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NON-INVASIVE IMAGING OF CORONARY ARTERY WITH 16-SLICE SPIRAL computed tomography

Chinese Medical Sciences Journal 2004年第3期19卷 174-179页

作者： Zhu-huaZhang Zheng-yuJin Dong-jingLi Song-baiLin Shu-yangZhang Ling-yanKong YunWang Lin-huiWang Wen-minZhao Wen-binMou Li-RenZhang Wen-lingZhu ChaoNi HuaRen Hong-quanYu QiMiao QiFang DepartmentofRadiology PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730 SpecialMedicalCareCenter PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730 DepartmentofCardiology PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730 DepartmentofThoracicSurgery PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730

To evaluate the value of 16-slice spiral CT in the demonstration of coronary artery and in the diagnose of coronary artery stenosis. Methods Plain and enhanced CT scans were performed with a 16-slice CT scanner (Sensation 16, Siemens, Germany) in 230 patients with suspected coronary heart disease (CHD). Parameters of the plain scan were: 120 kV, 133 mA, slice col-limation 16 mm×1.5 mm, rotation time 0.42 seconds, increment 1.5 mm, and slice width 3 mm. Parameters of the enhanced scan were: 120 kV, 500 mA, slice collimation 16 mm×0.75 mm, rotation time 0.42 seconds, increment 0.5 mm, and slice width 1 mm. Enhanced CT scan was performed with a rapid intravenous injection of 100 mL iothalamate meglumine (Ultravist) (370 mgI/mL) or Omnipaque (350 mgI/mL) and 30 mL 0.9% NaCl chaser bolus at a flow rate of 3.5 mL/s. Calcium scoring with plain scan images and two and three dimensional reconstruction with enhanced scan images were made in all cases, among which 30 cases underwent conventional coronary angiography. Demonstration of coronary arteries and their stenosis were evaluated and the factors that might influence the image quality were analyzed. Results Coronary calcium scores were calculated and coronary artery was demonstrated in our study. In the evaluationof image quality with volume rendering technique (VRT) images, 78.3% of the images were of the first class, 12.2% the sec-ond class, and 9.6% the third class. Multi-planar reconstruction (MPR) and maximal intensity projection (MIP) were better than VRT in the demonstration of small branches. The image quality was related to the heart rate, with or without arrhythmia, and breath-hold ability of patients. Comparative study of the stenosis of coronary arteries in 30 cases showed that the sensi-tivity and specificity of 16-slice coronary CT angiography (CTA) to diagnose significant stenosis were 95.8% and 94.8% resp-ectively. Conclusion As a non-invasive and quick method, 16-slice coronary CTA is sensitive and specifi

关键词： angiography tomography, x-ray computed coronary artery

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IMAGING DIAGNOSES OF LYMPHOMA OF OROPHARYNx

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Chinese Journal of Cancer Research 2004年第3期16卷 188-192页

作者：庄奇新朱莉莉李文彬顾一峰潘玉萍殷善开蒋智铭尚克中 Department of Radiology Affiliated Sixth Peoples Hospital Shanghai Jiaotong University Department of ENT Affiliated Sixth Peoples Hospital Shanghai Jiaotong University Department of Pathology Affiliated Sixth Peoples Hospital Shanghai Jiaotong University

Objective: To investigate the CT and MRI findings of lymphoma of oropharynx and their clinical values. Methods: CT and MRI findings of 18 cases of lymphoma of oropharynx were analyzed and compared with the operative and pathological findings. Results: 11 cases of lymphoma of the tonsil and 3 cases of lymphoma of the bases of tongue displayed regular soft tissue mass with protuberated into oropharynx. 4 cases of lymphoma of the lateral pharynx displayed irregular soft tissue mass in oropharynx. Their density and signal of the lymphoma were homogeneous and showed slight enhancement by CT and MRI. All lesions did not appear necrosis or cyst. 10 cases of cervical lymphoid metastasis were found in 18 cases of lymphoma of oropharynx. Conclusion: CT and MRI can provide the position, shape and range of lymphoma of oropharynx and metastases in lymph nodes and invasion to surrounding tissues. They had high clinical value in diagnosis and treatment of lymphoma of oropharynx.

