目的 探讨侧位肱骺角在儿童隐匿性肱骨外髁骨折诊断中的价值.资料与方法 回顾性分析2015年1月—2021年1月在厦门市儿童医院行肘关节正侧位拍片的 1～4岁儿童,其中肱骨外髁骨折 61 例,正常组80例.以肱骨下段前缘骨皮质最前缘作为肱骨长轴线,以椭圆形肱骨小头长轴线作为骺板线,测量侧位肱骺角,比较正常组不同年龄间以及骨折组与正常组间侧位肱骺角,并采用受试者工作特征曲线探讨侧位肱骺角对肱骨外髁骨折的诊断效能.结果 侧位肱骺角在正常组[45.04°(38.88°,50.88°)]及骨折组[35.24°(31.99°,39.69°)]差异有统计学意义(Z=-6.18,P=0.000).受试者工作特征曲线分析显示侧位肱骺角的诊断效能较高,曲线下面积为0.804.最佳界值选择41.20°时,诊断肱骨外髁骨折敏感度为85.2%,特异度为66.2%.结论 侧位肱骺角对肱骨外髁骨折的诊断敏感度较高,应用其诊断利于减少儿童隐匿性肱骨外髁骨折漏诊.

目的 探讨CT在诊断儿童消化道异物中的应用价值.方法 回顾性分析25例儿童消化道异物的临床及CT资料.结果 25例异物中,位于咽部3例,其中2例咽部软组织肿胀,1例引起咽后壁开放性损伤、颈部及纵隔间隙广泛积气;位于食管10例,其中4例食管梗阻性扩张,3例食管壁肿胀伴1例食管穿孔,3例腐蚀性食管炎伴1例食管穿孔、食管气管瘘;位于胃十二指肠4例,其中1例机械性肠梗阻、肠壁水肿,1例肠穿孔、腹膜炎;位于空回肠7例,其中1例机械性肠梗阻,5例肠穿孔、腹膜炎伴肠梗阻;位于结肠1例,肠穿孔、腹膜炎伴腹壁肿胀;除5例多发磁性异物外,其余均为单一异物.异物成分中骨块3例,纽扣电池3例,枣核3例,鱼刺1例,贝壳1例,筷子1例,玻璃球1例,玩具类1例,咽拭子头端1例,花生1例,棒棒糖棍2例,磁性异物5例,柿石1例.结论 CT能清楚显示异物的位置、形态、性质及有无并发症,对临床治疗具有重要指导意义.

目的 对比分析CT和X线检查在小儿肺部疾病影像诊断中的应用价值.方法 对2017年3月—2019年8月我院接收的小儿肺部疾病患儿82例的临床资料进行回顾性分析,所有患儿均行X线检查和CT检查.对比两种检查方法 的检出率和诊断准确率.结果 CT检查的检出率明显高于X线检查,差异显著(P<0.05).CT检查双侧间质性肺炎准确率95％、单纯性肺炎准确率100％、肺气肿准确率100％、真菌感染性肺炎准确率92.3％,均分别高于X线检查的80％,89.5％,63.6％,61.5％,但差异无统计学意义(P>0.05).结论 对小儿肺部疾病的影像诊断,CT诊断效果更理想,能将病灶程度、范围,以及周围组织受累情况清晰显示出来,为临床治疗提供参考依据.

目的 分析急性呼吸窘迫综合征(ARDS)患儿的影像诊断与鉴别诊断.方法 回顾性分析厦门市儿童医院2016年1月至2019年1月收治的60例ARDS患儿的临床资料,采用计算机体层成像(CT)评估患儿肺部表现,并分析CT分级与病情严重程度的相关性.结果 CT诊断ARDSⅠ级13例,Ⅱ级23例,Ⅲ级18例,Ⅳ级6例;肺部CT图像特征明显,且ARDS患儿CT分级与病情严重程度具有相关性,分级增加,病情越严重(P<0.05).结论 CT可在一定程度上反映ARDS患儿病情的严重程度,在ARDS患儿诊断及鉴别诊断中具有一定应用价值.

