多层螺旋CT三维重建技术在输尿管梗阻性疾病中的应用价值

目的:探讨多层螺旋CT输尿管三维重建技术诊断输尿管梗阻性疾病的临床应用价值。方法:应用西门子双排螺旋CT机,对36例输尿管梗阻性疾病的患者进行轴位扫描,将原始资料导入到工作站,并应用多种三维重建技术进行重建。结果:36例三维重建图像均能清楚显示输尿管梗阻的部位、形态、周围情况以及病变上方输尿管、肾盂扩张程度,并均作出正确的影像学诊断。结论:多层螺旋CT三维重建技术可全面直观地跟踪显示尿路全程,对诊断与鉴别诊断输尿管梗阻有重要价值。     

多排螺旋CT三维重建技术在泌尿系结石及积水诊断中的应用价值

目的:探究多排螺旋CT三维重建技术在泌尿系结石及积水诊断中的应用价值。方法:回顾性分析本院2022年1月1日至2022年12月31日收治的泌尿系结石和积水患者总计89例,患者术前均接受16排螺旋CT三维重建技术检查,以临床手术诊断结果为诊断金标准,分析多排螺旋CT重建技术在泌尿系统结石和积水中的诊断价值。结果:本次89例患者术前均顺利完成16排螺旋CT检查,结果证实,肾结石患者21例(23.60%),膀胱结石13例(14.61%),输尿管结石伴积水总计26例(29.21%),其中5例双侧发病,其余21例均为单侧发病,肾脏、输尿管和膀胱多发性结石3例(3.37%),单纯肾积水合并输尿管扩张总计26例(29.21%),其中双侧肾积水伴近端输尿管扩张总计4例,单侧肾积水伴近端输尿管扩张总计21例,肾积水伴输尿管全程扩张1例。多层螺旋CT三维重建诊断结果与临床手术诊断结果完全符合,未发现漏诊和误诊。结论:多排螺旋CT三维重建技术,能够获取高分辨率的泌尿系统图像,从而准确显示泌尿系结石位置及积水情况,为临床提供详实依据,且诊断准确度及安全性高,具备较好的临床应用价值。     

多层螺旋CT三维重建技术在肋骨骨折中的临床应用研究

目的:研究多层螺旋CT三维重建技术用于肋骨骨折中的价值。方法:2017年1月-2019年12月本院接诊的肋骨骨折病患60例,对其施以X线平片、普通螺旋CT和多层螺旋CT三维重建检查。分析不同方法检查的结果,并对其作出比较。结果:普通螺旋CT组诊断准确率91.67%、多层螺旋CT三维重建组诊断准确率98.33%,比X线平片组81.67%高,P<0.05。普通螺旋CT组和多层螺旋CT三维重建组的骨折数检出情况优于X线平片组,P<0.05。普通螺旋CT和多层螺旋CT三维重建组的诊断结果比较无显著差异(P>0.05)。结论:于肋骨骨折中运用多层螺旋CT三维重建技术,可清楚显示出肋骨病变的情况,提高诊断准确率。     

16层螺旋CT三维重建技术在髋臼骨折中的应用

目的：探讨16层螺旋CT三维重建技术在髋臼骨折中的应用。材料与方法：回顾性分析X线、16层螺旋CT证实的髋臼骨折患者80例影像资料。结果：所有病例16层螺旋CT扫描及重建均能显示骨折。横断面图像可以显示髋臼顶的骨折及移位、髋臼后壁骨折、受累范围及关节移位。三维重建立体显示骨折走行方向、骨碎片及股骨头移位情况。结论：16层螺旋CT对于术前充分了解损伤情况制定严格的手术计划具有重要的指导意义。因此,16层螺旋CT是髋臼骨折术前常规的检查手段。     

