Objective To investigate the clinical value of 18F-FDG PET/CT imaging in the diagnosis and treatment of nasopharygeal carcinoma(NPC).Methods Sixty-two patients with nasopharygeal carcinoma underwent 18F-FDG PET/CT examination.Sixteen of them received their first time examination and 46 had previous treatment.Another 14 patients with nasopharygeal inflammation were taken as control group.The examination was conducted before treatment or 6 weeks after treatment.The final diagnosis was determined by the results of pathological tests and the random follow-up.The follow-up was longer than 6 months.Results ① When nodular or massive hypermetabolism area in nasopharynx was detected in PET,the soft tissue mass or thickening was also detected in the same region in CT.The diagnostic sensitivity, specificity and accuracy of PET/CT in NPC were 93.8%,92.9.% and 93.3%.② For treated patients,13 of 24 cases that were positive in CT showed hypermetabolism in PET.Among them,8 cases were finally diagnosed as neoplasm residue/recurrence.Two of 22 patients without changing in CT show positive in PET,1 was diagnosed as neoplasm residue.③ Regional nodal involvement were detected in 43.8% and distant metastases to bone,lungs,liver and brain in 19.4%.Conclusion 18F-FDG PET/CT is a useful modality for diagnosis and staging of NPC and has the potential to detect the neoplasm residual/recurrent.

颈部是全身淋巴结转移癌的最常见部位.头颈部恶性肿瘤、胸部肿瘤、淋巴瘤等常转移或侵及颈部淋巴结,头颈部炎症、结核也可引起颈部淋巴结肿大,其病因不同,治疗方案和预后也截然不同.

Objective Discusses the meaning of multi-position radiogrphy in the diagnosis of fracture of rib.Methods There are 236 cases with 298 costal bone's X-ray photograph.Each of them has A-P position,oblique position,tangential projection and spot film under the X-ray fluoroscopy.Then analyzes the amount of them.Results The percent of fractures with orthophoria view is 67.5%.The total percent of fractures with oblique position,tangential projection and spot film under the X-ray fluoroscopy is 32.5% while doesn't find the A-P position.Conclusion We must add oblique view and tangential projection radiography alternatively according to different patient in diagnosis of fracture of costal bone.If necessary,spot film under the digital fluoroscopy should be done.

目的:探讨CT和MRI对脑内原发淋巴瘤的诊断价值.方法:对12例经手术和病理证实的脑内淋巴瘤的CT和MRI影像学表现进行回顾性分析.结果:单发10例、多发2例,CT表现多为等密度或稍高密度肿块.MRI表现T1WI呈等或稍低信号,T2WI多为稍高信号,CT和MRI增强扫描多为均匀强化.结论:脑内原发淋巴瘤少见,影像学表现与颅内其它肿瘤互相重叠,CT和MRI平扫和增强扫描的应用有助于脑内淋巴瘤的诊断和鉴别诊断.

自发性脊髓硬膜外血肿(spontaneous spinal epidural hematomas,SSEH)临床很少见,于1896年Jackson首次描述,至今全世界仅有200余例报道[1],X线和CT检查难于发现本病,自MRI问世以来,SSEH才得到正确认识.

目的:评价磁共振弥散加权成像对急性脑梗塞的诊断价值及对急性和非急性脑梗塞的鉴别诊断价值.方法:对临床怀疑急性脑中风35例患者,进行常规T2WI 和DWI检查,并采用盲法进行对照观察.对DWI图像上出现的异常高信号的病变部位进行准确定位,并判断病变部位与临床症状与体征是否相符,对DWI图像上出现的异常高信号与FSE序列T2WI像上的表现进行对照观察.结果:35例在DWI像上均出现异常信号,其中3例是在发病后6h内进行MRI检查,而在常规T2WI像上未显示异常信号;2例是在发病后12h内进行检查 ,而在常规T2WI像上仅表现稍高信号;10例患者在发病后12～24h内进行检查,20例患者在发病后24～72h进行检查,在T2WI和DWI像上均出现异常高信号;其中8例在FSE T2WI 像上表现为多发脑梗塞病灶,而在DWI像上显示为单一异常高信号.在DWI像上诊断急性脑梗塞的敏感性及特异性均为100%.结论:DWI图像比常规T2WI图像对诊断急性脑梗塞有较高的敏感性及特异性,能发现常规T2WI像不能发现的超早期脑梗塞,并能鉴别急性和非急性脑梗塞,故DWI图像在诊断急性脑梗塞具有十分重要的诊断价值.