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Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
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Humans , Hypopharynx/diagnostic imaging , Valsalva Maneuver , Hypopharyngeal Neoplasms/surgery , Tomography, X-Ray Computed , CarcinomaABSTRACT
Objective To investigate radiation doses to examinees undergoing computed tomography (CT) scanning of different body parts (the head, chest, and abdomen) in medical institutions of Shijiazhuang, China, and to provide a reference for optimizing radiation protection for examinees in medical institutions. Methods March 2021 to March 2022, eleven medical institutions of radiation monitoring in Shijiazhuang were surveyed for the basic information, scanning parameters, and dosimetric data of a total of 930 adults and children who received CT examinations. The dosimetric data of the subjects were analyzed and compared with the domestic and international diagnostic reference levels and the results of other cities in China. Results In the above hospitals, the CTDIvol(P50) of CT subjects in children's group were 17.42-50.45 mGy, 2.13-14.01 mGy and 3.58-28.20 mGy, respectively. DLP(P50) ranges from 228.87 to 966.97 mGy·cm, 33.20 to 296.03 mGy·cm, and 74.90 to 926.53 mGy·cm, respectively. In the adult group, the CTDIvol(P50) in the head, chest and abdomen of CT subjects were 37.28-54.05 mGy, 6.43-14.99 mGy and 8.28-18.75 mGy, respectively. DLP(P50) ranges from 372.81 to 630.56 mGy·cm, from 219.77 to 467.93 mGy·cm, and from 313.86 to 689.87 mGy·cm, respectively. The distribution of radiation doses in different-grade hospitals varied greatly. The abdomen dose of the children's hospital was higher than other hospitals. Especially the primary hospitals were significantly higher than the recommended diagnostic reference level (DRL). Conclusion In some secondary and primary hospitals, the setting of CT scanning parameters was simplified, not specific to the subjects’ age and body types. They should strictly comply with the principal of optimizing radiation protection to strengthen radiation dose optimization and supervision, reducing the radiation dose of examinees in future examinations .
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Objective:To investigate the effect of different scanning centers on eye lens dose, image quality, and the dose reduction rate when using the organ dose modulation (ODM) technique in head CT.Methods:The porus acusticus externus of the head phantom was considered the scanning isocenter. The ODM was initiated and the spiral scans were performed at the scanning centers with the height of porus acusticus externus and its upper and lower 2, 4, and 6 cm, respectively. The scanning range was from the top of the head to the base of the head. Three thermoluminescent dosimeters (TLD) were placed on the surface of two eyes at each scan and the average measurement value was regarded as the radiation dose to the eye lens. The volume CT dose index (CTDI vol) and dose length product (DLP) were recorded. The scans were repeated with no ODM and the dose reduction rates at each scanning center were calculated. The regions of interest (ROI) in each group of images with ODM were drawn and the noise (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. Results:Compared with the isocenter, the maximum change rates of CTDI vol and DLP in each scanning center were 2.46% and 2.43%, respectively. The eye lens dose increased as the scanning centre moving upwars (i.e. the bed dropping) by 39.02% at the position of 6 cm above the isocenter and decreased by 35.91% at the position of 6 cm below the isocenter. With the seven groups of scanning centers, the reduction rates of CTDI vol and DLP caused by ODM were 7.95%-8.61%, 7.91%-8.61% respectively, and the difference in the reduction rate of each dose value was not statistically significant( P>0.05). The reduction rate for eye lens dose ranged from 18.09% to 26.14%, with the highest reduction rate at the position of 4 cm above the isocentre and the second rate at the isocentre (24.73%). The difference in the rate of reduction at each scanning center was statistically significant( t=0.13, P<0.05). As the scanning center moved up, the SD of the eye region decreased and the SNR increased, and the highest CNR at the isocentre was 239.79. The SD and SNR of the brain parenchyma region were 6.85-7.96 and 3.08-4.19 respectively, and the highest CNR at the isocentre was 244.79. Conclusions:When ODM technique is used in head CT, the scan centre has a significant effect on the eye lens dose and image quality. Meanwhile, the reduction rate of the eye lens dose caused by ODM is also affected. Therefore, porus acusticus externus is recommended as the scanning center in head CT.
