BACKGROUND:Hepatic echinococcosis is a severe endemic disease in some underdeveloped rural areas worldwide. Qualified physicians are in short supply in such areas, resulting in low rates of accurate diagnosis of this condition. In this study, we aimed to develop and evaluate an artificial intelligence (AI) system for automated detection and subtyping of hepatic echinococcosis using plain CT images with the goal of providing interpretable assistance to radiologists and clinicians. METHODS:We developed EDAM, an echinococcosis diagnostic AI system, to provide accurate and generalisable CT analysis for distinguishing hepatic echinococcosis from hepatic cysts and normal controls (no liver lesions), as well as subtyping hepatic echinococcosis as alveolar or cystic echinococcosis. EDAM includes a slice-level prediction model for lesion classification and segmentation and a patient-level diagnostic model for patient classification. We collected a plain CT database (n=700: 395 cystic echinococcosis, 122 alveolar echinococcosis, 130 hepatic cysts, and 53 normal controls) for developing EDAM, and two additional independent cohorts (n=156) for external validation of its performance and generalisation ability. We compared the performance of EDAM with 52 experienced radiologists in diagnosing and subtyping hepatic echinococcosis. FINDINGS:EDAM showed reliable performance in patient-level diagnosis on both the internal testing data (overall area under the receiver operating characteristic curve [AUC]: 0·974 [95% CI 0·936-0·994]; accuracy: 0·952 [0·939-0·965] for cystic echinococcosis, 0·981 [0·973-0·989] for alveolar echinococcosis; sensitivity: 0·966 [0·951-0·979] for cystic echinococcosis, 0·944 [0·908-0·970] for alveolar echinococcosis) and the external testing set (overall AUC: 0·953 [95% CI 0·840-0·973]; accuracy: 0·929 [0·915-0·947] for cystic echinococcosis, 0·936 [0·919-0·950] for alveolar echinococcosis; sensitivity: 0·913 [0·879-0·944] for cystic echinococcosis, 0·868 [0·841-0·897] for alveolar echinococcosis). The sensitivity of EDAM was robust across images from different CT manufacturers. EDAM outperformed most of the enrolled radiologists in detecting both alveolar echinococcosis and cystic echinococcosis. INTERPRETATION:EDAM is a clinically applicable AI system that can provide patient-level diagnoses with interpretable results. The accuracy and generalisation ability of EDAM demonstrates its potential for clinical use, especially in underdeveloped areas. FUNDING:Project of Qinghai Provincial Department of Science and Technology of China, National Natural Science Foundation of China, and Tsinghua-Fuzhou Institute of Data Technology Project. TRANSLATION:For the Chinese translation of the abstract see Supplementary Materials section.

目的 探讨胃癌患者多层螺旋CT血流动力学参数与肿瘤标志物的关系.方法 选取2021年12月至2022年12月我院收治的100例胃癌患者,按照分化程度分为中高分化组(n=56)和低分化组(n=44).检测患者肿瘤标志物水平,分析多层螺旋CT血流动力学参数与其相关性.结果 低分化组达峰时间(TTP)低于中高分化组,Patlak表面通透性(PPS)、灌注血容量(PBV)、血流量(BF)水平高于中高分化组(P＜0.05).低分化组甲胎蛋白(AFP)水平高于中高分化组(P＜0.05).相关性分析显示,PPS与肿瘤标志物AFP、糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)呈正相关(P＜0.05).结论 胃癌患者多层螺旋CT血流动力学参数的变化可反映胃癌组织的分化程度,PPS与肿瘤标志物水平呈正相关.

