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@#Objective To investigate the diagnostic value and risk of gastrointestinal stromal tumors(GIST)by multislice spiral computed tomography(MSCT).Methods A total of 118 suspected GIST patients admitted to Huzhou Central Hospital from June 2021 to November 2022 were selected for MSCT examination and pathological examination.Taking pathological diagnosis as the gold standard,the efficacy of MSCT in diagnosing GIST was analyzed.Multifactor analysis was used to investigate the factors affecting the risk of GIST.Results Pathological diagnosis of GIST was confirmed in 103 of 118 suspected patients.The sensitivity,specificity and accuracy of MSCT diagnosis of GIST were 97.09%,86.67%and 95.76%,respectively.There were significant differences in maximum tumor diameter,tumor shape,tumor boundary,tumor density,cystic necrosis and fat space between high-risk group and low-risk group(P<0.05).The results of multifactor analysis showed that maximum tumor diameter,tumor shape,tumor density and fat space were all factors affecting the risk of GIST(P<0.05).Conclusion MSCT has a high accuracy in the diagnosis of GIST.The maximum tumor diameter,tumor shape,tumor density and fat space are all factors affecting the risk of GIST.
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Rectal cancer is a common malignancy of the gastrointestinal tract. Extramural vascular invasion (EMVI) is a key indicator of risk stratification for rectal cancer and an important reference factor in determining individualised treatment options, so it is important to accurately assess whether extramural vessels are infiltrated by the tumour before surgery. The main imaging methods for rectal cancer include magnetic resonance imaging (MRI), computed tomography (CT) and transrectal ultrasound (TRUS). This article focuses on the performance and diagnostic efficacy of these imaging methods in the diagnosis of EMVI in rectal cancer, and provides clinical reference.
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OBJECTIVES@#To explore the relationship between the height of alveolar bone resorption and sex and age in the adolescent dentition.@*METHODS@#Multi-slice computed tomography (MSCT) was used to measure the height of alveolar bone resorption at labial, lingual, mesial and distal sites of teeth in 149 adolescents aged from 10 to 20 years. SPSS 25.0 software was used to analyze the relationship between the height of alveolar bone resorption and sex and age.@*RESULTS@#There was no significant difference in the height of alveolar bone resorption between sex (P>0.05). The height of alveolar bone resorption was positively correlated with age in all types of teeth. The model constructed by combining the alveolar bone resorption height data of four sites (y=2.569x1+3.106x2+4.108x3+1.451x4-0.082, R2max=0.756)had a better ability to infer age than that of combining two sites (y=5.942x1+4.489x2+0.612, R2max=0.706) and a single site (R2max=0.638).@*CONCLUSIONS@#The height of alveolar bone resorption is positively correlated with the age of adolescents. The combination of four sites has a stronger ability to infer the relationship between the height of alveolar bone resorption and age in adolescents and has higher accuracy in practical application.
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Humans , Adolescent , Child , Young Adult , Adult , Alveolar Process/diagnostic imaging , Cone-Beam Computed Tomography , Bone Resorption/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Objective:To evaluate direct bilirubin /total bilirubin(D/T), B-mode ultrasound(BUS), multislice spiral computed tomography (MSCT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) in the diagnosis of choledocholithiasis abdominal pain (CAP).Methods:We retrospectively analyzed the materials of patients who were diagnosed with choledocholithiasis abdominal pain by above imagines in the emergency department of Beijing Friendship Hospital during March 2016 to December 2018. The stones were taken out by endoscopic retrograde cholangiopancreatography or surgical operation as the golden standard.Results:Among 256 patients, 195 cases, 138 cases, 107 cases and 26 cases were diagnosed by EUS, MRCP, CT and BUS, respectively. The sensitivity were 0.86, 0.62, 0.45, 0.13, respectively. The specificity were 0.86, 0.81, 0.75, 0.87. The positive predictive value were 0.97, 0.96, 0.91, 0.83.The negative predictive value were 0.55, 0.19, 0.21, 0.16. The accuracy rate were 0.88, 0.64, 0.48, 0.30, respectively. The sensitivity of D/T and D/T combined with EUS in the diagnosis of CAP were 0.57 and 0.67, and the accuracy were 0.16 and 0.56, respectively.Conclusions:EUS has a high diagnostic value for CAP. MRCP is superior to CT in the value of diagnosis of CAP. BUS in imaging diagnosis of CAP value is relatively low, but D/T combined with BUS can improve the sensitivity and accuracy of diagnosis for CAP.
