Three-dimensional Imaging of Multi-slice Spiral CT in Bronchial Artery Correlative Study on Blood Supply of Central Lung Cancer and Its Clinical Significance

Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.

Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

Objective:To analyze the value of multi-slice spiral computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of carpal joint injury.Methods:A total of 130 patients with suspected wrist injuries admitted to the Department of Orthopedics of our hospital from January 2023 to January 2024 were selected and randomly divided into a single group(n=65)and a joint group(n=65).The single group was diagnosed using multi-slice spiral CT,and the joint group was diagnosed using multi-slice spiral CT and magnetic resonance imaging,with pathological diagnosis as the gold standard.The diagnostic results of both groups were compared to the gold standard,and the diagnostic energy efficiency of both groups was compared.Results:The diagnostic results of the single group compared with the gold standard were significant(P<0.05).The diagnostic results of the joint group compared with the gold standard were not significant(P>0.05).The sensitivity and accuracy of diagnosis in the joint group were significantly higher than that in the single group(P<0.05).The specificity of diagnosis in the joint group was higher as compared to that in the single group(P>0.05).Conclusion:The combination of multi-slice spiral CT and MRI was highly accurate in diagnosing wrist injuries,and the misdiagnosis rate and leakage rate were relatively low.Hence,this diagnostic program is recommended to be popularized.

Multi-slice spiral CT angiography in evaluating donors of living-related liver transplantation

BACKGROUND: During the past years, the number of liver transplantation has increased greatly, but the number of available organs has not increased. In view of the critical shortage of organs, the indications for living-related liver transplantation (LRLT) have broadened since experience with the procedure has been achieved. This study was undertaken to assess the value of multi-slice spiral CT (MSCT) angiography in evaluating the hepatic arterial and veinous anatomy of potential donors for LRLT. METHODS: MSCT was performed after intravenous injection of contrast material at 3 ml/s. The total dose was calculated as 2 ml/kg. Twenty LRLT donors (2 men and 18 women) were subjected to MSCT angiography of hepatic blood vessels. These were generated by volume rendering and maximum intensity projection, while curved planar reformation was added in 5 patients. RESULTS: We identified 10 important hepatic vascular variants in 9 of the 20 donors (4 arterial, 4 venous, and 2 portal venous variants). In hepatic arterial variants, two had a replaced right hepatic artery arising from the superior mesenteric artery, an accessory right hepatic artery from the superior mesenteric artery and a replaced left hepatic artery arising from the left gastric artery. In hepatic venous variants, three had an accessory inferior right hepatic vein and one had two accessory inferior right hepatic veins. In hepatic portal venous variants, two had trifurcation of the main portal vein. CONCLUSIONS: As a non-invasive and reliable method, MSCT angiography is of value in the clinical evaluation of LRLT donors. MSCT angiography should be recommended as a routine preoperative examination for potential LRLT donors.

Multi-slice Spiral CT Three-dimensional Portography in Portal Vein Tumor Thrombus of Hepatic Cancer

Objective: To study the clinical significance of multi-slice spiral CT 3-dimensional (3D) portography in portal vein tumor thrombosis of hepatocellular cacinoma.Methods: 57 cases undergoing 3D portography were collected, of which 6 cases were normal, 5 cases were subjected to cirrhosis and hypertension of portal vein, 42 cases had portal tumor thrombus of hepatic cancer, and the remaining 4 cases showed lymph node enlargment in hilar of liver. All data of the patients came from conventional multi-slice spiral CT double phase of liver. Contrast media was 1.5–2 ml/kg with the injection rate being 2.5–3 ml/s. Axis and 3D portography was analyzed and compared in 42 cases of portal tumor thrombus of hepatic cancer.Results: According to portal tumor thrombus position, 42 cases were fallen into three categories: left (13 cases), right (20 cases), main (9 cases) of potal vein. There was no difference between axis and 3D portography in displaying portal tumor thrombus of hepatic cancer (P>0.05), but 3D portography showing collateral branches was better than axis portography after main portal vein thrombus.Conclusion: Multi-slice spiral CT 3D portography can display the position and types of portal tumor thrombus of hepatic cancer. 3D combined with axis portography can better evaluate the portal tumor thrombus of hepatic cancer and guide to select the therapies. Key words portal vein - tumor thrombus - multi-slice CT - 3 dimension imaging

Comparison of the Imaging Manifestations and Diagnostic Values of Multi-slice Spiral CT and Enhanced MRI Scans of Primary Liver Cancer(PLC)Intrahepatic Lesions

Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September.After the patients were admitted,they were examined by multi-slice spiral CT and enhanced MRI scanning,and the pathological diagnosis results were followed up.Relevant information was reviewed and analyzed.Results:The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection.The difference was statistically significant(P<0.05).The detection rate of lesions in the arterial phase and delayed phase was not statistically significant(P>0.05);the diagnostic accuracy of multi-slice spiral CT was 85.96%,and the diagnostic accuracy of enhanced MRI scanning was 91.11%,which was not statistically significant(P>0.05).MRI scans showed the capsules of primary liver cancer better than CT,but the difference was not statistically significant(P>0.05).Conclusion:In conclusion,both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions.The diagnostic value of the two is equivalent,but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.

Study on the combined value of multi-slice spiral CT in the diagnosis of elderly colorectal cancer colorectal cancer tumor markers

Objective:To investigate the value of tumor markers in colorectal cancer with multi-slice spiral CT in the diagnosis of elderly colorectal cancer.Methods:From January 2016 to September 2017 year period, 73 elderly patients with colorectal cancer treated in our hospital were selected as observation group;64 elderly patients with intestinal benign lesions were selected as control group during the same period. Serum samples were collected to detect contents of CEA, CA72-4, CA19-9 and CYFRA21-1 by Roche luminous immunoassay analyzer, and multi slice spiral CT was used.Results:Serum levels of CEA, CA72-4, CA19-9 and CYFRA21-1 levels of the observation group were significantly higher than that of the control group;the positive rate of CEA, CA72-4, CA19-9, CYFRA21-1 and their combined detection were all significantly higher than that of the control group;positive rate of MSCT in the observation group was higher than the control group;positive rates of tumor markers combining with MSCT examination of colorectal cancer were higher than that of combined detection of tumor markers and MSCT examination;but there was no significant difference in positive rate of combined detection of tumor markers and the positive rate of MSCT detection of colorectal cancer.Conclusion:Colorectal cancer tumor markers combined with multi-slice spiral CT in the diagnosis of colorectal cancer in elderly has important research value, can significantly improve the positive rate of diagnosis.

Value of Multi-slice Spiral CT in the Diagnosis and Resectability of Pancreatic Cancer

Objective:To analyze the value of multislice spiral CT in the diagnosis and resectability of pancreatic cancer.Method:56 patients with pancreatic cancer treated in our hospital from January 2018 to October 2019 were selected as the research subjects.All patients underwent multi-phase scanning by multislice spiral CT.According to the results of the images,observe whether the pancreatic cancer has affected the blood vessels surrounding the pancreas,evaluate the resectability based on the results of the examination,and analyze the final results of the operation which was taken as the standard.Results:all the 56 cases presented slightly low density or equal density,and 28 cases had complete outline.Multi-slice spiral assessment of patients’vascular invasion types found that 192 branches can be resected with 70 branches cannot;Multi-slice spiral assessment of the main arterial and venous invasion grades around the pancreas of the patients found that 212 branches can be resected with 50 branches cannot;Multi-slice spiral CT was used to evaluate the resectability of pancreatic cancer compared with surgical results.The accuracy of resectable types of vascular invasion was 72.52%;the accuracy of resectable vascular invasion grades was 79.39%.Conclusion:the application of multi-slice spiral CT in the diagnosis of pancreatic cancer can provide a clear understanding of the condition of vascular invasion and distant metastasis,and the accuracy of assessing resection can reach more than 70.00%,which provides a reference for clinical application.

