Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

Objective:To analyze the value of multi-slice spiral computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of carpal joint injury.Methods:A total of 130 patients with suspected wrist injuries admitted to the Department of Orthopedics of our hospital from January 2023 to January 2024 were selected and randomly divided into a single group(n=65)and a joint group(n=65).The single group was diagnosed using multi-slice spiral CT,and the joint group was diagnosed using multi-slice spiral CT and magnetic resonance imaging,with pathological diagnosis as the gold standard.The diagnostic results of both groups were compared to the gold standard,and the diagnostic energy efficiency of both groups was compared.Results:The diagnostic results of the single group compared with the gold standard were significant(P<0.05).The diagnostic results of the joint group compared with the gold standard were not significant(P>0.05).The sensitivity and accuracy of diagnosis in the joint group were significantly higher than that in the single group(P<0.05).The specificity of diagnosis in the joint group was higher as compared to that in the single group(P>0.05).Conclusion:The combination of multi-slice spiral CT and MRI was highly accurate in diagnosing wrist injuries,and the misdiagnosis rate and leakage rate were relatively low.Hence,this diagnostic program is recommended to be popularized.

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.

Derivative-Hilbert-Backprojection based image reconstruction from truncated projections in helical cone-beam CT

In helical cone-beam computed tomography(CT), Feldkamp-Davis-Kress(FDK) based image reconstruction algorithms are by far the most popular. However, artifacts are commonly met in the presence of lateral projection truncation. The reason is that the ramp filter is global. To restrain the truncation artifacts, an approximate reconstruction formula is proposed based on the Derivative-Hilbert-Backprojection(DHB) framework. In the method, the first order derivative filter is followed by the Hilbert transform. Since the filtered projection values are almost zero by the first order derivative filter, the following Hilbert transform has little influence on the projection values, even though the projections are laterally truncated. The proposed method has two main advantages. First, it has comparable computational efficiency and image quality as well as the conventional helical FDK algorithm for non-truncated projections. The second advantage is that images can be reconstructed with acceptable quality and much lower computational cost in comparison to the Laplace operator based algorithm in cases with truncated projections. To point out the advantages of our method, simulations on the computer and real data experiments on our laboratory industrial cone-beam CT are conducted. The simulated and experimental results demonstrate that the method is feasible for image reconstruction in the case of projection truncation.

Multi-slice Spiral CT Three-dimensional Portography in Portal Vein Tumor Thrombus of Hepatic Cancer

Objective: To study the clinical significance of multi-slice spiral CT 3-dimensional (3D) portography in portal vein tumor thrombosis of hepatocellular cacinoma.Methods: 57 cases undergoing 3D portography were collected, of which 6 cases were normal, 5 cases were subjected to cirrhosis and hypertension of portal vein, 42 cases had portal tumor thrombus of hepatic cancer, and the remaining 4 cases showed lymph node enlargment in hilar of liver. All data of the patients came from conventional multi-slice spiral CT double phase of liver. Contrast media was 1.5–2 ml/kg with the injection rate being 2.5–3 ml/s. Axis and 3D portography was analyzed and compared in 42 cases of portal tumor thrombus of hepatic cancer.Results: According to portal tumor thrombus position, 42 cases were fallen into three categories: left (13 cases), right (20 cases), main (9 cases) of potal vein. There was no difference between axis and 3D portography in displaying portal tumor thrombus of hepatic cancer (P>0.05), but 3D portography showing collateral branches was better than axis portography after main portal vein thrombus.Conclusion: Multi-slice spiral CT 3D portography can display the position and types of portal tumor thrombus of hepatic cancer. 3D combined with axis portography can better evaluate the portal tumor thrombus of hepatic cancer and guide to select the therapies. Key words portal vein - tumor thrombus - multi-slice CT - 3 dimension imaging

Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease

Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases （83%） with convict vascular stenosis and perfusion abnormalities, and five cases （45%） with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores 〉 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores 〈 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.

Diagnosis of peripheral lung cancer using MSCT perfusion imaging compared with microvessel density (MVD)

Objective: To investigate the clinical diagnostic value of peripheral lung cancer using multi-slice CT (MSCT) perfu- sion imaging and the relationship with microvessel density (MVD). Methods: 38 patients with pulmonary masses proved by pathology including 25 cases of peripheral lung cancer and 13 cases of benign masses were studied prospectively with GE Lightspeed Qx/I plus 16-slice helical CT perfusion imaging, and 25 patients with lung cancer were comparative studied with its MVD calculated using LSAB. With the CT perfusion 2-body tumor software, the parameters of CT perfusion including blood value (BV), blood flow (BF), mean transit time (MTT) and permeability surface (PS) were analyzed. Results: The four param- eter values in lung cancer were all higher than that in pulmonary benign masses, and there were significant differences among BV, MTT and PS (P<0.05), especially in BV (P<0.01). The MVD value of lung cancer was higher than that of pulmonary benign masses (P<0.05), and the MVD of adenocarcinoma was higher than that of squamous cell carcinoma (P<0.05). In 25 cases with lung cancer, there was positive correlation only between BV and MVD value (r=0.852, P<0.01). Conclusion: It is helpful to diagnose the peripheral lung cancer with MSCT perfusion imaging and to differentiate from pulmonary benign masses, its bases are MVD pathologically.

