Objective To estimate the value of the CT and MRI showed ovarian vessels and uterine tube in the localization diagnosis of solid tumors at adnexa area. Methods The CT or (and) MRI features of 55 (48 cases) tumors in ovarian or ectopic uterine proved by surgery and pathology were reviewed and compared with postoperative pathologic results. Results Of the 55 sides, the determine tumor origin accuracy was 94.55%(52/55), the sensitivity 100.00% (30/30), the specificity 88.00% (22/25), the false positive rate 12.00% (3/25), the false negative rate 0.00% (0/30), the positive predictive value 90.91% (30/33), and negative the predictive value 100.00% (22/22). The preoperative positioning diagnosis had high consistency with the postoperative pathological results (Kappa=0.89).The results showed that the accuracy of the 3 accessory structures was higher than that of the 1 and the 2, but with no statistical difference (P=0.35). Conclusions The ovaries, ovarian vessels, and uterine tube are shown to have a high diagnostic value in determining the origin of uterine tumors and ovarian tumors. The showed number is proportional to the accuracy of the judgment result. Key words: Ovarian tumor; Uterine tumor; Ovarian vascular; Tomography; X-ray computer; Magnetic resonance imaging

目的:探讨CT辅助检查在急性阑尾炎诊断中的临床应用的效果;方法:选取我院2015年至2016年间收治给予治疗的急性阑尾炎患者90例,随机分成观察组(CT检查组)和对照组(X线检查组),每组45例病患,比较两组的检查结果;结果:CT共检出86例急性阑尾炎病理,检出率高达95.56％.与X线检查结果相比,两组在检查结果上对比差异具有统计学意义(P＜0.05);结论:CT检查在急性阑尾炎诊断中具有重要的临床检查价值,特别是在辅助诊断不典型症状的急性阑尾炎患者更具有临床检查价值.

Objective To estimate the value of the CT and MRI showed ovarian vessels and uterine tube in the diagnosis of pelvic tumors.Methods The CT and (or) MRI features of 79(90 cases) ovarian and non-ovarian tumors proved by surgery and pathology were reviewed.By analyzing the tumor and ovarian blood vessels and fallopian tubes to identify the source of the tumor.According to the number,morphology and thickness of the arterial blood supply and other branches determine the nature of the tumor.The results were compared with the pathological results.Results The diagnostic accuracy of tumor origin was 94.44％ (85/90),the sensitivity was 95.89％ (70/73),the specificity was 88.24％ (15/17),the false positive rate was 11.76％ (2/17),the false negative rate was 4.11％ (3/73).The consistency between preoperative localization and surgical pathology was high (Kappa =0.82).The resuhs showed that three ovarian adjunctive structures were more accurate in determining the origin of the tumor compared with the display of one ovary structure and the display of two ovary structures.The results were statistically significant (P =0.035).When the double arterial blood supply was shown,the diagnostic accuracy of the ovarian malignant tumor was 90.41％,the sensitivity was 95.35％ (41/43),the specificity was 83.33％ (25/30),the false positive rate was 16.67％ (5/30),and the false negative rate was 4.65％(2/43).The diagnosis was highly consistent with the pathological results (Kappa =0.80).Conclusion CT and MRI show that ovary vessels and fallopian tubes have a higher diagnostic value in the positioning and characterization of pelvic tumors.

目的 探讨CT与磁共振成像(MRI)对卵巢肿瘤的诊断价值.方法 40例卵巢肿瘤患者,均进行CT和MRI诊断,比较两种不同方式对卵巢肿瘤诊断的准确性、敏感性和特异性,并对两种方式对肿瘤影像学表现、定位和定性进行分析.结果 CT对卵巢肿瘤患者诊断的准确性、敏感性与特异性分别为77.5％(31/40)、82.1％(23/28)和66.7％(8/12);MRI对卵巢肿瘤患者诊断的准确性、敏感性与特异性分别为85.0％(34/40)、85.7％(24/28)和83.3％(10/12).MRI对卵巢肿瘤患者诊断的准确性、敏感性、特异性均高于CT,但差异无统计学意义(P>0.05).MRI检查对患者肿瘤的具体定位和定性都能进行准确的显示,但是CT检查将2例卵巢肿瘤患者误诊为子宫,对3例良恶性肿瘤未能进行准确定位和定性.结论 CT和MRI在对卵巢肿瘤进行诊断的过程中都取得了较好的诊断效果,但MRI所得出的结论更加可靠,在定位和定性的过程中有着很大的优势.

目的 探讨64排128层螺旋CT血管造影(CTA)联合彩色多普勒超声诊断糖尿病下肢血管病变的应用价值.方法 回顾性分析2014年2月-2016年9月我院收治的糖尿病下肢血管病变患者128例,患者均进行64排128层螺旋CT、彩色多普勒超声及X线数字减影血管造影(DSA)检查,将DSA作为诊断标准,分析64排128层螺旋CT联合彩色多普勒超声诊断糖尿病下肢血管病变的诊断准确性.结果 CTA联合彩色多普勒超声检查正常23例,48例斑块,42例狭窄,15例闭塞;DAS检查正常23例,斑块43例,45例狭窄,闭塞17例;CTA联合彩色多普勒超声检查下肢血管病变阳性率与DSA相比,差异无统计学意义(P＞0.05).结论 CTA可清楚显示血管走向、内径等情况,彩色多普勒超声可监测血流情况,两者联合使用能在很大程度上提高诊断准确性,为临床提供可靠诊断依据.

