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.

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.

胸部多层螺旋CT低剂量联合血清S100A10和CST1在早期肺癌中的筛查价值

目的探究胸部多层螺旋CT低剂量联合血清S100钙结合蛋白A10(S100A10),胱抑素SN(CST1)在早期肺癌中的筛查价值。方法选取2018年1月1日至2020年8月31日本院收治的497例肺部结节患者,根据病理诊断结果分为良性病变患者86例,肺癌患者411例。对患者进行胸部多层螺旋CT低剂量扫描,采用ELISA法检测血清S100A10、CST1水平。用ROC曲线分析血清S100A10、CST1水平对早期肺癌的诊断价值;用四格表法分析胸部多层螺旋CT低剂量联合血清S100A10、CST1对早期肺癌的诊断价值。结果肺癌患者血清S100A10、CST1水平高于良性病变患者(P<0.05)。血清S100A10、CST1水平诊断早期肺癌的AUC为0.729、0.707,敏感性为67.64%、53.04%,特异性为69.77%、81.40%。CT低剂量扫描诊断敏感性为89.29%(367/411),特异性为73.26%(63/86),准确度为86.52%(430/497),其诊断结果与术后病理诊断结果具有一致性(Kappa值=0.570,P<0.05)。胸部多层螺旋CT低剂量联合血清S100A10、CST1早期诊断肺癌的敏感性为97.32%(400/411),特异性为67.44%(58/86),准确度为92.15%(458/497),三者联合对早期肺癌的诊断结果与术后病理诊断结果具有较好一致性(Kappa=0.703,P<0.05)。胸部多层螺旋CT低剂量联合血清S100A10、CST1诊断早期肺癌的敏感性和准确度显著高于胸部多层螺旋CT低剂量、S100A10、CST1单独诊断。结论胸部多层螺旋CT低剂量联合血清S100A10、CST1水平诊断早期肺癌的敏感性和准确性较高,三者联合诊断可能对早期肺癌筛查具有重要应用价值。

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.

多层螺旋CT低剂量胸部扫描对肺结节的诊断分析

目的探讨多层螺旋CT低剂量胸部扫描对肺结节的诊断价值,以期为临床诊断提供参考。方法对在我院行CT扫描发现的50例肺结节病患者的影像学资料进行回顾性分析,分别采用CT常规剂量和30 mA低剂量进行胸部扫描,对肺结节数量的检出情况和肺结节的形态学特征进行比较。结果两种剂量的检测方法均检查出68枚结节,低剂量扫描检测钙化、空洞、毛刺征、分叶征、支气管征和胸膜粘连征等肺结节形态学的结果与常规剂量比较,差异无统计学意义(P>0.05);常规剂量扫描测量肺结节直径为(11.2±6.5)mm,低剂量扫描测量肺结节直径为(11.3±6.1)mm,两者比较差异无统计学意义(P>0.05)。结论CT低剂量胸部扫描与常规扫描的价值等同,且低剂量CT扫描对患者的辐射危害性小,可见低剂量CT用于肺结节的诊断是可行的,可以推广应用。

肺部多排螺旋CT低剂量扫描技术的应用价值

目的:探讨16排螺旋CT低剂量扫描技术在肺部相关疾病诊断中的价值。方法:回顾性分析43例行16排螺旋CT低剂量技术扫描的患者图像资料,评价其图像质量。结果:所有患者均按照要求完成检查,图像质量级别良好以上,噪声虽有增大,但不影响解剖结构的显示,能够满足对肺部相关疾病的诊断要求。结论:肺部多排螺旋CT低剂量扫描在提高病变检出率的同时,能够减少患者的辐射剂量,延长球管的使用寿命,降低维修费用,值得进一步推广。

