在日常生活中我们经常听说B超、CT等检查方式,那么你了解CT检查到底是怎么一回事吗?做CT检查会不会有什么危害呢?让我们一起了解一下有关CT检查的知识吧.

1 什么是冠脉以及冠脉CT 冠脉是冠状动脉的简称.冠状动脉是指人体中分布在心脏表面的给心脏供血的血管.冠状动脉一般被分为左冠状动脉主干和右动脉,起源于主动脉根部,左侧先发出左动脉主干,然后分为两个分支,回旋支与前将支,右侧直接发出右冠状动脉.心脏是人体内最重要的器官之一,负责泵出动脉血分布于身体各部位,冠状动脉则是给心脏供血的重要血管,开口在主动脉瓣上方,由心脏给全身供血,所以心脏泵血时冠状动脉也会充盈,并给肌细胞供血,肌细胞得到冠脉的充分供血后方可正常地收缩和舒张.

肺结核可以通过胸部CT发现并诊断,但是肺结核主要是通过痰培养找到结核杆菌为金标准,许多肺结核患者的痰涂片未必找得到结核杆菌,所以需要有临床经验的一生通过影像学证据及患者临床表现来分析及确诊.但作为肺结核病影像特点,病变多发生在上叶的尖后段和下叶的背段,密度不均匀、边缘较清楚和变化较慢,易形成空洞和播散病灶.

目的:旨在通过数据成果分析海扶刀治疗子宫肌瘤的MRI(核磁共振)疗效评价;是否可以精简MRI(核磁共振)扫描成像序列或改进成像序列以达到更便捷的评估方法、更好的评估效果.方法:选择本地医院近期收入的子宫肌瘤患者100例,这100例患者在治疗前后均进行了磁共振平扫检查以及增强扫描检查.并且这100例患者均是进行了海扶刀治疗.回顾性研究的收集医院里患者治疗前后的检查资料,并进行分析比较.结果:仅通过磁共振平扫检查中的T1WI(T1加权成像)、T2WI(T2加权成像)、DWI(弥散加权成像)对子宫肌瘤患者的治疗前后就有显著的差别,子宫肌瘤体积减小,而通过增强扫描可以准确判断出子宫肌瘤的大小以及周围缺血组织的体积大小以及其位置.结论:可以在临床上对经过海扶刀治疗的子宫肌瘤患者应用磁共振平扫及增强扫描的手段来评价手术治疗的效果.

放射学检查作为新型冠状病毒肺炎诊断的主要手段之一,其价值在于检出病变、判断病变性质、评估疾病严重程度,以利于临床进行分型.由于核酸检测存在较高假阴性率,且检查周期长,容易增加疫情传播的风险,而CT具有较高准确性,特别是敏感性非常高,在人口密集且核酸检测试剂供应不足的情况下,通过CT来筛查新冠肺炎可有效控制疫情.

目的 分析磁共振成像(MRI)对钼靶乳腺影像报告数据系统(BI-RADS)Ⅲ～Ⅳ级乳腺病变患者的诊断效能.方法 选取2013年1月～12月经临床诊断及乳腺针吸活检确诊为Ⅲ～Ⅳ级乳腺病变患者49例,共计56个病灶.所有患者先后行MRI诊断及乳腺钼靶诊断,将手术病理结果作为金标准,统计不同诊断方式下的检验结果,对真、假阳性,真、假阴性的患者进行分类计数;计算不同诊断方式下的灵敏度、特异度、漏诊率、准确率、阳性预测率和阴性预测率,对比两种诊断方式单用和两者联用的结果差异.结果 接受检查的患者共49例(56个病灶),共19个病灶阳性,37个病灶阴性.MRI组准确率为91.07％,钼靶组准确率为83.93％,MRI组的灵敏度、准确度明显高于钼靶组,漏诊率明显低于钼靶组;而两者联用组准确率为98.21％,明显大于单用组,且差异均具有统计学意义(P＜0.05).结论 采用MRI和钼靶BI-RADS联合使用对Ⅲ～Ⅳ级乳腺病变患者的诊断效率明显高于单独的MRI和钼靶检查,可为早期筛查乳腺病变提供更为有效的依据,可在临床推广应用.