多层螺旋CT及三维重建在肺动脉栓塞诊断中的应用

肺动脉栓塞(PE)简称肺栓塞,是指内源性或外源性栓子栓塞肺动脉或其分支引起肺循环障碍的临床和病理生理综合征[1],是呼吸系统疾病的危急重症,死亡率20%~30%[2]。PE的临床表现各异,无特异性症状,误、漏诊率较高。为此,作者应用16层螺旋CT对疑似肺动脉栓塞患者进行检查,并利用最大密度投影(MIP),容积再现(VRT),多平面重建(MPR)技术对肺动脉进行三维重建,成功地检出肺动脉栓塞患者12例。本文旨在探讨和总结多层螺旋CT肺血管造影在肺动脉栓塞诊断中的应用价值。1材料与方法12例患者中,男8例,女4例。年龄23~75岁。临床表现:胸闷、呼吸困难、憋喘、咳嗽、咯痰、咯血、胸疼。病史1d~2个月。10例有下肢深静脉血栓,其中,脊柱骨折后5例;剖腹产术后3例;脑外伤后2例,2例无明显诱因。西门子Somatom Sensation 16层螺旋CT机,扫描参数为管电压120 kV,管电流160 mA。扫描条件为:探测器16&#215;0.75 mm,螺距1.25~2.0。对比剂为优维显(370 mgI/ml),注射速率3.5mL/秒,注射总量80~100 mL。延迟15~16 s开始扫描,扫描范围从肺尖至两肋膈角水平。检...     

多层螺旋CT与三维重建技术在肋骨隐匿性骨折诊断中的应用

目的 分析多层螺旋CT(MSCT)与三维重建技术在肋骨隐匿性骨折诊断中的应用。方法 回顾性分析2016年1月至2019年1月收治的84例疑为肋骨隐匿性骨折患者的临床资料,所有患者均行普通CT扫描和多层螺旋CT三维重建检查。以手术结果为金标准,比较两种影像学检查对肋骨隐匿性骨折的诊断应用价值,及灵敏度、特异度、准确率、阴性预测值和阳性预测值。结果 经手术证实肋骨隐匿性骨折66例,无骨折18例;多层螺旋CT三维重建诊断肋骨隐匿性骨折的灵敏度、特异度、准确率和阳性阴性预测值均高于CT扫描(P 0. 05)。结论 多层螺旋CT三维重建可准确判断和有效评估肋骨隐匿性骨折,辅助制定临床治疗方案。     

多层螺旋CT及三维重建在肺动脉栓塞诊断中的应用

肺动脉栓塞(PE)简称肺栓塞,是指内源性或外源性栓子栓塞肺动脉或其分支引起肺循环障碍的临床和病理生理综合征[1],是呼吸系统疾病的危急重症,死亡率20%～30%[2].     

多层螺旋CT及三维重建在肺动脉栓塞诊断中的应用

肺动脉栓塞（PE）简称肺栓塞，是指内源性或外源性栓子栓塞肺动脉或其分支引起肺循环障碍的临床和病理生理综合征 ，是呼吸系统疾病的危急重症，死亡率20％～30％ 。PE的临床表现各异，无特异性症状，误、漏诊率较高。为此，作者应用16层螺旋CT对疑似肺动脉栓塞患者进行检查，并利用最大密度投影（MIP），容积再现（VRT），多平面重建（MPR）技术对肺动脉进行三维重建，     

多层螺旋CT扫描和三维重建在骨折的应用价值

目的 探讨多层螺旋CT二维多平面重建和三维表面遮盖成像在骨折中的应用价值。方法 对40例骨折患行多排螺旋CT扫描后二维多平面重建和三维表现遮盖成像。结果 40例患共计34例骨折。二维多平面重建和三维表现遮盖成像能更直观的显示骨折的具体情况。结论 CT二维、三维图像重建对于骨折的显示各有优缺点，两应结合使用。     

