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.

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.

Multi-slice computerized tomography critical role in transcatheter aortic valve implantation plan: Review of current literature

Transcatheter aortic valve implantation(TAVI) has been shown in improve outcome of severe aortic stenosis(AS) patients, deemed surgical high-risk or inoperable, and has grown popular in the past decade. The procedure requires accurate prior planning, and demands an integration of a "Heart Team" consisted from cardiac surgeons, interventional cardiologists, and imaging experts. The role of cardiac imaging and especially multi-slice computerized tomography(MSCT) has been a mainstay of pre-evaluation of severe AS patients that allows to accurately depict and size the cardiac and vascular structures, and has become the primary tool for procedural planning. This article is aimed to evaluate current uses of MSCT in severe AS patients undergoing TAVI, delineate the various measurements derived from this modality and review current literature regarding it's advantages over other techniques.

Validation of a novel imaging approach using multi-slice CT and cone-beam CT to follow-up on condylar remodeling after bimaxillary surgery

The main goal of this study was to introduce a novel three-dimensional procedure to objectively quantify both inner and outer condylar remodelling on preoperative multi-slice computed tomography （MSCT） and postoperative cone-beam computed tomography （CBCT） images. Second, the reliability and accuracy of this condylar volume quantification method was assessed. The mandibles of 20 patients （11 female and 9 male） who underwent bimaxillary surgery were semi-automatically extracted from MSCT/CBCT scans and rendered in 3D. The resulting condyles were spatially matched by using an anatomical landmark-based registration procedure. A standardized sphere was created around each condyle, and the condylar bone volume within this selected region of interest was automatically calculated. To investigate the reproducibility of the method, inter- and intra-observer reliability was calculated for assessments made by two experienced radiologists twice five months apart in a set of ten randomly selected patients. To test the accuracy of the bone segmentation, the inner and outer bone structures of one dry mandible, scanned according to the clinical set-up, were compared with the gold standard, micro-CT. Thirty-eight condyles showed a significant （P〈O.05） mean bone volume decrease of 26.4%_ 11.4% （502.9 mm3＋ 268.1 mm3）. No significant effects of side, sex or age were found. Good to excellent （ICC〉 0.6） intra- and inter-observer reliability was observed for both MSCT and CBCT. Moreover, the bone segmentation accuracy was less than one voxel （0.4 mm） for MSCT （0.3 mm __. 0.2 mm） and CBCT （0.4 mm _ 0.3 mm）, thus indicating the clinical potential of this method for objective follow-up in pathological condylar resorption.

Portal vein computed tomography imaging characteristics and their relationship with bleeding risk in patients with liver cirrhosis undergoing interventional therapy

BACKGROUND This study aimed to analyze the predictive value of multi-slice spiral computed tomography(CT)perfusion imaging for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.A total of 62 patients with cirrhotic portal hypertension and 28 healthy individuals were included.The results showed that multi-slice spiral CT perfusion imaging had a significant predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.The vascular area,number of vascular cross-sections,and gastric coronary vein diameter(GCVD)showed high predictive values,with the vascular area having the best predictive value.AIM To investigate the predictive accuracy of multi-slice spiral CT perfusion imaging for upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension.METHODS This study included 62 patients with cirrhotic portal hypertension(disease group)and 28 healthy individuals(control group).The disease group was further divided into two subgroups:Group A(n=27,bleeding)and group B(n=35,no bleeding).All patients underwent multi-slice spiral CT perfusion imaging at our hospital,and we compared various parameters such as liver blood flow,vein size,number of blood vessels,and blood vessel area between the two groups.We employed statistical analysis to identify factors associated with upper gastrointestinal bleeding and created a graph comparing the predictive value of different factors for bleeding.RESULTS We found no difference in hepatic artery(HAP)levels among the three groups(all P>0.05).The portal vein levels in groups A and B were much lower than in the control group;group A was much lower than group B(all P<0.05).The HAP perfusion index levels in groups A and B were much higher than in the control group;group A was much higher than group B(all P<0.05).The portal vein diameter,splenic vein diameter,and GCVD levels in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The number of blood vessels and blood vessel area in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The statistical method showed a strong link between GCVD,number of blood vessels,blood vessel area,and upper gastrointestinal bleeding(odds ratio=1.275,1.346,1.397,P<0.05).The graph showed that GCVD,number of blood vessels,and blood vessel area could predict bleeding well,with blood vessel area having the best prediction power.CONCLUSION That multi-slice spiral CT perfusion imaging can predict upper gastrointestinal bleeding well in patients with cirrhosis and high blood pressure in the portal vein.GCVD,number of blood vessels,and blood vessel area had high prediction power.The blood vessel area had the best prediction power,with an area under the curve of 0.831.

Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers

Chronic inflammatory mechanisms in the arterial wall lead to atherosclerosis,and include endothelial cell damage,inflammation,apoptosis,lipoprotein deposition,calcification and fibrosis.Cardiac computed tomography angiography(CCTA)has been shown to be a promising tool for non-invasive assessment of theses specific compositional and structural changes in coronary arteries.This review focuses on the technical background of CCTA-based quantitative plaque characterization.Furthermore,we discuss the available evidence for CCTA-based plaque characterization and the potential role of CCTA for risk stratification of patients with coronary artery disease.

64排螺旋CT检测冠心病患者冠状动脉斑块分型的分布特点与其血清IL-6、TNF-α含量的相关性

目的通过64排螺旋CT检测各型冠心病中软斑块、混合斑块、钙化斑块的分布,探讨冠脉斑块稳定性与IL-6和TNF-α含量的相关性。方法选择89例住院接受冠脉造影的患者根据临床诊断分为正常对照组、稳定型心绞痛组(SAP)和急性冠脉综合征组(ACS)(不包括急性ST段抬高的心肌梗死)。64排螺旋CT检查后根据斑块性质分为正常对照组、软斑块组、混合斑块组和钙化斑块组,测定血清IL-6和TNF-α。结果①在ACS组软斑块、混合斑块的分布显著高于钙化斑块(P<0.001),而在SAP组钙化斑块的分布显著高于ACS组(P<0.001);②各斑块组平均血清IL-6和TNF-α水平显著高于对照组(P<0.05);软斑块组、混合斑块组平均血清IL-6和TNF-α水平高于钙化斑块组(P<0.05);而于软斑块组和混合斑块组间平均血清IL-6和TNF-α水平比较差异无显著性(P>0.05);③ACS组平均血清IL-6和TNF-α水平显著高于对照组及SAP组(均P<0.01)。结论①64排螺旋CT冠脉造影可较准确地显示冠心病患者病变冠状动脉斑块的性质;②血清IL-6、TNF-α平可较好反映冠心病患者冠状动脉斑块的不稳定性;③64排螺旋CT检测分析斑块在各型冠心病分布特点及IL-6、TNF-α含量分析,可对冠状动脉斑块的稳定性进行评估,对预测心血管事件及危险分级提供有益参考。

64排螺旋CT冠状动脉成像与冠状动脉造影对心肌桥诊断价值的探讨

目的探讨64排螺旋CT血管造影(CTA)与冠状动脉造影(CAG)对心肌桥诊断的应用价值。方法 912例患者先后进行CTA检查和CAG检查,判断有无心肌桥-壁冠状动脉存在,将两者结果进行Kappa检验和配对t检验,判断两者间差异有无统计学意义。结果 CTA发现104例患者共121段存在心肌桥-壁冠状动脉,其中深在型心肌桥-壁冠状动脉42段,浅表型心肌桥-壁冠状动脉79段;而CAG发现97例患者共114段存在心肌桥-壁冠状动脉,其中深在型心肌桥-壁冠状动脉42段,浅表型心肌桥-壁冠状动脉72段。两者相比较,诊断深在型及浅表型心肌桥-壁冠状动脉两者Kappa一致性好(Kappa=1.000、0.877),42段深在型-壁冠状动脉心肌桥长度CTA(11.25±4.20)mm vs CAG(9.56±3.67)mm,壁冠状动脉狭窄程度CTA(50±12)%vs CAG(59±12)%(均P<0.01);72段浅表型-冠状动脉心肌桥长度CTA(7.39±3.02)mm vs CAG(5.54±2.18)mm,壁冠状动脉狭窄程度CTA(31±10)%vs CAG(38±11)%(均P<0.01)。结论 CTA能够诊断各型心肌桥-壁冠状动脉存在以及准确测量心肌桥长度,而测量壁冠状动脉狭窄程度则CAG优于CTA。

腮腺腺淋巴瘤的多层螺旋CT诊断

目的探讨腮腺腺淋巴瘤的多层螺旋CT(MSCT)表现,提高对本病的认识。资料与方法回顾性分析经手术病理证实的16例腮腺腺淋巴瘤患者的临床及CT表现。结果 16例腮腺腺淋巴瘤患者全部为男性吸烟者,16例患者共发现18个肿瘤(其中单侧单发14例,单侧多发1例2个病灶,双侧多发1例2个病灶)。肿瘤居腮腺后下象限13例15个病灶,非后下象限3例3个病灶。肿瘤呈圆形、椭圆形或分叶状软组织肿块,囊实性或实性,边缘光整;增强后表现为动脉期明显强化,CT值>100Hu,平均增加约64Hu,静脉期密度减低。14个肿瘤边缘可见贴边血管影。结论腮腺腺淋巴瘤有一定的影像特点,测量肿瘤动脉期强化后的CT值>100Hu和肿瘤边缘贴边血管影显示对于诊断腮腺腺淋巴瘤具有重要价值。

