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Objective:To evaluate the diagnostic value of relative lesion length in differentiating extrahepatic bile duct infiltrating cholangiocarcinoma with inflammation.Methods:From October 2014 to February 2018, 24 cases of infiltrating extrahepatic cholangiocarcinomas confirmed operatively and pathologically and 23 cases of extrahepatic bile duct inflammation confirmed clinically from the Third People′s Hospital of Datong City were respectively enrolled in this study. Upper abdomen MR and/or CT image data of all patients were respectively reviewed. The extrahepatic duct wall was defined as wall thickening with obvious enhancement. The length of the lesion was measured. L lesion/L duct was referred as the ratio of the lengths of lesion to extrahepatic bile duct (common hepatic duct+common bile duct)was calculated. The difference in the average values of L lesion/L ductbetween the cholangiocarcinomas group and inflammation group was analyzed with t test, and the differential diagnostic efficacy of L lesion/L ductratio was analyzed with receiver operating characteristic curve (ROC) test. Results:Significant difference was found in the length of lesion between the extrahepatic cholangiocarcinoma group [(22.01±1.86) mm] and the cholangitis group [(47.36±2.81) mm] ( P<0.01). The average ratio of L lesion/L ductwere 0.26±0.02 for the cholangiocarcinomas group and 0.54±0.03 for the inflammation group, respectively ( P<0.01). The area under the ROC curve of L lesion/L duct in diagnosis of the infiltrating extrahepatic cholangiocarcinomas was 0.92. With <0.40 as cut-off point, the diagnostic sensitivity and specificity were 87.5% and 82.6%, respectively. Conclusion:The L lesion/L ductmight be taken as an important diagnostic sign in differentiation between infiltrating extrahepatic cholangiocarcinomas and extrahepatic bile duct inflammation.
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Objective To explore the correlation between ostiomeatal complex(OMC)variation, nasal septum deviation and nasosinusitis with CT imaging.Methods The clinical and imaging data of 256 patients undergoing nasal and paranasal CT examination from June 1, 2015 to May 30, 2016 were retrospectively analyzed. Patients with paranasal sinus fractures, tumors and artifacts were not included in this study.Taking the image of standard coronal MPR built with thin axial sections at the level of middle of semilunar fissure as observing image,and the direction,location and extent of OMC variations were observed and recorded. The patients were divided into two groups according to the presence or absence of nasal septum deviation.OMC mutation,the incidence of unilateral mutation,incidence of paranasal sinusitis and the incidence of unilateral bilateral nasal sinusitis between the two groups was analyzed by χ2test with two independent samples. Then according to the presence or absence of OMC mutation, the patients were divided into two groups.The incidence of paranasal sinusitis and bilateral paranasal sinusitis were compared between the two groups. Results Two hundred and fifty six cases of CT imging of parannasal sinus were included in the study,96 cases were with nasal septum deviation, 160 were with non-deviation of nasal septum. The incidence rate of OMC variation between the two groups showed significant difference(χ2=38.40,P<0.05).The incidence rate of unilateral and bilateral OMC variation showed significant difference(χ2=13.70,P<0.05),among which 54 were unilateral variations,50(92.6%)variations were located at the same side of nasal deviation(side of the nasal cavity widened).The incidence rate of sinusitis between the two groups showed non-significant difference(χ2=0.50,P>0.05).The incidence rate between unilateral and bilateral nasosinusitis showed non-significant difference(χ2=2.25,P>0.05).Of the 256 cases,128 were with OMC variations,and 128 were with non-OMC variation.The incidence rate of nasosinusitis between the two groups showed non-significant difference(χ2=0.56,P>0.05). The incidence rate between unilateral and bilateral nasosinusitis showed non-significant difference(χ2=3.57,P>0.05). Conclusion Ipsilateral OMC variation occurred in nasal septum deviation might be a compensation to nasal cavity widening while not a obstructive factor in causing nasosinusitis.