目的:分析CT引导和虚拟导航支气管镜(Virtual navigation bronchoscope,VBN)辅助导向鞘引导的超声支气管镜(Endobronchial ultrasound with guide-sheath,EBUS-GS)与周围型肺癌诊断效果,为临床应用提供依据.方法:选择我院2019年12月-2021年4月收治的106例周围型肺癌患者:按所行操作方法分为3组:超声引导(n=36)、CT引导(n=36)、CT引导联合VBN辅助EBUS-GS(n=34);以术后病理学检测结果为金标准,绘制ROC曲线分析各方法取样检测诊断的诊断价值.结果:采用CT联合VBN辅助EBUS-GS探查病变内部率明显高于超声引导和CT引导,且差异存在统计学意义(P＜0.05);以超声引导探查诊断为周围型肺癌的阳性率为66.7％,以CT引导探查诊断为周围型肺癌的阳性率为72.2％,以CT联合VBN辅助EBUS-GS探查诊断为周围型肺癌的阳性率为82.4％.CT引导VBN辅助EBUS-GS诊断周围型肺癌的敏感度、特异度和AUC均明显高于超声引导和CT引导,且差异存在统计学意义(P＜0.05).结论:CT引导VBN辅助EBUS-GS可显著提高周围型肺癌的诊断效能.

目的:分析小肝癌在 64 排上腹部增强多层螺旋CT检查及重建后影像特征和临床检出率.方法:选择2020 年 5 月至 2022 年 5 月本院收治的 83 例小肝癌患者的临床资料为研究对象.采用回顾性分析法对比各期检出的小肝癌病灶的数目、大小范围、边界及临床检出率等.结果:常规CT、动脉期增强CT(AP)、门脉期增强CT(PP)及延迟期增强CT(DP)临床检出率比较,差异具有统计学差异(P＜0.05);AP、DP 检出率均高于常规 CT(P＞0.05);而常规CT与PP临床检出率比较,差异无统计学意义(P＞0.05);AP与DP临床检出率比较,差异也无统计学意义(P＞0.05).结论:64 排上腹部增强多层螺旋CT检查可作为临床诊断评估小肝癌的重要手段,能有效提高小肝癌的诊断准确性和病灶检出率,为临床诊治提供更多的影像学依据.

Objective:To investigate the clinical value of computed tomography (CT) plain scan combined with CT angiography in the diagnosis of large-area acute cerebral infarction.Methods:A total of 78 patients diagnosed with large-area acute cerebral infarction treated in Nanyang Central Hospital from October 2018 to October 2022 were selected. All of them underwent CT plain scan and CT angiography examinations. The diagnostic positive rates of CT plain scan and CT angiography were analyzed and compared.Results:In the 78 patients with large-area acute cerebral infarction, 55 cases were positive according to CT plain scan, and 78 cases were positive according to CT plain scan combined with CT angiography. The positive rate of CT plain scan combined with CT angiography was 100.00% (78/78), which was higher than the 70.51% (55/78) of CT plain scan ( P<0.05). Conclusions:CT plain scan combined with CT angiography can effectively improve the positive rate in the diagnosis of large-area acute cerebral infarction, which can provide plenty information support for clinical diagnosis.

Objective:To compare and analyze the application value of thin computed tomography (CT) scanning and X-ray scanning in the diagnosis and differentiation of pulmonary fungal infection.Methods:A total of 124 patients with pulmonary fungal infection treated in Nanyang Central Hospital from March 2019 to August 2022 were selected and divided into control group and study group according to random number table method, with 62 cases in each group. X-ray scanning was used in the control group, and CT scanning was used in the study group. The positive detection rate of the two groups were counted, and the imaging findings of thin CT scanning were analyzed.Results:The positive detection rate of the study group was 75.81% (47/62), which was higher than the 16.13% (10/62) of the control group ( P<0.05). Among the 62 patients, CT imaging findings were mainly nodules or masses in 19 cases (30.65%, 19/62), cavities in 14 cases (22.58%, 14/62), halo sign in 13 cases (20.97%, 13/62), inflammatory infiltration in 7 cases (11.29%, 7/62), crescent sign in 6 cases (9.68%, 6/62). Conclusions:Compared with X-ray scanning, thin CT scanning has a higher positive detection rate in the diagnosis of pulmonary fungal infection, which can clearly show the signs of lung tissue and provide imaging basis for early clinical treatment.