MRI多b值成像联合低剂量多层螺旋CT扫描对肝硬化再生结节与小肝癌结节的鉴别诊断价值

目的探讨MRI多b值成像联合低剂量多层螺旋CT扫描在肝硬化再生结节与小肝癌结节鉴别诊断中的价值。方法随机选取肝硬化再生结节与小肝癌结节(均经病理证实)患者作为研究对象159例,其中肝硬化再生结节101例将其纳入肝硬化组,将小肝癌结节48例纳入肝癌组。使用MRI多b值成像、低剂量多层螺旋CT扫描检测。分析两种影像学和联合诊断结果及诊断鉴别效能比较。结果低剂量多层螺旋CT检出101例,59例肝硬化再生结节确诊,20例小肝癌结节确诊。MRI多b值成像CT检出124例,63例肝硬化再生结节确诊,27例小肝癌结节确诊。联合检出142例,81例肝硬化再生结节确诊,39例小肝癌结节确诊。MRI多b值成像与低剂量多层螺旋CT扫描在检出率和肝硬化再生结节与小肝癌结节确诊率方面比较差异无统计学意义(P>0.05)。联合诊断扫描在检出率和肝硬化再生结节与小肝癌结节确诊率均高于单纯MRI多b值成像、低剂量多层螺旋CT扫描(P<0.05)。MRI多b值成像联合低剂量多层螺旋CT扫描诊断鉴别效能最高(P<0.05)。结论MRI多b值成像联合低剂量多层螺旋CT扫描能提升肝硬化再生结节与小肝癌结节鉴别诊断价值,减少误诊,建议使用。

肋骨骨折多层螺旋CT最佳低剂量扫描参数的选择

目的探讨肋骨骨折低剂量多层螺旋CT扫描的最佳参数。方法将30名志愿者随机分为3组,分别行低剂量螺旋CT扫描,管电流分别设置为100 mA、50 mA及25 mA,扫描后行薄层及VR、MPR重建,由三位不同年资医师分别进行影像分析,并进行不同管电流组间统计学秩和检验(Kruskal Wallis检验),选取最佳低剂量扫描参数。再选择10例肋骨骨折患者利用最佳扫描参数进行检查以判断其对于诊断肋骨骨折的可靠性。结果统计学表明,χ2=18.921,P=0.000,三组间差异均有统计学意义。100 mA、50 mA扫描及重建影像显示肋骨结构清晰、完整,噪音小,无伪影,均能达到诊断目的。25 mA由于噪声及伪影的影响,影像不能完全达到诊断目的。50 mA肋骨骨折患者低剂量螺旋CT扫描后处理影像能完整显示肋骨骨折。结论 50mA管电流是肋骨骨折低剂量多层螺旋CT扫描的最佳参数。

低剂量扫描在多层螺旋CT冠状动脉成像中的应用进展

随着多层螺旋CT(MSCT)的飞速发展以及双源CT的问世,MSCT在诊断冠状动脉的粥样硬化斑块、评价支架的术后再狭窄以及评估搭桥血管中发挥了越来越重要的作用。但随着MSCT时间分辨率和空间分辨率的进一步提高,在追求更好冠状动脉成像质量的同时,也产生了更多的辐射剂量。流行病学调查显示,CT检查的X线辐射剂量的增高可增加癌症的风险。因此,有效降低CT冠状动脉造影检查中的辐射剂量以保护受检查者具有重要意义。

低剂量MSCT测量COPD患者肺指标与肺功能检查的相关性

目的考察低剂量MSCT测量COPD患者肺测量指标与常规肺功能检查的相关性,评价低剂量MSCT的使用价值。方法回顾性选取2016年1月~2019年1月于本院呼吸内科同时行MSCT和肺功能检查的COPD住院患者以及健康受试志愿者各37例,利用64排128层螺旋CT行肺部MSCT扫描,自动化软件测量和计算容积指标;利用肺功能机测定患者肺功能情况,采用SPSS22.0软件对MSCT肺容积指标和常规肺功能指标进行比较并分析二者的相关性。结果两组肺容积指标中,相比对照组,观察组Vin、Vex、Vex/Vin明显更高,Vin-Vex更低,差异均有统计学意义(P<0.05);肺功能检查结果中,相比对照组,观察组TLC、RV、RV/TLC明显更高,VC、FEV1、DLCO、FEV1/FVC更低,差异均有统计学意义(P<0.05);相关性分析中,Vin与TLC相关性最好,Vex与RV相关性最好,Vex/Vin与RV/TLC、Vin-Vex与VC均呈正相关(P均<0.05)。结论低剂量MSCT测量COPD患者的肺指标测量值与肺功能检查部分指标具有较高的相关性,可明确COPD患者肺功能结构的变化,可作为辅助评估COPD患者肺通气功能的手段,且扫描曝光剂量低,值得在临床中推广使用。

