腹膜后纤维化的影像学诊断

目的:探讨腹膜后纤维化(retroperitoneal fibrosis,RPF)的影像学表现及其鉴别诊断。方法:回顾性分析5例经病理证实为RPF的影像学表现。5例均行CT、MRI平扫和增强扫描。结果:5例中弥漫型4例,肿块型1例。CT平扫可呈低密度或等密度,增强扫描显示不同程度强化,MRI T1WI、T2WI呈低信号。结论:RPF的影像学表现有一定的特征性,可提示其诊断。     

腹膜后纤维化的影像学诊断

目的:探讨腹膜后纤维化(retroperitoneal fibrosis,RPF)的影像学表现及其鉴别诊断。方法:回顾性分析5例经病理证实为RPF的影像学表现。5例均行CT、MRI平扫和增强扫描。结果:5例中弥漫型4例,肿块型1例。CT平扫可呈低密度或等密度,增强扫描显示不同程度强化,MRI T1WI、T2WI呈低信号。结论:RPF的影像学表现有一定的特征性,可提示其诊断。     

腹盆部巨大淋巴结增生症的CT表现

目的:探讨腹盆部巨大淋巴结增生症的CT特征性表现。方法:回顾性分析5例发生于腹盆部,经病理证实的巨淋巴结增生临床资料,5例均行CT平扫及动态增强扫描。结果:5例均为透明血管型,2例伴有子灶,1例肿块内见散在斑点状钙化。CT动态增强扫描,5例均见动脉期显著强化、门静脉期、延迟持续强化,其中肿块内有钙化的1例不均匀强化。结论:腹部巨大淋巴结增生症的CT表现具有一定特征性,CT动态增强扫描可提高其诊断正确率,减少误诊。     

胸腹部巨大淋巴结增生症的CT和MR诊断

目的 了解巨大淋巴结增生症的CT和MRI表现以及与病理改变的联系。材料与方法 搜集我院8年间资料完整的13例巨大淋巴结增生症,均经手术及病理证实。其中胸部8例,腹部5例。局限性10例,弥漫性3例。病理诊断为透明血管型10例,浆细胞型3例。13例中10例行CT平扫和增强扫描,6例行MRI检查,其中3例同时作CT及MRI检查。MRI采用的序列为T1WI、T2WI以及梯度回波快速增强扫描。结果 局限性肿块均大于3cm,最大为6cm。弥漫性肿块大小不等,最大为3．5cm。肿块呈圆形、类圆形,部分伴有分叶,轮廓光滑。除3例伴有钙化外,CT平扫均为等密度。增强后透明血管型均有明显强化,且持续时间较长;浆细胞型则呈轻－中度强化。MR SE序列T1WI肿块呈等信号,T2WI呈高信号,并伴有扭曲扩张的流空小血管。Gd-DTPA增强扫描表现与CT大致相仿。结论 巨大淋巴结增生症的CT和MRI表现与病理改变密切相关。对透明血管型病例的术前明确诊断是可能的。     

腹盆部横纹肌肉瘤的CT表现(附5例报告)

目的探讨腹盆部横纹肌肉瘤的CT临床表现特征。方法回顾性分析5例经病理证实的腹盆部横纹肌肉瘤的CT表现。1行增强动脉期扫描,4例同时行增强三期扫描。结果 3例发生于腹腔,2例发生于盆腔,3例边界均模糊不清,2例可见假包膜形成。CT平扫显示5例均为不规则巨大软组织肿块,瘤内可见带、团状低密度区,1例可见散在斑点状高密度灶。5例肿瘤在CT增强扫描中动脉期均表现为轻中度不均匀强化,4例在静脉期显示肿瘤强化程度增高,平衡期强化度减弱,假包膜未见强化。5例周缘均未见明确肿大淋巴结。结论若出现腹盆部巨大密度不均匀软组织肿块,CT三期增强以静脉期强化明显,横纹肌肉瘤应纳入鉴别诊断中,最终确诊依靠病理检查。     

