Objective To analyze the method and value of using coronary CT imaging technology to diagnose coronaryheart disease. Methods 320 suspected coronary heart disease patients admitted to our hospital from June 2018 to June 2020 wereselected as the study subjects. All study subjects underwent coronary CT imaging technology and coronary angiography examination. Using coronary angiography as the gold standard, observe and analyze the value of coronary CT imaging technology. The differencein the grading of coronary artery stenosis between the two examination methods was observed. Results The difference in the gradingof coronary artery stenosis between CT imaging and traditional coronary angiography was relatively small, with a high degree ofagreement and no statistical significance（P＞0.05）. Coronary angiography was used as the gold standard, so the sensitivity andspecificity of the coronary angiography group were 100% in 104 cases（+）and 181 cases（-）. CT imaging examination wasperformed in 108 cases（+）and 190 cases（-）, with a sensitivity of 83.87% and a specificity of 92.35%. In the coronary CT imaginggroup, there were 67 non calcified plaques（20.94%）, 39 mixed plaques（12.19%）, and 117 calcified plaques（36.56%）; Therewas no statistically significant difference（P＞0.05）between 69 non calcified plaques（21.56%）, 39 mixed plaques（12.19%）, and 120 calcified plaques（37.50%）in the coronary angiography group. Conclusion Coronary CT imaging technology hasoutstanding value in the clinical diagnosis of coronary heart disease patients, with high resolution, high sensitivity and specificity, andhigh accuracy. It can clearly and accurately check the grading of coronary artery stenosis in patients, determine the lesion location andother detailed information, and has high clinical diagnostic and therapeutic value.

目的:探讨双源CT自动管电流调制技术降低辐射剂量在冠状动脉成像当中的诊断价值.方法:选取进行冠状动脉检查的患者80例为研究对象,根据患者的体重指数进行分组,对照组患者仅根据体重指数的不同手动调节管电流,研究组患者在对照组的基础上同时使用自动管电流调制技术进行检查.观察两组患者的检测当中的辐射剂量以及图像质量.结果:研究组患者的辐射剂量明显低于对照组,并且不同体重指数的三组患者之间的CT容积剂量指数(CTDIvol)剂量长度乘积(DLP)以及有效剂量(ED)之间比较,差异具有统计学意义(P＜0.05);结论:双源CT自动管电流调制技术在冠状动脉成像中降低辐射剂量可以保证图像质量,减少对患者的辐射危害.

多层螺旋CT肺动脉造影(CTPA)是肺栓塞、肺动脉高压、肺动脉瘘、肺恶性肿瘤是否侵犯肺血管等常用的诊断方法,在各种肺动脉疾病诊断中得到了广泛的应用.在实施C T P A诊断时往往需要给予60~90m l剂量的对比剂以保证准确性,但是近年来国内外均有关于小剂量对比剂应用于CTPA诊断中的价值研究.鉴于此,本文特对小剂量对比剂在CTPA诊断中的应用研究进行综述,并提出进一步的研究方向.

当前,大学生毕业生已经成为我国一个十分重要的社会群体,大学毕业生的就业区域选择,更是影响整个社会人力资源的配置是否合理的重要因素.本文以武汉理工大学即将毕业的大学生为研究对象,利用问卷调查,了解他们的就业区域选择意向,从而为当代大学毕业生的就业选择提供参考,为地区经济的发展提出合理的建议.

随着我国高等院校招生规模的不断扩大,大学毕业生已经成为当下社会一个特殊群体.他们刚刚步入社会,收入水平较低,但并没有被纳入城市低收入群体,不能享受现行住房保障政策,因而其住房问题令人堪忧.因此,应完善住房保障政策,将大学毕业生纳入到住房保障对象范围;加强宏观调控力度,稳定房价从而降低房租;鼓励大学毕业生到二、三线城市创业,降低其住房成本.

Objective: To study the influencing factors of dual source CT coronary artery imaging, and take effective mea-sures to control.Methods:In our hospital in July 2012 to 2014 July of dual source CT coronary angiography in patients with clinical data of 300 cases as the research object, research and analysis of the factors that affect the quality of imaging of the patients. Results: The results showed that the main factors affecting imaging technology were motion artifact, coronary lumen contrast agent filling, coronary venous development, and cardiac rhythm. The accept dual source CT examination in patients with a total of 80 cases of patients with image quality defects, including motion artifacts have 32 cases, 28 cases of coronary artery lumen con-trast agent perfusion in patients, coronary vein enhancement to the influence of strong contrast quality in 11 cases, cardiac factors lead to wrong dew artifacts in 9 cases.Conclusion:In patients receiving inspection process, factors that affect the image quality of dual source CT have many kinds, so we need to optimize the inspection plan, so as to improve the quality of inspection.

