多层螺旋CT肺静脉开口径线测量分析

目的探讨正常成人肺静脉开口径线（pulmonary vein ostia,PVO）的测量方法,并获得我院POV径线值的95%参考值范围。方法 2005年6月2006年1月收集无明显心肺疾病的正常成人236例,对其进行多层螺旋CT扫描,利用斜冠面重建和三维标定的方法测量PVO径线。结果四条PVO径线的95%参考值范围如下：右上肺静脉长径线为男性1.49～2.63cm,女性1.31～2.37cm,短径线为男性0.87～2.05cm,女性0.91～1.81cm;右下肺静脉长径线为男性1.12～2.06cm,女性1.05～1.95cm,短径线为男性0.77～1.83cm,女性0.79～1.69cm;左上肺静脉长径线为男性1.18～2.20cm,女性1.09～2.11cm,短径线为男性0.82～1.72cm,女性为0.80～1.62cm;左下肺静脉长径线为男性0.96～1.98cm,女性1.03～1.81cm,短径线为男性0.56～1.26cm,女性0.51～1.33cm。除左下肺静脉短径男女差异无统计学意义外,其余径线值男性均大于女性。结论采用CT三维重建像改进测量方法测量PVO径线值既简便又准确。     

500例国人正常脾脏大小的CT评价

本文分析了５００例正常脾脏大小的ＣＴ表现。其中男性３４７例，女性１５３例，年龄从５￣８２岁，平均４３岁，脾脏各径线、肋单元及脾指数分别为：（１）前后径７．３￣１３ｃｍ；（２）横径２．３￣４．７ｃｍ；（３）上下径６￣１３ｃｍ；（４）肋单元４￣８；（５）脾指数１０９．９￣６０５．４。笔者认为ＣＴ判断脾脏大小较为准确，应用径线测量及计算脾指数的方法并结合年龄与性别因素能够作出准确合理的综合评价。     

长寿老人心脏大血管X线测量及临床意义

目的　为长寿老人心脏大血管的测量积累资料。方法　搜集生活可自理的 90～ 10 2岁长寿老人站立后前位胸片 5 8例 ,采用国人报道的测量方法 ,分别对主动脉、肺动脉及心脏一些径线共计 11项指标进行X线测量研究。结果　长寿老人心脏呈主动脉型 ,代表心脏大血管改变的各项观测指标除了主动脉结宽径测量值男性与女性基本相同外 ,其他各径线测量值男性均较女性为大 (P <0 .0 5 )。结论　长寿老人心脏大血管一些径线在性别方面存有一定的差异 ;各项观测指标均大于其他各年龄组     

成年男性门静脉的CT测量及其意义

本文搜集连续100例正常成年男性、50例无明显侧支循坏血管的肝硬化门脉高压症(CPH)患者、50例伴有明显侧支循环血管的(CPH)患者,分别测量其门静脉主干(PV)宽径、肠系膜上动脉宽径(SMA)并计算PV/SMA的比值。经统计学分析,结果显示:正常成年男性的PV值为1.16±0.06cm,≤1.47cm;比值为1.72±0.27,≤2.25。当PC值≥1.87cm时,CPH在CT图像上常见有侧支循环血管。作者认为,本组测量结果可为CPH的CT诊断提供一项较实用的、客观的指标。     

CT测量眼眶容积回归方程的特征

目的:利用眼眶骨性径线CT测量结果,推导眶容积的回归方程并探讨其应用价值.方法:选择2004-01/03怀疑眼内病变而在解放军第四七四医院影像中心行眼部CT扫描患者26例,均为正常汉族成人,眶壁完整,无眼眶发育异常.按性别分成两组,男性15例(30只眼眶),女性11例(22只眼眶).所有受试者进行CT轴位及冠状位扫描,分别在神经–眼平面及过眶外缘点的冠状面图像上测量眶前后径,眶左右径及上下径;在TPS工作站上重建后测得眼眶容积,利用SPLM 3.0 for windows统计软件逐步回归法推导出眼眶容积的回归方程.结果:①眶容积男性平均(24.70±1.21)mL,女性平均(22.36±0.50)mL,平均相对误差为4.27%.②男性眼眶容积一般回归方程为:Y = 2.678 170 579 566 15X2(眼眶上下径) 2.885 631 028 878 08X3(眼眶前后径) 2.727 155 908 318 3X1(眼眶左右径)–8.053 242 884 229 06;女性眼眶容积一般回归方程为:Y = 3.799 079 355 193 91 X2 2.660 909 087 793 59 X1 1.553 250 669 853 41X3–6.388 006 447 283 01.方程预测值与影像测量值平均误差为3.42%.结论:利用眼眶径线推导的三元回归方程可以估算眶容积,对诊断眼眶畸形、指导眶内手术、眼眶重建等具有重要意义.     