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Virtual autopsy is a new technique for investigating the morphological changes of cadaveric tissues and organs by medical imaging technology. It has been widely used in the identification of causes of death. Multislice spiral computed tomography （MSCT） has become a routine inspection method in some identification institutions, although it cannot completely replace traditional autopsy, it plays a key auxiliary or substitute role in the identification of certain abnormal causes of death. Plain MSCT scan cannot visualize cadaveric vessels, but can perform cadaveric angiography to determine vascular injury or disease. This technology has entered a rapid development period in recent years, and has made a considerable progress in contrast agent, perfusion methods and imaging methods. This article summarizes several common cadaveric MSCT angiography methods, such as systemic angiography, angiography through cardiopulmonary resuscitation, targeted angiography, and angiography by cardiac puncture, and analyzes and compares the application prospects.
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Humans , Angiography , Autopsy , Coronary Angiography , Heart , Tomography, Spiral ComputedABSTRACT
Objective:To evaluate the diagnostic value of MSCT for small intestinal stromal tumors.Methods: The MSCT results of 27 cases diagnosed pathologically as small intestinal stromal tumors were retrospectively analyzed.Results: MSCT scan could clearly show the position, size, shape, fat space, density, calcification, growth pattern of the lesions. Enhanced MSCT scan showed that the arterial phase was significantly strengthened, the venous phase was significantly enhanced than the arterial phase, and the delay phase was significantly enhanced than the venous phase. Low-risk tumors were mainly with maximum diameter <5 cm, regular shape, clear fat gap, uniform density, and intraluminal growth-oriented, while high-risk tumors were mainly with maximum diameter ≥5cm, irregular shape, blur fat gap, uneven density, and cavity shape and mixed growth. The differences were statistically significant (x2=6.64,P<0.05).Conclusion:MSCT can be used as a preliminary judgement for benign and malignant small intestinal stromal tumors and its level, which can guide further clinical treatment and prognosis evaluation.
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Objective:To investigate the diagnostic value between CBCT and MSCT in the styloid process syndrome. Method:One case with styloid process syndrome is selected examination of CBCT and MSCT in the patient's position of styloid process. The length and the angle of the styloid process in the picture of CBCT and MSCT were measured and had a construct with each other. Result:MSCT is slightly clearer than CBCT in the imaging of styloid process, but there is no obvious difference in the length and angle measurement of styloid process between them. Conclusion:Except for MSCT, CBCT is another important means in the diagnosis of styloid process syndrome, CBCT has a great clinical application value.
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Objective: To analyze the characteristics of multislice spiral computed tomography (CT) for acute myocardial infarction. Methods: The anterior descending coronary arteries of 6 pigs were ligated at the 1/3 distal end to establish acute myocardial infarction model without reperfusion. Dual multislice spiral CT scanning was performed in all animals and the CT characteristics were analyzed. Results: Acute myocardial infarction model was successfully established in all 6 animals. Myocardial perfusion deficits were detected during early phase scanning; the area of deficits were significantly decreased during late phase scanning (13.52 ± 5.22% vs 9.07 ± 3.47% P = 0.004), with a mean decrease of 32.14%. CT value of different myocardial varied at different scanning times: the values of LV cavity decreased from (586 ± 111) HU to (294±53) HU (P = 0.001), that of the normal myocardial area decreased from (247±54) HU to (132±25) HU (P = 0.001); the values of the perfusion deficit regions were not significantly changed ([42 ± 14] HU vs [29 ± 23] HU, P = 0.289). During late phase scanning, CT value around residual perfusion deficit was higher than that of normal myocardium ([156±21] HU vs [132±25] HU, P = 0.004). Conclusion: The dual-phase MSCT characteristics of AMI include early perfusion deficits, late enhancement and residual perfusion deficits. Early phase scanning may overestimate the infarction area.
