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多层螺旋CT小肠造影在小肠疾病中的应用 总被引:1,自引:0,他引:1
目的:探讨多层螺旋CT小肠造影(MSCTE)对小肠病变的诊断价值。方法:对36例疑有小肠病变的患者行螺旋CT平扫及增强检查。检查前清洁肠道,肌注盐酸654-2 10~20mg以减少肠蠕动,口服足量等渗甘露醇水对比剂充盈肠管,结合多平面重组(MPR)或最大密度投影(MIP)观察。结果:经病理证实,病变组共20例:小肠肿瘤14例,其中腺癌4例,间质瘤6例,淋巴瘤2例,腺瘤和类癌各1例;Crohn’s病3例;术后粘连性肠梗阻3例。余为正常组。结论:多层螺旋CT小肠造影双期增强扫描结合重建技术对小肠病变的定位、定性及肿瘤分期有较高临床价值。 相似文献
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回顾性选择2013年10月~2015年5月本院收治的85例胰腺癌患者临床资料,均进行超声检查及多排螺旋CT多期扫描检查,设定行超声检查为对照组,多排螺旋CT多期扫描为研究组,比较两组肿瘤分期判断准确性及手术可切除性情况。研究组肿瘤分期判断准确性(76.47%)大于对照组(23.53%),比较差异具有统计学意义(P〈0.05);研究组手术可切除性评价的灵敏度、特异度、准确度均显著大于对照组,比较差异均具有统计学意义(P〈0.05)。多排螺旋CT多期扫描应用诊断胰腺癌价值高,具准确性、准确度、特异度、灵敏度高等优点,值得临床推广。 相似文献
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原发性小肠淋巴瘤的多层螺旋CT诊断 总被引:4,自引:0,他引:4
目的:探讨原发性小肠淋巴瘤(PSIL)的多层螺旋CT(MSCT)的影像学表现及其诊断价值.方法:回顾性分析32例经手术、病理确诊并符合Dawson标准的PSIL患者的MSCT资料.结果:32例PSIL病例中,单发生于回肠者23例,空肠6例,十二指肠1例,2例同时发生于空、回肠.根据PSIL患者的CT表现,可分为5型:浸润型(12例)、肠腔动脉瘤样扩张型(10例)、息肉肿块型(2例)、肠系膜型(3例)、混合型(5例).MSCT表现为病变肠管的黏膜面多连续、较光整,肠壁不规则增厚,以黏膜下层和肌层增厚为主,肠管仍保持一定的扩张度和柔软度,病灶轻-中度强化,且各型PSIL病灶增强前后CT值差异均无统计学意义.20例PSIL患者行多层螺旋CT小肠造影检查,其对小肠淋巴瘤定位、定性与术后诊断的符合率分别为100%、95%.结论:PSIL的MSCT表现有相对特征性,MSCT小肠造影检查对PSIL术前诊断有较高价值. 相似文献
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目的探讨16层螺旋CT对小肠疾病的检查方法和表现特点。方法回顾分析经手术或病理证实的原发性小肠肿瘤20例,小肠非肿瘤性疾病11例,均行螺旋CT增强检查和三维重组技术观察,检查前口服足量等渗甘露醇水对比剂。结果术后粘连性肠梗阻3例,十二指肠憩室5例,C rohn病3例。良性肿瘤8例,其中间质瘤6例,腺瘤1例,错构瘤1例。恶性肿瘤12例,其中腺癌8例,间质瘤1例,淋巴瘤2例,类癌1例。结论 16层螺旋CT口服等渗甘露醇充盈肠腔并作增强双期扫描结合重建技术,对小肠病变的定位、定性及肿瘤分期有较高临床价值。 相似文献
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目的 探讨护理配合在16层螺旋CT小肠水成像检查中的价值.方法 对104例需行多层螺旋CT检查的患者在予口服高渗甘露醇混合溶液1000ml加温开水1000ml后行16层螺旋CT小肠水成像检查,并进行检查过程中的基础护理和心理护理.结果 104例接受检查患者空、回肠均充盈良好,获得满意的检查效果.结论 良好的护理工作是16层螺旋CT小肠水成像检查取得成功的重要保证. 相似文献
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目的:采用经动脉插管双期螺旋CT扫描的方法,对胰头癌的可切除性进行评价。方法;对18例胰头癌行经动脉插管后双期螺旋CT增强扫描,动脉期扫描时间为10s,门静脉期50s,扫描速度2.5ml/s,造影剂为欧乃派克300或优维显30030ml,用0.9%生理盐水稀释至100ml,通过留置导管注入造影剂于肠系膜上动脉。扫描结果和经静脉双期扫描进行对比。结果:18例胰头癌,可行根治切除3例,不可根治切除15例。对于3例可行根治切除的,两种方法均做出了正确判断,15例不可根治手术者经动脉插管双期螺旋CT扫描作出了正确判断,而经静脉双期扫描只正确判断了12例。估计手术无法切除率经动脉双期扫描为83%(15/180,经静脉双期扫描为67%(12/18)。在判断胰周血管是否受侵的准确性方面,经动脉插管法优于静脉法。结论:经动脉插管双期螺旋CT扫描能够较经静脉双期扫描更准确地评价胰头癌的情况,有利于肿瘤可切除性的评价。 相似文献
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Background Pancreatic cancer is a devastating disease whose early detection remains difficult. There is no 100% reliable imaging test to diagnose and stage pancreatic cancer. We assessed the surgical value of contrast-enhanced spiral computed tomography (CT) in predicting the resectability and survival rates of patients who had pancreatic head cancer.Methods Eighty-nine patients who had pancreatic head cancer were investigated with spiral CT. Based on the preoperative CT results, we assigned patients to one of three CT groups based on resectability.Results A correlation between classification of CT resectability and intraoperative finding was found in 83% of patients. The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of