目的 分析肺部亚实性结节(subsolid nodule,SSN)与相应支气管之间的关系及其分型,探讨其临床诊疗意义.方法 回顾性分析经多排螺旋CT(MDCT)扫描的80例(102个SSN),依据病理结果与临床资料,将其分为4组.依据病灶有无实性成分,分为两大类:a类,部分实性结节(part solid nodule,PSN);b类,纯磨玻璃结节(pure ground glass nodule,PGGN).将SSN和支气管关系分为5型.结果 1)MDCT扫描,经薄层重建结合多平面重组(MPR),能很好地显示SSN与相应支气管间的关系及分型;2)4组SSN与支气管存在关系比率差异有统计学意义(x2=16.039,P=0.001);3)4组SSN与支气管的关系类型差异有统计意义(P<0.001)4)PSN、PGGN与支气管的关系分型存在相关性(r=0.533,P<0.001).结论 运用MDCT能分辨不同类型的SSN,分析其与支气管之间存在的关系,对SSN的性质诊断具有重要的参考意义.

Objective To investigate how to diagnosis traumatic subdural effusion (TSE) and differentiate it with senile encephalatrophy in aged people by CT scan. Methods Fifty-two aged patients with TSE and 40 aged patients with encephalatrophy, admitted to our hospital from March 2008 to March 2010, were chosen in the study. Their clinical data and CT manifestations were retrospectively analyzed and compared. Results Fifty-two patients with TSE had 91 sites of the lesion, including 31 lesions located in temporal-frontal lobe and 30 lesions in frontal lobe. Among the 52 patients, 34 were also noted as having encephalatrophy. First-time CT demonstrated 32 patients with TSE, and the second-time CT on the left patients showed 20 having TSE too. Among the 52 patients, increasing amount of fluid in a short term was noted in 32 patients; local widened gyri with a flattened surface and narrowed sulci was presented in 30; "compressed arachnoid sign" was found in 9. CT results demonstrated that no above-mentioned manifestations were presented in patients with encephalatrophy.Conclusion For aged person, TSE is usually located in the temporal and frontal lobe, and should be differentiated with senile encephalatrophy. The key-points for differentiation include the location and the extent of changes of extra-cerebral space, the space-occupying signs as local flattened gyri and narrowed sulci, the appearing of "compressed arachnoid sign" and the changes of effusion in a short-term review.

Objective To investigate the influence of volume,length and maximum diameter of the gross tumors on the short-term response of radiotherapy and concurrent chemo-radiotherapy(CCRT) for esophageal carcinoma.Methods Forty-seven newly diagnosed esophageal carcinoma patients from May,2006 to August, 2008 were included in this retrospective study.Among them 25 patients received radiotherapy alone and 22 patiemts received CCRT.All patients underwent CT scan with a same position before treatment,immediate after treatment,and 4 weeks after treatment.The gross tumor was delineated with a radiation oncologist and a radiologist separately on these 3 CT scans.The volume,length and maximum diameter of tumor were measured on the treatment planning system(TPS).The influences of volume,length and maximum diameter of tumor on the short-term response were analyzed,and the outcomes of the radiotherapy alone and CCRT group were compared.Results The median tumor volume was 58.28cm~3(range 6.9-317.53cm~3),the median length was 8.00cm(3.0-18.5cm) and the median maximum diameter was 4.40cm(1.5-8.0cm).The tumor volume, length,and maximum diameter were significantly correlated with the short-term response(P values: 0.000,0.000,0.001,respectively).In contrast,the correlation between the length and the short-term response was not significant(P=0.102) in the radiotherapy alone group,and the correlation between maximum diameter and the short-term response was not significant(P=0.069) in the CCRT group.Conclusion The tumor volume,length,and maximum diameter of esophageal tumor in general are important factors that influence the short-term response of radiotherapy.The maximum diameter may influence the short-term response in the radiotherapy alone group,but not in the CCRT group.

