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1.
【摘要】目的:分析腹壁子宫内膜异位症(AWE)的MRI表现,为临床诊断提供依据。方法:搜集本院经病理证实的9例AWE患者的病例资料,分析MRI平扫及增强扫描影像特征。结果:9例AWE患者中,囊实混合型6例、实质型2例、囊肿型1例。MRI平扫表现:囊实混合型AWE T1WI呈不均匀等低信号,T2WI脂肪抑制序列呈等高混杂信号;实质型AWE T1WI呈不均匀低信号,T2WI脂肪抑制序列呈高、低混杂信号;囊肿型AWE T1WI呈稍低信号,T2WI脂肪抑制序列呈高信号。增强扫描表现:囊肿型的囊变部分无强化,实质性部分有明显强化,肿块病变范围均大于平扫,肿块边缘不规则,与正常组织分界不清。结论:出血、纤维化、钙化等多种混杂信号及增强扫描明显强化是腹壁子宫内膜异位症的特征性表现,结合手术史,腹部切口周围包块伴周期性疼痛有助于确诊。 相似文献
2.
The aim of the study was to estimate the value of CT in the diagnosis of abdominal wall hernias and at the same time to create
a standard for this CT investigation. Twenty-four patients with suspected hernia of the abdominal wall were examined. All
were operated on. The CT scans were assessed by two radiologists to estimate the interobserver variation. The CT diagnoses
made by the two radiologists were correct in 83 % and 79 % of cases, respectively. The sensitivity was 0.83 in both CT evaluations
and the specificity was 0.83 and 0.67, respectively. The predictive value of a positive CT finding was 0.94 and 0.88, while
the predictive value of a negative CT finding was 0.63 and 0.57, respectively. The interobserver variation (kappa) was 0.87.
The study therefore indicates that a positive CT finding of abdominal wall hernia is reliable, while a negative finding does
not exclude the diagnosis. The interobserver variation of the CT diagnoses is acceptable. To achieve the highest diagnostic
accuracy, it is recommended to always use the Valsalva manoeuvre, oral intake of contrast and 10/10 mm CT slices.
Received: 19 November 1996; Revision received 17 February 1997; Accepted 17 March 1997 相似文献
3.
原发性肝癌腹壁转移的介入治疗 总被引:1,自引:1,他引:0
目的探讨对原发性肝癌腹壁转移灶采用介入治疗的方法和疗效。方法对8例原发性肝癌腹壁转移患者行动脉插管灌注化疗、栓塞治疗,或经皮穿刺瘤内无水乙醇注射术。结果7例患者行动脉插管化疗栓塞术获得技术成功,术后5例患者腹壁转移灶内碘油沉积良好;2例患者部分瘤灶内碘油沉积不满意,行分次瘤体内无水乙醇注射术;1例患者动脉插管未能找到供血动脉,单纯采用经皮穿刺瘤体内无水乙醇注射。所有患者瘤灶处腹壁疼痛缓解或消失,3例腹壁体表肿块隆起者,肿块变小,变软。7例AFP升高患者,术后有不同程度下降。1例隆起肿块发生破溃、感染,其他患者未发生严重并发症。结论对原发性肝癌腹壁转移灶采用动脉插管灌注化疗、栓塞治疗,结合经皮穿刺瘤体内无水乙醇注射,对控制肿瘤生长、缓解疼痛,提高生存质量是可行方法之一。 相似文献
4.
Buecker A Neuerburg JM Adam GB Nolte-Ernsting CC Hunter DW Glowinski A van Vaals JJ Guenther RW 《European radiology》2001,11(4):670-674
The aim of this study was to examine the feasibility of a hybrid interventional MR system, which combines a closed bore magnet
with a C-arm fluoroscopy unit for percutaneous drainage of abdominal fluid collections. During the past 2 years, we have performed
four drainage procedures in four patients (mean age 47 years). Three patients had abscesses (psoas muscle, kidney, subphrenic
location) and the fourth patient had a recurrent splenic cyst. All procedures were performed on an interventional MR system
consisting of a 1.5-T ACS-NT scanner combined with a specially shielded C-arm. The drainages were guided by T1-weighted fast
gradient-echo images, T2-weighted single-shot turbo spin-echo images or both. A standard 18 G (1.2 mm) nonferromagnetic stainless
steel needle with a Teflon sheath was used for the punctures following which a 0.89 mm nitinol guidewire was inserted into
the fluid collection. Thereafter, the patient was positioned in the immediate adjacent fluoroscopy unit and a drainage catheter
was placed under fluoroscopic control. All drainage catheters were successfully placed into the fluid collections, as proven
by fluid aspiration and resolution of the collection. The mean time needed for the entire drainage procedure (MR and fluoroscopy)
was 110 min. No procedure-related complications occurred. It is feasible to perform drainage procedures on a closed-bore MR
scanner. The multiplanar imaging capabilities of MR are particularly helpful for fluid collections in the subphrenic location.
