Imaging technique and clinical application of 16-slice spiral CT for coronary artery / 生物医学工程学杂志

This study was conducted in pursuit of the optimal imaging technique and for a primary clinical application of 16-slice multislice spiral computed tomography (MSCT) for coronary artery. Unenhanced and contrast-enhanced 16-slice SCT imaging was performed in 38 cases with retrospective electrocardiographic gating. MPR, MIP and VRT reconstruction of enhanced scan images were made in all cases, and CPR, VE reconstruction images were made in some cases. The demonstration of coronary artery was evaluated. The influencing factors of the image quality were analyzed. The results showed that the detection rates of RCA, PDA, LMA, LAD, DB, LCX and LMB were 36 (94.7%), 34 (89.5%), 37 (97.4%), 36 (94.7%), 34 (94.4%), 36 (94.7%), 34 (89.5%) on axial images, respectively, which were higher than those of the arteries on 3D images (P < 0.01). Therefore, 16-slice spiral CT is a reliable and accurate technique to demonstrate coronary artery and its branches, and is a noninvasive method to screen, diagnose and postoperatively evaluate coronary artery diseases. The factors influencing the image quality include the heart rate, the cardiac rhythm, the respiratory movement of patients and the trigger delays of imaging processing.

Diagnosis of Gastrointestinal Invasion by Carcinoma of Gallbladder on Spiral CT(Report of 8 Cases ) / 中国普外基础与临床杂志

Objective To study the spiral CT features of gastrointestinal invasion by carcinoma of gallbladder. Methods Eight patients with surgical-pathologically documented gastrointestinal invasion by carcinoma of gallbladder were analyzed retrospectively. All patients underwent plain and contrast-enhanced dual-phase scanning of the abdomen. Oral contrast medium (1.2% Angiografin) was used to fill the gastrointestinal tract before CT scanning. Results There were 2 cases of gastric antrum invasion, 6 duodenal invasion and 3 colonic invasion according to the surgical and pathological findings. Spiral CT correctly diagnosed 2 gastric invasion and 4 duodenal invasion based on several imaging features, like blurring of fat plane, focal wall thickening and luminal narrowing of involved gastrointestinal segments, and mass formation. However CT was unable to diagnose the 3 cases of hepatic flexure of colon invasion. Conclusion CT is valuable for diagnosing upper gastrointestinal tract invasion by carcinoma of gallbladder, yet the diagnosis of hepatic flexure of colon invasion is still difficult.

Gallbladder Carcinoma and Chronic Cholecytisis: Differential Diagnosis with Two-phase Spiral CT / 中国普外基础与临床杂志

Objective To investigate the features of gallbladder carcinoma in two-phase spiral CT, and to analysis the values of two-phase spiral CT for the differential diagnosis between gallbladder carcinoma and chronic cholecystitis. Methods The two-phase spiral CT manifestations of 30 cases of gallbladder carcinoma, proved by surgery and pathology, and 30 cases of chronic cholecystitis were analyzed. Results According to the CT findings, the gallbladder carcinoma was categorized into 3 types: intraluminal mass of gallbladder in 6 out of 30 (20.0%), thickening of the gallbladder wall in 11 (33.7%), and mass replacing the normal gallbladder in 13(43.4%). The most common enhancement patterns of the wall in gallbladder carcinoma were hyperattenuation during the arterial phase, while isoattenuation with the adjacent hepatic parenchyma during the venous phase; or hyperattenuation during both phases. The most common enhancement pattern of the wall in chronic cholecystitis was isoattenuation during both phases, with clear hypoattenuation linear shadow in the gallbladder fossa. Other ancillary features of gallbladder carcinomas included: infiltration of the adjacent parenchyma, local lymphadenopathy and intrahepatic metastasis. Conclusion Two-phase spiral CT scan can identify the features of the gallbladder carcinoma and is helpful for the differential diagnosis of these two different disease entities.