对85例疑肺动脉栓塞和治疗后复查患者采用多层螺旋CT行薄层肺动脉造影和间接法深静脉造影.结果 85例患者均顺利完成检查,45例疑肺动脉栓塞中24例确诊为急性肺动脉栓塞(双肺动脉栓塞14例、左肺动脉栓塞3例、右肺动脉栓塞7例),肺部感染8例,肺结核2例,肺癌2例,胸腔积液8例,肺动脉黏液性恶性纤维组织细胞瘤1例;深静脉血栓9例.提出加强患者心理护理,完善检查前准备,严格操作规程,掌握熟练的穿刺技术并积极预防并发症是保证检查成功,获得具有诊断价值的肺动脉及深静脉造影图像的重要措施.

对85例疑肺动脉栓塞和治疗后复查患者采用多层螺旋CT行薄层肺动脉造影和间接法深静脉造影。结果85例患者均顺利完成检查,45例疑肺动脉栓塞中24例确诊为急性肺动脉栓塞(双肺动脉栓塞14例、左肺动脉栓塞3例、右肺动脉栓塞7例),肺部感染8例,肺结核2例,肺癌2例,胸腔积液8例,肺动脉黏液性恶性纤维组织细胞瘤1例;深静脉血栓9例。提出加强患者心理护理,完善检查前准备,严格操作规程,掌握熟练的穿刺技术并积极预防并发症是保证检查成功,获得具有诊断价值的肺动脉及深静脉造影图像的重要措施。

目的 探讨健康教育及心理护理在老年患者CMRI中的应用价值.方法 对27例拟行CMRI老年患者采用焦虑自评表(Self-rating anxiety scale,SAS)进行焦虑评分,对存在焦虑症状的患者采用自制表调查焦虑源.而后进行相关健康教育及心理护理,于检查前再次进行SAS评分.结果 健康教育和心理护理前,27例患者SAS评分高于常模,差异有统计学意义(P＜0.001).其中19例患者有焦虑症状,可能的焦虑源中,主要是对MR认识不足占89.5%,其次为CMRI本身不良因素占57.9%及患者自身因素占36.8%.经过健康教育及心理护理,患者SAS评分低于健康教育及心理护理前,且有显著性差异(P＜0.001),但仍高于常模(P＜0.001).全部患者顺利完成检查.结论 健康教育及心理护理可以降低老年患者焦虑情绪,增加对CMRI的依从性,对检查顺利完成十分重要。

目的探讨155例CT导向下肺穿刺活检的护理要点。方法术前进行心理护理,指导患者屏气训练;术中严格执行无菌操作并密切观察有无并发症发生;术后协助医师完成标本的送检及告知患者穿刺伤口的护理。结果本组155例医护患3者配合良好,无护理并发症发生,并有较高的穿刺活检成功率。结论要达到好的预期效果,必须做到良好的护理,可减少并发症的发生,并有助提高穿刺活检的成功率。

Objective:To investigate the methods and technique of multislice spiral CT in diagnosis of acute pulmonary embolism (PE) and deep vein thrombosis (DVE).Methods:21 patients with clinically suspected PE were enrolled in this study.After the thorax plain CT scanning,multislice spiral CT pulmonary angiography (CTPA) was performed with a delay of 20 second from the beginning of intravenous administration of contrast material 100ml at a rate of 3ml/s.Indirect CT venography (CTV) was performed after a delay of 150s with a non-spiral scanning protocol of 1mm collimation and 30mm gaps from diaphragm to upper portion of gastrocnmius muscle.multi planar reconstruction (MPR) and surface shaded display (SSD)、maximum Intensity projection (MIP) were carried out.Results:MSCTPA demonstrated PE in 12 patients,and the CTV revealed 8 cases of DVT (There were 7 cases of DVT complicated with PE) in the 12 patients.With a delay of 20s for CTPA and 150s for CTV,the pulmonary artery and deep vein were well demonstrated.The embolism manifested as partial or complete intravascular filling defect.MPR was superior to SSD and MIP in depicting the embolism.Conclusion:CTPA is a safe,non-invasive and cost-effective diagnostic method for the diagnosis of PE and DVT.

对119例临床诊治需要行多平面重建的患者采用多排螺旋CT薄层扫描,标准冠状位或(和)矢状位多平面重建,并根据临床要求于操作台或工作站实施斜面及曲面重建.结果表明,多排螺旋CT可获得高质量的多平面和任意曲面重建图像,能够显示整个感兴趣病变的形态,清晰显示病变的部位、大小及病灶及周围组织和器官的关系.提示多平面及曲面重建图像能提供独特的解剖信息和相关病理征象,有助于病变的诊断及分期,指导临床治疗方案的选择与实施.

目的:评价CT引导下穿刺活检结果及其临床意义.方法:回顾性分析55例CT引导下穿刺活检病例,穿刺部位肺37例,纵隔2例,肝7例,胰腺1例,颈椎、胸椎、骶椎各1例,髂骨1例,腹膜后1例,腹腔2例,颌面部1例.结果:41例穿刺结果为恶性肿瘤,14例为良性.后经手术和随访证实其中11例为肯定性阴性,假阴性3例.结论:正确评价CT引导下穿刺活检结果有着重要的临床意义.

CT导引下对脊柱病变进行穿刺活检,对绝大部分病变可以达到定性诊断的目的,对拟定治疗方案具有指导意义。我院在2000年3月～11月行脊柱病变穿刺活检8例,均取得成功,现报道如下。

Objective To evaluate the MR imaging and CT appearances of focal nodular hyperplasia (FNH) of the liver and improve the accuracy of diagnosis in FNH. Methods 6 patients with solitary FNH underwent MR exiamnation. Dynamic Gd-DTPA enhancement were performed in all the lesions. Of the 6 patients, three underwent CT plain and dynamic contrast scan; one underwent CT plain scan. More attention was payed to the atypical appearances. Results Atypical lesion appearances ineludod:apparent hypointensity on T1 WI and hyperintensity on T2WI,diffusly heterogeneous enhancement in arterial phase, pseudocapsule enhancement in delayed phase;the dynamic contrast MR and CT appearance in each phase were not all similar. Conclusion MR and CT especially dynamic contrast enhancemenl is of great value to the diagnosis of FNH. The atypical appearances of FNH shoud keep in mind to avoid misdiagnosis.