超声评价成人睡眠呼吸暂停综合征与颈动脉病变关系的研究

目的：应用超声检测评价成人睡眠呼吸暂停综合征（SAS）与颈动脉病变的关系。方法彩色多普勒超声检查176例成人SAS患者与40名健康对照组的颈总动脉内中膜厚度（IMT）、颈动脉粥样硬化斑块、管腔狭窄等指标。结果①SAS组患者IMT较对照组显著增厚[（1.30＆#177;0.27）mm＞（1.05＆#177;0.21）mm,P＜0.05];②SAS组检测出粥样硬化斑块形成62例（35.2%）、管腔狭窄47例（26.7%）;对照组分别为5例及4例（12.5%、10.0%）,2组比较差异有统计学意义（P＜0.01）;③IMT与夜间最低血氧（LSaO2）呈正相关（r=0.46,P＜0.05）,与AHI无明显相关。结论颈动脉超声能较好评价SAS血管病变。夜间缺氧会增加SAS患者颈动脉病变发生率及程度。     

Imaging of late complications from mantle field radiation in lymphoma patients

Hodgkin lymphoma is one of the most curable cancers because of its sensitivity to both radiation and several chemotherapy agents. Radical radiotherapy alone provided curative therapy for patients who had Hodgkin lymphoma as early as six decades ago. Yet, the radiation field included normal organs, such as breast tissue, thyroid, and coronary arteries, which were at risk for long-term complications. Dedicated imaging approaches have been developed to evaluate late radiation effects on these structures.     

Hodgkin lymphoma

In the newly published WHO classification for tumors of the hematopoietic and lymphoid tissues, Hodgkin's disease has been renamed Hodgkin lymphoma, which reflects the recent confirmation of its germinal center B-cell origin. In the classification, nodular lymphocyte-predominant Hodgkin lymphoma has been added as a new entity with an excellent prognosis. For management of the disease, a risk-adapted classification is employed without staging laparotomy. In limited stages without risk factors, subtotal nodal irradiation with sophisticated techniques can cure more than 80% of patients. Multimodality therapy with chemo- plus radiotherapy can improve disease-free survival, but overall survival remains unchanged. In the intermediate stages with risk factors, chemo- plus radiotherapy is standard, with 3-4 cycles of ABVD and involved field irradiation. In advanced stages, chemotherapy plays a decisive role, with radiation therapy used as an adjuvant for bulky and/or slowly responding tumors. Long-term follow-up of cured Hodgkin patients has revealed increased incidences of solid malignancies and ischemic heart disease more than 15 years after therapy. Breast cancer and ischemic heart disease appear to be related to mantle irradiation, although sophisticated modern radiation therapy techniques are demonstrated to lower the incidence of these long-term morbidities. Meticulous radiation therapy remains the most effective tool for local control of Hodgkin lymphoma.     

Hodgkin disease: diagnostic value of FDG PET/CT after first-line therapy--is biopsy of FDG-avid lesions still needed?

PURPOSE: To retrospectively determine the sensitivity and specificity of co-registered fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with Hodgkin lymphoma after first-line therapy, with use of clinical follow-up or biopsy results as the reference standard. MATERIALS AND METHODS: Informed consent was obtained for imaging and included consent to use patient data for research purposes. Institutional review board approval was obtained. Between May 2001 and July 2005, the data for all patients (n=66) at the authors' institution with proved Hodgkin lymphoma after first-line therapy were retrospectively reviewed. PET/CT scans were evaluated for the presence of abnormal FDG uptake and residual masses after the end of treatment and at further follow-up. All patients with pathologic FDG lesions underwent surgical biopsy for histopathologic confirmation. All patients with negative PET/CT scans at follow-up were evaluated for disease-free survival. RESULTS: An FDG-avid lesion was detected at PET/CT in 27 of the 66 patients (mean age +/- standard deviation, 33.0 years +/- 12.2). Recurrence of Hodgkin lymphoma was confirmed with biopsy in 23 of the 27 patients. The mean maximum standardized uptake value (SUV) of the histopathologically proved lesions was 7.32 (+/-2.01). Four patients had false-positive findings at PET/CT: Biopsy revealed only inflammatory changes, and the mean maximum SUV was 7.30 (+/-2.53). Thirty-nine patients (mean age, 36.7 years +/- 10.8) did not have FDG-avid lesions and remained free of disease after a mean clinical follow-up of 26.2 months (+/-12.5) (specificity, 91% [39 of 43 patients]; sensitivity, 100% [23 of 23 patients]). The presence of bulky disease (>5 cm) after the end of treatment was a significant predictor of recurrent disease (P<.05). CONCLUSION: The authors conclude that FDG PET/CT can help exclude persistent and/or recurrent Hodgkin lymphoma after first-line therapy. Because of the false-positive results and the toxicity of salvage chemotherapy, including high-dose chemotherapy with autologous stem cell support, biopsy of the FDG-avid lesion is still needed.     

