肺栓塞的影像学诊断

探讨肺栓塞与肺梗死的影像学的诊断价值。方法对２０例临床疑诊为肺动脉栓塞的病人进行了胸部Ｘ线平片,核素肺灌注扫描和数字减影肺动脉造影诊断对比。结果数字减影肺动脉造影阳性发现１０例,以此为金标准,胸部Ｘ线平片检查,敏感性４２．９％特异性３３．３％;核素肺灌注扫描检查,敏感性７２．７％特异性７７．８％。     

胸部创伤的X线—CT诊断

探讨闭合性及开放性胸部创伤的ＣＴ表现及诊断价值，笔者对６９全胸部创伤者进行临床，Ｘ线平片，ＣＴ扫描诊断，对Ｘ线平片与ＣＴ片进行了对比分析。结果 ＣＴ表现为肺挫伤５１例，肺撕裂伤１２例，Ｘ线平片分别漏，误诊２１例和７例。结论ＣＴ能明确创伤病变的部位，性质，程度，敏感性和特异性高，为临床诊断及处理提供较单纯Ｘ线平片更多的信息及可靠的依据，为胸部创伤最重要的检查方法之一。     

小儿肺包虫病的X线表现（附126例胸部平片分析）

小儿肺包虫病的Ｘ线表现（附１２６例胸部平片分析）绽得庆肺包虫病是犬绦虫蚴肺内寄生所引起的包虫囊肿，在我国西北和内蒙等牧区较为常见。现从我院小儿肺包虫病例中，挑选出病历和Ｘ线资料比较完整的１２６例，重点分析胸部平片的Ｘ线表现，以供临床参考。一般临床资料...     

胸外伤X线平片和CT检查的评价

Ｘ线检查是发现胸部创伤最好的手段［１４］。ＣＴ的广泛应用，使更多的外伤病人特别是多发伤病人得以早期诊治。笔者从１９９３年起研究胸外伤病人的Ｘ线检查应用，根据外伤患者就诊的特点使之得以及时、合理、准确的检查。资料与方法本组１２４例除进行常规Ｘ线平片检查外，还接受了ＣＴ检查。由于胸部创伤病人多为急诊，大部分病例在Ｘ线平片检查时仅采用了仰卧前后位；少部分病人在摄取直立后前位胸部平片外，根据病情的允许和需要加摄特殊体位。ＣＴ扫描采用日本岛津４８００－ＴＦＣＴ机，以１０ｍｍ层厚进行胸部检查，部分病人增加…     

脓毒性肺栓塞:CT与常规X线对照

回顾性比较15例临床证实脓毒性肺栓塞的X线与CT征象。多数病例的X线表现不具特征性;相比之下,所有病例CT扫描能发现具有特征性改变,包括15例中10例(67％)周围肺结节与供血血管相连,并有播散性肺脓肿,15例中11例(73％)胸膜下楔形密影伴有或没有脓毒性梗塞引起的坏死。CT亦较易显示副裂、纵隔、腋窝及心包的异常。我们认为诊断脓毒性肺栓塞CT可以与其它影像技术相互补充。脓毒性肺栓塞产生一系列X线异常。尽管肺栓塞的平片、血管造影及闪烁照相征象已很熟悉,但其CT征象极少给予关注。本文目的在于综述一组临床证实脓毒性肺栓塞的胸部平片及CT征象。     

肺部病变的X线定位诊断

胸部Ｘ线平片包括胸壁、胸膜、胸腔、肺、纵隔、心血管及横膈等解剖结构。由于解剖结构相互叠加,不同的病变又可有相类似之影像,因此,单纯依靠胸部平片鉴别疾病位于肺、胸腔、纵隔、横膈有一定困难。虽然,ＣＴ检查对胸部病变的鉴别有一定帮助,但目前它尚不能取代普通Ｘ线检查。为了提高对胸部平片的诊断技能,本文就肺部病变的Ｘ线定位诊断知识作一重点介绍。判断病变是否在肺内肺部病变定位应根据胸部不同部位的Ｘ线特点,采用排除法来确定病变是位于肺内或是肺外肺内病变有一重要特点是按肺叶、肺段分布,且肺动脉又与支气管分支相伴行,有时…     

肺癌的X线胸片和胸部CT检查对比分析

肺癌的Ｘ线胸片和胸部ＣＴ检查对比分析胸外科王桂洪，臧德安，张文主题词：肺肿瘤；放射造影术；Ｘ线计算机断层摄影术经验交流对肺癌病变的估计和临床分期对手术病例的选择至关重要，纵隔淋巴结转移的病人手术疗效差。然而术前对纵隔的估计尚有一定的困难。本院自１９８...     