腹壁疝的多层螺旋CT评价

目的评价腹壁疝的多层螺旋CT（MSCT）诊断价值：方法收集182例临床拟诊腹壁疝的患者,经MSCT扫描和多方位重建（MPR）,观察和测量疝囊、疝颈及疝内容,并与手术所见对照：结果本组诊断腹壁切口疝143例,自发性白线疝2例,脐疝3例,腹股沟直疝和斜疝12例,腹壁造瘘口疝8例,外伤性腹壁疝14例。疝囊直径小于5cm者86例,在6～10cm者74例,大于10cm者22例。疝内容依据疝颈的部位和大小可为大网膜、肠管甚至临近的器官.结论MSCT可敏感地探测到腹壁疝,并可精确测量疝颈大小,为外科手术修补提供可靠依据.     

颅内动脉瘤的多层螺旋CT血管成像评估（附62例报道）

目的探讨多层螺旋CT血管成像（multi-slice computed tomography angiography, MSCTA）诊断颅内动脉瘤的价值：方法对62例临床怀疑为颅内动脉瘤患者的进行MSCTA检查,并与DSA和手术结果进行对照和分析。结果在62例患者中,MSCTA检出动脉瘤其66个,7例未检见动脉瘤,其中9例为多发动脉瘤,2个瘤灶者7例,3个瘤灶者2例。动脉瘤位于前交通动脉者26个,大脑中动脉15个,颈内动脉12个,大脑前动脉4个,后交通动脉4个,小脑后下动脉3个,基底动脉2个。最大瘤体直径为18mm,最小瘤体直径2mm。经DSA和手术对照,MSCTA诊断准确55例,漏诊3例,动脉瘤位置判断不准3例,假阳性1例。MSCTA诊断动脉瘤敏感性883％,特异性100％,准确率91．7％,阳性预测值97.0％,阴性预测值71．4％。结论MSCTA可安全、快捷、无创性血管成像,能清晰显示颅内动脉瘤瘤体（形态、大小、指向、轮廓）、瘤颈宽度、载瘤动脉及与颅骨之间的关系,推荐作为颅内动脉瘤检查的主要方法之一。     

Asymptomatic cardiac lipoma originating from the interventricular septum diagnosed by multi-slice computed tomography

A 45 year-old asymptomatic man was admitted to preoperative cardiovascular evaluation for noncardiac surgery. Physical examination and ECG were normal. Transthoracic echocardiography showed a 17 × 35 mm suspicious hyperechoic mass in the interventricular septum. Multi-slice computed tomograpy (MSCT) was used. Volume rendered image and an axial maximal intensity projection image demonstrated a mass with a density consistent with fat tissue ( − 78 HU). The MSCT findings were diagnostic of a benign lipoma. Thus, this mass was noninvasively diagnosed as cardiac lipoma. Neither life-threatening arrhythmia on Holter monitoring nor myocardial ischemia on exercise scintigraphy was observed. Transthoracic echocardiography is usually the initial diagnostic test in patients with a suspected cardiac mass. However, its sensitivity for differentiating tissue characteristics is limited. MSCT allow for detailed delineation of intra and pericardiac masses. In conclusion, we demonstrated the value of cardiac MSCT to diagnose an interventricular lipoma.     

16层螺旋CT冠状动脉重建成像在冠状动脉疾病诊断中的临床应用

目的总结16层螺旋CT冠状动脉(简称冠脉)重建成像在冠状动脉疾病诊断中的临床意义。方法回顾分析60例患者所做的16层螺旋CT冠脉重建图像。采用回顾性心电门控技术、分段(Segment)数据采集方式和选择75%的时间相位窗,对扫描数据进行容积再现技术(VRT)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)、CT仿真内镜(CTVE)等图像后处理。结果60例患者2例冠脉成像不良,不能用于影像诊断;33例冠脉成像未提示明确异常;21例冠脉成像提示有不同程度的冠脉病变;4例4枚支架有两枚支架显示通畅,1枚支架疑有软斑块形成,1枚支架阻塞。结论16层螺旋CT冠脉重建成像能较好地显示冠脉管腔II～III度狭窄情况及冠脉斑块形成情况,较好地评估冠脉支架植入情况,在早期发现和诊断冠心病及对高危人群进行普查方面有较高的临床应用价值,是一种较有效的无创性冠脉疾病检查诊断方法。     

