HRCT在孤立性肺结节鉴别诊断中的应用价值

目的探讨HRCT在孤立性肺结节鉴别诊断中的应用价值。方法对经肺部穿刺活检或手术病理证实的103例孤立性肺结节,进行回顾性分析HRCT 10种常见征象,与病理对比,研究其相关特征。结果肺癌47例,常见征象为：毛刺征、分叶征、血管纠集征、胸膜凹陷征、空泡征。炎性假瘤22例,常见征象：分叶征、毛刺征、空泡征。结核球,17例,常见征象：卫星灶、空洞、钙化、分叶征。错构瘤8例：钙化、分叶征、脂肪。转移瘤5例,常见征象：分叶征。曲霉菌病4例,常见征象：空洞、毛刺征。结论孤立性肺结节不同常见征象病变的HRCT表现具有一定的特征性,HRCT在孤立性肺结节的鉴别诊断中是一种非常重要的检查手段。     

螺旋CT结合高分辨率CT在尘肺诊断中的应用

目的：观察尘肺在螺旋CT（SCT）及高分辨率CT（HRCT）的表现,探讨两者的结合应用对提高尘肺诊断的价值。方法：已明确诊断尘肺患者25例均行全肺SCT扫描,然后在主动脉弓顶、气管隆凸、气管分叉下3cm、右膈上2cm重点兴趣区行HRCT检查。观察和比较尘肺在SCT与HRCT的表现。结果：本组25例患者SCT与HRCT能很好显示尘肺结节、大阴影、肺门及纵隔淋巴结增大、肺气肿及合并症：HRCT能清晰显示尘肺结节、肺小叶间隔增厚、各型肺气肿和大阴影等病变的特征。结论：SCT结合HRCT有利于尘肺的诊断与鉴别诊断。     

Lung CT densitometry in systemic sclerosis: correlation with lung function, exercise testing, and quality of life

BACKGROUND: To ascertain if analysis of lung density histograms in thin-section CT was more reproducible than visual assessment of lung changes in systemic sclerosis (SSc), and if such density histogram parameters as mean lung attenuation (MLA), skewness, and kurtosis could more closely reflect pulmonary function as well as exercise and quality of life impairment. METHODS: The intraoperator and interoperator reproducibility of visual and densitometric lung CT analysis in 48 SSc patients examined with CT were evaluated by means of weighted kappa statistics. Univariate and multivariate regression analyses were applied to evaluate the relationship of visual and densitometric CT measurements with functional parameters including functional residual capacity (FRC), FVC, FEV(1), diffusion capacity of the lung for carbon monoxide (Dlco), 6-min walking testing (6MWT), and health-related quality of life questionnaire (QLQ) parameters. RESULTS: The intraoperator and interoperator reproducibility of MLA (intraobserver weighted kappa = 0.97; interobserver weighted kappa = 0.96), skewness (intraobserver weighted kappa = 0.89; interobserver weighted kappa = 0.88), and kurtosis (intraobserver weighted kappa = 0.89; interobserver weighted kappa = 0.88) were higher than those of visual assessment (intraobserver weighted kappa = 0.71; interobserver weighted kappa = 0.69). In univariate analysis, only densitometric measurements were correlated with some exercise and QLQ parameters. In multivariate analysis, MLA (square regression coefficient corrected [R(2)c] = 0.70), skewness (R(2)c = 0.78), and kurtosis (R(2)c = 0.77) were predicted by FRC, FVC, Dlco, 6MWT, and QLQ parameters, while visual assessment was associated only with FRC and FVC (R(2)c = 0.40). CONCLUSIONS: In SSc, densitometric analysis is more reproducible than visual assessment of lung changes in thin-section CT and more closely correlated to pulmonary function testing, 6MWT, and QLQ. Density histogram parameters may be useful for cross-sectional and longitudinal studies of lung involvement in SSc.     

视神经管骨折HRCT诊断及临床意义

目的 探讨视神经管骨折的HRCT表现及早期诊断的临床意义.方法 骨算法重建,2 mm层厚,行轴位加冠位眼眶HRCT扫描.结果 13例病人中视神经管内壁骨折8例,下壁骨折5例,外侧壁骨折3例,上壁骨折2例,分别占61.5%,38.5%,23.1%,15.4%.其中6例病人为多发骨折.结论 早期行眼眶HRCT扫描,可明确诊断视神经管及眼眶骨折,为临床早期治疗,挽救病人视力提供可靠的影像依据.     

过敏性支气管肺曲菌病的临床分析及HRCT表现

目的提高对过敏性支气管肺曲霉菌病（ABPA）的认识和诊断准确率。方法回顾性分析9例经临床和实验室诊断的ABPA的CT表现。结果 9例患者均见中心性支气管扩张,4例为单侧,5例为双侧;上叶支气管受累11处,下叶支气管受累5处。8处扩张支气管呈囊状、串珠状改变,12处扩张支气管呈牙膏样、指套样改变,内见粘液栓充填,其中9处粘液栓呈高密度。扩张支气管周围见马赛克灌注、小叶中心结节、树芽征;2例见肺不张。结论中心性支气管腔扩张并周边支气管变细为ABPA相对特征性的HRCT表现,结合实验室化验检查可确定诊断。     

颞骨HRCT三维重建测量乳突气房表面积与容积的临床意义

目的 通过颞骨HRCT三维重建测量乳突气房表面积(SA)、容积(V),以揭示健康气化型乳突气房SA、V、表面积容积比(SA/V)的参考值范围及特征,为进一步乳突气房功能研究、生理建模及功能重建提供依据.方法 回顾性分析2016年1月-2017年6月广州市红十字会医院108例(216耳)乳突气化型成年患者的颞骨HRCT资...     

COVID-19 and pulmonary tuberculosis – A diagnostic dilemma

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Meanwhile, pulmonary tuberculosis(TB) is one of the most common infective lung diseases in developing nations. The concurrence of pulmonary TB and COVID-19 can lead to poor prognosis, owing to the pre-existing lung damage caused by TB. Case presentation: We describe the imaging findings in 3 cases of COVID-19 pneumonia with co-existing pulmonary TB on HRCT thorax. The concurrence of COVID-19 and pulmonary TB can be a diagnostic dilemma. Correct diagnosis and prompt management is imperative to reduce mortality and morbidity. Hence it is pertinent for imaging departments to identify and report these distinct entities when presenting in conjunction.     

Chronic Schistosomiasis Presenting with Migrating Pulmonary Manifestation after Recent COVID-19 Infection: HRCT Findings

Teaching Point: Chronic pulmonary schistosomiasis should be suspected in symptomatic patients with an endemic background presenting with migrating pulmonary lesions on high resolution computed tomography scan.     

高分辨螺旋CT在支气管哮喘气道重塑中的预测价值研究

目的 研究高分辨螺旋CT对中度哮喘患者气道重塑的评估.方法 本研究为单中心开放研究,通过纳入30例中度持续哮喘组和对照组30例行肺功能测试、高分辨螺旋CT扫描.比较对照组、哮喘组的肺功能指标、气道反应性,并与HRCT测试的气道壁厚度(WT)和气道壁相对面积(WA%)值做相关分析.结果 哮喘患者气道壁厚度(WT)较对照组增厚,相对气道壁面积(WA%)增加;WT和WA%与受试者气道高反应性正相关,而与FEV1/FVC、FEV1%呈负相关.近端气道相关程度强于远端气道.结论 高分辨螺旋CT影像能有效评估哮喘患者的气道重塑,并与哮喘患者症状、肺功能检查密切相关,可用于评估哮喘的严重性、分型和哮喘患者的预后,评定治疗效果和随访观察.