卵巢颗粒细胞瘤的CT、MRI诊断和误诊分析

目的 分析卵巢颗粒细胞瘤（granulosa cell tumor,GCT）的CT、MRI表现及误诊原因,提高对该肿瘤的认识.方法 回顾性分析经手术病理证实的10例GCT的CT、MRI表现.结果 10例GCT位于右侧4例,左侧6例.肿瘤最大径平均6.1 cm.全部肿瘤边界清楚,包膜完整呈圆形或卵圆形7例,不完整呈分叶状3例;肿瘤呈囊实性8例,实性2例.7例CT检查,平扫肿瘤实性成分平均CT值为35HU.3例行MRI检查,实性成分T1WI呈等信号,T2 WI呈稍高信号;囊性成分T1WI呈低信号,T2WI呈高信号.所有肿瘤实性成分增强后均呈中等程度强化.合并子宫内膜增生5例,腹水6例,同时合并子宫内膜癌及肌瘤1例.10例GCT术前均未能作出正确诊断.结论 典型的GCT多呈囊实性,包膜完整,边界清楚,增强后肿瘤实性成分中等程度强化;易合并子宫内膜增生及少量腹水.因对该肿瘤缺乏足够的认识、部分肿瘤缺乏典型的影像表现、阅片不够仔细等是导致误诊的主要原因.     

卵巢颗粒细胞瘤的CT表现

目的探讨卵巢颗粒细胞瘤的CT表现特点,并与病理结果对照。资料与方法回顾性分析经手术病理证实的21例卵巢颗粒细胞瘤的CT资料。结果14例原发,其中2例为双侧病变;7例复发。所有肿瘤边界清楚,形态多规则。原发肿瘤呈多房蜂窝状囊实性肿物10个,实性肿物伴不同程度低密度区域5个,厚壁囊性肿物1个;肿瘤实性成分密度同肌肉相仿,增强后呈轻度强化;伴有子宫内膜增厚7例,腹腔积液7例,大网膜及腹膜增厚各2例。复发肿瘤表现与原发肿瘤相似。结论CT图像上能显示卵巢颗粒细胞瘤的特征,结合临床症状有助于正确诊断。     

女性盆腔少见肿瘤的CT及MRI表现分析

目的回顾性分析经手术及病理证实的12例女性盆腔少见肿瘤的CT及MRI特征性表现。资料与方法12例盆腔肿瘤患者,年龄14～63岁,平均39岁。12例平扫,10例行增强扫描。结果 6例卵巢性索间质来源的肿瘤,均以囊实性为主呈网格状改变。2例子宫内膜间质肉瘤,均以肿块内见大片不规则坏死囊变为主。2例卵巢透明细胞癌,以较大囊性为主内见少许实性成分。侵袭性葡萄胎1例,子宫内壁凹凸不平,呈蜂窝状,子宫外缘轮廓完整。1例输卵管癌并卵巢转移瘤,肿块为不规则状,以囊性为主,内见实性结节。结论 CT及MRI检查是诊断盆腔内肿瘤的重要影像学手段,能显示上述盆腔少见恶性肿瘤的特征表现,对这些肿瘤的诊断及分期有重要指导意义。     

卵巢颗粒细胞瘤的CT及MRI表现

目的 探讨卵巢颗粒细胞瘤(OGCT)的CT及MRI表现特征.方法 回顾性分析12例经病理证实的OGCT患者的临床、影像学资料(10例行CT检查,5例行MRI检查,其中3例同时行CT及MRI检查),并分析其影像学特征.结果 12例均为单发病变.肿瘤呈圆形、类圆形、分叶状,边界清楚.12例病例中囊性3例,均呈多房囊性,囊壁和分隔厚薄不均,增强扫描间隔及囊壁轻度强化.混合囊实性7例,瘤内可见多发囊变,"海绵状"为其典型表现,增强扫描病灶实性成分大多呈轻中度强化.实性2例,病灶有分隔,1例明显强化,1例轻度强化.12例中子宫体积增大及内膜增厚6例,合并子宫内膜癌1例.结论 OGCT的CT和MRI表现具有一定特征,结合雌激素异常有助于做出正确诊断.     

卵巢蒂扭转的多层螺旋CT诊断

目的:探讨多层螺旋CT在卵巢蒂扭转中的诊断价值。方法:回顾性分析26例经手术病理证实为卵巢蒂扭转的临床资料与CT图像。术前均采用多层螺旋CT平扫,部分行多期增强扫描和多平面重建(MPR)后处理图像。结果:26例患者均表现为盆腔囊实性肿块,子宫均向实性肿块侧偏移,23例囊壁局限性增厚,3例囊壁均匀增厚,3例囊内渗血。其中17例患者经过CT增强扫描,12例实性成分无明显强化,5例轻度强化。17例见盆腔少量积液。结论:多层螺旋CT平扫结合多期增强扫描和多平面重建图像可以更好地观察卵巢蒂扭转CT表现特征,有助于提高术前诊断的准确率。     

