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【Objective】 To explore the clinical features and the imaging diagnosis value of tuberous sclerosis. 【Methods】 We retrospectively analyzed the clinical data and imaging findings of 22 patients with tuberous sclerosis clinically diagnosed in our hospital. 【Results】 There were 12 male and 10 female patients, with the mean age of 7.3 years. Among them, 2 patients had a family history; 3 had unclear symptoms and the rest 19 ones except 1 had facial skin rashes for two years, which led to seek for medical help, and the other 18 had epilepsy attack, including 4 with mental retardation. All the 22 patients had characteristic subependymal nodules, including 21 patients with multiple abnormal changes in the bilateral cerebral hemispheres. There were 12 cases with abnormal skin appearance, 2 cases accompanied by facial cortical adenoma, 1 case with right subependymal giant cell astrocytoma, 1 case with bilateral ependymoma, 1 case with Dandy-Wallker malformation, 1 case with right renal duplication, 2 cases with renal hamartoma, 1 case with multiple renal nodules, 1 case with congenital patent ductus arteriosus, 2 cases with cardiac rhabdomyosarcoma, 1 case with multiple hepatic hamartoma, and 2 cases with multiple sclerotin sclerosis changes. 【Conclusion】 The clinical manifestations of tuberous sclerosis are complex and variable, and there are certain imaging characteristics associated with multi-organ involvement. Familiarity with the characteristics and imaging manifestations of lesions in various systems can make the clinical diagnosis more concise and accurate.
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Objective To investigate the predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors (GISTs). Methods The MSCT manifestations of 120 GISTs patients confirmed by operation, pathology and immunohistochemistry were analyzed retrospectively. The age of tumor onset, location, maximum diameter, morphology, growth pattern, cystic necrosis, calcification, peritumoralfat space, enhancement pattern, peritumoralor intratumoral vessels, peak period of enhancement, metastasis, and the relationship between Ki-67 proliferation index and pathological risk grade were also analyzed. Results Among 120 cases, there were 55 cases of extremely low and low risk, 28 cases of moderate risk, and 37 cases of high risk. There were significant differences in location, tumor diameter, morphology, growth pattern, cystic necrosis, peritumoral fat space, enhancement pattern, peritumoral or intratumoral vessels, peak period of enhancement, and Ki-67 proliferation index of GISTs (P < 0.05). There was no significant difference in calcification, CT plain scan, enhanced scan (3 phase), peak value and Ap、Vp、Dp of GISTs with different risk (P > 0.05). Conclusion There are differences in the performance of multi-layer spiral CT (MSCT) in GISTs with different risk levels. It is closely related to the classification of pathological risk. For the diagnosis of GISTs, clinical treatment plan formulation and prognosis, it has important reference value.
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Objective To compare the effect of multislice spiral CT and 1.5T magnetic resonance imaging in the diagnosis of acute brain injury.Methods From June 2015 to February 2017,110 patients with suspected acute craniocerebral injury in Linfen Central Hospital were selected as study objects.All the patients received multi-slice spiral CT and 1.5T magnetic resonance imaging examination.The diagnostic value of two kinds of examination methods was compared.Results The accuracy rate,misdiagnosis rate,missed diagnosis rate,specificity and sensitivity of the magnetic resonance imaging were 95.00％,10.00％,5.00％,90.00％,95.00％,respectively,which of the multi-slice spiral CT were 58.00％,60.00％,42.00％,40.00％,58.00％,respectively,there were statistically significant differences between the two methods (x2 =38.075,5.494,98.075,5.494,38.075,P ＜ 0.05).Conclusion 1.5T magnetic resonance imaging for the diagnosis of acute craniocerebral injury is more significant.
