气肿性膀胱炎的CT表现

目的 分析气肿性膀胱炎患者的CT表现及诊断要点.资料与方法 回顾性分析6例临床确诊为气肿性膀胱炎患者的CT表现.结果 6例CT定位片均见膀胱体积增大,3例膀胱周围透亮气体影环绕,呈"气抱球"样;CT轴位扫描6例均见膀胱壁内气体影,4例膀胱内可见宽大液气平面,膀胱壁呈"锯齿"状,伴有膀胱壁外周气体带,较大时呈"新月"状;2例仅见膀胱壁散在分布小气泡影及膀胱内少许气体影.结论 气肿性膀胱炎的诊断主要依据影像学发现膀胱壁及膀胱内气体影为特征,CT检查对诊断气肿性膀胱炎敏感性高,是诊断此病的重要方法.     

膀胱腹膜外间隙放射解剖学研究现状

膀胱腹膜外间隙是临床医生比较重视的间隙,它是在腹前壁做切口,不经腹膜腔到达膀胱、前列腺的手术途径,也是血肿、积液的好发部位.明确此间隙的解剖结构及其通连关系,对膀胱及其周围病变的诊断、脓液引流和盆腔脏器手术方式的选择具有重要意义.但长期以来,由于对膀胱周围筋膜和韧带的胚胎发育及其附着有不同的观点,导致了膀胱腹膜外间隙的解剖划分及其通连关系存在较大争议,在影像诊断、手术方式存在一定的分歧.就膀胱腹膜外间隙放射解剖研究现状做一详细综述.     

膀胱非上皮性肿瘤的MDCT表现

目的 探讨膀胱非上皮性肿瘤的MDCT表现特征.方法 搜集经病理证实的19例膀胱非上皮性肿瘤患者的临床、膀胱镜和MDCT平扫及四期增强检查资料,结合相关文献分析MDCT表现特征.结果 19例膀胱非上皮性肿瘤中,良性肿瘤11例,其中平滑肌瘤6例,嗜铬细胞瘤4例,炎性肌纤维母细胞瘤1例;恶性肿瘤8例,其中原发性淋巴瘤3例,胚胎性横纹肌肉瘤2例,纤维肉瘤、低度恶性间质瘤及神经内分泌癌各1例.MDCT对膀胱非上皮性肿瘤的良恶性诊断准确率为89.47％ (17/19),病理类型诊断准确率为63.16％ (12/19).5例膀胱镜提示膀胱腔内肿瘤,诊断为膀胱癌,14例膀胱镜提示膀胱黏膜光滑,诊断为黏膜下病变.结论 膀胱非上皮性肿瘤各自有一定的MDCT表现特征,仔细分析大部分可正确诊断,有效地指导临床选择合适的治疗方案.     

MSCT低剂量扫描在膀胱病变中的应用

目的 探讨膀胱充气造影MSCT低剂量扫描对图像质量的影响.方法 对60例临床考虑膀胱病变患者,在膀胱充气状态下行120 mAs和40 mAs 2种剂量的螺旋CT扫描,然后由2名主治医师在不了解扫描、重建参数的情况下分别独立阅片,并对2种图像质量进行评价.结果 常规剂量120 mAs扫描与低剂量40 mAs扫描对膀胱病变、膀胱壁、膀胱黏膜及腔外间隙的显示影响很小,也不影响对病变的观察和诊断.结论 膀胱充气造影低剂量40 mAs螺旋CT扫描虽然图像噪声增加,但对其病变的显示和诊断没有明显影响,可适用于临床的筛查和诊断.     

3.0T磁共振DWI结合T2加权成像诊断前列腺癌侵犯膀胱

目的 探讨T2WI及DWI 2种成像序列对前列腺癌(PCa)侵犯膀胱的诊断价值.方法 68例经病理证实的PCa患者在行3.0T MR前列腺常规和DWI(b值分别为0、800 s/mm2)扫描后被诊断为PCa侵犯膀胱,所有患者均行膀胱镜检查.分析所有PCa癌灶、受侵膀胱和未受侵膀胱壁的MRI表现,比较其ADC值.采用5分制评分,将所得结果与膀胱镜病理结果对照,用SPSS11.5分别做受试者工作特征曲线(ROC)分析比较各组方法诊断的敏感度和特异度.结果 膀胱镜检查45例(66%)患者病理证实为PCa侵犯膀胱,PCa癌灶、受侵膀胱壁和正常膀胱壁的ADC值分别为(0.931±0.098)×10-3mm2/s,(0.963±0.155)×10-3mm2/s和(1.517±0.103)×10-3mm2/s,受侵膀胱壁的ADC值明显低于正常膀胱壁(P＜0.05),而PCa癌灶和受侵膀胱壁的ADC值之间无明显差异.分别应用T2WI和DWI诊断PCa侵犯膀胱的ROC曲线下面积(AUC)明显低于联合2种成像方法(P＜0.05).结论 PCa侵犯膀胱的ADC值明显低于正常膀胱壁;联合应用DWI和T2WI诊断PCa侵犯膀胱优于单独使用DWI或T2WI.     

