多层螺旋CT在诊断小儿急性阑尾炎中的应用

目的:探讨多层螺旋CT对小儿急性阑尾炎的诊断价值。方法:回顾分析经临床手术病理证实的53例小儿急性阑尾炎的CT表现特点。所有患儿均行多排CT横断面扫描及MPVR重建。结果:53例中,单纯性阑尾炎2例;急性化脓性阑尾炎伴周围炎4例,其中1例合并紫癜;急性化脓性阑尾炎伴穿孔33例,其中1例合并回肠末端美克尔憩室;坏疽性阑尾炎伴穿孔6例;阑尾脓肿8例。CT平扫以及MPVR重建显示阑尾肿大、增粗(直径大于6mm)30例,阑尾内粪石27例,阑尾周围蜂窝织炎23例,阑尾周围脓肿8例,大量腹水6例。结论:多层螺旋CT扫描及重建技术能为小儿阑尾炎的诊断提供有力依据,提高临床术前诊断能力。     

多层螺旋CT 对腹膜后纤维化的诊断价值

目的:评价MSCT对腹膜后纤维化的诊断价值。方法:回顾性分析经临床及手术、活检病理证实9例腹膜后纤维化患者的MSCT影像资料,分别由两名副主任医师采用盲法对RPF病变发生部位、病变范围、病灶形态、密度及与周围组织的解剖关系显示情况进行分析,所有病例均进行平扫及三期增强扫描,并进行平扫及增强后病变CT值测定。采用多平面重建(MPR)、曲面重建(CMPR)、容积重建(VR)及CT尿路造影(CTU)技术进行分析。结果:所有患者CT平扫表现为腹膜后不规则近似于肌肉密度的软组织病变,6例病灶边界清晰,3例边界不清。9例均不同程度包绕腹膜后大血管,8例始于肾门下方,一例累及十二指肠上动脉。9例均不同程度累及一侧或双侧输尿管,造成输尿管及肾盂扩张积水,输尿管管壁增厚。增强扫描7例有轻中度强化,2例强化不明显。结论:MSCT可以显示腹膜后纤维化的特征,MPR、CMPR、VR及CTU技术综合应用有利于明确病变部位、形态、范围及与周围组织的解剖关系,有利于提高该病的诊断准确率。     

HRCT及后处理技术在诊断鼻区复合性骨折中的价值

目的:探讨CT高分辨率扫描及其后处理技术在鼻区复合性骨折诊断中的应用价值。方法:77例鼻区骨折病例采用横轴面和冠状面高分辨率扫描并进行多平面重组(MPR)、容积重建(VR),分别评价有无骨折并分型。结果:77例鼻区骨折病例中:单纯性鼻骨骨折14例,单纯性鼻旁骨骨折5例,鼻区复合性骨折58例。在58例鼻区复合性骨折中:横轴面诊断与HRCT+MPR+VR诊断不一致23例,冠状面12例。结论:横轴面、冠状面高分辨率扫描均应结合后处理技术才能避免在鼻区复合性骨折诊断中漏误诊。     

64排CT血管造影在脑动静脉畸形诊断中的价值

目的：探讨64排CT血管造影（computedtomography angiographycTA）对脑动静脉畸形（cerebral arefiovenousmalformation,AVM）的诊断价值。方法：16例AVM患者,均行64排螺旋CT血管造影检查,使用多种重建方法,由两名有经验的医生对畸形血管团进行分析。结果：16例均为单发瘤巢,16例AVM均显示了大小不等的畸形血管团及供血动脉和引流静脉,其中,2例同时伴脑出血（12．5％）,3例有出血后软化灶形成（18．75％）,16例发现有供血动脉31支,16例发现有明确的引流静脉21支。结论：64排CTA安全．快速．结合多种重建方法．可以清晰显示AVM的供血动脉、瘤巢．引流静脉．为临床治疗提供了可靠的信息．     

多层螺旋CT低剂量扫描技术在胸部的应用价值

目的研究多层螺旋CT低剂量扫描技术对肺部疾病的诊断价值。方法将51例胸部CT检查者在同一时间分别行常规剂量（200mAs）与低剂量（25mAs）扫描。评定2种剂量对肺部CT常见征象的显示能力。结果在肺部CT常见征象的显示中,除病灶内结节的显示率低剂量扫描较常规剂量低外,其余征象如：钙化、毛刺、支气管征、形态和边缘等二者均无显著差异。结论胸部低剂量扫描技术能作为健康体检或肺部疾病治疗后复查的首选方法。     

