肾外肾盂的影像诊断

目的 研究肾外肾盂的影像表现和鉴别诊断。方法 回顾分析18例肾外型肾盂的影像表现,其中CT15例,MRI3例,逆行肾盂造影2例和静脉肾盂造影1例。结果 全部均在CT或MRI轴位扫描中,表现为在肾窦外囊样水密度影和长T1长T2信号,CT增强时造影剂均匀充盈。其中双侧2例,单侧16例。结论 掌握肾外型肾盂的影像特点。能将其与肾盂积水和肾盂旁囊肿等相鉴别。     

心包恶性间皮瘤的影像学表现

心包恶性间皮瘤是起源于心包浆膜层的恶性肿瘤,临床罕见,其影像学表现更是缺乏特征性。我院2018年确诊了1例心包恶性间皮瘤患者,其影像学检查资料比较全面,患者通过X线检查发现心影异常,CT及MRI进一步检查可以明确病灶的位置、形态及相关影像学表现。因此,影像学检查对于临床确诊心包间皮瘤起到关键作用。      

股骨头缺血坏死的影像学分析

目的:分析股骨头缺血坏死的平片、CT及MRI表现,并对其应用价值作一初步探讨。材料和方法:对32例股骨头缺血坏死的X线平片、CT及MRI摄片进行双盲分期和Kappa-致性检验及对照分析。结果:X线平片诊断主要依据股骨头塌陷、囊变、碎裂、硬化及股骨头变扁和股骨颈缩短。CT则以星芒缺失征、斑片状骨硬化、新月征、囊变及碎裂为特点。MRI则主要依据股骨头内出现斑片状或不规则形T_1低信号T_2高信号、双线征、新月征、囊变及股骨头塌陷。结论:MRI是诊断股骨头缺血坏死最敏感有效的方法,其次为CT。对于早期病变的发现需依靠MRI或CT检查。X线平片虽对早期诊断缺乏一定的优势,但依然是本病诊断和分期的常规手段。     

CT与磁共振成像对肝内胆管细胞癌的诊断价值

目的:探讨CT与磁共振成像(MRI)对肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)的诊断价值。方法:经手术或活检病理证实的ICC患者29例,其中15例行多层螺旋CT平扫和动态增强扫描,16例行MRI平扫和动态增强扫描。回顾分析肿瘤的形态学特征、CT及MRI影像学表现特征以及附属征象。结果:29例ICC,共检出32个病灶,肝左、右叶均见分布。CT共检出17个病灶,平扫仅1个病灶表现为混杂密度,其余均呈低密度;增强扫描动脉期显示10个病灶呈边缘强化,6个病灶呈轻度不均匀强化,1个病灶未见强化,门脉期显示12个病灶呈渐进性强化,5个病灶强化减退。MRI共检出17个病灶,T1WI、T2WI主要表现为混杂的异常信号;动态增强扫描动脉期显示16个病灶呈边缘环形或不规则强化,1个病灶无明显强化,门脉期和延迟期显示15个病灶瘤内实性部分的信号呈渐进性增强,强化程度更加明显,1个病灶瘤体边缘保持厚环状明显强化,1个病灶强化减弱。附属征象包括胆管扩张15例,局部肝包膜凹陷2例,肝叶萎缩1例,门静脉癌栓4例。结论:ICC的CT和MRI表现具有一定的特征性,动态增强扫描是其诊断和鉴别诊断的重要方法,术前详尽的影像学检查是及早发现ICC的重要途径。     

腮腺混合瘤的EBCT、CTS、3D-CT、流动扫描和MRI研究

目的:探索腮腺混合瘤影像学征象特点和EBCT,CTS,3D-CT,流动扫描和MRI对混合瘤诊断的优缺点,方法:对28例分别进行此五种影像学检查,结果与手术病理所见相对照.结果:CTS以 灶边界形态的显示较为有利;3D-CT可以显示病壮的立体形态及其与腮腺导管等周围结构的关系;混合瘤时间-密谋曲线呈缓升缓降型;MRI对显示病变的成份和其与面神经的关系最为理想.结论:混合瘤影学上具有一定的特点,几种检查互补有利于正确 诊断.     