多层螺旋CT及其后处理技术对隐匿性骨折的诊断价值

目的 探讨多层螺旋CT(MSCT)二维(MPR、MIP)和三维(VRT、SSD)重建技术对复杂结构的隐匿性骨折的诊断价值。资料与方法 对4 2例外伤患者普通X线平片中未显示而临床怀疑有骨折的患者进行MSCT扫描后,通过特殊的CT图像处理软件包在工作站上进行后处理(MPR、MIP、VRT及SSD) ,得到外伤部位骨骼高清晰度的二维和三维图像后,由两位有经验的放射科医师共同阅片,以共同意见为准。结果 4 2例X线平片中未显示骨折的患者经MSCT重建后,18例显示有骨折,其中枕骨骨折2例,肩胛骨骨折2例,肋骨骨折4例,脊椎骨折3例,骨盆骨折3例,股骨颈骨折3例,跟骨骨折1例。结论 MSCT二维和三维重建对临床怀疑骨折而普通X线不能确诊为骨折的病例能准确地作出诊断,并对治疗方案的选择及预后的估计有重要价值。

16层螺旋CT结肠三维成像与仿真内镜的临床应用研究

目的 探讨 16层螺旋CT三维成像与仿真内镜在结肠肿瘤诊断中的应用价值。资料与方法 应用Lightspeed 16CT对 2 6例纤维结肠镜活检证实的结肠癌 (19例 )和结肠息肉 (7例 )进行容积扫描 ,在AW4 .2工作站进行三维成像和仿真内镜观察 ,并与纤维结肠镜结果相比较。结果 2 5例三维成像效果良好 ,仿真内镜与纤维结肠镜显示基本一致 ,1例因肠道准备不彻底 ,成像效果欠佳 ,但不影响诊断 ;CT仿真结肠镜 (CTVC)结合 2D多平面重建(MPR)和透明显示 (RaySum)图像 ,可以提供更多信息 ,有助于病变的准确定位、定性。结论 16层螺旋CT仿真内镜结合三维成像能达到与纤维结肠镜同样的敏感性和特异性 ,加上MPR。

颌面外科及正畸中三维CT的临床应用

目的 探讨三维CT在颌面外科和正畸中的应用价值。资料与方法 颌面部骨折 5 5例 ,颌面部肿瘤 14例 ,颌骨及牙发育畸形 14例。所有病例均经螺旋CT扫描后进行骨的表面重建 ,肿瘤患者还行肿瘤区的多平面重建 ,颌骨畸形牙咬合错位者利用牙科软件行牙体的表面重建和牙根的多平面重建。重建图像分别与原始轴位图、手术所见对照 ,并与正畸模型进行对照。结果 (1) 5 5例颌面部骨折和 14例颌面部肿瘤三维重建图像显示的骨折、肿瘤部位与原始轴位图显示一致 ,与手术所见相符 ,而且立体感更强。 (2 ) 14例颌骨及牙发育畸形三维重建图像清楚显示颌骨畸形、牙咬合错位牙根方向的情况。根据三维图像制订、实施手术方案和矫形正畸计划 ,获得良好的效果。结论 三维CT可准确地显示颌骨的病变 ,可多方位、多角度观察病变 ,立体感强 ,有助于颌面外科疾病的治疗、手术计划的制订和实施 ,牙科软件行牙的表面重建及牙根的多平面重建 ,能清楚地显示各个牙根的走向 ,为牙的矫形。

16层螺旋CT多平面重建技术对肠梗阻的诊断价值

目的探讨多排螺旋CT多平面重建技术(MPR)对于肠梗阻的诊断价值。方法收集30例经手术(27例)或临床(3例)证实的肠梗阻病例CT资料,其中10例为单纯CT平扫,20例在平扫基础上加作门静脉期增强扫描。采用MPR技术对CT原始数据进行冠、矢状位的图像重建,并分析其表现。结果30例肠梗阻病例中粘连性8例,单纯肠肿瘤7例,肠套叠(包括肠肿瘤并发肠套叠)5例,腹部疝4例,肠扭转2例,回盲部脓肿1例,肠系膜动脉狭窄1例,腹膜后巨大囊肿1例,胰尾癌1例;其中6例合并肠壁缺血或肠绞窄。CT轴位图像、MPR冠状和矢状图像均显示了肠梗阻的存在;单独根据轴位图像能确定26例(86.7%)的梗阻部位和22例(73.3%)的梗阻原因,而结合MPR图像可以确定29例(96.7%)的梗阻部位和27例(90.0%)的梗阻原因;有5例(83.3%)肠壁缺血或绞窄病例均为两种方法所显示。结论螺旋CT多平面重建技术在显示肠梗阻的存在、确定梗阻部位和梗阻原因以及肠道血运状态方面优于单纯的轴位图像。

