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医学影像学杂志

医学影像学杂志

CSTPCD

Journal of Medical Imaging
本刊是由国家科技部批准、山东省医学影像学研究所、山东省医学影像学研究会主办的学术期刊，国内外公开发行。本刊宗旨为：努力提高与普及医学影像学知识，为保障人民身体健康而奋斗。
  • 发文量：12037
  • 被引量：6620
  • H指数：1
  • 开始收录时间：1990(1)
  • CNKI综合因子：0.816
  • 维普期刊影响因子： 1.37
  • 万方期刊影响因子：1.85
  • 创刊时间：1990
  • 国内刊号/CN：37-1426/R
    国际刊号/ISSN：1006-9011
  • 发行周期：月刊
    邮发代号：24-134
  • 主管单位：山东省卫生厅
    主办单位：山东医学影像学研究会；山东医学影像学研究所
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  • 主编：赵斌
  • 电话：0531-87920996 87031478
  • 邮箱：yxyxxzz@sina.cn
  • 地址：济南市经四纬九路37号
  • 邮编：250021
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医学影像学杂志 >2023年第7期

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  • 摘要：随着医院信息化建没的不断深入发腱，医院的信息化服务已经成为医疗服务过程中不可缺少的一部分。医院信息系统（hospitalinformationsystem，HIS）。
  • 摘要：患者男。63岁。尿频，尿急，尿痛，间歇性全程肉眼血尿就诊。超声检查：膀胱充盈良好．右后壁分别可见77mm×58mm及21mm×18mm囊性包块（图1，2）．
  • 摘要：目的 探讨磁敏感加权成像(ESWAN)在脑出血诊断中应用价值.方法 对41例临床确诊脑出血患者行常规MR序列(T1WI、T2WI、FLAIR、DWI)、T2*GRE、ESWAN检查,对ESWAN图像进行后处理,获得ESWAN幅度图、相位图及最小密度投影(MinIP)图.对常规序列、T2* GRE、ESWAN各序列检出的出血灶数量、大小进行评估及统计分析.结果 常规序列、T2* GRE、ESWAN对总出血灶及脑微出血灶(CMB)的检出率比较为:ESWAN＞T2*GRE＞常规序列；ESWAN序列对于微出血灶的检出率明显高于T2*GRE及常规序列.结论 相对于常规序列及T2*GRE,ESWAN能更准确的检测出血灶数量,对梗死后微出血独具诊断优势.%Objective To investigate applicable value of the susceptibility weighted imaging (ESWAN) in the diagnosis of cerebral hemorrhage. Methods 41 patients- who were climically diagnosed with cerebral hemorrhage, underwent routine MR sequence ( T1WI, T2 WI, FLAIR, DWI ) , T2 * GRE, ESWAN examination, ESWAN amplitude diagram, phase diagram and minimum intensity projection (MinIP) diagram. Subsequently, the hemorrhage quantity, size obtained by conventional sequence, T2 * GRE, ESWAN sequence were evaluated and statistically analysed. Results The detection rate of total cerebral hemorrhage and cerebral microbleedings (CMB) via conventional sequence, T2 * GRE, ESWAN was as follows: ESWAN > T2GRE > conventional sequences. The detection rate of micro hemorrhage by ESWAN sequence was significantly higher than that of T2 * GRE and conventional sequences. Conclusion Compared with the conventional sequence and T2 * GRE, ESWAN can more accurately detect hemorrhage quantity, the infarction microbleeds and posess the unique diagnostic advantage.
  • 摘要：患者男，42岁。20年前无意中发现右颈部鸽蛋大小肿块，随病程进展，肿块逐渐增大突出直至巨大，占据整个右侧颈部，起病以来患者自觉无明显不适。专科体检：右颈部见一巨大肿块，上及颞颌角，下达锁骨上窝，边界清，质韧，表面可触及搏动感及震颤，听诊可闻及杂音。
  • 摘要：目的 研究CT阻塞指数与血气分析评价急性肺栓塞(APE)严重性的价值.方法 接受CTPA和动脉血气分析检查并且无基础心肺疾病的APE患者共59例.利用肺动脉CT阻塞指数评价肺动脉栓子阻塞程度与范围.动脉血气分析包括PaCO2、PaO2、SaO2及P(A-a)O2.严重APE组和非严重APE组患者之间的CT阻塞指数、动脉血气分析指标之间的统计学差异用t检验评价.阻塞指数与动脉血气分析指标之间的相关性使用Spearman相关系数评价.结果 严重APE组患者的PaCO2、PaO2及SaO2明显低于非严重APE组患者(P＜0.01),而P(A-a)O2明显高于非严重APE患者(P＜0.01).阻塞指数分别与PaCO2、PaO2、SaO2及P(A-a)O2的相关性有统计学意义(P＜0.01).结论 综合分析APE患者的肺动脉阻塞指数、血气分析指标有利于评价APE患者的严重性.%Objective To study the value of CT obstruction index and arterial blood gas analysis on evaluating the severity of the patients with APE. Methods Fifty-nine patients with APE but no underlying cardiopulmonary disease had undergone CTPA examination and artery blood gas analysis. Pulmonary artery clot load was assessed by the pulmonary arter-y obstruction index. Atery blood gases included PaCO2 , PaO2 , SaO2 , and P(A-a)O2. T test was used to evaluate the statistical difference of CT obstruction index and the arterial blood gas values between severe and non severe pulmonary embolism. Spearman's rank correlation coefficients were used to assess the correlation between arterial obstruction index and blood gas values. Results The values of PaCO2 , PaO2 , and SaO2 were significantly lower and P(A-a)O2 were significantly higher in the severe group than non severe group ( P <0. 01). Correlations between the obstruction index and PaCO2 , PaO2 , SaO2 , and P(A-a)O2 were statistically different ( P <0. 01). Conclusion CT obstruction index and arterial blood gas analysis are helpful for evaluating the severity of the patients with APE.