嗅沟脑膜瘤的影像特征及鉴别诊断

目的：探讨嗅沟脑膜瘤的影像学表现与病理组织学之间的相关关系及其鉴别诊断。方法：对11例经手术及病理证实为嗅沟脑膜瘤的患者进行回顾性分析。男5例,女6例,年龄29～59岁,平均48岁。行CT检查3例,MRI检查8例,均为增强扫描。分析CT、MRI影像特征,并与手术、病理结果对照。结果：瘤灶起源于颅前窝嗅沟,多数密度或信号均匀,边界清楚,均匀增强;少数不均匀增强,大部分病例出现脑膜尾征,少数伴钙化、坏死、囊变。邻近颅骨受累时引起骨质增生或受侵。结论：起源于嗅沟的脑膜瘤均具有典型的影像学表现特征。嗅沟骨质及其脑膜影像改变的显示,对瘤灶起源具有重要的定位、定性诊断价值。MRI优于CT,但CT对钙化和骨质改变显示优于MRI。     

Emerging role of multimodality imaging in management of inflammatory pericardial diseases

The non-specific and highly variable symptomatology of inflammatory pericardial diseases create clinical challenges in making accurate diagnosis, which often requires the integration of clinical findings, imaging and invasive hemodynamic assessment. Echocardiography is considered to be a first-line imaging test in pericardial diseases. Emerging imaging modalities, especially cardiac MRI allowed better understanding of pericardial anatomy, physiology and, for the first time, enable demonstration of the pericardial inflammation. On the other hand, cardiac computed tomography is excellent tool to define pericardial thickness, pericardial calcification and is useful for preoperative planning once pericardiectomy is indicated especially in the patients with prior cardiac surgery.     

An adolescent male with an arteriovenous malformation presenting with reproducible seizures.

The patient who presents with new onset seizure is a difficult but common problem in emergency medicine. It is more difficult to make a specific etiologic diagnosis when the seizure patient is without fever, focal neurological deficit, prior medical history, electrolyte or acid-base imbalance. Such a patient with new onset seizures presented to our emergency department. The seizures were induced by a specific right arm position. The patient's initial evaluation included a normal physical examination, screening chemistries, and an unenhanced computed tomography (CT scan) of the head. Subsequent contrast-enhanced head CT scan and eventual magnetic resonance imaging (MRI) of the brain revealed a large arteriovenous malformation (AVM). The differential diagnosis of seizures is long and involved, but a majority of these diagnoses can be ruled in or out by simple and inexpensive screening examinations. Occasionally, more involved studies are indicated than the routine electroencephalogram (EEG) and CT scan. CT scan with contrast, angiography, and magnetic resonance imaging (MRI) may be required to elucidate the cause of the seizure. Of these, angiography and MRI are the most sensitive for AVM, but contrast CT scan is the most readily available with acceptable sensitivity and is therefore potentially more beneficial.     

CT Imaging of the Pericardium

Pericardial disease can be challenging to diagnose, and imaging can play a useful role in confirming or even suggesting the diagnosis. Computed tomography (CT) is a particularly appealing option for investigating pericardial disease in many patients because the differential diagnosis for symptoms of acute pericarditis or constrictive pericarditis often includes other diseases which are also well assessed with CT. In addition, many patients will have findings of pericardial disease manifest on CT imaging for other suspected diseases, and these findings can be missed if careful attention is not paid to the pericardium. CT also can play an important role in evaluating specific pericardial lesions, such as cysts, tumors, and abscesses. We will review findings of various pericardial diseases on CT with illustrative cases.     

Magnetic resonance imaging versus computed tomography scan: accurate diagnosis of soft tissue lesions.

Due to their cost effectiveness and accessibility, computed tomography (CT) scans are being utilized when magnetic resonance imaging (MRI) appears to be the diagnostic technique of choice. Because of their availability, CT scans are still used for diagnosis of disc herniations. MRI may, however, be superior in its specificity. In taking into account the subjective complaint and orthopedic and neurological findings, a disk herniation can often be diagnosed without a CT scan or MRI. However, should the patient fail to respond to conservative care or show unusual symptoms, an MRI is indicated. This article discusses a case where MRI would be the imaging procedure of choice.     