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Objective@#To study the the application characteristics of paediatric CT examination by investigating four main children′s hospital of Shanghai.@*Methods@#All the CT scan cases of paediatric patients in this work were obtained from the radiology information system (RIS) database in four hospitals between 2011 and 2014. The distribution of using CT scans was analysed according to the age, gender, anatomical regions and the duplicated cases of the patient, then estimated the paediatric CT scan rates of four hospitals in Shanghai.@*Results@#Retrospective review of RIS showed 249 350 CT examinations from 175 672 young patients were performed between 2011 and 2014 in the surveyed hospitals. More males (62%) were scanned than females (38%). The majority of children receiving the examinations were 1 to 5 years old, which amounted to 40.3% in all. Cardiac CT accounted for 14.5% among all children of ≤1 year old CTs and accounted for 63.0% among all cardiac CT scans. There were 33 634 (19.1%) individuals who had received 2 or more CT scans during the four years. The estimated paediatric CT scan frequencies of four hospitals in Shanghai from 2011 to 2014 were 37.9 examinations per 1 000 population in 2011, 43.3 examinations per 1 000 population in 2012, 43.3 examinations per 1 000 population in 2013 and 39.0 examinations per 1 000 population in 2014.@*Conclusions@#The CT scan frequencies of four hospitals in children and young adults was almost keeping stable in Shanghai.
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Objective To study the the application characteristics of paediatric CT examination by investigating four main children′s hospital of Shanghai. Methods All the CT scan cases of paediatric patients in this work were obtained from the radiology information system (RIS) database in four hospitals between 2011 and 2014. The distribution of using CT scans was analysed according to the age, gender, anatomical regions and the duplicated cases of the patient, then estimated the paediatric CT scan rates of four hospitals in Shanghai. Results Retrospective review of RIS showed 249350 CT examinations from 175672 young patients were performed between 2011 and 2014 in the surveyed hospitals. More males (62％) were scanned than females (38％) . The majority of children receiving the examinations were 1 to 5 years old, which amounted to 40. 3％ in all. Cardiac CT accounted for 14. 5％ among all children of≤1 year old CTs and accounted for 63. 0％ among all cardiac CT scans. There were 33634 (19. 1％) individuals who had received 2 or more CT scans during the four years. The estimated paediatric CT scan frequencies of four hospitals in Shanghai from 2011 to 2014 were 37. 9 examinations per 1000 population in 2011, 43. 3 examinations per 1000 population in 2012, 43. 3 examinations per 1000 population in 2013 and 39. 0 examinations per 1000 population in 2014. Conclusions The CT scan frequencies of four hospitals in children and young adults was almost keeping stable in Shanghai.
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Objective To compare the differences in radiation doses from CT scanning between children of different age groups and adult patients by using both traditional radiation dose assessment parameters and size-specific dose estimates (SSDE).Methods A total of 406 patients undergoing lung CT examination were studied.They were sampled retrospectively and continuously from the Union Hospital and divided into six groups by age distritution (0-2,3-6,7-10,11-14,15-18,＞18 years old).The CTDIvol and DLP values were randomly sampled using MATLAB platform-based dicom data software.The SSDE and water equivalent diameter were also calculated according to the AAPM 220 Report.The differences in radiation doses from lung CT scaning between children and adult patients were analysed.Results The CTDIvol values for all age groups were significantly lower than the SSDE values.The differences were statistically significant (t =-36.36,-32.83,-30.36,-28.74,-23.89,P＜0.05).The SSDE values were 137％,94％,79％,57％ and 42％ higher than the CTDIvol values,respectively.The CTDIvol values for the adult group were also lower than the SSDE values,and the difference was statistically significant (t=-21.92,P＜0.05),and the SSDE value was about 41％ higher than the CTDIvol value.With the increased age,CTDIvol value,DLP value,Dw value and SSDE value for children of all age groups gradually increased and were significantly smaller than those for the adult group.The difference was statistically significant (F=63.39,203.28,89.27,103.44,P＜0.05).The conversion coefficient f for all age groups decreased significantly with age,which was significantly higher than that for the adult group,and the difference was statistically significant (F =109.83,P ＜ 0.05).Conclusions In lung CT scanning,the CTDIvol value significantly underestimated the radiation doses to children as compared to adults.CTDIvol values are more easily underestimated for younger patients.The SSDE method allows for more accurate reflection of the radiation doses to different patients,taking into account differences in the examined patient size.
