脊髓造影X线、CT检查方法的探讨

CT检查脊髓病变具有一定局限性,其明确定位诊断较困难。本文采用非离子型水溶性造影剂Omnipaque,先行X线电视透视下常规脊髓造影;根据造影所见如阻塞形状,确定其病变部位。其后1—2小时再行CT扫描检查。以此为CT扫描作出指导性定位,45例均获得满意效果。

在CT灌注检查中的护理工作体会

目的:探讨CT灌注检查时的护理方法。方法:对35位患者行灌注检查,男15例,女20例。其中头部灌注29例,前列腺灌注1例,软组织肿瘤5例,扫描前询问病史,过敏史;注射造影剂时关注患者血管条件,幷进行预判;检查结束后对症处理出现的各种情况。结果:35例患者中30例成功完成检查,其中18例出现过一次性热感,其中5例合并皮肤瘙痒,7例单独出现皮肤瘙痒;10例无任何不良反应。无一例出现严重过敏反应。结论:灌注扫描前认真做好准备工作,排出血管条件不利于灌注检查病例,就能在检查过程中减少甚至避免出现不良反应。

Assessment of Gastric Cancer: Value of Two-phase Multidetector-row Spiral CT Three-dimensional Reconstruction Technique

Abstract Objective： To evaluate the diagnostic value of two-phase multidetector-row spiral CT threedimensional reconstruction technique in TNM staging of gastric cancer. Methods： In 29 patients with gastric carcinoma pathologically conformed, plan scans were done firstly. Two-phase spiral CT was performed within one breathhold each. Distension of the stomach was achieved by intravenous application of anisodamine and effervescent granules. After bolus injection of contrast medium, scanning was performed in the arterial and venous phase, and the source images were thin reconstructed. The stomach to three-dimension analysis was constructed by volume rendering （VR） multiplanaz volume reconstruction （MPVR）, shaded surface display （SSD） and CT virtual gastroscopy （CTVG） technique. In combination with the sources images, gastric tumour invasion and lymph node metastasis was assessed, and TNM staging was performed. Results： In 29 cases of gastric carcinoma, the sensitivity and specificity of two-phase multidetector-row spiral CT three-dimensional reconstruction technique in T1, T2, T3 and Ta staging, the sensitivity and specificity was 50% and 50%, 87.5% and 77.8%, 83.3% and 76.9% and 100% and 80% respectively. For the N staging, the sensitivity and specificity in No, N1, and N2 N3 was 83.3% and 71.4%, 87.5% and 77.8% and 81.8% and 75% respectively. The sensitivity and the specificity for M1 staging was 100%. Conclusion： The reconstruction technique in combination with 16-slices spiral-CT can perform TNM staging well and effectively guide the choice of the surgical procedures for gastric cancer.

螺旋CT诊断腰椎间盘突出症并发椎管狭窄分析

目的:探讨分析螺旋CT影像学检查方法在诊断腰椎间盘突出症并发椎管狭窄疾病过程中的应用价值。方法:以我院外科收治的104例腰椎间盘突出症并发椎管狭窄患者作为研究对象,借由针对患者依次实施螺旋CT影像学检查,总结计算患者的检出准确率,并针对患者实际发生的病变表现类型展开归纳分析。结果:在螺旋CT检查方法的应用背景之下,本组104例腰椎间盘突出症并发椎管狭窄病变患者中有100例成功检出,证实该种影像学检查方法在腰椎间盘突出症并发椎管狭窄患者群体中的检出准确率为96.15%(100/104)。结论:为临床中收治的腰椎间盘突出症并发椎管狭窄患者实施螺旋CT影像学扫描检查,能够实现对患者病理组织形成和分布情况的有效检出和揭示,值得推广。

Multi-detector CT enterography with iso-osmotic mannitol as oral contrast for detecting small bowel disease

