肺曲菌球病的多层螺旋CT诊断

目的:探讨多层螺旋CT诊断肺曲菌球病的价值.材料和方法:回顾性分析22例经病理及临床证实的肺曲菌球病的CT征象.结果:21例肺曲菌球中均有"气新月征"或"气环征",其中5例有"球中含气征".9例行CT平扫及增强扫描,增强扫描示肺曲菌球结节无明显增强.结论:多层螺旋CT扫描对肺曲菌球病的诊断具有较高的价值.     

多层螺旋CT在诊断肺隔离症中的应用

目的 评价多层螺旋CT血管成像对肺隔离症的诊断能力。方法 15例经病理（14例）和血管造影（1例）证实的叶内型肺隔离症患者均经多层螺旋CT平扫与增强扫描，并采用容积再现技术，最大密度投影及多平面重建显示异常血管与病灶的关系。结果 15例肺隔离症患者中，14例的病灶位于左下叶，1例的病灶位于右下叶，异常体动脉供血全部来自胸主动脉，其平均直径1．6cm。CT平扫表现为肿块形7例，圆形或卵圆形5例，不规则形3例。增强后15例均显示异常体动脉供血。结论 多层螺旋CT血管成像技术能准确诊断肺隔离症，并可取代其他有创性检查，如数字减影血管造影等。     

肺空洞多层螺旋CT仿真内镜成像初探

目的 :探讨肺空洞病变多层螺旋CT仿真内镜 (CTVE)成像技术及其初步临床运用。方法 :选择 13例肺空洞患者进行常规横断面CT扫描 ,将容积数据重建后输入GEAW 4.0工作站 ,用三维导航软件 (Navigator)重建成仿真内镜图像 ,调整阈值及视角并用伪彩技术立体观察空洞内表面情况。结果 :癌性空洞 8例 ,肺脓疡空洞 3例 ,结核性空洞 2例。癌性空洞内壁不规则 ,多伴大小不等壁结节 ,表面光滑 ;肺脓疡空洞内壁毛糙 ,显示多发锯齿状、柱状、火山口状改变 ;结核性空洞内壁光滑、规则 ,无结节状改变。对于直径 >3cm空洞 ,CTVE可较满意地获得立体的肺空洞内表面图像 ,空洞内结节的形态、大小、数量以及与空洞内壁联结关系 ,对直径 1.5～ 3 .0cm空洞 ,需调节适当阈值 ,扩大视角显示较好 ;对直径 <1.5cm空洞 ,CTVE显示困难。结论 :肺空洞CTVE成像是对常规CT重要补充 ,但不能作为独立诊断依据 ,必须结合CT原始图像及重建图像进行综合分析     

多层螺旋CT评估孤立性肺结节的临床进展

多层螺旋CT是目前检验孤立性肺结节最敏感的方法,它能显示肺结节的微细结构,消除或减少常规CT扫描的部分容积效应,从而提高对孤立性肺结节检测的准确性。本文重点综述多层螺旋CT扫描技术、孤立性肺结节形态学评估及其对孤立性肺结节的诊断价值、孤立性肺结节的CT增强扫描来探讨多层螺旋CT评估孤立性肺结节的临床进展。     

多层螺旋CT在肺撕裂伤诊断中的应用价值

目的 探讨多层螺旋CT诊断肺撕裂伤的价值.资料与方法 对67例外伤患者均使用螺旋CT进行胸部平扫,螺距0.9,扫描模式6×0.75 mm,重组层厚、层距0.75 mm.结果 CT特征表现为肺气囊肿、气液囊肿、血肿.其中气囊肿58个,多为薄壁.气液囊肿23个,壁厚薄不均,囊内积液少量.56个气囊肿、气液囊肿边界模糊,边界清楚25个.肺血肿球形血肿14例,直径20～50 mm,边界清楚.气囊肿、气液囊肿或血肿周围常有不同程度肺挫伤,表现为云絮状、斑片状模糊影.41例有肋骨骨折,38例液气胸,12例气胸,6例少量胸腔积液,5例纵隔气肿,49例胸壁皮下气肿,21例胸椎骨折,15例椎旁血肿;49例同时有颅内血肿、腹部脏器损伤.结论 多层螺旋CT能准确、迅速诊断肺撕裂伤的部位、范围、类型,以及合并征象,对临床治疗具有重要指导作用.     

