低剂量MDCT平扫与增强扫描诊断乳腺疾病的对比研究

目的:探讨乳腺疾病低剂量MDCT平扫及增强扫描的特点及其临床应用价值.材料和方法:对70例(73个病灶)进行低剂量MDCT平扫和增强扫描,分析比较乳腺癌在平扫和增强中的不同表现及其诊断意义.结果:乳腺癌组和良性病变组MDCT平扫显示率分别为71.8%和20.6%,增强扫描所有病灶均见显示.以病灶增强不均匀和增强程度大于25Hu为诊断乳腺癌的依据,其诊断的准确性分别为75.5%和79.5%.低剂量MDCT增强扫描可以提高诊断乳腺癌的敏感性和准确性,其中综合形态征象的诊断准确率平扫为68.4%,增强为 87.7%.结论:乳腺疾病低剂量MDCT扫描可以满足临床诊断需要.病灶增强特征具有较大的临床诊断价值,综合观察增强扫描的形态征象可以提高乳腺癌的诊断准确率.     

色素沉着-胃肠道多发性息肉综合征的影像学综合诊断

目的:探讨色素沉着-胃肠道多发性息肉综合征(PJS)的影像学综合诊断价值.材料和方法:回顾分析1996-11～2008-01 5例色素沉着-胃肠道多发性息肉综合征的MDCT、SCT、B-us钡灌肠和胃肠钡造影表现.结果:MDCT显示肠套叠改变2例,SCT显示肠梗阻表现1例,直肠癌变1例.B-us显示同心圆状强回声团块2例,假肾型包块影1例.钡灌肠示结肠内有多发大小不一的类圆形充盈缺损3例,其中伴癌变1例.胃肠钡造影发现肠内有类圆形或分叶状充盈缺损2例.结论:对于临床疑似或确诊患者,应早进行影像学的综合检查,MDCT多层面重建技术可更清楚地显示病变,为临床治疗提供更全面的信息.     

胰腺实性假乳头状瘤的临床和MDCT研究

目的:分析胰腺实性假乳头状瘤(SPTP)的临床和MDCT表现,探讨MDCT对该病的诊断价值。方法:回顾性分析经手术病理证实的39例SPTP的临床和MDCT资料,并与手术和病理结果进行对照研究。结果:39例SPTP中包括21例实性、11例囊实性和7例囊性肿瘤。实性部分在CT上呈渐进性强化,而囊性成分无强化。囊性部分间可有分隔,且分隔有强化。16例瘤内可见斑片样钙化,具有一定特征性。3例SPTP伴有胰管扩张,4例肿瘤远端胰腺萎缩。巨大肿瘤推压周围结构,交界性或恶性肿瘤与周围结构分界不清。结论:SPTP的MDCT表现具有一定特征性,MDCT对其具有重要的诊断价值。     

根据穿孔部位和患病时间评价MDCT对胃肠道穿孔的价值

目的评估多层CT(MDCT)根据胃肠道(GI)部位和患病时间预测穿孔部位的价值。方法对168例开腹探查胃肠道穿孔前进行MDCT扫描的病人,以患病时间7 h为     

MDCT对冠状动脉粥样硬化斑块成分分析的研究进展

多层螺旋CT(MDCT)作为一种无创诊断方法 对于分析冠状动脉粥样硬化斑块成分、评估冠心病风险具有广阔前景.总结MDCT对冠状动脉钙化斑块、非钙化斑块以及管腔狭窄检测的最新研究进展.指出其诊断价值与限度,探讨进一步提高其诊断准确度的措施.     

