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.

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.

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.

Spiral CT localization of pancreatic function-ing islet cell tumors

BACKGROUND: Surgeons are always concerned about the localization of pancreatic functioning islet cell tumor. If the tumor is accurately localized before operation, resection of the pancreatic body and tail without intention can be avoided. The purpose of this study was to evaluate spiral CT localization of pancreatic functioning islet cell tumors and CT techniques. METHODS: CT manifestations in 6 patients with clinically and pathologically proved pancreatic functioning islet cell tumors ware analyzed retrospectively. RESULTS: In 4 patients with insulinomas and 2 patients with glucagonomas, 5 were localized accurately by CT be- fore surgery and 1 was detected retrospectively. The en- hancement of tumors was greater than that of normal pan- creas in arterial phase and pancreatic parenchymal phase. Four patients showed mild high-density and 2, iso-density in the portal venous phase. CONCLUSION: Spiral CT multi-phase enhanced scan with 1.5 ml/kg contrast agent and 2-5 mm slice width can loca- lize functioning islet cell tumors accurately.

Arterial phase of biphase enhancement spiral CT in diagnosis of small hepatocellular carcinoma

Objectives: To evaluate the value of the arterial phase(AP) of biphase enhanced spiral CT(SCT) in the di-agnosis of small HCC and to investigate the criteria,initial time, ending time and duration of AP.Methods: From May 1995 to March 1999, patients withsmall HCC proved surgically and pathologically in-cluding 49 patients (n=53) in group A, 148 (n=186) ingroup B and 52 (n=52) in group C were collected.Biphase dynamic enhanced SCT scans were performedin all patients of the three groups and additional sin-gle-level dynamic scans only done in the group C. Thedetectability, diagnostic accuracy of lesions and en-hancement of the lesions in AP were analyzed statisti-cally. In addition, the initial time, ending time andduration of AP were measured.Results: The results of the group A showed the de-tectability of small HCC was 88.68% in AP and90.57% in both phases, higher than those by ultra-sound. Markedly enhanced lesions in AP accounted for76% and 78% in the groups B and C respectively. Theinitial time, ending time and duration of AP measuredon single-level dynamic scans were 16.9s, 39.6s and22.7s on average respectively.Conclusions: The biphase dynamic SCT especially itsarterial phase appears to be very valuable in diagnosingsmall HCCs. In light of short duration of AP, under-standing and strict control of AP is obviously impera-tive.

Clinical Effect of Magnetic Resonance Imaging and 64-slice Spiral CT in the Diagnosis of Ischemic Heart Disease Patients

Objective:To explore the clinical methods and clinical effects of applying magnetic resonance imaging(MRI)and 64・slice spiral computed tomography(CT)in the diagnosis of patients with ischemic heart disease.Methods:100 patients with ischemic heart disease were selected as the research objects.Selecting the patients from May 2020 to May 2021 as a sample,the patients were divided into two groups,and different diagnostic methods were used to compare the clinical diagnosis effects.Results:In terms of the diagnostic accuracy of the two groups of patients,the maximum value was 92.00%(experimental group)and the minimum value was 80.00%(control group).There was a big difference in data between the two groups,P<0.05,which was statistically significant.The patient9s(experimental group)diagnosis accuracy rate is highe Conclusion:In the process of research work for patients with ischemic heart disease,it is particularly important to diagnose the patients.The combined application of and 64-slice spiral CT can improve the clinical diagnosis efficiency and achieve significant results.

Contour reconstruction of three-dimensional spiral CT damage image

In order to improve the diagnosis and analysis ability of 3D spiral CT and to reconstruct the contour of 3D spiral CT damage image,a contour reconstruction method based on sharpening template enhancement for 3D spiral CT damage image is proposed.This method uses the active contour LasSO model to extract the contour feature of the 3D spiral CT damage image and enhances the information by sharpening the template en.hancement technique and makes the noise separation of the 3D spiral CT damage image.The spiral CT image was procesed with ENT,and the statistical shape model of 3D spiral CT damage image was established.The.gradient algorithm is used to decompose the feature to realize the analysis and reconstruction of the contour feature of the 3D spiral CT damage image,so as to improve the adaptive feature matching ability and the ability to locate the abnormal feature points.The simulation results show that in the 3D spiral CT damage image contour reconstruction,the proposed method performs well in the feature matching of the output pixels,shortens the contour reconstruction time by 20/ms,and provides a strong ability to express the image information.The normalized reconstruction error of CES is 30%,which improves the recognition ability of 3D spiral CT damage image,and increases the signal-to noise ratio of peak output by 40 dB over other methods.

