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CT Perfusion Imaging Principles, Techniques and Applications in Abdominal Imaging

Objective To review the principles and techniques of CT perfusion imaging and its applications in the imaging diagnosis of abdominal disorders. Methods All the relevant literatures were reviewed. The principles and techniques of CT perfusion imaging were described and summarized in detail. The functional information of a target abdominal organ (e.g. the liver and pancreas) revealed by CT perfusion imaging, such as hemodynamics and microcirculation status, was also evaluated. Results In addition to the morphologic information, CT perfusion imaging can also provide functional information about the circulation parameters of target abdominal organs. Moreover, such functional information can be generated for the neovasculature and microcirculation of tumor lesions of abdominal organs, which is very helpful for not only the diagnosis, but also the evaluation of tumor invasiveness and response to treatment. Conclusion CT perfusion imaging offers an effective method for studying abdominal disorders by providing functional information that is quite useful for the differential diagnosis and assessment of therapeutic response.

肝移植術后肝動脈假性動脈瘤破裂1例報道

CT Appearances of Mesenteric Tumors and the Differential Diagnosis

Objective To review the CT appearances and important differential diagnoses of various primary and secondary mesenteric neoplasms. Methods By describing the mesenteric anatiomy and major routes for the dissemination of metastatic mesenteric tumors, the article presents both the common and rare types of various primary and secondary mesenteric neoplasms, and addresses the characteristic CT appearances and important aspects of the differential diagnosis. Results CT study, especially the multislice spiral CT (MSCT), along with the clinical history and other related information, can nicely depict various mesenteric tumors and well differentiate them from infectious, inflammatory or vascular processes affecting the mesentery. Conclusion CT is the imaging method of choice for the evaluation of tumors of small bowel mesentery.

Imaging Evaluation of Complications of Orthotopic Liver Transplantation

Objective To introduce the imaging modalities used for the evaluation of postoperative complications of orthotopic liver transplantation (OLT) and to present the imaging findings of these complications. Methods The literatures related to the imaging methods and imaging manifestations of OLT complications were reviewed. Results Ultrasound was the initial imaging technique used for the detection of complications in the early postoperative period. Spiral CT and MRI yielded more accurate and comprehensive evaluation of postoperative complications in later stage. So far, there had been no specific imaging findings to suggest rejection reaction. The spectrum of imaging manifestations of OLT complications, such as vascular complications, biliary complications, liver parenchymal complications, and so on, were summarized and illustrated. Conclusion Imaging examination (especially ultrasound, spiral CT and MRI ) plays an important role in the evaluation of postoperative complications of OLT.

人工智能在影像學的發展、現狀及展望

Multimodal imaging study on localization and qualitative diagnosis of biliary obstruction

ObjectiveTo evaluate the diagnostic value of CT, MRI, and magnetic resonance cholangiopancreatography (MRCP) in the localization and qualitative diagnosis of biliary obstruction.MethodsA total of 80 patients with biliary obstruction in our hospital from January 2018 to June 2020 were retrospectively collected. The patients were all examined by CT, MRI, and MRCP. The imaging images of all patients were interpreted by two radiologists with more than 5 years of working experience. Taking the results of operation and histopathology as the gold standard, the diagnostic value of CT, MRI+MRCP, CT+MRI+MRCP in the localization and qualitative diagnosis of biliary obstruction lesions were evaluated.ResultsCompared with the location results of surgery and histopathology, the coincidence rates of CT+MRI+MRCP and MRI+MRCP were higher than that of CT (P<0.05), but there was no significant difference between CT+MRI+MRCP and MRI+MRCP (P>0.05); compared with the benign and malignant results of surgery and histopathology, the coincidence rates of CT, CT+MRI+MRCP and MRI+MRCP were close, and there was no statistical significance among them (P>0.05).ConclusionsMRI+MRCP and CT+MRI+MRCP have the same value in the localization and qualitative diagnosis of biliary obstruction. However, MRI+MRCP have the advantages ofnon-radiation or contrast media, it is more suitable for patients who are worried about the impact of radiation, have contrast media allergy or renal insufficiency.

