多层螺旋CT成像技术在结肠肿瘤诊治中的应用

目的：应用多层螺旋CT成像技术对结肠肿瘤者进行前瞻性研究，旨在提高多层螺旋CT在结肠肿瘤的诊断水平。方法：通过对30例结肠肿瘤病人的MSCT轴位图像和重建的4-D、MIP及仿真内窥镜图像进行观察分析，并与相应的钡灌肠及纤维结肠镜结果进行对照性研究。结果：全部病例诊断符合率为100％，仿真内窥镜结果与纤维结肠镜结果基本吻合。结论：多层螺旋CT在结肠肿瘤的诊断中具有独特的优越性。     

胃粘膜巨大肥厚症(附4例报告)

近年来,我们遇见4例胃粘膜巨大肥厚症,其中3例经胃镜证实,4例均经手术及病理证实。现举2例报告如下。例1:男,46岁。因上腹不适、腹泻4个月,全身浮肿50天入院。查体:除腹水征     

三维CT在先天性髋关节脱位及髋臼骨折的临床应用

三维ＣＴ(ｔｈｒｅｅｄｉｍｅｎｓｉｏｎａｌｃｏｍｐｕｔｅｄｔｏｍｏｇｒａｐｈｙ ;3ＤＣＴ) ,利用计算机将连续的ＣＴ横断图像进行重组 ,形成多种形式的三维图像 ,3Ｄ成像的条件要求较高 ,常规ＣＴ扫描中层厚越薄 ,层距越短 ,纵向空间分辨率就越高 ,三维图像质量也越高 ,但在纵向上不是连续取样 ;螺旋ＣＴ尤其多层螺旋ＣＴ将二维采样改为三维容积采样 ,很好地解决了这一问题。三维成像技术目前主要有表面遮盖显示(ｓｈａｄｅｄｓｕｒｆａｃｅｄｉｓｐｌａｙ ;ＳＳＤ) ;容积显示技术 (ｖｏｌｕｍｅｒｅｎｄｅｒｉｎｇ) ;最大密度投影(ｍ…     

PACS中动态图像传输格式比较

目的 评价多种动态图像格式在PACS中的应用情况.方法 用同一台超声扫描国标"仿组织超声体模"并以不同格式采集动态图像进行对比.结果 大部分格式的动态图像符合临床要求.结论 DICOM格式动态图像在临床应用中存在不足.     

MR扩散张量成像在急性一氧化碳中毒后迟发性脑病诊断中的应用价值

目的 探讨MR扩散张量成像(DTI)对急性CO中毒后迟发性脑病(DEACMP)的临床应用价值.方法 对35例DEACMP的患者(DEACMP组)和35例正常健康志愿者(对照组)行常规MRI及DTI扫描,分析其影像学表现,采用圆形感兴趣区(ROI)测量不同脑区的平均扩散系数(ADC)值、各向异性分数(FA)值,并对测值对进行统计学分析.结果 35例DEACMP患者均有异常影像表现.常规MRI表现可分为3个类型:脑白质受累型、神经核团受累型、皮层受累型.与对照组相比较,DEACMP组所测不同脑白质区的ADC值、FA值明显下降,差异有统计学意义(P＜0.05,P＜0.01),以半卵圆中心(ADC:3.87±0.42,FA:0.32±0.05)和侧脑室周围白质(ADC:4.48±0.51,FA:042±0.01)的ADC值、FA值下降最显著;而所测各神经核团的ADC值升高,FA值降低,差异有统计学意义(P＜0.05,P＜0.01),尤以苍白球的ADC升高(ADC:13.2±0.29,FA:0.19±0.07)及FA值降低最明显.结论 DTI技术可准确反映常规MRI所不能观察的DEACMP脑组织微观结构病理变化,量化脑组织损害的程度,为临床提供非常有价值的信息.     

多层CT血管成像技术对布加综合征的诊断价值

布加综合征（Budd—Chiari syndrome，BCS）是指南肝静脉和（或）其开口以上段下腔静脉梗阻引起的腹痛、肝功能障碍、腹水和下肢水肿及门静脉高压等病变。主要病理改变是肝后或肝上段下腔静脉和（或）肝静脉的膜性或节段性狭窄或闭塞及因此而导致的肝静脉和下腔静脉系统的回流障碍^[1]。该病在我国并不少见。山东省为高发区，     

0.23 T开放性磁共振实时引导下经皮激光热消融术 治疗肝脏恶性肿瘤

目的 评价肝脏肿瘤在磁共振介入激光治疗中的热消融变化及光学器械追踪系统对激光纤维的精确定位和实时监测激光治疗中热消融变化的能力，观察激光消融治疗肝脏恶性肿瘤的可行性与安全性。方法 对经病理学活检证实的14例恶性肝脏肿瘤患者(4例为肝细胞癌，10例为肝转移瘤，共22个肿瘤)进行0．23T开放性磁共振成像系统与介入引导下经皮激光热消融治疗术。结果 全部病灶均被成功定位、靶定并消融治疗。肿瘤形态、术后瞬间及3天后热消融形成的凝固坏死灶均在磁共振图像上显示。除1例有部分残余外，所有热消融灶均大于各自原始肿瘤大小；术后3天热消融凝固灶大于术后瞬间凝固灶。结论 磁共振引导经皮肝脏肿瘤激光热消融术是可行和安全的；光学追踪系统引导与磁共振温度监测对准确估计热治疗效果是有用且可信赖的工具。     