Planning mantle radiation therapy in patients with Hodgkin disease: role of gallium-67 scintigraphy

Detection of all sites of lymphoma is imperative for accurate planning of radiation therapy. In patients with Hodgkin disease, mantle radiation is used to treat the thoracic lymph nodes; in those with early-stage or nonbulky disease, mantle and paraaortic radiation may be the only treatment given. CT scanning of the chest adds important information to that obtained from chest radiographs. Gallium-67 scintigraphy has also been used to provide additional information on sites of active tumor. To determine the usefulness of 67Ga-citrate scintigraphy in planning the portals for radiation therapy, we analyzed the radiation treatment plans in 26 consecutive patients with Hodgkin disease; in all 26 patients, the disease had been staged by chest radiographs, chest CT scans, and gallium-67 images. Gallium-67 imaging alone provided unique information that affected the treatment plans in three patients (12%). The combined results of gallium-67 imaging and CT scans influenced the planning of radiation therapy in eight patients (31%). Gallium-67 imaging was found to be an important adjunctive study for optimal planning of radiation therapy in patients with Hodgkin disease.     

Thyroid gland: US in patients with Hodgkin disease treated with radiation therapy in childhood

The authors retrospectively assessed with sonography the prevalence of thyroid gland abnormalities in 30 patients who underwent radiation therapy for Hodgkin disease between 1962 and 1984. Doses ranged from 3,000 to 4,500 rad (3,000-4,500 cGy). Abnormalities were found in the sonograms of 24 patients and included unilateral (n = 6) or bilateral (n = 2) atrophy; multiple hypoechoic lesions smaller than 0.75 cm (n = 18); and dominant cystic (n = 2), solid (n = 3), or complex lesions (n = 4) larger than 0.75 cm. The risk of development of an abnormality increased as the time from irradiation increased and was comparable between patients who did and did not receive chemotherapy as part of the treatment regimen. Although the pathologic correlates of the various abnormalities seen on sonograms may differ, the findings indicate a need for long-term follow-up of patients who underwent cervical irradiation for Hodgkin disease.     

Prevalence of atherosclerosis in relation to atomic bomb radiation exposure: an RERF Adult Health Study

PURPOSE: To determine whether exposure to atomic bomb radiation altered the prevalence of asymptomatic atherosclerosis. MATERIAL AND METHODS: In a cross-sectional analysis, we examined aortic arch calcification by plain chest radiography and common carotid artery intima-media thickness (IMT) by ultrasonography among 1804 survivors of the atomic bombing in Hiroshima. We evaluated the association between atherosclerotic changes and radiation exposure, while adjusting for potentially confounding factors. RESULTS: Multivariate logistic regression analysis showed that aortic arch calcification was significantly associated with radiation exposure (p < 0.05). The odds ratio at 1 Gy was 1.30 (95% confidence interval [CI]: 1.05 - 1.53) for men and 1.31 (95% CI: 1.13 - 1.51) for women. Carotid artery IMT did not vary significantly with radiation dose (p = 0.18). CONCLUSION: Radiation dose contributed to the prevalence of aortic atherosclerosis but not carotid artery atherosclerosis in atomic bomb survivors.     

Prospective brain imaging evaluation of children with sickle cell trait: initial observations

