Pancreatic splenosis demonstrated by contrast-enhanced sonography

Pancreatic splenosis is a very rare condition whose features on contrast-enhanced ultrasound (CEUS) have not, to our knowledge, been previously reported. We present the imaging findings in a case of pancreatic splenosis, in which a confident diagnosis was achieved with the use of CEUS and confirmed by a labeled heat denatured red cell scan. Accumulation of ultrasound contrast microbubbles in splenic tissue can be readily visualized on late-phase CEUS and this technique has already been used to confirm the nature of intrapancreatic accessory spleens. This case shows that it can also confirm the diagnosis of splenosis.     

An unusual pelvic mass: Contrast-enhanced sonographic diagnosis of pelvic splenosis

Splenosis is an unusual condition representing auto-transplantation of splenic tissue following splenic trauma or surgery. When detected on imaging studies, the splenosis deposits are usually misinterpreted as pathological masses. We present a case where a pelvic mass incidentally visualized on an MRI examination, was proven to represent a deposit of splenosis by contrast enhanced ultrasound (CEUS). CEUS demonstrated persistent late-phase enhancement characteristic of splenic tissue. Ultrasound practitioners should be aware of this condition when an unusual abdominal or pelvic mass is encountered in a patient with a history of splenic trauma or surgery. CEUS is ideally suited to confirming the diagnosis.     

Robotically assisted removal of pelvic splenosis fifty-six years after splenectomy: A case report

BACKGROUND‘Splenosis’ is defined as the autotransplantation of splenic tissue following trauma or surgery, usually in the form of intraperitoneal nodules. The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules, and achieving a differential diagnosis can be challenging. Nuclear medicine studies have been playing an increasingly important role in this process, but the clinical significance of asymptomatic nodules remains uncertain.CASE SUMMARYWe present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography (CT) follow-up for B-cell lymphoma, presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space. 18F-fluorodeoxyglucose demonstrated weak metabolic activity. Since histological diagnosis was deemed necessary, the nodule was easily removed with robotically assisted laparoscopy, together with another 6 mm left a paracolic lesion. The latter was previously undiagnosed but retrospectively visible on the CT scan.CONCLUSIONIn a patient requiring differential diagnosis of splenosis nodules from lymphoma recurrence, the robotic approach provided a safe en bloc removal with short hospitalization. The Da Vinci Xi robot was particularly helpful because its optics can be introduced from all ports, facilitating visualization and lysis of multiple intra-abdominal adhesions.     

Intraperitoneal splenosis: Diagnosis by ultrasound and computed tomography

Splenosis is an unusual complication of abdominal trauma. We report a case of splenosis identified on ultrasonography (US) and computed tomography (CT). Usually it is a latent disease and an incidental finding, but it may be diagnosed by US and CT.     

床旁超声对急诊重症监护病房机械通气合并气胸患者的应用价值

目的 通过床旁超声在急诊重症监护病房（EICU）机械通气合并气胸患者诊治中的应用研究,探讨危重气胸患者更快捷、安全、可靠的诊断方法。方法 对入住EICU高度怀疑机械通气合并气胸的57例患者,分别进行床旁超声、床旁胸片与胸部CT检查,对各种检查方法诊断所需时间、诊断灵敏度、特异度、正确率进行分析。结果 床旁超声、床旁胸片、胸部CT 3种方法诊断耗时分别为（5.05±1.91） min、（16.04±3.73） min、（22.55±3.52） min,床旁超声诊断耗时最短（P＜0.01）;床旁超声与胸部CT对气胸的诊断一致性（Kappa=0.930）明显优于床旁胸片与胸部CT的诊断一致性（Kappa=0.444）。结论 床旁超声在EICU机械通气合并气胸患者诊治中高效快捷,有较高应用价值。     

Sonographic appearance of a dermoid cyst (mature cystic teratoma) of the spleen

Splenic dermoids are rare, with few published case reports and no ultrasound images in the English literature. We report the case of a 57‐year‐old woman with that diagnosis and illustrate it with ultrasound, CT, and pathology images. We discuss the differential diagnosis of solid splenic lesions. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 43 :132–134, 2015     

