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Objective To study the assisted diagnostic value and significance in precise surgery of MSCT angiography in torsion of ovar-ian tumors in children. Methods The dual-phase enhanced MSCT images data of 15 children patients with ovarian tumor torsion which were confirmed by surgery were retrospectively analyzed. Showed the vascular changes around the ovaries and judged the ovarian tumors arise and torsion side with the vascular reconstruction methods of multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering ( VR) ,then compared with the operation situation. Results Among the 15 cases aged from 2 months to 11 years old who were de-tected with MSCT scanning and angiography, there were 11 cases of benign tumor (9 cases of ovarian teratoma and 2 cases of serous cystade-noma) and 4 cases of malignant tumor (3 cases of yolk sac tumor and 1 case of malignant mixed germ cell tumor). MSCTA displayed that o-varian vessels changes were abnormal thickening and twisting of distal feeding artery and tumor vascular network formation;and there were thickening, tortuosity, increased density and a few visible‘whirl sign’ in draining veins. Preoperative MSCTA displayed ovarian tumor blood supply arteries were found 5 cases of downlink of ovarian artery and 10 cases of asscending branches of uterine artery. There were 4 cases of ovarian tumor originated from the left ovary combined with reverse and 11 cases originated from the right ovary combined with reverse, which were consistent with intraoperative findings. Intraoperative MSCTA provide information which helped accurate chose of the surgical incision, precise abruption of tumor blood vessels and resection of the tumor and ovarian lesions, thus saved the operation time and reduced the blood loss. Conclusion MSCT angiography can not only provide diagnosis information of torsion of ovarian tumors in children,but also more impor-tantly,it has an important assisted significance in precision surgery.
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Objective To discuss the value of multi-slice spiral CT angiography (MSCTA)and digital subtraction angiography (DSA)in lower extremity arteriosclerosis obliterans.Methods MSCTA and DSA of lower extremity arteries were performed in 41 patients with lower extremity arteriosclerosis obliterans sequentially.The interval of these two examinations was no more than 2 weeks.DSA served as the reference standard and compared with MSCTA in terms of grading of stenoocclusive lesions,visualization of collaterals in lower extremity arteries.Results No significant differences of grading of stenoocclusive lesions,visualization of col-laterals were observed between MCTA and DSA in lower extremity arteries.Compared with the results of DSA,the sensitivity,spe-cificity,accuracy,positive and negative predictive value of MSCTA in the detection of arterial stenosis (≥ 50%)were 97.2%, 98.2%,93.8%,94.6%,98.2%,respectively.Conclusion MSCTA shows relatively high sensitivity and specificity in the diagnosis of lower extremity arteriosclerosis obliterans,can provide effective guidance of planning treatment in lower extremity arteriosclerosis obliterans.
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Objective: To discuss the morphologic diagnosis value of CTA technical on myocardial bridge-wall coronary artery. Methods: Three hundred and seventy seven patients suspected MB-MCA and with CTA and CAG inspection voluntary in cardiology clinic or hospital were analyzed, and the occurrence of type MB-MCA and MCA MB length and degree of stenosis were recorded, the results were analyzed using SPSS17.0 statistical software. Results:103 cases of 377 were diagnosed as final MB-MCA, and there were 110 MB-MCA in total. CTA and CAG checked by means of two kinds of shallow and deep in the model type MB-MCA diagnostic analysis were compared through Kappa analysis, the Kappa value were 0.803 and 1.000. Two methods had a good consistency in the diagnosis of MB-MCA;There were statistically significant in CTA and CAG two kinds of examination methods in the diagnosis of superficial in type (t=-5.149)and deep in the type MB (t=-2.457, P=0.024)(P<0.05). Conclusion:The multi-slice spiral CT angiography CTA technology has good consistency with CAG in MB-MCA diagnosis, can achieve complementary advantages, can combine their respective advantages MB-MCA to improve the diagnostic accuracy for clinical richer diagnostic information.