AIM: To assess the feasibility and usefulness of multi-detector CT enterography with orally administered iso-osmotic mannitol as negative contrast in demonstrating small bowel disease.METHODS: Thirteen volunteers and 38 patients with various kinds of small bowel disease were examined. We administered about 1 500 mL iso-osmotic mannitol as negative contrast agent and then proceeded with helical CT scanning on a Siemens Sensation 16 scanner. All volunteers and patients were interviewed about their tolerance of the procedure. Two radiologists postprocessed imaging data with MPR, thin MIP, VRT and INSPACE when necessary and then interpreted the scans,and adequacy of luminal distention was evaluated on a four-point scale. Demonstration of features of various kinds of small bowel disease was analyzed.RESULTS: The taste of iso-osmotic mannitol is good (slightly sweet) and acceptable by all. Small bowel distention was excellent and moderate in most volunteers and patients. CT features of many kinds of diseases such as tumors, Crohn's disease,and small bowel obstruction,etc. were clearly displayed.CONCLUSION: Multi-detector CT enterography with iso-osmotic mannitol as negative contrast to distend the small bowel is a simple, rapid, noninvasive and effective method of evaluating small bowel disease.

Multiplanar reformations and minimum intensity projections using multi-detector row CT for assessing anomalies and disorders of the pancreaticobiliary tree

CT scan is regarded as the imaging modality of choice in patients with pancreaticobiliary ductal abnormalities. However, the axial orientation of the CT images provides only limited anatomical view of pancreaticobiliary ductal abnormalities. The technological advances of multi-de-tector row CT and three-dimensional image processing in workstations allows rapid image acquisition and a short postprocessing time. In particular, multiplanar reforma-tions (MPR) and minimum intensity projections (MinIP) offer rapid and accurate images of the anatomy and ab-normalities of the pancreaticobiliary tree. Moreover, MPR and MinIP help determine the relationship between the pancreaticobiliary ductal anatomy and the surrounding structures. This pictorial review illustrates the wide spec-trum of images obtained by the MPR and MinIP of the anomalies and disorders of the pancreaticobiliary tree.

Clinical value of CT three-dimensional imaging in diagnosing gastrointestinal tract diseases

AIM： To discuss the clinical value of CT three-dimensional （3-D） imaging in diagnosing gastrointestinal tract diseases.METHODS： Three-D imaging findings of 52 patients were retrospectively analyzed. Three-D imaging methods included shaded surface display （SSD）, volume rendering （VR）, virtual endoscopy （VE） and multiplanar reformatting （MPR）. The diagnosis results of CT 3-D were evaluated by comparison with those of endoscopy and/or surgical finding.RESULTS： Fifty-two patients with gastrointestinal tract diseases were diagnosed by CT 3-D imaging, of whom 50 cases were correctly diagnosed and 2 were misdiagnosed. There were 33 cases of gastric diseases （27 with carcinoma, 5 with peptic ulcer and 1 with leiomyoma） and 19 large intestinal diseases （10 with colon carcinoma, 2 with carcinoma of the rectum, 5 with colon polypus and 2 with tuberculosis of the ileocecal junction）. Twenty-two cases with prominent lesions （9 with subsequent hollow lesions）, 20 with stenosis of cavity （8 with concomitant prominent lesions） and 10 with hollow lesions （5 with concomitant prominent lesions） were shown in 3-D images. The minimal lesion shown was 1.0 cm × 0.8 cm × 0.5 cm.CONCLUSION： CT 3-D imaging, a non-invasive examination without pain, can display clearly and directly the lesions of gastrointestinal tract with accurate location and high diagnosis accuracy. It is an important complementary technique to endoscopy.

Large cell carcinoma of lung: analysis of CT signs and review of the literature

Objective: Large cell carcinoma of lung is a very rare tumor. The clinical characteristics and CT imaging feature of large cell carcinoma of lung were discussed in this article. Methods: Eight cases of large cell carcinoma of lung proven by post-operational pathology were retrospectively analyzed from 2000 to 2005 and the literature on it was reviewed. Results: All 8 cases were men. The average age of patients was 64.88 years. Seven cases were smokers. Six cases had obvious chest stuffy, short breath, thrill dry cough. Hereinto 3 cases had cardinal red blood sputum. CT images of large cell carcinoma of lung were represented as single and peripheral mass or nodule. The distribution of large cell carcinoma of lung was short of some rule. 75% focus had clear finitude. One case showed internal calcification and 2 cases showed cavity. They did not show internal fat density. Conclusion: Large cell carcinoma of lung is difficult to be diagnosed before operation. Its CT finding is nonspecific.

