ObjectiveTo investigate the vaules of multi-slice spiral CT (MSCT) in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer. MethodsFifty-nine patients with gastric cancer performed preoperative MSCT plain scan and triple enhanced scans from February 2019 to March 2021 in the First People’s Hospital of Wuhu City were collected. The results of postoperative pathology were taken as the gold standard, the short diameter, long diameter, short to long diameter ratio, CT values of triple enhanced scans and lymphatic hilar blur were compared between the metastatic lymph nodes and the non-metastatic lymph nodes. ResultsThe preoperative MSCT showed that there were 50 cases of metastatic lymph nodes and 9 cases of non-metastatic lymph nodes in 59 patients with gastric cancer. A total of 1 467 lymph nodes were harvested, including 562 metastatic lymph nodes and 905 non-metastatic lymph nodes. The short diameter, long diameter, short to long diameter ratio, and the CT values of plain scan, arterial phase, portal vein phase, and delayed phase of metastatic lymph nodes were higher than those of non-metastatic lymph nodes (P<0.05), and the incidence of lymphatic hilar blur was also higher than that of non-metastatic lymph nodes (P<0.05). Referring to the results of postoperative pathological examination, the accuracies of MSCT in judging of N0, N1, N2, N3a, and N3b stages were 88.9% (8/9), 83.3% (5/6), 85.7% (12/14), 92.3% (12/13), 88.2% (15/17), respectively, and the total accuracy was 88.1% (52/59), the specificity was 96.6% (57/59), and the sensitivity was 91.2% (52/57). ConclusionAccording to this study results, preoperative MSCT has higher specificity, sensitivity, and accuracy in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer.
Objective To evaluate the accuracy of pedicle guide device for the placement of the pedicle screws. Methods Pedicle guide device was designed and made for the anatomical trait of pedicle. The 3-Danatomical data of the thoracic pedicles were measured by multislice spiral CT in two embalmed human cadaveric thoracic pedicles spine(T1 -T10). Depending on transverse section angle(TSA) and sagittal section angle(SSA) of pedicle axis, the degree of horizontal dial and sagittal dial were adjusted in the guide device. The screws wereinserted bilaterally in the thoracic pedicles by using the device. After pulling the screws out, the pathways were filled with contrast media. The TSA and SSA of developed pathways were measured. Results Analysis of the difference between pedicle axis and developed pathway was of no statistical significance(P＞0.05). Conclusion The guide device could be easilyoperated and guarantee high accuracy of the pathways of screws and the incidence of pedicle penetration could be significantly reduced.
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer. Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years. Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer. There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels, on the degree of circumferential contiguity of tumor to vessel, on the degree of lumen stenosis, and on the degree of contiguity between tumor and vessels combined vascular caliber. Conclusion CT grading criteria are not uniform, each one has defects.
Objective To explore the diagnosis value of the low dose multi-slice spiral computed tomography (MSCT) imaging in pulmonary fungal infection in order to improve its diagnosis level. Methods CT manifestations of 106 cases of pulmonary fungal infection confirmed by operation, pathology, mycetes cultivation and follow-ups of clinical therapy were retrospectively analyzed. All cases underwent low dose MSCT examinations including CARE dose 4D and sinogram affirmed iterative reconstruction technology, and 6 cases underwent contrast-enhanced CT scanning. Results Among the basic MSCT findings of pulmonary fungal infection, they showed patch-nodular type in 54 cases, solid variant in 38 cases, and tumor type in 14 cases. In all cases, 91 cases displayed as mulifocality, 83 cases as polymorphism and 78 cases as polytropy. Among the 106 cases with comparative distinctive MSCT manifestations, bud of branch sign were showed in 39 cases, halo sign in 32 cases, wedge shape consolidation in 19 cases, ice needle sign in 15 cases, crescentic sign in 11 cases, air ring sign in 6 cases, and contra-halo sign in 4 cases. The nodules in the cavities were not enhanced in enhanced scan in 5 cases. Conclusions There are some distinctive MSCT findings in patients with pulmonary fungal infection. Pulmonary fungal infection can be diagnosed with typical MSCT findings in close combination with the clinical information.