  • 摘要：目的 探讨彩色多普勒超声心动图(CDE)在老年动脉导管未闭(PDA)封堵术中的价值.方法 封堵术前应用CDE筛选25例老年PDA适应证,彩色多普勒血流显像(CDFI)分流束血流信号估测PDA肺动脉端直径,与心血管造影对照,经统计学相关处理判断其正确性；连续波多普勒(CW)测量三尖瓣最大反流速度峰值,根据简化伯努利方程△P=4V2估算跨三尖瓣压力阶差,再加上右心房固有压力估测肺动脉压力,与心导管对照,经统计学相关处理判断其正确性；所有患者均行封堵术介入治疗,封堵术后再应用CDE判断封堵术疗效.结果 根据CDE特征筛选25例老年PDA实施封堵术全部获得成功,封堵术后CDE判断疗效满意.CDFI测量分流束血流信号估测PDA肺动脉端直径与心血管造影对照,呈正相关(r =0.71,P＜0.001)；CW估测肺动脉压力与心导管对照,呈正相关(r=0.63,P＜0.001).结论 CDE在老年PDA封堵术中具有重要价值,封堵术前筛选适应证应用CDFI估测PDA肺动脉端直径和应用CW估测肺动脉压力是关键,封堵术后判断疗效应用CDFI观察有无过PDA残余分流很重要.%Objective To investigate the value of color Doppler echocardiography (CDE) in the closure of patent ductus arteriosus (PDA) in the elderly. Methods Before the occlusion, the indicantions for twenty-five elderly patients with PDA were screened by CDE. Using the shunt flow signal of color Doppler flow imaging (CDFI) , we estimated the pulmonary side diameter of PDA and compared with the angiocardiography and determined its accuracy through statistics. Using the continuous wave Doppler (CW), we measured peak velocity of tricuspid regurgitation and estimated crosstricuspid pressure gradient according to the simplified Bernoulli equation △P = 4V2 , together with the inherent right atrial pressure to estimate pulmonary artery pressure. Then, we compared cross-trtcuspid pressure gradient and pulmonary artery pressure with cardiac catheterization and determined its accuracy through statistics. All patients underwent interventional therapy and were determined the efficacy of occlusion by CDE. Results All the occlusions of the elderly patients with PDA were successful through the examination by CDE. The diameter of the PDA pulmonary side estimated by the shunt flow signal had a positive correlation with angiocardiography ( r =0. 71, P <0. 001). Pulmonary artery pressure estimated by the CW had a positive correlation with cardiac catheterization contrast ( r =0. 63, P <0. 001). Conclusion CDE has an important value in the elderly during the procedure of patent ductus arteriosus occlusion. Using CDFI to estimate PDA pulmonary side diameter and CW to estimate pulmonary artery pressure before the occlusion is the key to screen the indication of occlusion. And it is also important for using CDFI to observe whether there is a residual PDA shunt after transcath-eter closure.
