双探头18F-FDG符合线路显像在不明原发转移癌中的临床价值

目的评价双探头^18F-FDG符合线路显像在探查不明原发转移癌（CUP）中的临床应用价值。方法对CUP患者40例进行^18F-FDG显像,以FDG浓聚程度作为异常判断标准探查可疑原发灶,并结合病理学、影像诊断方法及随访加以证实。结果双探头^18F-FDG符合线路显像对原发灶的检出率为30.0%（12/40）。结论双探头^18F-FDG符合线路显像是寻找CUP原发灶的一种有用方法。     

用全身PET/CT寻找转移瘤患者的原发灶

目的:对不明原因转移瘤患者,探讨利用正电子发射计算机断层显像（positron emission tomography/computed tomography,PET/CT）寻找肿瘤原发灶的临床价值。方法:回顾性收集经病理学证实或影像学检查诊断为转移瘤的137例住院患者的临床及PET/CT成像资料,计算全身PET/CT显像对不明原因转移瘤患者肿瘤原发灶的检出率,分析不同部位转移瘤原发灶检出率间的差异。结果:确诊1例淋巴瘤患者被排除,18F-FDG PET/CT正确检出原发病灶89例,检出率为65.4%（89/136）。18F-FDG PET/CT对于淋巴结转移、骨转移、肝转移及脑转移瘤肿瘤原发灶检出率分别为63.2%（36/57）、60.0%（18/30）、86.7%（13/15）和57.1%（8/14）。结论:全身PET/CT显像在不明原因转移瘤寻找肿瘤原发灶方面具有重要临床应用价值。     

18F-FDG PET/CT显像在胃癌诊断中的应用

[目的]评价18F-FDG PET/CT显像在胃癌诊断中的应用.[方法]49例经胃镜和病理确诊的胃癌患者进行18F-FDG PET/CT显像,其诊断结果与病理学检查、其他影像学检查及临床随访比较.[结果] 49例患者18F-FDG PET/CT阳性44例,阳性率89.8％;39例有淋巴结转移患者中18F-FDGPET/CT显像发现32例,灵敏度为82.1％(32/39); 12例有远处转移患者中18F-FDG PET/CT显像发现11例,灵敏度91.6％(11/12).[结论]18F-FDG PET/CT显像对胃癌原发灶、淋巴结转移和远处转移具有较高的灵敏度,18F-FDG PET/CT显像在胃癌诊断中具有较高的临床价值.     

^18氟-脱氧葡萄糖正电子发射计算机断层显像寻找未知原发灶肿瘤原发灶的临床价值

目的研究”氟一脱氧葡萄糖正电子发射计算机断层显像（^18F－FDGPET－CT）在寻找原发灶不明转移癌（CUP）患者原发灶中的临床价值。方法回顾性分析为寻找原发灶而行^18F-FDGPET．CT扫描的CUP患者48例,其中男28例,女20例;年龄41-82岁,平均（57±16）岁。依据转移癌部位不同将患者分为颈部淋巴结转移组（28例）及非颈部淋巴结转移组（20例）,计算并比较^18F-FDGPET-CT诊断各组原发灶的灵敏度。结果^18F-FDGPET-CT寻找CUP患者原发病灶的灵敏度为66．7％（32／48）,寻找颈部淋巴结转移CUP患者的灵敏度为78．6％（22／28）,非颈部淋巴结转移CUP患者的灵敏度为50．0％（10／20）;^18F-FDGPET-CT诊断颈部淋巴结转移组CUP患者原发灶的灵敏度与非颈部淋巴结转移组相比,差异有统计学意义（x。4．286,P〈0．05）。结论^18F-FDGPET-CT诊断CUP患者原发灶灵敏度较高,尤其适用于颈部淋巴结转移的CUP患者。、     

PET-CT在原发灶不明转移癌诊断中的价值

[目的]探讨18F-双脱氧葡萄糖（18F-FDG）正电子发射计算机断层扫描显像（PET-CT）在原发灶不明转移癌（CUP）临床诊断中的应用价值。[方法]对37例CUP患者进行PET-CT全身扫描,分析PET-CT扫描图像、临床资料、转移灶部位和病理等以评价PET-CT的诊断价值。[结果]①37例CUP患者经PET-CT检查,发现原发灶25例,原发灶检出率为67.6%（25/37）;假阴性1例,假阳性2例,PET-CT敏感度、特异性分别为96.2%（25/26）、81.8%（9/11）。②40.5%（15/37）患者发现的新转移灶,72.9%（27/37）患者抗肿瘤治疗策略有所改变。③颈部淋巴结转移患者其原发灶更多来源于头颈部肿瘤（P=0.004）。[结论]结合转移灶病理等临床信息,PET-CT在CUP诊断中具有重要价值。     

