Background Hepatocellular carcinoma (HCC) at the early stage frequently evades detection. Aberrant expression of miR-1233 has been reported in various malignancies, yet its level and potential clinical value in HCC remain unknown.Objective This study evaluated miR-1233 expression and potential diagnostic performance in HCC patients.Materials and Methods This prospective study enrolled 100 individuals with benign hepatic tumors and 120 cases with HCC. They all underwent dual-source CT imaging and were confirmed pathologically. The miR-1233 level was quantified by qRT-PCR. The multivariate logistic regression analysis was employed to identify the underlying risk factors of HCC. Pearson correlation analysis was carried out to assess the association of miR-1233 with alpha fetoprotein (AFP) or des-gamma-carboxy prothrombin (DCP). After statistical analysis in SPSS, ROC curves were generated for significantly different miR-1233, dual-CT parameters, and the combination to compare their diagnostic performance in distinguishing HCC patients.Results Serum miR-1233 was up-regulated in HCC patients. The expression pattern of miR-1233 showed positive correlation to AFP and DCP indicators. In ROC curve of miR-1233, AUC reached 0.821, with a sensitivity of 73.33% and specificity of 76.67%. Combined with the differential dual-CT parameters, the AUC reached 0.944, with both sensitivity and specificity exceeding 90%.Conclusion Serum miR-1233 was significantly up-regulated in HCC patients. The diagnostic efficacy of miR-1233 combined with dual-source CT was superior to that of the single one in recognizing HCC individuals.

To evaluate the clinical diagnostic value of third-generation dual-source CT for pulmonary embolism, focusing on the optimization of dual-source CT scanning with dynamic reconstruction in acute pulmonary embolism (PE) and various imaging manifestations. Eighty-two patients with pulmonary embolism were enrolled and randomly divided into standard CT angiography (SCTA) and dynamic CT angiography (DCTA). DCTA patients were divided into dynamic CT angiography arterial phase (DCTAa), time phase Angiography reconstruction (TMIP-CTA), and 4D noise reduction TMIP-CTA according to the image reconstruction. The region of interest was selected in the region of the pulmonary trunk and its branches, respectively. The vessel CT value and image background noise (IN) of each subgroup were also determined, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Simultaneously two radiologists performed a subjective evaluation of the quality of the picture images. The DCTA group had a lower contrast dose than the SCAT group, but the vessel CT value, IN, CNR, and SNR were significantly higher in the DCTA group compared with the SCTA group. CT of the vascular lumen was generally higher in all subgroups of DCTA than in SCTA, with the highest in the TMIP-CIA group. IN was significantly higher in both the DCTAa and TMIP-CTA groups than in the SCTA group. SNR and CNR were elevated in TMIP-CTA and 4D noise reduction TMIP-CTA compared to the SCTA group. In addition, the subjective image quality scores of the DCTA group were significantly higher than those of SCTA, and the 4D noise reduction TMIP-CTA had the most. However, the ED of the SCTA group was lower than that of the DCTA group. 4D noise reduction TMIP-CTA based on DCTA reconstruction significantly improves the quality of pulmonary artery CTPA images and increases the clinical diagnostic rate, with potential for clinical dissemination.