PURPOSE: To determine whether sickle cell trait (hemoglobin AS) is associated with abnormalities in the brain of asymptomatic children. MATERIALS AND METHODS: Magnetic resonance (MR) imaging and MR angiography were performed prospectively in 26 siblings (eight girls, 18 boys; mean age, 10.5 years) of patients with sickle cell disease. Two neuroradiologists, blinded as to whether a child had hemoglobin AS or AA, reviewed images obtained in siblings. With MR imaging, lacunae, loss of white matter volume, encephalomalacia, or leukoencephalopathy was identified. With MR angiography, arterial stenosis, occlusion, or tortuosity was identified. Images with definite or possible abnormalities were mixed with randomly selected images and were referred to a third neuroradiologist for a completely blinded review. In cases in which all neuroradiologists concurred, a score was assigned that indicated the sibling had an abnormality. MR angiographic findings were assigned a score for tortuosity with a new quantitative scale. RESULTS: Among 26 siblings screened, 21 children had sickle cell trait. Among these 21 children, two had mild abnormalities at MR imaging (sample prevalence rate, 10% [95% CI: 1%, 29%]), and four had arterial tortuosity (sample prevalence rate, 19% [95% CI: 5%, 42%]). When children with sickle cell trait were compared with 31 control subjects without the trait, arterial tortuosity was significantly more common in children with sickle cell trait (P =.014). Among children with sickle cell trait, percentage of hemoglobin S was significantly greater in children who had tortuosity than percentage of hemoglobin S in children who had normal blood vessels at MR angiography (P <.03). CONCLUSION: Findings suggest that greater percentage of hemoglobin S is associated with mild vasculopathy. This vasculopathy may explain some of the excess risk of stroke among African Americans.     

高频超声评价颈动脉管壁形态对冠心病的预测价值

目的应用高频超声观察临床疑诊为冠心病患者的颈动脉管壁形态,探讨其对冠状动脉病变的预测价值.资料与方法191例疑诊为冠心病的住院患者行冠状动脉造影及颈动脉超声检查,根据颈动脉管壁形态分为颈动脉正常组、内-中膜增厚(IMT ≥1.0mm)组、稳定性斑块组及不稳定斑块组,比较4组冠心病患病率,并评估颈动脉管壁形态对冠心病的预测价值及在冠心病危险因素中的作用.结果4组冠心病患病率依次递增,组间比较,差异有统计学意义(P <0.01).颈动脉管壁形态与冠心病呈正相关(r =0.404, P <0.01).IMT ≥1.0mm、稳定性斑块及不稳定斑块是冠心病患病的独立危险因子(P <0.01),三者对冠心病的阳性预测值分别为42.86%、61.76%、73.68%.结论应用高频超声观察颈动脉管壁形态对冠心病有一定的预测价值.     

Prevalence of atherosclerosis in relation to atomic bomb radiation exposure: An RERF Adult Health Study

Purpose: To determine whether exposure to atomic bomb radiation altered the prevalence of asymptomatic atherosclerosis.

Material and methods: In a cross-sectional analysis, we examined aortic arch calcification by plain chest radiography and common carotid artery intima-media thickness (IMT) by ultrasonography among 1804 survivors of the atomic bombing in Hiroshima. We evaluated the association between atherosclerotic changes and radiation exposure, while adjusting for potentially confounding factors.

Results: Multivariate logistic regression analysis showed that aortic arch calcification was significantly associated with radiation exposure (p < 0.05). The odds ratio at 1 Gy was 1.30 (95% confidence interval [CI]: 1.05 – 1.53) for men and 1.31 (95% CI: 1.13 – 1.51) for women. Carotid artery IMT did not vary significantly with radiation dose (p = 0.18).

Conclusion: Radiation dose contributed to the prevalence of aortic atherosclerosis but not carotid artery atherosclerosis in atomic bomb survivors.     

Hematologic toxic reaction to radiation therapy adjuvant to autologous peripheral blood stem cell transplantation for recurrent or refractory Hodgkin disease

PURPOSE: To evaluate the hematologic toxic reaction to external-beam radiation therapy after high-dose chemotherapy with peripheral blood stem cell (PBSC) support in patients with Hodgkin disease. MATERIALS AND METHODS: A retrospective study of 30 cases of Hodgkin disease in patients who underwent high-dose carmustine, etoposide, and cyclophosphamide chemotherapy with PBSC support was performed. Thirteen patients underwent radiation therapy (28.8-39.0 Gy) a median of 45 days after PBSC repeat infusion. RESULTS: Radiation therapy was delivered as planned, without interruption, in all patients. Five patients developed thrombocytopenia (one with grade 1 thrombocytopenia; two, grade 2; and two, grade 3) and included three with progressive disease prior to radiation therapy and two with a history of prior irradiation. None developed a bleeding complication or required transfusion support. Five patients who underwent irradiation had thrombocytopenia (three with grade 1 and two with grade 2) 100 days after PBSC repeat infusion, compared with three patients (two with grade 1 and one with grade 3) who did not undergo posttransplantation irradiation. At the most recent follow-up, no patient without evidence of disease had a platelet count of less than 100 x 10(9)/L. CONCLUSION: External-beam radiation therapy was well tolerated in the posttransplantation setting in patients with Hodgkin disease. Thrombocytopenia was common but was not related to clinical complications.     