  • 摘要：患者女性42岁。于两月前无明显诱因剧烈头痛，为间断性前额部胀痛，休息后可缓解，无时间规律，头部昏沉．头部转动后明显，无视物旋转感，多次呕吐．近3个月可见无痛肉眼血尿。
  • 摘要：Objective To evaluate the mammographic findings in patients with phyllode tumors of the breast (PTB), and to explore the value of molybdenum target radiography in the diagnosis of phyllodes tumor. Methods Retrospective analysis of breast X-ray data of 26 cases confirmed by pathology in patients with phyllodes tumor was performed before surgery. Results In all 26 patients, PTB was pathologically diagnosed as benign tumor in 21 patients (80. 8%), borderline in 3 patients (11. 5%) , andmalignant in 2 patients (7. 7%). 18 cases were located in the upper outer quadrant, diameter 1. 7~ 9. 3 cm, 19 cases of mass were round and with smooth margins, 5 cases manifested as lobulated, 7 cases were multiple mass, 2 cases presented with blur edgesand spicular signs, 1 case with calcifications, 21 cases with "transparent dizzy". Conclusion The characteristics of X-ray signs of breast phyllode tumor were large mass, lobulated and with "transparent dizzy" . Mass enlarged rapidly may help diagnose breastr phyllode tumor. There was a relationship between X-ray sign and histological type, X-ray signs of blur edges or Spicular signs were more malignant. Understanding of the pathological manifestations and X-ray features of phyllodes tumor is helpful to improve the rate of preoperative diagnosis.%目的 分析乳腺叶状肿瘤的X线表现,探讨钼靶X线摄影对乳腺叶状肿瘤的诊断价值.方法 回顾分析我院26例经手术病理证实的乳腺叶状肿瘤患者术前乳腺X线检查资料.结果 26例乳腺叶状肿瘤中,良性21例(80.8％)交界性3例(11.5％)恶性2例(7.7％).其中18例乳腺叶状肿瘤多位于外上象限,直径1.7～9.3cm,19例肿块表现为圆形、边缘光整,5例表现为分叶状,7例为多发肿块,2例为边缘模糊、有毛刺征,1例发现钙化灶,21例发现“透明晕”.结论 妇女乳房内肿块大、分叶状且周边有“透明晕”是乳腺叶状肿瘤较特征的X线征象,近期肿块迅速增大有助于叶状肿瘤的诊断.X线表现与组织学分型有一定关系,边缘模糊,有毛刺提示恶性程度较高.认识乳腺叶状肿瘤的病理表现和X线特征,有助于提高术前诊断率.
  • 摘要：目的 分析先天性胆总管囊肿(CCC)术前的影像学表现,并与需鉴别疾病相比较,旨在提高对本病的认识,避免误诊.方法 对20例经过手术病理证实的CCC进行影像学分析,所有病例术前均行MRCP检查.结果 男性4例,女性16例,年龄4～13岁,10岁以内发病为13例,胆管囊肿Ⅰ型17例,Ⅳ型3例.所有病例均表现为肝内和(或)外胆管薄壁囊性扩张,最大直径3.5～25cm不等,其囊壁厚度不均,肿块无包膜.大多数形态呈类圆形(15/20),部分为梭型(5/20).过半数患儿同时存在胆胰合流异常(11/20),部分合并胆囊结石(6/20),与术中所见相符合.术后病理与术前影像学诊断相符,并证实所有患儿均存在胆囊及囊肿壁的不规则增厚及炎性细胞浸润,提示存在慢性炎症.结论 明确胆总管囊肿的部位、形态及并发症特点是进行诊断及鉴别诊断的首要条件,MRCP能无损伤地显示囊肿及周围组织的情况,并能准确提示包括胰胆管合流异常在内的各种合并症,能有效、安全地为临床医师做出术前评估.%Objective To analyse of the preoperative image presentatios of congenital choledochal cyst (CCC) , and to compare these to diseases need to be distinguished in order to improve cognition, and to avoid misdiagnosis. Methods Twenty patients with CCC which comfirmed by surgery and pathology were analysed, all cases were checked by MRCP preoperatively. Results There were 4 males, and 16 females, aged 4 to 13 years old, 13 cases were first taken bad within 10 years old, there were 17 cases of type I of CCC and 3 cases of type IV. All cases were showed off for cystically dilated bile ducts inside and (or) outside livers, with the biggest diameters from 3. 5 to 25 cm differ, and the cystic walls thicken unevenly, while there were no capsule found on the hydatoncus. Most of the hydatoncus showed roundlike shapes (15/ 20), while the other showed the spindlelike shapes (5/20). There were abnormal cholangiopancreatic ducts confluences found in more than half of children (11/20) , some even superinduced cholecystolithiasis (6/20) , which corresponded to the intra-operative findings. Postoperative pathologic diagnosis were compliance with preoperative imaging studies, which demonstrated that all children were the irregular thickening and inflammatory cell infiltrates in gallbladder and cystic walls, suggesting the presence of chronic inflammation. Conclusion Making clear the location, morphology and complications characteristics was an initial term to diagnosis and differential diagnosis. MRCP could detect hydatoncus and the surrounding tissues without scathe, and prompt precisely varieties of complications including abnormal cholangiopancreatic ducts confluences, and give the preoperative evaluation effectively and safely to surgeries.
