78例脑囊虫病非典型CT征象分析

本文总结了７８例非典型ＣＴ征象的脑囊虫病，并根据其临床特点，分为脑炎型（２７例）、肉芽肿型（１３例）、脓肿型（１１例）、类多发梗塞型（１０例）、脑室型和脑膜型（９例）、类脑瘤型（８例）。并就各型ＣＴ征象及其鉴别诊断进行了分析探讨。     

2.0cm以下肺部结核结节和小肺癌的CT影像研究——附70例对比分析

目的 进一步评价结核结节和小肺癌的ＣＴ影像特点和鉴别要点，方法 对比分析７０例２．０ｃｍ以下结核结节（３０例）和小肺癌（４０例）ＣＴ影像。结果 结核结节以边缘光滑或清楚，无分叶，小空洞，钙化，胸膜增厚粘连，卫星病灶或病灶周围炎多见，并短期内动态形态改变，小肺癌以边缘毛糙，浅分叶，空泡征，空气支气管征，典型胸膜凹陷征多见，并短期动态形态不变，结论 薄层ＣＴ扫描可提供有价值的征象，短期内动态观察是重要     

内蒙古呼伦贝尔市饮茶型与饮水型氟骨症X线影像学差异

目的观察饮水型与饮茶型氟骨症X线影像学差异。方法对内蒙古呼伦贝尔市饮茶型和饮水型氟中毒居民拍摄前臂、骨盆正位X线片，分析比较两类病区患者X线征象。结果饮茶型氟骨症患者骨密度低骨质疏松、关节退行性变检出率明显高于饮水型氟骨症患者（P〈0，01），饮水型氟骨症患者骨密度高骨质硬化检出率明显高于饮茶型病区氟骨症患者（P〈0、01）。结论两类病区氟骨症X线征象虽无本质区别，但仍有其规律可循，提示饮茶型氟骨症发病机理更为复杂，可能为砖茶型氟铝联合中毒。     

高分辨率计算机X线断层摄影术在慢性间质性肺病诊断中的应用

高分辨率计算机Ｘ线断层摄影术（ＨＲＣＴ）的临床应用使慢性间质性肺病（ＣＩＬＤ）的影像学诊断水平大为提高。本文就ＨＲＣＴ在ＣＩＬＤ诊断中的应用方法，ＣＩＬＤ在ＨＲＣＴ上的基本征象及常见ＣＩＬＤ牟ＨＲＣＴ表现作一综述。     

24例肝泡型包虫病的临床分析

２４例肝泡型包虫病（泡球蚴病）患者，均来自四川省甘孜州牧区，男１９例，女５例，年龄２２～７１岁（平均４４岁）；病程１月～１６年（８例＜１年，１６例≥１年）；按临床表现分为四型：单纯肝肿大型，８例，梗阻性黄疸型，７例，巨肝结节型（又名类肝癌型），６例；远处转移型（肺、脑），３例。免疫学检查（包虫皮试＋血清ＥＬＩＳＡ）结果均呈阳性；Ｂ超和ＣＴ扫描显示病变累及肝脏左叶者３例，右叶占１４例，左右叶均受累者７例；肝门受累８例；病变中心坏死液化１５例，内有斑点状钙化１６例。对本病的诊断和治疗进行了重点分析讨论。     

原发性胆管癌CT、MRI研究

４６例原发性胆管癌和１２例壶腹癌术后病理证实者术前行ＣＴ和ＭＲＩ检查,本文研究了其直接和间接征象。结果表明ＭＲＩ确诊为１００％,优于ＣＴ（７７．６％）。分析表明ＣＴ和ＭＲＩ是诊断原发性胆管癌的重要方法。     

CT在自发性气胸诊断中的应用

ＣＴ在自发性气胸诊断中的应用裴福恩，朱灿宏，孙顺喜，李晓阳，金兆辰１９９１年１月至１９９３年１２月我科收治老年人自发性气胸８７例（占同期气胸患者的４５％），对其中因反复发生呼吸困难，经多次抽气和置管引流仍有发作而胸片无气胸征象的９例进行了胸部ＣＴ扫描...     