16层CT多平面重建与最大密度投影诊断孤立性肺结节的应用价值

目的:探讨多层CT后处理技术对孤立性肺结节的诊断价值。方法:对符合条件的56例患者行CT扫描,原始采集层厚为0.75mm,重建层厚7mm。发现结节时利用层厚为0.75mm的原始数据对病灶及周围组织进行三维重建,MPR重建包括冠状位、矢状位和病灶最大径平面图像,应用后处理软件重建出最大密度投影图像。结果:56例肺结节中恶性结节31例,良性结25例。4例假阴性包括2例腺癌、1例鳞癌和1例小细胞癌,4例病灶直径均小于1.0cm。5例假阳性包括2例肌纤维母细胞瘤和3例结核球。三维率>1.5的肺结节89%是良性SPN。结论:多层CT多平面重建与最大密度投影技术有助于孤立性肺结节的定性诊断,多平面重建技术的价值优于最大密度投影技术。     

多层螺旋CT血管成像对急性阻塞性肠系膜动脉缺血的诊断价值

目的:评价多层螺旋CT血管成像(MSCTA)对急性阻塞性肠系膜动脉缺血的诊断价值.方法:搜集12例急性阻塞性肠系膜动脉缺血的病例,全部行MSCTA检查,分析其影像学表现.结果:MSCTA能清晰显示肠系膜血管阻塞的部位、程度和范围,并能显示包括肠管扩张积液、肠管壁增厚、肠管壁积气和腹腔积液等征象.结论:MSCTA是诊断急性阻塞性肠系膜动脉缺血的一种快速,敏感、无创的影像学方法.     

64层螺旋CT血管造影在胸部大血管成像中的临床应用

目的探讨64层螺旋CT血管造影在胸部大血管成像的临床应用价值。方法回顾分析了112例患者行64层螺旋CT胸部大血管造影资料,以临床手术或随访结果为金标准,进行图像分析。结果CT能够显示主动脉、肺动静脉的结构,可以诊断主动脉夹层、主动脉瘤、肺栓塞、先天性心脏病等多种大血管病变,诊断准确率100%。结论64层CT血管造影扫描速度快、安全、准确,是胸部大血管病变的首选方法。     

螺旋CT诊断急性肠梗阻的临床价值

目的探讨螺旋CT在急性肠梗阻的诊断中的作用。方法 65例明确诊断的急性肠梗阻病例,回顾性分析其CT表现。结果 65例肠梗阻,其中完全性22例,不完全性43例;绞窄性为4例;肠肿瘤22例,肠扭转16例,腹内外疝5例。CT显示梗阻点位于小肠31例,结肠23例,小肠结肠均有11例;梗阻近段肠腔扩张,而远端肠腔萎陷;扩张的肠腔内可见气液平。靶征、鸟嘴征、缆绳征等具有诊断价值。增强后梗阻段肠壁异常强化。结论螺旋CT可以判断有无急性肠梗阻、梗阻部位、梗阻病因以及是否绞窄,是诊断急性肠梗阻的最重要的方法之一。     

多层螺旋CT二维法测量肱骨头扭转角探讨

目的:探讨肱骨头扭转角多层螺旋CT二维测量方法,着重讨论肱骨头扭转角远端定义线对测值的影响。方法:收集51根肱骨干标本,行16层螺旋CT扫描,肱骨头中轴线与肱骨远端前关节面的切线,或内外上髁连线的夹角为肱骨头扭转角。肱骨远端定义线取上中下三个不同平面得到六组肱骨头扭转角度数,进行统计学处理。结果:肱骨头扭转角最小值4°,最大值59.8°,六组肱骨头扭转角数据分别为:(27.9±11.9)°、(29.2±11.2)°、(30.2±10.7)°、(27.3±10.3)°、(26.3±10.2)°、(25.8±10.4)°,经统计学处理,以肱骨远端前关节面切线为远端定义线测得肱骨头扭转角度数越往远端越大;而以肱骨内外上髁连线为远端定义线测得的值越往远端越小;肱骨远端下方层面两种定义线测得肱骨头扭转角有显著性差异,其余层面所得值无差异,上部层面两种定义线肱骨扭转角均数最为接近,相差仅0.6°。结论:肱骨头扭转角变异较大,肩关节假体扭转角设计应个性化;多层螺旋CT二维法测量肱骨头扭转角应取鹰嘴窝较深且显示肱骨远端前关节面清楚的层面做为远端定义层面。     

