Thin slice CT signs combined with multiplanar reformation for diagnosing tracheobronchial tuberculosis / 中国医学影像技术

Objective To observe value of thin slice CT multiple signs combined with multiplanar reformation(MPR)for diagnosing tracheobronchial tuberculosis(TBTB).Methods Data of 234 TBTB patients who underwent chest thin slice CT scanning were retrospectively analyzed.MPR was performed,the direct signs and indirect signs of TBTB were observed.The diagnostic efficacy of axial plain CT images(direct observation)and of MPR combined with the former(combined observation)were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of direct observation was 38.88％(201/517),98.13％(1 789/1 823),85.53％(201/235),84.99％(1 789/2 105)and 85.04％(1 990/2 340),respectively,of combined observation was 91.10％(471/517),98.85％(1 802/1 823),95.54％(471/493),97.51％(1 802/1 848)and 97.14％(2 273/2 340),respectively.Significant differences of sensitivity,positive predictive value,negative predictive value and accuracy were found(all P＜0.001),whereas no significant difference of specificity was found between 2 methods(P＞0.05).Conclusion Thin slice CT multiple signs combined with MPR could be used to effectively diagnose TBTB.

Age Estimation in Han Adults by Thin-Layer CT Scan of Cranial Sutures / 法医学杂志

Objective To explore the value of degree of cranial suture closure in forensic adult age estimation by thin-layer CT scan and establish an adult age estimation model of the Han nationality. Methods Thin-layer CT scan samples of the heads of 220 healthy Sichuan Han adults （110 males, 110 females） aged 20 to 70 were collected, of which 20 samples （10 males, 10 females） were randomly selected as test samples. The sagittal suture, coronal suture （both left and right） and lambdoid suture （both left and right） were respectively and equally divided into 2 segments, and every segment was equally divided into 10 layers and the corresponding multiplanar reformation （MPR） images were selected. The closure of cranial sutures on MPR images was classified into the grades 1-7. The correlations between cranial sutures and age were analyzed to build regression equation for age estimation. Results The degree of closure of sagittal suture, coronal suture （both left and right） and lambdoid suture （both left and right） was positively correlated with age. The coefficient of determination （R2） of regression equation was 0.419 in males, 0.589 in females, and 0.522 in all samples. The results of the verification test showed that the mean absolute error （MAE） was 6.39 years in males, 6.16 years in females, and 6.29 years in all samples. Conclusion There was a higher accuracy in adult age estimation by thin-layer CT scan of cranial sutures. The age of Han nationality adults can be estimated by the degree of cranial sutures closure.

The application of 16-slice CT cholangiography with MPR technique in biliary obstruction / 重庆医科大学学报

Objective:evaluate the diagnostic use of 16-slice CT cholangiography with multiplanar reformation(MPR)for the assessment of patients with biliary obstruction.Methods:16-slice CT cholangiography with the MPR technique was performed in 60 patients who were thought to have biliary obstruction.No cholangiographic contrast agent was administered.MRCP in 24 patients,Endoscopic retrograde cholangiopancreatography(ERCP)in 16 patients,and 28 patients underwent biopsy or surgery.The findings on 16-slice CT cholangiography were compared with those of MRCP,ERCP,biopsy or surgery.the surgical-pathological result was regarded as gold standard.Results:The findings were as follows:choledocholithiasi(sn=34),malignant stricture(n=14),benign stricture(n=2),and cholelithiasi(sn=1).A small common bile duct stone in one patient could not be detected by 16-slice CT cholangiography.Two patients with initial diagnoses of small common bile duct stone by 16-slice CT cholangiography were disclosed to have malignant bile ductstricture by reference examination.The accuracy of 16-slice CT cholangiography for the diagnoses of bile duct stones and bile duct stricture were 91.1% and 88.9% respectively.Conclusion:16-slice CT cholangiography with the MPR technique is a fast and non-invasive technique with relatively high accuracy for the diagnoses of the causes of biliary obstruction.

