ABSTRACT
This article reviewed the present situation of the research on the relationship between the number of nursing staff, education level, skill combination and patient safety at home and abroad, as well as the indirect mechanism of nursing manpower factors on patient safety through intermediary factors such as working environment, attendance, nursing lack and so on. In view of the problems existing in domestic research, some suggestions were put forward, such as carrying out longitudinal and intervention research on patient safety, optimizing the allocation of nursing human resources and patient safety indicators, exploring the mechanism of multiple nursing factors and patient safety and conducting empirical analysis. To provide reference for hospital managers to improve nursing quality and ensure patient safety.
ABSTRACT
Objective:To explore the diagnostic accuracy and application value of 3.0 T non-contrast coronary magnetic resonance angiography (CMRA) in evaluating coronary artery in children with Kawasaki disease (KD).Methods:From May 2019 to January 2022, 75 children diagnosed with KD in our hospital were enrolled. All the patients underwent CMRA and transthoracic echocardiography (TTE) in one week, twenty-six of whom underwent coronary CT angiography (CCTA) or invasive coronary angiography (ICA) within two weeks. The diagnostic performance of CMRA and TTE was evaluated with CCTA/ICA as reference standard by per-patient basis, per-vessel basis, per-segment basis. Sensitivity and specificity of CMRA and TTE was compared by paired chi square test.The distribution of coronary artery aneurysm (CAA), thrombosis and other pathological changes of coronary artery were recorded and compared between two methods. The patients′ height and weight were collected to calculate the Z value. Z value>2.5 was defined as CAA.Results:All patients successfully completed CMRA examinations. Among the 26 patients, the sensitivity of CMRA was significantly higher than that of TTE by per coronary artery[97.7%(43/44)vs.84.1%(37/44), χ2=4.17, P<0.05]. CMRA showed a higher sensitivity than that of TTE both by proximal segments and middle/distal segments [97.7%(43/44)vs. 84.1%(37/44), 100%(21/21) vs. 52.4%(11/21), χ2=10.08, 7.11, both P<0.05). A total of 115 CAAs was found by CMRA, while only 87 (75.7%) CAAs were observed by TTE. Of the 28 (24.3%) CAAs missed by TTE, 16 (57.1%) were located in right coronary artery (RCA), 2(7.1%) in left main coronary artery, 7(25.0%) in left anterior ascending coronary artery (LAD) and 3(10.7%) in left circumflex coronary artery (LCX). Eleven (39.3%) missed CAAs by TTE were located in the proximal segment of RCA, LMCA, LAD and LCX, and 17 (60.7%) missed CAAs were located in the middle and distal segments. TTE missed coronary thrombosis in 5 patients compared with CMRA. Conclusions:3.0 T non-contrast CMRA is non-invasive and non-radiation, and the image quality can meet the needs of diagnosis, especially for detection of CAAs in RCA or in middle and distal segments of coronary artery in KD patients.
ABSTRACT
Objective@#To determine whether T1 mapping could monitor the dynamic changes of injury in myocardial infarction (MI) and be histologically validated. @*Materials and Methods@#In 22 pigs, MI was induced by ligating the left anterior descending artery and they underwent serial cardiovascular magnetic resonance examinations with modified Look-Locker inversion T1 mapping and extracellular volume (ECV) computation in acute (within 24 hours, n = 22), subacute (7 days, n = 13), and chronic (3 months, n = 7) phases of MI. Masson’s trichrome staining was performed for histological ECV calculation. Myocardial native T1 and ECV were obtained by region of interest measurement in infarcted, peri-infarct, and remote myocardium. @*Results@#Native T1 and ECV in peri-infarct myocardium differed from remote myocardium in acute (1181 ± 62 ms vs. 1113 ± 64 ms, p = 0.002; 24 ± 4% vs. 19 ± 4%, p = 0.031) and subacute phases (1264 ± 41 ms vs. 1171 ± 56 ms, p < 0.001; 27 ± 4% vs. 22 ± 2%, p = 0.009) but not in chronic phase (1157 ± 57 ms vs. 1120 ± 54 ms, p = 0.934; 23 ± 2% vs. 20 ± 1%, p = 0.109). From acute to chronic MI, infarcted native T1 peaked in subacute phase (1275 ± 63 ms vs. 1637 ± 123 ms vs. 1471 ± 98 ms, p < 0.001), while ECV progressively increased with time (35 ± 7% vs. 46 ± 6% vs. 52 ± 4%,p < 0.001). Native T1 correlated well with histological findings (R2 = 0.65 to 0.89, all p < 0.001) so did ECV (R2 = 0.73 to 0.94, all p < 0.001). @*Conclusion@#T1 mapping allows the quantitative assessment of injury in MI and the noninvasive monitoring of tissue injury evolution, which correlates well with histological findings.
