目的 探讨分析刀锋技术快速梯度自旋回波扩散加权成像(TGSE BLADE DWI)与分段读出平面回波扩散加权成像(RESOLVE DWI)在中耳胆脂瘤的图像质量差异.方法 选取经手术证实的中耳胆脂瘤患者44例,所有患者术前均行TGSE BLADE DWI、RESOLVE DWI、常规颞骨MR平扫及增强检查,将DWI图像依据扫描方法分为两组进行图像质量评价,由2位影像诊断医师分别从磁敏感伪影、图像失真变形、整体图像质量及病变清晰度4个方面进行评分,测算两组DWI图像的信噪比(SNR)、对比度及对比噪声比(CNR).2位医师对图像评分情况进行Kappa一致性检验,图像评分的组间比较采用Wilcoxon符号秩检验,SNR、对比度及CNR的组间比较采用配对样本t检验.结果 两组DWI图像间磁敏感伪影、图像失真变形、整体图像质量及病变清晰度的评分差异有统计学意义(P＜0.001),TGSE BLADE DWI组图像的评分高于RESOLVE DWI组.两组DWI图像间SNR的差异有统计学意义(P＜0.05),TGSE BLADE DWI的SNR低于RESOLVE DWI,对比度及CNR的差异无统计学意义(P＞0.05).结论 与RESOLVE DWI相比,TGSE BLADE DWI磁敏感伪影少,图像失真变形轻,对中耳胆脂瘤的显示更清晰,显著改善了 DWI图像质量,但整体图像信号强度略低.

Objective:To summarize the clinical and imaging presentations of stapical footplate hernia related to inner ear malformation (SFH-Re-IEM).Methods:The clinical and imaging data of 19 patients (24 ears) with SFH-Re-IEM from Shandong Provincial ENT Hospital between June 2014 to June 2022 were retrospectively analyzed. The clinical presentations and headache and the high resolution CT (HRCT) and MRI findings including associated inner ear malformation (IEM) type, internal auditory canal (IAC) malformation, bony defect of the stapical footplate, the extent, margin, density and signal of the herniation cysts, the density and signal of ipsilateral intratympanic, cochlear osseous labyrinthitis were recorded.Results:Among 19 SFH-Re-IEM patients, including 14 males and 5 females, 3 (1, 12) years old. All of the affected ears presented sensorineural or mixed hearing loss, 1 ear for moderate, 7 ears for severe and 16 ears for extremely severe. Besides this, the vertigo in 1 case, otalgia and ear fullness in 2 cases were found, and the others were detected accidentally. Among 24 ears with SFH-Re-IEM, 9 ears (37.5%) consisting with incomplete partition type Ⅰ, 3 ears (12.5%) with common cavity, 7 ears (29.2%) with cochlear aplasia, 3 ears (12.5%) with cochlear dysplasia type Ⅱ, and 2 ears (8.3%) with Mondini deformity were found respectively. Four ears (16.7%) were associated with IAC enlargement and the bony defect of IAC fundus, 19 ears (79.2%) were accompanied with dysplasia in the IAC fundus. In all the 24 ears with SFH-Re-IEM, the focal bony defect of the affected stapical footplate and the hemispherical soft-tissue-density herniating cysts protruding into the tympanium were presented on HRCT, and the herniating cysts presenting the cerebrospinal fluid-like signal with the well-defined margin and the ipsilateral normal tympanium were shown on the MRI hydrographic sequence. Two ears underwent the perilymphaticum gadolinium based on MRI, which demonstrated the hypersignal gadolinium in the perilymphatic space entered into the herniating cysts. Two ears were accompanied with the cochlear osseous labyrinthitis.Conclusion:The ears with IEM-Re-SFH usually present the serious hearing loss. The ipsilateral severe IEM, focal bony defect of the stapical footplate and perilymph herniating are characteristic imaging appearances.