Investigation on the optical scan condition for imaging of multi-slice spiral CT liver perfusion in rats

Background Multi-slice CT liver perfusion has been widely used in experimental studies of hemodynamic changes in liver lesions, and is usually performed as an adjunct to a conventional CT examination because of its high temporal and spatial resolution, simple protocol, good reproducibility, and ability to measure hemodynamic changes of liver tissues at the capillary level. Experimental rat models, especially those of induced liver cancer, are often used in studies of hemodynamic changes in liver cancer. Carcinogenesis in rats has a similar pathological progression and characteristics resembling those in human liver cancer; as a result, rat models are often used as ideal animal models in the study of human liver cancer. However, liver perfusion imaging in rats is difficult to perform, because rats＇ livers are so small that different concentrations, flow rates, and dose of contrast agents during the CT perfusion scanning can influence the quality of liver perfusion images in rats. The purpose of this study, therefore, was to investigate the optimal scan protocol for the imaging of hepatic perfusion using a deconvolution mathematical method in rats by comparing the results of rats in different injection conditions of the contrast agent, including concentration, rate and time. Methods Plain CT scan conditions in eighty 2-month-old male Wistar rats were 5.0 mm slice thickness, 5.0 mm interval, 1.0 pitch, 120 kV tube voltage, 60 mA tube current, 512x512 matrix, and FOV 9.6 cm. Perfusion scanning was carried out with different concentrations of diatrizoate （19%, 38%, 57%, and 76%）, different injection rates （0.3 and 0.5 ml/s）, and different injection times （1, 2-3, 4-5, and 6 seconds）. The above conditions were randomly matched and adjusted to determine the best perfusion scan protocol. Three-phase contrast-enhanced scanning was performed after CT perfusion. Histological examination of the liver tissues with hematoxylin and eosin stains was done after CT scanning. Results When the concentration of the contrast agent was 19% or 38%, no pseudo-color map was created. The viscosity increased when the concentration of the contrast agent was 76%; so it is difficult to inject the contrast agent at such a high concentration. Also no pseudo-color map was generated when the injection time was short （1, 2-3, and 4-5 seconds） or the injection rate was low （0.3 ml/s）. The best perfusion images and perfusion parameters were obtained during 50 seconds scanning. Each rat was given an injection of 57% diatrizoate at 0.5 mils via the tail vein using a high-pressure syringe for 6 seconds. The perfusion parameters included hepatic blood flow （HBF）, hepatic blood volume （HBV）, mean transit time （MTT） of the contrast agent, capillary permeability-surface area product （PS）, hepatic arterial index （HAl）, hepatic artery perfusion （HAP）, and hepatic portal perfusion （HPP）. All these parameters reflected the perfusion status of liver parenchyma in normal rats. Three phases of enhancement were modified according to the time-density curves （TDCs） of the perfusion imaging： hepatic arterial phase （7 seconds）, hepatic portal venous phase （15 seconds）, and a delayed phase （23-31 seconds）. On examination by microscopy, the liver tissues were pathologically normal. Conclusions The appropriate protocol with multi-slice spiral CT liver perfusion reflected normal liver hemodynamics in rats. This study laid a solid foundation for further investigation of the physiological characteristics of liver cancer in a rat model, and was an important supplement to and reference for conventional contrast-enhanced CT scans.

