High-riding superior pericardial recess: A pitfall in the upper mediastinum

The high-riding superior pericardial recess is an anatomical entity both radiologists and respiratory physicians should be aware of. Recognition that this high-riding portion of the recess is of water attenuation, that it connects to the inferior portion of the superior pericardial recess, and that it does not exert mass effect on adjacent structures should help avert misdiagnosis and subsequent inappropriate treatment.     

Imaging of pediatric bone tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

Malignant primary bone tumors are uncommon in the pediatric population, accounting for 3%–5% of all pediatric malignancies. Osteosarcoma and Ewing sarcoma comprise 90% of malignant primary bone tumors in children and adolescents. This paper provides consensus-based recommendations for imaging in children with osteosarcoma and Ewing sarcoma at diagnosis, during therapy, and after therapy.     

幽门螺杆菌阳性和阴性胃窦炎双对比影像特征比较及其临床意义分析

目的比较分析幽门螺杆菌阳性和阴性胃窦炎各自的X线双对比影像特征，并分析其临床意义。方法按统一标准对所获材料进行筛选和回顾性分析。各X线征象诊断标准：胃黏膜皱襞宽度≥5mm即诊断为胃黏膜皱襞增厚（胃窦炎），按常规诊断胃溃疡、胃黏膜糜烂和胃黏膜脱垂。统计分析各X线征象和幽门螺杆菌感染的关系。结果共筛选出173例患者，其中89例幽门螺杆菌阳性，84例阴性。幽门螺杆菌阳性病例中有胃黏膜皱襞增厚80例（89．89％），胃黏膜脱垂15例（16．85％），胃溃疡5例（5．62％）和胃黏膜糜烂9例（10．11％），幽门螺杆菌阴性病例中则分别有47例（55.95％）（P〈0．001）、2例（2．38％）（P〈0．001）、8例（9．52％）（P〉0．05）和11例（13．10％）（P〉0．05）。结论上消化道气钡双对比检查时发现胃黏膜增厚或胃黏膜脱垂，一般表示有幽门螺杆菌感染的存在；而发现胃黏膜糜烂或胃溃疡时，一般表示不一定有幽门螺杆菌的存在，但从其临床意义上讲，却可能较前者更严重，其中小部分可能发展成为胃癌。     

Clinicopathological study of bronchogenic carcinoma

OBJECTIVE: The present study was undertaken to explore the clinicopathological profile of bronchogenic carcinoma. METHODOLOGY: Four hundred consecutive patients with histopathologically proven bronchogenic carcinoma, hospitalized between 1985 and 1999 at a large teaching and tertiary care referral hospital at King George's Medical University in Lucknow, India, were analysed. RESULTS: The average age of the bronchogenic carcinoma patients was 57 years; 9.8% of patients were less than 40 years of age; the ratio of male to female patients was 4.3:1.0; 71% were smokers; and 87% of the smoking patients were bidi smokers. The most common histological type was squamous-cell carcinoma (46.5%), followed by adenocarcinoma (18.5%) and small-cell carcinoma (18.2%). The majority of patients (74.2%) were diagnosed in the late stages of the disease (IIIb and IV). CONCLUSION: Bidi smoking is an important contributory factor in the development of bronchogenic carcinoma in India, and approximately 25% of patients with bronchogenic carcinoma are non-smokers.     

急诊介入手术的护理31例

目的　正确掌握危重病人急诊介入手术的护理方法 ,是提高急诊介入手术抢救成功率的重要因素。方法　对 31例鼻腔大出血、支气管大咯血、肝癌自发性破裂出血、脑动脉瘤伴蛛网膜下腔出血、下肢动脉栓塞的急诊病人介入手术期护理作回顾性分析。结果　 31例急诊介入手术病人 ,抢救成功。结论　应该开展急救护理 ,密切配合手术医生 ,把握病情变化 ,从而有效地提高介入手术抢救成功率 ,减少并发症和死亡率。     

100例脊髓血管畸形介入检查或治疗的辐射剂量分析

目的 测量在脊髓血管畸形的介入放射学检查及治疗过程中患者及介入医生所受到的X线辐射剂量；分析影响X线辐射剂量的因素及其减低剂量的途径和方法。方法 应用热释光测量法对我中心近期100例脊髓血管畸形进行介入放射学检查和(或)介入治疗辐射剂量测量。结果 全脊髓血管造影患者皮肤剂量范围0．009～2．032Gy，介入医生所受剂量范围0．225～1．601mGy；进行栓塞治疗时患者皮肤剂量范围2．131～9．874Gy，介入医生所受剂量范围0．307～2．462mGy。结论 全脊髓血管造影是诊断脊髓血管畸形的金标准，并为手术或介入治疗提供重要依据。介入栓塞治疗是治疗脊髓血管畸形的重要而有效的方法之一，但是患者及介入医生所受的X线辐射剂量很大，个别患者可出现急性放射性皮肤红斑、脱发等症状。因此应该采取有效的防护措施来减低X线辐射剂量。     

Evaluation of the esophagus with a marshmallow bolus: Clarifying the cause of dysphagia

We reviewed the radiographic examinations of the esophagus and medical records in 117 patients (55 women and 62 men; mean age, 52 years) in which a marshmallow bolus was also given. A one-third to one-half piece of a standard marshmallow was used with a mean size of 23 mm (±4.5 mm SD) measured in vivo. In 62 patients with no intrinsic structural narrowing of the esophagus, impaction occurred in only seven (11%). Four of these patients had an esophageal motility disorder, and three had a previous Nissen fundoplication. The remaining 55 patients had lower esophageal mucosal rings (47) or peptic strictures (8). Marshmallow impaction was seen in 27 of 47 rings (57%) and was inversely related to ring size, and in six of eight strictures (75%). Also, impaction was related to the ratio of bolus size to ring caliber, and invariably occurred when this ratio was greater than 1.5. Dysphagia was the presenting complaint in 76 (65%) patients, but was found equally in those without intrinsic narrowing and in those with ring or stricture. However, dysphagia was reproduced by the marshmallow bolus only in patients with esophageal narrowing or abnormal motility.     

肝细胞肝癌门静脉癌栓介入分型及其临床应用价值

目的:探讨适合指导介入治疗的肝细胞肝癌门静脉癌栓介入分型。方法:根据肝细胞肝癌合并门静脉癌栓患者的动态增强CT或MR影像学表现,将门静脉癌栓分为Ⅰ~Ⅴ共5型,包括Ⅰ型、Ⅱa型/Ⅱb型、Ⅲa型/Ⅲb型/Ⅲc型、Ⅳa型/Ⅳb型、Ⅴ型,其中将Ⅰ~Ⅳ型同时合并肝动脉门静脉瘘归为Ⅴ型。观察不同分型患者经肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合门静脉支架+放射性碘-125粒子条植入治疗的效果。结果:117例入选患者介入分型为Ⅰ型占10.2%(12/117)、Ⅱ型占17.1%(20/117)、Ⅲ型占53%(62/117)、Ⅳ型占19.6%(23/117)、Ⅴ型占16.2%(19/117)。所有患者均接受介入治疗,术后即刻造影显示,68例(93.1%)患者门静脉灌注明显改善。术后1~3个月增强MR/CT随访显示,植入碘-125粒子部位的癌栓均较术前明显萎缩,有效控制。结论:肝细胞肝癌合并门静脉癌栓的介入分型有助于指导临床制定个体化的介入治疗策略,使患者获益,值得临床推广。