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Objective To investigate the value of morphological features in differentiating between tuberculous hydronephrosis and non-tuberculous obstructive hydronephrosis.Methods The abdominal enhanced-CT examination data of 33 patients with renal tuberculosis and 37 patients with non-tuberculous obstructive hydronephrosis were retrospectively collected.All patients were examined in Peking University First Hospital from September 2009 to November 2016 and confirmed by surgical pathology or clinical manifestation.The longest diameter and largest area of all dilated calices,the anteroposterior longest diameter and the area of renal pelvis at the renal hilum level were measured.The standard deviation of dilated calyx's longest diameter and largest area in each case,the ratio of the mean value of dilated calyx's longest diameter to the anteroposterior longest diameter of renal pelvis and the ratio of the mean value of dilated calyx's largest area to the area of renal pelvis were calculated.These data were compared between the two groups with the t test.Based on the ratio of dilated calyx's longest diameter and largest area to those of renal pelvis,receiver operating characteristic (ROC) curves were used to calculate cut-off values for diagnosis of tuberculous hydronephrosis.Results The standard deviation of dilated calyx's longest diameter and largest area were significantly different in the renal tuberculosis group and the non-tuberculosis group (P＜0.01).The ratio of dilated calyx's longest diameter and largest area to those of renal pelvis of tuberculosis group were significantly larger than those of non-tuberculous group (P＜0.01).ROC analysis of the ratio of dilated calyx's longest diameter to that of renal pelvis showed that the area under the curve was 0.87 (95％ confidence interval 0.77-0.94),the best cut-off point was 0.73,with 81.8％ sensitivity (27/33) and 81.1％ specificity (30/37).ROC analysis of the ratio of dilated calyx's largest area to that of renal pelvis,the area under the curve was 0.90 (95％ confidence interval 0.80-0.95),the best cut-off point was 0.42,with 81.8％ sensitivity (27/33) and 86.5％ specificity (30/37).Conclusions In tuberculous hydronephrosis,the dilatation of calices is more obvious than renal pelvis,and the size of dilated renal calices is remarkably different.In non-tuberculous obstructive hydronephrosis,the dilatation of renal pelvis is more obvious than calices,and the size of dilated renal calices is similar.The morphological differences are helpful in differentiating tuberculous and non-tuberculous hydronephrosis.
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Objective To determine the diagnostic value and necessity of excretory phase of CT urogrphy (CTU). Methods One hundred and one cases with 197 sides of cohort CTU studies were enrolled from PACS system retrospectively, and 44 cases had the records of radiation dosage. Three different seniority senior radiologists reviewed the images and diagnosed 2 times blindly with the clinical information. At the first time, plane scan, contrast enhanced renal cortical phase and renal parenchymal phase images (Diag. A) were reviewed. At the second time, with 3 kinds of images mentioned above plus excretive phase images (Diag. B) were reviewed, with interval of 3 months between the two reviews. With Diag. B as reference standard, accordance rate of diagnoses of Diag. A was calculated. The difference of the 3 rediologists's accordance rates were analyzed with Chi-square test, and the lesions with accordance rate ≤80% were recorded. The cases of 197 urinary tracts were divided into 4 groups: lesions of renal pelvic and ureter, lesions of bladder, lesions of kidney and extra-urinary tract, without lesion. The filling of contrast media in the urinary tract was recorded with 5-scale scoring system. The differences of the urinary tract filling among the 4 groups were analyzed with Kruskal-Wallis test. The effective radiation dosages of CTU with and without excretory phase scan were recorded and calculated, and the difference was analyzed with t test. Result The diagnostic accordance rate of CTU with and without excretory phase of the 3 radiologists was 95.4%(188/197), 93.9%(185/197), 92.4%(182/197)respectively(χ2=1.60, P>0.05). Lesions with diagnostic rate≤80%were parapelvic cyst and caliceal diverticulum. The median score of urinary tracts filling in the lesions of renal pelvic and ureter, lesions of bladder, lesions of kidney and extra-urinary tract, without lesion group were 2, 3, 3, 4, and the differences were significant (HC=31.7, P<0.05). The effective radiation dosages of CTU with and without excretory phase scan were (32.36±11.04)mSv and (41.47±14.27) mSv respectively (t=3.35, P<0.01). Conclusions No significant effect of excretive phase imaging is found on the diagnosis of most urinary system diseases. Poor contrast filling and high rate of failure of filling of the urinary tract with intra luminal pathologies, and increase of the radiation dosage make the excretory phase scan in CTU less useful and it should be used carefully and selectively.