Application of imaging postprocessing of spiral CT in the staging of lung cancer

Objective： To evaluate the role of spiral CT imaging postprocessing techniques in preoperative TNM staging of lung cancer. Methods： 106 patients with pathologically confirmed lung cancer received spiral CT examinations with a new revised TNM staging method of lung cancer which was taken as criterion of diagnosis. The images were reconstructed by using different postprocessing techniques such as MPR, MIP, SSD, VR, and their TNM staging capabilities were assessed by using postprocessing imaging and the results with axial CT images were compared. Results： In T staging, the accurate rates of axial CT images in T1-T4 staging were 77.3%, 60.6%, 60.7%, and 60.3% respectively; for postprocessing images, the accurate rates were 86.4%, 90.9%, 89.3%, and 87.0% respectively, In N staging, the accurate rates of axial CT images were 84.6%, 68.1%, 63.6%, and 64.2% in N0-N3 staging, respectively; but they were 92.3%, 90.9%, 90.9%, and 85.7% in postprocessing images, respectively. The postprocessing images were superior to axial CT images in T1-T3 and N1-N3 staging of lung cancer but there were no significant differences in T1 and NO staging. For metastasis, the postprocessing images may be helpful for the TNM staging of lung cancer. Conclusion： The postprocessing techniques of the spiral CT could improve the accurate rates of TNM staging of lung cancer, and represent a useful complement to the axial CT.

Diameters and form of skull base foramen ovale measured by three-dimensional spiral CT thin-slice scan in healthy adults

BACKGROUND： The accurate measurements of various data of the bone diameters of foramen ovale of living person can change the methods of puncturing trigeminal gasserian ganglion via foramen ovale for treating trifacial neuralgia from the experience of puncture operator only to puncture by taking the objective data of measurement as the evidence, which is good for improving the accuracy of puncturing trigeminal ganglion and reducing side effects. OBJECTIVE ： To observe the forms of foramen ovales in healthy adults displayed by volume rendering and multi-planar reconstruction after three-dimensional spiral CT thin-slice scan of skull base, and measure the longitudinal diameter and transverse diameter. DESIGN ： A repetitive observation and measurement SETTINGS ： Department of Neurosurgery and Department of Medical Imaging, Foshan Hospital of Traditional Chinese Medicine. PARTICIPANTS： Fifty healthy adults （100 sides）, who were examined with three-dimensional spiral CT scan, were randomly selected from the Department of Medical Imaging, Foshan Hospital of Traditional Chinese Medicine from January 2005 to January 2006, including 26 males and 24 females, aged 25-68 years with an average of 48 years old. They were all informed and agreed with the examination. METHODS ： The subjects were examined with the Philips 16-slice spiral CT-Mx 8000 IDT CT apparatus （Philips Company, Holland）, the scanning ranged from 2 cm below the canthomeatal line to the level of suprasellar cistem. The width of collimator was 0.75 mm, pitch was 0.663; tube current was 350 mA, voltage was 120 kV, resolution was 512×512 matrix; slice thickness of reconstruction was 1 mm, and interval was 0.5 mm. After the three-dimensional spiral CT thin-slice scan of skull base, the image post-processing techniques including volume rendering and multi-planar reconstruction were applied to observe the forms of foramen ovales, and measure the size, longitudinal diameter and transverse diameter of the foramen ovales. The figures of the foramen ovales were drawn with mouse along the boundary of bone porous margin and soft tissue. According to the indications, the diameters were measured with computer to observe the forms of foramen ovales. MAIN OUTCOME MEASURES ： The longitudinal diameter, transverse diameter and form of foramen ovales were observed. RESULTS： All the 50 healthy adults （100 sides） were involved in the analysis of results. （1） It was observed in the volume rendering images that foramen ovales had four forms of oval shape （77 sides）, kidney shape （12 sides）, round shape （7 sides）, ribbon shape （4 sides）. （2） The longitudinal diameters of left and right foramen ovales were （7.67±1.32） and （7.98±1.45） mm, and the transverse diameters were （4.04±0.83）, （4.09±1.07） mm; There was no obvious difference between left and right longitudinal diameters （t = 1.63, P = 0.11 ）, and left and right transverse diameters were close （t = 0.45, P= 0.65）. CONCLUSION ： The non-invasive techniques of volume rendering and multi-planar reconstruction after three-dimensional spiral CT thin-slice scan can clearly display the formand size of foramen ovale in healthy adults.

Diagnostic Value of Spiral CT Chest Enhanced Scan in Adult with Active Pulmonary Tuberculosis

Aim:To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis.Methods:The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed.All patients underwent conventional chest radiography and spiral CT chest enhanced scan.The number of tuberculosis diagnosis,the detection rate of special site lesions,and the detection rate of active pulmonary tuberculosis signs by the two methods were compared.Results:In 60 patients,the pathological results confirmed the existence of 75 tuberculosis lesions.The detection rate of spiral CT was 98.67%,which was not statistically significant compared with the detection rate of 92.00%(P>0.05)in the conventional chest X-ray.The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%,which was significantly higher than that of conventional chest X-ray of 7.69%,and the accuracy rate of active pulmonary tuberculosis signs was 98.85%higher than that of conventional chest X-ray of 79.31%.P<0.05).The difference was statistically significant(P<0.05).Conclusion:Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography,but also accurately determine active pulmonary tuberculosis in adults,which is of high diagnostic value.