关键词： Oropharynx Lymphoma tomography, x-ray computed Magnetic resonance imaging

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USING OF MULTISLICE HELICAL CT COLONOGRAPHY IN PATIENTS WITH MALIGNANT LESIONS OF COLON

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Chinese Medical Sciences Journal 2005年第3期20卷 171-175页

作者： Ming-wei Qin Wei-dong Pan Guan-ning Cong Yun Wang Yun-qing Zhang Wen-bin Mou Zheng-yu Jin Department of Radiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730

Objoctive To investigate the techniques and clinical applications ofmultislice helical computed tomography （CT） colonography in colonic lesions. Methods Fifty-nine patients with malignant lesions of colon underwent volume scanning using multislice helical CT. Four types of reconstruction including CT virtual colonoscopy （CTVC）, shaded surface display （SSD）, raysum, and multiple planar reconstruction （MPR） were used for image post-processing. The results were compared with those of colonoscopy and pathology. Results Multislice helical CT colonography detected 54 colorectal carcinomas, 4 adenomas with focal carcinoma, 1 non-Hodgkin＇s lymphoma （NHL）. The lesions＇ number, size, location, morphology, stricture of intestinal cavity, infiltration, and metastasis were shown satisfactorily by multislice helical CT colonography. Whole colon could be shown in all patients. CT colonography displayed 4 synchronous colonic tumors, 1 ascending colon carcinoma combined with left renal carcinoma among 54 patients with colonic carcinomas. The accuracy of location of CT colonography was 100%. There were 9 cases that CT showed the tumor location was different from the finding of conventional colonoscopy, while all of the CT location were proven exact by operation. CT colonography also displayed the infiltration of serous layer and fatty tissue in 45 cases; 21 cases matched the pathological results in all the 24 cases of suspicious lymph node metastasis, the sensitivity was 87.5%, the specificity was 90.6%; 9 cases hepatic metastasis, 2 ovarian metastasis, and 1 double adrenal gland metastasis. Conclusions Multislice helical CT colonography is effective in preoperative diagnosis, location, stage, and making treatment plan of colorectal carcinoma. It can display the portion not seen during colonoscopy and may have an adjunctive role.

关键词： tomography, x-ray computed colorectal neoplasms image processing, computer assisted

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Diagnosis and treatment of penetrating craniocerebral injury

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Chinese Journal of Traumatology 2004年第5期7卷 259-265页

作者：童鹰徐增斌詹仁雅刘凡隆 Department of Neurosurgery the First Affiliated Hospital Medical College Zhejiang University Hangzhou 310003 China Department of Radiology the First Affiliated Hospital Medical College Zhejiang University Hangzhou 310003 China

Objective: To evaluate the clinical characteristics and present the experience in the treatment of patients with penetrating craniocerebral injury (PCCI). Methods: The data of 7 cases with PCCI by foreign body were retrospectively studied and compared with associated literatures. The strategies of diagnosis and treatment of PCCI were analyzed. In this series, 3 cases underwent emergency debridements and 4 cases underwent craniotomies. All patients received surgical intervention within 3 hours after admission. Results: Outcomes were good in 3 cases, moderate disability was in 2 cases, severe disability in 1 case and persistent vegetative state in 1 case. One case developed wound and intracranial infection, but made good recovery after treatment. During the follow-up period, one patient died one month after discharge and other six patients (range from 8 months to 3 years) recovered well and no epilepsy, leakage of cerebrospinal fluid (CSF), or traumatic vascular disease occurred. Conclusions: Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of PCCI. CT scans are the mainstay in evaluating PCCI and three dimensional (3D) images reconstructed from spiral CT scans provide more information. Efficient debridement should be performed as early as possible. Minimizing the degree of surgical management of PCCI is preferred when there is no indication for aggressive operation. It is important to stress the rapid and effective management of CSF leakage in early stage of PCCI. Use of prophylactic broad-spectrum antibiotics is recommended for patients with PCCI. Traumatic vascular injury should be paid attention to after PCCI.

