特发性甲状旁腺功能减退的脑CT表现(附13例分析)

目的：探讨特发性甲状旁腺功能减退的脑CT表现。方法：回顾分析13例患者的临床特征和CT表现。结果：13例均有基底节和大脑叶钙化，其中对称性大脑叶钙化10例，对称性基底节区钙化9例，丘脑钙化8例，中脑钙化3例，小脑齿状核钙化7例，全部病例内囊均不受累。结论：基底节或／和大脑叶对称性钙化是特发性甲状旁腺功能减退的特征性CT表现。     

甲状旁腺功能减退症头颅CT表现

目的 进一步认识甲状旁腺功能减退症的头颅CT特征，以提高CT诊断的准确性。方法 回顾分析16例临床确诊甲状旁腺功能减退症的临床，实验室检查及CT资料，其中继发性7例，特发性9例，均行CT平扫，结果 16例均显示脑实质钙化。苍白球钙化见于16例，尾状核头钙化16例尾状核体钙化10例。豆状核钙化13例。壳核钙化12例。齿状核钙化12例，丘脑钙化8例，顶叶钙化11例，额叶钙化10例，枕叶钙化8例。颞叶钙化4例。钙化基本呈双侧对称性。结论 甲状旁腺功能减退症CT表现具有一定特征性，CT对病变程度的判定有一定价值，但明确定性则需结合临床特征及实验室检查。     

特发性甲状旁腺机能减退症颅脑CT及MRI表现

目的探讨颅脑CT及MRI检查对特发性甲状旁腺机能减退症(IHP)的诊断价值。方法回顾性分析16例经临床确诊的IHP患者头颅CT(16/16)和MRI(3/16)表现,观察病变的范围和密度/信号等特点。结果IHP颅内主要表现为多发钙化性病变,在CT上表现为高密度,CT值114～373HU,在MRT1WI呈稍高信号或高信号,T2WI呈等信号。双侧尾状核、苍白球、壳核及丘脑的对称性、条形或团块状钙化16例;双侧额、颞、顶、枕叶皮层下钙化10例;小脑齿状核钙化6例(双侧4例,单侧2例);侧脑室旁钙化2例。结论CT和MR对IHP的诊断非常重要,其中CT对病变的显示优于MR,与临床结果结合,对IHP具有定性诊断意义。     

特发性甲状旁腺机能减退症的脑CT表现与临床症状对照分析(附12例分析)

目的:探讨特发性甲状旁腺功能减退症的脑CT表现及临床特征的相关性.方法:回顾性分析12例特发性甲状旁腺功能减退患者的CT表现,并与相应临床症状对照研究.结果:12例均发生对称性基底节钙化,此外,小脑齿状核钙化6例,丘脑钙化6例,大脑半球钙化6例,12例内囊均无受累.患者病程1、2、3年以及3年以上者分别为3、4、3、2例,随着病程延长,脑内钙化部位逐渐增多.4例有癫痫发作均见基底节钙化之外的其它部位的脑钙化.结论:以基底节对称性钙化为主的脑内多部位钙化是特发性甲状旁腺功能减退的特征性CT表现.脑内钙化范围与临床病程及症状有关.     

甲状旁腺功能减退症的颅脑CT特征分析

目的探讨甲状旁腺功能减退症的颅脑CT表现及临床特点。方法对经临床确诊的甲状旁腺功能减退症11例患者进行颅脑CT平扫,将其cT表现进行分析。结果本组患者颅脑cT扫描均发现脑内有不同程度钙化,主要分布于双侧基底节区、丘脑、小脑齿状核、灰白质交界区及半卵圆中心,基底节区钙化为逗点状、三角形及倒八字形,丘脑钙化为斑点状,小脑齿状核钙化为肾形、片状,灰白质交界区钙化为钩子状,半卵圆中心钙化呈横行排列,而双侧内囊区未累及。脑内钙化部位频数依次为苍白球和壳核11例,丘脑10例,尾状核头部8例,小脑齿状核7例,额顶叶6例,半卵圆中心4例,枕叶2例。结论甲状旁腺功能减退症颅脑cT表现具有特征性,可为临床诊断提供可靠的影像学依据,结合低血钙、高血磷、甲状旁腺激素水平降低实验室检查即可明确诊断．     