Background: Chylopericardium refers to the accumulation of chylous fluid in the pericardial cavity. Non-enhanced magnetic resonance lymphangiography (MRL) can show neck and thoracic lymphatic abnormalities in the primary chylopericardium. It is not clear whether there is a relationship between neck and thoracic lymphatic abnormalities in primary chylopericardium and thoracic duct terminal release surgery. This study aimed to explore the correlation between the severity of neck and thoracic lymphatic abnormalities observed in non-enhanced MRL and the surgical outcomes in primary chylopericardium. Methods: This is a retrospective cohort study. A retrospective analysis was conducted on fifty-six patients diagnosed with primary chylopericardium between January 2016 and December 2021, all of whom underwent thoracic duct terminal release surgery. Ultrasonography, chest computed tomography (CT) and non-enhanced MRL were performed prior to the surgical intervention. Patients were categorized into four types based on the severity of neck and thoracic lymphatic abnormalities observed in the non-enhanced MRL. Clinical and laboratory examinations and surgical outcomes were compared across different types using chi(2)-test or Fisher's exact test, t-test, and Kruskal-Wallis H-test. Additionally, independent factors influencing surgical outcomes were analyzed. Results: Among primary chylopericardium cases (n=56), 22 (39.2%) were classified as type I or II, 17 (30.4%) as type III, and 17 (30.4%) as type IV. Surgical outcomes were more favorable for type I or II patients than those with type III or IV, accompanied by a reduction in postoperative primary chylopericardium volume (P=0.002). Postoperative chest CT scans indicated that type I or II patients had fewer instances of large grid shadows, small grid shadows, and bronchovascular bundle thickening compared to preoperative scans (P=0.001, P=0.02, P=0.03). Age and bronchomediastinal trunk dilation emerged as independent factors influencing surgical outcomes [odds ratio (OR) 0.03, 95% confidence interval (CI): 0.003-0.220, P=0.001; OR 11.10, 95% CI: 1.70-72.39, P=0.01, respectively]. Conclusions: A more severe degree of neck and thoracic lymphatic abnormalities is associated with worse surgical outcomes. Moreover, age and bronchomediastinal trunk dilatation are independent predictors of surgical outcomes. Preoperative utilization of non-enhanced MRL for severity of lymphatic abnormalities classification in primary chylopericardium patients offers a noninvasive means of assessing surgical risk.

Objective: To investigate the clinical value of thin-section chest computed tomography (CT) in the typing of coronavirus disease 2019 (COVID-19). Methods: A retrospective analysis was performed on 134 patients diagnosed with COVID-19 in our hospital’s Department of Infectious Diseases from December 20, 2022, to December 31, 2022. All patients underwent thin-section chest CT scan with complete clinical data. According to clinical classification, patients were divided into the non-severe and severe groups. Clinical data and imaging features of the two groups were compared and analyzed, and statistical analysis was conducted. Results: There was a statistically significant difference with respect to diabetes mellitus between the two groups, and the incidence of diabetes mellitus in the severe group (45.8%) was higher than that in the non-severe group (25.5%); There were no significant differences in sex, age, average course of disease, and clinical symptoms between the two groups; There were significant differences in the number of lesions, symmetrical distribution, predominant peripheral distribution, diffuse distribution, blurred edge, morphology of large flake and band, vascular bundle thickening, paving stone sign, arcade sign, and fried egg sign between the two groups, the number of lesions >10, diffuse distribution, morphology of large flake and band, vascular bundle thickening, paving stone sign, and arcade sign were more common in the severe group than in the non-severe group, while predominant peripheral distribution, blurred edge, and fried egg sign were more common in the non-severe group than in the severe group. Conclusions: Thin-section chest CT scan can identify the abnormal imaging manifestations of the lung in patients with COVID-19 and evaluate the number, distribution range, and morphological characteristics of the lesions. Combined background diseases, number, distribution characteristics, blurred edge, large flake and band morphology, vascular bundle thickening, paving stone sign, arcade sign, and fried egg sign can effectively indicate the classification of patients with COVID-19. This can provide imaging evidence for the diagnosis and treatment of COVID-19.

Objective: To explore the imaging characteristics of patients with novel coronavirus pneumonia (COVID-19) combined with different underlying diseases. Materials and methods: COVID-19 was diagnosed in 153 patients at Beijing Shijitan Hospital, Capital Medical University, from November 16, 2022 to December 16, 2022, and data were retrospectively collected. All patients underwent chest CT scan from 1 to 14 days after onset and were divided into two groups based on the presence or absence of underlying diseases. Forty-three patients had underlying diseases, and 110 patients had none. We compared the differences between the two groups. Result: The comparison between the two groups showed statistically significant differences in age, cough, bilateral lung distribution, diffuse distribution, honeycomb-like changes in the lungs, patchy distribution, large patchy distribution, band distribution, crazy-paving sign, air bronchogram sign, traction bronchiectasis, and pleural effusion. Conclusion: Fever and cough are the most common clinical symptoms in patients with COVID-19. Chest CT showed multiple lesions in both lungs. The most common types of lesions were thickening of bronchovascular bundle and GGO. Patients with underlying diseases had more honeycomb-like changes, crazy-paving sign, air bronchogram sign, traction bronchiectasis, and pleural effusion than those without underlying diseases. Chest thin-slice CT scan provides a key reference for the early detection and diagnosis of the disease.

