腕关节外伤X线平片,CT及三维CT对比研究

对１６例腕关节外伤患者的Ｘ线平片，ＣＴ及三维ＣＴ３种检查进行对比研究，评估在临床诊断中的价值。材料与方法１６例中，男８例，女８例，平均年龄４１岁。全部病例均经Ｘ线平片，常规ＣＴ和三维ＣＴ成像，Ｘ线平片包括常规位置和特殊位置。ＣＴ机为ＳｏｍａｔｏｍＣＲＦ。     

骨关节外伤X线平片、CT及三维CT对比研究

目的 本对４９例骨关节外伤患的Ｘ线平片、ＣＴ及三维ＣＴ三种检查进行对比研究，评估在临床诊断中的价值。材料与方法 ４９例中男２８例，女２１例，年龄９－８７岁，平均４２岁。全部病例均经Ｘ线平片、常规ＣＴ及三维ＣＴ成像。Ｘ线平片包括常规位置和特殊位置。ＣＴ为ＳＯＭＡＴＯＭＣＲＦ。结果 ４９例骨关节外伤中平片阳性３５例，ＣＴ阳性４７例，三维ＣＴ阳性４８例，阳性率比较有显差异。４９例６５处骨折或脱位中     

脊柱损伤的X线平片、CT、三维CT对比分析

目的对100例脊柱外伤患者的X线平片、CT、三维CT三种检查进行对比分析,评估在影像诊断中的价值。方法100例患者均经X线平片,螺旋CT扫描,其中84例(应临床,患者或病情需要)经多平面MPR重建,三维CT成像。结果100例中,X线平片阳性94例,CT阳性98例,而经多平面MPR重建,三维CT成像的84例全部为阳性。结论在脊柱外伤检查中,X线平片是首选检查方法,但CT优于平片,而三维CT是X平片和CT的重要补充。     

应力性骨折的X线平片与CT对比分析

应力性骨折临床上比较少见，又称为疲劳性骨折、假骨折、衰竭骨折等。近年来，由于对本病研究的不断深入和完善，名称逐渐统一为“应力性骨折”。我们搜集了本院1998-6-2005-6间经临床随访或手术证实的10例不同部位应力性骨折的影像学资料，主要为X线平片和CT，结合国内外的文献，分析其影像学特征及生物力学基础，旨在提高对本病的认识和降低误诊率。     

骨肉瘤平片和CT的影像诊断

目的 评估骨肉瘤平片和CT的影像诊断价值。方法 回顾性分析26例经手术病理证实且均有正侧位X线片和CT片病例。结果 成骨型5例；溶骨型7例；混合型14例。结论 X线平片是最重要的常规检查方法，CT可提供更多诊断依据，应根据设备和病情使用平片、CT联合检查，可提高诊断水平。     

外伤性骨盆损伤影像学检查分析

目的探讨骨盆损伤的影像学检查方法,以便采用更合理的骨盆外伤影像学检查方法。方法对36例骨盆骨折患者进行X线检查CT常规扫描及CT三维重建对比分析,并与手术所见对比。结果 CT常规轴位扫描与CT三维重建差异无显著性。但较X线检查诊断率明显提高（P〈0.05）结论采用CT平扫或CT三维重建,图像清晰,具有立体感强,可从不同的方位显示损伤、碎骨片多少和移位情况,能够准确诊断骨盆损伤,避免诱发医疗纠纷和事故。     

CT联合模板引导放射性粒子植入治疗不可手术的早期非小细胞肺癌

目的 探讨CT联合模板引导放射性粒子植入治疗不可手术的早期非小细胞肺癌（NSCLC）的疗效和不良反应。方法 回顾性分析2010年12月到2016年10月间在天津医科大学第二医院接受CT引导下放射性粒子治疗的21例不可手术的T_1-2N₀M₀早期非小细胞肺癌患者。所有患者术前取得组织学病理,选用粒子活度18.5~29.6 MBq,处方剂量120~160 Gy,均在1次手术内完成粒子植入,术前及术后经TPS制定计划和质量验证。随访评价肿瘤局部控制率、总生存时间、无进展生存期、剂量验证满意率及不良反应。结果 中位随访时间为25.1个月（范围4.4~72.7个月）。1、2、3年的原发肿瘤局部控制率分别为100%、95.2%、95.2%。所有患者的中位总生存期为48个月,中位无进展生存期为43.4个月。1、2、3年生存率分别为100%、91.7%、72.9%。3年无进展生存率为70.2%。术后质量验证满意率为100%。与治疗相关的不良事件包括：气胸、支气管出血、胸膜出血、咳嗽、肺部纤维化及粒子移位。其中7例患者发生1级不良事件（33.3%）;4例患者发生2级不良事件（19%）。无3级或更高级别不良事件发生。结论 CT联合模板引导放射性粒子植入治疗T_1-2N₀M₀的NSCLC肿瘤局部控制率较高,治疗相关不良反应较少,可作为不可手术的早期非小细胞肺癌治疗的一种选择。     