非上皮性膀胱肿瘤影像表现（附10例分析）

目的探讨非上皮性膀胱肿瘤的诊断.材料和方法对近8年10例经手术病理证实的非上皮性膀胱肿瘤的影像表现及临床资料进行回顾性分析.结果除横纹肌肉瘤增强明显状如葡萄、平滑肌瘤边缘清晰光滑、副神经节瘤可多发有参考作用外,大多数非上皮性膀胱肿瘤影像无特殊征象.结论多数非上皮性膀胱肿瘤单就影像表现诊断困难,需结合临床资料;有些病例术前无法诊断,要依靠膀胱镜活检病理确诊.     

膀胱结核的CT诊断

目的研究膀胱结核的CT表现及其诊断价值. 资料与方法 50例经实验室检查或膀胱镜证实的膀胱结核患者,行螺旋CT平扫、增强及延迟扫描. 结果早期病变位于输尿管口附近, 5例表现为膀胱壁局部结节,8例表现为膀胱壁局部僵硬、增厚;中晚期病变表现为膀胱壁广泛增厚和容积缩小,共37例,病变表面线状强化提示病变活动. 结论螺旋CT扫描能很好显示膀胱结核早期改变,结合临床可以做出正确诊断.     

膀胱平滑肌瘤的MRI诊断(附5例报告)

膀胱平滑肌瘤在临床中较为少见,但平滑肌瘤是膀胱非上皮性良性肿瘤中最常见的,文献报道中多为个案报道且检查方法多是B超和 CT,MRI对该病的报道罕见.本文收集了1999-2009年曾在本院行MRI检查、并经手术病理证实的5例膀胱平滑肌瘤,结合临床回顾性分析其MRI征象,以提高膀胱平滑肌瘤的MRI诊断与鉴别诊断水平.     

介入性超声诊断膀胱淋巴瘤1例

1 病历简介 患者,男,56岁.因间断性尿频、尿急、尿痛伴排尿困难3个月,肉眼血尿2天入院.查体: 无明显阳性体征.尿分析检查: 红细胞(++).免疫组化示: CD20(-)、 CD79A(-) 、CD45RO(+)、 CD3(++) 、CEA4.63↑.经直肠彩色多普勒超声检查示: 膀胱右前壁间见4.9cm×4.8cm×3.7cm边界清晰,形态尚规整的均匀低回声肿块,向膀胱腔内突出.局部膀胱黏膜欠规整,呈不规则增厚.CDFI: 肿块周边见星点状血流信号.超声诊断: 膀胱前壁实性占位性病变(性质待定,图1).膀胱镜检查: 膀胱前壁明显增厚,向膀胱内弧形凸起.诊断: 膀胱肿瘤.     

膀胱肿瘤的气钡双重造影诊断

膀胱肿瘤的气钡双重造影诊断中原油田中心医院放射科王晓轩，李先启，马宗训，杨思福膀胱镜检查目前仍然是膀胱肿瘤最直接、最主要的诊断手段，而影像学检查仍是十分重要的辅助诊断手段。１９８８－０７～１９９１－１２我们应用膀胱气钡双重造影诊断经膀胱镜活检（下称镜...     

补体受体1型的结构功能及sCR1基因克隆表达的策略

补体受体1型（Complement receptor type 1,CR1）具有外源性及内源性活性,既可灭活组装于非自身细胞膜上的C3/C5转化酶,也可灭活自身细胞膜上形成的C3/C5转化酶。CR1是唯一既对经典,替代及植物凝集素（MBL）3个补体激活途径的,对C3/C5转化酶拥有衰变加速活性,又有辅助1因子裂解C3b和C4b作用的补体调节蛋白。对补体分子的过度活化具有抑制和调节作用,在防治补体介导的缺血再灌注损伤以及异种器官移植超急性排斥反应等疾病具有广阔的应用前景。本文主要综述CR1的结构功能及生物学活性,sCR1基因的克隆与表达及在创伤、缺血再灌注损伤中的应用研究现状。     

Possibilities and limitations of radiology--CT and MRT in cases of tumors of the uterus and ovary

The author describes the present possibilities of computed tomography (CT) and of magnetic resonance (MR) tomography. MR is superior to CT in the visualisation of carcinomas of the cervix and endometrium, especially in the initial stages, whereas in the diagnosis of the spread of tumours (especially the advanced ones) CT yields results similar to those of MR. In carcinoma of the ovary, however, MR has so far not proved to be definitely superior to CT despite the multiplanar visualisation possibilities it offers. It is in fact inferior to CT especially in clarifying the extent of extrapelvic spread. In posttherapeutic diagnostics MR explores new avenues in respect of delineation between scar and recurrence, as initial investigations have shown.     

闭合性喉气管断裂伤的诊断与治疗

目的 提高对闭合性喉气管断裂伤的诊治水平.方法 报告38例闭合性喉气管断裂伤病例的临床资料,其中急性外伤16例,陈旧性外伤22例.对临床易发生的问题进行分析.结果 38例中16例急性喉外伤在24～48小时之间行手术治疗,22例陈旧性喉外伤因其它原因在32～129天后行手术治疗.35例手术成功拔管,3例因喉气管狭窄手术失败不能拔管,均为陈旧期手术患者.结论 对于急性闭合性喉气管断裂伤应根据其病情轻重程度进行早期处理,尽快恢复喉和气管通气功能,预防后遗症及并发症的发生,提高治愈率.     