Primary EBV-positive Hodgkin’s lymphoma of the CNS under azathioprine treatment

Background

Retrospective and prospective cohort studies suggest that central nervous system involvement occurs in approximately 0.5?% of patients with advanced Hodgkin’s lymphoma. The isolated primary intracranial manifestation of Hodgkin’s lymphoma is an extremely rare finding, with few cases reported in the literature. Little is known about the optimal treatment and prognosis of these tumors. Here, we present a case report with a review of the literature.

Case presentation

A 47-year-old Caucasian man with persistent frontal headache and unspecific vertigo for half a month was diagnosed with nodular space-occupying lesions in the cerebellum. His medical history included multiple sclerosis, which was treated for 20 years with the immunosuppressive drug azathioprine. Further staging revealed no additional lesions suspected of being malignant. The patient underwent total tumor resection. Immunohistopathological examination showed Epstein–Barr virus-associated classic Hodgkin’s lymphoma. Diagnostic bone marrow punction excluded lymphoma involvement of the bone marrow. The patient had no B symptoms. Consequently, the patient was classified as having stage I_EA disease according to the Modified Ann Arbor Classification of Hodgkin Lymphoma and received systemic chemotherapy followed by radiation therapy for the former cerebellar tumor region. He was in complete clinical remission atthe last follow-up 9 months after the initial diagnosis.

Conclusion

This case report and literature review suggest that multimodal treatment leads to a remarkable clinical outcome in Hodgkin’s lymphoma with intracranial involvement.     

Primary mediastinal lymphoma: characteristic features of the various histological subtypes on CT

OBJECTIVE: To assess the characteristic features of the primary mediastinal lymphoma (PML) on CT and to test the relationship between CT findings and the likelihood of the 3 most common subtypes (Hodgkin lymphoma [HL], mediastinal diffuse large B-cell lymphoma [Med-DLBCL], and precursor T-cell lymphoblastic lymphoma [T-LBL]). METHODS: Sixty-six consecutive patients with pathologically proven PML including 29 patients with HL, 21 with Med-DLBCL, and 16 with T-LBL underwent CT prior to therapy. CT scans were independently reviewed by 2 radiologists who were blinded to the pathologic diagnosis for the following considerations: pattern of involvement (i.e., morphologic features, mass size, and contrast enhancement pattern), and ancillary findings at other sites including neck, abdomen, and pelvis. Interobserver agreement was measured by Kappa statistics, and independent predictors were calculated using multiple logistic regression analysis for determining the likelihood of the subtypes based on CT. RESULTS: Characteristic features of HL included irregular contour of the anterior mediastinal mass (20 of 29, 69%) and high prevalence of associated mediastinal lymphadenopathy (28 of 29, 97%). Characteristic features of Med-DLBCL included regular contour (14 of 21, 67%) and absence of cervical and abdominal lymphadenopathy (0 of 21). Characteristic features of T-LBL included regular contour (12 of 16, 75%) and high prevalence of cervical (9 of 16, 56%) and abdominal (6 of 16, 38%) lymphadenopathy and splenomegaly (11 of 16, 69%). CT findings independently associated with increased likelihood of HL were surface lobulation (P <0.01), the absence of vascular involvement (P <0.01), or pleural effusion (P <0.05). The presence of vascular involvement was associated with increased likelihood of Med-DLBCL (P <0.001). Furthermore, CT findings including the presence of cervical lymph nodes or inguinal lymph nodes (P <0.001), the presence of pericardial effusion (P <0.05), and the absence of surface lobulation (P <0.05) were significantly associated with the likelihood of T-LBL. CONCLUSION: The various histologic subtypes of PML have characteristic manifestations in the neck, chest, and abdomen, which allow their distinction on CT.     