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Objective To evaluate the clinical value of 16 slice spiral CT 3D imaging in bone and joint trauma. Methods 30 patients with bone and joint trauma were collected.The patients received the 16 slice CT three-dimensional imaging and X -ray examination .The detection rate of bone and joint trauma , bone fracture , the collapse of the diagnosis were compared between the two methods .Results The detection rate of tibial fracture of 16 slice CT was 26.20％,which was higher than 3.33％of X-ray (χ2 =5.19,P=0.02).The detection rate of spinal fractures of 16 slice CT was 28.50％,which was higher than 6.67％of X-ray (χ2 =5.45,P=0.02).The detection rate of rib fracture of 16 slice CT was 30.00％,which was higher than 10.00％of X-ray (χ2 =4.81,P=0.02).The detection rate of pelvic fracture of 16 slice CT was 14.50％,which was higher than the X -ray (χ2 =4.29,P=0.04).The detection rate of tibial broken bone of 16 slice CT was 20.00％,which was higher than 3.33％ of X-ray (χ2 =4.04,P=0.04).The detection rate of pelvis broken bone of of 16 slice CT was 13.33％,which was higher than X-ray (χ2 =4.29,P=0.04).Conclusion 16 slice spiral CT three -dimensional reconstruction can accurately display the three-dimensional shape of lesions ,but also display the anatomical structure of spatial relations ,it is an ideal method for the diagnosis of fracture fragments of traumatic fracture .
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Objective To investigate the CT signs of small intracranial aneurysm and the application value of multi-slice spiral CT angiography (MSCTA) before and after clipping surgery and in follow-up.Methods MSCTA imaging data of 81 patients with highly suspected small intracranial aneurysms from March 2013 to March 2015 were analyzed retrospectively.The confirmed patients underwent clipping surgery of small intracranial aneurysms.The imaging findings before and after clipping surgery were analyzed and compared with those by DSA and what observed during surgery.Results The relative accuracy,sensitivity and specificity of MSCTA over DSA and surgical diagnosis were 93.83％,93.75％ and 94.12％respectively,and MSCTA gained high relative consistency over DSA and surgical diagnosis (Kappa=0.825).The accuracy of MSCTA for diagnosing small intracranial aneurysm was not significantly different from those by DSA and surgical diagnosis.MSCT plain scan mainly showed subarachnoid or intracranial hemorrhage,and found 71 rhomboic or saccular aneurysms in 60 patients before operation.Totally 64 patients went through clipping surgery,60 ones had satisfactory results in the reexamination by MSCTA 2 weeks after surgery,and there were no abnormality found in 36 patients in 6 to 12-month follow-up.Conclusion MSCTA can provide abundant information for clipping surgery of small intracranial aneurysms,and can be used as the preferred imaging method for postoperative evaluation and follow-up.
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Objective To investigate the clinical value of spiral CT in diagnosis of fracture of tibia plateau, to provide a reference for clinical treatment.Methods 50 cases of tibial plateau fracture were selected,they were diagnosed with X -ray and diagnostic multislice spiral CT three dimensional reconstruction scan respectively.The fracture type and so on of the two groups were compared.Results 50 patients were diagnosed as 14 cases of type Ⅰ, type Ⅱ 10 cases,Ⅲ type 6 cases,Ⅳ type 7 cases,Ⅴ type 5 cases,Ⅵ 8 cases,CT three -dimensional reconstruction diagnosis accuracy rate was 100.00%.X -ray diagnosis was accurate in 41 cases,diagnostic accuracy rate was 82.00%,the difference of two diagnostic ways was statistically significant (χ2 =8.657,P =0.000).All patients were not detected with significant artifacts,the line was good,the fracture line was blurred and visible fracture callus formation surgical outcome was good.Conclusion Spiral CT diagnosis in tibial plateau fracture has high accuracy,through clear and intuitive display morphological characteristics of the patients improves anatomical repair treatment,it is worthy of clinical application.
