目的 探讨后胡桃夹综合征和后胡桃夹现象多层螺旋CT诊断价值.方法 搜集9例后胡桃夹综合征和5例后胡桃夹现象患者的CT资料进行回顾性分析,观察左肾静脉(LRV)的走行及形态,测量LRV扩张段内径、狭窄段内径和扩张段与狭窄内径比值.结果 14例患者中,LRV经腹主动脉后方单支注入下腔静脉11例,经腹主动脉前后方注入下腔静脉2例,于腰4椎体下缘水平单支注入下腔静脉1例.9例后胡桃夹综合征患者狭窄段LRV内径1.18 ～3.97 mm,平均(2.70±0.84) mm;扩张段LRV内径9.65 ～14.40 mm,平均(11.39±1.76) mm;狭窄段与扩张段内径比值1∶3.17～1∶8.05,平均为1∶(4.80±1.98),内径比值＞3,符合胡桃夹综合征的诊断标准.5例后胡桃夹现象患者(包括2例环主动脉型)狭窄段LRV内径为4.62 ～7.60 mm,平均(6.30±1.09) mm;扩张段LRV内径为7.90～11.58 mm,平均(10.23±1.39) mm;狭窄段与扩张段内径比值1∶1.18～1∶2.35,平均为1:(1.68±0.46),内径比值＜3,不符合胡桃夹综合征的诊断标准.结论 MSCT可准确显示变异的LRV走行及形态,并可明确诊断后胡桃夹综合征和后胡桃夹现象,为临床选择治疗方案提供重要依据.

Objective To investigate the characteristics and diagnostic value of multislice spiral CT (MSCT) of intestinal lipomas causing intussusception.Methods The MSCT findings of 25 cases with intestinal lipomas causing intussusception were retrospectively analyzed,the tumor location,size,shape,density,enhancement patterns and shape and length of intussusception were also observed retrospectively.Results Tumors were 1.2-6.5 cm in diameter,round or oval in shape (n =18),irregular shape (n =4),tubular shape (n =3) with uniform density (n =19),or uneven density (n =6).Under CT enhancement tumor capsule was moderately intensified.Intussusception included ileum-ileum type (n =7),jejunum-jejunum type (n =5),jejunum-ileum type (n =2),ileum-colon type (n =4),and colon-colon type (n =7).Intussusception was 5.0-5l.0 cm in length;presenting as "concentric circles" (n =12),"round target sign" (n =7),or " banana" (n =6).Conclusion Intestinal liporna complicating secondary intussusception has definite MSCT characteristics which can help establish diagnosis.

Objective To investigate the radiological and clinical features of osteoarthrosis in congenital insensitivity to pain with anhidrosis (CIPA).Methods The clinical and radiological features in 8 cases of CIPA diseases were retrospectively analyzed. There were five males and three females,age ranged from 11 to 18 years with a median age of (14±3) years. X-ray plain film findings in eight cases were analyzed for the location, extent and contour of the lesions, surrounding bony sclerosis, as well as joint and soft tissue changes. Results The main clinical presentations were insensitivity to pain, anhydrosis, fever, mental retardation and infection. In these eight cases, a total of 166 pieces of bone were involved, including the plantar and phalanges (n=115),phalanx (n=29).The radiological findings include dissolution of the entire bone or most of the bone (n=113), dissolution of a few small areas of the bone (n=40), dissolution of the bone with only residual punctate areas (n=7), the“pushpin sign”and“pencil tip sign”and“flat cut sign”of the finger osteolysis (n=6), sclerosis of peripheral bone (n=12), pathological fractures (n=2). Joint dislocation (n=3),joint deformity (n=3), and Charcot joint (n=3) were observed.Necrosis of soft tissue(n=4), complete absence of soft tissue in the finger or toe (n=4), dot-like calcification of the soft tissue(n=3) were also observed. Conclusion Osteoarthrosis in patients with CIPA had certain X-ray and clinical characteristic findings, which could facilitate its diagnosis.

