目的 分析新型冠状病毒肺炎(COVID-19)患者的薄层CT特征.方法 回顾性分析51例确诊的COVID-19患者,对其发病后的薄层CT表现进行分析总结.结果 51例患者中,病变累及双肺38例(74.51％),累及单肺12例(23.53％),胸部CT无明显异常1例(1.96％).病变累及肺下叶48例(94.12％),仅累及肺上叶2例(3.92％),病变主要沿支气管血管束及胸膜下分布.病变形态学表现为磨玻璃密度影48例(94.12％),实变影42例(82.35％),实变影伴磨玻璃密度影41例(80.39％),细网格影或"铺路石样"改变23例(45.10％),空气支气管征30例(58.82％),血管增粗征13例(25.49％).31例CT随访病例中,16例(51.61％)经抗病毒、抗感染等积极治疗后病变范围缩小,密度减低,12例(38.71％)治疗效果不佳,肺内病变范围扩大,密度增高,由局限性进展为多发、弥漫性,3例(9.68％)治疗后肺部病灶变化不明显.结论 COVID-19患者薄层CT最主要特征是下叶胸膜下分布磨玻璃密度影伴间质性改变.

目的 分析肺隐球菌病(PC)的CT表现,提高对PC的CT诊断水平.方法 回顾性分析2 9 例经病理或病原学检测证实为PC患者的临床及CT资料.结果 2 9 例中 1 0 例有基础疾病,1 8 例有咳嗽、咳痰,1 6 例胸痛或胸闷,7 例体检或其他原因发现.CT分型:①孤立结节、肿块型 6 例;②多发结节、肿块型 5 例;③单发或多发实变型 9 例;④实变与结节、肿块混合型 8 例;⑤弥漫混合型 1 例.2 3 例分布于肺外周带,6 例随机分布;8 例见"晕征",9 例见空洞,1 7 例见"充气支气管征".2 6 例增强扫描均表现为延迟性强化,2 3 例均匀强化,3 例不均匀强化;其中 1 9 例CT平扫+增强扫描,4 例轻度强化,1 0 例中度强化,5 例明显强化;1 9 例动脉期见"CT血管造影征".结论 CT出现"充气支气管征"、"血管造影征"、"晕征"对诊断 PC有一定价值;增强扫描多表现中度均匀延迟性强化.

目的 研究阻塞性睡眠呼吸暂停(OSA)患者前、后默认网络功能连接情况,探讨OSA患者认知功能损害的潜在神经生理机制.方法 采集43例OSA患者(OSA组)及43名健康男性(HC组)的静息态磁共振脑功能成像(rs-fMRI)和临床量表评估数据.选用基于种子点的功能连接方法,分别以内侧前额叶(mPFC)和后扣带回(PCC)为种子点计算其与全脑的功能连接值,组间的功能连接差异比较采用双样本t检验.结果 与HC组相比,OSA组mPFC与左侧小脑后叶功能连接减低,而与左侧顶下小叶、双侧额中回、左侧额下回功能连接增高;OSA组PCC与双侧中央后回、右侧中央前回功能连接减低,而与右侧小脑后叶功能连接增高.结论 OSA患者前、后默认网络功能连接存在显著差异,这可能为进一步理解OSA认知功能的损害提供了新的视角.