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Objective To investigate the feasibility of using optimized protocol of iodine contrast agent with fixed injection time in triple-rule-out CT examination of acute chest pain patients. Methods A prospective study was conducted. The patients who underwent triple-rule-out CT examination of acute chest pain at the Second Hospital of Shanxi Medical University from September 2017 to June 2018 were enrolled. According to the patient's body mass index (BMI), they were divided into BMI ≤ 23 kg/m2 group and BMI > 23 kg/m2 group. The patients in each group were subdivided into two subgroups according to the random number table, and they were given two iodine contrast injection protocols with fixed injection time (14 s). Protocol 1 was performed with 55 mL of total iodinated contrast media: iodinated contrast media was first injected at 5.0 mL/s for 8 s, followed by the same contrast media injection at 2.5 mL/s for 6 s, finally followed by injection of 40 mL of saline at a rate of 2.5 mL/s. Protocol 2 with 60 mL of total iodinated contrast media: iodinated contrast media was first injected at 5.0 mL/s for 10 s, followed by the same contrast media injection at 2.5 mL/s for 4 s, finally followed by injection of 40 mL of saline at a rate of 2.5 mL/s. The primary and objective evaluation was conducted on the image quality of the patients' blood vessels in different segments. The primary score, CT value and contrast-to-noise ratio (CNR) of the pulmonary artery, coronary artery, aorta and total effective radiation dose for the examination were recorded. Results A total of 92 patients were enrolled in the analysis. There were 44 patients in BMI≤ 23 kg/m2 group, in which 22 patients received in protocol 1 and protocol 2, 48 patients in BMI > 23 kg/m2 group, in which 24 patients in protocol 1 and protocol 2, respectively. There was no significant difference in the effective radiation dose between the two subgroups receiving different injection protocols in different BMI groups (mSv: 6.7±1.1 vs. 6.5±0.8 between protocol 1 and protocol 2 in BMI ≤ 23 kg/m2 group; 7.8±1.0 vs. 8.0±1.1 between protocol 1 and protocol 2 in BMI > 23 kg/m2 group, both P > 0.05). In BMI ≤ 23 kg/m2 group, the CT value, CNR and primary scores of pulmonary artery images in patients receiving protocol 2 were significantly higher than those receiving protocol 1 [CT value (HU): 584±110 vs. 472±86 for main pulmonary artery, 561±93 vs. 467±78 for left pulmonary artery, 555±91 vs. 472±83 for right pulmonary artery; CNR: 24.2±7.5 vs. 18.7±4.6 for main pulmonary artery, 23.2±6.8 vs. 18.6±4.8 for left pulmonary artery, 22.9±6.7 vs. 18.8±4.7 for right pulmonary artery; primary score:4.0 (4.0, 4.0) vs. 3.5 (3.0, 4.0), all P < 0.05]; and there was no statistically significant difference in the primary or objective evaluation of coronary artery or aortic image quality between the two protocols. In BMI > 23 kg/m2 group, the CT value, CNR and primary scores of coronary artery and aortic images in patients receiving protocol 2 were significantly higher than those receiving protocol 1 [CT value (HU): 369±63 vs. 315±61 for proximal right coronary artery (RCA), 388±63 vs. 323±63 for proximal left coronary artery (LCA), 328±83 vs. 272±51 for ascending aorta, 348±82 vs. 272±49 for aortic arch; CNR: 