  • 摘要：目的 探讨胰腺实性假乳头状瘤CT表现.方法 回顾分析经手术病理证实的15例胰腺实性假乳头状瘤,患者均为女性.年龄15～40岁.术前其中13例均经CT平扫及双期CT增强扫描.其中2例仅行CT平扫.结果 15例中肿瘤位于胰头者8例,肿瘤位于胰体尾者7例.肿瘤直径约4～15cm.CT平扫肿瘤成囊实性,其边界清晰.增强扫描动脉期实性成分成轻度强化,静脉期强化程度增加.结论 CT对胰腺实性假乳头状瘤的诊断具有一定的诊断价值.%Objective To analyze CT appearance of solid-pseudopapillary toumors of pancreas (SPTP) so as to enhance the accurate diagnostic rate. Methods 15 patients with surgically and pathologically confirmed SPTP were reviewed. All cases were females and aged 15-40 year. 13 cases underwent unenhanced spiral canning CT and tow phases post-contrast scanning, 2 cases only underwent unenhanced spiral scanning CT. Results 8 cases were located in pancreatic head. 7 cases located in pancreatic body and tail. The diametes of tumors were 4~15 cm. All SPTP were manifested solid-cystic mass in the head or body and tail of pancreas on CT scan. On arterial phase of enhanced CT images, the solid part and capsule wall were heterogeneously gently enhanced. On the vein and delayed phase, there was a further enhancement in the lesions. The hemorrhagic or necrotic regions remained unchanged. Conclusion CT is valuable in the diagnosis of SPTP.
  • 摘要：目的 探讨多层螺旋CT(MSCT)对结肠癌的诊断价值.方法 对检查中的36例疑为结肠癌的患者行低张水或3％泛影葡胺充盈结肠,进行MSCT平扫及增强扫描,以横断面为主,结合多平面重组(MPR),观察肿瘤部位、形态、大小及周围侵犯及转移情况,作出诊断及分期,并与术后病理对照.结果 乙状结肠5例,升结肠12例,横结肠6例,降结肠8例,盲肠5例；大体病理呈息肉型或肿块型18例,溃疡型6例,浸润型或狭窄型12例.术前诊断与术后结果符合率100％.术前CT分期与术后分期总符合率91.1％.结论 MSCT在结肠癌检查中具有独特的优越性,是一种快速、安全、无创伤且较准确的检查方法.%Objective To explore the value of multi - slice spiral CT (MSCT) in the diagnosis of colon cancer. Methods 36 patients with suspected colon cancer were subjected to hypotonic water or 3% diatrizoate filling of colon and then underwent unenhanced and enhanced MSCT. By mainly examining the cross-section in combination with multiplanar reconstruction (MPR), we observed the tumor location, shape, size, movement, and the status of adjacent tissues and metastasis. Subsequently, we made diagnosis and staging and finally, compared the imaging data with pathological findings. Results We found that 5 cases were located in sigmoid colon, 12 cases in ascending colon, 6 cases in transverse colon, 8 cases in descending colon, and 5 cases in caecum. Gross pathological examination showed that 18 cases were polyp or tumor type, 6 cases were ulcer type, and 12 cases were infiltration or narrow type. The concordant rate of preoperative findings and postoperative results in the diagnosis was 100%. The accordance between the preoperative CT staging and postoperative stages was 91. 1%. Conclusion MSCT possesses a unique advantage in the examination of colon cancer and represents a fast, safe, non-invasive and more accurate method.
  • 摘要：患者 男性，3岁。间歇性鼻糍伴鼻痛半年余，偶有打喷嚏．鼻痒，流清涕。查体：右侧上颌窦区压痛．打鼻腔外侧膨出，下鼻甲稍增大。
  • 摘要：患者女，的岁。闪发现左侧颈部肿块就诊。体检：左侧颈部触及一约25mm×25mm肿块。质软，界清。曾于外院B超榆查提示脂肪瘤。
  • 摘要：Objective To discuss the ways of the security and the effect of curing vertebra contusion in old people with PMMA by CT-guided. Methods There were 19 cases of vertebra pathology in old people had been treated with PMMA, CT and restrain fat order MRI had been scaned befor treating. The needles had been punctured through the vertebral arches. The ratio of PMMA powder to liquid was 1.1 to 1:4 while 2 to 5 ml was injected per place. Results All of the 22 vertebra contusion in 19 cases had been treated successfully. The pain relief completely were 17 cases, relief markedly was 1 case, relief mildly was 1 case, no case was avail. No major complications occurred in this series. Conclusion It is simple and effectivle and safet for curing vertebra contusion in old people with PMMA by CT-guided.%目的 探讨CT引导下骨水泥成形术治疗老年人椎体骨挫伤的方法、疗效、安全性.方法 19例老年人椎体骨挫伤患者,术前CT扫描,并行磁共振脂肪抑制序列成像检查确诊,行CT引导下经皮穿刺椎体成形术治疗,椎弓根入路,骨水泥(PMMA)的粉液比例为1:1～1:4,用量为2～5ml.结果 19例老年人21个椎体骨挫伤患者手术均成功,疼痛完全缓解17例,显著缓解1例,轻度缓解1例,无效0例.无严重并发症发生.结论 CT引导下骨水泥成形术治疗老年人椎体骨挫伤的方法简单、疗效可靠、治疗安全,值得应用.