关键词： Head injuries, penetrating tomography, x-ray computed Anti-bacterial agents

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Application of CT 3D reconstruction in diagnosing atlantoaxial subluxation

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Chinese Journal of Traumatology 2004年第2期7卷 118-121页

作者：段少银林清池庞瑞麟 First Clinical Academy of Medical College of xiamen University Xiamen Zhongshan Hospital Medical Imaging Department First Affiliated HospitalKunming Medical College

Objective:To evaluate and compare the diagnosti c value in atlantoaxial subluxation by CT three-dimensional (3D) reconstruction . Methods:3D reconstruction findings of 41 patients with atlanto axial subluxation were retrospectively analyzed, and comparisons were made among images of transverse section, multiplanar reformorting (MPR), surface shade dis play (SSD), maximum intensity project (MIP), and volume rendering (VR). Results:Of 41 patients with atlantoaxial subluxation, 31 belon ged to rotary dislocation, 5 antedislocation, and 5 hind dislocation. All the ca ses showed the dislocated joint panel of atlantoaxial articulation. Fifteen case s showed deviation of the odontoid process and 8 cases widened distance between the dens and anterior arch of the atlas. The dislocated joint panel of atlantoax ial articulation was more clearly seen with SSD-3D imaging than any other metho ds. Conclusions:Atlantoaxial subluxation can well be diagnosed by CT 3D reconstruction, in which SSD-3D imaging is optimal.

关键词： Joints, atlantoaxial tomography, x-ray computed Image processing, Computer-assisted

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Hemiparesis in carotid cavernous fistulas (CCFs): a case report and review of the literature

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Chinese Journal of Traumatology 2004年第5期7卷 317-320页

作者：王慧晓白如林黄承光卢亦成张光霁 Department of Neurosurgery Changzheng Hospital Shanghai 200021 China

Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low), or pathogenesis (direct or indirect). The most commonly adopted classification is that described by Barrow based on arterial supply. Traumatic CCFs are almost always direct shunts between the internal carotid artery (ICA) and the cavernous sinus. General features of CCFs, which may be apparent with any lesion, including bruit, headache, loss of vision, altered mental status and neurological deficits. Some fistulae may present primarily with hemorrhage before any evaluation can be performed. However, hemiparesis has been rarely observed. Only a literature review of Murata et al reported a case of hemiparesis caused by posttraumatic CCF, in which the fistula resulted in venous hypertension and subsequent brainstem congestion. While in our case, cerebral infarction was caused by total steal of the blood flow. The patient recovered after occlusion of the fistula with a detachable balloon.

关键词： Adult Balloon Occlusion Carotid-Cavernous Sinus Fistula Cerebral Angiography Craniocerebral Trauma Follow-Up Studies Humans Male Paresis Recovery of Function Risk Assessment Severity of Illness Index tomography, x-ray computed Treatment Outcome Wounds, Nonpenetrating

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Splenosis simulating an intrahepatic mass

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Chinese Journal of Traumatology 2004年第1期7卷 62-64页

作者：晁明徐宏伟 Department of Radiology

Splenosis is the autotransplantation of splenic tissue that usually follows traumatic rupture of the spleen. Splenic implants may be seeded within or beyond the peritoneal cavity.1 The most frequent locations of splenosis in the descending order are the serosal surface of the small intestine, the greater omentum, parietal peritoneum, surface of the large intestine, mesentery, undersurface of the diaphragm and the thorax.1,2 However, intrahepatic splenosis is very rare. We recently encountered a patient in whom results of ultrasonography (US) and computed tomography (CT) revealed an intrahepatic mass that consisted of ectopic splenic tissue. To our knowledge, this is the fifth report of ectopic splenic tissue in the liver in the English-language literature. We present the imaging findings of the splenic implants in the liver and discuss the diagnosis and its practical significance.