目的:探讨早期新型冠状病毒肺炎(COVID-19)的胸部薄层平扫CT表现特征.材料与方法:收集2022年11月至12月我院感染科确诊COVID-19且胸部CT表现阳性的患者153例,所有患者自发病后1～14天行胸部薄层平扫CT检查和有较完整的临床资料.根据患者年龄(≤60岁和＞60岁)和发病与CT检查的时间间隔(≤7天和＞7天)将患者各分为两组,比较两组患者的CT表现特征的差异性.结果:153例COVID-19患者中,累及肺部(100％)、血管(93.5％)、气道(73.4％)和胸膜(70.1％),其中年龄组间的对比显示病变数量、部位、大小、容积和束带影的差异有统计学意义;发病与CT检查时间间隔分组患者之间,病变的形态、密度、机化和纤维化以及胸膜受累等差异有统计学意义.结论:胸部薄层平扫CT可明确早期COVID-19的病变位置和范围,对COVID-19的定性诊断和鉴别有一定的特征,即以形态的多样化、胸膜内和血管周分布、肺泡为单元的间质性病变、早期混合性磨玻璃影常伴明显的机化和纤维化、胸膜局限性增厚而胸水极少等有助于COVID-19的诊断和鉴别.

Objective: To investigate the applicability of DR Bedside chest radiography and chest computed tomography (CT) scanning for the imaging and clinical diagnosis of severe novel coronavirus pneumonia. Methods: Imaging and clinical data of 43 patients with novel coronavirus pneumonia who were admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from December 10, 2022 to January 10, 2023 were retrospectively analyzed. Joint diagnoses by multidisciplinary experts according to the clinical and laboratory diagnosis criteria confirmed that all the 43 enrolled patients were severely infected with novel coronavirus pneumonia. All 43 patients underwent digital DR Bedside chest radiography; of these, 6 patients underwent chest CT scanning as they had relatively mild symptoms. The time interval for chest X-ray reexamination was 1~5 days, with 1~4 reexaminations. The chest CT scan review interval was 1~4 days, with 2 reviews. The imaging findings of chest radiography and chest CT scanning were observed and analyzed. Results: Among 43 patients with severe novel coronavirus pneumonia, 25 cases showed the first digital DR Bedside chest radiographs showing plaques and solid shadows in both lungs, 6 cases of pleural effusion in both lungs, 18 cases of unilateral lung exudation and solid shadows, 4 cases of unilateral pleural effusion, 7 cases of cardiac enlargement combined with pulmonary edema, and 2 cases of suspected pulmonary tumor mass shadows. There were multiple ground glass shadows in both lungs in 6 patients who underwent chest CT scanning. Spot shadows, grid shadows, thickened interlobular septum, and thickened pulmonary vessels and subbronchus were identified in the lesion area. Double lung spot density increased in the chest radiographs; the shadow area expanded in 5 cases and pleural effusion increased in 2 cases. Reexamination of chest CT images showed that 4 cases of increased ground-glass shadow transformed into irregular patchy high CT value shadow, 1 case of new atelectasis and 1 case of new pleural effusion. Conclusion: Digital DR Bedside chest radiography and chest CT scanning are the primary imaging methods for the diagnosis of novel coronavirus pneumonia. In particular, the former plays an important auxiliary diagnostic role when chest CT scan cannot be performed in patients with severe disease, and can greatly assist in the later review and clinical evaluation of the disease during active treatment.

