目的 探讨常规注射速率下单倍剂量对比剂在颈部三维对比增强磁共振血管成像（3D-CEMRA）中的可行性及临床应用价值。 方法 2011年8月－11月，连续纳入30例临床怀疑颈动脉或椎动脉狭窄并要求颈部磁共振血管成像检查的患者，随机分成A、B两组（每组各15例）。使用西门子Magnetom Avanto 1.5 T磁共振成像仪及其配备的颈部线圈和头部线圈进行CEMRA成像。A组使用双倍剂量对比剂（0.2 mmol/kg），B组使用单倍剂量对比剂（0.1 mmol/kg）。用三维快速小角度激发序列进行颈部血管成像。由2位有丰富经验的高年资医生对两组原始图像的信噪比以及最大密度投影（MIP）图像的质量进行评价，并对结果进行统计学分析和处理。 结果 A、B两组的所颈动脉信噪比分别为189.95 ± 71.31、175.07 ± 68.61，差异无统计学意义（t=?0.566，P=0.576）；所得的MIP图像质量均达到优良，差异无统计意义（χ2=0.180，P=0.671）。 结论 与双倍剂量相比，单倍剂量对比剂获得颈部血管的图像清晰，能够满足临床诊断要求。
ObjectiveTo investigate the CT and MR imaging features and distribution characteristics of lymphatic nodal involvement in patients with gallbladder carcinoma. MethodsThirtyseven histopathologically proven cases of gallbladder carcinoma with regional lymphatic nodal enlargement in upper abdomen were included into the study. The lymph nodal short diameter of equal to or larger than 10 mm was used as the criteria for positive lymphadenopathy. Thirtyone cases underwent contrastenhanced spiral CT scanning, 6 cases had MR imaging studies. CT and MR images were jointly evaluated by three radiologists with especial attention to the size and location of enlarged lymph nodes in upper abdomen.ResultsThe enlarged lymph nodes were observed in four anatomic locations in the upper abdominal region. ①The retroportal and retropancreatic group in which lymph nodes were located along the cystic duct and common bile duct, in the portocaval space and behind the pancreatic head. ②The celiac group in which enlarged nodes distributed along the common hepatic artery and surrounded the celiac trunk. ③The mesenteric group in which lymph nodes assembled at the mesenteric root and around the superior mesenteric vessels. ④The abdominal aorta group in which lymph nodes scattered at the left side of abdominal aorta and in the aortocaval space at the level of the left renal vein. The spiral CT visualization rates for the above 4 groups of lymphadenopathy were 89.1%(33/37), 78.3%(29/37), 29.8%(11/37) and 51.3%(19/37) respectively.ConclusionCT and MR can clearly depict the four location sites of lymphadenopathy in patients with gallbladder carcinoma, which closely reflects the three major lymphatic spreading pathways of gallbladder carcinoma, namely, the cholecystoretropancreatic, cholecystoceliac and cholecystomesenteric routes.
Objective To evaluate the clinical value of multi-detector row helical CT (MDCT) in Diagnosing the TN staging and typing of adenocarcinoma of esophagogastric junction. Methods From January 2008 to June 2011，149 consecutive cases with AEG confirmed surgery were examined by using MDCT scanner before surgery in West China Hospital，pathologic and operative finding diagnosis were correlated with that results of MDCT . Results The accuracies of MDCT for the T1, T2, T3, and T4 staging was 97.3%，91.3%，84.5%， and 89.3%，respectively， and for the typing of Ⅰ,Ⅱ, andⅢwas 84.6%, 63.8%, and 79.2%，respectively. The accuracies of MDCT to judge the metastasis of lymph node was 88.6%（132/149）. The feature of metastasis of lymph node with circular and fusion，significantly and obviously enhanced，ring and heterogeneous enhanced, which the positive rate of pathological metastasis was higher (P=0.000). Conclusions MDCT is an excellent diagnostic tool for the diagnosis of the TN staging and typing of AEG, which is useful for the selection of the surgical procedure and decision operation path.
【Abstract】Objective To compare radiologists’ performance on combined unenhanced and feridexs-enhanced MR imaging （MRI） with their performance on helical CT enhanced, unenhanced MRI, and feridexs-enhanced MR alone imaging for the characteristics of local hepatic lesions. Methods MR images and CT scans obtained in 26 patients with 57 local hepatic lesions were analyzed with reviewer operator characteristic (ROC) curve analysis. The imaging of patient were divided into 4 groups including combined unenhanced and feridexs-enhanced MRI group, helical CT enhanced group, unenhanced MRI group, and feridexsenhanced MR alone group. Results The combined approach resulted in larger area under the ROC curve (Az=0.926 0) and accuracy (86.8%),P＜0.05，as compared with the others methods. There were no significant differences among the other three methods. Conclusion Feridexs-enhanced MRI was more accurate than enhanced helical CT scan in characterization of local hepatic lesion. The combined analysis of unenhanced and feridexs-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of feridexs-enhanced images alone.