全身^18F-FDGPET／PET-CT在脑转移瘤寻找原发灶中的诊断价值

背景与目的：恶性肿瘤发生颅内转移十分常见，据统计其发生率约占颅内肿瘤的5％—20％。本文总结因脑转移瘤查原发灶的62例患者的原发灶发现情况及全身转移灶情况，旨在评价全身^18F-FDG PET／PET-CT在脑转移瘤寻找原发灶中的诊断价值。方法：对62例因脑转移瘤查找原发灶为主诉的肿瘤患者进行了回顾性分析。结果：本组62例患者中52例患者的原发灶位置得到了确诊，原发灶的检出率为83．8％(52／62)，其中原发性肺癌占55．7％(29／52)，所有肺癌中低分化腺癌占44．8％(13／29)。除可检出原发灶外，^18F-FDGPET／PET-CT全身显像还检出肺转移、淋巴结转移、骨转移、肝转移及其它少见部位的转移灶。全身行^18F-FDG PET-CT扫描对肿瘤原发灶的检出率为84．6％；行全身^18F-FDG PET扫描对肿瘤原发灶的检出率为82．6％；与^18F-FDG PET-CT相比，^18F-FDG PET图像对肺转移病灶的检出率仅为10．9％。结论：^18F-FDGPET／PET-CT的全身扫描有利于发现原发灶及其他转移灶。对恶性肿瘤发现方面具有重要的临床实用价值，     

18F-FDG PET判断头颈部癌复发的作用

目的：探讨^18F-氟脱氧葡萄糖（^18F-fluoro-deoxyglucose,^18F-FDG）正电子发射断层显像术（positron emission tomography,PET）在头颈部癌复发诊断中的作用。方法：54例临床上怀疑复发的头颈部癌患者同期均行^18F-FDGPET显像（25例全身显像,29例局部显像）和CT或MR检查,最后诊断依靠病理检查或临床随访。结果：54例患者中^18F-FDGPET显像阳性39例,其中假阳性2例;阴性15例,其中假阴性3例。^18F-FDGPET显像和CT或MR的敏感性分别为92.5%（37/40）和55.0%（22/40）,差异有统计学意义,χ^2=14.528,P〈0.05;特异性分别为85.7%（12/14）和85.7%（12/14）,差异无统计学意义,χ^2=1.875,P=0.483;阳性预测值、阴性预测值分别为94.9%（37/39）、80.0%（12/15）和100.0%（22/22）、52.2%（12/23）;准确率分别为90.7%（49/54）和63.0%（34/54）,差异有统计学意义,χ^2=11.711,P=0.001。在25例18F-FDGPET全身显像中,16例除头颈^18F-FDG异常浓聚外,9例还发现有远处转移。结论：判断头颈部癌治疗后复发,^18F-FDGPET比CT或MR更敏感和有更高的准确性,并且在临床分期上有一定价值。     

18 F-脱氧葡萄糖PET显像在原发灶不明转移癌中的应用

目的：探讨^18F-脱氧葡萄糖（FDG）正电子发射型体层摄影术（PET）全身显像在原发灶不明转移癌中的作用。方法：对29例原发灶不明转移癌患者行EDG PET全身显像，并与临床随诊、组织活检和手术病理结果对照。结果：29例原发灶不明转移癌患者，FDG PET发现可疑原发灶15例，其中13例为病理结果所证实，2例病理结果为阴性，FDG PET对原发灶的检出率为44．8％（13／29）。FDG PET全身显像另外检检出淋巴结转移和远地转移灶26个，CT和MRI只检出13个。14例FDG PET未确定原发灶者，经随访3－13个月,死亡率42．9％（6／14）。13例FDG PET确定原发灶者，经过有针对性的治疗，经随访2－13个月，死亡率为15．4％（2／13）。结论：FDG PET全身显像对原发灶不明转移癌原发灶的确定、临床分期、治疗方案的制定以及预后的改善均有一定的价值。     