80kV结合迭代算法进行多层螺旋CT小儿胸部成像可行性

目的：探讨多层螺旋CT（MSCT）低千伏小儿胸部成像的可行性和相关图像质量评价。方法：60位行低千伏胸部扫描的儿童（2个月～9岁，中位数2岁）纳入研究。使用256层CT（PhilipsBrillianceiCT）完成胸部平扫（80kV，10-15mAs），并记录辐射剂量长度乘积（DoseLengthProduct,DLP），计算有效辐射剂量（EffectiveDosage，ED）o所有图像数据采用6组不同的滤波函数进行回顾性重建：A组，滤波反投影（FilteredBackProjection，FBP）＋平滑函数；B组，FBP＋标准函数；C组，FBP＋锐利函数；D组，迭代4（iDose4）＋平滑函数；E组，iDose4＋标准函数；F组，iDose4＋锐利函数。在工作站上分别完成多平面投影重建（Multi．PlanarReformation，MPR）、最小密度投影（MinimumIntensityProjection，MinIP）和容积重建（VolumeRendering，VR），并在左心室最大的横断面测量脂肪、肌肉、降主动脉和肺野的图像噪声值，由两位资深放射科医师共同评价图像质量。结果：迭代图像质量评价优于传统滤波反投射图像，D组在降主动脉横断面上噪声和信噪比与A组相比，分别下降55％、提高69％，DLP为（6．4±2．6）mGy·cm，ED为（0．11±0．04）mSv。结论：80kV结合迭代算法的低剂量MSCT小儿胸部成像是可行的。

MSCT静脉成像在诊断脑静脉窦血栓中的价值

目的探讨MSCT静脉成像(MSCTV)在诊断脑静脉窦血栓中的价值,以期为临床诊断脑静脉窦血栓提供一种更加简单、可靠的检查手段。方法对32例脑静脉窦血栓形成的患者进行38次MSCT双期血管成像(复查6例),即动脉期及静脉期(CTA+CTV),由3位影像科高年资医师对图像进行独立分析,综合一致的意见作为诊断结果,以MRI+MRV和/或DSA结果结合临床最终诊断作为判断诊断准确性的标准。结果横断面增强扫描清晰显示受累的静脉窦内无对比剂充填,窦壁较明显强化,上矢状窦及乙状窦表现为典型的三角形充盈缺损区,即空三角征,横窦及直窦血栓表现为带状充盈缺损区,冠状及矢状位MPR可以很清晰显示病灶。MSCTV图像更能直观地显示窦内充盈缺损区,与MRV或DSA图像完全一致,扩张的脑表面静脉MSCTV也能很好显示,同时可显示脑实质内的静脉性脑水肿和静脉性脑梗死及伴随的出血灶。结论 MSCTV可以清晰显示脑静脉窦血栓的影像特征,且较DSA及MRV简单、易行,可作为临床上可疑病例可靠的影像学检查手段。

原发性肝透明细胞癌的CT及MRI诊断分析

目的：探讨原发性肝透明细胞癌（PCCCL）的CT、MRI表现及其诊断价值。方法选取2008年1月-2013年7月我院经病理证实的PCCCL患者7例，均行CT平扫和双期增强扫描，其中5例另行MRI横断面T2加权像（T2WI）＋脂肪抑制（FS）、扩散加权成像（DWI）、 T1加权像（T1WI）和动态增强扫描。回顾性分析7例患者的CT、MRI表现。结果7例患者中，6例为单发病灶，病灶直径为2.2～4.7cm，平均约3.3cm；1例为多发病灶，最大病灶直径约14.7 cm。 CT平扫：病灶均呈相对低密度改变，6例密度不均匀，其中1例病灶内伴稍高密度出血灶。CT增强扫描：5例病灶动脉期轻度强化，以边缘强化为主，门脉期持续强化，逐步充填改变；其中1例病灶中央同时出现斑片状异常强化，1例出现延迟强化包膜；2例病灶动脉期强化明显，门脉期未见明显扩清。 MRI T1WI：3例病灶呈稍低信号，信号均匀，反相位信号程度均有下降；2例T1 WI病灶信号混杂，内伴斑状高信号，其中1例反相位序列高信号区信号减低。 MRI T2WI：所有病灶呈混杂高信号。 DWI：4例呈高信号，1例呈等信号。 MRI增强扫描：3例病灶动脉期轻度强化，边缘强化明显，门脉期病灶持续强化；2例病灶动脉期强化明显，门脉期强化程度无下降；4例显示延迟强化包膜。结论 PCCCL的影像学表现差异较大，但T1 WI及动态增强的运用仍能表现出一定的特征，为术前正确诊断提供依据。

