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Objective To explore the clinical efficacy and application value of CT virtual endoscopy (CTVE) in endoscopic resection of pituitary via transsphenoidal approach. Methods From January 2015 to December 2017, 21 patients with pituitary adenomas undergoing endoscopic transsphenoidal approach surgery were selected. All the patients were performed CT scan with GE64 spiral CT before operation, then reconstructed by CTVE. The preoperative CTVE simulated images and the observed images in the operation were compared, and the consistency of the 2 images was analyzed. Results CTVE simulated images and the observed images in the operation showed good consistency in the ratings of sphenoid sinus opening, optic canal protuberance, internal carotid artery protuberance and optic canal internal carotid recess (O-C recess) ( Kappa ＝ 0.774, 0.912, 0.959 and 0.958); and general consistency in the ratings of septum of sphenoid sinus, sellar floor and ramp recess ( Kappa＝0.479, 0.691 and 0.721). Conclusions CTVE technology can accurately simulate the reconstruction of the important anatomical structure of the saddle area before operation, which helps to design the operation plan and improve the curative effect and safety of the operation; this technique also helps to learn and master the endoscope technology.
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Objective To explore the diagnostic value of capsule endoscopy and small bowel CT virtual endoscopy( CTVE) in identifying of small intestinal diseases. Methods Fifty?five cases patients of suspected small intestinal diseases who were treated by Capsule endoscopy and small bowel CTVE examination in the Affili?ated Hospital of North China University of Science&Technology and Kailuan Majiagou Mine Hospital from Janu?ary 2009 to December 2015 were chosen. The detection rate and diagnostic accuracy of small bowel disease were compared between the two methods. Results There was no significant difference in the detection rate of CTVE and capsule endoscopy( 80. 7% vs. 89. 5%,P=0. 719) . There was significant difference in the accuracy of CTVE and capsule endoscopy in the diagnosis of small intestinal non space occupying lesions ( 60. 7% vs. 89. 3%, P=0. 040) . The correct rate of diagnosis of small bowel lesions was 93. 1% in CTVE,and 51. 7% in capsule en?doscopy,there was statistically significant difference between the two ways( P=0. 032) . Conclusion Capsule endoscopy and CTVE are both non invasive tests,the operation is simple,safe,and the patients are easy to ac?cept,and they are both helpful in the diagnosis of small bowel diseases. Capsule endoscopy has an advantage in the diagnosis of small bowel lesions,while CTVE is superior to capsule endoscopy in terms of small bowel occup?ying lesions. Combined use of the two ways can improve the diagnostic rate of small bowel disease.
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Objective To investigate the diagnostic value of CT virtual endoscopy on the small intestine (CTVE)technology for intestinal diseases. Methods Forty-nine cases with suspected small bowel disease were tested by CTVE from December 2010 to February 2014. They also were performed. Results Of 49 patients, operation or electronic endoscopy showed that 9 cases were benign tumors,29 cases with malignant tumors,3 cases with intestinal polyps,4 cases with intestinal inflammation,2 cases with bowel dysfunction and 2 cases with normal intestinal. CTVE test showed that 11 cases were with benign tumors,29 cases with malignant tumors,2 cases with intestinal inflammation,1 case with intestinal polyps,4 cases with intestinal dysfunction and 2 cases with normal small intestine. Better consistency between the two diagnosis was seen(Kappa = 0. 70). The accurate rate of diagnosis was 85. 71%(42 / 49). The correct rate of CTVE diagnosis of space occupying lesions was 90. 24%(37 / 41). The correct rate of non occupied lesions was 50. 00%(3 / 6). Conclusion CTVE technology has the advantages of simple operation,safe,painless,and clinical diagnosis of small bowel disease rate is higher especially for small bowel accounted disease. It is worthy of clinical application.
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Objective To assess the diagnostic value of capsule endoscopy (CE) and CT virtual endoscopy (CTVE) for small intestinal diseases.Methods The data of 31 patients with suspected small bowel diseases who were examined by both CTVE and CE were collected.The diagnostic rates of CE and CTVE was compared by paired data McNemar test,using the diagnosis confirmed by surgery or follow-up as the golden standard.Results The confirmed diagnosis of 31 patients were small intestinal tumor in 16,nontumorous lesion in 10 and no abnormal lesion in 5.CE identified positive findings in 24 patients,including 14 cases of tumorous lesion (with mis-location in 2 and failure in definite diagnosis in 7) and 10 cases of non-tumorous lesion.CTVE identified positive findings in 17 patients,including 14 cases of tumorous lesion (with mis-location in 1 and failure in definite diagnosis in 4) and 3 cases of non-tumorous lesion.The combination of CE and CTVE could identified positive findings in 26 patients,including 16 tumorous and 10 nontumorous lesions.The diagnostic rates of CE and CTVE for tumorous lesions were both 87.5％ (14/16).The overall diagnostic rate of combined CE and CTVE was 83.9％ (26/31),which was significantly higher than that of CTVE alone (54.8％,17/31) but similar to that of CE alone (77.4％,24/31).Conclusion Both CE and CTVE are effective in diagnosis of small intestinal lesions and the combined use of 2 methods can increase diagnosis yield.
