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@#Primary small bowel tumors have low incidence and contain predominantly solid components, and the lesions are similar and difficult to be detected and distinguished with multislice spiral CT (MSCT) plain scans. In this article we describe contrast-enhanced MSCT technique and imaging characteristics for solid small bowel tumors or small bowel tumors containing predominantly solid components, including the type and use of contrast agents. In contrast-enhanced MSCT, small bowel imaging with CT has the advantages of determining the true extent of intestinal wall lesions, the possible extent of wall penetration, the degree of mesenteric involvement, and distant metastases, as well as easiness to detect and identify the blood supply vessels of small bowel tumors and assessment of the corresponding complications. Contrast-enhanced MSCT has become the best noninvasive imaging technique for the diagnosis, evaluation, and staging of solid small bowel tumors or small bowel tumors containing predominantly solid components. CT texture analysis (CTTA) is a new research hotspot and can be useful for the correct diagnosis of primary small bowel tumors containing predominantly solid components.
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Objective To investigate the value of 64 row CT low dose scanning technique in thyroid enhancement scanning.Methods From Jan.2016 to Dec.2017,152 patients with thyroid occupying lesions were studied in our hospital.All the patients underwent multislice spiral CT enhanced scan and pathological examination.The patients were divided into four groups according to the different current and voltage of multislice spiral CT.The significance of multi slice spiral CT scanning in the 4 groups was compared.Results There were no significant differences (U=0.1825,P=0.351 8＞0.05)among the four groups of multi-slice spiral CT in the detection rate of nodular thyroid lesions (96.21％,94.38％,85.71％,87.50％) or the detection rate of diffuse thyroid lesions (77.78％,83.33％,80.00％,83.33％).There were significant differences in CTDIvol,DLP and ED among the four groups (P＜0.05),and the radiation dose of group D was lower than that of group A and C.There were significant differences in thyroid CT value,background noise and background signal among the four groups (P＜0.05).The thyroid CT value,background noise and background signal in group D were higher than those in group A,B and C (P＜0.05).There was no significant difference in SNR and CNR among the four groups (P＞0.05).There was no significant difference in subjective evaluation of CT scan images between the four groups (P＞0.05).Conclusion The multislice spiral CT low-dose scanning technique used in thyroid enhanced scan can obtain satisfying scanning images,which is not only beneficial to the quality of the images,but also can improve the accuracy of the diagnosis and reduce the ionizing radiation damage to the patients.
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Objective:To explore the application value of multislice spiral CT scanning on abdomen for the detection of complication of acute pancreatitis.Methods: 120 patients with acute pancreatitis were divided into observation group (70 cases) and control group (50 cases) according to different detection method. The patients of control group were applied basic clinical detections included X-ray radiography and ultrasound imaging, while patients of observation group were supplemented CT detection besides these detections of control group. And situation of complication of patients in two groups were observed.Results: The positive rate of complications, which involved pancreatic pseudocyst, cellulitis, complications of gastrointestinal tract, pancreas hemorrhage and pancreatic ascites, in observation group was 97.14%, that was significant higher than that (62.0%) of control group (x2=24.74,P<0.05). Among 20 patients with pancreatic pseudocysts, there were 9 patients located at tails of pancreases, 6 patients located in bodies of pancreases, 3 patients located in small omental bursas, 2 patients located at heads of pancreases, and the CT images of them showed quasi-circular liquid form density lesions with clear boundaries appeared in lesion field. The CT images of cellulitis showed the volume of pancreas increased and the boundaries were fuzzy, and a larger range of density lesions with irregular soft tissue shape appeared in its periphery. CT detetions of gastrointestinal complications showed fuzzy point-shaped, strip-shaped and flake-shaped soft tissue-styled density shadow appeared in gastrointestinal tracts. The CT image of pancreatic ascites showed intraperitoneal fluid density shadow.Conclusion: Abdominal CT scan applied on patients with acute pancreatitis can increase the positive rate of complications and may be used as preferred detection method for clinical evaluation on the complications of acute pancreatitis.
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Objective To explore MSCT optimal examination time window for patients with occult rib fracture, and provide objective evidence for forensic injury. Methods Totally 105 cases with chest trauma were retrospectively analysed. They were examined in the first week after trauma and re-examined in different time windows by MSCT. The quantities of occult rib fractures in the first examination were compared to those in re-examinations. Results The quantities of occult rib fractures at different inspection time windows were mostly different. There was no statistically significant between the quantities of rib fractures in the first week and the second week, the first week and the sixth week later, the fourth week and the fifth to sixth weeks (P>0.05). There was statistically significant between the quantities of rib fractures in the first week and the thrid to sixth weeks, the second week and the third to sixth weeks, the third week and the fourth to sixth weeks (P<0.05). Conclusion The result of the study imply that the fourth to sixth week is the optimal time window of MSCT examination in the occult rib fracture.