Comparison of echocardiography and 64-slice spiral computed tomography in the diagnosis of congenital heart disease in children

The diagnosis of congenital heart disease in children has been an issue in the medical community. Timely diagnosis and treatment can provide a greater guarantee for children's healthy growth. In recent years, there have been more and more studies on the diagnosis of congenital heart disease in children. This paper compares the advantages and disadvantages of echocardiography and 64-slice spiral computed tomography (CT) in the diagnosis of congenital heart disease in children. In clinical trials, we also tested 64 patients with spiral computed tomography (SCT) and transthoracic echocardiography (TTE) detection of patients and then confirmed the accuracy of the diagnosis by the surgical methods. The two methods of detection, the rate of missed diagnosis, and the rate of misdiagnosis were counted. Through the test results and pathological diagnosis results, the diagnostic accuracy of the two methods were all above 90%, each with its own advantages and disadvantages. The sensitivity of echocardiographic in detecting intracardiac structure abnormalities was relatively high, but when the diagnosis of extracardiac structural abnormalities less than 64-slice spiral CT method, misdiagnosis of TTE was mainly due to extracardiac vascular malformations. Therefore, it is recommended to combine the two methods to improve the diagnosis of congenital heart disease in children.     

64层螺旋CT三维重建技术对下肢动脉粥样硬化病变的显示

目的探讨64层螺旋CT三维重建技术对下肢动脉病变的显示。方法103例下肢动脉粥样硬化的患者行64层螺旋CT血管造影检查资料在工作站进行多种三维重建,分析其影像表现。结果103例患者均获得了成功的造影图像,2459根下肢动脉血管得到了显示。其中845根(34.4%)下肢动脉血管正常;672根(27.3%)轻度狭窄;327根(13.3%)中度狭窄;292根(11.9%)重度狭窄,323根(13.1%)下肢动脉血管闭塞。结论64层螺旋CT三维重建是又一种无创性的、可靠的、简便的检查下肢动脉粥样硬化的方法,具有较高的临床价值。     

Performance of longitudinal and volumetric tube current modulation in a 64-slice CT with different choices of acquisition and reconstruction parameters

Aim of the study was to evaluate the performance of a tube current modulation (TCM) system (^SUREExposure 3D).On a 64 detector-row CT scanner (Aquilion 64, Toshiba), performance of fixed tube current, longitudinal TCM, and volumetric TCM acquisitions were assessed. A homogeneous cone-shaped phantom and an anthropomorphic phantom were used. Tube current and noise profiles were quantitatively analysed by box and whisker plots when phantom size, acquisition, and reconstruction parameters were varied.At similar median noise, fixed tube current scanning showed a noise range of 16.8–38.3 HU, while longitudinal TCM showed a range of 19.4–31.4 HU and volumetric TCM showed an even lower range of 20.7–28.7 HU. When acquisitions resulting in similar image quality (noise) were compared, the use of volumetric compared to longitudinal TCM resulted in a variable radiation dose reduction up to 6.6%.In conclusion, ^SUREExposure 3D resulted in more uniform image quality at a lower dose. Volumetric TCM shows improved results over longitudinal TCM.     

The braincase of the basal sauropod dinosaur Spinophorosaurus and 3D reconstructions of the cranial endocast and inner ear

Background

Sauropod dinosaurs were the largest animals ever to walk on land, and, as a result, the evolution of their remarkable adaptations has been of great interest. The braincase is of particular interest because it houses the brain and inner ear. However, only a few studies of these structures in sauropods are available to date. Because of the phylogenetic position of Spinophorosaurus nigerensis as a basal eusauropod, the braincase has the potential to provide key evidence on the evolutionary transition relative to other dinosaurs.