Study on the directing role of multi-slice spiral CT and multiplanar reformation(MPR)in bronchoscopy / 中国实用内科杂志

Objective To study on the directing role of multi-slice spiral CT and multiplanar reformation(MPR)in bronchoscopy and enhance the yield of peripheral pulmonary carcinoma(PPC).Methods This study was carried in 60 PPC patients from Respiratory Department in the First Hospital Affilliated to Suzhou University during 2002—2005.They underwent MSCT.Images were reconstructed with MPR(CPR)to evaluate the relationship between PPC and bronchi and the type of BS was identified.Compare the diagnosed yields of bronchoscopic multiple diagnostic procedure(BMDPs)with types of BS.Results (1)In all patients the third to the seventh level branches of the bronchi were clearly shown.The tumor-bronchus relationship was identified as four types on MSCT.(2)MSCT demonstrated the BS in 22 of 25 adenocarcinomas and 13 of 17 squamous-cell carcinomas and 4 of 6 small cell lung carcinomas and 4 of 8 bronchiolo-alveolar carcinomas.(3)BS typeⅠwas shown in 15of 48(31.3%).Type Ⅱ was seen in 7 of 48(14.6%).Type Ⅲ was shown in 12 of 48(25%)squamous tumors.Type Ⅳ was seen in 14 of 48(29.2%).(4)Total positive rate of bronchoscopy was 58.3%,73.3% with BS and 13.3% without BS.Type of BS was closely associated with positive rate of BMDPs.Conclusion Axial CT and MPR can show the relationship between PPC and bronchi better.BS can direct fiberoptic bronchoscopy(FOB)diagnosis procedure and enhance the yield of PPC.

Acetabular Defect in Cerebral Palsied Hip Instability: Quantitative Analysis of 3D CT / 대한정형외과학회잡지

PURPOSE: To analyze the acetabular wall defects of cerebral palsied hips using 3 dimensional computed tomography (3D CT). MATERIALS AND METHODS: 56 hips of 28 cerebral palsy patients with hip instability were included and contralateral hips of unilateral LCP patients were used as a control. We categorized the instabilities into dislocation and subluxation, and described the location of acetabular defects qualitatively. Anterosuperior, lateral, and posterosuperior acetabular indices were measured on the quantitative base by multi-planar reformation, and acetabular volume was calculated. RESULTS: In qualitative study, posterior defect was the most predominant in subluxation group, whereas global defect was predominant in dislocation group. All three indices in both subluxation and dislocation group increased when compared with those of control (p<0.05). On the other hand, lateral index increased in dislocation group when compared with subluxation (p<0.05). The acetabular volume was largest in control group, while the volume of dislocation group was least, and that of subluxation was between the two (p<0.05). CONCLUSION: Subluxated hips mainly represent posterior acetabular wall defects. As dislocation progresses, global wall defect was noticeable and acetabular volume decreased. Gross visual wall defects was not always consistent with true wall defect. So, quantitative measurement should be considered when determining the acetablular defects.

Diagnostic value of multi-slice spiral CT for lesions in middle and inner ears / 第三军医大学学报

Objective To assess the clinical value of multi-slice CT(MSCT)in showing the ear lesions.Methods MSCT high resolution scan images of 52 ears of 11 normal adult and 15 patients with hearing loss were reconstructed,by bone plus with 0.625 mm collimation,9.6 cm small field of vision(FOV)and 0.3 mm reconstruction interval before volume rendering(VR)and multiplanar reformation(MPR)were performed.Results VR,MIP and MPR images of 40 normal ears clearly showed the complicated anatomic structures.VR,MIP and MPR images of twelve abnormal ears displayed 3 ears of malformations of crus longum incudis,1 ear of destructed semicircular canals,2 ears of malleus dysplasia,2 ears of fusion of incudostapedial joint,2 ears of bony atresia of external auditory complicated with auditory ossicles dysplasia,and 2 ears of crus stapedis dysplasia.MPR is easier to manipulate than VR that has three dimensional effect butis difficult to handle.Conclusion HRCT images,combined with post-processing technique of VR,MIP and MPR,can clearly show the anatomic structures and lesions of middle and inner ears.

