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Objective To investigate the diagnostic efficiency of artificial intelligence(AI)in rib frac-ture under the computed tomography(CT)images with different reconstruction slice thickness.Methods The first CT images of 100 patients with rib fractures were selected,and the interval-free recon-struction was carried out with the thickness of 0.625 mm,1.250 mm,2.500 mm and 5.000 mm,respectively.The rib fracture screening function of AI was used to automatically detect the CT images of four groups,and the diagnostic efficiency of AI for rib fracture under different reconstruction thickness conditions was com-pared.Results The sensitivity of AI in the diagnosis of rib fracture at 0.625 mm,1.250 mm,2.500 mm and 5.000 mm thickness was 99.32%(436/439),98.41%(432/439),89.52%(393/439)and 83.60%(367/439),respectively.The false positive rate was 4.80%(22/458),0.92%(4/436),0.76%(3/396)and 0.27%(1/368).The diagnostic sensitivity of AI in 0.625 mm and 1.250 mm thickness was higher than that in 2.500 mm and 5.000 mm,and the difference was statistically significant(P<0.05),while there was no significant difference in the thickness of 0.625 mm and 1.250 mm.The false positive rate of AI in the diagnosis of 0.625 mm slice thickness was higher than that of 1.250 mm,2.500 mm and 5.000 mm,and the difference was sta-tistically significant(P<0.05),while there was no significant difference in the thickness of 1.250 mm,2.500 mm and 5.000 mm(P>0.05).Conclusion The diagnostic efficiency of AI in 1.250 mm CT images is better than that in 0.625 mm,2.500 mm and 5.000 mm CT images.
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Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)perfusion imaging parameters in the differential diagnosis of benign and malignant solitary pulmonary nodules(SPN).Methods:A total of 80 patients with SPN admitted to our hospital from Oct 2021 to Oct 2022 were selected.All patients underwent MSCT perfusion imaging and pathological examination after admission.According to the histopathological examination results,the patients were divided into benign nodule group and malignant nodule group.MSCT perfusion imaging parameters(blood volume,mean transit time,blood flow,surface permeability coefficient)of the two groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the value of MSCT perfusion imaging parameters in the differential diagnosis of benign and malignant SPN.Results:Among the 80 patients with SPN,47 were diagnosed as malignant nodules and 33 as benign nodules by pathological examination.There was no significant difference in mean transit time between 2 groups(P＞0.05).The blood volume,blood flow and surface permeability coefficient in malignant nodule group were higher than those of benign nodule group(P＜0.05).The results of ROC curve showed that the area under the curve(AUC)of blood volume,blood flow and surface permeability coefficient separately and in combination were 0.823(95% CI:0.721-0.926),0.855(95% CI:0.761-0.949),0.850(95% CI:0.752-0.948)and 0.963(95% CI:0.924-1.000)for the diagnosis of benign and malignant SPN,all of which had certain diagnostic value.When blood volume,blood flow and surface permeability coefficient were 4.405 ml/100 g,51.325 ml/(min·100 g)and 21.115 ml/(min·100 g),respectively,the best diagnostic efficiency could be obtained,and the combined diagnosis value was higher.Conclusion:The combination of blood volume,blood flow and surface permeability coefficient of MSCT perfusion imaging parameters have high value in the differential diagnosis of benign and malignant SPN,which can provide effective basis for the early diagnosis and treatment of benign and malignant SPN.
