目的:探讨联用洛铂、表柔比星和丝裂霉素对原发性肝癌患者进行介入治疗的效果.方法:选择2014年1月至2018年12月期间广东省英德市人民医院收治的100例原发性肝癌患者作为研究对象.根据治疗方案的不同将其分为Oxaliplatin组(50例)和Lobaplatin组(50例).为Oxaliplatin组患者联用奥沙利铂、表柔比星和丝裂霉素进行介入治疗,为Lobaplatin组患者联用洛铂、表柔比星和丝裂霉素进行介入治疗.然后对比两组患者的治疗效果.结果:Lobaplatin组患者治疗的总有效率高于Oxaliplatin组患者,P<0.05.在治疗期间,Lobaplatin组患者不良反应的发生率低于Oxaliplatin组患者,P<0.05.结论:联用洛铂、表柔比星和丝裂霉素对原发性肝癌患者进行介入治疗的效果较为理想,且安全性较高.

目的:分析数字减影血管造影(DSA)引导下经皮肝穿胆管引流术(PTCD)治疗急性梗阻性化脓性胆管炎(AOSC)的临床疗效及安全性.方法:回顾性分析2005年1月1日-2019年3月18日于我院治疗的100例AOSC患者临床资料,依据治疗方法的不同将其分为两组,将接受DSA引导下PTCD+择期手术治疗的60例患者作为观察组,将接受急诊手术治疗的40例患者作为对照组.比较两组治疗存活率及并发症.结果:观察组存活率为98.33％,高于对照组的85.00％,并发症发生率为6.67％,低于对照组的37.50％,差异有统计学意义(P<0.05).结论:AOSC患者接受DSA引导下PTCD治疗有助于缓解全身状态,辅以择期手术治疗,利于提升生存率,减少并发症.

目的:分析髓外造血的影象学诊断的临床意义.方法:选取住院接受治疗的髓外造血患者22例,选取时间为2008年5月—2018年10月,所有患者在治疗前均接受MRI和CT(胸腔、肝、脾、肠管)影像学检查,对MRI和CT影像学资料进行分析(病灶的部位、病变的情况、病灶周围的组织变化),总结该病的影像学的特点和表现.结果:在对患者实施CT平扫时发现,患者的软组织肿块的密度均匀,增强后中度强化.MR表现为T1WI低信号以及T2WI高信号,增强后可见肝脾造血时可见肝脾增大,但缺乏特异性.结论:对髓外造血的CT或MRI表现具有明显的特征性,可以结合典型的影像学特点对患者的疾病做出准确的诊断.

目的 探讨MSCT在肝癌TACE术前预测碘化油沉积率的线性关系.方法 回顾性分析2 01 0年1月至201 7年1 0月我院诊治的79例肝癌经TACE介入治疗病例,根据术前MSCT病灶强化面积是否超过50％划分为研究组(强化面积均≥50％,n=55)及对照组(强化面积均＜50％,n=24),探讨两组的肿瘤碘油沉积率和近期疗效之间的差异.结果 研究组肿瘤碘油沉积率和近期疗效均显著高于对照组.两组的TACE介入术后碘油沉积率Z与术前最大截面长径X均呈显著性负相关,与强化面积比Y呈显著性正相关,研究组回归线性方程式为:碘油沉积率Z=0.555-0.041X+0.458Y.结论 MSCT增强扫描动脉期的肿瘤强化面积与TACE术后碘油沉积率呈正相关,MSCT动脉期表现为富血供的原发性肝癌在TACE术后有较高的碘油沉积率和较好的近期疗效.

Objective To analyze the clinical features and CT imaging data of acute appendicitis. Methods The clinical and CT imaging data of 62 cases with acute appendicitis proved by surgical resection and pathology in our hospital from November 2015 to October 2017 were retrospectively analyzed. Results In the 62 cases with acute appendicitis, the appendix positions: 56 cases of common positions, 5 cases of low positions, 1 case of high position.CT findings: 4 cases were illegible by appendicular CT. The diameter of the appendixes was ( 1. 04 ± 0. 31) cm in 58 cases among whom the diameters were larger than 6 mm in 53 cases and smaller than 6 mm in 5 cases. Appendiceal effusion occurred in 41 cases, appendix wall thickening (＞ 2 mm) in 48 cases, appendicium calculi in 17 cases, appendicium exudation in 54 cases, cellulites in 10 cases, abscess around appendicium in 5 cases, cumulation around appendicitis in 6 cases, peritonitis in 29 cases, ascites in 9 cases, thickening of ileum in 39 cases and enlarged lymph nodes in 10 cases. In 1 case with acute appendicitis, the swelling of appendix was thickened and strengthened obviously. The surgical and pathological results: simple appendicitis was found in 8 cases, pyogenic appendicitis in37 cases, and gangrenous appendicitis in 17 cases. The complications: perforation occurred in 9 cases, abscess formation in 5 cases, diffuse peritonitis in 11 cases and localized peritonitis in 18 cases. Conclusion Some specific CT signs are found in acute appendicitis: enlargement of the appendix, effusion of the appendix, thickening of the wall of the appendix and the exudation around the appendix. CT has a high diagnostic value for acute appendicitis.