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Objective To investigate the combination of multiple CT signs in diagnosis and differential diagnosis of nodular goiters (NGs).Methods The CT images of 242 pathologically confirmed lesions (＞ 10 mm in diameter) from 188 patients with nodular goiters were retrospectively reviewed.The CT signs,including regular shape,cystic degeneration,clearer enhancement margin,strong enhancement of nodular goiters were compared with those of 236 pathologically confirmed lesions (＞ 10 mm in diameter)from 225 patients with papillary thyroid carcinomas (PTCs).The sensitivity,specificity and accuracy of different CT signs or their combination in diagnosis and differential diagnosis of NGs were analyzed.Results Regular shape was present in 208 of 242 NGs (86.0％) and in 35 of 236 PTCs (14.8％) (x2 =241.804,P =0.000).Cystic degeneration was present in 143 of 242 NGs (59.1％) and 7 of 236 PTCs (3.0％)(x2 =174.783,P =0.000).Clearer enhancement margin was present in 192 of 242 NGs (79.3 ％) and in 51 of 236 PTCs (21.6％) (x2 =159.318,P =0.000).Strong enhancement was present in 41 of 242 NGs(16.9％) and in 3 of 236 PTCs (1.3％) (x2 =35.108,P =0.000).Regular shape showed the highest sensitivity and accuracy for diagnosis of NGs (86.0％ and 85.6％),while strong enhancement showed the highest specificity (98.7％).The combination of regular shape and clearer enhancement margin showed the highest sensitivity and accuracy of 67.4％ and 80.5％,respectively.The combination of strong enhancement with any of other signs showed the highest specificity of 100.0％.The combination of regular shape,cystic degeneration and clearer enhancement margin showed the highest sensitivity,specificity and accuracy of 45.5％,99.6％ and 72.2％ respectively.The combing of 4 signs showed a sensitivity,specificity,and accuracy of 2.9％,100.0％ and 50.8％.Conclusion CT scan is effective for diagnosis of NGs,and the combination of different CT signs can significantly improve the specificity and reduce the incidence of misdiagnosis to avoid unnecessary surgery.
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Objective: To evaluate the diagnosis value of percutaneous puncture biopsy technique under CT guiding in clinical pathological changes of breast. Methods:46 patients with breast lumps or nodules, including six cases of pleural disease, were carried out percutaneous puncture biopsy under CT guide, where a coaxial Angiotech 17G trocar together with BiopincelSG were used in the puncture process. Results: 44 cases of pathological findings were acquired and the diagnosis ratio was 93.4%, including 9 cases of squamous cell carcinoma, 24 cases of adenocarcinoma, 3 cases of small cell carcinoma, 1 case of metastatic tumor, 1 case of tuberculosis cases, 5 cases of inflammation and 1 case of normal reflexed pleura. 2 cases have no clear diagnosis. Conclusion: The percutaneous lung biopsy technique under CT guide has the merits of less diagnosis trauma, high diagnosis accuracy and high clinical application value.
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Objective:Analysis of nasal lymphoma CT and MRI data, summarize imaging characteristics, provide help for clinical diagnosis. Method:Retrospectively analyzed the image manifestations of 32 cases of nasal lymphoma diagnosed by surgery and pathology. Lesion locations, tumor extension, bone destruction and its density, signal characteristics, enhancement degree, the situation of adjacent tissues were evaluated. Result:NK/T cells, T cell NHL have the characteristics: the lesions to diffuse growth, widely existed in nasal breathing zone, often involving middle and inferior turbinate, local bone slightly damaged, and no obvious bony shift. Tumor of uneven density, fuzzy boundaries, mixed signalse. The characteristics of B cell NHL: the lesion originated in the front of the nasal cavity, on the surrounding adjacent tissue compression performance, local feature is swelling growth and bone have insect damage sample sample, the dotted line change, very mild osseous shift, the tumor boundary is relatively clear, lesions density is uniform, and part of the uniform tumors had signal. Conclusion:Nasal lymphoma imaging changes have its characteristics. Image change prompts the pathological classification, providing help for clinical diagnosis.
