CT鉴别诊断原发性小肝癌与肝脏小血管瘤的研究

目的探讨多层螺旋CT扫描对原发性小肝癌和肝脏小血管瘤的鉴别诊断。方法选取本院2011年2月至2012年12月收治的原发性小肝癌患者23例及肝脏小血管瘤患者27例;所有患者均经术前症状、体征、影像、血清标记物等综合诊断,均行CT检查,并由术后病理确诊;分别对其CT多期扫描特征进行回顾性分析和对比研究。结果 CT平扫对SPLC及SLH的诊出率和鉴别力均较低,联合三期增强扫描,对SPLC及SLH患者的病灶诊出率可达100%;在三期增强扫描中,SPLC及SLH的强化征象有显著差异(P<0.05或P<0.01),以门静脉期和延迟期表现最为显著(P<0.01)。结论 SPLC及SLH的CT多期扫描在各增强期的强化征象均有其个体化特征,可根据其差异性对多数SPLC及SLH做出鉴别。

Detection of small hepatocellular carcinoma:Comparison of dynamic enhancement magnetic resonance imaging and multiphase multirow-detector helical CT scanning

AIM: To compare the gadolinium-enhanced multiphase dynamic magnetic resonance imaging (MRI) and multiphase multirow-detector helical CT (MDCT) scanning for detection of small hepatocellular carcinoma (HCC). METHODS: MDCT scanning and baseline MRI with SE T1-WI and T2-WI sequence combined with FMPSPGR sequence were performed in 37 patients with 43 small HCCs. Receiver operating characteristic (ROC) curves were plotted to analyze the results for modality. RESULTS: The areas below ROC curve (Az) were calculated. There was no statistical difference in dynamic enhancement MDCT and MRI. The detection rate of small HCC was 97.5%-97.6% on multiphase MDCT scanning and 90.7%-94.7% on MRI, respectively. The sensitivity of detection for small HCC on MDCT scanning was higher than that on dynamic enhancement MRI. The sensitivity of detection for minute HCC (tumor diameter ≤ 1 cm) was 90.0%-95.0% on MDCT scanning and 70.0%-85.0% on MRI, respectively. CONCLUSION: MDCT scanning should be performed for early detection and effective treatment of small HCC in patients with chronic hepatitis and cirrhosis during follow-up.

Clinical study of stomach neoplasm CT perfusion imaging

Objection:The purpose of this study is preliminarily to discuss stomach perfusion imaging technique with Multi-slice CT and its clinical application value in stomach neoplasm.Methods:Fifteen patients with known stomach neoplasm performed perfusion imaging with 4 or 16 slice CT.Performing perfusion imaging in central slice of neoplasm,using CT cine scan,slice thick 10 mm/2i;with high pressure syringe,injecting quickly from right elbow-front vein,dosage 45-50 mL,injec-tion rate 3.5-4.0 mL/s,scanning delay time 5 s,scanning total time 45 s.We performed perfusion CT post-processing using pancreatic mode of perfusion CT software.Blood flow(BF),blood volume(BV),mean transit time(MTT),and permeability surface(PS) of gastric wall and tumor were computed for every case.Results:BF,BV,MTT and PS of gastric tumor were 116.68 ± 90.09 mL/(min·100 g),9.57 ± 8.12 mL/100 g,10.07 ± 7.74 s,20.78 ± 19.68 mL/(min·100g),respectively.The P values for each CT perfusion parameters between gastric tumor and normal gastric wall were 0.001,0.021,0.155 and 0.031,respectively.Conclusion:Perfusion CT can provide hemodynamics of gastric tumors and play a key role in the diagnosis of gastric tumors.It's clinical application prospect will be fully broad.

Multislice computed tomography angiography in the diagnosis of coronary artery disease

Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease. High diagnostic value has been achieved with multislice CT angiography with use of 64- and more slice CT scanners. In addition, multislice CT angiography shows accurate detection and analysis of coronary calcium, characterization of coronary plaques, as well as prediction of the disease progression and major cardiac events. Thus, patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures. The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease; prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques. Limitations of multislice CT angiography in coronary artery disease are also briefly discussed, and future directions are highlighted.

超声对盆腔囊性肿块病变的鉴别诊断价值

探究超声对盆腔囊性肿块病变的鉴别诊断价值。方法:选取最近三年内到我院进行盆腔囊性肿块鉴别诊断的88名患者,根据采用的检查技术的不同,将其平均的分为两组,组1的44名研究对象采用的检查术为超声技术,组2的44名研究对象采用的检查技术是多螺旋CT扫描技术(MSCT)。在进行两组技术对盆腔囊性肿块病变的鉴别诊断的准确幸性和便捷性研究的时候,需要同患者的满意度进行综合的分析,这样才能够更为全面的获得本次研究的结果。本次两组患者的诊断结果研究对比,主要是根据设备对患者进行扫描以后的影像学资料。 结果:本次实验中MSCT的组2能够获得更好的影像学,但是使用超声技术能够对盆腔囊性肿块病变有一个清楚的了解,患者对两种技术的满意度有所不同,超声的患者满意度高于MSCT。通过本次研究发现超声能够及时的发展患者的盆腔囊性肿块病变,而MSCT技术同样能够得到这个效果,但是患者更加的喜欢超声。结论:对患者的盆腔囊性肿块病变进行诊断的时候,在临床上能够使用超声技术和MSCT技术,因此两种技术都有较大的临床使用价值,但是超声技术同MSCT技术使用相比较而言,超声具有更大的临床资源合理利用率,超声检查的费用没有MSCT技术的费用高,而对盆腔囊性肿块病变具有同样的诊断效果。