早产儿支气管肺发育不良的X线表现

目的 分析早产儿支气管肺发育不良的X线表现,提高对支气管肺发育不良的诊断.方法回顾分析11例早产儿支气管肺发育不良的动态胸片检查表现.结果 支气管肺发育不良的胸部X线表现主要为弥漫混浊影,线网状影,小囊状透亮影,肺过度膨胀.出现以上2种X线表现者4例,分别为弥漫混浊影和线网状影2例,弥漫混浊影和小囊状影1例,弥漫混浊影和肺过度膨胀1例;3种X线表现以上者2例,均表现为弥漫混浊影、小囊状透亮影及线网状影;上述4种X线表现均有的有1例.结论 支气管肺发育不良的胸部X线有一定的特征性.     

肺不发育的X线及CT表现(附3例报告)

目的探讨肺不发育的X线及CT表现,提高对本病的认识及影像诊断水平。方法分析3例经临床证实的肺不发育的X线及螺旋CT表现。结果 X线可见患侧肺野透过度明显减低,未见明显肺纹理;CT可见患侧主支气管变短,支气管分支发育不全或畸形闭塞;健侧或邻近肺叶代偿性膨胀。结论肺不发育的X线及CT表现具有一定特征性,对诊断有一定价值。     

肺不发育和发育不全的X线及CT诊断

目的探讨肺不发育和发育不全的X线和cT诊断。方法对X线片、cT、支气管造影联合确诊的6例患者图像进行综合分析.结果肺不发育和发育不全分三型，I型1例，肺、支气管均不发育；Ⅱ型3例，肺不发育，有发育不全的盲端主支气管；Ⅲ型2例，肺、支气管均发育不全。结论X线及CT对肺不发育和发育不全有较高的诊断价值。     

49例小儿支气管透X线异物的X线诊断

目的：探讨小儿支气管透X线异物的X线诊断。方法：对49例5月-10岁小儿临床疑有支气管异物均进行常规电视透视，胸部正侧位片，UF检查，结果：45例一次性诊断支气管异物。3例因未获明确异物吸入吏、临床又高度怀疑，24小时后复查胸片诊断为支气管透X线异物。1例因突感咳嗽、气喘气紧，本人否认有异物吸入史，临床以支气管炎伴感染治疗10天无效，X线胸片提示有支气管异物可能，经纤支镜确诊有支气管透X线异物（纸团），结论：一是强调选择曝光时间；二是观察双侧肺野、膈肌的光滑锐利与否，这是X线平片诊断支气管透X线异物的重要检查方法和X线征象。     

不典型肺结核X线表现

本文将我院2000年-2006年经手术病理证实或痰菌检查阳性并经临床抗结核治疗9个月以上证实18倒不典型肺结核X线表现进行回顾性分析。旨在提高对不典型肺结核X线表现认识，并提鉴别诊断要点。本组18例不典型肺结核X线表现有三种：（1）孤立性肿块影。（2）下肺单个厚壁空洞，病灶附近肺野有斑片状及小结节影。（3）两肺多发性结节（结节大小约1cm），附近肺野有条片状影。     

气管-支气管结核的胸部X线与CT诊断

目的 了解气管-支气管结核的胸部X线与CT征象及其诊断价值。方法 36例气管-支气管结核患，其中临床证实16例，手术病理证实20例，均经胸部X线与CT检查，对全部患的胸部X线与CT表现进行了回顾性分析。结果 36例患中，胸部X线显示肺段叶及全肺不张12例，两肺结核性病灶18例，其中有陈旧性结核灶，粟粒播散灶，浸润灶及肺门淋巴结肿大。病变支气管表现有完全性支气管阻塞10例，支气管肺内结节状突起5例；胸部CT扫描显示支气管管腔变窄伴管壁增厚25例，管腔表面凹凸不平5例。管腔内有结节状突起6例，纵隔淋巴结肿大及钙化15例。结论 对气管-支气管结核的胸部X线与CT表现进行综合分析。大大有助于提高其诊断准确性。     

