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Objective To investigate the differential MSCT diagnostic features and comparative study of subtypes of renal cell carcinoma (RCC). Methods All of the renal cell carcinomas including 14 chromophobe RCCs (ChRCC), 10 papillary RCCs type 1(PRCC Ⅰ), 15 papillary RCCs type 2 (PRCC Ⅱ), 7 mucinous tubular and spindle cell carcinomas (MTSCCs) were investigated except for clear cell RCC. Dynamic contrast-enhanced CT was conducted in each case after intravenous administration of contrast agent, and the data including all the CT manifestations and the enhancement features were analyzed and contrasted together. Results The indexes including enhancement homogeneity, border of the tumor, renal pelvis violation, blood vessel in tumor showed statistically significant difference between the 4 subtypes (P<0.05), but no difference in the calcification of the tumor. Only the enhancement degree of MTSCC was lower than the kidney medulla in all of the three enhancement scanning phases, while the other 3 tumors' enhancement degree was higher than the kidney medulla in the cortical phase. Peak contrast enhancement of ChRCC was located in the cortical phase, however, peak contrast enhancement of the others did in the nephrographic phase. Conclusions Enhancement characteristics combined CT features is of great help in differential diagnosis of 4 subtypes of RCC.
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[Objective]To discuss the CT diagnosis and differential diagnosis of solid pseudopapillary tumor of the pancreas (SPTP).[Methods]The CT findings of 20 patients with SPTP proved by surgically pathology were retrospectively analyzed and summa?rized.[Results]SPTP were composed of solid and cystic components with surrounding capsule resulting to clear demarcation between tumor and normal pancreas without dilation of pancreatic duct. The tumor parenchyma was slightly hyperenhancement on arterial phase and showed gradual enhancement on venous and delayed phase.[Conclusions]The CT findings of SPTP have relative specifici?ty and can contribute to early diagnosis and differential diagnosis of SPTP.
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OBJECTIVE: To investigate the significance of intra-appendiceal air at CT for the evaluation of appendicitis. MATERIALS AND METHODS: We retrospectively analyzed 458 patients (216 men, 242 women; age range, 18-91 years) who underwent CT for suspected appendicitis. Two independent readers reviewed the CT. Prevalence, amount, and appearance of intra-appendiceal air were assessed and compared between the patients with and without appendicitis. Performance of CT diagnosis was evaluated in two reading strategies: once ignoring appendiceal air (strategy 1), and the other time considering presence of appendiceal air as indicative of no appendicitis in otherwise indeterminate cases (strategy 2), using receiver operating characteristic (ROC) analysis. RESULTS: Of the 458 patients, 102 had confirmed appendicitis. The prevalence of intra-appendiceal air was significantly different between patients with (13.2%) and without (79.8%) appendicitis (p < 0.001). The amount of appendiceal air was significantly lesser in patients having appendicitis as compared with the normal group, for both reader 1 (p = 0.011) and reader 2 (p = 0.002). Stool-like appearance and air-fluid levels were more common in the appendicitis group than in the normal appendix for both readers (p < 0.05). Areas under the ROC curves were not significantly different between strategies 1 and 2 in reader 1 (0.971 vs. 0.985, respectively; p = 0.056), but showed a small difference in reader 2 (0.969 vs. 0.986, respectively; p = 0.042). CONCLUSION: Although significant differences were seen in the prevalence, amount, and appearance of intra-appendiceal air between patients with and without appendicitis, it has a limited incremental value for the diagnosis of acute appendicitis.
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Acute Disease , Appendicitis/pathology , Appendix/pathology , Prevalence , ROC Curve , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Objective To investigate the clinical and head CT imageological features features in 276 cases of intracranial tubercu‐losis .Methods The clinical and CT features in 276 inpatients with confirmed intracranial tuberculosis were analyzed .Results These 276 cases of intracranial tuberculosis all were complicated by pulmonary tuberculosis ,among them blood‐borne type accoun‐ted for 49 .6% ; young and middle‐aged cases were predominant (72 .5% ) ; the majority manifested by the symptoms of fever (70 .0% ) and headache(66 .2% ) ;the summer and autumn had the higher incidence rate ,which were 167 cases(80 .7% ) .The posi‐tive detection rate of head CT plain scanning was 63 .4% ,which of enhanced scanning was 98 .6% .Among them ,236(85 .5% ) cases were tuberculous meningitis lesions ,158 cases(57 .2% ) were tuberculous encephalitis ,144 cases (52 .2% ) were tuberculoma and 133 cases (48 .2% ) were tuberculous vasculitis .Conclusion The clinical menifestations of intracranial tuberculosis are atypical ,but the head CT plain scannig displays multiple abnormalities .Moreover ,the enhanced scanning increases the positive detection rate . The lesions of meninges ,brain vessels and brain parenchyma often occur together .Therefore ,the diagnosis basis should be combined with clinic ,laboratory tests and head CT ,especially the clinical application of head CT enhanced scanning should be paid attention to .