MRCP对胰头癌与胰头部肿块型慢性胰腺炎的鉴别诊断价值

目的探讨磁共振胰胆管成像（MRCP）对胰头癌与胰头部肿块型慢性胰腺炎的诊断与鉴别诊断价值。方法分析30例胰头癌与30例胰头部肿块型慢性胰腺炎患者的MRCP表现。结果胰头癌组的MRCP征象包括不相交征（83.3%）、双管征（46.7%）、四管征（36.7%）、软藤征（36.7%）、胰管贯通征（13.3%）。胰头部肿块型慢性胰腺炎的MRCP特征包括双管征（20%）、枯树枝征（36.7%）、胰管贯通征（86.7%）。结论双管征和软藤征是胰头癌的重要征象,四管征与不相交征是胰头癌的特异性征象;枯树枝征是胰头部肿块型慢性胰腺炎的重要征象,胰管穿通征是肿块型胰腺炎的特异性征象。     

癫痫发作后短暂性CT异常4例报告

癫痫发作后短暂性ＣＴ异常４例报告中国医科大学第一临床学院神经内科（１１０００１）李淑贤，孙谅，王慕一癫痫发作后出现的可逆性放射学征象，包括核放射扫描上摄取增强，毛细血管充盈及轻微脑水肿等，已有很多报道。但癫病发作后头ＣＴ呈现的短暂异常却报道极少，此Ｃ...     

双螺旋高分辨力CT对胆脂瘤型中耳炎的诊断价值

双螺旋高分辨力ＣＴ对胆脂瘤型中耳炎的诊断价值山东省医学影像学研究所（２５００２１）徐卓东徐华单玉成＊普通影像学检查手段对胆脂瘤型中耳炎的术前诊断意义不大。我们对３４例经手术、病理证实的胆脂瘤型中耳炎患者的高分辨力ＣＴ（ＨＲＣＴ）资料进行了分析，旨在探...     

The ultrasonographic assessment of carotid plaques in relation to cerebral events and damage over 3 years]

Three hundred carotid plaques (stenosis 45 to 65%) in 300 asymptomatic patients were included into a follow-up study considering three ultrasound types of plaques: type 1, non echogenic; type 2 intermediate, partially echogenic and type 3 highly echogenic. Types 1 and 2 had regular contour/surface while type 3 was irregular and in some patients associated with ultrasonographic signs of ulceration and intra-plaque haemorrhage. Patients were clinically evaluated for 3 years, randomly selected subgroups were studied with cerebral CT or magnetic resonance (MR) scanning to evaluate brain damage. There were no signs of cerebral damage in type 1 plaque patients. The incidence of signs and symptoms were higher in type 2 and 3 plaque patients. This was associated with an increased incidence of CT lesions and an even higher incidence of MR lesions in plaque type 3. In conclusion type 3 plaques are associated both with more clinical problems and evidence of CT/MR brain damage. Furthermore MR reveals more brain lesions than CT.     

Clinical value of technetium-99m-HMPAO-labeled leukocyte scintigraphy and spiral computed tomography in active Crohn's disease

