Multislice Spiral Computed Tomography Imaging Research Articles

Investigation of Relationship between Hemodynamic and Morphometric Characteristics of Aortas in Pediatric Patients.

Background: The utilization of hemodynamic parameters, whose estimation is often cumbersome, can fasten diagnostics and decision-making related to congenital heart diseases. The main goal of this study is to investigate the relationship between hemodynamic and morphometric features of the thoracic aorta and to construct corresponding predictive models. Methods: Multi-slice spiral computed tomography images of the aortas of patients with coarctation diagnoses and patients without cardiac or vascular diseases were evaluated to obtain numerical models of the aorta and branches of the aortic arch. Hemodynamic characteristics were estimated in key subdomains of the aorta and three branches using computational fluid dynamics methods. The key morphometric features (diameters) were calculated at locations in proximity to the domains, where hemodynamic characteristics are evaluated. Results: The functional dependencies for velocities and pressure on the corresponding diameters have been fitted, and a metamodel has been constructed employing the predicted values from these models. Conclusions: The metamodel demonstrated high accuracy in classifying aortas into their respective types, thereby confirming the adequacy of the predicted hemodynamic characteristics by morphometric characteristics. The proposed methodology is applicable to other heart diseases without fundamental changes.

Multi-slice spiral computed tomography diagnosis of juxta-papillary duodenal diverticulum and its relationship with biliopancreatic diseases.

Juxta-papillary duodenal diverticula (JPDD) are common but are usually asymptomatic, and they are often diagnosed by coincidence. To analyse the anatomy and classification of JPDD and its relationship with biliary and pancreatic disorders, and to explore the diagnostic value of multi-slice spiral computed tomography (MSCT) in patients with JPDD. The imaging data of patients with JPDD, which was obtained via abdominal computed tomography examination and confirmed via gastroscopy and/or upper gastrointestinal barium enema, in our hospital from 1 January 2019 to 31 December 2020 were retrospectively analysed. All patients were scanned using MSCT, and the imaging findings, classification and grading were analysed. A total of 119 duodenal diverticula were detected in 96 patients, including 73 single diverticula and 23 multiple diverticula. The imaging findings were mainly cystic lesions of the inner wall of the duodenum protruding to the outside of the cavity. The thin layer showed a narrow neck connected with the duodenal cavity, and the shape and size of the diverticula were different: 67 central-type cases and 29 peripheral-type cases. There were 50 cases of type I, 33 cases of type II, 19 cases of type III and six cases of type IV. Furthermore, there were seven small, 87 medium and 14 large diverticula. The differences in the location and size of the JPDD in MSCT grading were statistically significant (P< 0.05). The MSCT method has an important diagnostic value for the classification of JPDD, and MSCT images are helpful in the clinical evaluation of patients with JPDD and the selection of treatment options.

Retracted: Multi-Slice Spiral Computed Tomography Image Features under Hybrid Iterative Reconstruction Algorithm in Staging Diagnosis of Bladder Cancer.

[This retracts the article DOI: 10.1155/2021/7733654.].

Differentiation of localized pneumonic-type lung adenocarcinoma from localized pulmonary inflammatory lesion based on clinical data and multi-slice spiral computed tomography imaging features.