MDCT对比增强在胃肠道穿孔定位定性的诊断价值

目的探讨多排螺旋CT(MDCT)对比增强在胃肠道穿孔位置、病因的诊断价值,旨在提高对该病的认识。方法回顾性分析经手术病理证实的82例胃肠道穿孔患者影像资料。结果胃十二指肠穿孔的游离气体出现在门静脉旁、镰状韧带周围、肝圆韧带周围、胃十二指肠周围的概率,明显高于空回肠、大肠(包括阑尾)穿孔;空回肠、大肠穿孔游离气体出现在其周围的概率,明显高于胃十二指肠穿孔,差异有统计学意义。MDCT表现:70例可见腹腔游离气体征,15例可见灶性肠壁缺损伴肠内容物外渗。58例可见节段肠壁增厚伴周围脂肪间隙模糊。4例可见管腔狭窄,局部呈肿块样改变,增强扫描明显强化。2例可见高密度异物影。结论对于胃肠道穿孔的精准诊断及术前评估,MDCT对比增强扫描检查具有重要意义。     

肝小静脉闭塞病:MDCT诊断和疗效评价

目的 探讨MDCT在诊断、鉴别诊断肝小静脉闭塞病(HVOD)及评价其临床疗效中的的价值.方法 对10例HVOD住院患者行MDCT肝脏三期扫描,在工作站中对原始数据进行多平面重组(MPR)及肝脏血管成像,分析HVOD在MDCT上的表现.10例MDCT诊断为HVOD患者中,1例肝穿证实,9例结合临床和MDCT表现得出诊断结果.结果 10例患者均有不同程度的胸腹水、胆囊壁增厚、肝大但尾状叶大小形态正常;肝静脉均未显影而门静脉通畅;肝实质强化不均匀,门静脉期呈"地图样"强化;6例门静脉周围水肿;下腔静脉各段显示通畅.结论 MDCT结合MPR和血管成像在诊断和鉴别诊断HVOD及评价其临床疗效中有较高价值.     

MDCT对冠状动脉粥样硬化斑块成分分析的研究进展

多层螺旋CT（MDCT）作为一种无创诊断方法对于分析冠状动脉粥样硬化斑块成分、评估冠心病风险具有广阔前景。总结MDCT对冠状动脉钙化斑块、非钙化斑块以及管腔狭窄检测的最新研究进展,指出其诊断价值与限度,探讨进一步提高其诊断准确度的措施。     

CT三维重建与轴位平扫诊断颈椎间盘突出症的对比研究

目的：比较多排螺旋CT（MDCT）三维重建与轴位平扫诊断颈椎间盘突出症的价值。方法：选择颈椎间盘突出症62例,采用MDCT进行颈椎轴位平扫,在ADW 4.2工作站进行MDCT三维重建,分别根据轴位平扫图像及三维重建图像进行诊断。比较两种方法诊断颈椎间盘突出症的阳性率。结果：共观察椎间隙372个。其中通过MDCT三维重建发现突出椎间盘152个,阳性率40.9%;通过轴位CT平扫发现突出椎间盘121个,阳性率32.5%;两种方法诊断的阳性率比较,差异显著（P〈0.05）。结论：MDCT三维重建诊断颈椎间盘突出症较轴位平扫具有显著优势。     

多层螺旋CT后重组对中央气道良性病变的诊断价值

目的 评价MDCT多种后重组方法对中央气道良性病变的诊断价值. 资料与方法 运用MPR、SSD、VB、MinIP及RAYSUN 5种重组方法对61例中央气道良性病变进行MDCT检查,并统计不同重组方法对横断面图像信息的补充价值. 结果 MDCT多种后重组图像对中央气道良性病变提供更多的信息,MPR重组、SSD、MinIP、RAYSUN及CTVB分别对90.16%、54.10%、50.18%、40.98%及39.34%的患者提供了补充信息;SSD、VB、MinIP、MPR及RAYSUN分别对13.11%、13.11%、11.48%、8.20%及6.56%的患者基于横断面获得的诊断进行了修改. 结论 MDCT后重组图像对中央气道良性病变提供更多的信息.     

