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Objective@#To study the clinical application value of B-ultrasound in the diagnosis of hepatic cystic hydatid disease.@*Methods@#From June 2017 to July 2017, 400 suspected patients with hepatic cystic hydatid disease in the Traditional Chinese Medicine Hospital of Zhoushan were screened in Tibet.All the patients were examined by CT and B-ultrasound.Two CT diagnostics experienced in CT diagnosis and two ultrasound doctors experienced in ultrasound diagnosis were selected to analyze the CT images, B-ultrasound images of the patients, and make the diagnosis.The results of operation or serological examination(clinical diagnosis) were used as the reference.The sensitivity, specificity and accuracy of CT, B-ultrasound in the diagnosis of hepatic cystic hydatid disease were calculated and compared.The consistency between CT, B-ultrasound diagnosis and clinical diagnosis of hepatic cystic hydatid disease was analyzed by consistency test.According to the results of clinical diagnosis, the patients with hepatic cystic hydatid disease were divided into simple cyst type, multiple cyst type, daughter cyst cysts type, cyst calcification type and cyst solid type.The diagnostic coincidence rate of CT, B-ultrasound for different types of hepatic cystic hydatid disease was compared.@*Results@#A total of 358 cases were confirmed as hepatic cystic echinococcosis by operation and serological examination, and the remaining 42 cases were confirmed as hepatic bubble echinococcosis.The sensitivity, specificity and accuracy of CT in the diagnosis of liver cystic echinococcosis were 94.13%, 83.33%, 93.00%, respectively, which were lower than those of B-ultrasound (98.88%, 97.62% and 98.75%) (χ2=11.978, 4.974, 16.720, all P<0.05). According to the consistency test, the consistency coefficient(Kappa) of CT and B-ultrasound in the diagnosis of hepatic cystic echinococcosis was 0.549 and 0.713, respectively, and the diagnostic consistency between B-ultrasound and clinical diagnosis was better than CT.The diagnostic coincidence rates of B-ultrasound for hepatic cystic echinococcosis of simple cyst type, multiple cyst type, descendant cyst type and cyst consolidation type was higher than those of CT(χ2=13.832, 6.747, 6.331, 5.008, all P<0.05). The diagnostic coincidence rate of B-ultrasound and CT for calcified hepatic cystic echinococcosis had no statistically significant difference (χ2=0.213, P>0.05).@*Conclusion@#B-ultrasound can accurately diagnose hepatic cystic hydatid disease and can be used as the first choice for diagnosis of hepatic cystic hydatid disease, and B-ultrasound can also differentiate different types of hepatic cystic hydatid disease.The diagnostic value is significant.
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Objective To probe into the anatomy and clinical application of the facial nerve canal surface by multislice spiral CT image curved planar reformation. Methods Fifty patients with facial nerve disease were selected as study group from January to November in 2010, 50 healthy subjects were selected as control group, using models of multislice spiral CT scan for the patient, scanning from the upper edge of the orbital under external auditory canal edge of the connection as a horizontal line, ranging from the lower edge of mastoid process to the petrous bone on the edge of the data obtained in the Wizard workstation reconstruction. All the measurements were more than two measurements of the average physician. Results Normal facial nerve canal in control group could be displayed clearly in an image, display rate was 100.00%(50/50), and the segment data could be accurately measured; axial reconstruction, reconstruction of coronal and sagittal reconstruction of the three comparison of measured direction, fan sections, horizontal and vertical segments of the length and diameter were not significantly different (P＞0.05), and the first and second bending angle of bending angle was no significant difference (P ＞ 0.05 ). Compared with control group, the patients with vascular disease in study group showed significantly decreased rate, the difference was significant (P ＜ 0.05). Conclusion Curved planar reformation of multislice spiral CT diagnosis of facial nerve canal disease has great clinical significance, should be widely applied.