Diagnostic value of multi-slice spiral CT in aortic dissection

Background Aortic dissection occurs at a low incidence, but is associated with high mortality. It is generally acute onset, complicated and is often misdiagnosed; therefore is a macro vascular disease that poses major threat on patients’ lives. Timely diagnosis and management are essential, so we investigated the diagnostic value of multi-slice spiral CT in aortic dissection. Methods clinical data from 21 patients with confirmed aortic dissection were retrospectively analyzed. All patients had undergone plain and contrasted multi-slice spiral CT scans. Results true lumen and pseudo cavity were clearly revealed in all 21 patients, of which 17 showed intimal flap, four showed intimal calcification and inward displacement, while 2 had thrombosis in the pseudo cavity. As for classification among these 21 patients, 9 had type Ⅰ aortic dissection, including two patients with innominate artery involvement, 1 with celiac trunk involvement and 2 with left renal artery involvement; 2 had type Ⅱ aortic dissection, including 1 patient with innominate artery involvement; Another ten patients had type III aortic dissection, including 2 patients with left subclavian artery involvement and 1 with celiac trunk involvement. Nineteen out of 21 patients had clearly revealed initial rupture. Conclusion multi-slice spiral CT is characterized by rapidness, non-invasiveness and accuracy. It provides clear visualization of the location and scope of aortic dissection, location of the rupture as well as the valves, which makes it a first-choice imaging approach for the diagnosis of aortic dissection.

Segmental radiofrequency ablation of pulmonary vein ostia for patients with refractory paroxysmal atrial fibrillation using multi-slice spiral computed tomography guidance

Objective： To evaluate the safety and clinical efficacy of segmental radiofrequency ablation of pulmonary vein （PV） ostia for patients with refractory paroxysmal atrial fibrillation （AF） under multi-slice spiral computed tomography （MSCT） guidance before the procedure. Methods： A series of 58 consecutive patients with refractory paroxysmal AF were enrolled to undergo segmental radiofrequency ablation ofPV ostia. The 36 male and 22 female patients with mean age of （57.4±9.5） （32-79） years and no obvious organic heart disease. Before ablation, patients received MSCT to generate 3-dimentional image of the left atrium （LA） and proximal PVs. Patients then underwent segmental radiofrequency ablation ofPV ostia using PV circular mapping catheter manipulated several times to ensure complete isolation between PVs and LA. Results： No complications occurred during the procedure. One patient developed delayed cardiac tamponade, which was drained percutaneously. The mean follow-up time was （17.1±9.3） months. Forty-one patients （95%） experienced improved quality of life one month after the procedure. Thirty-six patients （83%） showed stable sinus rhythm, while 10 patients （23%） required additional anti-arrhythmic drugs. AF returned≥1 time in 6 （14%） patients who underwent anti-arrhythmic drug therapy, but the number of episodes was less than that before the procedure. However, one patient experienced recurrent episodes of atrial flutter. Conclusion： It is safe and effective to perform segmental radiofrequency ablation of PV ostia for patients with refractory paroxysmal AF using MSCT guidance mappening.

Multi-slice spiral computed tomography in diagnosing unstable pelvic fractures in elderly and effect of less invasive stabilization

BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.

Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection

BACKGROUND Recurrence is the major challenge facing endoscopic submucosal dissection(ESD)-based treatment therapies for early gastric cancer(EGC).Urgent development of simple and easy surveillance approaches will enhance clinical treatment of the disease.AIM To explore the role of computed tomography(CT)recurrence in evaluating EGC after ESD treatment.METHODS We retrospectively recruited patients from our endoscopy department,between January 2002 and December 2015,and analyzed their basic characteristics,including symptoms,CT results,and results of endoscopy with biopsy,among others.RESULTS Among a total of 2150 patients EGC patients surveyed,1362 met our inclusion and exclusion criteria and were therefore enrolled in our study.The cohort’s sensitivity of CT for recurrent GC and specificity were 44.22%and 43.86%,respectively,with negative and positive predictive values of 40.15%(275/685)and 48.01%(325/677),respectively.The area under the curve of arterial and venous CT values for recurrent EGC were 0.545,and 0.604,respectively.Receiver operating characteristic curve revealed no statistically significant differences between arterial and venous CT values for recurrent EGC.CONCLUSION Enhanced CT has superior diagnostic efficacy,but less accuracy,compared to gold standard techniques in patients with recurrent EGC.

