不同性质腹腔积液CT表现的分析探讨

目的:探讨不同性质腹腔积液的CT表现。方法:搜集除外伤及代谢类疾病外性质明确的17例腹腔积液患者的病例资料17例,观察分析其液体分布、量、CT值及合并脏器、腹膜腔改变的CT表现。结果:3例脏器肿瘤破裂、1例小肠腺癌腹腔广泛转移及2例结核性腹膜炎为大量积液,8例胃肠道炎症、穿孔可有少量(4例)、中量(2例)和大量(2例)不同的积液表现。2例肿瘤腹膜种植转移的重要CT表现为中量～大量腹水及肠壁、腹膜增厚强化,或发现存在于腹腔内强化结节。3例肿瘤破裂腹水CT值达38～72HU,明显高于其它原因所致腹腔积液(8～42HU),2例肿瘤引起腹水而腹腔未见转移灶,腹水CT值不高(6～12HU)。结论:CT检查对于了解腹腔积液的范围、积液量、积液的性质和来源有重要意义,全面分析、综合考虑有助于提高CT对腹腔积液的诊断能力。     

急性胰腺炎并发症的CT研究及其解剖基础分析

目的：研究急性胰腺炎并发症的CT表现，并分析其解剖基础。材料和方法收集经临床证实的120例急性胰腺炎病例的CT资料，观察其并发症的CT表现，分析其解剖基础。结果：CT显示并发症为腹膜后和腹腔积液，肝、肿、肾、胃、肺等脏器损害及亚腹膜间隙受累。结论：急性胰腺炎并发症主要为多间隙积液及箩脏器受累。积液的分布与腹腔、腹膜后间隙的解剖结构及其相互通连情况密切相关，亚腹膜间隙是病变扩散的重要途径。     

腹腔积液声像769例特征分析

对７６９例腹水患者根据腹膜腔的解剖特征，对腹腔积液的分布情况、腹腔积液量的估算、腹腔积液伴腹膜改变及多浆膜腔积液观察其声像特征并作分析。提出腹腔积液粗定量的意见；结核性腹腔积液与肿瘤性腹腔积液的不同声像特征及鉴别点；腹腔积脓的声像特征。结果表明：对腹腔积液声像的特征分析，为临床诊断提供了准确依据。     

腹腔和腹膜后间隙结核的CT表现及其病理基础

目的：明确腹腔、腹膜后间隙结核的ＣＴ表现与病理基础的相关性。材料和方法：对１３例淋巴结结核、２例结核性腹膜炎以及２例淋巴结结核合并结核性腹膜炎采用ＣＴ增强扫描，观察其病变的形态、密度及解剖分布。结果：淋巴结结核表现为淋巴结增大，增强扫描呈环状强化，可融合成多房样肿块，主要分布于系膜、网膜及Ｌ２平面以上的腹膜后间隙；而结核性腹膜炎ＣＴ表现为腹水密度较高，网膜、系膜上斑片和结节影，网膜增厚，卷缩成不规则肿块，受累的系膜、网膜与肠曲粘连、固定。结论：淋巴结结核病理改变决定其ＣＴ增强扫描特征以及优势解剖分布；ＣＴ扫描可揭示结核性腹膜炎解剖病理特点。     

闭合性腹部外伤肠破裂的CT表现

目的：探讨闭合性腹部外伤性肠破裂的CT表现。材料与方法：对32例经手术证实的闭合性外伤性肠破裂的CT资料进行回顾性分析。结果：32例中腹腔积气22例(膈下、肠管及肠系膜间、腹膜后间隙)；腹腔积液30例(肠管及其系膜间隙及腹腔间隙)；肠梗阻11例；合并胸腹部脏器损伤15例。结论：1．肠管及腹膜后积气是肠破裂的可靠征象；2．肠管壁血肿和增厚，肠管及其系膜间隙增帘模糊。合并腹腔积液可提示诊断。     

CT扫描上腹部层面胸腔积液与腹腔积液的CT表现及鉴别

在上腹部ＣＴ扫描层面上，胸腔积液及腹腔积液的表现也会混淆，容易误诊。本文对３２例胸腔积液和腹腔积液的ＣＴ表现进行分析，并探讨胸腔积液与腹腔积液的ＣＴ表现及其鉴别要点。１材料与方法我院ＣＴ室１９９３年９月至１９９４年９月经ＣＴ扫描发现胸腔积液或／和腹腔...     