15.0±4.6 vs. 12.3±4.7 for proximal RCA, 15.7±3.8 vs. 12.8±5.2 for proximal LCA, 13.2±5.3 vs. 10.4±4.1 for ascending aorta, 14.1±5.3 vs. 10.4±3.9 for aortic arch; primary score: 4.0 (3.0, 4.0) vs. 3.0 (3.0, 4.0) for coronary, 4.0 (3.0, 4.0) vs. 3.0 (2.0, 4.0) for aorta; all P < 0.05]; and there was no statistically significant difference in the primary or objective evaluation of pulmonary artery image quality between the two protocols. Conclusions The effective radiation dose of triple-rule-out CT examination of acute chest pain is relatively low. The low-dose iodine contrast agent application program with fixed injection time can meet the needs of clinical diagnosis of triple-rule-out CT examination of acute chest pain patients. For patients with BMI ≤ 23 kg/m2, both protocols 1 and 2 can obtain excellent image quality; in order to avoid the influence of superior vena cava artifacts, protocol 1 is recommended. For patients with BMI > 23 kg/m2, application protocol 2 can obtain stable, excellent image quality that is more suitable for clinical applications.
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Objective To explore the applicability of the three commonly used CT examination decision rules in Chinese head injured children. Methods This prospective observational study included 1538 children and adolescents (aged < 18 years), who were treated at the Emergency Department of First Hospital of Shanxi Medical University after head injuries. The three clinical decision rules include the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE; UK); the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury, that was developed by the Pediatric Emergency Care Applied Research Network (PECARN; USA), and the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule. Diagnostic accuracy had been evaluated by using the rule-specific predictor variables to predict each rule-specific outcome measure in populations who met inclusion and exclusion criteria for each rule. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and ROC curve were referred to the diagnostic accuracy. Indicators were characterized by 95％ CI. Results Of the 1538 patients, CTs were obtained for 339 patients (22.04％). Forty-nine patients (3.19％) had positive CT results, 8 patients (0.52％) underwent neurosurgery, 2 patients (0.13％) died, and 1 patient (0.07％) may be missed. In this study, CHALICE was applied for 1394 children (90.70％; 95％ CI: 89.24％-92.15％), PECARN for 801 children (52.11％; 95％ CI: 49.62％-54.61％), and CATCH for 325 patients (21.15％; 95％CI: 19.10％-23.19％). The validation sensitivities of CHALICE, PECARN, and CATCH rules were 92.6％(74.2％-98.7％), 100％ (56.1％-100％), and 85.7％ (42.0％-99.2％), respectively; the specificities were 78.1％(75.7％-80.2％), 48.0％ (44.5％-51.5％) and 70.8％ (65.4％-75.6％); positive predictive value were 7.7％ (5.1％-11.3％), 0.9％ (0.4％-1.9％) and 6.1％ (2.5％-13.2％); and negative predictive value were 99.8％ (99.2％-100％), 99.1％ (98.1％-99.6％), and 99.6％ (97.2％-100％), respectively. Conclusions The clinical decision rules of CHALICE, PECARN and CATCH have high sensitivities. The specificity of PECARN rule is lower than those of CHALICE and CATCH rules. The above three clinical decision rules can be used for the decision of CT examination in Chinese children with head injury in practice.