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Objective To analyze the diagnostic efficacy and clinical significance of magnifying endoscopy combined with narrow-band imaging(ME-NBI),acetate-indigo rouge staining and multi-slice spiral CT for early gastric cancer and precancerous lesions.Methods 202 patients with suspected early gastric cancer and precancerous lesions from February 2019 to March 2022 were regarded as the subjects of this study,all the patients underwent ME-NBI,acetate-indigo rouge staining,and multi-slice spiral CT examination;The diagnostic value of different examination methods for early gastric cancer and precancerous lesions was analyzed using the receiver operator characteristic curve(ROC curve),using the pathological results of gastric cancer as the gold standard,the diagnostic value of ME-NBI,acetate-indigo rouge staining combined with multi-slice spiral CT and their combination in early gastric cancer and precancerous lesions was analyzed using a four grid table.Results The image quality of ME-NBI and acetate-indigo rouge staining combined examinations was significantly higher than that of their respective independent examinations(P<0.05).There was significant difference in the degree of differentiation in the clinical features of patients with early gastric cancer and precancerous lesions(P<0.05).The area under the curve(AUC)of ME-NBI for the diagnosis of early gastric cancer and precancerous lesions was 0.853,the accuracy was 85.64%,the sensitivity was 88.37%,and the specificity was 83.62%.The AUC of acetate-indigo rouge staining for the diagnosis of early gastric cancer and precancerous lesions was 0.814,the accuracy was 81.68%,the sensitivity was 83.72%,and the specificity was 80.17%.The AUC of multi-slice spiral CT for the diagnosis of early gastric cancer and precancerous lesions was 0.804,with an accuracy of 80.69%,a sensitivity of 82.56%,and a specificity of 79.31%.And the AUC of the three methods combined to diagnose early gastric cancer and precancerous lesions was 0.893,with an accuracy of 89.60%,a sensitivity of 93.02%,and a specificity of 87.07%.Conclusion ME-NBI,acetate-indigo rouge staining combined with multi-slice spiral CT has high diagnostic efficacy in early gastric cancer and precancerous lesions,and can be used in clinical practice.
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Objective:To investigate the correlations between multi-slice spiral CT (MSCT) atypical pleomorphic signs and pathological findings of lung metastases.Methods:From January 2012 to July 2019, the MSCT chest imaging data of 168 metastatic tumor of lung from the General Hospital of Central Theater Command of the Chinese People′s Liberation Army and Shaanxi Provincial Tumor Hospital were collected. According to the pathological type, they were divided into metastatic adenocarcinoma group ( n=88) and metastatic squamous cell carcinoma group ( n=80). The atypical imaging signs of MSCT of the two groups were observed and recorded, and classified after labeling one by one. The difference of atypical MSCT imaging features between the two groups was compared, and the correlations between lesion size and atypical imaging features of MSCT in the metastatic adenocarcinoma group and metastatic squamous cell carcinoma group were analyzed. Results:The spicule sign in metastatic adenocarcinoma and metastatic squamous cell carcinoma were 61 (69.32%) and 28 (35.00%), with a statistically significant difference ( χ2=19.811, P<0.001). The pleural depression sign in the two groups were 48 (54.55%) and 16 (20.00%), and there was a statistically significant difference ( χ2=21.206, P<0.001). The vacuole/cavity sign in the two groups were 10 (11.36%) and 61 (76.25%), and there was a statistically significant difference ( χ2=72.303, P<0.001). The air bronchial sign in the two groups were 43 (48.86%) and 13 (16.25%), with a statistically significant difference ( χ2=20.057, P<0.001). The halo sign/ground glass shadow in the two groups were 58 (65.91%) and 37 (46.25%), with a statistically significant difference ( χ2=6.591, P=0.010). The results of the Spearman rank correlation analysis indicated a positive correlation between the size of metastatic adenocarcinoma and spicule sign, pleural depression sign ( r=0.270, P=0.011; r=0.226, P=0.035). There was no correlation between the nodule size and atypical MSCT imaging features in metastatic squamous cell carcinoma (all P>0.05). Conclusion:The atypical MSCT of metastatic lung adenocarcinoma are mostly spicule sign, pleural depression sign, air bronchial sign and halo sign/ground glass shadow. The characteristic atypical imaging of metastatic squamous cell carcinoma is vacuole/cavity sign. The spicule sign and pleural depression sign are related to the size of metastatic lung adenocarcinoma nodules.