  • 摘要：Objective'To ..study of the long-term effect in total hip arthroplasty by three-dimensional CT technology. Methods To select 18 patients of total hip arthroplasty and follow up for 2 ~4 years, study the linear wear and osteolysis of periprosthetic. Results 18 patients have a good functional recovery from THA after 2 years (Harris score is 84. 5) , the acetabular cup have little displacement and lighter wear (0. 17 ± 0. 05) mm. Conclusion The three-dimension CT is better than other technology in accuracy and repeatability, and fit for the evaluation of preoperative and long-term effects.%目的 利用三维CT技术评价全髋关节置换术后远期临床效果.方法 选取18例全髋关节置换术患者,跟踪随访2～4年,通过三维CT影像技术,对人工假体磨损、移位及周围骨溶解情况进行分析.结果 18例全髋关节置换术患者术后2年假体功能良好(Harris评分85.4),髋臼杯移位程度较小,磨损情况较轻(0.17±0.05)mm.结论 三维CT技术与传统X线方法相比精密度高、重现性好,适用于全髋关节置换术术前及远期临床效果的评价.
  • 摘要：目的 探讨剖宫产子宫疤痕妊娠(CSP)的声像图特征,评价彩色多普勒超声在诊治CSP中的价值.方法 对19例CSP病例的超声图像进行回顾性分析.结果 根据19例CSP的声像图特征,可将其大致分为两种类型:妊娠囊型(12例),混合回声包块型(7例),初诊误诊率21.1％(4/19),超声诊断符合率78.9％ (15/19).结论 CSP具有特征性的超声图像表现,经彩色多普勒超声在诊断CSP和判断治疗效果中起了重要作用.%Objective To summarize the ultrasonographic imaging of caesarean scar pregnancy (CSP) and to investigate the value of color Doppler ultrasonography in the diagnosis and treatment of CSP. Methods 19 cases of CSP were retrospectively analyzed with ultrasonography. Results CSP were classfied into two subtypes according to ultrasonic characteristics;12 cases of the gestational sac-type and 7 cases of the mass-type. The rate of misdiagnosis was 21. 1% (4/19) during preliminary diagnosis, the diagnosis coincidence rate was 78. 9% (15/19). Conclusion According to the distinctive ultrasonographic features, Color Doppler ultrasonography plays an important role in the diagnosis of CSP and in the evaluation of the therapeutic effect.
  • 摘要：基底动脉尖综合征（top of the basilar syndrome，TO—BS）是一种特殊类型的缺血性脑血管病，由Capland在1980年首先报道，常见于中老年人，其临床表现复杂且预后差。现对我院近年确诊的12例TOBS患者的影像及临床资料分析如下。
  • 摘要：血管瘤是软组织中较常见的良性肿瘤。由大量新生血管所构成，约占软组织肿瘤的7％。位置表浅的血管瘤，如位于皮肤或皮下，临床上可根据其特征性皮肤颜色改变和查体多能明确诊断，但位置较深血管瘤，如发生于肌肉内和肌间隙，单靠临床查体难以明确诊断。而MRI检查则在这方面具有优势。本文收集了32例经手术病理证实的软组织血管瘤的病例，对其MRI表现进行回顾性分析，旨在探讨和提高其影像诊断的准确性。
  • 摘要：本文对2010年8月～2012年3月来我院就诊的106例疑似异位妊娠患者经阴道B超和经腹部B超检查结果进行对比研究，探讨经阴道B超与经腹部B超在异位妊娠临床诊断中的应用价值。
  • 摘要：本文收集2008年5月～2010年5月期间收治的足踝外伤33例患者临床资料，分析多层螺旋CT诊断足踝隐匿性骨折临床价值。
  • 摘要：临床采取单纯二维超声进行胎儿畸形的筛查，能检查出部分脊柱或四肢方面形态结构明显改变的畸形，包括部分肢体或骨骼缺如、四肢短小、脊柱裂等，随着三维超声技术的日益成熟，利用三维表面成像或透明成像，重建胎儿表面及骨骼立体图像，对脊柱和四肢进行直观多方位的显示，能确切地对脊柱或四肢方面结构形态的异常提供诊断依据。本文通过分析对比单纯二维和二维三维超声结合诊断胎儿脊柱及四肢方面发育异常的准确率及特异性，探讨其诊断价值。
  • 摘要：患者男，51岁。因视力下降3月，加重1月在基层医院检查发现双视网膜球内占位，后就诊上海复旦大学附属眼科医院查胸片示右上肺大片致密阴影，B超示双侧眼球内不均质占位可能。2010年5月10日在我院CT示：右肺门占位，纵隔淋巴结肿大。腹部CT示肝右叶占位，眼眶MRI：双侧眼球内后壁异常信号，考虑眼球内转移癌可能。
  • 摘要：Objective To evaluate the effect and the feature of percutaneous microwave coagulation therapy (PMCT) for treating liver cancer with 1. 5 T MRI plain scan and dynamic enhanced scan. Methods MRI imaging appearances of 26 cases containing 32 focuses of liver cancer being treated by percutaneous microwave coagulation therapy were analyzed retrospectively. And the results of alpha-fetoglobulin protein (AFP) and digital subtraction angiography (DSA) were analyzed and compared. Results The MRI imaging appearances at 3 rd day after percutaneous microwave coagulation therapy were high signal on T1WI and low signal on T2WI relatively, and low signal on T1WI and high signal on T2WI around the focuses. The MRI imaging 1 month after being treated