Relationship Between the Abdominal Imaging and Abdominal Surgery

醫學影像學是臨床醫學科學中發展較快的學科之一。為了將影像檢查技術合理、高效、及時地應用于臨床，為患者服務，需要影像醫師與臨床醫師的密切合作。在具有一定學術地位和雄厚技術力量的本院放射科的鼎力支持與合作下，本刊自2003年第1期起增設“腹部影像”專欄，旨在為腹部外科醫師和腹部影像醫師搭建起一個學術交流的橋梁，促進相互了解、認識、滲透與合作，使腹部外科醫師能及時了解到影像學檢查手段的進展和影像醫學的發展，又能使影像醫師了解到腹部外科醫師對影像檢查的具體要求，從而一方面使影像學檢查技術更好地為腹部外科服務，另一方面又使腹部外科促進影像學檢查的合理化和提高影像診斷水平。基于這一宗旨，本欄目將著重推出一些具有特色、圖文并茂的綜述性文章，作為讓腹部外科醫師了解腹部影像學現狀與進展的的窗口。同時，我們也將選登一些與腹部外科密切相關、臨床實用性比較強的腹部影像學方面的原著介紹給腹部外科醫師。此外，有關影像學檢查的新技術、新方法以及它們在腹部疾病診治中的臨床應用的短篇文章或報道也將是我們選稿的重點。我們殷切希望，本刊增設的這一新欄目能夠得到外科醫師和影像醫師的認可和支持，并讓大家從中獲得有用的信息。我們相信，在主編、各位編委和雜志編輯部的共同努力下，特別是有廣大讀者的支持和鼓勵，背靠華西放射的雄厚技術力量，我們有信心把腹部影像專欄辦好，實現它的宗旨，更好地為臨床工作服務。

Imaging Evaluation of Portosystemic Collateral Vessels of Liver Cirrhosis by MultiDetector Row Spiral CT Portal Venography

ObjectiveTo introduce the technique of threedimensional portal venography of multidetector row spiral CT and its clinical application in the evaluation of the portosystemic collateral shunts of liver cirrhosis. MethodsAll relevant literatures were retrospectively reviewed on the application of twodimensional and threedimensional reconstruction techniques such as MIP, SSD, VRT of multidetector row spiral CT to demonstrate the collateral vessels of liver cirrhosis.ResultsThe distribution, pathway and anatomy of portosystemic collateral vessels were well shown by multidetector row spiral CT portal venography. Conclusion Multidetector row spiral CT portal venography provides excellent depiction of the anatomic characteristics of the collateral shunts and enables the continuous tracing of vascular structures, thus it is very helpful in the imaging evaluation of the collateral vessels of liver cirrhosis.

Nodular Lesions of Cirrhotic Liver: Imaging Manifestations with Pathologic Correlation

ObjectiveTo introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.MethodsUltrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.ResultsMany of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, lowgrade dysplastic nodule, highgrade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.ConclusionModern stateoftheart medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.

Research status and progress of imaging diagnosis of periampullary carcinoma

Objective To summarize the research status and progress of imaging diagnosis of periampullary carcinoma. Methods The literatures on imaging diagnosis of periampullary carcinoma were reviewed. Results At present, the commonly used imaging diagnosis methods for periampullary carcinoma mainly include ultrasound, CT, MRI, and endoscopic retrograde cholangiopancreatography. Some other new imaging techniques had also been applied in the diagnosis and evaluation of periampullary carcinoma. Conclusions Different imaging methods have their own advantages and disadvantages in the diagnosis of periampullary carcinoma. Therefore, the detection rate and diagnostic accuracy of periampullary carcinoma can be improved by rational selection of imaging techniques or combined application of multiple techniques.