冠状动脉狭窄的多层螺旋CT诊断

目的 旨在评价多层螺旋CT（MDCT）诊断冠状动脉（简称冠脉）狭窄的可行性和准确性。方法 65名患者行冠脉MDCT造影（MDCTA），扫描数据在回顾性心电门控下重建。有32例同时接受选择性冠脉造影（SCA）。分析CT图像质量，并与SCA比较，评价MDCTA诊断50％以上狭窄的准确性。结果 心率70次／min以下患者CT图像质量明显优于心率70次／min以上组（W＝539，P＜0．0001）。32例MDCTA图像与相应SCA比较，MDCTA诊断50％以上狭窄的敏感度、特异率、阴性预测值和准确度分别为95％、80％、89％和90％。结论 MDCT对冠脉能够高质量成像并可较准确诊断冠脉狭窄。     

多层螺旋CT的进展

多层螺旋CT(multi-sliceCT,MSCT)继1999年的4层采集、2000年的8层采集设备问世之后,2001年GE、Philips、Siemense和Toshiba 4家公司均推出了16层采集的螺旋CT.CT的进一步发展提出并体现了"CT绿色革命"的概念,即在所有的技术改良中,要突出实现更低的X线剂量、更快的采集与重组速度、更便捷和多样的重组处理、更短的病人等候时间及更好的病人舒适度.     

多层螺旋CT及重建技术对肺动静脉畸形的诊断价值

目的：评价多层螺旋CT及重建技术对肺动静脉畸形诊断的价值。材料和方法：对9例肺动静脉畸形的病人行MSCT检查，然后进行三维肺血管重建，并与DSA检查进行对照分析。结果：全部病例的MSCT检查及重建诊断结果与PADSA诊断相符，MSCT及三维肺血管重建均能充分显示供血肺动脉、引流静脉的空间关系与解剖细节，能准确、直观地观察畸形血管的走行、数目、直径。结论：MSCT及重建技术对肺动静脉畸形的诊断具有重要价值，并能为治疗提供重要依据。     

Diagnosis of bronchiectasis with multislice spiral CT: accuracy of 3-mm-thick structured sections

The aim of this study was to evaluate the accuracy of 3-mm-thick reconstructed sections in the diagnosis of bronchiectasis with multislice CT (MSCT). Forty consecutive patients suspected of bronchiectasis (23 females, 17 males; mean age 51 years) underwent MSCT of the entire thorax with a 4×1-mm collimation (120 kV, 0.5 s/rotation, 80 mAs/slice) and a pitch of 1.75. From each data set (mean z-axis coverage: 257 mm; mean duration: 21 s), two series of images were systematically generated: 1-mm (group 1) and 3-mm (group 2)-thick reconstructed scans. Both series of images were obtained at 10-mm intervals and reconstructed with a high-spatial-frequency algorithm. Two observers independently analyzed the presence of bronchiectasis and associated abnormalities in group-1 and group-2 lung images. No significant difference between group 1 and group 2 was found in: (a) the detection of bronchiectasis, identified in 24 patients (60%) in group 1 and in 23 patients (57.5%) in group 2 (p=0.08); (b) the evaluation of the extent of bronchiectasis, identifying focal bronchiectasis in 10 patients (25%) in group 1 and 7 patients (17.5%) in group 2 (p=0.39) and multifocal bronchiectasis in 16 patients (40%) in both groups; (c) the characterisation of bronchiectasis (cylindral bronchiectasis: group 1, n=24, 60%; group 2, n=21, 53%, p=0.08); varicose bronchiectasis: group 1, n=5, 12.5%; group 2, n=6, 15%, p=0.56); and cystic bronchiectasis: group 1, n=2, 5%; group 2, n=2, 5%). Apart from the identification of abnormal bronchial wall thickening (group 2, n=35, 87.5%, vs group 1, n=31, 77.5%, p<0.05), recognition of associated bronchopulmonary anomalies did not differ between the two groups. This study demonstrates a comparable accuracy of the 3- and 1-mm-thick reconstructed scans in the detection and characterization of bronchiectasis. These results suggest the potential usefulness of 3-mm-thick scans generated from 4×2.5-mm acquisitions in the screening of bronchiectasis, which would allow a 20% radiation dose reduction compared with the present investigation. Electronic Publication     