螺旋CT门静脉血管造影的临床应用价值

目的 :评价螺旋CT门静脉血管造影 (CTP)的临床应用价值。材料和方法 :对 10 8例对疑有肝脏疾病的患者分别行最大强度投影 (MIP)和表面遮盖法 (SSD)CTP成像。结果 :MIPCTP能同时显示 4级以上门静脉分支和 2级以上的肝静脉分支。CTP能直观地评价门静脉和肝静脉的位置、管径、有无门静脉受侵或癌栓形成 ,了解门解脉高压侧支循环的分布范围和程度。CTP有助于经颈静脉肝内门腔静脉分流术 (TIPS)术前定位、Budd Chiari综合症的诊断和术后随访。SSDCTP立体感强 ,但不利于细微结构和癌栓的显示。结论 :CTP是门静脉和肝静脉无创性检查的可靠方法 ,有较高的临床应用价值。

螺旋CT图像常见伪影的分析和处理

目的研究螺旋CT成像中常见伪影的产生原因与处理方法,以减少螺旋CT检查时产生的伪影,提高图像质量,为临床提供良好的影像资料。方法收集本院156位患者不同类型和不同程度CT图像伪影病例,进行系统性分析,其中头颈部扫描61例,胸部扫描37例,腹部扫描33例,盆腔扫描15例,其它部位10例。结果针对螺旋CT常见伪影产生的机理和成因进行了分析,给出了避免、抑制以及消除基于物理结构、基于患者本身、基于扫描系统和基于重建方法四类不同图像伪影的处理方法。结论螺旋CT成像中伪影产生受多种因素影响,利用各种技术有效避免、抑制或消除图像伪影,对优化图像质量和提高临床医学诊断质量和效率具有重要意义。

多层螺旋CT灌注成像技术的临床应用和进展

利用影像学技术进行多层螺旋CT灌注成像可测量局部组织血流灌注,了解其血流动力学及功能变化,对临床诊断及治疗均有重要参考价值。复习多层螺旋CT成像方面的文献,就CT灌注成像的临床应用和前景,特别是体部实质性器官的CT灌注成像的临床应用予以综述。

多层螺旋CT三维成像技术岩心裂缝观测

储层裂缝研究是裂隙性油气田勘探开发的一个难点。图像重建是多层螺旋CT技术的主要优势功能之一,它集显微技术、高速激光螺旋分层扫描技术和图像处理技术为一体,在现代临床医学诊断中有着重要的应用,近年来CT技术在石油地质及开发研究中的应用日益增加。选取具有代表性的含裂缝岩心,利用多层螺旋CT机对岩心裂缝进行扫描,把获得的储层含裂缝岩心的图像容积数据导入CT-3D工作站,利用设备附带的图像分析处理软件,对导入数据进行三维立体成像,来探讨多层螺旋CT三维成像技术在储层岩心裂缝研究中的应用价值。实验结果表明,多层螺旋CT成像技术能够实现对储层裂缝形态的定性观察和定量测量,具有原位、快捷、准确、无损岩样等特点,是观测、描述、评价储层岩心裂缝形态的一种新的有效方法。

CT仿真喉镜的临床应用

目的探讨ＣＴ新技术仿真内窥镜成像在喉科的临床应用价值。方法对４名健康者、９例喉癌、１例喉癌术后复发气道狭窄、１例喉内外弥漫纤维瘤样增生、１例双侧声带息肉患者行螺旋ＣＴ扫描后经软件处理获得仿真喉镜影像，并与纤维喉镜、手术所见对照分析。结果ＣＴ仿真内窥镜显示喉内正常解剖结构与纤维喉镜所见一致；显示喉内病变的位置、范围与纤维喉镜所见类似，还可从足端入路观察到喉镜所看不到的狭窄远端和声门下区情况。结论ＣＴ仿真内窥镜是纤维喉镜的很好补充手段，具有一定的发展潜力。