目的 探讨Ki-67在下咽癌及喉癌中表达情况与肿瘤分期的相关性.方法 回顾分析35名下咽癌及喉癌患者资料,其中下咽癌患者23例,喉癌12例,患者均为男性,年龄46～79岁,平均(61.7±7.6)岁.本研究利用SPSS 13.0软件进行Spearman相关性分析,绘制ROC曲线并计算曲线下面积.结果 根据肿瘤TNM分期:T1期1例,T2期10例,T3期13例,T4期11例;N0期11例,N1期2例,N2期10例,N3期12例;所有患者均为M0期.Ki-67表达百分率及等级与肿瘤TNM分期中T分期无明显相关性(P=0.600、P=0.958);Ki-67表达指数与肿瘤TNM分期中N分期存在相关性(P=0.017),相关系数为r=0.402;ROC曲线下面积0.75(0.58-0.93).Ki-67表达等级与肿瘤TNM分期中N分期有相关性(P=0.004),相关系数为r=0.478;ROC曲线下面积0.72(0.54-0.899).结论 下咽癌及喉癌中Ki-67表达水平与肿瘤TNM分期中N分期存在相关性,Ki-67表达水平越高,肿瘤越易发生区域淋巴结转移.

目的 研究下咽癌强化CT纹理分析相关参数与Ki-67表达情况之间的相关性.方法 搜集行手术病理证实的23例下咽癌患者.所有患者在外科手术前进行颈部增强CT检查,在肿瘤最大截面勾画感兴趣区,分别测量CT平扫、动脉期、静脉期病灶纹理分析相关参数值(平均值、标准差、熵值、不均匀度、偏度及峰度),采用Spearman非参数相关分析,P＜0.05时认为存在相关关系,对有统计学意义的纹理参数进行受试者操作特征曲线(ROC)分析,评估纹理参数对Ki-67低、高表达组的鉴别诊断效能,确定诊断阈值,并计算曲线下面积、敏感性、特异性.结果 平扫期平均值与Ki-67表达情况之间呈负相关(r=-0.446,P=0.033),动脉期平均值、偏度与Ki-67表达情况之间呈负相关(r=-0.554,P=0.006;r=-0.463,P=0.026),静脉期平均值与Ki-67表达情况之间呈负相关(r=-0.514,P=0.012).平扫期平均值的阈值为1056.738时,其ROC曲线下面积、敏感性和特异性分别为0.639、100％和38.5％.动脉期平均值的阈值为1069.593时,其ROC曲线下面积、敏感性和特异性分别为0.908、100％和53.85％.动脉期偏度的阈值为-1.034时,其ROC曲线下面积、敏感性和特异性分别为0.762、90.0％和46.2％.静脉期平均值的阈值为1087.047时,其ROC曲线下面积、敏感性和特异性分别为0.862、100％和61.54％.结论 下咽癌CT纹理参数可以有效反映Ki-67表达水平,对临床了解肿瘤的增殖活性有一定的参考价值.

Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.

OBJECTIVE:To evaluate the relationship between human papilloma virus (HPV) infection and the occurrence, recurrence and malignant transformation of nasal inverted papilloma (NIP).METHOD:With comprehensive retrieval of related literature that had been published in databases included Pubmed (1990--2011), Cochrane Library, CNKI (1979-2011), VIP (1989-2011), CBM (1990-2011) and WANFANG Meta-analysis software Rev-Man 5.0 was used to analyze the raw data and to calculate the value of combined odd ratio (OR) and 95% confidence interval (CI).RESULT:According to Meta-analysis, the occurrence group between HPV and NIP, the OR was 34.44 and 95% CI was 12.96-91.56; the recurrence group, the OR was 3.66 and 95% CI was 1.77-7.56, to the high-risk HPV, the OR was 1.94 and 95% CI was 0.30-12.58; the malignant transformation group, the OR was 1.79 and 95% CI was 0.94-3.40 to the high-risk HPV, the OR was 49.35 and 95% (CI was 0.45-11.23.CONCLUSION:HPV may play an important role in the occurrence and recurrence of NIP and high-risk HPV was closely related to the progress of NIP.

Objective To evaluate the CT imaging of pulsatile tinnitus caused by transverse-sigmoid sinus diverticulum.Methods We retrospectively studied CT arteriography and venography imaging of 18 cases of pulsatile tinnitus caused by transverse-sigmoid sinus diverticulum.Results 18 cases of transverse-sigmoid sinus diverticulum of pulsatile tinnitus patients were all found in the dominant side of cerebral venous drainage system.Dual energy bone removal imaging of CTV can display the local expansion of the transverse-sigmoid sinus visually,like saccular,digitatio and processus spinosus.It was seen in CTV that the cerebral venous sinus focally protruding into the neighboring mastoid through the focal defect of bone shell overlying the transverse-sigmoid sinus and formed diverticulum in 18 patients.Conclusion CTA/V can be a valuable imaging tool in the diagnosis of pulsatile tinnitus caused by transverse-sigmoid sinus diverticulum.