金黄色葡萄球菌肺炎18例临床X线分析

目的：探讨X线检查对金葡菌肺炎的诊断价值。方法：回顾分析18例金葡菌肺炎的胸部X线影像学表现，并加以总结。结果：18例中支气管源性感染14例，表现为急性呼吸道感染症状。血源性感染4例，在脓毒血症的基础上出现的肺部感染症状。胸部X线影像学改变主要为肺内炎性浸润（61．11％）：肺气囊（22．22％）；肺脓肿（11．11％）和脓胸及脓气胸（5．56％）。结论：X线影像学动态变化是本病特征性表现。X线平片检查经济、快捷，对肺内病灶的观察和进一步指导临床治疗具有重要的临床价值和意义。     

先天性支气管闭锁的多层螺旋CT和X线表现

目的分析先天性支气管闭锁的CT和X线表现，以提高对该病的认识和诊断。方法对11例支气管闭锁患者进行了多层螺旋CT（MSCT）扫描。其中3例经手术证实，6例有支气管镜结果，2例随诊1年以上。肺部常规10mm层厚扫描，在16层螺旋CT机进行1．25mm后处理重组，获得多平面重建（MPR）、最大密度投影（MIP）和最小密度投影（MinIP）图像，记录病变的部位和周围肺组织改变。结果11例病变CT均能显示黏液栓和周围气肿改变，其中3例黏液栓内含气体；x线平片亦能显示全部黏液栓，但仅显示8例气肿改变和2例黏液栓内的气液平。3例支气管闭锁位于左侧，8例位于右侧；发生于段支气管者10例，亚段1例；6例位于肺门旁，5例远离肺门。结论黏液栓和周围肺气肿改变是先天性支气管闭锁的典型表现，在先天性支气管闭锁诊断和鉴别诊断上，多层面螺旋CT能提供比x线平片更多的信息。     

胸部闭合性损伤诊断中CT与X线临床价值比较

目的探讨CT与X线用于胸部闭合性损伤诊断临床价值差异。方法对X线检查胸部闭合性损伤患者175例临床影像学资料进行分析,比较两种检查方式不同类型胸部闭合性损伤临床诊断符合率。结果血气胸、肺不张、肺挫伤及创伤性湿肺等CT检查临床诊断符合率均显著高于X线（P〈0.05）;但两种检查方式骨折、肺撕裂伤及纵隔气肿临床诊断符合率比较差异无统计学意义（P〈0.05）。结论 CT在诊断肺实质损伤及血气胸方面家价值优于X线,适用于受伤较重患者;而X线骨折诊断准确率高,且操作简便、价格低廉,可作为临床首选影像学检查方式。     

应用X线诊断胎儿骨骼发育异常的探讨

目的通过对引产后骨骼发育异常胎儿进行骨骼X线检查,探讨骨骼X线检查对终止妊娠后的骨骼发育异常胎儿的诊断价值。材料与方法对25例妊娠17～40周、因严重短长骨并伴有其他异常而引产的胎儿进行全身正侧位骨骼X线检查;对同期65例妊娠13～34周、母亲自愿要求引产的发育正常的胎儿进行骨骼X线检查作为正常对照。分析正常胎儿骨骼发育的特点以及各种胎儿骨骼异常的X线特征。结果(1)妊娠13周后胎儿全身大部分骨骼已骨化,正常胎儿股骨、肱骨、胫骨、L1、髂骨等径线及胸径、腹径随孕周呈线性增长。(2)25例骨骼异常胎儿最后分别诊断为10种类型的骨骼疾病:软骨发育不全(6例),致死性发育不良Ⅰ型(4例),成骨不全(6例),短肋-多指综合征(2例),软骨成长不全Ⅰ型(1例),窒息性胸廓发育不良(1例),弯腿性发育不良(1例),脊椎干骺端发育不良(2例),骨硬化症(1例),局灶性股骨发育不良(1例)。不同类型的骨骼异常有各自特异性改变:成纤维细胞生长因子受体-3基因相关的骨骼发育异常如致死性发育不良Ⅰ型、软骨发育不全均出现长骨粗短、长骨骺端呈杯口样扩张、方形髂骨及坐骨切迹呈鱼嘴状改变;致死性发育不良Ⅰ型、成骨不全Ⅱ型、软骨成长不全Ⅰ型...     

