ObjectiveTo analyze the multidetector computed tomography (MDCT) findings of normal appendices and appendices of acute appendicitis in old patients, and to explore the clinical value of MDCT in assessing acute appendicitis in old patients. MethodsSixty-six cases of acute appendicitis confirmed by surgery in 24 hours after MDCT scan from Jun. to Oct. 2016 (acute appendicitis group), and 40 cases underwent MDCT scan for non-abdominal pain causes without appendiceal lesions from Sep. to Oct. 2016 (normal appendices group), were included, and the MDCT images of both 2 groups were retrospectively analyzed. Observation items included:location, diameter, mural thickness, intra-luminal contents, and changes of surrounding structures. Results① Rate of appendices visualization. In total of 95.5% (63/66) appendices were visualized on MDCT in acute appendicitis group, while 95.0% (38/40) appendices were visualized on MDCT in normal appendices group (P > 0.05). ② Locations of appendices. Acute appendicitis group:appendices were found to be located at pelvic cavity in 22 cases, in front of ileum in 2 cases, behind ileum in 10 cases, below cecum in 25 cases, and behind cecum in 4 cases. Normal appendices group:appendices were found to be located at pelvic cavity in 15 cases, in front of ileum in 3 cases, behind ileum in 7 cases, below cecum in 5 cases, and behind cecum in 8 cases. There was significant difference between 2 groups in terms of location of appendices (P < 0.05). The appendices in acute appendicitis group located mainly at pelvic cavity and below cecum, while the appendices in normal appendices group located mainly at pelvic cavity. ③ The diameter and thickness of appendices. The appendiceal diameter and thickness in acute appendicitis group were (11.4±4.2) mm (6.2-21.9) mm and (4.3±2.2) mm (1.1-8.6) mm, respectively, while those in normal appendices group were (6.1±1.4) mm (3.7-8.6) mm and (1.7±0.8) mm (0.5-3.2) mm, respectively. The diameter and thickness of appendices in acute appendicitis group were significantly greater than those in normal appendices group, respectively (P < 0.05). ④ Contents of appendices. Acute appendices group:there was effusion with air in 14 cases in appendiceal cavity, full of effusion in 36 cases, and appendicolith combined with effusion in 13 cases. Normal appendices group:there was full of air in 15 cases in appendiceal cavity, air with a little faeces of higher density in 13 cases, and nothing in 10 cases. Effusion was more common in appendiceal cavity in acute appendicitis group, while air was more common in normal appendices group. ⑤ Around appendices. Fat stranding was seen in 57 cases, adjacent parietal peritoneum thickening was seen in 56 cases, focal effusion was seen in 18 cases, abscess was seen in 2 cases, free air in peritoneal cavity was seen in 8 cases, and lymphadenopathy was seen in 35 cases. None of these imaging features were seen in normal appendices group. ConclusionsMDCT can demonstrate features of normal appendices and acute appendicitis in old patients. MDCT yield high diagnostic accuracy in acute appendicitis in old patients, and can provide useful information before surgery.
ObjectiveTo study the clinical and pathological characteristics and imaging manifestations of pulmonary mucosa associated lymphoid tissue (MALT) lymphoma.MethodsThe clinical and multidetector computed tomography (MDCT) imaging data of 17 patients with pathological proven pulmonary MALT lymphoma were reviewed retrospectively.ResultsThe MDCT manifestations were divided into 4 types: ① pneumonia/consolidation, ② mass/nodule type, ③ bronchovascular lymphatic type, ④ mixed type. The imaging features included air bronchiectasis in 13 cases and bronchiectasis in 9 cases. Multiple small pulmonary nodules were found in 11 cases, ground glass opacity in 9 cases, 4 cases of pleural effusion, pulmonary hilar and mediastinal lymph node enlargement in 3 cases. Among these 17 cases, 4 had extra-pulmonary involvement and 2 without obvious symptoms. The main clinical symptoms including cough, expectoration, dyspnea, fever, chest pain, hemoptysis, night sweats. The pathological manifestation is the infiltration of a large number of B lymphocytes and nuclear heterocells.ConclusionsThe clinical manifestations of pulmonary MALT lymphoma are not specific, but the progress is slow, and may be associated with autoimmune diseases. The main MDCT findings of pulmonary MALT lymphoma include consolidation, nodules or masses with air bronchogram. Lymph node enlargement is rare. Clinical diagnosis should also be based on pathological results.
ObjectiveTo explore the preoperative evaluation result of multidetector computed tomography (MDCT) in aortic stenosis (AS) patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR) in order to summarize relevant experience.MethodsA total of 33 consecutive AS patients who underwent TAVR in Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University from March 2016 to June 2020 were enrolled, and the preoperative evaluation characteristics of MDCT were compared between tricuspid aortic valve (TAV) and BAV.ResultsIn the 33 patients, whose mean age was (74±6) years, 22 were male and 11 were female, 17 were with BAV and 16 were with TAV. The medium (lower quartile, upper quartile) of calcification score was 360 (192, 1 034) mm3. There were 12 cases of artificial valve model to be speculated Downsize, including 9 calcific BAV cases (75%).ConclusionThe calcific BAV has a higher ratio of Downsize in the TAVR procedure.