Localized pneumonic-type lung adenocarcinoma (L-PLADC) is a special type of lung adenocarcinoma, which mimicking localized pulmonary inflammatory lesion (L-PIL), and many delayed diagnoses of L-PLADC have been identified due to insufficient clinical understanding or the lack of knowledge regarding the radiological findings. Multi-slice spiral computed tomography (MSCT) not only observes the fine structure of the lesion clearly, but also can evaluate the lesion and its surrounding tissues more intuitively, stereoscopically, and accurately using a variety of reconstruction techniques. The present study aimed to investigate the diagnostic value of clinical data and MSCT imaging features in differentiating L-PLADC from L-PIL. The clinical data and chest MSCT imaging features of 71 patients with L-PLADC and 70 patients with L-PIL were retrospectively analyzed. Seventy-one patients with L-PLADC underwent surgical resection or puncture and were confirmed as having invasive adenocarcinoma by pathology. Seventy patients with L-PIL were confirmed by clinical anti-inflammatory treatment or by puncture and surgery. The Chi-square and Mann-Whitney U tests were used to analyze the clinical data and MSCT imaging features of the included patients. Variables with P<0.05 in the univariate analysis were included in the multivariate logistic regression analysis to determine the independent risk factors for the diagnosis of L-PLADC. The clinical data analysis showed that multivariate logistic regression analysis showed that irregular air bronchogram [odds ratio (OR) =15.946; P<0.001], ground-glass opacity (GGO) component (OR =12.369; P<0.001), pleural traction (OR =10.982; P<0.001), necrosis (OR =0.078; P<0.001), adjacent bronchial wall thickening (OR =0.017; P<0.001), pleural thickening (OR =0.074; P<0.001), and respiratory symptoms were independent risk factors for the diagnosis of L-PLADC [OR =0.117; the area under the curve (AUC), sensitivity, specificity, and accuracy values were 0.989, 97.2%, 94.3%, and 95.7%, respectively]. L-PLADC and L-PIL exhibit different clinical and MSCT imaging features. Determining these characteristics is conducive to the early diagnosis and clinical treatment of L-PLADC.

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps, and gastric stromal tumor risk stratification assessment.

BACKGROUNDThe biological characteristics of gastric stromal tumors are complex, and their incidence has increased in recent years. Gastric stromal tumors (GST) have potential malignant tendencies, and the probability of transformation into malignant tumors is as high as 20%-30%.AIMTo investigate the value of multi-slice spiral computed tomography (MSCT) in the differential diagnosis of GST and benign gastric polyps, and GST risk stratification assessment.METHODSWe included 64 patients with GST (GST group) and 60 with benign gastric polyps (control group), confirmed by pathological examination after surgery in PLA General Hospital, from January 2016 to June 2021. The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared. According to the National Institutes of Health’s standard, GST is divided into low- and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTSThe incidences of extraluminal growth, blurred boundaries, and ulceration in the GST group were significantly higher than those in the control group (P < 0.05). The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group (P < 0.05). The MSCT differential diagnosis of GST and gastric polyp sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, and areas under the curve (AUCs) were 73.44 %, 83.33%, 26.56%, 16.67%, 0.784, respectively. The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value, with a statistical difference. The results showed that the sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%, 62.20%, 19.82%, 37.80%, and 0.710, respectively. The sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%, 60.40%, 32.37%, 39.60%, and 0.710, respectively. The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group (P < 0.05). The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group (P < 0.05).CONCLUSIONPresurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.

Application Value of MRI Combined with MSCT in Diagnosis and Staging of Colon Carcinoma.

Objective To clarify the application value of magnetic resonance imaging (MRI) combined with multislice spiral computed tomography (MSCT) in the diagnosis and staging of colon carcinoma (CC). Methods A total of 103 patients with histopathologically diagnosed CC were enrolled. Patient clinical and imaging data were collected, and MRI and MSCT images were analyzed to assess the accuracy of MRI, MSCT, and their combination in diagnosing tumor (T) staging of CC. Results Among the 103 cases of histopathologically diagnosed CC, 26 cases (25.24) were in stage T1-2, 72 cases (69.90) were in stage T3, and 5 cases (4.85) were in stage T4. The accuracy of MRI in diagnosing stage T1-2, T3, and T4 was 80.77%, 88.89%, and 60.00%, respectively, with an average of 76.55%. The accuracy rates of MSCT in diagnosing T1-2, T3, and T4 stages were 73.08%, 90.27%, and 60.00%, respectively, with an average of 74.45%. The accuracy rates of MRI+MSCT in diagnosing T1-2, T3, and T4 were 88.46%, 95.83%, and 80.00%, respectively, with an average of 88.10%. Conclusions Compared with single use of MRI or MSCT, MRI+MSCT provides accurate imaging data with higher accuracy, which is more helpful for the T-staging evaluation of CC.