探讨腹腔镜胃癌根治术中容积再现技术重建血管图像的应用价值.选取2017年1月至2020年1月收治的胃癌患者100例,根据患者是否接受容积再现技术重建血管图像检查分为观察组(n=56)和对照组(n=44).两组患者均行腹部CT和腹腔镜胃癌切除术,观察组另行容积再现技术重建血管图像.比较两组围手术期指标.观察组手术时间、术中出血量均少于对照组(P<0.05),淋巴结清扫数目多于对照组(P<0.05),胃肠道功能恢复时间、术后住院时间亦少于对照组(P<0.05).观察组术前35.71％的患者CTA显示腹腔动脉血管变异,与术中所见一致.腹腔镜胃癌根治术前应用容积再现技术重建血管图像有助于缩短手术时间,减少血管损伤,促进患者术后恢复.

探讨CT三维重建(3D-CT)评估肝门部胆管癌切除术的应用价值.选取2017年1月至2020年1月在我院治疗的肝门部胆管癌患者75例,根据检查方法分为观察组(n=41)和对照组(n=34).两组均给予腹部CT、肝门部胆管癌切除术,观察组加用3D-CT.观察组手术时间和术中出血量明显低于对照组(P<0.05),RO切除比例高于对照组(P<0.05),术后引流管放置时间少于对照组(P<0.05);两组术后住院时间比较差异无统计学意义(P>0.05),并发症发生率比较差异无统计学意义(P>0.05).观察组3D-CT术前Bismuth-Corlette分型与手术结果一致性Kappa值为0.573(P<0.05).3D-CT有助于肝门部胆管癌切除术术前评估,能够提高肿瘤R0切除,减少术中出血量等,具有临床推广价值.

目的 探讨CT联合血清肿瘤标志物对早期肺癌的诊断价值.方法 选取102例早期肺癌患者和102例肺部良性疾病患者,分别作为恶性组和良性组,比较两组患者的血清肿瘤标志物[胃泌素释放肽前体(ProGRP)、癌胚抗原(CEA)、糖类抗原211(CA211)、神经元特异性烯醇化酶(NSE)]水平.以手术病理或纤维支气管镜活检为金标准,分析CT和血清肿瘤标志物单独及联合应用对早期肺癌的诊断效能及其与金标准的一致性,采用受试者工作特征(ROC)曲线分析CT和血清肿瘤标志物单独及联合应用对早期肺癌的诊断价值.结果 恶性组患者的血清ProGRP、CEA、CA211、NSE水平均明显高于良性组,差异均有统计学意义(P﹤0.01).CT和血清肿瘤标志物联合应用对早期肺癌的诊断结果与金标准具有高度一致性(P﹤0.05),灵敏度、特异度和准确度均高于二者单独应用的诊断结果.CT和血清肿瘤标志物联合应用对早期肺癌具有较高诊断价值(AUC=0.980),单纯CT对早期肺癌具有中等诊断价值(AUC=0.863),单纯血清肿瘤标志物对早期肺癌具有较高诊断价值(AUC=0.907),CT和血清肿瘤标志物联合应用的诊断价值最高.结论 CT联合血清肿瘤标志物对早期肺癌具有较高诊断价值,且具有重复性较好、应用范围广泛等优势.

目的 探讨双能CT影像组学指标在进展期胃癌脉管生成及临床预后评估中的价值.方法 以80例进展期胃癌患者为研究对象,行双能CT检查,并检测微血管密度(MVD).比较不同MVD值患者的碘浓度(IC)、标准化碘浓度(nIC)值及能谱曲线的斜率,分析其与MVD值的相关性,并采用ROC曲线分析双能CT影像组学指标对进展期胃癌脉管浸润及预后的诊断评估价值.结果 高MVD组IC、nIC值及斜率大于低MVD组(P<0.05);IC、nIC值与MVD值呈正相关(P<0.05);脉管浸润组IC、nIC值及斜率大于非浸润组(P<0.05).IC、nIC值及斜率诊断进展期胃癌脉管浸润的AUC大于0.7;死亡组IC、nIC值及斜率大于生存组(P<0.05).IC、nIC值预测患者预后的AUC大于0.7.结论 进展期胃癌患者IC、nIC值与脉管生成相关,且对进展期胃癌脉管浸润及预后具有诊断评估价值.