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To analyze the characteristics of the results of serum immunological tests and brain CT image examinations of atypical cerebral cysticercosis patients, so as to provide the reference for improving the diagnosis of the disease.Totally 446 suspected cerebral cysticercosis patients were chosen as the study objects, all of them were given experimental treatment with praziquantel, and then the patients with atypical cerebral cysticercosis were diagnosed according to the treatment effect and review results of brain CT or MRI. Meanwhile, all the 446 patients were tested for serum specific IgG and IgG4 antibodies and cysticercus circulating antigen (CAg) by ELISA, McAb ELISA and PEG-ELISA respectively, and the IHA test was also performed. All the patients received the brain CT examinations. The test results were analyzed statistically and the test performances of the methods above-mentioned were calculated.Among the 446 suspected cerebral cysticercosis patients, after the praziquantel treatment, there were 315 patients whose symptoms were alleviated, and they were diagnosed as atypical cerebral cysticercosis. Among the 446 suspected cerebral cysticercosis patients, the positive rates of specific IgG and IgG4 antibodies, and CAg were 15.47%, 15.02%, and 11.21% respectively, and the positive rate of IHA was 28.47% (χ2 = 52.45, P ＜ 0.01). The brain CT examinations showed that there were 79.14% (353/446) of patients with suspected cysticercus foci. The sensitivities of ELISA, McAb-ELISA, PEG-ELISA, IHA test and brain CT examination (suspected cysticercus foci) for the diagnosis of atypical cerebral cysticercosis were 15.36%–96.82%, the specificities were 63.36%–99.24%, the positive predictive values were 86.40%–98.52%, the negative predictive values were 32.83%–98.25%, the positive likelihood ratios were 2.64–27.86, the negative likelihood ratios were 0.05–0.81, and the OR values were 7.16–52.80. The consolidation of the five tests above-mentioned showed the OR value was 108.00, which was 2 times of the OR value of CT examination.Atypical cerebral cysticercosis is definitely diagnosed mainly by means of evaluating the effect of the diagnostic therapy (anti-cysticercus), and the serum immunological examinations and brain CT examination also have important reference values.
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Objective: To establish the relationship between the measured dose and the displayed dose in CT scans for children, and assess whether the displayed dose could be used as the basis to monitor the actual dose so as to provide data support for establishing a fast estimation method of actual dose in CT examination for children. Methods: The CT equipments with 16 slices detectors and 64 slices detectors of two manufacturers that often were used in clinical practice were selected in the research. CT dosage phantom that suited to children was used and pencil-ionization chamber was adopted to measure CT dose indexes of head scan and breast scan for children under various scan parameters. At the same time, displayed dose of the equipment was recorded and the ratio of measured dose and displayed dose was calculated . Results: The measured doses of the two manufacturers for head of children were 1.30-1.39 times and 1.17-1.26 times of displayed dose, respectively. And on thorax sequence, the measured doses were 1.95-2.27 times and 1.75-1.97 times of displayed dose, respectively. Based on above results, the measured dose of head was more close to the displayed dose than that of thorax sequence. Conclusion: In the CT examination of children, the ratio of measured dose to displayed dose shows good consistency under the different exposure conditions of same CT device model, and thus provides possibility to rapidly estimate the real dose on children according to the displayed dose in CT examinations.
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Revolution energy spectral CT had its structural innovation introduced from the aspects of detector,driving system and CT bulb as well as high voltage generator,technical principle analyzed from the aspects of SSF,multi-model iterative reconstruction, cardiac imaging unlimited as well as material separation and quantitative analysis, and clinical application described in diagnoses of liver cancer, cholecystolithiasis and kidney stone, coronary arteriongraphy and metal artifact elimination.It's pointed out Revolution energy spectral CT was a new method for identifying the focal nature,tumor homology and components of inorganic substance as well as analyzing multi material quantitatively and qualitatively.
