12例Dandy—Walker综合征的临床CT与MRI分析

目的分析Dandy—Walker综合征的临床及cT与MR!影像特征。方法采用cT与MRI常规扫描，对12例Dandy—Walker综合征的临床表现、CT与MRI征象进行回顾性分析；结果12例Dandy—Walker综合征的CT与MRI表现归纳为①小脑蚓部缺失，小脑半球发育不良、完全分离，分离的小脑半球可以不对称；②第四脑室呈囊状、扇形、三角形显著扩张或后颅窝巨大囊状阴影与第四脑室相通；③窦汇异常抬高，越过人字缝／天幕抬高；④幕上脑室对称性扩张，脑积水。结论对Dandy—Walker综合征的诊断，CT扫描能够显示后颅凹及天幕上下脑的形态与结构，其CT表现具特征性；MRI可多平面扫描，无骨质伪影，显示后颅凹优于CT，在矢状面上可显示小脑、第四脑室、导水管、后颅凹囊肿以及与天幕的关系。CT与MRI扫描对Dandy—Walker综合征能够做出定性诊断，是术前诊断的主要依据，检查无痛苦，有重要的诊断和鉴别诊断价值。     

脑原发性淋巴瘤的CT、MRI诊断

目的:探讨脑原发性淋巴瘤的CT、MRI特征,以提高诊断水平。材料和方法:回顾性分析经病理证实的20例脑原发性淋巴瘤的CT和MRI表现。结果:20例共52个病灶,其中脑干4个、基底节14个、丘脑1个、胼胝体8个、枕叶10个、顶叶5个、颞叶5个、额叶4个、硬脑膜1个。位于脑深部近中线区域占78.8%;形态不规则(71.2%),内部发现囊变(15.4%),均未见钙化、出血。CT平扫均呈等或略高密度。T1WI呈低信号(30.7%)等信号(63.5%),T2WI等信号(69.3%),高信号(26.9%),增强后均呈显著增强。周围水肿(84.6%)。结论:脑原发性淋巴瘤的CT、MRI表现有一定特点,熟悉其临床及表现特点有助于对本病作出正确的诊断。     

亚急性甲状腺炎的CT诊断

目的:探讨亚急性甲状腺炎的CT表现和特点,提高对该病影像表现的认识。材料和方法:回顾性分析10例亚急性甲状腺炎CT影像特征及临床资料,共16个病灶,其中9例经手术病理证实,1例临床证实。同时抽取局限型甲状腺癌65例,就部分征象作对照分析。结果:亚急性甲状腺炎局限性3例,弥漫性7例。CT表现分3型:①局限于甲状腺一侧叶的低密度病变,病变甲状腺肿大,峡部可受累,3例;②甲状腺两叶各有一低密度病变,呈不对称肿大,病灶之间有正常甲状腺组织,6例共12个病灶;③甲状腺两叶及岬部均匀肿大,略不对称,1例。CT平扫病变为低密度,增强扫描后呈轻到中度均匀强化(15/16),腺内更低密度结节少见(1/16)。病变处甲状腺边缘模糊(16/16),与正常甲状腺组织界限不清(15/16),而局限型甲状腺癌病灶与正常甲状腺腺组织分界清楚(62/65),两者极不一样(P<0.01)。结论:亚急性甲状腺炎CT表现有一定特点,熟悉这些特点对于诊断及鉴别诊断很有帮助。     

多层螺旋CT肺密度测定对结缔组织病肺问质病变的早期诊断

目的探讨多层螺旋CT(MSCT)肺密度测定对结缔组织病(CTD)肺间质病变(ILL)早期诊断的临床意义。方法对222例CTD患者及50名正常对照者，应用MSCT附带的Pulmo自动评估软件进行上、中、下肺区的密度测定，并同时进行肺高分辨扫描(}-IR(_1、)，分析二者的变化与CTD伴ILL的关系。结果222例cm患者中197例平均肺密度有不同程度的增高，25例平均肺密度正常。157例HRCT有不同程度的肺间质病变，65例HRCT正常。50名正常对照者HRCT均正常，8名平均肺密度有不同程度的增高，42名平均肺密度正常。结论采用MSCT与HRCT对CTD伴ILL的检测结果差异有统计学意义，P=0．000(双侧)，因此MSCT平均肺密度测定对早期诊断CTD伴ILL比HRCT更敏感，更有临床意义。     

Alveolar hydatid disease of the liver: Brief review and spectrum of adjacent organ invasion