showed as follow: ① 19 focuses only treated by PMCT showed coagulation necrosis. The MRI imaging appearances were high signal on T1 WI and low or equal signal on T2WI relatively, and had no enhancement; ② 5 focuses treated with many intervention therapy methods, especially combining with transcathe-ter arterial chemoembolization (TACE), showed both coagulation and liquefaction necrosis coexisting. The MRI imaging appearances were low signal on T1WI and high signal on T2 WI relatively, and had not been enhanced; ③ 8 focuses showed necrosis no fully. The MRI imaging displayed low signal scobination or luniform zone around the high signal focus on T1WI and high signal scobination or luniform zone around the equal signal focus on T2WI, and displayed enhancement fast in and out. Conclusion It is reliability and accurate to assess the effect of PMCT for treating liver cancer with MRI plain scan and dynamic enhanced scan. And it is important to follow up regularly with MRI after PMCT.%目的 评价1.5TMRI平扫和动态增强对肝癌微波固化治疗后表现和疗效随访的价值.方法 回顾性分析26例32个病灶肝癌微波固化治疗后MRI表现,并与AFP和DSA结果进行对照.结果 微波固化治疗3天后的MRI平扫表现,T1WI呈相对高信号,T2 WI呈相对低信号,病灶周围可见长T1,长T2水肿带.微波固化治疗1月后的MRI表现①单独行微波固化治疗的19个病灶以凝固性坏死为主,平扫T1WI呈相对等高信号,T2WI呈相对低信号或等信号,动态增强扫描无强化；②多种介入方法联合应用的5个病灶,特别是与TACE联合治疗的病灶,以凝固性坏死、液化性坏死合并存在,表现为局部T1WI呈相对低信号,T2 WI呈相对高信号,但动态增强扫描无强化；③8个病灶不完全坏死:在T1WI上呈相对高信号的病灶周边有低信号结节或同时伴新月形低信号带,在T2WI上则表现为等低信号病灶周边出现相对高信号结节或新月形高信号带,在动态增强扫描时呈快进快出强化表现.结论 MRI平扫和动态增强评价微波固化的疗效可靠、准确,微波固化术后定期MRI随访具有重要意义.
  • 摘要：目的 比较MRI及MSCT动态增强扫描在诊断肝细胞癌中的临床应用价值.方法 选择我院普外科接受手术治疗的单发肝细胞癌患者36例,所有患者均行MRI及MSCT增强扫描,术后均行病理学检查明确肿块性质.观察肝细胞癌MSCT及MRI增强扫描图像特点,比较两种检查方法对肝细胞癌的诊断敏感度、特异度.结果 ①肝细胞癌患者均为单发,其中位于肝右叶21例,肝左叶15例,29例呈类圆形,7例呈不规则形,其中直径≥3cm 5例,1～3cm 10例,≤1cm21例.MSCT及MRI多呈“快进快出”型强化,并可见包膜强化；②MRI动态增强扫描诊断肝细胞癌ROC曲线下面积为0.957±0.087,显著高于MSCT增强扫描的0.854±0.072(t=5.4725,P＜0.01).MRI动态增强扫描对肝细胞癌诊断的敏感度、特异度显著高于MSCT(P＜0.01).结论 在肝细胞癌的诊断中,MRI动态增强扫描能够清晰病灶特点,具有较高的临床应用价值.%Objective To compare the MRI and MSCT dynamic contrast-enhanced clinical value of scanning in the diagnosis of hepatocellular carcinoma. Methods 36 cases of single general surgery hepatocellular carcinoma in patients undergoing surgery in our hospital were selected, all patients underwent MRI and MSCT enhanced scan, postoperative pathological examination clear mass nature. The hepatocellular carcinoma MRI and MSCT enhanced scan image haracteristics were observed, comparison of two methods of diagnosis of hepatocellular carcinoma (HCC) in sensitivity and specificity was performed. Results ① Patients with hepatocellular carcinoma were single, which was located in the right lobe of 21 cases, left lobe of liver of 15 cases, there were 29 cases of round, 7 cases of irregular shape in the 36 cases. The diameter in 5 cases was ≥3 cm, diameter in 10 cases was≥l~3 cm, diameter in 21 cases was ≤1 cm, MRI and MSCT mostly "Fast in, fast out" strengthening, seen envelope strengthen; ② MRI dynamic contrast-enhanced scan in the diagnosis of hepatocellular carcinoma ROC curve area was 0. 957 ±0. 087, significantly higher than MSCT enhanced scan (0. 854± 0. 72, t = 5. 4725, P <0. 01). MRI dynamic contrast enhanced scan sensitivity and specificity of diagnosis of hepatocellular carcinoma were significantly higher than that of MSCT ( P <0. 01). Conclusion MRI dynamic enhanced scanning can show clearly the lesion characteristics, which has a high clinical value in the diagnosis of hepatocellular carcinoma.
