目的 探讨胃血管球瘤(GGT)的CT及其病理表现特征.方法 回顾性分析经手术和病理证实的13例GGT患者的临床、病理及CT影像学资料.分析总结病灶发生的部位、体积、形态、生长方式、肿瘤内部及其周围情况,分析CT强化方式并对比其病理特征.结果 13例GGT均为单发;肿块体积0.5～45.36 cm3;肿块多呈圆形或卵圆形;均位于黏膜下或肌层内,其中胃窦部10例、胃体远端1例、胃窦体交界处2例.CT平扫10例密度均匀,2例瘤内见点状钙化,1例瘤内合并局灶性低密度区.增强扫描10例呈明显均匀持续性强化,1例呈明显不均匀强化(其瘤内局限性低密度影,未见强化),2例呈中度持续性均匀强化.组织学上,固有球瘤8例、球血管瘤3例、球血管肌瘤2例,仅1例瘤内见局灶性囊变、坏死区,均未见肿瘤出血及溃疡形成.其中固有球瘤和球血管瘤型呈明显强化,而球血管肌瘤型呈中度强化.结论 GGT有特定的发病部位及CT强化特征,固有球瘤和球血管瘤型以明显持续性强化为特征.少见类型的GGT由于内部组织成分所占比例不同,CT表现不典型,确诊需病理诊断.

目的 探讨正电子发射计算机断层显像/计算机体层成像(PET/CT)对肺癌淋巴结转移的诊断效能.方法 选取2017年1月至2018年12月我院收治的肺癌患者89例为研究对象,对患者进行常规CT检查及PET/CT检查,分析淋巴结转移的诊断情况,以病理结果为"金标准",探讨PET/CT对肺癌淋巴结转移的诊断效能.结果 病理测量、CT检查及PET/CT检查结果分别为(3.97±1.58)、(4.15±1.27)、(4.32±1.61)mm,三者比较无统计学差异(P>0.05);临床病理分期N0、N1、N2、N3分别有30、26、33、0例;PET/CT检查结果发现N0、N1、N2、N3分别有27、22、30、0例,准确率分别为90.00％、84.62％、90.91％;CT检查结果发现N0、N1、N2、N3分别有26、13、24、0例,准确率分别为86.67％、50.00％、72.73％.89例患者在手术后清扫出390组淋巴结,以术后病理结果为标准,PET/CT检查对肺癌淋巴结转移的诊断敏感度、特异性、准确度、阳性预测值、阴性预测值均显著高于CT检查.结论 PET/CT检查、CT检查在肺癌淋巴结转移中均具有一定的诊断价值,且PET/CT检查的诊断效能显著高于CT检查,但仍存在一定的假阳性及假阴性,在临床诊断中需结合患者的临床资料提高诊断准确率.

PURPOSE This study aimed to investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of different histological types of renal cell carcinoma (RCC) (clear cell RCC (ccRCC), papillary RCC (pRCC), chromophobe RCC (chRCC). METHODS The clinical data of 67 patients (including 38 patients with ccRCC, 20 patients with pRCC and 9 patients with chRCC) with RCC confirmed pathologically in the Affiliated Hospital of Jining Medical University were retrospectively analyzed. All patients underwent CT, MRI plain scan and three-phase enhanced scan, and their CT and MRI imaging features were analyzed. RESULTS Most of the enhancement was non-uniform. Most of the lesions presented as fast-in, fast-out, with obvious enhancement in the early stage and enhancement decline in the later stage. Non-uniform and slightly higher signals were mostly present in DWI. The CT scan of pRCC patients showed equal density and homogeneous enhancement. Some of the larger lesions showed cystic necrosis and hemorrhage. MRI showed a lower signal on T1WI and a slightly higher signal on T2WI. The CT of patients with chRCC showed equal density and more uniform enhancement. DWI showed high signal, and central radial scar showed low signal. There was a significant difference in the percentage of cystic necrosis in ccRCC, pRCC and chRCC among groups (p<0.05). The incidence of cystic necrosis in ccRCC and pRCC was significantly higher than that in chRCC (p<0.05). The CT values in ccRCC patients were significantly higher than those in pRCC and chRCC patients in the parenchymal phase, corticomedullary phase and excretory phase (p<0.05). The CT value of chRCC patients in the parenchymal phase was significantly higher than that of pRCC (p<0.05). CONCLUSION The CT and MRI of ccRCC, pRCC and chRCC have their own imaging characteristics, which has important reference value for the preoperative differential diagnosis of RCC.

Objective: To discuss the imaging features of renal oncocytoma, and to improve the preoperative diagnostic accuracy. Methods: Radiology data of 16 renal oncocytoma patients were analyzed retrospectively. All the cases were confirmed by pathology. All patients underwent pre-contrast and multiple phase contrast scanning on multi-slice CT. The patients also underwent MRI examination. Results: All patients had solitary lesion, the location of oncocytoma were in right kidney (n = 9) and left kidney (n = 7). Round or round-like shape, clear boundary, protruding mass. Isodense or slightly higher density on CT pre-contrast scanning, among them, 2 cases developed into the renal sinus, 2 cases with calcification. 13 lesions showed obvious enhancement on the cortical phase, and on the medullary phase showed continuous enhancement. 4 lesions showed segmental enhancement inversion and central stellate scar was found in 8 lesions. Bleeding, necrosis, cystic change or fatty change was rare. 9 lesions showed tortuous expansion of the support vessel on the cortical phase, 6 lesions with invasion to the perirenal fat tissue. In our study, 3 samples of lesions underwent MR examination, which showed iso/hypo-intensity on T1WI. On T2WI, 1 lesion showed slightly lower signal, 2 lesion showed mixed signal. Clear pseudocapsule was revealed in MR imaging. Enhanced scan showed mild continuous enhancement. Conclusion: Most of the oncocytomas showed certain characteristic imaging, multiple phase contrast scanning are helpful in the accurate preoperative diagnosis.