Multiplanar functional imaging of the larynx and hypopharynx with multislice spiral CT

The purpose of this study is to evaluate multislice spiral CT (MSCT) in multiplanar functional imaging of the larynx and hypopharynx and to define the optimal image planes for the delineation of the tumor and specific anatomical structures. Forty patients with suspected tumors of the larynx or hypopharynx were examined with MSCT during quiet breathing (QB), E-phonation (EP) and modified Valsalva maneuver (VM). Images were read in the axial, coronal and sagittal planes. Overall image quality, delineation of the tumor and anatomic structures for different conditions and orientations were graded using a three-point scale; the conditional permutation test was applied to detect quality differences. Differences between image types were statistically significant. The axial plane was superior in overall image quality and the delineation of the tumor, pyriform sinus, vocal cords and fat within the parapharyngeal/visceral space. The coronal plane was best for delineating the ventricle and the paraglottic space, the sagittal plane for the retropharyngeal and the preepiglottic space. For tumor detection, sensitivity, specificity and accuracy were 0.92, 1.0 and 0.93 for QB.ax, 0.94, 0.8 and 0.92 for EP.ax and 0.85, 1.0 and 0.87 for VM.ax, respectively. Examination during QB should be the standard procedure; additional scanning with EP improved tumor assessment.     

肺硬化性血管瘤的CT表现

目的探讨肺硬化性血管瘤(PSH)的多层螺旋CT表现特征,以提高对该病的认识。方法分析经手术或CT导引下穿刺病理证实的肺硬化性血管瘤20例,20例均做了64层螺旋CT检查,其中12例行增强扫描。结果肿瘤呈圆形7例,椭圆形9例,类三角形4例,肿瘤边缘清晰,3例病灶可见浅分叶。肿瘤密度欠均匀,9例病灶内部或边缘见点状钙化,3例病灶周边可见"含气裂隙征"。12例增强扫描,4例呈斑片样强化,7例肿瘤呈均匀一致性明显强化,1例无明显强化、病灶内部密度均匀,4例肿瘤边缘肺门侧见"贴边血管征"。结论多层螺旋CT层厚薄,图像的空间分辨率和增强扫描的时间分辨率高,可以显示病灶内部的细微钙化及增强特征,较普通CT确诊率明显提高。     

多层螺旋CT图像后处理在输尿管微小结石中的诊断

目的探讨多层螺旋CT（MSCT）图像后处理在输尿管微小结石诊断中的应用价值。方法对28例共29枚微小结石,应用多排螺旋CT扫描,图像拆薄后进行重建及图像后处理,在横断位、MPR、CPR、MIP、CTU、VR图像上对输尿管微小结石CT征象进行分析。结果对29枚微小结石在MSCT及图像后处理后全部明确诊断。输尿管上段10枚结石,中段8枚,下段11枚。检出率明显优于KUB及BUS。结论MSCT及图像后处理明显提高了输尿管微小结石的检出率,是诊断输尿管微小结石可靠的检查方法。     

多层螺旋CT血管成像在肺动脉疾病中的临床应用

目的评价多层螺旋CT血管成像对探测肺动脉疾病的临床应用价值。方法 60例经临床或病理证实的肺动脉疾病患者均经MSCT肺动脉成像检查,对所有患者的影像表现进行回顾性分析。结果本组60例患者肺动脉CTA的图像质量完全满足诊断需要。研究证实,60例中38例为肺动脉栓塞,6例中央型肺癌侵犯肺血管,3例为肺动静脉瘘,5例为肺动脉高压,8例肺动脉成像未见异常。结论 MSCT的三维肺血管图像可立体、直观地显示肺血管的解剖结构及其与周围组织的空间关系,能及时发现和诊断肺动脉疾病,指导肺栓塞的治疗及评价疗效,也可为中央型肺癌制定手术方案提供准确的影像学信息。     

Coronary artery aneurysm and type-A aortic dissection demonstrated by retrospectively ECG-gated multislice spiral CT

The case of a 40-year-old male patient with a coronary aneurysm of the proximal left descending artery (LAD) combined with circumferential type-A dissection of the ascending aorta is reported. Computed tomography angiography of the coronary arteries was performed using multislice spiral computed tomography (MSCT) with retrospective ECG gating. Anatomical relations of the LAD aneurysm as well as the origin of the left coronary artery from the false lumen of the dissection were well depicted for planning of the surgical intervention using this new noninvasive imaging modality.     