B超对正常女童子宫的探测

目的建立正常女童子宫大小的正常值，并对各年龄小儿子宫的生长发育情况做初步探讨。方法B超测量正常女童宫体前后径，长径及宽径并计算三径线之和。结果新生儿期子宫发育相对较快，此后至10岁相对缓慢，10岁以后女童子宫发育个体差异较大。结论三峡库区蓄水后，环境改变对小儿子宫发育影响不大。     

股骨近段髓腔的CT测量及股骨假体设计

背景：人工关节大多根据西方人种设计,与国人股骨近段髓腔存在一定差异。目的：通过CT测量股骨近段横断面的髓腔内径参数,为设计符合国人的髋关节假体提供数据。方法：通过CT对61例初次行全髋关节置换成年人的健侧股骨近段进行扫描,连续扫描3层,层厚均2mm,测量股骨颈平面、股骨小转子平面、股骨峡部平面的髓腔内径等参数。结果与结论：股骨峡部平面的各径线之间、股骨颈平面的宽径与内侧径之间、股骨小转子平面的长径与内侧径之间都存在着显著相关性（P〈0.05）。股骨颈平面的长径、宽径、内侧径及股骨峡部平面的皮质厚度在男女之间差异具有显著性意义（P〈0.05）。所测3个平面的径线可为该类型股骨假体的设计提供数据支持。     

骨密度CT测量

目的：测量我国正常成人骨密度值．为老年骨质疏松症的诊断提供依据。方法：使用,QCT体模对100例健康进行骨密度CT测量。结果：正常成人骨密度与年龄明显相关．其骨密度值以21～30岁最高,男性170Mg／cm．女性180.6mg／cm．女性骨密度高于男性,41～50岁后男性高于女性,51～60岁女性骨密度40％低于骨折阈值(100～110mg／cm),而61～70岁女性低于骨折阈值占70％,男性则在61～70岁始有低于骨折阐值占30％。结论：我国老年男女,尤其女性普遍患有骨质疏松症。     

男性乳房肥大症的超声诊断

目的探讨超声诊断男性乳房肥大症的价值及正常男性乳腺测值。方法应用高频超声探头对35例(40只)男性乳房肥大症患者进行探测，并对50例(100只)健康男性乳房和3例男性乳腺癌患者进行对照研究。结果男性乳房肥大症表现为以乳头为中心或略偏向一侧的扇状低回声，与周围组织间分界较清楚，其内可见向乳头方向聚拢的管状回声。40只肥大症乳腺的左右径(2.26±0.96)cm，上下径(2.11±0.86)cm，前后径(1.02±0.22)cm，正常对照组乳腺测值的95%可信区间分别为左右径0.52～1.20cm，上下径0.50～1.18cm,前后径0.31～0.75cm。结论超声诊断男性乳房肥大症具有较高的应用价值，与男性乳腺癌鉴别时亦可提供重要依据。     