  • 摘要：目的 探讨原发性脾脏B细胞淋巴瘤的CT表现特征.方法 回顾性分析11例经病理证实的原发性脾脏B细胞淋巴瘤CT表现.结果 左上腹不适8例、隐痛6例、胀痛5例、乏力10例、低热8例、食欲下降7例、体重减低8例,左上腹扣击痛8例、压痛6例.弥漫大B细胞淋巴瘤8例:其中孤立肿块型7例,肿块5.5～12.0cm,平扫呈低密度5例,等密度2例；界限清楚5例,不清楚2例；增强扫描于动脉期轻度强化5例,无强化2例；界限清楚5例,不清楚2例；静脉期轻度强化3例,无强化4例；实质期轻度强化2例,无强化5例.粟粒结节型1例,平扫呈等密度,增强扫描脾脏实质强化,内见直径2.1～2.8cm多发低密度结节.小B细胞淋巴瘤1例(粟粒结节型):平扫示脾脏肿大,内见1.5～2.0cm多发结节状低密度灶,界限不清楚；增强扫描脾脏实质强化,低密度小结节灶无强化,界限清楚.套细胞淋巴瘤1例(多发肿块型):平扫见脾脏增大,肿块呈等密度,增强扫描动脉期显示脾脏实质强化,内见3.5～7.8cm的低密度肿块影,界限清楚,静脉期和实质期肿块边缘模糊.毛细胞淋巴瘤1例(弥漫型):脾脏呈弥漫性增大,平扫和增强均未发现明确肿块及结节灶.结论 原发性脾脏B细胞淋巴瘤以孤立巨块型弥漫性大B细胞淋巴瘤多见,CT平扫以低密度或等密度；增强扫描轻度强化或不强化为特征.%Objective To study of CT features of primary splenic B-cell lymphoma. Methods CT findings of 11 primary splenic B-cell lymphoma, which were proven by pathology, were retrospectively analysed. Results There were 8 patients with discomfort in left upper abdomen, 6 with dull pain, 5 with distending pain, 10 with hypodynamia, 8 with low fever, 7 with loss of appetite, 8 with decreased body weight, 8 with button strike pain, and 6 with tenderness of left upper abdomen. There were 8 patients with diffuse large B-cell lymphoma. Of these 8 patients, 7 were isolated massive type, with an average of 5. 5-12. 0 cm in diameter; 5 presented with low density and 2 wit isodense density, 5 with clear limit and 2 with unclear bound; 5 showed slight enhancement, 2 no enhancement, 5 clear boundaries, and 2 unclear boundaries in arterial phase; 3 presented with slight enhancement and 4 without enhancement in venous phase; 2 had been showed slight enhancement and 5 no enhancement in parenchymal phase in enhanced scans. The remaining one was miliary nodule type, which presented with isodense density in plain scan, with multiple low density nodules of 2. 1~2. 8 cm in diameter in spleen parenchyma of enhanced scan. There was 1 patient with small B-cell lymphoma (miliary nodules). The patient showed enlarged spleen, with multiple nodular low-density lesions of 1. 5 - 2. 0 cm in diameter in enlarged spleen, unclear of massive limit of plain scan, but no enhancement and clear limit were found in enhanced scan. There was 1 patient with mantle cell lymphoma (multiple tumor types). The patients showed enlarged spleen and isodense density, with low-density mass 3. 5~7. 8 cm in diameter in plain scan, clear limit in enhanced scan in arterial phase, and blur edge in venous phase. There was 1 patient with hair-cell lymphoma (diffuse types). The patient showed diffuse increased spleen, but arnclear mass and nodules were not found in plain scan and enhanced scan. Conclusion Most of the diffuse large B-cell lym-phoma were belonged to isolated massive type. The low density and isodense density in plain scan, slight enhancement and no enhacement in enhanced scan, were the CT characteristics of primary splenic B-cell lymphoma.