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Objective:To investigate the imaging characteristics of chest CT angiography in patients with active pulmonary tuberculosis complicated with pulmonary embolism, so as to improve the detection rate of active pulmonary tuberculosis complicated with pulmonary embolism.Methods:The clinical data of 103 patients with active pulmonary tuberculosis treated in Tianjin Haihe Hospital from January 2013 to January 2020 were retrospectively analyzed, including general conditions, symptoms and complications. According to the occurrence of pulmonary embolism, the patients were divided into active pulmonary tuberculosis complicated with pulmonary embolism group (study group, n=43) and active pulmonary tuberculosis without pulmonary embolism group (control group, n=60). The time between the onset of pulmonary embolism and the onset of tuberculosis of the patients in the study group was collected. The chest CT imaging characteristics of the patients of two groups were analyzed. The imaging characteristics, embolism distribution and secondary changes of the patients in the study group were summarized. Results:Time from onset of tuberculosis to pulmonary embolism of the patients in the study group was about 60 days (14 days to 75 days). The incidence of chest tightness and dyspnea of the patients in the study group was significantly higher than that in the control group (all P<0.05). The number of lung lobes involved in lung lesions of the patients in the study group was significantly higher than that in the control group ( P<0.05). The incidence of lesions in the middle lobe of the right lung, the tongue lobe of the left lung and the lower lobes of both lungs of the patients in the study group was higher than that in the control group (all P<0.05). The incidence of peripheral pulmonary embolism was significantly higher than that of central pulmonary embolism ( P<0.05). However, the incidence of atelectasis, pulmonary artery widening, and right heart enlargement in the patients with central pulmonary embolism was significantly higher than that in the patients with central pulmonary embolism (all P<0.05). Conclusions:Multi-slice spiral CT chest angiography can show some important imaging manifestations of patients with active pulmonary tuberculosis and pulmonary embolism, which is helpful for the early detection of the disease and the improvement of its prognosis. Multi slice spiral CT chest angiography can show some important imaging manifestations of patients with active pulmonary tuberculosis complicated with pulmonary embolism, and timely detection is helpful to improve the prognosis of patients with active pulmonary tuberculosis complicated with pulmonary embolism.
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Objective To investigate the diagnostic value of multi-slice spiral CT (MSCT) perfusion imaging combined with serum cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA) and neuron specific enolase (NSE) for peripheral non-small cell lung cancer (NSCLC). Methods Based on diagnosis, 109 patients with suspected peripheral NSCLC admitted from Aug. 2017 to Aug. 2019 in the Xinxiang Central Hospital were divided into peripheral NSCLC group (n=65) and benign pulmonary nodule group (n=44). Another 56 healthy subjects undergone physical examination during the same period were selected as control group. The parameters of MSCT perfusion imaging and serum levels of CYFRA21-1, CEA and NSE in the 3 groups were compared. The receiver operating curve (ROC) was used to analyze the diagnostic value of MSCT perfusion imaging combined with serous levels of CYFRA21-1, CEA and NSE for peripheral NSCLC. Results The blood volume (BV) was larger in peripheral NSCLC group than those in benign pulmonary nodule group and control group [(10.76±1.26) ml/100 mg vs. (4.01±0.59) ml/100 mg and (2.32±0.42) ml/100 mg]; the same was for surface permeability (PS) [(42.56±5.60) ml/ (100 mg·min) vs. (16.13±1.88) ml/(100 mg·min) and (8.49±0.91) ml/(100 mg·min)]; and for the mean transit time (MTT) of contrast medium [(20.14±3.67) s vs. (12.85±1.49) s and (7.21±0.95) s]. All the BV, PS and contrast medium MTT were higher (larger) in benign pulmonary nodule group than those in control group (P<0.05). The serum level of CYFRA21-1 was higher in peripheral NSCLC group than that in benign pulmonary nodule group and control group [(8.94±1.67) ng/ml vs. (4.73±0.51) ng/ ml and (1.93±0.26) ng/ml]; the same was for the CEA level [(27.91±3.25) ng/ml vs. (7.88±0.92) ng/ml and (2.06±0.47) ng/ml]; and for the NSE level [(19.53±2.16) ng/ml vs. (15.02±1.74) ng/ml and (11.96±1.22) ng/ml]. All the serum levels of CYFRA21-1, CEA and NSE were higher in benign pulmonary nodule group than those in control group (P<0.05). The ROC results showed that the diagnosis of peripheral NSCLC alone and combined with MSCT perfusion imaging, serum levels of CYFRA21-1, CEA and NSE were 0.802, 0.794, 0.698, 0.712 and 0.841, respectively. The diagnostic value of combined detection of the four methods was higher than that of individual detection. Conclusion MSCT perfusion imaging combined with serum levels of CYFRA21-1, CEA and NSE have high diagnostic value for peripheral NSCLC.
