The diagnostic value of multislice computed tomography in children with congenital lobar emphysema.

OBJECTIVE: To investigate the diagnostic value of multislice computed tomography (MSCT) in children with congenital lobar emphysema (CLE). MATERIALS & METHODS: Seven children with CLE diagnosed by surgery pathology had undergone thin-slice scanning of MSCT, multiplanar reconstruction and volume rendering technique. The diagnostic value of MSCT in children with CLE was evaluated. RESULTS: Among seven patients with CLE, three cases were located in the left upper lobe, two cases in the right upper lobe and two cases in the right middle-upper lobe. All cases were manifested by variable degrees of bronchus stenosis in the corresponding lung segment or lobe, increased lung radiolucence and volume, and reduced lung markings. In this group, there was one case, respectively, associated with left posterior mediastinal bronchogenic cyst, bronchiectasis in the right lung, a lung cyst in the right upper lobe, angiodysplasia in the right upper lung and congenital funnel chest; two cases of multiple lung bullae in the right lung, three cases of infection in both lungs and four cases of mediastinal hernia. CONCLUSION: MSCT and multidimensional reconstruction is a noninvasive diagnostic method that displays the location, degree and accompanying anomalies of CLE in three dimensions. It has significance for clinicians in that it reduces both misdiagnosis and the time taken to receive treatment.

[The diagnostic value of MSCT multi-dimensional reconstructions for congenital vascular ring with tracheal stenosis].

OBJECTIVE: To evaluate the diagnostic value of multi-slice CT (MSCT) reconstructions for congenital vascular rings together with tracheal stenosis. METHODS: 9 cases of children with congenital vascular ring and tracheal stenosis confirmed by surgery were collected in the study, all cases had undergone thin slice CT contrast enhancement, the MSCT data were transmitted to the workstation for multiplanar reconstruction (MPR), volume rendering technique (VRT) and VR transparency reconstruction. With the surgical results as the gold standard, the imaging characteristics of echocardiography (UCG) and MSCT were comparatively analyzed. RESULTS: In 9 cases, there were 4 cases of pulmonary artery sling, 3 cases of right aortic arch combination with left aberrant subclavian artery, 1 case of double aortic arch, 1 case of innominate artery compression syndrome. In this group, 5 cases were accompanied with other cardiac malformations (tetralogy of Fallot in 2 cases, double outlet right ventricle with patent ductus arteriosus and ventricular septal defect in 1 case, ventricular septal defect in 1 case, double superior vena cava in 1 case), 1 case of tetralogy of Fallot demonstrated many tortuous collateral arteries around aorta. All malformations were well displayed by VRT, MPR. VR transparency reconstruction can stereoscopically display trachea and bronchial compression condition, the main trachea was compressed in 6 cases, the main trachea and left main bronchus was compressed in 2 cases, the main trachea and left main bronchus was compressed in 1 cases, UCG detected all intracardiac malformations, 1 case of pulmonary artery sling was misdiagnosed as patent ductus arteriosus, 8 cases of vascular rings, tracheal and bronchial stenosis were missed. CONCLUSION: MSCT reconstruction technology is a noninvasive, rapid diagnostic method, it can clearly show the congenital vascular rings abnormalities and the degree of tracheal stenosis, it has important significance for clinic treatment.

[Left ventricular longitudinal rotation changes in patients with dilated cardiomyopathy detected by two-dimensional speckle tracking imaging].

OBJECTIVE: To assess the left ventricular longitudinal rotation (LR) in patients with dilated cardiomyopathy (DCM). METHODS: Conventional echocardiography (GE-Vivid7) was performed in 35 healthy subjects and 42 DCM patients. Left atrial diameter was measured by M-mode echocardiography, left ventricular end-systolic, end-diastolic volume and left ventricular ejection fraction (LVEF) were calculated by bi-plane simpson's method. The peak velocity during early diastole (Ve) and late diastole (Va) of anterior mitral valve were measured by pulse-waved doppler, and the ratio Ve/Va was calculated. The peak radial systolic strain, strain rate in systolic, early and late diastolic periods were measured. Segmental LR and global LR were assessed using two-dimensional speckle tracking imaging (2D-STI). RESULTS: The peak radial systolic strain, strain rate in systolic, early and late diastolic periods in DCM group were significantly lower than in healthy subjects, the rotation degrees of the middle and base lateral, the apex and the base septum walls were significantly lower than those of the healthy subjects. A prominent counterclockwise LR (0.76° ± 2.63°) was shown in healthy subjects while prominent clockwise LR (-1.58° ± 3.42°) was present in DCM patients. The time delay between the left ventricular lateral wall and the base septum wall in DCM patients significantly correlated with the peak LR of the left ventricular (r = 0.409, P < 0.01; r = 0.396, P < 0.01). CONCLUSIONS: 2D-STI can be used to assess the LR in DCM patients and a clockwise LR is present in DCM patients which might be caused by the time delay between the left ventricular lateral wall and the base-septum wall.