Objective: This study aimed to investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR) and chest high-resolution computed tomography (HRCT) findings of coronavirus disease 2019 (COVID-19). Materials and Methods: NLR and chest HRCT findings of 132 patients diagnosed with COVID-19 in the department of infectious diseases of Beijing Shijitan Hospital Capital Medical University from December 1, 2022 to February 1, 2023 were retrospectively analyzed. The patients were divided into two groups with NLR cut-off value of 3.0, and their HRCT characteristics and imaging manifestation patterns were analyzed. For the measurement data of normal distribution, the t-test of continuous variables was used between the groups. The data of non-normal distribution are expressed as median and quartile and compared using Mann-Whitney U test. The counting data are expressed as frequency, and the chi-squared or Fisher's exact test was used for comparison between the groups. P<0.05 indicates that the difference is statistically significant. Results: The number of lesions ≤5 and the proportion of lesions ≤10% were higher in the low NLR group than that in the high NLR group. The number of lesions >10 and the proportion of lesions >50% were higher in the high NLR group than that in the low NLR group. The high NLR group was prone to mixed density shadow, crazy-paving pattern, mosaic sign, anti-halo sign, subpleural black belt, arcade-like sign than that in the low NLR group. The high NLR group was most likely to have nonspecific interstitial pneumonia-like, organizing pneumonia-like, and diffuse alveolar damage-like patterns than that in the low NLR group. Conclusion: Different NLRs have different manifestations of COVID-19 chest HRCT. The high NLR group is more prone to mixed density shadow, crazy-paving pattern, mosaic sign, anti-halo sign, subpleural black belt, and arcade-like sign, as well as most likely to have radiologic patterns of nonspecific interstitial pneumonia, organizing pneumonia, diffuse alveolar damage.

CT淋巴管造影成像(CTL)是直接淋巴管造影(DLG)和MSCT相结合的多模态影像学检查方法,是目前诊断淋巴回流障碍性疾病的重要影像学技术.为了更好地在临床上推广普及和提高此技术的使用率及成功率,本文通过CTL的成像技术和扫描参数、适应症或优缺点以及在诊断淋巴管疾病中的临床应用价值等多个方面进行综述,旨在让相关临床和影像科医师进一步了解和掌握,并能实现该技术临床上安全有效的开展和精准诊断.

本研究目的为探讨淋巴反流性塑型性支气管炎（LRPB）的CT淋巴管成像（CTL）的影像学表现。回顾性分析2013年5月至2020年10月在首都医科大学附属北京世纪坛医院7例确诊为LRPB患者的临床特征和影像学资料。7例LRPB患者中，咳嗽和咳痰7例，伴乳糜性胸腔积液4例、小肠淋巴管扩张症和淋巴管瘤各1例。7例均显示淋巴管异常，其直接影像学征象包括气管周围管状或囊状影7例，支气管血管束增厚伴淋巴对比剂反流沉积5例；间接影像学征象主要为淋巴导管梗阻伴随的继发性改变，即胸导管和/或右淋巴导管末端梗阻7例，支气管纵隔干反流或扩张6例、锁骨下干反流或扩张3例和颈干反流或扩张1例；双肺磨玻璃影7例、双肺多发结节影6例、周围间质增厚5例、中轴间质增厚5例。其他胸部表现为“蛙卵征”3例、“铺路石征”2例和单发肉芽肿1例；纵隔异常包括后纵隔及隆突下管状影7例。本研究结果提示CTL在显示淋巴管异常反流等方面可以提供重要的诊断信息，可为本病的诊断和鉴别提供重要的影像学依据。

目的 探讨低剂量全肝灌注CT在肝细胞癌(HCC)经动脉化疗栓塞(TACE)术后残余肿瘤活性组织血流动力学变化判断中的价值.方法 选取行TACE治疗的HCC患者,所有患者均在治疗后4～6周行低剂量全肝灌注CT扫描.选取其中有残余肿瘤活性组织的病例共30例,使用肝脏肿瘤灌注软件对坏死组织(T1)、残余活性肿瘤组织(T2)及背景肝组织(T3)进行灌注参数测量,包括肝动脉灌注分数(HAF,％)、毛细血管表面通透性(PS,ml/min/100 g)、血容量(BV,ml/100 g)、达峰时间(TTP,s).采用单因素配对符号秩和检验对T2与T1、T3之间的差异进行对比.结果 共发现35个有残余肿瘤活性组织的HCC病变,T2的HAF、PS、BV均高于T1与T3(P<0.05);T2与T1、T3之间的TTP差异均无统计学意义(P>0.05).有效辐射剂量约(19.71±4.28)mSv.结论 低剂量全肝灌注CT可反映HCC TACE术后残余活性肿瘤组织的血流动力学改变,从而对HCC进一步治疗策略的选择提供可靠依据.