目的 基于静息态功能磁共振(rs-fMRI)技术采用图论分析方法研究阻塞性睡眠呼吸暂停(OSA)患者功能脑网络的拓扑属性改变.方法 搜集未经治疗的男性重度OSA患者及正常睡眠组(GS组)各45例并采集被试的多导睡眠监测、临床量表评分及rs-fMRI数据.采用AAL模板构建功能脑网络,通过图论方法比较功能脑网络的整体和局部网络拓扑属性,并分析拓扑属性与临床变量之间的关系.结果 OSA及GS组均存在高效的“小世界”网络属性.然而OSA患者小世界指数(σ),标准化聚类系数(γ),整体效率(Eglob)值显著减低,最短路径长度(Lp),标准化最短路径长度(λ)值显著增高,且部分默认网络(DMN)、突显网络(SN)和中央执行网络(CEN)脑区节点中心性受损.OSA患者整体网络属性与爱泼沃斯嗜睡量表(ESS)评分、蒙特利尔认知量表(MoCA)评分和血氧饱和度显著相关.结论 虽然OSA患者功能脑网络具有“小世界”属性,但其功能整合和功能分离受损,且部分DMN、SN和CEN脑区的节点中心性存在异常破坏.OSA患者功能脑网络的拓扑属性异常可能是认知功能障碍的潜在生物学标志.

Objective Obstructive sleep apnea (OSA) is accompanied by widespread abnormal spontaneous regional activity related to cognitive deficits. However, little is known about the topological properties of the functional brain connectome of patients with OSA. This study aimed to use the graph theory approaches to investigate the topological properties and functional connectivity (FC) of the functional connectome in patients with OSA, based on resting-state functional magnetic resonance imaging (rs-fMRI). Methods Forty-five male patients with newly diagnosed untreated severe OSA and 45 male good sleepers (GSs) underwent a polysomnography (PSG), clinical evaluations, and rs-fMRI scans. The automated anatomical labeling (AAL) atlas was used to construct the functional brain connectome. The topological organization and FC of brain functional networks in patients with OSA were characterized using graph theory methods and investigated the relationship between functional network topology and clinical variables. Results Both the patients with OSA and the GSs exhibited high-efficiency “small-world” network attributes. However, the patients with OSA exhibited decreased σ, γ, Eglob; increased Lp, λ; and abnormal nodal centralities in several default-mode network (DMN), salience network (SN), and central executive network (CEN) regions. However, the patients with OSA exhibited abnormal functional connections between the DMN, SN, and CEN. The disrupted FC was significantly positive correlations with the global network metrics γ and σ. The global network metrics were significantly correlated with the Epworth Sleepiness Scale (ESS) score, Montreal Cognitive Assessment (MoCA) score, and oxygen desaturation index. Conclusion The findings suggest that the functional connectome of patients with OSA exhibited disrupted functional integration and segregation, and functional disconnections of the DMN, SN, and CEN. The aberrant topological attributes may be associated with disrupted FC and cognitive functions. These topological abnormalities and disconnections might be potential biomarkers of cognitive impairments in patients with OSA.

Impaired spontaneous regional activity and altered topology of the brain network have been observed in obstructive sleep apnea (OSA). However, the mechanisms of disrupted functional connectivity (FC) and topological reorganization of the default mode network (DMN) in patients with OSA remain largely unknown. We explored whether the FC is altered within the DMN and examined topological changes occur in the DMN in patients with OSA using a graph theory analysis of resting- state functional magnetic resonance imaging data and evaluated the relationship between neuroimaging measures and clinical variables. Resting-state data were obtained from 46 male patients with untreated severe OSA and 46 male good sleepers (GSs). We specifically selected 20 DMN subregions to construct the DMN architecture. The disrupted FC and topological properties of the DMN in patients with OSA were characterized using graph theory. The OSA group showed significantly decreased FC of the anterior-posterior DMN and within the posterior DMN, and also showed increased FC within the DMN. The DMN exhibited small-world topology in both OSA and GS groups. Compared to GSs, patients with OSA showed a decreased clustering coefficient (C-p) and local efficiency, and decreased nodal centralities in the left posterior cingulate cortex and dorsal medial prefrontal cortex, and increased nodal centralities in the ventral medial prefrontal cortex and the right parahippocampal cortex. Finally, the abnormal DMN FC was significantly related to C-p, path length, global efficiency, and Montreal cognitive assessment score. OSA showed disrupted FC within the DMN, which may have contributed to the observed topological reorganization. These findings may provide further evidence of cognitive deficits in patients with OSA.