多层螺旋CT三维重建在脊柱骨折中的应用研究

目的探讨多层螺旋CT（MSCT）三维重建诊断脊柱骨折的应用价值。方法对200例脊柱创伤患者进行螺旋CT容积扫描,将原始图像进行软组织算法及骨算法薄层重建,然后将薄层重建图像导入Syngo3D软件工作站,进行MPR,MIP,SSD和VR成像。结果多层螺旋CT三维重建清晰直观显示了脊柱骨折的部位、类型、脱位、稳定性情况及三维空间关系;对内固定术后脊柱,能清楚显示内固定物与周围组织的关系及固定物立体形态。结论MSCT三维重建成像可全面、清楚、直观、立体、多方位地观察骨折伞貌及术后改变,为临床选择治疗方案、制定手术路径及随访提供可靠依据。     

Pancreatic carcinoma: the role of high-resolution multislice spiral CT in the diagnosis and assessment of resectability

The purpose of our study was to evaluate multislice computed tomography (MSCT) in the assessment of patients with clinical, laboratory, and US suspicion of pancreatic neoplasm, and to evaluate resectability status. Forty-six patients with a suspected pancreatic tumor underwent MSCT. After a preliminary precontrast survey, a postcontrast scan was performed in the arterial and portal venous phase with the following protocol: 4×1-mm collimation; 1.25- and 5-mm slice thickness width, respectively, and 1- and 5-mm reconstruction interval. In all patients pathological correlation was obtained. The evaluation of all images provided a diagnosis in 44 patients, with a sensitivity, specificity, and accuracy of 97, 80, and 96%, respectively. The MSCT correctly provided a diagnosis of unresectability with sensitivity of 96%, specificity of 86%, and accuracy of 93%. Evaluation of 1-mm slices demonstrated 83 of the 91 liver metastases found at surgery; conversely, the 5-mm slices detected only 76 of these lesions. Infiltration of peripancreatic major vessels was demonstrated, and was confirmed at surgery in 18 patients. High-resolution MSCT improves prediction of resectability in patients with suspected pancreatic carcinoma. Parenchymal and vascular information can be achieved with a single MSCT examination. Electronic Publication     

粪石性肠梗阻的MSCT表现分析

目的通过探讨粪石性肠梗阻MSCT表现,以提高粪石性肠梗阻的诊断率。方法 2005年7月~2012年11月期间经临床证实的粪石性肠梗阻患者21例CT检查及相关资料。结果所有病例中小肠梗阻19例,结肠梗阻2例。不完全性肠梗阻16例,完全性肠梗阻5例。结论 MSCT对诊断粪石所致肠梗阻的定位、定性具有高度敏感性及特异性。     

兰州地区成人脾脏容积多层螺旋CT测量

目的:探讨正常成人脾脏容积多层螺旋CT测量的方法和正常值,并研究脾脏容积与脾脏各径线长度及肋单元的相关性。方法:应用多层螺旋CT自带的Volume软件对400例正常成人脾容积进行测量。结果:400例检查者脾容积的平均值为(173.94±52.17)cm3,200例男性脾容积平均值为(184.99±51.01)cm3,200例女性脾容积平均值为(162.90±51.08)cm3。脾容积与肋单元相关系数r=0.32,与上下径相关系数r=0.62,与前后径相关系数r=0.64,与脾厚径相关系数r=0.52,P0.01。结论:多层螺旋CT脾容积测量方法简便,结果较其他方法更为准确。脾脏上下径、前后径和脾厚径与脾容积相关性较大,两项以上超过正常上限,可做为判断脾脏增大的初步指标。