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.

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.

Segmental radiofrequency ablation of pulmonary vein ostia for patients with refractory paroxysmal atrial fibrillation using multi-slice spiral computed tomography guidance

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.

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps,and gastric stromal tumor risk stratification assessment

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.

Multi-slice spiral computed tomography in diagnosing unstable pelvic fractures in elderly and effect of less invasive stabilization

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.

Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection

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.

Study on the combined value of multi-slice spiral CT in the diagnosis of elderly colorectal cancer colorectal cancer tumor markers

Objective:To investigate the value of tumor markers in colorectal cancer with multi-slice spiral CT in the diagnosis of elderly colorectal cancer.Methods:From January 2016 to September 2017 year period, 73 elderly patients with colorectal cancer treated in our hospital were selected as observation group;64 elderly patients with intestinal benign lesions were selected as control group during the same period. Serum samples were collected to detect contents of CEA, CA72-4, CA19-9 and CYFRA21-1 by Roche luminous immunoassay analyzer, and multi slice spiral CT was used.Results:Serum levels of CEA, CA72-4, CA19-9 and CYFRA21-1 levels of the observation group were significantly higher than that of the control group;the positive rate of CEA, CA72-4, CA19-9, CYFRA21-1 and their combined detection were all significantly higher than that of the control group;positive rate of MSCT in the observation group was higher than the control group;positive rates of tumor markers combining with MSCT examination of colorectal cancer were higher than that of combined detection of tumor markers and MSCT examination;but there was no significant difference in positive rate of combined detection of tumor markers and the positive rate of MSCT detection of colorectal cancer.Conclusion:Colorectal cancer tumor markers combined with multi-slice spiral CT in the diagnosis of colorectal cancer in elderly has important research value, can significantly improve the positive rate of diagnosis.

Value of Multi-slice Spiral CT in the Diagnosis and Resectability of Pancreatic Cancer

Objective:To analyze the value of multislice spiral CT in the diagnosis and resectability of pancreatic cancer.Method:56 patients with pancreatic cancer treated in our hospital from January 2018 to October 2019 were selected as the research subjects.All patients underwent multi-phase scanning by multislice spiral CT.According to the results of the images,observe whether the pancreatic cancer has affected the blood vessels surrounding the pancreas,evaluate the resectability based on the results of the examination,and analyze the final results of the operation which was taken as the standard.Results:all the 56 cases presented slightly low density or equal density,and 28 cases had complete outline.Multi-slice spiral assessment of patients’vascular invasion types found that 192 branches can be resected with 70 branches cannot;Multi-slice spiral assessment of the main arterial and venous invasion grades around the pancreas of the patients found that 212 branches can be resected with 50 branches cannot;Multi-slice spiral CT was used to evaluate the resectability of pancreatic cancer compared with surgical results.The accuracy of resectable types of vascular invasion was 72.52%;the accuracy of resectable vascular invasion grades was 79.39%.Conclusion:the application of multi-slice spiral CT in the diagnosis of pancreatic cancer can provide a clear understanding of the condition of vascular invasion and distant metastasis,and the accuracy of assessing resection can reach more than 70.00%,which provides a reference for clinical application.

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.

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.

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.

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.

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

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。

多层螺旋CT后处理技术对颈面部血管性病变的诊断价值初探

目的:探讨多层螺旋CT后处理技术对颈面部血管性病变的诊断价值。方法:22个颈面部血管异常的病例,行CT增强扫描后以各种后处理技术如VR、MPR、MIP、SSD等方法进行重建。结果:22例颈面部血管畸形,其中动脉瘤6例,动静脉畸形16例,二维和三维图像对病人定位的准确性均较高(86.4%<95.5%)。但在来源血管(45.5%<91.7%)、病变走行(68.2%<100%)、与周围组织的关系(72.7%<100%)等方面,3D重建图像均较2D图像显示出了明显的优势。结论:多层螺旋CT各种后处理技术的综合应用对颈面部血管性病变有较高的诊断价值。

New progress in CT and MRI examination and diagnosis of small intestinal tumors

Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscopy cannot exhibit the intestinal wall and extra-luminal structure well. With the development and advancement of multi-slice spiral computed tomography and magnetic resonance imaging (MRI), computed tomography enteroclysis (CTE) and magnetic resonance enteroclysis (MRE) are widely used in the examination and diagnosis of small intestinal tumors. CTE and MRE, with three-dimensional imaging capabilities and excellent soft-tissue contrast, can analyze the abnormalities of peripheral intestinal structure as well as the tunica mucosa. In addition, these two technologies can clearly reveal the localization, appearance, degree of mesenteric infiltration and remote tumor metastasis, which increases our cognition of the imaging diagnosis for intestinal tumors. Here we review recent progress in imaging (CT and MRI) examination and diagnosis of small intestinal tumors.

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.

Portal vein computed tomography imaging characteristics and their relationship with bleeding risk in patients with liver cirrhosis undergoing interventional therapy

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.

Analysis of CT and MRI in the Diagnosis of Shoulder Joint Injury

Objective: To observe the effect of multi-slice spiral CT and magnetic resonance imaging (MRI) in the diagnosis of shoulder injury. Methods: 120 patients with shoulder injury who were treated in our hospital (January 2020 to December 2021) and underwent surgical treatment were diagnosed as shoulder injury. They were divided into CT group, MRI group and joint diagnosis group. The detection rates of the two methods were compared. Results: In the diagnosis of shoulder injury, MRI group was higher than CT group, and the joint diagnosis group was higher than the other two groups. Conclusion: In the diagnosis of shoulder injury, the joint examination of multi-slice spiral CT and magnetic resonance imaging (MRI) can obtain a higher diagnostic rate and ideal effect.