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Objective To evaluate 64-MSCT virtual endoscopy in the examination method,displaying ability and clinical application of colon lesions.Methods Compared the results of 49 cases of patients examined with 64-MSCT with that got from Coloscopy,and statistical analysis was conducted.Results A total of 19 cases of adenocarcinoma and 2 cases of colonic diverticula as well as 44 cases of adenomatous polyp were detected.The display rate of polyps was 100％ in which was larger than 10mm,73％ in which was range of 5 ～ 10mm in size and 50％ in which was smaller than 5mm.Conclusion As an relatively noninvasive examination method,64-MSCT virtual endoscopy is concordant with onventional colonoscopy in the aspect of detectable rate and revealing the lesion morphologic and can be used as an important examination measure in the diagnosis for colonic diseases.
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ObjectiveTo explore the value of CT virtual endoscopy in the treatment strategies in low rectal cancer surgery.MethodsFifty- seven cases of rectal cancer in Jining First Hospital were collected,preoperative rectum CT virtual endoscopy,detailed records of patients with rectal invasion and the circumstances surrounding lymph nodes were investigated.Differences were compared in patients after routine pathological examination.And the distance of the tumor from the anal margin was compared with the preoperative rectum on rectal examination and rectal CT virtual endoscopy.ResultsPreoperative rectum CT virtual endoscopy had no significant difference in evaluation of metastases of the surrounding lymph nodes.Compared with postoperative pathological examination( x2 =2.5,P ＞ 0.05 ),while had significant difference in evaluation in perirectal infiltration( x2 =4.44,P ＜ 0.05 ).Rectal examination and rectum CT virtual endoscopy had no significant difference judgement of the tumor from the anal margin ( P ＞ 0.05 ).ConclusionsCT virtual endoscopy has a great significance in the preoperative evaluation of rectal cancer surgical treatment strategies,which should be further studied.
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@#Objective To evaluate the value of CT virtual endoscopy(CTVE)for microsurgery of pituitary microadenomas via transsphenoidal approach.Methods In 18 patients with pituitary micmadenomas underwent microsurgery via transsphenoidal approach,the presurgical CT data was transfered to work station,the anatomies of the sphenoid sinus were then reconstructed by CTVE.The CTVE images were used to make the preoperative planning and indentify sphenoid sinus, sellar floor,and the position of the tumor during surgery.The CTVE images and the views from intraoperative microscope were compared. Results CTVE could display the anotomoties of sphenoid sinus in a three-dimentional mode.The display rates of superfical antomies such as sphenoid septa,sellar floor,carotid prominence,optic prominence and opticocarotid recess were 344.4%,100%,41.7%,36.1%and 58.3%respectively and the visual fields of these anatomic landmarks were larger than the views from the intraoperative microscope. CTVE could depcit the anatomies of the enhanced carotid ateries and pituitary tissue and some optic canals underlying the sellae by transparent function or heighten the threshold.The sites of the tumor could be marked correctly on CTVE images.CTVE could simulate the operative approach and some operating procedures properatively. Conclusion CTVE can display the anatomies of sphenoid sinus in a three-dimensional mode. In transsphenoidal treatment of pituitary microadenoma,CTVE can help to make preoperative planning,locate the intraoperative structures and make a precise bone window during surgery.
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Objective (1)To observe the imaging features of the normal anatomic structures of middle ear using CT virtual endoscopy.(2)To study morphologic changes of ear ossicles and auditory ossicular chain of patients with conductive deafness.Methods CTVE of the auditory ossicular chain was performed on GE Hispeed CT/I with 1.0 mm slice thickness at pitch 1, bone algorithm, voltage 140 kV, electric current 170～220 mA, 9.6 cm field of view.Results CTVE could clearly demonstrate the normal auditory ossicular chain and its anatomic details. The demonstration rate of CTVE images in detecting the malleus-incus joint was 100%(162/162), in detecting "L"type incus-stapes joint was 80%(130/162), in detecting the anterior and posterior stapes footplate was 73%(121/162); CTVE could well display the destruction of auditory ossicular chain in otitis media and cholesteatoma and could acurately show the malformation of the auditory ossicular chain.Conclusion CTVE can quickly, non-invasively, three-dimensionally display the middle ear auditory ossicular chain, can provide direct and reliable imaging information for discovering the cause of a disease of conductive deafness.