Objective: To validate multi-slice three-dimensional spiral CT cholangiography (3-D CTC) in clinical di- agnosis of biliary diseases. Methods: This study included 146 patients with bili- ary diseases, involving 73 cas...Objective: To validate multi-slice three-dimensional spiral CT cholangiography (3-D CTC) in clinical di- agnosis of biliary diseases. Methods: This study included 146 patients with bili- ary diseases, involving 73 cases of biliary tumor, 87 cases of radioparent calculus, 12 cases of post cholan- gio-jejunostomy and one case of congenital choledo- chocyst. The data of thin-slice volumetric CT scan were sent to the workstation (GE Advantage Win- dows 3. 1). Rational 3-D CTC including maximum intensity projection, minimum intensity projection, surface shaded display, CT virtual endoscopy and ray sumption was performed. The diagnostic accura- cy of 3-D CTC was compared with that of conven- tional CT, ultrasonography and endoscopic retro- grade cholangiopancreaticography (ERCP). Results: Different biliary diseases showed distinct ima- ging manifestations on 3-D CTC, As a new technique for assessing the status of post cholangio-jejunosto- my, 3-D CTC was superior to conventional CT, ul- trasonography and ERCP in diagnosis of negative bil- iary calculus, extrahepatic cholangiocarcinoma, cancer embolus of the biliary duct, carcinoma of the pancreas head and periampullar carcinoma. It was also superior to conventional CT, ultrasonography or equal to ERCP in diagnosis of hilar cholangiocarcino- ma, but inferior to conventional CT and ultrasonog- raphy in diagnosis of gallbladder cancer. Conclusion: 3-D CTC as a non-invasive and sensitive technique for the diagnosis of biliary diseases with high diagnostic accuracy will greatly increase the de- tection rate of biliary diseases.展开更多
BACKGROUND Severe acute pancreatitis(SAP)is a common critical disease of the digestive system.In addition to the clinical manifestations and biochemical changes of acute pancreatitis,SAP is also accompanied by organ f...BACKGROUND Severe acute pancreatitis(SAP)is a common critical disease of the digestive system.In addition to the clinical manifestations and biochemical changes of acute pancreatitis,SAP is also accompanied by organ failure lasting more than 48 h.SAP is characterized by focal or extensive pancreatic necrosis,hemorrhage and obvious inflammation around the pancreas.The peripancreatic fat space,fascia,mesentery and adjacent organs are often involved.The common local complications include acute peripancreatic fluid collection,acute necrotic collection,pancreatic pseudocyst,walled off necrosis and infected pancreatic necrosis.After reviewing the literature,we found that in very few cases,SAP patients have complications with anterior abdominal wall abscesses.CASE SUMMARY We report a 66-year-old Asian male with severe acute pancreatitis who presented with intermittent abdominal pain and an increasing abdominal mass.The abscess spread from the retroperitoneum to the anterior abdominal wall and the right groin.In the described case,drainage tubes were placed in the retroperitoneal and anterior abdominal wall by percutaneous puncture.After a series of symptomatic supportive therapies,the patient was discharged from the hospital with a retroperi-toneal drainage tube after the toleration of oral feeding and the improvement of nutritional status.CONCLUSION We believe that patients with SAP complicated with anterior abdominal abscess can be treated conservatively to avoid unnecessary exploration or operation.展开更多
Objective: To analyze the pre- and post-contrast CT findings of liver focal nodular hyperplasia (FNH) so as to improve their diagnostic accuracy. Methods: Pre- and post-contrast tri-phase (arterial, portal venous and ...Objective: To analyze the pre- and post-contrast CT findings of liver focal nodular hyperplasia (FNH) so as to improve their diagnostic accuracy. Methods: Pre- and post-contrast tri-phase (arterial, portal venous and delayed) scans were performed in 21 patients with FNH proved surgically and patholo- gically. Transcatheter arterial angiography was per- formed in 2 patients. Results: Pre-contrast scans showed hypodensity in 16 patients, isodensity in 5, and punctate, streak and radial scars in 12. Except central scar, all lesions were markedly and homogeneously enhanced in the arterial phase. Nine of the 21 patients showed dilated and tortuous arteries in the central and peripheral areas of the focus. In the portal venous phase, focal density was decreased, though still higher or slightly higher in FNH than in parenchyma. In the delayed phase, the lesions showed isodensity or slight hypo- density. Enhanced capsules were seen in 3 patients. Dilated arteries and drainage veins were seen on an- giographic images. Conclusion: The characteristic manifestations of FNH on multiphasic helical CT scan are of great sig- nificance in diagnosing FNH and choosing viable therapy.展开更多