Methodology/Principal Findings

The only known braincase of Spinophorosaurus (‘Argiles de l''Irhazer’, Irhazer Group; Agadez region, Niger) differs significantly from those of the Jurassic sauropods examined, except potentially for Atlasaurus imelakei (Tilougguit Formation, Morocco). The basisphenoids of Spinophorosaurus and Atlasaurus bear basipterygoid processes that are comparable in being directed strongly caudally. The Spinophorosaurus specimen was CT scanned, and 3D renderings of the cranial endocast and inner-ear system were generated. The endocast resembles that of most other sauropods in having well-marked pontine and cerebral flexures, a large and oblong pituitary fossa, and in having the brain structure obscured by the former existence of relatively thick meninges and dural venous sinuses. The labyrinth is characterized by long and proportionally slender semicircular canals. This condition recalls, in particular, that of the basal non-sauropod sauropodomorph Massospondylus and the basal titanosauriform Giraffatitan.

Conclusions/Significance

Spinophorosaurus has a moderately derived paleoneuroanatomical pattern. In contrast to what might be expected early within a lineage leading to plant-eating graviportal quadrupeds, Spinophorosaurus and other (but not all) sauropodomorphs show no reduction of the vestibular apparatus of the inner ear. This character-state is possibly a primitive retention in Spinophorosaurus, but due the scarcity of data it remains unclear whether it is also the case in the various later sauropods in which it is present or whether it has developed homoplastically in these taxa. Any interpretations remain tentative pending the more comprehensive quantitative analysis underway, but the size and morphology of the labyrinth of sauropodomorphs may be related to neck length and mobility, among other factors.     

十六排螺旋CT血管造影在颅内疾病中应用初探

脑血管疾病是危及人体生命的危险疾病。传统的血管造影虽然是诊断该类疾病的最佳方法,但属于有创伤检查,且有1．5％-2．0％的合并症或死亡危险的报导^[1]。CT血管造影(computed tomographic angiography cTA)的应用给传统的血管造影带来了极大的挑战。1998年问世的多层螺旋CT(MSCT)以亚秒级的扫描速度具有更长的解剖覆盖、更薄的层厚、多种后处理能力、更简单方便等优势。2002年7月,我院引进GE公司Lightspeed十六排螺旋CT机,并进行了几十例颅内CTA检查,现对其应用情况进行分析。目的：初讨十六排螺旋CT血管造影在颅内病变中的应用及其技术优势。材料与方法：使用GE公司的十六排螺旋CT对自发性脑内出血、动脉瘤、脑肿瘤等几十例病人进行CTA检查,对血管显示情况进行评价;其中AVM和动脉瘤进行DSA检查并与CTA结果比较;另外颜面部AVM及脑肿瘤病人与手术结果比较。结果：CTA检查结果如下,脑血管主干及其1-3级分支显示率为100％,大脑中动脉4—5级分支显示率为94．7％。发现动脉瘤并清晰显示了瘤体、瘤颈、载瘤动脉及其详细关系;AVM清楚地显示了AVM的畸形团及其供血动脉和引流静脉;脑肿瘤显示了肿瘤与周围血管、颅骨间的三维关系。结论：十六排螺旋CT血管造影重建图像质量显著提高,它对颅内各种血管性病变以及血管与颅内其他病变三维空间关系,对各类疾病的诊断具有重要价值,它能显示更细小分支,具备作为动脉瘤等其他血管性病变筛选的首选方法。     

64层螺旋CT增强扫描对结直肠癌术前T分期的临床应用价值

目的:探讨64层螺旋CT增强扫描检查对结直肠癌术前T分期的临床应用价值。方法:对2012年3月~10月在我院行64层螺旋CT增强扫描,术后病理证实为结直肠癌的173例患者的CT成像结果进行回顾性分析。将CT分期的结果与术后病理分期结果进行一致性比较分析,并对肿瘤长度、CT值、病理分型等进行相关分析及比较。结果:CT术前T分期:T1-2期、T3期、T4期的灵敏度分别为60.90%(14/23)、89.92%(116/129)、95.24%(20/21),特异度为95.33%(143/150)、77.27%(34/44)、96.05%(146/152),准确率为66.67%(14/21)、92.01%(116/126)、76.92%(20/26),诊断一致性检验结果 Kappa=0.685,P=0.000,P0.05,有统计意义。不同病理分期中肿瘤长度及不同病理分型中肿瘤CT值方差分析结果,P0.05,有统计意义。不同病理分期中CT值方差分析结果,P0.05,没有统计意义。病理分期与病理分型的X2检验结果,P0.05,有统计意义。对T1-2过分期和T3低分期两组病例进一步分析,发现增强扫描后强化程度、管壁僵硬和浆膜不光整有助于鉴别T1-2过分期和T3期低分期,能够提高T1-2期和T3期的准确性。结论:64层螺旋CT增强扫描多种征象的相互结合有助于提高结直肠癌术前分期的准确性,对临床诊治有重要价值。     

