Objective:To study the chest X ray features in patients with severe acute respiratory syndrome (SARS), providing useful radiologic information for clinical diagnosis and treatment of SARS.Methods: From March 5, 2003 to March 30, 2003, 28 patients with SARS underwent chest radiograph in wards and the results were compared at acute stage and recovery stage.Results: At acute stage 13 cases had single opacity or small subtle opacity in peripheral lung;3 cases had 2 opacities in periphery unilaterally;6 cases had opacities in central lung;6 cases had opacities or consolidations bilaterally;4 cases had widespread consolidation. At recovery stage the lesions were all resolved in 19 slight cases;some strip and line shades showed in 6 severe cases and the other severe cases died. Conclusion: X ray of SARS are various consolidative opacities.Single subtle opacity is commonly located in peripheral distribution and easy to resolve; large and widespread consolidation was commonly located in middle and lower zone of bilateral lungs and not easy to resolve. The results demonstrate that extension of lesions were related to prognosis of patients with SARS.

Objective To study the imaging manifestations and characters of infectious atypical pneumonias.Methods The imaging materials of 80 cases of infectious atypical pneumonias which were proved by clinical were collected, the characters of imaging manifestations were analysed.Results The abnormal appearance of lung appeared after fever occured, the average time was 2.3 days. The most appearance was high density patchy and was found in every lung field. The multiple focuses were 43.8% in all the cases. The focuses changed fast. CT could have some help in early diagnosis and prognosis observation of infectious atypical pneumonias. Conclusion Medical imaging can play important part in the diagnosis and determining the treatment effect of infectious atypical pneumonias.

Objective To investigate methods and feasibility of percutaneous regional isolated hepatic perfusion combined with charcoal hemoperfusion(PRIHP-CHP).Methods Four out of 12 dogs underwent the procedure of routine transhepatic arterial infusion(TAI) as control group, 8 underwent PRIHP-CHP as experimental group. Adriamycin was used in our study, the concentration of plasma in hepatic vein and systemic vein was detected in both groups. Results All the procedures were successful in the PRIHP-CHP group eight, but 1 dog died because of air embolization. The average procedure duration for each was (132.3±15.3) minutes. The peak level of adriamycin concentration in hepatic vein and systemic in TAI were (3709.676±385.723) ng/ml and (1576.140±226.933) ng/ml respectively. In PRIHP-CHP, the peak level were (4653.420±430.204) ng/ml and (433.612±40.501) ng/ml. There were statistically significant differences between TAI and PRIHP-CHP (Ρ0.01). Conclusion PRIHP-CHP is a feasible method which has many advantages such as simple, minimally invasive, normal liver can be protected, easy for retreatment. Compared with TAI, using the technology of PRIHP-CHP, the concentration of chemotherapeutic agents can increase in regional liver, and even more markedly decrease in systemic circulation.

化学治疗及介入治疗在肝细胞癌(HCC)的治疗中发挥着重要作用.近年来,新的治疗方法及观点不断涌现,现复习近期有关文献,综述各种治疗方法的进展、应用范围及其疗效.

目的:评价CT对胸片正常严重急性呼吸综合征(SARS)患者的诊断价值.材料和方法:对临床疑似SARS而X线胸片正常的21例患者进行了胸部螺旋CT扫描及系列床边X线胸片复查.分析肺部病变的CT表现特征.结果:21例疑似SARS患者中CT显示12例有肺部病变(57.1%).根据系列复查胸片结果将12例患者分成2组:第一组,复查胸片异常组,共7例.其中单发磨玻璃样影3例、多发磨玻璃样影4例;第二组,复查胸片正常组,共5例.其中单发磨玻璃样影1例、多发磨玻璃样影3例和左下叶实变影1例.磨玻璃样影多位于肺周边部(27/35),均为圆形,直径小于3cm.结论:胸片阴性SARS患者肺部病变的CT特点是以周围性分布为主的磨玻璃样影.CT可早于胸片发现肺部病变,并可提高SARS 的肺部病变检出率.

自2002年11月首例严重急性呼吸道综合征(severe acute respiratory syndrome,SARS)发病以来,全世界已有30多个国家发病.虽然初步证实,SARS的病原体是一种新的冠状病毒,但是其发病机制、临床特征及其影像学表现等还不甚清楚.我院是北京地区最早收治SARS的医院之一,现将早期收治的28例SARS的胸部X线表现总结如下.

目的探讨原发性肝癌卫星病灶的影像特点及经肝动脉化疗栓塞的方法.方法4l例经病理证实的巨块型或单发结节型肝癌患者,采用螺旋CT肝脏双期强化扫描和血管造影,观察卫星病灶的情况;使用肝动脉化疗栓塞术对其进行治疗,观察治疗效果.结果41例患者中17例经CT和/或血管造影发现卫星病灶,10例为多血供,7例为少血供.17例发现卫星病灶者中11例分布在原病灶边缘1 cm范围内.化疗栓塞时,将导管头端置于肿瘤供血动脉稍近端,使栓塞范围包括卫星病灶范围.治疗后在6～19个月的随访期内,17例有卫星病灶的患者中CR及PR 5例,无病情进展病例.结论卫星病灶存在于部分HCC病例,运用合理的方法,经肝动脉化疗栓塞术可有效对其进行治疗.

经肝动脉灌注化疗在肝癌的治疗中发挥着重要作用,但如何进一步提高治疗效果备受关注.肝脏隔离灌注化疗随着介入放射学的发展渐受重视,就肝脏隔离灌注化疗的历史背景、方法、动物实验及初步的临床应用进行综述.

OBJECTIVE To evaluate the significance of temporary block of gastroduodenal artery in hepatic artery chemotherapy. METHODS Forty patients were randomized into two groups with 20 in each. In the trial group, when the catheter was introduced into the gastroduodenal artery, pituitrin was infused slowly (2 U/min) till the gastroduodenal artery became blocked, then the catheter was pulled back to the common hepatic artery to start chemotherapy. In the control group, saline (10 ml) was infused slowly (4 ml/min) instead of pituitrin. RESULTS In the trial group, all patients had temporary increase of blood pressure ranging from 20 to 50 mm Hg, which was tolerated with most recovered in 20 to 30 minutes. Two patients had pain in the upper abdomen and others only had slight gastrointestinal discomfort. In the control group, epigastric upset or pain during operation was present in 5 patients. In 9 patients, upper abdominal pain after the operation was present which was serious in two. One of these two patients was confirmed as having gastric antrum erosion by gastroscopy. There was statistically significant difference in the upper abdomen pain in these two groups by Chi-square test (P < 0.025). The relative and absolute risk reduction were 77.8% and 35.0% and the mean number of patients needed to treat was 2.86. The time of resuming preoperative appetite in the trial and control groups were 7.1 +/- 1.37 and 11.8 +/- 2.56 days, with the difference statistically significant (P < 0.01). CONCLUSION Temporarily block of the gastroduodenal artery, being simple, safe, and effectively reducing patients' untoward and finacial burden, is advised to be practiced in hepatic artery chemotherapy.

直肠癌是一种常见的消化道恶性肿瘤,对于晚期或术前病例静脉化疗是主要治疗手段之一,本文采用介入疗法进行治疗,现将临床意义报告如下: