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1.
Retroperitoneal cyst: sonographic findings 总被引:1,自引:0,他引:1
Konno K Ishida H Naganuma H Komatsuda T Sato M Ishida J Watanabe S 《Abdominal imaging》2002,27(6):0680-0684
Background: Retroperitoneal cyst (RC) is a relatively rare disease, and its sonographic (US) findings have not been analyzed sufficiently.
Methods: We studied US findings of five patients with RC, with special attention to location, size, shape, internal echoes, the presence
or absence of lateral shadowing, and the mode of back echoes.
Results: In all cases, the cyst was situated behind (four cases) or lateral to (one case) the pancreas: behind or lateral to the pancreatic
head in two cases, behind the pancreatic body in one case, and behind the pancreatic tail in two cases. Four cases showed
a round mass (three cases) or multiple round mass (one case). Internal echoes were present in those cases and showed a “pseudo-solid”
pattern. In those cases, M-mode US confirmed the movement of those internal echoes. In the remaining case, the lesion was
imaged as an irregularly shaped multilocular mass. No case showed posterior echo enhancement, and no case showed lateral shadowing.
No blood flow signals from the lesion were seen.
Conclusion: Unlike ordinary cysts, RC usually is imaged as a round mass behind the pancreas, with dense internal echoes without lateral
shadowing or posterior echo enhancement, which presents a “pseudo-solid” pattern. A diagnosis of RC should be considered when
encountering a mass with such US findings.
Received: 6 June 2001/Accepted: 25 July 2001 相似文献
2.
Late-phase enhancement of the upstream portion of pancreatic adenocarcinoma on dual-phase helical CT 总被引:1,自引:0,他引:1
Background: Late-phase enhancement of pancreatic parenchyma upstream (tail side) of pancreatic adenocarcinoma is found frequently on
dual-phase helical computed tomography (CT). We measured the frequency of late-phase enhancement of the upstream portion of
pancreatic adenocarcinoma and normal pancreatic parenchyma using dual-phase helical CT.
Methods: Twenty-one patients with pancreatic adenocarcinoma and nontumorous pancreas upstream of tumors were compared with 100 control
patients without pancreatic disease. Early and late scans started at 25 and 75 s, respectively, after intravenous injection
of contrast material. The attenuation values of normal and nontumorous pancreas upstream of tumors were assessed in three
phases: precontrast, early, and late enhanced. Enhancement ratio (ER) was calculated as ER = (late phase − precontrast)/(early
phase − precontrast).
Results: Late-phase enhancements (ER > 1.0) were seen in 86% of upstream pancreas and 10% of normal pancreas. The mean ER of upstream
pancreas was significantly higher than that of normal pancreas (p < 0.01).
Conclusion: Late-phase enhancement of the pancreas upstream of the tumor is frequently observed in patients with pancreatic adenocarcinoma.
Late-phase enhancement and histology showed a correlation for chronic obstructing pancreatitis in five patients.
Received: 30 October 2000/Revision accepted: 7 February 2001 相似文献
3.
目的 分析胃肠道异位胰腺的CT及胃肠道钡餐造影表现。方法 回顾性分析本院经手术病理证实的12例异位胰腺患者的临床表现、CT及胃肠钡餐造影的影像特征,其中5例行CT增强检查,2例行胃肠道钡餐造影。结果 5例为小肠异位胰腺,7例为胃异位胰腺;病灶均呈类圆形,向腔内生长。其中2例小肠异位胰腺合并肠梗阻、肠套叠。8例病灶CT平扫呈软组织密度影,部分可见点状低密度,5例病灶增强扫描病灶强化方式与正常胰腺相似,其中4例病灶动脉期可见点状低密度影。2例异位胰腺消化道钡餐造影显示病变区类圆形充盈缺损。结论 胃肠道异位胰腺的CT及X线钡餐造影表现具有一定的特征性,且在诊断胃肠道异位胰腺中有重要的作用。 相似文献
4.