spiral CT in identifying predictive unresectability were 79%, 82%, 91%, 62%, and 81%, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosis of vascular invasion were 94%, 84.2%, 94%, 84%, and 91.3%, respectively.Conclusion The use of CT in the evaluation of pancreatic tumors provides valuable preoperative assessment of surgical resectability and should be performed for clinical examination. Classifying patients by tumor resectability on CT helps to estimate more precisely the tumor stage and to prognosticate survival rates of these patients. 相似文献
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Preoperative evaluation of Klatskin tumor: accuracy of spiral CT in determining vascular invasion as a sign of unresectability 总被引:6,自引:0,他引:6
Cha JH Han JK Kim TK Kim AY Park SJ Choi BI Suh KS Kim SW Han MC 《Abdominal imaging》2000,25(5):500-507
Background: To assess the accuracy of spiral computed tomography (CT) in predicting the resectability of Klatskin tumor as determined
by vascular invasion.
Methods: Twenty-one consecutive patients with Klatskin tumor who had undergone laparotomy were included in this study. The preoperative
thin-section (5-mm-thick) spiral CT scans of these patients were assessed for the surgical resectability of tumor by evaluating
the vascular invasion. The criterion for vascular invasion indicating unresectability was the tumoral invasion of the proper
hepatic artery or main portal vein or simultaneous invasion of one side of the hepatic artery and the other side of the portal
vein.
Results: All nine patients with tumors thought to be unresectable on the basis of CT findings had tumors that were unresectable at
surgery (positive predictive value, 100%). Of 12 patients with tumors thought to be resectable, six had resectable tumors
(negative predictive value, 50%). Spiral CT failed to detect small hepatic metastasis (n= 1), lymph node metastasis (n= 1), extensive tumor (n= 2) and variation of bile duct (n= 2), which precluded surgical resection.
Conclusion: Spiral CT is a reliable method for detecting vascular invasion and unresectable tumors. However, it has limitations in detecting
variations of the bile duct or the intraductal extent of tumor.
Received: 24 November 1999/Accepted: 26 January 2000 相似文献
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The purpose was to assess capabilities of the multidetector-row computed tomography (MDCT) with multiplanar reformations (MPR)
for predicting of pancreatic adenocarcinoma resectability. Forty-eight patients deemed to have resectable pancreatic adenocarcinoma
after assessment using biphasic MDCT with MPRs underwent surgery for potential tumor resection. Imaging findings were retrospectively
evaluated for tumor resectability and correlated with surgical and pathological results. Curative resection was successful
in 44 of 48 patients. The positive predictive value for tumor resectability made up 91% with four false-negative results.
