目的 探究MRI常规序列、SWI序列以及DWI序列在脑外伤微出血患者诊断中的应用价值.方法 选取2019年8月～2020年4月我院收治的71例脑外伤微出血患者作为观察对象,所有患者在入院3天后行头部MRI常规序列(T1WI、T2WI、T2FLAIR)、扩散加权成像(DWI)序列及磁敏感加权成像(SWI)序列检查.观察脑外伤微出血病灶在不同扫描序列中的影像学表现,对比不同扫描序列对脑外伤微出血病灶的检出率.结果 微出血病灶在T1WI序列中多表现为大小不等的斑片状、条状等、低信号影,T2WI、T2FLAIR序列中多为稍高信号或等信号,DWI序列中多表现为低信号或等信号.微出血病灶在SWI序列中多为点状、斑片状、类圆形或环形低信号影,与T1WI、T2WI、T2FLAIR等MRI常规序列以及DWI序列相比,SWI对微出血病灶的显示更加明显,所显示的微出血病灶更多,病灶边缘更加清晰,病灶范围更大.71例患者共检出微出血病灶169个,T1WI序列检出78个病灶,T2WI序列检出103个病灶,T2FLAIR序列检出126个病灶,DWI序列检出117个病灶,病灶检出率分别为46.15％、60.95％、74.56％和69.23％.SWI序列检出147个病灶,病灶检出率为86.98％,均明显高于T1WI、T2WI、T2 FLAIR和DWI序列,差异有统计学意义(P＜0.05).结论 在诊断脑外伤微出血病灶上,SWI序列与MRI常规序列、DWI序列相比具有更高的检出率,对于脑外伤微出血患者的临床诊治及预后评估都具有重要意义.

目的 探究MRI常规序列、弥散加权成像(DWI)及磁敏感加权成像(SWI)对脑外伤所致弥漫性轴索损伤(DAI)病灶及其微出血病灶的诊断价值.方法 选择因脑外伤导致DAI合并微出血的57例患者作为研究对象,所有患者均在入院后即可完成MRI常规序列、DWI、SWI等序列扫描检查.分析各序列检查DAI病灶的信号特征及分布情况,对比各序列对不同分布区域DAI病灶以及微出血病灶、水肿性病灶的检出情况.结果 DAI病灶主要分布在基底节、胼胝体、丘脑、深部白质区、脑干和皮髓质交界区.SWI、DWI的DAI病灶总检出率均明显高于T1WI、T2WI,差异有统计学意义(χ2分别=357.06、174.96、236.47、84.30,P均<0.05).SWI对微出血病灶的检出数目明显多于DWI、T1WI和T2WI(χ2分别=345.21、307.75、234.92,P均<0.05),DWI对水肿性病灶的检出数目明显多于SWI、T1WI和T2WI(χ2分别=159.04、45.83、145.46,P均<0.05).结论 DWI序列和SWI序列与常规MRI序列相比,能够明显提升DAI病灶的检出率.SWI序列在检出微出血病灶上的敏感性优于DWI序列,DWI序列则在检出单纯水肿性病灶方面更具优势.