目的 探讨MSCTA技术(双源64排螺旋CT血管成像)在头颈部血管病变的临床诊断中的应用价值.方法 选取我院2018年6月到2020年6月间进行头颈部MSCTA检查的88例患者作为研究对象,结合DSA的检查结果,根据MSCTA检查的血管成像图片质量,观察和分析采用MSCTA检查方式所示的血管狭窄及斑块的病变情况.结果 88例患者的264段影像图片,图像质量1级的占87.88％,2级的占9.09％,3级的占3.03％;MSCTA检查所示血管的狭窄情况、斑块病变情况与DSA相当,差异无统计学意义(P＞0.05).结论 MSCTA技术对头颈部血管病变具有独特优势,可在保证图像质量的同时,对头颈部血管的病变提供早期诊断依据,值得临床推广.

目的 探讨螺旋CT三维重建技术对唇腭裂继发鼻腔畸形患者畸形特征的评估价值.方法 应用螺旋CT设备分别对2018年3月至2021年10月某院收治的43例唇腭裂继发鼻腔畸形患者(研究组)及45例鼻唇部正常者(对照组)行颌面部螺旋CT检查,并运用Mimics17.0影像处理软件对影像资料进行三维重建处理,测量并比较其鼻部解剖形态,分析评估其鼻腔畸形特征.结果 研究组43例唇腭裂继发鼻腔畸形患者平均鼻腔总体积为(14.54+2.38)cm3,其中患侧平均鼻腔体积为(6.57士1.49)cm3,健侧为(7.97士1.52)cm3,患侧鼻腔体积明显小于健侧,差异有统计学意义(t=4.313,P＜0.05);研究组患者平均鼻腔总体积明显小于对照组,差异有统计学意义(t=3.333,P＜0.05).研究组患者平均鼻黏膜表面积为(143.19士24.27)cm2,其中患侧平均鼻黏膜表面积为(66.14士12.48)cm2,健侧为(77.05士13.71)cm2,患侧鼻黏膜表面积明显小于健侧,差异有统计学意义(t=3.859,P＜0.05);研究组患者平均鼻黏膜表面积明显小于对照组,差异有统计学意义(t=3.435,P＜0.05).研究组患者鼻黏膜表面积与鼻腔体积比值大于对照组,差异有统计学意义(t=5.335,P＜0.05).研究组患者鼻道存在明显畸形,呈鼻道中部向患侧,两端向健侧的"月形"畸形,且鼻阈区明显后移伴狭窄,鼻底下沉.结论 唇腭裂继发鼻腔畸形患者鼻腔形态明显与健康人存在差异,螺旋CT三维重建技术可有效展现鼻道结构,直观地观察鼻道位置及走向,为临床整形修复手术提供可靠数据支持,具有较高临床应用价值.

Objective:To explore the value of dual-source CT dual-energy in the diagnosis of invasive lung adenocarcinoma of pure ground glass nodules (pGGN).Methods:A retrospective analysis was performed on the clinical data of 70 patients with lung pGGN lesions admitted to Nanyang Central Hospital from July 2018 to July 2020. According to the pathological results, the patients were divided into control group andstudy group. Patients in control group were with non-invasive lung adenocarcinoma (33 cases), and patients in study group were with invasive lung adenocarcinoma (37 cases), and both groups underwent dual-source dual-energy CT examination. The differences in distribution of CT signs, average plain scan CT value and average normalized iodine content ration (NIC) were comparedbetween the two groups. Receiver operating characteristic (ROC) curve was used to determine the average plain scan CT value, average NIC diagnostic efficacy and the best cut-off value.Results:There was no significant difference in the location of the lesion between the two groups ( P>0.05); the maximum diameter of the lesion in study group was higher than that in control group ( P<0.05); there were significant differences in the lobulation sign, spicule sign and vessel convergence sign between the two groups ( P<0.05), and there were no significant differences in pleural indentation, air bronchogramand vascular penetrating sign ( P>0.05); the average plain scan CT value and average NIC values in the arterial and venous phasesin study group were higher than those in control group ( P<0.05). ROC analysis results showed that the AUC of the average plain CT value was 0.764, the sensitivity and specificity were 69.70% and 83.78% respectively, the AUC of average NIC in arterial phase was 0.864, the sensitivity and specificity were 96.97% and 72.97% respectively, and AUC of the average NIC in venous phase was 0.943, the sensitivity and specificity were 96.97% and 83.78% respectively. Conclusions:Dual-source CT dual-energy in detection of pGGN has certain value in the diagnosis of invasive lung adenocarcinoma.

