The Different Patterns of Coronary Artery Calcification in Acute and Chronic Coronary Syndromes Determined by Electron Beam Computed Tomography

Objectives To compare the different patterns of coronary artery calcification (CAC) in acute and chronic coronary syndromes utilizing electron beam computed tomography. Background Pathologic, angiographic, and intracoronary ultrasound studies revealed sharp differences in the plaque morphology between patients with acute versus chronic coronary syndromes. Whether there are different patterns of coronary artery calcification in patients with stable angina pectoris (SAP) and in those with unstable angina pectoris (UAP) or acute myocardial infarction (AMI), however, remains unclear. Methods Two hundred and sixty - four patients, including 67 with SAP, 94 with UAP and 103 with AMI were studied with electron beam computed tomography for analysis of coronary artery calcification and with selective coronary angiography for determination of atherosclerotic lesions. CAC prevalence and calcium score were compared among three groups, and relation of CAC to the severity of atherosclerotic disease in the SAP and UAP patients was separately analyzed. Results Prevalence of CAC was 100 % in the SAP patients, significantly higher than the 87. 23 % in UAP patients and 86. 41 % among the patients with AMI ( P < 0. 05) . More patients and arteries in the SAP group had severe forms of calcium than those in the UAP and AMI group ( P < 0. 01), and the mean LN [CS + 1] (natural logarithm transformation of calcium score) of the SAP patients was much greater than that of the UAP and AMI patients (P < 0.001). The distribution of vessels with various CAC by luminal stenosis was different between SAP and UAP patients. The average CAC extent of the infarct - related arteries was less severe than that of the noninfarct - related arteries. Conclusions U-tilizing electron beam computed tomography, we demonstrated that there exist different patterns of coronary artery calcification in patients with acute versus chronic coronary syndromes, which may provide insight into the differences observed in the clinical and pathologic development between these two types of coronary artery disease.

孤立性蝶窦炎的CT表现及其临床意义

目的探讨孤立性蝶窦炎的CT临床征象及诊断价值。方法回顾性分析我院1998年～2006年6月诊治的18例孤立性蝶窦炎的临床和影像学资料。全部患者均行蝶窦冠状位及水平位薄层CT扫描。结果本组中17例以头痛为主诉就诊。18例中,蝶窦气化分型为鞍前型7例(7/18,38.9%),鞍后型6例(6/18,33.3%),甲介型5例(5/18,27.8%)。12例蝶窦有中隔,其中1个中隔6例,2个中隔4例,2个以上中隔者2例;6例蝶窦为单房。CT表现为蝶窦腔的部分或全部混浊变暗,蝶窦内密度增高。11例行鼻内窥镜蝶窦开放冲洗术,7例行抗感染治疗,均治愈。结论CT可提供蝶窦解剖的细节和病变的范围,对鼻内窥镜手术有指导意义。CT可作为诊断孤立性蝶窦炎的首选方法。

真菌性蝶窦炎的影像诊断和鉴别诊断

目的:探讨蝶窦真菌感染的影像学特征、诊断和鉴别诊断。方法:回顾性分析11例经病理证实的真菌性蝶窦炎的临床和影像学检查资料。结果:CT与MRI表现为窦腔内结节样软组织密度影8例(73%);伴有沙粒状、小条片状、团块状的钙化6(45%)例;累及后组筛窦5例(45%),伴窦腔扩大7例(64%);局限性骨质增生和破坏4例(36%)。结论:真菌性蝶窦炎具有较特征性影像学表现,鉴别诊断要考虑一般性炎症、息肉、粘液囊肿和肿瘤。

蝶窦CT解剖与内窥镜鼻窦外科学的对照研究

57例蝶窦CT扫描做以下测量:1.蝶窦的类型:鞍前型14％,半鞍型7％,全鞍型45.6％,枕鞍型17.5％,甲介型14％,未发育型1.7％,2.蝶窦开口:水平宽度平均2.1mm,蝶窦开口与蝶骨嵴的距离平均2.3mm。3.颈内动脉鞍后段隆起出现率为34.2％,视神经隆起出现率为48.3％。CT扫描是内窥镜鼻窦外科中用于诊断,判定病变范围和设计手术方案最重要的方法。

蝶窦炎并眼-神经科综合征5例的临床分析

目的 :探讨蝶窦炎所致眼 神经科综合征的临床特征和治疗方法。方法 :回顾性分析 5例蝶窦炎并眼 神经科综合征病例的临床资料 ,CT扫描是主要诊断依据 ;手术治疗 3例 ,保守治疗 2例。结果 :蝶窦开放术或保守治疗均缓解了头痛症状 ,但视力障碍和其它眼 神经科体征无改善。结论 :CT扫描有利于早期诊断和排除球后占位性病变 ;对于有并发症的蝶窦炎宜尽早手术 。

慢性鼻窦炎鼻窦CT的评估分类

由于鼻内窥镜技术和CT扫描检查在临床的广泛应用,对于慢性鼻窦炎外科治疗日益受到国内外医师的重视。国外许多专家学者建立了多种临床评估系统以准确判断慢性鼻窦炎的严重程度,既便于临床医师接受,又可以指导药物和外科治疗。评估方法越简便易行其接受程度就越高。而判断慢性鼻窦炎的病理情况,CT比症状表现和鼻内镜下的表现更准确,故临床评估多以CT为判断依据。本文综述了目前国内外的研究现状和CT评估方法,同时指出了研究中的不足。