Received: 3 April 2000 Revised: 30 August 2000 Accepted: 31 August 2000 相似文献
5.
A 70 years old male on ventilatory and circulatory support for sepsis and non ST segment elevation myocardial infarction developed abdominal distension 14 d after placement of a percutaneous endoscopic gastrostomy tube for enteral feeding. Radiography revealed free air in the abdomen and gastrograffin (G) study showed no extravasation into the peritoneum. The G tube was successfully repositioned with mechanical release of air. Imaging showed complete elimination of free air but the patient had a recurrence of pneumoperitoneum. Mechanical release of air with sealing of the abdominal wound was performed. Later, the patient was restarted on tube feeding with no complications. This case demonstrates a late complication of pneumoperitoneum with air leakage from the abdominal wall stoma. 相似文献
6.
Aynur Solak Neslin Şahin Berhan Genç Ali Rıza Sever Mine Genç Oya Nermin Sivrikoz 《European journal of radiology》2013
Objective
The purpose of this study is to investigate the value of susceptibility-weighted imaging (SWI) for the evaluation of cyclic morphological and hemorrhagic changes in abdominal wall endometriomas (AWE).Materials and methods
Fourteen patients with a total of 17 lesions who were admitted with complaints of abdominal wall mass and cyclic pain were evaluated by MRI. Patients were scanned during the first three days of the menstrual cycle and during the mid-cycle phase (day 13–15). In addition to conventional images SWI was performed. The signal changes within the lesions on SWI were compared and graded on both studies.Results
There was no significant difference in the size of the lesions in the early days of the menstruation compared to the mid-menstrual period. The SWI taken on mid-cycle phase showed that the center was hyperintense and the peripheral zone was hypointense in all lesions. A signal void related to increased blood and the shrinkage of complete disappearance of hyperintensity in the venter of the lesion was seen 15 (88%) of the 17 cases on the SWI series performed during the menstrual phase scan.Conclusion
SWI is a sensitive technique and has the capability to show hemorrhage and deposition of hemosiderin within the lesions. For patients suspected with AWE, valuable diagnostic findings may be obtained if the MRI examination including SWI is performed during the early and mid phase menstrual cycle. 相似文献7.
Yang R Jing ZL Zhang XM Tang W Xiao B Huang XH Yang L Feng ZS 《European journal of radiology》2012,81(11):3041-3047
Objective
To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system.Materials and methods
A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed.Results
In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2 ± 1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r = 0.441, p = 0.000). According to APACHE III scores, the averages were 2.0 ± 1.1 and 2.6 ± 1.1 points in mild AP and severe AP, respectively (P = 0.016). AWE was slightly correlated with the APACHE III scores (r = 0.222, p = 0.005).Conclusion
AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP. 相似文献8.
Aim
A review of complication and success rates of the “mixed” technique in percutaneous nephrostomy using both the Seldinger and one-step techniques in dilated and non-dilated systems.Materials and methods
We retrospectively analysed 500 percutaneous nephrostomies in dilated an non-dilated systems in 353 patients from 2006 to 2007 (208 males (range 19-95 years), 127 females (range 27-91 years) and 21 children (range 3 months-16 years: 6 females, 15 males)). Percutaneous nephrostomy was considered successful if catheter was placed in renal pelvis and drained urine spontaneously. Successful percutaneous nephrostomies were classified as primary (renal system drained instantly) or postponed (drainage achieved within 24 h after initial failure). Number of complications was registered.Results
All of the 500 nephrostomies were successful within 24 h (96.2% primary; 3.8% postponed). The success rate of primary nephrostomy in dilated and non-dilated systems was 98.2% and 82%, respectively. Major complications occurred in 0.45% and minor complications in 14.2%.Conclusion
Percutaneous nephrostomy using the “mixed” technique is very successful in dilated systems, is not superior to other PCN techniques in non-dilated systems and has a very low rate of major complications. 相似文献9.
