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Objective To investigate the predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors (GISTs). Methods The MSCT manifestations of 120 GISTs patients confirmed by operation, pathology and immunohistochemistry were analyzed retrospectively. The age of tumor onset, location, maximum diameter, morphology, growth pattern, cystic necrosis, calcification, peritumoralfat space, enhancement pattern, peritumoralor intratumoral vessels, peak period of enhancement, metastasis, and the relationship between Ki-67 proliferation index and pathological risk grade were also analyzed. Results Among 120 cases, there were 55 cases of extremely low and low risk, 28 cases of moderate risk, and 37 cases of high risk. There were significant differences in location, tumor diameter, morphology, growth pattern, cystic necrosis, peritumoral fat space, enhancement pattern, peritumoral or intratumoral vessels, peak period of enhancement, and Ki-67 proliferation index of GISTs (P < 0.05). There was no significant difference in calcification, CT plain scan, enhanced scan (3 phase), peak value and Ap、Vp、Dp of GISTs with different risk (P > 0.05). Conclusion There are differences in the performance of multi-layer spiral CT (MSCT) in GISTs with different risk levels. It is closely related to the classification of pathological risk. For the diagnosis of GISTs, clinical treatment plan formulation and prognosis, it has important reference value.
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Objective To compare the effect of multislice spiral CT and 1.5T magnetic resonance imaging in the diagnosis of acute brain injury.Methods From June 2015 to February 2017,110 patients with suspected acute craniocerebral injury in Linfen Central Hospital were selected as study objects.All the patients received multi-slice spiral CT and 1.5T magnetic resonance imaging examination.The diagnostic value of two kinds of examination methods was compared.Results The accuracy rate,misdiagnosis rate,missed diagnosis rate,specificity and sensitivity of the magnetic resonance imaging were 95.00％,10.00％,5.00％,90.00％,95.00％,respectively,which of the multi-slice spiral CT were 58.00％,60.00％,42.00％,40.00％,58.00％,respectively,there were statistically significant differences between the two methods (x2 =38.075,5.494,98.075,5.494,38.075,P ＜ 0.05).Conclusion 1.5T magnetic resonance imaging for the diagnosis of acute craniocerebral injury is more significant.
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Objective To investigate the clinical value of spiral CT in diagnosis of fracture of tibia plateau, to provide a reference for clinical treatment.Methods 50 cases of tibial plateau fracture were selected,they were diagnosed with X -ray and diagnostic multislice spiral CT three dimensional reconstruction scan respectively.The fracture type and so on of the two groups were compared.Results 50 patients were diagnosed as 14 cases of type Ⅰ, type Ⅱ 10 cases,Ⅲ type 6 cases,Ⅳ type 7 cases,Ⅴ type 5 cases,Ⅵ 8 cases,CT three -dimensional reconstruction diagnosis accuracy rate was 100.00%.X -ray diagnosis was accurate in 41 cases,diagnostic accuracy rate was 82.00%,the difference of two diagnostic ways was statistically significant (χ2 =8.657,P =0.000).All patients were not detected with significant artifacts,the line was good,the fracture line was blurred and visible fracture callus formation surgical outcome was good.Conclusion Spiral CT diagnosis in tibial plateau fracture has high accuracy,through clear and intuitive display morphological characteristics of the patients improves anatomical repair treatment,it is worthy of clinical application.
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Objective To investigate the combination of multiple CT signs in diagnosis and differential diagnosis of nodular goiters (NGs).Methods The CT images of 242 pathologically confirmed lesions (＞ 10 mm in diameter) from 188 patients with nodular goiters were retrospectively reviewed.The CT signs,including regular shape,cystic degeneration,clearer enhancement margin,strong enhancement of nodular goiters were compared with those of 236 pathologically confirmed lesions (＞ 10 mm in diameter)from 225 patients with papillary thyroid carcinomas (PTCs).The sensitivity,specificity and accuracy of different CT signs or their combination in diagnosis and differential diagnosis of NGs were analyzed.Results Regular shape was present in 208 of 242 NGs (86.0％) and in 35 of 236 PTCs (14.8％) (x2 =241.804,P =0.000).Cystic degeneration was present in 143 of 242 NGs (59.1％) and 7 of 236 PTCs (3.0％)(x2 =174.783,P =0.000).Clearer enhancement margin was present in 192 of 242 NGs (79.3 ％) and in 51 of 236 PTCs (21.6％) (x2 =159.318,P =0.000).Strong enhancement was present in 41 of 242 NGs(16.9％) and in 3 of 236 PTCs (1.3％) (x2 =35.108,P =0.000).Regular shape showed the highest sensitivity and accuracy for diagnosis of NGs (86.0％ and 85.6％),while strong enhancement showed the highest specificity (98.7％).The combination of regular shape and clearer enhancement margin showed the highest sensitivity and accuracy of 67.4％ and 80.5％,respectively.The combination of strong enhancement with any of other signs showed the highest specificity of 100.0％.The combination of regular shape,cystic degeneration and clearer enhancement margin showed the highest sensitivity,specificity and accuracy of 45.5％,99.6％ and 72.2％ respectively.The combing of 4 signs showed a sensitivity,specificity,and accuracy of 2.9％,100.0％ and 50.8％.Conclusion CT scan is effective for diagnosis of NGs,and the combination of different CT signs can significantly improve the specificity and reduce the incidence of misdiagnosis to avoid unnecessary surgery.
