Objective To investigate the clinical value of 256-slice CT angiography (CTA) in diagnosing coronary artery fistula(CAF).Methods A total of 18 patients with CAF were analyzed retrospectively.The raw data were transferred to the work station.Image reconstruction techniques were employed, including multiplanar reconstruction (MPR),curved planar reconstruction (CPR),maximum intensity projection (MIP) and volume render (VR).Results Coronary artery angiography showed fistula affluxed to the pulmonary artery in 5 cases,affluxed to the coronary sinus in 5 cases,affluxed to the right atrium in 3 cases,affluxed to the left atrium in 3 cases, affluxed to the right ventricle in 2 cases.The blood flow from abnormal vessels to pulmonary arteries was demonstrated in 5 patients,and injection sign or hyper-density of contrast material in the main pulmonary artery was seen.The tortuous vascular networks on the surface of the main pulmonary artery trunk were seen in 2 cases.Formation of aneurysm was seen in 3 cases.Conclusion 256-slice CTA can precisely show the detailed anatomy variations and heomodynamic information of CAF, and directly display the abnormal vessels with multiple image reconstruction techniques.

Objective To investigate the clinical value of 64-slice spiral computed tomography(64-MSCT)triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters de-termined metastatic perigastric lymph node as follows:①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters (①+②)in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters (①+②+③)were 98.2% and 1 9.4%,respec-tively.The sensitivity and specificity of combining four parameters (①+②+③+④)were 99.7% and 13.2%,respectively.In ad-dition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.