First of all, the huge number of migrant worker and the different level of economic development are the barriers to solve the problems. What’s more, the reform of the household registration system has puzzled us for years. Especially the new generation of migrant workers yearning for city life, they demand the higher service of urban housing security. Therefore, the government not only needs to help them solve the basic housing conditions, but also help them realize their housing dreams.

住房问题是关乎社会稳定大局的民生问题,也是发展问题.如何解决我国中低收入阶层的住房问题,已成为从中央到地方各级政府的工作重点之一,反映出我国建设保障性住房的紧迫性.新加坡的以立法保障住房用地供应、实施多渠道购房融资,以及完善组屋分配等组屋政策,其成功经验可以为解决当前我国城镇中低收入阶层的住房保障提供一些有益借鉴.结合我国国情,我国在保障居民安居乐业方面政府不能缺位;同时要建立完善保障性住房管理运行机制;健全住房保障政策动态调控机制;循序渐进,倡导新型住房消费模式.

Objective To investigate the advantages of susceptibility-weighted imaging (SWI) over conventional T2*-weighted spoiled phase gradient-echo imaging (T2* WI) in detecting brain hemorrhage in patients with mild traumatic brain injury (MTBI) and its relationship to outcome after MTBI.Methods Clinical information,T2* WI and SWI of 57 patients with MTBI were collected.Bleeding cases and number of cerebral micro-cerebral bleeds (MCBs) detected using T2* WI and SWI were compared statistically.Correlation analysis between SWI and clinical outcome was performed.Results Hemorrhage in 43 patients (75％) with MCBs amounting to 237 was detected using SWI,while hemorrhage in 32 patients (56％) with MCBs amounting to 123 was found using T2* WI (P＜0.01).Thirty-five patients experienced short-term unconsciousness,including 22 being detected with post cerebral traumatic syndrome (PCTS) at follow-up.Twenty-two patients experienced no coma,among which 10 developed PCTS at follow-up.Based on the SWI,patients who experienced coma showed higher incidence of hemorrhage compared with patients who did not (86％ vs 59％,P＜0.05),and patients with hemorrhagic focus was associated with higher probability of PCTS compared with patients without (65％ vs 29％,P＜0.05).Conclusions SWI is more sensitive than conventional T2* WI in detecting cerebral MCBs.MCBs are related to the late prognosis of MTBI patients,but SWI can supply certain valuable and objective information.

城市内生型低收入群体受其收入制约，无力承担在市场经济条件下的住房成本，只能依赖政府提供的保障性住房。政府在这方面的职责包括相关立法工作、确定保障目标、制定建设计划、提供保障性住房的实物供给或货币补贴、保障房的监管等。但目前，政府存在着对社会保障的认识有偏差、廉租房制度有缺陷、棚户区改造责任不到位等问题。因此，政府需要转变执政观念、明确职责，完善廉租房制度，加快棚户区改造进程。

Objective:To analyze the arteriography image of gynecological hemorrhagic diseases and to approach the clinical application value of uterine artery embolization.Methods:Thirty-eight patients with gynecological hemorrhagic diseases,including 22 cases of postpartum hemorrhage and 16 cases of ectopic pregnancy,underwent arteriography of bilateral internal iliac artery and uterine artery,and then the abnormal vessels were embolized using spongia gelatinosa.Results: Thickened and sinuous uterine arteries were found in 38 cases,irregular stains in 25 cases,and contrast medium extravasation or vascular pools in 16 cases.The ovarian arteries were uncorrelated with hemorrhage.The bilateral embolization to uterine arteries were successful in 38 cases,which resulted in hemorrhage termination or obvious decrease,blood pressure increasing,and heart rate decreasing immediately.Statistical analysis showed significant changes of blood pressure,heart rate,and hemoglobin levels after embolization(P<0.01).No recurrence of hemorrhage and severe complications were observed in hospital.Conclusion:Uterine artery embolization is a safe and effective method for gynecological hemorrhagic diseases and has very important clinical value.