Objective:To investigate the value of high-resolution CT (HRCT) in diagnosis of pathological subtypes of lung adenocarcinoma of pure ground-glass nodules (pGGN).Methods:The clinical data of 70 patients diagnosed with lung adenocarcinoma of pGGN by surgery and pathological biopsy from October 2018 to October 2020 in Nanyang Central Hospital were retrospectively analyzed. According to the pathological subtypes, the patients were divided into pre-invasive lesion group ( n=46) and invasive lung adenocarcinoma group (micro-invasive lung adenocarcinoma and invasive lung adenocarcinoma, n=24). Both groups of patients underwent HRCT examination, and the imaging features and manifestations (pleural indentation sign, lobular sign, spiculation sign, vacuole sign, clear tumor-lung interface, abnormal blood vessel sign, bronchus sign), lesion sites (upper lobe of left lung, lower lobe of left lung, upper lobe of right lung, middle lobe of right lung, lower lobe of right lung), lesion density uniformity, shape. Results:There were statistically significant differences in the assessments of vacuole sign, clear tumor-lung interface, abnormal blood vessel sign, bronchussign and lesion density uniformity between the two groups ( P<0.05); there were no statistically significant differences in the assessments ofpleural indentation sign, lobular sign, spiculation sign, lesion sites and lesion shape ( P>0.05). Conclusions:Lung adenocarcinoma of pGGN is characterized by vacuole sign, clear tumor-lung interface, abnormal blood vessel sign and bronchus sign. And the lesion density uniformity are helpful for the evaluation and differentiation of pathological subtypes.

Objective:To explore the diagnostic value of high-resolution CT (HRCT) for inner ear malformations in children with sensorineural hearing loss (SNHL) .Methods:A total of 202 cases of children with SNHL (401 ears) admitted to Nanyang Central Hospital from January 2016 to December 2019 were selected as observation group, and another 105 cases of normal children (210 ears) who underwent physical examination in the hospital during the same period were selected as control group. All subjects underwent HRCT scan, and the HRCT performance and the malformation of the inner ear were observed in 202 children patients with SNHL. The width of the central bone island in the lateral semicircular canal and the diameter of the inner auditory canal were compared between the observation group and the control group.Results:Among 202 children with SNHL, 57cases (111 ears) showed inner ear malformations on HRCT, and the other 145 cases (290 ears) showed no abnormalities on HRCT. The specific manifestations of HRCT inner ear malformations showed 24 cases (47 ears) with simple vestibular aqueduct enlargement, 1 cases (2 ears) with simple inner ear canal stenosis, 7 cases (12 ears) with vestibular semicircular canal malformation and 25 cases (50 ears) with cochlear malformations. Children patients with cochlear malformations included 29 ears of IP-Ⅱ malformations, 6 ears of common cavity malformations, 5 ears of IP-Ⅰ malformations, 5 ears of cochlear hypoplasia, 2 ears of Michael malformations, 2 ears of undeveloped cochlear hypoplasia and 1 ear of IP -Ⅲ malformation. The width of central bone island in lateral semicircular canal and the diameter of the inner ear canal in observation group were smaller than those in control group ( P<0.05). Conclusions:HRCT can effectively diagnose the bone labyrinth structure of inner ear malformations in children patients with SNHL, but it is difficult to observe the nerves, small blood vessels and membranous labyrinth structures, and there are certain limitations in the fine examination.