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Accurate preoperative staging of gastric cancer is of great significance for choosing an optimal therapeutic schedule and for evaluating the prognosis. Accurate preoperative preparation can avoid unnecessary treatment and help with selecting optimal treat-ment modalities. In recent years, the preoperative staging of gastric cancer has been greatly improved owing to the use of diagnostic methods such as endoscopic ultrasonography, multi-slice spiral computed tomography, positron emission computed tomography, and staging laparoscopy, among other such modalities. However, all diagnostic methods are associated with advantages and limitations. Thus, a combination of various diagnostic modalities is essential for accurate preoperative staging. This paper reviews the research progress in the aforementioned diagnostic methods for preoperative staging.
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Objective@#To differentiate the inflow and outflow channels of gastric varices in cirrhotic portal hypertension patients using multi-slice spiral CT (MSCT), and to assess the relationship between calculable CT volume of gastric varices and the amount of tissue adhesive.@*Methods@#97 cases with cirrhotic gastric varices who were admitted from November 2013 to August 2017 were selected. The type and shape of gastric varices were observed before tissue glue injection treatment by MSCT. The correlation between CT volume of gastric varices and the amount of tissue adhesive was evaluated by Spearman rank correlation coefficient and Univariate linear regression analysis.@*Results@#MSCT showed that Le, g type had the highest proportion (54.6%), followed by Le, g, Lg (20.6%). Le, Lg and Lgf type accounted for 17.5%, and 5.2%, respectively, while Lgf+b accounted for 2.1%. On MSCT, varices of the gastric fundus were in the direction from bottom to top, and 75% of the fundus had a large curved side varices combined with gastric and renal shunt. Under the gastroscopy, varices in the small curved side of the gastric fundus from near to far were formless. In addition, varices in the large curved side of the gastric fundus when observed from different angles to the direction of blood flow (reverse gastroscope) were 72.7% (near and far) or 20.5 % (far and near). There was a positive correlation between CT volume (R = 0.97, P < 0.001) and the amount of tissue adhesive (Y1 = 0.35 + 0.65X1, Univariate linear regression equation; ρ = 0.89, P < 0.001, Spearman correlation analysis).@*Conclusion@#MSCT can recognize the vascular shape and inflow and outflow channels of gastric varices. A positive correlation between CT volume and the amount of tissue adhesive, suggested that the CT volume measurement before treatment could be used as one of the method to predict the amount of tissue adhesive.
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Objective To compare the role on determining the functional location of primary hyperaldosteronism (PHA)by multi-slice spiral CT (MSCT)and by adrenal vein sampling (AVS),and to discuss the reasonable method to use MSCT and AVS in localization diagnosis of PHA.Methods Clinical data of 78 patients with PHA were analyzed retrospectively.These patients were diagnosed in our department from June 2014 to June 2018.There were 27 male and 51 female patients.With mean age of (47.5 ± 11.2) years old.The mean systolic blood pressure was (190 ± 24)mmHg and mean diastolic blood pressure was (111 ± 16) mmHg.The mean history of hypertension was (6.0 ± 6.0) years.The mean serum potassium was (2.4 ± 0.6) mmol/L.The mean plasma aldosterone concentration (PAC) was (415.7 ± 235.4) pg/ml.The mean plasma renin activity (PRA) was (3.2 ± 5.7) ng/(ml · h).The mean aldosterone/renin ratio (ARR) was 409.0 ± 434.9.All PHA patients underwent MSCT and AVS,the accuracy on determining the functional location of PHA by MSCT and by AVS were evaluated based on the pathological results and clinical outcomes.The influence of adrenal size and character on the accuracy of determining the functional location of PHA by MSCT were analyzed.Results The rate of accuracy of determining the location of PHA by AVS was higher than that by MSCT[100.0％ (78/78) vs.71.8％ (56/78),P ＜ 0.05].When MSCT indicated:adrenal hyperplasia,adrenal tumor volume less than 1 cm,1 cm ＜ adrenal tumor volume ≤ 2 cm,adrenal tumor volume ＞ 2 cm,the rate of accuracy in localization diagnosis with MSCT was 50.0％ (4/8),81.0％ (17/21),92.9％ (26/28),100.0％ (9/9) respectively.Its trend has statistical significance (P ＜ 0.05).The diagnostic accuracy rate of MSCT for aldosterone adenoma was 79.6％ (43/54),while that of adrenal hyperplasia was 58.3 ％ (7/12).There was no statistical significance between two diagnostic accuracy rate of MSCT(P ＞ 0.05).Conclusions AVS is the gold standard for localization diagnosis.When MSCT indicates that there is no obvious abnormality in the adrenal gland,adrenal hyperplasia,small tumor (≤ 2 cm),and bilateral adrenal lesions,AVS should be examined at the same time,which can be considered as the gold standard for localization diagnosis.For isolated adrenal tumor (＞ 2 cm) in PHA,the accuracy of localization diagnosis in MSCT is very high and the AVS is unnecessary.