Anterior tibial tendon abnormalities: MR imaging findings

PURPOSE: To retrospectively evaluate the magnetic resonance (MR) imaging findings of anterior tibial tendon (ATT) abnormalities. MATERIALS AND METHODS: Institutional review board approval was not necessary for review of patient images and was granted for examination of the volunteers; informed consent was obtained. MR imaging findings in 28 consecutive patients (20 women, eight men; mean age, 63.2 years) clinically suspected of having an ATT abnormality were compared with those in an age- and sex-matched control group of 28 asymptomatic volunteers (20 women, eight men; mean age, 62.9 years). Surgical correlation was available for 11 patients. The short-axis diameter of the ATT and the longitudinal extent of signal intensity abnormalities were measured (Mann-Whitney U test). Signal intensity abnormalities of the ATT and irregularities of the underlying tarsal bones were analyzed in consensus by two blinded radiologists (chi2 test). RESULTS: In the symptomatic group, three cases of tendinosis and 13 partial and 12 complete ATT tears were diagnosed. In 11 cases (one case of tendinosis and two cases of partial and eight cases of complete ATT tear), surgical correlation was available and the MR imaging diagnosis was confirmed. In the asymptomatic group, four cases of tendinosis of the ATT were seen. The ATT diameter was significantly thicker in symptomatic patients at 1 cm (5.1 vs 3.1 mm in control group, P < .001), 3 cm (5.8 vs 3.4 mm, P < .001), and 6 cm (5.4 vs 4.3 mm, P = .006) proximal to the distal point of insertion. Most ATT abnormalities (in 23 [82%] of 28 patients) were located within the first 3 cm proximal to the insertion. Signal intensity abnormalities were seen in the anterior portion of the ATT in two (7%) of the 28 symptomatic patients and in the posterior portion in 11 (39%); diffuse involvement was seen in 15 (54%). Bone spurs on the navicular surface (nine [32%] patients vs no [0%] control subjects, P = .001), a ridged shape of the medial surface of the medial cuneiform bone (13 [46%] vs one [4%], P < .001), and osteophyte formation at the first tarsometasarsal joint (eight [29%] vs two [7%], P = .036) were significantly more common in the symptomatic patient group. CONCLUSION: Characteristic findings of ATT abnormalities include tendon thickening (> or =5 mm) and diffuse or posterior signal intensity abnormalities of the tendon within 3 cm from the distal point of insertion.     

Highly diffusion-sensitized tensor imaging of unilateral cerebral arterial occlusive disease

BACKGROUND AND PURPOSE: Selective neuronal death is a well-recognized histopathologic sequel to moderate ischemic brain damage. However, radiologic visualization of these changes has not been established, even with diffusion tensor imaging (DTI). We sought to determine whether DTI with b values > or =1900 s/mm(2) reveals occult diffusion abnormalities in patients with cerebral arterial occlusive disease. METHODS: Six patients (five men, one woman; mean age +/- standard deviation, 66 +/- 8 years) with unilateral internal carotid or middle cerebral arterial occlusive disease but not parenchymal T2 hyperintensity underwent 3T fast DTI with b < or = 1300 s/mm(2) and slow DTI with b > or = 1900 s/mm(2). We postprocessed mean diffusibility and fractional anisotropy (FA) images from the fast and slow DTI datasets. Standardized asymmetry indices (AIs) were used to identify regional asymmetries. Diagnostic accuracy among the DTI modalities was assessed by means of receiver operating characteristic analysis. RESULTS: In hemispheres ipsilateral to occluded vessel, AIs were significantly elevated on fast mean-diffusibility images of white matter at the levels of the internal capsule (95% confidence interval [CI]: 1.00, 1.09; P = .045) and corona radiata (95% CI: 1.01, 1.12; P = .034). AIs were significantly decreased on slow FA images at the internal capsule (95% CI: 0.84, 0.98; P = .018) and white matter at the internal capsule level (95% CI: 0.92, 1.00, P = .043). The slow FA map had the highest accuracy (89.8%) for detecting the hemisphere ipsilateral to arterial occlusion. CONCLUSION: Slow FA maps acquired by using DTI with high b values are useful for visualizing ischemic brain damage in apparently normal WM.     

Evaluation of carotid artery wall volume measurement using novel semiautomated analysis software

PURPOSE: To evaluate semiautomated analysis software for measuring the total carotid arterial wall volume (TWV) as a measure of atheroma burden. MATERIALS AND METHODS: Semiautomated-software and manual analyses of TWV measured by cardiovascular magnetic resonance (CMR) were compared in two phantom models, 10 subjects with no known carotid artery disease, and eight subjects with known carotid disease. The subjects were scanned twice for reproducibility. RESULTS: In subjects with no known carotid disease, semiautomated analysis of 98% of slices showed an improved interstudy coefficient of variation (COV) compared to manual analysis of 50% of slices (4.0% vs. 6.2%, P = 0.02). The proportion of matched cross-sectional slices usable for TWV measurement was superior (99% vs. 49%, P = 0.005) and the median analysis time was shorter (31 minutes vs. 90 minutes, P < 0.001) using the semiautomated software. In subjects with known carotid disease, semiautomated (99% of slices) and manual (56% of slices) analyses had comparable interstudy COVs (4.1% vs. 3.9%, P = 0.01). However, the proportion of matched cross-sectional slices usable for TWV measurement was greater using semiautomated contouring (96% vs. 56%, P = 0.01). CONCLUSION: Carotid CMR measurement of TWV using novel semiautomated analysis software shows good reproducibility, enables greater coverage of arterial vessel wall length, and is considerably faster compared to manual contouring.     