胸部创伤的X线-CT诊断(附69例分析)

目的探讨闭合性及开放性胸部创伤的ＣＴ表现及诊断价值。材料与方法笔者对６９例胸部创伤患者进行临床、Ｘ线平片、ＣＴ扫描诊断，对Ｘ线平片与ＣＴ片进行了对比分析。结果ＣＴ表现为肺挫伤５１例，肺撕裂伤１２例，Ｘ线平片分别漏、误诊２１例和７例。结论ＣＴ能明确创伤病变的部位、性质、程度，敏感性和特异性高，为临床诊断及处理提供较单纯Ｘ线平片更多的信息及可靠的依据，为胸部创伤最重要的检查方法之一。     

急性脑血栓性栓塞的核素显像诊断与疗效判断

目的 评价核素显像对急性肺血栓性栓塞的诊断与疗效评价的价值。方法对１０例临床确诊或可疑为肺栓塞的患者进行核素肺灌注、肺通气、肺血栓灶以及双下肢深静脉显像，４例与肺动脉造影或电子束ＣＴ结果对照。８例患者溶栓后复查肺灌注显像，２例患者昨查肺血栓灶显像，结果 肺灌注显像＋下肢深静脉显像对急性肺栓塞诊断的阳性率为１００％，与Ｘ线检查结果基本一致，溶栓后复查提示肺血流均有明显改善乃至恢复正常。结论 核素显像     

CT在胸部常见疾病诊断中的应用（附74例分析）

本文总结了二年中较为典型的７５例ＣＴ检查病例结合胸部Ｘ线所见，例重于对Ｘ线与ＣＴ对比，强调ＣＴ在胸部疾病中的应用价值。     

64层螺旋CT三维成像在肋骨及肋软骨损伤病变中的应用

目的探讨多层螺旋CT三维成像在肋骨及肋软骨损伤中的临床应用价值。方法回顾性分析20例肋骨及肋软骨骨折病例,采用MIP、SSD和VRT技术进行肋骨及肋软骨三维重建,并与X线平片和轴扫资料对照。结果7例X线平片、5例常规平扫不能确诊,经图像后处理明确了诊断;3例在三维图像中可疑或未显示骨折,结合MPR(包括曲面重建)明确了骨折。结论多层螺旋CT三维成像对肋骨及肋软骨骨折的显示优于普通X线及常规胸部轴位扫描,尤其对临床可疑肋骨及肋软骨损伤者是一种重要的补充检查手段。     

SARS的临床与影像分析

目的 总结SARS患者的临床及胸部影像学资料，以期提高对这一烈性传染病的认识。方法回顾性分析175例临床诊断SARS患者的临床和影像学资料。175例患者共摄胸片1060张，行CT扫描20例次。结果SARS的典型影像学表现为双侧或单侧多叶、多片的肺实质浸润，共97例(59．5％)，61例(37．4％)为局限性单侧肺浸润。以快速进展变化为特征；病死率为8．0％。结论胸部影像异常是SARS诊断的必要指标，系列X线平片可以观察SARS的病情变化，指导治疗并提示预后，CT能够早期检出SARS肺部的异常征象。     

Displacement of coils into the lung during embolotherapy: clinical importance and follow-up with helical CT

RATIONALE AND OBJECTIVES: The authors performed this study to evaluate the clinical importance and computed tomographic (CT) appearance of coils displaced into the lung during embolotherapy. MATERIALS AND METHODS: The authors retrospectively studied clinical charts and serial chest images from 25 consecutive patients after coil embolization. Chest radiography was performed in all patients, whereas helical chest CT was performed only in patients in whom dislocated coils were visible on chest radiographs. Coils were applied for the treatment of peripheral arteriovenous (AV) malformations and fistulas (n = 9), renal AV malformations or fistulas (n = 8), and primary or secondary tumors (n = 8). Clinical charts were analyzed for short- and long-term symptoms; chest radiographs and CT scans were reviewed for signs indicative of pulmonary infarction. RESULTS: None of the patients had clinical symptoms suggestive of pulmonary infarction. In two of the 25 patients (8%), displaced coils were seen in the pulmonary vasculature at chest radiography; these patients had been treated for renal AV fistula and peripheral AV fistula, respectively. One patient had two coils in the left hemithorax (upper and lower lobe), and the other patient had two coils in the right hemithorax (middle lobe). Neither of the patients had abnormalities suggestive of pulmonary infarction at helical CT. CONCLUSION: Chest radiography can help confirm the presence of coils displaced to the pulmonary vasculature during embolotherapy. Helical CT can also help rule out the presence of coil-associated pulmonary infarction.     

高分辨力CT诊断和鉴别诊断肺结核的价值

目的探讨高分辨力CT诊断和鉴别诊断肺结核的价值.材料和方法回顾性分析经手术、活检/临床治愈证实的肺结核病76例.全部病例均做了胸部平片和HRCT扫描,其中24例做了CT增强扫描.结果HRCT能够发现平片和CT常规不能或不能全部显示的许多征象,如小叶中心分布的气腔结节,小气道结节(树芽征),肺间质异常和马赛克灌注等.结论HRCT能够对肺结核做出准确诊断.     