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Objective@#To investigate the clinical value of endoscopic ultrasonography (EUS) and Multi-slice Spiral CT (MSCT) in the preoperativestaging of tumor(T) and lymph node (N) metastasis in patients with SiewertⅡand Ⅲ typeadenocarcinoma of esophagogastric junction(AEG).@*Methods@#Clinical data of 145 Siewert Ⅱ and Ⅲ type AEG patientswithout preoperative chemoradiotherapy were retrospectively reviewed. Theyall received preoperative EUS and MSCT examination and underwent surgical resection, and the results of EUS and MSCT were compared with their postoperative pathologic staging.@*Results@#The sensitivity, specificity, and accuracy of EUS for T stage in Siewert Ⅱ and Ⅲ type AEG were higher than those of MSCT. The total accuracy of EUS and MSCT were 90.3% and 63.5%, respectively, and the difference was statistically significant (χ2=29.52, P<0.01). The sensitivity of EUS for T1, T2 and T3 were 89.5%, 91.1% and 85.2%, respectively, which were significantly higher than 42.1%, 66.7% and 29.6% of MSCT (χ2=9.47, P<0.01 for T1; χ2=8.07, P<0.01 for T2; χ2=17.40, P<0.01 for T3). In addition, the total accuracy of EUS and MSCT for lymph node metastasis status of Siewert Ⅱ and Ⅲ type AEG were 75.9% and 64.8%, respectively, showing a statistically significant difference(χ2=4.23, P=0.04). The sensitivity of EUS for N1 and N2 were 82.1% and 79.2%, respectively, which were significantly higher than 53.6% and 60.4% of MSCT (χ2=5.24, P=0.02; χ2=4.48, P=0.03). There was no statistical significance for sensitivity of EUS and MSCT in N0 and N3 (P>0.05).@*Conclusion@#EUS diagnosis of T and N staging in Siewert Ⅱ/Ⅲ type AEG showed significantly greater performance than MSCT.
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Objective To analyze the diagnostic value of multi-slice spiral CTin patients with emergency chest pain. Methods 81 patients with chest pain admitted in the Department of Emergency in our hospital from October 27, 2016 to October 27, 2017 were investigated. All patients underwent multi-slice spiral CTexamination. The examination results of multi-slice spiral CTexamination were compared with those of conventional coronary angiography. At the same time, the patient's heart rate and satisfaction during different examinations was compared. Results There were 64 patients with coronary artery stenosis, 9 patients with aortic dissection, 8 patients with pulmonary embolism were detected by multi-slice spiral CT, accounting for 79. 01％, 11. 11％ and 9. 88％ respectively. There were 64 cases of coronary artery stenosis, 10 cases of aortic dissection and 7 cases of pulmonary embolism detected by routine coronary angiography examination, accounting for 79. 01％, 12. 35％ and 8. 64％, respectively. There was no significant difference between the results of the two examination methods (P＞0. 05). There was no significant difference in the level of heart rate between patients with multi-slice spiral CTand those with conventional coronary angiography(P＞0. 05). The patient's satisfaction with multi-slice spiral CTwas 96. 30％, which was significantly higher (P＜0. 05). Conclusion For patients with emergency chest pain, the detection of multi-slice spiral CTis similar to that of routine coronary angiography in the cause of the disease, and has little influence on the patient's heart rate, which is an ideal method for clinical diagnosis of chest pain.