Objective:To analyze the value of dual-energy computed tomography (CT) iodine quantification parameters in evaluating hepatic blood perfusion and liver function in patients with liver cirrhosis.Methods:A total of 128 patients with liver cirrhosis treated in Nanyang Central Hospital from January 2019 to December 2020 were selected as the cirrhosis group, and 128 patients who underwent healthy physical examination during the same period were selected as the healthy control group with a ratio of 1∶1, and they all underwent enhanced dual energy CT scanning. The hepatic perfusion parameters, including portal venous blood flow iodine content (PVIC), arterial iodine fraction (AIF), iodine concentration in hepatic parenchyma of portal venous phase (Ip) and iodine concentration in hepatic parenchyma of arterial phase (Ia), and hepatic hemodynamic parameters, including peak value of blood flow parameters (PV), positive enhancement integral (PEI) and signal enhancement rate (SER), were compared between the two groups. The hepatic perfusion parameters and hepatic hemodynamic parameters of patients with different Child-Pugh grades in the cirrhosis group were compared. The relationship of Child-Pugh classification with hepatic perfusion parameters and hepatic hemodynamic parameters was analyzed.Results:PVIC and Ip in the cirrhosis group were lower than those in the healthy control group, and AIF and Ia were higher than those in the healthy control group, and the difference was statistically significant ( P<0.05). The PV, PEI and SER of the liver cirrhosis group were higher than those of the healthy control group, and the difference was statistically significant ( P<0.05). In the liver cirrhosis group, the PVIC and Ip of patients with Child-Pugh grade C were lower than those of patients with Child-Pugh grade A and B, while AIF and Ia were higher than those of patients with Child-Pugh grade A and B ( P<0.05). In the liver cirrhosis group, the PV, PEI and SER of patients with Child-Pugh grade C were lower than those of patients with Child-Pugh grade A and B ( P<0.05). Pearson analysis showed that Child-Pugh grade were negatively correlated with PVIC ( r=-0.516), Ip ( r=-0.534), PV ( r=-0.671), PEI ( r=-0.582) and SER ( r=-0.635), and it positively correlated with AIF ( r=0.725) and Ia ( r=0.649), P<0.05. Conclusions:The abnormal expression of hepatic hemodynamic parameters and hepatic perfusion parameters in patients with liver cirrhosis has significant correlation with Child-Pugh classification. Dual-energy CT iodine quantitative parameters can provide a scientific basis for clinical evaluation of liver function reserve.

目的 研究CT灌注成像观察原发性肝癌患者经肝动脉化疗栓塞术(TACE)后血流状态及对预后的评估价值.方法 纳入2014年3月至2019年11月257例接受T ACE治疗的原发性肝癌患者作为研究对象,分别在T ACE治疗前后行CT灌注成像扫描,记录肝血流量(HBF)、肝动脉灌注指数(HPI)、达峰时间(TTP)及肝动脉灌注量(HAP).同时取TACE治疗前病灶组织,检测血管内皮生长因子(VEGF)水平与微血管密度计数(MVD).分析VEGF水平、MVD与CT灌注参数的相关性.记录治疗效果,比较不同疗效患者HBF、HPI、TTP及HAP水平.分析CT灌注成像参数对判断TACE近期预后的价值.结果 TACE治疗后3个月复查,257例患者中,完全缓解(CR)38例,部分缓解(PR)128例,疾病稳定(SD)36例,疾病进展(PD)55例.经Pearson线性相关分析显示,VEGF、MVD与HBF、HPI及HAP呈正相关,与TTP呈负相关(P<0.05).受试者操作特征曲线(ROC)分析结果显示HBF、HPI、HAP及TTP有助于判断TACE治疗效果(P<0.05),根据ROC分析结果建立疗效指数模型:Y=X1+X2+X3+X4(HBF:X1,HPI:X2,HAP:X3,TTP:X4),疗效指数模型判断近期疗效的AUC为0.870(AUC=0.870,S.E.=0.025,95％CI=0.821～0.919,P=0.000).结论 CT灌注成像有助于评估原发性肝癌患者T ACE治疗前后血流状态,为近期预后判断提供依据.