The reasons for unresectability were venous involvement (1), small liver metastases (2) and peritoneal involvement associated
with small metastases to lymph nodes (1). MDCT yielded a negative predictive value of 99% (286 of 288 vessels) for detection
of vascular invasion. Our results indicate the tendency towards improved prediction of resectability using MDCT compared to
single-detector CT. 相似文献
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目的:探讨64排螺旋CT对不明原因下消化道出血的诊断价值。方法:回顾性分析2006年7月~2007年1月26例不明原因下消化道出血病例行64排螺旋CT扫描。结果:26例中结肠恶性肿瘤13例(50%),小肠间质瘤4例(15.3%),小肠套叠2例(7.6%),腹股沟斜疝3例(11.5%),肠系膜静脉血栓形成3例(11.5%),肠系膜血管畸形1例(3.8%),均经手术病理证实,其中4例肠系膜血管病变还由DSA证实。本组应用64排螺旋CT病变定位准确率100%,定性诊断正确率97%(1例炎性病变定性不清)。结论:64排螺旋CT对不明原因下消化道出血的定位、定性诊断和指导临床制定治疗方案均具有重要价值。 相似文献
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【目的】探讨双气囊电子小肠镜在小肠肿瘤诊断中的作用。【方法】对2005年6月至2008年6月202例经胃镜,肠镜及全消化道钡餐等常规检查无异常发现、疑患小肠疾病患者进行双气囊小肠镜检查。分析双气囊小肠镜检查对小肠肿瘤的检出率及诊断准确率等。【结果】202例患者中,92例经肛进镜,69例经口进镜,41例分别经口及经肛进镜检查。172例检出阳性病灶,总阳性率为85.15%(172/202)。38例镜检诊断为小肠肿瘤,检出率18.81%(38/202),占所检出病变的22.09%(38/172)。36例经手术病理证实,诊断准确率94.74%(36/38)。36例小肠肿瘤中26例(72.22%)为恶性肿瘤,10例(27.78%)为良性肿瘤。【结论】双气囊电子小肠镜诊断小肠肿瘤具有较高临床价值。小肠肿瘤以恶性多见。 相似文献
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刘卫星 《实用医院临床杂志》2011,8(3):102-104
目的探讨螺旋CT胰腺期、门脉期双期增强扫描在胰腺癌诊断中的影像学特征。方法 65例胰腺癌患者均行螺旋CT双期增强扫描,扫描延迟时间分别定为30 s(胰腺期)和70 s(门脉期),造影剂用量100 ml(非离子型),高压注射器团注,速率2.5~3 ml/s。观察并比较肿瘤及正常胰腺在两期的增强情况,根据CT征象对肿瘤可切除性进行评价。结果 65例中肿瘤位于胰头颈部34例,钩突部18例,体尾部13例。发现小胰腺癌3例,直径均小于2 cm。增强扫描肿瘤在胰腺期、门脉期的增强值比较,差异无统计学意义(P〉0.05);正常胰腺组织在胰腺期增强值明显高于门脉期(P〈0.05);肿瘤-胰腺对比在胰腺期与门脉期比较,差异有统计学意义(P〈0.05)。胰周大血管受侵占不可切除性肿瘤的62%,胰周小静脉迂曲扩张占40%,肝脏转移灶占38%。结论运用螺旋CT进行胰腺期和门脉期双期增强扫描,能更好地发现病灶,有助于胰腺癌的及时诊断。 相似文献
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螺旋CT扫描结合CA19-9检测在胰腺癌术前分期中的探讨 总被引:2,自引:0,他引:2
目的探讨螺旋CT双期扫描结合CAl9-9对判断胰腺癌可切除性方面的价值。方法回顾性收集37例在我院行螺旋CT双期扫描并经手术病理证实的患者,全部患者均有术前血清CAl9-9检测结果。结果CT对胰腺癌不可切除的判断准确率高达100%,对可切除性判断准确率只有78.57%。胰腺癌病人中CAl9-9的阳性率为82.86%,CAl9-9与肿瘤大小有关;CAl9—9在可切除组与不可切除组间存在显著性差异。结论螺旋CT结合CAl9-9在判定胰腺癌不可切除性方面有一定价值,尚不能得出CAl9-9对协助CT判定胰腺癌可切除性方面有肯定意义的结论。 相似文献
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结肠癌肝转移的螺旋CT特征及临床价值 总被引:2,自引:0,他引:2
目的 评价螺旋CT对于结肠癌肝转移术前检出与可切除性评估价值。方法 螺旋CT扫描对100例肝转移病例进行术前分期,层厚5mm,重建间隔5mm;以2.0~3.0ml/s速率静脉注入100ml含碘造影剂后60~70s后开始扫描。螺旋CT征象与手术及病理所见按病灶逐一对照。结果 触诊与病理学检查揭示了184个肝转移灶,螺旋CT扫描正确预测了其中的156个,总体检出率84.8%,阳性预测值96.0%,假阳性率3.8%(7/184)。在72例患者的76例次手术中,71例次为可治愈切除,可切除率为93.4%(71/76)。病例五年生存率为54.2%。结论 螺旋CT扫描应被看作是结肠癌肝转移的标准或最佳术前检出方法. 相似文献
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甲状腺肿瘤的螺旋CT诊断价值 总被引:15,自引:2,他引:15
目的 分析螺旋CT对甲状腺肿瘤的诊断价值。以得出甲状腺肿瘤的影像学诊断要点。方法 回顾性分析52例甲状肿瘤的CT资料,并将影像学诊断结果与手术病理检查结果进行符合率对比分析。结果 52例甲状腺肿瘤中,甲状腺腺瘤占比例最大(90.35%),甲状腺癌诊断准确率为83.3%。甲状腺腺瘤钙化比较多,可以发生出血,甲状腺囊腺瘤增强后周边强化明显,甲状腺癌肿瘤无明显边界,增强后呈不均匀强化。结论 螺旋CT检查在显示甲状腺内肿块以及对肿瘤定性诊断方面有非常大的优越。 相似文献