Synchronous mucinous tumors of the ovary and the appendix associated with pseudomyxoma peritonei: CT findings 总被引:2,自引:0,他引:2
Background: To present the computed tomographic (CT) findings of synchronous mucinous tumors of the ovary and the appendix associated
with pseudomyxoma peritonei (PMP).
Methods: Imaging studies, mainly abdominal CT scans, of three women aged 49–75 years were reviewed. Attention was directed to the
ovarian masses, peritoneal seeding, and the presence of an appendiceal mucocele.
Results: The ovarian tumors and the appendiceal mucocele were clearly demonstrated in two cases, and they were part of the extensive
PMP in the third patient. Ascites was found in all cases, with internal septation in one. Associated scalloping of the liver
margins and hypodense peritoneal implants, with extensive bowel involvement, were seen in another one. Pathologically, there
was one case of right ovarian mucinous cystadenoma and villous adenoma of the appendix, one case of right ovarian and appendiceal
mucinous cystadenocarcinoma, and one case of bilateral metastatic ovarian implants of appendiceal mucinous cystadenocarcinoma.
PMP was found in all. In the case with benign tumors of the ovary and the appendix, the PMP was classified as a benign mucinous
spillage. This patient returned 33 months after surgery with PMP, in which epithelial cells were found.
Conclusions: Radiologists should be familiar with the clinical occurrence of synchronous mucinous tumors of the ovary and the appendix
associated with PMP and with the typical CT findings of the latter two entities. Alternatively, when the imaging findings
suggest ovarian cystic tumor with PMP, the radiologist should be alerted to the probability of a clinically unsuspected appendiceal
mucocele and should search for it.
Received: 10 August 1999/Accepted: 22 September 1999 相似文献
5.
Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer: correlation with the histopathology 总被引:21,自引:0,他引:21
Background: To evaluate the usefulness of dynamic and delayed magnetic resonance (MR) imaging in the T-staging of stomach cancer and
to compare the enhancement pattern of the cancerous lesion and the normal wall.
Methods: We performed MR imaging in 46 patients with stomach cancer (including four early gastric cancers and 42 advanced gastric
cancers). Axial, sagittal, or coronal two-dimensional fast low-angle shot) MR images for the water-distended stomach were
obtained with dynamic protocol, including precontrast images and images obtained 30, 60, 90, and 240–300 s after intravenous
injection of the 0.1 mM Gd-DTPA/kg solution. We evaluated the thickness, interruption (or not) of the low signal intensity
bands, and enhancement pattern of the cancerous wall and normal gastric wall. We prospectively evaluated the depth of cancer
invasion, perigastric infiltration (extraserosal invasion), perigastric organ invasion, and regional lymph nodes and determined
tumor staging on MR images. These MR evaluations including MR-determined staging were correlated with the surgicopathologic
findings.
Results: Stomach cancer was shown as having a thickened wall with a rapid enhancing pattern after intravenous Gd-DTPA administration.
The mucosa (and/or submucosa) affected by stomach cancer showed an early enhancement pattern (30–90 s after Gd-DTPA administration)
in 43 of 46 patients (93%). The normal gastric mucosa demonstrated a delayed peak enhancement pattern (>90 s after Gd-DTPA
administration) in 29 of 46 patients (63%) and variable enhancement pattern in 17 of 46 patients (37%). An interrupted low
signal intensity band or highly enhanced tumorous lesion penetrating through the gastric wall was seen in 17 of 19 pT3 patients
(90%). Consistency between MR-determined staging and surgicopathologic staging occurred in three of four pT1 tumors (75%),
10 of 13 pT2 tumors (77%), 17 of 19 pT3 tumors (90%), and eight of 10 pT4 tumors (80%); overall accuracy was 83%. Overall
accuracy of regional lymph node involvement, as determined by enhanced MR, was 52%; 24 of 46 node groups were positive.
Conclusions: Dynamic and delayed MR imaging can be useful for predicting depth of cancer invasion, perigastric infiltration (extraserosal
invasion), and perigastric organ invasion by gastric cancer.
