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Segmental radiofrequency ablation of pulmonary vein ostia for patients with refractory paroxysmal atrial fibrillation using multi-slice spiral computed tomography guidance 被引量:6
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作者 JIANG Chen-yang(蒋晨阳) +7 位作者 WANG Jian-an(王建安) HE Hong(何红) SUN Yong(孙勇) ZHOU Bin-quan(周斌全) 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2005年第12期1153-1156,共4页
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 ... 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. 展开更多
关键词 Atrial fibrillation Pulmonary vein Radiofrequency ablation multi-slice spiral computed tomography
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Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps,and gastric stromal tumor risk stratification assessment 被引量:5
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作者 Xiao-Long Li Peng-Fei Han +2 位作者 Wei Wang Li-Wei Shao Ying-Wei Wang 《World Journal of Gastrointestinal Oncology》 SCIE 2022年第10期2004-2013,共10页
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 t... 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. 展开更多
关键词 multi-slice spiral computed tomography Differential diagnosis Gastric stromal tumor Benign gastric polyps Risk stratification
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Multi-slice spiral computed tomography in diagnosing unstable pelvic fractures in elderly and effect of less invasive stabilization 被引量:5
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作者 Jian-Guo Huang Zhi-Yuan Zhang +2 位作者 Liang Li Guang-Bao Liu Xiong Li 《World Journal of Clinical Cases》 SCIE 2022年第14期4470-4479,共10页
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 c... 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. 展开更多
关键词 multi-slice spiral computed tomography Three-dimensional reconstruction Unstable pelvic fracture Minimally invasive internal fixation Diagnostic value
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Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection 被引量:2
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作者 Jian-Jun Yin Xiao Hu +1 位作者 Sen Hu Guo-Hong Sheng 《World Journal of Gastrointestinal Oncology》 SCIE 2023年第9期1636-1643,共8页
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 enha... 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. 展开更多
关键词 computed tomography Early gastric cancer Gastric cancer multi-slice spiral computed tomography
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Portal vein computed tomography imaging characteristics and their relationship with bleeding risk in patients with liver cirrhosis undergoing interventional therapy 被引量:3