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps,and gastric stromal tumor risk stratification assessment

BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.

Establishing models of portal vein occlusion and evaluating value of multi-slice CT in hepatic VX2 tumor in rabbits

AIM： To establish models of portal vein occlusion of hepatic VX2 tumor in rabbits and to evaluate the value of multi-slice CT. METHODS： Forty New Zealand rabbits were divided into 4 groups according to digital table： Immediate group （group A; transplantation of tumor immediately after the portal vein occlusion）, 3-wk group （group B; transplantation of tumor at 3 wk after the portal vein occlusion）, negative control group （group C） and positive control group （group D）, 10 rabbits in each group. Hepatic VX2 tumor was transplanted with abdominalembedding innoculation immediately after the portal vein occlusion and at 3 wk after the portal vein occlusion. Meanwhile, they were divided into negative control group （Left external branch of portal vein was occluded by sham-operation, and left exite was embedded and inoculated pseudoly） and positive control group （Transplanted tumor did not suffer from the portal vein occlusion）. All rabbits were scanned with multi-slice CT. RESULTS： All 40 animals were employed in the final analysis without death. Tumor did not grow in both immediate group and 3-wk group. In 3-wk group, left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was significantly smaller than that in positive control group （2.55±0.46 vs 3.59±0.37 cm, t = 5.57, P 〈 0.001）. Incidences of metastasis in the liver and lung were lower in 3-wk group than those in positive control group （10% vs 400, and 90% vs 100%, respectively）. The expression intensities of the vascular endothelium growth factor （VEGF） in groups A, B, C and D were 0.10±0.06, 0.66±0.21, 0.28±0.09 and 1.48±0.32, respectively. VEGF expression level in the test group A was significantly lower than that in the negative control group C （t = 5.07; P 〈 0.001）.In addition, VEGF expression in the test group B was significantly lower than that in the positive control group D （t = 6.38; P 〈 0.001）. Scanning with multi-slice CT showed that displaying rate of hepatic artery branches was obviously lower in grade Ⅲ（40%） than that in grade Ⅰ（70%） and Ⅱ（100%） （P 〈 0.05）; but there was no significant difference in displaying rate of the portal vein at various grades. Values of blood flow （BF） of the liver, blood volume （BV）, mean transit time （MTT） and permeability of vascular surface （PS） were lower in the immediate group and 3-wk group than those in control groups, but values of hepatic arterial fraction （HAF） were increased. Significant positive correlations were existed between BF and BV （r = 0.905, P 〈 0.01）, and between BF and PS （r = 0.967, P 〈 0.01）, between BV and PS （r = 0.889, P 〈 0.01）. A significant negative correlation existed between PV and HAF （r = -0.768, P 〈 0.01）, between PS and HAF （r = -0.557, P 〈 0.01）. The values of BF, BV and PS had a positive correlation with VEGF （rBF = 0.842, rBV = 0.579, rPS = 0.811, P 〈 0.01） . However, there was no significant correlation between the values of MTT and HAF and the VEGF expression （rMTt = 0.066, rHAF = -0.027）. CONCLUSION： Ligating the left external branch of portal vein is an ideal way to establish models of portal vein occlusion in rabbits with hepatic VX2 tumor. Multi slice CT plays a key role in evaluating effect of portal vein occlusion.

Using receiver operating characteristic curves to evaluate the diagnostic value of the combination of multislice spiral CT and alpha-fetoprotein levels for small hepatocellular carcinoma in cirrhotic patients