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Objective To evaluate the rules and features of the pseudoenhancement phenomenon of renal cysts during the multi-phases of contrast enhanced MSCT scan.Methods Ninety one patients with 112 simple renal cysts with B-ultrasound,CT examination,improved clinically enrolled in this retrospective study.The attenuation of the renal cysts were measured blindly in the images of CT plain scan and scans of arterial,venal and secrete phases,and the attenuation change of the cysts between pre-and post-enhanced scans were calculated; the accuracies of pseudoenhancement judging were calculated with 10 HU,15 HU and 18 HU as a threshold;the size were recorded; degree of intra renal parenchyma of the cyst were also confirmed,and so renal cysts were divided into three groups:type Ⅰ,Ⅱ and Ⅲ; The differences of attenuation among 3 enhancement phases,different size,different type were analyzed statistically with the Kruskal-wallis rank sum test,the correlation between the diameter and the pseudoenhancement in each enhancement phases were analyzed statistically with Spearman test.Results The attenuation median of the 112 cysts in plain scan,arterial,venal and secrete phase was 6.0 HU,11.0 HU,12.0 HU and 12.0 HU respectively,there was significant difference(x2=53.32,P＜0.01).The attenuation of the cysts in enhanced phases was higher than unenhanced.The range of attenuation change of the cysts between pre-and postenhanced scans was-10 to 31 HU,the number of cysts in groups of pseudoenhancement of 1 to 5 HU and 6 to 10 HU in each enhanced phase was dominant.The pseudoenhancement median of arterial,venal and secrete phase was 4.0 HU,5.0 HU and 6.0 HU respectively,There was significant difference among three groups(x2=10.062,P＜0.01).Taking 10 HU,15 HU and 18 HU as threshold for judging pseudoenhancement,the accuracy was 83.0％(239/288),95.1％(274/288) and 96.9％(279/288) respectively; Pseudoenhancement of small cysts(≤10 mm) was higher than other groups in each enhancement phase,and there was significant difference(P＜0.05).Type Ⅰ,Ⅱ and Ⅲ renal cysts were 62,23 and 27 respectively,the pseudoenhancement median of type Ⅰ renal cyst was 5.0 HU,6.0 HU and 8.0 HU respectively in arterial,venous,and excretion phase,which were higher than Type Ⅱ and Ⅲ (P＜0.05).It showed low negative correlation between pseudoenhancemen and diameter in arterial,venous and secrete phase(r =-0.326,-0.332 and-0.447,P＜ 0.01).Conclusion The pseudoenhancement correlated with the renal cyst size,the type and the enhance phases,which should be considered when making diagnosis.
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ObjectiveTo derive and evaluate the formula of exactly calculating the contrast dosage used during pulmonary CT angiography ( CTPA ). Methods Time density curves in 27 patients who underwent CTPA were collected and analyzed,the formula for calculating contrast dosage during CTPA was derived.68 patients suspected of pulmonary embolism ( PE ) clinically but no PE on CTPA were divided randomly into group A,with bolus tracing technique ( n =26 ),and group B,with small dose injection contrast test (SDCT) (n =42).The CT values of the right main pulmonary artery (RMPA),right upper pulmonary vein ( RUPV),right posterior basal PA,right lower PV (RLPV) and the aorta were calculated.The total contrast dosage and the hard beam artifact in the SVC were compared between the two groups.Student's t test,Chi-square test and Mann-Whitney U test were used.ResultsThe ratio of the time from starting injection to enhancement peak of caudal end of SVC and the time to enhancement peak of the main pulmonary trunk was 0.65 ±0.09 (about 2/3),the formula for contrast dosage calculation was derived as (DTs/3 + STs/2) FR ml/s.The CT values of RMPA and RLPA between the two groups[ (301 ±117),(329 ± 122) and (283 ±95),(277 ±98) HU respectively] were not significantly different (t =1.060,P =0.292 ;t =2.056,P =0.044),but the differences of CT values in the paired PA and PV between the two groups (median were 22.5,58.0 and 170.5,166.5 HU respectively ) were significant (U =292,P =0.001 and U =325,P =0.005),contrast artifact of the SVC (grade 1-3) in group B ( n =34,7,1 respectively) was significantly less than in group A (n =11,10,5 respectively,x2 =10.714,P =0.002),the contrast dosage injected in group A was ( 87.6 ± 7.3 ) ml,and in group B was ( 40.0 ±5.4) ml (P ＜0.01 ).ConclusionCTPA with SDCT technique is superior to that with conventional bolus tracing technique regarding contrast dosage and contrast artifact in the SVC.