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Objective:To correct the characterizations of MDCT radiation dose by exploring the relationship between CTDIw,∞ and CTDIw.Methods: CTDI100 and CTDI∞ were measured under the conditions of different collimations, pitches and tube voltages of Siemens Definition Flash CT, and CTDIw and CTDIw,∞ were calculated.Results: There were significant differences between CTDIw and CTDIw,∞ which were measured at 0.05 level. And there were no significant differences between CTDIw,∞ after corrected and CTDIw,∞ which were measured at 0.05 level.Conclusion:The characterizations of MDCT which were commonly used were not accurate enough. The result after correction were very closed to the real CTDIw,∞. This showed that the method to correct CTDIw of Siemens Definition Flash CT was mostly accurate. And methods to correct CTDIw of other MDCT needed to be further studied.
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Objective:To retrospectively analyze the CT features among gastric cancer, gastric lymphoma and gastric malignant stromal tumors, evaluated the application value of MDCT in gastric malignant tumor.Methods: Sixty two patients with gastric malignancies tumor confirmed by pathology underwent MDCT plain scanning and triphasic contrasted scanning before operation. Referring to the pathological results, to observe the CT signs, include: scope of tumors and involvement, the density of tumors and enhanced characteristics, mucosal membrane, the change of the stomach softness, peripheral lymph node enlargement, the involvement of other organs, and to make statistical analysis for imaging features of these tumors byx2 testing.Results: Sixty two cases of gastric malignant tumor included 42 cases of gastric carcinoma, 12 cases of gastric lymphoma and 8 cases of gastric malignant stromal tumor, were confirmed by postoperative pathology. The CT manifestations were as follows: the stomach mucous membrane surface involvement in all the gastric cancer, the positive rate was significantly higher than gastric lymphoma and stromal tumor. The area involved by lymphoma were more than two partitions, significantly higher than that of gastric cancer and stromal tumor (x2=36.643,x2=20.00;P<0.05). 39 cases (92.8%) of gastric cancer and 8 cases (100%) of malignant stromal tumors were significantly enhanced, but all gastric lymphoma were not obvious enhancement. The positive rate of enlarged lymph nodes in gastric cancer(61.9%) and lymphoma(83.3%) were higher than stromal tumor(12.5%)(x2=9.731,x2=6.603;P<0.05).Conclusion: The CT manifestations of the gastric cancer, lymphoma, malignant stromal tumors had different characteristics. Multislice CT for the diagnosis and differential diagnosis of gastric malignant tumor has important value.
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Objective To explore the diagnostic value of multislice spiral CT enterography(MSCTE) in patients with primary tumors of the small intestine.Methods Clinical data of 40 patients with primary tumors of the small intestine from Jan.2011 to Dec.2013 were analyzed.All patients were underwent MSCTE examination.Analyzed the coincidence rate between diagnostic results and pathological diagnosis.Results Pathological diagnosis of all patients showed that 15 cases were with small intestinal stromal tumors,10 cases with primary intestinal adenocarcinoma,9 cases with intestinal lymphoma and 6 cases with leiomyoma.The diagnoses of MSCTE were as follows:Twelve cases were with gastro intestinalstromaltumors,10 cases with primary intestinal adenocarcinoma,9 cases with intestinal lymphoma and 9 cases with leiomyoma.Consistency test(Kappa test) results showed that there was a good consistency between two dignosis methods(Kappa values =0.71).The coincidence rate of MSCTE in the diagnosis of primary tumors of the small intestine was 92.5％.Conclusion MSCTE is a convenient and safe method with high degree of accuracy,which provides a broad prospect for the diagnosis of primary tumors of the small intestine.
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Objective Ankylosing spondylitis (AS) can affect both the lumbar zygapophyseal joint and the centrum .This study was to compare multislice spiral CT ( MSCT) and MRI in the diagnosis of zygapophyseal joint lesions in AS patients and assess the role of zygapophyseal joint lesions in the early diagnosis of AS . Methods We retrospectively analyzed the lumbar imaging data of 41 male patients with AS .Forty-one male AS patients underwent MSCT , 18 receiving normal MRI , and the other 23 diffusion weighted imaging (DWI) and CE-T1WI-STIR in addition.Using Fisher′s Exact Test, we compared MSCT and MRI in their detection rates of a-pophyseal joint lesions and positive changes in the zygapophyseal joint and lumbar centrum .Then we analyzed the relation between the zygapophyseal joint lesions and the disease duration . Results The detection rates of zygapophyseal joint and centrum lesions were 90.2%and 58.5%on MSCT (P>0.05), and 80.5%and 46.3%on MRI (P>0.05), respectively.MSCT and MRI exhibited sig-nificant differences in the detection rate of centrum lesions (P0.05). These lesions could appear within 1 year after the onset of AS or ahead of vertebral changes . Conclusion Both MSCT and MRI can manifest zygapophyseal joint lesions , which may develop in the lumbar spine at the early stage of AS , ahead of centrum lesions .This is important for the early diagnosis of AS .