Diagnosis of Liver Cirrhosis and Liver Fibrosis by Artificial Intelligence Algorithm-Based Multislice Spiral Computed Tomography.

This research was aimed at investigating the artificial intelligence (AI) segmentation algorithm-based multislice spiral computed tomography (MSCT) in the diagnosis of liver cirrhosis and liver fibrosis. Besides, it was aimed at providing new methods for the diagnosis of liver cirrhosis and liver fibrosis. All patients were divided into the control group, mild liver fibrosis group, and significant liver fibrosis group. A total of 112 patients were included, with 40 cases in the mild liver fibrosis group, 48 cases in the significant liver fibrosis group, and 24 cases who underwent computed tomography (CT) examination in the control group. In the research, deconvolution algorithm of AI segmentation algorithm was adopted to process the images. The average hepatic arterial fraction (HAF) values of patients in the control group, mild liver fibrosis group, and severe liver fibrosis group were 17.59 ± 10.03%, 18.23 ± 5.57%, and 20.98 ± 6.63%, respectively. The average MTT values of patients in the control group, mild liver fibrosis group, and severe liver fibrosis group were 12.69 ± 1.78S, 12.53 ± 2.05S, and 12.04 ± 1.57S, respectively. The average blood flow (BF) values of patients in the control group, mild liver fibrosis group, and severe liver fibrosis group were 105.68 ± 15.57 mL 100 g−1·min−1, 116.07 ± 16.5 mL·100 g−1·min−1, and 110.39 ± 16.32 mL·100 g−1·min−1, respectively. Besides, the average blood volume (BV) values of patients in the control group, mild liver fibrosis group, and significant liver fibrosis group were 15.69 ± 4.35 mL·log−1, 16.97 ± 2.68 mL·log−1, and 16.11 ± 4.87 mL·100 g−1, respectively. According to statistics, the differences among the average HAF, MTT, BF, and BV values showed no statistical meaning. AI segmentation algorithm-based MSCT imaging could promote the diagnosis of liver cirrhosis and liver fibrosis effectively and offer new methods to clinical diagnosis of liver cirrhosis and liver fibrosis.

Multi-Slice Spiral Computed Tomography Image Features under Hybrid Iterative Reconstruction Algorithm in Staging Diagnosis of Bladder Cancer.

Objective This study was aimed to explore the accuracy of multi-slice spiral computed tomography (CT) scan in preoperative staging diagnosis of bladder cancer based on hybrid iterative reconstruction algorithm, so as to provide a more reasonable supporting basis for guiding clinical work in the future. Methods Retrospectively, 120 patients admitted to hospital from July 2019 to April 2021, who were confirmed to be with urothelial carcinoma of the bladder by pathological examination after surgical treatment, were selected. CT images before processing were set as the control group and those after processing were set as the observation group according to whether they were processed by the hybrid iterative algorithm. Postoperative pathological examination was utilized as the standard for analysis. The accuracy and consistency of the two methods were compared. Results The accuracy of the results of each stage of the observation group (T1 stage: 91.09%, T2 stage: 89.66%, T3 stage: 88.89%, and T4 stage: 88.89%) and consistency (T1 stage: 0.66, T2 stage: 0.69, T3 stage: 0.71, and T4 stage: 0.82) were higher than those of the control group (accuracy: T1—57.01%, T2—48.28%, T3—44.44%, and T4—44.44%). The consistency was as follows: T1—0.32, T2—0.24, T3—0.37, and T4—0.43, and the comparison was statistically significant (P < 0.05). Conclusion The adoption value of the image features based on the hybrid iterative reconstruction algorithm in the diagnosis of bladder cancer staging was higher than that of the conventional multi-slice spiral CT, indicating that the hybrid iterative reconstruction algorithm had a good adoption prospect in clinical examination.

Is Panoramic Radiography Really a Key Examination before Chemo-Radiotherapy Treatment for Oropharyngeal Cancer?