目的 探讨小肝癌螺旋CT诊断及临床资料.方法 选取65例经手术病理学或临床证实的小肝癌患者作为研究对象,均进行螺旋CT诊断,回顾性分析所有患者应用螺旋CT检查的诊断结果 .结果65例患者经螺旋CT诊断有63例患者确诊为小肝癌,CT诊断准确率为96.92％,与手术病理检查结果比较差异无统计学意义(χ2=2.031,P=0.154>0.05).65例患者共有128个病灶,经CT平扫后确诊的63例患者共检出84个病灶,CT平扫检出率为65.63％(84/128),其中单病灶35例、双病灶10例、3个病灶18例,增强扫描肝动脉期、门静脉期以及延迟期检出率分别为76.56％、84.38％、60.94％,平均病灶直径为(1.6±0.7)cm.结论 小肝癌螺旋CT诊断具有较高诊断准确性,能够充分准确显示病灶部位、病灶大小以及病灶形态,值得临床大力推广.

目的 分析、研究肠系膜血管疾病的诊断与治疗.方法 对英德市人民医院2013年6月-2018年4月收治的44例肠系膜血管疾病患者的临床资料进行回顾性分析,研究肠系膜血管疾病的发病特点、诊断方式及治疗情况.结果 本研究44例患者中,36例白细胞计数升高;8例腹部B超检查有3例明确诊断为肠系膜上动脉栓塞(MAE);腹部X线检查12例;CT检查24例.CTA检查中2例确诊为肠系膜上动脉血栓形成(MAT),4例确诊为肠系膜上静脉血栓形成(MVT),6例确诊为MAE;数字减影血管造影(DSA)检查中3例确诊为MAT,2例确诊为MAE.误诊11例(25.0％),急性胰腺炎1例,急性胆囊炎2例,急性肠梗阻4例,急性阑尾炎4例.保守治疗14例,4例因拒绝手术治疗而死亡;手术治疗26例,22例治愈后出院,4例术后死亡;介入治疗4例,其中1例转开腹手术治疗.结论 肠系膜血管疾病的发病危急,诊断难度大,死亡率较高,及时进行CTA及DSA检查,根据病情状况予以保守、手术及介入治疗,是提高患者生存率的关键.

目的 探讨高频彩超和钼靶联合应用于Ⅰ～Ⅱa期乳腺癌诊断中的临床价值.方法 抽取我院2010年10月～2016年10月收治的96例经手术病理证实为早期乳腺癌的患者作为研究对象,回顾性分析患者的高频彩超、钼靶X线摄片检查阳性结果,并做出分期,以病理诊断结果为依据,计算两种检查方法单独或联合诊断早期乳腺癌的诊断阳性率以及分期符合率.结果 高频彩超、钼靶X线摄片单独及联合诊断乳腺癌的阳性率分别为82.29％、71.88％和90.63％.联合诊断的阳性率显著高于单独诊断,差异有统计学意义(P＜0.05).联合诊断的总符合率为88.54％,显著高于高频彩超、钼靶单独判断的79.17％、64.58％,差异有统计学意义(P＜0.05).结论 高频彩超和钼靶都是诊断乳腺癌的可靠方法,联合应用两种乳腺癌诊断方法不仅可以提高乳腺癌的诊断阳性率,而且可以为乳腺癌的准确分期提供依据,有利于早期乳腺癌的治疗和预后改善.