CT评价跆拳道足部应力对足弓形态的影响

目的观察跆拳道运动员足部应力对足弓形态的影响,为运动损伤康复影像解剖学和人类学提供依据。资料与方法选择10名高水平跆拳道运动员作为跆拳道组,10名普通在校生作为对照组,均为男性。采用64层螺旋CT扫描受试者足部,三维重建后测量足内外侧纵弓角度、高度(足背高、弓高)、高度/长度、内外侧纵弓高度比、前弓角及后弓角。结果与对照组相比,跆拳道组右足(进攻足)外侧纵弓角、内/外侧纵弓高度比均明显增大(P<0.05、P<0.01),外侧纵弓高度、外侧纵弓高度/长度、前弓角和后弓角均明显减小(P<0.01、P<0.001、P<0.01、P<0.01)。两组内侧纵弓角、高度、高度/长度和足背高度均无显著改变(P>0.05),跆拳道组右足与左足之间内、外侧纵弓角、高度、高度/长度及足背高度、前弓角、后弓角、内外侧纵弓高度比均无显著差异(P>0.05)。结论足部长期经受跆拳道运动应力可以使足弓形态发生特异性和适应性改变,表现为外侧足纵弓呈现下降趋势,并有足内翻倾向,以右足(进攻足)最为明显。

64层螺旋CT对肋骨隐匿性骨折的诊断价值

目的探讨64层螺旋CT(MSCT)后处理技术[多平面重建(MPR)、四面重建(CPR)、最大密度投影(MIP)、容积显示法(VR)]对肋骨隐匿性骨折的诊断价值。方法将129例临床上高度怀疑肋骨骨折,经X线片[直接数字化X线摄像系统(DR)]检查阴性或可疑的外伤患者于外伤后2周内均经64层螺旋CT容积扫描,图像拆薄重建,传入随机工作站处理,得到MIP、MPR、CPR及VRT图像。并由2名放射科高年资医师共同阅片,以确定有否骨折。结果 129例患者中124例显示有骨折共207处,阳性率达96.1%(124/129);其中肋软骨骨折14例21处,肋骨骨折110例186处,VR显示肋骨骨折177处。MPR、CPR是诊断隐匿性骨折的主要方法。结论 MSCT后处理技术是诊断肋骨隐匿性骨折有效而可靠的检查手段。

肾上腺节细胞神经瘤的影像学表现

目的探讨肾上腺节细胞神经瘤的影像学表现,以提高该病的诊断准确性。资料与方法回顾性分析15例经手术病理证实的肾上腺节细胞神经瘤的影像特点。结果 15例肾上腺节细胞神经瘤中,11例行CT平扫及增强检查,CT平扫8例呈均匀低密度,3例呈不均匀低密度;7例病灶内可见钙化,以散在点状或小斑块状钙化为主;增强扫描后2例病灶未见明显强化,9例病灶表现为不均匀轻、中度进行性强化,2例增强后可显示包膜。5例行MRI检查,病灶呈稍长T1不均匀长T2信号,反相位无信号减低,DWI呈等低信号,4例增强后呈渐进性轻、中度强化,1例表现为较明显的不均匀团块状强化,4例T2WI及增强后可显示完整包膜。结论肾上腺节细胞神经瘤一般表现为渐进性轻、中度强化,CT可见散在点状钙化,MRI可清晰显示包膜及内部组织成分,二者结合可对大多数病变作出正确的术前诊断。