多层螺旋CT低剂量扫描在胸部体检中的应用

目的探讨多层螺旋CT小毫安低剂量肺部体检的临床应用价值。方法运用多层螺旋CT对50例受检者行肺部扫描,扫描条件为120kV,25或50mAs,并进行标准与肺模式两种方式重建。结果 50例受检者中发现病变13例。结论多层螺旋CT小毫安低剂量肺部体检普查值得推广。

双能量减影与低剂量多排螺旋CT在输尿管结石诊断中的应用价值

目的探讨双能量减影(DES)与低剂量多排螺旋CT(MSCT)在输尿管结石诊断中的应用价值。方法选择2020年1月至2021年6月中山市中医院收治的62例疑似输尿管结石患者作为研究对象。62例患者均接受DES与低剂量MSCT检查,观察DES与低剂量MSCT诊断输尿管结石结果。以临床最终诊断结果作为金标准,比较DES与低剂量MSCT诊断输尿管结石的特异度、准确度和灵敏度,比较DES与低剂量MSCT对不同部位输尿管结石的诊断检出率。结果临床最终诊断结果显示,62例疑似输尿管结石患者中阳性49例,阴性13例。其中下段输尿管结石19例,中段输尿管结石16例,上段输尿管结石14例。DES诊断输尿管结石的准确度、灵敏度高于低剂量MSCT,差异有统计学意义(P<0.05);两种检查方法诊断输尿管结石的特异度比较,差异无统计学意义(P>0.05);两种检查方法在下段、中段、上段输尿管结石诊断检出率比较,差异无统计学意义(P>0.05)。结论DES诊断输尿管结石敏感度、准确度较高,有利于提高输尿管结石检出率,降低漏诊、误诊风险,进而为患者的诊断及治疗提供确切指导,可作为诊断输尿管结石的优选方法。

多层螺旋CT低剂量扫描在儿童鼻窦炎中的诊断价值

目的探讨多层螺旋CT低剂量扫描在儿童鼻窦炎中的诊断价值。方法对150例鼻窦炎患儿进行多层螺旋CT扫描,根据扫描剂量分为A组(100 kV/100 mA)、B组(100 kV/25 mA)、C组(100 kV/40 mA),各50例。3组均进行两次扫描,对所得图像进行三维重建后,比较3组的诊断准确率及图像质量。结果3组诊断准确率差异有统计学意义(P<0.05),其中C组的诊断准确率高于A组和B组(均P<0.05)。3组患儿的图像质量评分差异有统计学意义(P<0.05),其中B组和C组的图像质量评分均高于A组(均P<0.05)。结论多层螺旋CT低剂量(100 kV/40 mA)扫描诊断儿童鼻窦炎的价值更高,可为临床诊疗提供影像依据。

低剂量低对比剂低张胃充气造影MSCT诊断胃肿瘤的临床研究

目的探讨低剂量低对比剂低张胃充气造影多层螺旋CT(MSCT)诊断胃肿瘤的临床应用价值。方法选取2015年1月至2016年1月在我院进行胃镜检查拟患有胃肿瘤的患者90例,所有患者均进行MSCT检查,将患者按就医顺序随机分为三组,每组30例。对照组采用固定毫安的方式进行检查,实验组使用低剂量低对比剂低张胃充气的方式进行检查,观察组同样使用该方法但在噪声指数中标准差方面有所不同,其中实验组SD为12,观察组为15,造影剂均使用碘海醇。对三组患者的MSCT图像质量和剂量加权指数降低率进行比较。结果对照组与实验组在胃壁情况、脏器间情况及脏器显示方面图像均较为清晰,而观察组在胃壁情况、脏器间情况及脏器显示方面,图像质量均相对较差,但并未影响定性诊断;对照组与实验组图像质量评分为10分的比例比较,差异无统计学意义(P>0.05),二者与观察组相比较,差异具有统计学意义(P<0.05);三组剂量加权指数降低率分别为12.7%、35.7%、78.6%,组间比较,差异均具有统计学意义(P<0.05)。结论在不影响图像质量的情况下,尽量减少对比剂及使用智能毫安调节的方式进行MSCT能减少人体受到的辐射量,提高安全性,同时有效减少患者的经济负担。低剂量低对比剂低张胃充气可有效提高胃肿瘤的MSCT诊断效果,具有重要的临床推广价值。

