多层螺旋CT成像技术在结肠肿瘤诊治中的应用

目的：应用多层螺旋CT成像技术对结肠肿瘤者进行前瞻性研究，旨在提高多层螺旋CT在结肠肿瘤的诊断水平。方法：通过对30例结肠肿瘤病人的MSCT轴位图像和重建的4-D、MIP及仿真内窥镜图像进行观察分析，并与相应的钡灌肠及纤维结肠镜结果进行对照性研究。结果：全部病例诊断符合率为100％，仿真内窥镜结果与纤维结肠镜结果基本吻合。结论：多层螺旋CT在结肠肿瘤的诊断中具有独特的优越性。     

0.23 T开放性磁共振实时引导下经皮激光热消融术 治疗肝脏恶性肿瘤

目的 评价肝脏肿瘤在磁共振介入激光治疗中的热消融变化及光学器械追踪系统对激光纤维的精确定位和实时监测激光治疗中热消融变化的能力，观察激光消融治疗肝脏恶性肿瘤的可行性与安全性。方法 对经病理学活检证实的14例恶性肝脏肿瘤患者(4例为肝细胞癌，10例为肝转移瘤，共22个肿瘤)进行0．23T开放性磁共振成像系统与介入引导下经皮激光热消融治疗术。结果 全部病灶均被成功定位、靶定并消融治疗。肿瘤形态、术后瞬间及3天后热消融形成的凝固坏死灶均在磁共振图像上显示。除1例有部分残余外，所有热消融灶均大于各自原始肿瘤大小；术后3天热消融凝固灶大于术后瞬间凝固灶。结论 磁共振引导经皮肝脏肿瘤激光热消融术是可行和安全的；光学追踪系统引导与磁共振温度监测对准确估计热治疗效果是有用且可信赖的工具。     

胃粘膜巨大肥厚症(附4例报告)

近年来,我们遇见4例胃粘膜巨大肥厚症,其中3例经胃镜证实,4例均经手术及病理证实。现举2例报告如下。例1:男,46岁。因上腹不适、腹泻4个月,全身浮肿50天入院。查体:除腹水征     

三维CT在先天性髋关节脱位及髋臼骨折的临床应用

三维ＣＴ(ｔｈｒｅｅｄｉｍｅｎｓｉｏｎａｌｃｏｍｐｕｔｅｄｔｏｍｏｇｒａｐｈｙ ;3ＤＣＴ) ,利用计算机将连续的ＣＴ横断图像进行重组 ,形成多种形式的三维图像 ,3Ｄ成像的条件要求较高 ,常规ＣＴ扫描中层厚越薄 ,层距越短 ,纵向空间分辨率就越高 ,三维图像质量也越高 ,但在纵向上不是连续取样 ;螺旋ＣＴ尤其多层螺旋ＣＴ将二维采样改为三维容积采样 ,很好地解决了这一问题。三维成像技术目前主要有表面遮盖显示(ｓｈａｄｅｄｓｕｒｆａｃｅｄｉｓｐｌａｙ ;ＳＳＤ) ;容积显示技术 (ｖｏｌｕｍｅｒｅｎｄｅｒｉｎｇ) ;最大密度投影(ｍ…     

少见化学性肺炎的影像学表现

1　引　言化学性肺炎少见 ,其发生、发展与吸入物质的毒性反应、强度、持续时间以及生理的、生物的宿主易感性有关。依据被吸入物质的物理状态 :溶解性、反应性、气体动力学特性 ,决定肺内病变部位 ,一般下呼吸道多见。经证实 ,有炎症和水肿的急性反应及有纤维化或颗粒形成的慢性反应 ,是环境因素所致[1] 。2　化学性肺炎毒性化学物质的吸入少见。不同肺毒性物质的作用机制不同。其种类繁多 ,包括有机的 (如磷酸盐、百草枯、氯化聚乙烯、聚合物粉尘、烟 ) ,无机的 (如氨、硫化氢、氧化氮、二氧化硫 )以及金属 (如镉、汞、镍、钒 )复合物。有…     

前瞻性心电门控双源CT冠状动脉成像在高心率患者中应用的可行性研究

Objective To explore the optimal reconstruction windows in patients with heart rate (HR) over 91 (beats per minute) bpm, and to explore the feasibility of prospective ECG-gated DSCT coronary angiography.Methods Two hundred and thirty-two patients[body mass index (BMI):23-25 kg/m2, with stable HR, and average HR ≥91 bpm]with suspected or known coronary artery disease underwent retrospective ECG-gated DSCT coronary angiography.They were divided into 3 groups (A-C) according to the average HR of scanning.Images were reconstructed from 29% to 80% of the R-R interval in 3% increments.Two independent readers assessed the overall image quality by a five-point scale and determined the optimal reconstruction windows of each coronary segment and the ranges.Coronary arteries were segmented according to the guideline of the American Heart Association (AHA).The degree of interobserver agreement was determined by Kappa statistics.Results Three thousand three hundred and fortythree segments were considered to have diagnostic image quality in 232 patients.The ranges of optimal reconstruction windows of images were concentrated on 81%-61% and 51%-31%.In group A(91-95 bpm), there were 1183 segments in 83 patients, and the according proportions were 5.49%, 94.51%,respectively; In group B(96-100 bpm), there were 986 segments in 68 patients, and the according proportions were 0.20%, 99.80%, respectively; In group C(≥ 101 bpm), there were 1174 segments in 81 patients, and the according proportions were 0.17%, 99.83%, respectively.The optimal construction windows in 3274 segments out of 3343 segments in 232 patients were concentrated in 41%, ranged from 51%-31%.The image quality assessment in 3343 segments in 232 patients have a high inter-observe agreement (Kappa=0.883,P <0.05).Conclusion The optimal reconstruction windows of patients with stable HR(≥91 bpm) was concentrated in 41%, ranged from 51%-31%.When nothing except the window of data acquisition is considered, the prospective ECC,-gated DSCT coronary angingraphy can be used in patients with stable HR(≥91 bpm).     

