ABSTRACT
Objective To analyze CT findings in adhesive intestinal obstruction caused by different adhesion pattern.Methods Clinical data of 83 adhesive intestinal obstruction cases proved by laparotomy were reviewed.Before surgery two experienced abdominal radiologists randomly double blindly inspected and evaluated the CT findings,as to whether there was intestinal obstruction,the severity of obstruction,the site of obstruction,the adhesion type of obstruction and the diagnosis of strangulated intestinal obstruction,the consensuses were accomplished by discussion.Results The accuracy of diagnosis was 100％ for the existence of obstruction,the severity of obstruction and the site of obstruction.There were intra-abdominal hernia caused by intestinal adhesion (44 cases),a cluster of loop (12 cases),bowel twisted angle (8 cases),the intestine and abdominal adhesions (6 cases),intestinal adhesion contracture stenosis (5 cases),adhesive band compression (4 cases),intestinal volvulus caused by adhesion (1 case).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CT in diagnosing strangulated intestinal obstruction were 78％,47％,100％,100％,73％,respectively.Conclusion CT can clearly diagnose different adhesion pattern leading to ileus and ensuing strangulation.
ABSTRACT
Objective To explore the diffusion-weighted imaging(DWI) values in diagnosis and differential diagnosis in multiple system atrophy (MSA),progressive supranuclear palsy (PSP) and Parkinson's disease (PD).Methods Conventional MRI and DWI were performed in 24 clinically proved MSA patients,35 PD patients,12 PSP patients,and 32 age-matched normal controls (the control group).DWI was performed using a single shot-spin echo-echo planar imaging sequence,and ADC values were measured in the ROIs of different brain regions(including basal ganglia,thalamus,middle cerebellar peduncles and superior cerebellar peduncles).Then one way ANOVA test was used for statistical analysis.Results PSP group had the largest ADC values in putamen,globus pallidus,caudate,andsuperiorcerebellar peduncles[(0.75±0.43) ×10-3 mm2/s,(0.77±0.06)×10 3 mm2/s,(0.77±0.44)×10-3 mm2/s and (1.11±0.22)× 10-3 mm2/s].The ADC values of globus pallidus and caudate had statistically difference comparing with MSA [(0.73±0.04) × 10-3 mm2/s and (0.73±0.40) × 10-3 mm2/s],PD[(0.67±0.11) × 10-3 mm2/s and (0.73±0.04) × 10-3 mm2/s],and control group[(0.71±0.05) × 10-3 mm2/s and (0.72±0.04) × 10-3 mm2/s].MSA group had the largest ADC values in middle cerebellar peduncles[(0.95±0.16) × 10-3 mm2/s],and there was statistically significant difference,comparing with PSP,PD and control group[(0.74±0.49) × 10-3 mm2/s,(0.69±0.50) × 10-3 mm2/s and (0.68±0.31) × 10-3 mm2/s].The ADC values of PD group and control group had no statistically significant difference in putamen,globus pallidus,caudate,thalamus,middle cerebellar peduncles and superior cerebellar peduncles(P＞0.05).Conclusion ADC values in the basal ganglia,the middle cerebellar peduncles and superior cerebellar peduncles have very important significance in differential diagnosis in MSA,PSP and PD.
ABSTRACT
Objective To explore the MRI features of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) for providing early evidence in differential diagnosis. Methods The MRI features of 24 patients with MSA, 30 patients with PD and 30 healthy people as controls were retrospectively analyzed. Abnormal intensity in MRI included the hot-cross bun sign and the slitlike changes. The atrophies of brain included cerebellar, middle cerebellar peduncles, medulla oblongata and pon. Cerebral ventricle dilatation included fourth ventricle and cisterna pontis. The midbrain area, pons area and middle cerebellar peduncles width were measured. Results All patients with MSA had at least one of the features observed on MR images, and there were some differences in the subtypes of MSA. The high sensitive features were the atrophies of middle cerebellar peduncles (79.2%), the atrophies of pons (79.2%) and the hot-cross bun sign (75.0%). The parameters with high specificity and high positive predictive value were hot-cross bun sign (both 100%), the slit-like sign (both 100%), the atrophies of middle cerebellar peduncles (93.3% and 90.1%), and the atrophies of pons (96.7% and 95.0%). MSA group had the statistically significantly decreased values of pons area, midbrain area and middle cerebellar peduncles width [(288. 7±75. 4) mm2, (127.8±25.8) mm2 and (10. 7±2.8) mm, respectively], as compared with PD group [(477. 5 ± 54. 3) mm2, (145.9±21.6) mm2 and (16.2±1.3) mm, respectively] and healthy group [(454. 5±36. 8) mm2 , (146.4±17.4) mm2 and (16.7±1.2) mm, respectively] (all P ＜0. 05). Conclusions The routine MRI is helpful in differential diagnosis between MSA and PD and has some values in diagnosing the subtypes of MSA.