胰周小静脉的观察在胰腺癌分期中的价值

目的　探讨胰周小静脉在胰腺癌分期中的作用。方法　对正常组 3 0例及胰腺癌 44例行螺旋CT双期扫描 ,即胰腺期和肝脏期 (注射对比剂后 3 5s和 70s)扫描。统计正常组胰腺期及肝脏期胰周小静脉的显示率 ,观察胰腺癌病例胰周小静脉扩张情况及其他改变。结果　正常组胰周小静脉的显示率为 73 %～ 90 % ,胰腺期优于肝脏期 ;胰周小静脉扩张者占不可切除性肿瘤的 41% (13 /3 2 )。结论　胰周小静脉的显示率胰腺期优于肝脏期 ,胰周小静脉的扩张可作为胰腺癌不可切除的重要参考。     

低管电压联合低剂量对比剂扫描方案用于MSCT门静脉成像

目的探讨低管电压联合低对比剂扫描方案用于MSCT门静脉成像(MSCTP)的可行性。方法纳入接受MSCTP、体质量指数25kg/m2的患者118例,随机分为两组:双低组(n=59),管电压90kVp,管电流395mAs,对比剂用量1.2ml/kg体质量;常规组,管电压120kVp,管电流200mAs,对比剂用量1.5ml/kg体质量。比较两组门静脉期图像质量评分、肝实质CT值(CTH)、门静脉CT值(CTP)、图像噪声(SD),肝实质SNR(SNRH)、门静脉与肝实质CNR(CNRP)及有效剂量(ED)差异。结果双低组图像质量评分(4.53±0.32)高于常规组(3.71±0.32,P0.05);双低组CTH[(101.11±16.65)HU]、CTP[(186.94±29.29)HU]、SNRH(6.92±2.28)和CNRP(5.71±2.00)均明显高于常规组[CTH:(83.61±13.94)HU,CTP:(141.85±26.89)HU,SNRH:6.05±1.58,CNRP:4.23±1.65;P均0.05],两组图像SD差异无统计学意义[(16.32±9.21)HU vs(14.33±2.32)HU,P0.05];双低组ED[(3.81±0.44)mSv]明显低于常规组[(5.77±0.52)mSv,P0.05)。结论采用低管电压结合低剂量对比剂扫描方案进行MSCTP可提高图像质量,并降低辐射剂量。     

肺结核基本病理改变的MSCT表现

<正>结核病是机体受结核分支杆菌感染后引发的炎症性疾病。在病理上表现为血管改变而致的炎性渗出、组织改变出现的增殖、变质三大改变。结核性炎症与一般炎症不同,渗出的细胞常以单核细胞为主;增生引发结核结节;变质则出现干酪样坏死[1]。MSCT的推广应用,使得薄层高分辨力扫描成为常规扫描,与以往的CT比较,可以更精细地显示肺内的病理改变。因此,有必要对结核病三大基本病理改变的MSCT表现进行更加深入的探讨。     

18F-FDG PET/CT显像在恶性胸膜间皮瘤诊断中的价值

Objective Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the diagno-sis and to staging of MPM and to determine if the mean standardized uptake value (SUVmax) of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 pa-tients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pa-thology were proven by histopathology and clinical follow-up. 18F-FDG PET/CT imaging was performed 1 h af-ter injection of 7.4 MBq/kg 18F-FDG. Patients with MPM confirmed by histopatholagy were divided into two groups: with and without metastasis. PET/CT findings were analyzed to determine if SUVmax of primary tumor correlates with staging and prognosis. Receiver operating characteristic (ROC) curve of SUVmax of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmax between MPM and benign pleural were statistical significant (5.78±1.81 vs 2.72± 2.51, t = 2. 8, P < 0.05). The diagnostic sensitivity, specificity and accuracy of 18F-FDG PET/CT imaging for MPM were 100% (12/12) , 4/5 and 94% (16/17). All 7 cases of bone and lymph node metastases were detected by 18F-FDG PET/CT imaging. Area under the curve (AUC) was 0.80. Conclusions 18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmax in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.     

脑池段面、前庭蜗神经及其病变的磁共振成像研究

目的:通过探讨3D-CISS磁共振成像序列对脑池段面、前庭蜗神经及内耳结构显示的价值,为临床耳科病例选择最优检查方式.方法:对48位正常体检者和8位伴有面神经或前庭蜗神经异常的病人行3D-CISS MR成像,在MPR、MIP图像上最大程度地显示面、前庭蜗神经及内耳膜迷路.结果:48位正常体检者的脑池段面神经、前庭蜗神经及其分支、内耳膜迷路显示率均为100%;8例面神经或前庭蜗神经异常患者均有明显异常MRI表现:其中1例显示双侧听神经瘤,1例显示右侧桥小脑角区胆脂瘤包绕面听神经,1例为右侧脑池内蛛网膜囊肿压迫前庭蜗神经,1例为面、前庭蜗神经及相邻血管粘连,1例获得性感音神经性聋患者显示蜗神经萎缩变细,3例显示动脉血管压迫面听神经.结论:3D-CISS能够清晰显示面神经、耳蜗前庭神经及内耳膜迷路的精细结构,对于内耳异常的发现具有重要价值.     

多层探测器CT心脏成像的原理及进展

多层探测器CT技术的迅猛发展使其在心脏血管成像方面取得了广泛的应用,非常有潜力成为一种无创诊断心脏和冠脉疾病的理想工具。理解多层探测器CT心脏成像的原理及影响因素对于优化扫描程序、提高图像质量、降低辐射剂量是非常必要的。     

CT导向穿刺治疗的临床价值

ＣＴ导向穿刺治疗的临床价值邵广瑞，柳澄，王锡明，杨青，李卫东，王林，吴云本文总结３２例ＣＴ导向穿刺治疗脓肿及囊肿的资料，进一步探讨其临床实用价值。１资料本组３２例，男２０例，女１２例，年龄２０～６２岁，病程１０天至５年，肝脓肿１２例，腰大肌脓肿５例，...     

腹部螺旋CT血管成像技术

随着螺旋CT和多层螺旋CT技术的发展,CT血管成像(CTA)在腹部的应用范围扩大.腹部CTA对扫描和后处理技术有较高要求.本文对CTA的各方面技术及其进展作一综述.     

多发性硬化的颅脑MR表现

资料与方法本组包括37例经临床确诊的多发性硬化病人。女29例,男8例。年龄13～59岁。使用Picker公司生产的1.5T和0.5T两种MR机器。共进行41次扫描(4人经两次扫描)。扫描序列用自旋回波(SE)序列:①TR/TE=500/25msec(T_1加权图像);②多回波:TR/TE=2000/30,60(90)msec(质子密度图像与T_2加权图像)。     

影像学对骨肉瘤和尤文氏瘤化疗反应评价进展

骨肉瘤患者在放疗及术前进行化疗越来越被广泛应用,影像学对其化疗反应评价有重要意义。影像检查用来估计预后,修正术前化疗方案,制定放疗、手术及术后化疗方案。本文对常规X线,血管造影,CT,核素闪烁检查优缺点做一阐述,并讨论最近MRI及MR波谱在评价治疗方面的应用。