腹腔和腹膜后间隙结核的CT诊断

探讨腹腔和腹膜后间隙结核的CT表现特征及其解剖病理基础。材料和方法：回顾性分析8例淋巴结结核，7例淋巴结结核合并结核性腹膜炎及4例结核性腹膜炎的CT表现。结果：淋巴结结核主要表现为淋巴结肿大，增强扫描呈环状强化，可融合成分隔状肿块，主要累及肠系膜、网膜、胰周及L2平面以上腹膜后间隙，且腹腔淋巴结受累程度明显重于腹膜后间隙淋巴结。结核性腹膜炎之腹水密度较高，系膜、网膜上有斑片状及结节状病灶，肠曲粘连固定。结论：CT扫描可反映淋巴结结核及结核性腹膜炎的解剖病理改变特征。     

结核性腹膜炎的CT诊断(附11例报告)

目的：探讨结核性腹膜炎的ＣＴ表现。材料与方法：搜集１１例有ＣＴ检查资料的结核性腹膜炎病例进行分析,其中５例经手术病理证实,６例由抗痨治疗效果显著而确诊。结果：１１例结核性腹膜炎的ＣＴ表现如下：（１）腹水９例,其中７例表现为高密度腹水（ＣＴ值大于２０ＨＵ）,３例表现为腹腔包裹性积液;（２）壁腹膜光滑增厚７例,轻度不规则增厚１例,其中２例增强扫描时壁腹膜有强化;（３）１１例肠系膜均有改变,表现为增厚、结节状或“污点”状影;（４）大网膜饼形增厚、结节状或“污点”状改变５例。结论：ＣＴ对诊断结核性腹膜炎有较大价值,其主要鉴别诊断为腹膜转移癌。     

肾周间隙CT扫描的临床意义

本文总结了１８例肾周间隙内积血、２８例积脓和３７例肾癌累及肾周间隙共８３例的ＣＴ征象。ＣＴ主要表现为不同程度的肾周筋膜增厚；肾周间隙内纤维间隔线增粗；肾周间隙内积血积脓呈局限或包囊性分布；腰大肌受累等。根据肾周间隙解剖，认为肾周间隙内纤维间隔线有限制积液的扩散作用，并因腹主动脉和下腔静脉的阻挡，血或脓液等较稠的液体不进入对侧肾周间隙。     

胃肠道钝伤的CT表现及诊断价值

目的：探讨胃肠道钝伤的ＣＴ特征及临床价值。方法：回顾性分析经手术证实的８例胃肠道钝伤者的ＣＴ表现。结果：①损伤特异性征象：腹腔积气４例;②提示性征象：肠壁 增厚４例,肠系膜增厚,浸润２例,肠管间系膜积液４例,肠管扩大１例;③腹腔积液８例。结论：胃肠道损伤的ＣＴ表现对定性、定位诊断,并发症显示具有重要的价值,适宜的扫描技术可为诊断提供重要信息。     

Feasibility of 19F imaging of perfluorochemical emulsions to measure myocardial vascular volume.

19F magnetic resonance images were obtained of the ventricular walls of isolated rabbit hearts perfused with a perfluorochemical (PFC) emulsion. Since the PFC is known to stay within the vascular space in normal myocardial tissue, the 19F signal should reflect myocardial vascular volume. 19F MRI of PFC emulsions represents a new investigational tool for the study of coronary vascular volume.     

Validation of 19f-magnetic resonance determination of myocardial blood volume

The use of perfluorochemical (PFC) emulsions to study the myocardial circulation by means of ¹⁹F NMR requires that the biodistribution of the PFC be known. The authors tested the hypothesis that PFC particles remain within the myocardial vascular space by infusing rats with both a PFC emulsion and ¹²⁵I-albumin. Measurement of myocardial vascular volume by ¹⁹F NMR and by standard radiotracer analysis of the same tissue yielded concordant values by the two methods, establishing the PFC emulsion as an intravascular agent in this tissue. Perfluorochemical emulsions should be useful for the noninvasive study of myocardial vascular physiology by magnetic resonance.     

