Objective To review the principles and techniques of CT perfusion imaging and its applications in the imaging diagnosis of abdominal disorders. Methods All the relevant literatures were reviewed. The principles and techniques of CT perfusion imaging were described and summarized in detail. The functional information of a target abdominal organ (e.g. the liver and pancreas) revealed by CT perfusion imaging, such as hemodynamics and microcirculation status, was also evaluated. Results In addition to the morphologic information, CT perfusion imaging can also provide functional information about the circulation parameters of target abdominal organs. Moreover, such functional information can be generated for the neovasculature and microcirculation of tumor lesions of abdominal organs, which is very helpful for not only the diagnosis, but also the evaluation of tumor invasiveness and response to treatment. Conclusion CT perfusion imaging offers an effective method for studying abdominal disorders by providing functional information that is quite useful for the differential diagnosis and assessment of therapeutic response.
Objective To review the CT appearances and important differential diagnoses of various primary and secondary mesenteric neoplasms. Methods By describing the mesenteric anatiomy and major routes for the dissemination of metastatic mesenteric tumors, the article presents both the common and rare types of various primary and secondary mesenteric neoplasms, and addresses the characteristic CT appearances and important aspects of the differential diagnosis. Results CT study, especially the multislice spiral CT (MSCT), along with the clinical history and other related information, can nicely depict various mesenteric tumors and well differentiate them from infectious, inflammatory or vascular processes affecting the mesentery. Conclusion CT is the imaging method of choice for the evaluation of tumors of small bowel mesentery.
Objective To introduce the imaging modalities used for the evaluation of postoperative complications of orthotopic liver transplantation (OLT) and to present the imaging findings of these complications. Methods The literatures related to the imaging methods and imaging manifestations of OLT complications were reviewed. Results Ultrasound was the initial imaging technique used for the detection of complications in the early postoperative period. Spiral CT and MRI yielded more accurate and comprehensive evaluation of postoperative complications in later stage. So far, there had been no specific imaging findings to suggest rejection reaction. The spectrum of imaging manifestations of OLT complications, such as vascular complications, biliary complications, liver parenchymal complications, and so on, were summarized and illustrated. Conclusion Imaging examination (especially ultrasound, spiral CT and MRI ) plays an important role in the evaluation of postoperative complications of OLT.
ObjectiveTo introduce the technique of threedimensional portal venography of multidetector row spiral CT and its clinical application in the evaluation of the portosystemic collateral shunts of liver cirrhosis. MethodsAll relevant literatures were retrospectively reviewed on the application of twodimensional and threedimensional reconstruction techniques such as MIP, SSD, VRT of multidetector row spiral CT to demonstrate the collateral vessels of liver cirrhosis.ResultsThe distribution, pathway and anatomy of portosystemic collateral vessels were well shown by multidetector row spiral CT portal venography. Conclusion Multidetector row spiral CT portal venography provides excellent depiction of the anatomic characteristics of the collateral shunts and enables the continuous tracing of vascular structures, thus it is very helpful in the imaging evaluation of the collateral vessels of liver cirrhosis.
医学影像学是临床医学科学中发展较快的学科之一。为了将影像检查技术合理、高效、及时地应用于临床，为患者服务，需要影像医师与临床医师的密切合作。在具有一定学术地位和雄厚技术力量的本院放射科的鼎力支持与合作下，本刊自2003年第1期起增设“腹部影像”专栏，旨在为腹部外科医师和腹部影像医师搭建起一个学术交流的桥梁，促进相互了解、认识、渗透与合作，使腹部外科医师能及时了解到影像学检查手段的进展和影像医学的发展，又能使影像医师了解到腹部外科医师对影像检查的具体要求，从而一方面使影像学检查技术更好地为腹部外科服务，另一方面又使腹部外科促进影像学检查的合理化和提高影像诊断水平。基于这一宗旨，本栏目将着重推出一些具有特色、图文并茂的综述性文章，作为让腹部外科医师了解腹部影像学现状与进展的的窗口。同时，我们也将选登一些与腹部外科密切相关、临床实用性比较强的腹部影像学方面的原著介绍给腹部外科医师。此外，有关影像学检查的新技术、新方法以及它们在腹部疾病诊治中的临床应用的短篇文章或报道也将是我们选稿的重点。我们殷切希望，本刊增设的这一新栏目能够得到外科医师和影像医师的认可和支持，并让大家从中获得有用的信息。我们相信，在主编、各位编委和杂志编辑部的共同努力下，特别是有广大读者的支持和鼓励，背靠华西放射的雄厚技术力量，我们有信心把腹部影像专栏办好，实现它的宗旨，更好地为临床工作服务。
Objective To investigate the CT manifestations of acute pancreatitis (AP) and its complications and to evaluate the imaging modalities for staging the severity of AP. Methods Literatures on CT manifestations of AP and its complications and severity staging of AP were reviewed.Results CT has shown an early overall detection rate of 90% for pancreatic necrosis with close to 100% sensitivity 4 days after episode. The CT severity index has shown a bly positive correlation with the development of local complications and mortality of AP.Conclusion Contrastenhanced CT is the imaging modality of choice to help detect pancreatic necrosis, stage the severity of the inflammatory processes, and depict local complications.
ObjectiveTo introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.MethodsUltrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.ResultsMany of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, lowgrade dysplastic nodule, highgrade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.ConclusionModern stateoftheart medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.
Objective To review the current status of magnetic resonance imaging (MRI) techniques in the evaluation of hepatic fibrosis. Methods The application and recent advances of various kinds of MRI techniques in evaluating hepatic fibrosis were summarized by literature review. Results The state-of-the-art of MRI evaluating of hepatic fibrosis included common contrast-enhanced MRI, double contrast-enhanced MRI, and various functional MRI techniques. Common contrast-enhanced MRI could detect morphological changes of the liver, but little value in phasing. Double contrast-enhanced MRI markedly increased the contrast to noise ratio. Except diagnosis liver fibrosis, functional MRI also could phase it by its serverity. Conclusion MRI techniques, especially those functional MRI techniques, are advancing very fast and have very great potentiality in both the diagnosis and severity assessment of hepatic fibrosis.
Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.