家族性Fahr病两家系报告

目的 通过颅脑CT表现及家族调查，提高对Fahr病临床表现，遗传特点，CT表现的认识。方法 2个家族先证者颅脑CT检查发现脑内钙化后，经实验室血钙，磷生化指标检查，排除甲状旁腺功能低下，并对其家族3代内共14例进行了调查。所有患者及被调查者均行颅脑CT平扫，取10层，层厚10mm,层距10mm。结果 CT表现脑内钙化呈多发对称性，钙化首先累及基底节，随病情轻重及进展，逐渐累及丘脑，皮层下，小脑齿状核，钙化的轻重与临床表现出现的早晚成正相关。成年后脑内钙化进展缓慢。结论 Fahr病有明显家族遗传性，为特发脑内钙化，轻者钙化局限于基底节，无临床症状，易被漏诊，在血钙，磷代谢无异常的情况下，家族随访至关重要，CT检查是明确诊断Fahr病的重要依据。     

Fahr氏病1例

患者女,70岁,头部轻微外伤后就诊.患者语言迟钝,行走不稳.家属代诉此症状已有30余年,并偶有癫痫发作. CT平扫示:小脑齿状核、基底节、丘脑均见对称性斑片状钙化阴影,CT值约290 HU,额叶白质区亦可见对称小斑片状钙化影(图1～4).考虑为Fahr氏病(特发性家族性脑血管亚铁钙沉着病).     

有机磷中毒性脑病恢复期MRI表现(附4例报告)

目的:探讨有机磷中毒性脑病恢复期的MRI特征.方法:回顾性分析4例重度有机磷中毒慢性期脑结构变化.结果:双侧巴宾斯基征阳性4例,脑电图轻度异常4例.1例右侧小脑半球和中脑长T1长T2信号.1例双侧尾状核和壳核对称性长T2信号,T1WI高信号.1例双侧尾状核、壳核和苍白球对称性长T1长T2信号,侧脑室扩大,小脑萎缩.1例双侧尾状核、壳核和苍白球对称性异常信号,T1WI部分萎缩的小脑回呈高信号;脑室扩大,双侧枕叶内侧回、脑干和小脑萎缩.结论:有机磷中毒性脑病恢复期MRI表现主要累及尾状核、苍白球、丘脑、中脑和小脑;严重者皮质出现软化灶,伴有脑萎缩.     

颅脑CT诊断甲状旁腺功能减退的价值：附14例报告

本文报道了甲状旁腺功能减退，低血钙，高血磷四肢抽搐１４例。ＣＴ表现：基底节，小脑齿状核，丘脑，尾状核，脑干及脑皮质与髓质之间对称性钙化。本文对甲旁减临床表现，病因，病理进行了讨论。     

Fahr''s病CT表现(附3例报告并文献复习)

目的探讨Fahr's病的诊断与鉴别诊断.方法临床诊断为Fahr's病的3例患者均经头部CT扫描.对每例的临床表现与实验室检查进行了观察和记录,并结合文献讨论了对该病的诊断与鉴别.结果3例患者均表现有不同程度的精神神经症状.实验室检查表明,3例患者的血清钙、磷及甲状旁腺素水平大体上均在正常范围.CT扫描显示,双侧大脑基底节区,尾状核、豆状核及丘脑内有对称性钙化灶.结论双侧大脑基底节区、尾状核、豆状核及丘脑对称性钙化是Fahr's病的CT特征,而血清中钙、磷及甲状旁腺素水平正常是Fahr's病与其他疾病鉴别的关键指标.     

Basal ganglia calcification: a Fahr's disease case report

Idiopathic basal ganglia calcification (IBGC), known as Fahr''s disease, is a rare neurological disorder characterized by metabolic, biochemical, neuroradiological and neuropsychiatric alterations caused by symmetrical and bilateral intracranial calcifications. The disease has, in most cases, an autosomal dominant pattern of inheritance and genetic heterogeneity. Overlap of neuropsychiatric symptoms is common with movement disorders accounted for 55% of the manifestation. Here we present the case of a 58-year-old woman, presenting to the emergency department because of an accidental fall. Her past medical history was unremarkable and she denied any neurological symptoms a part from insomnia and anxiety. Patient was sent to the emergency department to perform a Brain Computed Tomography (CT) exam that showed bilateral symmetrical calcifications in cerebellar white matter, the corpus striatum, the posterior thalami, and the centrum semiovale of both cerebral hemispheres. Beeing a case of IBGC without relevant symptoms, diagnosis was mainly obtained thanks to the characteristics features of CT examination.     