健康成人直肠刺激脑fMRI研究

目的:运用功能磁共振成像(f MRI)探讨健康成年人直肠内气囊扩张刺激后脑内活动区的分布和状况。方法:11例健康志愿者,以不同气体量进行直肠内气囊扩张刺激,以静息-刺激为一个周期,得到脑f MRI图像并将其与T1WI进行图像融合,测量脑内活动区的面积和信号强度并进行统计学分析。结果:直肠内气囊扩张刺激明显激活扣带回前皮层(ACC,11/11),脑岛皮层(IC,11/11),前额叶皮层(PFC,11/11)和丘脑(THAL,9/11)。在注气量达到90ml和120ml时,均以ACC内活动区面积最大,以PFC和ACC内活动区MRI信号强度变化幅度最大。结论:健康成年人直肠内气囊扩张刺激,脑内激活区主要位于ACC和PFC,其次是IC和THAL,提示这些区域是脑内内脏感觉中枢的组成部分。f MRI能够反映大脑中枢的活动。     

Decompression sickness in a swine model: isobaric denitrogenation and perfluorocarbon at depth

INTRODUCTION: Disabled submarine survivors could achieve inert gas tissue saturation likely to cause severe decompression sickness (DCS) on surfacing. This risk increases with time and depth of exposure. Methods to reduce DCS risk and severity are needed specifically for such an operational scenario. METHODS: Yorkshire swine (16.2-26.6 kg) fitted with an external jugular catheter were compressed to 5 ATA for 22 h. They then received an enriched breathing mix of 44% N2 and 56% O2, and an infusion of either saline or a perfluorocarbon (PFC) emulsion, and were observed for 2 h before surfacing without decompression stops. Controls were surfaced after 22 h saturation at 5 ATA. Surface observations continued for another 2 h on all animals and signs of DCS were recorded to the nearest minute. RESULTS: Seizure activity at depth was noted in 0/26 controls, 1/16 in the saline group, and 7/16 in the PFC group. DCS in < 2 h occurred in 25/26 air controls, 2/15 in the enriched mix/saline group, and 4/9 not suffering seizure in the enriched mix/PFC group. Death in < 2 h occurred in 23/26 controls, 1/15 in the saline group, and 1/9 in the PFC group. DISCUSSION/CONCLUSION: This study demonstrates the benefits of breathing increased O2 at depth prior to rapid decompression and the deleterious effects of PFC administration at depth in a swine saturation model with rapid decompression. Future studies should examine a minimal O2 pre-breathe period to offer protection against DCS as well as the role of PFC use after surfacing.     

螺旋CT多平面重建对腹膜后神经源性肿瘤的诊断价值

目的:探讨螺旋CT容积扫描结合多平面重建(MPR)在对腹膜后神经源性肿瘤诊断中的临床应用价值.方法:21例经手术和病理证实腹膜后神经源性肿瘤行螺旋CT容积扫描,结合MPR征象进行对比分析,观察肿瘤的位置、大小、密度、形态及与邻近结构的关系.结果:21例腹膜后肿瘤,良性17例,恶性4例.良性肿瘤大多圆形或类圆形软组织肿块...     

Treatment of decompression sickness in swine with intravenous perfluorocarbon emulsion

BACKGROUND: We examined an adjunctive treatment for severe decompression sickness (DCS) to be used when hyperbaric treatment is delayed or unavailable. HYPOTHESIS: It has been hypothesized that intravenous perfluorocarbon (PFC) emulsion combined with 100% inspired O2 would improve the outcome in severe DCS. METHODS: Swine (n = 45) were compressed to 4.9 ATA on air for 22 h and brought directly to 1 ATA at 0.9 ATA min(-1). The animals were then randomized to three groups. The first group breathed ambient air, the second group breathed 100% O2, and a third group received 6 ml x kg(-1) of perflubron emulsion (Oxygent) intravenously and breathed 100% O2. Outcomes of neurological and cardiopulmonary DCS and death were recorded. RESULTS: Animals that received PFC emulsion sustained less DCS (p < 0.01) than the other groups (53% vs. 93%). No animals in the PFC group sustained neurological DCS, which was present in 69% of the subjects in the other two groups. CONCLUSION: O2 breathing postdive did not significantly reduce morbidity or mortality in this model. Postdive treatment with PFC emulsion and 100% O2 decreased the incidence of DCS after nonstop decompression from saturation.     