Received: 28 July 1998/Revision accepted: 27 January 1999 相似文献
6.
Fascioliasis: US, CT, and MRI findings with new observations 总被引:2,自引:0,他引:2
Kabaalioğlu A Cubuk M Senol U Cevikol C Karaali K Apaydin A Sindel T Lüleci E 《Abdominal imaging》2000,25(4):400-404
Background: The purpose of this study is to describe the ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging
(MRI) findings in fascioliasis and to emphasize the impact of radiology in diagnosis.
Methods: Radiologic findings in 23 consecutive patients with fascioliasis were prospectively recorded. All patients had at least one
US and CT examination, and 10 of them were studied by MRI. All diagnoses were confirmed by serologic methods. In the first
three cases, initial diagnosis was reached by microscopic demonstration of the parasites' eggs in bile obtained by US-guided
gallbladder aspiration.
Results: In the hepatic phase of fascioliasis, multiple, confluent, linear, tractlike, hypodense, nonenhancing hepatic lesions were
detected by CT. On US, the parasites could be clearly identified in the gallbladder or common bile duct as floating and nonshadowing
echogenic particles. MRI showed the lesions as hypo- or isointense on T1-weighted images and as hyperintense on T2-weighted
images.
Conclusions: CT findings in the hepatic phase and US findings in the biliary phase are characteristic of fascioliasis. Because clinical
and laboratory findings of fascioliasis may easily be confused with several diseases, radiologists should be familiar with
the specific radiologic findings of the disease to shorten the usual long-lasting diagnostic process.
Received: 15 December 1999/Accepted: 26 January 2000 相似文献
7.
Abdominal tuberculous lymphadenopathy: MR imaging findings 总被引:7,自引:0,他引:7
Background: The purpose of this study was to evaluate the utility of magnetic resonance imaging (MRI) as a diagnostic tool in abdominal
tuberculous lymphadenopathy.
Methods: MRI studies of 11 patients with histologically proven abdominal tuberculous lymphadenopathy were reviewed with regard to
anatomic distribution, size, shape, degree, and pattern of enhancement and relation of the lesions to adjacent structures.
Results: The most common site of involvement was the periportal area (n= 6), followed by the peripancreatic (n= 5), mesenteric (n= 1), and paraaortic (n= 1) areas. Eight patients were readily diagnosed as having tuberculous lymphadenopathy on abdominal computed tomography.
Three patients had a heterogeneously enhancing masslike lesion adjacent to the pancreas and were initially diagnosed as having
cystic tumor of the pancreas. On MRI, 11 lesions showed T1 iso- or hypointensity and central T2 hyperintensity. Two lesions
showed T1 iso- or hypointensity and central T2 hypointensity. The lesions with different T2 signal intensities showed different
patterns of enhancement on contrast-enhanced dynamic studies. The relations between the enlarged lymph nodes and adjacent
bile ducts or vascular structrues were well depicted on MRI.
Conclusion: MRI was useful in differentiating enlarged lymph nodes abutting the pancreas initially diagnosed as cystic neoplasms on abdominal
computed tomography. RID=" ID=" <E5>Correspondence to:</E5> M.-J. Kim
Received: 9 May 2000/Accepted: 14 June 2000 相似文献
8.
Intestinal malrotation as an incidental finding on CT in adults 总被引:3,自引:0,他引:3
R. Zissin V. Rathaus A. Oscadchy E. Kots G. Gayer M. Shapiro-Feinberg 《Abdominal imaging》1999,24(6):550-555
Background:Intestinal malrotation in adults is usually an incidental finding on computed tomography (CT). We present the CT findings
of 18 adult patients with malrotation and discuss the clinical implications.
Methods: Abdominal scans of 18 patients (12 women, six men; age range = 15–79 years) with intestinal malrotation were reviewed. Special
attention was directed to the location of the superior mesenteric vessels, the location of the small and large bowels, the
size of the uncinate process, the situs definition, and additional anomalies.