The Sturge-Weber syndrome: comparison of MR and CT characteristics

Four patients with Sturge-Weber syndrome were evaluated with CT and MR. MR demonstrated the characteristic features of the disease: cerebral atrophy (four patients), ipsilateral bone and sinus hypertrophy (three), ocular findings (one), intracranial calcification (four), prominent deep venous system (three), and enlarged choroid plexus (two). CT demonstrated the following: cerebral atrophy (four), ipsilateral bone and sinus hypertrophy (three), calcification (four), gyral enhancement (two), prominent deep venous system (two), and enlarged choroid plexuses (three). The features of Sturge-Weber syndrome were visualized equally well with MR and CT with the exception of intracranial calcification. Conventional spin-echo MR revealed fewer calcifications, and those visualized appeared smaller than with CT. Gradient-echo acquisition sequences were more effective in the detection of intracranial calcification.     

Peritoneal calcification: causes and distinguishing features on CT

OBJECTIVE: We undertook this study to determine the causes of peritoneal calcification seen on CT and to investigate which CT features distinguish benign from malignant peritoneal calcification. MATERIALS AND METHODS: Seventeen patients with peritoneal calcification were identified through retrospective review of reports from 74765 abdominopelvic CT examinations performed during a 7-year period. We determined the cause of peritoneal calcification by examining medical and histopathologic records. Calcification morphology was classified as nodular or sheetlike on the basis of the consensus interpretation by two independent radiologists. The radiologists also recorded the presence or absence of associated soft-tissue components or lymph node calcification. The association between the CT findings and the cause of calcification was assessed using chi-square analysis. RESULTS: Peritoneal calcification was due to peritoneal dialysis (n = 4), prior peritonitis (n = 3), cryptogenic origin (n = 1), or peritoneal spread of ovarian carcinoma (n = 9). Sheet-like calcification was more common in patients with benign calcification (seven of eight patients) than in those with malignant calcification (two of nine patients, p < 0.05). Nodal calcification was seen only in patients with malignant calcification (five of nine patients vs none of eight, p < 0.05). CONCLUSION: Common causes of peritoneal calcification are dialysis, prior peritonitis, or ovarian cancer; sheetlike calcification indicates a benign cause, whereas associated lymph node calcification strongly suggests malignancy.     

Calcification of the olfactory bulbs in three patients with hyposmia

An estimated two million Americans suffer from chemosensory disorders. We present the clinical and imaging findings in three hyposmic patients with bilateral olfactory bulb calcification detected by CT. To our knowledge, these are the first cases of olfactory bulb calcification reported in the literature. A review of the literature concerning calcification of cranial nerves, olfactory neuritis, and the potential etiology and clinical significance of olfactory bulb calcification in our patients is presented.     

CT features of retroperitoneal neurilemmoma

Purpose: The aim of this study was to characterize the CT features of retroperitoneal neurilemmoma. Methods: The CT findings were reviewed in seven patients with retroperitoneal neurilemmoma. Results: All of the tumours were well-demarcated round or oval masses. In five cases, heterogeneous contrast enhancement was noted after contrast medium administration. Areas of minimal enhancement reflected diffuse edema in one tumour. Areas without definite enhancement represented prominent cyst formation in three tumours. There were three cases with tumour calcification (two with punctate calcification and one with mottled calcification). Conclusion: CT findings may suggest the diagnosis of retroperitoneal neurilemmoma preoperatively.     

