胃肠道间质瘤的MSCT表现与病理危险程度分析

目的研究胃肠道间质瘤的MSCT表现与病理危险程度分级的关系。方法此项研究对象为医院2014年1月—2018年12月经过手术、病理等确诊为胃肠道间质瘤的患者,共计50例,对其MSCT表现进行回顾分析,评估肿瘤最大径、生长方式等和病理危险程度分级关系。结果50例胃肠道间质瘤患者中,胃部18例,胃肠道外5例,肠道27例;病理分级中低度危险7例,中度危险8例,重度危险35例。不同危险程度肿瘤出现的位置和强化情况差异无统计学意义(P>0.05),肿瘤生长方式、形态、转移情况等对比差异有统计学意义(P<0.05)。结论胃肠道间质瘤的MSCT表现有特性,和病理危险程度分级密不可分,对治疗、确定预后等有积极影响。     

CT增强造影剂不同注射速度对小肝癌诊断的影响分析

目的探讨不同速度注射造影剂进行螺旋CT(multi-slice spiral CT,MSCT)增强扫描在小肝癌(small hepatocellular carcinoma,SHCC)诊断中的价值。方法选取2014年2月—2015年6月间于本院住院治疗的SHCC患者共44例(54个病灶),将所有选中患者以随机分组的方式平均分为两组,3 ms/组(22例,25个病灶)及5 ml/s组(22例,29个病灶)。邀请3位具有多年临床经验的放射科医师对所成图像进行评价。计量资料比较采用t检验,P0.05为差异有统计学意义。结果 3位医师对两组患者诊断一致性良好(K=0.61~0.74),分别为0.61、0.66、0.72、0.65、0.74、0.61。两组患者的Az平均值分别为(0.94±0.02)、(0.93±0.02),两组患者比较差异无统计学意义(t=1.658,P0.05)。结论 SHCC的临床诊断中,3 ml/s和5 ml/s均可以采用。但因还需要进一步扩大样本量来进行进一步探讨不同注射速度的灵敏度和特异度,来证实不同注射速度的可行性。     

Micro computed tomography features of laryngeal fractures in a case of fatal manual strangulation

Cases of subtle fatal neck compression are often complicated by the lack of specificity of the post-mortem signs of asphyxia and by the lack of clear signs of neck compression.Herein we present a forensic case of a 45-year-old schizophrenic patient found on the floor of the bedroom of a psychiatric ward in cardiopulmonary arrest and who died after two days in a vegetative state. The deposition of the roommate of the deceased, who claimed responsibility for the killing of the victim by neck compression, was considered unreliable by the prosecutor.Autopsy, toxicological analyses, and multi-slice computed tomography (MSCT), micro computed tomography (micro-CT) and histology of the larynx complex were performed. Particularly, micro-CT analysis of the thyroid cartilage revealed the bilateral presence of ossified triticeous cartilages and the complete fragmentation of the right superior horn of the thyroid, but it additionally demonstrated a fracture on the contralateral superior horns, which was not clearly diagnosable at MSCT. On the basis of the evidence of intracartilaginous laryngeal hemorrhages and bilateral microfracture at the base of the superior horns of the larynx, the death was classified as a case of asphyxia due to manual strangulation.Micro-CT was confirmed as a useful tool in cases of subtle fatal neck compression, for the detection of minute laryngeal cartilage fractures, especially in complex cases with equivocal findings on MSCT.     

多层螺旋CT冠状动脉钙化积分分析

目的 探讨多层螺旋CT在冠状动脉钙化积分分析中的应用。方法 使用多层螺旋CT在心电门控监测下，对2例健康人、5例确诊为冠心的病人进行心脏平扫。再对冠状动脉钙化情况进行积分计算、分析，并结合临床回顾性分析冠状动脉钙化积分的临床意义。结果 5例冠心病人的钙化积分分析结果与其临床发病危险性程度相符。钙化积分越高，2根或2根以上的冠状动脉钙化．钙化积分在积分与年龄、性别曲线图中大于或等于50％时，冠状动脉钙化具有更大的临床意义。结论 多层螺旋CT冠状动脉钙化积分分析可以作为冠心高危人群普查并预测其发病可能性的有效检查方法。     

