多层螺旋CT联合C反应蛋白、纤维蛋白原对老年结肠癌患者术前评估

目的：探讨多层螺旋CT（MSCT）联合检测血清C反应蛋白（CRP）、纤维蛋白原（FIB）对老年结肠癌患者术前评估的临床意义。方法前瞻性纳入108例老年结肠癌患者,随机分为观察组和对照组各54例,对术前分期及术式预测分别与术后病理分期及实际手术方案进行比较。结果观察组术前T、N、M及TNM分期准确度分别为75.93％、87.04％、100％、85.19％,对照组分别为61.11％、66.67％、94.44％、68.52％,观察组术前N、TNM分期的准确度明显高于对照组,差异均有统计学意义（χ2=6.30、4.22,P均＜0.05）,两组T、M分期比较,差异无统计学意义（χ2分别=2.75、3.09,P均＞0.05）;观察组手术方案预测符合率92.59％高于对照组77.78％,差异有统计学意义（χ2=4.70, P＜0.05）。结论 MSCT联合CRP对于老年结肠癌患者术前N、TNM分期及手术方案预测优于MSCT联合FIB。     

Anatomy Relationship around Internal Carotid Artery in the Endoscopic Surgery of Nasopharynx: A Study Based on Computed Tomography Angiography

Objective Anatomic knowledge is needed to avoid injury to internal carotid artery (ICA) during the endoscopic surgery around nasopharynx and its surrounding space. Design We prospectively studied the computed tomography angiography (CTA) data of 28 patients with image processing software. Special attention was given to ICA and various landmarks around nasopharynx. Results The anatomic relationship between ICA and different landmarks around nasopharynx was clearly presented in three-dimension. The fossa of Rosenmuller is the nearest point of the nasopharyngeal cavity to ICA. The opening of the Vidian canal in the middle cranial fossa could be either above, below, or at the level of the horizontal segment of petrous ICA. The pharyngeal trunk of the ascending pharyngeal artery can also be clearly identified in most reconstructed CTA images. Multiple anatomic relationships were also quantified. Conclusions Reconstructed CTA can provide key anatomic information for a safe and accurate endoscopic dissection around nasopharynx.     

Unsuspected colorectal carcinoma on routine abdominopelvic computed tomography

Colorectal carcinoma is a common lethal disease with signs and symptoms that may be nonspecific. Computed tomography (CT) of the abdomen and pelvis with or without contrast is frequently performed for various general abdominal complaints, but unlike CT colonography, the large bowel may not be optimally prepared for evaluation. As such, careful and diligent assessment of the non-prepared colon in all CT images of the abdomen and pelvis is important, as it ensures that incidental colorectal malignancy is not missed, especially in older patients. This article gives an overview of multidetector CT imaging signs and subtle clues to aid in the diagnosis of colorectal carcinoma, as well as their pitfalls.