小脑发育不良性神经节细胞瘤CT、MRI表现(附二例报告及文献复习)

目的分析小脑发育不良性神经节细胞瘤的CT及MRI表现,提高对其认识。资料与方法回顾性分析2例经手术及病理证实小脑发育不良性神经节细胞瘤的CT、MRI表现,并结合文献复习总结其影像学特点。结果 CT表现为小脑半球低密度,密度不均匀,其内可见条纹状等密度影及钙化影。MRI表现为长T1、长T2信号,其内见条纹状等T1、等T2信号,增强扫描无强化。病变常较大,占位效应明显,周围水肿较轻。结论小脑发育不良性神经节细胞瘤具有一定的影像学特征,术前可作出定性诊断,为临床治疗及预后提供了重要依据。     

乏脂肪性肾血管平滑肌脂肪瘤的CT表现

目的探讨乏脂肪肾血管平滑肌脂肪瘤（RAML）的CT表现,以提高其诊断准确性。方法 14例RAML患者均经腹部CT平扫和动态增强扫描,对所有患者RAML病灶的数目、形态、密度、是否合并钙化以及强化型式进行回顾性分析,全部病例经手术和病理学确诊。结果多数病灶为边界清楚的圆形肿物,单发或多发,CT平扫多呈等或高密度影,本组病例未见瘤内钙化灶。所有患者的RAML病灶在动态增强的皮质期与实质期均表现为均匀的持续性强化。结论乏脂肪RAML病灶多表现为边界清楚的实性肿块,少有钙化。CT观察病灶的形态,密度及强化形式等特征性表现,有助于提高其定性诊断的准确性。     

霉菌性上颌窦炎CT表现特征及误诊分析

目的探讨霉菌性上颌窦炎CT特征及误诊原因。方法分析26例霉菌性上颌窦炎患者CT和临床资料,总结CT特征,结合临床,分析误诊原因。结果霉菌性上颌窦炎CT多单侧受累（23例）。受累窦腔内不均匀密度增高影及其内斑点、团块及条状钙化（21例）,分布在中间15例,散在4例,边缘2例。窦壁增厚7例,窦壁骨质吸收4例。5例均误诊为一般上颌窦炎。结论与窦壁无关的腔内钙化是CT诊断较可靠特征。无钙化的霉菌性上颌窦炎应注意鉴别诊断,充分考虑临床和基础病。     

支气管内膜结核的CT诊断

目的分析支气管内膜结核的CT表现，探讨CT对支气管内膜结核的诊断价值。方法回顾性分析20例经纤支镜活检证实的支气管内膜结核的CT表现。结果20例支气管、叶支气管狭窄，11例锥形狭窄，9例管壁增厚，其中．向心性狭窄5例，偏心性狭窄4例，伴支气管扩张7例，钙化4例。6例继发肺不张，19例患者肺野内均可见不同性质肺结核灶，12例并发胸膜病变。肺门纵隔淋巴结肿大及钙化11例。结论CT是诊断支气管内膜结核的有效方法，其CT表现具有一定的特征性。     

Angiographic correlation of CT calcification in the carotid siphon

BACKGROUND AND PURPOSE: Calcification in the coronary arteries has been correlated with significant vessel stenosis. The predictive value of calcification within the carotid siphon has not been characterized; however, stenosis in the carotid siphon is potentially important in determining management of patients with ipsilateral carotid bifurcation stenosis. The purpose of this study was to determine optimal parameters for assessing carotid siphon calcification on head CT scans and to compare the CT findings with angiographic results. METHODS: We performed a retrospective review of patients referred for diagnostic carotid arteriography. Those patients who also had undergone a head CT study at our institution were selected. The CT scans and angiograms of 64 patients (128 vessels) were reviewed. Carotid siphon calcification on CT scans was characterized on brain and bone windows as mild, moderate, or severe. Comparison was then made with angiographic findings. RESULTS: The sensitivity and specificity of CT for depicting greater than 50% angiographic stenosis in the carotid siphon were 86% and 98%, respectively, for bone windows and 100% and 0%, respectively, for brain windows. The positive predictive value (PPV) for a stenosis of greater than 50% as evidenced by severe calcification was 86% on bone windows and 11% on brain windows. The PPV for mild and moderate calcification on bone windows was 2.5% and 0%, respectively. CONCLUSION: Severe CT calcification in the carotid siphon as characterized on bone windows correlates with a carotid siphon stenosis of greater than 50% as determined angiographically. Therefore, the identification of severe calcification offers a potential noninvasive method for identifying stenosis of the carotid siphon. This information may be essential in determining management and prognosis for patients with carotid bifurcation stenosis.