卵巢颗粒细胞瘤的临床和CT、MRI表现

目的 分析卵巢颗粒细胞瘤的临床、CT和MRI表现.方法 回顾性分析18例经手术病理证实的卵巢颗粒细胞瘤的临床、CT(6例)和MRI(12例)表现.结果 (1)12例原发,6例复发,临床表现不规则阴道出血者9例(50.0%).(2)6例患者CA125升高,最高者428.5 u/mL,余5例均＜60 u/mL.(3)18例均为单发病灶,肿瘤长径在3.0～22.0 cm之间,平均长径8.6 cm.(4)9例肿瘤形态较明显不规则,并且肿瘤越大形态越不规则;(5)3例肿瘤表现为实性肿块,3例表现为实性为主的囊实性肿块;12例表现为囊性为主的囊实性肿块,其中4例内见呈簇状分布的多发小囊性灶.(6)增强后中等强化,6例增强CT值增幅约20～40 HU.(7)仅1例复发患者伴有右侧胸腔及盆腔少-中等量积液,余病例未见明显胸腹盆腔积液.(8)5例合并子宫内膜轻度增生,1例合并明显增生,1例合并子宫内膜癌变.结论 卵巢颗粒细胞瘤具有较为特征性的临床及影像表现.     

卵巢颗粒细胞瘤的MRI表现及与病理对照分析

目的探讨卵巢颗粒细胞瘤MRI特点,以提高其诊断与鉴别诊断能力。方法回顾性分析25例经手术病理证实的卵巢颗粒细胞瘤MRI资料,并与病理结果对照,总结MRI的表现特征及其与病理改变的相关性。结果 25例患者中幼年型4例,其中囊性1例,实性1例,囊实性2例;成人型21例,囊性3例,实性4例,囊实性14例,所有肿瘤均包膜完整,呈类卵圆形,8例边缘呈分叶状,所有病灶囊性部分呈稍长T_1、长T_2信号影,实质性部分呈稍长T_1、稍长T_2信号影,分隔及囊壁呈稍低信号影,其中6例行动态增强扫描,实质性部分呈速升-平台曲线,峰值低于邻近子宫肌层,另外13例行多期增强扫描,病灶实质性部分及分隔均呈明显强化,实质部分强化程度低于同层子宫肌层,肿瘤内部小囊腔及囊性部分壁呈"渔网状"或"蜂窝状"强化,13例肿瘤部分囊腔内合并出血信号影,大体病理标本切面与MRI表现相符合,另16例患者内膜增厚,其中5例子宫内膜不典型增生,1例子宫内膜癌,6例合并子宫肌瘤,1例伴有卵巢液性乳头状瘤,3例合并子宫内膜异位囊肿。结论卵巢颗粒细胞瘤的MRI具有一定特征,结合临床相关症状及激素改变,对于该病的术前诊断及鉴别诊断能够提供重要的诊断依据。     

卵巢颗粒细胞瘤的CT诊断

目的 探讨卵巢颗粒细胞瘤的CT特点.方法 回顾分析11例经手术病理证实的卵巢颗粒细胞瘤的CT表现.结果 11例肿块均为单侧,肿块边界清晰,形态规则,5例肿块表现为多房蜂窝状囊实性肿块,6例肿块表现为实性成为主,其内散在小囊腔,实性成分的密度与肌肉相近,增强扫描大多呈中度强化,11例中伴腹水4例,合并子宫增大、子宫内膜增厚10例,子宫肌瘤6例.结论 卵巢颗粒细胞瘤的CT表现有一定特征性,结合临床症状有助于正确诊断.     

卵巢卵泡膜-纤维瘤的CT和磁共振成像表现及病理对照分析

目的探讨卵巢印泡膜一纤维瘤的CT及磁共振成像（MRI）表现特点,与病理结果进行对照,以提高对卵泡膜一纤维瘤影像表现的认识。方法回顾分析经手术病理证实的26例卵泡膜一纤维瘤患者的临床和影像资料。结果26例患者中行cT检查22例,MRI检查9例,均查者5例。其中1例患者双侧发生,27个肿瘤均呈阋形或分叶状,其中实性肿块18例．囊实性肿块9例。肿块边界均较清楚。其中13例伴有少量盐腔积液,2例伴子宫内膜增生。盆腔均未见肿大淋巴结。CT平扫显示实性肿瘤和囊实性肿瘤的实性部分的密度较子宫肌层相仿,增强后轻度强化或无强化：MRI显示病灶T1WI均呈等低信号,1例病灶T2WI呈稍高信号,8例T2WI呈低信号。镜下见肿瘤细胞呈短梭形,细胞质内含有大量脂肪小滴,细胞核未见明显核分裂。细胞呈漩涡状、束状排列,周丽被大量纤维组织分隔。结论卵巢卵泡膜．纤维瘤的影像表现具有一定的特征,对该病的术前正确诊断具有重要意义     