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Objective To establish an orthotopic rat model of bladder cancer induced by N-methyl.nitrosourea (MNU)and to evaluate the diagnostic value of CT(computed tomography)scanning in this experimental model.Methods 50 SD rats were randomly divided into the control group(group A)with 15 rats and experimental group(group B)with 35 rats.Each rat of group B was treated with 2 mg MNU per dose every other week,totally 4 doses,by per urethra administration.Meanwhile,each rat of group A was treated with normal saline.Then,at the 14th week,all the rats were evaluated by CT scanning and pathological examination.Results Abnormal changes were detected in each of the 28 rats in group B by CT scanning,and manifested as local mass,thickening bladder wall accompanied with heterogeneous density.Bladder cancer was diagnosed by pathology.However,no bladder tumor was detected by CT scanning and pathologicalexamination in group A.Conclusion A rat model of orthotopic bladder cancer can be established by per urethra administration of MNU.CT scanning is a reliable diagnostic technique concerning this model.Furthermore,this technique can render US a more suitable rat model for further experimental studies on chemotherapy and radiotherapy of bladder Cancer.
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@#Objective To screen the parameter of CT scan for distinguishing patellofemoral malalignment. Methods 22 patients (42 knees) with patellofemoral pain and 12 asymptomatic volunteers (24 knees) were studied. The patellofemoral joints were examined with CT scan at 0°, 15°, 30° and 60° flexion. The parameters including femoral trochlear angle, lateral patellofemoral angle, patellar tilt angle, congruent angle and patellofemoral index were compared. Results Congruent angle and patellofemoral index in symptomatic group were bigger than those in asymptomatic group (P<0.01), but others were not different significantly between two groups (P>0.05). Conclusion CT scans is useful in diagnosis of patellofemoral malalignment. Congruent angle and patellofemoral index are more susceptible parameters for it.
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Objective To observe the change of brainstem auditory evoked potential(BAEP)of cerebral concussion patients.Methods The results of BAEP of 60 patients with cerebral concussion were analyzed and were compared with the results of CT test.Results Among the results of 60 cases of cerebral concussion,the abnormal rate of BAEP was 83%;the abnormal rate of CT test results was 21%.Conclusion BAEP is of great value in the early diagnosis of cerebral concussion and in the efficient evaluation of the function of brain stem.
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A retrospective study on 55 subjects with surrenal gland tumors diagnosed by CT showed that the tumors are commonly benign and pheocromocytoma was detected lately with a large size (> 3 cm, accounted for 73.5%). Heterogenous structure of the tumors before and after the injection of the contrasts showed characterustic sign of pheocromocytoma. The CT procedure has had a sensitivity of 100% and a positive predictive value of 89%. In the diagnosis of ganglion metastasis, these ratios were 2/3 and 99% respectively, in the evaluation of infiltration into the liver and the right kidney, these ratios were 58.30% and 95% respectively
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Tomography, X-Ray Computed , Neoplasms , MethodsABSTRACT
Objective To explore the value of the multi-phasic spiral CT scan in the diagnosis of gallbladder carcinoma.Methods The characteristic CT findings were reviewed in 42 cases with gallbladder carcinoma proven pathologically.Results The gall bladder carcinoma had certain enhancing characteristics: high density in hepatic artery period,same or high density in porch vein period,and no clear fadeaway in delaying period.In other words,the gall bladder carcinoma was higher enhancement than normal gallbladder wall and liver,and had long-term enhancement.Conclusion The multi-phasic spiral CT scan plays an important role in diagnosis and differential diagnosis of gallbladder carcinoma.
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Objective To detect CT appearances of different stomach diseases and evaluate the value of CT in the diagnosis of gastric diseases.Methods 62 cases of stomach diseases were detected by CT.Results 49 cases of gastric cancer,7 cases of stomach leiomyoma,3 cases of stomach ulcer,1 cases pylorus fleshy were examined,2 cases of stomach epineurial tumor.There was 91% correspondent rate of CT with pathologic examination.Conclusion CT imaging analysis is not only important to determine to gastric cancer,but also is great valuable to diagnose and differentiate the different stomach diseases.