目的:胃癌应用气钡双重造影与多排螺旋CT临床诊断价值对比分析.方法:本实验共选取胃癌患者共208例,按照随机数字表法将其分成研究组和对照组(均n=104),本实验将多排螺旋CT和气钡双重造影分别应用于两组患者临床病症诊断中,对比相关临床指标数据情况.结果:相比于对照组,研究组患者阳性病理符合率和各影像学图像指标检出率均更高(P＜0.05),另外多排螺旋CT临床诊断准确率与手术病理结果一致性较强.结论:胃癌患者在临床诊断中应用多排螺旋CT能够进一步确定患者实际患病病情、提高确诊率同时参考诊断分析结果可以制定相应治疗方案,对于提高临床治疗效果、预后质量等均具有重要意义.

目的 研究早期肺癌肺小结节患者采用多排螺旋CT诊断的临床价值.方法 选取2015年3月至2016年2月在医院行肺部检查的患者120例.选用多排螺旋CT对患者进行扫描,排查肺癌出现情况.结果 经过检查,120例中非钙化结节78例,其中良性结节66例,恶性结节12例.在对高危患者进行复查的过程中,发现恶性结节1例,根据病理检查诊断为早期肺癌(鳞癌).12例首次检查出现恶性结节的患者,复查时发现1例结节有所增长,病理诊断为早期肺癌(腺癌),其余11例均进行手术治疗,经病理诊断为鳞癌5例,腺癌7例,均属于早期肺癌.结论 早期肺癌肺小结节采用多排螺旋CT机加以诊断,具有较好的诊断效果,可有效筛查出早期肺癌患者.

Objective To explore the value of DR dual energy subtraction technology in the diagnosis of pneumothorax. Methods 46 cases of pneumothorax examined by dual energy subtraction technology in our hospital during Mar 2015 to May 2016 were selected and got three images respectively as regular DR image, soft tissue image and bone tissue image at the same time. Compared the detection rate of pneumothorax and lung bullae which was the potential causes of pneumothorax by dual en-ergy subtraction technology and conventional DR. Results The detection rate of middle and large amount of pneumothorax by dual energy subtraction technology were the same as conventional DR. The detection rate of little amount of pneumothorax and lung bullae by dual energy subtraction technology were higher than conventional DR[90.0% vs 60.0%,81.3% vs 37.5%],the dif-ference was statistically significant (P<0.05). Conclusion The detection rates of dual energy subtraction technology in pneu-mothorax and lung bullae are higher than conventional DR, it can reduce missed diagnosis, and it is worthy of popularization and application in the clinic.

Objective To analyze the clinical characteristics and CT findings of cerebral vascular spasm (CVS) after subarachnoid hemorrhage (SAH).Methods The clinical data of 54 patients with SAH who were treated in our hospital between February 2010 and May 2015 were collected. All patients were examined by CT and digital subtraction angiography (DSA) after admission, and the clinical data were complete. With DSA as the golden standard, the accuracy of CT in the diagnosis of CVS after SAH was statistically analyzed. The CT imaging findings were summarized.Results There was 1 cases with ACA, MCA distal segment CVS missed diagnosed by CTA, and the accuracy rate in the diagnosis of CVS was 88.24%, slightly lower than that of DSA (P>0.05); CBV and CBF in patients with SAH and CVS were lower than those in patients with SAH and without CVS (P<0.05). The MTT and TTP were significantly longer than those of patients with SAH and without CVS (P<0.05).Conclusion The cerebral perfusion of patients with CVS after SAH decreases. MTT and TTP are prolonged. Vascular spasm shows homogeneous stenosis. The coincidence rate of CT and CTP diagnosis with DSA is high, which can provide imaging basis for clinical diagnosis and treatment.

目的：探讨应用 CT 诊断小细胞肺癌的临床价值及误诊分析。方法回顾性分析我院的51例小细胞肺癌患者的临床资料。所有患者入院后应用螺旋 CT 进行早期影像学检测，将检测结果与术后病理结果相对照，评估 CT 诊断技术的临床应用价值及误诊病例分析。结果51例确诊为小细胞肺癌的患者中，燕麦细胞型21例，中间细胞型15例，复合燕麦细胞型15例。经 CT 诊断后确诊31例，CT 诊断符合率为60.78％。误诊20例：肺炎6例，肺脓肿5例，肺结核6例，纵隔旁肿瘤3例。结论CT 做为小细胞肺癌的重要检测技术，其诊断准确率约为60.78％，误诊病例中以肺炎与肺结核病例为主，故需要结合穿刺活检与纤维支气管镜等技术提高其诊断准确率。