血色病肝脏铁过度沉着症1例

1.病例资料：患者，男，48岁。以“乏力、多饮、多尿、多食，伴消瘦4个月，加重1周”入院。既往有乙型肝炎和地中海贫血病史30年，无输血史，无血色病家族史，曾行“脾脏切除”治疗。查体：慢性贫血面容，全身皮肤黄染有散在色素沉着，巩膜黄染，双手肝掌，男性乳房发育；肼右肋下3cm，剑突下5cm，质硬；腹部未触及肿块。     

高分辨率CT对颞部疾病的检查价值

目的：探讨高分辨率CT（HRCT）对颞部疾病的检查价值。方法：对43例颞部疾病患者行常规CT和高分辨率CT（HRCT）检查所获图像对比分析，并讨论HRCT的检查技术和图像后处理。结果：HRCT对病变的显示率及病变引起骨质破坏的程度，病变边缘，轮廓的显示均明显优于常规CT，尤其能清楚显示常规CT难以显示的中耳及内耳的细微结构，结论：高分辨率CT是颞部疾病的首选检查方法，使用高分辨率CT对颞部疾病的检查给临床提供更多，更准确的诊断信息。     

X-Ray Study of the Cat Hindlimb During Treadmill Locomotion

With pulsed X-ray cinematography we have analysed the angular excursions of the distal hindlimb joints (proximal interphalangeal, PIP; metatarsophalangeal, MTP; ankle) in cats walking on a treadmill. These distal joints transmit the body weight and the dynamic forces onto the ground. We have included the knee and hip joints in the analysis to relate the angular excursions of the proximal and distal joints and to verify the data previously obtained with external markers on the kinematics of the proximal joints. At the beginning of the stance phase the PIP joints flexed rapidly, the MTP joints extended slowly and the ankle and knee yielded under body weight. Whereas the PIP joints maintained a rather constant angular position of −75° throughout the stance phase, extension continued in the MTP joints from −230° at touch-down to −270° at the end of the stance phase. Around 50 ms before lift-off the MTP joints flexed rapidly. Early (−30 ms) after lift-off this flexion changed into a slow extension. The PIP joints extended swiftly at the stance-swing transition and moderately at the end of the swing phase. During the middle part of the swing phase they flexed slowly. Small rotatory movements around the long axis of the foot took place in the last 100 ms of the swing phase. The results of this study on the distal joints are discussed in relation to the placing of the paw, to the translation of forward propulsion into a MTP movement and to the lifting of the paw (conventionally described as toe curling). They show a differentiated mechanical interaction between the different distal limb joints during these different phases, which must be known in detail to interpret the corresponding electromyographic data and to understand how the hip is moved forward over the MTP joints which serve as the final pivot during stance.     

脾脏钝伤的CT诊断

本文回顾性分析了３２例脾脏钝伤ＣＴ平扫的表现；对脾损伤进行ＣＴ分类；指出腹腔积血和脾周血块（“哨兵血块征”）在诊断脾损伤方面的作用。ＣＴ平扫诊断钝性脾脏损伤是一种敏感、可靠的方法，可帮助外科医生制订治疗方案。ＣＴ平扫诊断钝性脾损伤的灵敏度为９４％，诊断正确率为９１％     

鼻部源性突眼的CT分析

目的：为了提高对鼻部源性突眼的认识。材料和方法：本文19例鼻部源性突眼，其中鼻咽癌7例，鼻咽纤维血管瘤2例，鼻腔纤维血管瘤、恶性肉芽肿和嗅神经母细胞瘤各1例，上颌窦癌和软骨肉瘤各2例，上颌窦恶性肉芽肿、纤维肉瘤和恶性纤维组织细胞瘤各1例，全部病例均作轴位CT扫描，12例加作增强扫描，详细分析了它们CT表现。结果：源于鼻咽的放疗前鼻咽癌和纤维血管瘤，其病变主要位于鼻咽腔和咽旁，后者显著增强并有钙斑，与前者不同；源于上颌窦的肿瘤，病变占据上颌窦的全部或大部分，软骨肉瘤有钙斑且无强化，易与其它肿瘤区别，它们破坏上颌窦顶部进入眼眶；鼻腔嗅神经母细胞瘤在鼻腔和筛窦形成肿块，破坏筛骨眶板侵入眼眶。结论：根据CT所见，可判断突眼原因。     