Aim: To evaluate the diagnostic accuracy of panoramic radiography (PAN) for the identification of infectious foci of the tooth and periradicular bone before definitive chemo-radiotherapy treatment for oropharyngeal cancer, using multislice spiral computed tomography (MSCT) imaging as the reference standard. Materials and methods: 50 patients with oropharyngeal cancer who had performed both pre-treatment MSCT and PAN were retrospectively evaluated. Pre-radiotherapy MSCT showed 65 deep caries, 37 root remnants, 143 stage III periodontal diseases, and 77 apical periodontitis, for a total of 322 infectious foci. The same number of healthy teeth (control group) was selected via MSCT to be analysed by PAN. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for PAN images with respect to MSCT imaging were examined. Results: PAN showed sensitivity, negative predictive value, and diagnostic accuracy of 100% for deep caries, root remnants, and stage III periodontal disease, whereas there were 46.8%, 64.7%, and 72.1% apical periodontitis respectively. Conclusions: PAN did not show great diagnostic accuracy in the assessment of apical periodontitis, and therefore maxillofacial MSCT carried out before chemo-radiotherapy treatment should always be examined to identify dental and jaw diseases. Deep caries, root remnants, and stage III periodontal disease were perfectly detected on PAN.

Predictive value of computed tomography with coronal reconstruction in right hemicolectomy with complete mesocolic excision for right colon cancers: a retrospective study

BackgroundUnderstanding the vascular anatomy is critical for performing central vascular ligation (CVL) in right hemicolectomy with complete mesocolic excision (CME). This study aimed to investigate the predictive value of multi-slice spiral computed tomography (MSCT) with coronal reconstruction in right hemicolectomy with CME.MethodsThis is a retrospective descriptive study. Eighty patients with right colon cancer who underwent right hemicolectomy from December 2015 to January 2020 were included. The intraoperative reports (including imaging data) and MSCT images with coronal reconstruction were analysed and compared. The detection rates of the ileocolic vein (ICV) and ileocolic artery (ICA) roots and the accuracy in predicting their anatomical relationship were analysed. The detection rate and accuracy in predicting the location of the gastrocolic trunk of Henle (GTH), middle colic artery (MCA) and middle colic vein (MCV) were analysed. The distance from the ICV root to the GTH root (ICV-GTH distance) was measured and analysed. The maximum distance from the left side of the superior mesenteric artery (SMA) to the right side of the superior mesenteric vein (SMV), named the ‘lsSMA-rsSMV distance’, was also measured and analysed.ResultsIn seventy-four (92.5%) patients, both the ICV and ICA roots were located; their anatomical relationship was determined by MSCT, and the accuracy of the prediction was 97.2% (72/74). The GTH was located by MSCT in 75 (93.7%) patients, and the accuracy of the prediction was 97.33% (73/75). The MCA was located by MSCT in 47 (58.75%) patients, and the accuracy was 78.72% (37/47). The MCV was located by MSCT in 51 (63.75%) patients, and the accuracy of the prediction was 84.31% (43/51). The ICV-GTH distance was measured in 73 (91.2%) patients, and the mean distance was 4.28 ± 2.5 cm. The lsSMA-rsSMV distance was measured in 76 (95%) patients, and the mean distance was 2.21 ± 0.6 cm.ConclusionsWith its satisfactory accuracy in predicting and visualising the information of key anatomical sites, MSCT with coronary reconstruction has some predictive value in CME with CVL in right hemicolectomy.

Developing and verifying automatic detection of active pulmonary tuberculosis from multi-slice spiral CT images based on deep learning