肺黏膜相关淋巴组织(mucosa-associated lymphoid tissue, MALT)淋巴瘤是一种原发于淋巴结外边缘区的惰性 B细胞型非霍奇金淋巴瘤,而原发于肺内相对罕见,术前易误诊为肺癌、实变型肺炎等病变.本文回顾性分析 13 例经病理证实的肺MALT淋巴瘤的CT征象及误诊原因,以提高对该病的认识及影像诊断水平,指导临床治疗.

目的 采用基于图论的分析方法研究阻塞性睡眠呼吸暂停(OSA)患者默认网络(DMN)的“小世界”网络拓扑属性改变.方法 搜集首次确诊的重度OSA患者及年龄、受教育程度相似的正常睡眠组(GS组)各46例进行静息态功能磁共振成像(rs-fMRI)数据采集,选取20个特定的DMN感兴趣区(ROI)构建二值化网络,获取并比较DMN整体及局部属性参数,分析网络参数与临床变量的相关性.结果 OSA及GS组DMN均存在“小世界”属性.与GS组相比,OSA患者DMN在0.05≤稀疏度(Sp)≤0.12和0.15≤Sp≤0.50范围内聚类系数(Cp),Eloc显著减低,OSA组DMN的特征性最短路径长度(Lp),Eglob值无明显变化.与GS组相比,OSA患者左侧后扣带回的节点度、节点介数、节点效率均显著减低,而右侧海马旁回节点度、节点介数、节点效率均显著增高;背内侧前额叶皮层的节点介数显著减低,而腹内侧前额叶皮层节点介数显著增高.结论 OSA患者DMN具有“小世界”属性,但其整体网络属性和局部属性均存在改变,且血氧饱和度减低可能导致OSA患者DMN拓扑属性重塑,而OSA患者DMN的网络属性异常可进一步解释OSA患者认知功能障碍.

目的 观察阻塞性睡眠呼吸暂停(OSA)患者脑默认网络(DMN)内部各亚区的功能连接(FC)及拓扑属性的异常改变.方法 采集40例男性重度OSA患者(OSA组)和43名睡眠正常的男性志愿者(对照组)的静息态fMRI数据,以20个DMN亚区为种子点构建DMN的FC网络,获得OSA患者DMN各亚区间FC异常的脑区.计算拓扑属性参数小世界指数(ο)、网络全局效率(Eglob)和网络局部效率(Eloc),并评估与临床资料的相关性.结果 OSA组和对照组DMN均存在小世界属性.与对照组比较,OSA组前-后DMN、后DMN内部FC减低(P均＜0.05),Eloc减低(P=0.02).OSA组DMN异常的FC与Eglob值(r=-0.736,P＜0.001)、蒙特利尔认知(MoCA)量表评分(r=-0.453,P=0.006)呈负相关.结论 OSA患者DMN内部各亚区功能连接受损,且DMN拓扑属性异常改变,可能是其认知、记忆等功能障碍的神经影像学机制.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.

The aim of this study is to investigate changes in regional cerebral blood flow (rCBF) in awake people with untreated severe obstructive sleep apnoea (OSAs) compared with good sleepers (GSs).

Objective To explore the CT and MRI features of chordoma and analysis misdiagnosis.Methods The CT and MRI imaging data were analyzed retrospectively in 1 8 patients with chordoma.The imaging findings of the preoperative misdiagnosed lesions were analyzed and summarized.Results 1 2 cases were diagnosed correctly preoperatively,6 cases were misdiagnosed.Chordoma was located in the skull base in 9 cases,in the sacrum in 8 cases,and in cervical vertebrae in 1 case.CT and MRI showed oval or round shape lesions in 12,and irregular shape in 6.14 cases of them displayed clear boundary,4 cases displayed unclear boundary.CT showed soluble osseous bone destruction and uneven isodensity or slightly low density mass.Spot or lamellar shaped calcifications or residual substances of bone were found around or inside of the lesions in 9 cases.MRI showed equal or low signal intensity on T1 WI and high signal intensely on T2 WI.After the CT and MRI contrast enhancement,mass showed mild-to-moderate heterogeneity enhancement. Conclusion Chordoma has certain characteristics on CT and MRI imaging.The combination use of CT and MRI scans has an important value in localization quantitative and qualitative diagnosis of chordoma.

