小儿低血糖脑损伤的CT、MR诊断

目的 研究新生儿及早产儿低血糖脑损伤的CT、 MRI特点。方法 总结分析,收集本院2010年1月至2020年12月临床诊断为19例小儿低血糖脑病的CT、MRI影像材料。结果 回顾总结小儿低血糖脑病的CT、 MRI特征。CT常双枕顶叶的灰白质对称性条状低密度边缘模糊影,合并双侧胼胝体压部对称性片状低密度,边缘模糊。晚期顶枕叶脑沟增宽萎缩。CT发现5例涉及部分颅内部位无描述,对上述病例进行阅片改良模式后,发现有低血糖脑损伤早期影像,须掌握影像读片的方法,充分发挥薄层后处理重建功能,调动适当的窗位窗宽,细致查找,对早期轻微低血糖脑病改变及时诊断。MRI表现常有位置选择,大部分呈对称改变;新生儿及早产儿低血糖脑损伤大多数在双侧顶枕叶皮层及皮层下白质范围为主、部分涉及到胼胝体压部,部分表现弥漫皮层及皮层下白质受累,甚至基底节受侵,脑干、幕下小脑未见病灶。所有患者需加扫DWI序列后,大大提高了对该病的诊断。结论 应该在认识CT、MRI各种低血糖脑损伤征像的同时,还要注意读片方法和技巧,才能减少低血糖脑病的后遗症。     

99Tcm-环丙沙星显像检测重症急性胰腺炎继发感染的实验研究

Objective To evaluate the characteristics of 99Tcm-ciprofloxacin and explore its feasibility in early detection of secondary infectious foci of severe acute pancreatitis (SAP).Methods Ciprofloxacin was labeled with 99Tcm.The labeling efficiency and radiochemical purity of 99Tcm-ciprofloxacin were calculated and its biodistribution in normal pigs was measured.The recruited baby pigs were divided into three groups:normal control group (6), non-infected group (6) and infected group (16).370-400 MBq of 99Tcm-ciprofloxacin was injected into each pig intravenously.SPECT scanning was performed at 0.5, 1,2, 3, 4 and 6 h after administration.The differences of 99Tcm-ciprofloxacin uptake among groups were calculated and the tracer activity ratio of lesion-to-background was recorded at each time point.The diagnostic value of 99Tcm-ciprofloxacin SPECT imaging for the dectection of secondary infection of SAP was assessed using histopathological results as the gold standard.Variance analysis and least significant difference test were used to analyze the data.Results Both the labehing efficiency and radiochemical purity of 99Tcm-ciprofloxacin were over 90% within 6 h.Organs with rich blood supply, such as kidney, liver and spleen were the target organs for the accumulation of 99Tcm-ciprofloxacin; while no significant uptake was found in gastrointestinal tract or normal pancreas tissue of SAP.Rapid plasma clearance and renal excretion were observed.In the infected group, the lesion was visualized at 1 h after administration.The highest radioactivity ratio of lesion-to-background (3.36 ± 0.33) was at 3 h after administration, which was significantly higher than that of the other time point ( F =99.570, P ＜0.001 ).The sensitivity, specificity, positive and negative predictive values, Youden's index (YI) and Kappa value of 99Tc%ciprofloxacin imaging were 88.2% (15/17), 83.3% (5/6), 93.8% ( 15/16), 71.4% (5/7), 0.715 and 0.667 respectively.Conclusions The biodistribution of99Tcm-ciprofloxacin is suitable for imaging infectious focus of SAP.The optimal imaging time for the detection of secondary infection of SAP is 3 h after administration, with high sensitivity and specificity.     

三例多脾综合征患者的CT、MRI表现

多脾综合征(polysplenia syndrome)是一种少见的先天性多系统畸形组成的综合征,主要为多脾、心血管及其他内脏发育异常的联合畸形.以往多在尸检或手术时发现,现在由影像检杳发现的报道逐渐增多.     