颅脑损伤CT计分与手术指征的相关研究

目的: 探讨颅脑损伤CT计分与手术指征的关系.材料和方法: 对520例颅脑损伤患者外伤后24h内行头颅CT扫描和并行CT计分,得到CT图像计分.分保守治疗组(312例)和手术组(208例)进行预后对照分析.结果: 按CT计分将颅脑损伤分为轻型(<5分)占22.7%(118例),中型(5～10分)占35.6%(185例),重型(>10分)占41.7%(217例).中型手术组预后的重残死亡率(21.0%)远低于保守组(44.2%)(P<0.05);轻、重型无显著差异.结论: 颅脑损伤CT计分是较准确可靠的手术指征之一.     

Correlation between CT and DNA contents in peripheral lung cancers

The DNA contents of 30 lung cancers were correlated with preoperative chest CT findings. Tumors with diameters less than 4 cm had lower DNA contents than larger ones, and tumors with spiculated margins had lower DNA than those with lobulated or smooth margins. As DNA contents are correlated with prognosis, the border configuration of peripheral lung cancers may be enough to predict prognosis.     

Aspergillus infection of the respiratory tract after lung transplantation: chest radiographic and CT findings

The objective of our study was to assess radiographic and CT findings in lung transplant patients with evidence of Aspergillus colonization or infection of the airways and correlate the findings with clinical, laboratory, bronchoalveolar lavage, biopsy and autopsy findings. The records of 189 patients who had undergone lung transplantation were retrospectively reviewed for evidence of Aspergillus colonization or infection of the airways. Aspergillus was demonstrated by culture or microscopy of sputum or bronchoalveolar lavage fluid or histologically from lung biopsies or postmortem studies in 44 patients (23 %). Notes and radiographs were available for analysis in 30 patients. In 12 of the 30 patients (40 %) chest radiographs remained normal. In 11 of 18 patients with abnormal radiographs pulmonary abnormalities were attributed to invasive pulmonary aspergillosis (IPA) in the absence of other causes for pulmonary abnormalities (8 patients) or because of histological demonstration of IPA (3 patients). In these 11 patients initial radiographic abnormalities were focal areas of patchy consolidation (8 patients), ill-defined pulmonary nodules (2 patients) or a combination of both (1 patient). In some of the lesions cavitation was demonstrated subsequently. At CT a “halo” of decreased density was demonstrated in some of the nodules and lesion morphology and location were shown more precisely. Demonstration of Aspergillus from the respiratory tract after lung transplantation does not necessarily reflect IPA but may represent colonization of the airways or semi-invasive aspergillosis. The findings in patients with IPA did not differ from those described in the literature in other immunocompromised patients, suggesting that surgical disruption of lymphatic drainage and nervous supply or effects of preservation and transport of the transplant lung do not affect the radiographic appearances. Received 24 March 1997; Revision received 27 June 1997; Accepted 20 August 1997     

Blunt nonaortic chest trauma: radiographic and CT findings

Following initial clinical evaluation and stabilization of a patient who has sustained blunt chest trauma, imaging has an important role in the evaluation of thoracic injuries. The initial study is the chest radiograph. However, chest CT is being used with increased frequency in the evaluation of blunt chest trauma. Although CT is used primarily to assess for traumatic aortic injuries, it is also useful in the evaluation of pulmonary and bronchial, airway, skeletal and diaphragmatic injury. The aim of this article is to review the characteristic imaging findings of pulmonary and bronchial, esophageal, thoracic, skeletal and diaphragmatic injuries. Electronic Publication     