Diagnosis of tuberculosis (TB) in multi-slice spiral computed tomography (CT) images is a difficult task in many TB prevalent locations in which experienced radiologists are lacking. To address this difficulty, we develop an automated detection system based on artificial intelligence (AI) in this study to simplify the diagnostic process of active tuberculosis (ATB) and improve the diagnostic accuracy using CT images. A CT image dataset of 846 patients is retrospectively collected from a large teaching hospital. The gold standard for ATB patients is sputum smear, and the gold standard for normal and pneumonia patients is the CT report result. The dataset is divided into independent training and testing data subsets. The training data contains 337 ATB, 110 pneumonia, and 120 normal cases, while the testing data contains 139 ATB, 40 pneumonia, and 100 normal cases, respectively. A U-Net deep learning algorithm was applied for automatic detection and segmentation of ATB lesions. Image processing methods are then applied to CT layers diagnosed as ATB lesions by U-Net, which can detect potentially misdiagnosed layers, and can turn 2D ATB lesions into 3D lesions based on consecutive U-Net annotations. Finally, independent test data is used to evaluate the performance of the developed AI tool. For an independent test, the AI tool yields an AUC value of 0.980. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value are 0.968, 0.964, 0.971, 0.971, and 0.964, respectively, which shows that the AI tool performs well for detection of ATB and differential diagnosis of non-ATB (i.e. pneumonia and normal cases). An AI tool for automatic detection of ATB in chest CT is successfully developed in this study. The AI tool can accurately detect ATB patients, and distinguish between ATB and non- ATB cases, which simplifies the diagnosis process and lays a solid foundation for the next step of AI in CT diagnosis of ATB in clinical application.

Multislice spiral computed tomography imaging in evaluating hemophilic arthropathy.

BackgroundCertain hemophilia patients are unable to cooperate with or afford magnetic resonance imaging (MRI) examinations. The purpose of our study was to explore the value of multislice spiral computed tomography (MSCT) in evaluating hemophilic arthropathy (HA).MethodsThirty-eight patients with 73 joints of HA were consecutively selected from January 2016 to May 2018 for this prospective study. All 73 joints were examined by X-ray, CT, and MRI within 2 days. The MRI scores of the joints were determined by the International Prophylaxis Study Group (IPSG) standard. The CT findings were quantified according to the IPSG standard, except for cartilage injury, which was quantified by joint space narrowing using the X-ray Pettersson score. The CT and MRI scores were compared by the paired Wilcoxon signed-rank test. The correlations between the CT score of joint space narrowing and MRI score of cartilage injury and the total CT and MRI scores were analyzed by Spearman rank correlation. The kappa test was used to compare the consistency of CT and MRI scores.ResultsMRI was superior to CT based on the scores for small amount of effusion (P < 0.05), synovial hypertrophy and hemosiderin deposition in the mild groups (P < 0.05). The CT and MRI scores were not significantly different for moderate and massive effusion, synovial hypertrophy, and hemosiderin deposition in the moderate and severe groups, bone erosion or cystic changes (P > 0.05), and there was a high degree of consistency between the two scores (kappa > 0.81). The consistency between the Pettersson scores of joint space narrowing on CT and the IPSG scores of cartilage injury on MRI was high (kappa = 0. 774, P < 0.05).ConclusionThe image scores of MSCT are generally consistent with MRI except for mild synovitis, which can be used as an alternative for the evaluation of HA.

Evaluation of multi‐slice spiral computed tomography application in the diagnosis of arterial root lesions

AbstractThe purpose of this study was to investigate the value of multi‐slice spiral computed tomography (MSCT) enhanced scanning and postprocessing techniques in the diagnosis of arterial root lesions (ARL) in order to improve the understanding and diagnostic accuracy of ARL. We retrospectively analyzed the MSCT imaging findings of 1546 patients. MSCT parameters included the aortic valve annulus level, sinuses of Valsalva level, a sinotubular junction level, ascending aorta, effective diameter, aortic wall thickness, coronary artery height, and coronary sinus depth. The specific measurement method used was curved planar reformation. MSCT found 93 cases of aortic valve disease (AVD). The diagnostic accuracy of MSCT for AVD was 91.7% (33/36). MSCT found 95 cases of acute aortic syndrome involving the aortic root, 71 of which were Stanford type A‐aortic dissection (AD), 22 cases of Stanford type A‐interstitial hematoma (IHM), and two cases of penetrating aortic ulcers (PAU). MSCT diagnosed Stanford type A‐AD, Stanford type A‐IHM, and PAU had a specificity of 99.8% and a sensitivity of 98.9%. In conclusion, MSCT enhanced scanning and postprocessing techniques can accurately display the aortic root and adjacent structures, with clear positioning and high diagnostic accuracy, which can provide important basis for clinical diagnosis, preoperative localization, and postoperative follow‐up.