Accuracy of digital and film panoramic radiographs for assessment of position and morphology of mandibular third molars and prevalence of dental anomalies and pathologies

OBJECTIVES: To compare the accuracy of digital and film panoramic radiographs for determining (1) the position and morphology of mandibular third molars before surgical removal and (2) the prevalence of dental anomalies and pathologies. METHODS: Three hundred and eighty-eight third mandibular molars were available for examination. Position and morphology of third molars observed on film radiographs and on digital panoramic images from five systems (DenOptix, DigiDent, Digora, Dimax2 and Orthophos Plus) were recorded by two observers and were compared with surgeons' findings at the time of the operation (gold standard). One observer further recorded the prevalence of dental anomalies and pathologies on both imaging modalities. RESULTS: Few differences were found between the digital and film-based panoramic systems in the assessment of accuracy of position and morphology of mandibular third molars. The prevalence of dental anomalies and pathologies determined with the two modalities was roughly similar. CONCLUSION: The five digital panoramic systems evaluated in this study were equally as useful for third molar treatment planning and diagnosis of dental anomalies and pathologies as conventional film-based panoramic radiographs.     

Science and medicine of canoeing and kayaking

Canoeing and kayaking are upper-body sports that make varying demands on the body, depending on the type of contest and the distance covered. The shorter events (500 m) are primarily anaerobic (2 minutes of exercise), calling for powerful shoulder muscles with a high proportion of fast-twitch fibres. In contrast, 10,000 m events call for aerobic work to be performed by the arms. Such contestants need a high proportion of slow-twitch fibres, and an ability to develop close to 100% of their leg maximum oxygen intake when paddling. In slalom and whitewater contests, the value of physiological testing is somewhat limited, since performance is strongly influenced by experience and the ability to make precisely judged rapid paddling efforts under considerable emotional stress. Paddlers face dangers from their hostile cold water environment; causes of fatalities (drowning, cardiac arrest, ventricular fibrillation and hypothermia) are briefly reviewed. Medical problems include provision of adequate nutrition and a clean water supply, effects of repeated immersion (softening of the skin, blistering, paronychial infections, sinusitis, otitis), varicose veins (secondary to thoracic fixation) and hazards of exposure to fibreglass and polystyrene in the home workshop. Surgical problems include muscle sprains and mechanical injuries (haemotomas, lacerations, contusions, concussion, and fractures).     

创伤性膈疝合并胸腔胃破裂的早期诊断与急救

对创伤性膈疝合并胸腔胃破裂的致伤原因、临床表现、早期诊断与急救进行回顾性分析.认为早期诊断、及时救治,妥善处理腹部其他合并伤是增加治愈率,减少并发症,降低死亡率的关键.     

阑尾黏液性肿瘤的CT和MRI诊断及良恶性鉴别

【摘要】目的：探讨阑尾黏液性肿瘤的CT及MRI特征,并分析其良、恶性鉴别要点。方法：回顾性分析67例经病理证实的阑尾黏液性肿瘤的临床资料,其中黏液腺癌27例,黏液性囊腺瘤22例,低级别黏液性肿瘤18例。分组对照分析CT及MRI征象并行Logistic回归分析性别、年龄、部位、大小、形态、境界、根蒂和囊壁（厚度、均匀度、光滑度、完整度）、内容物（壁结节、分隔、钙化、囊液、气体）、强化（强度、均匀性、方式）、腹水、淋巴结等因素与良、恶性的相关性。结果：黏液腺癌多表现为长茄子形,最大径6.5cm（2.9～11.2cm）,长径与短径比值平均2.5。27例均囊壁不光整,边界不清,强化不均匀,多伴附壁结节样（n=11）或分隔条絮样强化（n=13）,钙化(n=17)以囊内颗粒状多见（n=14）,部分可见囊壁破裂形成腹腔假性黏液瘤（n=12）及腹腔种植转移（n=8）。黏液性囊腺瘤多为球形,最大径3.5cm（2.2～9.5cm）,长径与短径比值平均1.65,囊壁相对光整,边界相对较清,强化较均匀;钙化（n=17）多为附壁蛋壳样钙化（n=11）,腹水少见。低级别黏液性肿瘤恶性度较低,影像表现介于黏液腺癌与囊腺瘤之间, 1例穿孔但未见腹腔种植转移。Logistic回归分析提示良性组的根蒂和囊壁均匀度、光滑度及其强化均匀性与恶性组间差异有统计学意义（P<0.05）。结论:阑尾黏液性肿瘤病理上分为上述三类,CT、MRI表现有一定特征性,但术前相互鉴别困难;根蒂和囊壁的均匀度、光滑度及强化均匀性等因素对判断良恶性有帮助,由于样本量有限,其他因素的鉴别价值有待进一步研究。