Objective:To analyze the value of magnetic resonance T 2 mapping in the diagnosis of early cervical disc degeneration in adolescents. Methods Patients who underwent cervical MRI examination and magnetic resonance T 2 mapping in Wenzhou Hospital of Traditional Chinese Medicine between November 2019 and September 2020 were included in this study. They were divided into observation and control groups ( n = 50 per group) according to the time of lowering their heads (≥ 2 hours) every day. The T 2 values corresponding to the nucleus pulposus of cervical intervertebral disc in each segment was compared between the two groups. Cervical disk degeneration was graded using the Pfirrmann classification. T 2 value was compared between different Pfirrmann disc grades. The efficacy of T 2 value in the diagnosis of early cervical disc degeneration in adolescents was evaluated using the receiver operating characteristic curve. The specificity and sensitivity of T 2 value in the diagnosis of early cervical disc degeneration in adolescents and the area under the receiver operating characteristic curve were calculated. Results:T 2 value measured in each cervical intervertebral disc segment in the observation group was significantly greater than that in the control group ( t = 5.06, 4.47, 3.57, 2.93, 4.98 for C2-3, C3-4, C4-5, C5-6, C6-7 segments, all P < 0.05). In the observation group, the number of patients with Pfirrmann grade II cervical intervertebral disc degeneration was highest, accounting for 42% (21/50). There was a significant difference in cervical intervertebral disc segment T 2 value between different Pfirrmann disc grades ( t = 2.62, P = 0.018, vs. Pfirrmann disc grade I ; t = 2.12, P = 0.045, vs. Pfirrmann disc grade II; t = 2.24, P = 0.049, vs. Pfirrmann disc grade III). The higher Pfirrmann grade, the lower T 2 value of cervical intervertebral disc nucleus pulposus. The receiver operating characteristic curve showed that the sensitivity and specificity of T 2 value in the diagnosis of early cervical disc degeneration and the area under the receiver operating characteristic curve were 81.2%, 79.8% and 0.756, respectively. Conclusion:T 2 mapping imaging technology can predict early cervical intervertebral disc degeneration in adolescents by quantitatively analyzing the T 2 value of cervical intervertebral disc nucleus pulposus and has a high value in the diagnosis of cervical intervertebral disc degeneration. This achievement is of innovation and science.

目的:探讨磁共振T2-mapping成像技术诊断青少年颈椎间盘早期退变的价值.方法:2019年11月至2020年9月招募100位青少年志愿者,采用GE Signa1.5 T超导磁共振系统进行颈椎常规磁共振和磁共振T2-mapping检查.按照Pfirrmann分级标准对所有志愿者的C4～5椎间盘退变程度进行分级,并测定C4～5椎间盘髓核的T2值.结果:共纳入100位志愿者,男48位、女52位;年龄13～18岁,中位数15岁.100个C4～5椎间盘中,PfirrmannⅠ级25个、Ⅱ级52个、Ⅲ级18个、Ⅳ级5个,4个级别C4～5椎间盘髓核的T2值总体比较,差异有统计学意义(79.82±20.56,72.26±18.35,56.62±15.78,46.26±12.58,F=6.172,P=0.000);PfirrmannⅠ级椎间盘髓核的T2值高于Ⅱ级(P=0.015),PfirrmannⅡ级椎间盘髓核的T2值高于Ⅲ级(P=0.028),PfirrmannⅢ级椎间盘髓核的T2值高于Ⅳ级(P=0.038).按照PfirrmannⅡ级以上为椎间盘退变标准进行受试者操作特征曲线(receiver operating characteristic curve,ROC)分析,结果显示磁共振T2-mapping成像技术诊断青少年颈椎间盘退变的ROC曲线下面积为0.798(P=0.013),最佳诊断分界点为T2值为76.53.结论:应用磁共振T2-mapping成像技术诊断青少年颈椎间盘早期退变具有一定的价值.

目的 研究CT纹理分析联合CT值在输尿管结石狄激光碎石术疗效评估中的应用价值,为临床诊疗提供指导.方法 选取本院2018年1月至2020年1月经狄激光碎石术治疗的输尿管结石106例患者进行研究,在术前测量其CT值,根据CT值将患者分为观察组(CT值>1000 HU)和对照组(CT值≤1000 HU),各53例.通过Mazda软件于结石最大横截面处选取兴趣区,提取CT纹理参数灰度值,观察组的CT纹理参数平均灰度值为(1723.39±177.43),对照组的CT纹理参数平均灰度值为(1872.59±192.56).观察并比较两组的碎石成功率,手术时间、术后3个月清石率、术后并发症发生率等情况,评估输尿管结石狄激光碎石术的疗效.结果 观察组碎石成功率、术后3个月清石率明显高于对照组,观察组的手术时间以及术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05).结论 CT纹理分析联合CT值在输尿管结石狄激光碎石术疗效评估中具有一定价值.