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Objective To determine and evaluate the method of localization of anal verge by mutislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the 5th sacral vertebra (Lb), the inferior aperture of minor pelvis(Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the midsagittal images obtained by MPR. The averages, the standard deviations(s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ± 1.96 s or ± 1.28 s ＜ 5 mm as the standard of meeting the clinical requirement. The distances meeting the clinical requirement between different sex groups or age groups were compared with t test. Results The Ld was (9.8 ± 1.2) mm, ofwhich intervals of ± 1.96 s and ± 1.28 s were 4. 8 mm and 3.0 mm respectively, meeting the clinical need.This distance was also measured conveniently. There were no significant differences ( P ＞ 0.05 ) between two different sex groups [ male group, ( 10.0 ± 1.2) mm], female group, (9.6 ± 1.2) mm and between two age groups [ young group, (9.6 ± 1.2) mm, elderly group, ( 9.9 ± 1.3 ) mm ]. Conclusions The lower margin of the basement of external anal sphincter was a useful anatomic lanmark for localizing the anal verge,and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge.
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Objective To study the relationship between the enhancement of renal cortex and medulla during the conventional CT scans with and without contrast enhancement and the renal glornerular filtration rate (GFR). Methods Thirty five cases with unilateral posternal obstructive hydronephrosis According to GFR, the 70 kidneys were divided into 4 groups: normal, slightly impaired, moderately impaired and severely impaired. In the cortical phase of enhanced CT scan, the enhancing intensity of the renal cortex and medullar was measured and following measures were calculated: CTce - CTcp, CTmc -CTmp,ratio of enhancement of affected and unaffected renal cortex and medullar, and the ratio of those of each case: CTac/CTnc, CTam/CTum, CTac/CTam, CTnc/CTnm, (CTac/CTam) / (CTuc/CTum). The differences of these measures in different groups were analyzed with one-way ANOVA and their correlation with GFR was studied with Pearson test. The best indicator to reflect enhancement of renal cortex was selected from these measures, and all the kidneys were divided into 4 groups accordingly: strong, less strong, medium and weak. Then its consistency with GFR groups were calculated. Result (1) The differences of CTce - CTcp ( 154. 98 ± 28. 70 ), ( 122.67 ± 39. 32 ), ( 81.30 ± 32.94 ) and ( 57.60 ±23.49) HU respectively, CTac/CTuc 0. 97 ±0. 09, 0. 79 ±0. 18, 0. 64 ±0. 24 and 0. 51 ±0. 13 respectively,CTam/CTum 0. 98 ±0. 26, 0. 89 ±0. 18, 0. 86 ±0. 31 and 0. 75 ±0. 28 respectively, CTam/CTum 2. 76 ±0. 35,2. 35 ± 0. 79, 1. 83 ± 0. 68 and 1.73 ± 0. 28 respectively, CTac/CTam and ( CTac/CTam)/( CTuc/CTum) 1.00 ±0. 28,0. 89 ±0. 34, 0. 75 ±0. 17 and 0. 69 ±0. 14 respectively of different GFR groups were evident( P < 0. 05 ) . ( 2 ) Positive correlation was found between GFR and CTce-CTcp ( r = 0. 887, P <0. 01 ), CTac/CTuc ( r = 0. 872, P < 0. 01 ), CTam/CTum ( r = 0. 504, P < 0. 01 ), CTac/CTam ( r =0. 772, P < 0. 01 ), (CTac/CTam) / (CTuc/CTum) ( r = 0. 663, P < 0. 01 ). ( 3 ) Selecting CTac/CTam to reflect enhancement of renal cortex, the diseased kidneys can be divided into groups of strong ( CTac/CTam ≥2. 60); less strong (2. 20 ≤CTac/CTam <2. 60); medium ( 1.80 ≤CTac/CTam <2. 20); and weak ( CTac/CTam < 1. 80). The consistency with GFR grouping was 80. 0%. Conclusions There is significant correlation between renal cortex-related indicators and GFR, especially CTac/CTam, which can be used as the indicator of renal function in patients with unilateral or bilateral postrenal obstructive hydronephrosis. The conventional contrast enhanced CT scan can be taken as a semi-quantitative method of GFR measuring with relative low X-ray dosage compared with CT perfusion.
