ObjectiveTo explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. MethodsThirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. ResultsIn the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). ConclusionCTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.
目的 应用128层螺旋CT冠状动脉成像，探讨冠状动脉不同成分斑块与狭窄程度的诊断价值。 方法 对2010年3月－2012年10月150例临床拟诊冠心病及确诊冠心病患者的128层螺旋CT冠状动脉成像检查，冠状动脉影像表现由两位心血管CT诊断医师独立判断冠状动脉斑块成分及测量冠状动脉狭窄程度。应用Circulation血管分析软件，分析冠状动脉斑块成分与狭窄程度之间的相关性。 结果 150例患者中，共发现319处斑块，其中软斑块104处，纤维、混合斑块103处，钙化斑块112处。冠状动脉轻度狭窄114处中，钙化斑块86处 （75.4%）；冠状动脉中度狭窄113处中，纤维、混合斑块75处（66.3%）；冠状动脉重度狭窄92处中，软斑块68处（73.9%）。 结论 128层螺旋CT冠状动脉成像能够有效检测患者冠状动脉斑块的成分及准确判断冠状动脉狭窄程度。
目的 探讨镰状韧带引起假性病灶的影像学表现，以提高对其的认识，减少误诊。 方法 对2010年1月－2012年1月收入的817例患者进行上腹部64排CT平扫加增强扫描，筛选出肝镰状韧带附近假病灶，详细记录其部位、大小、形状以及扫描各期图像的密度变化情况。 结果 有72例存在镰状韧带假病灶，绝大多数位于肝左叶内侧段（69例），并呈单发病灶（70例）。假病灶最大直径约5.1～22.0 mm，平均约13.1 mm，假病灶分别呈三角形43例、类圆形19例、结节状10例。CT扫描：平扫显示10例，动脉期显示63例，门脉期几乎全部显示清晰。 结论 镰状韧带形成假病灶比较少见，其发生部位特殊，在门脉期易于显示，可与肝内真性病灶鉴别，以免误诊。
目的 探讨小肠扭转的CT影像学表现及多层螺旋CT的诊断价值。 方法 回顾性分析2006年2月－2011年8月14例经手术证实肠扭转患者的临床及影像资料。 结果 14例小肠扭转患者中有9例出现“U形征”，13例有肠管和血管的“漩涡征”，4例有“鸟喙征”，2例可见“靶环征”，1例可见空回肠“转位征”。 结论 肠管及血管的“漩涡征”是诊断小肠扭转的特异性征象，“鸟喙征”、“靶环征”等其他CT征象为小肠扭转的正确诊断提供可靠依据。多层螺旋CT扫描及三维重组对小肠扭转的诊断具有重要价值。
目的 探讨64排螺旋CT血管探针技术在评价肾动脉狭窄中的价值。 方法 回顾分析2010年4月－2012年1月51例行64排螺旋CT肾动脉血管成像且肾动脉狭窄患者的临床资料，对双侧肾动脉行血管探针重组，分析血管狭窄的原因，以及累及范围、狭窄程度。 结果 51例患者双侧肾动脉共105支（3支副肾动脉），其中管腔正常肾动脉27支，管腔有狭窄肾动脉78支。管腔狭窄者中，肾动脉斑块血管共65支，累及范围主要为局限性，以混合性及轻度狭窄为主；肾动脉夹层4支，累及范围主要为节段性，假腔内无对比剂，真腔轻中度狭窄为主；肾动脉肿瘤包绕共有9支，累及范围主要为节段性，腔轻度狭窄为主。 结论 64排螺旋CT血管成像清晰显示肾动脉，血管探针技术分析血管快速、可靠，能准确评价肾动脉狭窄，对指导临床治疗具有重要的意义。
ObjectiveTo evaluate the value of computed tomography examination in the clinical diagnosis guidance and therapeutic effect assessment for patients with uremic pneumonia. MethodsWe reviewed the clinical situation and pathogenesis turnover of 64 cases of uremic pneumonia from February 2011 to January 2013,and analyzed the correlation between image modification and treatment effectiveness. ResultsSixty-four cases of uremic pneumonia had different image manifestations in each phase of the disease course,including 27 cases of pulmonary venous pleonaemia,51 of lung interstitial edema,8 of pulmonary alveoli effusion,and 15 of pulmonary interstitial fibrosis.Dropsy of serous cavity and the heart shape could be viewed by CT scanning.CT rechecking was carried out after hemodialysis and symptom-targeted treatment.The results showed that CT results of 27 cases of pulmonary venous pleonaemia,51 cases of edema in the interstitial tissue and 41 cases of pleural effusion changed significantly after treatment (P<0.001);the image manifestations of 8 cases of pulmonary alveoli edema also changed significantly (P<0.05);the CT result of 15 cases of pulmonary interstitial fibrosis had no change;six cases among the fourteen cases of pericardial effusion were not absorbed by treatment (P>0.05). ConclusionThe diagnosis of uremic pneumonia mainly depends on imaging results.CT scanning plays an important role on the determination of clinical stage,the choice of therapeutic method,and evaluation of curative effect for uremic pneumonia.