目的 对比肺隔离症诊断中CT与高分辨率MRI序列的临床应用价值.方法 选定本院及温州医科大学附属第一医院2018年8月至2020年8月住院治疗的180例疑似肺隔离症患儿,将手术病理诊断作为金标准,对比CT、高分辨率MRI序列诊断效能,比较CT、高分辨率MRI序列病变位置检出率.结果 高分辨率MRI序列诊断准确率(97.22％)、灵敏度(97.74％)、特异度(66.67％)、阴性预测值(33.33％)均高于CT (88.89％、89.83％、33.33％,5.26％),p＜0.05;高分辨率MRI序列阳性预测值(99.43％)与CT (98.76％)比较,p＞0.05.高分辨率MRI序列右肺下叶基底段(40.00％)、左肺下叶基底段(56.67％)、左肺上叶舌段检出率(1.67％)与CT (37.78％、50.56％、0.56％)比较,p＞0.05;高分辨率MRI序列总检出率(98.33％)高于CT (88.89％),p＜0.05.结论 高分辨率MRI序列可提高肺隔离症诊断准确率、灵敏度、特异度,明确病变位置.

目的 探讨磁共振T2-mapping检查在青少年颈椎间盘退行性变中应用价值.方法 收集因颈部疼痛行磁共振检查的50例青少年患者,分为对照组与观察组,对照组采用常规颈椎磁共振检查,观察组采用T2-mapping进行扫描.比较两组颈椎间盘各兴趣区的T2值及不同解剖节段颈椎间盘髓核的T2值.结果 观察组前纤维环区、髓核区及全间盘区T2值均高于对照组(均P＜0.05),而两组后纤维环区T2值差异无统计学意义(P＞0.05).观察组不同解剖节段颈椎间盘髓核T2值均高于对照组(均P＜0.05).结论 磁共振T2-mapping检查可对颈椎间盘退变程度进行定量检测,对颈椎疼痛情况进行有效评估.

目的 探讨MRI对慢性失眠患者大脑皮层灰质体积的变化.方法 基于MRI体素形态学测量用于分析39例慢性失眠患者相对39例状态匹配的健康睡眠者大脑灰质体积变化.结果 相对健康睡眠组,慢性失眠组MRI灰质体积增加和减低的区域均位于右侧大脑半球.其中,灰质体积增加的区域主要包括右侧梭状回(BA 37),右侧小脑前叶突入右侧视觉联合皮层(BA18),右侧屏状核突入右侧岛叶(BA13),右侧初级听觉区(颞上回,BA22,BA42)和右侧辅助运动区(BA 6),灰质体积减低的区域位于右侧视觉联合皮层(BA18).结论 慢性失眠引起听觉系统、视觉系统、情绪系统相关脑区的过度觉醒,这种变化可能是失眠发生的结构基础.

