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肢静脉深静脉血栓(DVT)常见疾病,以往影像学诊断依靠超声及下肢静脉造影。多层螺旋CT的应用,为其诊断提供了新的影像学诊断方法。本文通过对21例DVT患者的CT下肢静脉成像,进行CT扫描技术的探讨,以得出最佳的成像技术。 相似文献
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目的探讨膀胱副神经节瘤的CT诊断价值。方法回顾性分析我院2005年4月~2012年6月经手术病理证实为膀胱副神经节瘤6例患者的CT资料。所有患者均行CT增强扫描及三维后处理重建。重建方法包括MPR、VR及MIP等。以手术结果为标准,分析CT检查显示膀胱副神经节瘤的准确性。结果 6例患者中,5例病变呈均匀或不均匀明显强化,1例呈中度强化。1例发生盆腔淋巴结转移。CT检查在病变位置、大小、形态、供血动脉及周围淋巴结转移的显示上与手术结果一致。结论 CT增强扫描及三维重建在膀胱副神经节瘤的诊断中有重要价值,可用于临床手术计划的制定。 相似文献
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目的:探讨门静脉瘤的影像学表现、发病机制以及各种影像学检查方法在该病诊断中的价值.方法:对经CT确诊的5例门静脉瘤的病例资料进行回顾性分析,比较CT、MR和超声检查对本病的诊断价值.结果:门静脉瘤的主要影像学表现是门静脉主干或其分支的局限性扩张,好发部位为血管交汇处,可伴有其它血管畸形.5例中肝内型3例、肝外型2例.2例合并有肝硬化,其中1例伴有门静脉高压和肝动脉-门静脉瘘,另1例伴有原发性肝癌(HCC);3例无肝硬化征象者,1例伴有门静脉双干畸形,1例伴有脾肿大但无肝硬化门静脉高压表现,1例未发现其它伴发病变.结论:超声、CT和MRI均可对本病做出定位、定性诊断,MSCTA能提供更为直观地三维图像,因而具有更重要的诊断价值. 相似文献
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目的 通过对局部晚期和区域复发性乳腺癌患者区域淋巴结累及范围的分析,探讨常规区域淋巴结放疗技术对淋巴引流区照射的合理性,并为合理的靶区勾画原则提供临床证据.方法 搜集2003-2009年本院收治的影像和临床资料完整的局部晚期和局部-区域复发性乳腺癌患者111例胸部CT片.将淋巴结引流区分为以下亚结构:锁骨上内侧组(SC-M)、锁骨上外侧组(SC-L)、第Ⅰ站腋窝淋巴结(ALN-Ⅰ)、第Ⅱ站腋窝淋巴结(ALN-Ⅱ)、第Ⅲ站腋窝淋巴结(ALN-Ⅲ)、锁骨下淋巴结(IFN),肌间淋巴结(RN)、内乳淋巴结(IMN).统计各亚结构累及淋巴结频率及解剖特征.结果 共111例患者199处亚结构进入分析,其中SC-M 33处,SC-L 21处,ALN-Ⅰ 30处,ALN-Ⅱ25处,ALN-Ⅲ和IFN 35处,RN 27处,IMN 28处.锁骨上及腋窝是累及频率最高区域,达72.3%.SC中心平均深度分别为内侧组33.48 mm(>3 cm者51.5%),外侧组45.62 mm(>3 cm者71.4%).局部晚期患者和术后患者淋巴结在腋静脉头侧与脚侧比分别为5:20和64:28.IMN除2处外余26处均位于1~3肋间.复发IMN中心距表皮和体中线平均距离分别为24.23 mm和29.38 mm,与内乳血管横向距离为6.19 mm,纵向距离为5.73 mm.结论 区域淋巴结个体差异变化较大,传统固定野照射技术无法达到合理的剂量覆盖,建议采用CT定位为基础的三维适形计划优化.Abstract: Objective The frequency and the anatomic distribution of involved regional nodes in recurrent and locally advanced breast cancer were analyzed, in order to evaluate the rational of conventional regional node radiation technique and provide evidence for target definition of breast cancer . Methods Patients with recurrent or locally advanced breast cancer who were treated in our hospital from August 2003 to December 2009 were included in this study. 111 patients had contrast enhanced chest CT images of the whole regional nodes before treatment. The regional nodes were categorized into 8 anatomical substructures including medial and lateral supraclavicular nodes ( SC-M, SC-L), axilla nodes ( ALN )- Ⅰ , Ⅱ , Ⅲ,infraclavicular nodes (IFN), Rotter's nodes (RN) and internal mammary nodes (IMN). The frequency of involvement and anatomical distribution of the involved nodes on CT images were analyzed. Results A total of 111 patients were enrolled this study and 199 anatomical substructures with involved nodes were identified. The frequency of involvement were :SC-M 33, SC-L 21, ALN- Ⅰ 30, ALN-Ⅱ 25, ALN-Ⅲ + IFN 35, RN 27, IMN 28. Supraclavicular region and axilla were the most frequently involved area (72. 