小儿膀胱横纹肌肉瘤的CT与MR诊断

目的：探讨CT及MRI对儿童膀胱横纹肌肉瘤的诊断价值。方法：回顾性分析4例经病理证实的儿童膀胱横纹肌肉瘤的CT和MRI表现，并与手术所见对照。其中CT平扫及增强扫描3例；MR平扫及增强扫描1例。结果：4例病变均起于膀胱三角区，2例侵犯了下壁。其中局限性膀胱壁呈葡萄状充盈缺损3例，3例中的1例，肿瘤外的膀胱壁均普遍性增厚；另外1例仅表现为膀胱壁局限性增厚。瘤内均未见坏死及钙化。以上表现与大体病理所见一致。1例MR检查，肿瘤T1WI呈等低信号，T2WI呈等高信号，增强后明显强化，冠状、矢状扫描见病变同时累及前列和后尿道3例CT检查，平扫肿瘤为等密度。增强扫描肿瘤边缘性强化1例，中度强化2例。结论：CT及MRI检查对儿童膀胱横纹肌肉瘤的诊断具有重要的价值。MR可以通过冠状、矢状扫描显示肿瘤的范围，在这点上，MR比CT优越。     

基底动脉尖综合征的临床分析

目的：研究基底动脉尖综合征(Top of the Basilar Syndrome，TOBS)的临床和影像学表现，加深对这种疾病的认识。方法：对30例TOBS患的临床症状和体征进行分析，并行头颅CT及MRI检查明确病变的部位。结果：8例经头颅CT确诊，余22例经MRI确诊。CT及MRI提示重要的特征是中脑或丘脑梗塞合并其他部位梗死，如枕叶、小脑、颞叶。结论：TOBS的诊断主要依赖临床及影像学表现，MRI对后颅凹病变诊断优于CT。     

A review of the complementary information available with cardiac magnetic resonance imaging and multi-slice computed tomography (CT) during the study of congenital heart disease

The incidence of congenital heart disease is approximately 4–6 per 1000 new births; however, the number of people living with congenital heart disease (CHD) is increasing, because of improved diagnosis, medical, and surgical management. While echocardiography continues to be the mainstay of non-invasive imaging, cardiac MRI (cMRI) and computed tomography (CT) have taken on increasing roles in the diagnosis of congenital heart disease in infants, children, and importantly, adults who may have limited echocardiographic windows, especially if post-operative. Cardiac MRI and multi-slice CT can complement the diagnostic information obtained by echocardiography and invasive cardiac catheterization. Post-operative imaging of CHD is especially enhanced by the spin echo MRI techniques, while gradient cine echo MRI imaging allows functional information that is not encumbered by geometric assumptions. Phase contrast (velocity encoding) cardiac MRI data can provide information about flow, allowing accurate determination of regurgitation and shunt volume. Gadolinium enhanced cMRI or three-dimensional reconstructed images from multi-slice CT angiography allow excellent delineation of vascular structures in complex heart disease. Coronary imaging, while possible with both modalities, appears more facile with fast CT imaging. This article reviews the literature to provide an assessment of the special techniques and considerations needed during the conduct of cardiac MRI/MRA and multi-slice CT examinations during the diagnosis of congenital heart disease in pediatric and adult patients.     

MRI对脑血管畸形的诊断价值

目的：评价ＭＲＩ在脑血管畸形诊断中的价值。材料和方法；本文选择经ＭＲＩ平扫加增强检查，并经过手术、磁共振血管造影（ＭＲＡ）或减影血管造影（ＤＳＡ）证实的脑血管畸形４０例，分析其ＭＲＩ特征。结果：ＭＲＩ表现可分为直接征象与间接征象。结论：ＭＲＩ对脑血管畸形有定性定位诊断价值，特别是适用于血管造影生的隐匿性血管畸形。     