Combined effects of intravenous perfluorocarbon emulsion and oxygen breathing on decompression-induced spinal cord injury in rats

The spinal cord is one of the most commonly affected sites in decompression sickness (DCS). Alternative methods have long been sought to protect against DCS spinal cord dysfunction, especially when hyperbaric treatment is unavailable. Use of perfluorocarbon (PFC) emulsion with or without oxygen breathing has shown survival benefits in DCS animal models. The effectiveness of intravenous PFC emulsion with oxygen breathing on spinal cord function was studied. Somatosensory-evoked potentials (SSEPs) and histologic examination were chosen to serve as measures. After fast decompression (203 kPa/minute) from 709 kPa (for 60 minutes), male Sprague-Dawley rats randomly received: 1) air and saline; 2) oxygen (O2) and saline; 3) O2 and PFC emulsion. The incidence and average number of abnormal SSEP waves in survival animals that received O2 and PFC emulsion were significantly reduced (P < 0.05). Foci of demyelination, necrosis and round non-staining defects in white matter regions of the spinal cord could be found in severe DCS rats. We concluded that administration of PFC emulsion combined with oxygen breathing was beneficial for DCS spinal conductive dysfunction in rats.     

PET imaging of the brain serotonin transporters (SERT) with N,N-dimethyl-2-(2-amino-4-[18F]fluorophenylthio)benzylamine (4-[18F]-ADAM) in humans: a preliminary study

Purpose

The aim of this study was to assess the feasibility of using 4-[¹⁸F]-ADAM as a brain SERT imaging agent in humans.

Methods

Enrolled in the study were 19 healthy Taiwanese subjects (11 men, 8 women; age 33?±?9?years). The PET data were semiquantitatively analyzed and expressed as specific uptake ratios (SUR) and distribution volume ratios (DVR) using the software package PMOD. The SUR and DVR of 4-[¹⁸F]-ADAM in the raphe nucleus (RN), midbrain (MB), thalamus (TH), striatum (STR) and prefrontal cortex (PFC) were determined using the cerebellum (CB) as the reference region.

Results

4-[¹⁸F]-ADAM bound to known SERT-rich regions in human brain. The order of the regional brain uptake was MB (RN) > TH > STR > PFC > CB. The DVR (n?=?4, t*?=?60?min) in the RN, TH, STR and PFC were 3.00?±?0.50, 2.25?±?0.45, 2.05?±?0.31 and 1.40?±?0.13, respectively. The optimal time for imaging brain SERT with 4-[¹⁸F]-ADAM was 120?C140?min after injection. At the optimal imaging time, the SURs (n?=?15) in the MB, TH, STR, and PFC were 2.25?±?0.20, 2.28?±?0.20, 2.12?±?0.18 and 1.47?±?0.14, respectively. There were no significant differences in SERT availability between men and women (p?<?0.05).

Conclusion

The results of this study showed that 4-[¹⁸F]-ADAM was safe for human studies and its distribution in human brain appeared to correlate well with the known distribution of SERT in the human brain. In addition, it had high specific binding and a reasonable optimal time for imaging brain SERT in humans. Thus, 4-[¹⁸F]-ADAM may be feasible for assessing the status of brain SERT in humans.     

支气管动脉造影栓塞治疗老年大咯血的临床分析(附50例报告)

目的:探讨支气管动脉造影栓塞治疗老年大血的临床疗效。方法:对50例老年大咯血患者采用选择性支气管动脉造影栓塞进行治疗。采用Seldinger法经皮动脉插管,作选择性支气管动脉造影,证实出血动脉后,用明胶海绵行支气管动脉栓塞。结果:45例即时止血,5例在15h内出血停止。42例在拴塞后35天又出现小量的咯血,4例在6个月后反复咯血,4例在1年后又出现痰血或间歇性痰中带血丝。结论:选择性支气管动脉造影栓塞术为治疗老年大咯血有效、安全的微创手术。