目的:探讨儿童急性坏死性脑病临床表现及影像学特征，以提高诊断水平。方法:回顾性分析1例儿童急性坏死性脑病临床及MRI影像资料并复习相关文献。结果:患儿临床表现为流感季节发病，发热48 h后陷入浅昏迷并有惊厥抽搐发作；脑脊液蛋白轻度增高，生化检查ALT、AST、CK-MB、LDH明显增高。MRI示双侧丘脑、侧脑室周围白质和小脑髓质及中脑被盖见T2WI高信号影，呈对称多灶性分布，100%双侧丘脑累及是本病的特异性标志，弥散加权成像的表观弥散系数(ADC)图表现病变区中央ADC值低，周围ADC值高，磁敏感加权成像显示丘脑及中脑被盖灶性出血。结论:急性坏死性脑病临床及MRI表现具有特征性，小血管病变与其病理过程有密切关系，早期识别需重视磁敏感加权成像的应用。

Objective: To investigate the value of imaging findings in the diagnosis of ovarian torsion and the evaluation of ovarian necrosis in children. Methods:The clinical and imaging data of 33 pediatric patients with ovarian torsion confirmed by surgery and pathology, were retrospectively analyzed. All patients underwent pre-and post-contrast CT and/or MRI study. The incidence of various imaging features was calculated and statistically analyzed. All cases were divided into the necrosis group and the non-necrotic group according to the pathological results, and the difference of the incidence of image features between these two groups was compared. Results: Ranking from high to low incidence, imaging features in all 33 patients were as follows: lack of contrast enhancement (85.7％), hemorrhage within adnexa (60.6％ ), ovarian enlargement ≥5cm (57.6％), twisted vascular pedicle(39.4％), eccentric wall thickening (36.4％), edematous ovary with peripheral follicles (27.3％), uterine deviation toward torsion (24.2％ ) and ovary subcapsular effusion (9.1％). There was statistically significant difference between necrotic group and non-necrotic group in the incidence of hemorrhage within adnexa (χ2 =22.074, P<0.001), but there was no significant difference in other signs between the two groups (P>0.05). Conclusion: Lack of contrast enhancement is the most common imaging features of ovarian torsion in children, but this does not indicate ovarian necrosis. Hemorrhage within adnexa can suggest ovarian necrosis, this provides valuable information for clinical treatment and decision making.

Objective To investigate the clinical value of CT on preoperative diagnosis of colon cancer and diagnosis of postoperative recurrence.Methods Thirty patients with colon cancer admitted by the inpatient department of the hospital from June, 2013 to June, 2014 were selected as research subjects, who were subject to preoperative condition assessment by stages and monitoring of postoperative recurrence through CT, and simultaneously CT diagnosis were evaluated with pathological diagnosis as the standard.Results The comparison between preoperative staging accuracies of CT in the diagnosis of colon cancer at Period I and Period Ⅱ and diagnosis results of histopathologic tissue satisfied χ2=14.97 and 16.13 respectively, the comparison between postoperative staging accuracies at Stage Ⅰ and Stage Ⅱ and diagnosis results of histopathologic tissue satisfiedχ2=66.33 and 39.32 (average P<0.05), and the differences were statistically significant. Both diagnostic accuracies in StageⅢ and Stage Ⅳbefore operations were 100.00%.Conclusions CT could be used for the assessment of preoperative staging of colon cancer, evaluate the recurrence and metastasis, demonstrate the tumor infiltrating of the adjacent tissue, and prompt the metastasis of lymph nodes and distant organs. The diagnostic accuracy of CT is high and deserve widely used in clinical.

目的:探讨急性创伤性液、气胸仰卧位胸片的X线征象,分析应用价值及病理基础。方法:对资料完整的143例急性创伤性液、气胸卧位胸片进行回顾性分析。结果:中、少量胸腔积液77例,大量胸腔积液38例,液气胸28例。合并创伤性湿肺48例,肺撕裂伤12例,支气管断裂3例,张力性气胸7例。单侧胸部损伤126例,双侧胸部损伤17例。结论:仰卧位X线胸片有其独特的影像学特点,对急性胸部创伤的诊断有非常重要的价值。