肺硬化性血管瘤CT征象及病理分析

目的探讨肺硬化性血管瘤（PSH）的CT表现,旨在提高PSH的影像诊断水平。方法回顾分析42例2004年9月-2009年6月在我院经手术及病理证实的PSH的CT资料与病理结果。结果本组女性38例（90.48%）,男4例;发病年龄19-66岁,中位年龄46.6岁;病灶均为单发,位于肺野内、中带居多（39例,92.86%）;结节30例（71.43%）,肿块12例;边界光滑31例,浅分叶9例,毛刺2例;钙化11例（26.19%）,瘤体〉3cm发生率高（66.7%）;31例增强扫描中,增强前密度不均匀8例（25.81%）,增强后不均匀强化18例（61.29%）,增强幅度1-64HU,均值（31.16±11.93）HU;瘤周磨玻璃密度11例,空气新月征6例。结论PSH好发于中老年女性,CT表现为位于肺野内、中带孤立性结节或肿块,增强扫描不均匀显著强化,一些特殊征象如空气新月征、瘤周磨玻璃密度具有相对特征性,有助于术前诊断。     

综合治疗在重症慢性静脉功能不全的应用

目的:探讨重症慢性静脉功能不全(CVI)患者的治疗方案。方法:统计我院2008年7月至2011年7月间收治的31例重症CVI患者的治疗方法及疗效。结果:29条患肢溃疡中28条愈合,所有31例患者中局部肿胀和湿疹25例明显改善。结论:对于重症CVI应该采用综合治疗方案,提高患者对治疗的依从性对疗效有重要作用。     

硬化性肠系膜炎多层螺旋CT诊断的价值

目的探讨硬化性肠系膜炎的多层螺旋CT表现及其诊断价值。方法回顾性分析13例硬化性肠系膜炎患者的完整的临床资料及多层螺旋CT资料,其中7例行平扫及增强扫描,6例平扫,所有图像均行多平面重组（MPR）及最大密度投影（MIP）重建后分析。结果13例SM病变均起自肠系膜根部,且包绕肠系膜血管,有明显占位效应,平均大小约45mm×113mm,平扫呈雾状系膜,增强后强化不明显,9例有假包膜,6例肿块内可见血管周围脂肪环征。结论多层螺旋CT是诊断硬化性肠系膜炎的首选工具之一,有非常重要的价值。     

Idiopathic sclerosing encapsulating peritonitis — Is a preoperative diagnosis possible? Report of three cases

Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is usually diagnosed during a laparotomy; however, a preoperative diagnosis is possible. Sclerosing encapsulating peritonitis can be classified as primary or idiopathic and secondary types and only about 70 cases of idiopathic type have been reported since it was first described. It is characterized by a total or partial encasement of the small bowel by a thick fibrotic membrane. This report presents a series of three cases in which a diagnosis of idiopathic SEP was made preoperatively based on the clinical features and radiological findings, which were confirmed by a laparotomy and histopathology. All of the cases were successfully managed by the excision of the membrane. This report demonstrates that based on the clinical features and radiological investigations, in the absence of other plausible etiologies for intestinal obstruction, it is possible to suspect a preoperative diagnosis of SEP, thereby preventing a “surprise“ finding during a laparotomy and allowing for better management.     

Abdominal Cocoon: Clinical Presentation, Diagnosis, and Management

A 15-year-old girl presented with features suggestive of sub-acute intestinal obstruction (SAIO) with a palpable abdominal lump. Contrast-enhanced computed tomogram (CECT) abdomen revealed congregated small gut loops confined to a single area and encased in a thick membrane suggestive of abdominal cocoon. On laparotomy, a thick white membrane was found encasing most of the small gut. The cocoon was excised releasing the encased small bowel. The patient was relieved of her symptoms following surgery. Histopathology of excised cocoon membrane revealed granulomatous inflammation consistent with tuberculosis. The patient was discharged on ninth postoperative day with advice to take anti-tuberculosis drugs for 6 months. The possibility of abdominal cocoon should be considered in patients with SAIO and abdominal lump. Abdominal cocoon being a rare condition, CECT is useful in clinching the diagnosis and planning elective surgery in experienced hands.     

A case of eosinophilic cholangitis： Imaging findings of contrast-enhanced ultrasonography, cholangioscopy, and intraductal ultrasonography

A 38-year-old woman was referred to our institution due to epigastralgia. She presented with obstructive jaundice and eosinophilia. Endoscopic retrograde cholangiopancreatography showed diffuse narrowing from the distal common bile duct to the bifurcation of the hepatic ducts. An endoscopic plastic biliary stent was inserted; the specimen obtained from the common bile duct wall revealed dense infiltration by eosinophils. Treatment was started with prednisolone 60 mg daily. The patient＇s biliary stenosis and eosinophilia gradually improved. Eosinophilic infiltration in the lungs or stomach is relatively common, but it is rare in the common bile duct. Most of the reported cases of eosinophilic cholangitis presented with eosinophilia; our patient＇s eosinophil count was over 1000/mm^3. Since our patient had allergies to pollen and house dust, a relationship between the allergies and the eosinophilic cholangitis was suspected, but no cause was identified.     

Case report of a patient with osteopoikilosis

Osteopoikilosis (OPK) is a benign osteosclerotic dysplasia of unknown origin, which is an inherited autosomal disorder. Males and females are equally affected. It is usually asymptomatic and may only be recognized on radiological examination. In this study we report a 33-year-old woman with fibromyalgia who suffers from back and leg pain and was diagnosed OPK by radiologically and review literature.     

Hemodynamics of small sclerosing hepatocellular carcinoma without fibrous capsule: evaluation with single-level dynamic CT during hepatic arteriography

The tumor drainage pathway of a hypervascular liver tumor without fibrous capsule was evaluated histologically and using single-level dynamic CT during hepatic arteriography (CTHA) in a case of sclerosing type of hepatocellular carcinoma. This tumor had a thin corona on CTHA, which represented drainage from the tumor sinusoids to the surrounding liver sinusoids. Additionally, the corona of the hypervascular tumor was thinner without than with the fibrous capsule.     

A rare cause of vaginal bleeding in a 7-month-old female infant

Ovarian sex cord stromal tumor (OSCST), sclerosing type, is an extremely rare ovarian tumor. Sex hormone production by OSCST can result in isosexual or heterosexual precocious puberty in younger patients. We present a case of a 7-month-old female infant found to have a sclerosing-type OSCST that presented with vaginal bleeding and very prominent vellus hair at the mons pubis. This represents the youngest patient reported in the literature with this subset of OSCST.