目的:评价先天性心脏病（CHD）不同病变类型在64层螺旋CT（64-MDCT）三维重建图像上的表现及显示效果。方法:回顾性分析36例CHD患者的64-MDCT资料,分别在轴位、冠状、矢状位及容积再现（VR）重组图像上观察病变,统计分析不同重组图像显示总体病变及房、室间隔缺损效果有无差异。结果:36例患者共有病变59处,轴位、冠状及矢状位图像在发现病变（59处,100.0%；57处,96.6%；53处,89.8%）及室间隔缺损显示（显示效果评分:41、38及39分）方面无明显差异（P＞0.05）,但轴位图像显示房间隔缺损明显优于冠、矢状位图像（显示效果评分:19、13及12分）（P＜0.05）。VR图像与轴位及冠、矢状位图像显示心外大血管病变效果无差异P＞0.05）。不同类型病变在轴位,冠、矢状位及VR图像上表现特征不尽相同,而不同重组图像有各自优势显示的病变类型。结论:64-DCT三维重建图像能够很好地显示先心病各种类型病变,了解不同重建图像上病变表现特征及显示效果有利于做出准确、全面的诊断。
ObjectiveTo introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.MethodsUltrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.ResultsMany of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, lowgrade dysplastic nodule, highgrade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.ConclusionModern stateoftheart medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.
ObjectiveTo analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP). MethodsEight patients with SPTP received triple phasic contrast-enhanced CT, and its consistency with pathological findings was analyzed. ResultsSPTP manifested as a solitary and exogenous mass, with a heterogeneous pattern composed of solid and polycystic parts. The shape of SPTP was spherical in four patients, oval in two patients, and shallow lobulation in another two patients. In contrast-enhanced phase images, the solid parts showed mild to moderate enhancement in both arterial and portal phases. Complete capsule was showed in seven patients, and nodules were found in the wall of mass in five patients. Hemorrhage was seen in two patients and calcification was showed in five patients. The dilation of pancreatic duct was found in one patient, liver metastases was showed in one patient, and the invasion of tumor to posterior gastric wall was found in one patient. Pseudopapillary structure, hemorrhage, necrosis, and cystic degeneration were showed in all patients by histological study. ConclusionSPTP has certain characteristic CT imaging manifestations consistent with histological features, which is helpful for the diagnosis and differential diagnosis of SPTP.
Objective To evaluate CT and ultrasonic imaging as a diagnostic means of acute intestinal obstruction. Methods Acute intestinal obstruction of 30 patients diagnosed by preoperative CT scanning and ultrasonic imaging was retrospectively viewed, compaired with intraoperative and pathologic findings.Results The overall accuracy of CT for detection of obstruction was 86.7% (26/30),CT and ultrasonic imaging was 93.3% (28/30). Conclusion CT with ultrasonic imaging is of great advantages for senile patients especially having malignant tumors and for patients with intestinal intussuception. CT with ultrasonic imaging is found to be reliable for diagnosing ileolithiasis and abdominal abscess and mesentery vein thrombosis, but is less sensitive in cases of bowel torsion.
【Abstract】Objective To investigate the imaging features of malignant invasion of major intrahepatic ductal structures (the portal and hepatic venous vasculature, the bilie duct) by primary hepatocellular carcinoma (HCC) using multidetector-row spiral CT (MDCT). Methods We retrospectively analyzed 68 documented HCC patients with tumorous invasion of the major intrahepatic ductal structures who had undergone contrast-enhanced dual-phase MDCT scanning of the upper abdomen.The morphological changes of the portal and hepatic venous vasculature, the bile duct, and the liver parenchyma at both the hepatic arterial phase and portal venous phase images were carefully observed and recorded. Results Among the 68 patients, 47 patients had malignant invasion of the intrahepatic portal venous vessels with secondary tumor thrombus formation; 12 patients had tumor involvement of the hepatic veins and intraheptic segment of the inferior vena cava; Tumor invasion of the bile duct was seen in 9 patents. The direct CT signs of tumor invasion of intrahepatic venous vessels included: ①dilatation or enlargement of the involved vein with intraluminal softtissue “filling defect”； ②enhancement of the tumor thrombus at hepatic arterial phase, the so-called “venous arterialization” phenomenon. The indirect CT signs included: ①arterial-venous shunt, ②early and heterogeneous enhancement of the hepatic parenchyma adjacent to HCC focus, ③cavernous transformation of the portal vein. The CT signs suggesting tumor invasion of the bile duct included: ①dilation of the bile ducts near or proximal to HCC lesion, ②soft-tissue nodule or mass inside the bile ducts. Conclusion Invasion of major intrahepatic ductal structures by HCC will present corresponding CT imaging features. Contrast-enhanced MDCT dualphase scanning combined with appropriate image postprocessing techniques can better evaluate the malignant invasion of major intrahepatic ductal structures.