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作者 Xue-Jing Song Jing-Lei Liu +1 位作者 Shu-Ya Jia Kai Zhang 《World Journal of Clinical Cases》 SCIE 2023年第18期4277-4286,共10页
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 ... 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. 展开更多
关键词 multi-slice spiral computed tomography PERFUSION CIRRHOSIS Portal hypertension Upper gastrointestinal bleeding Predictive value
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Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers
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作者 Gitsios Gitsioudis Hugo A Katus Grigorios Korosoglou 《World Journal of Cardiology》 CAS 2014年第7期663-670,共8页
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 ang... 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. 展开更多
关键词 ATHEROSCLEROTIC PLAQUE composition Quantification analysis multi-slice CARDIAC computed tomography Biomarkers
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Validation of a novel imaging approach using multi-slice CT and cone-beam CT to follow-up on condylar remodeling after bimaxillary surgery 被引量:7
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作者 laura ferreira pinheiro nicolielo jeroen van dessel +5 位作者 eman shaheen carolina letelier marina codari constantinus politis ivo lambrichts reinhilde jacobs 《International Journal of Oral Science》 SCIE CAS CSCD 2017年第3期139-144,共6页
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 postopera... 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. 展开更多
关键词 condylar resorption Cone-beam computed tomography mandibular condyle multi-slice computed tomography three-dimensional imaging
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Animal experiments and clinical application of CT during percutaneous splenoportography 被引量:2
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作者 ZHANG Xue Lin, QIU Shi Jun, CHANG Ren Min and ZOU Chang Jing 《World Journal of Gastroenterology》 SCIE CAS CSCD 1998年第3期34-38,共5页
AnimalexperimentsandclinicalapplicationofCTduringpercutaneoussplenoportographyZHANGXueLin,QIUShiJun,CHANGR... AnimalexperimentsandclinicalapplicationofCTduringpercutaneoussplenoportographyZHANGXueLin,QIUShiJun,CHANGRenMinandZOUChang... 展开更多
关键词 portography tomography X-ray computed animals laboratory liver neoplasms/radiography
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Enhancement characteristics of the hepatic parenchyma in CT scanning during splenoportography