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Objective Toinvestigatetheapplicativevalueof3D-DSAandheadMRIorCTfusion technology for guiding the individualized treatment of intracranial arteriovenous malformation (AVM ). Methods Twenty-onepatientswithAVMdiagnosedwithDSAattheDepartmentofNeurosurgery,Nanjing General Hospital of Nanjing Military Command from January 2015 to May 2015 were analyzed retrospectively. All patients performed DSA,MRI,and CT scan respectively before procedure,and they also performed 3 D-DSA and MRI or CT fusion. Of the 21 patients,15 performed MRI and 3D-DSA fusion,6 performed CT and 3D-DSA fusion. According to the image fusion results of the patients,the individualized treatment regimens were further developed,including microsurgical resection,endovascular embolization,and stereotactic radiotherapy (alone or combined treatment). The patients were followed up and observed for 2 to 6 months after procedure.Results Fromthe3D-DSAwithheadMRIorCTfusionimagesofthepatientsbeforetheprocedure not only could observe the vascular architecture of AVM,the relationship between the niduses and the surrounding nerve structures,but also could precisely locate the positions of AVM with small aneurysms or tiny AVMs. According to the results of image fusion,17 patients with AVM were treated with microsurgical resection,2 were treated with interventional embolization and stereotactic radiotherapy,and 2 were treated with stereotactic radiotherapy only. Of the 17 patients with AVM underwent microsurgical resection, none experienced intracranial rebleeding during the follow-up period. The last Glasgow outcome scale (GOS)score was 5 in 13 cases,and 4 in 4 cases. One patient with AVM underwent combined stereotactic radiotherapy had intracranial rebleeding during the follow-up period,and their last GOS score was 4. The other remaining 3 patients did not have new neurological deficits or rebleeding during the follow-up period,and theirGOSscorewas5.Conclusions 3D-DSA,headMRI,andCTfusiontechnologyarenovel, the operative method is simple,and the fusion image is accurate. They can effectively develop the individualized treatment regimens for patients with AVM.
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Objective To explore the preoperative assessment of airway morphology affecting the early-phase prognosis by observing congenital tracheal stenosis survival after surgical treatment.Methods Totally 52 cases of CTS surgically treated in the Shanghai children's Medical Center,from April 2007 to June 2013,were retrospectively analyzed to study their clinical characteristics,survival condition and related factors influencing the early-phase prognosis.Using log-rank test and Cox multiple factors analysis for statistical analysis.Results Overall postoperative survival rate of 3 months was 73.1％.There were 14 deaths among 48 patients.Single factor and multiple factors analysis showed that the cross-sectional area(CSA) of stenosis and Anton-Pacheco classification were both associated with early-phase prognosis as independent factors(P ＜0.05).Long CPB duration was a prognostic factor for the outcome of surgical treatment for CTS(P ＜ 0.05).CPB time was significantly longer in death cases than in surviving cases.Conclusion CSA and Anton-Pacheco classification were significant prognostic factors for CTS.The proper utilization of radiologic imaging allow for improved patient care.
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Objective To analysis the spiral CT scan diagnosis value of lymph node metastasis in thoracic esophageal carcinoma and investigate the rules of lymph node metastasis distributions.Methods 117 patients with surgically and pathologically proved esophageal carcinoma underwent CT scans of the chest before the surgical operation to identify the presence of lymph node metastasis and evaluate the diagnosis value of spiral CT in lymph node metastasis.CT imaging which was detected by CT and histopathological analysis performed with attention to the distribution characteristics.Results In 117 cases of esophageal patients,the diagnosis of sensitivity,specific and accuracy degree on lymph node metastasis were 86.0 ％,80.6 ％,84.6 ％.The most lymph node metastasis in the upper thoracic esophagus is the mediastinum group[8/14(57.1％)]and the trachea group[4/14(28.6 ％)].the middle is on the trachea surrounding group[21/41(51.2 ％)],the main pulmonary artery window group[17/41(41.5 ％)]and subcarinal group[15/41(36.6 ％)].the lower thoracic esophagus is around the side of preventriculus[7/19(36.8 ％)]and the left gastric artery[5/19(26.3 ％)]respectively.Conclusion Spiral CT imaging can accurately evaluate the lymph node metastasis of esophageal and distribution characteristics.