  • 摘要：Objective : To explore the role of holistic nursing in interventional therapy of malignant obstructive jaundice. Methods 167 patiens with malignant obstructive jaundice underwent operation of percutaneous transhepatic choledochus drainage (PTCD). Besides the routine nursing, holistic nursing methods were adopted, which included continuous psychological care and health education. Results All the patients increased their understanding of interventional therapy, following treatment in a positive manner and finish the treatment successfully. Conclusion Holistic nursing can promote patient 's recovery and improve quality of life.%目的 探讨整体护理在介入治疗恶性梗阻性黄疽中的作用.方法 167例恶性梗阻性黄疽实施了PTCD,并在常规护理的基础上,引入了全程心理护理和健康教育等整体护理的方法.结果 全部患者通过整体护理,提高了对介入治疗的理解和认识,以积极的心态配合治疗和护理,顺利地完成了治疗.结论 整体护理是一种先进的护理模式,能够促进患者康复,提高患者生活质量.
  • 摘要：脊柱脑脊液漏比较少见，一般为外伤性居多，本院收治1例脊柱巨大自发性脑脊液漏患者，报道如下。
  • 摘要：目的 探讨多层螺旋CT血管成像(MSCTA)在肠系膜上动脉夹层(SMAD)中的应用价值.方法 回顾性分析13例SMAD的MSCT、CTA表现,采用平面重组(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR)重建图像,分析其影像特征.结果 MSCTA结合多种重建图像分辨真腔及假腔11例；清晰显示肠系膜上动脉(SMA)内膜片形成10例,破裂口均位于SMA近心端.Yun分型:Ⅰ型2例,Ⅱa型6例,Ⅱb型4例,Ⅲ型1例.结论 MSCTA能早期诊断SMAD,对及时采取临床治疗具有重要的意义.%Objective To assess the value of Multi-slice computed tomographic angiography (MSCTA) in diagnosis of superior mesenteric artery dissection (SMAD). Methods The MSCT and CTA images of thirteen patients were retrospectively analyzed. Multiplanar and three dimensional images were obtained by imaging postprocessing techniques including multiplanar reformation (MPR) , curved planar reformation (CPR) , maximum intensity projection (MIP) and volume rendering (VR) . Results True and false lumen were showed in 11 cases by MSCT combined multiplanar images. Intimal flaps were seen in ten patients with intimal tears at the proximal SMA. According to Yun's classification, there were two cases of type I , six of type IⅡ a, four of typeⅡ b and one of type Ⅱ. Conclusion MSCTA is effective in the early diagnosis and clinical treatment of SMAD.
  • 摘要：Objective To investigate the the diagnostic value of MRI in the tethered cord syndrome (TCS), and its clinical significance. Methods The MRI imaging performance of 12 patients with clinical diagnosis of TCS were retrospectively analysed in this work. The MRI scanning range included the thoracic, lumbar, sacral, conventional sagittal, axial scanning and 9 cases underwent the coronal scanning. Results In the series, we found that 12 cases were located at less than L1/L2 disc level of the spinae, 9 cases appeared cord end silk thickening (final wire diameter was greater than 3 mm), 7 cases were the myelomeningocele, 6 cases were the spinal canal fat, 6 cases were syringomyelia, 4 cases were syringomyelia, 4 cases were spina bifida, 4 cases were lumbosacral dermal sinus, 3 cases were vertebral deformity, 3 cases were scoliosis. Conclusion Multiple Sequence of MRI, multi-dimensional imaging can clearly show the location of the conus, the form of the filum terminale, the spinal lipoma of inside and outside, a variety of pathological changes in spinal cord meninges and spine, which is of great significance in the clinical diagnosis and treatment of the TCS.%目的 探讨MRI对脊髓拴系综合征(tethered cord syndrome,TCS)的诊断价值及其临床意义.方法 回顾分析12例临床确诊的TCS患者MRI影像学表现,扫描范围包括下胸椎、腰椎、骶椎,常规矢状位、横轴位扫描,9例加扫了冠状位.结果 本组12例TCS患者中脊髓圆锥下端低于L1/L2椎间盘水平的12例,脊髓终丝增粗(终丝直径大于3mm)9例,脊髓脊膜膨出7例,椎管内脂肪6例,脊髓空洞4例,脊柱裂4例,腰骶部皮毛窦4例,椎体畸形3例,脊柱侧弯畸形3例.结论 MRI多序列、多方位成像能清晰显示脊髓圆锥的位置、终丝的形态、椎管内外脂肪瘤、脊髓脊膜以及脊柱的各种病理变化,对TCS的临床诊治具有重要意义.
  • 摘要：肾性高血压（renal hypertension）由于肾脏性高血压实质性病变和肾血管性病变引起的血压升高。肾动脉狭窄性高血压是可治愈的继发性高血压，其病情进展迅速，常引起难治继发性高血压，因此及早诊断并采取相应的干预措施具有非常重要的临床意义。彩色多普勒诊断肾动脉狭窄具有无创、价廉、方便、无对比剂损伤等临床优点，因而在临床上应用越来越广泛，本文旨在探讨彩色多普勒超声在肾动脉狭窄的诊断价值。

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