不同重建触发单位对MSCT冠脉成像质量的影响

目的探讨不同重建触发单位(%-百分比法和ms-固定时间法)对MSCT冠状动脉成像质量的影响。方法选取连续的12例CT检查过程中心率控制在70次/分以下、没有早搏等严重心律不齐,但采用固定时间法重建冠脉有运动伪影的患者,在原始扫描数据基础上每位患者再分别经百分比法和固定时间法重建,以右冠状动脉作为对比参照,辅以多平面重建、曲面重建等后处理,比较两种不同重建方法对成像质量的影响。结果在12例病人中,4例在固定时间法基础上再采用百分比法重建后图像质量有不同程度改善,其余8例经2种方法重建的图像质量基本相同。结论当心率控制在70次/分以下并且没有早搏等心律不齐的病人,采用百分比法重建有助于消除或减少图像的运动伪影。     

Comparison of scattered entrance skin dose burden in MSCT,CBCT, and X-ray for suspected scaphoid injury: Regional dose measurements in a phantom model

IntroductionScaphoid radiography has poor sensitivity for acute fracture detection and often requires repeat delayed imaging. Although magnetic resonance (MR) imaging is considered the gold standard, computed tomography (CT) is often used as an alternative due to ease of access. Cone-Beam CT (CBCT) offers equivalent diagnostic efficacy to Multi Slice CT (MSCT) at reduced dose. We aimed to establish the difference in scattered dose between modalities for scaphoid imaging.MethodsAnatomical regional entrance surface dose measurements were taken at 3 regions on an anthropomorphic torso phantom positioned as a patient to a wrist phantom undergoing scaphoid imaging for three modalities (CBCT, MSCT, four-view projection radiography). Exposure factors were based on audit of clinical exposures. Each dose measurement was repeated three times per anatomical region, modality, exposure setting and projection.ResultsUnder unpaired T-test CBCT gave significantly lower mean dose at the neck (1.64 vs 18 mGy), chest (2.78 vs 8.01) and abdomen (1.288 vs 2.93) than MSCT (p < .0001). However CBCT had significantly higher mean dose than four-view radiography at the neck, chest and abdomen (0.031, 0.035, and 0.021 mGy) (p < .0001).ConclusionCBCT of the wrist carries a significantly higher scattered radiation dose to the neck, chest and abdomen than four view scaphoid radiography, but significantly lower scattered dose than MSCT of the wrist of equivalent diagnostic value.Implications for practiceThe use of CBCT for scaphoid injury carries significantly lower scattered dose to radio-sensitive structures investigated here than equivalent MSCT, and may be of greater use as an early cross-sectional investigation for suspected scaphoid fracture.     

Dissected Aorta Repair Through Stent Implantation trial: Canadian results

Objectives

We describe the Canadian results of the Ascyrus Medical Dissection Stent (AMDS), a novel partially uncovered aortic arch hybrid graft implanted antegrade during hypothermic circulatory arrest to promote true lumen expansion and enhance aortic remodeling.

Analysis of 96 cases of solitary pulmonary nodule diagnosed by MSCT

Objective： The aim of this study was to explore the diagnostic value of multi-slice computer tomography （MSCT） in solitary pulmonary nodule （SPN）. Methods： Contrastive analysis of the differences of CT signs between benign and malig- nant SPN. Results： The typical sign of pleural indentation was a reliable sign for lung cancers. Vacuole sign suggested lung cancer highly. Blood vessels cluster involving the vein alone had big opportunity to lung cancer. Type I tumor-bronchial relation was the most common relation in lung cancers. Type V tumor-bronchial relation was the most common relation in benign SPN. Conclusion： MSCT had a very high diagnostic value in SPN.     

MSCT诊断胆囊癌的临床价值

目的探讨MSCT在胆囊癌的影像学诊断中的价值。方法回顾性分析32例经手术或病理活检证实的胆囊癌患者的MSCT资料,所有病例均经MSCT平扫及三期动态增强扫描。结果胆囊癌MSCT直接征象表现为:肿块型16例、结节型6例、胆囊壁肥厚型10例,病灶均明显强化,伴有胆囊黏膜破坏、囊壁僵硬;间接征象有:合并胆囊结石14例、邻近侵犯12例、肝脏转移8例、淋巴结转移17例、胆道梗阻15例。29例术前诊断与手术病理结果一致。结论 MSCT平扫结合三期动态增强扫描可显示胆囊癌的特征性征象及常见的间接征象,对胆囊癌的诊断有重要作用。