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Objective To investigate the effect of different injection rate of contrast medium on the quality of multislice spiral CT portography(SCTP). Methods Thirty patients with no prominent difference in the age and weight randomly divided into 3 groups (10 cases each group) underwent contrast-enhanced CT scan of abdomen. Non-ionic contrast medium (300 mgⅠ/ml, 1.5 ml/kg) was injected through antebrachium veins with power injector at the rates of 2.0 ml/s,3.0 ml/s and 4.0ml/s. Arterial phase acquisi-tion was made using the software of automated bolus triggering with a ROI placed on abdominal aorta when 100 HU was reached, and 7 seconds and 20 seconds later, portal phases were done respectively. The attenuations of portal vein(PV) and hepatic parenchy-ma of 3 groups were measured on source images. Then the oblique axial and coronal maximum intensity projection(MIP) maps were reconstructed at workstation and PVs were observed. Statistics analysis was made with software of SPSS 11.5. Results The attenu-ations of PV in 2.0ml/s, 3.0 ml/s and 4.0 ml/s groups were (150.80±21.16)HU, (170.90±17.26)HU and [181.90±22.88) HU respectively. There was obvious difference between 2.0ml/s and 4.0ml/s groups for atteuation of PV(P=0.017). The differences of CT attenuation of PV-hepatic parenchyma in three groups were (50.20±17.40) HU, (67.10±23.08) HU and (76.20±22.75) HU respectively. Prominent difference was also found between 2.0 ml/s and 4.0 ml/s groups(P=0.039). The grades of segment of PV displayed on SCTP maps were 4.20±1.14,4.90±0.99 and 5.50±0.53 in 2.0 ml/s,3.0 ml/s and 4.0 ml/s groups respectively, which were of obvious differences between them (P=0.013). Conclusion Injection rate of contrast medium dose influence the quality of SCTP of PV,SCTP quality is best with velocity of flow at 4.0 ml/s.
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Objective To muhi-directionally visualize and measure the normal anatomy of palatovaginal canal and its communications with high-resolution multi-slice spiral CT and its post-processing technologies.Methods One hundred and sixty-seven subjects with normal PPF and its communications were examined by 16-MSCT using high-resolution technique.The MPR and CPR images of palatovaginal canal were obtained on postproeessing workstation.The length and diameter of the palatovaginal canal and its communications was measured and analyzed with one way ANOVA analysis and independent samples t test.Results In this study, the detection rate of palatovaginal canal on 167 subjects was 98.8% (330/334).The mean length of left and right palatovaginal canal was (1.18 ± 0.22) cm and (1.07 ± 0.29) cm, respectively.The mean diameter of anterior opening (0.19±0.06)cm was significantly larger than median (0.10 ± 0.04) cm and posterior opening (0.16 ± 0.07)cm in left palatovaginal canal (F = 211.109, P < 0.01).Similarly,The mean diameters of anterior, median and posterior opening in right palatovaginal canal were (0.19±0.06)cm, (0.10±0.03)cm and(0.16±0.06) cm, respectively (F = 139.350,P <0.01).No significant difference on length measurements was revealed between the men [left: (1.18±0.22) cm; right: (1.12 ± 0.31)cm] and women [left: (1.07±0.25)cm; fight: (1.02±0.25)cm] (left: t = 0.919, P > 0.05 ;right:t = 1.117,P > 0.05).Between the men [left: (0.19±0.06) cm, (0.10 +0.04) cm and (0.16±0.07) cm; right: (0.19±0.06) cm,(0.10±0.04) cm,(0.16±0.06) cm] and women [left: (0.20±0.08) cm, (0.10±0.04) cm and (0.15±0.05) cm; right: (0.20±0.06) cm, (0.09± 0.04) cm and (0.15±0.05) cm], no significant difference on diameter measurements was revealed (left: t =- 1.183,0.190 and 1.660 ; fight: t = - 1.420,1.210 and 0.802 ; all P > 0.05).Conclusion On the basis of high-resolution MDCT scan, MPR and CPR images could visualize clearly the morphologic features of the palatovaginal canal, which may be helpful for making diagnostic and therapeutic decisions because more imaging information could be obtained.