大鼠种植型肝癌电化学治疗后影像学特征的改变

目的 了解大鼠种植型肝癌电化学治疗前后的影像学特征变化。方法 采用直接注射法制作大鼠肝癌动物模型，应用CT、MRI观察大鼠种植型肝癌电化学治疗前后肿瘤大小、密度、边缘、强化、信号等影像学特征变化。结果 大鼠肝癌种植后7d，种植肝叶均可见类圆形、单发瘤灶影，大小约0．6～0．8cm，CT平扫为低密度，增强后边缘强化；MRI扫描T1WI为低信号．T2WI为高信号。电化学治疗后7d，CT平扫均为低密度，增强后无明显强化；MRI扫描T1WI为高信号为主混杂信号，T2WI为相对低信号。结论 大鼠种植型肝癌电化学治疗前后影像学特征分析有助于评价治疗效果。     

中枢神经系统白血病的CT及MRI主要表现

目的 分析经临床证实的11例中枢神经系统白血病的CT及MRI表现,探讨其影像学特征,增进对该病的认识,为临床诊断提供依据.方法 回顾性分析经临床证实的11例中枢神经系统白血病CT及MRI的影像学表现.其中4例CT平扫后行MRI平扫及增强扫描检查;其余7例直接行MRI平扫或平扫+增强扫描检查.结果 ①白血病浸润软脑膜5例,CT表现为脑沟、脑池消失,内可见条状低密度灶,对应MRI表现为T1WI呈低信号,T2WI/FLAIR呈高信号,脑回肿胀,DWI呈稍高信号,增强后明显强化;合并蛛网膜下腔出血1例.②脑实质浸润6例,单发肿块2例,余均为多发,MRI表现T1WI低信号,T2WI/FLAIR高信号,DWI高信号,无明显占位效应,增强后明显强化;其中3例合并出血.③硬脑膜受累1例,累及额部板障,CT表现为软组织密度灶,MRI表现为软组织信号灶,增强后明显强化.结论 中枢神经系统白血病影像学表现有一定的特征性,影像学检查尤其是MRI增强检查有助于对中枢神经系统白血病表现的认识,以及诊断及鉴别诊断.     

肺血管外皮瘤的影像学诊断

目的　探讨肺血管外皮瘤的影像学表现。方法　分析 3例经病理证实的肺血管外皮瘤的CT、MRI表现。结果　 3例患者均表现为肺内单发的巨大肿块 ,CT平扫示密度不均匀 ,强化扫描示肿块实质明显强化 ,并可以见到其中异常强化的血管影。MRI平扫示肿块信号不均匀 ,并可以见到血管流空征象。结论　肺内单发的巨大肿块 ,CT强化扫描见到异常强化的血管 ,MRI扫描见到血管流空征象 ,可以高度提示肺血管外皮瘤的诊断     

小儿腹盆部横纹肌肉瘤的CT、MRI表现

目的：分析小儿腹盆部横纹肌肉瘤（RMS）的CT/MRI特点,为临床提供影像学诊断依据。方法：回顾性分析8例RMS患儿的临床资料,结合相关文献总结该病的CT/MRI图像特征。结果：8例肿块均较大,位于膀胱直肠隐窝6例,腹膜后2例。CT平扫密度均匀,2例内部见偏向性带状、团片状低密度区,1例见斑片状高密度区;增强扫描动脉期呈轻中度不均匀强化,边缘强化较中心明显,静脉期及延迟期持续强化。3例瘤体内见迂曲走行的供血动脉,2例内部低密度区无明显强化。MRI平扫T₁WI呈均匀等低信号,T₂WI呈不均匀高信号,增强扫描强化不均匀。5例侵犯周围组织,2例伴腹壁及大网膜转移,1例伴淋巴结转移。结论：RMS好发于15岁以内儿童,恶性程度高,腹盆部RMS早期即可侵犯周围组织,病理类型以胚胎型为主,其影像学表现具有一定特征性。     