前瞻性心电门控双源CT冠状动脉成像在高心率患者中应用的可行性研究

Objective To explore the optimal reconstruction windows in patients with heart rate (HR) over 91 (beats per minute) bpm, and to explore the feasibility of prospective ECG-gated DSCT coronary angiography.Methods Two hundred and thirty-two patients[body mass index (BMI):23-25 kg/m2, with stable HR, and average HR ≥91 bpm]with suspected or known coronary artery disease underwent retrospective ECG-gated DSCT coronary angiography.They were divided into 3 groups (A-C) according to the average HR of scanning.Images were reconstructed from 29% to 80% of the R-R interval in 3% increments.Two independent readers assessed the overall image quality by a five-point scale and determined the optimal reconstruction windows of each coronary segment and the ranges.Coronary arteries were segmented according to the guideline of the American Heart Association (AHA).The degree of interobserver agreement was determined by Kappa statistics.Results Three thousand three hundred and fortythree segments were considered to have diagnostic image quality in 232 patients.The ranges of optimal reconstruction windows of images were concentrated on 81%-61% and 51%-31%.In group A(91-95 bpm), there were 1183 segments in 83 patients, and the according proportions were 5.49%, 94.51%,respectively; In group B(96-100 bpm), there were 986 segments in 68 patients, and the according proportions were 0.20%, 99.80%, respectively; In group C(≥ 101 bpm), there were 1174 segments in 81 patients, and the according proportions were 0.17%, 99.83%, respectively.The optimal construction windows in 3274 segments out of 3343 segments in 232 patients were concentrated in 41%, ranged from 51%-31%.The image quality assessment in 3343 segments in 232 patients have a high inter-observe agreement (Kappa=0.883,P <0.05).Conclusion The optimal reconstruction windows of patients with stable HR(≥91 bpm) was concentrated in 41%, ranged from 51%-31%.When nothing except the window of data acquisition is considered, the prospective ECC,-gated DSCT coronary angingraphy can be used in patients with stable HR(≥91 bpm).     

MRI引导下骨骼肌肉病变活检的应用价值

目的：介绍iPath200辅助MPI引导下骨骼肌肉系统活检的技术操作方法，并评价其应用价值。方法：24例骨骼肌肉系统病变患者，均在iPath200辅助MPI引导下进行经皮活检。所用设备为Philips公司生产的开放式0．23T。常导磁共振检查仪(Proview)，并配有iPath200光学引导系统。活检针采用德国Daum公司的磁共振兼容性活检针。24例病人中的6例在活检中行Nil对比增强检查。所用对比剂为Gd-DTPA。24例病人中的10例后来行外科手术治疗或活检。结果：MPI引导活检取得足够的标本，所有的病例均获得了组织病理学诊断(24／PA)。在10例后来行外科手术治疗或活检的病人中，初步诊断与最终诊断基本符合(10／10)。未发现明显并发症如严重出血及神经损害等。结论：iPath200辅助MPI引导下的骨骼肌肉系统病变的经皮活检是一种安全、准确的新技术。     

缺血性心脏病CT、MRI心肌灌注技术的应用进展

心肌细胞的重要特性是具有自律性舒缩功能 ,其功能的精确调控有赖于营养性心肌灌注和细胞代谢间的平衡。心肌灌注的定义为单位时间内通过单位重量心肌的血流容积 ,表示为ml·10 0g-1·min 1。在正常静息状态下 ,心肌的灌注量为 80ml·10 0g-1·min-1。精确的灌注测定显示心肌的灌注量随部位和时间的变化而有不同 ,例如心内膜到心外膜心肌灌注呈梯度性变化 ,心外膜的灌注量较心内膜增加约 2 0 % ,并且有些部位不存在心内膜到心外膜心肌灌注的梯度性变化 ,部位的不同心肌灌注量也有较大的变化。心肌收缩期和舒张期灌注量的变化依赖于心肌内压…     

MSCT在冠状动脉粥样硬化性心脏病中的应用进展

冠心病已成为人类死亡的重要原因,目前我国冠心病的发病率不断升高.根据其临床表现可分为心绞痛和心肌梗死两型.前者可通过药物治疗、PTCA或冠脉搭桥术来缓解症状,而后者由于起病突然、预后差且导致无可逆转的变化,其诊断和治疗倍受重视,对无症状冠心病的检出具有很高的临床价值.故而寻求简便、有效、无创伤的检查方式为临床所亟需.