Objective:To investigate the computed tomography (CT) features of gastric neuroendocrine neoplasm (GNEN).Methods:The retrospective and descriptive method was conducted. The clinicopathological data of 30 GNEN patients who were admitted to two domestic medical centers (13 cases in Wenzhou Hospital of Traditional Chinese Medicine and 17 cases in Wenzhou People′s Hospital) from January 2010 to December 2018 were collected. There were 23 males and 7 females, aged (62±4)years, with a range from 27 to 78 years. The patients underwent abdominal CT plain scan and dynamic enhancement scan. Two associate chief radiologists with more than 20 years of work experience observed and analyzed all the images respectively. Observation indicators: (1) CT examination; (2) treatment and postoperative pathological examination; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect the survival of patients up to December 2018. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Results:(1) CT examination: of the 30 patients, 14 had the tumor located in the fundus of stomach, 10 had the the tumor located in the body of stomach, and 6 had the tumor located in the antrum. The tumor was elliptical in 18 cases and irregular in 12 cases. There were 15 cases of endogenous type, 13 cases of exogenous type, and 2 cases of intramural type. Patients with G1 neuroendocrine tumor had the maximum diameter of (6.8±1.6)cm, of which 4 cases had the maximum diameter less than 5.0 cm and 4 cases had the maximum diameter of 5.0 to 10.0 cm. Patients with G2 neuroendocrine tumor had the maximum diameter of (8.3±2.7)cm, of which 1 case had the maximum diameter less than 5.0 cm, 4 cases had the maximum diameter of 5.0 to 10.0 cm, and 2 cases had the maximum diameter greater than 10.0 cm. Patients with G3 neuroendocrine carcinoma had the maximum diameter of (17.8±2.2)cm, of which 6 cases had the maximum diameter of 5.0 to 10.0 cm and 9 cases had the maximum diameter more than 10.0 cm. The tumor showed swelling growth in 14 cases and invasive growth in 16 cases. The tumor boundary was clear in 14 cases and unclear in 16 cases. CT plain scan showed homogeneous tumor density in 10 cases and heterogeneous density in 20 cases. Nine patients had iso-density in the tumor parenchymal part, and the CT value was (34.0±3.5)HU. In the 18 cases of low density, the CT value was (16.6±1.4)HU. In the 3 cases of high density, the CT value was (45.3±3.6)HU. Of the 30 patients, 21 cases had small punctate or small round necrotic cyst lesions in the tumor, 10 cases had mesenteric lymph node, peritoneum, liver metastasis and adjacent omentum invasion; 17 cases had abdominal effusion. In the CT enhancement examination, 12 cases showed mild enhancement, and the CT value was (56.5±6.3)HU; 15 cases showed moderate enhancement, and the CT value was (66.0±5.4)HU; 3 cases showed significant enhancement, and the CT value was (76.6±5.8)HU. Seven cases showed homogeneous enhancement and 23 cases had heterogeneous enhancement. There were 8 cases with tortuous vessels. (2) Treatment and postoperative pathological examination: of the 30 patients, 10 cases with mesenteric lymph nodes, peritoneum, liver metastasis and adjacent omentum invasion underwent radical total gastrectomy; 14 cases without surrounding tissue invasion or metastasis underwent radical subtotal gastrectomy; 6 cases with tumor diameter less than 4.0 cm and without surrounding tissue invasion or metastasis underwent endoscopic resection. All the 30 patients were confirmed GNEN by postoperative pathological examination, including 8 cases of G1 neuroendocrine tumor, 7 cases of G2 neuroendocrine tumor, and 15 cases of G3 neuroendocrine carcinoma. Results of immunohistochemical staining showed that 30 patients were positive for synaptophysin, 23 were positive for chromogranin A, and 9 were positive for cytokeratin. (3) Follow-up: all the 30 patients were followed up for 10-80 months, with a median follow-up time of 39 months. The 5-year survival rate of 30 patients was 43.3% (13/30). The 5-year survival rates were 6/8, 3/7 and 4/15 of patients with G1 neuroendocrine tumor, G2 neuroendocrine carcinoma, and G3 neuroendocrine carcinoma.Conclusions:GNEN has the main manifestation as abdominal pain, with G3 as pathological classification, which is common in fundus and body of stomach. The CT findings of GNEN are characterized by swelling or infiltrating growth and round or irregular low-density masses. Tumors are prone to cystic transformation, and showed the mildly to moderately heterogeneous enhancement.

