Objective： To evaluate the clinical application of multi-slice spiral CT angiography（MSCTA） in the assessment of abdominal aortic disease. Methods： Fifty-four patients underwent multi-slice spiral CT angiography o...Objective： To evaluate the clinical application of multi-slice spiral CT angiography（MSCTA） in the assessment of abdominal aortic disease. Methods： Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent （Omnipaque 300 I g/L） 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique, Tll level abdominal aorta was set as the target vessel and the threshold was 180-200Hu, slice width was 3mm and with a pitch of 4-6. Original data were transferred to working-station to perform functional reconstruction. Results： Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms （Debakay type Ⅲ） and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rapture site of abdominal aorta intima and mural thrombus. Conelusion： MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.展开更多
BACKGROUND The aim of this study was to define clinical evidence supporting that triple ruleout computed tomography angiography(TRO CTA)is a comprehensive and feasible diagnostic tool in patients with novel coronaviru...BACKGROUND The aim of this study was to define clinical evidence supporting that triple ruleout computed tomography angiography(TRO CTA)is a comprehensive and feasible diagnostic tool in patients with novel coronavirus disease 2019(COVID-19)who were admitted to the emergency department(ED)for acute chest pain.Optimizing diagnostic imaging strategies in COVID-19 related thromboembolic events,will help for rapid and noninvasive diagnoses and results will be effective for patients and healthcare systems in all aspects.AIM To define clinical evidence supporting that TRO CTA is a comprehensive and feasible diagnostic tool in COVID-19 patients who were admitted to the ED for acute chest pain,and to assess outcomes of optimizing diagnostic imaging strategies,particularly TRO CTA use,in COVID-19 related thromboembolic events.METHODS TRO CTA images were evaluated for the presence of coronary artery disease,pulmonary thromboembolism(PTE),or acute aortic syndromes.Statistical analyses were used for evaluation of significant association between the variables.A two tailed P-value<0.05 was considered statistically significant.RESULTS Fifty-three patients were included into the study.In 31 patients(65.9%),there was not any pathology,while PTE was diagnosed in 11 patients.There was no significant relationship between the rates of pathology on CTA and history of hypertension.On the other hand,the diabetes mellitus rate was much higher in the acute coronary syndrome group,particularly in the PTE group(8/31=25.8%vs 6/16=37.5%,P=0.001).The rate of dyslipidemia was significantly higher in the group with pathology on CTA while compared to those without pathology apart from imaging findings of the pneumonia group(62.5%vs 38.7%,P<0.001).Smoking history rates were similar in the groups.Platelets,D-dimer,fibrinogen,C-reactive protein,and erythrocyte sedimentation rate values were higher in COVID-19 cases with additional pathologies.CONCLUSION TRO CTA is an effective imaging method in evaluation of all thoracic vascular systems at once and gives accurate results in COVID-19 patients.展开更多
Patients with Crohn's disease may develop an abdominal or pelvic abscess during the course of their illness.This process results from transmural in ammation and penetration of the bowel wall,which in turn leads to...Patients with Crohn's disease may develop an abdominal or pelvic abscess during the course of their illness.This process results from transmural in ammation and penetration of the bowel wall,which in turn leads to a contained perforation and subsequent abscess formation.Management of patients with Crohn's related intra-abdominal and pelvic abscesses is challenging and requires the expertise of multiple specialties working in concert.Treatment usually consists of percutaneous abscess drainage(PAD)under guidance of computed tomography in addition to antibiotics.PAD allows for drainage of infection and avoidance of a two-stage surgical procedure in most cases.It is unclear if PAD can be considered a definitive treatment without the need for future surgery.The use of immune suppressive agents such as anti-tumor necrosis factor-α in this setting may be hazardous and their appropriate use is controversial.This article discusses the management of spontaneous abdominal and pelvic abscesses in Crohn's disease.展开更多
It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography(PMCT).This article reported a case of sudden natural death after the complaint of anterior c...It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography(PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification(CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation(MPR) and volume-rendering reconstruction(VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous;the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity(GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.展开更多
Background The abnormalities of coronary arteries, though rare and sometimes benign, may first present clinically as myocardial infarction or sudden death. Multi-detector computed tomography （MDCT） is a non-invasive...Background The abnormalities of coronary arteries, though rare and sometimes benign, may first present clinically as myocardial infarction or sudden death. Multi-detector computed tomography （MDCT） is a non-invasive test that is highly suitable for detecting these anomalies. The study aimed to review the 64-MDCT appearance of the coronary artery anomalies in 66 patients and to discuss the clinical importance of these anomalies.Methods In 6014 consecutive patients examined over 12 months by 64-MDCT for the study of coronary artery disease, 66 were diagnosed for coronary artery anomalies. All patients were symptomatic for one or more of the following diseases： chest pain, dyspnoea, palpitations, arrhythmia and myocardial infarction. Nine patients had undergone a coronary angiography. All the CT images were evaluated by two radiologists and one cardiologist. The right coronary artery （RCA） and the conus branch arising separately, myocardial bridging and duplication of arteries were not analysed in our study.Results The incidence of coronary artery anomalies found in our study group was 1.097%. In the selected patients, seven different types of coronary anomalies were found by 64-MDCT examination. The high takeoff, origin of the coronary artery from the opposite or noncoronary sinus with an anomalous course, and coronary artery fistula were the three common forms of anomalies （n=16, 18 and 16, respectively）. Compared with the results of the coronary angiography, the number of the drainage sites of two coronary artery fistula was less in MDCT images （3 small sites in total）. In all cases, coronary artery computed tomography angiography （CTA） technique was able to recognize the origin of the coronary artery, its three-dimensional course and its spatial relationship with the adjacent structures. Conventional coronary angiography in two cases, however, was unable to provide sufficient information for correct and complete diagnosis.Conclusions In conclusion, the study showed that 64-MDCT, especially the volume rendering technique （VRT）, may be useful for the assessment of complex variations, even if the conventional angiography may not be sufficient. It may be considered as the first-choice imaging modality when an anomalous coronary artery is suspected.展开更多
文摘Objective： To evaluate the clinical application of multi-slice spiral CT angiography（MSCTA） in the assessment of abdominal aortic disease. Methods： Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent （Omnipaque 300 I g/L） 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique, Tll level abdominal aorta was set as the target vessel and the threshold was 180-200Hu, slice width was 3mm and with a pitch of 4-6. Original data were transferred to working-station to perform functional reconstruction. Results： Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms （Debakay type Ⅲ） and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rapture site of abdominal aorta intima and mural thrombus. Conelusion： MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.