Sensory epithelia of the fish inner ear in 3D: studied with high-resolution contrast enhanced microCT

Introduction

While a number of studies have illustrated and analyzed 3D models of inner ears in higher vertebrates, inner ears in fishes have rarely been investigated in 3D, especially with regard to the sensory epithelia of the end organs, the maculae. It has been suggested that the 3D curvature of these maculae may also play an important role in hearing abilities in fishes. We therefore set out to develop a fast and reliable approach for detailed 3D visualization of whole inner ears as well as maculae.

Results

High-resolution microCT imaging of black mollies Poecilia sp. (Poeciliidae, Teleostei) and Steatocranus tinanti (Cichlidae, Teleostei) stained with phosphotungstic acid (PTA) resulted in good tissue contrast, enabling us to perform a reliable 3D reconstruction of all three sensory maculae of the inner ears. Comparison with maculae that have been 3D reconstructed based on histological serial sections and phalloidin-stained maculae showed high congruence in overall shape of the maculae studied here.

Conclusions

PTA staining and subsequent high-resolution contrast enhanced microCT imaging is a powerful method to obtain 3D models of fish inner ears and maculae in a fast and more reliable manner. Future studies investigating functional morphology, phylogenetic potential of inner ear features, or evolution of hearing and inner ear specialization in fishes may benefit from the use of 3D models of inner ears and maculae.

     

64层螺旋CT对胸部创伤的诊断价值

目的:评价64层螺旋CT相对于CR片在胸部创伤诊断中的价值。方法:我院2006年1月～2008年3月收治81例胸部创伤,全部患者在伤后10min至5h进行了64层螺旋CT检查,其中58例在初次检查后12～38h内进行了CR或床旁CR检查,CT扫描采用GE LightSpeed 64层螺旋CT机,层厚0.625 mm,螺距为0.984:1。结果:81例中诊断肋骨骨折72例,肺挫裂伤65例,气胸36例,血胸53例,血气胸31例,锁骨骨折12例,肩胛骨骨折13例,皮下及纵隔积气18例,右横膈破裂2例。在同时进行过CR检查的患者中,非错位性及撕脱性肋骨、肋软骨骨折在CR上常显示不佳,而在64层螺旋CT多平面或三维重建图像上显示非常清晰。结论:64层螺旋CT多平面及三维重建对胸部创伤各种病变的检测明显优于x线平片,对临床急救计划的制定有重要的指导意义。     

Histochemistry of glycogen in the inner ear

Synopsis The effect of fixation and processing upon the morphological appearance of glycogen within the outer hair cells of the guinea-pig was investigated using two methods. In each method, tissue was fixed for 12 h in cold phosphate-buffered 4% paraformaldehyde and eventually dehydrated in ethanol, embedded in Epon 812, and cut into 4 m sections. In procedure A, after complete processing, the sections were tained using the periodic acid-Schiff reaction (PAS) or the periodic acid-thiocarbo-hydrazide-osmium tetroxide (PATCO) reaction which resulted in the appearance of listinct, coarse granules in the cytoplasm of the outer hair cells. Diastase digestion on one of the two matched sections after Epon removal and prior to staining, confirmed the granules to be glycogen. In procedure B, after primary fixation, the tissue was post-fixed in 1% osmium tetroxide and then processed exactly as in procedure A. Here, unless the Epon and osmium was remoyed, there was no staining of the outer hair cell cytoplasm. However, after Epon removal there was diffuse, grainy appearance of the outer hair cell cytoplasm which we considered to be due to glycogen although diastase confirmation was not possible. We have concluded that osmium tetroxide (1) inhibits PAS or PATCO staining, (2) prevents diastase digestion, and (3) prevents the appearance by light microscopy of distinct granules of glycogen.