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Objective Toinvestigatetheapplicativevalueof3D-DSAandheadMRIorCTfusion technology for guiding the individualized treatment of intracranial arteriovenous malformation (AVM ). Methods Twenty-onepatientswithAVMdiagnosedwithDSAattheDepartmentofNeurosurgery,Nanjing General Hospital of Nanjing Military Command from January 2015 to May 2015 were analyzed retrospectively. All patients performed DSA,MRI,and CT scan respectively before procedure,and they also performed 3 D-DSA and MRI or CT fusion. Of the 21 patients,15 performed MRI and 3D-DSA fusion,6 performed CT and 3D-DSA fusion. According to the image fusion results of the patients,the individualized treatment regimens were further developed,including microsurgical resection,endovascular embolization,and stereotactic radiotherapy (alone or combined treatment). The patients were followed up and observed for 2 to 6 months after procedure.Results Fromthe3D-DSAwithheadMRIorCTfusionimagesofthepatientsbeforetheprocedure not only could observe the vascular architecture of AVM,the relationship between the niduses and the surrounding nerve structures,but also could precisely locate the positions of AVM with small aneurysms or tiny AVMs. According to the results of image fusion,17 patients with AVM were treated with microsurgical resection,2 were treated with interventional embolization and stereotactic radiotherapy,and 2 were treated with stereotactic radiotherapy only. Of the 17 patients with AVM underwent microsurgical resection, none experienced intracranial rebleeding during the follow-up period. The last Glasgow outcome scale (GOS)score was 5 in 13 cases,and 4 in 4 cases. One patient with AVM underwent combined stereotactic radiotherapy had intracranial rebleeding during the follow-up period,and their last GOS score was 4. The other remaining 3 patients did not have new neurological deficits or rebleeding during the follow-up period,and theirGOSscorewas5.Conclusions 3D-DSA,headMRI,andCTfusiontechnologyarenovel, the operative method is simple,and the fusion image is accurate. They can effectively develop the individualized treatment regimens for patients with AVM.
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Objective To analysis the spiral CT scan diagnosis value of lymph node metastasis in thoracic esophageal carcinoma and investigate the rules of lymph node metastasis distributions.Methods 117 patients with surgically and pathologically proved esophageal carcinoma underwent CT scans of the chest before the surgical operation to identify the presence of lymph node metastasis and evaluate the diagnosis value of spiral CT in lymph node metastasis.CT imaging which was detected by CT and histopathological analysis performed with attention to the distribution characteristics.Results In 117 cases of esophageal patients,the diagnosis of sensitivity,specific and accuracy degree on lymph node metastasis were 86.0 ％,80.6 ％,84.6 ％.The most lymph node metastasis in the upper thoracic esophagus is the mediastinum group[8/14(57.1％)]and the trachea group[4/14(28.6 ％)].the middle is on the trachea surrounding group[21/41(51.2 ％)],the main pulmonary artery window group[17/41(41.5 ％)]and subcarinal group[15/41(36.6 ％)].the lower thoracic esophagus is around the side of preventriculus[7/19(36.8 ％)]and the left gastric artery[5/19(26.3 ％)]respectively.Conclusion Spiral CT imaging can accurately evaluate the lymph node metastasis of esophageal and distribution characteristics.
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Objective To explore the application value of VCT 64-row with 128-layer spiral extremities arterial imaging techniques and methods in the double lower limb artery.Methods 60 patients on lower limbs MSCTA angiography after Saul,flat on intravenous regiment note contrast agents CT angiography,image the maximum intensity projection(MIP),curved planner reconstruction(CPR),volume rendering(VR)after-treatment technology reconstructed vessels.Results All 60 patients showed the lower limb arterial and main branch.Conclusion 64-row helical VCT angiographic with 128-layer could clearly show that lower limb artery and pathological changes,and become main methods of preoperative evaluation and selection for the lower limb artery disease.