ABSTRACT
Objective@#To determine whether T1 mapping could monitor the dynamic changes of injury in myocardial infarction (MI) and be histologically validated. @*Materials and Methods@#In 22 pigs, MI was induced by ligating the left anterior descending artery and they underwent serial cardiovascular magnetic resonance examinations with modified Look-Locker inversion T1 mapping and extracellular volume (ECV) computation in acute (within 24 hours, n = 22), subacute (7 days, n = 13), and chronic (3 months, n = 7) phases of MI. Masson’s trichrome staining was performed for histological ECV calculation. Myocardial native T1 and ECV were obtained by region of interest measurement in infarcted, peri-infarct, and remote myocardium. @*Results@#Native T1 and ECV in peri-infarct myocardium differed from remote myocardium in acute (1181 ± 62 ms vs. 1113 ± 64 ms, p = 0.002; 24 ± 4% vs. 19 ± 4%, p = 0.031) and subacute phases (1264 ± 41 ms vs. 1171 ± 56 ms, p < 0.001; 27 ± 4% vs. 22 ± 2%, p = 0.009) but not in chronic phase (1157 ± 57 ms vs. 1120 ± 54 ms, p = 0.934; 23 ± 2% vs. 20 ± 1%, p = 0.109). From acute to chronic MI, infarcted native T1 peaked in subacute phase (1275 ± 63 ms vs. 1637 ± 123 ms vs. 1471 ± 98 ms, p < 0.001), while ECV progressively increased with time (35 ± 7% vs. 46 ± 6% vs. 52 ± 4%,p < 0.001). Native T1 correlated well with histological findings (R2 = 0.65 to 0.89, all p < 0.001) so did ECV (R2 = 0.73 to 0.94, all p < 0.001). @*Conclusion@#T1 mapping allows the quantitative assessment of injury in MI and the noninvasive monitoring of tissue injury evolution, which correlates well with histological findings.
ABSTRACT
Objective To investigate the feasibility of chemical exchange saturation transfer (CEST) imaging in the measurement of myocardial creatine (Cr) metabolites in phantom model using 3.0 T MR. Methods Five phantoms were made according to the volume percentage of Cr ranging from 10 to 50 mmol/L with an interval of 10 mmol/L. 3.0 T MR examinations with base protocol sequence,sequence with and without ECG were performed. Signal to noise,CrEST effect and Z spectra were analyzed. Comparison of signal noise ratio (SNR) among the three methods was performed using an analysis of variance. Bivariate correlations were obtained through Pearson analysis. Results Phantom studies demonstrated that different concentrations of Cr exhibited significant CEST effect with the three sequences. The SNR obtained by sequences with and without ECG were both higher than that of base sequence (both P<0.05). Moreover,no significance of SNR was found between sequences with and without ECG (P>0.05). There were positive correlation of MTR between sequences with ECG,sequences without ECG and base protocol sequence (r2= 0.974 and 0.997, both P<0.05). Conclusion Compared with base protocol sequence, the optimized sequence with ECG can acquire higher SNR CrEST images,indicating that myocardial CrEST imaging could be performed in clinical practice.