Value of three-dimensional multi-slice spiral computed tomography imaging in the diagnosis and activity evaluation of Crohn's disease

Objective To evaluate the diagnostic value of three-dimensional multi-slice spiral computed tomography (CT) imaging in Crohn's disease(CD) of small intestine and its active and remission stages. Methods The clinical and CT data of 34 patients with Crohn's disease confirmed by digestive endoscopy were retrospectively analyzed. According to whether the lesions were active, the patients were divided into active group (25 cases) and remission group (9 cases). The difference of CT signs between the two groups was compared. Chi square test was used to evaluate the diagnostic efficiency of CT three-dimensional imaging for polyps and their activity evaluation of Crohn's disease. Results The incidences of intestinal wall stratification, moderate enhancement, severe enhancement, ulcer, cellulitis, lymph node enlargement and wood comb sign in active group were higher than those in remission group (χ2=20.193, 9.018, 4.986, 3.947, 9.551, 4.986, 6.766, 4.986 respectively, P 0.05). Conclusions Spiral CT three-dimensional reconstruction imaging can show the intestinal wall thickening, intestinal lesions and parenteral complications of Crohn's disease comprehensively, carefully and intuitively, and play an important role in guiding clinical treatment by evaluating the active and remission stages of CD. Key words: Crohn disease; Tomography, spiral computed; Imaging, three-dimensional

The diagnostic value of multi-slice spiral computed tomography in patients with renal carcinoma.

This study was aimed to investigate the characteristics of multi-slice spiral computed tomography (CT) image in kidney cancer patients and its clinical value in staging diagnosis of kidney cancer. This study included 57 patients who were confirmed as kidney cancer through postoperative pathological examination; they were diagnosed within February 2014 and December 2016 in our hospital. The data obtained from multi-slice spiral CT plain scan and contrast-enhanced CT of these patients was retrospectively analyzed. Moreover, we determined the characteristics of multi-slice spiral CT image for kidney cancer and analyzed their consistency with pathological staging. CT plain scan showed that kidney lumps were mostly found in the prominent renal contour or renal parenchyma, and they were round-like or round in shape. Among the 57 included patients, the tumors of 43 cases showed regular edges, and 14 showed irregular edges. Among the 14 cases, 10 patients had tumors with lobulated edges and 5 with spinous tumor edge. Among all the 57 patients, CT plain scan showed there were 5 cases with slightly higher density, 24 cases with mixed density, 28 cases with equal density or slightly lower density. The range of tumor diameter was 2.1-12.6 cm; the tumor diameter was smaller than 3 cm in 11 cases, 3-7 cm in 34 cases, and larger than 7 cm in 12 cases. In terms of contrast enhancement, the arterial phase was obviously enhanced in 31 cases, moderately and irregularly enhanced in 18 cases, and slightly enhanced in 8 cases. Moreover, the renal parenchymal scan showed a rapid decline in the enhancement and a further decline in the enhancement of renal pelvic tumor; the three stages of enhancement could be expressed in terms of fast forwardness and fast backwardness. A total of 33, 4, 9, and 11 cases were classified as postoperative pathological Stage I, II, III, and IV, respectively; 35, 5, 7, and 10 cases were classified as CT scan Stage I, II, III, and IV, respectively; and 34, 5, 8, and 10 cases were classified as contrast-enhanced CT scan Stage I, II, III, and IV, respectively. No significant difference was observed in the frequency of CT scan, the enhanced stage and pathological stage (P > 0.05). CT image of kidney cancer revealed the morphological and enhanced features of this tumor. The consistency between CT stage and pathological stage was high; thus, this method can be applied as a forecasting method for pathological staging.

Accuracy of Multi-Slice Spiral Computed Tomography for Preoperative Tumor Node Metastasis (TNM) Staging of Colorectal Carcinoma.

