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Objective:To investigate the application value of dual-source CT urography with stellar photon detectors in the diagnosis of gout.Methods:Forty patients who were diagnosed with gout according to American College of Rheumatology Guideline for the Diagnosis of Gout and received treatment between April 2018 and May 2020 were included in the observation group. Forty patients who were concurrently diagnosed with osteoarthritis and received treatment in the same hospital were included in the control group. All patients underwent dual-source CT urography with stellar photon detectors and corresponding biochemical index detection. Blood levels of uric acid, urea nitrogen, creatinine, total cholesterol, and triglyceride were compared between the observation and control groups.Results:Blood levels of uric acid, creatinine, urea nitrogen, total cholesterol, and triglyceride in the observation group were (519.38 ± 97.91) μmol/L, (110.21 ± 18.29) μmol/L, (12.21 ± 3.29) mmol/L, (6.49 ± 1.22) mmol/L, (3.45 ± 1.89) mmol/L, respectively, which were significantly higher than those in the control group (310.45 ± 61.40) μmol/L, (86.22 ± 13.12) μmol/L, (6.82 ± 1.75) mmol/L, (4.75 ± 0.56) mmol/L, (1.98 ± 0.85) mmol/L, respectively ( t = 11.43, 6.741, 9.148, 8.198, 4.486, all P < 0.05). Dual-source CT urography with stellar photon detectors revealed that urate crystals (color coded as green) were detected in 3 and 36 patients from the control and observation groups, respectively, with the detection rate of 7.5% (3/40) and 90% (36/40), respectively. There was significant difference in urate crystal detection rate between the observation and control groups ( χ2 = 24.993, P < 0.05). In the control group, no obvious destruction of bone, tendon and ligament were observed, urate deposition, total volume of (1.023 ± 0.83) cm 3, was found in feet and knee joint of a small number of patients. In the observation group, there were 30 patients with uric acid crystals and bone destruction in the metatarsophalangeal joint ( n = 6), distal tibia ( n = 7), distal fibula ( n = 3), proximal talus ( n = 4), proximal calcaneus ( n = 6), and wrist joint ( n = 4). There were 20 patients with ligament or tendon damage, involving deltoid ligament ( n = 2), Achilles tendon ( n = 10), and extensor and flexor tendon ( n = 53). Total volume of uric acid crystals was (32.22 ± 5.83) cm 3. The volume of uric acid crystals deposited in the hand, elbow, feet and knee was (8.00 ± 4.92) cm 3, (5.32 ± 2.75) cm 3, (36.00 ± 15.54) cm 3, and (13.31 ± 9.14) cm 3, respectively. Conclusion:Dual-source CT urography with stellar photon detectors has a high sensitivity in the diagnosis of gout, can accurately locate and quantify uric acid crystals and is of high application value in the diagnosis of gout.
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A 56 years old female was admitted to our department with complaint of a painless cervical mass. Clinical feature:there was a painless mass above left lobe of thyroid gland, which was about 3.0 cm x 2.5 cm in size, and could move with swallowing action. B-mode ultrasound features: there was a solid mass in left lobe of thyroid gland, which was about 3.2 cm. Nodule was found in isthmus, accompanied with lymphadenovarix on the left neck possibly be MCA. fT3: 4.64 pmol/L, fT4:16.56 pmol/L,TSH:3.74 mIU/L, anti-TG:17.75 U/ml, anti-TPO:40.77 U/ml. Pathological result of the neoplasm: papillocarcinoma. Clinical diagnosis: papillary thyroid carcinoma.
Subject(s)
Female , Humans , Middle Aged , Carcinoma , Diagnosis , Pathology , Carcinoma, Papillary , Diagnosis , Pathology , Deglutition , Neck , Pathology , Parathyroid Glands , Pathology , Recurrent Laryngeal Nerve , Pathology , Thyroid Cancer, Papillary , Thyroid Neoplasms , Diagnosis , PathologyABSTRACT
Objective To study the diagnostic value of contrast-enhanced CT patterns in focal hepatic lesions.Methods Contrast-enhanced CT patterns in 44 patients with focal hepatic lesions (54 foci) were retrospectively analysed.Results (1)78% of the hepatocellular carcinoma presented "rapid-filling and rapid-washout" feature.(2)All hepatic hemangioma presented "rapid-filling and slow-washout", progressive opacification from the periphery to center. (3)All cholangiocarcinoma presented "slow-filling and slow-washout" .(4)Metastatic hepatocarcinoma in 14 cases and hepatic abscesses in 5 cases were presented a enhanced ring around the lesion, metastatic hepatocarcinomas showed single ring,however, hepatic abscesses showed multi-ring. (5)Focal nodular hyperplasia in 3 cases and hepatic adenomas in 1 case presented "rapid-filling and slow-washout".Conclusion The contrast-enhanced patterns at spiral CT can fully reflect the blood supply of focal hepatic lesions, it has significant value in diagnosing focal hepatic lesions.
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Objective To investigate the atypical appearances of small hepatocellular carcinoma(SHCC) with triple-phase spiral CT enhanced scan, and its correlation with the histopathology .Methods The atypical CT signs in triple-phase and histopathologic changes of SHCC confirmed pathologically in 30 cases (32 lesions) were analysed.Results 32 atypical lesions were found in 30 patients,of them,14 lesions were hypodense in hepatic arterial phase(HAP),portal venous phase(PVP) and delayed phase(DP).10 lesions enhanced markedly in the AP,while these lesions became isodense or slight hyperdense in the PVP and DP.8 lesions were enhanced as ring like or punctual shape in the AP,and constant enhancement in PVP and DP.Conclusion The atypical appearances are present in triple- phase spiral CT scan in SHCC,the pattern of blood supply and the base of histopathology are usually the cause of these findings .
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Objective To study the CT findings of late onset intracranial hemorrhage in vitamin K(Vit K) deficiency.Methods 56 cases of late onset intracranial hemorrhage in Vit K deficiency proved clinically were presented.There were 42 male and 14 female,age ranging 28～60 days.Brain CT scans were obtained in all 56 cases. Results Subarachnoid hemorrage(SAH) in 33 cases,subdural hemorrage(SDH) in 32 cases,intracerebral hemorrage(ICH) in 19 cases and inraventricular hemorrage(IVH) in 8 cases were found.The hemorragic amount was ranged 2～150 ml.Simple hemorrage was demonstrated in 26 cases,and multiple mixed hemorrage in 30 cases.The cerebral edema was displaied in 16 cases.Conclusion SAH,SDH and multiple mixed hemorrage are common seen in the late onset intracranial hemorrage in Vit K deficiency.
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Objective To investigate the features of the enhancement of SHCC at triple-phase spiral CT scanning and compare its sensitivity in different phase.Methods The pre- and post-contrast CT scanning of the entire liver in 70 patients with SHCC was carried out with a helical CT scanner. The contrast material was infused at a rate of 3ml/s, followed by sequential arterial-, portal- and equilibrium- phase scans of the liver. The number of the detected lesions was calculated in each phase, the characterization of lesions in each phase was observed.Results Of the 82 detected SHCC, the sensitivity in three phases was 92.68%, 70.73% and 73.17% respectively. The sensitivity increased significantly to 95% by combining the detection of three phases. Conclusion Triple-phase contrast enhanced spiral CT can fully demonstrate the patterns of SHCC and improve its detection rate.