目的 探讨Willis环变异与交通动脉瘤发生的相关性.方法 采用双源Flash CT血管成像技术,回顾性分析102例交通动脉瘤患者的临床及影像学资料,同期行颅脑CTA检查未见交通动脉瘤的患者42例作为对照组,观察交通动脉瘤的形态以及Willis环变异特点.结果 前交通动脉瘤(ACoAA)、后交通动脉瘤(PCoAA)患者中Willis环变异率分别为69.2％、72％,对照组为45.2％;其中ACoAA组中大脑前动脉A1段变异率61.5％,PCoAA组中大脑后动脉P1段变异率48％,而对照组中分别为14.3％、23.8％;以上各组间比较均有显著性差异(P＜0.05).另外ACoAA组中,右侧Al段发育变异的发生率明显高于左侧(P＜0.01).结论 Willis环变异与交通动脉瘤的发生存在一定的相关性,特别是大脑前动脉Al段和大脑后动脉P1段的变异.同时,还发现了Willis环的一些少见变异.

Objective To analyze the imaging features of renal oncocytoma, so as to improve the preoperative diagnostic accuracy. Methods The imaging data of 16 patients with renal oncocytoma admitted to the Affiliated Hospital of Jining Medical College from January 2010 to December 2018 were retrospectively analyzed, and compared with their pathological data. All the cases were confirmed by pathology. Kidney plain scan and multi-phase enhanced scan were performed in all 16 cases, including cortical, medullary and secretory stages. Three of them underwent simultaneous magnetic resonance imaging ( MRI) examination. Results All the 16 cases were with single tumor, including 9 cases of right kidney and 7 cases of left kidney. The tumors were round or elliptical with clear margins, 14 cases protruded outside the outline of the kidney and 2 cases protruded into the renal sinus. CT plain scan showed isodense or hypodense in most of tumors, a few tumors with mixed low-density shadows, and 2 cases of calcification. Enhanced scan showed that 13 cases of marked enhancement in corticomedullary phase and homogeneous density in delayed phase. Among them, 4 cases showed"segmental enhancement reversal" on enhanced scan, and 8 cases showed "star-like" scar in the focus of the tumors. There were no signs of hemorrhage, necrosis and cystic degeneration in the tumors according to enhanced scan. Nine lesions showed tortuous expansion of the support vessel on the corticomedullary phase, 6 lesions with invasion to the perirenal fat tissue. Three lesions underwent MRI examination, which showed iso/hypo-intensity on T1WI. On T2WI, 1 lesion showed slightly lower signal, 2 lesion showed mixed signal. Clear psudocapsule was revealed in MRI, which showed mild continuous enhancement by enhanced scan. Conclusions The imaging manifestations of renal oncocytoma have certain characteristics. Multiphase&nbsp;enhanced scan is conductive to improving the accuracy of preoperative diagnosis.

目的 探讨MRI对早期类风湿性关节炎(rheumatoid arthritis,RA)的诊断价值.方法 对40例早期RA患者(26例为临床确诊,14例为随访确诊)行双手、腕关节MR扫描,观察有无滑膜增厚/血管翳强化、骨侵蚀、骨髓水肿、腱鞘炎和关节积液等征象,同时收集患者的临床症状和实验室指标,分析各种MR征象和临床指标在临床诊断和随访诊断RA的诊断价值.选取10例正常志愿者作对照.结果 MR表现在临床确诊RA组和随访确诊RA组间比较差异无统计学意义(P＞0.05);对称性关节肿胀、3处及以上关节肿胀、内分湿因子(RF)及C反应蛋白(CRP)在2组比较差异有统计学意义(P＜0.05).结论 早期RA临床症状、实验室指标不具特征性是延误病情的主要原因,MR增强可显示早期RA的滑膜改变和骨侵蚀,为临床正确诊断和早期治疗提供可靠的依据.

Objective To investigate the CT characteristics of skull chlesteatoma,and explore its diagnostic accuracy.Methods CT characteristics of 15 skull chlesteatomas confirmed by surgery and pathology were retrospectively analyzed.CT plain scan were performed in all the patients,while extra enhanced CT scan was done in 2 cases.Results On the CT images,all cases were solitary.14 cases originated from intradiploe,and one case from skull suture.Extensive destruction of the skull with hard margin was found in 15 patients.7 cases presented crater-form deossificatio.11 cases demonstrated inhomogeneous density in which 6 cases showed calcification.The fat-like density was noticed mainly in one case,the water-like density mainly in 2 cases,the iso-density mainly in 2 cases,and homogeneous density in 4 cases.MPR and VR images could display the shape and scope of destruction.2 cases showed mild enhancement on contrast CT.Conclusion CT scanning of skull chlesteatomas has some features,CT combining with post-processing techniques are very effective in the diagnosis of skull chlesteatomas.

小儿异物吸入是常见的危重急症,诊断不及时常给患儿造成严重的痛苦,甚至危及生命.该病诊断除根据临床病史外,还须影像学检查.普通X线检查对金属异物可作出明确诊断,而对非金属异物只能根据间接征象推测诊断,缺乏可靠的诊断方法,因此确诊率低,易误诊或漏诊.随着多层螺旋CT软件及硬件技术的飞速发展,其在小儿气道异物中的诊断价值日益提高.