BACKGROUND： The various combination of multiphase enhancement multislice spiral CT （MSCT） makes the diagno- sis of a small hepatocellular carcinoma （sHCC） on the back- ground of liver cirrhosis possible. This study was to explore whether the combination of MSCT enhancement scan and alpha-fetoprotein （AFP） level ficiency for sHCC. could increase the diagnostic ef- METHODS： This study included 35 sHCC patients and 52 cir- rhotic patients without image evidence of HCC as a control group. The diagnoses were made by three radiologists em- ploying a 5-point rating scale, with postoperative pathologic results as the gold standard. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the diag- nostic value of the three MSCT combination modes （arterial phase＋portal-venous phase, arterial phase＋delayed phase, arterial phase＋portal-venous phase＋delayed phase） and AFP levels for sHCC on the background of liver cirrhosis. RESULTS： The area under ROC curve （AUC）, sensitivity, and specificity of the combination of arterial phase＋portal- venous phase＋delayed phase were 0.93, 93%, and 82%, respectively. The average AUC of the arterial phase＋portal- venous phase＋delayed phase combination was significantly greater than that of the arterial phase＋portal-venous phase （AUC=0.84, P=0.01） and arterial phase＋delayed phase （AUC=0.85, P=0.03）. Arterial phase＋portal-venous phase had a smaller AUC （0.84） than arterial phase＋delayed phase （0.85）, but the difference was insignificant （P=0.15）. After combining MSCT enhancement scan with AFP, the AUC, sensitivity, and specificity were 0.95, 94%, and 83%, respectively, indicating a greatly increased diagnostic efficiency for sHCC. CONCLUSIONS： The combination of AFP and 3 phases MSCT enhancement scan could increase the diagnostic efficiency for sHCC on the background of liver cirrhosis. The application of ROC curve analysis has provided a new method and reference in HCC diagnosis.

Spiral CT三维重建图像在复杂性颌面部骨折诊断中的应用

目的:探讨Spiral CT三维图像重建系统在复杂性颌面部骨折诊断中的意义。方法:对48例颌面部复杂性骨折患者行颌面部CT三维重建,多方位、多视角观察Spiral CT三维重建的效果。结果:Spiral CT三维重建图像清晰,直观立体的反映骨折的部位、类型、骨折断段移位的方向和距离以及周围组织空间位置关系。结论:Spiral CT三维重建对颌面部多发性、复杂性骨折具有独特的诊断价值。

第二代双源CTFlashSpiral模式高心率冠状动脉成像的图像质量及准确性评价

目的评价第二代双源CT大螺距前瞻性螺旋扫描（Flash Spiral）高心率冠脉成像的图像质量、准确性及有效射线剂量。方法前瞻性入选心率〉65次／min的连续性患者268例，随机分为两组。A组134例，采用Flash Spiral模式扫描，采集图像时间为RR间期20％-30％；B组134例，采用回顾性心电门控扫描模式（Spiral）扫描。30d内A组有47例行冠状动脉造影术（CCA）检查（A1组），B组中有45例行CCA检查（B1组）。比较两组患者一般情况、图像质量评分、图像噪声、对比信噪比（CNR）和有效射线剂量。以CCA结果为金标准，分别计算A1、B1两组FlashDSCT显示冠脉病变的敏感性、特异性、准确率、阳性预测值和阴性预测值。结果①两组患者一般情况比较差异无统计学意义。②两组不可诊断节段基于血管节段评价分别为1．52％和1．74％，基于患者评价分别为7．5％和6．7％，差异均无统计学意义（P=0．345，P=0．812）。两组图像质量评分均数分别为1．064±0．306和1．084±0．327，差异无统计学意义（P=0．063）。A组平均图像噪声19±27（21．4±4．5）HU，CNR6．4-25．3（12．1±4．2）：B组分别为19±28（20．9±4.3）HU和7．1-28．2（13．8±5．1），两组比较差异无统计学意义。③心率变异性：A组图像质量评分3分的病例平均心率变异性明显小于B组。④与CCA比较，两组患者评价冠状动脉狭窄的敏感性、特异性差异均无统计学意义。⑤射线剂量：A组平均有效射线剂量显著低于B组[（1．04±0．16）mSv比（7．05±1．05）mSv，P=0．001]。结论高心率患者（心率〉65次／min）采用Flash双源CT大螺距前瞻性心电门控螺旋扫描在RR间期20％±30％成像，图像质量、准确性与回顾性心电门控扫描接近，而有效射线剂量显著减低。心率变异性对高心率患者FlashSpiral模式扫描图像质量的影响较大。