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Objective To explore the application value of VCT 64-row with 128-layer spiral extremities arterial imaging techniques and methods in the double lower limb artery.Methods 60 patients on lower limbs MSCTA angiography after Saul,flat on intravenous regiment note contrast agents CT angiography,image the maximum intensity projection(MIP),curved planner reconstruction(CPR),volume rendering(VR)after-treatment technology reconstructed vessels.Results All 60 patients showed the lower limb arterial and main branch.Conclusion 64-row helical VCT angiographic with 128-layer could clearly show that lower limb artery and pathological changes,and become main methods of preoperative evaluation and selection for the lower limb artery disease.
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Objective To determine the diagnostic value of double-phase enhancement and virtual endoscopy with multi-slice spiral CT (MSCT) on clinical staging of preoperative bladder cancer.Methods Seventy-five patients with bladder cancer diagnosed by fibercystoscope or operation. All of them were examined by double-phase enhancement and virtual endoscopy with MSCT. The images were analyzed and clinical staging were obtained. The findings of MSCT (71 cases)were compared with the post-operative histopathological results. Results There were 94 lesions to be found. The staging of MSCT: T1 26 cases,T2, 27 cases, T2b 13 cases, T3 12 cases, T4 16 cases. Histopathological results: pT1 28 cases, pT2a 24 cases, pT2b 14 cases, pT3 12 cases, pT4 16 cases. The sensitivity of preoperative staging on bladder cancer was 89.4 % (84/94) by double-phase enhancement of MSCT;the sensitivity of virtual endoscopy was 96.6% (84/87)for polyploidy tumors and 90. 9 % (10/11) for sessile lesions. When double-phase enhancement and virtual images were evaluated together, the sensitivity rate increased to 94.5%. When the tumors were confined within the bladder wall (≤T2b), the diagnostic accuracy of double-phase enhancement and virtual images was 91.2% (51/56). When the tumors had invaded the tissues and organs beyond the bladder wall (≥T3), the accuracy was 100% (28/28). Conclusion Double-phase enhancement and virtual endoscopy of MSCT is of great value in clinical staging of bladder cancer.
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Objective To explore the diagnostic value of multi-slice computer tomography (MSCT) in cause and location of agnogenic intestinal obstruction. Methods With light speed 16 multiple slice spiral-CT, 68 patients clinically suggested intestinal obstruction were underwent plain scan and second phase enhanced scan in whole abdomen. The image data was post-processed through GEADW4. 4 station with multi-planar reconstruction (MPR) and maximum intensity projection (MIP). The CT image characters of agnogenic intestinal obstruction were analyzed by comparing CT image suggestions with operation findings. Results MSCT clearly indicate the location, cause and severity of intestinal obstruction, and the diagnose accordance rate with operation findings was 95.6 % (65/68). Conclusions MSCT is a quick, simple and effective means for diagnosis of the location,causes and severity of agnogenic intestinal obstruction. It could provide an important clue for the doctors when making clinical decisions.
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Objective To investigate the diagnostic value of Multislice CT scanning in patients with acute thoracic trauma. Methods151 patients with chest wound admitted after Multislice CT scanning were reviewed and analyzed. ResultsThis group of 151 patients with chest wound after X-ray and CT inspection were as follows:lungs were damaged in 139 cases including 52 cases with traumatic wet lung,94 cases with lung rip,28 cases with lacerated wound and 7 cases with tracheal bronchial tube damage.Damages outside the lungs were found in 108 patients including 83 patients with trauma in pleural membrane(hemothorax 27 cases,pneumothorax 32 cases and blood pneumothorax 24 cases),mediastinum damage in 9 cases(vertical mediastinal pneumatosis 6 cases,hematocele 4 cases and traumatic disphragmatic hernia 2 cases),thoracic wall damage in 76 cases(rib bone fracture 59 cases,breast bone fracture 18 cases and costal cartilages damage 5 cases).Clavicle and scapula fracture in 31 cases. ConclusionMultislice CT scanning was principal method for the diagnosis of chest wound,it had the advantages of scanning range,quick scanning and characteristics of high sensitivity,and it would certainly play a vital role in first aid process in emergency medical treatment of wound.