超声造影谐频成像与螺旋CT对肝癌非手术治疗后疗效的评价

目的 评价比较超声造影双向脉冲谐频成像和螺旋CT在判断肝肿瘤治疗效果方面的价值。方法 对经多种非手术治疗后的肝癌患者 72例共 82个肿瘤分别进行超声造影和螺旋CT检查 ,比较两种影像技术的结果。结果 超声造影谐频成像的连续成像和间歇成像可分别显示肝肿瘤的血管影像和血流灌注情况。超声造影显示造影增强者 5 4.9% (4 5 /82 ) ,负性增强者 45 .1% (3 7/82 ) ;螺旋CT显示不完全治愈者 5 3 .7% (4 4 /82 ) ,完全治愈者 40 .2 % (3 3 /82 ) ,其余 6.1% (5 /82 )因碘油沉积而不能明确判断。结论 与螺旋CT相比 ,超声造影揭示治疗后的肿瘤内血流信号的敏感性、特异性和准确性均较高 ;由于超声声像图较少受碘油沉积的影响以及其影像可直接引导进一步的穿刺局部治疗 。

320排CT肺三期增强扫描诊断孤立性肺病变

目的探讨最佳320排CT肺三期增强扫描时相,评价其诊断孤立性肺病变(SPL)的临床价值。方法对100例SPL患者[A组(周围型肺癌)55例;B组(良性肿瘤或慢性炎症)23例;C组(活动性炎症)22例]及40名健康成年人(D组)行320排CT容积灌注扫描,采用体部灌注软件处理得到时间-密度曲线(T-DC),记录并比较各组肺动脉峰值时间(PA-TTP)、左心房峰值时间(LA-TTP)、胸主动脉峰值时间(AO-TTP)和SPL强化峰值时间(SPL-TTP)。在平扫,肺动脉、左心房、胸主动脉和SPL达强化峰值时以及延迟3min共6个时相测量病灶CT值,计算CT净增值(NE)。应用ROC曲线分析比较各时相NE对SPL的诊断效能。结果 A、B、C、D组PA-TTP、LA-TTP及AO-TTP差异均无统计学意义(P均>0.05)。A、B、C组SPL-TTP差异有统计学意义(F=52.163,P<0.001),C组SPL-TTP为(17.36±2.52)s,明显早于A、B组。A组中,应用SPL达强化峰值时(28s)NE诊断周围型肺癌的ROC曲线下面积(AUC)最大,为0.872,敏感度92.7%,特异度80.0%。C组中,应用SPL达强化峰值时(18s)NE诊断炎症的AUC最大,为0.985,敏感度100%,特异度88.5%。结论以18s、28s、3min为扫描时相,320排CT肺三期增强扫描对鉴别诊断SPL具有较高价值。

多层螺旋CT及多平面重组在脊柱结核诊断中的应用

目的探讨多层螺旋CT及多平面重组在脊柱结核诊断中的应用价值。方法回顾分析间经多层螺旋CT及多平面重组检查诊断,并经临床、手术及病理检查证实的125例脊柱结核。结果125例脊柱结核中多层螺旋CT及多平面重组共显示累及颈椎者5例,占4%,累及颈胸段者2例,占1.6%,累及胸椎者29例,占23.2%,累及胸腰段者10例,占8%,累及腰椎者72例,占57.6%,累及腰骶段者7例,占5.6%。其中125例骨质破坏,27例死骨形成,75例椎旁或腰大肌脓肿,78例椎间盘破坏,35例骨性椎管狭窄。结论脊柱结核的传统X线检查,有其明显局限性,多层螺旋CT及多平面重组可清晰显示骨质破坏的细节,死骨、脓肿及钙化的形成,椎间盘的破坏,对病变范围、椎管狭窄及脊髓压迫的情况有明显的显示优越性。这二者的结合已成为目前脊柱结核的有效影像诊断方法。

扁骨、不规则骨的螺旋CT三维重建技术分析

目的 :评价螺旋CT三维成像技术在扁骨和不规则骨中的诊断作用。方法 :对 3 1例扁骨、不规则骨进行快速螺旋CT扫描和三维重建 ,使用GEProspeedSXadvantage螺旋CT三维成像装置为SUNAW 3 .1。 结果 :螺旋CT三维成像能清晰显示扁骨、不规则骨的正常和异常表现。结论 :螺旋CT三维成像重建技术对扁骨。

16层螺旋CT后处理技术在颈椎损伤中的应用

目的:探讨16层螺旋CT图像重建技术在颈椎损伤中的应用价值。方法:回顾分析利用16层CT检查的32例颈椎损伤病例,分别采用MPR、MIP、VR等图像重建处理,找出最佳的重建方式。结果:经过专家评分,MPR、MIP、VR重建的得分分别为4.75、1.75、4.5分,MPR和VR得分较高。结论:常规颈椎损伤检查采用MRP、VR重建基本能够达到临床要求。