急性膀胱炎超声表现特点

目的探讨急性膀胱炎(AC)的超声声像图特点。方法将32例AC自然充盈膀胱后的左右径、上下径、前后径,膀胱壁厚度、膀胱壁光滑度及膀胱内透声状态与63例正常组所测膀胱对应各值比较。结果炎症组与正常对照组膀胱左右径、上下径及前后径比较均无显著性差异,膀胱壁厚度炎症组(0.446±0.036)cm,对照组(0.224±0.036)cm,两者间有非常显著性差异P<0.01。尿频症状明显同时伴有血尿者,膀胱壁增厚的几率增加。结论膀胱壁增厚(以黏膜层为著),尿液透声差或透声欠佳是AC的主要超声征像。     

CT在老年人硬膜下血肿诊断中的作用

老年人硬膜下血肿(SDH)系指60岁以上高龄人的SDH而言。由于近年来各国人口老年化率上升,老年人颅脑损伤的比例也随着增高,老年SDH也相应增多[1]。这类病人的临床表     

外伤性脑梗死的CT诊断

目的总结外伤性脑梗死的CT特征,探讨其发生机制,揭示其对疾病预后的判定价值。方法回顾性分析40例外伤性脑梗死患者头颅CT表现及相关临床资料。结果轻微外伤引起的脑梗死多发于儿童,好发部位为基底节内囊区,预后较好;重症外伤引起的脑梗死好发于成人,发病部位多见于颅内血肿同侧,且大脑后动脉支配区域最为多见,预后较差。结论CT扫描对外伤性脑梗死的诊断及预后判定有重要价值。     

多层螺旋CT对胫骨平台骨折的诊断价值

目的:评价MSCT在胫骨平台骨折的分类及制定合理的治疗方案方面的价值。方法:对24例常规X线平片或临床诊断为胫骨平台骨折的患者进行MSCT扫描,并对图像进行MPR、SSD和VR重建,对骨折的部位、范围、碎骨片的数量或骨折程度、胫骨平台受累情况、手术入路、骨质疏松程度及骨组织的缺损等做出评价。骨折的分型根据Swiss AO-ASIF法。结果:24例患者中有19例进行了手术治疗,术中所见与轴位MSCT和MPR、SSD及VR重建图像综合做出的诊断一致。结论:MSCT及其MPR、SSD、VR重建技术对于胫骨平台的骨折分型及术前评价有重要意义。     

多层螺旋CT在胰腺癌诊断中的应用

多层螺旋CT（MSCT）使扫描速度，薄层，覆盖范围达到了很好的统一，是胰腺癌最佳的单项检查手段。本文介绍了MSCT运用于胰腺的技术优势以及具体检查方法，重点叙述其在胰腺癌的诊断，术前可切除性的评估等方面的应用。     

碘对比剂在CT检查中的应用

我院自 1994年使用CT检查以来 ,需增强检查者的比例越来越高。增强检查确实提供了CT平扫不可替代的诊断信息 ,但是碘对比剂的副作用却令人担忧 ,因此 ,CT室的护理人员应认真做好对患者的筛选、敏试工作 ,严格掌握禁忌证 ,加强对副反应的预防性措施及意外抢救工作 ,合理使用对比剂 ,现将我院应用碘对比剂的方法介绍如下。1　严格掌握禁忌证严重的甲状腺功能亢进、失代偿性心肌功能不全者禁忌。妊娠及急性盆腔炎症时禁行子宫输卵管造影。2　认真筛选高危因素有碘造影剂过敏、严重肝肾功能损害、心脏和循环功能不全、肺气肿、体质极差者 ,重…     

18F-FDG符合线路显像与同机CT融合在肿瘤诊断的应用

【目的】评价~(18)F-FDG符合线路显像及同机CT图像融合在肿瘤诊断中的价值。【方法】经病理确诊或临床确诊为恶性肿瘤的病人79例,良性肿块病人19例进行~(18)F-FDG符合线路显像及同机CT图像融合检查,经COSEM重建,结果与解剖显像比较。【结果】①~(18)F-FDG符合显像诊断恶性肿瘤的敏感性、特异性、准确率、阳性预测值和阴性预测值分别为92.4％、89.5％、91.8％、97.3％和73.9％,解剖显像分别为79.8％、63.2％、76.5％、90.0％和42.9％。②同部位显像比较中,~(18)F-FDG显像病灶探测数为302个,而解剖显像为286个。③同机CT融合明显提高对肺部近纵隔、膈缘及腹部等部位的定位诊断。【结论】~(18)F-FDG符合线路显像较解剖显像更好地对恶性肿瘤作出鉴别诊断,并且能探测到更多的恶性病灶,同机CT融合较大地提高定位诊断的准确性,具有重要的临床价值,值得临床广泛应用。     

Interobserver Agreement for the Diagnosis of Venous Thromboembolism on Computed Tomography Chest Angiography and Indirect Venography of the Lower Extremities in Emergency Department Patients

Objectives: To determine interobserver agreement between radiologists for computed tomography (CT) angiography and venography. CT venography of the lower extremities combined with standard CT angiography of the chest may result in an increased overall diagnosis rate of venous thromboembolism (pulmonary embolism or deep venous thrombosis).
Methods: The study had a retrospective cohort design. The population consisted of emergency department patients who were evaluated for suspected pulmonary embolism. A random sample of 50 patients diagnosed and treated for venous thromboembolism and 50 age- and gender-matched patients whose CT angiograms and venograms were read as negative were enrolled. The original reading (R1) was compared with readings of two study radiologists: R2, a general radiologist, and R3, a radiologist with fellowship training in cross-sectional imaging. All readers were blinded to each other.
Results: Both R2 and R3 found both CT angiogram and venogram components technically adequate in 95% (95% CI = 89% to 98%) and 86% (95% CI = 78% to 92%) of studies, respectively. The agreement was very good for CT angiography (lowest agreement = 92%; lowest κ = 0.83) and was good for CT venography (85%, κ = 0.65). In nine cases, R1 read the CT angiogram as negative but the venogram as positive for DVT, whereas both R2 and R3 read both components as negative in four of these nine, suggesting a false-positive isolated DVT rate of 44% (95% CI = 19% to 73%). In no case did R1 read both scan components as negative when R2 and R3 agreed on presence of pulmonary embolism or DVT.
Conclusions: Diagnosis of pulmonary embolism on CT angiography is more reliable than diagnosis of isolated DVT on CT venography.     

螺旋CT在肺动脉栓塞诊断中的价值

目的:评价螺旋CT在诊断肺动脉栓塞中的作用。方法:16例肺动脉栓塞患者行螺旋CT肺动脉造影 (SCTA)检查,层厚3mm,扫描时间0.8s,对比剂注射速度3.5ml/s,总量100ml,扫描延迟时间15s。结果:16例 共644支,其中134支肺动脉及分支显示了栓塞,占20.8%。228支肺段肺动脉中,有56支显示肺动脉栓塞,占分 析肺动脉支的24.5%。204支亚段肺动脉中37支显示肺动脉栓塞,占分析肺动脉支15.4%。肺动脉栓塞的CT形 态:①直接征象为不同程度的肺动脉分支内充盈缺损。中心型充盈缺损17支,偏心型充盈缺损44支,附壁血栓型 34支,完全阻塞型39支。②间接征象胸膜下肺梗死灶,内乳动脉一侧增粗,肺纹理稀少,胸水,肺动脉高压。结论: 螺旋CT肺动脉造影是诊断肺动脉栓塞的快速、有效、无创伤的诊断方法。