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Objective:To investigate the clinical characteristics of patient with giant ovarian mature cystic teratoma with contralateral ovarian endometriosis cysts,and to analyze the diagnostic experience and treatment process.Methods:The chinical materials of one case of giant hepatic mature cystic teratoma with contralateral ovarian endometriosis cyst was analyzed retrospectively,and the related literatures were reviewed.Results:The patient was admitted to the hospital for peritoneal giant mass in a physical examination.A large abdominal cysts was seen by gynecologic ultrasound.In the left ovary,a 61 mm× 48 mm cystic light mass was seen,and the viscous liquid was found in it.The abdominal CT showed a huge lump of mixed density in the right abdomen.The areas of density of fat,calcification density and density of soft tissue were found in the abdomen.The liver was pressured by the mass.The right ovarian tumor size was about 40 cm×35 cm×30 cm,up to the diaphragm,down to the pelvic tumor;the posterior wall of tumor adhered the left lobe of liver and the liver was squeezed to the upper right.The size of the left ovarian endometriosis cyst was about 7 cm × 6 cm× 6 cm.The operation was to remove the right ovarian tumor and left ovarian endometriosis cyst,and to reconstruct bilateral ovaries.The pathological diagnosis was right ovarian mature cystic teratoma and left ovarian endometriosis cyst.After 2 years of follow-up,norecurrence of the tumor was found.The patient was conceived with in vitro fertilization frozen embryo transfer (IVF-ET).Conclusion:The huge mature teratoma combined with contralateral ovarian endometrial cyst,which adhereds to the liver,is rare.Surgical treatment will gain good prognosis.IVF-ET should be early done when the patient is going to be infertile after surgery.
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Objective: To investigate the clinical characteristics of patient with giant ovarian mature cystic teratoma with contralateral ovarian endometriosis cysts, and to analyze the diagnostic experience and treatment process. Methods: The chinical materials of one case of giant hepatic mature cystic teratoma with contralateral ovarian endometriosis cyst was analyzed retrospectively, and the related literatures were reviewed. Results: The patient was admitted to the hospital for peritoneal giant mass in a physical examination. A large abdominal cysts was seen by gynecologic ultrasound. In the left ovary, a 61 mm×48 mm cystic light mass was seen, and the viscous liquid was found in it. The abdominal CT showed a huge lump of mixed density in the right abdomen. The areas of density of fat, calcification density and density of soft tissue were found in the abdomen. The liver was pressured by the mass. The right ovarian tumor size was about 40 cm×35 cm×30 cm, up to the diaphragm, down to the pelvic tumor; the posterior wall of tumor adhered the left lobe of liver and the liver was squeezed to the upper right. The size of the left ovarian endometriosis cyst was about 7 cm × 6 cm × 6 cm. The operation was to remove the right ovarian tumor and left ovarian endometriosis cyst, and to reconstruct bilateral ovaries. The pathological diagnosis was right ovarian mature cystic teratoma and left ovarian endometriosis cyst. After 2 years of follow-up, no recurrence of the tumor was found. The patient was conceived with in vitro fertili zation frozen embryo transfer (IVF-ET). Conclusion: The huge mature teratoma combined with contralateral ovarian endometrial cyst, which adhereds to the liver, is rare. Surgical treatment will gain good prognosis. IVF-ET should be early done when the patient is going to be infertile after surgery.
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Objective To compare the image quality of sinus coronal CT scan before and after the involvement of quality control circle (QCC) to explore QCC's effect.Methods A QCC team was founded in April 2014,in which 10 key steps of QCC activities were executed,and the related data from April to November 2014 were analyzed to determine the effect of QCC on coronary sinus CT examination.Results The rate of excellent film was increased from 69.5％ to 96.3％ after the involvement of QCC,and the desired requirement was met.Conclusion QCC contributes to improving coronary sinus CT examination and enhancing the ability of the members,and thus is worthy promoting clinically.
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Objective To compare the image quality of sinus coronal CT scan before and after the involvement of quality control circle (QCC) to explore QCC's effect.Methods A QCC team was founded in April 2014,in which 10 key steps of QCC activities were executed,and the related data from April to November 2014 were analyzed to determine the effect of QCC on coronary sinus CT examination.Results The rate of excellent film was increased from 69.5％ to 96.3％ after the involvement of QCC,and the desired requirement was met.Conclusion QCC contributes to improving coronary sinus CT examination and enhancing the ability of the members,and thus is worthy promoting clinically.