Objective:To study the magnetic resonance imaging (MRI) features of hepatocellular adenomas (HCA).Methods:The MRI images of 36 patients who were diagnosed to have HCA by pathology at Wenzhou Chinese Medicine Hospital and Wenzhou People’s Hospital between January 2013 to May 2018 were reviewed retrospectively. There were 14 males and 22 females, age ranged from 27 to 85 (46±4) years. The location, size, morphology, signal intensity and enhancement modes of tumors were observed.Results:For plain scans of MRI: among 36 patients, the lesions of 10, 23 and 3 patients respectively were located in the left, right and both left and right hemilivers. The lesions of 15, 12 and 9 patients were round-like, oval-like and nodular shape, respectively. The maximum diameter ranged from 2.0 to 11.0 (4.8±2.6) cm. T 1 weighted imaging (T 1WI) of 21, 11, and 4 patients showed low signal, iso-signal, and slightly high signal, respectively. T 2 weighted imaging (T 2WI ) of 33, and 3 patients showed high, or slightly high signal and iso-signal, respectively. T 2WI on fat-suppression of 32 and 4 patients showed high, or slightly high signal and iso-signal, respectively. Diffusion weighted imaging (DWI) of 24, and 12 patients showed high or slightly high signal and iso-signal, respectively. T 2WI of 11 patients showed a high signal ring while the center had a relatively low signal, called the " atoll" sign. Of the 36 patients, 30 had a peritumoral low-signal pseudo-envelope, 11 had intratumoral necrosis, and 8 had intratumoral hemorrhage. On dynamic contrast enhancement scanning: the arterial phase of 22 and 14 patients showed uniform enhancement and uneven enhancement, respectively, while 16 lesions showed significant enhancement, in 15 patients moderate enhancement, and in 5 patients mild enhancement. In the portal venous phase of 7, 12 and 17 patients, the tumor signals were higher, equal and lower than the liver parenchyma signal, respectively. In the delayed phase of 1, 18 and 17 patients, the tumor signals were higher, equal and lower than the liver parenchyma, respectively. In the portal vein and delayed phase, 30 and 6 patients, the pseudocapsules showed mildly enhanced and no enhancement, respectively. Conclusion:HCA is mostly round or oval, T 1WI low signal, T 2WI, T 2WI fat suppression and DWI showed high or slightly high signal. Significant enhancement of arterial phase enhancement, mild enhancement of portal phase and delayed phase, a " atoll sign" and a peritumoral pseudocapsule are helpful for diagnosis.

目的 对颅脑损伤患者进行术后CT复查,探讨其对改善预后情况的价值分析.方法 选取医院2017年6月至2019年6月收治的行颅脑损伤手术的患者76例,根据患者是否定期复查将其分为研究组(n=38)与对照组(n=38),其中研究组患者术后3、7天均计划性复查CT,对照组未复查.对两组患者术前、术后临床症状、住院时间、出院时格拉斯哥昏迷指数(GCS)评分及术后半年格拉斯哥预后(GOS)评分情况等进行统计比较.结果 术前,在GCS评分、头颅CT分级、受伤时间等方面,研究组与对照组比较均无明显差异(P>0.05);术后3、7天进行CT复查发现异常者中,其中伴有临床症状的患者分别占75.0％、66.7％.术后,在二次手术率及住院天数方面,研究组与对照组比较均明显降低,在术后7天GCS评分及术后半年GOS评分方面,研究组与对照组比较均明显提高,差异均具有统计学意义(P<0.05).结论 对于医院行颅脑损伤手术的患者,术后对其进行定期CT复查有助于对患者预后情况的改善,在临床应用方面具有非常重要的意义.