ABSTRACT
Objective To quantitative evaluate the myocardial microcirculation dysfunction in patients with end-stage renal disease (ESRD),and to provide the imaging characteristic for early detection myocardial dysfunction and microcirculation damage in the ESRD patients after dialysis therapy.Methods Sixty-seven patients with ESRD and 1 9 healthy subj ects were enrolled in our study, and the ESRD patients were divided into two groups including patients with preserved systolic function (n=51,EF≥50%)and patients with impaired systolic function (n=16,EF＜50%).The LV regional myocardial perfusion parameters were analyzed including upslope, time to maximum signal intensity (TTM)and max signal intensity (Max SI).Those continuous variables were compared using one-way analysis of variance (A N OVA )in all three groups.Results Compared with the controls and the ESRD patients with preserved EF,the ESRD patients with impaired EF had a significantly lower SV and markedly increased LV mass (all P＜0.001).For the fist-pass perfusion analysis,first-pass perfusion Max SI of all segments were significantly reduced in the ESRD patients with preserved/impaired EF compared with the normal subjects (all P＜0.05).Compared with the ESRD patients with preserved EF and controls,the ESRD patients with impaired EF had lower upslope in the basal segment (P＜0.05).And the ESRD patients with preserved/impaired EF had shorter TTM in the apical segment than that in normal controls (P＜0.01).Conclusion The CMR first-pass perfusion can detect the myocardial deformation and dysfunction in ESRD patients,the Max SI may be more valuable to early detect myocardial microcirculation dysfunction.
ABSTRACT
Objective To evaluate the clinical diagnostic value of prospective electrocardiograph (ECG)-gating of CT cardiac angiography in congenital heart diseases of Chinese population through a Meta-analysis.Methods The articles were searched to study CT prospective ECG-gating in diagnosis of congenital heart disease from January 1995 to February 2016 in domestic and foreign publications.The study quality was assessed by the Quality Assessment for Diagnostic Accuracy Studies and the data extraction was performed.The software of Meta-disc1.4 was used for heterogeneity test.Different effect models were choosen according to the results of heterogeneity analysis.Meanwhile,this soft was used to calculate the sensitivity,specificity,likelihood ratio and its 95％ confidence interval (CI),respectively.The forest maps and summary receiver operator characteristic (SROC) curve were drawn.In addition,the area under curve (AUC) was calculated.Results Twelve articles were included in the Meta-analysis.The study included 1 431 congenital heart malformations confirmed by surgery or cardiac catheterization angiography.CT prospective ECG-gating technique had no heterogeneity in sensitivity and specificity of congenital heart disease.The total sensitivity,the total specificity,positive likelihood ratios,negative likelihood ratios and its 95％ CI of CT cardiac angiography were 96％ (95％ CI 94％ to 97％),100％ (95％ CI 100％ to 100％),365.94(95％ CI 231.18 to 579.26),0.04(95％ CI 0.03 to 0.05) with fixed effect model,respectively.The AUC of the SROC was 99.86％,Q =0.987 9.Conclusions Prospectively ECG-gating of CT cardiac angiography has high sensitivity and specificity in the diagnosis of congenital heart diseases.Its AUC of the SROC is large.It has high diagnostic value in congenital heart diseases.
ABSTRACT
Mesenchymal stem cells(MSCs)is a kind of non hematopoietic stem cell from the mesoderm, which can self renew, proliferate and perform multilineage differentiation. Due to the characteristics of acquiring easily and low immunogenicity, it has become the main cell for myocardial infarction. In this article, the biology and the immunology of the MSCs is reviewed, the safety and the validity of the therapy on myocardial infarction with MSCs and the HGF/MSCs is introduced. And furthermore, it also explains the possible mechanism and the problems of how to improve the cardial function.