Thoracic wall involvement by Hodgkin disease and non-Hodgkin lymphoma: CT evaluation

Thoracic computed tomographic (CT) scans of 250 patients with newly diagnosed or recurrent lymphoma revealed thoracic wall involvement in 24 patients (11 with Hodgkin disease, 13 with non-Hodgkin lymphoma). Thoracic wall involvement occurred without contiguous mediastinal or parenchymal involvement in 17 patients. Of these, 13 patients had masses beneath the pectoralis muscles or within the breast, and four had masses arising from the ribs. Five additional patients had mediastinal masses with thymic involvement and parasternal extension through the thoracic wall. Pulmonary parenchymal lymphoma with thoracic wall invasion was noted in the remaining two patients. In five of nine patients receiving radiation therapy, treatment plans were modified by CT demonstration of thoracic wall lymphoma.     

Brain imaging findings in pediatric patients with sickle cell disease

PURPOSE: To determine prevalence of imaging abnormalities in the brain of children with sickle cell disease (SCD) and to identify clinical and methodological factors that influence prevalence estimate. MATERIALS AND METHODS: Magnetic resonance (MR) imaging and MR angiographic findings for 185 patients with SCD examined at St Jude Children's Research Hospital since 1993 were reviewed. At least two readers independently reviewed images. Standard MR imaging criteria were used to identify lacunae, loss of white matter volume, encephalomalacia, or leukoencephalopathy. Patients were assigned grades to indicate limited or extensive abnormalities. Standard MR angiographic criteria were used to identify arterial tortuosity (limited vasculopathy) and stenosis or occlusion (extensive vasculopathy). Findings were evaluated as a function of patient clinical status (including stroke) and diagnosis. Recent methods (T1- and T2-weighted MR imaging plus fluid-attenuated inversion recovery [FLAIR] at 3-mm section thickness) were compared with older methods (T1- and T2-weighted MR imaging without FLAIR at 5-mm section thickness). RESULTS: At mean age of 10 years, overall prevalence of infarction, ischemia, or atrophy in patients with SCD was 44% (82 of 185), and prevalence of vasculopathy was 55% (102 of 185), without evidence of a significant referral bias. Twenty-six of 27 patients with clinical stroke had abnormal findings at imaging, but even if patients with stroke were excluded, 35% (56 of 158) had a "silent infarction" (MR imaging-visible injury without clinical stroke), and 49% (78 of 158) had abnormal findings at MR angiography. Patients with clinically severe disease had more abnormalities at MR imaging (P <.001) and MR angiography (P <.004) than did patients with milder disease. Severe vasculopathy was more prevalent in patients with hemoglobin SS than in those with hemoglobin SC (P <.001). Recent imaging methods showed more abnormalities than did older methods (P <.01). With newer methods, 43% (29 of 67) of patients had extensive abnormalities, whereas with older methods, 28% (33 of 116) had extensive abnormalities. CONCLUSION: Prevalence of ischemic brain injury in pediatric patients with SCD is substantially higher than was previously reported, in part because of improvements in imaging methods.     

老年冠心病患者颈动脉内-中膜厚度的超声测定（附60例报告）

目的通过分析颈动脉内-中膜厚度与老年冠心病的关系,探讨颈动脉超声在老年冠心病诊断中的临床意义。方法将60例入选的老年冠心病患者分为稳定型心绞痛（SA）组,不稳定型心绞痛（UA）组,急性心肌梗死（AMI）组,每组20例,并设立对照组20例,分别给予超声检测颈动脉内-中膜厚度（IMT）,进行分析比较。同时对48例老年冠心病患者进行冠脉造影检查,根据造影结果分为正常组11例,单支病变组16例,多支病变组21例,比较不同组间IMT水平的差异。结果老年冠心病患者颈动脉IMT较正常对照组有显著增厚（P〈0.01）,且在冠心病不同严重程度组中颈动脉IMT也存在一定的差异。对冠脉造影正常组与单支病变、多支病变组间IMT进行比较,结果也存在统计学差异（P〈0.05）。结论通过颈动脉超声测定颈动脉IMT水平,对老年冠心病的预测具有一定的临床意义。