CT扫描诊断直肠癌术后局部复发

本院1987年以来 CT 扫描诊断为直肠癌术后盆腔内复发23例,吻合口复发8例,其中经手术与病理学诊断证实29例复发。CT 确诊率为93.5%,检出肿瘤大小2～8 cm,其中6例无复发临床表现。CT 所见:(1)骶前区单发分叶状或结节状肿块,或多发性肿块。(2)新直肠腔不规则偏心肿块或肠腔狭窄。(3)肿瘤侵及膀胱、卵巢、前列腺、骶尾骨、精囊或盆壁肌肉的征象。CT 是当前诊断盆腔内复发的较敏感、准确的工具。     

计算机近红外扫描在乳腺癌诊断中的应用

分析有病理学证据的１７８例乳腺疾病的近红外检查结果，发现Ｃ型血管中乳腺癌所占的比例较Ａ型、Ｂ型血管高（Ｐ＝０．００２），统计学差异显著，认为应用胡－刘氏血管三种分型及５级灰度作为诊断标准是可行的；近红外线扫描对乳腺癌的敏感性达８７．０％。同时还分析了出现假阳性和假阴性的原因。     

Early diagnosis of pancreatic cancer by routine CT scanning; significance of the pancreatic bile duct scanning

Early recognition of dilated tail-side pancreatic duct and liver-side bile duct is one of the main diagnostic goals for an early diagnosis of pancreatic cancer. In order to attain these objectives, a new scanning method involving Target Volume Scan for the pancreas as a routine CT scanning modality has been devised. The picturing capability of this imaging method for the pancreatic bile duct and its role in the early diagnosis of pancreatic cancer are discussed. In phantom experiments, clinical experiments and clinical applications, the pancreatic duct within the pancreas body and the intra-hepatic bile duct, which were expanded into a cylindrical form of pure circular cross section with a diameter greater than 2 mm, have been pictured as continuous, linear, low-density regions. Similarly, the pancreatic duct within the pancreas head and the choledoch duct with diameters greater than 3 mm have also been pictured as low-density circular areas. In healthy pancreatic bile ducts, the tail section of the pancreas head and the intra-hepatic bile duct do not appear in scans, and although 70% of healthy choledoch ducts have been pictured, many deformed lumens have been observed in cross section. The conditions for obtaining successful images of lumens depended upon the degree of intra-lumen filling with either pancreatic juice or bile rather than the diameter of the lumen. Consequently, pancreatic cancer, which causes changes in the pancreatic duct and bile duct lumen, can be detected as a discontinuity in the image of the lumen obtained in the Target Volume Scan, regardless of the cancer, suggesting that the Target Volume Scan could be an important diagnostic imaging tool for the early detection of pancreatic cancer.     

Positron emission tomography scanning for the diagnosis and management of lung cancer

Opinion statement The dissemination of positron emission tomography (PET) technology has enabled a functional approach to the evaluation of lung cancer that complements the anatomic assessment provided by chest radiography, computed tomography (CT) scanning, and magnetic resonance imaging. PET has excellent sensitivity and good specificity for the determination of malignancy in the solitary pulmonary nodule, but these data must be weighed against the evidence of instances of false-positive results because of inflammatory lesions and false-negative results in small-or low-metabolism neoplasms. Therefore, PET may not be advisable when these scenarios apply. Furthermore, in a patient with a very high pretest likelihood of lung cancer (eg, a new or enlarging spiculated nodule in a long-time smoker), the value of PET is less certain because a negative result may be discounted. PET has altered the approach to the staging of lung cancer. It adds value to the evaluation of the mediastinum and extrathoracic structures compared to conventional methods by upstaging or downstaging a substantial proportion of patients. If the staging assessment is negative on PET, the use of mediastinoscopy may be obviated in selected cases. Histologic confirmation of positive PET findings should be obtained before excluding patients from curative resection. PET provides incremental information to CT in the evaluation of persistent and recurrent disease, and response measured on PET appears more accurate as a predictor of ultimate survival. The more recent development of PET-CT permits fusion of anatomic and functional information. Early investigations suggest that this strategy provides superior results compared to either technique alone.     

Radioisotope diagnosis of postoperative deep-vein thrombosis of the leg in oncological patients]

The authors have studied the frequency and characteristic features of postoperative thrombosis of profound crural veins (PTPCV), using the method of radioindication with fibrinogen J125. Among 80 oncological patients PTPCV), was found in 47 (58.7%). It is noted that PTPCV in 92% of cases developed during 5 days postoperatively, bilateral involvement is more frequently observed (70.2%), and in 28.7% of cases thrombosis involved the upper crural third. Clinical signs of PTPCV were revealed only in 44% of cases and, on the average, 2 days following the onset of the thrombotic process. Radioindication of PTPCV with fibrinogen J125 is a simple, early and precise method of establishing the diagnosis of theis postoperative complications.