卵巢甲状腺肿超声与CT影像比较分析

目的探讨超声与CT对卵巢甲状腺肿的临床诊断价值。方法回顾性分析经手术和病理证实的11例卵巢甲状腺肿患者的超声与CT表现,并与病理检查结果行对照研究,对卵巢甲状腺肿的超声和CT诊断的准确率行统计学分析。结果 11例卵巢甲状腺肿病例中:1)发生于左侧卵巢者4例,发生于右侧卵巢者7例;2)单发囊性病灶1例,囊实性病灶10例;3)6例形态不规则,5例呈类圆形或椭圆形;4)超声显示单发囊性病灶回声均匀,囊实性病灶呈混杂回声,其中10例囊实性病灶均呈中高回声的不规则间隔及实性结节,7例呈多房、且各房回声不等,3例囊壁及间隔见强回声钙化,1例见高回声脂肪,4例彩色多普勒超声可探及实性成分及分隔的血流信号;5)CT显示单发囊性病灶密度高于水,10例囊实性病灶中7例呈多房、密度不等,7例囊壁及间隔见钙化,2例见脂肪密度,增强扫描9例实性成分明显强化,1例轻度强化,5例伴盆腔积液,1例伴胸腔积液。结论卵巢甲状腺肿的超声及CT表现具有一定特征性,认识其影像学特征对减少误诊具有重要意义。     

Principles of CT and CT technology

This article provides a review of the basic principles of CT within the context of the evolution of CT. Modern CT technology can be understood as a natural progression of improvements and innovations in response to both engineering problems and clinical requirements. Detailed discussions of multislice CT, CT image quality evaluation, and radiation doses in CT will be presented in upcoming articles in this series.     

Principles of CT: multislice CT

This article describes the principles and evolution of multislice CT (MSCT), including conceptual differences associated with slice definition, cone beam effects, helical pitch, and helical scan technique. MSCT radiation dosimetry is described, and dose issues associated with MSCT-and with CT in general-as well as techniques for reducing patient radiation dose are discussed. Factors associated with the large volume of data associated with MSCT examinations are presented.     

PET/CT in malignant melanoma: contrast-enhanced CT versus plain low-dose CT

Purpose  

The aim of this study was to evaluate the diagnostic value of contrast-enhanced CT (CECT) versus non-enhanced low-dose CT (NECT) in the staging of advanced malignant melanoma with ¹⁸F-fluordeoxyglucose (FDG) positron emission tomography (PET)/CT.     

Multidetector CT and CT angiography in mesenteric ischemia

Purpose

To evaluate the role of 64-multidetector CT in assessment of mesenteric vascular ischemia in clinically suspected patients.

Patients and methods

This study included 38 patients during period from October 2009 to October 2011. The patients age ranged from 38 to 72 year old (mean age was 57 ± 11.2 years). All cases met the criteria of acute non traumatic (28 patients) or chronic abdominal pain (10 patients) and suspected mesenteric vascular ischemia. All 38 cases were evaluated in surgery department, then underwent CT of the abdomen and pelvis & CTA by using 64 multislice GE light speed VCT. MDCT& CT angiographic findings were correlated with surgical findings in acute mesenteric ischemia (AMI) cases & conventional angiography in chronic mesenteric ischemia (CMI) cases.

Results

MDCT findings alone were nonspecific for detection of MI. The sensitivity, specificity& accuracy of CTA in diagnosis of AMI after surgical confirmation were 96%, 66.6% & 92.8% respectively, while in CMI the sensitivity, specificity & accuracy were 88.8%, 100%, 90% respectively, after confirmation by conventional angiography.

Conclusion

CTA scan appears to be an excellent tool to find out and localize cases of AMI rather than in CMI cases.     

CT扫描参数对人体组织CT值影响的研究

目的 探索不同CT扫描参数对人体同一种组织CT值的影响。方法 通过在同一台CT机上,分别改变其中1个扫描参数,如X线管电压、毫安秒和重建函数等,而保持其他扫描参数不变,多次扫描标准体模,测量和分析体模中不同物质的CT值。结果 X线管电压的改变对物质的CT值影响具有显著意义。聚乙烯、聚碳酸酯、有机玻璃的CT值与管电压成正相关;聚四氟乙烯的CT值与管电压成负相关。毫安秒和重建函数对CT值的影响差异无统计学意义。结论 同一个人体组织在不同的X线管电压条件下CT值是变化的。因此,在临床影像诊断和放疗中应该考虑图像扫描参数的设置对诊断和治疗结果的影响。     

CT Enteroclysis

Computed tomographic (CT) enteroclysis is a hybrid technique that combines the methods of fluoroscopic intubation-infusion small-bowel examinations with that of abdominal CT. The use of multidetector CT technology has made this a versatile examination that has evolved into two distinct technical modifications. CT enteroclysis can be performed by using positive enteral contrast material without intravenous contrast material and neutral enteral contrast material with intravenous contrast material. CT enteroclysis has been shown to be superior to other imaging tests such as peroral small-bowel examinations, conventional CT, and barium enteroclysis, except in the demonstration of early apthous ulcers of Crohn disease. CT enteroclysis is complementary to capsule endoscopy in the elective investigation of small-bowel disease, with a specific role in the investigation of Crohn disease, small-bowel obstruction, and unexplained gastrointestinal bleeding.