Role of multi slice computed tomography in the evaluation of congenital anomalies of tracheobronchial tree and lungs

ObjectiveTo evaluate the role of MSCT in the evaluation of congenital anomalies of tracheobronchial tree and lungPatients and methodsTwenty nine patients with congenital anomalies of tracheobronchial tree and lung were examined using four and six MDCT.ResultsSeven patients (24%) had congenital cystic adenomatoid malformation where successful differentiation of the type was possible. Three patients (10.3%) with bronchopulmonary sequestration were categorized as two (7%) intralobar and one (3.5%) extralobar sequestrations. Four patients (14%) had congenital lobar overinflation. Four patients had Scimitar syndrome with right pulmonary artery hypoplasia, right sided lung hypoplasia, anomalous arterial supply and anomalous pulmonary venous drainage together with pulmonary hypertension. Abnormal bronchial anatomy was revealed in two patients with pulmonary isomerism and one patient with situs inversus. Bronchogenic cyst, tracheal bronchus, Kertagner's syndrome, pulmonary agenesis and horse shoe lung were seen in one patient each. Dynamic MSCT shows the lunate configuration of the trachea during forced expiration in one patient with tracheomalacia. In one patient with tracheo-esophageal fistula, the extent of fistulous tract and the resulting bronchial aspiration were demonstrated.ConclusionMSCT proved to be indispensable as a preoperative planning modality and an essential investigation for congenital anomalies of the lung and tracheobronchial tree.     

临床拟诊为独肾患者的影像学诊断

目的：探讨腹部影像检查表现为“独肾”患者的全腹部及盆腔CT和／或MRI影像特征及其发病规律。方法：回顾性分析2007年-2011年腹部影像呈“独肾”表现的48例患者的腹盆腔CT或MRI检查资料。年龄1个月～78岁（其中30岁以下37例）,男17例,女31例。其中行CT检查36例,MRI检查12例。结果：48例中先天性孤立肾7例,一侧发育正常的异位肾（低位肾）2例,一侧肾发育不良并低位4例,余35例均合并其它泌尿生殖系异常（72％）,均经临床或手术证实。35例中肾发育不良并低位及各种输尿管异常14例;肾缺如并同侧精囊囊肿（Zinner’s syndrome）7例;肾缺如或肾发育不良加子宫发育异常12例;多重复杂变异2例。影像特征和发病规律：①肾缺如或发育不良常合并其它泌尿生殖道畸形,大部分为同侧泌尿生殖系异常。②肾缺如常合并生殖系异常,而肾发育不良时多见泌尿系（尤其是输尿管下段）异常。③发育不良的肾几乎都出现在输尿管走行区,体积一般小于正常,大部分为低位（腰3椎体水平以下至盆腔内）。④性别特异性：男性为Zinner综合征（中肾管未发育导致肾缺如,残留于精囊形成囊肿）,女性出现多种子宫异常。输尿管异常男女均可发生,女性更易同时出现输尿管异位开口。结论：对于初诊腹部影像学表现为“独肾”的患者,全腹部及盆腔影像学检查是非常必要的,可进一步明确诊断。这类患者常合并泌尿生殖系异常,其病变位置、病变类型有一定规律,应重点观察同侧输尿管、精囊和子宫。     

Evaluation of pulmonary hypoplasia with congenital diaphragmatic hernia

Congenital diaphragmatic hernia (CDH) is a developmental defect of the diaphragm with herniation of abdominal viscera into the thorax. The morbidity and mortality in cases is caused primarily by pulmonary hypoplasia. A prenatal diagnosis of CDH can be established by ultrasound, but ultrasound cannot detect pulmonary hypoplasia with certainty. We evaluated pulmonary hypoplasia by the simple method of lung intensity. The subjects were eight fetuses. In four fetuses, the lungs showed low intensity, and these fetuses all had pulmonary hypoplasia. Two of the four fetuses with high intensity showed a good prognosis, however, the other two fetuses did not. One of the two cases with poor prognosis had complex congenital heart disease, and the other died of sepsis and pulmonary hypertension. A high signal did not always promise a favorable prognosis, probably because accompanying abnormalities dominated the prognosis. MR assessment of lung intensity in fetuses with CDH may be useful in evaluating the severity of pulmonary hypoplasia. Low signal of the lung may reflect pulmonary hypoplasia and suggests a poor prognosis.     

