Multi-Detector Row Computed Tomography Urography (MDCTU) in the Evaluation of Microscopic Hematuria in Adults

Multi-detector row computed tomography urography (MDCTU) becomes the imaging modality of choice for evaluation of the kidneys and urinary tract. The aim of this study was to discuss and illustrate the role of MDCTU, on a 32-row CT scanner in the evaluation a variety of entities that were frequently associated with microscopic hematuria in adults. This prospective cohort study was performed in the period of August 2013 to October 2014. Fifty positive participants to microscopic hematuria were examined at the radiology department of Alnilin Diagnostic Medical Center and Antalya Medical Center. Computed tomography urography (CTU) scanning was performed using two powerful performances, high speed multi-detector row on 32-row CT scanners (Siemens Healthcare Global, Somatom Emotion Duo Eco). Statistical analysis was done through the standard Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 15 for windows. MDCTU established the correct cause of microscopic hematuria in (44;88%) of participants. In (6;12%) of participants, no cause of hematuria was identified based on the standard of references. The causes of hematuria in (41;82%) participants were diseases in the upper urinary tract, while urinary bladder neoplasms (2;4%) and diverticulum (1;2%) were the causes of hematuria (3;6%) in the lower urinary tract. Thirty two-row MDCTU scanner demonstrated satisfactory results in the investigation of microscopic hematuria, being able to demonstrate a wide spectrum of diseases affecting the urinary tract is the main advantage of the technique.

Chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease:Correlations with blood eosinophil level

Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level.

Values of high-resolution computed tomography and pulmonary function tests in managements of patients with chronic hepatitis C virus infection

AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.

Utility of Spiral Computed Tomography in the Study of Dislocation of Cricoarytenoid Joint

The cricoarytenoid relationship presented with spiral computed tomography was demonstrated and the reconstruction of arytenoid dislocation was presented by using multiplanar reconstruction algorithms. Fifteen patients with arytenoid dislocation documented by fiberoptic laryngoscopy and strobovideolaryngoscopy and 10 normal persons were displayed by spiral computed tomography (CT). A making design of our own had been used to diagnose arytenoid dislocation on axial CT image. Results showed that dislocation of cricoarytenoid joint was consistently demonstrated on several of the overlapping thin axial reconstructions in each of the 15 patients, in whom asymmetry of the bilateral cricoarytenoid joints was noted on axial images. It was found that on the glottic-fissure level the basal angle on abnormal side was larger in 8 patients than that on the normal side and smaller in 7 patients in patient group, whereas right basal angle was equal to the left in 8 subjects, except 2 in control group. There was statistically significant difference in the number of the equal to two basal angles of glottic fissure between control group and patient group (P<0.025). High-quality sagittal and coronal reconstructive images often were helpful in confirming or clarifying the complex arytenoid orientations. The findings that two-side basal angle was not equal in triangle of glottic fissure can be used as an objective parameter to diagnose arytenoid dislocation. Spiral CT is a useful adjunct in the diagnosis and treatment of dislocation of cricoarytenoid joint.

Impact of X-radiation in the management of COVID-19 disease

Coronaviruses are a diverse group of viruses that infect both animals and humans.Even though the existence of coronavirus and its infection to humans is not new,the 2019-novel coronavirus(nCoV)caused a major burden to individuals and society i.e.,anxiety,fear of infection,extreme competition for hospitalization,and more importantly financial liability.The nCoV infection/disease diagnosis was based on non-specific signs and symptoms,biochemical parameters,detection of the virus using reverse-transcription polymerase chain reaction(RTPCR),and X-ray-based imaging.This review focuses on the consolidation of potentials of X-ray-based imaging modality[chest-X radiography(CXR)and chest computed tomography(CT)]and low-dose radiation therapy(LDRT)for screening,severity,and management of COVID-19 disease.Reported studies suggest that CXR contributed significantly toward initial rapid screening/diagnosis and CT-imaging to monitor the disease severity.The chest CT has high sensitivity up to 98%and low specificity for diagnosis and severity of COVID-19 disease compared to RT-PCR.Similarly,LDRT compliments drug therapy in the early recovery/Less hospital stays by maintaining the physiological parameters better than the drug therapy alone.All the results undoubtedly demonstrated the evidence that X-ray-based technology continues to evolve and play a significant role in human health care even during the pandemic.