Many previous studies have demonstrated that the blindness patients have has functional and anatomical abnormalities in the visual and other vision-related cortex. However, changes in the brain function in late monocular blindness (MB) at rest are largely unknown. In this study, we investigated the underlying regional homogeneity (ReHo) of brain-activity abnormalities in patients with late MB and their relationship with clinical features. A total of 32 patients with MB (25 male and seven female) and 32 healthy controls (HCs) (25 male and seven female) closely matched in age, sex, and education underwent resting-state functional MRI scans. The ReHo method was used to assess local features of spontaneous brain activities. Patients with MB were distinguishable from HCs using the receiver operating characteristic curve. The relationship between the mean ReHo in brain regions and the behavioral performance was calculated using correlation analysis. Compared with HCs, patients with MB showed significantly decreased ReHo values in the right rectal gyrus, right cuneus, right anterior cingulate, and right lateral occipital cortex and increased ReHo values in the right inferior temporal gyrus, right frontal middle orbital, left posterior cingulate/precuneus, and left middle frontal gyrus. However, there was no significant relationship between the different mean ReHo values in the brain regions and the clinical features. Late MB involves abnormalities of the visual cortex and other vision-related brain regions, which may reflect brain dysfunction in these regions.

Background: Extramedullary plasmacytoma is a rare plasma cell neoplasm within soft tissue and without bone marrow involvement or other systemic characteristics of multiple myeloma. Primary pulmonary plasmacytoma is a rare type of extramedullary plasmacytoma.Case presentation: A 48-year-old male with a tumor in the right middle ear was referred to our hospital. A routine chest X-ray was arranged and showed enlargement of the left lung hilum. His bilateral breathing sounded clear. A chest CT scan revealed a well-circumscribed mass. Pathological biopsy yielded a diagnosis of isolated pulmonary plasmacytoma.Conclusions: This is the first presentation of primary pulmonary plasmacytoma with a solitary pulmonary nodule and no lymph node involvement.

Purpose Obstructive sleep apnea (OSA) has been associated with changes in brain structure and regional function in certain brain areas. However, the functional features of network organization in the whole brain remain largely uncertain. The purpose of this study was to identify the OSA-related spatial centrality distribution of the whole brain functional network and to investigate the potential altered intrinsic functional hubs. Methods Forty male patients with newly confirmed severe OSA on polysomnography, and well-matched good sleepers, participated in this study. All participants underwent a resting-state functional MRI scan and clinical and cognitive evaluation. Voxel-wise degree centrality (DC) was measured across the whole brain, and group difference in DC was compared. The relationship between the abnormal DC value and clinical variables was assessed using a linear correlation analysis. Results Remarkably similar spatial distributions of the functional hubs (high DC) were found in both groups. However, OSA patients exhibited a pattern of significantly reduced regional DC in the left middle occipital gyrus, posterior cingulate cortex, left superior frontal gyrus, and bilateral inferior parietal lobule, and DC was increased in the right orbital frontal cortex, bilateral cerebellum posterior lobes, and bilateral lentiform nucleus, including the putamen, extending to the hippocampus, and the inferior temporal gyrus, which overlapped with the functional hubs. Furthermore, a linear correlation analysis revealed that the DC value in the posterior cingulate cortex and left superior frontal gyrus were positively correlated with Montreal cognitive assessment scores, The DC value in the left middle occipital gyrus and bilateral inferior parietal lobule were negatively correlated with apnea-hypopnea index and arousal index in OSA patients. Conclusion Our findings suggest that OSA patients exhibited specific abnormal intrinsic functional hubs including relatively reduced and increased DC. This expands our understanding of the functional characteristics of OSA, which may provide new insights into understanding the dysfunction and pathophysiology of OSA patients.