急性脑外伤CT、MRI敏感性,特异性比较分析

目的：比较急性脑外伤CT、MRI的敏感性和特异性。方法：选取1998年1月－1999年12月122例均进行CT、MRI检查的脑外伤病例,且这些病例的CT、MRI诊断均得到复查或手术核实。把所获得的数据进行列表,分别计算敏感性和特异性。为了减少主观因素的影响,我们采用了ROC曲线图来评价此组资料。结果：在ROC曲线图中发现MR曲线位于CT曲线的左上方。结论：检测急性脑外伤MR比CT更具有优越性。     

低剂量与常规剂量对比剂双能量肺灌注图像质量对比分析

目的:探讨对比剂剂量对双源CT双能量肺灌注成像质量的影响.方法:疑肺动脉栓塞患者行双源CT双能量肺灌注扫描,30例使用低剂量(0.7ml/kg)对比剂,30例使用常规剂量对比剂(1.5ml/kg),注射速率均为4.5ml/s.扫描后同时获得肺动脉CTA及肺灌注图像.测量左、右叶肺动脉干及各肺叶动脉增强后的CT值,对比分析两组间增强后的CT值.判断肺灌注图像质量并分级,比较两组的肺灌注图像质量差异.结果:低剂量组与常规剂量组左、右叶肺动脉干及各肺叶动脉增强后的CT值无明显差异(P＞0.05).肺段及亚段肺动脉图像清晰显示.低剂量组肺灌注图像大部分信号均匀(26/30),常规剂量组肺灌注图像大部分信号均匀(24/30).常规剂量组上腔静脉、右心房高密度对比剂所致灌注伪影明显多于低剂量组(48:10).结论:低剂量与常规剂量双能量肺灌注成像的肺动脉图像质量无明显差异,降低对比剂剂量可以减少双能量肺灌注图像的伪影.     

Integrated FDG-PET/CT compared with intravenous contrast-enhanced CT for evaluation of metastatic regional lymph nodes in patients with resectable early stage esophageal cancer

Objective  To assess whether integrated fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can improve the diagnostic accuracy of metastatic regional lymph nodes (LNs) in esophageal cancer compared with contrast enhanced CT (CECT). Methods  We examined 180 consecutive patients with esophageal cancer by integrated PET/CT between April 2006 and March 2007. Eighteen patients (M:F 14:4) underwent radical esophagectomy after evaluations by PET/CT and CECT of 5–7-mm-thick slices 70–80 s after injection. Regional LNs of esophageal cancer were retrospectively reviewed on CECT images by two blinded evaluators on the basis of the following cutoff sizes: 7 mm for all regional LNs (Protocol A), 10 mm for paratracheal LNs (Protocol B), and 7 mm for others. In addition, the maximum standardized uptake value (SUVmax) on PET/CT was evaluated for positive uptake by LNs. Results  Of 210 LNs excised at surgery, 25 were positive and 185 were negative for metastasis at pathology. The PET/CT images identified 15 true-positive and 184 truenegative LNs, whereas CECT identified 15 true positives and 176 true negatives in Protocol A, and 14 true positives and 180 true negative in Protocol B. The sensitivity, specificity, accuracy, positive, and negative predictive values of PET/CT were respectively 60.0%, 99.5%, 94.8%, 93.8%, and 94.8%, whereas those of CECT were 60.0%, 95.1%, 91.0%, 62.5%, and 94.6% (Protocol A) and 56.0%, 97.3%, 92.4%, 73.7%, and 94.2% (Protocol B). A comparison of the two CECT protocols revealed fewer false-positive LNs in Protocol B, but slightly lower sensitivity in Protocol B than in Protocol A. Substantial numbers of false-positive LNs were determined by CECT in the paratracheal regions (6 of 9, 66.7%) and CECT revealed central necrosis in 4 of 15 (26.7%) true-positive LNs > 1.8 cm. The mean SUVmax on PET/CT was 2.9 (range 1.7–5.5) in true-positive LNs. The smallest LN metastasis detectable by PET/CT was 6 mm. Conclusions  Integrated PET/CT improves the PPV of regional LNs when compared with CECT.     

CT perfusion in non-small cell lung cancers for assessing treatment response,monitoring treatment and predicting prognosis

Introduction

To determine whether Computed Tomography Perfusion (CTP) can predict treatment response and prognosis in non-small cell lung cancers (NSCLC). To determine which one of the perfusion parameter correlated best with treatment outcome.