Bone diseases in rabbits with hyperparathyroidism: computed tomography, magnetic resonance imaging and histopathology

Background Hyperparathyroidism （HPT） occurs at an early age and has a high disability rate. Unfortunately, confirmed diagnosis in most patients is done at a very late stage, when the patients have shown typical symptoms and signs, and when treatment does not produce any desirable effect. It has become urgent to find a method that would detect early bone diseases in HPT to obtain time for the ideal treatment. This study evaluated the accuracy of high field magnetic resonance imaging （MRI） combined with spiral computed tomography （SCT） scan in detecting early bone diseases in HPT, through imaging techniques and histopathological examinations on an animal model of HPT. Methods Eighty adult rabbits were randomly divided into two groups with forty in each. The control group was fed normal diet （Ca：P = 1：0.7）; the experimental group was fed high phosphate diet （Ca：P = 1：7） for 3, 4, 5, or 6-month intervals to establish the animal model of HPT. The staging and imaging findings of the early bone diseases in HPT were determined by high field MRI and SCT scan at the 3rd, 4th, 5th and 6th month. Each rabbit was sacrificed after high field MRI and SCT scan, and the parathyroid and bones were removed for pathological examination to evaluate the accuracy of imaging diagnosis. Results Parathyroid histopathological studies revealed hyperplasia, osteoporosis and early cortical bone resorption. The bone diseases in HPT displayed different levels of low signal intensity on T1WI and low to intermediate signal intensity on T2WI in bone of stage 0, Ⅰ, Ⅱ or Ⅲ, but showed correspondingly absent, probable, osteoporotic and subperiosteal cortical resorption on SCT scan. Conclusion High field MRI combined with SCT scan not only detects early bone diseases in HPT, but also indicates staging, and might be a reliable method of studying early bone diseases in HPT.

Differential diagnosis of coronavirus disease 2019 from community-acquired-pneumonia by computed tomography scan and follow-up

Objective Coronavirus disease 2019(COVID-19)is currently the most serious infectious disease in the world.An accurate diagnosis of this disease in the clinic is very important.This study aims to improve the differential ability of computed tomography(CT)to diagnose COVID-19 and other community-acquired pneumonias(CAPs)and evaluate the short-term prognosis of these patients.Methods The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province,China from January 21 to February 28,2020 were retrospectively analysed.The CT manifestations of the two groups were recorded and compared.A correlation analysis was used to examine the relationship between COVID-19 and age,size of lung lesions,number of involved lobes,and CT findings of patients.The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.Results The typical CT findings of COVID-19 are simple ground-glass opacities(GGO),GGO with consolidation or grid-like changes.The sensitivity and specificity of the combination of age,white blood cell count,and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%,respectively.Pulmonary consolidation,fibrous cords,and bronchial wall thickening were used as indicators to exclude COVID-19.The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%,respectively.The follow-up results showed that 67.8%(112/165)of COVID-19 patients had abnormal changes in their lung parameters,and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age.Conclusions Age,white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP.Patients aged over 60 years with COVID-19 have a poor prognosis.This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.

64层螺旋CT泌尿系成像在泌尿系病变中的应用

目的探讨多层螺旋CT泌尿系成像(MSCTU)在泌尿系病变中的应用价值。方法采用64层螺旋CT对60例临床疑诊泌尿系病变患者行泌尿系容积扫描及三维重建,评价MSCTU对泌尿系病变的诊断价值。结果泌尿系肿瘤14例,输尿管息肉2例,泌尿系结核9例,泌尿系结石13例,良性狭窄并积水13例,邻近器官病变累及输尿管致积水2例,泌尿系外伤性病变2例,肾梗死1例,术后随访复查者4例,未见异常2例。其中28例经手术病理证实,MSCTU诊断泌尿系肿瘤的敏感度100%(14/14),特异度85.71%(12/14),准确率92.86%(26/28)。结论 MSCTU能够直接清晰显示肾脏、输尿管、膀胱病变,可作为临床疑诊泌尿系病变患者、特别是肿瘤患者的首选检查方法。

