脑转移瘤的CT诊断

评价脑转移瘤的CT诊断。方法：回顾分析51例脑转移瘤的CT表现。结果：CT能显示肿瘤的数目、部位及侵犯范围，转移瘤具有一定特征性。结论：CT能较准确地诊断脑转移瘤。     

A Case of Renal Primitive Neuroectodermal Tumor Confirmed by Fluorescence in situ Hybridization

Primitive neuroectodermal tumor (PNET) is a member of the Ewing''s sarcoma family of tumors (ESFT). We report a case of PNET in a 66-year-old male who presented with a large solid tumor within the parenchyma of the middle pole of the left kidney with metastases to the left adrenal gland and right ischium. A fine-needle biopsy was performed and showed a small round cell tumor. Results of immunohistochemical staining suggested this tumor belonged to ESFT. Preoperative VDC-IE (combined vincristine, doxorubicin and cyclophosphamide followed by another combination of ifosfamide and etoposide) chemotherapy and left radical nephrectomy and adrenalectomy were performed. The histopathological findings of the resected tumor were similar to those in the biopsy specimen, but the results of AE1/AE3 were different. For the diagnosis, fluorescence in situ hybridization was performed. Split signals of the EWSR1 gene were detected, and transmission electron microscopy showed neuroendocrine granules and microtubules. The final diagnosis of this tumor was PNET of the kidney.Key Words: Primitive neuroectodermal tumor, Kidney, Fluorescence in situ hybridization, VDC-IE chemotherapy     

双平面CT 扫描诊断鞍区脊索瘤的价值

 目的　评价轴位加冠状位 CT扫描在诊断鞍区脊索瘤中的作用。方法　回顾性分析 9例经手术证实的脊索瘤的轴位和冠状位 CT扫描资料 ,其中 7例同时行增强扫描。结果　所有病例的病灶中心均位于鞍区 ,其边缘不规则或模糊 ,蝶骨体骨质明显破坏 ,4例鼻咽部有巨大软组织肿块 ,6例患者的瘤体内可见斑片状或不规则块状钙化影。结论　双平面 CT扫描可准确显示肿瘤向颅内侵犯的范围以及骨质破坏的程度 ,在排除鞍区的其它病变后 ,结合临床表现和 CT特征可诊断脊索瘤.     

A Rare Case of an Osteoid Osteoma of the Rib Treated under Computed Tomography Guidance: A Case Report and Review of the Literature

Osteoid osteoma (OO) usually occurs in the extremities of young adults. The tumor can arise in any part of the skeletal tissue; however, it is rarely found in the rib, with limited reports to date. In this report, we present a rare case of OO arising in the rib, which was successfully treated under computed tomography guidance with minimal invasiveness. At the final follow-up after 4 years, no local recurrence was observed.Key Words: Osteoid osteoma, Rib, Computed tomography guidance     

Successful Diagnosis of Pulmonary Artery Sarcoma by Contrast-Enhanced Computed Tomography

Pulmonary artery sarcoma is a rare tumor of the cardiovascular system. We reported a case of primary pulmonary artery sarcoma. In this case, the patient was misdiagnosed with tuberculosis for nearly 1 year and diagnosed by contrast-enhanced computed tomography and histopathologic examination at last.     

Computed Tomography in Carcinoma of the Larynx

CT scanning in the investigation of carcinoma of the larynx is compared with direct laryngoscopy and laryngectomy specimens. Scans of twenty-two patients studied on a GE 8800 scanner over a two-year period are retrospectively reviewed. CT scanning compares closely with direct laryngoscopy in ability to define the longitudinal extent of tumours and is superior in evaluating the soft tissues deep to the mucosal surface and in identifying cervical lymphadeno-pathy. Our findings agree with previous reports and we conclude that CT scanning is an imaging modality complementary to direct laryngoscopy and uniquely useful in characterizing the extent of carcinoma of the larynx in areas vital to planning of appropriate therapy.     

Computed Tomography of Adult Herpes Simplex Encephalitis

The CT appearances of Herpes Simplex Encephalitis (HSE) were examined in a retrospective study of seventeen patients aged from 13 to 79 years (average 48 years). Forty-two examinations were performed on a combination of second and third generation scanners. The most frequent finding was a low density area in the temporal lobe (95%) with sparing of the basal ganglia (88%). Other features included mass effect (76%), enhancement (71%) and haemorrhage (24%). These were not seen as commonly in initial scans. However, of nine scans performed on or before the 5th day of illness, 7 (78%) were abnormal.     

Volume Doubling Time of Pulmonary Carcinoid Tumors Measured by Computed Tomography

IntroductionPulmonary carcinoid tumor (PCT) is a rare neuroendocrine lung neoplasm comprising approximately 2% of lung cancer diagnoses. It is classified as either localized low-grade (typical) or intermediate-grade (atypical) subtypes. PCT is known clinically to be a slow-growing cancer, however few studies have established its true growth rate when followed over time by computed tomography (CT). Therefore, we sought to determine the volume doubling time for PCTs as visualized on CT imaging.Materials and MethodsWe conducted a retrospective analysis of all PCTs treated at our institution between 2006 and 2020. Nodule dimensions were measured using a Picture Archiving and Communication System or retrieved from radiology reports. Volume doubling time was calculated using the Schwartz formula for PCTs followed by successive CT scans during radiographic surveillance. Consistent with Fleischner Society guidelines, tumors were considered to have demonstrated definitive growth by CT only when the interval change in tumor diameter was greater than or equal to 2 mm.ResultsThe median volume doubling time of 13 typical PCTs was 977 days, or 2.7 years. Five atypical PCTs were followed longitudinally, with a median doubling time of 327 days, or 0.9 years.ConclusionsTypical pulmonary carcinoid features a remarkably slow growth rate as compared to more common lung cancers. Our analysis of atypical pulmonary carcinoid included too few cases to offer definitive conclusions. It is conceivable that clinicians following current nodule surveillance guidelines may mistake incidentally detected typical carcinoids for benign non-growing lesions when followed for less than 2 years in low-risk patients.     