Subject(s)
Humans , Cell Differentiation , Hematopoietic Stem Cells , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Myocardial Infarction , TherapeuticsABSTRACT
This study is designed to test the agreement in measuring left ventricular systolic function between transthoracic two-dimensional echocardiography (2DTTE) and "gold standard" of non-invasive cardiac imaging, magnetic resonance imaging (CMRI) and their impacts on the classification of patients according to the left ventricular ejection fraction (EF). 32 patients who were suspected with heart disease were evaluated by CMRI and 2DTTE examinations. End diastolic volume (EDV), end systolic volume (ESV), EF and left ventricular function category were then calculated and compared. There was no significant difference (P=0.504) for EDV, while ESV of CMRI was significantly higher than that of 2DTTE (P=0.049), and EF of CMRI was significantly lower than that of 2DTTE (P= 0.018). There was no significant difference (P=0.077) in left ventricular functional category. Bland-Altman analysis of LV volumetric data and EF measurements showed a good agreement between two methods. The 2DTTE over-estimated I (n=5) or II (n=1) degrees of functional classification when compared with the CMRI. Both CMRI and 2DTTE are of great clinical value in evaluating left ventricular systolic function, while CMR may be more beneficial to patients with abnormal LV functions.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Echocardiography , Heart Diseases , Magnetic Resonance Imaging , Retrospective Studies , Systole , Physiology , Ventricular Function, Left , PhysiologyABSTRACT
With the development of life science and medical technology,myocardial fibrosis is being increasingly recognized as a new therapeutic target for heart diseases.However,traditional methods for detection of myocardial fibrosis,such as myocardial biopsy and laboratory assay of serum metabolites or enzymes,are not satisfactory in meeting the clinical demands because of their intrinsic limitations.Molecular imaging may non-invasively and quantitatively evaluate the presence/absence,degree and turnover of myocardial fibrosis in vivo with good specificity,thus being useful for clinical assessment and intervention.Currently,the commonly used molecular imaging modalities for evaluation of myocardial fibrosis include SPECT,PET and MRI.It is hopeful that the molecular probe for targeted ultrasound technology may also be developed in the near future.This review highlights the current status and future trends of molecular imaging in myocardial fibrosis.
ABSTRACT
Objective To determine the value of CT and MRI in the evaluation of littoral cell angioma(LCA) of spleen.Methods Two experienced radiologists retrospectively analyzed the clinical data,CT and MRI findings of 12 patients with pathology proven LCA of spleen.The patients underwent noncontrast enhanced CT scan,then enhanced CT (n =10) and MRI (n =3) were performed.Results The majority of patients (8/12) showed splenomegaly,with no obvious signs and symptoms of hypersplenism.The majority of patients (10/12) had the uncountable hypodense lesions,a few (2/12) had only a single lesion.None of the lesions contained any calcification or envelopement.On CT,the majority (7/10) of the lesions demonstrated well circumscribed border,with some lesions (3/10) demonstrating a less distinct border.The enhanced scan for low-density nodules demonstrated slow progressive enhancement.On MRI,all the LAC had well circumscribed borders,and demonstrated T1-hypointense and T2-hyperintense signalswith punctual hypointense in the T2 WI,and progressive enhancement on the post contrast images.DWI showed an increased diffusion of the lesions compared to the normal appearing splenic tissue.Conclusion CT and MR imaging of littoral cell angioma of spleen has certain imaging characteristics,those particular findings may potentially aid in the diagnosis.