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Objective:To comparative Research with MSCT and CAG in the myocardial bridge-wall diagnostic coronary. Methods: Selected 93 patients for the study in January 2011 to the end of December 2013,MB-MCA patients diagnosed in Beijing North Hospital, all patients underwent catheter coronary angiography (CAG) and 64-slice spiral CT (MSCT), comparison of the diagnostic accuracy of the two inspection methods, and the results of the correlation analysis, results processing and analysis using statistical software SPSS17.0. Results:MSCT and CAG were two examination methods in the diagnosis of superficial and deep type MB-MCA, with a high degree of consistency in the diagnosis of MB-MCA average length, average depth comparison with statistical significance(t=3.021, t=3.758;P<0.05), there was not statistically significant comparison in the narrow detection rate. Conclusion:MSCT as a novel, non-invasive means of MB-MCA examination, the diagnosis results are reliable, accurate and capable of providing a richer diagnostic information for clinicians, clinician and patient can be widely applied.
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Objective To compare the diagnostic value of CT and diffusion-weighted imaging in extremity soft tissue tumors. Methods A total of 104 cases of extremity soft tissue tumors were examined with CT scanning and MRI. All cases were histologically proven. Then we compared the CT value of various types of tumors. The b values of diffusion were 0 and 500 s/mm2. The apparent diffusion coefficient (ADC) values of a large region with no hemorrhage, necrosis, scar tissue, or calcification representing the lesion were measured. ADC values of benign tumors, malignant tumors and normal muscles were compared. Results There were 68 cases of benign tumors and 36 cases of malignant tumors. The CT findings of 45 cases and the MRI findings of 87cases were in accordance with pathological examination. The diagnosis of 59 cases by CT and 17 cases by MRI were wrong. The CT features of soft tissue tumors showed the low density masses. The features of lipoma or cyst were typical on CT. There were large differences among the different types of tumors performance on T1WI and T2WI. The ADC values of the malignant tumors were significantly lower than those of benign lesion sand muscles (P < 0.01). There was no significant difference in ADC values between benign lesions and muscles. there was significant difference between the detection level of CT and MRI (P < 0.01). Conclusion CT can clearly show soft tissue tumor lesions and to clarify their relationship and the surrounding tissue, but can not accurately characterize. MRI diffusion-weighted imaging can better differentiate benign and malignant, and speculate the histological lesions sources. MRI detection level is significantly higher than CT and more consistent with a higher degree of pathology. Thus in the preoperative diagnosis of soft tissue tumors, diffusion-weighted imaging MRI should be preferred.
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Objective To evaluate the diagnostic value of 128-slice spiral CT angiography( MSCTA)for bypass grafts in patients after coronary artery bypass grafting(CABG).Methods One hundred and thirty-three bypass grafts (44 IMA grafts,89 saphenous veins grafts) of 46 patients after CABAG operation for 12 to 76 months were examined by MSCTA.Then the coronary angiography(CAG) was performed on those patients 3 - 10 days after MSCTA examination.The MSCTA results were compared with the angiography results.Results Among the 133 bypass grafts,MACTA examination showed that 17 grafts were occluded and 20 grafts were severe restenosis( restenosis degree ＞ 50％ ).There was also 17 occluded grafts showed in CAG examination as in MSCTA results.But 21 restenosis ( restenosis degree ＞ 50％ ) bypass grafts were identified by CAG.Compared with the CAG results,there was 1 false positive and 2 false negative in the MSCTA results.The overall sensitivity and specificity of MSCTA on evaluating the bypass grafts were 94.7％ and 98.9％.The positive predictive value and the negative predictive value were 97.3％ and 97.9％,respectively.Conclusion As a noninvasive examination,128-slice spiral CT could accurately identify and evaluate the bypass grafts lesions after CABG.
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Extracranial carotid athcrosclcrosis is the major cause of ischcmic stroke.The intumescence of carotid atherosclerotic plaque in meries results in lumen stenosis or detachment of plaque organisms.causing the distal vascular embolization,and thus resulting in a reduced cerebral blood supply and cerebral ischemic event.The volume data acquisition of multislice spiral CT angiography can provide high-quality two-dimensional and three-dimensional images,its imaging technique has become a very effective detection tool for carotid atherosclerosis.This article reviews the diagnosis application of multislice spiral CT angiograohy of carotid atherosclerosis and its pitfalls.