Objective To explore the advantages and importance of low-dose scanning in the diagnosis of tuberculosis, Siemens 16-slice spiral CT TB cases routine chest CT scans and low-dose scans were analyzed contrast, and the GE 64-slice spiral CT our hospital cases were part of the chest scan contrast too. Low-dose scans can signiifcantly reduce radiation dose without impacting disease diagnosis to avoid the risk of radiation can cause cancer, so as to achieve the green scan. Methods Collected our hospital Siemens 16-slice spiral CT TB cases routine chest CT scans 80 cases (2012-1-12) of low-dose scan, chest scan GE 64-slice spiral CT TB cases 40 cases, some of which did DR examination by experienced radiologists several three-pronged approach comparative analysis. First, unknown the high-dose or low-dose CT scans under the premise of image sharpness, image analysis of the accuracy of the diagnosis. Further statistics on the premise of meeting the diagnosis of low-dose chest scan their proportion. Second, Parameters comparison between GE 64-slice spiral CT chest scan meet the diagnostic requirements of 40 cases of tuberculosis cases and Siemens 16-slice spiral CT scan low-dose contrast. Third, Contrast DR and CT scan results. Results 120 cases of tuberculosis diagnostic CT slices can meet the requirements of patients, lung lesions can be clearly showed that the 112 cases of meditational lymph vascular space or clear display, only eight cases of blood vessels or lymph node clearance signiifcantly blurred edges, but does not affect the diagnosis, which conventional scanning two cases, low-dose scan six cases. DR examination done 42 patients, comparative analysis of CT slice, 12 slice CT slice showing empty DR not clearly shown, 15 cases showed DR iflm failed to show secondary bronchiectasis. Conclusion Siemens 16-slice spiral CT low-dose chest scan in the diagnosis of tuberculosis can reduce the radiation dose signiifcantly ensuring the diagnostic accuracy, so as a routine screening and treatment of tuberculosis review.

Objective To explore the CT imaging features difference between pulmonary tuberculosis with AIDS and pure pulmonary tuberculosis. Methods The CT features of 142 pulmonary tuberculosis patients with AIDS were analyzed retrospective-ly according to the location and character of scan findings and in comparison with that in 127 patients with pure pulmonary tubercu-losis. Results The location and range of lesions:distributed in two lungs,more than two lobes,apicoposterior segment of lobus su-perior and superior segment of lower lobe had no statistical significance between two groups(P>0. 05). The occurrence rate of le-sions involving the pleura or lymph nodes between the two groups was statistically significant(P<0. 05). Features:patchy or large sheet consolidation shadows,large consolidation combined with multiple cavities,swollen lymph nodes in the mediastinum,pleural effusion,and pericardial effusion,the difference between the two groups was statistically significant(P<0. 05),however,ocurrence rate of the mere cavities,multiple nodules between the two groups was not statistically significant(P>0. 05). Conclusion Ima-ging features of pulmonary tuberculosis with AIDS can be showed by CT,the lesions of pulmonary tuberculosis with AIDS are atypi-cal,Widely-ranging,large sheet consolidation, swollen lymph nodes in the mediastinum, pleural effusion, and pericardial effusion rate of occurrence are higher performance compared to pure pulmonary tuberculosis.