局灶性机化性肺炎的HRCT表现（附12例分析）

为了加深对局灶性机化性肺炎ＨＲＣＴ表现的认识，作者搜集近年来经手术和纤维支气管镜活检，病理证实的局灶性机化性肺炎１２例，回顾性研究其ＨＲＣＴ表现。     

多体位短间隔及加压追踪法全消化道钡餐检查的临床分析

目的:探讨多体位、短间隔及加压追踪法在全消化道钡餐透视检查的应用价值。方法:回顾性分析34例经手术病理确诊或内科治愈或钡餐明确诊断(憩室)的X线表现。年龄12岁81岁,男19例,女15例。采用多体位、短间隔加压追踪法的全消化道钡餐透视检查。结果:空肠近段神经鞘瘤并溃疡出血1例,先天性巨小肠1例,小肠粘连连带压迫空肠近段并不完全性肠梗阻1例,回盲部腺癌并不完全性肠梗阻1例,阑尾切除术后回肠末段肠粘连并不完性肠梗阻1例,美克尔憩室炎并周围溃疡伴不完全性肠梗阻1例,空回肠多发憩室4例,空肠炎9例,回肠炎5例,空回肠炎3例,肠激惹综合征3例。结论:多体位、短间隔加压追踪法全消化道钡餐透视检查,检出率较高,在小肠疾患的检查中有重要的临床意义。     

优化CT扫描参数,降低患者辐射剂量

CT检查中如何有效减少辐射剂量,保护患者,同时保证图像质量,作为从事放射的工作人员应该充分认识。本文从CT检查辐射剂量、优化参数及降低CT检查辐射剂量的途径等方面加以综述。     

钝性肝脾肾损伤的CT平扫与增强扫描比较

目的:比较CT平扫与增强扫描对肝脾肾钝性损伤的诊断能力。方法:回顾性分析临床疑似钝性肝脾肾损伤,并经手术和临床观察证实的CT平扫和增强扫描的患者84例。结果:平扫确定的损伤:肝12例,脾25例,肾5例;平扫可疑损伤:肝22例,脾15例,肾5例。增强确定的损伤:肝32例,脾40例,肾12例(全肾梗塞1例,局限性梗塞3例);对比剂外溢(活动性出血)3例;无可疑损伤。平扫无异常而增强确定有损伤:肝10例,脾5例,肾2例。增强显示的损伤灶比平扫范围明显大、病灶多、界限清楚。结论:CT增强扫描显示肝脾肾损伤明显优于平扫,延时扫描有助于发现活动性出血,应常规增强扫描。     

18F-FDG符合线路显像与异机CT图像融合诊断非小细胞肺癌复发转移的价值

目的 评价18F-脱氧葡萄糖(FDG)符合线路显像与异机CT图像融合诊断非小细胞肺癌(NSCLC)术后放化疗后复发转移的价值.方法 对可疑复发转移的40例NSCLC患者行18F-FDG符合线路显像,并于显像前后1周内行CT扫描.用三维(3D)图像融合软件进行图像融合.结果 在18F-FDG符合线路显像与CT扫描相同的范围内,40例患者共检出病灶58处,其中恶性52处,良性6处.融合图像诊断NSCLC复发转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值、阳性似然比及阴性似然比分别为94.23%(49/52),5/6,93.10%(54/58),98.00%(49/50),5/8,5.65及0.07.图像融合灵敏度、准确性明显高于CT.单纯18F-FDG符合线路显像诊断效能与图像融合无差别,但与CT图像融合可明显提高对病灶的定位诊断(提高44.83%).结论 18F-FDG符合线路与CT图像融合诊断NSCLC术后放化疗后复发转移灵敏度高,定位准确,值得推广应用.