文摘BACKGROUND The aim of this study was to define clinical evidence supporting that triple ruleout computed tomography angiography(TRO CTA)is a comprehensive and feasible diagnostic tool in patients with novel coronavirus disease 2019(COVID-19)who were admitted to the emergency department(ED)for acute chest pain.Optimizing diagnostic imaging strategies in COVID-19 related thromboembolic events,will help for rapid and noninvasive diagnoses and results will be effective for patients and healthcare systems in all aspects.AIM To define clinical evidence supporting that TRO CTA is a comprehensive and feasible diagnostic tool in COVID-19 patients who were admitted to the ED for acute chest pain,and to assess outcomes of optimizing diagnostic imaging strategies,particularly TRO CTA use,in COVID-19 related thromboembolic events.METHODS TRO CTA images were evaluated for the presence of coronary artery disease,pulmonary thromboembolism(PTE),or acute aortic syndromes.Statistical analyses were used for evaluation of significant association between the variables.A two tailed P-value<0.05 was considered statistically significant.RESULTS Fifty-three patients were included into the study.In 31 patients(65.9%),there was not any pathology,while PTE was diagnosed in 11 patients.There was no significant relationship between the rates of pathology on CTA and history of hypertension.On the other hand,the diabetes mellitus rate was much higher in the acute coronary syndrome group,particularly in the PTE group(8/31=25.8%vs 6/16=37.5%,P=0.001).The rate of dyslipidemia was significantly higher in the group with pathology on CTA while compared to those without pathology apart from imaging findings of the pneumonia group(62.5%vs 38.7%,P<0.001).Smoking history rates were similar in the groups.Platelets,D-dimer,fibrinogen,C-reactive protein,and erythrocyte sedimentation rate values were higher in COVID-19 cases with additional pathologies.CONCLUSION TRO CTA is an effective imaging method in evaluation of all thoracic vascular systems at once and gives accurate results in COVID-19 patients.
文摘Patients with Crohn's disease may develop an abdominal or pelvic abscess during the course of their illness.This process results from transmural in ammation and penetration of the bowel wall,which in turn leads to a contained perforation and subsequent abscess formation.Management of patients with Crohn's related intra-abdominal and pelvic abscesses is challenging and requires the expertise of multiple specialties working in concert.Treatment usually consists of percutaneous abscess drainage(PAD)under guidance of computed tomography in addition to antibiotics.PAD allows for drainage of infection and avoidance of a two-stage surgical procedure in most cases.It is unclear if PAD can be considered a definitive treatment without the need for future surgery.The use of immune suppressive agents such as anti-tumor necrosis factor-α in this setting may be hazardous and their appropriate use is controversial.This article discusses the management of spontaneous abdominal and pelvic abscesses in Crohn's disease.
基金This study was funded Natural Science Foundation would like to thank Prof. technical assistance, who Huadong Hospital, Shangh by the Council of National of China （GY2012-1）. We ZHANG Guo-zhen for his works in the CT room of ai, China.
文摘It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography(PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification(CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation(MPR) and volume-rendering reconstruction(VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous;the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity(GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.
文摘Background The abnormalities of coronary arteries, though rare and sometimes benign, may first present clinically as myocardial infarction or sudden death. Multi-detector computed tomography （MDCT） is a non-invasive test that is highly suitable for detecting these anomalies. The study aimed to review the 64-MDCT appearance of the coronary artery anomalies in 66 patients and to discuss the clinical importance of these anomalies.Methods In 6014 consecutive patients examined over 12 months by 64-MDCT for the study of coronary artery disease, 66 were diagnosed for coronary artery anomalies. All patients were symptomatic for one or more of the following diseases： chest pain, dyspnoea, palpitations, arrhythmia and myocardial infarction. Nine patients had undergone a coronary angiography. All the CT images were evaluated by two radiologists and one cardiologist. The right coronary artery （RCA） and the conus branch arising separately, myocardial bridging and duplication of arteries were not analysed in our study.Results The incidence of coronary artery anomalies found in our study group was 1.097%. In the selected patients, seven different types of coronary anomalies were found by 64-MDCT examination. The high takeoff, origin of the coronary artery from the opposite or noncoronary sinus with an anomalous course, and coronary artery fistula were the three common forms of anomalies （n=16, 18 and 16, respectively）. Compared with the results of the coronary angiography, the number of the drainage sites of two coronary artery fistula was less in MDCT images （3 small sites in total）. In all cases, coronary artery computed tomography angiography （CTA） technique was able to recognize the origin of the coronary artery, its three-dimensional course and its spatial relationship with the adjacent structures. Conventional coronary angiography in two cases, however, was unable to provide sufficient information for correct and complete diagnosis.Conclusions In conclusion, the study showed that 64-MDCT, especially the volume rendering technique （VRT）, may be useful for the assessment of complex variations, even if the conventional angiography may not be sufficient. It may be considered as the first-choice imaging modality when an anomalous coronary artery is suspected.