Objective:To investigate the diagnostic value of MSCTP in Alzheimer's disease with sleep disorders as the primary manifestation.Methods:Seventy-six patients with Alzheimer's disease who had sleep disorders as the primary manifestation from January 2018 to December 2018 in the Seventh People's Hospital of Wenzhou were selected as study group, and 76 healthy subjects were selected as control group.Both two groups of subjects were diagnosed with MSCTP.The Pittsburgh sleep quality index(PQSI) score and the mini mental state examination (MMSE) score were compared between the two groups.The cerebral blood flow(CBF) was measured in the bilateral temporal lobe, frontal lobe, hippocampus and basal ganglia of the two groups.Results:The PQSI score of the study group[(9.42±0.60)points] was significantly higher than that of the control group[(2.87±0.17)points], the difference was statistically significant( t=11.379, P<0.05). The MMSE score of the study group[(16.54±1.19)points] was significantly lower than that of the control group[(27.49±0.82)points], the difference was statistically significant( t=9.637, P<0.05). The CBF of the left and right temporal lobe, frontal lobe, hippocampus and basal ganglia in the study group[left: (14.12±1.00)mL·min -1·100g -1, (18.40±1.29)mL·min -1·100g -1, (18.41±1.30) mL·min -1·100g -1, (31.90±11.41)mL·min -1·100g -1; right: (14.09±0.97)mL·min -1·100g -1, (18.42±1.02)mL·min -1·100g -1, (17.27±0.96)mL·min -1·100g -1, (15.48±6.28)mL·min -1·100g -1] were significantly lower than those in the control group[left: (19.30±1.12)mL·min -1·100g -1, (27.10±1.94)mL·min -1·100g -1, (27.13±1.42)mL·min -1·100g -1, (39.95±19.12)mL·min -1·100g -1; right: (19.32±1.11)mL·min -1·100g -1, (23.32±1.61)mL·min -1·100g -1, (22.18±1.00)mL·min -1·100g -1, (22.13±8.79)mL·min -1·100g -1], the differences were statistically significant( t=8.412, 8.469, 13.076, 4.763, 13.125, 5.183, 9.874, 7.376, all P<0.05). Conclusion:The sleep quality and cognitive ability of Alzheimer's disease patients with sleep disorders as the primary manifestation are poor, the diagnosis of MSCTP shows that CBF of patients are significantly reduced, which has certain value for clinical diagnosis.

目的 探讨拟行CT冠脉成像的妊娠期冠心病患者焦虑和抑郁情况,同时评价CT冠脉成像检查对其不良情绪的影响.方法 选取2016年6月-2018年6月该院收治的妊娠期冠心病患者66例为观察组,同期在该院治疗未接受CT冠脉成像检查的妊娠期冠心病患者66例为对照组.分别采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价两组研究对象焦虑、抑郁状况.结果 观察组患者SDS评分和SAS评分均明显高于对照组,差异均有统计学意义(均P＜0.05).观察组抑郁心境、哭泣、焦虑及害怕评分均明显高于对照组,差异均有统计学意义(均P＜0.05).观察组睡眠障碍、性欲减退、尿频、食欲减退、便秘、心动过速、易疲劳症状评分明显高于对照组,差异均有统计学意义(均P＜0.05).结论 拟行CT冠脉成像检查妊娠患者存在一定程度焦虑、抑郁症状,尤其是精神情感与躯体感觉症状,因此要做好拟行CT冠脉成像检查妊娠期冠心病患者的心理干预,积极给予引导,并加强心理干预和健康宣教,缓解其不良情绪,避免对自身和胎儿造成不良影响.

目的 探讨16排螺旋CT对急性肠梗阻患者的诊断意义.方法 收集2016年1月-2017年9月至本院就诊的急性肠梗阻患者48例作为研究对象,采用16排螺旋CT行全腹部扫描和腹部X线片检查,经临床、手术及病理证实,回顾性分析对比16排螺旋CT与X线片2种检查方法的诊断准确率.结果 16排螺旋CT对肠梗阻诊断符合率(97.92％)较X线片(66.67％)显著更高(P＜0.05),16排螺旋CT在肠梗阻程度、定位、定性诊断符合率较X线片显著更高(P＜0.05).结论 16排螺旋CT有助于诊断急性肠梗阻的定位、定性、病因分析,对患者治疗和预后有重要临床意义.

