; 12 patients had tumor involvement of the hepatic veins and intraheptic segment of the inferior vena cava; Tumor invasion of the bile duct was seen in 9 patents. The direct CT signs of tumor invasion of intrahepatic venous vessels included: ①dilatation or enlargement of the involved vein with intraluminal softtissue “filling defect”； ②enhancement of the tumor thrombus at hepatic arterial phase, the so-called “venous arterialization” phenomenon. The indirect CT signs included: ①arterial-venous shunt, ②early and heterogeneous enhancement of the hepatic parenchyma adjacent to HCC focus, ③cavernous transformation of the portal vein. The CT signs suggesting tumor invasion of the bile duct included: ①dilation of the bile ducts near or proximal to HCC lesion, ②soft-tissue nodule or mass inside the bile ducts. Conclusion Invasion of major intrahepatic ductal structures by HCC will present corresponding CT imaging features. Contrast-enhanced MDCT dualphase scanning combined with appropriate image postprocessing techniques can better evaluate the malignant invasion of major intrahepatic ductal structures.
Objective To compare the macular imaging and measurements of patients with idiopathic epiretinal membranes (ERM) by stratus optical coherence tomography (OCT) and two different types of spectral-domain OCT. Methods Forty-six consecutive patients (46 eyes) diagnosed as idiopathic ERM in the period of August 2008 to October 2008 were enrolled in this study. The patients included 11 males and 35 females, with a mean age of (61.04plusmn;10.13) years. Twenty-one age- and sex- matched normal subjects (21 eyes) were enrolled in this study as control group. All the subjects underwent stratus OCT, cirrus OCT and 3D OCT-1000 examinations. The macular area was divided into three concentric circles which including central region with 1 mm diameter, inner area with ＞1 mm but le;3 mm diameter, and outer ring area with ＞3 mm but le;6 mm diameter. The inner area and outer ring area were divided into superior, nasal, inferior and temporal quadrants by two radioactive rays. The characteristics of OCT images and the quantitative measurements were compared among these three machines. The macular thickness of ERM group and control group was also compared. And the correlation of visual acuity and the macular thickness in idiopathic ERM patients was evaluated. Results The increased macular retinal thickness, disorder structure of inner retina, uneven surface and proliferative inner and outer plexiform layer were observed in ERM group by stratus and spectral-domain OCT. But the minor pathological changes on inner retina structure and internal surface proliferation could be observed more clearly by spectral-domain OCT than those by stratus OCT.The macular thicknesses of all the subjects measured by Cirrus OCT and 3D OCT-1000 were thicker than those measured by Stratus OCT (t=7.445-11.253,P=0.000). The correlations of measurements between three OCTs were good (r＞0.9). The flatted or disappeared fovea of ERM patient group was observed by all three OCTs. The macular thicknesses on different subfields of patients in ERM group were thicker than those in control group, especially in the 1-3 mm inner ring (t=2.477-10.139,P＜0.05). Moderate negative correlations were shown on the macular thickness and visual acuity in ERM group (r=-0.216-0.517). Conclusions Spectral domain OCT yields better visualization of the intraretinal layers than time domain OCT. The images in spectral domain OCT are more clear and fine compared to stratus OCT. Stratus OCT correlates with spectral domain OCT, but they are different, and cannot be replaced by each other.
Optical coherence tomography angiography (OCTA) is a new and non-invasive imaging technique that is able to detect blood flow signal in the retina and the choroid within seconds. OCTA is different from the traditional angiography methods. The major advantages of OCTA are that it can observe blood flow signal in different layers of the retina and the choroid without injecting any dye, provide blood flow information that traditional angiography cannot provide, and enrich pathophysiological knowledge of the retinal and choroidal vascular diseases., which help us to make an accurate diagnosis and efficient evaluation of these diseases. However there is a large upgrade potential either on OCTA technique itself or on clinical application of OCTA. We need to fully understand the advantage and disadvantage, and differences of OCTA and traditional angiography. We also need to know how to interpret the result of OCTA. With that we could make a fast diagnosis in a non-invasive way and improve our knowledge of the retinal and choroidal vascular diseases.
【摘要】 目的 探讨结核性腹膜炎的CT诊断价值。 方法 回顾性分析2009年10月-2010年7月22例经手术、病理或抗结核治疗确诊的结核性腹膜炎CT完整资料。主要观察:淋巴结、腹水、腹膜、系膜、网膜改变。 结果 淋巴结肿大12例，增强后呈“环状”强化改变。腹腔积液15例，少～中量12例，聚集在肠系膜根部、结肠旁沟及盆腔较多，CT值20～28HU。腹膜增厚16例，其中14例均匀光滑增厚，10例明显强化；大网膜增厚15例，其中饼状增厚2例、污垢样增厚9例、结节样4例。肠系膜增厚18例，3例肠袢聚集、粘连。伴有其他脏器结核13例。 结论 CT对诊断和鉴别诊断结核性腹膜炎具有较大的临床价值，结合临床多数结核性腹膜炎可作出正确诊断。【Abstract】 Objective To evaluate the diagnostic value of CT scan for tuberculotic peritonitis. Methods The complete CT image data of 22 patients with tuberculotic peritonitis confirmed by surgical, pathologically, or therapeutic procedures from October 2009 to July 2010 were retrospectively analyzed. The changes of lymph nodes, ascites, thickened peritoneum, mesentery and greater omentum were observed. Results In 22 patients, enlargement and rim enhancement of lymph nodes were found in 12; ascites with CT value of 20-28 HU was in 15, of whom 12 had small or middle amount of effusion which located in mesentery or abdominal cavity; thickened parietal peritoneum was in 16, including smooth peritoneum in 14 and evident enhancement in 10; thickened greater omeutum was in 15, including cake-like thickening in 2, filth-like thickening in 9 and tuber-like thickening in 4; thickened mesentery was in 18, including intestinal loop adhesion in 3.A total of 13 patients were combined with other tuberculosis. Conclusion CT scan is very important in diagnosing and differentially diagnosing tuberculous perinitis.
【摘要】 目的 观察肝包虫病的螺旋CT表现，以便作出正确的CT诊断。 方法 2003年1月-2010年1月，临床证实的35例肝包虫病患者行螺旋CT平扫及增强扫描，对其CT表现进行分析。 结果 多发病变30例，单发病变5例。囊性病变32例，其中囊壁钙化29例，囊壁内囊分离2例，囊内见子囊11例；实质性肿块3例，均见斑点状钙化。 结论 肝包虫病的螺旋CT表现有其特殊性，螺旋CT基本能作出正确的诊断。但有时需与肝脏其它疾病鉴别。【Abstract】 Objective To improve the understanding of liver echinococcosis and make correct diagnosis of the disease by analyzing its spiral CT characteristics. Methods From January 2003 to January 2010, 35 patients with clinically confirmed liver echinococcosis underwent spiral CT simple scan and enhanced scan. The results of CT scan were analyzed. Results There were 30 cases of multiple lesions and five cases of single lesion. Cystic lesion occurred in 32 cases, including 29 cases of cystic wall calcification, two cases of separated endocyst from the cystic wall. Daughter cysts could be seen in 11 cases of cystic lesion. Substantial mass could be seen in therr cases with spotty calcification. Conclusion The spiral CT manifestation of liver echinococcosis has its particularity. Basically, it can make the correct diagnosis. However, the diagnostic results sometimes need to be distinguished from other liver diseases.