关键词： Biopsy, Needle Diagnosis, Differential Follow-Up Studies Humans Laparotomy Liver Diseases Liver Neoplasms Male Middle Aged Risk Assessment Splenosis tomography, x-ray computed Ultrasonography, Doppler

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Solitary pulmonary nodules： comparison of multi-slice computed tomography perfusion study with vascular endothelial growth factor and microvessel density

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Chinese Medical Journal 2009年第5期122卷 541-547页

作者： BAI Rong-jie CHENG xiao-guang QU Hui SHEN Bao-zhong HAN Ming-jun WU Zhen-hua Department of Radiology Beijing Jishuitan Hospital Peking University Beijing 100035 China Department of Radiology Fourth Affiliated Hospital of Harbin Medical University Harbin Heilongjiang 150001 China Department of Radiology First Affiliated Hospital of China Medical University Shenyang Liaoning 110001 China Department of Radiology Second Affiliated Hospital of China Medical University Shenyang Liaoning 110004 China

Background The solitary pulmonary nodule （SPN） is one of the most common findings on chest radiographs. The objectives of clinical practice are to differentiate malignant nodules from benign nodules in the least invasive way and to make a specific diagnosis. This study was aimed to evaluate the correlation between perfusion imaging features and microvessel density （MVD） and vascular endothelial growth factors （VEGF） in SPNs using multi-slice computed tomography （MSCT）; and to provide the theoretical basis for SPN blood flow pattern and blood flow quantitative features. Also, the study called for the discussion of the method＇s clinical application value in the differential diagnosis of benign and malignant *** Sixty-eight patients with SPN underwent multi-location dynamic contrast enhanced （nonionic contrast material was administrated via the antecubital vein at a rate of 4 ml/s） MSCT. Precontrast and postcontrast attenuations on every scan was studied. Perfusion, peak height, and the ratio of the peak height of the SPN to that of the aorta were analyzed. Perfusion was calculated using the maximum gradient of the time-density curves （TDC） and the peak height of the aorta. The quantitative parameters （perfusion, peak height, ratio of peak height of the SPN to that of the aorta） of the blood flow pattern were compared with MVD and the VEGF expression of immunohistochemistry. Results The perfusion peak heights of malignant （（96.15±11.55） HU） and inflammatory （（101.15±8.41） HU） SPNs were significantly higher than those of benign （（47.24±9.15） HU） SPNs （P 〈0.05, P 〈0.05）. Ratios of SPN-to-aorta of malignant and inflammatory SPNs were significantly higher than those of benign SPNs （P 〈0.05, P 〈0.05）. No significant differences were found between the peak height and SPN-to-aorta ratio of malignant SPNs and inflammatory SPNs （P 〉0.05, P 〉0.05）. The precontrast densities of inflammatory SPNs were lower than those of malignant SPNs （P 〈0.05）. Perfusion values of malig

关键词： coin lesion, pulmonary regional blood flow noevascularization, pathologic endothelial growth factors tomography, x-ray computed

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Clinical significance of multislice spiral CT scans in hepatic veins occlusion in Budd-Chiari syndrome

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Chinese Medical Journal 2007年第2期120卷 100-105页

作者： MENG xiao-chun ZHU Kang-shun QIN Jie ZHANG Jian-sheng WANG xiao-hong ZOU Yan ZHANG Ya-qin SHAN Hong Department of Radiology Third Affiliated Hospital Sun Yat-sen University Guangzhou 510630 China