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Objective To evaluate the radiation dose in both low radiation dose and to conventional radiation dose mode in multislice spiral CT scan for children with embedded teeth,and explore the lowest conditions of exposure in multislice spiral CT scan for children embedded teeth.Methods Eighty cases of children with embedded teeth examined by 16 slices spiral CT were divided into 5 ,25,125 and 250 mAs scanning groups.The scanned pictures of four groups were evaluated by two chief physicians and three associate chief physicians in the radiological department with double blind method.The CTDI_w and DLP in different radiation dose mode were recorded and analyzed with statistics.Results All the four groups scanned pictures in different radiation dose mode could accurately show the structure and the adjacency relation of embedded teeth.Even though the resolution of scanned pictures in S mAs group were inferior to the other three groups on bone trabecula,gingiva and their surrounding soft tissue,it still could meet the requirements of examination.The average DLP in 5 mAs group was only 2% of value in 250 mAs group.Conclusions MSCT in 5 mAs group can not only meet the requirements of examination,but also reduce the radiation dose to patients to the greatest extent.
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Objective To evaluate the diagnostic value of the multislice spiral computed tomography angiography (MSCTA) in the diagnosis of moyamoya disease and explore its future application. Method The image data of 10 patients with moyamoya disease undertaken MSCTA and digital subtraction angiography (DSA) were reviewed analysis. Results MSCTA could clearly show stenosis, multiple occlusion or abnormalities of the cerebral vessels. Volume-rendering helped to show the relationship between the abnormal vessels and the surrounding tissues. Combined maximum intensity projection (MIP) and multiplsnar reconstruction (MPB) images could clearly show abnormally increased vessels (moyamoya disease vessels). The rate of occlusion and stenosis showed by MSCTA were 66.2%(53/80)and 67.5%(54/80)by DSA. There was no significant difference between the two methods (P>0.05). The images of MSCTA were basically same as those of DSA. Conclusions MSCTA is sensitive in diagnosing moyamoya disease, which is an important basis for early diagnosis. Early diagnosis and treatment is effective in improving prognosis of moyamoya disease.
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Objective To study the different therapeutic proportion of the patient populations undergone coronary angiography (CAG) in the era of development in multislice spiral computed tomography(MSCT).Methods Two hundred and fifty four consecutive patients(mean age 59.24±10.65),who underwent CAG at Daxing Hospital from February 2007 through October 2007,were enrolled,160 patients were male and 94 were female.By evaluating from the coronary angiogram,the patients were not diagnosed to have coronary heart disease(CHD) with less than 50% diameter stenosis of coronary artery;the patients to have CHD with more than or equal to 50% stenosis of coronary artery;the patients were performed the procedure of percutaneous coronary intervention(PCI) with more than or equal to 70% stenosis;the patients were proposed to have coronary aortic bypass graft(CABG) surgery with left main coronary artery lesions or diffuse triple coronary artery lesions.Results In the 254 consecutive patients,59 patients(23.2%) had not been diagnosed to have CHD;195(76.8%)to have CHD,of these patients with CHD,49 patients(19.3%)were not indicated for PCI (including the patients receiving follow-up coronary angiography after stenting),81(31.9%)had been performed the procedure of stent implantation,57(22.4%)proposed to have CABG,8(3.1%)the procedure of PCI had not been successful,or had not been performed because of patients opposing to this therapy.Conclusion Multislice spiral computed tomography can be applied as a non-invasive screening tool to exclude the presence of CHD,to increase the positive proportion of the populations with CHD in all patients receiving coronary angiograhpy,to avoid the use of CAG in a subset of patients.
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Objective To examine the morphological changes in the cervical intervertebral foramen during axial rotation of cervical spine and explore its clinical significance for the diagnosis and treatment of cervical degenerative disease. Methods Ten healthy volunteers (5 male, 5 female) were subjected to transectional scan by multislice spiral computed tomography of cervical spine from the upper edge of C 3 vertebra to the lower edge of C 7 vertebra. On the 45 degree oblique reconstructions of C 3～4, C 4～5, C 5～6 and C 6～7 intervertebral foramina, four parameters were measured, including foraminal height, foraminal width (both superior and inferior), and cross-sectional area of the foramen. Statistic analyses were performed to examine the morphological changes in the cervical intervertebral foramen. Results It was found that the foraminal cross-sectional area was decreased on the side of rotation,and increased on the opposite side of rotation. Significant correlation was revealed between the variation rate of the C 3～4 intervertebral foramen cross-sectional area and the rotational degree between C 3 and C 4. Conclusion Morphologic changes were found in the cervical intervertebral foramen due to axial rotation. The correlation between the cross-sectional foraminal areas with the degrees of rotation of the vertebrae was statistically significant. The results of the test have the clinical significance on the prevention, diagnosis and treatment of the cervical degenerative diseases, especially of the radiculopathy.