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Objective:To investigate the diagnostic value of 1.5T magnetic resonance imaging(MRI) and multi-slice spiral CT (MSCT) for subacromial impingement syndrome(SIS).Methods: The clinical data of 60 patients with SIS were researched by using retrospective analysis. All of patients were detected by using MRI and CT, respectively. And the diagnosis value of the two methods were compared.Results: The differences of sensitivity and Youden index between MRI and MSCT were significant, respectively (x2=12.987,x2=12.987,P<0.05), and the diagnostic sensitivity of MRI was higher than that of MSCT. While the diagnostic specificities of the two method were 100％. The differences of detectable rate for Bigliani I and Bigliani II between MRI and MSCT were no significant (x2=2.492,x2=2.031, P>0.05), respectively. The detectable rate of MRI for Bigliani III was significantly higher than that of MSCT (x2=9.087, P<0.05).Conclusion: The diagnostic sensitivity of MRI for SIS is higher than that of MSCT, and the main reason is that MRI has higher resolution ratio for soft tissue. Besides, it has no radiation. Therefore, it is appropriate to the diagnosis of SIS.
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Objective To analyze the typical imaging features of various internal biliary fistulas by multislice spiral CT (MSCT),and the diagnostic value.Methods the data of 56 cases of internal biliary fistula in Wuxi No.2 Affiliated Hospital of Nanjing Medical University from January 2011 to March 2018 were analyzed retrospectively.All cases were examined by MSCT plain scan and enhanced examination.The imaging features of various biliary fistula were analyzed and studied.Results Among 56 cases of biliary fistula,39 cases were gallbladder duodenum fistula,and the diagnostic sensitivity was 87.2％ (34/39).The total coincidence rate was 85.7％ (48/56).21 cases were fistula formation,and 11 cases of narrow neck syndrome.Gallbladder bile duct fistula,liver-gallbladder fistula,bile duct and duodenal fistula of 6 cases were showed.In 4 cases of complex gallbladder fistulas,3 cases showed fistula clearly including 2 cases of fistula and a "clover" sign.In the indirect CT signs of 56 cases of internal biliary fistula,the common imaging features:atrophy of gallbladder or incarceration,stone incarceration of biliary tract,gallbladder or choledochal duct and cavity viscera.Conclusion MSCT scan can not only distinguish the type of biliary fistula and the structure of fistula,but also display the fistula,shape,atrophy of gallbladder,gallbladder and bile duct gas,stone and surrounding conditions,which have important guiding significance for the formulation of the operation scheme.
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[Objective]To study the relationship between bridging septa thickening in the perinephric space and split renal function in acute unilateral upper urinary tract obstruction.[Methods]50 patients with acute unilateral upper urinary tract obstruction by calculus were analyzed retrospectively. According to the images of multi-slice spiral CT (MSCT)scanning,all cases were divided into thickened bridging septa group(n=25)and normal bridging septa group (n=25),The CT values of renal cortical in the plain(CTp)and renal cortical enhancing(CTe)phase were measured, the difference of increasement value(CTe-CTp)and the CT value ratio of the ipsilateral and opposite in renal cortical phase was analyzed by independent sample T test.[Results]The CT increasement value of bridging septa thickening and normal group were(103±30)HU and(128±24)HU respectively,the difference between the two groups was statistically significant(P<0.01);and CTac/CTuc were 0.81±0.13 and 0.96±0.06 respectively(P<0.01).[Conclusion]Thickening of bridging septa in the perinephric space with acute unilateral upper urinary tract obstruction will weaken the enhancement of renal cortical,and increased the likelihood of split renal function impairing.