Objective: To evaluate medical imaging for localizing pheochromocytoma and for directing operation and clinical treatment. Methods: Ultrasonography(USG), computed tomography(CT), magnetic resonance imaging(MRI), 131I-Metaiodobenzylguanidine(MIBG) SPECT were performed in 45 patients. All the patients subsequently underwent surgery. The lesions were histopathologically examined. Results: Seventeen tumors arose from left adrenals, 15 tumors arose from right adrenals, 2 tumors occurred bilaterally, 1 patient with multiple tumor localized in right adrenals, 10 tumors were found extraadrenally. Thirty-nine lesions were benign tumors, 6 lesions were malignant tumors. The diagnostic sensitivity of USG, CT, MRI, 131I-MIBG SPECT was 90%, 96%, 95%, 100% respectively. Conclusion: Comprehensive imaging technology scanning had highly sensitivity and specificity for localizing pheochromocytoma.

目的探讨多层螺旋CT常规扫描对心包病变的诊断价值.方法对46例临床疑为心包病变病例进行多层螺旋CT扫描,与最终临床结果对照分析.结果多层螺旋CT普通检查诊断心包病变的敏感性89.7%,特异性57.1%.结论多层螺旋CT扫描对心包病变的诊断有较高临床价值,可提供心包增厚、积液、钙化等信息,并对病变性质作出较可靠的诊断.

目的探讨多层螺旋CT(MSCT)仿真支气管镜的临床应用价值.方法 34例患者先行MSCT普通检查,然后再行MSCT仿真支气管镜检查.两组资料分别由两位影像科医师阅片并诊断,并与最终诊断进行对比.结果 MSCT普通检查敏感性100%,正确率为91.2%,MSCT仿真支气管镜检查敏感性97.1%,正确率为88.2%.结论 MSCT普通检查与仿真支气管镜检查的敏感性及诊断率差异无显著性,但后者可提供三维信息,有利于临床医师把握病情.

肠梗阻是外科常见的急腹症,早期诊断和治疗至关重要.临床拟诊肠梗阻较易,但其病因诊断却依赖于影像学检查.近年来,随着高分辨率CT的应用,病因诊断水平不断提高.笔者对临床拟诊肠梗阻的病人行腹部螺旋CT多平面重建(MPR),以探索多平面重建技术对肠梗阻病因诊断的应用价值.

目的研究探讨磁共振尿路造影在临床常见梗阻性尿路疾病中的应用价值.方法应用西门子Vision1.5T超导型磁共振仪器对36例梗阻性尿路疾病患者进行磁共振尿路造影检查.结果磁共振尿路造影对梗阻性尿路疾病梗阻程度及位置均清晰显示,并对梗阻原因定性有较高的准确性.结论磁共振尿路造影能为梗阻性尿路疾病提供无创伤性、简便安全、可靠的检查手段而得到广泛应用.

目的：探讨临床常见脑血管病颅脑MRA表现及其临床应用价值。方法：采用西门子Vision 1.5T超导型磁共振仪对63例颅脑常见脑血管病患者进行MRA检查。结果：MRA能清楚显示颅内主要血管形态，并展示颅脑常见血管疾病的异常改变：其中脑动脉瘤20例，脑血管畸形36例，脑动脉栓塞3例，脑动脉硬化5例。结论：颅脑MRA能为临床常见颅脑血管病提供无创伤性简便检查手段，而得到广泛应用。

目的:探讨磁共振(MR)多平面重建(MPR)对主动脉病变的显示能力和临床价值.方法:对126例主动脉病变进行MPR,46例并行数字减影血管造影(DSA)检查,43例手术证实.结果:MPR良好地显示了血管内腔,夹层动脉内膜瓣,假性动脉瘤破口.结论:MPR可明确显示主动管腔及周围结构,有助诊断和指导手术,有着独特的应用价值.