单发右心室发育不良的影像学诊断

目的 报道6例单发右心室发育不良并评价其影像学诊断方法。方法 6例单发右心室发育不良患者均行X线平片、心电图、超声心动图、心导管及心血管造影检查，2例经外科手术证实。结果 6例中，5例小梁部发育不全，1例三尖瓣、流入道及小梁部皆发育不良。6例均伴有Ⅱ孔型房间隔缺损。结论 单发右心室发育不良是少见的紫绀属先天性心脏病，确诊需行心血管造影检查。     

Agenesis of the internal carotid artery and cavernous sinus hypoplasia with contralateral cavernous sinus meningioma

We report a cavernous sinus meningioma encasing the cavernous internal carotid artery in a patient with congenital agenesis of the contralateral internal carotid artery and cavernous sinus hypoplasia.     

先天性肺结核：胸片在诊断中的价值

目的 探讨胸部X线片在先天性肺结核中的诊断价值。材料与方法 对1992年10月－1999年4月经细菌学检查或尸解证实的先天性肺结核5例进行了分析。结果 肺部X线表现虽复杂多变,但有两种形式的表现仍具有一定的特殊性;（1）弥漫性栗粒病变;（2）广泛分布的斑片－结节病变。结论 胸部X线片在先天性肺结核的诊断中具有十分重要的作用,它常能首先提出诊断,引导临床及时确诊和治疗,降低死亡率。     

Isolated Left Ventricular Apical Hypoplasia with Infundibular Pulmonary and Aortic Stenosis: a Rare Combination

Isolated left ventricular (LV) apical hypoplasia is a rare congenital cardiac anomaly which is not accompanied by other cardiac abnormalities, with the exception of two cases. We report a case of a 33-year-old male patient with isolated LV apical hypoplasia combined with infundibular pulmonary stenosis and aortic stenosis. We review a literature focusing on the characteristic magnetic resonance features and combined cardiac abnormalities.     

Role of CT and MRI in the preoperative evaluation of auditory brainstem implantation in patients with congenital inner ear pathology

PURPOSE: The purpose of this study was to evaluate the reliability of computed tomography (CT) and magnetic resonance imaging (MRI) in characterising cochlear nerve anomalies in auditory brainstem implant candidates with congenital hearing loss. MATERIALS AND METHODS: Seventeen patients affected by congenital sensorineural hearing loss were examined by CT and MRI. Inner ear malformations eligible for auditory brainstem implants were classified according to the Casselman classification. All patients subsequently received auditory brainstem implants. RESULTS: Suspected congenital anomalies were confirmed by CT and MRI in all 17 patients. There were 5/17 bilateral cochlear nerve aplasias and 12/17 cochleovestibular anomalies. Of these, 5/12 patients had a common cochleovestibular cavity, 2/12 had bilateral cochlear aplasia and cochlear nerve agenesis, 1/12 had type I incomplete partition, 2/12 had type II incomplete partition and 2/12 had cochlear hypoplasia. CONCLUSIONS: Preoperative CT and MRI assessment of patients with sensorineural hearing loss is reliable. MRI provided additional information, identifying the possible absence of cochlear nerve and excluding other central nervous system (CNS) diseases.     

MRI in cerebellar hypoplasia

Cerebellar hypoplasia may present with a wide variety of neurological and systemic features, ranging from aplasia causing neonatal death to mild hypoplasia in an asymptomatic adult. MRI clearly documents the size of the cerebellum and any associated abnormalities. We describe 7 cases of cerebellar hypoplasia of varying aetiology-3 inherited, 2 associated with spinal dysraphism, 1 with Joubert's syndrome and 1 with pontine agenesis, probably as a result of basilar artery infarction in utero. T1- and T2-weighted images were obtained in each case and gadolinium-DTPA was administered in one. Associated features such as a Chiari malformation (2 cases), brain stem hypoplasia (2 cases), Dandy-Walker cyst and pachygyria (3 cases) and spinal dysraphism (2 cases) were clearly identified. Accurate documentation of these appearances assists in genetic counselling.