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Objective To explore the early predictive value of red cell distribution width (RDW) for contrast-induced nephropathy (CIN) in patients after enhanced computed tomography (CT). Methods A total of 218 patients who underwent enhanced CT between June 2015 and June 2017 at Huizhou Central Municipal Hospital were enrolled in this study. Patients were divided into CIN group and no-CIN group. The diagnostic criteria for CIN is an increase in serum creatinine (Scr) of more than 44.2 μmol/L or 25％ of the baseline value within 3 days of contrast agent use. The general information and clinical characteristics in two groups were compared. The risk factors of CIN were analyzed by logistic regression analysis. The receiver operator characteristic curve (ROC) was used to assess the value of RDW for predicting the occurrence of CIN. Results Among 218 patients, 10(4.59％ ) patients had CIN. In the CIN group age, baseline Scr and baseline RDW were significantly higher, while hemoglobin, baseline estimated glomerular filtration rate (eGFR), red blood cell, white blood cell, albumin, and high - density lipoprotein cholesterol were significantly lower than those in the no - CIN group (all P＜0.05). Binary logistic regression analysis revealed that baseline RDW (OR=2.250, 95％CI 1.031-4.911, P=0.042) and eGFR (OR=0.963, 95％ CI 0.928-0.999, P=0.044) were correlated with the occurrence of CIN. ROC analysis confirmed the area under the curve of RDW as a predictor of CIN was 0.798 (P＜0.001). The cut - off value of RDW was 14.5％ , and the diagnostic sensitivity and specificity in CIN were 70.00％ and 85.58％, respectively. Conclusions Increased baseline RDW and decreased eGFR are the risk factors of the occurrence of CIN after enhanced CT. RDW has a good predictive value, and it may be a good biomarker for the early diagnosis of CIN.
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Objective To explore the imaging characteristics of common malignant sinonasal tumors for improving the diagnostic accuracy of the disease. Methods Radiological and clinical data of 78 patients with sino-nasal malignant tumors confirmed by pathological examination were retrospectively analyzed. Results Sinonasal malignant tumors lacked imaging specificity. Most of CT showed uneven soft tissue densities with unclear boundary and destruction of bone which invaded the soft tissue outside of the cavity including orbit or intra-cranium. There was moderate to remarkable enhancement of the lesion. T1WI in MR demonstrated homo-and hypo-intense signal , while T2WI revealed homo- and hyper-intense signal ,and post contrast MR imaging displayed heterogeneous con-trast enhancement. There was no significant statistical difference between CT and MRI in the detection rate of ma-lignant tumors(P > 0.05),but CT in combination with MRI improved the positive rate of detection(P < 0.05). Conclusions The imaging of sinonasal malignant tumors is complicated and lacks specificity. For complicated si-nonasal malignant tumors,enhanced CT in combination with MRI should be used to determine the nature and limi-tation of the tumor,and its relationship with the surrounding structures,resulting in improvement of the diagnostic accuracy of the disease.
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ObjectiveTo evaluate the inter-and intra-fractional clinical target volume (CTV) positioning errors of patients receiving postoperative simplified intensity-modulated radiotherapy (SIMRT) using cone beam computed tomography (CBCT).MethodsTwelve patients with liver tumors underwent postoperative SIMRT.CBCT images were acquired before and after the treatment.The clipbox volume for registration included the fiducial markers in the tumor bed and excluded the ribs and vertebral bodies.If any translational parameter of setup error before treatment exceeded 3 mm or rotational parameter exceeded 3°,the treatment couch was adjusted and a verification CBCT was acquired to assess residual setup error.Automatic bone match was used.A total of 214 acquisitions of CBCTs in 111 groups were analyzed.Inter-fractional translational CTV positioning errors in left-right (x),superior-inferior (y) and anterior-posterior (z) axis were calculated in 111 groups,and intra-fractional translational CTV positioning errors in 70 groups.Clinical to planning target volume (PTV) margins were calculated according to the formula:margin =2.0 ∑ + 0.7σ ( ∑ is systematic error,σ is random error).ResultsInter-fractional translational CTV positioning errors in x,y and z axis were -0.03 mm,-0.43 mm,1.02 mm,with systematic error ( ∑ ) of 1.50 mm,5.89 mm,1.97 mm,and random error (σ) of 1.76 mm,4.13 mm,2.42 mm,respectively.Intra-fractional translational CTV positioning errors in the x,y,z axis were 0.04 mm,0.86 mm,- 0.46mm,with systematic error (∑) of 0.46 mm,1.14 mm,0.31 mm,and random error (σ) of 0.95 mm,1.38 mm,0.91 mm,respectively.The calculate CTV to PTV margins were 4.5 mm,15.0 mm,5.8 mm in the x,y,z axis,respectively.ConclusionsThe CTV errors were inevitable when patients with liver tumors received SIMRT.Fiducial markers placed in tumor bed during operation were helpful for accurate positioning error analysis.
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Objective To assess the imaging characters and clinical applications of triphasie spiral computer tomography (CT) scanning in ureteral lesions. Methods We analyzed of 76 eonseeutive eases of elinieaUy evidenced ureteral lesions using the cross - sec-fional images and CTU derived from triphaaie spiral CT scanning retrospectively. Results Twetny - four cases of 76 ureteral lesions pa-tients were diagnosed as ureteral tumor, resulting in severe urinary tract obstruction. The shape, size, number, regional ureter wall in-flammatory infiltration of visible mass were verified as well. Twetny- six cases were caused by ureteral stones. The "edge" sign was shown clearly. Ten cases were ureteral inflammation, characterized by different ureteral wall thickening and enhancement feature. Eight cases were ureteral tuberculosis that secondary to renal tuberculosis. Uneven ureteral wall thickening, stiffness and mild to moderate densi-ty were shown in CT scanning. Ureteral congenital malformations were found in 3 patients. The other five cases were caused by exogenous factors. CT scanning could identify the mass general profile. Conclusion Triphasic spiral CT scanning plays an important role in ureteral lesions diagnosis and differentiation from other similar diseases.
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Objective To evaluate clinical applications of CT virtual endoscopy. Mathods 60 patients were examined with CTVE includes various body cavities such as air way , digestive tract, nose, pharynx,larynx and vessel. All cases were examined with spiral CT, then transfered the source images to work station dealt with special soft - ware package imitated the examination of fiberoptic endoscopy,some cases were compared with real fiberoptic endoscopy. Results In 30 cases of CT virtual bronchoscopy,all segmental and parts of sub - segmental bronchi were showed clearly, CTVE could reveal stenosis and bronchi occlusions in 20 patients with pulmonary carcinoma,but missed mucosal metastasis infitration and details in surface of mass showed with bronchiscopy. Digestive tract(n = 20) CTVE also well revealed mid and late carcinoma in stomach and colon (n = 8), but missed small polypus(n =1) and stomach ulcer(n = 2). In 7 cases of nasopharynx and larynx CTVE, carcinoma of nasopharynx(n =1) and carcinoma of larynx(n = 2) can clearly displayed. Vascular CTVE (n = 3) could display the details of aneurysm, such as the site of the entry tear,false lumen, neck and lumen of aneurysm. Conclusion CTVE plays an important role in the diagnosis of diseases body cavities.