64层螺旋CT尿路成像技术在泌尿系统疾病中的临床应用

目的探讨64层螺旋CT尿路成像技术对泌尿系统疾病的诊断价值。方法收集50例手术或临床确诊的泌尿系统疾病患者,均进行64层螺旋CT尿路成像检查,对影像资料进行回顾性分析。结果 50例中,泌尿系统结石29例,泌尿系先天性畸形8例,输尿管炎性狭窄5例,肾盂癌3例、输尿管癌3例,膀胱癌2例。CT尿路成像技术能够清晰显示输尿管走行、腔内情况、梗阻部位和原因。结论 64层螺旋CT尿路成像技术能够准确的诊断泌尿系统疾病,图像清晰直观,可以作为早期确诊泌尿系统疾病的有效影像检查方法。

多层螺旋CT尿路造影诊断泌尿系病变的价值(附40例分析)

目的 :探讨多层螺旋CT尿路造影 (MSCTU)技术对泌尿系病变的临床诊断价值。方法 :对 4 0例泌尿系病变患者行CT平扫、肾实质期扫描 (80s开始 )或直接行肾实质期扫描 ,根据肾脏积水程度决定延迟扫描时间 ,无积水者延迟 10～ 15min ,积水者延迟 30～ 12 0min扫描 ,将原始资料传送至工作站进行图像后处理 ,获得尿路立体图像。结果 :4 0例中 ,肾癌 3例 ,肾盂癌 7例 ,输尿管癌 7例 ,结石 5例 ,炎症 6例 ,先天性发育异常 11例 ,膀胱阴道瘘 1例。 33例经手术病理 ,7例经临床证实 ,术中所见与多层螺旋CT显示的病变部位、形态、大小均一致。结论 :多层螺旋CT尿路造影具有扫描速度快、覆盖范围广、图像质量高及薄层扫描的特点 ,对泌尿系病变的诊断具有重要价值。

螺旋CT尿路成像的临床应用价值

目的:探讨螺旋CT尿路成像(SCTU)的临床应用价值。方法:应用螺旋CT对120例经临床和病理证实的泌尿道病变患者做平扫及四期增强扫描,并作曲面多平面重建(MPR)和SCTU重建,观察SCTU显示和诊断泌尿道病变的能力,并与其他检查技术及手术病理结果进行比较。结果:99.2%的患者SCTU结合轴位及曲面MPR能很好地三维立体显示泌尿道病变的部位、大小、形态和分布范围及尿路梗阻的情况;101例手术患者,泌尿道病变在螺旋CT图像上的表现与手术所见有很好的一致性。SCTU能显示部分病变的特征,可作为轴位和MPR图像的补充,并可弥补其他影像学检查的不足。结论:SCTU对泌尿道病变的显示和诊断有优越性,具有很高的临床应用价值,但必须密切结合多期轴位和MPR图像,才能对病变做出全面、准确的诊断。

螺旋CT尿路造影对输尿管病变的诊断价值

目的评价螺旋CT尿路造影(CTU)对输尿管疾病的诊断价值。方法回顾分析60例输尿管疾病患者的CTU三维图像表现,并与手术病理对照。结果CTU图像质量很好、好、差分别占58.3%、38.3%、3.3%。单纯轴位像与轴位像结合CTU对各种输尿管疾病的定性诊断符合率分别为76.7%和95%(χ2=10.38,P<0.01)。结论应用CTU作为辅助诊断手段,可得到比单纯轴位像更多的诊断信息,并对输尿管病变作出准确的定位、定性诊断。

CT尿路成像和静脉肾盂造影在泌尿系统疾病诊断中的比较研究

目的 比较CT尿路成像（CTU）和静脉肾盂造影（IVU）诊断泌尿系统疾病的准确率、放射线辐射剂量、检查费用等。探讨临床上CTU能否取代IVU。方法 共108例患者行IVU和CTU检查,男性78例,女性30例,平均年龄42（18~71）岁。结石54例、肾囊肿3例、各种原因的输尿管梗阻16例、结核3例、腹膜后纤维化2例、膀胱癌16例、肾癌2例、输尿管癌2例、盆腔肿物2例、肾输尿管畸形3例、肾盂癌3例、正常3例。以临床病理学诊断为标准,判断IVU和CTU的诊断准确率。结果 CTU诊断准确率为90.43%,IVP诊断准确率为49.69%（P〈0.05）。其中结石的诊断准确率为CTU 100%,IVP 78.40%;肾囊肿CTU 100%,IVP 11.11%;除结石肿瘤外的输尿管梗阻CTU 77.08%,IVP 8.33%;结核CTU 77.78%,IVP 11.11%;腹膜后纤维化CTU 100%,IVP 33.33%;膀胱癌CTU 89.58%,IVP 22.92%;肾癌CTU 100%,IVP33.33%;输尿管癌CTU83.33%,IVP50%;盆腔肿物CTU 100%,IVP 0%;肾盂癌CTU77.78%,IVP77.78%;肾输尿管畸形CTU83.33%,IVP 50%;正常CTU100%,IVP 88.89%。检查费IVU约600元,CTU约1600元。结论 CTU的诊断准确率显著高于IVU,但由于放射线辐射剂量远高于IVU、设备昂贵且检查费用高于IVU,故临床上CTU不能完全替代IVU。

