ctc幻翼灯结肠.ppt

黑腔技术 白腔技术 Crohn 病 结肠脾曲息肉 左图， 3D threshold rendering 近盲肠5毫米小息肉。右图为横轴扫描 粪便残渣。A，3维容积阈腔内，肿物需与肿瘤区别。B，同区2维冠状面重建，肿物内有气泡，证明为粪便。 MRC粪便标志（fecal tagging）法 将稀薄钡剂200毫升混合在病人检查前1日进食的所有食物中 病人于检查前36小时起在当日分4顿将这些食物吃下 所食应为无纤维、无渣食物 检查当日检查前不进食 这种食物在MRC成像时显示为均质的黑色 与CTC比较，MRC具有更多的优势 无放射性 如不作肠道清洁时可更清晰地辩识有标 志的粪便残渣 用钆作增强对比剂无肾毒性，较CT的碘 对比剂更为安全 随着设备和技术的进一步发展，亦有可能成为结直肠肿瘤筛查的方法  CTC—complication 191 Some studies of symptomatic patients, however, have reported higher perforation rates, ranging from 0.03% (1 in 3,400 patients) to 0.06% (1 in 1,700 patients) Colonic distention with low-pressure carbon dioxide delivery may be safer than insufflation of room air 谢谢 * Figure 1 Adenomatous polyp of 13 mm of the ascending colon in a 61-year-old female with initial colonoscopy interrupted at the descending colon for severe discomfort. A: Endoluminal CT image of the ascending colon shows 13 mm sessile polyp lying on a fold; B and C: Axial CT images acquired in supine and prone position show the polypoid lesion (arrow) on a fold; D: Sessile polyp of 13 mm of the ascending colon found at repeat colonoscopy. Histology evaluation revealed adenomatous polyp. * Figure 2 Stenosing mass of the proximal sigmoid colon in a 69-yearold female with initial colonoscopy interrupted at the distal sigmoid colon for diverticular disease. A: Axial CT image acquired in prone decubitus shows a stenosing lesion of the proximal sigmoid colon with CT findings suspicious for malignancy: eccentric wall thickening, “shoulder sign”, absence of pericolonic fat stranding; B: Coronal oblique multiplanar reformation shows the lesion in the sigmoid colon; C: Endoluminal CT image shows the passage from the normal colonic wall to the stenosis; D: Surgical specimen from left hemicolectomy shows a stenosing lesion of about 5 cm in the proximal sigmoid colon with marked wall thickening due to advanced diverticular disease confirmed at histological evaluation. * CT colonographic image of 10-mm tubulovillous adenoma (white arro