目的 探讨CT对恶性腹膜间皮瘤的诊断价值.方法 回顾性分析12例经组织学证实的恶性腹膜间皮瘤的CT征象,并讨论其CT特点.结果 12例恶性腹膜间皮瘤中,1例为局限型腹膜间皮瘤,11例为弥漫型腹膜间皮瘤.主要CT表现:1例局限型腹膜间皮瘤表现为孤立性的巨大囊实性肿块,以囊性为主,实性区显著强化;11例弥漫型腹膜间皮瘤均表现为腹腔积液及腹膜、大网膜、肠系膜不规则增厚,其中8例见广泛的明显强化的腹膜结节、肿块,6例形成网膜饼,腹膜后淋巴结肿大2例,合并胸膜病变2例.结论 显著的腹腔积液伴不规则腹膜增厚及广泛腹膜强化结节、肿块是弥漫型恶性腹膜间皮瘤的主要表现.

<正>粪石性肠梗阻是由于肠内粪石等引起的单纯性、机械性肠梗阻,发病率较低,以往文献报道较少。近年来,随着CT的发展,特别是螺旋CT在不明原因肠梗阻的广泛应用,粪石性肠梗阻的报道逐渐增多。笔者回顾分析9例粪石性肠梗阻的CT表现,评价螺旋CT对该病的诊断价值。

目的探讨16层螺旋CT血管成像对椎动脉变异的诊断价值及其三维影像解剖特征。方法对300例接受椎动脉多层螺旋CT血管成像(MSCTA)检查的患者图像进行回顾性分析,结合横断面、容积重建(VR)、多平面重建(MPR)及最大密度投影(MIP)观察椎动脉变异情况。结果共94例椎动脉先天变异(6种类型),占31.3%,其中3例合并2种以上的变异,包括单侧椎动脉先天性狭窄32例(10.7%);椎动脉起源变异18例(6.0%);椎动脉行径变异37例(12.3%);椎动脉窗式变异1例,双椎动脉1例,单干椎动脉形成基底动脉7例(2.3%)。结论椎动脉先天变异较为常见,解剖变异较为复杂,MSCTA能予以较好的评价。

作者收集本院2004年9月至2006年7月经病理证实的胃癌30例,探讨多层螺旋CT(MSCT)在胃癌诊断中的应用价值. 1 资料与方法 1.1 一般资料 30例胃癌患者男18例,女12例;年龄20～70岁.CT检查距手术均在1周以内.

Objective:To study the feasibility of transcutaneous needle interventional thrombolysis combined with traditional Chinese medicine on treating acute venous thrombosis in lower limb.Methods:A colander was first put in antrum vein and urokinase combined with traditional Chinese medicine and ligustrazine was then injected slowly by thrombolysis catheter through thrombosis.Results:The effective rate of thrombolysis Was 100 percent.The tumefaction of trouble limb relieved slowly.The symptom Was obviously improved and the size of the thigh becomes normal.Conclusion:Interventional thrombolysis combined with traditional Chinese medicine is an effective and simpie operated method to treat acute venous thrombosis in lower limb.

人工耳蜗植入是先天性内耳畸形引起极重度和全耳聋患者目前实现听力语言康复的唯一有效的治疗方法[1].内耳畸形有其特殊的形态学表现,可被影像学方法所诊断,而高分辨率CT因其可以显示精细的骨结构而成为颞骨检查的首选方法[2].

目的探讨黄色肉芽肿性肾盂肾炎的CT表现。方法搜集手术病理证实的黄色肉芽肿性肾盂肾炎患者5例,所有患者术前均进行了CT检查,分析其CT表现。结果5例患者均为单侧肾脏受累,体积明显增大,功能降低;收集系统内均见结石,4例为多发,1例为单发,其中4例结石呈鹿角状;病肾内均可见多个囊性占位,密度较低,大小不一,增强后囊壁强化;1例患者伴腰大肌和腹壁脓肿形成。结论CT能够显示黄色肉芽肿性肾盂肾炎的特征性表现,准确显示病变范围和邻近组织的改变,是影像学检查的首选方法。

目的评价CT引导下自动切割活检枪经皮肺穿刺活检的临床价值。方法CT引导下,使用16~20G自动切割活检枪,对88例肺部周围性病灶行经皮肺穿刺活检。结果82例获定性诊断,定性诊断率为93%,气胸、咯血并发症发生率分别为10%和14%,无严重并发症发生。结论CT引导下,采用自动切割活检枪经皮肺穿刺,是一种准确、安全、有效的肺部病灶诊断方法,值得临床推广。