彩色多普勒超声诊断四肢动脉假性动脉瘤25例

目的 提高超声对四肢动脉假性动脉瘤的诊断能力。方法 观察四肢动脉假性动脉瘤的超声特征，并与螺旋CT或动脉造影及手术结果进行对照，且6例病人在超声引导下局部注射凝血酶治疗。结果 本组假性动脉瘤的超声诊断与螺旋CT、动脉造影及手术结果对照，符合率100％。6例病人在超声引导下局部注射凝血酶治疗获得成功。结论 超声诊断四肢假性动脉瘤准确、简便、无创，且还可在超声引导下进行治疗。     

移植肝胆管并发症的超声、CT、MRI诊断比较

目的：探讨移植肝胆管并发症超声、CT、MRI诊断效果。方法：回顾分析98例移植肝患者超声、CT、MRI资料。结果：全部患者均行超声检查，超声诊断胆管扩张25例，胆管壁回声增强7例，胆漏5例，胆管结石3例，胆泥5例。15例行MRI检查，MRI诊断胆管扩张9例，胆泥1例，肝内胆漏1例。39例行CT检查，CT诊断胆管扩张15例，胆漏4例，结石2例。超声与CT、MRI相比，诊断结果无显著差别。结论：超声、CT、MRI诊断移植肝胆管并发症效果相当，超声适合肝移植术后定期随访，CT、MRI对肝外胆管病变诊断优于超声，介入超声有助于胆漏的鉴别诊断及治疗。     

Splenic implant in the jejunum: Radiographic and pathologic findings

We report a patient in whom barium studies and computed tomography revealed an intramural mass in the jejunum that consisted pathologically of ectopic splenic tissue. Because the patient had a prior splenectomy, the lesion probably represented splenosis rather than an accessory spleen. When intramural lesions are detected on barium studies in patients who have had prior abdominal trauma or splenectomy,^99mTc-tagged, heated-red blood cell scintigraphy may be performed to confirm the diagnosis, thereby eliminating the need for surgery in these patients.     

多层螺旋CT多层面重建技术在胆道梗阻性疾病诊断中的应用

目的评价多层螺旋CT(MSCT)多层面重建技术(MPR)在胆道梗阻性疾病中的诊断价值.方法 201例经超声诊断为梗阻性黄疸的患者,行MSCT平扫及薄层增强扫描,并以MPR技术进行冠状位、矢状位及沿胆总管走行方向斜位重建,然后与超声及磁共振胰胆管成像(MRCP) 进行对比,以手术病理结果为标准.结果定位诊断超声为89.05%,MSCT MPR及MRCP均为100%;病因诊断超声为80.1%,MSCT MPR为97.0%,MRCP为92.0%.结论 MSCT MPR技术在胆道梗阻性疾病中定位诊断能力高于超声,与MRCP相同;病因诊断能力明显高于超声,略高于MRCP.MSCT MPR技术可以显示胆管腔内的肿物,结石等病变形态,显示与周围组织的关系.     

急性胰腺炎患者超声表现与CT表现对比分析

目的 比较急性胰腺炎(AP)患者超声与CT表现,评价超声和CT对AP的诊断价值.方法 回顾性分析98例临床和手术病理证实的AP患者超声表现和CT表现,并进行比较.其中轻型AP患者74例,重症AP患者24例.结果 参照Balthazar CT分级标准,本组98例AP患者超声表现为A级为23.5%(23/98),CT为22.4%(22/98),差异无统计学意义(χ2=0.0288,P=0.8651);B级为81.6%(80/98),CT为79.5%(78/98),差异无统计学意义(χ2=0.1306,P=0.7178);C级为35.7%(35/98),低于CT的55.1%(54/98),差异有统计学意义(χ2=7.4300,P=0.0064);D级为49.0%(48/98),高于CT的38.8%(38/98),差异有统计学意义(χ2=7.0719,P=0.0054);E级为10.2%(10/98),低于CT的24.5%(24/98),差异有统计学意义(χ2=8.9746,P=0.0083).本组74例轻型AP患者超声检查诊断正确65例(87.8%),误诊6例(8.1%),不能给出明确诊断3例(4.1%);CT诊断正确61例(82.3%),误诊7例(9.5%),不能给出明确诊断6例(8.1%).本组24例重症AP患者超声检查诊断正确8例(33.3%),误诊6例(25.0%),不能给出明确诊断4例(16.7%).CT诊断正确率为100%.结论 对于轻型AP患者,超声诊断准确率与CT相近,二者可互补;对于重症AP患者,CT诊断准确率高于超声.     