目的 探究低剂量和常规剂量螺旋CT扫描应用于早期肺癌诊断中的应用价值.方法 选取2017年8月—2019年2月南阳市中心医院收治的40例早期肺癌患者为研究对象,先进行低剂量螺旋CT扫描检查,间隔3天后再进行常规剂量螺旋CT扫描检查.按剂量的不同将研究对象分为低剂量组和常规剂量组,比较两组肺癌检出率、肺结节的细节情况、有效辐射剂量、显示结节的平均大小以及图像质量.结果 低剂量组和常规剂量组的肺癌检出率比较差异无统计学意义(P>0.05);低剂量组的有效辐射剂量和显示结节的平均大小均低于常规剂量组,差异均有统计学意义(P<0.05);低剂量组在分叶、毛刺、空洞和钙化方面的结节细节检出情况与常规剂量组比较,差异无统计学意义(P>0.05);低剂量组图像质量优良率低于常规剂量组,但差异无统计学意义(P>0.05).结论 与常规剂量螺旋CT扫描检查相比,低剂量螺旋CT扫描检查早期肺癌的图像质量略差,但辐射剂量小,并可保证检出率和检出效果,具有一定的临床价值.

目的 观察多层螺旋CT扫描及三维重建技术对小耳畸形再造患者肋软骨形态学参数测量结果的精确性,探讨该方法对小耳畸形再造术前肋软骨组织量评估及耳廓支架方案设计的参考价值.方法 根据患者的体重、年龄等情况,设置64排螺旋CT设备扫描参数,对2018年5月至2020年3月在南阳市某三甲医院接受小耳畸形耳廓再造治疗的82例患者双侧1～12肋骨进行CT扫描,并运用三维重建技术模拟还原肋骨三维形态,测量三维图像中肋软骨近肋骨处宽度(W)及肋软骨全长(L),指导术前耳廓支架方案设计,并与术中肋软骨近肋骨处宽度(W#)及肋软骨全长(L#)实际测量值进行比较,以评价三维技术测量精确性.结果 分别在三维图像和术中对207根手术相关肋软骨进行测量,结果显示,W为(9.71±1.59)mm,W#为(9.73±1.61)mm,差异无统计学意义(t=0.973,P=0.117);L为(82.96±21.38)mm,L#为(83.58±23.07)mm,差异无统计学意义(t=0.836,P=0.162).所有术前参考三维重建技术对肋软骨评估结果所设计的耳廓支架制作方案均满足手术要求,参考价值较高.结论 通过合理参数设置和三维重建技术处理,术前对小耳畸形再造患者肋软骨近肋骨处宽度及肋软骨全长评估精确,可为术前耳廓支架方案设计提供精确参考.

目的 总结并归纳特定CT征象对原发性腹膜后肿瘤鉴别诊断的价值.方法 回顾性分析2016年12月～2017年12月期间本院收治的60例原发性腹膜后肿瘤患者的临床资料,所有研究对象均经病理学诊断为原发性腹膜后肿瘤.对患者行特定CT征象,根据肿瘤良恶性将其分为良性组和恶性组各30例,比较两组患者CT征象,总结并归纳特定CT征象对原发性腹膜后肿瘤鉴别诊断的价值.结果 特定CT征象对原发性腹膜后良、恶性肿瘤的诊断准确率分别为86.67％(26/30)和83.33％(25/30);特定CT征象对原发性腹膜后良性肿瘤的漏诊率和误诊率分别为16.67％(5/30)和13.33％(4/30).结论 特定CT征象对于原发性腹膜后肿瘤患者的诊断具有极高的临床价值,且可对肿瘤的良恶性进行判断.值得应用.