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Objective To locate the points where the superior epigastric artery perforates the rectus abdominis muscle by using the spiral CT,in order to evaluate its control on abdominal complications after breast reconstruction.Methods Fifty cases had received abdominal spiral CT angiography,respectively.Then the coordinate system was established,with the umbilicus as the origin,the umbilicus horizontal line as X axis,vertical umbilical level line as Y axis.The point where superior epigastric artery perforates the rectus abdominis muscle in the coordinate system was located as described above.Results There were 392 perforating points in the rectus abdominis muscle in all 50 cases,with a mean of 7.84 perforators per patient.In the first quadrant,the points where superior epigastric artery perforate the rectus abdominis muscle were located in the range from 1.45 cm to 5.47 cm on the X axis,and in the range from 2.52 cm to 16.38 cm on the Y axis,respectively.In the second quadrant,the points where superior epigastric artery perforates the rectus abdominis muscle were located in the range from 2.02 cm to 6.80 cm on the X axis,and in the range from 2.30 cm to 14.46 cm on the Y axis,respectively.Conclusions The spiral CT angiography has high sensitivity and specificity,it can locate the point where the superior epigastric artery perforates the rectus abdominis muscle,which can avoid to cut extra rectus abdominis muscle.It is significant to reach best postoperative effect with the lowest donor site complications.
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Extracranial carotid athcrosclcrosis is the major cause of ischcmic stroke.The intumescence of carotid atherosclerotic plaque in meries results in lumen stenosis or detachment of plaque organisms.causing the distal vascular embolization,and thus resulting in a reduced cerebral blood supply and cerebral ischemic event.The volume data acquisition of multislice spiral CT angiography can provide high-quality two-dimensional and three-dimensional images,its imaging technique has become a very effective detection tool for carotid atherosclerosis.This article reviews the diagnosis application of multislice spiral CT angiograohy of carotid atherosclerosis and its pitfalls.
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Objective To evaluate the ability of multi-slice spiral CT angiography(MSCTA)in showing the celiac trunk and its degree branches,and the value of MSCTA in preoperative evaluation of laparoscopic-assisted gastrectomy for advanced gastric carcinoma.Methods A total of 25 consecutive patients scheduled for laparoscopic-assisted gastrectomy with D2 lymph node dissection were evaluated by MSCT,CT angiography(CTA)were reconstructed separately using a volume rendering algorithm(VR).The space anatomy characteristics of celiac artery and its degree branches were evaluated according to the CTA results,and with anatomy information,laparoscopic-assisted gastrectomy with D2 lymph node dissection was processed with references to anatomy.Results In all the 25 cases,the left gastric artery and gastroduodenal artery were accurately identified on MSCTA.In 12 of them,the right gastric artery was accurately identified.The origin of the spleen artery is relatively constant.Laparoscopic-assisted gastrectomy with D2 lymph node dissection was successfully completed without conversion to open surgery in all the cases.The reconstructed celiac trunk and branches are identical with anatomy.Conclusions Three-dimensional CTA using MSCT clearly reveals the anatomy of celiac artery and their space structure.It plays an important role in guiding lymph node dissection during laparoscopic-assisted gastrectomy for advanced gastric carcinoma.
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OBJECTIVES: Three-dimensional computed tomographic angiography(3D-CTA) is recently developed diagnostic imaging modality. We have studied this noninvasive method for possible role in replacing conventional angiography(CA) in the detection of aneurysms of the circle of Willis in patients with subarachnoid hemorrahge(SAH). METHODS: We studied retrospectively, the 100 patients with SAH or unruptured aneurysms admitted to our hospital from October 1997 to December 1998. Among there, 85 patients underwent CTA, 82 patients underwent CA and 67 patients underwent both of CTA and CA. 3D-CTA was obtained using maximum intensity projection(MIP) and shaded-surface display(SSD) reconstruction. RESULTS: Total 107 aneurysms were detected in 92 patients, and 64 aneurysms were detected in 67 patients underwent both CTA and CA. In five cases of those 67 cases, aneurysms were detected by CA but not by 3D-CTA. The detection rate of aneurysms(91.8%) and the detection rate of parent artery in cases of anterior communicating artery aneurysms(86.9%) with total 3D-CTA were relatively compatible with that of CA. But 3D-CTA was not enough in detection of posterior communicating artery aneurysms, internal carotid artery aneurysms as well as small sized aneurysm(<3mm). Conclusion : We consider CTA is valuable in as a screening test for cerebral aneurysm and follow-up test. And it is also valuable in early surgery for patients with aneurysmal rebleeding because of simple, quick, non-invasive method.
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Humanos , Aneurisma , Angiografia , Artérias , Artéria Carótida Interna , Círculo Arterial do Cérebro , Diagnóstico por Imagem , Seguimentos , Aneurisma Intracraniano , Programas de Rastreamento , Pais , Estudos Retrospectivos , Hemorragia SubaracnóideaRESUMO
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.