目的 探讨颅骨创伤后骨质溶解的影像特征.方法 回顾性分析经临床、病理证实的19例颅骨创伤后骨质溶解影像表现.结果 骨质溶解位于顶骨9例,额骨4例,颞骨3例,枕骨3例.骨质溶解范围2.0 ～5.0 cm,平均3.3 cm.内外板完全溶解7例;外板完全溶解,内板残留条片状及点状小骨片7例;外板不全或完全溶解,内板凹凸不平3例;上下层面内外板完全溶解,中间层存留正常骨质2例.溶解边缘骨质均无硬化,溶解区界限清楚16例,界限不清楚3例.结论 颅骨创伤后骨质溶解与外伤密切相关,影像表现具有一定特征,结合外伤史可以作出明确诊断.

目的：探讨16层螺旋CT 低剂量扫描及重建在诊断肺动脉栓塞中的价值。方法选择临床确诊的肺动脉栓塞患者78例行肺动脉增强扫描，随机分为常规剂量组46例和低剂量组32例。常规剂量组设定管电流为150～250mAs，低剂量组为50mAs，进行 CT 扫描及重建技术。结果肺动脉栓塞阳性：常规剂量组37例（80.4%），低剂量组25例（78.1%）；两组阳性诊断率差异无统计学意义。低剂量组的图像质量稍差，噪声较多，但均能满足诊断需要。结论在不影响CT 诊断质量前提下，适当降低扫描剂量是可行的。

Objective To investigate the correlation between subacromial space and acromial shoulder impingement syndrome (SIS).Methods The clinical and imaging data of 40 patients with SIS were collected and retrospectively reviewed.The shape of acromion and tears of rotator cuff of all patients were classified.A cromion-Humerus (A-H) distance was measured.Results Among 40 patients,there were 9 cases of type Ⅰ,12 cases of type Ⅱ,19 cases of type Ⅲ.32 patients had subacromial space narrowing.7 cases had calcification in the supraspinatus tendon and 10 patients had acromioclavicular joint ostcoarthritis.There were 17 cases of type Ⅰ,15 cases of type Ⅱ,18 cases of type Ⅲ of tears of rotator cuff.6 patients had subacromial bursa thickening,5 patients had subacromial-deltoid sac fluid and 10 patients had the joint capsule fluid.2 patients had jointlabrum avulsion,3 patients had the supraspinatus muscle atrophy and 4 patients had Bankart Lesion.There was no significant difference was found in A-H distance measured with X-ray and MRI(P =0.137 0).There was positive correlation between the A-H distance and class of rotator cuff(r =0.545,P =0.000 1).Conclusion There exists some correlation between subacromial space and SIS.The diagnosis and class of SIS can be assessed according to narrowing range of subacromial space.

Esophageal submucosal hematoma is rarely seen in clinical practice and its clinical presentations are untypical.Gastroscopy might injure the esophageal mucosa and cause bleeding.Computed tomography had the advantages of quick examination and formation of imaging,as well as non-invasiveness,which is helpful for the diagnosis and differential diagnosis of the esophageal submucosal hematoma.The clinical data of 9 patients with esophageal submucosal hematoma who were admitted to the Yueqing People's Hospital,the First Affiliated Hospital of Wenzhou Medical University,the First Affiliated Hospital of the Zhengzhou University and the Third People's Hospital of Wenzhou from July 2005 to February 2014 were retrospectively analyzed.The features of computed tomography examination of esophageal submocosal hematoma include the range of the esophageal submucosal hematoma exceeds 2 parts of the esophagus,the rip of the esophageal mucosa begins and ends at the physiological narrowing of the esophagus,thickening of the esophageal wall,stricture of the esophagus,annular thickening and eccentric thickening of the esophageal wall,crescent,spot or gas shadows of the esophageal cavity,the density of the hematoma decreases as the time passed by.These features of computed tomography are of great importance for the diagnosis of esophageal submucosal hematoma.

