目的 分析急性阑尾炎及易与之混淆的其他急腹症的CT图像特征，探讨CT检查对急性阑尾炎诊断及鉴别诊断思路的辅助意义。方法 收集2009年6月至2012年6月期间南方医科大学附属小榄医院收治的120例初步诊断为急性阑尾炎患者的CT影像资料，回顾性分析和对比CT征象，研究其与最终诊断之间的内在联系。结果 120例患者中，单纯性阑尾炎15例，化脓性阑尾炎45例，阑尾坏疽、穿孔25例，阑尾脓肿10例；其他急腹症20例；5例未确诊。阑尾炎患者的术前CT征象因阑尾炎种类不同而略有区别，有56例发现粪石；而其他急腹症的CT征象有结肠管壁局限性增厚、肾输尿管高密度影、肾周筋膜增厚、子宫附件区囊性或实性肿物、肠系膜淋巴结肿大、腹水等。结论 CT检查对急性阑尾炎诊断与鉴别诊断思路的形成具有重要的价值。
目的交流肝脏外伤非手术治疗的病例选择与治疗体会。方法对该院57例非手术治疗的肝脏外伤病例资料进行回顾性分析。结果57例肝脏外伤患者中55例经非手术治疗后痊愈出院，另2例在治疗过程中经中转手术治愈，全组病例无一例死亡。结论对经过严格选择的肝脏外伤病例进行非手术治疗，疗效肯定，也是安全可行的。CT检查在病例选择中具有非常重要的作用。
目的探讨脾梗塞的诊断和治疗方法。方法回顾性分析2005年1月至2010年4月期间7例脾梗塞患者的临床资料。结果7例患者中有明确病因者5例，无明确病因者2例。 7例患者均行增强CT检查明确诊断。 除1例患者胰体尾囊腺癌侵犯脾动脉行胰体尾部、远端胃及全脾切除术外，其余6例均经保守治疗好转。结论增强CT检查对诊断脾梗塞有重要价值，大多数脾梗塞可经保守治疗痊愈。
ObjectiveTo discuss the characteristics of coronary artery disease in patients with type 2 diabetes using coronary angiography of Dual Source CT. MethodsWe collected the clinical data of patients who underwent coronary angiography of Dual Source CT between December 2010 and November 2012 in Sichuan Provincial People's Hospital and Sichuan Orthopedic Hospital. A total of 302 patients (74 with type 2 diabetes, and 228 with no diabetes) were examined with CT coronary angiography. All images were comprehensively assessed. Types of plaques and luminal narrowing were evaluated. ResultsPatients with type 2 diabetes had more plaques (P<0.05), especially mixed plaques and non-calcified plaques, than non-diabetic patients (P<0.05). The proportions of calcified plaque, mixed plaques, non-calcified plaque in patients with type 2 diabetes were 29.1%, 41.1%, 29.8%, respectively. The proportions of calcified plaque, mixed plaques, non-calcified plaque in patients with nondiabetic patients were 39.7%, 36.0%, 24.3%, respectively. The difference of the composition between diabetes and nondiabetic was significant (P<0.05). There were more mild, moderate and severe narrowing in type 2 diabetic patients than those in non-diabetic patients (P<0.05). ConclusionCoronary angiography of CT depicts a high plaque burden in patients with type 2 diabetes mellitus (mixed plaque is the most common type), which may cause stenosis easily.
Objective To discuss the diagnostic value of multidetector CT(MDCT) on encapsulated fat necrosis after operation of abdominal cancer, and to investigate the key differences of CT features between encapsulated fat necrosis and postoperative recurrence or metastasis. Methods CT data of 36 patients with encapsulated fat necrosis after operation of abdominal cancer, who received CT in our hospital between Feb. 2012 to May. 2014 during followed-up were retrospectively analyzed, for the purpose of summarizing the CT characteristics. In addition, the clinical presentation, level of carcinoembryonic antigen (CEA) and CA-125 before and after operation were also taken into account, to explore the difference between encapsulated fat necrosis with tumor recurrence and metastasis. Results Among the 36 patients who had suffered from encapsulated fat necrosis after operation of abdominal cancer, 3 patients (8.3%) had 2 lesions and the rest of 33 patients (91.7%) had solitary lesion(a total of 39 lesions). All lesions showed non homogeneous masses consistent with the surgery path and surrounded by fat density ring and soft tissue density capsule. The size of most lesions (94.8%, 37/39) decreased over time. All lesions were found slightly enhancement in portal phase. Five patients with postoperative tumor metastasis, 31 patients had no recurrence or metastasis. Among the 5 patients who had postoperative tumor metastasis at the same time, postoperative CEA was positive in 3 patients, and postoperative CA-125 was positive in 2 patient. Among the other 31 patients who had no recurrence or metastasis, the levels of postoperative CEA and CA-125 of 1 patient were unknown, and the postoperative CEA and CA-125 of 27 patients in the rest patients(90.0%, 27/30) were both negative. Most of them had no special clinical symptoms, only a few (1 patient)patient had mild abdominal pain without other associated symptoms. Conclusion CT is a valuable tool to reveal and diagnose encapsulated fat necrosis in postoperative abdominal cancer. Combined CT findings(such as location, shape, and density) with CEA, CA-125, and clinical presentation, that is easy to differ it from postoperative recurrence and metastasis.
Objective To conclude the CT manifestations and pathological features of low-grade appendiceal mucinous neoplasms. Methods We reviewed the clinical and CT findings of 24 patients with low-grade appendiceal mucinous neoplasms, who were confirmed by pathology within 1 month after CT examination in SichuanProvincial People’s Hospital from January 2018 to December 2020. The distribution, morphological characteristics, cyst wall and internal characteristics, CT value and enhancement characteristics of tumors were be detected in detail. Results ① Distribution: of the 24 patients, 22 patients located in the appendix area of the right lower quadrant, 2 patients located in the right middle abdomen, and 2 patients located in the pelvic cavity. ② Morphological characteristics: of the 24 patients, 15 patients manifested as tubular, 3 patients manifested as ellipsoidal, 5 patients manifested as saccular, and 1 patient manifested as irregular shape. The average length of tumors was about 6.4 cm (4.2–12.0 cm), and the average short diameter of tumors was about 2.2 cm (0.8–5.0 cm). The short diameter of 17 patients were more than 1.5 cm. ③ The cyst wall and internal characteristics: all the 24 patients demonstrated as cystic mass, 6 patients had evenly thin and smooth cyst wall, and other 18 patients had uneven cyst wall. Of all the patients,8 patients had arc-shaped, punctate or eggshell-like calcification. ④ The CT value and enhancement characteristics: 24 patients examined by plain CT scan, 22 patients showed uniform low density (the CT value were 7–25 HU), 2 patients contained some slightly high density, 16 patients examined by enhanced CT, the cyst wall, separation, or mural nodules of 8 patients were slightly or moderately enhanced. ⑤ Pathological results: of all the gross specimens, 15 patients showed tubular dilation, 9 patients showed partial or complete dilation as cystic mass. All the 24 patients had gelatinous or mucinous contents. Microscopically, all the patients showed low-grade mucinous epithelial hyperplasia, submucosa, and mucosal muscle atrophy, accompanied by fibrosis or calcification. Conclusion Low-grade appendiceal mucinous neoplasms show some specific CT manifestations, recognize these features can improve the accuracy of preoperative CT.