Diagnosis of extreme lateral lumbar disc herniation with spiral CT multiplanar reformation / 中华放射学杂志

Objective To investigate the characteristics of extreme lateral lumbar disc herniation (ELLDH) with spiral CT multiplanar reformation (MPR), and to determine the effectiveness of MPR in the diagnosis of ELLDH. Method Twenty-five cases with ELLDH underwent conventional CT scans, thin slice spiral scan, and MPR on coronal and sagittal plane. Results Operative findings basically matched the MPR results in 25 ELLDH patients concerning the disc herniation position and compression of the nerve roots. The herniation involved the intervertebral foramina in 15 cases, external intervertebral foramina in 4, both intervertebral and external intervertebral foramina in 3, and intervertebral foramina and vertebral tubes of parity plane in 3. They were demonstrated on MPR as shapes of hillock, circular or trigonal soft-tissue density mass in intervertebral foramen, or outside and tread on the nerve root of parity plane. Among these 25 ELLDH cases, ELLDH was not found by conventional CT scans in 7 cases, but was found by MPR. ELLDH was suspected by conventional CT in 8, and was confirmed to be ELLDH by MPR. ELLDH was revealed by conventional CT scans in 10, but without indications of nerve root compression status, while MPR clearly indicated nerve root compression status. Conclusion MPR has important value in the diagnosis of ELLDH. It can properly identify the ELLDH site, shape, size, and its relation to nerve roots. It is very helpful for the surgeons in the selection of operation method.

Application of multi-model Reconstruction of 16-slice Spiral CT in Diagnosis of Rib Fracture / 实用放射学杂志

Objective To explore the value of multi-model reconstruction of 16-slice spiral CT in diagnosis of rib fractures.Methods 16-slice spiral CT volumetric scanning was performed in 72 patients with rib fracture proved by clinical,all images were reconstructed in thin slice and transferred into ADW4.1 workstation.Images such as multiplanar reconstruction(MPR),maximum intensity projection(MIP)and volume rendering(VR)were performed,then the reconstructed images of injured ribs were observed and analyzed by two experienced radiologists and compared with radiographs.Results In 72 cases,there were 217 rib fracture and 7 costal cartilage fracture depicted on MSCT.The location and number of fracture and displacement of fracture could be showed clearly on images of multi-model reconstruction.VR images were betten in demonstration of the anatomical structure,MPR images were better to show the minor lesion of rib fracture,MIP was the best imaging method in detecting the costal cartilage fracture,while axial image was the basic CT scanning section.Radiographs revealed 169 rib fractures but no costal cartilage fracture.Conclusion 16-slice spiral CT of multi-model reconstruction is superior to radiography in diagnosis of rib fracture and costal cartilage fracture.But the combinalion of various reconstruction techniques should be acquired.

The Clinical Usefulness of Spiral CT Angiography in the Diagnosis of Pulmonary Thromboembolism / 결핵

BACKGROUND: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary value(clinical utility) of the spiral CT angiography with 2D image (multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. METHODS: We retrospectively analysed spiral CT angiography and prlmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=1 case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. RESULTS: Anatomical distribution of PTE was as follows : 1) left lung(n=103) < right lung(n=129), 2) upper and middle(or lingular) lobe(n=101) < lower lobe(n=116), 3) proximal < distal but 5th order in lower lobe was decreased in distribution. Spiral CT angiography could allow accurate demonstration of 19/20 cases(95%) PTE in our study. Spiral CT angiography could demonstrate acute PTE in 16 patients and chronic PTE in 3 patients. Spiral CT angiography could also showed the combined lung parenchymal lesions(Infarction(n=9 cases), atelectasis(n=4 cases), pleural effusion(n=6 cases)). CONCLUSIONS: Spiral CT angiography with 2D image (multiplanar reformation) and 3D images(shaded surface display, minimal intensity projection) is a noninvasive diagnostic tool in the pulmonary thromboembolism. This method had several advantages; 1) It was showed the distribution of pulmonary embolism in total lung field. 2) It had high sensitivity in diagnosis of pulmonary embolism. 3) It discriminated between acute and chronic PTE. 4) It was showed the associated disease such as lung infarction, atelectasis, pleural effusion. 5) It was correlated with scintigraphic findings.