OBJECTIVES: The diagnostic accuracy of technetium-99m-HMPAO-labeled leukocyte scintigraphy (LS) and spiral CT for the detection of inflammatory activity was assessed; the extent of the inflammation and the complications were compared with the clinical and laboratory parameters and with the endoscopic and radiological findings in patients with clinically active Crohn's disease (CD). METHODS: Twenty-eight patients (13 men, 15 women, average age 32.5 yr, range: 18-59 yr) with an acute exacerbation of CD were enrolled in the study. The disease behavior type and the maximum extent of inflammation were established by means of endoscopy (jejunoscopy and colonoscopy) and enteroclysis. Nine patients with severe complications (abscess and stenosis) underwent operation. The GI tract was divided into five segments (small bowel, ascending colon, transverse colon, descending colon, and rectosigmoid), the LS, CT, endoscopic, and radiological pictures of all segments were graded (range: 0-3) and the scores were summed and compared. RESULTS: The investigations indicated that LS and CT had sensitivities of 76.1% and 71.8%, specificities of 91.0% and 83.5%, and accuracies of 82.6% and 77.5%, respectively, for detection of segmental inflammatory activity. With regard to the disease behavior type, the sensitivities of LS and CT were, respectively, 77% and 100% in the penetrating-fistulizing, 80% and 73% in the stricturing, and 68% and 64% in the inflammatory form of CD. CT detected all abdominal abscesses, whereas the diagnostic value of LS for the detection of the complications of CD was lower. The inflammatory activity scores measured by LS displayed a closer correlation than that of CT with the Best index (r = 0.71, p < 0.0005 vs r = 0.63, p < 0.001), the van Hees index (r = 0.61, p < 0.005 vs r = 0.59, p < 0.005), the serum fibrinogen level (r = 0.67, p < 0.005 vs r = 0.59, p < 0.005), or the C-reactive protein level (r = 0.64, p < 0.005 vs r = 0.51, p < 0.01). CONCLUSIONS: Both LS and CT are valuable noninvasive diagnostic methods in cases involving severe, active CD. LS seemed better for the detection of segmental inflammatory activity, whereas CT displayed excellent suitability for the recognition of complications: abdominal abscesses were diagnosed with 100% efficiency.     

Cognitive function and brain atrophy in elderly type 2 diabetic patients in comparison with non-diabetic elderly subjects]

Previous studies have suggested that type 2 diabetic mellitus could lead to learning and memory deficits. We studied cognitive function tests and brain computed tomography (CT) findings in elderly subjects with drug-treated type 2 diabetic patients (n = 9), diet-treated type 2 diabetic patients (n = 8) and nondiabetic subjects (CR, n = 21). A battery of cognitive function tests (Cog-T; WAIS-R's digit span test and symbol test, Stroop Test, ADAS's verbal memory test, and MMSE) was carried out on two occasions, separated by at least 6 months. Brain CT was analyzed by the following 5 variables; 1) Evan's Ratio, 2) Inverse Cella Media Index, 3) maximum width of the third ventricle, 4) maximum width of temporal horn tips on both sides and 5) maximum width of the Sylvian fissure at the insula, bilaterally. The scores of Cog-T did not differ significantly between the groups. On brain CT measurements, maximum width of the temporal horn tips on right side were significantly different in the three groups (ANOVA, P = 0.035). The drug-treated diabetics subjects had wider temporal horn tips on the right side than did the diet treated diabetics and nondiabetic subjects (Fisher's post hoc test, P = 0.030, P = 0.016).     

Adenovirus meningoencephalitis in a patient with large B-cell lymphoma

We report a case of a 58-year-old female with neuromeningeal relapse of a large B-cell lymphoma which developed a meningoencephalitis due to adenovirus (ADV). Diagnosis of suspected viral meningoencephalitis was based on computed tomography (CT) scan radiological pictures, which were atypical for CNS neoplastic infiltrations, and it was confirmed by direct immunofluorescence performed on cerebrospinal fluid. Cultural exams identified adenovirus type 7. The ADV infection resolved after treatment with total four doses of cidofovir. Unfortunately, the hematological disease progressed and the patient died 2 months later from disseminated lymphoma.     