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 evaluate the correlation between MRI imaging indexes and subacromial impingement syndrome ( SIS) .Methods We retrospectively analyzed the clinical and MRI imaging data of 40 cases diagnosed SIS from May 2009 to A-pril 2013, And 40 healthy volunteers were selected as the control group.Acromion index ( AI), Acromiohumeral distance (AHD), the acromion morphology were observed and their Constant scores were assessed.Results AI in SIS group was signifi-cantly higher than that of the control group (P<0.05), while AHD and Constant scores in the SIS group were significantly lower than that of the control group (P<0.05).Acromion species distribution in SIS group was nine cases of type I, 12 cases of type II, and 19 cases of type III, showing no significant difference with the control group (P<0.05).Spearman correlation analysis showed that, SIS group acromion morphology and Constant score were no significant correlation (r=-0.092, P>0.05).AI and AHD in SIS group with Constant score then showed a positive correlation between (rAI=0.221, P<0.05; rAHD=0.406, P<0.05).Conclusion AI and AHD showed correlation with SIS, and clinical conditions can be changed according to the diagno-sis and classification of the SIS.

Objective To study the CT features of pulmonary primary lymphoma in order to improve the understanding of this disease .Methods CT findings of 21 cases with lung primary lymphoma confirmed by pathology were retmspective-ly analyzed .Results 21patients were non-hodgkin lymphoma ,of which 16 cases were mucosaassociated lymphoid tissue lymphoma ,4 were high grade malignant Diffuse large B-cell lymphoma ,1 case was T cell lymphoma .8 cases were mass or nodular type ,7 cases were pneumonic-type ,and 6 cases were consolidation-type .14 cases showed air bronchogram ,4 ca-ses showed perifocal interlobular septal thickening ,2 cases showed cross lobe growing ,and 5 cases showed merger pleural effusion .Conclusion Pulmonary primary lymphoma shows the diversity with multidetector-row CT .The distribution of interstitial lung masses or the clearly edge lesion with bronchial wall thickening ,and peripheral lobular septal thickening , may be pulmonary lymphoma ,especially anti-infection treatment is invalid .

Objective To study the value of diffusion weighted imaging (DWI) in the differentiation of benign and malig-nant bile duct carcinoma and liver space -occupying lesions .Methods Using DWI technique ,we tried to differentiate the bile duct carcinoma ,benign or malignant liver space-occupying lesions in patients with liver disorders ,to explore the role of DWI in qualitative diagnosis of bile duct carcinoma and the other space-occupying lesions in the liver ,and to identify the characteristics of other diseases .Results ADC values of hepatocellular carcinoma (HCC) ,liver metastases ,and bile duct cancer were no significant difference .However ,the ADC values of liver hemangioma ,liver cyst and normal liver tissue were statistically significant higher than that of bile duct carcinoma .ADC values of duct carcinoma were no significant difference compared with these of malignant lesions ,whereas ,ADC values of the bile duct carcinoma were markedly low-er ,with statistically significant difference .Conclusion DWI sequence ,which has high speed ,can differentiate the be-nign ,malignant bile duct carcinoma ,and liver space-occupying lesions via image characteristics and the quantitative analy-sis of ADC value .Therefore ,DWI can provide quantitative diagnostic information and can be used as a supplement for the upper abdomen scan check sequence ,which should be taken as one of routine MRI sequences .

Objective: To investigate the MRI findings and differential diagnosis of spontaneous spinal epidural hematoma. Methods: There were 9 cases of spontaneous spinal epidural hematoma. Four were male and 5 were female. All cases did not have history of trauma. The routine SE T1WI and T2WI sagittal and transversal planes were performed with MRI scanner. Seven cases were examined by enhanced MRI. Results: The hematomas located at the dorsum of spinal canal in 8 cases and at the ventral side of spinal canal in 1 case. The hematomas covered 3 to 5 vertebral bodies with average of 4 vertebral segments. There were 4 cases at cervical segment, 4 cases at cervicothoracic segment, 1 case at lumbar segment. The hematomas had crescent or long ribbon shape. Hematomas in 3 cases were of homogeneous high signal on T1WI and T2WI, 4 cases were of medium signal on T1WI and high signal on T2WI. Two cases had heterogeneous high signal both on T1WI and T2WI. There was a low signal septum between spinal cord and henatoma on T1WI and T2WI, especially clear on T2WI. The wall of hematoma was enhanced in 3 cases on MRI enhancement scan. Conclusion: MRI is the best method in diagnosing spontaneous spinal epidural hematoma. It not only can show clearly the location and the extent of hematoma clearly, but also the age of hematoma and injury of the spinal cord.