Objective To evaluate the value of spiral CT portography in demonstrating the PV systems and collaterals in portal hypertension. Methods Fifty-one patients with HCC and/or liver cirrhosis associated with portal hypertension underwent spiral CT portography and conventional portography.The patency of the main portal vein,its right and left branches were examined.The distribution and extent of collaterals were also assessed.The findings of CTP were compared with those from conventional portography.Results In the 153 portal veins and branches of 51 patients,CTP displayed 104 of 107 patented portal veins and 44 of 46 obstructed ones with high concidence(96.7%,148/153). The presence of collaterals revealed by CTP was correlated well with portography,and the concidence rate is 95.3%(41/43). Conclusion Compared with conventional portography,CTP can determine the portal venous patency accurately,and display collaterals with high concidence.It can essentially replace the invasive portography.

Objective: To report a new X-sign on esophagram which is a strip shadow of soft tissue density in the upper part of esophagus behind the barium and study its anatomical basis. Methods: 306 cases on barium esophagram were analyzed retrospectively. 70 cases of them with the sign were observed and measured. Results: The prevalence is 22.9%. The strip shadow is 0.2～0.5cm in wide and about 5.0cm in long. The strip shadow were composed of the wall of the upper esophagus of the right posterior, pleura parietal and pleura visceral between the lung and sulcus of esophagus and a little loose connective tissue. Conclusion: The strip shadow varies in width and length, but should be straight and soft which is proof of being diagnosed as non-mass and non-thichen lesion.

结肠双重造影(Colonic Double Contrast Examination以下简称"CDCE")技术已在临床广泛应用,成为诊断结肠内微小、浅表病变不可缺少的检查方法.在CDCE术中摄片有分段法与全结肠法,各有特点.我们在工作中设计了一种CDCE全结肠摄片新方法,经临床应用较为简便、实用,适合基层医院,现介绍如下.

1 病历摘要 患者男,41岁.主诉因胸闷、心悸、气短、水肿2个月,于1999年11月9日收住入院.患者约10余年前逐渐出现疲乏、纳差等症状,肝功能检查异常,诊断为病毒性肝炎.予中西药物护肝治疗,此后丙氨酸转氨酶时有上下波动,多次B超检查提示慢性肝病,肝脾肿大.5年前逐渐出现皮肤色素沉着,伴有性功能减退.1年前出现多饮、多尿、消瘦等症状,多次检测空腹血糖明显增高,曾在杭州和上海数家医院诊治,C肽释放试验呈低平曲线,诊断为1型糖尿病、慢性肝炎、肝硬化,需用胰岛素40～50U/d控制血糖,血糖波动较大.近2个月胸闷、心悸、气短、咳嗽、水肿等症状逐渐加重,以至不能坚持日常工作而入院.无畏寒、发热,不伴胸痛.既往无烟酒等嗜好,家族中否认有类似病史.入院检体:T 37.5℃,P 108/min,R18/min,BP 15/8kPa,慢性病容,半坐卧位,全身皮肤色素沉着呈灰黑色,以颜面部及手背为明显,无蜘蛛痣,浅表淋巴结无肿大,巩膜无黄染,颈静脉怒张,甲状腺无肿大,胸廓无畸形,右中下胸叩浊音,右下肺呼吸音减低,双肺少量干湿性口罗音,心界向左下扩大,心率108/min,早搏2～3/min,心音低钝,P2＞A2,各瓣膜区未闻及杂音.腹稍膨隆,未见曲张静脉,肝肋下2.5cm、剑下3.5cm,质偏硬,无触痛,脾肋下可及,肾区无叩痛,阴毛分布稀疏,双下肢凹陷性水肿,神经系统无阳性体征.

植物性胃石症在南方较为少见,笔者遇到12例,通过X线钡餐检查确诊后用药物消溶治疗,经复查与随访疗效良好.现就植物性胃石症的临床X线表现和消溶治疗方法总结报告如下. 1 材料与方法 1.1 临床资料 本组12例,男7例,女5例,年龄21～84岁,平均38岁.全部病例均以上消化道症状来院诊治 ,通过X线钡餐检查确诊.12例均有食柿子、山楂史.食量在250～500g以上,最多者一次食鲜山楂约750g.大部分在食后当日至3天后出现症状.患者均有上腹饱胀、反酸、呃逆及不同程度疼痛与食欲减退,3例食后有呕吐.查体时5例上腹部摸到肿块,其中4例肿块活动度