Detection of brain metastasis in potentially operable non-small cell lung cancer: a comparison of CT and MRI

STUDY OBJECTIVE: To compare the usefulness of MRI and CT in the detection of brain metastases during preoperative evaluation and postoperative follow-up. DESIGN: A prospective and sequential comparison. PATIENTS AND METHODS: Of 332 patients with potentially operable non-small cell lung cancer who were free of neurologic signs and symptoms, brain CT was performed preoperatively on 155 patients (CT group) and brain MRI on 177 patients (MRI group). Patient characteristics in both groups were comparable. In 279 patients with complete resection of the primary lung tumor, intensive follow-up with CT and MRI was performed in the respective groups. The preoperative detection of brain metastases, postoperative intracranial recurrence rates, and characteristics of detected brain tumors were compared between the two groups. The survival of patients with brain metastases was also compared. Results: From the first evaluation to 12 months after surgery for primary lung cancer, brain metastases were observed in 11 patients (7.1%) from the CT group and 12 patients (6.8%) from the MRI group. MRI detected brain metastases preoperatively in 6 of the 12 patients (3.4% of the total MRI group), whereas CT detected brain metastases preoperatively in 1 of the 11 patients (0.6% of the total CT group). MRI showed a tendency toward a higher preoperative detection rate of brain metastases than CT (p = 0.069). Furthermore, the mean (+/- SD) maximal diameter of the brain metastases was significantly smaller in the MRI group (12.8+/-9.1 mm) than in the CT group (20.3+/-7.0 mm) (p = 0.041). However, the median survival time and 2-year survival rate after treatment of detected brain metastases, respectively, were 10 months and 27% in the CT group and 17 months and 28% in the MRI group. There was no significant difference between the groups in survival time. CONCLUSIONS: Preoperative evaluation and intensive follow-up with MRI could facilitate early detection of brain metastases in patients with potentially operable lung cancer. However, further studies on detection and treatment of the metastatic tumors are considered necessary.     

糖尿病患者脑地形图检查的临床研究——附254例分析

对２５４例糖尿病患者进行脑地形图（ｂｒａｉｎｅｌｅｃｔｒｉｃａｌａｃｔｉｖｉｔｙｍａｐｐｉｎｇ，ＢＥＡＭ）检查，结果ＢＥＡＭ异常率为５２．９％，明显高于脑干听觉诱发电位（ｂｒａｉｎａｕｄｉｔｏｒｙｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ，ＢＡＥＰ）和脑电图（ＥＥＧ）的异常率（各为２６．４％和４７％）。ＢＥＡＭ的改变及病变程度与空腹血糖、糖化血红蛋白水平呈显著相关（Ｐ均＜０．０１）。糖尿病合并各类型脑血管病的ＢＥＡＭ异常率均高于ＢＡＥＰ和ＥＥＧ。缺血性脑血管病的ＢＥＡＭ异常率虽较ＣＴ的略低，准确性和层次清晰也稍差，但对短暂性脑功能性损害（如ＴＩＡ）或一些亚临床型的脑组织病变，则ＢＥＡＭ优于ＣＴ检查。     

多层螺旋CT脑血管成像的临床应用

目的：探讨多层螺旋CT脑血管成像的方法与临床应用价值。方法：对18例病人用西门子Sensation4四层螺旋CT机按照CT脑血管成像参数进行扫描，然后将所获图像数据导入CT3D工作站，利用后处理软件——MPR、MIP、SSD、VRT、CTVE进行成像，由两位放射科医生和两位内科医生对图像进行分析。结果：18例中，正常8例，脑动脉瘤1例，血管狭窄3例，动静脉畸形2例，脑肿瘤4例。几种后处理软件——MPR、MIP、SSD、VRT都能清楚地显示脑血管，尤其以MIP效果最好；CTVE的优势在于显示血管腔内情况。结论：多层螺旋CT脑血管成像具有安全、无创、准确的优点，可部分替代DSA。     

Validity of the ischemic score in degenerative and vascular dementia and depression in old age