本文聚焦政府卫生支出,结合现阶段国内的"新背景和新形势",依据《新医改》方案中的具体对策措施为指导,运用一个适用的具有中国区域特点的CGE模型,定量研究政府公共卫生支出总量和分配结构对宏观经济、区域经济增长和地区差异等方面的影响。

OBJECTIVE:To evaluate the complication rate and analyze its impact of multiple facts of CT-guided percutaneous lung automated cutting needle biopsies (ACNB) with extrapleural locating method (EPL). METHODS:Retrospective study where information was obtained from the department of medical imaging, the sign of complication after 480 cases CT-guided ACNB with EPL was observed and its relationship with multiple factors were analyzed by multiple logistic regression model. RESULTS:The diagnostic accuracy was made in 456 cases (95.0%). The length of the biopsy procedures was 16 ± 2 min and the time of the biopsy needle in pulmonary parenchyma was < 20 s. Seventy-one (14.8%) cases presented pneumothorax which include 7 (1.5%) cases later pneumothorax, and 2 (0.4%) required chest tube insertions. The multivariate logistic regression analysis showed that emphysema, depth of intrapulmonal biopsy path and lesion size were sole effective factors of pneumothorax (OR = 7.991, 1.083, and 0.945 respectively). Lesions with emphysema, depth of intrapulmonal biopsy path and lesion size ≤ 10 mm had higher pneumothorax rates. Eight-seven (18.1%) cases presented pulmonary hemorrhage and twenty-six (5.4%) presented hemoptysis. The multivariate logistic regression analysis showed that depth of intrapulmonal biopsy path, emphysema, and number of pleural needle passes were sole effective factors (OR = 1.143, 0.712, and 0.521, respectively) of pulmonary hemorrhage. In patients with depth > 10 mm or 20 mm, emphysema and number of pleural needle passes had higher hemorrhage rates. The multivariate logistic regression analysis showed that depth of intrapulmonal biopsy path and emphysema were sole effective factors (OR = 1.077, and 0.578, respectively) of hemoptysis. Lesions with depth > 20 mm had higher hemoptysis rate. One case with pulmonary Cryptococcus presented pleural reaction, and three cases had the insistent pain. The total number of severe complications was 15 (3.1%) cases. CONCLUSION:ACNB with EPL was an accurate method for diagnosing pulmonary lesions. ACNB can be safely performed, which reduces the rate of pneumothorax and hemorrhage. Pneumothorax rate was influenced by emphysema, depth of intrapulmonal biopsy path and lesion size ≤ 10 mm. Hemorrhage was related with depth >10 mm or 20 mm, emphysema and number of pleural needle passes. Hemoptysis was related with depth of intrapulmonal biopsy path >20 mm. Later and severe complications should be considered in procedure.

Objective:To discuss the technique and postprocessing of multi-detector row CT hepatic venography.Methods:20 patients underwent tri-phase MDCT using a Siemens Sensation 16 scanner.Contrast material (80~100ml) was injected at a rate of 3ml/s.The arterial phase,portal venous phase and hepatic venous phase images were conducted with a fixed scanning delay of 30s,65s and 85s after contrast material administration respectively.The hepatic venous phase images were reconstructed at an interval of 1.0mm and 2mm respectively.Maximum intensity projection,multi-plannar reformation,shaded surface display,and volume rendering were created to show the hepatic veins.Results:The hepatic veins of the second hilum (including left,middle and right hepatic veins) were shown clearly in all cases,and hepatic veins of the third hilum were shown in 18 cases.Comparing the advantages of four postprocessing methods in showing the third hilum,SSD could demonstrate stereoscopic structure of the portal veins,second hilum hepatic veins and third hilum hepatic veins.Conclusion:Multi-detector row CT hepatic venography can demonstrate the main hepatic veins clearly.Images after being reconstructed at an interval of 1.0mm were to be better postprocessed.All postprocessing methods can be used to demonstrate stereochemical structure of the portal veins and the hepatic veins.