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Objective To analyze the injury types and radiologic findings of the wounded in the major Wenchuan earthquake of May 12, 2008. Methods Radiologic results of 1013 victims admitted to MianYang Central Hospital from May 13, 2008 to May 19, 2008 were studied retrospectively, including X-ray of 854 cases (about 2900 local exam positions) and CT scan of 259 cases (about 300 local exam positions). Results 733 cases showed radiologic abnormalities, including 527 cases of single region injury (accounting for 52. 0%) and 206 cases of multi-region injury (accounting for 20. 3%), the overall positive rate was 72. 4%. The results were in the following order on the basis of the incidence, 288 cases of lower extremity injuries (28.4%), 151 cases of thoracic injuries(14. 9%), 136 cases of upper extremity injuries(13.4%), 133 cases of spine fracture(13.1%), 114 cases of pelvic fracture and dislocation(11.3%),88 cases of craniocerebral injuries (8. 7%), 25 cases of maxillofacial fracture (2. 5%) and 8 cases of abdominal tranma(0. 1%). Thoracic injuries included: rib fracture in 136 cases, pulmonary injury in 59 cases, and sternal fracture in 3 cases. Spinal fracture included: cervical vertebrae involved in 12 cases,thoracic vertebrae involved in 43 cases, lumbar vertebrae involved in 93 cases, and Sacrococcygeal vertebraeinvolved in 12 cases. Craniocerebral injuries included: skull fracture in 41 cases, endocranial abnormalities in 72 cases. Abdominal trauma included: intestinal obstruction in 4 cases, renal contusion in 3 cases and abdominal wall hematoma in 1 case. Conclusion Most parts of the body can be injured by earthquake.Bone fracture and dislocation of lower extremity are the most common manifestations.
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Objective To evaluate the role of CT and MR/in the diagnosis of posterior reversible encephalopathy syndrome(PRES).Methods Eight women with PRES(6 pregnant women,1 case after chemotherapy,and 1 patient with hypertension)were enrolled in our study.All of them had MR imaging (T_1WI,T_2WI,FLAIR,DWI),and five cases underwent post-contrast T_1WI and three dimensional contrast enhanced MR angiography(3D CEMRA).Two cases also had CT scan.Results MRV in all 8 patients showed no evidence of stenosis,dilation,or thrombosis in cranial veins and sinuses.MRI demonstrated multiple lesions located in bilateral parieto-occipital lobes(8 cases),bilateral basal ganglia(2 cases),and bilateral frontal lobes(4 cases).The lesions were prominent within white matter,some of them involved gray matter(3 cases).Lesions appeared as hyperintense signals on FLAIR and T_2-weighted images, isointense or mildly hypointense signals on T_1-weighted images,normal or decreased intensity on DWI,and isointensity or hyperintensity on apparent diffusion coefficient(ADC)maps.Post-contrast T_1WI showed mild reversible enhancement and 3D CEMFdisplayed numerous reversible“grape-like”enhancements in terminal arterial branches along the middle cerebral artery(MCA),anterior cerebral artery(ACA)and posterior cerebral artery(PCA).Follow-up scan showed decreased abnormal signals.Conclusion Lesions of PRES are usually located in parieto-occipital lobes,especially in white matter,but they can also be seen in frontal lobes and basal ganglia bilaterally.Post-contrast T_1WI and 3D enhanced MRA can provide useful information in the manifestation of reversible enhancement.MRI has advantages to display lesion in PRES,