Objective To analyze the value of 16-slice spiral CT in diagnosis of early stage central type lung cancer.Methods Ninety-two patients with early stage central type lung cancer from February 2016 to September 2017 in Taizhou Traditional Chinese Medicine Hospital were enrolled.All patients were scanned by 16-slice spiral CT before surgical operation.Detection number of lung carcinoma,display rate of segmental bronchi and postoperative pathological results were analyzed.Results The display rate of lobar bronchi and segmental bronchi was 100.0％ (92/92).All patients diagnosed of early stage central type lung cancer by CT were confirmed the diagnosis by postoperative pathological examination.Spiral CT showed 34 cases (37.0％) of infiltrative type,32 cases(34.8％) of intracanalicular type and 26 cases(28.3％) of exophytic type;pathological results showed 33 cases(35.9％) of infiltrative type,31 cases (33.7％) of intracanalicular type and 28 cases (30.4％) of exophytic type;there was no significant difference between lung cancer types diagnosed by the 2 means (P ＞0.05).Conclusion The 16-slice spiral CT is non-invasive,precise and effective in diagnosis of early stage central type lung cancer.

目的:探讨骨斑点症的X线特征.方法:收集2010年1月至2017年12月在温州市中医院、温州市人民医院和乐清市人民医院就诊的15例骨斑点症患者的X线片.男9例,女6例;年龄20岁 ～58岁,中位数35岁;15例均为偶然发现病变,其中因外伤行X线检查时发现骨质异常9例、因腹痛行腹部X线检查时发现骨质异常6例.8例患者同时拍摄头颅、胸腰椎、肱骨、股骨、双手及双足X线片,5例同时拍摄头颅、腰椎、骨盆、胫腓骨、双手及双足X线片,2例同时拍摄股骨上段、胫腓骨及双足X线片.分析病变的X线表现,探讨该病的X线特征.结果:①病变部位.病变累及双手诸骨、双胫腓骨、双足诸骨2例;累及单侧掌指骨、单侧足骨2例;累及单侧足骨及单侧胫腓骨下段2例;累及双手诸骨、双足诸骨、脊柱1例;累及单侧股骨上段、骨盆、双足诸骨1例;累及全身诸骨1例;累及骨盆、双股骨上下段、双胫腓骨全段、双手诸骨、双侧尺桡骨远段及双足骨1例;累及双足、双胫腓骨下段、单侧股骨上段、单侧髋臼及单侧耻骨梳1例;累及骨盆、单侧肱骨上段、单侧肩胛骨、脊柱1例;累及双足骨、单侧股骨上段、双胫腓骨下段1例;累及双手及骨盆1例;累及双足骨1例.②病灶大小与形状.病变区骨松质内均可见大小不等、分布不均、边缘清楚、圆形或椭圆形的致密斑点状骨质硬化灶,直径0.3～2.3 cm;部分病灶呈细条状致密影,长度1.0～2.0 cm,病灶沿骨小梁走行分布;病灶以骨盆、腕骨、跗骨、指(趾)骨和长管状骨的骨骺及干骺端多见,越靠近关节病灶越密集;病灶部位骨质均未见骨膜反应及软组织肿胀.结论:骨斑点症多发于骨盆、腕骨、跗骨、指(趾)骨和长管状骨的骨骺及干骺端,X线片上多表现为直径0.3～2.3 cm、大小不等、分布不均、边缘清楚的圆形或椭圆型的致密斑点状骨质硬化灶.

Objective To investigate the spiral CT features of solid pseudopapillary tumor of pancreas (SPTP).Methods Spiral CT features of 34 SPTP cases confirmed by surgery and pathology were analyzed retrospectively.Results There were 30 females and 4 males.Tumors located in the tail,head,body and neck of the pancreas were respectively in 14,11,6 and 3 cases.The maximum diameter was 2.0-20.0 cm,with an average of 6.5 cm.There were 29 cases of solid-cystic mass with a CT value of 12.6-21.3 HU and 5 cases of solid mass with a CT value of 24.5-42.8 HU;Complete capsule were observed in 24 cases,while incomplete capsule were observed in 10 cases;15 cases were found with tumor calcification,13 with hemorrhage and 2 cases with liver metastasis.After dynamic enhancement,the solid part and capsule showed progressive and slight enhancement in the arterial phase with a CT value of 30.1-43.6 HU,and slight enhancement in portal phase with a CT value of 41.2-68.9 HU,and persistent enhancement in delayed phase with a CT value of 48.2-63.8 HU.Conclusions Spiral CT features of SPTP are characterized by progressive enhancement of solid mass in enhanced scan.