Results: The malrotation was an incidental finding in all but one patient. The malrotation was type Ia in 17 patients and IIc in the
one symptomatic patient. The superior mesenteric vessels were vertically oriented in 10, inverted in two, normally positioned
in four, and mirror imaged in two cases with situs ambiguus. All patients had aplasia of the pancreatic uncinate process,
five had a short pancreas, and two had a preduodenal portal vein. Fourteen patients had a normal situs and four had heterotaxia.
Seven patients had polysplenia, six of which with associated inferior vena cava anomalies.
Conclusions: Intestinal malrotation can be diagnosed on CT by the anatomic location of a right-sided small bowel, left-sided colon, an
abnormal relationship of the superior mesenteric vessels, and aplasia of the uncinate process. Awareness of these abnormalities
is necessary to diagnose this anomaly. It should be sought in patients with a situs problem, inferior vena cava anomalies,
polysplenia, or preduodenal portal vein. Although usually an incidental finding, it is important to diagnose such a malrotation
because it may cause abdominal symptoms. Also, knowledge of associated vascular anomalies is important when abdominal surgery
is planned.
Received: 1 October 1998/Revision accepted: 27 January 1999 相似文献
9.
Background: We investigatedspiral computed tomographic (CT) findings and underlying hemodynamic alterations in acute hepatic vein occlusion.
Methods: In nine dogs, immediately after balloon occlusion of the right (n = 4) or left (n = 5) hepatic vein through the transjugular or transfemoral route, we performed single-level dynamic CT with intravenous administration
of contrast medium. We created time attenuation curves of individual hepatic segments showing attenuation differences. To
investigate underlying hemodynamic alterations, hepatic arteriograms were obtained in two dogs.
Results: In all cases, there were three compartments with different time attenuation curves: normal, occluded, and adjacent. The normal
compartment, which comprised segments far from the occluded hepatic compartment, showed the normal pattern of hepatic enhancement.
The occluded compartment, which was the drainage territory of the occluded hepatic vein, showed high attenuation in the early
arterial phase and low attenuation in the portal phase. The adjacent compartment, which shared the same portal vein with the
occluded compartment and was drained by the patent hepatic vein adjacent to the occluded one, showed strong contrast enhancement
in the late arterial and early portal phase. Spiral CT and hepatic arteriography demonstrated the arterioportal shunt and
reversed portal venous flow in the occluded compartment, which drained into the adjacent compartment.
Conclusion: Acute hepatic vein occlusion on spiral CT appears as mild, early arterial, high attenuation and portal low attenuation of
the occluded compartment and strong enhancement in the late arterial and early portal phases of the adjacent compartment due
to arterioportal shunt and reversed portal flow.
Received: 15 March 2001/Revision accepted: 4 July 2001 相似文献
10.
Background: This study was conducted to estimate the prevalence and morphologic computed tomographic (CT) features of renal and perirenal
space abnormalities in acute pancreatitis in correlation with the severity of pancreatitis.
Methods: One hundred fifty-nine contrast-enhanced CT scans of 100 consecutive patients with acute pancreatitis were retrospectively
and independently reviewed by three observers. All CT images were obtained using contrast-enhanced helical CT (collimation
width = 5 mm, table increment = 7 mm/s, reconstruction interval = 5 mm, scan delay time = 30–50 s). Additional maximized images
(field of view = 260 mm) of the perirenal space were available for review. All CT scans were scored with the CT Severity Score
Index: pancreatitis was graded as mild (0–2 points), moderate (3–6 points), and severe (7–10 points). Interobserver agreement
for both the severity score and the presence of renal and perirenal involvement was calculated. Correlation between the prevalence
of complications and the degree of pancreatitis was estimated.