The current status of multidetector row CT and three-dimensional imaging of the small bowel

Radiologists have played an important role in evaluation of patients with small bowel pathology. The small bowel series and, later, enteroclysis were the mainstays in radiologic diagnosis of many small bowel diseases, because the resolution and speed of CT was limited. Continued improvements in CT technology over the last 2 decades have resulted in a expanding role of CT for evaluation of the gastrointestinal tract, including the small intestine. Many conditions, such as small bowel obstruction and ischemia, that would traditionally be imaged with other modalities (small bowel series or angiography) are now routinely imaged with CT. The development of MDCT and improvements in 3D imaging systems have greatly improved the ability to examine the small bowel and mesenteric vasculature. With the introduction of new CT oral contrast agents and faster 32-detector row CT scanners, the diagnosis and evaluation of patients with small bowel disease will continue to improve.     

Role of multidetector CT in the management of acute female pelvic disease

The purpose of this study is to highlight the role of multidetector CT (MDCT) in emergency radiology as a useful tool in the diagnosis and management of acute female pelvic disease and to describe key radiologic signs to improve differential diagnosis. We restrospectively reviewed MDCT findings of acute pelvic disease and its mimics in women reporting to the emergency room at our institution from December 2006 to August 2008. We describe MDCT findings of gynecologic and obstetric disorders such as hemorrhagic ovarian cysts, ovarian torsion, pelvic inflammatory disease, ruptured ectopic pregnancy, intravascular leiomyomatosis, blunt maternal trauma, and postpartum and post-cesarean section complications. We also briefly review gastrointestinal tract entities that may mimic these conditions. Although ultrasound is the imaging modality of choice for the evaluation of female pelvic pain, the role of MDCT remains essential in the management of patients in which gynecologic exploration is not diagnostic or undone since it is not the initial suspicion.     

Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis

The diagnosis of small bowel neoplasms can present a difficult challenge to the radiologist because the tumors are uncommon, often small, and may be difficult to detect radiographically. The most common small bowel neoplasms include adenocarcinoma, carcinoid, lymphoma, and gastrointestinal stromal tumors. The location and computed tomography (CT) appearance of the small bowel tumors may aid in the diagnosis. For instance, small bowel adenocarcinoma occurs more frequently in the duodenum and may result in obstruction. Carcinoid tumors are more common in the ileum and are typically hypervascular submucosal masses that produce a characteristic mesenteric mass when they spread to the mesenteric nodes. Lymphoma can occur anywhere along the gastrointestinal tract and have a variable CT appearance. It may appear as a single mass, multiple masses, an infiltrating lesion resulting in aneurysmal dilatation of the bowel, or as an exophytic mass. Gastrointestinal stromal tumors are more common in the jejunum and ileum and usually appear exophytic and bulky often with ulceration. Traditionally, small bowel series and enteroclysis have been used for imaging patients with suspected small bowel tumors. More recently, CT is beginning to play a more important role for this clinical indication. The thinner collimation possible with multidetector CT (MDCT) along with water as oral contrast and a good intravenous contrast bolus may improve the sensitivity of CT for detecting small bowel tumors. In addition, MDCT scanners improve the quality of the 3-dimensional CT (3D CT) images that are valuable to the clinicians and surgeons for surgical planning. It is important for the radiologist to be familiar with the CT appearance of these neoplasms and the potential role of MDCT and 3D imaging in their diagnosis and surgical planning.     

The increasing impact of multidetector row computed tomography in clinical practice

Multidetector row computed tomography (MDCT) is a powerful noninvasive imaging tool with a number of advantages over previous computed tomography (CT) technology. The incorporation of multiple detector rows enables faster scanning and thinner collimation. As a result, the entire body can be imaged in a single breath hold with improved z-axis resolution. These improvements have also expanded the clinical applications of CT. MDCT is considered an acceptable alternative to conventional imaging techniques such as catheter angiography, intravenous urography, and barium enema. This article will provide an overview of MDCT technology and its use in the diagnosis of diseases affecting coronary and peripheral vasculature, head and neck, lungs, as well as the gastrointestinal and genitourinary tracts.     

Diagnostik vaskulärer Erkrankungen als Ursache für das akute Abdomen

Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding.     