目的 研究MRI诊断新生儿低血糖脑病的临床价值及影像学特征.方法 选取2012年1月～2014年1月收治的42例新生儿低血糖脑损伤患儿(脑损组),并与同期就诊的45例新生儿低血糖无脑损伤患儿(对照组)进行MRI检查,以临床治疗及其他多种影像学综合诊断作为金标准,分析MRI诊断新生儿低血糖脑损伤的临床价值和MRI特征.结果 脑损组血糖最低值显著低于对照组,低血糖持续时间显著长于对照组,治疗24h、48h时血糖水平显著低于对照组,差异均有统计学意义(P＜0.05);MRI诊断新生儿低血糖脑病灵敏度为92.9％(39/42),特异度为88.9％(40/45),准确度为91.0％(79/87).结论 新生儿低血糖脑损伤患儿一般双侧枕顶叶后部以及胼胝体受损严重,且常呈对称性分布,MRI在对新生儿低血糖脑损伤的评估上准确性较高,对新生儿低血糖脑病患儿的治疗以及预后判断均有重要的临床指导意义.

Objective: To study the Langerhans cell histiocytosis invading the pituitary MR findings and associated clinical performance.Methods: We collected six patients who were diagnosed as Langerhans cell histiocytosis and pituitary expression abnormalities in children,5 males,1 female,aged from 2 to 11 years,average age(6 ±3).Their images findings and clinical performance were taken as a retrospective analysis.Results: The main diagnosed reason for children was that they got head and face mass,polydipsia,urine.At the same time,we toke MR scan(T1W1) and found that the high signal of neurohypophysis disappeared,unfounded in six cases,pituitary stalk thickened in five cases,pituitary stalk distinctness in one case,pituitary plumped in one case,and the signal of pituitary and pituitary stalk all changed by MR scan retest after treatment.Conclusion: Pituitary high signal disappears,pituitary stalk thickening or distinctness,are the MR imaging performance for the Langerhans cell histiocytosis invading brain.Polydipsia and polyuria will almostly appear if pituitary is invaded by the Langerhans cell histiocytosis.Currently,MRI is the only reliable imaging diagnosis for the Langerhans cell histiocytosis invading the pituitary,and has an important role for follow-up.

目的分析少数重度肾积水在逆行尿路造影(RGU)中的特殊影像表现,以提高诊断准确性。方法回顾性分析两例经手术后确诊为重度肾积水患者的影像表现,两例均为中年女性。结果两例临床患者均表现为反复腰痛,一例胀痛放射至会阴部,两例均进行了静脉肾盂造影及逆行尿路造影,静脉肾盂造影表现为阴性,逆行尿路造影在盆腔内可见造影剂呈片状弥散,随后进行手术治疗。结论重度肾积水达盆腔内,当静脉肾盂造影表现为阴性、逆行尿路造影中表现特殊时,要注意和造影剂外漏等鉴别,为临床提供正确指导。

Objective To probe the relationship between lung-head imaging findings and clinical performance for scrub typhus.Methods A retrospective collection of recent 70 cases of scrub typhus patients diagnosed as clinical and imaging performance were analyzed.Results The main clinical manifestations were fever,convulsions,eschar and skin ulcers,rashes,body aches,or superficial lymph nodes,headache,heart palpitations,but the performance of children and adults had some differences.30 patients were taken chest plain film,24 cases were found abnormal.Head CT scan were detected in 7 cases,2 cases were abnormal.After treatment,69 cases recovered or improved and discharged,one died.Conclusion Although the diagnosis of scrub typhus depends mainly on clinical and laboratory examinations,but imaging has an important supporting role in clinical.The appearance of outer skin Eschar and the positive of WiFi test have a characteristic sense for the diagnosis,but not necessarily linked.Scrub typhus can lead to complications of multiple organ involvement.Early diagnosis is very important.We will see that the cure rate is very high if timely being cured by effective medicine.

一、资料与方法 1.一般资料:1998年-2006年枪伤5例,男4例,女1例.年龄7～48岁,平均21岁.就诊时间2h-3d,平均10.5h.贯通伤2例,盲管伤2例,深切线伤1例.伤后原发昏迷4例,GCS评分4～7分.嗜睡1例,GCS评分12分.