A Longitudinal Computed Tomography Study of Lenalidomide and Bortezomib Treatment for Multiple Myeloma: Trabecular Microarchitecture and Biomechanics Assessed Using Multidetector Computed Tomography

BackgroundBone disease is a common feature in patients with multiple myeloma. In this study, we investigated whether lenalidomide, similar to bortezomib, affects the microarchitecture and biomechanics of bones using clinical CT-based FEM.Materials and MethodsBone lesions were evaluated using whole-body 64-section multidetector CT scan. For microstructural- and CT/FEM analyses, the volume of interest was defined as a 10-mm thickness of the central part of the L3 vertebral body. Microstructural parameters and mechanical properties were calculated using a 3-D image analysis system. The changes from baseline to the second examination within groups were calculated. Relationships between baseline disease characteristics and percent changes of trabecular parameters were assessed using Spearman correlation analysis.ResultsThirty-two patients were treated with bortezomib and 18 patients were treated with lenalidomide. At the second CT scan, apparent trabecular number, failure load, and stiffness were decreased in the bortezomib group and failure load and stiffness were increased significantly in the lenalidomide group. In the lenalidomide group, response to chemotherapy was positively associated with increases in failure load (ρ = 0.57; P < .05) and stiffness (ρ = 0.50; P < .05).ConclusionLenalidomide treatment resulted in significant increases in CT/FEM-derived estimates of bone strength. Response to chemotherapy predicted lenalidomide-induced bone changes and good responders had increased bone strength.     

False-Positive Mediastinal Lymphadenopathy on 18F-Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography after Rectal Cancer Resection: A Case Report of Thoracoscopic Surgery in the Prone Position

(18)F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (integrated FDG PET/CT) has been used to diagnose recurrence and differentiate postoperative changes from lymph node metastasis in colorectal cancer, although its accuracy is questionable. We report a prone thoracoscopic surgery for a rectal cancer patient in which false-positive mediastinal lymph nodes were found on FDG-PET/CT. A 60-year-old man underwent a laparoscopic high anterior resection and D3 lymph node dissection for rectal cancer. The histopathological diagnosis was moderately differentiated adenocarcinoma of the rectum, stage IIIB (pT3N1M0), necessitating oral fluoropyrimidine agent S-1. After the primary surgery, a solitary mediastinal lymph node measuring 30 mm in diameter was detected, and abnormal accumulation was confirmed by FDG-PET/CT (SUV(max), 11.7). Thoracoscopic resection was performed in the prone position, but histopathological results showed no metastasis. He was subsequently diagnosed with reactive lymphadenitis. The patient was discharged on postoperative day 4 in good condition and is alive without recurrence 12 months after surgery. PET/CT is useful for the detection of colorectal cancer recurrence; however, it does have a high false-positive rate for mediastinal lymph nodes. There is a limit to its diagnostic accuracy, and one must determine the indication for surgical treatment carefully. Surgery in the prone position is a useful and minimally invasive approach to the mediastinum and allows aggressive resection to be performed.     

机载锥形束CT的质量控制

机载锥形束CT主要通过放疗在线获得图象,并根据在线与计划参考图象对比,校正位置误差和离线分析肿瘤及器官运动,以辅助提高和确保精度放疗的效果。因此同样需要规范的质量控制,并定期执行。文章简要介绍目前形成的较为合理规范的机载锥形束CT质量控制内容、基准和执行频度。     

Three-dimensional Computed Tomography Image of Small Pulmonary Lesions

To evaluate diagnostic imaging of small lesions in the peripherallung, three-dimensional (3D) reconstruction CT images were usedto study 36 cases (including which had been 19 resected) ofpulmonary nodules > 3 cm in diameter. Rapid scanning wasemployed in 17 cases and helical scanning (in which the X-raytube rotates continuously with simultaneous table sliding) in19 cases. The rapid scanning could not be evaluated in two casesbecause respiratory motion resulted in discontinuous image data.We were able to evaluate 34 cases. The addition of 3D imagesto the conventional iamges made it possible for us to obtainuseful information on visualizing relations between nodulesand vascular structures in 32% (11/34) of the cases. The 3Dimages enabled us to visualize the lesions and pulmonary vesselsthree-dimensionally. It was, however, difficult to evaluatelesion shape since we were able to obtain useful informationin only 3% (1/34) of the cases. In helical scanning, data areacquired from an extensive area within a short time, providingconsecutive axial-slice images remain free of any respiratoryartifacts. In this regard, helical scanning is suitable forgenerating 3D images. A diagnostic procedure based on 3D lesionanalysis should be developed and standardized.     

Agenesis of the Right Lobe of the Liver: Diagnosis by Computed Tomography

Agenesis of the right lobe of the liver is a rare congenital anomaly with characteristic features on computed tomography (CT). We present a case diagnosed as an incidental finding and describe the CT appearances.