Objective To estimate the value of the CT and MRI showed ovarian vessels and uterine tube in the diagnosis of pelvic tumors.Methods The CT and (or) MRI features of 79(90 cases) ovarian and non-ovarian tumors proved by surgery and pathology were reviewed.By analyzing the tumor and ovarian blood vessels and fallopian tubes to identify the source of the tumor.According to the number,morphology and thickness of the arterial blood supply and other branches determine the nature of the tumor.The results were compared with the pathological results.Results The diagnostic accuracy of tumor origin was 94.44％ (85/90),the sensitivity was 95.89％ (70/73),the specificity was 88.24％ (15/17),the false positive rate was 11.76％ (2/17),the false negative rate was 4.11％ (3/73).The consistency between preoperative localization and surgical pathology was high (Kappa =0.82).The resuhs showed that three ovarian adjunctive structures were more accurate in determining the origin of the tumor compared with the display of one ovary structure and the display of two ovary structures.The results were statistically significant (P =0.035).When the double arterial blood supply was shown,the diagnostic accuracy of the ovarian malignant tumor was 90.41％,the sensitivity was 95.35％ (41/43),the specificity was 83.33％ (25/30),the false positive rate was 16.67％ (5/30),and the false negative rate was 4.65％(2/43).The diagnosis was highly consistent with the pathological results (Kappa =0.80).Conclusion CT and MRI show that ovary vessels and fallopian tubes have a higher diagnostic value in the positioning and characterization of pelvic tumors.

Objective To explore the clinical value and safety of radioactive 125 I combined with high-frequency hyperthermia in the treatment of patients with recurrent cervical cancer.Methods A total of 52 cases randomly divided into two groups,with 26 patients in each group,were collected.The observation group accepted 125I seeds combined with high-frequency hyperthermia in treatment,while the control group only received simple particle implantation.The control of tumor response,local control rate of pain relief and the adverse reactions were evaluated.A comparison between groups was done using Chi-square test.Results Two months after treatment,the response rate of the tumor was 96.2％ in the observation group,which was higher than that in the single treatment group(73.1％;x2 =8.35,P ＜ 0.05).Response rates of pain relief were 88.2％ and 38.9％ (x2 =5.33,P ＜ 0.05).One month after treatment,there was no significant difference in the prevalence of adverse effects between the two groups(x2 =2.79,P ＞ O.05).Conclusion Interstitial permanent implantation of 125I seeds combined with high-frequency hyperthermia for recurrent cervical cancer has a good short-term response and less adverse reactions.

Objective:To study the diagnostic value of CT and MRI for hydrosalpinx.Materials and Methods:The clinical data of 64 patients diagnosed with hydrosalpinx in our hospital between August 2013 and August 2016 were analyzed,and were divided into a control group and an observation group according to the different imaging techniques applied,with 32 cases in each group.The control group was diagnosed by CT,and the observation group by MRI.The specific diagnostic values in the two groups were observed and compared.Results:All the 32 cases were confirmed with cystic masses by CT diagnosis,among which 22 (68.75％) were with clear boundary masses and 4 with bilateral masses (12.50％),with 15 cases (46.88％) with masses in the left adnexa and 13 (40.63％) in the right adnexa,MRI diagnosis showed that,the edge of the masses was smooth,S-shaped or C shaped like sausage.The proportion of missed diagnosis and misdiagnosis in the observation group was 3.12％,lower than the 21.88％ in the control group,and diagnosis accuracy was 96.88％,higher than the 78.13％ in the control group (P＜0.05).Conclusions:For the diagnosis of hydrosalpinx,MRI is with higher diagnostic value,which can obtain clear imaging data,reduce misdiagnosis or missed diagnosis,and improve the diagnosis accuracy,therefore,it is of significant value to be popularized in clinical application.Besides,in actual practice,CT and MRI could be combined together to play their respective advantages.

Objective To summarize the dynamic contrast-enhanced CT findings of rare pathological subtypes of renal cell carcinoma,so as to improve the imaging diagnosis.Methods We retrospectively analyzed the CT manifestation of 11 patients with rare pathological subtypes of renal cell carcinoma confirmed by surgical pathology and reviewed literatures.Results In 5 cases of papillary carcinoma,CT plain scan showed inhomogeneous density in 4 cases and cystic hypodense in 1 case,and enhanced CT showed insufficient blood supply.In 4 cases of chromophobe carcinoma,plain scan showed homogeneous density in 3 case and inhomogeneous density in 1 case,and enhanced CT showed mild to moderate homogeneous or inhomogeneous enhancement.In 1 case of Bellini collecting duct carcinoma,plain scan showed enlarged kidney volume and inhomogeneous density,ambiguous boundary;enhanced CT showed mild inhomogeneous delayed enhancement and invasion of renal adipose capsule.In 1 cases of Xp11.2 translocation/TFE3 fusion-associated renal carcinoma,ring-like calcifications were observed on CT scan,the enhanced CT showed that the solid portion of mass was enhanced obviously.Conclusion CT is a valuable method to diagnose rare pathological subtypes of renal cell carcinoma.But the final diagnosis should be based on pathology.

