多层螺旋CT在法洛四联症诊断中的应用进展

法洛四联症是紫绀型先天性心脏病中最常见的一种疾病,常合并冠状动脉走行异常。多层螺旋CT(MSCT)是一种无创的检查方法,能清晰地显示肺动脉远端狭窄及分支狭窄,对室间隔缺损、主动脉骑跨、右心室肥厚也有较好的诊断。同时,MSCT可以直观、立体地观察冠状动脉管腔及管壁表面,通过二维、三维、四维图像对血管病变进行全面观察、分析,在疾病诊断、制定治疗方案、手术计划及估计手术风险方面有重要的应用价值。该文讨论MSCT在法洛四联症诊断中的应用进展。     

螺旋CT 成像技术在脊柱创伤的诊断和治疗中的应用

目的　通过对 2 0例脊柱创伤病人SCT扫描的前瞻性研究 ,旨在提高SCT在脊柱创伤的诊断和治疗中的价值。方法　回顾性地分析 2 0例脊柱创伤病人的SCT扫描资料。结果　单纯裂纹骨折的 8例 ,粉碎性压缩骨折同时伴有不同程度的椎管狭窄的 12例 (11例椎管内见游离骨碎片 ,2例椎管内有血肿 ) ,其中 10例同时伴有脊柱不同程度的滑脱、错位致脊柱不稳。结论　SCT成像技术在脊柱创伤诊断和治疗方案的选择上具有独特的优越性。     

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).     

A new method for computerized tomography diagnosis of early transtentorial hernia.

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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。     

双源CT前瞻性心电触发大螺距扫描在小儿先天性心脏病诊断中的初步应用

目的 探讨双源CT前瞻性心电触发大螺距扫描(简称大螺距扫描)在小儿先天性心脏病(简称先心病)中的临床应用价值.方法 搜集行大螺距扫描的36例先心病患儿的影像资料,记录其剂量长度乘积(DLP),计算出有效辐射剂量(ED).由2名放射科医师在双盲的情况下独立诊断并用5分法对图像质量进行评估.2名医师对图像质量评估符合程度的评价采用Kappa检验.以手术或DSA结果为金标准,计算大螺距扫描诊断先心病的准确度、敏感度和特异度.结果 36例患儿大螺距扫描的DLP为(2.4～9.2)mGy·cm,平均(5.1±1.6) mGy·cm,ED为(0.078 ～0.179)mSv,平均(0.125±0.027) mSv.图像质量均符合诊断要求;2名放射科医师的图像质量评价一致性好(K=0.774,P＜0.05).大螺距扫描诊断先心病的准确度、敏感度、特异度分别为98.9％、94.2％、99.8％.结论 双源CT大螺距扫描技术降低了受检患儿的辐射剂量,图像仍满足诊断要求,为小儿先心病的诊断提供了一种新的可供选择的方法.     

多层螺旋CT联合CAl99、ALP、GGT及CRP在胆管癌诊断中的应用价值

目的探讨多层螺旋CT联合CAl99、ALP、GGT及CRP在胆管癌诊断中的应用价值。方法连续入选2013年1月~2018年12月本院经病理证实的胆管癌患者60例,同时选取同期胆道良性病变患者60例为对照组。所有患者均行多层螺旋CT动态容积增强检查与血清学CA199、ALP、GGT、CRP检测。结果CA199结果:胆管癌患者CA199阳性率为88.3%(53/60),对照组为38.3%(23/60),胆管癌组阳性率显著高于对照组(P<0.05);ALP、GGT、CRP结果:胆管癌组与对照组均具有统计学差异(P<0.05)。在胆管癌的诊断方面,CT单独检测的准确性为88.3%,CT结合CAl99、ALP、GGT及CRP血清学多指标诊断准确性为98.3%。CT联合CAl99、ALP、GGT及CRP血清学检测在胆管癌诊断中的敏感性、特异性及准确性均高于CT单独检测诊断(P<0.05)。结论多层螺旋CT联合CAl99、ALP、GGT及CRP检测显著提高胆管癌诊断效能。     

脑面血管瘤综合征的CT诊断

本文报导了9例脑面血管瘤综合征（Sturge－Weber综合征）的CT表现，认为此病CT的特征性改变为：面部血管瘤或痣的同侧大脑表面的高密度的钙化影，呈均匀的宽大锯齿状或脑回样。其它表现为病侧局部或广泛的脑萎缩或发育不良，蛛网膜下胜及脑室相应扩大，中线结构移向患侧。颅板增厚，头颅不对称等。