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Objective To analyze the correlation factors between CT imaging features of pulmonary embolism(PE)and clinical severity stratification,to explore the value of CT pulmonary angiography (CTPA)in acute PE severity stratification.Methods According to the clinical severity,48 patients with acute PE proved by CTPA were classified into two groups,including 21 critical and 27 non-critical patients. Embolism index,ratio of central pulmonary involvement,ratio of right ventricle maximum minor axis (RVMMA)to left ventricle maximum minor axis(LVMMA),namely RV:LV,dilation of main pulmonary and/or right pulmonary trunk,and dilation of bronchial arteries in both groups were analyzed comparatively. The correlation factors between CT imaging features and PE clinical severity stratification were explored.The correlation between RV:LV and embolism index of 48 patients was analyzed.Results Pulmonary embolism index(22.0%—85.0%,median 38.0%),ratio of central pulmonary involvement(42.5%),RV:LV (0.90—1.90,median 1.30),dilation of pulmonary artery(14 cases),and dilation of bronchial artery (8 cases)in critical group(21 cases)were higher than those corresponding factors(5%—48%,median 21.5%,31.25%,0.80—1.40,median 1.00,5 eases,and 3 eases)in non-critical group(27 cases) (Z=4.27,X~2=5.40,Z=2.58,X~2=11.45,X~2=4.87,P
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Objective To investigate the CT features of pulmonary sarcoidosis.Methods Ninety patients with histologically proved pulmonary sarcoidosis were retrospectively studied by using CT scans and clinical recording.Results The main CT findings of pulmonary sarcoidosis were nodules which were seen in 69 cases(76.7%),and the nodules mostly distributed around the bronchovascular bundle(n=37, 41.1%).Other abnormalities included consolidation(n=31,34.4%),ground-grass(n=39,43.3 %), thickening of bronchovascular bundle(n=30,33.3%),interlobular septal lines(n=58,64.4%), fibrosis(n=17,18.9%)including bronchial distortion(n=8,8.9%),linear shadow(n=5,5.6%), and honeycombing shadow(n=4,4.4%),air-trapping(n=3,5.3%),bronchial straitness(n=8, 8.9%),pleural thickening(n=42,46.7%),and hilar and mediastinal adenopathy(n=76,84.4%). Two or more abnormal findings co-existed in 83 cases.The pulmonary lesions co-existed with hilar and mediastinal adenopathy in 76 cases.The nodules(n=25),consolidation(n=9),ground-grass(n=11), thickening of bronehovascular bundle(n=10)were improved after therapy.Ten cases of the interlobular septal(10/22),0 of bronchial distortion(0/4),1 case of diffuse linear(1/3),and 0 case of honeycombing(0/2)were improved.Conclusion CT manifestations of pulmonary sarcoidosis are varied, but has some specific radiographic features.A correct diagnosis can be made.combined with hilar and mediastinal adenopathy.
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Objective To explore application of the bolus-triggered technique and optimal match between collimation and pitch of MSCTA in intracranial and cervical arteries.Methods(1)The small-dose tests were performed in 19 healthy volunteers and the theoretical threshold was obtained by the time-density curve.(2)forty healthy volunteers were divided randomly into two groups and the scanning parameters were as follows.Group A:collimation 1.0 mm,pitch 1.750. Group B:collimation 2.5 mm,pitch 0.625. Statistical significance was determined with the X~2 test and t test(?=0.05).Results(1)In 19 volunteers,CT value 4 seconds before the peak was 75 HU,the CT value at the beginning segment of the carotid artery and the C_1 segment of internal carotid artery was in accordance with the standard.(2)Image quality ofⅠ,Ⅱgrades artery structures of group B was superior to that of group A.Image quality ofⅢ,Ⅴ grades artery structures of group A was superior to that of group B.Conclusions(1)MSCTA in intracranial and cervical arteries can display systematically the cerebral and carotid arteries.(2)The bolus-triggered technique can improve the image quality of the target vessels.The image quality of the MSCTA of intracranial and cervical arteries is better with the threshold of 75 HU on the basis of 3.5 ml/s injection rate.(3)On the basis of the same other parameters,the optimal scanning parameters are a collimation of 1.0 mm with a pitch of 1.750.
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0.05)between the images from the two groups.Conclusion When scanning the heart with volume CT(VCT),the application of ECG modulated mA can effectively reduce the exposure dosage without sacrificing the image quality.