目的 探讨肺硬化性血管瘤(PSH)的CT表现,分析其误诊原因.方法 回顾性分析25例经手术病理证实的PSH患者临床及CT资料,总结其CT特征,并对术前诊断错误病例进行分析总结.结果 25例PSH,术前CT正确诊断10例,误诊为肺癌6例、结核球1例、炎性假瘤1例、孤立性纤维瘤2例、炎性肌纤维母细胞瘤1例,另4例考虑良性病变,性质不明.肿瘤位于左肺17例,其中上叶9例、下叶8例;右肺8例,其中上叶3例、中叶5例;中央型8例,周围型17例.病灶大小0.8 cm×0.8 cm～4.8 cm ×3.7 cm,平均约2.7 cm ×2.3 cm.24例CT表现为圆形或类圆形结节或肿块,边界清楚,11例浅分叶;1例为不规则肿块,边界尚清.CT平扫密度均匀18例,7例密度不均匀;增强扫描7例不均匀强化,中央轻度强化区,边缘明显强化;18例均匀明显强化,净强化值30～80HU,平均52.3 HU.9例病灶内或边缘可见钙化.血管贴边征10例,空气新月征2例,尾征4例,肺动脉为主征3例,血管集中征2例,胸膜牵拉凹陷1例,长毛刺1例,棘状突起1例.结论 PSH表现具有一定CT特征(血管贴边征,空气新月征,尾征等),仔细多平面观察及增强扫描可以提高术前正确诊断率.

目的 应用多层螺旋CT血管成像技术(CTA)研究肾动脉解剖变异类别、部位及数目,为肾脏手术术前提供指导.资料与方法 选择2014年10月-2015年3月间在南昌大学第一附属医院影像科因腹部不适行肾动脉增强及全腹部CT增强扫描的1074例患者.回顾性分析研究对象的肾血管CTA,统计肾动脉变异即肾动脉提前分支和副肾动脉的情况,并比较不同性别与不同侧发生率之间的差别.结果 肾动脉变异分别占病例数和肾脏数的53.4％和45.1％,其中提前分支变异率为38.9％,副肾动脉变异率为33.4％.变异肾动脉从肾门入肾最常见,占67.1％;变异数目以1支型最多见,占66.3％.单侧、双侧变异率分别为38.4％、14.9％.男性变异率显著高于女性,差异有统计学意义(x2=17.693,P＜0.01).右侧肾动脉变异发生率显著高于左侧,差异有统计学意义(x2=6.490,P＜0.05).结论 多层螺旋CT血管造影可清晰显示肾动脉的解剖变异,能够作为肾脏手术术前检查的重要方法.

目的 采用种子点功能连接方法,分析阻塞性睡眠呼吸暂停综合征(OSAS)患者静息态下海马与全脑功能连接的改变,探索OSAS患者认知功能下降的神经生理机制.方法 40例OSAS患者及40例正常对照组(NC)进行静息态下脑功能磁共振成像(fMRI)数据采集.以左、右侧海马为种子点进行全脑的功能连接,采用两样本t检验比较组间功能连接差异.结果 与NC组比较,OSAS患者左侧海马与双侧楔前叶、额中回、前扣带回、中央前回及右侧后扣带回功能连接减低,而与双侧小脑后叶功能连接增高.OSAS患者右侧海马与双侧额中回、后扣带回、边缘叶及右侧楔前叶功能连接减低,而与左侧顶下小叶及右侧小脑后叶功能连接增高.结论 OSAS患者海马与多个脑区存在功能连接异常,可能是OSAS患者认知功能下降的神经机制.