Results: CT scans were graded as mild (n= 59), moderate (n= 82), and severe (n= 18). Abnormalities detected included perirenal stranding (n= 37 patients, 26 bilateral), perirenal fluid collections (n= 10 patients, one bilateral), ureteral encasement (n= 2 patients), renal vein thrombosis (n= 1 patient), and renal parenchymal abnormalities (n= 1 patient). The interobserver agreement range for scoring the degree of pancreatitis and the overall presence of abnormalities
was 75.5–79.2% and 59.8–100%, respectively. Except for stranding of the perirenal fat, no statistically significant differences
between the presence of abnormalities and the severity of pancreatitis (moderate or severe) was observed with Fisher's exact
test. Also, no preferential left-sided localization of complications was observed.
Conclusions: The incidence of renal and perirenal complications from acute pancreatitis is higher than previously estimated (7%). We found
no significant correlation between the prevalence of major complications and the severity of pancreatitis. These findings
are important because these complications may have an impact on therapeutic strategy and can affect prognosis.
Received: 31 March 1999/Revision accepted: 25 August 1999 相似文献
11.
Altered flow dynamics of intravascular contrast material to the liver in superior vena cava syndrome: CT findings 总被引:2,自引:0,他引:2
Baba Y Miyazono N Inoue H Kanetsuki I Niwatsukino H Tanaka D Nishi H Nandate T Ohkubo K Nakajo M 《Abdominal imaging》2000,25(2):146-150
Background: To evaluate the findings of altered flow dynamics in the livers of patients with obstruction of superior vena cava (SVC)
on helical computed tomography (CT).
Methods: In six patients (age range = 28–80 years) with SVC obstruction, CT findings were retrospectively reviewed to identify the
abnormal enhancement patterns of the liver and the relation with the extrahepatic collateral vessels and hepatic vessels.
Results: Abnormal hepatic enhancement was observed in the following four (A–D) portions: (A) anterior portion of segment IV (n = 5), (B) subdiaphragmatic portion of the liver (n = 4), (C) posterior portion of the right lobe (bare area; n = 1), and (D) lateral segment of the left lobe (n = 2). Two major collateral pathways to the liver were demonstrated as follows: A and D → from the umbilical vein to the left portal
vein, and B and C → from the subcapsular vein to the bare area of the liver or to the hepatic veins. On helical CT, these
collateral pathways were also clearly visualized.
Conclusion: When these abnormal enhancements of the liver on CT are recognized within the liver, these findings indicate diversion of
contrast material into collateral pathways to the liver with SVC obstruction.
Received: 31 March 1999/Revision accepted: 25 June 1999 相似文献
12.
Lee MW Lee JY Kim YJ Park EA Choi JY Kim SH Lee JM Han JK Choi BI 《Abdominal imaging》2007,32(3):293-298
Background In this study, we evaluated the CT findings of patients with hepatoid adenocarcinoma of the stomach.
Methods The CT scans of eight patients (seven males and one female; age range 44–70 years; mean age 59 years) with histologically
proven hepatoid adenocarcinoma of the stomach were retrospectively evaluated by two radiologists in consensus. Scans were
evaluated for gastric wall thickening, involved site enhancement, adjacent organ invasion, lymphadenopathy, distant metastases,
and venous tumor thrombosis.
Results Tumors appeared as eccentric wall thickening (n = 8) and heterogeneous enhancement (n = 7). Adjacent organ invasions were noted to liver (n = 3), pancreas (n = 2), and esophagus (n = 1). All eight patients had a regional lymphadenopathy larger than 8 mm in its short axis. Distant metastases (liver, n = 4; non-regional lymph node, n = 1) were also noted. Venous tumor thrombosis was identified in the portal vein (n = 3), splenic vein (n = 1), main portal vein (n = 1), or right gastroepiploic vein (n = 1) in the regions near primary gastric tumors or metastatic masses.
Conclusion On CT scans, hepatoid adenocarcinoma of the stomach appears as an eccentric gastric wall thickening and shows a strong tendency
for liver and lymph node metastasis and venous invasion around the primary gastric tumor or a metastatic hepatic mass. 相似文献
13.