18F-FDG PET/CT在寻找颈淋巴结转移瘤原发灶中的应用价值

背景与目的:颈部淋巴结转移瘤在颈部恶性肿瘤中最常见,原发灶检出与否直接影响患者的生存期和生活质量.本研究旨在评估18F-FDG PET/CT在寻找颈淋巴结转移瘤原发灶中的应用价值;另外,设定不同的PET/CT原发灶诊断标准,分别评价其阳性预测价值.方法:对93例病理学诊断为颈淋巴结转移瘤的患者行18F-FDG PET/CT显像,根据不同的PET/CT原发灶诊断标准寻找原发灶,即明确诊断、可疑诊断及未见原发灶征象;所有PET/CT诊断均与病理或其它影像检查相对照.结果:PET/CT明确诊断原发灶40例,均经病理或临床证实,阳性预测值100%;PET/CT可疑诊断28例,经病理证实为原发灶16例.其阳性预测值57.1%;2例患者经PET/CT提示为纵隔淋巴结转移但未见原发灶征象.最终临床诊断为原发纵隔型肺癌;2例患者PET/CT未见原发征象,经内窥镜检出原发灶;PET/CT原发灶检出率为60.2%(56/93).结论:18F-FDG PET/CT在寻找颈淋巴结转移瘤原发灶中有较大的临床价值.     

18F-FDG SPECT显像用于食管癌复发的诊断价值

目的：评价^18F-FDG SPECT显像在食管癌手术和／或放射治疗的随访中的临床价值。方法：对15例食管癌手术或放射治疗后的患者同期行^18F-FDG SPECT显像和CT检查，采用双盲法对结果进行比较。结果：15例食管癌患者根据病理活检及临床随访结果最后诊断12例复发和转移，^18F-FDG SPECT显像检出11例病人共17个病灶，胸部CT检出9例病人共13个病灶，其敏感性和特异性分别为83％（10／12），75％（2／3）和67％（2／3）、67％（8／12）。结论：判断食管癌手术或放射治疗后复发和／或转移，一次^18F-FDG SPECT全身显像较CT有更高的准确性和优越性。     

Non‐vascular intervention with real‐time CT fluoroscopy

The emerging technology of CT fluoroscopy (CTF) represents the first opportunity for real‐time CT guidance in non‐vascular intervention. As with any new technology, its efficacy requires validation before widespread application can be advocated. A review of our initial experience is presented with particular attention to room, procedure and fluoroscopy time savings, complication rates and dosimetry. Computed tomography fluoroscopy is useful for pulmonary, pelvic, retroperitoneal and other deep organ lesions that are not easily accessible by other modalities. Computed tomography fluoroscopy decreases procedure time by at least a factor of 2 compared with conventional CT (C‐CT) guidance, resulting in improved throughput in a busy interventional CT department. Accurate targeting of small lesions, previously considered inaccessible, can also be achieved with CTF. Exposure to the physician’s hands can be reduced to a level that is acceptable to the International Commission on Radiological Protection guidelines.     

Comparison of two imaging protocols for acute stroke: Unenhanced cranial CT versus a multimodality cranial CT protocol with perfusion imaging

The aim of the study was to validate a multimodality cranial computed tomography (CCT) protocol for patients with acute stroke in the United Arab Emirates as a basic imaging procedure for a stroke unit. Therefore, a comparative study was conducted between two groups: retrospective, historical group 1 with early unenhanced CCT and prospective group 2 undergoing a multimodality CCT protocol. Follow‐up unenhanced CCT >48 h served as gold standard in both groups. Group 1: Early unenhanced CCT of 50 patients were evaluated retrospectively, using Alberta Stroke Program Early CT Score, and compared with the definite infarction on follow‐up CCT. Group 2: 50 patients underwent multimodality CCT (unenhanced CCT, perfusion studies: cerebral blood flow, cerebral blood volume, mean transit time and CT angiography) <8 h after clinical onset and follow‐up studies. Modified National Institute of Health Stroke Scale was used clinically in both groups. Group 1 showed 38 men, 12 women, clinical onset 2–8 h before CCT and modified National Institute of Health Stroke Scale 0–28. Group 2 included 38 men, 12 women, onset 3–8 h before CCT, modified National Institute of Health Stroke Scale 0–28. Sensitivity was 58.3% in group 1 and 84.2% in group 2. Computed tomography angiography detected nine intracranial occlusions/stenoses. The higher sensitivity of the multimodality CCT protocol justifies its use as a basic diagnostic tool for the set‐up of a first‐stroke unit in the United Arab Emirates.     

Computed tomography and radiotherapy in the treatment of cancer

Computed tomography (CT) has shown to be of great value in the treatment of cancer with radiation therapy. It is used more and more in the estimation of tumor volume and for treatment planning, with the aid of the computerized treatment unit. At the James Graham Brown Cancer Center, Department of Radiation Oncology, CT has been used routinely for the treatment planning. From October 1, 1981 to June 30, 1982, we performed 180 CT scans for the treatment planning, 380 simple dose calculations, 237 complex treatment plans, and 42 intracavitary dosimetry using the treatment planning unit. This is a review of our experience with some illustrations. Accurate tumor dose can be delivered with reducing the complications with the use of CT and the computerized treatment unit.     

