Objective:To investigate the CT and MRI features of meningiomas of the skull.Methods:A retrospective analysis was performed; the CT and MRI findings of 20 patients with meningiomas of the skull confirmed by pathology after surgery in our hospital from January 2008 to December 2020 were collected.Results:Fourteen patients had skull osteolytic destruction, 4 had osteogenic destruction, and 2 had mixed destruction. There were 12 patients with soft tissue masses and 11 with radial spicules. In 16 patients accepted CT examination, uniform density was noted in 10 and uneven density in 6; 8 had high density, 5 had equal density, and 3 had low density; 5 patients were with calcification. In 17 patients accepted MRI examination, 11 had uniform signal and 6 had un-uniform signal; T1WI had slightly low signal in 12 patients and equal signal in 5 patients; T2WI had slightly high signal in 12 patients and slightly low signal in 5 patients; diffusion weighted imaging (DWI) had high signal in 12 patients and slightly high signal in 5 patients. Totally, enhanced homogeneous enhancement was noted in 12 patients and inhomogeneous enhancement was noted in 8 patients; and there were 13 patients with "meningeal tail sign" and 11 with peritumoral edema.Conclusion:Bone in patients with meningiomas of the skull is characterized by osteolytic or osteogenic destruction with soft tissue masses and radial spicules; CT shows uniform or un-uniform tumor density, MRI shows uniform or un-uniform signals, and enhanced "meningeal tail sign" is characterized.

Objective To investigate the CT characteristics of primary pulmonary sarcomatoid carcinoma (PSC). Methods CT characteristics of 14 cases with primary pulmonary saromatoid cacinoma confirmed by surgical pathology were analyzed retrospectively. Results Among the 14 cases, the clinical manifestations were chest pain and cough in 6 cases, cough with blood-stained sputum in 5 cases, chest tightness and asthma in 2 cases, and no symptoms in 1 case. All the 14 cases had solitary masses in the lung. Carcinoma of 7 cases located in the upper lobe of the right lung, and carcinoma of 1 case located in the inferior lobe of the right lung. Carcinoma of 3 cases was located in the upper lobe of the left lung, and 3 cases were found in the inferior lobe of the left lung. Eleven cases had peripheral tumors and 3 cases had central tumors. CT plain scan revealed an isodense mass. There were 12 cases with uneven mass density and necrosis, and 2 cases had uniform mass density. The smooth margin was identified in 7 masses, and ill-defined margin and lobulation was shown in 7 masses. Cavity was observed in 1 mass, and speckled calcification was seen in 1 mass. Pleural invasion and thickening was in 5 cases, pneumothorax occurred in 1 case, and there was 1 case of liver metastasis. Enhancement scan showed patchy or annular enhancement around the mass, and the central enhancement of the mass was not obvious or uneven patchy enhancement. Conclusions The CT characteristics of primary pulmonary sarcomatoid carcinoma are solitary masses in the lung, especially if the mass is located in the periphery of the upper lobe of the right lung with uneven density, and enhancement scan shows patchy or annular enhancement around the mass.

Objective: To explore CT and MRI features of aggressive fibromatosis.Methods: The CT and MRI ifndings of aggressive ifbromatosis conifrmed by surgical pathology in 23 cases were retrospectively analyzed.Results: CT examination: the abdominal wall outside type of 7 cases: 4 mass clear boundaries and 3 unclear; 5 mass with homogeneous density and 2 uneven; 3 even density, 2 equal low density, 2 low density. The abdominal wall type of 16 cases: 15 mass clear boundaries and 1 unclear; 13 mass with homogeneous density and 3 uneven; 9 even density, 4 slight low density, 3 equal low density. The enhancement of 12 cases: 4 moderate en-hancement and 8 slight enhancement in the arterial phase, mild persistent enhancement in the venous phase and de-layed phase. MRI examination: 1 mass signals even and 3 uneven; 2 slightly high signal and 1 high with low signal and 1 high with low or on T2WI; 1 low or even signal and 3 low signal on T1WI; 2 low signal and 2 high signal on T2WI fat suppression. 4 bone invasion damaged, 1 compression, 1 uterine, sigmoid compression.Conclusion: The CT and MRI manifestations of aggressive ifbromatosis have certain characteristics features, CT and MRI examina-tion is of great value in the diagnosis of the disease.