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Objective To investigate the diagnostic value of Multislice CT scanning in patients with acute thoracic trauma. Methods151 patients with chest wound admitted after Multislice CT scanning were reviewed and analyzed. ResultsThis group of 151 patients with chest wound after X-ray and CT inspection were as follows:lungs were damaged in 139 cases including 52 cases with traumatic wet lung,94 cases with lung rip,28 cases with lacerated wound and 7 cases with tracheal bronchial tube damage.Damages outside the lungs were found in 108 patients including 83 patients with trauma in pleural membrane(hemothorax 27 cases,pneumothorax 32 cases and blood pneumothorax 24 cases),mediastinum damage in 9 cases(vertical mediastinal pneumatosis 6 cases,hematocele 4 cases and traumatic disphragmatic hernia 2 cases),thoracic wall damage in 76 cases(rib bone fracture 59 cases,breast bone fracture 18 cases and costal cartilages damage 5 cases).Clavicle and scapula fracture in 31 cases. ConclusionMultislice CT scanning was principal method for the diagnosis of chest wound,it had the advantages of scanning range,quick scanning and characteristics of high sensitivity,and it would certainly play a vital role in first aid process in emergency medical treatment of wound.
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Objective To explore the diagnostic value of multi-slice computer tomography (MSCT) in cause and location of agnogenic intestinal obstruction. Methods With light speed 16 multiple slice spiral-CT, 68 patients clinically suggested intestinal obstruction were underwent plain scan and second phase enhanced scan in whole abdomen. The image data was post-processed through GEADW4. 4 station with multi-planar reconstruction (MPR) and maximum intensity projection (MIP). The CT image characters of agnogenic intestinal obstruction were analyzed by comparing CT image suggestions with operation findings. Results MSCT clearly indicate the location, cause and severity of intestinal obstruction, and the diagnose accordance rate with operation findings was 95.6 % (65/68). Conclusions MSCT is a quick, simple and effective means for diagnosis of the location,causes and severity of agnogenic intestinal obstruction. It could provide an important clue for the doctors when making clinical decisions.
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Objective To evaluate the CT and MRI characteristics of Primary Central Nervous System Lymphoma(PCNSL)in immunocompetent patients,and enhance its diagnosis level.Methods CT and MRI data of 20 patients with PCNSL confirmed by histo-pathology were analyzed retrospectively.MRI scans were performed with and without Gadolinium contrast.Two of them had contrast-enhanced CT scan;six had CT scan without contrast administration;1 had CT scan with both non-contrast and contrast enhancement.Re- suits Totally,38 lesions were found in all patients:14 lesions of them were single and 24 lesions were found in 6 patients.Generally,the lesions were located in the surface and/or midline of the brain.The signal features and density were similar to meningioma,and strongly enhancing after contrast administration.Thirty-six of the 38 lesions had spicular sign peripheral to the lesion.Conclusion Although the manifestations of the PCNSL are variety,there are still many characteristics in the medical imaging,especially in the locations,the signal features,and spicular sign in the edge of the lesions after contrast material injection.
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Objective To study the findings of not common adrenal space occupying lesion with spi- ral CT scanning.Methods The spiral CT scan datum of 10 patients pathologically proved uncommon adrenal occupying lesion were analyzed retrospectively.Results In all 10 cases of uncommon adrenal occupying le- sion,including 2 cases of primary adrenocortical carcinoma at right adrenal gland,1 case of right adrenal schwannoma,1 case of left adrenal ganglioneuroma,1 case of multiple endocrine neoplasiaⅠ,1 case of Castleman disease in the area of left adrenal gland,3 cases of adrenal myelolipoma with 4 lesions,1 case of fight adrenal gland cyst.Adrenal myelolipoma and cyst were diagnosed easily.CT manifestations of primary a- drenocortical carcinoma were usually malignant cues.To determine the nature of other uncommon adrenal oc- cupying lesion was difficult.Conclusion There are some characteristics with different values at different un- common adrenal space occupying lesions with spiral CT scanning,and dynamic SCT scans are very valuable.
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Objective To recognize the features of the ligamentum teres hepatic(LTH) in multi-slice spiral CT,and to preliminarily explore its clinical value.Methods A total of 130 patients without liver disease underwent abdominal scanning with a 16-slice spiral CT scanner.LTHs,as focused points,were observed by using postprocessing techniques such as multi-planar reformation(MPR),slab maximum intensity projection(slab-MIP) and slab volume rendering(slab-VR).Results The LTH was detected by multi-slice spiral CT in 90.8%(118/130).On these oblique-sagittal MPR,slab-MIP and slab-VR images,LTH presentedas slightly high density smooth cord-like structure in accordance with its anatomical morphology and position.The mean diameter of fissure portion of normal LTH was(5.44?0.96) mm(range 3.2-7.2 mm) measured at its middle region,and that of free portion of normal LTH was(3.43?0.91) mm(range 1.6-6.0 mm).Conclusions Multi-slice spiral CT demonstrates the LTH clearly,and has a potentialto evaluate the LTH before abdominal operation in which the LTH is to be used as an autogenous repairmaterial.