Right atrial angiosarcoma and electrocardiogramgated cardiac computed tomography： a case report

Primary cardiac tumors are quite rare and most of these tumors are benign. In this report, a patient presented with chest distress and shortness of breath after activity. Echocardiography of other hospital showed a hyperechoic right atrial mass. Electrocerdiogram-gated cardiac computed tomography (ECG-Gated CT) of our hospital provided accurate information about the site and extent of the tumor, and the involvement of neighboring structures, even about the malignant nature of the lesion. The pathological study indicated angiosarcorna. The role of ECG-Gated CT in the assessment of cardiac masses and tumors was discussed. Cardiac tumors are extremely rare and can be divided into benign and malignant lesions. Myxomas are the most common type of cardiac benign tumor, while angiosarcomas are the most common type of cardiac malignant tumor.Imaging studies play an important role in the diagnosis of cardiac angiosarcomas. Echocardiogram, computed tomography (CT) and magnetic resonance imaging (MRI) are the most common imaging studies for tumors evaluation. However, the precise tumor location is often difficult to evaluate precisely on the basis of two-dimensional source images. We conducted ECG-gated cardiac CT examination with 3D reconstruction for preoperative assessment in a patient with a angiosarcorna arising in the right atrium.     

多层螺旋CT血管成像观察结直肠癌供血动脉

  目的  探讨计算机断层血管造影（computed tomography angiography,CTA）及计算机断层结肠成像（computed tomography colonography,CTC）及融合图像对腹腔镜直肠癌根治术的临床价值。  方法  回顾性分析2012年2月至2019年2月大连医科大学附属市中心医院收治的100例经手术病理证实的接受腹腔镜直肠癌根治术患者的临床病例资料,50例为CTA-CTC融合组,50例为常规CT组。测量CTA-CTC融合组患者肠系膜下动脉起始处至分叉的距离及肿瘤远端至直肠末端的距离,对肿瘤的解剖定位、肠系膜下动脉分支走行及空间毗邻关系进行术前评估,并与术中所见进行对比。比较两组患者术中及术后恢复情况及3年总体生存率和3年无复发生存率。  结果  肠系膜下动脉起始处至分叉距离及肿瘤远端至直肠末端的距离与术中测量数据差异无统计学意义（均P>0.05）。CTA-CTC融合图像能三维立体显示肿瘤解剖定位、肠系膜下动脉、左结肠动脉、直肠上动脉、乙状结肠动脉的走行,与术中所见一致。两组患者手术时间、术中出血量差异有统计学意义（t=−2.433,t=−2.346;均P<0.05）。两组患者淋巴结清扫数目、术中输血例数,术后并发症发生例数、术后通气时间、术后住院时间差异无统计学意义（均P>0.05）。两组患者3年总体生存率及无复发生存率差异无统计学意义（均P>0.05）。  结论  CTA、CTC及融合图像可以清晰地显示直肠癌的解剖定位、肠系膜下动脉分支走行及空间毗邻关系,有利于手术医生准确地选择腹腔镜直肠癌根治术的手术方式和手术入路,缩短手术时间,减少术中出血量。     

Localization of small liver tumors.

Thirty-six patients with small liver tumor were diagnosed by alpha-fetoprotein (AFP); sonography, and computed tomography (CT), and underwent hepatectomy. The pathological types included 23 hepatocelluler carcinoma (HCC), 11 hepatic cavernous hemangioma, and 2 secondary liver cancer. In 22 patients, the tumor nodules were located in the right lobe and 14 cases in the left lobe. The diagnostic accuracy rate of CT was 100% for HCC and secondary liver cancer, but for hepatic cavernous hemangioma it was only 72.2%. However, the accuracy rate of sonography was as high as 81.8% for hepatic cavernous hemangioma and only 60.4% for liver malignancies. The positive rate of AFP for the HCC patients of this series was only 66.6%. The method of intraoperative detection of small liver tumor is introduced, if the tumor was invisible grossly or nonpalpable during exploratory laparotomy. In the series, 7 cases in whom the right lobe lesion was too small to be located by routine manual examination during exploratory laparotomy were detected by this method, and all small liver tumors were resected successfully.     

CT appearances of hydatid disease at various locations

Hydatid disease has characteristic imaging features on CT, which allow accurate preoperative diagnosis in most cases. However, when it occurs at unusual locations the diagnosis is often difficult, especially as the imaging appearance varies at different sites. In this article we have presented a pictorial review of the CT features of disease due to Echinococcus granulosus at various sites in the human body.