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Objective:To observe the diagnosis effect about the MRI and CT examination for the patients with lacunar cerebral infarction(LAC).Methods: 82 cases early LAC patients during April 2014- June 2016 were diagnosed by two methods, MRI and CT, respectively. And the application effect of the two methods were compared based on image result.Results: In 82 cases of LAC 742 lesions confirmed by MRI and only 145 lesions confirmed by CT, and there was statistical significant between the two methods; especially in front lobe and thalamic, lesions detection rate using MRI was higher than CT, and there was statistical significant between the two methods(x2=6.59,x2=5.64,x2=6.42;P0.05);Conclusion: Both of CT and MRI can be used in early diagnosis of LAC, and MRI examination is more accurate for early or micro lesions and lesions happened in the frontal lobe, thalamus, capsula internal than CT. Therefore, MRI can be used as first choice eximination method in early diagnosis of LAC.
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Objective To discuss the risk factors of progressive hemorrhagic injury(PHI)in patients with craniocerebral injury.Methods Clinical data of 149 patients with closed craniocerebral injury were retrospectively analyzed,and the patients were divided into PHI group (42 cases)and non -PHI group (107 cases)according to PHI appeared or not.The patients were immediately given CT scan after admitted,the first CT review was given in the non -PHI group within routine 4 -8h after first CT scan,and due to deterioration of clinical symptoms,the PHI group was given CT review in advance.The intracranial hematoma volume changes between first CT and first CT review in the two groups were observed,then clinical symptoms,signs,biochemical indicators and CT performance in the two groups were compared,and analyzed risk factors of PHI.Results The intracranial hematoma volume showed in CT scan,first CT review and increment volume of the PHI group were significantly higher than the non -PHI group [(14.59 ±4.60)mL vs.(7.28 ±2.94)mL,(25.92 ±8.84)mL vs.(8.35 ±3.41)mL,(10.20 ±3.45)mL vs. (2.10 ±0.65)mL],the differences were significant (t =6.796,11.894,9.367,all P 10mL were major risk factors of PHI (P 50 years old,mydriasis,conscious disturbance,intracranial hematoma volume >10mL in first CT scan.
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Objective:To study the diagnostic value about enhanced CT and gastroscopy for esophageal varices.Methods: Ninety eight patients with esophageal varices were selected as objects. All the patients underwent enhanced CT and gastroscopy, took detailed records of the test results, and analyzed CT scan at the portal vein and spleen vein values.Results: The results of enhanced CT detection and gastroscopy diagnosis were similar in liver cirrhosis combined with esophageal varices, liver cirrhosis combined with esophageal and gastric fundus varices, and liver cirrhosis complicated with gastric fundus varices. The diagnosis of enhanced CT is significant difference (F=33.06,F=20.22;P<0.05) in detection of portal vein value and spleen vein value for mild, moderate, and severe patients.Conclusion: The enhanced CT and gastroscopy for detecting of esophageal and gastric fundus has satisfactory value, and enhanced diagnostic CT for detecting severities of the esophageal and gastric fundus varices also has a important significance.
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Objective To explore patients' recognition and demand for enhanced-CT examination-related knowledge. Method A self-designed questionnaire was used to investigate the recognition and demands for the knowledge among 295 patients who receiving enhanced-CT examination for the first time. Results The awareness rate of enhanced-CT examination related knowledge was 19.0%~51.5%and the demand rate was 62.4%~87.1%. The routes by which the patients acquired the knowledge included lecturing by medical staff personnel, reading the handouts and watching video. Conclusions The level of patients'recognition about the enhanced-CT examination related knowledge is low, but their demands for it is high. Therefore, the medical personnel should improve patients'awareness of enhanced-CT examination related knowledge in various ways.