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作者 赵修义 张雪林 +2 位作者 郑卫权 王劲 文戈 《Journal of Medical Colleges of PLA(China)》 CAS 2002年第2期125-128,共4页
Objective: To evaluate the enhancement characteristics of the hepatic parenchyma during scanning with computed tomography (CT) during splenoportography (CTSP). Methods: Thirty patients refferred for CTSP were included... Objective: To evaluate the enhancement characteristics of the hepatic parenchyma during scanning with computed tomography (CT) during splenoportography (CTSP). Methods: Thirty patients refferred for CTSP were included in the study. Attenuation was measured at different time after contrast medium injection, and time-attenuation curves were created. Enhancement characteristics were evaluated, and the parenchyma-to-tumor difference of attenuation were compared. Results: CTSP led to high parenchymal enhancement. The highest enhancement value in the left lobe was (218. 0±53. 2) Hu and (246. 0±60. 2) Hu in the right lobe. The difference between the right and left lobes was statistically significant (P<0. 05); The parenchyma-to-tumor difference of (65. 3±25. 6) Hu was observed during scanning after injection. Conclusion: The high levels of liver parenchymal enhancement and parenchyma-to-lesion contrast can be achieved within the scanning time with CTSP. 展开更多
关键词 portal veins portography tomography! X-ray computed liver neoplasms
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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 被引量:13
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作者 丛也彤 亓波 +2 位作者 金龙哲 张宏 刘雅文 《中国老年学杂志》 CAS CSCD 北大核心 2009年第19期2446-2448,共3页
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)... 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。 展开更多
关键词 多层螺旋计算机体层摄影术(multi-slice SPIRAL computed tomography MSCT) 冠状动脉 白细胞介素-6 肿瘤坏死因子-α 斑块 稳定性
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多层螺旋CT及其门静脉造影在TIPS联合胃冠状静脉栓塞术前应用价值 被引量:18
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作者 李松蔚 张捷 +6 位作者 闫东 王家平 孙勇 童玉云 李琳 谢雯钰 李迎春 《介入放射学杂志》 CSCD 北大核心 2015年第6期476-480,共5页
目的探讨多层螺旋CT(MSCT)及多层螺旋CT门静脉造影(MSCTP)在经颈静脉肝内门体分流(TIPS)联合胃冠状静脉栓塞(GCVE)术前应用的价值。方法对126例肝硬化门静脉高压伴发食管胃底静脉曲张破裂出血或顽固性腹水拟行TIPS联合GCVE患者,术前行M... 目的探讨多层螺旋CT(MSCT)及多层螺旋CT门静脉造影(MSCTP)在经颈静脉肝内门体分流(TIPS)联合胃冠状静脉栓塞(GCVE)术前应用的价值。方法对126例肝硬化门静脉高压伴发食管胃底静脉曲张破裂出血或顽固性腹水拟行TIPS联合GCVE患者,术前行MSCT及MSCTP检查。采用最大密度投影(MIP)、多平面重组(MPR)、遮蔽表面显示(SSD)和容积再现(VR)等后处理技术全面了解肝脏情况。结果 MSCT及MSCTP能清晰显示肝硬化肝脏形态变化、肝静脉与门静脉空间位置关系、门静脉侧支循环开放程度和范围以及腹水等情况,为TIPS联合GCVE术前评估提供了重要的解剖信息。结论 MSCT及MSCTP是无创性检查并明确诊断肝硬化门脉高压症的可靠方法,对TIPS联合GCVE术中准确引导门静脉穿刺及曲张静脉栓塞治疗具有重要指导意义。 展开更多
关键词 肝硬化 颈静脉肝内门体分流术 多层螺旋CT 多层螺旋CT门静脉造影
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螺旋CT门静脉成像评价门脉高压的价值 被引量:14