目的 对比分析小肠粪便征(SBFS)在正常与异常人群的多层螺旋CT(MSCT)征象,探讨MSCT诊断SBFS的临床价值.方法 搜集184名无腹部症状的健康体检者(A组)以及72例小肠梗阻患者(B组)的影像学资料,两组均伴有SBFS.所有受检者均行全腹MSCT平扫,其中同时行增强扫描30例(A组20例,B组10例),将原始图像传到工作站进行多平面重组(MPR),对两组SBFS的MSCT征象进行统计学分析,分类变量采用X2检验,数值变量采用t检验,P ＜0.05为差异有统计学意义.结果 A组均无肠梗阻,肠壁不厚,肠系膜脂肪间隙清晰;B组均有肠梗阻,其中轻度梗阻7例,中度梗阻44例,重度梗阻21例,肠壁轻度增厚17例,肠系膜脂肪间隙浑浊41例,CT增强扫描A、B两组SBFS均无强化.SBFS出现的位置、形态、数目及边缘,两组差异均有统计学意义(P＜0.05).A、B两组在性别、发病年龄及腹部手术史差异均有统计学意义. 结论 MSCT在鉴别正常人群及小肠梗阻患者中的SBFS有重要价值,正确认识SBFS有助于临床诊断和治疗.

目的:通过体模实验,探讨能谱CT单能量成像结合降低金属植入物伪影(MAR)技术的应用价值.方法和材料:利用环氧树脂制成的定量标准体模,在其周围8个标准圆柱形筒内注入不同浓度的碘溶液各20 mL,分别模拟金属植入物周围人体不同组织器官的密度.中间圆筒内注入氯化钠溶液,内置弹簧圈.将标准体模行能谱CT扫描,根据扫描模式不同,分A和B两组,A组采用常规CT扫描模式获得常规混合能量CT图像;B组采用能谱扫描模式,扫描后数据采用能谱分析软件获得3组图像,分别为单纯MAR图像(68 keV单能量)、40～140 keV单能量图像(MonoE)、MAR+(40～140 keV)MonoE图像.四组图像中,弹簧圈周围均可见到条形高密度伪影和低密度伪影,分别测量记录伪影区的CT值和SD值,计算伪影指数、硬化伪影去除率;采用ANOVA检验及配对t检验统计方法对A和B组图像的伪影指数、硬化伪影去除率进行统计分析.结果:与常规混合能量CT图像比较,对于高密度伪影,MAR、MonoE、MAR+MonoE图像伪影指数均减小,差异有统计学意义;对于低密度伪影,MAR、MonoE、MAR+MonoE图像伪影指数均减小,差异有统计学意义.MAR图像高低密度伪影的硬化伪影去除率分别为82％和92％;MonoE和MAR+MonoE图像的高低密度伪影的硬化伪影去除率随着单能量级别的递增,硬化伪影去除率逐级增大,其中MAR+140keV MonoE图像高低密度伪影的硬化伪影去除率最高.结论:能谱CT使用MAR、MonoE和MAR+MonoE重建方法均可不同程度的减少金属植入物伪影.三种方法中使用MAR+MonoE重建方法降低金属伪影效果最好.

目的:探讨甲状旁腺腺瘤的多层螺旋CT(MSCT)双期增强扫描及三维重建影像特征,评价其对甲状旁腺腺瘤的术前诊断及定位价值.资料和方法:回顾性分析经手术及病理证实的63例甲状旁腺腺瘤患者的影像学检查资料,分析其影像征象.结果:62例(98.4％)为单发病灶,1例(1.6％)为多发病灶,共计病灶64枚.45枚(70.3％)病变位于甲状腺下极后方,15枚(23.4％)位于甲状腺上极后方,4枚(6.3％)为异位腺瘤,其中1枚异位于甲状腺内,3枚异位于纵隔内食管旁.CT平扫,病变呈均匀或不均匀软组织密度影,部分病变内可见低密度坏死区,33枚(51.6％)病灶与正常甲状腺之间可见"短线征".CT增强早期,肿瘤明显均匀或不均匀强化,增强晚期病变强化程度减低,病变与周围组织之间的密度差减小,"短线征"未见明显变化.18枚(28.1％)病灶可见细小动脉血管进入病灶.三维重建图像显示53枚(82.8％)病灶长轴平行于身体长轴.结论:MSCT双期增强扫描及三维重建可较好地显示甲状旁腺腺瘤的部位、大小、形态和内部质地成分等特征,并可清晰显示与周围组织结构关系,对于病变的定性和定位具有重要价值.