Objective To explore the computed tomography(CT)manifestations of extra-adrenal ganglioneuroma for improving the diagnostic accuracy and understanging of the disease.Methods Imaging features of 13 of patients with extra-adrenal ganglioneuroma confirmed by surgical pathology were analyzed retrospectively and compared with pathological findings.Results Two of 13 lesions were located in neck,4 in posterior mediastinum,4 in retroperitoneal space,2 in front of sacrum,1 in the region of renal hilus.All these masses were well defined,5 appeared as round or oval,8 as irregular shaped.Of 8 cases,6 lessions presented a tendency of wedging into the space encasing and lapsing the vessel,with no evidence of invasion of the surrounding oragans or vessels.2 tumors grew along the vertebrae and invaded intervertebral foramen.On plain CT imagings,the attenuations of the tumors were less than that of muscle,the masses with homogeneous and nonhomogeneous density were found in 4 and 9 cases,respectively.2 patients were associated with scattered and patchy cafilication.After contrast administration,8 lesions showed inhomogeneous enhancement:slight enhancement were seen in the arterial phase and gradually more strong enhancement during the portal venous and delayed phase.Enhancing lines or patchy were observed inside these tumors.Pathologically,the tumors appeared that,on a large amount mucus background,a few of scattering or nesting ganglion cells were distributed in many mature spindle cells,which lined in weave or fasciculation.Conclusion The CT manifestations of extra-adrenal ganglioneuroma have characteristic features,which are correlated closely with histopathology,therefore can contribute to the diagnosis and differential diagnosis.

创伤性肺囊肿(traumatic pulmonary cysts,TPC)临床上较少见,但近年来随着螺旋CT在胸外伤中的广泛应用,检出率明显提高.笔者回顾性分析乐清市人民医院2010年1月-2012年10月收治的53例TPC患者螺旋CT表现和动态变化,旨在提高对本病的诊断水平.

患者男,67岁.因"皮肤巩膜黄染伴全身瘙痒2周"入院.人院查体:体温36.8℃,皮肤巩膜轻度黄染,表浅未触及肿大淋巴结,心肺未见异常,未扪及肿块,腹肌软,无压痛及反跳痛,肝脾肋下未触及.实验室检查:总胆红素226.8μmol/L,直接胆红素143.2 μmol/L,间接胆红素83.6 μmol/L. 术中见胆总管内乳头状增生物,呈弥漫性生长,长为5.4 cm,胆石钳置入切口上方胆总管内即见较多胆汁流出,因病变呈弥漫性生长,无法切除,留置"T"管关腹.

Objective To study the efficacy, safety and compliance of insulin human analog insulin aspart (NovoRapid) and insulin zinc protamine analog (Basulin) in the application on type 2 diabetes mellitus(T2DM)pafients during perioperative period. Methods Sixty T2DM patients were divided into 3 groups (n=20). Group A was treated with NovoRapid+Basulin, group B was treated with insulin human (Humulin R + Humulin N) and group C was treated with insulin pump (Humulin and NovoRapid). Blood glucose was detected in all of the patients before the meal, 2 hours after meal, before the sleep and during the operation. Results Blood glucose could all achieve the control level with the three methods of treatment. The rates of hypoglycemia in the three groups were 10%, 30% and 5% respectively, and the rates of patient satisfaction were 95%, 70% and 100% respectively. Conclusions Insulin human analog could control blood glucose effectively and safely, the compliance is also high. It is feasible of applying insulin human analog in the blood glucose control during perioperative period.