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Objective:To discuss the value of low dose scanning technique of 16-slice spiral CT for the diagnosis of pulmonary diseases.Methods: A retrospective analysis was adopted to analyze 43 image documents were scanned by 16-slice spiral CT and to evaluate their qualities.Results:All of patients were examined in accordance with the requirements and all of image qualities were more than good. Although their background noise were increased, the image quality did not affect the display of anatomical structure. Therefore, it can satisfy the requirements for the diagnosis of pulmonary diseases.Conclusion:The pulmonary multi-slice spiral CT based on low-dose scanning technology can improve the detection rate of lesions, reduce radiation dose for patients, prolong the service life of the tube and reduce the maintenance cost, therefore it is worthy for further promotion.
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Objective@#To investigate the value of Multislice computed tomography volume rendering(VR) technique and 3D printing technique in auricular reconstruction.@*Methods@#Six patients were enrolled for auricular reconstruction with costal cartilage, including 5 congenital microtia patients and 1 traumatic auricular defect patient. We harvest the three-dimensional reconstructive data of the contralateral sixth, seventh, eighth and ninth costal cartilage with VR technique. Three-dimensional solid models were 3D printed with nylon material according to the data exported in STL format. Preoperative simulation was performed on the models, accordingly, we determined the strategies of costal cartilage harvest and framework fabrication, and operations were performed based on the pre-designed plan.@*Results@#In all 6 patients, the actual costal cartilage harvest and framework fabrication process was consistent with the preoperative design and simulation results, and more scientific than before. The shapes of reconstructed ears were vivid and natural. No complications such as infection, absorption, distortion and chest deformity happened.@*Conclusions@#Through costal cartilage VR and 3D printing technique, we could make more reasonable preoperative design and simulation. The results can be improved with reduced injury, while avoiding the risks of thoracic deformity.
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Objective To discuss the feasibility of double-low technique applied in aortic MSCTA.Methods Totally 70 patients with BMI not more than 25 kg/m2 were divided into a routine group and an experimental group randomly and equally,and then went through aortic MSCTA.Iohexol (350 mgI/ml) was injected with the velocity of 4 ml/s.The routine group had the parameters as 120 kV,120 mAs and 1.5 ml/kg contrast agent,and the experimental group had the parameters as 90 kV,120 mAs and 1.0 ml/kg contrast agent,while the other scanning parameters were kept the same in the two groups.The radiation doses,contrast agent doses and iodine contents were recorded in the two groups,and the image quality was assessed with double-blind method objectively and subjectively.Results The experimental group had the CT dose index volumes (CTDIvol),dose length product (DLP) and effect dose (ED) significantly lower than those in the routine group (P＜0.05).The two groups had the consistency of subjective scores (Kappa＞0.6) and image quality scores (not lower than 2) meet the desired requirements,and there were no significant differences between the scores (P＞0.05).Objective evaluation showed that the signal values of aortic trunk and major branch vessels as well as image noise SD of the experimental group were obviously higher than those in the routine group (P＜0.05).There were no statistical differences between the signal noise ratios (SNR) and contrast to noises (CNR) in the two groups (P＞0.05),The iodine content in the contrast agent of the experimental group was significantly lower than that in the routine group (P＜0.05).Conclusion Double-low technique applied in aortic MSCTA of the patient with BMI not more than 25 kg/m2 reduces the radiation dose and iodine content in the contrast agent,has the image quality meet the desired requirements,and thus is of great value for clinical application.