The purpose of this study is to show the spectrum of adjacent organ invasion and to make a brief review of hepatic alveolar hydatid disease (AHD), using CT and MR imaging. We retrospectively reviewed CT and MR images of three patients with various adjacent organ invasions surgically and histologically proven to be AHD. Local invasion to right kidney and adrenal, right hemidiaphragm and lung were detected in one patient, right adrenal in another patient and gall bladder, duodenum, gastric wall and pancreas invasion in the other. AHD may rarely extend to the gall bladder, stomach, duodenum, pancreas, right adrenal and kidney, diaphragm, pleura and lung. The extension of the disease outside the liver is usually encountered in patients with large, peripherally located masses in the advanced stage of the disease.     

齿状突骨折的MRI诊断

目的分析齿状突骨折的MRI表现,探讨MRI扫描在诊断齿状突骨折中的价值。方法回顾性分析我科CT确诊的52例齿状突骨折患者的MRI资料,MRI扫描包括横断面、矢状面、冠状面的T1WI及T2WI像。结果根据骨折部位将齿状突骨折分为三型,Ⅰ型:尖端骨折,本组3例;Ⅱ型:基底骨折,本组35例;Ⅲ型:枢椎椎体部骨折,本组14例。所有患者中,并发脊髓损伤16例,韧带损伤8例,3例合并颈椎脱位。结论MRI能清晰显示齿状突骨折线,确定骨折类型,显示椎旁软组织损伤,脊髓损伤。对于齿状突骨折患者,MRI对临床治疗有重要指导价值。     

冠状CT扫描对颅脑疾患的诊断意义

作者通过对30例颅脑疾患冠状CT扫描资料进行研究,提出在一定情况下,在横断CT扫描的基础上,加用冠状CT扫描或冠矢重建图象,对病变的精确定位、病变的起源和发展方向以及病变与周围结构的关系等很有裨益。     

CT scan and threshold vibrometry in the diagnosis of spinocerebellar degenerations

45 patients with spinocerebellar degeneration (SCD) underwent through quantitative investigation of the ventricular and cisternal systems by CT scanning and threshold vibrometry in the limbs to find out whether these parameters could be used for distinguishing mainly spinal from cerebellar forms or from olivopontoce-rebellar atrophy. The increase in the vibration sense threshold and the mild atrophy in the posterior cranial fossa proved typical of spinal forms and the reverse for cerebellar forms. In olivopontocerebellar atrophy enlargement of the cisterns and dilatation of the ventricles always exceeded 85% of normal values.

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Sommario 45 pazienti affetti da degenerazione spinocerebellare (SCD) sono stati sottoposti ad uno studio approfondito di esplorazione quantitativa del sistema ventricolare e cisternale alla TAC e della soglia di percezione vibratoria agli arti per valutare la possibilità di distinguere con questi parametri le forme prevalentemente spinali da quelle cerebellari o delle atrofie olivopontocerebellari. L'aumento della soglia vibratoria e la modesta atrofia in fossa posteriore è risultata tipica delle forme spinali, mentre l'inverso si verifica per le forme cerebellari. Nelle atrofie olivopontocerebellari l'allargamento delle cisterne e la dilatazione dei ventricoli supera quasi sempre l'85% rispetto ai casi normali.

     

False positive-false negative CT scan in late epileptic seizure: a meningioma-glioblastoma association

Summary A false-negative finding on initial CT is reported in a case of supratentorial glioma. This observation was peculiar because the first CT revealed a meningioma which might initially have been related to the clinical symptoms. The term false positive-false negative CT is proposed. The reasons for such CT failures are discussed. The accuracy of clues as to the localization of the glioma provided by EEG is emphasized.     

自发性颅内低压综合征的影像学特点

自1938年Schaltenbrand第一次描述1例自发性颅内低压综合征病例以来,该病症逐渐为人们认识。颅内低压综合征的诊断主要根据临床有典型的体位性头痛症状(直立位出现或加重,平卧位减轻或消失),同时腰椎穿刺测脑脊液压力低于8kPa(60mmH2O)。自20世纪90年代以来,文献报道的本综合征神经影像学表现越来越多,并使其诊断发生了革命性的变化。本文将就其影像学特点及发生的病理生理机制进行简要介绍。1自发性颅内低压综合征影像学表现的病理生理基础腰椎穿刺脑脊液压力低于8kPa(60mmH2O)是诊断自发性颅内低压综合征的主要依据,脑脊液压力降低也一…