Objective:To discuss the technique and postprocessing of multi-detector row CT hepatic venography.Methods:20 patients underwent tri-phase MDCT using a Siemens Sensation 16 scanner.Contrast material (80~100ml) was injected at a rate of 3ml/s.The arterial phase,portal venous phase and hepatic venous phase images were conducted with a fixed scanning delay of 30s,65s and 85s after contrast material administration respectively.The hepatic venous phase images were reconstructed at an interval of 1.0mm and 2mm respectively.Maximum intensity projection,multi-plannar reformation,shaded surface display,and volume rendering were created to show the hepatic veins.Results:The hepatic veins of the second hilum (including left,middle and right hepatic veins) were shown clearly in all cases,and hepatic veins of the third hilum were shown in 18 cases.Comparing the advantages of four postprocessing methods in showing the third hilum,SSD could demonstrate stereoscopic structure of the portal veins,second hilum hepatic veins and third hilum hepatic veins.Conclusion:Multi-detector row CT hepatic venography can demonstrate the main hepatic veins clearly.Images after being reconstructed at an interval of 1.0mm were to be better postprocessed.All postprocessing methods can be used to demonstrate stereochemical structure of the portal veins and the hepatic veins.

Objective: To evaluate the complication rate of CT-guided percutaneous lung automated core needle biopsies (ACNB) with extrapleural locating method (EPL) and to analyze the impact of multiple factors on the incidence of pulmonary hemorrhage and pneumothorax. Methods: The signs of complication after 352 cases of CT-guided ACNB with EPL were observed and their relationship with multiple factors were analyzed by a multiple logistic regression model. Results: The final diagnostic accuracy was made in 334 cases (94.9%). Mean puncture time was (16. 0±2. 0) min. Eighty (22.7%) cases presented pulmonary hemorrhage and 18 (5.1%) presented hemoptysis. Single variate analysis showed that the sign of hemorrhage related to lesion diameter, pulmonary atelectasis, length of intrapulmonal biopsy path, and number of pleural needle passes. The multivariate logistic regression analysis showed that pulmonary atelectasis was protective factors (OR = 0.321) of pulmonary hemorrhage. Sixty (17.0%) cases presented pneumothorax including 5 cases of later pneumothorax, 2 (0.6%) cases required chest tube insertions. Single variate analysis showed that the sign of hemorrhage related to lesion size, chronic obstructive pulmonary disease (COPD), length of intrapulmonal biopsy path, and number of pleural needle passes. The multivariate logistic regression analysis showed that COPD and lesion diameter were risk factors of pneumothorax (OR=11.224, 2.556 respectively). One case with pulmonary cryptococcus presented pleural reaction, and one case had the insistent pain. The total number of severe complications was 5 (1.4%) cases. Conclusion: ACNB with EPL is an accurate method for diagnosing pulmonary lesions. Pulmonary atelectasis could reduce bleeding rate. Patients with COPD and smaller lesion diameter significantly increase the risk of pneumothorax. Later and severe complications should be considered during the procedure.

胸腺瘤是纵隔常见的肿瘤之一,异位胸腺瘤少见,其定性及定位诊断对临床治疗及预后有重要意义,其影像表现国内外报道少见[1-4].笔者报道3例异位胸腺瘤的CT及MRI表现,并结合文献分析,以提高对该肿瘤的诊断水平。

Objective: To describe clinical and CT manifestations of pulmonary carcinosarcoma(PCS).Methods: The clinical and CT findings in three patients with histopathologically proved PCS were retrospectively analyzed.Results: PCS is a rare malignant tumor and is mainly consisted of squamous carcinoma or adenocarcinoma and fibrosarcoma.X-ray showed that most cases were in peripheral type.All the three cases were misdiagnosed before operation and the follow-up analysis showed a poor survival rate.Conclusion: It is difficult to diagnose the pulmonary carcinosarcom before operation by CT examination.Although case history is helpful for the diagnosis,but the final diagnosis is dependent on the histopathologic examination.

<正>患者女,43岁。因头胀痛渐加重2个月伴走路不稳而行头颅CT及MRI检查,提示鞍上蛛网膜囊肿,大小约4．2 cm×3cm×3cm,伴梗阻性脑积水。神经系统查体见行走不稳,双眼视乳头轻度水肿,余无特殊异常发现。手术方法：局麻下安装脑立体定向仪头架后行CT定位扫描,以蛛网膜囊肿壁与右侧脑室前角交界处为靶点计算其X、Y、Z轴的坐标。回到手术室后局麻下于眉间上9cm右侧旁开2．5cm处

CT增强过程中常有伪影产生,认识伪影特征、形成原因及掌握限制和消除伪影的方法可为临床正确诊断提供有力的证据.