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作者 吴东 周康荣 +3 位作者 陈祖望 陈锦 陈惠明 陈刚 《临床放射学杂志》 CSCD 北大核心 2001年第10期767-770,共4页
目的 评价螺旋 CT门静脉成像 (SCTP)显示门静脉高压的价值。材料与方法  5 1例患者分别进行了 SCTP和常规门静脉造影 ,间隔时间 0~ 3天。其中 42例为肝癌患者伴或不伴门静脉高压 ,9例为单纯肝硬化伴门静脉高压患者。分析 SCTP图像上... 目的 评价螺旋 CT门静脉成像 (SCTP)显示门静脉高压的价值。材料与方法  5 1例患者分别进行了 SCTP和常规门静脉造影 ,间隔时间 0~ 3天。其中 42例为肝癌患者伴或不伴门静脉高压 ,9例为单纯肝硬化伴门静脉高压患者。分析 SCTP图像上门静脉主干及左、右分支的开放性 ;侧支循环发生的部位和分布范围 ,结果与常规门静脉造影 (直接和间接法 )相对照 ,评价两者的符合情况。结果 在 5 1例患者共 15 3支门静脉主干和左、右分支中 ,SCTP显示 10 7支通畅中的 10 4支 ,46支充盈缺损、闭塞中的 44支 ,总符合率为 96 .7% (148/ 15 3)。除 1例冠状静脉曲张及 1例脐静脉开放未显示外 ,SCTP清楚显影其余侧支血管 ,总符合率为95 .3% (41/ 43)。结论  SCTP与常规门静脉造影诊断符合率高 ,能准确显示门静脉开放性和门静脉高压侧支循环分布情况 。 展开更多
关键词 门静脉造影术 门脉高压 螺旋CT 诊断
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超声和CT门静脉成像显示胆道闭锁婴幼儿活体肝移植术前门静脉通畅性的对比观察 被引量:5
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作者 顾莉红 李凤华 +4 位作者 方华 杜晶 李萍 朱彩霞 唐韵 《中国医学影像技术》 CSCD 北大核心 2009年第8期1440-1442,共3页
目的比较超声与螺旋CT门静脉成像(SCTP)在评价胆道闭锁婴幼儿活体肝移植术前门静脉通畅性中的应用价值。方法对15例胆道闭锁患儿活体肝移植术前行超声和SCTP检查,超声观察门静脉管腔、管径、血流速度和方向及流速曲线形态,SCTP观察门静... 目的比较超声与螺旋CT门静脉成像(SCTP)在评价胆道闭锁婴幼儿活体肝移植术前门静脉通畅性中的应用价值。方法对15例胆道闭锁患儿活体肝移植术前行超声和SCTP检查,超声观察门静脉管腔、管径、血流速度和方向及流速曲线形态,SCTP观察门静脉管腔、管径,并以术中解剖结果作为诊断标准,比较两者评估门静脉通畅性的准确性。结果15例患儿术前超声检查示门静脉管腔均通畅,管径平均为(4.37±0.76)mm(3.10~6.10mm);最大流速平均为(22.99±4.71)cm/s(16.40~32.60cm/s);血流方向向肝5例(33.33%),流速曲线形态为持续性单相带状,血流方向离肝10例(66.67%),流速曲线形态为规律的反相类动脉样改变。SCTP示门静脉管腔通畅9例,门静脉栓塞6例,管径平均为(4.14±0.78)mm(3.20~5.30mm)。术中证实门静脉管腔均通畅。超声与SCTP诊断门静脉通畅性的准确性分别为100.00%(15/15)和60.00%(9/15),两种检查方法的准确性差异有统计学意义(P<0.05)。结论超声对胆道闭锁婴幼儿术前门静脉通畅性评估的准确性明显高于SCTP,并且能进一步提供门静脉血流动力学方面的信息。 展开更多
关键词 超声检查 门静脉成像 肝移植 婴幼儿 体层摄影术 X线计算机
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动脉门脉造影CT(CTAP)研究肝癌门脉供血的初探 被引量:12
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作者 曾蒙苏 周康荣 +1 位作者 颜志平 马曾辰 《临床放射学杂志》 CSCD 北大核心 1996年第2期90-93,共4页
目的:动脉门脉造影CT(CTAP)技术能够在门静脉期观察肝恶性肿瘤在CT图上增强变化以及能够清楚显示门静脉4~5级细小分支。本文重点研究CTAP技术在活体状态下肝细胞癌和转移性肝癌门脉供血的情况。材料与方法:本组41... 目的:动脉门脉造影CT(CTAP)技术能够在门静脉期观察肝恶性肿瘤在CT图上增强变化以及能够清楚显示门静脉4~5级细小分支。本文重点研究CTAP技术在活体状态下肝细胞癌和转移性肝癌门脉供血的情况。材料与方法:本组41个患者作了CTAP检查,男31例,女10例,年龄23~75岁。36例为病理证实或临床多种影像诊断技术和甲胎蛋白阳性综合诊断是肝细胞癌,5例为转移性肝癌。CTAP共发现大小肿瘤72个,其中48个肿瘤直径≤3.0cm,24个肿瘤直径>3.0cm。结果:CTAP图上共发现6个肿瘤有门脉参与供血,其中5个肿瘤为肝细胞癌,1个为转移性肝癌。肿瘤最大直径8.2cm,最小为2.0cm,平均3.7cm。CTAP图上肿瘤有门脉参与供血的表现:(1)细小门静脉分支进入部分肿瘤边缘;(2)肿瘤病灶全部或周边部有明显强化呈高密度影。结论:本研究揭示活体状态下有少部分肝细胞癌和转移性肝癌的部分肿瘤细胞有门脉参与供血。作者认为CTAP技术能够在活体状态下研究肝恶性肿瘤的门脉供血提供了一种手段。 展开更多
关键词 动脉造影 CT 细胞癌 门脉供血 肝肿瘤
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低管电压联合低剂量对比剂扫描方案用于MSCT门静脉成像 被引量:6
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作者 王道才 刘凯 +7 位作者 林令博 韩梅 孔祥荣 段艳华 李春卫 张翼 柳澄 王锡明 《中国介入影像与治疗学》 CSCD 2014年第10期684-687,共4页
