Objective To compare diagnostic performance of CT and MRI for cystic renal masses using the Bosniak classification system.Methods CT and MRI data of 30 cases(42 cystic renal masses) with pathologically or clinically follow-up confirmed were retrospectively reviewed.Diagnostic performance of both modalities was compared using receiver operating characteristic curve.Results Six,twenty four,nine,and three lesions were classified as Bosniak I,II,IIF,III and IV respectively under CT.And false positive number was zero while false negative number was 14 with pathological correlation.Eight,eighteen,ten and six lesions were classified as Bosniak I,II,IIF,III and IV respectively under MRI.And false positive number was zero while false negative number was 11 with pathological correlation.The area under the receiver operating characteristic curve for MRI was larger than CT.Both specificity and sensitivity of the former were higher than those of the latter.Conclusion Diagnostic performance of Bosniak classification with MRI is higher than that of Bosniak classification with CT.Bosniak classification with MRI is recommended as soon as condition permits.

目的观察在CT增强检查静脉注射非离子型碘帕醇对比剂和碘克沙醇对比剂后对患者肾功能的影响。方法回顾性分析在我院行CT增强检查并符合条件485病例,其中碘帕醇组236例,碘克沙醇组257例,两组患者在增强前12h及增强后72h内测定血肌酐值(Scr),计算Scr绝对值及CIN的发生率。结果碘帕醇组及碘克沙醇组血肌酐绝对值无明显差异,分别为3.57μmol·L-1和3.21μmol·L-1P>0.05,两组对比剂肾病发生率亦无显著性差异.分别为2.54%和2.72%P>0.05。结论碘帕醇和碘克沙醇对患者肾功能的影响无显著性差异。

目的 探讨CT对恶性腹膜间皮瘤的诊断价值.方法 回顾性分析12例经组织学证实的恶性腹膜间皮瘤的CT征象,并讨论其CT特点.结果 12例恶性腹膜间皮瘤中,1例为局限型腹膜间皮瘤,11例为弥漫型腹膜间皮瘤.主要CT表现:1例局限型腹膜间皮瘤表现为孤立性的巨大囊实性肿块,以囊性为主,实性区显著强化;11例弥漫型腹膜间皮瘤均表现为腹腔积液及腹膜、大网膜、肠系膜不规则增厚,其中8例见广泛的明显强化的腹膜结节、肿块,6例形成网膜饼,腹膜后淋巴结肿大2例,合并胸膜病变2例.结论 显著的腹腔积液伴不规则腹膜增厚及广泛腹膜强化结节、肿块是弥漫型恶性腹膜间皮瘤的主要表现.

Objective:To investigate the manifestations of non-hodgkin's lymphoma involving deep lymph nodes and large vessels on contrast-enhanced multi-slice spiral CT.Methods:We retrospectively reviewed the CT imagings of 62 cases of pathologically proved non-hodgkin's lymphoma(NHL) with deep lymph nodes and large vessels involved,including 38 cases of diffuse large B-cell lymphoma,13 peripheral T-Cell Lymphoma,3 follicular lymphoma,3 mantle cell lymphoma,3 small B-cell lymphoma and 2 small lymphocytic lymphoma.Results:① Distribution site: all pathological types of non hodgkin lymphoma mainly involved retroperitoneal and abdominal lymph node,as well as mediastinal and pelvic lymph nodes in some cases;② Discreteness and coalesce: lymph nodes especially retroperitoneal involved by Diffuse large B cell lymphoma,mantle cell lymphoma and small B cell lymphoma tends to be coalesce,but lymph nodes involved by peripheral T-Cell Lymphoma and small lymphocytic lymphoma are all discrete;③ "vascular embedding" sign: when large vessels embedded by discrete lymph nodes,"vascular embedding" sign was formed,all embedded vascular had no sign of luminal irregularity,stenosis and rough wall.Conclusion:Non-hodgkin's lymphoma with deep lymph node involvement mainly involved retroperitoneal lymph node,followed by abdominal lymph nodes."Vascular embedding" sign,which indicates no luminal irregularity,stenosis and rough wall,is helpful for the differentiation from other malignant tumors.

目的 探讨CT三维成像评价蝶腭孔相关结构的价值.方法 使用Philips Mx8000型多层CT对5个成人头颅标本进行准直1 mm或0.5 mm的容积采集,并将数据输入配套Mxview工作站(SGI O2)进行三维重建处理,包括容积显示(VR)和三维正交多平面重建(MPR).并将图像上测量的数据与标本上实际测量的数据进行配对t检验.同时用相同的技术对12例临床病人进行扫描重建,并与标本CT图像进行比较.结果 蝶腭孔区各结构均能在三维重建图像中直观、清楚地显示,并且在VR所测数据与实际标本上所测数据基本一致.临床病例检查图像与标本图像质量相当.结论 CT容积采集三维重建可以直观、立体地显示蝶腭孔相关结构,准确地测定相关数据,并可应用于临床.

