Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislic...Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease. High diagnostic value has been achieved with multislice CT angiography with use of 64- and more slice CT scanners. In addition, multislice CT angiography shows accurate detection and analysis of coronary calcium, characterization of coronary plaques, as well as prediction of the disease progression and major cardiac events. Thus, patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures. The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease; prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques. Limitations of multislice CT angiography in coronary artery disease are also briefly discussed, and future directions are highlighted.展开更多
Objective To review experience in preoperative detection of islet cell tumors using multislice computed tomography （MSCT） and summarize various imaging features of functioning islet cell tumors on enhanced MSCT. Me...Objective To review experience in preoperative detection of islet cell tumors using multislice computed tomography （MSCT） and summarize various imaging features of functioning islet cell tumors on enhanced MSCT. Methods Seventy patients with clinical or pathological diagnosis of functioning pancreatic islet cell tumor between October 2003 and February 2007 were included in this retrospective study. Seventy-four enhanced MSCT scans in these patients were identified. All MSCT scans were interpreted by two experienced radiologists by consensus interpretation. Surgery and pathology reports were used to confirm the diagnosis, localization, and size of tumors. Results Totally, 73 functioning islet cell tumors including 65 benign insulinomas, 2 benign glucagonomas, 3 malignant insulinomas, and 3 malignant glucagonomas were pathologically diagnosed. Tumors in only two cases were not found by MSCT. In 67 benign lesions, 32 showed typical enhancement style, 21 showed prolonged enhancement in portal venous phase, 4 showed delayed enhancement, 4 had iso-dense enhancement with normal pancreatic parenchyma, 2 had no enhancement at all in arterial phase and portal venous phase, and 4 had inhomogeneous enhancement with necrosis or cyst-formation. Patchy or spotty calcifications were found in 3 of the 67 tumors. In 6 malignant islet cell tumors, vessel invasion （2/6） and bowel invasion （1/6） were seen. Different enhancement patterns were shown. All hepatic metastases showed hyper-enhancement during their arterial phase. Conelttsions Pancreatic islet cell tumor may display a wide spectrum of presentations in MSCT. Tumors with unusual appearances often present as diagnostic challenges. Non-contrast and post-contrast multiphase scans are recommended for the localization of functioning islet cell tumors.展开更多
AIM: To investigate the research directions of coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease (CAD) based on a systematic review of the literature.METHODS: A search of articl...AIM: To investigate the research directions of coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease (CAD) based on a systematic review of the literature.METHODS: A search of articles on coronary CT angiography in the diagnosis of CAD was performed during a 6-year-period between 2005 and 2010 from f ive main radiology journals namely, Radiology, American Journal of Roentgenology, European Radiology, European Journal of Radiology and British Journal of Radiology. Analysis of the references was focused on the research directions of coronary CT angiography with regard to the type of studies in terms of diagnostic value, application of dose-reduction strategies and resultant effective radiation doses with use of these techniques.RESULTS: One hundred and forty two studies were identified which met the selection criteria and were included in the analysis. 64-slice CT (single source anddual-source CT) dominated 78% of the coronary CT angiography studies. Prior to 2007, research was focused on the diagnostic value of coronary CT angiography, but since 2008 more attention has been paid to radiation dose reduction. Radiation dose was reported in 64 studies, representing 45% of total studies published in the f ive radiology journals. Various dose-saving strategies have been implemented and prospective electrocardiography-triggering and high pitch techniques were found to be the most effective approaches for radiation dose reduction, with the corresponding mean effective dose being 3.5 ± 1.9 mSv and 1.7 ± 0.6 mSv, respectively.CONCLUSION: This review shows that the current research in coronary CT angiography has shifted from the previous focus on diagnostic accuracy in CAD to more emphasis on radiation dose reduction.展开更多
Acute appendicitis is a common surgical emergency with varied clinical presentations. Early diagnosis is absolutely necessary to minimize morbidity whereas delayed or missed diagnosis can cause adverse consequences. C...Acute appendicitis is a common surgical emergency with varied clinical presentations. Early diagnosis is absolutely necessary to minimize morbidity whereas delayed or missed diagnosis can cause adverse consequences. Computed tomography is a highly accurate imaging technique for diagnosing appendicitis. Hence it plays a valuable role in selected patients with suspected appendicitis;[1]. In this essay, we review the normal Computed tomography anatomy of the appendix and the right lower quadrant and illustrate the Computed tomography signs of appendicitis and important differential diagnostic entities. The Computed tomography appearance of complications of acute appendicitis is also presented, as are issues concerning clinical presentation and duration of the symptoms. Computed tomography signs can be varied and overlooked as they say what is easy to see is also easy to miss.展开更多