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Objective To study the assisted diagnostic value and significance in precise surgery of MSCT angiography in torsion of ovar-ian tumors in children. Methods The dual-phase enhanced MSCT images data of 15 children patients with ovarian tumor torsion which were confirmed by surgery were retrospectively analyzed. Showed the vascular changes around the ovaries and judged the ovarian tumors arise and torsion side with the vascular reconstruction methods of multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering ( VR) ,then compared with the operation situation. Results Among the 15 cases aged from 2 months to 11 years old who were de-tected with MSCT scanning and angiography, there were 11 cases of benign tumor (9 cases of ovarian teratoma and 2 cases of serous cystade-noma) and 4 cases of malignant tumor (3 cases of yolk sac tumor and 1 case of malignant mixed germ cell tumor). MSCTA displayed that o-varian vessels changes were abnormal thickening and twisting of distal feeding artery and tumor vascular network formation;and there were thickening, tortuosity, increased density and a few visible‘whirl sign’ in draining veins. Preoperative MSCTA displayed ovarian tumor blood supply arteries were found 5 cases of downlink of ovarian artery and 10 cases of asscending branches of uterine artery. There were 4 cases of ovarian tumor originated from the left ovary combined with reverse and 11 cases originated from the right ovary combined with reverse, which were consistent with intraoperative findings. Intraoperative MSCTA provide information which helped accurate chose of the surgical incision, precise abruption of tumor blood vessels and resection of the tumor and ovarian lesions, thus saved the operation time and reduced the blood loss. Conclusion MSCT angiography can not only provide diagnosis information of torsion of ovarian tumors in children,but also more impor-tantly,it has an important assisted significance in precision surgery.
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OBJECTIVE:To evaluate the effects of Sennae Folium combined with mannitol for bowel cleaning on multi-slice spiral CT bowel imaging. METHODS:52 patients receiving multi-slice spiral CT imaging examination in our hospital during Jun. 2011 to Jun. 2012 were collected retrospectively,and then divided into control group(22 cases)and observation group(30 cases) according to the methods of bowel preparation. Both groups fasted for 12 h before examination. Sennae Folium 20 g soaked in boiled water 500 ml for half an hour was given to patients in control group 12 h before examination,and then was soaked in boiled water 500 ml again for drinking and other pure water 1 000 ml was also given to patients. Sennae Folium 10 g soaked in boiled wa-ter 500 ml was given to patients in observation group 1 d before examination and 2 h after breakfast;soaked in boiled water 500 ml again 2 h after lunch;10% mannitol 500 ml and pure water 1 000 ml were given to patients after supper. Both groups received multi-slice spiral CT bowel imaging until the patients defecated watery stool after medication. The effective rate of bowl cleaning, image quality and the incidence of ADR were compared between 2 groups. RESULTS:The effective rate of bowel cleaning was 100% in observation group,which was significantly higher than that of control group(81.82%),with statistical significance(P<0.05). The excellent and good rate of imaging quality was 96.67% in observation group,which was significantly better than that of control group(81.82%),with statistical significance(P<0.05). The incidence of ADR as abdominal distension,nausea,intestinal mucosa damage in observation group were significantly lower than those of control group,with statistical significance (P<0.05). CONCLUSIONS:Sennae Folium combined with mannitol is effective method to prepare enteric multi-slice spiral CT imaging exam-ination,and perform good bowl cleaning effect,high image quality and low incidence of ADR.
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Objective:To investigate the 256 slice spiral CT pulmonary angiography (CTPA) application value by using multiple stage double mixed injection velocity tracking method in the diagnosis of pulmonary embolism.Methods: Fifty patients with pulmonary embolism from 2014 January to 2015 January were treated in our hospital patients as the research object. Using a random number table method, all patients were randomly divided into observation group and control group, 25 cases each group of patients, two groups of patients in our hospital by imaging with 256 slice spiral CT pulmonary artery (CTPA), the control group were treated by routine pre injection time density curve method, was used in the observation group than in mixed injection agent tracking method by two physicians, CT, using the double-blind assessment of two groups of patients with image quality and quantification of pulmonary artery trunk.Results: in the control group, 25 patients were satisfied with the time - density curve, the results of 5 conventional image quality scores showed no significant difference between the two imaging methods, was not statistically significant; two groups of patients with pulmonary artery trunk, branch clear imaging score and endovascular CT value had no significant difference(t=1.892,t=1.952,t=1.832;P>0.05), but the observation group patients with CTPA were examined by contrast agent dose was significantly lower than the control group, the patient''s heart rate, blood pressure was significantly lower than the control group(t=2.315,t=1.958,t=2.982;P<0.05), with statistical significance. Conclusion: CTPA with multi period mixed double flow injection method can guarantee the tracking based on image quality and diagnostic value can effectively reduce the contrast agent dosage and application effects of cardiac function, and the examination is relatively simple, safe, has clinical value of application and popularization.