Automated lung segmentation algorithm for CAD system of thoracic CT

Objective: To design and test the accuracy and efficiency of our lung segmentation algorithm on thoracic CT image in computer-aided diagnostic (CAD) system, especially on the segmentation between left and right lungs. Methods: We put forward the base frame of our lung segmentation firstly. Then, using optimal thresholding and mathematical morphologic methods, we acquired the rough image of lung segmentation. Finally, we presented a fast self-fit segmentation refinement algorithm, adapting to the unsuccessful left-right lung segmentation of thredsholding. Then our algorithm was used to CT scan images of 30 patients and the results were compared with those made by experts. Results: Experiments on clinical 2-D pulmonary images showed the results of our algorithm were very close to the expert’s manual outlines, and it was very effective for the separation of left and right lungs with a successful segmentation ratio 94.8%. Conclusion: It is a practicable fast lung segmentation algorithm for CAD system on thoracic CT image.

探讨分析螺旋CT在诊断腰椎间盘突出症并发椎管狭窄疾病过程中的应用价值

目的探讨分析对腰椎间盘突出症并发椎管狭窄的患者采用螺旋CT影像学检查方法进行诊断的临床应用价值。方法本次研究对象均为本院于2018年7月至2020年1月收治的接受手术治疗的腰椎间盘突出症并发椎管狭窄患者,共计43例。对全部患者采用螺旋CT影像学检查方法进行诊断后,对比手术结果(金标准),确认螺旋CT影像学检查方法的应用价值。结果螺旋CT影像学检查的检出率为97.67%,与金标准的检出率(100.00%)对比无显著差异(P>0.05)。同时检出椎间盘突出患者(15例)、韧带肥厚患者(8例)、硬膜囊受损患者(10例)、侧隐窝狭窄患者(7例)、椎间孔狭窄患者(3例),诊断结果与手术结果基本相符。结论根据本次的研究结果可以确认,腰椎间盘突出症并发椎管狭窄的患者采用螺旋CT进行诊断有很高的准确率,还可以有效地判断患者的疾病病理类型,对主治医生制定治疗方案有十分显著的参考价值,能够有效改善患者的预后。

食管、胃肿瘤螺旋CT检查探讨

目的探讨食管、胃肿瘤的CT检查方法及对术前临床分期的指导意义。方法60例患者,其中食管癌25例,贲门癌15例,胃癌20例,均经手术病理证实,采用低张充水法行螺旋CT扫描。结果60例患者CT检查可清楚显示病变区食管壁、胃壁增厚,管腔狭窄,轮廓改变以及病变向管腔外浸润程度及周围器官、淋巴结转移情况。结论低张充水法螺旋CT扫描,可以清楚显示食管癌、胃癌向管壁内外浸润的程度,对术前肿瘤分期及治疗方案选择有重要指导意义。

MRI检查与CT检查诊断脊柱结核患者的临床效果比较

分析MRI检查方法与CT检查方法诊断脊柱结核患者的临床效果。方法:研究对象为我院收治的脊柱结核患者60例,收治时间为2018年1月~2020年12月。检查方法为MRI检查法与CT检查法。对比MRI检查方法与CT检查方法对患者骨质破坏、椎间盘及椎间盘软组织损伤病变的确诊率。结果:MRI检查方法下骨质破坏的确诊率明显较高,达到了55.00%,CT检查方法下确诊率为40.00%;椎盘软组织损伤的MRI确诊率达到了16.67%,大大高于CT检查方法的3.33%(P<0.05),椎间盘损伤的确诊率则是CT检查效果更好,达到了61.67%,明显高于MRI检查方法的35.00%(P<0.05)。结论MRI检查方法与CT检查方法对脊柱结核患者确诊均有较好的效果。