Preoperative evaluation of gastric cancer: value of spiral CT during gastric arteriography (CTGA) 总被引:7,自引:0,他引:7
Background: To evaluate the utility of dual-phase spiral computed tomography during gastric arteriography (CTGA) in the preoperative
staging of gastric cancers.
Methods: We performed CTGA in 21 patients with pathologically proven gastric cancers. CTGA findings were prospectively analyzed and
correlated with surgical and pathologic findings. Dual-phase scans were performed at 10 s (early) and 60–100 s (delayed) after
injection of 120 mL of contrast medium at an injection rate of 6 mL/s through a preset 5-Fr catheter positioned in the celiac
trunk. Spiral CT scans were assessed for enhancing pattern of the normal gastric wall, tumor detectability, and accuracy of
tumor staging.
Results: Normal gastric mucosa was clearly visible as two or three layers in all patients on early-phase scans and in eight patients
on delayed-phase scans. The primary tumors were correctly detected with CTGA in seven (88%) of the eight early gastric cancers
and in all 13 (100%) advanced gastric cancers. The accuracy of CTGA for T staging was 50% and 77% in early and advanced gastric
cancers, respectively. The overall accuracy for tumor detection and T staging was 95% and 67%, respectively. The accuracy
of CTGA for the degree of serosal invasion and regional lymph node metastasis was 77% and 76%, respectively.
Conclusion: The CTGA technique improved tumor detection rate and accuracy of tumor staging, especially in early gastric cancer, and may
be very useful in the preoperative staging of gastric cancer.
Received: 31 August 2000/Accepted: 20 September 2000 相似文献
14.
Zissin R Gayer G Bernheim J Kots E Shapiro-Feinberg M Hertz M 《Abdominal imaging》2003,28(2):0280-0283
Background: We present the computed tomographic (CT) findings of granulomatous appendicitis.
Methods: Five of 652 (0.9%) patients who had undergone appendectomy for clinically suspected acute appendicitis over a 19-month period
proved to have granulomatous appendicitis. One patient had surgery based on a clinical diagnosis of acute appendicitis. Four
patients (three men and one woman; age range = 14–39 years) underwent abdominal CT. The CT findings were retrospectively reviewed
with special attention to the appendiceal abnormalities.
Results: All four patients presented with subacute clinical presentation. Enlarged appendices of 4.5 and 2 cm in diameter with thickened
walls of soft tissue density were found in two patients, and periappendicular inflammatory masses were found in the other
two. Enlarged mesenteric lymph nodes and right lower quadrant fat stranding was seen in all four patients. Histopathology
showed numerous granulomas within the inflamed appendix.
Conclusion: Radiologists should be familiar with the rare entity of granulomatous appendicitis in patients examined by CT for suspected
acute appendicitis. An insidious clinical presentation with CT findings of an exceptionally large appendix and associated
periappendiceal inflammatory changes should raise the possibility of granulomatous appendicitis or carcinoma or lymphoma of
the appendix. 相似文献
15.
Background: The purpose of the study was to describe the computed tomographic (CT) findings of the alimentary canal and mesentery in
amyloid infiltration of the gastrointestinal (GI) tract and to correlate the CT findings with histologic extent and distribution
and with amyloid subtype.
Methods: Abdominal CT scans performed between 1988 and 1997 on patients with pathologically proven amyloidosis of the alimentary canal
were reviewed for abnormalities of the alimentary canal and mesentery. Histology was graded for extent of mucosal, submucosal,
and muscularis propria involvement and for degree of interstitial and vascular distribution. CT findings were correlated with
histologic extent, histologic distribution, and amyloid histochemical type.
Results: Twenty-three patients were included. Four (17%) had bowel wall thickening, which was associated with a higher submucosal
extent and interstitial distribution than in patients with normal bowel by CT. Four (17%) patients had bowel wall dilatation
without thickening, which was not associated with statistically significantly different histology than in patients with normal
bowel by CT. There was no statistically significant correlation between CT findings and histochemical subtype. Mesenteric
soft tissue infiltration was seen in two patients, and mesenteric adenopathy was seen in one patient.