Non-invasive coronary angiography: the clinical value of multi-slice computed tomography in the assessment of patients with prior coronary bypass surgery

Background Contrast enhanced multi-slice computed tomography (MSCT) is the leading modality in non-invasive coronary angiography (CTA) today. We investigated MSCT based assessment of coronary artery bypass grafts (CABG) by analyzing assets and drawbacks of CTA in order to define demands on latest technology. Methods In a clinical setting 39 CABG patients (69.2 ± 1.4 years; male n = 36) underwent CTA (collimation 16 × 0.75 mm, contrast medium 100 ml; 320 mAs, 120 KV). Ninety-seven CABG (61 venous, 36 arterial grafts) were evaluated. A subgroup of 18 patients underwent additional invasive coronary angiography (CA). Results CTA for CABG assessment resulted in an overall sensitivity (sens.) of 100%, specificity (spec.) of 92.4% and positive and negative predictive values (PPV, NPV) of 60% and 100%, respectively. CABG anastomoses showed slightly inferior diagnostic accuracy than other CABG segments. Limitations in imaging quality caused 21% unevaluable segments of the CABG anastomoses. Evaluation of native vessel segments proximal and distal to the anastomoses resulted in a sens, spec, PPV and NPV of 57.5, 94.6, 92 and 67.3%, respectively. With 28.5% unevaluable segments, the native vessel segments showed serious limitations in imaging quality. Radiation exposure was 9.88 ± 3.20 mSv (9.69 ± 3.25 mSv male; 12.08 ± 1.35 mSv female). Conclusion 16-slice MSCT based CABG assessment offers sufficient diagnostic accuracy. However, focussing on the bypass anastomoses and the native revascularized coronary arteries, clinical value is limited.     

Three-dimensional computed tomography mapping of posterior malleolar fractures

BACKGROUND Posterior malleolar fractures have been reported to occur in<40%of ankle fractures.AIM To reveal the recurrent patterns and characteristics of posterior malleolar fractures by creating fracture maps of the posterior malleolar fractures through the use of computed tomography mapping.METHODS A consecutive series of posterior malleolar fractures was used to create threedimensional reconstruction images,which were oriented and superimposed to fit an ankle model template by both aligning specific biolandmarks and reducing reconstructed fracture fragments.Fracture lines were found and traced in order to generate an ankle fracture map.RESULTS This study involved 112 patients with a mean age of 49,comprising 32 pronationexternal rotation grade IV fractures and 80 supination-external rotation grade IV fractures according to the Lauge-Hansen classification system.Three-dimensional maps showed that the posterior ankle fracture fragments in the supinationexternal rotation grade IV group were relatively smaller than those in the pronation-external rotation grade IV group after posterior malleolus fracture.In addition,the distribution analyses on posterior malleolus fracture lines indicated that the supination-external rotation grade IV group tended to have higher linear density but more concentrated and orderly distribution fractures compared to the pronation-external rotation grade IV group.CONCLUSION Fracture maps revealed the fracture characteristics and recurrent patterns of posterior malleolar fractures,which might help to improve the understanding of ankle fracture as well as increase opportunities for follow-up research and aid clinical decision-making.     