目的 探讨肾脏孤立性纤维瘤(SFT)的CT特征.方法 回顾性分析经手术病理证实的6例肾脏SFI的临床、CT影像表现.结果 6例均为单发肿块,呈类圆形或椭圆形,长径3.2～12.4 cm.6例三期增强扫描,5例肿瘤密度均低于周围正常肾皮质,1例前两期强化后等于或高于肾皮质,最高强化在排泄期或实质期各3例.4例三期强化密度均匀,3例皮质期、实质期及排泄期分别呈轻、中、重度强化,呈“渐进持续”型强化;1例呈“快进快退”型强化,表现皮质期显著强化,实质期强化密度迅速增高,排泄期强化骤降.2例不均匀强化,呈“慢进慢出”型强化,表现为皮质期至实质期强化缓慢增高,排泄期缓慢下降,低密度囊变区始终未见强化.5例动脉期肿块内见点、条状小血管影.4例密度及强化均匀者病理为良性,2例密度及强化不均匀或多发点状钙化者病理为恶性.结论 肾SFF三期强化后肿瘤密度大多数低于周围正常肾皮质,最高强化在排泄期或实质期,强化方式多种多样,在CT上较具有特征性,具有较高的诊断价值.

目的 探讨卵巢黄体囊肿破裂(OCLCR)的MRI表现.方法 回顾性分析经手术病理证实的28例OCLCR的临床、MR影像资料.结果 28例附件区可见单囊、多囊或多房囊性包块,长径3.0～12.0 cm.根据肿块形态不同在MRI上分为3型:Ⅰ型为单囊型,17例,根据单囊与血肿位置不同又分为2种亚型,Ⅰ a型(囊内血块型)8例,Ⅰb型(囊肿旁血肿型)9例;Ⅱ型为多囊型,5例;Ⅲ型为多房型,6例.增强扫描25例,囊壁及分隔厚约2.5～5.0 mm,呈环形、分隔状明显强化,20例囊壁见破裂口表现环形强化连续性中断、塌陷或缺损.与手术病理结果对照,MRI对OCLCR破裂口的诊断敏感度为90.91％(20/22)、特异度为100％ (6/6),准确率为92.86％(26/28).MRI与手术病理诊断的一致性高(Kappa=0.81,P＜0.001).结论 OCLCR MRI表现附件区单囊、多囊或多房厚壁囊肿,MRI能准确识别囊壁破裂口,与手术病理具有高度一致性.

目的:探讨阔韧带平滑肌瘤(BLL)在低场MRI中的不典型表现及其病理学基础,以提高BLL的诊断及鉴别诊断水平.材料与方法:回顾性分析经手术病理证实的13例不典型BLL患者的MRI表现和病理资料.结果:13例不典型BLL,3例以囊性成分为主,包绕不规则实性成分(实性成分T2WI呈高信号),增强扫描瘤实质不均匀明显强化,病理上肿瘤由纵横交错的胶原纤维束、梭形细胞束构成,伴有程度不同的玻璃样变性、透明变性;4例(T2WI上呈低信号)轻度强化,病理上肿瘤内平滑肌细胞较少,而胶原纤维组织较多;9例在T2WI上呈高信号(均为明显强化),病理上肿瘤由较多平滑肌细胞构成,且细胞胞体大,含水量多,间质少.结论:BLL在低场MRI上具有多种不典型的表现,熟悉其病理学基础有助于提高BLL的诊断与鉴别诊断水平.

目的 总结分析28例垂体瘤的低场强MRI表现.方法 使用0.23T磁共振扫描仪,回顾性28例经手术和病理证实的垂体瘤的MRI表现,结合相关文献,对MRI表现进行归纳.结果 垂体巨腺瘤23例在T1WI上为低、等信号,T2WI呈中等高、高信号,占位效应明显,常向上累及视交叉(69％)及向两侧侵袭海绵窦(43％);5例微腺瘤在T1WI上多为低、等信号,T2WI为等高信号.结论 低场强MRI对垂体瘤有很高的诊断价值,对形态学改变不明显的垂体微腺瘤,结合GD-DTPA可获得满意诊断结果.

目的:探讨分析输卵管积液的低场强磁共振成像特点以及其鉴别诊断。方法:随机选取笔者所在医院近两年来输卵管积液病例86例,按患者所采用的辅助检查方式将患者分为试验组与对照组,试验组患者采用低场强MRI诊断,对照组患者采用B超进行诊断,比较两组患者诊断准确率。结果:经过对比分析发现试验组患者输卵管积液的诊断准确率(95.35%)明显高于对照组患者(67.44%);患者输卵管积液腊肠状、多囊状以及类圆状发生率分别为27.91%、37.21%、30.23%,明显高于其他形态(4.65%),差异具有统计学意义(P<0.05)。结论:低场MRI用于输卵管积液的诊断效果显著,适合在临床上得以推广。

目的 探讨卵巢囊性畸胎瘤的MRI表现及诊断价值.方法 回顾性分析52例经临床手术病理证实的卵巢囊性畸胎瘤的MRI表现.结果 52例均经病理证实为囊性畸胎瘤,其中单侧43例,双侧9例,瘤体61个,瘤体直径最大12.8cm,最小2.7cm.MRI表现以囊性为主,囊区T1WI呈低信号、T2WI呈高信号,囊壁光整;部分区域含有T1WI和T2WI均呈高信号而脂肪抑制序列呈低信号的脂肪信号影,呈囊性或实性混杂信号病灶;增强扫描囊壁可强化.MRI诊断符合率为100%.结论 卵巢囊性畸胎瘤有MRI特征性表现,MRI检查可作出明确诊断.