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Objective To explore the main influence factors(heart rate,rotation speed,and reconstruction algorithm)on the image quality of coronary artery with 40 mm VCT(64-detector row helical CT)using a pulsating cardiac phantom.Methods An adjustable pulsating cardiac phantom(GE) containing predetermined simulated coronary arteries was scanned using a 40 mm VCT(GE LightSpeed CT) with cardiac pulsating rates of 40,45,50,55,60,65,70,75,80,85,90,95,100,105,110,and 115 beats per minute(bpm).The variable rotation speeds technique of 0.35 s,0.40 s,and 0.45 s were used, respectively.The raw data were reconstructed using both one-sector and multi-sector reconstruction algorithm at optimal window of the R-R interval.The image quality score(IQS)was evaluated by two radiologists according to the same evaluation standard of reformated image.The correlation between heart rate(HR), roation speed,reconstruction algorithm,and IQS were analyzed.The IQS as independent variable and the HR,rotation speed,reconstruction algorithm as dependent variables were analyzed by multiple linear regression analysis.Restllts The heart rate and the reconstruction algorithm had significant influence on IQS.The rotation speed(0.35s,0.40s,and 0.45s)didn't have significant influence on IQS.There was linear regression relationship between heart rate,reconstruction algorithm and IQS(P
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Objective To evaluate the image quality of 64-multi detector computed tomography (MDCT)and the clinical accuracy in detecting coronary artery lesions.Methods One hundred and five patients were studied by MDCT.The results were compared with invasive coronary angiography(ICA). Patients were excluded for atrial fibrillation,but not for high heart rate,coronary calcification,or obesity. MDCT was analyzed with regard to image quality and presence of coronary artery lesions.Results The data evaluation of the image quality was based on a total of 1365 segments(13 coronary segments for each patient),of which 1144 segments were considered to have diagnostic image quality,but 221 segments (16.2%)could not be sufficiently evaluated because of severe calcifications(153 segments)and motion artifacts(68 segments).The median calcium score[Agatston score equivalent(ASE)]was 154(range 0—1983).87 of the 105 patients had an ASE of less than 1,000[median 105(range 0—994)],and 18 patients had an ASE greater than 1000[median 1477(range 1115—1983)].For detecting lesions with 50% or greater narrowing(without any exclusion criteria),the overall sensitivity,specificity,positive predictive value,and negative predictive value were 85.7%,97.9%,93.0%,and 95.5%,respectively. When limiting the number of patients to those with a calcium score of less than 1000 ASE,the threshold- corrected sensitivity for lesions with 50% or greater narrowing was 96.0%;specificity,98.9%;positive predictive value,95.3%;and negative predictive value,99.0%.Conclusion Our results indicate high quantitative and qualitative diagnostic accuracy of 64-slice MSCT in comparison to QCA in a broad spectrum of patients.
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Objective To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location,size,morphology,attenuation and enhancement patterns on CT images,and compared with clinical and pathological materials.Results The common CT manifestations were as follows:enlargement of the adrenal glands in all 30 cases(bilateral 90%,mfilateral 10%)including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity(28 cases,93.3%),calcification(17 cases,56.7%),and low attenuation in the center with peripheral enhancement(16 cases,53.3%)of the lesions.After antituberculosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration,with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases.Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration(X~2= 7.47,P
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Objective To recognize the CT manifestations of benign metastasizing leiomyoma (BML).Methods Four cases of BML proved by pathology were retrospectively analysed.Among these, 2 cases were pulmonary BML,1 ease was leiomyomatosis peritonealis diseminata(LPD),and 1 case was combined with pulmonary BML and LPD.All of them were female,and had a history of hysterectomy,the average age were 45.The CT findings of them were analyzed.Results The CT of pulmonary BML in three cases showed multiple rounded,well-defined discrete nodules,0.2—2.0cm in diameter,random distribution,and no calcification in the nodules.No hilum or mediastinum lymphadenopathy,and no pleural effusion.There were no enhancement after intravenous contrast examination.The CT findings of LPD in two cases were many masses around the vena cava,abdominal aorta and/or iliac artery.The masses were 4— 5cm in diameter with smooth margin and homogeneous density.No lymph node or ascites were found.One case who got intravenous contrast enhanced CT scan showed significant enhancement of the lesions;another case who got PET CT study showed no significant tracer concentration.Conclusion When multiple metastasizing nodular lesions with sharp margin and homogeneous density were found in the lungs or abdomen,they should be considered the possibility of BML in women with hysterectomy history.