少见化学性肺炎的影像学表现

1　引　言化学性肺炎少见 ,其发生、发展与吸入物质的毒性反应、强度、持续时间以及生理的、生物的宿主易感性有关。依据被吸入物质的物理状态 :溶解性、反应性、气体动力学特性 ,决定肺内病变部位 ,一般下呼吸道多见。经证实 ,有炎症和水肿的急性反应及有纤维化或颗粒形成的慢性反应 ,是环境因素所致[1] 。2　化学性肺炎毒性化学物质的吸入少见。不同肺毒性物质的作用机制不同。其种类繁多 ,包括有机的 (如磷酸盐、百草枯、氯化聚乙烯、聚合物粉尘、烟 ) ,无机的 (如氨、硫化氢、氧化氮、二氧化硫 )以及金属 (如镉、汞、镍、钒 )复合物。有…     

前瞻性心电门控双源CT冠状动脉成像在高心率患者中应用的可行性研究

Objective To explore the optimal reconstruction windows in patients with heart rate (HR) over 91 (beats per minute) bpm, and to explore the feasibility of prospective ECG-gated DSCT coronary angiography.Methods Two hundred and thirty-two patients[body mass index (BMI):23-25 kg/m2, with stable HR, and average HR ≥91 bpm]with suspected or known coronary artery disease underwent retrospective ECG-gated DSCT coronary angiography.They were divided into 3 groups (A-C) according to the average HR of scanning.Images were reconstructed from 29% to 80% of the R-R interval in 3% increments.Two independent readers assessed the overall image quality by a five-point scale and determined the optimal reconstruction windows of each coronary segment and the ranges.Coronary arteries were segmented according to the guideline of the American Heart Association (AHA).The degree of interobserver agreement was determined by Kappa statistics.Results Three thousand three hundred and fortythree segments were considered to have diagnostic image quality in 232 patients.The ranges of optimal reconstruction windows of images were concentrated on 81%-61% and 51%-31%.In group A(91-95 bpm), there were 1183 segments in 83 patients, and the according proportions were 5.49%, 94.51%,respectively; In group B(96-100 bpm), there were 986 segments in 68 patients, and the according proportions were 0.20%, 99.80%, respectively; In group C(≥ 101 bpm), there were 1174 segments in 81 patients, and the according proportions were 0.17%, 99.83%, respectively.The optimal construction windows in 3274 segments out of 3343 segments in 232 patients were concentrated in 41%, ranged from 51%-31%.The image quality assessment in 3343 segments in 232 patients have a high inter-observe agreement (Kappa=0.883,P <0.05).Conclusion The optimal reconstruction windows of patients with stable HR(≥91 bpm) was concentrated in 41%, ranged from 51%-31%.When nothing except the window of data acquisition is considered, the prospective ECC,-gated DSCT coronary angingraphy can be used in patients with stable HR(≥91 bpm).     

前瞻性心电门控双源CT冠状动脉成像在高心率患者中应用的可行性研究

Objective To explore the optimal reconstruction windows in patients with heart rate (HR) over 91 (beats per minute) bpm, and to explore the feasibility of prospective ECG-gated DSCT coronary angiography.Methods Two hundred and thirty-two patients[body mass index (BMI):23-25 kg/m2, with stable HR, and average HR ≥91 bpm]with suspected or known coronary artery disease underwent retrospective ECG-gated DSCT coronary angiography.They were divided into 3 groups (A-C) according to the average HR of scanning.Images were reconstructed from 29% to 80% of the R-R interval in 3% increments.Two independent readers assessed the overall image quality by a five-point scale and determined the optimal reconstruction windows of each coronary segment and the ranges.Coronary arteries were segmented according to the guideline of the American Heart Association (AHA).The degree of interobserver agreement was determined by Kappa statistics.Results Three thousand three hundred and fortythree segments were considered to have diagnostic image quality in 232 patients.The ranges of optimal reconstruction windows of images were concentrated on 81%-61% and 51%-31%.In group A(91-95 bpm), there were 1183 segments in 83 patients, and the according proportions were 5.49%, 94.51%,respectively; In group B(96-100 bpm), there were 986 segments in 68 patients, and the according proportions were 0.20%, 99.80%, respectively; In group C(≥ 101 bpm), there were 1174 segments in 81 patients, and the according proportions were 0.17%, 99.83%, respectively.The optimal construction windows in 3274 segments out of 3343 segments in 232 patients were concentrated in 41%, ranged from 51%-31%.The image quality assessment in 3343 segments in 232 patients have a high inter-observe agreement (Kappa=0.883,P <0.05).Conclusion The optimal reconstruction windows of patients with stable HR(≥91 bpm) was concentrated in 41%, ranged from 51%-31%.When nothing except the window of data acquisition is considered, the prospective ECC,-gated DSCT coronary angingraphy can be used in patients with stable HR(≥91 bpm).