Thirty six male and 45 female patients (mean age 66 years) suffering from either dementia of Alzheimer type (DAT) or dementia of vascular type (DVT) with comparable severity and suffering from depression in old age were included in the investigation. The study was performed to evaluate the diagnostic value of Ischemic Score, EEG and CT scan of the brain in differentiating dementia types and depression in old age. The patients underwent physical, psychiatric, psychometric, neurological, neurophysiological and CT scan examinations. Clinical diagnosis and diagnosis related to Ischemic Score were consistent in 86% of DAT and in 65% of DVT. Patients suffering from DVT showed significantly higher incidence of distinct Ischemic Scale items than was found in DAT patients. The Ischemic Scale items were found to be of major importance in differentiating vascular dementia from both DAT and depression. However, it was insufficient to distinguish between the latter two. In EEG, general slowing predominated in DAT (68%), and focal disturbances in DVT (71%). Patients with DAT and depression could not be differentiated on the basis of their EEG findings. CT scans of the brain yielded a higher incidence of brain atrophy in patients with DAT (71%) and DVT (70%) as compared to depressive patients (37%). In DAT, ventricular enlargement seems to be rather disease- than age-related. Psychological testing showed abnormalities in attention and memory performance in DAT and DVT to a significantly greater extent as compared to depression. This study demonstrated that the combination of Ischemic Score and EEG was found to be most valid in differentiating DAT from DVT. Additional cranial computerized tomography and the psychological testing of attention and memory were able to confirm the diagnosis of dementia and to differentiate dementia from depression in old age.     

Evidence for calcitonin receptor heterogeneity: binding studies with nonhelical analogs

Binding of the nonhelical salmon calcitonin (sCT) analog, [Gly8,Ala16]-des-Leu19-sCT to membrane preparations from rat brain could be analyzed in terms of two independent binding sites. The high and low affinity binding sites for this analog were named CT-L (L, linear) and CT-H (H, helix), respectively. Although the CT-H type receptor has a low affinity for the nonhelical analogs, it binds the helical sCT with high affinity and therefore represents a CT binding site. The physiological significance for the existence of subtypes of specific CT receptors is not clear. The [Gly8,Ala16]-des-Leu19-sCT suppressed the osteoclastic bone resorption in tissue culture at low concentration (0.1 nM). The dose of [Gly8,Ala16]-des-Leu19-sCT required for this hypocalcemic activity was highly correlated with the binding affinity of this analog to the CT-L receptor subtype. In addition, human CT interacted with the CT-L type receptor at about 100th the concentration of that required for the displacement of sCT. We conclude that binding to the CT-L type receptor is required for hypocalcemic activity in mammals.     

Long-term effects of lipoprotein(a) on carotid atherosclerosis in elderly Japanese

BACKGROUND: Serum level of lipoprotein(a) [Lp(a)] is hereditarily constant throughout life within an individual, but the relationship between Lp(a) and atherosclerosis in elderly people is still controversial. METHODS: Serum Lp(a) levels were studied in 208 elderly Japanese participants aged 80 years with a variety of diseases, using carotid ultrasonography (US), brain computerized tomography (CT), electrocardiography (ECG), and ankle brachial pressure index (ABPI). Carotid plaque lesions were divided into 3 types based on the US echogenicity assessed by a computer-assisted system: L type (hypoechoic plaque), H type (hyperechoic plaque), and M type (heterogeneous plaque). RESULTS: The frequency of the L type and occlusion was significantly higher in the high Lp(a) group (n = 38) than in the normal Lp(a) group (n = 170). The mean height of the plaque was also greater in the high Lp(a) group than in the normal Lp(a) group. There was no difference in CT findings between the two groups. Myocardial ischemia on ECG and low ABPI (<0.9) were both frequently, but not significantly, seen in the high Lp(a) group. Among factors influencing US findings, multiple regression analysis showed that high Lp(a) correlated markedly to L type and cigarette smoking correlated to M type. CONCLUSIONS: These findings indicate that, in Japanese elderly patients aged 80, serum Lp(a) strongly correlates with hypoechoic carotid lesions, which correspond histologically to lipid-rich, unstable atherosclerosis. This suggested that Lp(a) could promote the formation of atherosclerosis throughout life, and play a role as an independent risk factor for circulatory disturbance of the organ later in life.