Conclusions: Normal bowel is a common abdominal CT finding in amyloidosis of the alimentary canal. When findings are present, GI wall
thickening and/or bowel wall dilatation without wall thickening may be seen. Bowel wall thickening on CT correlates with submucosal
extent and interstitial distribution of disease. Soft tissue infiltration and adenopathy are also occasionally seen.
Received: 15 January 1999/Accepted: 10 March 1999 相似文献
16.
Sato M Ishida H Konno K Komatsuda T Konno S Watanabe S Ishida J Sakai T Hirata M 《Abdominal imaging》2000,25(3):306-310
Background: Mesenteric cyst (MC) is a relatively rare disease, and its sonographic characteristics have not been sufficiently analyzed.
Methods: We studied the sonographic findings of eight patients with MC, with attention paid to its size, shape, internal echoes, and
especially the presence or absence of lateral shadowing and the mode of back echoes. In four cases, the sound velocity and
acoustic impedance of cystic fluid were also measured. The mode of blood flow was evaluated by color Doppler sonography.
Results: Six cases showed an oval or comma-shaped mass. Internal echoes were present in six cases, and two of them showed a pseudosolid
pattern. In these cases, M-mode sonography confirmed the movement of these internal echoes. Only one case showed a posterior
echo enhancement, and no case showed lateral shadowing. Sound velocity measured in four cases was 1515–1537 m/s, with an acoustic
impedance of 1.550–1.576 kg/m2/s. No blood flow signals were obtained from the lesion.
Conclusion: MC exhibits so many patterns on ultrasound that we should consider the possibility of MC when encountering an avascular oval
mesenteric mass.
Received: 30 August 1999/Accepted: 6 October 1999 相似文献
17.
Detection of pancreatic adenocarcinoma: relative value of arterial and late phases of spiral CT 总被引:11,自引:0,他引:11
Background: Spiral computed tomography (CT) allows the pancreas to be imaged during peak contrast levels owing to the capability of fast
data acquisition. The objective of this study was to evaluate the relative value of the arterial and late phases of spiral
CT for detecting pancreatic adenocarcinomas.
Methods: Twenty-two patients with pathologically proved pancreatic adenocarcinomas underwent two-phase spiral CT. The CT scans were
performed with 5 mm collimation and 5 mm/s table speed. Images during the arterial and late phases were obtained at 30- and
180-second delays, respectively. The images of the arterial phase were compared with those of the late phase in terms of tumor
conspicuity from surrounding pancreatic parenchyma and tumor detectability by means of a 3-point grading system: 1 (poor),
2 (fair), and 3 (good).
Results: In terms of tumor conspicuity from surrounding pancreatic parenchyma, 16 lesions (73%) were good, 5 lesions (23%) were fair,
and 1 lesion (4%) was poor during the arterial phase, whereas 6 lesions (27%) were good, 9 lesions (41%) were fair, and 7
lesions (32%) were poor during the late phase (p= 0.0007). The arterial phase was superior to the late phase in 16 patients (73%) and equal in 6 patients (27%). For tumor
detectability, 18 lesions (82%) were good, 3 lesions (14%) were fair, and 1 lesion (4%) was poor during the arterial phase,
whereas 10 lesions (45%) were good, 7 lesions (32%) were fair, and 5 lesions (23%) were poor during the late phase (p= 0.0033). For detectability, the arterial phase was superior to the late phase in 14 patients (64%) and equal in 8 patients
(36%).
Conclusion: The arterial phase of spiral CT is superior to the late phase, which is equivalent to conventional CT for detecting pancreatic
adenocarcinoma.
Received: 1 August 1995/Accepted: 12 September 1995 相似文献
18.
Appendiceal mucocele: sonographic findings 总被引:1,自引:0,他引:1
Sasaki K Ishida H Komatsuda T Suzuki T Konno K Ohtaka M Sato M Ishida J Sakai T Watanabe S 《Abdominal imaging》2003,28(1):0015-0018
Background: Appendiceal mucocele (AM) is a relatively rare disease, and its sonograms (US) have not been sufficiently analyzed.