Coronary vessel visualization using true 16-row multi-slice computed tomography technology

Background :Multi-slice computed tomography (MSCT) scanners with retrospective ECG-gating permit visualization of the coronary arteries. Limited spatial and temporal resolution as well as breathing artefacts due to the scan time can cause poor distal vessel segment and side branch visualization. The latest MSCT generation with true 16-detector slices (Sensation 16 ^®, Siemens, Forchheim, Germany) provides furthermore improved temporal and spatial resolution, as well as significantly reduced scan time. To assess, whether this technical improvement has also an impact on image quality we conducted the following study. Methods and material :Sixty-two consecutive patients (33 male, 29 female, mean age 63±8 [47–79] years, heart rate after -blockade 63±7 [45–86] bpm) with suspicion of coronary artery disease (CAD) were examined by cardiac MSCT. Parameter settings were: 0.75mm collimation, 2.8mm table feed/rotation, caudocranial scan direction, 80cc contrast media biphasic injection protocol, gantry rotation time 375ms, temporal resolution 188ms). Thirteen coronary segments (sgts) were evaluated in each patient (total number: 806sgts). Image quality of each segment was determined as: excellent – free of motion artefacts, good – mild motion artefacts, relevant artefacts – still diagnostic value, severe calcification and insufficient image quality – not visualized segment. Results :301/806 (37%) sgts showed excellent and 294/806 (36%) sgts good image quality. Relevant artefacts were seen in 107/806 (13%) sgts, calcifications in 41/806 (5%) sgts. 63/806 (8%) sgts could not be visualized (34 of them (54%) either segment 9 or 10). Diagnostic image quality was achieved in 702/806 (87%) sgts. Conclusions :Due to true 16-slice technology and faster gantry rotation time MSCT image quality could be improved and allows a visualization of the entire coronary tree. Larger, randomized, catheter-controlled studies have to be conducted to determine, whether this improved visualization also translates into better diagnostic accuracy.Both authors contributed equally     

急性脑缺血多层螺旋CT灌注成像临床研究

目的 探讨多层螺旋CT(MSCT)灌注成像在急性脑缺血中的临床应用价值.方法 对发病时间≤24小时的35例急性缺血性脑卒中患者应用16排螺旋CT依次进行头颅CT平扫与CT灌注成像(CTPI)检查,观察脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、峰值时间(TTP)和峰值增强(PE)各个灌注参数图.结果 35例急性缺血性脑卒中患者CTPI异常34例,诊断脑缺血的敏感性97.14%(34/35).35例35组CTPI参数CBF、CBV、MTT、TTP和PE异常者分别为34,28,33,32和27例;诊断脑缺血的敏感性分别为97.14%、80.00%、94.29%、91.43%和77.14%.35例140层面灌注参数图像单层面CTPI上述参数异常者分别为108、84、106、98和76例次;诊断脑缺血的敏感性分别为77.14%、60.00%、75.71%、70.00%和54.30%,两者差异均具有统计学意义(P＜0.05).CTPI的各个参数图异常灌注区面积之间相关性较好.结论 CTPI能够早期准确显示急性脑缺血存在与否及部位、范围,对早期诊断急性缺血性脑卒中和早期溶栓治疗具有重要指导意义.     

双排螺旋CT三维重建技术诊断骨关节损伤的价值探讨

目的探讨双排螺旋CT三维重建技术对诊断骨关节损伤患者的临床应用价值。方法选取2011年6月至2013年6月在该院就诊的72例骨关节损伤患者,所有患者均经X线片、普通轴位CT及CT三维重建技术检查,比较各种检查方法的价值。结果普通轴位CT、多平面重建(MPR)及表面遮盖(SSD)对骨关节损伤的显示数目均明显多于X线片,差异有统计学意义(P0.01),尤其在对髋关节、肩关节、骨盆及脊柱等部位复杂损伤或可能存有隐匿骨折部位,双排螺旋CT重建技术明显优于X线片。CT三维重建对骨折或脱位数显示数目与普通轴位CT相比,差异无统计学意义(P0.05)。结论双排螺旋CT三维重建可直观准确地判定骨折的类型、结构及位置,明显提高骨折的诊断率,并可清晰显示关节损伤的程度,尤其在复杂及隐匿性骨关节损伤诊断上有较高的价值,拥有广泛的应用前景。