18F-FDG与18F-FLT PET/CT延迟显像对肺结节诊断效能的评价

目的 通过对多中心、前瞻性研究中接受了18F-脱氧葡萄糖(FDG)与18F-脱氧胸腺嘧啶核苷(FLT)延迟显像病例的分析,探讨18F-FDG与18F-FLT延迟显像对肺结节诊断的效能.方法 6个PET/CT中心,从2006年1月至2007年6月,按照统一标准,采用同机型、同一扫描条件,开展了肺结节样病变18F-FLT和18F-FDG PET/CT显像的多中心临床研究.在经确诊的55例病例中,25例患者进行了18F-FLT显像和延迟显像,34例患者进行了18F-FDG延迟显像.按常规计算延迟显像时病灶最大标准摄取值(SUVmax)及与早期显像时SUVmax相比的变化率(△SUVmax).对照临床确诊结果分析其诊断效能.采用SPSS11.0软件进行统计学处理.结果 18F-FDG延迟显像患者中,6例肺癌中5例、12例结核中9例、16例炎症或其他良性结节中9例的SUVmax较早期相升高.18F-FLT延迟显像组中,7例肺癌中3例、8例结核中3例和10例其他良性病灶中2例的SUVmax上升.经分组统计分析,不同疾病组间18F-FDG延迟显像SUVmax和△SUVmax差异无统计学意义;18F-FLT延迟显像SUVmax和△SUVmax组间差异也无统计学意义.无论18F-FDG还是18F-FLT,延迟显像的诊断效能均不如早期相.无论早期还是延迟显像,单独18F-FDG或18F-FLT显像的诊断效能均不如二者联合应用.结论 18F-FDG和18F-FLT延迟显像的SUVmax变化规律性不强,不宜单独应用于肺结节的鉴别诊断.     

多排螺旋CT在乳腺癌术前评估中的应用

多排螺旋CT的出现为乳腺癌诊断评估提供了一个全新的工具。本文旨在介绍乳腺多排螺旋CT高分辨率薄层增强扫描和相应之图像重建技术路线,及其在乳腺癌术前诊断评估中的作用与意义。     

螺旋CT三期扫描对肝纤维化诊断价值研究

目的探讨螺旋CT三期扫描对肝纤维化的诊断价值。方法对66例经肝穿刺活检病理证实的慢性乙型肝炎肝纤维化患者组和42例正常对照组进行螺旋CT三期增强扫描。根据纤维化程度分期进行影像资料和相关指标的统计分析。结果肝左叶增大,肝表面形态及肝实质密度的改变,脾脏增大,门静脉增宽和侧枝循环的建立等影像学改变,随着肝纤维化严重程度的加重而有统计学差异。本研究显示57例肝纤维化患者螺旋CT三期扫描诊断肝纤维化52例,敏感性91.2%,特异性77.8%。各期肝纤维化分期准确28例,准确率49.1%;准确判断轻度纤维化(S1、S2)或重度纤维化(S3、S4)44例,准确率77.2%,诊断早期肝硬化16例,准确率84.2%。结论螺旋CT三期扫描能判断肝纤维化的程度,而且是动态观察肝纤维化的病程演进和临床随访的有效手段。     

Correspondence analysis as a screening method for indicants for clinical diagnosis

In clinical diagnosis, a patient's symptoms are observed and the probabilities of various diseases are assessed. A widely used method of formalizing this approach is independent Bayes in which symptoms are assumed to be independent conditional on the disease category. Correspondence analysis provides a method for examining the dependence between symptoms and assists in the selection of a reduced set of symptoms for the application of the independent Bayes method. This approach is illustrated on two data sets concerned with patients attending Accident and Emergency departments with chest pain and acute abdominal pain, respectively.     

64排螺旋CT冠状动脉造影与DSA的对照研究

目的:通过和冠脉造影对比,评价64排螺旋CT冠状动脉成像在冠状动脉狭窄中的临床应用价值。方法:28例患者同时行64排螺旋CT冠状动脉成像和有创性冠脉造影检查,依据AHA17段分段法,评价所有有效节段,并将两者进行对比。结果:冠脉造影显示阴性病例占7.1%(2例),单只病变占21.4%(6例),多支病变占71.4%(20例)。按节段分析,CT检出冠脉狭窄的敏感度,特异度,阳性预测值和阴性预测值分别为91.1%,94.6%,90.0和95.3%。结论:64排螺旋CT冠状动脉成像和传统的冠脉造影检查对检出正常冠脉节段以及狭窄节段具有很好的一致性。     

547例垂体腺瘤延迟诊断原因及影像诊断分析

目的:提高垂体腺瘤特别是微腺瘤早期影像诊断率。方法:通过对所搜集病史资料完整,经医学影像学确诊和手术病理证实的547例垂体腺瘤(内有251例微腺瘤)延迟诊断原因的分析,找到影响垂体腺瘤早期诊断的因素。结果:296例垂体大腺瘤蝶鞍X线平片、CT、MR常规检查即可诊断。CT骨窗蝶鞍片有助于垂体微腺瘤的诊断,251例微腺瘤经高分辨力CT薄层冠状强化扫描和高场强MR薄层强化扫描得以明确诊断。结论:熟悉垂体腺瘤的首发症状,及时行CT、MR常规扫描可明确大腺瘤的诊断,CT骨窗片可发现垂体微腺瘤的佐证。高场强MR薄层强化扫描是目前诊断垂体微腺瘤的最佳方法,高分辨力CT冠状薄层强化扫描次之,结合神经内分泌学检查是提高垂体腺瘤影像学早期诊断率的主要措施。     

Focal vulnerability of developing brain: CT studies on disproportionally dilated lateral ventricles

Summary Cranial computed tomography (CT) of 108 cases with dilated lateral ventricles was reviewed to elucidate the relationship between focal vulnerability of developing brain and disproportional dilatation of lateral ventricles. CT findings of 108 cases with symmetrical dilatation of lateral ventricles were classified into three types by morphometry of lateral ventricles: anterior horn predominant type (31 cases), diffuse type (36 cases), posterior horn predominant type (41 cases). Posterior horn predominant type has a tendency to occur in congenital anomalies and premature brain damage, and anterior horn predominant type in infantile brain damage. This disproportional dilatation of anterior or posterior horns suggests a vulnerability of periventricular structure in developing brain.     

The relationship between jaw deformity and scoliosis

Objectives To analyze the relationship between lateral displacement of the mandible and scoliosis. Methods From April 2002 through July 2003, we examined posteroanterior cephalometric radiographs and chest X-rays from 85 patients with jaw deformities and a control group of 20 patients with no jaw deformities. To measure the lateral shift of the mandible, we drew a horizontal baseline (X axis) on the cephalogram connecting the intersection of the external margins of the orbits and the most lateral points of the greater wings of the sphenoid. A vertical baseline (Y axis) was then marked perpendicular to the X axis, intersecting the ethmoid crista galli. Then, we measured the lateral displacement of the mandibular mentum from the Y axis. Displacement to the right was designated positive; that to the left was designated negative. Cobb's method was used to measure scoliosis curves on chest X-rays; the direction of the curve was designated similarly. Results Of the 85 patients with jaw deformity, 23 (27.1%) had a Cobb angle exceeding 10°. None of the control group had scoliosis exceeding 10°. No correlation was found between the direction of mandibular displacement and the direction of scoliosis. Conclusion This study suggests a relationship between jaw deformities and scoliosis, as scoliosis was found in 27.1% of the patients with a main complaint of jaw deformity.     

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.