IntroductionDesmoid tumors are benign myofibroblastic neoplasms, originating from the muscle aponeurosis and classified as deep fibromatoses. The aim of this study was to evaluate the utility of multi-parametric (mp)-MRI for the diagnosis of abdominal wall desmoid tumor (awdt).Material and methodsThis Institutional review board approved retrospective study compared 10 patients (mean age ± SD; 38.2 ± 13 years; 9 females and 1 male) with awdt to 14 subjects (mean age ± SD; 45.6 ± 14.7 years; 9 females and 5 males) with non-desmoid abdominal wall tumors (ndawt). All included subjects underwent mp-MRI, which included conventional, diffusion weighted and dynamic contrast-enhanced (DCE) MRI. Two blinded experienced fellowship trained radiologists (MK and SR) evaluated each lesion characteristics qualitatively and quantitatively which included margin, homogeneity, T2W/T1W signal intensity (SI), T2 dark strands, and fascial tail together with measurements of apparent diffusion coefficient (ADC) and semi-quantitative DCE analysis. Inter-observer agreement was assessed using Cohen’s kappa and data were compared between groups using independent sample t-tests and Chi-square tests.ResultsNo significant differences in age or gender appeared between groups. On qualitative analysis, T2 dark strands were identified in 90% by both radiologist (K = 0.82) of awdt, while fascial tail was identified in 70% by radiologist 1 and 80% by second radiologist (k = 0.91) of awdt; however no other lesions showed these findings. Other subjective imaging findings did not significantly differ between groups with moderate-to-strong agreements (k = 0.7–1.0). On quantitative measurements, diffusion imaging awdt lesions showed higher mean ADC value compared to other lesions, although it did not reached at the level of significance. While on DCE MRI, all awdt lesions showed type 1 (progressive) DCE curve, however no significant difference was observed between groups.ConclusionsT2 dark strands and fascial tail are characteristic features of awdt, whereas other subjective/qualitative findings are not useful. Quantitative findings such as ADC measurements and DCE curve analysis may have additional value to differentiate awdt from ndawt, but will require further analysis. 相似文献
10.
Purpose
To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE).Materials and methods
Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up.Results
All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up.Conclusion
US-guided HIFU ablation appears to be safe and effective for the treatment of AWE. 相似文献11.
Interventional MR imaging: percutaneous abdominal and skeletal biopsies and drainages of the abdomen
Since the introduction of open magnets and short-bore closed magnets, and the availability of fast imaging sequences, MR
imaging has become a tool for guidance and control of percutaneous nonvascular and vascular procedures. In general, percutaneous
biopsies or drainages require no specific hardware or software modifications. For lesion localization and control of the needle
track, simple fast imaging sequences such as fast T1-weighted gradient-echo techniques or fast single-shot T2-weighted spin-echo
sequences are sufficient and can be applied depending on the best tissue-to-lesion contrast. Typical scan times range from
1 to 3 s. Different types of biopsy needles are commercially available, allowing sampling of sufficient amounts of tissue.
For drainage procedures non-ferromagnetic materials, such as nitinol wires, should be preferred to minimize image distortion
by metallic artifacts. Indications for percutaneous biopsies include subdiaphragmatic liver lesions, lesions poorly visible
on ultrasound or contrast-enhanced computed tomography, and lesions of the bone marrow characterized by an unspecific bone
marrow edema. For percutaneous drainages, subdiaphragmatic lesions appear to be a good indication. With some experience the
procedure time is not longer than that under CT or US guidance. 相似文献
12.
We report an uncommon case of spontaneous massive hemorrhage of the abdominal wall caused by rupture of a deep iliac circumflex
(DIC) artery. Enhanced computed tomography (CT) demonstrated a marked extravasation in a huge hematoma of the abdominal wall.
Although a pelvic arteriogram demonstrated no extravasation, a superselective DIC arteriogram subsequently revealed an extravasation
of the artery. We successfully performed transcatheter arterial embolization for the artery. There have been few reports in
the literature of spontaneous hemorrhage in the abdominal wall resulting from rupture of DIC artery, which were defined by
diagnostic imaging and successfully treated by transcatheter arterial embolization.
Received 14 July 1997; Revision received 1 September 1997; Accepted 3 September 1997 相似文献
13.
The combination of biliary ascariasis and cholangiocarcinoma is rare. A 56-year-old female presented with progressive jaundice.
Ultrasonography revealed a curvilinear structure with anechoic center consistent with ascariasis within the dilated common
bile duct. Ultrasonography also demonstrated that a slightly echogenic soft tissue mass projecting into the mid segment of
the common bile duct proved to be coexistent cholangiocarcinoma. Percutaneous transhepatic cholangiography did not confirm
the presence of worm. In this report ultrasonographic and percutaneous transhepatic cholangiographic findings of the case
are described and the relative merits of these two techniques are discussed.