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.

Imaging Effect and Accuracy Analysis of 64-Slice Spiral CT in the Diagnosis of Coronary Artery Stenosis

Objective:To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary artery stenosis.Methods:30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected.All patients underwent both 64-slice spiral CT and digital subtraction angiography(DSA).DSA is considered the gold standard for diagnosis,so it was used to analyze the diagnostic performance of 64-slice spiral CT.Results:(1)The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other.The 64-slice spiral CT had an accuracy of 96.67%(29/30),a sensitivity 96.55%(28/29),and a specificity of 100.00%(1/1)in diagnosing coronary artery stenosis.(2)There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion,the positive detection rate of left main lesion,the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion(P>0.05).(3)There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis,moderate stenosis,and severe stenosis of coronary arteries(P>0.05).Conclusion:64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries,which allows for the accurate diagnosis of coronary artery stenosis.

Value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating differential glomerular filtration rate for chronic obstructed kidneys

Objective To evaluate the value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating the differential glomerular filtration rate ( GFR) for chronic obstructed kidneys,and to compare the correlations between two morphologic indices of renal parenchyma and GFR for chronic obstructed kidneys.

Application of spiral CT three dimentional reconstruction on developmental dysplasis of the hip in children

Objective To evaluate the value of surface shaded reconstruction (SSD) of CT scanning on developmental dysplasia of the hip (DDK). Methods Unilateral DDH in 39 cases was examined with Picker 2000S spiral CT to perform SSD of the affected pelvis. All patients were females with the age ranging from 3.5 to 8 years old ( average 4.25 years). Of 39 cases, 22 cases were complete dislocation the hip, 17 cases were subluxation of the hip. The measurement of SSD included of the depth and surface area of normal and affected acetabulum; the distances from the lowest point of the bottom of the acetabulum (O point) to the anterior end (A point) of the lateral margin of anterior acetabular column (OA), the middle point (point) of the acetabular roof (OB) and the posterior end (C point) of lateral margin of the posterior acetabular column (OC). Results In normal hip, the medial and lateral margin of the acetabular roof was overlapping, and in DDH, a bony defect was found in the lateral acetabular margin in

The diagnostic value of 3D spiral CT imaging of cholangiopancreatic ducts on obstructive jaundice

Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study was designed to evaluate the diagnostic value of 3D spiral CT imaging of cholangiopancreatic ducts on obstructive jaundice. Methods: Thirty patients with obstructive jaundice had received B-mode ultrasonography, CT, percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP), and 3D spiral CT imaging of cholangiopancreatic ducts preoperatively. Then the diagnose accordance rate of these examinational methods were compared after operations. Results: The diagnose accordance rate of 3D spiral CT imaging of cholangiopancreatic ducts was higher than those of B-mode ultrasonography, CT, or single PTC or ERCP, which showed clear images of bile duct tree and pathological changes. As to malignant obstructive jaundice, this examinational technique could clearly display the adjacent relationship between tumor and liver tissue, biliary ducts, blood vessels, and intrahepatic metastases. Conclusion: 3D spiral CT imaging of cholangiopancreatic ducts has significant value for obstructive diseases of biliary ducts, which provides effective evidence for the feasibility of tumor-resection and surgical options.

Design Consideration and Reconstruction Method for Double-source Double-multislice Spiral CT

To accelerate the scan speed and improve the image quality, a new type of CT configuration, "double-source double-multislice spiral CT" (DSDMS-CT), which is based on two sets of single-source multislice spiral CT was proposed with a special reconstruction algorithm. Simulation results using the fan-beam filtered backprojection algorithm with a special interpolation method were presented for both single-source multislice spiral CT and DSDMS-CT. The results of new CT model show that it scans faster than the traditional spiral CT and has a better slice sensitivity profile (SSP) with larger pitch value.

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.

Strangulated obturator hernia diagnosed preoperatively by spiral CT:case report

Obturator hernia is a relatively rare pelvic hernia and usually occurs in elderly, thin, multiparous women.Because symptoms are nonspecific in most cases, diagnosis is often delayed until laparotomy is performed for treatment of bowel obstruction or peritonitis. Delay in diagnosis and surgical intervention directly contribute to high morbidity and mortality rates,Here we report a case of obturator hernia where the diagnosis was made by emergency preoperative abdominal CT scan.

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.

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。