BackgroundWith the advances in imaging technologies, multi-slice spiral computed tomography (MSCT) has demonstrated superiority in the diagnosis and staging of colorectal carcinoma. In the current study, preoperative TNM staging of colorectal carcinoma by using MSCT was conducted and compared with the corresponding postoperative pathological examination findings, in order to evaluate the accuracy of preoperative MSCT for TNM staging.Material/MethodsCombinations of biphasic or triphasic enhanced-phase MSCT scans were obtained for 76 patients with colorectal carcinoma, and the TNM stage was determined based on imaging reconstruction from various angles and perspectives to display the size, location, and affected range of tumors. The preoperative TNM stage was compared with the postoperative pathological stage, and the consistency between the 2 methods was tested by the κ test using SPSS 17.0 software.ResultsAmong the different combinations of enhanced-phase MSCT scanning, triphasic MSCT imaging, comprising the arterial, portal venous, and delayed phases, showed the highest accuracy rates, at 81.6% (62/76), 82.89% (63/76), and 96.1% (73/76) for T, N, and M staging, respectively, with κ values of 0.72, 0.65, and 0.56, respectively, indicating consistency with the postoperative pathological staging.ConclusionsCombined MSCT scanning comprising the arterial phase, portal venous phase, and delayed phase showed satisfying consistency with the postoperative pathological analysis results for TNM staging of colorectal carcinoma. Thus, MSCT is an important clinical value for improving the accuracy of TNM staging and for planning the appropriate colorectal cancer treatment.

Value of multi-slice spiral CT in preoperative diagnosis of pancreatic cancer

Objective: To analyze the diagnostic value of multi-slice spiral computed tomography (MSCT) in preoperative tumor staging, lymphatic metastasis, vascular invasion and perineural invasion. Methods: From January 2013 to December 2015, MSCT images of 87 patients from the Second Hospital of Harbin Medical University who were examined by contrast-enhanced MSCT and diagnosed as pancreatic cancer by surgical pathology within 2 weeks were collected.MSCT images were retrospectively analyzed to evaluate the tumor staging, lymphatic metastasis, vascular invasion and perineural invasion and then compared with surgical pathology.Kappa test and receiver operation characteristic (ROC) curve were used to evaluate the diagnostic value of MSCT in pancreatic cancer. Results: The overall accuracy of MSCT in T staging of pancreatic cancer was 85.1% (kappa =0.67, P<0.01); the accuracy of T1, T2, T3 and T4 staging were 75.0%, 57.1%, 95.0% and 66.7%; the sensitivity were 75.0%, 80.0%, 87.7% and 75.0%; the specificity were 98.8%, 92.2%, 86.4% and 96.2%; the positive predictive value (PPV) were 75.0%, 57.1%, 95.0% and 66.7%; the negative predictive value (NPV) were 98.8%, 97.3%, 70.4% and 97.4%.The accuracy, sensitivity, specificity, PPV and NPV of MSCT in diagnosing lymphatic metastasis were 62.1%, 62.3%, 61.5%, 79.2% and 41.0%.The accuracy, sensitivity, specificity, PPV and NPV of MSCT in diagnosing vascular invasion were 94.3%, 78.6%, 97.3%, 84.6% and 95.9%.The accuracy, sensitivity, specificity, PPV and NPV of MSCT in diagnosing MSCT perineural invasion were 80.5%, 81.1%, 76.9%, 95.2% and 41.7%.The area under curve (AUC) was 0.79(95%CI 0.68-0.90, P=0.001). Conclusion: Contrast-enhanced MSCT plays important roles in evaluation of preoperative tumor staging, vascular invasion and perineural invasion of pancreatic cancer while it has little value on diagnosis of lymphatic metastasis.

Virtual facial reconstruction based on accurate registration and fusion of 3D facial and MSCT scans.