腹盆部局限性透明血管型Castleman病的影像学表现

目的 研究腹盆部局限性透明血管型Castleman病(HV-CD)的CT和MR特点.方法 回顾性分析12例经手术病理证实的腹盆部局限性HV-CD患者的CT(9例)和MR(3例)表现.结果 8例位于腹部,4例位于盆腔.主要CT及MR表现:边界清楚的孤立性肿块,伴或不伴周围多发子灶或肿大淋巴结,8例(66.67％)周围脂肪间隙清晰,4例(33.33％)周围脂肪间隙模糊、见晕状低密度带.CT平扫5例(55.56％)密度均匀,3例(33.33％)伴有裂隙样、灶状或囊柱状低密度区,2例(22.22％)伴有斑点状、细条状、分支状或簇状钙化.MR平扫表现为T1 WI等或略低信号,T2 WI高信号.11例增强(8例CT,3例MR)扫描中3例表现为延迟均匀强化,3例为均匀强化(2例轻中度强化,1例明显强化),5例表现为中度或明显不均匀强化.结论 腹盆部局限性HVCD的CT和MR表现有一定特征性,有助于该病的术前诊断.     

Castleman disease of the abdomen: imaging spectrum and clinicopathologic correlations

PURPOSE: The purpose of this work was to define the imaging spectrum of Castleman disease of the abdomen and to correlate the results with clinicopathologic findings. METHOD: Seventeen patients (male/female 7:10; mean age 35.6 years) with pathologically proved Castleman disease in the abdomen were included in this study. Radiologic findings (CT, n =17; US, n =10; MR, n =1) were retrospectively reviewed by two readers and were correlated with clinical and pathologic findings. RESULTS: Subjects were divided into those with localized (n = 11) and disseminated (n = 6) disease. In localized disease, the pathologic subtypes were hyaline vascular type in eight and plasma cell type in three. Radiologic studies showed a single large mass in six and a single dominant mass with small satellite nodules in five. Central low attenuation was seen in two cases, and calcification was seen in three cases. Regional lymphadenopathy was found in five cases. In disseminated disease, there were three hyaline vascular types and three plasma cell types. Radiologic findings included diffuse lymphadenopathy (n = 6), hepatosplenomegaly (n = 5), ascites (n = 3), and thickening of the retroperitoneal fascia (n = 3). Disseminated disease revealed symptoms and abnormal laboratory findings (anemia, hypoalbuminemia, elevated erythrocyte sedimentation rate/C-reactive protein, etc.) more frequently than localized disease and showed poor prognosis. CONCLUSION: There are two distinctive types of radiologic manifestations in Castleman disease of the abdomen: localized and disseminated. The localized type usually shows single or multiple discrete masses, and the disseminated type frequently shows nonspecific organomegaly and lymphadenopathy.     

Castleman病的CT表现（附9例报告）

目的 分析Castleman病的CT表现,提高对其的认识. 资料与方法 回顾性分析9例经手术病理证实的Castleman病患者CT表现,总结其特征. 结果 9例中5例位于纵隔和右肺门,左颈部和腹膜后各2例.9例中局限型8例,弥漫型1例.局限型8例病理诊断均为透明血管型,CT平扫与肌肉相比呈等密度;动态增强CT扫描,多数肿块动脉期明显强化,在延迟期均表现为持续强化,强化程度接近大动脉.弥漫型1例为浆细胞型,表现为腹膜后多个软组织结节,轮廓光整,轻度强化. 结论 Castleman病的CT表现与组织病理学密切相关,局限透明血管型CT表现具有一定特征性;弥漫浆细胞型无特征性影像学表现,确诊依赖组织病理学.     

CT features of Castleman disease of the abdomen and pelvis

OBJECTIVE: The purpose of this study was to describe the CT features of Castleman disease in the abdomen and pelvis. CONCLUSION: The most frequent appearance of abdominal or pelvic Castleman disease is of a single, well-defined enhancing mass. Smaller tumors (<5 cm) display homogeneous contrast enhancement; larger tumors (>5 cm) show heterogeneous enhancement and attenuation when correlated with central necrosis and degeneration. Calcification was seen in 31% of the cases. Castleman disease may be considered in the differential diagnosis of a discrete enhancing mass in the abdomen or pelvis.     