颅底凹陷症伴寰枢椎脱位手术前后螺旋CT对颈枕区骨性径线测量价值

目的:探讨MSCT对评价成人颅底凹陷症伴寰枢椎脱位手术效果的价值。方法:根据本研究确定入选标准共选取患者37例,所有患者皆来自我院入院患者,经临床确诊为成人颅底凹陷症伴寰枢关节脱位,于我院接受手术治疗,手术前后行影像学检查,分析其MSCT三维重组图像,依据患者是否伴有脊髓空洞,将患者分为2组,A组不伴脊髓空洞,B组伴脊髓空洞。应用测颅法获取BDI、ADI、SAC、CCA、HI、CBL数据。对比手术前后各项指标,分析发生的变化,同时记录手术疗效。应用统计软件进行分析,获得相关结果。结果:A组手术前后BDI、ADI、SAC、CCA、HI、CBL分别为12.6、8.3mm,4.5、3.3mm,18.2、20.8mm,138.3°、150.4°,28.7、43.4mm,6.3、3.3mm,JOA评分手术前后分别为8.87、12.6分。有统计学差异(P<0.05);有效和稳定分别为12例和3例。手术前后JOA评分与各指标显著相关(r值-0.667、-0.673,-0.771、-0.719,0.682、0.625,0.595、0.658,0.787、0.696,-0.647、-0.796;P<0.05)。B组手术前后BDI、ADI、SAC、CCA、HI、CBL分别为12.2、8.6mm,5.9、3.1mm,16.3、17.6mm,136.8°、150.2°,32.3、41.5mm,8.7、4.8mm,JOA评分分别为9.59分、13.59分,有统计学差异(P<0.05)。有效和稳定者分别20例和2例。手术前后JOA评分与各指标有显著相关(r值-0.756、-0.728,-0.651、-0.619,0.684、0.672,0.726、0.695,0.578、0.632,-0.748、-0.821)。结论:MSCT测量有助了解手术前后骨性结构变化,可以用于判断疗效。

多层螺旋CT多平面重组技术在茎突综合征中的诊断价值

目的探讨多层螺旋CT(MSCT)多平面重组(MPR)在茎突测量中的应用及对茎突综合征(SPS)的诊断价值。资料与方法临床确诊的27例SPS患者(54侧)均行64层螺旋CT扫描,采用MPR技术测量茎突的长度、方位角以及茎突与扁桃体的间距,分析茎突与扁桃体间距与茎突长度、方位角之间的相关性。结果茎突长度为2.5～3.0cm者15侧(27.8%),>3.0cm者36侧(66.7%);茎突向内偏斜角<20°者7侧(13.0%),20°～25°者18侧(33.3%),>25°者29侧(53.7%);54侧向前偏斜角均<20°;茎突与扁桃体间距<1.0cm者42侧(77.8%),1.0～1.5cm者9侧(16.7%),>1.5cm者3侧(5.6%)。茎突与扁桃体间距与茎突长度、向内偏斜角均呈负相关(r=-0.743、-0.352,P<0.01),茎突与扁桃体间距与茎突向前偏斜角无显著相关性(r=-0.106,P>0.05)。结论茎突过长(>3.0cm)、茎突向内偏斜角>25°或<20°是诊断SPS的重要影像学依据,茎突与扁桃体间距缩短(<1cm)可作为补充依据。MSCTMPR可作为茎突测量的首选方法。

缺血修饰白蛋白与MSCT联合检查诊断早期冠脉综合征的意义

目的评价缺血修饰白蛋白(ischemia modified albumin,IMA)测定与多层螺旋CT三维成像(three-dimensional imaging of multi-slice spiral computed tomography,MSCT)联合检查诊断早期冠脉综合征的临床价值。方法对78例疑诊早期冠脉综合征患者分别进行MSCT检查、IMA检测及冠状动脉造影检查。以冠状动脉造影结果为标准,分别评价IMA、MSCT单独或联合检查诊断早期冠脉综合征的敏感性与特异性。结果 IMA及MSCT联合诊断早期冠脉综合征的敏感性(94.74%vs.91.23%,P<0.05;94.74%vs.85.97%,P<0.05)、特异性(90.48%vs.71.43%,P<0.05;90.48%vs.76.19%,P<0.05)均高于单项检测,差异有统计学意义。结论 IMA和MSCT联合检测诊断早期冠脉综合征的敏感性和特异性均明显优于单项检测,值得在临床推广。

肝局灶性结节性增生CT动态增强影像学特征(附35例报告)

目的:探讨肝局灶性结节性增生(FNH)的CT影像学特征,提高FNH的诊断能力。方法:通过回顾性分析近7年病理证实的35例FNH患者CT资料,对FNH的CT影像学特征进行总结分析。结果:本资料35例FNH患者中,30例为典型FNH、5例为非典型FNH,总共44枚FNH病灶;3例为肝内多发病灶、32例为孤立结节,32枚孤立结节中有12枚存在中央瘢痕、多发病灶中未发现存在中央瘢痕;44枚病灶在CT动态增强动脉期37枚明显强化,延迟期12枚中央瘢痕有10枚明显强化。结论:FNH的CT动态增强具有特征性表现及央瘢痕在动态增强延迟期明显强化特征,对FNH的诊断具有重大的意义,有助于FNH的诊断。