股骨近段CT扫描与全髋关节置换的术前计划

背景：做好全髋关节置换前假体型号预测的前提是对股骨近段的充分了解和精确测量,但X射线片仅提供一个平面图像,不能了解股骨近段横断面的情况,而股骨上段CT扫描可以提供更多信息。目的：观察股骨近段CT扫描在全髋关节置换前计划中的作用。方法：对61例进行初次全髋关节置换的患者行股骨近端CT扫描,选取股骨小转子最突出处上方2cm股骨颈平面（T20）、股骨小转子最突出点处的股骨转子区平面（T0）和股骨干髓腔最狭窄处平面（N）的横断面CT影像。测量股骨颈平面髓腔长径、宽径、内侧径;小转子平面髓腔长径、内侧径;股骨峡部平面髓腔长径、宽径、皮质厚度。结果与结论：股骨颈T20长径40.8～63.3mm,平均（49.6±5.1）mm;T20宽径13.3～29.1mm,平均（22.4±3.4）mm;T20内侧径7.2～14.6mm,平均（10.6±1.6）mm。股骨转子区T0长径20.5～40.2mm,平均（28.7±4.4）mm;T0内侧径4.3～13.0mm,平均（8.1±1.7）mm。股骨峡部N长径8.2～22.4mm,平均（14.1±3.1）mm;N宽径6.1～17.9mm,平均（10.2±2.9）mm;N皮质厚度2.7～12.7mm,平均（7.5±1.8）mm。提示股骨近端CT扫描可以提供更多的影像信息和更精确的测量数据,对全髋关节置换前计划有所帮助。     

Abdominal aortic aneurysm morphology in candidates for endovascular repair evaluated with spiral computed tomography and digital subtraction angiography.

PURPOSE: To analyze the morphology of abdominal aortic aneurysms (AAAs) and to study the usefulness of spiral computed tomography (CT) versus digital subtraction angiography (DSA) in the evaluation of patients for endovascular repair. METHODS: Of 133 AAA patients (120 men, mean age 67 years, range 52 to 84) evaluated preoperatively with CT imaging, 77 endograft candidates (68 men) were also assessed with intra-arterial DSA. Arterial parameters were measured on axial CT scans and angiographic films for comparison. RESULTS: Mean maximum AAA diameter was 58 +/- 11 mm (range 39 to 95). Aneurysmal neck diameter was consistently smaller on DSA than on CT (20.7 +/- 3.6 mm versus 23.0 +/ 3.5 mm, p < 0.0001). The distance from the most distal renal artery to the aortic bifurcation was longer on angiography than on CT (mean difference 10.0 mm, p < 0.0001). There was a positive correlation between the maximum AAA diameter and the AAA length (r = 0.49, p < 0.0001) and an inverse relationship between the neck length and the neck diameter (r = -0.36, p < 0.0001). No correlation was found between the maximum AAA diameter and maximum iliac diameter, angulation, or length. CONCLUSIONS: AAA anatomy varies widely and independently of the aneurysm size. Therefore, the maximum size of the aneurysm is a poor predictor of whether or not an aneurysm is suitable for endovascular repair. The discrepancy between angiographic and axial CT measurements suggests that neither alone is sufficient as a preoperative imaging technique when evaluating a patient for an endovascular graft procedure.     

Is the inter-nipple line the correct hand position for effective chest compression in adult cardiopulmonary resuscitation?

BACKGROUND: Despite the new release of CPR guidelines, there was insufficient evidence for or against a specific hand position for manual chest compression in adults. Computed tomography (CT) images of the chest can demonstrate objectively the spatial relationship between the surface landmarks on the chest and the inner viscera underneath them. This study is designed to examine the spatial relationship between the inter-nipple line (INL) and the heart in order to determine the proper hand position for more effective CPR. METHODS: We enrolled 189 adult patients who underwent low dose chest CT from 16 October to 10 November 2006. Patients' demographic data were collected. The sternal length, the distance from the xiphoid to the INL, and the distance from the xiphoid to the maximal heart diameter were measured by using 3D reconstructed CT images. RESULTS: In about 80% of the 189 patients' CT images, the intrathoracic structure just underneath the INL was the ascending aorta (18.0%), the root of aorta (48.7%), or the left ventricular outflow tract (12.7%), rather than the left ventricle itself (20.6%). The INL was 6.2+/-1.8cm and 5.6+/-1.9cm cephalad to the xiphoid for the male and the female, respectively. The coronal CT image plane of the maximal heart diameter was 2.8+/-1.6cm and 2.3+/-1.6cm cephalad to the xiphoid for the male and the female, respectively. CONCLUSION: For more efficient and effective chest compression during CPR, compressing the sternum more caudally than the INL could be considered if it is not associated with the risk of increasing internal visceral injuries.     