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Objective To elevate accuracy of CT T4 staging diagnosis of esophageal carcinoma, we analysed relativity between CT diagnosis and postoperational pathology for the tracheal, bronchial, carinate early invasion. Methods From 1996 to 2002, 49 patients with cervical and middle-upper segment esophageal carcinoma proved by esophagectomy and pathology, whom were taken cervical or thoracic CT scaning before operation. Comparison was studied between postoperational pathology and CT diagnosis of tumor early invasion of the trachea, bronchus and carina. Results Of 49 patients with esophageal carcinoma, 21 lesions were in the cervical esophagus, out of 18 cases with tracheal early invasion performed by CT scaning, 14 cases comfirmed by postoperational pathology; 28 lesions in the middle-upper segment of thoracic esophagus, out of 17 cases with tracheal, bronchial or carinate early invasion diagnosed by CT scaning, 14 cases testified by postoperational pathology. Tracheal, bronchial and carinate early invasion of esophageal carcinoma proved by CT did not accord with postoperational pathology completely. The sensitivity, specificity, and accuracy of CT diagnosis for the tracheal, bronchial and carinate early invasion of esophageal carcinoma were 93.3 %, 33.3 %, 76.2 % in cervical esophageal and 82.4 %, 72.7 %, 78.6 % in thoracic esophageal respectively. The contingency coefficients of preoperational CT scaning comparison with postoperational pathology are 0.52, 0.77 respectively. Conclusion Early invasion to the trachea, bronchus and carina identified by conventional CT procedure for patients with esophageal cancer was more accurate and specific in thoracic than that in cervical. Esophageal tumor early invasion to the trachea, bronchus and carina performed with CT corresponded to postoperational pathology in some measure. Operatablity did not completely depend on the invasion of the trachea, bronchus and carina of esophageal carcinoma performed with CT.
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Objective To evaluate the clinical value of three-dimensional ultrasonography(3DUS) for breast cancer operation. Methods Sixty-eight patients with breast cancer were examined with two-dimensional ultrasonography(2DUS) and three-dimensional ultrasonography before operation. Results 3DUS not only improved the rate of sonography's diagnosis for breast cancer(88.2 % for two-dimension, 94.1 % for three-dimension), but also clearly showed patterns of breast lumps with the neighboring structure and the adjacent three-dimensional relations and the level of violations, such as the skin, chest muscle, chest wall, etc(the display rate is 75.0 %, 63.6 % and 60.0 % respectively). And it displayed the blood stream distribution in the mass of breast tumor more clearly and sensitively (95.6%). Conclusions 3DUS demonstrated the tumor's configuration, relations and the blood stream distribution. It had great significance in the operation for breast cancer.
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Objective To investigate the efficacy of CT on diagnosis of mediastinal neoplasms and tumor-like lesion to analyze the causes of misdiagnosis. Methods Forty two patients were examined with CT, 11 patients received contrast CT scan. All cases were confirmed by pathology. Results Various mediastinal neoplasms and tumor-like lesions with heterogeneous density have their own special demonstration on CT image and frequently occurred sites. The accuracy of diagnosis before surgery is 71.4 %(30/42). Conclusions CT is useful in improving the preoperative diagnosis rate of mediastinal neoplasms or tumor-like lesions and in helping clinicians work out treatment plan.
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90 cases of intracranial tumors confirmed by CT diagnosis and perative pathological ex- amination were reported in this article.According to the typical CT findings in combination with clinical manifestations,a qualitative diagnosis of the tumors might be made.Atypical CT findings in some cases were analyzed and correlated with pathological data in order to raise the accurate rate in the qualitative disgnosis of tumors.Authors' experience in the misdiagnostic cases was summed up.
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This anrticle analyses CT manifestation of 44 patients with obstructive jaundice demonstrated by surgical operation and pathological examination. It indicates that aocording to the distention of the biliary ductal system, the assured rate of the diagnosis may be attained to 100%. Aocording to the distensible range of the billiary ductal system, the assured rate of the diagnosis in the obstructive sites is 88.6 %. In combination with the disease history and the obstructive sites and the form changes of the obstructive sites, the assured rate of the diagnosis of the disease, causes is 81. 8%. This paper indicates that the malignant tumor is the main cause of the biliary ductal system obstruction. It aocounts for 72. 7%.