目的 应用MRCT扫描及多平面重组(MPR)技术,探讨贝尔面瘫患者面神经管解剖特点与发病机制之间的关系.方法 回顾性分析49例贝尔面瘫患者的MSCT影像资料,原始数据传至工作站进行MPR后处理,分别获得双侧颞骨同层显示面神经管迷路段、膝状神经节段及鼓室段的斜轴位图像,对患侧及健侧面神经管迷路段、膝状神经节段及鼓室段宽度分别进行同层测量,采用配对t检验进行比较.结果 其中2例患者单侧面神经管斜轴位MPR未能同层显示面神经的三段骨管结构,MPR同层显示率为98.0％(96/98).47例患者纳入测量,患侧面神经管迷路段、膝状神经节段、鼓室段内径平均值分别为(0.89±0.19)mm(0.60 ～1.49 mm)、(3.07 ±0.21)mm(2.66 ～3.80 mm)、(1.08 ±0.18)mm(0.72～1.44 rmm);健侧面神经管迷路段、膝状神经节段、鼓室段内径平均值分别为(0.94 ±0.17) mm (0.73 ～ 1.55 mm)、(3.22±0.27)mm (2.05～3.95 mm)、(1.11±0.16)mm (0.80～1.57mm).患侧面神经管迷路段、膝状神经节段内径较健侧窄,差异存在统计学意义(P＜0.05).结论 MSCT扫描及其MPR技术能够最大程度同层面对称显示双侧面神经管情况,贝尔面瘫患者面神经管迷路段、膝状神经节段骨管相对较窄可能是贝尔面瘫患者发病的解剖学基础.

Clinically significant portal hypertension (CSPH) is associated with an incremental risk of esophageal varices and overt clinical decompensations. However, hepatic venous pressure gradient (HVPG) measurement, the gold standard for defining CSPH is invasive and impractical for routine clinical practice. This study aims to develop and validate a radiomics-based model as a noninvasive method for accurate detection of CSPH in cirrhosis. The prospective multicenter diagnostic trial (CHESS1701, ClinicalTrials.gov identifier: NCT03138915) involved 385 patients with cirrhosis from 5 liver centers in China between August 2016 and September 2017. Patients who had a HVPG measurement and contrast-enhanced CT within 14 days prior to the catheterization were collected. The noninvasive radiomics model, termed rHVPG for CSPH was developed based on CT images in a primary cohort that consisted of 222 consecutive patients and the diagnostic performance was prospectively assessed in 163 consecutive patients in 4 external validation cohorts. rHVPG showed a high diagnostic accuracy for detection of CSPH with a C-index of 0.849 (95%CI: 0.786-0.911). Application of rHVPG in 4 external prospective validation cohorts still gave excellent performance with the C-index of 0.889 (95%CI: 0.752-1.000, 0.800 (95%CI: 0.614-0.986), 0.917 (95%CI: 0.772-1.000), and 0.827 (95%CI: 0.618-1.000), respectively. Intraclass correlation coefficients for inter- and intra-observer agreement were 0.92-0.99 and 0.97-0.99, respectively. A novel radiomics signature was developed and prospectively validated as an accurate method for noninvasive detection of CSPH in cirrhosis. The tool of rHVPG assessment can facilitate the identification of CSPH rapidly when invasive transjugular procedure is not available. Trial Registration Number: ClinicalTrials.gov identifier: NCT03138915 Funding: This work was supported by the grants from National Natural Science Foundation of China (81600510, 81672725); Guangzhou Industry-Academia-Research Collaborative Innovation Major Project (201704020015); Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding (ZYLX201610), Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20151602), Application Research on Clinical Characteristics of the Capital (z161100000516197), Capital’s Funds for Health Improvement and Research (2018-1-2081). Conflict of Interest: No author has any potential conflict to disclose (financial, professional or personal) relevant to the manuscript. Ethical Approval Statement: The study was performed according to Helsinki declaration and approved by all institutional review board.