目的探讨低管电压联合低对比剂扫描方案用于MSCT门静脉成像(MSCTP)的可行性。方法纳入接受MSCTP、体质量指数<25kg/m2的患者118例,随机分为两组:双低组(n=59),管电压90kVp,管电流395mAs,对比剂用量1.2ml/kg体质量;常规组,管电压120k... 目的探讨低管电压联合低对比剂扫描方案用于MSCT门静脉成像(MSCTP)的可行性。方法纳入接受MSCTP、体质量指数<25kg/m2的患者118例,随机分为两组:双低组(n=59),管电压90kVp,管电流395mAs,对比剂用量1.2ml/kg体质量;常规组,管电压120kVp,管电流200mAs,对比剂用量1.5ml/kg体质量。比较两组门静脉期图像质量评分、肝实质CT值(CTH)、门静脉CT值(CTP)、图像噪声(SD),肝实质SNR(SNRH)、门静脉与肝实质CNR(CNRP)及有效剂量(ED)差异。结果双低组图像质量评分(4.53±0.32)高于常规组(3.71±0.32,P<0.05);双低组CTH[(101.11±16.65)HU]、CTP[(186.94±29.29)HU]、SNRH(6.92±2.28)和CNRP(5.71±2.00)均明显高于常规组[CTH:(83.61±13.94)HU,CTP:(141.85±26.89)HU,SNRH:6.05±1.58,CNRP:4.23±1.65;P均<0.05],两组图像SD差异无统计学意义[(16.32±9.21)HU vs(14.33±2.32)HU,P>0.05];双低组ED[(3.81±0.44)mSv]明显低于常规组[(5.77±0.52)mSv,P<0.05)。结论采用低管电压结合低剂量对比剂扫描方案进行MSCTP可提高图像质量,并降低辐射剂量。 展开更多
关键词 体层摄影术 X线计算机 门静脉造影术 辐射剂量 对比剂
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经肠系膜上动脉行门静脉血管成像及CT灌注成像评价肝转移癌血供 被引量:13
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作者 时高峰 王琦 +3 位作者 李志岗 王士杰 杜煜 王亚宁 《癌症》 SCIE CAS CSCD 北大核心 2007年第11期1257-1262,共6页
背景与目的:肝转移癌的血供来源关系到血管介入治疗的给药途径和栓塞靶血管的选择。本研究探讨经肠系膜上动脉(superior mesenterica arterial,SMA)CT门静脉血管造影(CT arterial portography,CTAP)和多层螺旋CT灌注成像方法两种技术相... 背景与目的:肝转移癌的血供来源关系到血管介入治疗的给药途径和栓塞靶血管的选择。本研究探讨经肠系膜上动脉(superior mesenterica arterial,SMA)CT门静脉血管造影(CT arterial portography,CTAP)和多层螺旋CT灌注成像方法两种技术相结合评价肝转移癌的血供来源。方法:选取20例肝转移癌患者,采用经肠系膜上动脉间接门静脉血管造影(CTAP)及肝脏单纯门静脉灌注成像,观察血管走行与肿瘤的关系,通过时间密度曲线判断20例患者的33个转移灶肿瘤强化前后CT值变化特点,同时使用单血供灌注软件测量转移灶及瘤周正常肝组织的血流量(blood flow,BF)、血容量(blood volume,BV)、平均通过时间(mean transit time,MTT)、毛细血管表面通透性(capillary vessel permeability surface,PS),并进行统计学分析。结果:33个结节直径0.8~3.5cm,所有病灶通过时间-密度曲线观察强化后CT值增量均不超过10Hu。经SMA注射造影剂后肝内肿块内部无肿瘤血管。以门静脉作为单血供肝脏灌注扫描后得到肝内转移灶及瘤周正常肝组织各项灌注参数值,转移癌组织的BF、BV、MTT、PS的平均值分别为(17.15±11.38)ml·min-1·100ml-1、(1.62±0.97)ml·100g-1、(9.47±2.78)s、(3.97±3.44)ml·min-1·100ml-1。33个转移癌的BF值均小于30ml·min-1·100ml-1。瘤周正常肝组织的BF、BV、MTT、PS的平均值分别为(133.43±67.17)ml·min-1·100ml-1、(16.56±11.15)ml·100g-1、(9.52±2.84)s、(35.16±14.03)ml·min-1·100ml-1。其中BF、BV和PS两者之间差异有显著性(P值均<0.001),MTT两者比较差异无显著性(P=0.96)。结论:经肠系膜上动脉动脉插管门静脉造影CT灌注成像可以准确测量纯门静脉血流量。门静脉未参与肝转移癌的血液供应,肝转移癌主要由肝动脉供血。 展开更多
关键词 肝肿瘤/继发性 灌注 体层摄影 X线计算机 肠系膜上动脉 门静脉 CT血管成像 血供
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双能CT非线性融合技术提高门静脉血管图像质量 被引量:17
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作者 王琦 刘响 +1 位作者 王丽佳 时高峰 《中国医学影像学杂志》 CSCD 北大核心 2014年第6期427-430,共4页