成年患者与喉罩置入相关咽喉部解剖的影像学研究

目的：通过咽喉部CT测量成年患者咽喉部与喉罩置入相关的解剖径线并探讨各径线与临床指标的相关性。方法：选择使用喉罩全麻行择期手术的患者121例,男性60例,女性61例。术前行CT平扫,经三维重建后测量会厌舌面长度(径线1)、会厌舌面根部宽度(径线2)、会厌舌面根部至食管入口处的距离(径线3)、两侧梨状窝外侧缘间距(径线4)。比较男、女各径线的差异并将各径线长度与年龄、身高、体重、BMI分别做Pearson相关分析。结果：各径线长度分别为径线1(1.56±0.34)cm、径线2(2.18±0.37)cm、径线3(2.15±0.34)cm以及径线4(3.79±0.43)cm。男性和女性的4条径线的差别均有统计学意义(P<0.01)。咽喉部各径线与年龄、身高、体重、BMI进行Pearson相关分析,结果显示4条径线长度与年龄的相关性无统计学意义,患者的身高与4条径线的相关性均有统计学意义(P<0.01),体重与径线1、径线3和径线4长度相关(P<0.01),而BMI只与径线3长度相关(P<0.01)。结论：本研究提供了中国人与喉罩设计相关的咽喉部解剖数据,发现性别、身高和体重是影响咽喉部解剖径线长度的重要因素,提示在设计适合中国人的喉罩和型号选择方面应综合以上三个因素。     

Normal organ volume assessment from abdominal CT

We determined the normal distribution of abdominal organ volumes measured from abdominal computed tomographic (CT) images. A total of 149 adult abdominal CT studies were selected, and 711 organs (388 from males, 323 from females) were outlined by hand on each CT image by using a computer. More than 18,000 organ outlines were traced. The organs studied included left and right kidneys, left and right adrenals, spleen, pancreas, and liver, and the first lumbar vertebrae was also evaluated. Using the known pixel size and section thickness, organ volumes were computed. Organ volumes were corrected for height and weight for each sex. The normal and cumulative normal distributions for each organ studied were computed, demonstrating the range of organ volumes for each sex that exist in the normal adult population. Organ volumes ranged from a mean of 4.4 mL (female left adrenal) to 1710 mL (male liver). Mean organ volumes were 64.4, 156.5, 179.8, and 1411 mL for the female pancreas, kidneys, spleen, and liver, respectively. Corresponding male volumes were 87.4, 193.1, 238.4, and 1710 mL, respectively. Tabular data are provided that indicate the relative size for each organ volume in terms of the cumulative probability distribution. Normative data are provided to allow physicians to estimate where in the normal range a particular organ volume lays. Organ volumes may be useful as quantitative indices of pathologic conditions.     

多层螺旋CT三维重建国人下颈椎椎弓根的临床解剖学意义

背景：因颈椎解剖结构复杂以及个体化差异较大,导致颈椎弓根钉置入内固定技术应用受到很大限制。目的：应用螺旋CT三维重建国人的下颈椎椎弓根,并对重建图像进行测量评估。方法：对60例需行颈椎CT扫描的患者C3～C7进行颈椎CT扫描,使用Syngo应用软件对原始CT图像进行所需面的重建,测量CT重建后的椎弓根各项指标。结果与结论：颈椎绝大部分椎弓根峡部的宽度小于高度,男性高度和宽度C4～C7逐渐增大,女性则从C3开始逐渐增大。C3～C7椎弓根侧块投射点到上关节突下缘的距离并无规律性,而到侧块外缘的距离从头端到尾端是不断增大的。男性与女性的椎弓根水平角在C7均最小。结果提示,国人女性患者的C3及C4椎体行经颈椎椎弓根内固定应谨慎,大部分国人的C5到C7椎体是适合行椎弓根内固定的,但考虑到颈椎弓根个体的差异较大,内固定前颈椎弓根的CT扫描及重建后的评估是必要的。     