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Objective To evaluate the CT and MRI characteristics of Primary Central Nervous System Lymphoma(PCNSL)in immunocompetent patients,and enhance its diagnosis level.Methods CT and MRI data of 20 patients with PCNSL confirmed by histo-pathology were analyzed retrospectively.MRI scans were performed with and without Gadolinium contrast.Two of them had contrast-enhanced CT scan;six had CT scan without contrast administration;1 had CT scan with both non-contrast and contrast enhancement.Re- suits Totally,38 lesions were found in all patients:14 lesions of them were single and 24 lesions were found in 6 patients.Generally,the lesions were located in the surface and/or midline of the brain.The signal features and density were similar to meningioma,and strongly enhancing after contrast administration.Thirty-six of the 38 lesions had spicular sign peripheral to the lesion.Conclusion Although the manifestations of the PCNSL are variety,there are still many characteristics in the medical imaging,especially in the locations,the signal features,and spicular sign in the edge of the lesions after contrast material injection.
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Objective To explore the image characteristics of the opening of the blood brain barrier (BBB) at the early stages of severely scalded rabbits. Methods Twenty-six rabbits inflicted with 50% total burn surface area (TBSA) of Ⅲ degree were randomized into 7 groups: pre-scald, post-scald at 1, 2, 3, 4, 5, and 6 h groups. The spiral CT (SCT) and MRI were used to observe the image changes during the corresponding phases. Samples from the anterior cortex, temporal lobe, posterior cortex, cerebellum, and brain stem were examined by light and transmission electron microscopy (TEM), respectively. Results The pathological features showed that neurons and oligodendrocytes swelled lightly and blood vessels were congested and dilated at 3-4 h after scald. CT image changes were found at 5 h after scald and became more remarkable at 6 h after scald. MRI image changes could not be found within 6 h after scald. Conclusion The opening of BBB is earlier than the formation of edema. Enhanced CT plays an important role in manifesting the opening of BBB at the early stages of severely scalded rabbits.
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Objective To study the findings of not common adrenal space occupying lesion with spi- ral CT scanning.Methods The spiral CT scan datum of 10 patients pathologically proved uncommon adrenal occupying lesion were analyzed retrospectively.Results In all 10 cases of uncommon adrenal occupying le- sion,including 2 cases of primary adrenocortical carcinoma at right adrenal gland,1 case of right adrenal schwannoma,1 case of left adrenal ganglioneuroma,1 case of multiple endocrine neoplasiaⅠ,1 case of Castleman disease in the area of left adrenal gland,3 cases of adrenal myelolipoma with 4 lesions,1 case of fight adrenal gland cyst.Adrenal myelolipoma and cyst were diagnosed easily.CT manifestations of primary a- drenocortical carcinoma were usually malignant cues.To determine the nature of other uncommon adrenal oc- cupying lesion was difficult.Conclusion There are some characteristics with different values at different un- common adrenal space occupying lesions with spiral CT scanning,and dynamic SCT scans are very valuable.
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Objective To recognize the features of the ligamentum teres hepatic(LTH) in multi-slice spiral CT,and to preliminarily explore its clinical value.Methods A total of 130 patients without liver disease underwent abdominal scanning with a 16-slice spiral CT scanner.LTHs,as focused points,were observed by using postprocessing techniques such as multi-planar reformation(MPR),slab maximum intensity projection(slab-MIP) and slab volume rendering(slab-VR).Results The LTH was detected by multi-slice spiral CT in 90.8%(118/130).On these oblique-sagittal MPR,slab-MIP and slab-VR images,LTH presentedas slightly high density smooth cord-like structure in accordance with its anatomical morphology and position.The mean diameter of fissure portion of normal LTH was(5.44?0.96) mm(range 3.2-7.2 mm) measured at its middle region,and that of free portion of normal LTH was(3.43?0.91) mm(range 1.6-6.0 mm).Conclusions Multi-slice spiral CT demonstrates the LTH clearly,and has a potentialto evaluate the LTH before abdominal operation in which the LTH is to be used as an autogenous repairmaterial.