Objective To investigate the correlation of CT grade in emphysema patients with the morphologic change in the anterior mediastinum.Methods Retrospectively analyzed 50 patients met the diagnostic criteria of chronic ob structive pulmonary disease(COPD),all the patients included in the study showed vary degree of progress in the patient's condition,anteroposterior diameter and emphysema degree were measured by chest CT before and after the emphysema patient's condition progress.Results Before and after emphysema patient's condition progress,the differ ences of the total score of CT grading and the anteroposterior diameter were statistically significant(P < 0.01).There was positive correlation between the CT grade and the anteroposterior diameter(r = 0.851,P < 0.01).Conclusion The morphologic change in anterior mediastinum can reflect the degree of emphysema,the change of anteroposterior diam eter can predict the degree of emphysema,and it provides a more simple and effective imaging study for early clinical diagnosis and treatment of emphysema,and is also worth promoting and applying in the primary hospital.

Objective To investigate MR imaging characteristics and healing process of bone contusion of the knee.Methods MRI appearances of bone contusions of the knee joint in 32 cases were observed in 1,3,6 and 12 months respectively by MRI.Results In the first month,the extent of bone contusion increased in 7 cases,decreased in 20 cases and disappeared completely in 5 cases.3 months later,the extent of bone contusion did not increased in all cases and disappeared completely in 14 cases.6~12 months later,the bone contusion disappeared in 7 cases,the signal intensity of bone contusion was not disappeared completely over one year.Conclusion MRI can offer early diagnosis of bone contusions of the knee.The extent of bone contusion of the knee joint may be increased in short times after injury,and disappearance completely of the bone contusion in part of patient needs more than one year later.

Objective:To study the CT diagnosis of splenic metastatic tumor.Methods:15 cases scanned by CT of Siemens Somatom Plus 4 were confirmed by operation,biopsy and follow up.Results:The CT findings of 15 cases were single or multiple low density lesions with types including 7 cysts,4 nodules,4 masses.Conclusion:The imaging manifestation of splenic matastatic tumor is frequently in cystiform.CT is now the important method for diagnosing the splenic metastatic tumor.And CT combined with clinical analysis can make a definite diagnosis.

目的:总结成人胆总管囊肿合并胆道系统肿瘤的影像学表现.方法:回顾分析15例经手术病理证实的成人先天性胆总管囊肿合并胆道系统肿瘤的影像资料,总结其影像学特征.结果:先天性胆总管囊肿合并胆管癌11例,其中5例为肝门部胆管癌,表现为肝门部肿块,具有特征性表现;其中6例为囊肿内合并肿瘤,表现为附壁小结节或乳头样突起.胆总管囊肿合并胆囊癌3例,表现为胆囊腔内软组织肿块或囊壁不规则增厚,MRI上信号较结石略高.胆总管囊肿合并胰腺癌1例.15例中,胆总管囊肿同时合并胆道系统肿瘤、结石6例.结论:成人胆总管囊肿较易合并胆道肿瘤,CT、MRI检查时应该提高警惕,MRCP对囊肿显示清晰,准确,结合动态增强,可以提高肿瘤的检出率及定性.

目的:改善CT扫描技术以提高鼻骨骨折的CT诊断正确率.材料和方法:对60例临床和CT诊断的鼻骨骨折病人和40例正常志愿者的HRCT横断位和改良冠状位扫描图像进行回顾性分析.结果:对照组CT改良冠状位显示鼻骨孔35对,优于横断面扫描(显示20对);60例鼻骨骨折中改良冠状位扫描检出鼻骨骨折58例(96.7%),高于横断位检出(42例,70%),但鼻区并发症检出(17例)明显低于横断位(46例).结论:改良冠状位HRCT扫描可以提高鼻骨骨折检出率,结合横断位则更好,并可以提高鼻区并发症的检出率.

患者 女,36岁.间歇性腹部钝痛7年余,加剧4 d入院.患者食欲不振,消瘦,呈贫血貌.实验室检查:血常规:WBC 6×109/L,L 0.47,N 0.53,RBC 3.0×1012/L,Hb 102 g/L,血沉32 mm/h;结核菌素试验(+),大便隐血试验(-).患者既往有肺结核病史,发作期间均以慢性肠炎治疗,服药后病情缓解.

Objective:To investigate the spiral CT features of single hepatic metastasis.Methods:With 12 cases of single hepatic metastasis for research object,9 among those cases was confirmed by the surgical operation pathology,3 cases were confirmed with visit to countercheck CT,and all the cases in liver underwent CT scan,plus the dynamic enhanced scan,to retrospectively analyze the CT characteristics of single hepatic metastasis.It is of much more difficulty to diagnose the single hepatic metastasis with CT,and this group was diagnosed correct with five cases.Results:In addition to the fami- liar CT characteristics of the hepatic metastasis,the single hepatic metastasis has the following special symptoms:the diameter of lesion is small,and there is a false envelope to enhance the edge,equal density can be showed on enhancement in portal phase,the lesion around the liver has hollow change in envelope.Conclusion:The diagnosis of single hepatic metastsis is difficult,understanding the CT features could raise the correct diagnosis.

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.

目的:为股骨颈骨折复位及内固定提供X线解剖学资料,提高复位、内固定的质量.方法:在7具(14侧)成人整尸上,研究髋关节各方向位置变化时(包括屈曲、内旋、外旋位上股骨头内部骨小梁)的X线变化规律.结果:髋关节在屈曲、内旋、外旋时,其内部骨小梁的排列方向在正侧位上有规律可循,并将之应用于临床,明显提高了复位及内固定的质量,并降低了股骨头的坏死率及骨不连率.结论:研究髋关节功能X线解剖,有助于临床上对股骨颈骨折的解剖复位及牢固固定,进而降低了股骨头的坏死率及骨不连率.

患者男,39岁.右中上腹阵发性疼痛6天伴恶心、呕吐入院.入院前近半月来经常酗酒.无明显外伤史.体检:T 37.2℃,P 92次/分,Bp 150/110mmHg,WBC 15×109/L,N 0.77.右中上腹压痛,右肾区叩痛. CT检查: 右侧腹膜后见9cm×8cm大小类圆形高密度灶,密度均匀,边缘清楚,CT值62HU,十二指肠降部受压略前移,水平部显示不清.肝、脾周围见积液征象,两侧肾前旁间隙亦见积液,右肾周模糊.增强后块影无明显强化(图1、2).CT诊断:腹膜后肿瘤,性质待查.

神经鞘瘤是发生在周围神经鞘瘤雪旺氏细胞的一种肿瘤,可以发生在身体的各个部位,以颈部神经鞘瘤较多见,而颈部的肿块种类繁多,从这众多种类肿块中区别出神经鞘瘤,有赖于识别神经鞘瘤的CT表现特征,本文收集我院1990年以来经病理证实的颈部神经鞘瘤21例,对其表现进行分析.

材料与方法一、一般资料:收集我院从1993年-1999年资料完整的肝癌病例共35例,均经手术,病理证实为HCC.35个病例中,共有46个病灶,男25例,女10例,其中年龄最大66岁,最小34岁,平均47岁,临床有心肾功能障碍3例,有肝炎肝硬化病史30例,AFP增高30例.