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Objective To observe and measure the anatomical structure of approach of vertical facial nerve canal and put forward the normal measurement range and the location relationship among the vertical segment of facial nerve canal, the posterior wall of external acoustic meatus and the rear edge of external ear,and discuss the relationship and clinical significance between the mastoid gasification and the vertical segment of facial nerve canal. Methods 1. Evaluate the accuracy of CT image of related structure, using spiral CT in scanning four skull specimens, get the horizontal distances of the vertical segment of facial nerve canal to the posterior wall of external acoustic meatus and the rear edge of external in the axial position, and get the sagittal diameter of mastoid (the horizontal distance from the lowest point of external auditory inferior canal to the rear edge of mastoid) and the height (the vertical distance between the lowest points of the external auditory canal wall to the mastoid tip) in the sagittal position. And then saw the skull specimens to measure the distance in the same lay with CT image, and discuss the statistics difference of the distance between the values of CT imaging measurements and the dry entities cranial measurements on hand. 2. Study on people: 118 patients (236 sides) with non-ear disorders were randomly selected, among which there were 63 females (126 sides) and 55 males (110 sides). They were subjected to maxillofacial CT scan in the same layer that used above, and the horizontal distances of the facial nerve canal to the posterior wall of external acoustic meatus and the rear edge of external ear were measured. In addition, half of the product of diameter and height of the mastoid was defined as mastoid area, which was used to define the extension of mastoid gasification. Then related analysis and regression analysis were done between the vertical segment of facial nerve canal and the posterior wall of external acoustic meatus, as well as the rear edge of external ear. Results 1.Part of the experiment: There was no significantly different on the indicator values between CT image the entity measurements among the four skull specimens (P>0.05). 2. Study on people: There was no significantly different between left side and right side(P>0.05), but significantly different between genders(P<0.05). Between mastoid area and the distance from the vertical segment of facial nerve canal to the posterior wall of external acoustic meatus there is inverse correlation, and the relevance has the remarkable significance. However, there was no correlation between mastoid area and the vertical segment of facial nerve canal to the rear edge of external ear. Conclusion There was some relationship between the location of the vertical segment of facial nerve canal and external acoustic meatus. Anatomic position of vertical facial nerve cancal and the posterior wall of external acoustic meatus can be showed clearly. CT and in combination with primitive axial images may provide reliable evidence for the diagnosis facial nerve dieases and the choice of ear surgery route.
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Objective To evaluate the usefulness of extrapleural locating method in CT-guidod transthoracic pulmonary biopsy to prevent or reduce the size of peumothorax.Methods One hundred and fifteen cases of CT-gnided transthoracic pulmonary biopsy with the pulmonary lesions not in direct contact with the pleura were selected.Of 115 cases,46 were performed with extrapleural locating method (EPL) and 69 cases with lesion edge locating method (LEL).Taking the maximum distance between the partial and visceral pleura (MPVD) measured on the CT image after the procedure as the index of the volume of pneumothorax.The incidence and volume of pneumothorax of both groups were compared and statistically analysed with R ×C Chi-Square test.The retention time of the biopsy needle in the lung parenchyma of the two group was documented and the average time was calculated in each group.Results The incidence of pneumothorax was 45.7% (21/46),median 0.4 cm with EPL group,and 66.7% (46/69) and median 0.3cm with LEL group.When the distance between the lesion and pleura was equal or smaller than 2 cm (≤2cm),the incidence of pneumothorax was 39.4% (13/33) with EPL group and 73.2% (30/41) with LEL group,and the difference of incidence and volume of the pneumothorax between two groups was statistically signifieant(X2 =9.981,P =0.019).When the distance was larger than 2 cm( >2 cm),the incidence and volume of pneumothorax between two groups were not significant statistically.The average retention time of the biopsy needle in the lung parenchyma was (7.2±1.8)s with EPL group and (58.3±11.6) s with LEL group.Conclusion The extrapleural locating method can reduce effectively the retention time of the biopsy needle in the lung parenchyma and the incidence and volume of pneumothorax in CT-gnided transthoracic pulmonary biopsy.