下段直肠及肛管CT轴位图像测量方法的研究

目的:研究直肠肛管的轴位CT测量方法。材料与方法:84例标记肛门的盆腔增强CT检查,其中15例同时行结肠气钡双对比检查。测量并计算直肠壶腹距肛门的实际长度与其层面距离的比值,同时在CT及气钡双对比造影图像上测量肛门距坐骨结节下缘平面的垂直距离、肛管长度及肛直角。用SPSS 11.5软件对数据进行统计分析。结果:在横轴位CT图像上,肛管由环行变为开口向后的U形时,即为肛门所在位置。CT与钡灌肠两种方法测量肛门距坐骨结节下缘平面距离、肛管长度及肛直角,差异无统计学意义。通过CT测量的直肠壶腹距肛门的实际长度与相应层面距离的比值均值为1.3。结论:CT图像可以清楚显示肛门及肛管,下段直肠距肛门的CT层面距离与实际长度间存在差异,通过本研究提出的比值法可以较准确的在轴位CT上测量下段直肠距肛门长度。     

Epidermoid cyst in intrapancreatic accessory spleen: computed tomography findings and clinical manifestation

Objective

This study aims to assess retrospectively the imaging features of computed tomography (CT) and clinical characteristics of epidermoid cyst in intrapancreatic accessory spleen (ECIPAS).

Methods

Seven consecutive patients with pathologically confirmed ECIPAS were included. CT images and clinical data were analyzed. The CT features emphasized included the location, size, calcification, cystic features, surrounding accessory spleen, density, and enhancement of the lesions.

Results

Five patients were male and two were female with a mean age of 43.2?years ranging from 25 to 66?years. Most cases were incidentally detected. All lesions were situated in the pancreatic tail, wherein the mean size was 4.4?cm. The cyst appeared unilocular in four cases and multilocular in three cases. An accessory spleen surrounding the cyst was recognized in all seven cases, and the cystic wall of ECIPAS showed a contrast enhancement similar to that of the spleen during multiphasic scans.

Conclusion

ECIPAS is an extremely rare entity. The diagnosis of an ECIPAS should be considered when enhancing the cystic wall of the lesion in the pancreatic tail similar to that of the spleen during multiphasic scans.     

国人成人腰椎管的CT测量

目的：通过CT测量求得国人成人腰椎管横径、矢径、关节突间距的数值以及相应的椎管指数，并探讨临床意义。方法：使用CT测量青岛地区100例（男女各50例）正常成人腰椎管L1～L5的径值。结果：腰椎管的横径平均径值性别间有显著差异（P〈0．001）。椎管矢径性别间无明显差异（P〉0．05）。关节突间距性别间有显著差异（L1～L3水平，P〈0．01；L4～L5水平，P〈0．001）。椎管横径与椎体横径的比值为0．52-0．55，关节突间距与椎管横径的比值为0．76-0．79，性别间无明显差异（P〉0．05）。结论：CT测量腰椎管可以得出相对准确的腰椎管径值，为临床提供相关参考指标。     

基于CT影像的中国成年人群与喉罩置入相关咽喉部解剖径线的测定

目的:基于咽喉部CT影像,测定中国成年人群咽喉部与喉罩置入相关的解剖径线,探讨各径线与临床指标的相关性。方法:选择2018年5月至2019年1月复旦大学附属金山医院收治的使用喉罩全麻行择期手术的患者121例,男性60例,女性61例。术前行CT平扫,经三维重建后测量会厌舌面长度(径线1)、会厌舌面根部宽度(径线2)、会厌舌面根部至食管入口处的距离(径线3)、两侧梨状窝外侧缘间距(径线4)。比较男、女各径线的差异并将各径线长度与年龄、身高、体质量、体质量指数(body mass index,BMI)分别做Pearson相关分析。结果:各径线长度分别为径线1(1.56±0.34) cm、径线2(2.18±0.37) cm、径线3(2.15±0.34) cm以及径线4(3.79±0.43) cm。男女4条径线长度差别有统计学意义(P0.01)。4条径线长度与年龄无相关性,与身高均正相关(P0.001),体质量与径线1、径线3和径线4长度正相关(P0.001),而BMI只与径线3长度正相关(P=0.009)。结论:性别、身高和体质量是影响中国成年人群咽喉部解剖径线长度的重要因素,在设计适合中国人的喉罩和型号选择方面应综合以上3个因素。