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Objective CT angiography (CTA) of the portal vein system by 16 detector spiral CT was performed to determine etiopathogenisis, collateral and gastro-renal shunt in the patients with portal hypertension. MethodsThirty-two patients suspected of portal hypertension were examined and reconstructed by arterial-venous double-phase scan. Results Twenty-seven patients with portal hypertension were revealed by CT scan and reconstruction, with spleen vein thrombosis in 4 cases, congenital cavernous transformation of portal vein in 3 cases, gastro-renal shunt in 9 cases, and simply liver cirrhosis and portal hypertension in 11 cases. Conclusion Portal CTA is a significantly important and useful examination method for portal hypertension patients, it could help to determine not only the range, degree and variation of esophageal and gastric varices, but also the etiopathogenisis of non-cirrhotic portal hypertension.
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Objective To explore the diagnostic value of multislice spiral CT (MSCT) for breast carcinoma.Methods One hundred and twenty consecutive suspicious cases of breast carcinoma diagnosed clinically and/or by imaging modalities were studied with MSCT prospectively. The dynamic contrast-enhanced serial scanning was done as follows:Scanning was triggered 35 s (early arterial phase) after beginning of contrast agent infusion at a speed of 3 mL/s by high pressure automatic injector, and would be repeated at the time point of 60 s and 150 s. Eventually, the CT diagnostic results were compared with the pathological consequences to calculate the diagnostic accuracy of MSCT for breast carcinoma. Results Eighty-nine patients with 100 foci of breast cancer from 120 suspicious cases were confirmed pathologically and their imaging data were analyzed. Among the 89 cases, 61 cases were invasive ductal carcinomas,12 ductal carcinomas in situ, 8 invasive lobular carcinomas, 6 medullary carcinomas and 2 inflammatory carcinomas. According to lesion morphologic appearance, lesion enhancement mode, time-density curve of lesion, and combination of all the above three parameters, the diagnostic accuracies were 78%, 82%, 84% and 92%, respectively. Conclusion MSCT has a great clinical value in diagnosing breast carcinoma.
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Objective To determine the CT features of the 16 - slice Spiral CT (MSCT) for aortic dissection (AD). Methods 16 - slice spiral CT were porformed in 25 patients of aortic dissection. All of patients were performed with unenhanced, contrast - enhanced scanning and three - dimensional reconstruction. Results 10 patients were normal on unenhanced and 15 patients were seen enlargred diameter of aorta. Intimal calcification and intimal displacement was seen in 8 cases and outer wall calcification was presented in 7 cases. After contrast - enhanced scanning, true and false lumen and intimal flap of AD could be shown in all of 25 cases (100%). The entry tears was revealed in 22 cases (88.9%). Beak sign was presented in all cases, but it was seen in the false lumen. The larger lumen was the false lumen in 88.5% of the cases. Intraluminal thrombus was presented in 12 cases. Conclusion Multislice spiral CT angiography is a safe,no - traumation,fast and accurate examination method. It can fully display theintimal flap,the true and false lumen and tear entrance, as well as the branches involved details and is therefore of important value for the diagnosis of aortic dissection.
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Objective To evaluate the value of clinical application of the three dimensional (3D) and multiplanar reconstruction (MPR) with multislice spiral CT(MSCT) in skull and maxillofacial fracture. Methods Twenty patients with skull and maxillofacial fracture were examined with MSCT, then MPR and three-dimensional surface shaded display (3D-SSD) were performed in work-station. Results MSCT MPR imaging clearly showed all fractures in 20 patients, and were more accurate than 3D-SSD in displaying tiny fracture and fracture of deep structure. 3D-SSD imaging could stereoscopically and directly show the fracture location, type, range, the course of irregular fracture line and fragment displacement. Conclusion MSCT MPR imaging in combination with 3D imaging is of high value in diagnosis and treatment of skull and maxillofacial fracture.
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Objective To investigate the quality assurance(QA) and quality control(QC)of 16 slices helical CT angiography in the lower limb. Methods 42 cases clinically suspected as the arterial disease of lower limb undergoing MSCTA were analyzed retrospectively. All reconstructed images were reformed by means of MIP, VR, MPR and CTVE. Results 22 patients were diagnosed correctly by using MSCTA. Compared to DSA and/or surgical results. Sensitivity, specificity and accurate rate were all 100%. Conclusion It is important to strengthen the QA and QC of the 16 slices helical CT angiography in the lower limb.
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0.05).The degree of angiostegnosis:1-grade stenosis in MSCTA was higher than that in DSA.The 2-grade,3-grade and 4-grade stenosis in DSA were higher than that in MSCTA(all P