Objective To investigate the value of multislice spiral CT （MSCT） findings in the diagnosis of hepatic tuberculosis. Methods MSCT imaging data, including both plain and contrast-enhanced CT scan, of 14 patients with hepatic tuberculosis confirmed by surgery (5 patients), aspiration biopsy (4 patients), or clinic follow-up (5 patients) were collected for the study. MSCT findings were analyzed with correlation of pathological changes. Results Hepatic tuberculosis was classified into 2 types. ①The parenchymal type (12 patients), which was further divided into 4 subtypes: Miliary subtype (2 patients) showed multiple tiny hypodense dots with faint border and had no enhancement; Nodular subtype (5 patients) showed blurring border on plain CT scan, 2 patients had no enhancement, 2 had peripheral rim-like enhancement, and peripheral rim enhancement mixed with no enhancement in 1 patient; Abscess subtype (4 patients) showed central hypodense area with peripheral zone-like enhancement in 2 patients, or patchy like slight enhancement in 2 patients; Fabric and calcific subtype (1 patient) depicted enplaque calcification. ②The serohepatic type (2 patients) showed thickened hepatic capsule, sub-capsule nodules with slight enhancement, and local subcapsular fluid collection. Other signs included hepatomegaly, tuberculous lymphadenopathy, splenic tuberculosis, and tuberculosis of pancreas, adrenal glands, intestine and thorax. Conclusion MSCT plays an important role in diagnosis of hepatic tuberculosis, by reflecting underlying pathological changes.
Objective To investigate multi-slice spiral CT (MSCT) and MRI features of stasis cirrhosis and the diagnostic value of MSCT and MRI. Methods MSCT and MRI findings of 35 patients with stasis cirrhosis were studied. The size of liver and spleen, the diameter of hepatic vein (HV), enhancement pattern of liver parenchyma, contrast medium reflux in inferior vena cava (IVC) and (or) HV, ascites, number of varices and correlated abnormalities were reviewed. Results The volume index of liver and spleen of 35 patients was 4434.95 cm3 and 621.92 cm3 respectively. The mean diameter of HV of 27 patients (77.1%) was 3.61 cm and HV of other 8 patients (22.9%) were too small to show. Number of patients showed waves of borderline, inhomogeneous pattern of parenchymal contrast enhancement, contrast medium reflux in IVC and (or) HV, varices and ascites was 5 (14.3%), 29 (82.9%), 20 (57.1%), 16 (45.7%), and 6 (17.1%), respectively. Correlated abnormalities included cardiac enlargement 〔4 cases (11.4%)〕, pericardium thickening 〔11 cases (31.4%)〕, and pericardial effusion 〔2 cases (5.7%)〕. Conclusions Stasis cirrhosis mainly demonstrate liver enlargement, inhomogeneous pattern of parenchymal contrast enhancement, contrast medium reflux in IVC and (or) HV, and slight portal hypertension. MSCT and MRI play invaluable roles in diagnosis, differential diagnosis and etiological diagnosis of stasis cirrhosis.
Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes （one had chronic cholangitis with choledochal lithiasis）， another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.
Objective To investigate the effects of X-ray dose on the expressions of microRNA-221 （miR-221） and phosphatase and a tensin homolog deleted from chromosome10 （PTEN） in human colorectal carcinoma （CRC） cells. Methods Human CRC-derived cell line， Caco2， was cultured conventionally. The cells were divided into five groups and exposed to different doses of X-ray （0， 2， 4， 6， and 8 Gy） respectively. The total RNA and protein of the Caco2 cells were extracted after irradiation， and the miR-221 and PTEN mRNA expressions were detected by real-time RT-PCR.Moreover， the protein alteration of PTEN in Caco2 cells was detected by Western-blot analysis. Results The radiation dose of X-ray significantly affected the expressions of miR-221 and PTEN protein in human Caco2 cells in a dose-depen-dent manner. Moreover， the miR-221 expression level was up-regulated gradually with the increase of irradiation dose， on the contrary， the PTEN protein expression level was down-regulated gradually （P＜0.01）. Conclusion The radiation dose can affect the miR-221 and PTEN protein expression pattern in CRC cells.
【摘要】 目的 探讨结核性腹膜炎的CT诊断价值。 方法 回顾性分析2009年10月-2010年7月22例经手术、病理或抗结核治疗确诊的结核性腹膜炎CT完整资料。主要观察:淋巴结、腹水、腹膜、系膜、网膜改变。 结果 淋巴结肿大12例，增强后呈“环状”强化改变。腹腔积液15例，少～中量12例，聚集在肠系膜根部、结肠旁沟及盆腔较多，CT值20～28HU。腹膜增厚16例，其中14例均匀光滑增厚，10例明显强化；大网膜增厚15例，其中饼状增厚2例、污垢样增厚9例、结节样4例。肠系膜增厚18例，3例肠袢聚集、粘连。伴有其他脏器结核13例。 结论 CT对诊断和鉴别诊断结核性腹膜炎具有较大的临床价值，结合临床多数结核性腹膜炎可作出正确诊断。【Abstract】 Objective To evaluate the diagnostic value of CT scan for tuberculotic peritonitis. Methods The complete CT image data of 22 patients with tuberculotic peritonitis confirmed by surgical, pathologically, or therapeutic procedures from October 2009 to July 2010 were retrospectively analyzed. The changes of lymph nodes, ascites, thickened peritoneum, mesentery and greater omentum were observed. Results In 22 patients, enlargement and rim enhancement of lymph nodes were found in 12; ascites with CT value of 20-28 HU was in 15, of whom 12 had small or middle amount of effusion which located in mesentery or abdominal cavity; thickened parietal peritoneum was in 16, including smooth peritoneum in 14 and evident enhancement in 10; thickened greater omeutum was in 15, including cake-like thickening in 2, filth-like thickening in 9 and tuber-like thickening in 4; thickened mesentery was in 18, including intestinal loop adhesion in 3.A total of 13 patients were combined with other tuberculosis. Conclusion CT scan is very important in diagnosing and differentially diagnosing tuberculous perinitis.