文摘Objective: To validate multi-slice three-dimensional spiral CT cholangiography (3-D CTC) in clinical di- agnosis of biliary diseases. Methods: This study included 146 patients with bili- ary diseases, involving 73 cases of biliary tumor, 87 cases of radioparent calculus, 12 cases of post cholan- gio-jejunostomy and one case of congenital choledo- chocyst. The data of thin-slice volumetric CT scan were sent to the workstation (GE Advantage Win- dows 3. 1). Rational 3-D CTC including maximum intensity projection, minimum intensity projection, surface shaded display, CT virtual endoscopy and ray sumption was performed. The diagnostic accura- cy of 3-D CTC was compared with that of conven- tional CT, ultrasonography and endoscopic retro- grade cholangiopancreaticography (ERCP). Results: Different biliary diseases showed distinct ima- ging manifestations on 3-D CTC, As a new technique for assessing the status of post cholangio-jejunosto- my, 3-D CTC was superior to conventional CT, ul- trasonography and ERCP in diagnosis of negative bil- iary calculus, extrahepatic cholangiocarcinoma, cancer embolus of the biliary duct, carcinoma of the pancreas head and periampullar carcinoma. It was also superior to conventional CT, ultrasonography or equal to ERCP in diagnosis of hilar cholangiocarcino- ma, but inferior to conventional CT and ultrasonog- raphy in diagnosis of gallbladder cancer. Conclusion: 3-D CTC as a non-invasive and sensitive technique for the diagnosis of biliary diseases with high diagnostic accuracy will greatly increase the de- tection rate of biliary diseases.
基金Supported by Beijing Municipal Science and Technology Commission,No.Z171100001017077Beijing Municipal Science and Technology Commission Clinical Diagnosis and Treatment Technology Research and Demonstration Application Project,No.Z191100006619038+1 种基金Capital Medical Development and Research Special Project,No.2020-1-2012Construction Project of Clinical Advanced subjects of Capital Medical University,No.1192070312.
文摘BACKGROUND Severe acute pancreatitis(SAP)is a common critical disease of the digestive system.In addition to the clinical manifestations and biochemical changes of acute pancreatitis,SAP is also accompanied by organ failure lasting more than 48 h.SAP is characterized by focal or extensive pancreatic necrosis,hemorrhage and obvious inflammation around the pancreas.The peripancreatic fat space,fascia,mesentery and adjacent organs are often involved.The common local complications include acute peripancreatic fluid collection,acute necrotic collection,pancreatic pseudocyst,walled off necrosis and infected pancreatic necrosis.After reviewing the literature,we found that in very few cases,SAP patients have complications with anterior abdominal wall abscesses.CASE SUMMARY We report a 66-year-old Asian male with severe acute pancreatitis who presented with intermittent abdominal pain and an increasing abdominal mass.The abscess spread from the retroperitoneum to the anterior abdominal wall and the right groin.In the described case,drainage tubes were placed in the retroperitoneal and anterior abdominal wall by percutaneous puncture.After a series of symptomatic supportive therapies,the patient was discharged from the hospital with a retroperi-toneal drainage tube after the toleration of oral feeding and the improvement of nutritional status.CONCLUSION We believe that patients with SAP complicated with anterior abdominal abscess can be treated conservatively to avoid unnecessary exploration or operation.
文摘Objective: To analyze the pre- and post-contrast CT findings of liver focal nodular hyperplasia (FNH) so as to improve their diagnostic accuracy. Methods: Pre- and post-contrast tri-phase (arterial, portal venous and delayed) scans were performed in 21 patients with FNH proved surgically and patholo- gically. Transcatheter arterial angiography was per- formed in 2 patients. Results: Pre-contrast scans showed hypodensity in 16 patients, isodensity in 5, and punctate, streak and radial scars in 12. Except central scar, all lesions were markedly and homogeneously enhanced in the arterial phase. Nine of the 21 patients showed dilated and tortuous arteries in the central and peripheral areas of the focus. In the portal venous phase, focal density was decreased, though still higher or slightly higher in FNH than in parenchyma. In the delayed phase, the lesions showed isodensity or slight hypo- density. Enhanced capsules were seen in 3 patients. Dilated arteries and drainage veins were seen on an- giographic images. Conclusion: The characteristic manifestations of FNH on multiphasic helical CT scan are of great sig- nificance in diagnosing FNH and choosing viable therapy.