ABSTRACT
The purpose of this study was to find whether Cardiac Magnetic Resonance [CMR] could assess the myocardial interstitium in patients suffering from systemic amyloidosis with normal left ventricular ejection fraction. Twenty Six patients in whom systemic amyloidosis was confirmed by kidney biopsy were investigated. Five patients with normal left ventricular ejection fraction were selected. The heart function of the patients was diagnosed by two-dimensional transthoracic echocardiography. The main MR sequences include an inversion recovery prepared echo planar imaging perfusion sequence, inversion recovery TrueFISP sequence [delayed enhancement] and TrueFISP cine sequence for heart function measurement [including ejection fraction [EF]], end diastolic volume [EDV], end systolic volume [ESV], stroke volume [SV] and cardiac output [CO]]. Perfusion defects were seen in three patients. In these patients, myocardial enhancement was visible on late gadolinium enhancement images. The enhancement pattern was diffuse in three patients and focal in two patients. Heart dysfunction was mild, as follows: EF normal [range, 56-75%; mean, 69.4%], ESV normal [range, 15.7-30.0; mean, 23.0], EDV decreased [range, 42.1-96.6; mean, 72.7], SV decreased [range, 23.7-68.6; mean, 49.6] and CO normal [range, 2.6-5.9; mean, 3.9]. Hematoxylin and eosin stain and Congo red stain demonstrated typical amyloid deposits. Amyloidosis was classified as amyloid light chain by kappa and lambda stain. Cardiac Magnetic Resonance could detect abnormal myocardial interstitium in systemic amyloidosis patients with normal left ventricular ejection fraction
ABSTRACT
This paper is to determine relationship between MDCT features and anatomic-pathology of the diseases in central thoracic-abdominal junctional region. 3 cadavers were cut transversely and another 3 vertically to observe the anatomy of thoracic-abdominal junctional zone. 93 patients with diseases in central thoracic-abdominal junctional zone were scanned with MDCT. The correlation between MDCT features of the diseases in central thoracic-abdominal junctional region and the anatomic-pathology of the diseases in this region was evaluated. On cadaver sections, central thoracic-abdominal junctional region was an area between anterior chest wall and dorsal spine in vertical direction. The region was separated into upper and lower sections by diaphragm. The upper section mainly contains heart and pericardium, while the lower contains broad ligament and left lobe of liver. The hiatus of diaphragm are vena caval foramen, esophageal foramen and aortic foramen in anterior-posterior turn. In the present study, 23 patients had portal hypertension, 18 had dissection of aorta, 8 got diseases in inferior vena cava, 9 had lymphoma, 12 got diseases in multiple vertebrae, 7 had lower thoracic esophageal carcinoma accompanied with metastasis in upper abdominal lymph nodes, 9 had carcinoma of abdominal esophagus and/or gastric cardia, 4 had esophageal hiatal hernia and 3 patients had neurogenic tumor in posterior mediastinum and/or superior spatium retroperitoneale. The MDCT features and distribution of the diseases in central thoracic-abdominal junctional region influence the anatomic-pathology characteristics in this region.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Abdominal Cavity , Diagnostic Imaging , Pathology , Aortic Dissection , Diagnostic Imaging , Aortic Aneurysm, Thoracic , Diagnostic Imaging , Cadaver , Diaphragm , Diagnostic Imaging , Pathology , Hypertension, Portal , Diagnostic Imaging , Multidetector Computed Tomography , Methods , Radiography, Thoracic , Thoracic Cavity , PathologyABSTRACT
This paper was objected to determine the relationship between MDCT features and anatomic-pathology of diseases in right thoracic-abdominal junctional region. We cut 3 cadavers transversely and another 3 vertically to observe the anatomy of thoracic-abdominal junctional zone. We scanned 69 patients with diseases in right thoracic-abdominal junctional zone by MDCT. The correlation between MDCT features of right thoracic-abdominal junctional region and the anatomic-pathology in this region was evaluated. We found results as that in cadaver sections, the right pulmonary ligament, which was below inferior pulmonary vein, attached the inferior lobe of right lung to the esophagus, that the coronary ligament, which interiorly extended from falciform ligament and laterally formed into right triangular ligament, contained two layers, and that the bare area of liver, which positioned between the two layers of coronary ligament, was directly next to diaphragm with no peritoneum covered. There were 50 cases with both pleural and ascitic fluid, while the pleural fluid was divided into anterior and posterior compartments by the right pulmonary ligament, whereas the ascitic fluid was limited in perihepatic space in majority. Among the 50 cases, 5 patients had lung cancer with diaphragmatic pleura, diaphragm and upper abdomen involved. 5 patients had right hepatic lobe cancer with subdiaphragmatic peritoneum, crura diaphragmatis and lower thoracic cavity involved. 1 patient had right adrenal carcinoma with phrenic metastasis. 8 patients had inflammation in right lower thorax and/or right upper abdomen. The spreads of these diseases include mainly direct invasion, blood and lymphatic spread routs in the region. Conclusion could be drawn that the MDCT features and distribution of right thoracic-abdominal junctional region diseases correlate with the anatomical characteristics in this region.