输尿管囊肿的影像学诊断

目的:研究输尿管囊肿的影像学诊断并评价其诊断价值。方法:对18例输尿管囊肿患者进行了平片、静脉肾盂造影(IVP)、超声(US)、膀胱造影、CT及MRI检查并结合膀胱镜、临床手术及病理结果进行了全面分析。结果:18例输尿管囊肿患者术前均作出了正确影像诊断及分型,US、IVP及膀胱镜的联合应用可明显提高诊断符合率。结论:多种影像学检查的联合应用对输尿管囊肿具有很高的诊断效果和价值。

64排螺旋CT尿路成像的临床应用价值探讨

目的:探讨64排螺旋CT尿路成像的临床应用价值。方法:对临床怀疑泌尿系统病变的52例患者行64排螺旋CT容积扫描及尿路三维重建。结果:52例中输尿管瘘1例,输尿管结石12例,输尿管癌5例,双肾盂2例,肾盂癌5例,膀胱癌2例,其他3例,正常22例。CT图像不仅能清晰地显示输尿管走行、腔内改变、梗阻部位及原因,还可以同时显示管壁及腔外情况。结论:64排螺旋CT可多方位动态观察肾盂、输尿管及膀胱的正常解剖形态及各种病理改变,并从三维立体图像上获得更丰富的诊断信息,是全面立体动态诊断泌尿系统病变较好的影像检查方法。

多层螺旋CT尿路造影在泌尿系统病变诊断中的价值

目的;探讨多层螺旋CT尿路造影（MSCTU）对泌尿系病变的诊断价值。方法:收集经KUB、IVU检查单侧输尿管显示欠佳或不显影患者38例,健康志愿者4例,行CT平扫、肾脏增强双期扫描及尿路造影,将平扫及尿路造影资料传送至工作站,进行最大强度投影（MIP）、多平面重建（MPR）及容积重建（volume-rendering）,获得完整尿路影像。结果:所有病例在14～22s内完成全尿路扫描。24例输尿管结石,重建图像能清晰显示结石位置及上段积水情况;2例肾肿瘤及1例输尿管切开取石术后患者显示输尿管内多发血块;2例术后输尿管粘连及肿胀致输尿管梗阻;1例结肠癌淋巴结转移侵犯输尿管;3例肾盂输尿管重复畸形清晰显示输尿管汇合部位;1例尿瘘可见尿湖位于输尿管中段,肾盂瘘口与之相连;1例先天性巨输尿管和1例腔静脉后榆尿管完整显示其形态和走行。结论:多层螺旋CT具有超高速、大范围、薄层扫描能力,应用于尿路造影有其独特优势,可作为临床一种新的辅助诊断手段。

低剂量延迟期扫描在泌尿系统疾病MSCTU中的临床应用

目的:探讨MSCT尿路成像(MSCTU)中延迟期低剂量扫描方案(100 k V+CARE Dose 4D)对泌尿系统疾病的诊断价值,并探讨三种不同后处理重组技术(MPR/CPR、MIP、VR)图像对泌尿系统疾病诊断的敏感性。方法:34例MSCTU患者延迟期采用低剂量扫描方案,所有患者延迟期1 mm薄层数据进行CTU图像重组,并与临床、病理诊断进行对照研究。结果:34例中全尿路MSCTU图像的定位诊断准确率为97.1%(33/34),定性诊断准确率为91.2%(31/34)。三组不同图像组合对泌尿系统疾病的定位诊断准确性均高于定性诊断的准确性。其定位、定性诊断敏感性,从高到低依次为:全尿路MSCTU图像>含延迟期CT轴位>常规CT轴位,其中全尿路MSCTU图像与常规CT轴位的诊断差异有显著统计学意义(P<0.012 5),其余组合均无统计学意义(P>0.012 5)。CT尿路造影后处理重组三种技术对泌尿系统疾病的定位、定性诊断准确率从高到低依次为MPR/CPR>MIP>VR图像,定位诊断准确率高于定性诊断准确率。其中MPR/CPR技术与MIP、VR技术对照,差异均有统计学意义(P=0.000),而MIP技术与VR技术比较,两组差异均无统计学意义(P>0.012 5)。结论:MSCTU技术延迟期采用100 k V结合CARE Dose 4D技术方案,不仅能够明显减少单期辐射剂量,而且能提高泌尿系统疾病的定位、定性诊断的准确性,值得临床推广应用。