低剂量胸部CT扫描技术的应用分析

目的探讨低剂量CT胸部扫描技术的临床应用价值。方法将100例患者随机分2组，各50例，均为男18例，女32例。身高1．60～1．78m，体重50～80kg。常规A组采用管电流90mAs，对照B组管电流70mAs。管电压均为120kV，两组胸部扫描的差异对比采用t检验进行比较。扫描图像质量由2名高年资诊断医师进行盲审。结果两组对比单次扫描剂量CTDI分别为6．84mGy、5．32mGy，降幅为23．3％。常规组的平均有效管球剂量、总管球剂量和放射容积剂量指数分别为（75．83±4．92）mAs、（2092±128．14）mAs和（5．77±0．42）mGy。低剂量组分别为（56．24±5．87）mAs、（1592±114．02）mAs和（4．29±0．69）mGy，两者差异有统计学意义（t=20．62，t=35．41，t=5．48，P〈0．05）。常规组的图像噪声为（11．4±2．97）HU，低剂量组为（14．22±3．39）HU，两者差异有统计学意义（t=6．71，P〈0．05）。结论低剂量胸部CT扫描技术可明显减少对患者的辐射剂量，且图像质量能满足临床诊断要求。

儿童肺结核低剂量MSCT扫描图像特征及诊断价值研究

目的探究儿童肺结核低剂量MSCT扫描图像特征及诊断价值。方法回顾性分析本院2017年11月至2019年5月收治的48例儿童肺结核患者的临床资料,将低剂量MSCT检查诊断结果进行讨论和分析;分析其图像特征,对比不同剂量的MSCT对肺结核的病灶显示率。结果48例患者中,共检出122个病灶。经常规剂量MSCT检出109个,经低剂量MSCT检出108,两者在肺结核病灶检出率的比较上差异无统计学意义(P>0.05)。低剂量MSCT在扫描支气管气相、空洞、钙化灶等方面与常规剂量MSCT扫描比较无明显差异(P>0.05);经低剂量MSCT扫描,发现炎症型支气管淋巴结结核有11例,结节型支气管淋巴结结核9例,原发综合征性13例,急性血行散播型肺结核9例,结核性胸膜炎6例。结论低剂量MSCT在诊断儿童肺结核中具有重要的价值,临床上可对该检查的影像学特征进行全面分析,结合患儿表现出的临床特征对肺结核进行诊断和治疗。

宝石能谱CT扫描在肺肿瘤诊断中的应用价值

目的探讨宝石能谱CT扫描在肺肿瘤诊断中的应用价值。方法选择2018年1~12月我院肿瘤科收治的40例肺肿瘤患者的临床资料进行回顾性分析,按照检查方法的不同分为对照组和实验组,各20例。对照组实施低剂量多层螺旋CT检查,实验组实施宝石能谱CT扫描,比较两组患者的临床检查结果。结果实验组的病灶检出率为95%,高于对照组的85%,差异有统计学意义(P<0.05)。实验组的诊断准确性为95%,高于对照组的85%,差异有统计学意义(P<0.05)。实验组的漏诊率明显低于对照组,差异有统计学意义(P<0.05)。两组均未出现误诊。实验组的辐射剂量为(0.65±0.05)mSv,低于对照组的(0.83±0.07)mSv,差异有统计学意义(P<0.05)。结论应用宝石能谱CT扫描对肺肿瘤进行检查,具有更高的检查准确性和安全性,能够为肺肿瘤的诊断和治疗提供可靠依据,因而推广应用价值更高。