目的 探讨肾脏孤立性纤维瘤(SFT)的CT特征.方法 回顾性分析经手术病理证实的6例肾脏SFI的临床、CT影像表现.结果 6例均为单发肿块,呈类圆形或椭圆形,长径3.2～12.4 cm.6例三期增强扫描,5例肿瘤密度均低于周围正常肾皮质,1例前两期强化后等于或高于肾皮质,最高强化在排泄期或实质期各3例.4例三期强化密度均匀,3例皮质期、实质期及排泄期分别呈轻、中、重度强化,呈“渐进持续”型强化;1例呈“快进快退”型强化,表现皮质期显著强化,实质期强化密度迅速增高,排泄期强化骤降.2例不均匀强化,呈“慢进慢出”型强化,表现为皮质期至实质期强化缓慢增高,排泄期缓慢下降,低密度囊变区始终未见强化.5例动脉期肿块内见点、条状小血管影.4例密度及强化均匀者病理为良性,2例密度及强化不均匀或多发点状钙化者病理为恶性.结论 肾SFF三期强化后肿瘤密度大多数低于周围正常肾皮质,最高强化在排泄期或实质期,强化方式多种多样,在CT上较具有特征性,具有较高的诊断价值.

目的 探讨卵巢黄体囊肿破裂(OCLCR)的MRI表现.方法 回顾性分析经手术病理证实的28例OCLCR的临床、MR影像资料.结果 28例附件区可见单囊、多囊或多房囊性包块,长径3.0～12.0 cm.根据肿块形态不同在MRI上分为3型:Ⅰ型为单囊型,17例,根据单囊与血肿位置不同又分为2种亚型,Ⅰ a型(囊内血块型)8例,Ⅰb型(囊肿旁血肿型)9例;Ⅱ型为多囊型,5例;Ⅲ型为多房型,6例.增强扫描25例,囊壁及分隔厚约2.5～5.0 mm,呈环形、分隔状明显强化,20例囊壁见破裂口表现环形强化连续性中断、塌陷或缺损.与手术病理结果对照,MRI对OCLCR破裂口的诊断敏感度为90.91％(20/22)、特异度为100％ (6/6),准确率为92.86％(26/28).MRI与手术病理诊断的一致性高(Kappa=0.81,P＜0.001).结论 OCLCR MRI表现附件区单囊、多囊或多房厚壁囊肿,MRI能准确识别囊壁破裂口,与手术病理具有高度一致性.

Chiari畸形（CM）是一种以小脑扁桃体下疝为主要特征的先天性后脑疾病。临床上根据其病变程度分为Ⅰ～Ⅳ型，其中Ⅰ型临床最常见。该病的诊断主要依赖影像学检查，同时结合临床相关资料。 X线和CT检查对该病诊断价值有限。 MRI在CM的诊断中起重要作用，可提供CM的各种形态学改变（如小脑扁桃体下疝的程度、是否伴脊髓空洞等），尤其是MRI新技术（如MRI脑脊液成像技术、电影成像和DTI）的发展和应用，可评估脑脊液流动、小脑扁桃体的节律性运动、脊髓纤维束等功能方面的信息，为该病的术前诊断和术后评估、随访提供更加丰富的信息。本文通过对国内外最新文献进行复习，对CM的不同影像学检查方法作一综述，总结分析CM影像学研究特别是MRI研究的相关进展及临床价值。

目的 探讨Joubert综合征的MRI表现.方法 回顾性分析6例Joubert综合征患者的临床和MRI资料.结果 Joubert综合征的典型MRI表现包括小脑半球间“中线裂”、“蝙蝠翼”状和“三角形”第四脑室,以及脑桥中脑连接处的“磨牙征”.结论 Joubert综合征具有特征性的MRI表现,结合临床资料可明确诊断.

目的探讨双排螺旋CT的Dental CT成像技术的临床应用价值。方法对24例患者颌骨进行1 mm薄层扫描,利用Dental CT软件重建出牙齿、颌骨的冠状曲面图像和矢状位断层图像,与原始轴位图像结合,对牙科疾病进行分析。结果Dental CT软件能清楚的重建出牙、牙槽骨及颌骨的冠状曲面图像和矢状位断层图像,能清楚显示牙、颌骨微小病变,可为牙科疾病的诊断治疗提供重要的客观依据。结论Dental CT密度分辨率高,无重叠、无伪影,为牙科疾病提供了一种新的检查手段及诊断方法,具有较高的临床应用价值。

石骨症比较罕见,我们在临床工作中遇到1例,现报道如下: 患者男19岁,1 h前骑自行车跌伤致右髋部疼痛,活动受限,来我院就诊.患诉既往经常头晕、头痛,双髋疼痛,双侧股骨颈多次骨折.体检:贫血貌,发育一般,双眼上斜伴震颤、双眼裸视0.1;腹部触诊肝肋下3 cm、脾中度肿大:检验血红蛋白:80g/L,红细胞:3.0×1012/L.