US和CT对甲状腺癌定性和淋巴结转移的比较

目的：评价超声（US）和CT检查对甲状腺癌的诊断价值。方法：我们回顾性分析42例甲状腺癌的US和CT表现。42例均行US和CT检查，CT都用对比增强扫描和多平面重建（MPR）来鉴别原发性肿瘤和颈部转移淋巴结。结果：US和CT诊断结果与病理结果进行对比分析。US诊断甲状腺癌的符合率为64．3％，CT为83．3％。对于颈部淋巴结转移诊断US的符合率为75．0％，CT为50．0％。结论：CT对甲状腺癌定性诊断正确率高于US检查，但是US对于怀疑颈部淋巴结转移的晚期病人评价要优于CT。US和CT结合可以提高诊断甲状腺癌的准确性。     

Carcinoid tumors of the pancreas: CT findings

Computed tomographic (CT) and ultrasound (US) findings in four cases of carcinoid tumors of the pancreas are reported. Differential diagnosis with other endocrine and nonendocrine pancreatic tumors is discussed. CT and US techniques play an important role in diagnosis, prognosis, and treatment of these tumors.     

多平面三维超声诊断膀胱肿瘤及其术前分期

目的 探讨多平面三维超声结合表面三维成像诊断膀胱肿瘤及其术前分期的应用价值.方法 对75例膀胱肿瘤患者进行二维、多平面三维和表面三维超声检查,并与手术病理诊断和分期结果及CT术前分期结果进行对照.结果 二维与三维超声诊断符合率分别为 93.3%与 98.7%;二维与三维超声分期诊断符合率分别为 83.5%与 93.2%,两者差异有统计学意义(P＜0.05);术前CT对膀胱肿瘤的诊断符合率为 90.7%,分期符合率为 79.7%.将三维超声分期符合率与CT分期对照,两者差异有统计学意义(P＜0.05).结论 多平面三维超声结合表面三维诊断膀胱肿瘤及其对肿瘤的术前分期符合率较高,可为临床诊断本病提供更多的信息.

Abstract：

Objective To evaluate the clinical value of multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging in diagnosing and staging bladder tumors.Methods Seventy-five patients were examined with three-dimensional ultrasound and two-dimensional ultrasound.In addition,54 cases were undergone preoperative multislice spiral CT.All cases were proved by pathology after operation.Results The qualitation accuracy in the diagnosis of bladder tumor with two-dimensional ultrasound was 93.3%(70/75) and that of three-dimensional ultrasound was 98.7%(74/75).The staging accuracy rates with two-dimensional ultrasound and three-dimensional ultrasound were 83.5%(106/127) and 93.2%(123/132) respectively.The difference of bladder tumor staging between three-dimensional ultrasound and two-dimensional ultrasound was significant (P＜0.05).The qualitation accuracy in the diagnosis of bladder tumor with CT was 90.7%(49/54).The preoperative staging rate of CT was 79.7%(59/74),compared with that of three-dimensional ultrasound,the difference was significant(P＜0.05).Conclusions Multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging can provide useful information and makes an improvement in detecting and staging bladder tumors.     