Objective To explore the impact of obesity on lumbar disc degeneration using magnetic resonance T 2‐map‐ping .Methods Thirty volunteers with simple obese and 30 healthy volunteers with normal body weight undwewent sagit‐tal lumbar conventional sequence M RI scan and magnetic resonance T 2‐mapping scan ,and then obtained original map and pseudo‐color map of T2‐mapping .T2 values of L1 ~S1 intervertebral disc nucleus pulposus of the two groups were meas‐ured respectively .ANOVA was used for hypothesis test on T2 values of nucleus pulposus from different levels within group ,LSD test was used for paired comparison .For T2 values of nucleus pulposus from corresponding levels between the two groups ,t test of two independent samples was used .Results Obesity group :T2 values of nucleus pulposus were from 79 .50 ms to 123 .50 ms;Mean T2 values of nucleus pulposus in each level of L1 ~S1 were from (89 .82 ± 6 .34) ms to (112 .65 ± 5 .75) ms .T2 values of nucleus pulposus were from 91 .70 ms to 145 .40 ms in normal group;Mean T2 values of nucleus pulposus in each levels of L1 ~S1 were from (108 .17 ± 10 .37) ms to (126 .65 ± 10 .22) ms .Significant differences were found in the paired comparisons of L1 ~S1 ( P <0 .05) in obesity group except the difference between L2~3 and L4~5 ( P>0 .05);No significant differences were found between L1~2 and L5 ~S1 ,between L2~3 and L4~5 ,and between L2~3 and L5 ~S1 in normal group ( P>0 .05) ,while other paired comparisons all showed statistically significant differences ( P<0 .05) .Significant differences of T2 values were found in the corresponding level ( P<0 .05) between obesity group and normal group except L1~2 ( P>0 .05) .Conclusion Magnetic resonance T2‐mapping can early detect changes of biochemi‐cal ingredients in early lumbar nucleus pulposus degeneration .Obesity may be one of the reasons for promotion or accelera‐tion of lumbar nucleus pulposus degeneration .

目的：探讨CT对进展期胃癌和胃原发性淋巴瘤鉴别诊断的价值。方法选取病理证实进展期胃癌患者和胃淋巴瘤患者各80例作为研究对象。采用C T检查分别由三名医师盲法阅片，观察患者的病变情况。结果进展期胃癌患者胃窦、胃体分别受累30例和33例，高于胃淋巴瘤患者的8例12例（礸2＝16．70、13．64， P ＜0．01）；进展期胃癌患者和胃淋巴瘤患者受累2个部位以上者分别占21．25％和75％（礸2＝46．29，P＜0．01）。进展期胃癌患者有53例出现白线征，胃淋巴瘤患者未见白线征（礸2＝79．25，P＜0．01）；进展期胃癌患者出现胃腔狭窄、形态固定和近侧胃腔扩大33例，胃淋巴瘤患者出现3例（礸2＝32．26， P ＜0．01）。进展期胃癌患者累计器官受累20例，胃淋巴瘤患者未见器官受累情况发生（礸2＝22．86， P ＜0．01）。结论螺旋C T可以在多个方面对进展期胃癌和胃原发性淋巴瘤进行很好的区分，具有较高的鉴别诊断价值。

目的：探讨磁共振扩散加权成像在肝癌诊断的价值。方法采用DWI技术对肝良、恶性占位性病变患者进行了鉴别。结果肝转移瘤组（1．52±0．23）、肝血管瘤组（1．84±0．32）、肝囊肿组（3．32±0．60）的表观扩散系数（ADC）值明显高于肝细胞癌组（1．24±0．17），且差异具有统计学意义（ t ＝3．68、5．92、8．30，P ＜0．05）。结论通过DWI图像特点及量化分析ADC值，提高M RI对肝癌的诊断能力。