Subject(s)
Humans , Abdominal Cavity , Diagnostic Imaging , Pathology , Cadaver , Diaphragm , Diagnostic Imaging , Pathology , Multidetector Computed Tomography , Methods , Radiography, Thoracic , Thoracic Cavity , PathologyABSTRACT
Right ventricular (RV) function is very important for patients with respiratory and cardiovascular disorders resulting in RV impairments. Since RV has complex geometry of the chamber, it is difficult to accurately measure the RV volumetric parameters with conventional imaging modalities, especially those with dilated and abnormal RV. With the emergence and wide use of new noninvasive imaging modalities in accessing the cardiac anatomy and function, real-time three-dimensional echocardiography (RT3DE), multi-detector row computed tomography (MDCT) and new MRI sequences, noninvasive quantitative assessment of the RV function has attracted more and more worldwide attention.
ABSTRACT
To evaluate the global left and right ventricular function and establish the CT reference data of global ventricular function parameters in normal people, 56 normal subjects (male, 28 cases; female, 28 case) were scanned with retrospective ECG gated 64-detector row CT. Ten time-phases in the cardiac cycle were reconstructed and short-axis images were acquired. On the cardiac analysis software, endo-cardium and epi-cardium of left and right ventricle were delineated and global function parameters were calculated. Left and right ventricular end-diastolic volume (LV/RVEDV), end-systolic volume (LV/RVESV), stroke volume (LV/RVSV), and wall mass (LV/RVWM) were significantly greater (P < 0.05) in men than in women, but cardiac output (LV/RVCO) and ejection fraction (LV/RVEF) exhibited no difference in women and men. In man group and woman group, LVWM was greater than RVWM (P < 0.01). LVESV, RVESV and body mass Index (BMI) were shown to have significant negative-correlation; the correlation coefficient = -0.54 and r = -0.53. LV/RVSV, LV/RVEF and BMI were noted to have significant positive-correlation; the correlation coefficients were 0.87/0.97 and 0.69/0.62, respectively. The normal global left and right ventricular functions differ significantly according to gender and body size.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Electrocardiography , Heart Ventricles , Diagnostic Imaging , Image Processing, Computer-Assisted , Reference Values , Retrospective Studies , Stroke Volume , Tomography, Spiral Computed , Methods , Ventricular Function, Left , Physiology , Ventricular Function, Right , PhysiologyABSTRACT
To evaluate the regional left ventricular function (LVF) and to establish the reference data of LVF parameters in the normal people with retrospective ECG gating 64-detector row CT, ten time phases in the cardiac cycle were reconstructed. Scanning was performed on 42 normal adult, and short axis images of the left ventricular were acquired. Endo-cardium and epi-cardium were delineated along with function parameters based on the cardiac analysis software. End-systolic thickness (EST) was thicker than end-diastolic thickness (EDT) (P<0.05). EDT and EST increased, but thickness decreased from apical, mid-ventricular to basal segments. Statistically significant difference was noted between mid-ventricular and basal segments (P<0.05). EDT, EST, thickness and motion of anterior, lateral and inferior segments were greater than those of septal segments in the same ventricular slices (P<0.05). 64-detector row CT could depict the regional LVF accurately. The LVF parameters of normal adults might be useful in diagnosing abnormal left ventricular function.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Heart Ventricles , Diagnostic Imaging , Image Processing, Computer-Assisted , Myocardial Contraction , Physiology , Radiographic Image Interpretation, Computer-Assisted , Methods , Tomography, Spiral Computed , Methods , Ventricular Function, Left , PhysiologyABSTRACT