外伤性延迟性脾破裂的诊治探讨(附17例报道)

目的：探讨外伤性延迟性脾破裂的发病规律、临床特点、诊断和治疗方法。方法：结合国内外资料及本组病例进行回顾分析。结果：明确诊断13例，误诊为肝破裂1例，腹膜后血肿1例，肾挫裂伤1例，宫外孕破裂1例。16例手术治疗，1例非手术治疗。行脾切除术10例，其中保留副脾1例，脾切除加自体脾组织网膜内移植术1例，脾缝合修补术3例；脾部分切除术3例。治愈16例，死亡1例。结论：本病由于腹腔内出血与受伤时间间隔长，容易误诊。诊断除依靠病史、临床表现外，应及时进行腹腔穿刺、B超及CT检查。治疗以脾切除为主，可根据病情、脾破裂的程度以及是否有合并伤等情况采取保脾手术或非手术治疗。     

超声联合CT对小儿不典型急性阑尾炎的诊断价值

目的探讨超声联合CT对小儿不典型急性阑尾炎的诊断价值。方法分析经手术病理证实的65例不典型急性阑尾炎患儿的超声和CT图像特征,比较二者单独诊断及联合诊断的准确率。结果对小儿不典型急性阑尾炎的准确率超声为82%,CT为85%,两种方法联合诊断为97%,高于单独使用超声和CT诊断(P0.05)。结论联合应用超声和CT检查有助于提高小儿不典型急性阑尾炎的诊断准确率。     

CT评估颈动脉粥样硬化的研究进展

颈动脉粥样硬化是缺血性脑卒中发生的主要危险因素之一。目前常用的影像学检查方法包括超声、DSA、CT、MRI及光学相干断层成像（OCT）等。其中,CT具有无创、快捷、空间分辨率高等优势,且近年来CT成像设备及技术发展迅速,使其在颈动脉斑块的早期诊断及随访等方面均发挥重要作用。本文对CT评估颈动脉粥样硬化的研究进展进行综述。     

国内超声与CT诊断急性胰腺炎患者符合率Meta分析

目的 系统评价国内超声与CT诊断急性胰腺炎(AP)患者的符合率.方法 检索中国期刊全文数据库(2000～2012年)、万方医学数据库(2000～2012年)及中文科技期刊全文数据库(2000～2012年),纳入超声与CT诊断AP患者的研究文献,手工检索其他相关文献.并对纳入的研究文献进行质量评价,采用RevMan5.1软件进行Meta分析.结果 共有16篇研究文献符合纳入标准.Meta分析结果显示:超声与CT诊断胆源型AP患者符合率差异有统计学意义(P ＜0.01)(RR =1.14、95％CI=1.08～1.19);诊断轻型AP患者符合率差异有统计学意义(P＜0.05)(RR =0.69、95％CI=0.48～1.00);诊断重型AP患者符合率差异有统计学意义(P＜0.01)(RR=0.70、95％CI=0.55～0.91).结论 对于胆源型AP超声优于CT;对于轻型和重型AP诊断CT优于超声.二者相互结合使用,有利于AP的诊断.     

头颈部异位甲状腺的CT诊断及评价

目的探讨头颈部异位甲状腺的分布规律及CT诊断价值,以提高诊断水平。方法回顾性分析12例证实的头颈部异位甲状腺患者的临床及影像学资料,比较超声、CT及核素的诊断优势。结果本组头颈部异位病灶主要分布于甲状腺水平及以上部位的15腔和颈部,其中颅底岩尖处1例,口腔舌根2例,颈前外侧区3例,口腔舌根一颈前外区2例,气管内2例,气管旁2例。3例有2个异位病灶。单纯异位甲状腺3例共4个病灶,异位结节性甲状腺肿9例共11个病灶。常见临床表现有吞咽不适、呼吸困难、颈部包块。本组病例的病灶检出率CT高于超声及核素。结论头颈部异位甲状腺分布具有一定规律,CT对发现及诊断ETG具有重要优势,可发现超声难以发现的特殊部位的病灶,能提供清晰直观的解剖关系,为临床处理提供重要依据。