胃肠道淋巴瘤的多层螺旋CT影像学分析

目的 回顾分析胃肠道淋巴瘤多层螺旋CT表现.资料与方法 回顾61例胃肠道淋巴瘤患者的多层螺旋CT扫描资料,分析其相关CT表现,并对病变的厚度、分期、平扫和增强CT值与及其病变发生部位和病理结果 之间的关系进行分析和对比.结果 胃肠道淋巴瘤大多表现为胃肠壁的弥漫性增厚及周围淋巴结增大;动脉瘤样扩张和病灶内积气是回肠淋巴瘤的特征性表现;黏膜相关性淋巴瘤(MALT)多见于胃部,且病变厚度较其他类型淋巴瘤略薄.结论 多层螺旋CT是诊断胃肠道淋巴瘤的有效手段,特别是回肠淋巴瘤有较为特异的表现.     

MDCT of acute lower gastrointestinal bleeding

OBJECTIVE: We evaluated the use of MDCT in the diagnosis and management of lower gastrointestinal bleeding (hematochezia). CONCLUSION: MDCT is proposed as an alternative first-line investigation to locate lower gastrointestinal bleeding before placing the patient under observation or performing embolization or surgery.     

Two-dimensional and three-dimensional CT diagnosis of alimentary tract]

The recent development of multidetector-row CT(MDCT) has made it possible to obtain three-dimensional images of the alimentary tract that offer new diagnostic potential. In its two-dimensional diagnosis of the alimentary tract, MDCT has also changed the concept of the oral contrast agent. Before MDCT, we routinely used a positive contrast agent to distinguish the stomach and intestine from other organs and masses. The excellent slice profile acquired by MDCT can distinguish the alimentary tract and depict abnormal findings without the use of a positive contrast agent. With the use of an intravenous contrast medium, the alimentary tract itself, alimentary tumors, and inflammatory disease are well demarcated with water and air. Moreover, the combination of two-dimensional and three-dimensional diagnostic images makes it possible to detect and assess early gastric and colonic cancers as conventional gastroscopy and colonoscopy. Although the lack of texture information is one of the disadvantages of three-dimensional CT, three-dimensional CT diagnosis of the alimentary tract is less invasive and more objective than conventional studies. Advances in three-dimensional imaging with isotropic data sets will lead to the use of two-dimensional and three-dimensional CT diagnosis as one of the standard examinations of the alimentary tract.     

Mesenteric ischemia

Mesenteric ischemia is a difficult clinical diagnosis that requires a high index of clinical suspicion because the clinical and imaging features of intestinal ischemia and infarction overlap with many other intestinal disorders, and patients who have mesenteric ischemia often have coexisting diseases. Multidetector CT (MDCT) evaluation of the abdomen is the examination of choice when mesenteric ischemia is suspected because of its ability to provide two-dimensional multiplanar and three-dimensional display of the mesenteric vasculature and small intestine. This article reviews the clinical features, pathophysiology, and MDCT features of mesenteric ischemia.     

Bilateral popliteal artery entrapment syndrome: reemphasis on reading axial tomograms

A 33-year-old man with bilateral popliteal artery entrapment syndrome (PAES) presented with right calf claudication. He underwent radiological studies including conventional arteriography, multidetector row CT (MDCT), and magnetic resonance imaging (MRI) of the lower extremities. He had been fine since birth and athletic in his school days. Axial tomographic images by MDCT and MRI at the popliteal fossa bilaterally showed an anomalous medial head of the gastrocnemius muscle between the popliteal artery and vein, resulting in right popliteal artery occlusion and leading to the diagnosis of bilateral PAES type II. MDCT or MR facilitates noninvasive computer-aided arteriography and is often utilized for screening patients with claudication for peripheral arterial diseases. However, axial tomograms are more essential for confirming PAES than arteriography, and radiologists should continue to look for possible abnormalities on popliteal fossa tomograms because early diagnosis of PAES allows better choices and outcomes of treatment.