原发性肠系膜巨大淋巴结增生症的MSCT表现与病理对照分析

目的 探讨原发性肠系膜巨大淋巴结增生症的多层螺旋CT(MSCT)特征。 方法 回顾性分析经手术及病理证实的8例肠系膜巨大淋巴结增生症患者的MSCT表现, 分析肿块的位置、形态、大小、边界、密度及增强特点。 结果 8例肠系膜巨大淋巴结增生症中, 7例为单发, 1例为多发, 共检出9个病灶, 均为透明血管型。病灶边界均清晰, 呈类圆形或浅分叶, CT平扫均为稍低密度影, 1例病灶中央区见钙化; 8例患者病灶均明显强化, 其中6例的7个病灶均匀强化, 2例不均匀强化。4例的5个病灶表现为一个较大病灶周围伴多个小结节; 8例患者病灶周围或病灶内均见粗大血管影。 结论 MSCT对巨大淋巴结增生症的诊断及鉴别诊断具有重要价值。     

腹部巨大淋巴结增生CT及MRI表现

目的：巨大淋巴结增生的CT和MRI增强表现特点,旨在提高对本病的认识,方法：自1984年1月－2000年5月间,4例巨大淋巴结增生病例接受CT和MRI检查并经手术和病理证实,其中,男2例,女2例,年龄18＝56岁平均41岁,结果：4个病例中2例病灶位于肠系膜,2例位于腹膜后区,局限型3例弥漫型1例,采用动态增强和螺旋CT多期扫描, 灶在动脉期或在动态增强早期明显强化,所有的病灶在延期均表现为持续强化,MRI T1WI 1例表现为低信号,1例为中等信号,T2WI均呈高信号,动态增强扫描病灶的强化方式与CT一致,结论：系膜或腹膜后区富血供的病变,在动脉期明显强化,延迟期持续强化,CT值接近主动脉密谋者,提示巨大淋巴结增生的诊断。     

Castleman病的影像学表现与手术、病理对照分析

目的探讨Castleman病的CT、MR及血管造影的影像学特征,以期在术前做出正确诊断。方法回顾性分析经手术、病理证实的16例Castleman病患者的临床、影像、手术及病理资料。结果 16例患者按病理分型:透明血管型12例,浆细胞型1例,混合型3例。按临床分型:为局灶型13例,多中心型3例。影像学表现:CT扫描15例,平扫表现病灶为直径1.3～20 cm[平均(6.21±4.75)cm]大小的单发、多发结节或软组织肿块,其中1例盆腔病变内可见簇状钙化;增强扫描病灶动脉期显著强化且与动脉几乎同步强化;浆细胞型病灶呈轻-中度强化。MR检查4例,MRI 2例,1例考虑盆腔海绵状血管瘤可能,1例后纵隔囊性占位,MRI+MRA 1例,诊断Castleman病,MRA 1例诊断为颈动脉体瘤,此例同时做数字减影血管造影,诊断为甲状腺实质性肿瘤。结论透明血管型Castleman病的影像表现与病理类型密切相关,CT及MRI增强表现有其特征,具有重要的诊断价值。而浆细胞型Castleman病影像表现不典型,术前诊断困难。     

原发性肺透明细胞癌的影像学表现与临床病理对照

目的:探讨原发性肺透明细胞癌(PCCCL)的影像学表现与临床病理特点。方法:回顾分析经手术和/或病理证实的7例PCCCL影像学和临床病理的特点,并复习文献。结果:PCCCL影像学上主要表现为右肺周围性肿块或结节(6/7),结节边缘可见毛刺征,无胸膜凹陷征、空泡征;肿块较大时,边缘光滑,无棘状突起、空洞等征象,1例左肺上叶中心性分叶状肿块,边缘光滑,酷似其它类型肺癌。结论:PCCCL罕见,临床无特异性,病灶较大时,仅有相对影像学特征,确诊依赖病理检查。     