猪正常胰腺的CT、MRI表现及多期增强扫描方案的研究

目的：探讨大动物猪正常胰腺的CT、MRI表现及多期增强扫描的最佳方案,为猪作为胰腺病模型动物提供参考资料。方法：健康幼猪10只,行CT平扫及薄层动态增强扫描,其中6只同时行MRI扫描,序列包括T1WI、T2WI、DWI、MRCP。扫描结束后10只猪均剖腹及离体观察胰腺的形态及位置,并与影像学表现对照。结果：①猪胰腺分为胰头及左、右两叶,呈“三叶草”形。其中左叶为胰腺的主体部分,其解剖位置、大体形态、胰周血管、胰实质密度、MRI T1加权像、T2加权像信号、弥散加权成像（DWI）信号及ADC值等均与人类胰腺十分相近;②MRCP显示猪的胰胆管系统与人不同,分别开口于十二指肠,相距约5—9cm;胆管较粗,直径约5～6mm,易显示;而胰管纤细,值径约1～1．5mm,生理状态下MRI对其显示欠佳;③螺旋CT多期增强扫描时间密度曲线与人类相似,但胰腺三期增强扫描即动脉期、胰实质期、门脉期最佳延迟时间较人早,分别为15s、35s、45s。结论：大动物猪胰腺的CT、MRI表现及多期增强扫描方案与人类有许多相似之处,可作为胰腺疾病影像学研究的理想平台。     

原发于纵隔(胸腺)淋巴瘤的MRI诊断

目的 探讨MRI多序列合理应用和动态增强扫描对原发于纵隔(胸腺)淋巴瘤的诊断价值.方法 对9例病理证实的原发于纵隔(胸腺)淋巴瘤的MRI表现进行了回顾性分析,并与胸腺瘤(癌)进行鉴别,归纳总结原发于纵隔(胸腺)淋巴瘤的MRI特征性表现.结果 9例原发性胸腺淋巴瘤中2例为霍奇金淋巴瘤(HL),5例为弥漫性大B细胞淋巴瘤,2例为前驱T细胞淋巴母细胞淋巴瘤/白血病.与胸腺上皮源性肿瘤比较:①淋巴瘤发病年龄明显较胸腺瘤、胸腺癌轻,为(29.7±17.0)岁.②肿瘤边缘模糊征象,淋巴瘤发生率与胸腺上皮源性肿瘤差异无统计学意义.③本组1例淋巴瘤可见假包膜,胸腺上皮源性肿瘤未见此征象;④分叶征,淋巴瘤发生率明显高于胸腺瘤,而与胸腺癌无明显差异.⑤延迟期"边缘环形强化"征象,淋巴瘤发生率高于胸腺瘤及胸腺癌.其他征象差异无明显统计学意义.结论 MRI 多种序列及动态增强扫描综合应用在对原发性胸腺淋巴瘤诊断方面具有一定价值.     

CT引导下125Ⅰ粒子植入治疗腹部淋巴结转移癌的临床应用

目的 探讨CT引导下125Ⅰ粒子植入术治疗腹部恶性肿瘤的腹腔及腹膜后区转移性淋巴结的安全性及疗效.方法 回顾性分析27例经病理确诊的腹部恶性肿瘤患者共31枚腹腔及腹膜后区转移性淋巴结(直径2.2 ～ 4.7 cm)接受经CT引导下125Ⅰ放射性粒子植入治疗的临床资料.植入量遵循Halarism 125Ⅰ经验公式确定,粒...     

CT、MRI在周围性面瘫诊断中的应用

目的 探讨多层螺旋CT与MRI技术在周围性面瘫的定位及病因诊断中的价值.方法 回顾性分析68例周围性面瘫患者的CT、MRI资料,分析总结影像学在周围性面瘫的定位、定性诊断中的意义.结果 本组68例周围性面瘫中影像学能明确定位45例(66.2%).病因分别是耳部先天畸形时伴面神经管异常2例,外伤性面瘫25例,慢性中耳乳突炎合并胆脂瘤10例,肿瘤11例及Bell's面瘫20例.除Bell's面瘫影像学无异常发现外,其他均准确发现病变并提示诊断.结论 合理运用CT、MRI技术,对耳部先天性发育畸形、脑外伤、慢性中耳乳突炎及肿瘤所致的周围性面瘫具有重要的诊断意义.     

三例多脾综合征患者的CT、MRI表现

多脾综合征(polysplenia syndrome)是一种少见的先天性多系统畸形组成的综合征,主要为多脾、心血管及其他内脏发育异常的联合畸形.以往多在尸检或手术时发现,现在由影像检杳发现的报道逐渐增多.