Received 5 June 1997; Revision received 30 July 1997; Accepted 30 September 1997 相似文献
14.
Kishi K Takifuji K Shirai S Sonomura T Sato M Yamaue H 《Acta radiologica (Stockholm, Sweden : 1987)》2006,47(2):157-161
Purpose: To report a technique of interstitial brachytherapy for the treatment of subcutaneous metastatic abdominal wall tumors.
Material and Methods: We developed a brachytherapy technique consisting of ultrasound-guided insertion of applicator needles to avoid the organs at risk, such as intestines, and saline injection into the subcutaneous tissue between the tumor and the skin to decrease the skin dose. We encountered three patients with painful metastases from rectal carcinoma in the abdominal wall refractory to external radiotherapy. They were subjected to this brachytherapy with a single dose of 20 Gy.
Results: The procedure was safely achieved in all three patients. Long-lasting pain reduction and tumor shrinkage was obtained without early or late complications.
Conclusion: This interstitial brachytherapy technique seems to be feasible in the treatment of metastatic abdominal wall tumors. 相似文献
Material and Methods: We developed a brachytherapy technique consisting of ultrasound-guided insertion of applicator needles to avoid the organs at risk, such as intestines, and saline injection into the subcutaneous tissue between the tumor and the skin to decrease the skin dose. We encountered three patients with painful metastases from rectal carcinoma in the abdominal wall refractory to external radiotherapy. They were subjected to this brachytherapy with a single dose of 20 Gy.
Results: The procedure was safely achieved in all three patients. Long-lasting pain reduction and tumor shrinkage was obtained without early or late complications.
Conclusion: This interstitial brachytherapy technique seems to be feasible in the treatment of metastatic abdominal wall tumors. 相似文献
15.
Abdominal wall hernias: imaging with spiral CT 总被引:4,自引:0,他引:4
Computed tomography is an accurate method of identifying the various types of abdominal wall hernias, especially if they
are clinically occult, and of distinguishing them from other diseases such as hematomas, abscesses and neoplasia. In this
study we examined the CT images of 94 patients affected by abdominal wall hernias observed over a period of 6 years. Computed
tomography clearly demonstrates the anatomical site of the hernial sac, the content and any occlusive bowel complications
due to incarceration or strangulation. Clinical diagnosis of external hernias is particularly difficult in obese patients
or in those with laparotic scars. In these cases abdominal imaging is essential for a correct preoperative diagnosis and to
determine the most effective treatment.
Received: 20 May 1999; Revised: 10 August 1999; Accepted: 13 August 1999 相似文献
16.
Quantification of abdominal aortic aneurysm wall enhancement with dynamic contrast‐enhanced MRI: Feasibility,reproducibility, and initial experience
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V. Lai Nguyen MD Walter H. Backes PhD M. Eline Kooi PhD Mirthe C.J. Wishaupt BS Femke A.M.V.I. Hellenthal MD PhD E. Marielle H. Bosboom PhD Rob J. van der Geest PhD Geert Willem H. Schurink MD PhD Tim Leiner MD PhD 《Journal of magnetic resonance imaging : JMRI》2014,39(6):1449-1456
17.
Weishaupt D Hetzer FH Ruehm SG Patak MA Schmidt M Debatin JF 《European radiology》2000,10(12):1958-1964
The aim of this study was to compare the performance of 3D MRI in conjunction with an intravascular contrast agent to spiral
contrast-enhanced CT, regarding the detection of abdominal parenchymal injuries as well as peritoneal hemorrhage in an animal
model. Liver and kidney injuries were created surgically in six female pigs under general anesthesia. All pigs underwent contrast-enhanced
spiral CT and 3D MR imaging following administration of an intravascular contrast agent (NC100150 Injection). Two readers
rated their confidence independently on MR and CT data sets using a five-point scale for the presence of organ injury and
hemoperitoneum. Autopsy findings served as standard of reference. Sensitivity and specificity for MR in detecting hepatic
and renal injuries as well as hemoperitoneum was 100 %. Computed tomography was less accurate with sensitivity and specificity
values of 90 and 94 %, respectively. Receiver operating characteristics (ROC) analysis revealed a higher confidence when interpretation
was based on MR images. In an animal model 3D MR imaging in conjunction with an intravascular contrast agent proved highly
accurate in detecting and localizing parenchymal injuries to the upper abdomen as well as in detecting intraperitoneal blood
collections.
Received: 4 November 1999, Revised: 5 May 2000, Accepted: 9 May 2000 相似文献