Objective:To compare the diagnostic value of three quantitative evaluation methods based on three-dimensional rapid fluid attenuation inversion recovery sequence (3D-FLAIR) vein-enhanced labyrinth images in endolymphatic hydrops.Methods:From October 2017 to April 2019, a retrospective study was conducted on 86 patients with unilateral otogenic vertigo who were admitted to Beijing Tongren Hospital, Capital Medical University. MRI was performed 8 h after the single-dose Gd-DTPA intravenously injection in all patients. Three evaluation methods were used to calculate the ratio of the endolymphatic area to the total lymphatic area, the ratio of the saccule to utricle area, and the ratio of the endolymphatic volume to the total lymphatic volume, respectively. The paired t test was used to compare the three ratios between the affected and healthy ears. With clinical diagnosis as the gold standard, the receiver operating characteristic (ROC) curve analysis was used to analyze the efficacy of three methods in diagnosing endolymphatic hydrops. Results:Totally 65 cases were finally diagnosed endolymphatic hydrops clinically. There were statistically significant differences of all the 3 ratios between the affected and healthy ears ( t=9.93, 7.22, 8.20, all P<0.001). The ROC curve showed that the area under the curve (AUC) of endolymph/total lymph area ratio, saccule/utricle area ratio, endolymph/total lymph volume ratio for diagnosis of endolymphatic hydrops were 0.882, 0.768, 0.884 (all P<0.001). And there were no significant differences between each paired AUCs (all P>0.05). Conclusions:All three methods of endolymph/total lymph area ratio, saccule/utricle area ratio, endolymph/total lymph volume ratio can quantitatively evaluate endolymphatic hydrops. The endolymphatic/total lymphatic area ratio method is still the most convenient method at present.

目的 探讨乳腺恶性肿瘤骨肉瘤样变的影像学特征表现,提高对该病的认识水平及诊断能力.方法 收集经临床及影像综合诊断为乳腺恶性肿瘤,最终经病理证实伴有局灶性骨肉瘤样变3例,对其影像资料中的肿块大小、形态及边缘,肿块内钙化形态、分布等X线表现综合分析.结果 肿块大小,其中＞5cm 2例,＜5cm 1例,边缘清晰3例,均光滑锐利无毛刺征象,肿块内钙化呈斑块状、粗颗粒状,放大4倍后钙化边缘模糊等特点,病史短期内急速增长3例.结论 乳腺恶性肿瘤骨肉瘤样变的影像学表现具特征性,结合临床病史及专科检查,有助于该病的诊断.

目的 探讨在退变性腰椎滑脱(LDS)中全腰椎椎体及椎间盘形态变化的临床意义.方法 以2011年1月至2016年1月在某院CT诊断的LDS(L4)患者为研究对象(滑脱组),随机挑选60例,其中男30例,女30例,年龄51~89岁,平均(67.9±7.5)岁,以性别和年龄匹配无LDS的60例受检者为对照组,其中男30例,女30例,年龄45~85岁,平均(64.6±9.6)岁.在CT图像正中矢状位上,分别测量腰1-5椎体(前柱 、中柱 、后柱)的高度(VBH)、椎间盘(前 、中 、后)的高度(IVDH)、腰椎前凸角(LLA)、椎间盘的角度(IVDA);在CT图像横轴位上,分别测量腰1-5椎体上 、下终板的长度(BVL)和宽度(VBW).采用单因素方差分析,比较滑脱组与对照组间各测量值的差异.采用Logistic逐步回归分析全腰椎椎体及椎间盘的角度与LDS的相关性.结果 与对照组相比,女性LDS椎体的变化:L1 VBH中柱 、L3 VBH前柱和中柱高度变矮,L5下终板的VBL变长,L2上 、下终板以及L3上 、下终板的VBW变宽,L5 LLA变小;椎间盘的变化:L1/2后份IVDH、L2/3后份IVDH、L3/4后份IVDH、L4/5前份及中份IVDH、L5/S1前份及中份IVDH变矮.L1/2 IVDA、L3/4 IVDA变大 、L5/S1 IVDA变小.男性LDS中椎体的变化:L3 VBH中柱高度变矮,L2上 、下终板以及L3上 、下终板的VBW变宽,L1 LLA变小,L4 LLA变大;椎间盘的变化:L3/4中份及后份IVDH、L4/5前份 、中份及后份IVDH、L5/S1前份IVDH变矮.L2/3 IVDA变大 、L4/5 IV-DA变小.Logistic回归分析结果显示LDS与L4 LLA、L2/3 IVDA、L3/4 IVDA、L5/S1 IVDA有显著性相关关系,回归系数分别为0.718、1.330、0.900、1.093.结论 L4 LLA、L2/3 IVDA、L3/4 IVDA、L5/S1 IVDA的变化与LDS的发病有一定的相关性.