采用MSCT灌注成像检查评估周围型非小细胞肺癌分化程度的可行性分析

目的分析多层螺旋CT(MSCT)灌注成像检查评估周围型非小细胞肺癌(NSCLC)分化程度的可行性。方法选取本院2017年7月至2018年10月本院收治确诊的52例周围型NSCLC患者作为研究对象,比较不同分化级别患者的MSCT灌注成像参数;分析灌注参数与分化程度的相关性。结果高分化、中分化周围型NSCLC患者BF、BV、PS、MTT及PH数值均高于低分化周围型NSCLC,以高分化周围型NSCLC的BF、BV、PS、MTT及PH数值最高。各个灌注参数值,其中高分化、中分化周围型NSCLC的BF、PH与低分化周围型NSCLC比较差异显著(P<0.05),三者BV、PS及MTT数值比较,均为明显差异(P>0.05)。周围型NSCLC患者灌注参数BF、PH与其分化程度成负相关,且相关性显著(P<0.05)。结论MSCT灌注成像检查可有效反映周围型NSCLC的分化程度,其灌注参数中BF、PH对评估其分化程度有一定帮助,与周围型NSCLC分化程度具有一定相关性。

多层螺旋CT增强扫描诊断结直肠癌肺转移的相关因素分析

目的研究多层螺旋CT(MSCT)增强扫描技术在结直肠癌肺转移中的诊断价值,并对肺转移的危险因素进行分析。方法入选2019年1月至2022年2月于我院就诊的结直肠癌患者223例为研究对象,比较X线、MSCT对结直肠癌肺转移的诊断效能。根据活检结果将患者分为转移组和对照组,比较两组患者的临床资料,对影响结直肠癌肺转移的危险因素进行多元Logistic回归分析。结果在评价结直肠癌肺转移的诊断效能指标中,MSCT的准确度更高,且灵敏度、特异度以及阳性和阴性预测值均高于X线,结果具有统计学差异(P<0.05)。38例肺转移患者中11例(28.95%)病灶数目≥3个,MSCT图像中绝大多数病灶为实性结节,68.35%病灶边缘不光整,81.01%的病灶分叶,54.43%的病灶出现短毛刺,82.28%的病灶呈不均匀强化,长毛刺病灶比例较低,为26.58%。多元Logistic回归分析提示癌胚抗原表达升高、肿瘤原发于直肠以及Dukes C期为导致结直肠癌肺转移的独立危险因素。结论MSCT对结直肠癌肺转移的诊断价值较高,影像表现多样化,肿瘤原发部位为直肠、癌胚抗原表达升高及Dukes C期是结直肠癌肺转移的独立危险因素,对此类患者行MSCT增强扫描具有一定的意义。

多层螺旋CT血管造影(MSCTA)诊断颅内动脉瘤的影像学特征及诊断效能研究

分析多层螺旋CT血管造影(multislice CT angiography,MSCTA)诊断颅内动脉瘤的影像学特征及诊断效能。选取河北省衡水市第五人民医院2019年1月—2022年12月收治的80例颅内动脉瘤患者为研究对象,根据随机数表法将所有患者分为对照组与观察组,每组各40例。对照组接受数字减影血管造影技术(digital subtraction angiography,DSA)诊断,观察组接受MSCTA诊断。对比两组患者不同部位的脑动脉瘤检出率、两种检测方法下的图像质量分级情况及诊断效能。研究发现,针对颅内动脉瘤的临床诊断,可为患者实施MSCTA检查,此检查与DSA检查相比同样具有理想的诊断价值,动脉瘤检出率与图像质量较高,但与DSA此类有创检查项目相比,MSCTA对患者的影响更小,具有便捷、实惠等优势,可应用于临床诊断中。