Methods: We studied the US findings of five patients with AM, with special attention to AM size, shape, internal echoes, and the mode
of back echoes.
Results: All five cases showed an elongated mass in the lower right abdomen. Internal echoes were present in all cases and M-mode
US confirmed the movement of those echoes. The echogenecity of the lesion changed according to the frequency of the transducer
used. Only one case showed posterior echo enhancement, and no case showed lateral shadowing.
Conclusion: AM appears as an elongated echo-poor mass without posterior echo enhancement. The cyst wall is less distinct than what one
would expect for a cyst. When encountering such a mass in the lower right abdomen, one should strongly suspect an AM. In such
cases, appropriate diagnostic and therapeutic strategies are especially necessary to prevent rupture that results in development
of pseudomyxoma peritonei.
Received: 7 November 2001/Accepted: 5 December 2001 相似文献
19.
Helical CT anatomy of pancreatic arteries 总被引:3,自引:0,他引:3
J. S. Sim B. I. Choi J. K. Han M. J. Chung J. W. Chung J. H. Park M. C. Han 《Abdominal imaging》1996,21(6):517-521
Background: To assess the frequency of visualization of pancreatic arteries in the arterial phase of helical computed tomography (CT).
Methods: The visibility of pancreatic and peripancreatic arteries in helical CT images was evaluated in 20 consecutive patients who
had no evidence of pancreatic disease. CT examinations were performed by using a continuously rotating CT scanner and intravenous
injection of contrast media. The scans were taken 35 s after the start of injection and with a table speed of 3 mm/s. Images
were reconstructed in 3-mm section increments.
Results: Frequently visualized arteries were the gastroduodenal, anterior and posterior superior pancreaticoduodenal, and right gastroepiploic
arteries. Infrequently visualized arteries were the dorsal pancreatic, pancreatica magna, caudal pancreatic, transverse pancreatic,
and common, anterior, and posterior inferior pancreaticoduodenal arteries.
Conclusion: Helical CT enabled us to recognize small pancreatic arteries, and the evaluation of these arteries should be considered in
the staging of pancreatic carcinoma.
Received: 6 June 1995/Accepted: 22 July 1995 相似文献
20.
Background: Hyperattenuating nodules detected by arterial phase helical computed tomography (HCT) in patients with cirrhosis usually
are believed to represent hepatocellular carcinomas (HCCs). We correlated HCT morphology of hyperattenuating hepatic nodules
detected during arterial phase scans with the histopathology of explanted livers of patients with hepatic cirrhosis undergoing
liver transplantation.
Methods: Three hundred fifty-four patients had arterial and portal phase HCT performed before subsequent hepatic transplantation.
Each patient received 180 mL of contrast by power injection at 5 mL/s. All hyperattenuating nodules detected on arterial phase
HCT were assessed for morphology and evidence for contrast enhancement. Explanted livers in all patients were then sectioned
at 10-mm intervals, and the histology of the nodules was correlated with the HCT findings.
Results: Sixty-one hyperattenuating nodules were detected on the arterial phase HCT in 43 patients: 41 nodules were benign regenerating
nodules (RN), three were dysplastic nodules (DP), and 17 were HCCs. Most RN/DP nodules were 5–20 mm in diameter, had distinct
margins, were homogeneous, and were isoattenuating on precontrast, portal, and delayed scans. Thirty-six showed positive contrast
enhancement and displayed a wide range of attenuation profiles. HCC nodules were 6–50 mm. All showed positive contrast enhancement
and displayed a wide range of attenuation profiles.
Conclusion: Hyperattenuating nodules seen on arterial phase HCT are likely to be RN/DP nodules. In many cases, it is not possible to
distinguish between RN/DP and HCC. Thus, clinical decisions regarding inclusion criteria for transplantation based on CT morphology
of liver lesions may be tenuous. 相似文献