目的探讨多层螺旋CT(MSCT)对肠系膜非肿瘤性病变的诊断价值。方法回顾性分析经手术病理及随访观察证实的84例肠系膜非肿瘤性病变的CT表现与诊断,其中72例经穿刺/手术病理证实,其余按照CT标准做出诊断。应用GE LightSpeed Pro 16 CT机进...目的探讨多层螺旋CT(MSCT)对肠系膜非肿瘤性病变的诊断价值。方法回顾性分析经手术病理及随访观察证实的84例肠系膜非肿瘤性病变的CT表现与诊断,其中72例经穿刺/手术病理证实,其余按照CT标准做出诊断。应用GE LightSpeed Pro 16 CT机进行腹部平扫和双期增强扫描,并采用1.25mm层厚和1mm重建间隔在ADW4.2工作站获取最大密度投影(MIP)和多平面重建(MPR)图像,评价不同病变时肠系膜及其血管及邻近脏器的改变。结果 84例中:肠系膜水肿30例,其中肝硬化所致10例,肾衰所致4例,门脉、肠系膜上静脉栓塞4例,肠系膜上动脉栓塞4例,肠系膜扭转4例,肠系膜上静脉、门脉广泛积气2例,肠脂垂炎2例;炎性渗出34例,其中胆囊炎、阑尾炎、附件炎各6例,胰腺炎、升结肠憩室炎2例,肠系膜脓肿4例,肠穿孔5例,淋巴结炎3例;肠系膜血管挫伤10例,其中4例合并肠破裂;其他病变10例,包括脂肪沉积2例,肠系膜脂膜炎8例。肠系膜非肿瘤性病变的主要MSCT表现:肠系膜密度增高82例,其中弥漫性发布39例,节段性分布43例,表现为肠系膜雾状线条状增高即云雾状肠系膜。肠间隙内积液37例,9例同时伴积气。环绕肠系膜根部的脂肪肿块样改变8例,肠系膜增厚呈缆绳样改变2例,肠系膜旋转4例,肠系膜血管内对比剂缺损8例、积气2例,肠系膜上动脉增粗4例。3例淋巴结炎表现为回盲部多发小结节,边缘模糊。结论常见的肠系膜非肿瘤性病变病种多、表现相近,大部分具有特征性的CT表现,必须结合病史,方可提高定性诊断符合率。展开更多
文摘Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease. High diagnostic value has been achieved with multislice CT angiography with use of 64- and more slice CT scanners. In addition, multislice CT angiography shows accurate detection and analysis of coronary calcium, characterization of coronary plaques, as well as prediction of the disease progression and major cardiac events. Thus, patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures. The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease; prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques. Limitations of multislice CT angiography in coronary artery disease are also briefly discussed, and future directions are highlighted.
文摘Objective To review experience in preoperative detection of islet cell tumors using multislice computed tomography （MSCT） and summarize various imaging features of functioning islet cell tumors on enhanced MSCT. Methods Seventy patients with clinical or pathological diagnosis of functioning pancreatic islet cell tumor between October 2003 and February 2007 were included in this retrospective study. Seventy-four enhanced MSCT scans in these patients were identified. All MSCT scans were interpreted by two experienced radiologists by consensus interpretation. Surgery and pathology reports were used to confirm the diagnosis, localization, and size of tumors. Results Totally, 73 functioning islet cell tumors including 65 benign insulinomas, 2 benign glucagonomas, 3 malignant insulinomas, and 3 malignant glucagonomas were pathologically diagnosed. Tumors in only two cases were not found by MSCT. In 67 benign lesions, 32 showed typical enhancement style, 21 showed prolonged enhancement in portal venous phase, 4 showed delayed enhancement, 4 had iso-dense enhancement with normal pancreatic parenchyma, 2 had no enhancement at all in arterial phase and portal venous phase, and 4 had inhomogeneous enhancement with necrosis or cyst-formation. Patchy or spotty calcifications were found in 3 of the 67 tumors. In 6 malignant islet cell tumors, vessel invasion （2/6） and bowel invasion （1/6） were seen. Different enhancement patterns were shown. All hepatic metastases showed hyper-enhancement during their arterial phase. Conelttsions Pancreatic islet cell tumor may display a wide spectrum of presentations in MSCT. Tumors with unusual appearances often present as diagnostic challenges. Non-contrast and post-contrast multiphase scans are recommended for the localization of functioning islet cell tumors.
文摘AIM: To investigate the research directions of coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease (CAD) based on a systematic review of the literature.METHODS: A search of articles on coronary CT angiography in the diagnosis of CAD was performed during a 6-year-period between 2005 and 2010 from f ive main radiology journals namely, Radiology, American Journal of Roentgenology, European Radiology, European Journal of Radiology and British Journal of Radiology. Analysis of the references was focused on the research directions of coronary CT angiography with regard to the type of studies in terms of diagnostic value, application of dose-reduction strategies and resultant effective radiation doses with use of these techniques.RESULTS: One hundred and forty two studies were identified which met the selection criteria and were included in the analysis. 64-slice CT (single source anddual-source CT) dominated 78% of the coronary CT angiography studies. Prior to 2007, research was focused on the diagnostic value of coronary CT angiography, but since 2008 more attention has been paid to radiation dose reduction. Radiation dose was reported in 64 studies, representing 45% of total studies published in the f ive radiology journals. Various dose-saving strategies have been implemented and prospective electrocardiography-triggering and high pitch techniques were found to be the most effective approaches for radiation dose reduction, with the corresponding mean effective dose being 3.5 ± 1.9 mSv and 1.7 ± 0.6 mSv, respectively.CONCLUSION: This review shows that the current research in coronary CT angiography has shifted from the previous focus on diagnostic accuracy in CAD to more emphasis on radiation dose reduction.
文摘Acute appendicitis is a common surgical emergency with varied clinical presentations. Early diagnosis is absolutely necessary to minimize morbidity whereas delayed or missed diagnosis can cause adverse consequences. Computed tomography is a highly accurate imaging technique for diagnosing appendicitis. Hence it plays a valuable role in selected patients with suspected appendicitis;[1]. In this essay, we review the normal Computed tomography anatomy of the appendix and the right lower quadrant and illustrate the Computed tomography signs of appendicitis and important differential diagnostic entities. The Computed tomography appearance of complications of acute appendicitis is also presented, as are issues concerning clinical presentation and duration of the symptoms. Computed tomography signs can be varied and overlooked as they say what is easy to see is also easy to miss.