Objective To provide the anatomical basis for avoiding damage to the superior gluteal artery in the sacroiliac screw placement horizontally, by means of radiologic anatomy study on the anatomical relationship between the first sacral vertebral ( S1 ) sacroiliac screws' entry points and the pelvic outer superior gluteal artery branches. Methods Seventy-four superior gluteal artery CTA vascular images of adults (37 women and 37 men) were done with 128-slice spiral CT. The CT attendant measuring software was used to portray the " safe bony entrance area" (short for " safe area" ) of the S1 segment in the standard lateral pelvic view of three dimensional reconstruction. The anatomical relationship between S1 sacroiliac screws' safe area and the pelvic outer superior gluteal artery branches was observed and recorded. The number of cases in which artery branches intersected the safe area was counted. The cases in which superior gluteal artery branches disjointed from the safe area were chosen and measured. And the measuring point was the nearest distance between the safe area and the superior gluteal artery branch closest to the safe area. Results Among the 74 cases, 3 cases were found no bony space for horizontal screw placement in S1 segment, so they were excluded from this study. Among the remaining 71 cases, there were 32 cases(45. 1% ) whose the deep superior branch of superior gluteal artery passed through the safe area of S1 entrance point. There were no distinguishing feature and regularity of the overlap of the deep superior branches and the safe area. In the 39 cases in which superior gluteal artery branches disjointed from the safe area, the deep superior branches of superior gluteal artery were the branches closest to the safe area. And the part of the branch closest to the safe area located in front of the widest part of the safe area. The nearest distance between the deep superior branch and the safe area was (0. 86 ± 0. 84)cm. Conclusions There is a high risk of accidental injury of the deep superior branches of superior gluteal artery in the process of S1 sacroiliac screw placement. Even entry points are located in the safe bony entrance area, the secure placement cannot be assured absolutely. We suggest that great attention must be paid to makeing thorough preoperative plans.

Objective To provide the anatomical basis for avoiding damage to the superior gluteal artery in the sacroiliac screw placement horizontally,by means of radiologic anatomy study on the anatomical relationship between S2 sacroiliac screws' entry points and the pelvic outer superior gluteal artery branches.Methods 74 superior gluteal artery CTA vascular imaging of adults (37 women and 37 men) were done with 128-slice spiral CT.The CT attendant measuring software was used to portray the safe entrance bony area (safe area for short) of the S2 segment in the standard lateral pelvic view of three dimensional reconstruction.The anatomical relationship between S2 sacroiliac screws' safe area and the pelvic outer superior gluteal artery branches was observed and recorded.The number of cases in which artery branches intersected the safe area was counted.The cases in which superior gluteal artery branches disjointed from the safe area were chosen and measured.And the measuring point was the shortest distance between the safe area and the superior gluteal artery branch closest to the safe area.Results Among the 74 sample cases,21 cases were found have no bony space for horizontal screw placement,so were excluded from this study.Among the remaining 53 sample cases,there are 12 cases (22.6％)where the deep superior branch of superior gluteal artery passes through the safe area of S2 entrance point,and there are 16 cases (30.2％) where the superficial branch of superior gluteal artery passes through the safe area of S2 entrance point.The total rate of overlap between the safe area and the artery is as high as 52.8％.There is not distinguishing feature and regularity of the overlap between the deep superior and superficial branches and the safe area.Among the 53 sample cases,there are 20 cases (37.7％) where the safe area of S2 entrance point is located between the superficial branch and the deep superior branch of superior gluteal artery.There are 5 cases (9.4％)where the safe area of S2 entrance point is located posterior to the superficial branch of superior gluteal artery.In the sample cases where the superior gluteal artery and the entrance point do not intersect,the part of superior gluteal artery closest to the safe area is located in front or back of the widest part of the safe area.Conclusion There is a higher risk of accidentally injury of the deep superior branch and the superficial branch of superior gluteal artery in the process of S2 sacroiliac screw placement.Even entry points are located in the safe entrance bony area,absolutely secure placement cannot be assured.We suggest that great attention must be paid to make thorough preoperative plans.