Background Budd-Chiari syndrome with hepatic vein occlusion （HVBCS） can induce severe portal hypertension and liver damage. We retrospectively analyzed hepatic CT features of HVBCS and evaluated the usefulness of triphasic enhancement of CT examinations and CT angiography （CTA） in its diagnosis. Methods Twenty-five cases with HVBCS, confirmed by digital subtraction angiography （DSA）, received a triphasic enhancement CT scan within one week before DSA. The CTA images of the relevant blood vessels were reconstructed with maximum intensity projection, volume rendering and oblique reformat techniques. Results Compared with DSA, the detection rate of transverse CT and CTA images for abnormal hepatic vein were 81.7% （58/71） and 95.8% （68/71）（x^2=7.044, P=-0.008）, for membranous obstruction were 47.4% （9/19） and 84.2% （16/19） respectively （x^2 =5.729, P=-0.017 ）, for segmental obstruction were 88.0% （22/25） and 100% （25/25） respectively （x^2=1.418, P=-0.234）. The detection rates for hepatic vein stenosis were 100% with each method. Diffuse hepatomegaly was found in all 6 cases in acute phase and 3 of 19 cases in chronic phase who had severe obstruction of three hepatic veins without patent intrahepatic collaterals. The other 16 cases in chronic phase had hepatatrophia to different extents related to the obstructed hepatic vein. All in acute phase and 15 in chronic phase presented typical patchy enhancement initially in caudate lobe and perihilar areas and enlarged with time delay. In all cases, parenchyma areas with atrophy, necrosis and congestion demonstrated lower and later enhancement. In all the parts, which had normal enhancement at least one patent outflow hepatic vein, accessory hepatic vein or collateral vessel was detected.Conclusion Dynamic enhancement CT examination by multislice spiral CT not only could improve the diagnosis of HVBCS by CTA technique, but also could noninvasively provide anatomical information and reveal damage to the hepatic parenchyma

关键词： Budd-Chiari syndrome hepatic veno-occlusion disease tomography, x-ray computed angiography

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Post-radiation CT changes and recurrent nasopharyngeal carcinoma

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Chinese Medical Journal 2008年第10期121卷 916-922页

作者： LUO De-hong ZHOU Chun-wu LI Er-ni WEN Bi-xiu Department of Diagnostic Radiology Cancer Hospital Uhlnese Academy of Medical Sciences Peking Union Medical CollegeBeijing 100021 China

Background Nasopharyngeal carcinoma （NPC） is endemic in Southern Asia. Radiation therapy remains the mainstay of treatment strategies for NPC. Although approximately 19%-56% of patients develop a recurrent disease 5 years after their primary treatment, recognition of post-radiation changes and early detection of relapse are important in improving the outcome of NPC. Our aim was to analyze the post-radiation changes and recurrent diseases related to NPC using computed tomography （CT） scans and to investigate their relationship. Methods CT scans of 510 pathologically proven NPC patients who have been followed up for more than 2 years after radiation were reviewed. The tumor＇s response to the radiation therapy and its relevance to recurrence were evaluated. Results For patients who were followed up for more than 2 years, their CT scans-obtained within 3 months, during the 4th to the 6th month, and beyond 7 months after radiation therapy, showed a normal nasopharyngeal cavity with a slight thickening in the wall in 93.5%, 95.0% and 84.8% of the patients respectively. The degree of tumor regression had no significant relevance to the risk of recurrence within the initial 3 months （P=0.094）. During this term, the relapse rates in the cases in which the nasopharyngeal walls were displayed as normal, slightly or moderately thickening, or with obvious residual masses on CT scans were 7.1%, 11.7%, 23.5% and 23.1% respectively. The degree of tumor regression beyond 3 months after radiation therapy had a considerable reverse relevance to the risk of recurrence （P=-0.000）. The relapse rates were 13.2%, 14.1%, 10.2% and 2.1%, respectively, in the cases with a normal and a slightly thickening nasopharyngeal wall during the 4th to the 6th month, the 7th to the 12th month, the 13th to the 24th month, and beyond 25 months after radiation. In contrast, the percents in cases with moderate or more aggressive thickening walls in the corresponding periods were 62.5%, 88.9%, 100% and 1

关键词： nasopharyngeal neoplasms lymphatic metastasis neoplasm recurrence, local tomography, x-ray computed radiation therapy

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