To determine the clinical value of 64-slice computed tomography angiography (CTA) in the evaluation of vessel before and after coronary artery bypass graft (CABG) surgery, we retrospectively collected the coronary artery imaging data of 46 patients undergoing 64 slice CT before CABG surgery in the period from July 2006 to May 2007, and we evaluated 14 patients with 39 coronary grafts in the same period to determine the diagnostic accuracy of CTA before and after CABG surgery. In 46 patients, 64-slice CT enabled the visualization of the entire coronary tree with diagnostic image quality. Sensitivity, specificity, and accuracy for the detection of stenosis > or = 50% were 92.11%, 95.64%, 94.97%, respectively. In 14 patients with 39 coronary grafts, 35 (35/39, 89.74%) bypass grafts were found to be of no stenosis; low degree of restenosis was found in 4 (4/39, 10.26%) bypass grafts, and no graft was found to have high degree of restenosis. So we concluded that, with the use of 64-slice CTA, we can accurately evaluate the degree of stenosis of vessel before and after CABG surgery.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Coronary Artery Bypass , Coronary Artery Disease , Diagnostic Imaging , General Surgery , Coronary Vessels , Pathology , Perioperative Period , Retrospective Studies , Tomography, Spiral Computed , MethodsABSTRACT
The objective of this comparative study is to determine the MDCT features of solitary pulmonary tuberculous cavity and malignant cavity and to analyze the advantages there-of in differential diagnosis. The clinical data and MDCT findings of 51 cases of pulmonary tuberculous cavities and 39 cases of malignant cavities were reviewed retrospectively, which include the general aspects of patients, the manifestation of cavity and the changes of adjacent structures. The results revealed that the tuberculous cavity tends to locate in the upper lobe or the superior segment of lower lobe, and it is usually acompanied with cavity wall calcification, satellite lesions, peripheral inflammation, lymph node calcification, small diameter and thin wall thickness. The malignant cavities, showing no disposition to locate in a lobe or segment, are characterized by mural nodules, off-center cavity, lobulation, coarse speculation, lymph node enlargement, vascular clustering sign, big diameter and thick wall. In conclusion, with multiplanar reconstruction on multi-detector row CT, we could elaborate the cavities and the accompained lesions, thus contributing to a correct diagnosis in most cases.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Adenocarcinoma , Diagnostic Imaging , Pathology , Carcinoma, Squamous Cell , Diagnostic Imaging , Pathology , Diagnosis, Differential , Lung Neoplasms , Diagnostic Imaging , Pathology , Retrospective Studies , Tomography, Spiral Computed , Methods , Tuberculosis, Pulmonary , Diagnostic Imaging , PathologyABSTRACT
This is a retrospective study aimed at the clinical application of 64-slice computed tomography angiography (CTA) in evaluation the lumen before and after coronary artery stent implantation. We collected the coronary artery imaging data of 46 patients undergoing 64-slice CT before coronary artery stent implantation from July 2006 through May 2007; we also collected the data of 21 patients with 34 coronary artery stents in the same period to determine the diagnostic accuracy of CTA before and after coronary artery stent implantation. The results showed that, in 46 patients, 64-slice CT enabled the visualization of the entire coronary tree with diagnostic image quality. Sensitivity, specificity, and accuracy for the detection of stenosis > or = 50% were 92.11%, 95.64% and 94.97%, respectively. In 21 patients with 34 stents implanted, 23 (67.65%) stents showed no stenosis, 8 (23.53%) stents showed low degree of restenosis, and 3 (8.83%) stents showed high degree of restenosis. In conclusion, we can accurately evaluate the degree of stenosis of lumen before and after coronary artery stent implantation with the application of 64-slice CTA.