某高校学生足踝部骨折CT和DR辅助检查结果分析

目的通过分析南京农业大学学生足踝部骨折CT和DR辅助检查的结果,以便今后选择检出率高的仪器用于类似伤情的辅助检查。方法将本校60例足踝部骨折的学生患者随机分为CT辅助检查组和DR辅助检查组各30例,对2组患者辅助检查结果进行分析研究。结果应用CT辅助检查的患者骨折检出率为100%,应用DR辅助检查的患者骨折检出率为90%左右。结论 DR辅助检查足踝部骨折具有便捷和价廉的特点,但易造成漏诊或误诊;CT辅助检查足踝部骨折具有100%检出率的优势,足踝部骨折应选择CT辅助检查。

比较腰椎间盘突出MRI与CT诊断的准确性及临床价值

目的:比较腰椎间盘突出MRI与CT诊断的准确性及应用价值.方法:选择我院2015年1月-2018年1月收治的腰椎间盘突出患者80例,对患者先进行CT检查,然后进行MRI检查.比较CT和MRI对腰椎间盘突出的诊断准确率.结果:和CT检查对比,MRI诊断准确率明显更高,P<0.05.结论:对腰椎间盘突出患者采取CT和MRI进行检查,均可以获得较高的诊断准确率,2种方法各具优缺点,可以联合2种方法对腰椎间盘突出进行诊断,有利于进一步提高诊断准确率.螺旋CT检查方式通过结合患者的症状进行综合分析,可以有效地提高诊断准确率.但是对检出椎间游离会受到较大限制.而MRI可以通过任意角度显示病变组织的异常信号,直观性更加强.

肝脏增强CT技术与肝脏MRI技术诊断肝癌的效果分析

目的分析MRI和CT增强技术在肝癌诊断中的临床效果。方法回顾性分析2016年2月-2018年6月收治的70例肝癌患者的临床资料。所有患者均通过手术或经皮穿刺活检确诊为肝癌,且均接受CT增强和MRI检查。比较2种方法的准确性。结果 CT增强扫描检出肝外病变(1.60±0.46),肝内病变(2.15±0.38);MRI检出肝外病变(2.34±0.41),肝内病变(2.91±0.59),差异有统计学意义(P<0.05)。CT增强检出肝癌的准确率为85.71%(60例),MRI检出的准确率为92.86%(65例),MRI对肝癌患者诊断的准确性明显高于CT增强(P<0.05)。结论 MRI在诊断肝癌方面具有比CT更高的准确性。

超声造影技术对老年颈动脉粥样硬化斑块的稳定性分析

目的:探讨超声造影技术对老年颈动脉粥样硬化斑块的稳定性分析。方法:将2017年3月~2019年12月本院50例老年颈动脉粥样硬化斑块患者设为研究对象,采用随机数字表方法作分组设计,均实施超声造影技术、计算机体层成像(Computed Tomography,CT)检查方法;以CT检查方法的检查结果为标准,分析超声造影技术对老年颈动脉粥样硬化斑块的稳定性。结果:超声造影技术的软斑块检出率、硬斑块检出率、钙化斑块检出率、混合检出率与超声造影技术增强技术均无明显差异性,P>0.05。超声造影技术与超声造影技术增强技术的软斑块检出率、混合斑检出率均无明显差异性,P>0.05;超声造影技术的硬斑块检出率、钙化斑块检出率较超声造影技术增强技术升高明显,P<0.05。结论:对老年急性脑梗死患者实施超声造影技术可以作出准确的颈动脉斑块稳定性情况评估、斑块内部新生血管情况评估,并且可以实现实时无创检查,能够有效区别颈动脉斑块的稳定性,而且超声造影技术具备良好的重复性,操作简便,无创性,而且无需注射造影剂等优势,对于肾功能不全、造影剂过敏等患者更适用,能够为临床急性脑梗死诊断提供预测价值。