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<p><b>OBJECTIVE</b>To investigate an available method for quantitative diagnosis of zygomatic fractures to quantitatively classify and diagnose the deformities of zygomatic fractures.</p><p><b>METHODS</b>Traditional X-ray, two and three dimensional CT images of 96 patients with zygomatic fractures were measured and analysed by computer-assisted measuring system before and after operation to diagnose the displacement and deformity of the fractures.</p><p><b>RESULTS</b>1. Using anthropology points and computer assisted measuring system, a new method was established to assess the displacement of the zygomatic fractures. 2. Displacement of the zygomatic fractures was approximately diagnosed by measuring different angle of 3D CT photographs. 3. A classification was proposed based on the deformities of the zygomatic fractures.</p><p><b>CONCLUSIONS</b>Computer-assisted 3D CT measuring system is accurate, reliable and feasible in clinic for diagnosing zygomatic fractures.</p>
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Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Reproducibility of Results , Sensitivity and Specificity , Tomography, X-Ray Computed , Methods , Zygomatic Fractures , DiagnosisABSTRACT
Objective To study the CT manifestations of delayed traumatic hematomas of the brain and evaluate their diagnostic significance in predicting the delayed traumatic brain hematoma. Methods The manifestations of initial CT studies and follow-up CT examinations of 31 delayed traumatic brain hematomas were analyzed. Another 50 CT studies of head trauma without delayed brain hematomas were included randomly as control. Results The abnormal findings of CT studies of the 31 delayed traumatic brain hematomas included: (1)Decreased density of the local brain parenchyma and disappeared difference between gray and white matter of the same area in 18 cases; (2)Local subarachnoid space hemorrhage in 24 cases; (3)Slight mass effect of local brain parenchyma in 16 cases. (4)Subdural hematoma in 9 cases. The locations of the abnormalities were roughly the same with the delayed hematoma except one local subarachnoid space hemorrhage, which was in the opposite of the delayed hematoma. The appearing rate of those abnormal findings in the control group was low and the difference was statistically significant. Conclusion The decrease of density of local brain parenchyma, the disappeared difference between the gray and white matter, local subarachnoid space hemorrhage, and local swollen of brain presented in the initial CT study of the patient with head trauma should be taken as indicators of delayed hemorrhage of the same area of brain, and it is necessary to do follow-up CT studies to exclude it.
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Objective To study the relationship between the renal cortical thickness and age,and to establish the range of the normal renal cortex thickness by using CT measurement in different age groups so as to obtain a best age-related and practicable method for clinical measurement. Methods (1) the accuracy of measuring renal cortical thickness by CT was evaluated; 18 kidneys resected due to renal neoplasm were studied and the cortical thickness of the normal part of these specimens was assessed. The difference between the renal cortical thickness of specimens and preoperative measurements of renal cortex of the same patient by contrast enhanced CT was analyzed statistically. (2) 120 patients without history of renal disease or long term usage of potentially renal toxic drugs or history of hypertention were examined by CT with indication(s) other than renal disease. All the patients were divided into 20-40, 41-60, and 61-80 year-old groups. The renal cortical and parenchymal thickness and renal size were measured in three CT sections. The difference of the measurements among the three groups and their relationship to age was analyzed statistically. Results There was no significant difference between the renal cortical thickness measured by enhanced spiral CT and measured in renal specimens(t =0. 80,P =0. 43). The renal cortical thickness in three groups was 0. 73 cm, 0. 65 cm, and 0. 53 cm, respectively, and the differences among the three groups were significant ( F = 93.430, P 0. 05). Conclusion The measurement of the renal cortical thickness with enhanced spiral CT was reliable and was a sensitive method in investigating the morphologic changes of the kidney. The renal cortical thickness of normal kidney diminishes with age, but the change of the ratio of thickness of renal cortex to renal parenchyma with age was not significant.
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0.70). The detection rate of 5 mm nodules declined when large pitch was used. Conclusion The detection rates of 10 mm and 5 mm nodules had no difference between low-dose CT and conventional-dose CT. As the pitch augmented, the detection rate for the nodules declined.
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Objective To investigate CT value in diagnosing hypopharyngeal and laryngeal disease.Methods The clinical data and CT images of 76 patients with hypopharyngeal and laryngeal tumors and tumor-like lesions were retrospectively reviewed.There were malignant lesions in 66 cases and benign lesions in 10 cases.CT findings in these patients were evaluated and correlated with surgical and pathologic findings.First,we used a CT features were qualitatively analysed using logistic regression model for predicting the lesion to be malignant or benign.Then,two experienced radiologists who were unknown the results of final diagnosis of these patients,retrospectively analyzed all CT images and made their diagnosis.Finally,CT images of 10 benign and 10 randomly selected malignant patients were reviewed by the other two experienced radiologists,who known the component ratio of the cases and unknown the final results.Interobserver agreement of the two reviewers was assessed by calculation of Kappa value for their diagnosis.Results The logistic regression model revealed that the location of lesion and the surrounding structure infiltrated by the tumor were the only significant factors for predicting the malignancy.Of the two factors,the surrounding structure infiltrated by the tumor had the accuracy of 55% with sensitivity 53% and specificity 80%.When most of the cases were malignant(66/76),there was a moderate interobserver agreement for the two radiologists in diagnosis of the diseases.When the malignant and benign cases were equal,there was a poor interobserver agreement(Kappa=0.20) for the two reviewers,and the diagnostic accuracy was slightly higher than the rate by random selection.Conclusion It is difficult to use the CT features in qualifying the hypopharyngeal and laryngeal diseases.