心脏肿瘤的MRI诊断

本文简述了心脏肿瘤的ＭＲＩ扫描技术，重点按心脏肿瘤的发生部位依次介绍了心内膜肿瘤、心腔壁内肿瘤和心包肿瘤的ＭＲＩ诊断，并对ＭＲＩ诊断心脏肿瘤的能力进行评价。     

CT and MRI of acute thoracic cardiovascular emergencies

A wide spectrum of acute cardiovascular disorders is seen in patients who are hospitalized in a critical care setting. Imaging plays a central role in the diagnosis and management of these conditions. The most frequently used imaging remains chest radiography; however, more advanced modalities, including coronary angiography, echocardiography, and radioisotope scintigraphy, have well established roles in the assessment of patients in the critical care setting. More recently, multidetector row CT (MDCT) and MRI are being used increasingly for evaluation of coronary artery disease, cardiac structure and function, coronary artery anomalies, cardiac masses, pericardial disease, valvular disease, postoperative cardiovascular abnormalities, venous thromboembolism and acute aortic syndromes, often with other ancillary findings that can provide important clinical information. The three most common life-threatening cardiovascular processes in which advanced imaging plays a role, particularly CT, are discussed, including pulmonary embolism, aortic dissection, and coronary artery disease.     

CT及MRI诊断良性嗜铬细胞瘤价值

目的总结腹部良性嗜铬细胞瘤的影像学表现,以提高其术前诊断准确率。方法回顾性分析经手术组织病理证实的23例良性嗜铬细胞瘤患者CT及MRI影像资料。结果行CT检查13例,MRI检查8例,CT和MRI均检查者2例;23例嗜铬细胞瘤均为单发;与手术组织病理进行对照,CT术前诊断嗜铬细胞瘤12例,诊断符合率为80％;行MRI检查10例均明确嗜铬细胞瘤诊断,诊断符合率100％。结论CT及MRI均有助于良性嗜铬细胞瘤的诊断。     

Multidetector row CT and MR imaging in diagnosing hepatocellular carcinoma

It is important to diagnose hepatocellular carcinoma (HCC) correctly and in early stage, because viral hepatitis and liver cirrhosis are often complicated by HCC. Noncontrast and enhanced CT and MRI are very useful to visualize and diagnose HCC objectively. Especially, CT and MR imaging with dynamic study is essential to diagnose HCC, because it is usually hypervascular. Dynamic CT and MR study also improve differential diagnosis in the characterization of the tumor. However, to perform useful dynamic study, it is necessary to use a CT unit which can make a helical scan, or a MR system with fast imaging technique available that can obtain more than 15 slices within a single breath hold. Tissue specific contrast medium, such as superparamagnetic iron oxide that is available only on MRI, is also useful for diagnosis of HCC.     

儿童睾丸卵黄囊瘤的CT和MRI诊断

【目的】分析儿童睾丸卵黄囊瘤的临床特点和CT、MRI表现,以提高对该病的认识。【方法】回顾性分析15例经手术和病理证实的儿童睾丸卵黄囊瘤的临床表现和CT、MRl征象。12例行CT检查,3例行MRI检查。【结果】15例均表现为睾丸内软组织肿块,无钙化及脂肪成分,10例密度／信号不均匀,5例密度均匀。CT平扫肿瘤密度稍低于肌肉密度,增强扫描肿块表现为明显不均匀强化,以周边部强化明显。MRI平扫肿瘤T1WI呈不均匀或略低信号,T2WI呈不均匀高信号,增强扫描表现为明显不均匀强化。1例腹膜后淋巴结转移。【结论】CT及MRI检查在儿童睾丸卵黄囊瘤的诊断中有重要价值,了解其影像学特点,结合临床资料可以提高术前诊断和分期的准确性。     

影像学检查在蝶窦占位性病变诊断中的应用

蝶窦占位性病变是一类症状隐匿、临床相对罕见的疾病.复习相关文献,对各种蝶窦占位性病变的影像学特征及相关解剖、临床症状、体征进行综述,探讨影像学检查在蝶窦占位性病变诊断中的应用.资料表明,影像学检查特别是CT、MRI对蝶窦占位性病变的鉴别诊断与确诊、治疗与预后判断均具有重要参考价值.CT在显示骨性病变方面具有一定优势,MRI则更适于软组织显像,均可作为该病的常规检查.