一例疑似小肠梗阻患者的循证CT诊断

目的针对急诊收治的一例疑似小肠梗阻(SBO)患者,检索当前最佳证据,为临床合理诊断提供依据。方法计算机检索MEDLINE/PubMed (1978～2006．4)、SUMsearch(1978～2006．4)、CNKI(1978～2006．4),查找有关计算机体层摄影术(CT)诊断小肠梗阻的系统评价、横断面研究等,并对所获证据进行评价。结果临床证据表明,与参考标准小肠造影及外科手术诊断相比较,CT诊断小肠梗阻的敏感度和特异度均较高,并能在早期明确梗阻的类型及病因,提高临床医师正确处理小肠梗阻的能力。据此临床证据,结合患者意愿,对患者进行CT检查,CT结果提示绞窄性小肠梗阻,需立即进行手术治疗。结论CT是诊断小肠梗阻敏感性及特异性均较高的影像学检查方法。     

Coronary Stent Imaging with Multidetector Row Computed Tomography

Multidetector row Computed Tomography (MDCT) is developing rapidly as a potential non-invasive imaging method for the direct visualization of coronary arteries in patients presenting with suspected coronary artery disease. Recent technical improvements have led to improved spatial and temporal resolution and may even allow evaluation of coronary stents, which has remained difficult due to the small diameter and radio-opaque material. We describe two cases, a 65- and a 72-year old patient. Both patients had previously undergone percutaneous transluminal coronary angioplasty in combination with stent placement and were re-admitted to our hospital with recurrent angina. MDCT was performed prior to or after coronary angiography in order to assess stent patency non-invasively.     

Multidetector Computed Tomography to Facilitate Transcatheter Aortic Valve Implantation

Minimally invasive balloon expandable transcatheter aortic valve replacement (TAVR) is currently the standard of care for patients with inoperable severe symptomatic aortic stenosis and is an acceptable alternative to traditional aortic valve replacement in selected high-risk operable patients. Multidetector computed tomography (MDCT) is an integral component of diagnostic workup prior to TAVR. We review the pivotal role of MDCT in patient selection by discussing pre-procedural assessment of iliofemoral, aortic root, and annular geometry. We summarize how MDCT can help guide percutaneous vascular access as well as accurately determine the correct co-axial valve plane and transcatheter valve size. Finally, we discuss how MDCT provides important information about long-term valve durability by assessing valve eccentricity, leaflet and stent integrity, valve recoil, and valve migration.     

螺旋CT对消化道梗阻的诊断价值

目的:探讨螺旋CT对消化道梗阻的诊断价值。方法:回顾性分析12例临床怀疑为消化道梗阻病例的螺旋CT检查结果并将其中螺旋CT确诊为消化道梗阻病例与临床结果对照,图像重建方法主要为多平面重建法(MPR)和最大密度投影法(MIP)。结果:12例患者,阴性2例,阳性10例,其中9例经手术病理证实,1例经临床确诊。9例手术病例CT诊断梗阻部位与手术对照符合率为100%(9/9),病因诊断符合率为88.9%(8/9)。结论:螺旋CT扫描及重建对消化道梗阻具有重要诊断价值。     

Clinical Utility of Positron Emission Tomography/Computed Tomography in Inflammatory Bowel Disease

Purpose  

The clinical utility of positron emission tomography/computed tomography (PET/CT) in comparison to standard workup in patients with known or suspected inflammatory bowel disease (IBD) is unknown.     

术后早期炎性肠梗阻的诊疗进展

术后早期炎性肠梗阻（early postoperative inflammatory small bowel obstruction,EPISBO）系在腹部手术后早期（术后7～30d）,由于腹部手术创伤或腹腔内炎症等原因导致肠壁水肿和渗出而形成的一种机械性与动力性同时存在的黏连性肠梗阻。