The ultrasonic inspection and test technology is widely used in the quality inspection and test of the cast-in-site pile and pavement because of its inspection and test having the portable and agility advantages with the large range of application. The article focuses introduction on its basic principle and its application in the inspection and test of cast-in-site pile.

目的:探讨肝转移瘤的螺旋CT表现特征,着重讨论双期扫描表现.方法:回顾性分析78例已证实的肝转移瘤的螺旋CT扫描资料.检查机型采用西门子Somatom Plus4螺旋CT机扫描.结果:肝转移瘤CT表现大多数为多发性低密度结节病灶,少数为孤立性低密度结节病灶,双期扫描显示大多数病灶为少血供,少部分病灶为多血管,各具有不同的影像学特征.结论:螺旋CT双期扫描可提高肝转移瘤的检出率,并有利于病灶特征的显示.

Objective To study the correlation between anatomical measurement and CT measurement of adult occipital thickness so as to provide anatomic evidence for the selection of screw length in occipital-cervical fusion. Methods The occipital thickness was measured on the occipital specimens of 10 normal adults in two ways: direct anatomic measurement and CT measurement. Measurements were made on the basis of the McRac' s line and according to a matrix of 66 points following a grid with one cm spacing. The results of both measurements were statistically analyzed using SPSS 10.0. Results The results of both measurements were highly correlated. The external occipital protuberance was the thickest while the region of cerebellar fossa was the thinnest. The regions two cm lateral to the midline between plane Five and plane Six, one cm lateral to the midline between plane Four and at plane Five, and median between plane Three and plane Four were found to have a thickness of more than eight mm. Conclusions The occipital thickness varies with individuals. CT measurement and direct anatomic measurement are highly correlated. Preoperative CT measurements can be reliable evidence for optimal screw placement before performing occipital-cervical fusions.

鼻骨骨折临床上较为常见.当颜面部受到暴力外伤时,鼻骨极易发生骨折.鼻骨骨折的影像学诊断极为重要,它可为临床治疗提供重要依据;同时鼻骨骨折最常发生于斗殴、车祸,涉及司法鉴定[1],详细、准确的影像学资料同样重要.本文收集本院2003年8月至2004年11月同时行CR及HRCT检查明确诊断为鼻骨骨折病例进行回顾分析.

急性肠套叠是婴幼儿最常见的急腹症之一,好发于春夏季节,常见于2岁以下的婴幼儿,采用空气灌肠来诊断和治疗肠套叠为最有效的首选的非手术疗法,其操作简便,复位迅速,安全可靠,整复成功率可达90%以上.本文回顾性分析我院237例婴幼儿肠套叠用空气灌肠来诊断和治疗的操作方法,探讨整复成功的因素,指导将来的诊断和治疗.

目的探讨肝脓肿的螺旋GT表现特征,着重讨论动态增强扫描表现.方法回顾性分析32例已证实的肝脓肿的CT平扫,动态增强扫描资料.结果增强扫描表现为:(1)高灌注异常:非病变肝组织一过性不均匀强化.(2)边缘强化:肝脓肿灶周环状或不规则强化.(3)分隔状强化:肝脓肿整个病灶呈蜂窝状,簇状,分隔状持续强化.结论螺旋CT平扫和动态增强扫描对肝脓肿的定性诊断和鉴别诊断有很大帮助.