Computed Tomography Enterography

Computed tomography enterography (CTE) is an abdominopelvic computed tomography (CT) tailored for evaluation of the small bowel. This multidetector CT examination uses neutral oral contrast to optimally distend small bowel. Patients are scanned after the rapid injection of intravenous contrast during peak bowel wall enhancement. CTE is excellent for the evaluation of many small bowel disorders, particularly Crohn's disease. The purpose of this article is to review CTE indications, contraindications, technique, safety considerations, and imaging findings of common small bowel diseases.     

口服低浓度阳性对比剂在MSCTE中的应用价值

目的:评价低浓度阳性对比剂在MSCT小肠造影检查中的应用价值。方法:分段口服自配肠道低浓度碘稀释液2000毫升进行肠道准备,采用多层螺旋CT容积扫描,应用多平面重建(MPR)、曲面重建(CPR)等后处理方式进行轴位、冠状位和矢状位二维图像。结果:34例均无不良反应及并发症,均顺利完成肠道准备和螺旋CT容积采集,肠道里对比剂均可清晰识别肠道,13例小肠充盈较好,21例小肠充盈稍欠佳,回肠充盈效果优于空肠。结论:口服低浓度阳性对比剂MSCTE是小肠疾病实用的检查方法,尤其适合基层医院应用,其临床价值较大。     

口服甘露醇CT小肠造影对小肠肿瘤的诊断价值

[目的]评价口服大剂量5%等渗甘露醇螺旋CT小肠造影(spiral CT enterography,SCTE)在小肠肿瘤诊断中的价值.[方法]36例小肠肿瘤患者每人口服约1 000～1 500 mL 5%等渗甘露醇后,肌注20 mg山莨菪碱注射液,10～15 min后行螺旋CT三维扫描,分析不同小肠肿瘤的SCTE表现,并比较42例传统CT扫描与SCTE的诊断结果.[结果]36例SCTE患者除2例回盲部充盈欠佳外,余病例十二指肠、空肠及回肠肠腔充盈良好,对肿瘤的显示、衬托满意.SCTE检查与临床诊断符合率为94.4%(34/36),高于传统CT扫描78.57%(33/42)(χ2=4.03,P＜0.05).[结论]SCTE是一种简便、安全、非侵袭性、有效评价小肠肿瘤的方法,能明显提高肿瘤的检出率.     

CT

The development of multidetector-row CT(MDCT), which can rapidly scan a large longitudinal volume and enables us to obtain thinner section collimation with a shorter acquisition time, obtained isotropic voxel data for three-dimensional(3D) imaging. Isotropic voxel data enables us to obtain sagittal and coronal images with the spatial resolution which is identical to axial images. Excellent volume data, which was acquired by MDCT, obtain serviceable 3D images by using various reconstruction methods, such as multi-planar reconstruction(MPR), maximum intensity projection(MIP), minimum intensity projection(MinIP), surface rendering, volume rendering and virtual endoscopy. However, relation between Ct and MRI is still complementary even in the times of MDCT.     

CT gastrography

The rapid dissemination of multidetector-row computed tomographic (CT) technology will make faster and more accurate gastric imagining available. Two-dimensional multiplanar reconstruction and CT gastrography including virtual gastroscopy and transparency rendering using volume rendering are types of interactive two- and three-dimensional medical imaging tools. It provides multiplanar cross-sectional imaging, gastroscopic viewing, and upper gastrointestinal series imaging in the same data acquisition. Two-dimensional multiplanar reconstruction provides accurate staging of gastric cancer and extraluminal information such as lymphadenopathy and distant metastasis. Virtual gastroscopy detects subtle mucosal changes and differentiates them from submucosal lesions in the same way as gastroscopy. Transparency rendering provides global orientation of the focal findings in the stomach in the same way as upper gastrointestinal series findings and provides useful information for preoperative mapping. Thus, CT gastrography is a promising method for evaluating gastric lesion despite its limitations.     

双能量CT虚拟平扫对胰腺的显示:与真实平扫对比

目的 比较第二代双源双能量CT胰腺虚拟平扫（VNC）和真实平扫（TNC）的图像质量。方法 采用Siemens第二代双源双能量CT对21例怀疑胰腺病变的患者行腹部增强扫描,包括单能量TNC图像、胰腺实质期及门静脉期图像,后处理得到胰腺实质期及门脉期的虚拟平扫（VNCp、VNCv）图像。比较TNC、VNCp、VNCv图像的胰腺病灶、胰腺实质、肝脏、竖脊肌、腹主动脉及门静脉的CT值、噪声、CNR、主观评分。结果 TNC、VNCp、VNCv图像主观评分均满足诊断要求（P=0.150）。与TNC图像比较,VNC图像噪声明显减低（P<0.001）。胰腺实质的CT值在VNCv与TNC图像上差异无统计学意义（P=0.063）。胰腺囊性与实性病灶的CT值在VNCp、VNCv、TNC图像上差异均无统计学意义（P=0.277、0.799）。囊性病灶的CNR在VNCp最高。结论 第二代双源双能量CT对胰腺扫描的VNC图像质量接近TNC,并且可减少辐射剂量。     

CT bronchoscopy

CT bronchoscopy with volumetric rendering can play a significant role in patients with mediastinal/hilar tumor and lymphadenopathy. By localizing (tagging) tumor foci on the axial images, volumetric rendering allows the tumors to be seen through normal-appearing mucosa. Such images can guide the bronchoscopist in finding the ideal site to biopsy and allow the bronchoscopist to become more aggressive in the biopsy of more difficulty positioned lesions. In addition, delineation of normal extraluminal vessels and other vital anatomical structures potentially decreases biopsy complications. Although further research is needed to prove the value of CT bronchoscopy, preliminary work performed to date by the author and others indicates great promise.     

骨淋巴管瘤CT淋巴管造影及常规CT表现

目的 探讨骨淋巴管瘤CT淋巴管造影（CTL）及常规CT表现。方法 回顾性分析79例病理证实或临床综合诊断为骨淋巴管瘤患者的临床及影像学资料。79例均接受直接淋巴管造影及造影后CT平扫,16例接受CT平扫及增强检查,分析其CTL和常规CT表现。结果 骨淋巴管瘤CT表现为骨内单发或多发低密度影,多位于脊柱（n=71）及骨盆（n=73）。79例中,囊状病变37例,筛网状病变18例,24例二者均存在;28例患者所有骨病变均可见硬化边,47例患者部分骨病变可见硬化边,4例患者所有骨病变均未见硬化边。骨内病变增强CT扫描均未见强化。CTL检查中,24例病变内可见碘化油沉积。结论 骨淋巴管瘤CTL及常规CT表现较具特征性,且常伴淋巴系统其他异常改变,有助于诊断。