目的 探讨肝脓肿伴随的一过性肝灌注异常(THPD)的CT表现及其可能形成机制.方法 44例临床证实的肝脓肿病例纳入研究,男25例,女19例,年龄33～84岁,平均66岁;采用16层螺旋CT机完成平扫、动脉期和门脉期的三期扫描.动脉期为开始注射对比剂后约23～30 s,门脉期为约55～75 s.两位有经验的放射科医生共同回顾性分析所有图像.结果 共出现THPD18例(40.9 %),仅见于动脉期10例,同时见于动脉期和门脉期7例,仅见于门脉期1例.6例THPD明显大于病变,呈肝叶型分布,其余呈肝段、亚段或楔形分布,与血管性解剖一致.2例动脉期MIP显示肝动脉门脉瘘.结论 肝脓肿伴随的THPD有一定特点,有助于肝脓肿的诊断;多种机制造成THPD现象的发生.

目的探讨16层螺旋CT血管成像对椎动脉变异的诊断价值及其三维影像解剖特征。方法对300例接受椎动脉多层螺旋CT血管成像(MSCTA)检查的患者图像进行回顾性分析,结合横断面、容积重建(VR)、多平面重建(MPR)及最大密度投影(MIP)观察椎动脉变异情况。结果共94例椎动脉先天变异(6种类型),占31.3%,其中3例合并2种以上的变异,包括单侧椎动脉先天性狭窄32例(10.7%);椎动脉起源变异18例(6.0%);椎动脉行径变异37例(12.3%);椎动脉窗式变异1例,双椎动脉1例,单干椎动脉形成基底动脉7例(2.3%)。结论椎动脉先天变异较为常见,解剖变异较为复杂,MSCTA能予以较好的评价。

Objective:To study the feasibility of transcutaneous needle interventional thrombolysis combined with traditional Chinese medicine on treating acute venous thrombosis in lower limb.Methods:A colander was first put in antrum vein and urokinase combined with traditional Chinese medicine and ligustrazine was then injected slowly by thrombolysis catheter through thrombosis.Results:The effective rate of thrombolysis Was 100 percent.The tumefaction of trouble limb relieved slowly.The symptom Was obviously improved and the size of the thigh becomes normal.Conclusion:Interventional thrombolysis combined with traditional Chinese medicine is an effective and simpie operated method to treat acute venous thrombosis in lower limb.

目的探讨黄色肉芽肿性肾盂肾炎的CT表现。方法搜集手术病理证实的黄色肉芽肿性肾盂肾炎患者5例,所有患者术前均进行了CT检查,分析其CT表现。结果5例患者均为单侧肾脏受累,体积明显增大,功能降低;收集系统内均见结石,4例为多发,1例为单发,其中4例结石呈鹿角状;病肾内均可见多个囊性占位,密度较低,大小不一,增强后囊壁强化;1例患者伴腰大肌和腹壁脓肿形成。结论CT能够显示黄色肉芽肿性肾盂肾炎的特征性表现,准确显示病变范围和邻近组织的改变,是影像学检查的首选方法。

Objective To evaluate the value of spiral CT portography in demonstrating the PV systems and collaterals in portal hypertension. Methods Fifty-one patients with HCC and/or liver cirrhosis associated with portal hypertension underwent spiral CT portography and conventional portography.The patency of the main portal vein,its right and left branches were examined.The distribution and extent of collaterals were also assessed.The findings of CTP were compared with those from conventional portography.Results In the 153 portal veins and branches of 51 patients,CTP displayed 104 of 107 patented portal veins and 44 of 46 obstructed ones with high concidence(96.7%,148/153). The presence of collaterals revealed by CTP was correlated well with portography,and the concidence rate is 95.3%(41/43). Conclusion Compared with conventional portography,CTP can determine the portal venous patency accurately,and display collaterals with high concidence.It can essentially replace the invasive portography.

植物性胃石症在南方较为少见,笔者遇到12例,通过X线钡餐检查确诊后用药物消溶治疗,经复查与随访疗效良好.现就植物性胃石症的临床X线表现和消溶治疗方法总结报告如下. 1 材料与方法 1.1 临床资料 本组12例,男7例,女5例,年龄21～84岁,平均38岁.全部病例均以上消化道症状来院诊治 ,通过X线钡餐检查确诊.12例均有食柿子、山楂史.食量在250～500g以上,最多者一次食鲜山楂约750g.大部分在食后当日至3天后出现症状.患者均有上腹饱胀、反酸、呃逆及不同程度疼痛与食欲减退,3例食后有呕吐.查体时5例上腹部摸到肿块,其中4例肿块活动度