多层螺旋CT曲面重建尿路成像技术的应用

目的 :探讨多层螺旋CT(MSCT)任意角度曲面重建 (CPR)尿路成像技术在泌尿系病变诊断中的临床应用价值。方法 :3 1例泌尿系病变患者中 ,肾盂癌 4例 ,肾盂结石 1例 ,输尿管结石 5例 ,输尿管单纯狭窄 3例 ,输尿管癌 2例 ,迷走血管压迫输尿管 2例 ,膀胱癌 2例 ,前列腺癌侵犯膀胱 1例 ,腹腔脓肿压迫输尿管 1例 ,膀胱炎 3例 ,输尿管炎 7例。 3 1例均采用 10mm层厚、层距行腹盆部MSCT容积扫描 ,获得原始横断面图像 ,采用 2 .5mm层厚、1.2 5mm层间距重叠 5 0 %重建轴面源像 ,传输至AW 4.0图像工作站 ,利用reformat软件进行尿路多平面重建 (MPR) ,获得冠状面、矢状面及任意斜面尿路图像 ,再沿尿路走行划曲线进行CPR尿路成像。采用双盲法 ,对泌尿系病变作出定位、定性诊断。结果 :3 1例CPR尿路成像成功率为 10 0 % ,图像清晰 ,均清楚地显示尿路全程及其周围组织结构。结论 :任意角度CPR技术可获得良好的尿路成像 ,CPR尿路成像可全面、直观地跟踪显示尿路全程 ,在泌尿系病变诊断方面具有独特的优势。

多层螺旋CT三维尿路成像技术对泌尿系梗阻性疾病的诊断价值探讨

目的探讨多层螺旋CT泌尿系二维、三维成像的有关影像学表现和临床价值。方法选取泌尿系梗阻病例27例,行16层螺旋CT扫描,将原始数据重建后传至工作站(Vitrea2,Version3.4,Toshiba),应用多平面成像(MPR)、曲面重建(CPR)及容积重建(VR)等后处理技术进行尿路成像,并对结果进行对比分析研究。结果泌尿系结石7例,肿瘤10例,感染4例(慢性炎症3例,结核1例),盆腔手术致输尿管医源性破裂1例,迷走血管压迫狭窄1例,先天畸形2例,输尿管外压性梗阻2例,结论多层螺旋CT泌尿系成像,是一种无创伤检查,操作简便,能可靠地显示泌尿系统结构。多层螺旋CT泌尿系成像比静脉肾造影有更高的显影率。MSCTU重组图像清晰,对泌尿系肿瘤、结石或其他尿路梗阻性疾病有着独特的临床应用价值。

自发性肾破裂的综合影像学诊断与评价(附22例报道)

目的:总结自发性肾破裂的影像学表现,评价US、IVU、CT、MRI等多种影像学检查技术对自发性肾破裂及其病因的诊断价值。材料与方法:22例均经US检查,17例经CT检查(13?17增强),8例经MRI检查(5?8增强,2?8MRU),14例经IVU检查,2例经逆行肾盂造影检查。结果:自发性肾破裂的病因中AML5例,肾癌3例,肾胚瘤1例,肾上腺嗜铬细胞瘤1例,盂管交界部狭窄继发脓肾1例,前列腺肥大1例,反流性肾病并肾结石2例,结石微波碎石后输尿管结石梗阻1例,妊高症1例,腹膜后纤维化1例,腹膜后恶性淋巴瘤1例,Bertin柱增生1例,原因不明3例。16例经手术病理证实,1例经超声引导下穿刺证实,5例经影像及临床诊断,随诊观察。结论:CT或MRI增强扫描对自发性肾实质破裂的直接征象及病因诊断最有价值,多种影像检查与临床资料的综合分析是正确、全面诊断的关键。