目的 探讨多层螺旋CT对下颌骨骨折的诊断价值。 方法 对2007年4月-2009年10月下颌骨不同部位骨折的45例患者进行多层螺旋CT轴位扫描，并行多平面、表面遮盖法等三维重建，对下颌骨骨折CT表现特征作回顾性分析。 结果 45例下颌骨骨折中，位于下颌体骨折24例，下颌角骨折5例，下颌升支骨折6例，髁部骨折13例，冠突骨折2例；颞下颌关节脱位中，单侧脱位3例，双侧脱位5例。 结论 多层螺旋CT能准确诊断下颌骨各部位骨折，对诊治方案具有重要价值。
ObjectiveTo investigate the accuracy of multi-slice spiral CT (MSCT) scan and image reconstruction technology for measuring morphological parameters of costal cartilages and to evaluate the volume of costal cartilages. MethodsBetween March and August 2013, 75 patients with congenital microtia and scheduled for auricle reconstruction were included in the study. Of 75 patients, there were 49 males and 26 females with a mean age of 8 years and 5 months (range, 5 years and 7 months to 32 years and 7 months) and a mean weight of 29.5 kg (range, 21-82 kg). A Philips Brilliance 64 MSCT machine was used to scan 1st-12th costal cartilages with the parameters based on the age and weight of the patients. All the data were transported to the workstation for reconstructing the image of the costal cartilages with the technique of maximum intensity projection (MIP) and volume rendering technique (VRT). Then the morphologies of costal cartilages were observed through the images on VRT; the width of the costal cartilaginous ends close to ribs (W) and the length of the total cartilage (L) were measured and compared with their counterparts (W' and L') after the costal cartilages were harvested during the processes of auricle reconstructions to analyze consistency between these two sets of data. ResultsThe morphologies of ribs and costal cartilages shown on VRT image got fine sharpness, verisimilitude, and stereoscopic impressions. A total of 192 costal cartilages were examined. The results showed that the widths of the costal cartilaginous ends close to ribs (W) was (9.69±1.67) mm, and W' was (9.73±1.64) mm, showing no significant difference between W and W' (t=-1.800, P=0.073), and interclass correlation coefficient (ICC) test showed Cronbach's α=0.993. The length of the total cartilage (L) was (83.03±23.86) mm, and L' was (81.83±16.43) mm, showing no significant difference between L and L' (t=1.367, P=0.173), and ICC test showed Cronbach's α=0.904. Linear-regression analysis showed L=1.28×L'-21.93 (R2=0.780, F=673.427, P=0.000). The results suggested there was a good consistency between these two sets of data. ConclusionScanning costal cartilages with appropriate parameters and reconstructing the cartilaginous image with MIP is an effective method to measure the width and length of costal cartilage and to estimate costal cartilage volume, which can provide accurate reference for plastic surgery together with reading the morphology from the image on VRT.
目的 探讨多层螺旋CT在评价颈动脉斑块特征中的价值。 方法 回顾性分析2011年7月－10月132例行CT颈部血管造影患者的影像资料。对颈动脉斑块特征进行评价，重建方法包括多层面重建、容积再现技术、最大密度投影及曲面重建。 结果 132例患者中，80例检出颈动脉斑块，最常出现钙化斑块的部位为海绵窦段和床突上段，右侧海绵窦段52例（65.0%）、左侧海绵窦段49例（61.3%），右床突上段37例（46.3%）、左侧床突上段30例（37.5%）。最常出现软斑块的部位为双侧颈总动脉，均为12例（15.0%）。最常出现混合斑块的部位为颈总动脉，右侧颈总动脉9例（11.3%）、左侧颈总动脉12例（15.0%）。颈动脉最容易轻度狭窄294处（294/1 440，20.4%），中、重度狭窄少见，分别为8处（8/1 440，0.5%）和6处（6/1 440，0.4%）。颈部动脉血管斑块最易出现钙化，总计249处（249/1 440，17.3%），其次是软斑块和混合斑块，均为39处（39/1 440，2.7%）。 结论 多层螺旋CT可准确评价颈动脉斑块特征。
ObjectiveTo explore the value of multi-slice CT angiography (MSCTA) in peripancreatic vascular invasion of pancreatic carcinoma. MethodsThirty-eight patients with pancreatic carcinoma were detected by MSCTA technology before operation. The peripancreatic vascular invasion of pancreatic carcinoma was evaluated by multi-planar reconstruction (MPR) and maximum intensity projection (MIP) combined with axial image, and compared with the surgical results. ResultsThe MSCTA results showed that there were 12 patients (31.6%) with vascular invasion in 38 patients with pancreatic carcinoma, and the surgical results showed that there were 16 patients (42.1%) with vascular invasion. There was a b fit goodness of two results (kappa=0.665, P=0.000). The sensibility and specificity of MSCTA was 68.8% (11/16) and 95.5% (21/22), respectively. ConclusionsMSCTA technology has a high correct rate in evaluation of peripancreatic vessel encroached by pancreatic carcinoma, the MSCTA result has a b consistency to the surgical result. It has a value of clinical application in evaluation of peripancreatic vessel encroached by pancreatic carcinoma.