3% ).The average depth of the SC-M and SC-L nodes was 33.48 mm ± 10. 57 mm and 45.62 mm ±20. 45 mm,and 51.5% and 71.4% of the SC-M and SC-L nodes were located more than 3 cm deep from the skin. The axilla nodes were located cranial and caudal to the axillary vein in 5 and 20 locally advanced breast cancer patients and in 64 and 28 patients who received prior axillary dissection. The majority of involved IMN was located within the first 3 intercostal spaces (26/28). The average distance between the center of involved IMN and chest skin was 24. 23 mm ± 10. 28 mm. The average distance between the center of involved IMN and midline of the body was 29. 38 mm ±6. 7 mm. The center of involved IMN was 6.19 mm ±5.73 mm lateral and 5.73 mm ± 4. 56 mm posterior to the internal mammary vessels. Conclusions Conventional field design is unlikely to provide sufficient dose to the entire risk region because of individual differences.Individualized treatment planning based on CT would become feasible with increasing knowledge of natural risk of nodal involvement. 相似文献
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1胃部炎症
理论上讲,多种胃炎可能引起胃黏膜及胃壁增厚。CT尽管有仿真内镜的应用,但实际上CT对胃腔内黏膜结构的显示显然不及胃镜和胃钡餐双重造影。然而CT对胃壁和壁外结构的显示却比后两种技术更有优势。故CT主要用于胃部肿瘤的分期等,而在胃炎性病变中的应用较少。尽管如此,CT对胃窦炎,肥厚性胃炎、结核等胃部炎性病变的诊断仍有一定的价值。 相似文献
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目的探讨CT血管成像术(CT angiography,CTA)在腘血管陷迫综合征(Popliteal vascular entrapment syn-drome,PVES)诊断及治疗中的应用价值。方法回顾性分析12例经手术证实的PVES患者的CTA资料,其中10例行DSA检查。以手术结果为标准,评价CTA检查在PVES诊断中的准确性。以DSA检查为标准,评价CTA在显示腘动脉走行及狭窄闭塞程度的准确性。结果 12例CTA图像均可清晰显示腘血管与周围组织之间的关系,明确分型,与手术结果一致。CTA横断面图像及三维重建图像能直观显示腘血管狭窄闭塞的位置、范围、程度,与DSA中立位检查一致。结论 CTA不但能够显示腘血管的形态,而且能清晰显示腘窝内腘血管与周围肌肉组织间的关系,在PVES的诊治中有重要的价值。 相似文献
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目的:比较乳腺 X 线摄影、超声及 MRI 对乳腺 MRI 非肿块强化(NME)病灶的诊断效能。方法回顾性分析116例(123个病灶)患者乳腺 MRI NME 病灶的乳腺 X 线摄影、超声及 MRI 的影像学表现。结果病理结果恶性99例,良性24例,乳腺X 线摄影、超声及 MRI 的敏感度分别为72.73%、65.66%、84.85%,特异度分别为66.67%、79.17%、79.17%,准确度分别为71.54%、68.29%、83.74%,阳性预测值分别为90.00%、92.86%、94.88%,阴性预测值分别为37.21%、35.85%、55.88%。MRI 对 NME 病灶的敏感度、特异度、准确度、阳性预测值及阴性预测值均明显高于乳腺 X 线摄影和超声(P <0.05)。且 MRI 与 MRI+乳腺 X 线摄影及 MRI+乳腺 X 线摄影+超声结果相近,差别无统计学意义。结论MRI 对于乳腺 NME 病灶有较高的诊断价值,应作为首选检查方法。 相似文献
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目的:探讨原发性乳腺弥漫性大B细胞淋巴瘤的MRI表现及其临床病理特征.方法:回顾性分析18例经组织病理学证实的原发性乳腺弥漫性大B细胞淋巴瘤的临床、MRI及病理学特征.结果:18例患者均为女性,平均年龄51岁.临床触及肿块18例,6例在短期内迅速增大.MRI检查共发现病灶25处,其中单发病灶13例,单侧多发病灶2例,双侧多发病灶3例.病灶在T1 WI上呈等或略低信号,T2 WI呈高或稍高信号.增强后呈肿块样强化19处(76.0%),其中形态呈椭圆形或不规则形16处(84.2%),内部均匀强化14处(73.7%);非肿块样强化6处,其中内部不均匀强化3处(50.0%);10处病灶内可见“血管造影征”.伴有皮肤增厚7例,同侧腋窝淋巴结肿大10例.病理学镜下表现为肿瘤性淋巴样细胞较大或中等大小,弥漫性分布,部分呈单行索条状排列.结论:原发性乳腺弥漫性大B细胞淋巴瘤的病理学基础决定了其MRI表现有一定特征性,MRI检查有助于本病的诊断及鉴别诊断. 相似文献