目的 探讨双能CT非线性融合技术在提高肝门静脉三维图像质量中的应用价值。资料与方法 回顾性分析50例行肝脏双能CT增强扫描患者的图像,通过调整非线性融合技术的参数值Blending Width和Blending Center获得高对比噪声比的门静脉期图像... 目的 探讨双能CT非线性融合技术在提高肝门静脉三维图像质量中的应用价值。资料与方法 回顾性分析50例行肝脏双能CT增强扫描患者的图像,通过调整非线性融合技术的参数值Blending Width和Blending Center获得高对比噪声比的门静脉期图像,比较融合系数0.5和非线性融合图像的对比噪声比及三维门静脉成像情况。结果 当Blending Center设定为门静脉与肝实质的平均值、Blending Width设定为0~40 Hu时,门静脉CT血管成像的图像对比噪声比清晰、质量好。与融合系数0.5的图像比较,非线性融合图像的门静脉CT值、门静脉与肝实质的CT值差值及图像的对比噪声比均明显提高(t=15.83、16.99、12.37,P〈0.001)。结论 非线性融合技术可以在不增加扫描期相的前提下提高门静脉CT成像的质量。 展开更多
关键词 放射摄影术 双能扫描投影 体层摄影术 X线计算机 门静脉造影术 信噪比
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64层螺旋CT门静脉造影在显示肝硬化门静脉高压侧支循环中的价值 被引量:10
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作者 李大勇 郭应林 +5 位作者 李大庆 陆海波 黄亚华 姜慧杰 李金平 王金娥 《中国医学影像学杂志》 CSCD 北大核心 2010年第4期343-347,共5页
目的:评价64层螺旋CT门静脉造影对肝硬化门静脉高压侧支循环显示的价值。材料和方法:肝硬化患者28例,采用64层螺旋CT行动脉期、门脉期及平衡期扫描后,运用容积重建法(VR)、多层面重建法(MPR)和最大密度投影法(MIP)对门静脉及其分支进行... 目的:评价64层螺旋CT门静脉造影对肝硬化门静脉高压侧支循环显示的价值。材料和方法:肝硬化患者28例,采用64层螺旋CT行动脉期、门脉期及平衡期扫描后,运用容积重建法(VR)、多层面重建法(MPR)和最大密度投影法(MIP)对门静脉及其分支进行重建,观察门静脉高压肝内门静脉、属支及侧支循环的影像学特征。结果:64层螺旋CT门静脉造影能准确显示侧支循环分布范围,初步评估病变程度;门静脉高压时,门静脉属支管径显著扩张(门静脉主干、脾静脉、肠系膜上静脉、胃冠状静脉)。胃冠状静脉曲张24例、食管胃底静脉曲张21例、食管周围静脉曲张17例、胃短静脉曲张10例、脾/胃-肾分流6例、脐静脉和腹壁静脉曲张5例、腹膜后静脉曲张2例和直肠上静脉曲张2例,门静脉海绵状变性1例。结论:64层螺旋CT门静脉造影能够多角度、准确地显示门静脉高压时侧支循环开放的情况,对判断病变程度、预测其并发症、选择治疗方案具有重要意义。 展开更多
关键词 高血压 门静脉 体层摄影术 螺旋计算机 门静脉造影术 侧支循环
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SCTAP对肝癌检测和治疗的临床应用价值 被引量:5
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作者 曹觉 李海平 +6 位作者 彭光春 王志明 龙学颖 陈友良 李乔秀 谢江平 简明 《医学影像学杂志》 2001年第4期214-217,共4页
目的 :评价螺旋CT经动脉门静脉造影 (SCTAP)对肝癌的检测和治疗的临床应用价值。方法 :比较 2 3例肝局灶性病变采用SCTAP、常规CT、DSA显示病灶个数的差异性 ,分析肝局灶性病变SCTAP影像学征象。结果 :SCTAP较常规CT及DSA对显示小于 30 ... 目的 :评价螺旋CT经动脉门静脉造影 (SCTAP)对肝癌的检测和治疗的临床应用价值。方法 :比较 2 3例肝局灶性病变采用SCTAP、常规CT、DSA显示病灶个数的差异性 ,分析肝局灶性病变SCTAP影像学征象。结果 :SCTAP较常规CT及DSA对显示小于 30 .0mm病灶数及小于 10 .0mm病灶数差异有高度显著性 (P <0 .0 1)或有显著性 (P <0 .0 5 ) ,而对大于 30 .0mm病灶的显示 ,差异无显著性 (P >0 .0 5 )。病灶周边可有门脉供血而内部无门脉供血是肝癌的特征性表现。SCTAP为肝癌的可切除性判断及介入治疗方案的选择提供了有价值的信息。结论 :SCTAP与常规CT、DSA比较 ,对小肝癌或微小肝癌的检测具有极高的敏感性 ,结合其它影像学手段 ,可明显提高其特异性。对于肝癌治疗方案的选择 ,SCTAP具有较大的临床应用价值。 展开更多
关键词 经动脉门静脉造影 肝肿瘤 X线计算机体层摄影术 诊断 治疗 SCTAP
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多层螺旋CT门静脉成像对门脉高压侧支循环血管的研究 被引量:3
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作者 肖杰 韩萍 +1 位作者 冯敢生 柳曦 《医学影像学杂志》 2006年第1期72-75,共4页
目的:评价多层螺旋CT门静脉成像(MDCTP)在门脉高压侧支循环血管显示中的价值。方法:31例经临床检查确诊的门静脉高压患者行MDCTP检查,采用MIP、MPR、VR等重建技术进行图像后处理,获得门静脉系统及侧支血管图像,两名医师分别判断... 目的:评价多层螺旋CT门静脉成像(MDCTP)在门脉高压侧支循环血管显示中的价值。方法:31例经临床检查确诊的门静脉高压患者行MDCTP检查,采用MIP、MPR、VR等重建技术进行图像后处理,获得门静脉系统及侧支血管图像,两名医师分别判断侧支血管显示情况。结果:MDCTP不仅显示肝内门静脉3—4级分支,还显示了整个门脉侧支血管系统。31例患者中,胃左静脉曲张28例,食管或食管旁静脉曲张27例,脾静脉曲张21例,胃短/胃后静脉曲张7例,脾一肾分流血管1例,脐静脉曲张伴腹壁静脉曲张2例,门静脉栓塞4例,肠系膜上静脉血管闭塞2例。结论:MDCTP能显示门静脉高压侧支血管开放的部位、范围及程度,有助于对门脉高压患者治疗方案的选择,是一种有重要临床价值的无创性门脉检查方法。 展开更多
关键词 体层摄影术 X线计算机 门脉高压 侧支循环 门脉造影术
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