Accurate registration and feasible fusion of a three-dimensional (3D) photorealistic surface images (captured using the FaceSCAN3D® Scientific Photo Lab) from multislice spiral computed tomography (MSCT) images is important to achieve optimal craniomaxillofacial surgery outcomes; thus, the aim of this work was to optimize this process. MSCT and 3D facial scans were acquired from 37 randomly selected patients. Using the Invesalius software package, skin and bone tissue models were reconstructed. The 3D photorealistic surface images were then constructed. Four image registration processes were performed using Geomagic Studio software: manual Procrustes and semi-automatic registration (global modified ICP) using both 7 and 15 anthropometric landmarks. The statistical differences were assessed using one-way ANOVA and LSD tests. P values <0.05 were considered significant. Average distances between these two surfaces measured 0.99 (SD 0.13 mm), 0.77 (SD 0.11 mm), 0.99 (SD 0.15 mm), and 0.77 mm (SD 0.10 mm) via the four image registration methods. Statistical differences were observed between the manual and semi-automatic registration groups (according to 7 and 15 anthropometric landmarks, respectively). Image registration errors for the entire virtual face were <0.8 mm in the semi-automatic registration groups. Employing the Procrustes registration system using seven anthropometric landmarks together with global registration allows accurate registration and feasible fusion of 3D facial scans with reconstructed 3D MSCT image data.

Morphological relationship analysis of impacted maxillary canines and the adjacent teeth on 3-dimensional reconstructed CT images.

To examine whether there is a relationship between maxillary canine impaction and the morphologic characteristics of the maxillary dentition, especially the root of the lateral incisor. In this study, we selected only patients with unilateral maxillary canine impaction to compare the morphologic characteristics of the dentition on the impaction side and the clinically normal eruption side. The sample size was decided to be 40 based on the pilot study. To minimize bias depending on sex and location of the maxillary canine impaction, we selected equal numbers (20) of boys and girls, and equal cases (20) of buccal impaction and palatal impaction. Under the aforementioned conditions, the mean age was 13.5 ± 2.3 years. The multislice spiral computed tomography images of these 40 subjects were converted into three-dimensional (3D) reconstructed images using the OnDemand 3D program (Cybermed Co, Seoul, Korea). Then we measured the morphologic characteristics of the individual teeth on the obtained 3D teeth images. Length and volume of the maxillary lateral incisor's roots were significantly smaller on the impaction side compared with the normal eruption side (P = 0.001 and P = 0.006, respectively). The width and volume of the canine's crown were significantly greater on the impaction side compared with the normal eruption side (P = 0.020 and P < .0001, respectively). These results might help to prove the hypothesis that the smaller-sized lateral incisor roots and greater-sized canine crowns are the influential etiologic factors in maxillary canine impaction.

Cone beam computed tomography-based models versus multislice spiral computed tomography-based models for assessing condylar morphology

To quantitatively compare condylar morphology using cone beam computed tomography (CBCT) and multislice spiral computed tomography (MSCT) virtual three-dimensional surface models. The sample consisted of secondary data analyses of CBCT and MSCT scans obtained for clinical purposes from 74 patients treated with condylar resection and prosthetic joint replacement. Three-dimensional surface models of 146 condyles were constructed from each scan modality. Across-subject models were approximated and voxel-based registration was performed between homologous CBCT and MSCT images, making it possible to create average CBCT- and MSCT-based condylar models. SPHARM-PDM software provided matching points on each corresponding model. ShapeAnalysisMANCOVA software assessed statistically significant differences between observers and imaging modalities. One-sample t-tests evaluated the null hypothesis that the mean differences between each CBCT- and MSCT-based model were not clinically significant (<.5 mm). Tests were conducted at a significance level of P < .05. ShapeAnalysisMANCOVA showed no statistically significant difference between the average CBCT- and MSCT-based models (P > .68). During pairwise comparison, the mean difference observed was .406 mm (SD, .173). One sample t-test showed that mean differences between each set of paired CBCT- and MSCT-based models were not clinically significant (P = .411). Three-dimensional surface models constructed from CBCT images are comparable to those derived from MSCT scans and may be considered reliable tools for assessing condylar morphology.