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Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Six of 7 lesions were located in the right adrenal gland,1 in the left.The diameter of the tumors was 3.7—7.5cm,with a mean diameter of 4.6cm.The CT value of the plain scans, AP phases and PVP phases was 16.2—31.7 HU(with a mean value of 24.3 HU),20.9—36.6 HU(with a mean value of 30.2 HU),and 27.4—45.5 HU(with a mean value of 36.0 HU),respectively.The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as IV,but didn't compress or occlude them.Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious,dynamic SCT scans could suggest the diagnose.
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Objective To explore the imaging features and dynamic CT findings of primary adrenocortical carcinoma and evaluating its clinical value.Methods All 11 cases patients with primary adrenocortical carcinoma confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.Contrast injection was done by using nonionic Omnipaque at a flow rate of 3 ml/s with a power injector.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Five of 11 lesions were located in the right adrenal gland,6 in the left.The diameter of the tumors was 4.1—16.0cm with 2 cases10.0cm.The attenuation of the plain scans,two phases contrast scans was 21.9—46.7 HU(with a mean value of 35.3 HU),30.5—65.8 HU(mean value 47.1 HU),and 52.6— 97.0 HU(mean value 74.2 HU),respectively.Four were in the shape of capsule,6 reticular,1 slightly inhomogeneous masses.The irregular tumor vessels of 6 reticular masses were seen in the artery phase. Conclusion The dynamic CT features of primary adrenocortical carcinoma were obvious,dynamic SCT scans could suggest the diagnose.
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Objective To evaluate the significance of multi-slice helical CT with multiplanar reconstruction in laryngeal carcinoma.Methods Thirty-five patients with laryngeal carcinoma were studied by helical CT,MPR were subsequently done.The lesion extent of the axial image findings,MPR findings and the combined image findings were compared with the pathological results respectively.The data were statistically analyzed.Results In the evaluation of the anterior commissure,the axial image findings,MPR findings and the combined image findings were 82.9%,68.6% and 91.4% in accuracy respectively,the results were statistically different(P0.05).The combined images were superior to the axial images and the MPR images in sensitivity,specificity and accuracy of the lesion extent.Conclusion The axial images could show the shape,size,extension of the tumor and the lymphadenopathy,MPR images displayed the shape,size and extension roundly and directly,they were the supplement for the axial images.Axial images combined with MPR could improve the accuracy in the diagnoses of laryngeal carcinoma.
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70 bpm during scan),the proportion of segments that could not be assessed because of motion artifact were 0.1%(1/759),1.1%(7/649),2.5% (10/407),42.6%(103/242),and 75.5%(108/143),respectively.With conventional selective coronary angiography as the golden standard,the sensitivity,specificity,positive and negative prediction values to detect≥50% stenotic lesions in the assessable segments were 79.2%,96.0%,83.8%,and 94.6%,respectively.There was a significant correlation between the number of segments per patient not assessable because of motion artifact and heart rate during the scan(r=0.655,P=0.000).Conclusion MSCT is capable of achieving high accuracy for detection of coronary artery stenosis,and is a reliable technique to diagnose coronary artery disease.
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Objective To study the relationship between renal morphology and renal function,and to assess the value of CT as a criterion to grade renal function.Methods Enhancement CT were performed in 89 patients with no local renal disease whose split renal glomerular filtration rates(GFR)were measured by renal dynamic imaging with ~(99)Tc~m-DTPA.The 178 kidneys were divided into normal renal function,mild and severe renal impairment groups according to renal function.Differences between three groups respect to the mean thickness of renal cortex and parenchyma were assessed by ANOVA.Using Pearson's correlation test,the correlation between the renal cortex,parenchyma thicknesses and renal GFR were examined.The value of CT in predicting renal function was assessed by using ROC analysis.Results The renal cortex thicknesses of normal renal function,mild and severe renal impairment groups were(5.9?1.1),(4.6? 1.1),and(3.3?1.0)mm respectively,and the renal parenchyma thicknesses were(26.3?4.2), (21.3?4.6),(16.2?4.6)mm.There were significant differences of renal cortex,parenchyma thicknesses between 3 groups(cortex F=54.78,P