INTRODUCTION:To analyse the findings of multiple detector computed tomography (MDCT) after direct lymphangiography in primary intestinal lymphangiectasia (PIL).METHODS:Fifty-five patients with PIL were retrospectively reviewed. All patients underwent MDCT after direct lymphangiography. The pathologies of 16 patients were confirmed by surgery and the remaining 39 patients were confirmed by gastroendoscopy and/or capsule endoscopy.RESULTS:After direct lymphangiography, MDCT found intra- and extraintestinal as well as lymphatic vessel abnormalities. Among the intra- and extraintestinal disorders, 49 patients had varying degrees of intestinal dilatation, 46 had small bowel wall thickening, 9 had pleural and pericardial effusions, 21 had ascites, 41 had mesenteric oedema, 20 had mesenteric nodules and 9 had abdominal lymphatic cysts. Features of lymphatic vessel abnormalities included intestinal trunk reflux (43.6%, n = 24), lumbar trunk reflux (89.1%, n = 49), pleural and pulmonary lymph reflux (14.5%, n = 8), pericardial and mediastinal lymph reflux (16.4%, n = 9), mediastinal and pulmonary lymph reflux (18.2%, n = 10), and thoracic duct outlet obstruction (90.9%, n = 50).CONCLUSIONS:Multiple detector computed tomography after direct lymphangiography provides a safe and accurate examination method and is an excellent tool for the diagnosis of PIL.

目的 探讨支气管色素沉着纤维化(BAF)的MSCT表现特征.方法 搜集经支气管镜确诊的60例BAF患者的MSCT资料,回顾性分析其CT表现.所有患者均于支气管镜检查前后1～2周内行胸部MSCT扫描,其中46例行胸部平扫+增强扫描.结果 60例中MSCT显示支气管狭窄或闭塞48例,其中呈平滑狭窄30例,不规则或结节样狭窄18例;支气管狭窄伴远端肺不张40例;纵隔和/或肺门淋巴结增大40例;淋巴结钙化27例.肺内其他异常情况:肺内磨玻璃及实变7例,纤维索条26例,结节12例,肿块3例,肺内间质性病变7例,胸膜病变14例.结论 支气管管壁增厚,管腔呈光滑向心性狭窄或闭塞,纵隔和/或肺门多发增大、钙化的淋巴结是BAF主要的MSCT特征性表现.

目的 分析小肠粪便征(SBFS)的MSCT表现,提高对该征象的认识.方法 搜集27例SBFS患者的临床及影像学资料.所有患者均行全腹MSCT平扫,其中9例同时行MSCT增强扫描,将原始数据传入工作站进行多平面重组(MPR).结合临床治疗及预后,分析SBFS的MSCT表现及临床意义.结果 27例SBFS患者中,18例(66.7％)伴有肠梗阻,9例(33.3％)无肠梗阻.SBFS的主要MSCT表现:含有气泡的混杂密度斑驳影,长条形、卵圆形或不规则形,以不规则形(74.1％)多见,边界清或不清,无包壳结构,大部分单发(70.4％),亦可多发(29.6％),增强后SBFS无强化.结论 SBFS具有特征性的MSCT表现,全腹扫描、MPR及合适的窗宽、窗位有助于该征象的检出,为临床治疗提供重要的参考依据.

目的 探讨适当低浓度对比剂在冠状动脉CTA成像中的应用价值.方法 对136例拟行冠状动脉CTA检查的患者行前瞻性研究,按所用对比剂浓度不同分为三组,所用对比剂浓度分别为320 mgI/ml、350 mgI/ml、370 mgI/ml,将扫描所得原始数据进行后处理重组,然后对重组后的冠状动脉图像质量进行主观评价,并对主动脉起始部及同层面降部的CT值进行测量,对其结果分别进行统计学分析.结果 三组冠状动脉图像质量的主观评价差异无统计学意义(x2 =0.785,P=0.675).采用前瞻性心电门控扫描的三组患者主动脉起始部CT值的分析结果为:F值=0.992、P值=0.376;主动脉降部CT值的分析结果为:F值=1.527、P值=0.224,采用回顾性心电门控扫描的三组患者主动脉起始部CT值的分析结果为:F值=1.206、P值=0.307;主动脉降部CT值的分析结果为:F值=1.703、P值=0.191,各组CT值的差异无统计学意义.结论 适当低浓度对比剂(320 mgI/ml)能够满足冠状动脉CTA的诊断要求,在行冠状动脉CTA检查时推荐使用.