Early clinical experience with high-field 1.5 Tesla magnetic resonance imaging

Despite early concerns regarding potential tissue attenuation of signal and lack of inherent contrast, magnetic resonance imaging at 1.5 Tesla has proved to be a valuable extension of magnetic resonance imaging. In this report, we review our initial experience in imaging of the central nervous system, abdomen, chest and pelvis. In the central nervous system, exquisite morphologic detail has been demonstrated. This has added both in terms of sensitivity and specificity to neuroradiologic diagnosis. In the chest and abdomen, despite problems with respiratory and cardiac motion, good morphologic detail can be obtained. In the thorax, our work has demonstrated the ability of magnetic resonance imaging to clearly define the relationship of masses to the hilum and mediastinum. Imaging of the great vessels with magnetic resonance imaging has also proved useful. In the abdomen, magnetic resonance imaging has been useful in looking at the extent of masses identified, in characterizing focal liver masses, and in staging a variety of neoplasms. The high contrast resolution and the ability to image in a variety of planes is particularly helpful in the pelvis. In the male pelvis our work has primarily dealt with staging extracapsular prostatic carcinoma. In the female pelvis, ascertaining the nature of adnexal masses and defining staging primary carcinomas and their response to therapy has been the major thrust of our efforts. Surface coils and other technical improvements will undoubtedly extend the range of application at high field.     

巨淋巴结增生（附五例分析）

目的：探讨巨淋巴结增生的X线及CT诊断。材料和方法：5例（8个病灶）经手术及病理证实巨淋巴结增生，3个病灶有正侧位胸片，1个病灶有副鼻窦瓦氏位及柯氏位片。8个病灶均有CT扫描（其中平扫2个，直接增强扫描5个，平扫加增强扫描1个）。结果：胸片检查3个病灶，椭圆形肿块2个，类似胸腔大量积液1个。CT扫描8个病灶，椭圆形肿块7个，类圆形肿块1个。8个病灶边界锐利，密度均匀。6个病灶显著强化。结论：呈良性肿瘤表现且显著强化是巨淋巴结增生CT特点，CT检查对其诊断有一定价值。     

Prospective randomized study for an injection protocol for intravenous contrast media in abdominal and pelvic helical CT.

OBJECTIVE: To develop an injection protocol for intravenous administration of contrast media in abdominal and pelvic helical CT which provides optimal contrast enhancement of arterial and venous vessels. MATERIAL AND METHODS: For the study on a Somatom Plus 4 unit, a standard helical CT examination procedure of abdomen and pelvis consisted firstly of a native helical examination of the liver, a second one of the liver after intravenous injection of 120 ml nonionic contrast medium with a constant start delay of 50 s, and subsequently a third helical CT of the lower abdomen and pelvis. 125 patients were randomized for examination under different protocols, varying the injection flow from 2.0-4.0 ml/s and the time delay between the second and the third helical examinations from an additional 20-40 s. The efficacy of the contrast injection was checked by region of interest (ROI) measurements of HUs in aorta, inferior vena cava, and in femoral arteries and veins. The results were compared by t-test statistics. RESULTS: A slow flow rate of 2.0 ml/s led to a higher contrast enhancement in the aorta than a flow rate of 3.0 and 4.0 ml/s. The difference between 2.0 ml/s and 4.0 ml/s was statistically significant. In the inferior vena cava, a flow of 3.0 ml/s caused a better contrast than a flow of 2.0 ml/s or 4.0 ml/s, but the measurements did not reach statistical significance. The measurements in the femoral arteries and veins did not show any significant differences. Maximal enhancement in the pelvic vessels was achieved when the third helical examination was started immediately after the second one had ended. Adding any delay (20 s, 40 s) led to a reduced contrast in the pelvic vessels, with a significant reduction in aorta and femoral arteries. CONCLUSION: For routine abdominal and pelvic helical CT, we recommend an injection of 120 ml contrast medium with a flow rate of 3.0 ml/s. Contrast-enhanced examination of the liver should be started after 50 s, and examination of the lower abdomen and pelvis region should be performed without any further delay. This gives an appropriate contrast in the major vessels.