严重急性呼吸综合征的X线与CT特征

目的 探讨严重急性呼吸综合征(SARS)的X线平片与CT特征。资料与方法回顾性分析17例经临床证实为SARS的X线平片与CT表现。结果 X线平片显示双肺受累12例，CT显示13例。X线平片与CT共显示双肺受累15例，受累肺叶46叶，受累肺段103个。14例病变主要表现在肺的周边部，且以下叶多见。9例病变进展迅速。结论 SARS的影像表现是肺内出现浸润性病变，分布在肺周边部，下叶多见，进展迅速。结合 临床可提供诊断依据。     

Cystic fibrosis: a comparison of computed tomography and plain chest radiographs

In patients with cystic fibrosis, plain chest radiographs may suggest the presence of bronchiectasis, bronchoceles, hilar adenopathy, or pulmonary arterial hypertension. We compared computed tomography (CT) with conventional chest radiography in 12 patients. CT clearly reveals the cause of increased linear markings, nodular lesions, and enlarged hila as seen on plain chest radiographs. It showed that nine patients had hilar adenopathy, five had enlarged pulmonary arteries, and 11 had bronchiectasis. Bronchoceles, a finding that may influence therapy, were seen on seven CT scans but on only four of the plain films.     

Small bowell volvulus - combined radiological findings]

PURPOSE: We retrospectively evaluated the radiological findings observed at plain abdominal film, abdominal sonography and abdominal CT performed in 66 patients with surgically proven small bowel volvulus. MATERIAL AND METHODS: Sixty-six patients (35 women and 31 men, ranging in age 38-77 years) with surgically proven small bowel volvulus were submitted to plain film, sonography and CT of the abdomen. Abdominal plain film was performed in the upright position (postero-anterior view) in 46 cases, and in the supine position in 20 cases. On plain abdominal film we evaluated the following findings: bowel loops dilatation, air-fluid levels and site of obstruction. At abdominal US, performed with 3.5 e 7.5 MHz probes, we retrospectively searched for: bowel loop dilatation, bowel wall thickening, peristalsis alteration, extraluminal fluid. CT was performed with a helical unit (thickness 4 mm, reconstruction interval 4 mm, pitch 1.5), after intravenous contrast agent (120 ml) infusion (3 ml/s, 55 s acquisition delay from bolus starting) and using a power injector. The following CT findings were searched for: whirl sign, beak sign, extraluminal fluid, bowel loop dilatation, bowel wall thickening, bowel wall or mesenteric alterations. RESULTS: Plain abdominal film showed the following findings: air-fluid levels (92.4% of cases), bowel loops dilatation (71.2%), site of obstruction (42.4%). Abdominal sonography demonstrated bowel loop dilatation (48.5%), extraluminal fluid (48.5%), peristalsis alteration (27.3%), bowel wall thickening (27.3%). The most frequent CT findings were: bowel loop dilatation (95.5%), bowel wall thickening (78.8%), beak sign (69.7%), mesenteric alterations (66.7%), extraluminal fluid (54.5%), whirl sign (13.6%). CONCLUSIONS: Air-fluid levels and bowel loop dilatation were the most frequent radiological findings in our series. Plain abdominal film allowed us to identify signs of obstruction, whereas signs of bowel wall necrosis were accurately shown by abdominal CT.     

37例肺部肿中瘤平片漏诊因素的探讨(附37 例分析)

目的探讨肺部CT扫描在脑转移瘤诊断中的作用。材料和方法分析37例脑转移瘤病例肺部平片为阴性而CT为阳性的影像特点及平片漏诊的原因。结果胸部平片漏诊的原因为肺癌位于纵隔后脊柱侧方的肺段24(24/37)例,主支气管或段支气管7例(7/37),胸片观察漏诊5例(5/37)。31例(31/37)肺部病灶的最大直径小于脑内转移的最大直径。结论肺部CT扫描可以有效地检测肺部恶性病灶,提高颅脑转移瘤肺部原发病灶的检出率。     

骨肉瘤的CT征象

目的 总结骨肉瘤的ＣＴ征象及其特点。方法 分析４０例经手术病理证实的骨肉瘤的ＣＴ,Ｘ线平片征象和病理切片,３２例平扫,８例平扫后行增强扫描,病理检查４０例,其中病理大切片９例,结果 骨肉瘤的基本征象有骨质破坏,肿瘤骨形成,骨膜反应及软组织肿块,这些征象在平片,ＣＴ上均可见到,但两者的表现有所不同,ＣＴ还可显示平片不可或难以发现的征象,肿瘤与周围软组织的分界,肿瘤坏死,出血,肿瘤侵犯关节及跳跃性病灶     

军团菌肺炎的胸部CT表现（附14例分析）

目的：了解军团菌肺炎的ＣＴ表现特点及ＣＴ能否提供较平片更多有利于本病诊断及治疗的信息，材料与方法，收治１４例经临床及血清学证实的军团菌肺炎患者，分析其胸部ＣＴ表现特点，并与平片进行对比分析，结果：ＣＴ扫描示病变呈多叶段受累者１１例，大片及斑片状阴影为最常见的表现，见于本组１０例患者，空洞病变３例，其中１例似金葡萄菌肺炎表现余１列表现双肺弥漫毛玻璃密度及索条影，在本组病例中，１０例伴胸腔积及胸膜肥厚