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Objective To study the relationship between MRI and clinical profiles of periventricular leukomalacia (PVL) in children Methods The clinical and MRI findings in 34 cases with PVL were retrospectively analyzed Results (1) Periventricular hyperintensity on T 2WI was more prominent in the preterm group than that in the term group, and P value was 0 000; (2) Cortical lesion and subcortical leukomalacia was seen in 9 of 19 cases in the children with PVL born at term, but detected in only 1/15 in the preterm group P value was 0 020; (3)Seizure was common in term children P value was 0 036; (4) The degree of reduction of periventricular white matter correlated with motor impairment and mental retardation in all children, and P values were 0 002 and 0 000, respectively The thinning of the corpus callosum also correlated with mental retardation and P value was 0 012 The degree of reduction of periventricular white matter correlated with visual impairment in preterm group Conclusion The end stage PVL can been clearly displayed by MRI, and gestational age and clinical manifestation were closely related to the findings of MRI
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Objective To investigate enhanced CT scanning in differentiation of solitary pulmonary nodule and relationship between the degree and pattern of enhancement and vascularity. Methods 11 patients with surgically confirmed pulmonary carcinoma and 13 patients with inflammatory nodules and 6 patients with tuberculoma were studied with plain chest CT sean and enhanced scanning after injection of 100 ml iodinated contrast medium to observe the enhancement degree and pattern of the lesion before the surgery. Vaseularity of specimens of 11 carcinoma and 13 inflammatory nodules and 6 tuberculoma were examined pathologically and correlated with degree of enhancement. Results The pulmonary carcinoma and inflammatory nodules showed a significantly higher degree of enhancement than tuberculoma. But the carcinoma and the inflammation showed no differences in degree and pattern of enhancement. The degree of enhancement was positively correlated with the number of blood vessles. The vascularity of carcinoma and inflammation was far richer than that of tuberculoma. Conclusion The results suggested that the enhanced CT scanning are distinctively different between carcinoma and tuberculoma,whereas little different between carcinoma and inflammation. Vascularity of the lesion plays an important role in the manifestation of enhancement.
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Objective To summarize the cl inical characteristics and imaging features of psittacosis. Methods The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed . Results The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dis sociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of ne utrophils might be increased. The chest X-ray and CT scan showed air-space co nsolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were a lso present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittac i. Erythromycin was effective in all 3 patients. Conclusion Although the appearance of psittacosis on clinical findings and chest X-r ay and CT scan is not characteristic, psittacosis can be diagnosed with the comb ination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging f eatures of psittacosis is helpful in differential diagnosis.
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Objective To evaluate the accuracy of 16-detector row computed tomography coronary angiography in detection of hemodynamically relevant stenosis(≥50%) of the coronary artery. Methods Twenty-six patients undergoing both multi-detector row CT and conventional coronary angiography were included in this retrospective study. CT scan were obtained with collimation of 16 and rotation time of 500 ms. Retrospective electrocardiographic(ECG) gating was used for image reconstrution. The stenosis degree was detected with axial scanning and three-dimensional reformation. Results With the results of conventional coronary angiography as golden standard, the sensitivity, specificity, accuracy, positive predicted value and negative predicted value of the CT angiography in detection of hemodynamically relevant stenosis(≥50%) were 90.0%, 95.5%, 94.7%, 77.6%, and 98.2% respectively. Conclusion Sixteen-detector row computed tomography coronary angiography has high clinical value with evaluating hemodynamically relevant stenosis(≥50%) of coronary artery,and could be a significant guide for diagnosis and therapy of coronary heart disease.
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0.5). Conclusion To some extent, the cup sign and split sign on CT reflect the biologic character of AMLs, and the signs are helpful in making the specific diagnosis of AML combined with other imaging manifestations.