下腔静脉畸形并发症及其介入诊疗

目的：探讨下腔静脉畸形导致的相关临床并发症及其介入诊断和治疗。方法回顾性分析4例下腔静脉畸形并发症及介入诊断和治疗的临床资料。结果双下腔静脉畸形2例,1例并发右下腔静脉、右下肢深静脉血栓形成,未予介入治疗;1例因下腔静脉肝内段癌栓继发双下腔静脉血栓形成,亦未予介入治疗。左下腔静脉畸形2例,1例表现为镜下血尿、腰背酸痛,未予介入治疗;1例左下腔静脉畸形伴腹痛,左下腔静脉跨越段支架植入成形术后症状无明显改善。结论下腔静脉畸形临床并发症少见,应根据影像学表现、相关临床症状及血流动力学、静脉压力差等指标综合判断,以免误诊误治。     

肝硬化肺部血流动力学改变的影像学研究

肝硬化常并发全身各脏器的损害，而肝肺综合征和门脉性肺动脉高压是肝硬化肺部严重并发症。主要病理机制是不同程度的肺部血流动力学改变，而且这种改变可能贯穿于肝硬化整个病理进程中。就血流动力学改变机制的影像学研究进展予以综述。     

椎基底动脉供血不足临床与TCD结果分析

目的：探讨椎基底动脉供血不足病人脑血流动力学改变与临床的相关性，提供临床医生在治疗过程的用药依据。方法：应用经颅彩色多谱勒[TCD]检测椎基底动脉供血不足的病人椎基度动脉系统的血流动力学。结果：临床诊断为椎基底动脉供血不足的病人，经TCD检查大多数有异常改变，可表现脑血流速度的变化[血流速度增快或减慢]，频谱形态及频谱性质的改变，以及转颈试验时峰值流速的变化。结论：TCD是一种无损伤性检查，简单、快速，可为医生诊断椎基底动脉脉供血不足提供重要的诊断依据，对医生选择用药有实际意义。     

脂肪肝患者的肝血流动力学研究

脂肪肝具有其独特的声像学特征。但目前对肝血流动力学的研究甚少。我们应用彩色多普勒声像仪对临床及超声影像学诊断明确的脂肪肝患者及正常人门静脉进行血流动力学测定,以探讨脂肪肝对肝血流动力学的影响。１资料和方法１．１对象受试者均为临床并经超声影像学诊断标准...     

肝海绵状血管瘤的研究进展——图例式阐述

肝海绵状血管瘤(cavernous hemangioma of the liver,CHL)从胚胎发生学和组织病理学上均已确认其并非肿瘤,而是源自肝脏血窦胚胎发育障碍所致的先天性肝脏血管畸形。本文旨在从CHL的血供和血流动力学、影像学表现、临床分型和介入治疗方面进行论述,并配以例证/插图,以使读者对CHL有一全面的新认识。     

猪胸部枪弹伤后眼组织超声显像早期观察

目的：探讨猪胸部枪弹伤远达效应致眼部组织结构及血流动力学改变的规律及意义，为平战时胸部枪弹伤伤病员的早期、全面救治提供参考依据。方法：采用高速弹射击10只猪（20只眼），建立胸部枪弹伤动物模型，利用超声显像技术对动物模型致伤前、后不同时相点的眼部组织结构及视网膜中央动脉血流动力学进行研究，并与眼组织病理做对照分析。结果：（1）伤后眼形态大小正常，2只眼玻璃体后脱离，4只眼玻璃体混浊，球后未见异常回声；（2）彩色多普勒血流成像显示致伤前后视网膜中央动脉血流频谱形态无变化。伤后24h内，视网膜中央动脉的血流动力学参数有显著改变，血流速度减慢，阻力指数增高。结论：胸部枪弹伤后部分眼的二维超声显像有显著改变，视网膜中央动脉血流速度低、阻力大；高频二维超声和彩色多普勒血流成像技术为胸部枪弹伤后早期眼组织变化提供准确的参考依据，对提高临床救治水平，防治眼部并发症具有重要价值。     

婴幼儿心血管畸形的X线平片诊断第Ⅱ部分 复杂心血管疾病,如肺动脉闭锁和三尖瓣闭锁

本文第I部分介绍了某些先天性心血管畸形诊断有重要价值的胸片表现,因而有必要了解婴幼儿的某些临床表现,如紫绀、心脏杂音和心电图改变结果是必要的。对一些复杂的联合心血管疾病更需要上述的详细描述。否则单凭胸片很难作出鉴别诊断。肺动脉血流系认识先天性心血管畸形胸片的基础,且较其它检查方法更为简单,凡临床上疑及或诊断为先天性心脏病者,需行血流动力学检查证实。如肺动脉闭锁和三尖瓣闭锁有助于阐明它们之间的关系。     

彩色多普勒检测老年人颈动脉与脑梗塞的研究

目的：应用彩色多普勒超声技术检测老年人颈动脉结构及血流动力学改变与脑梗塞的相关性，评价其临床价值。方法：使用彩色多普勒超声诊断仪检测颈、椎动脉结构及血流参数。结果：脑梗塞患者颈动脉粥样硬化(CAS)斑块侧向性188／236占79．7％；血流参数以颈内动脉(ICA)、舒张末期血流速度(EDV)、平均血流速度(TAV)明显减慢，(阻力指数)RI增高。结论：CAS斑块，且多为软斑、溃疡斑和颈动脉血流参数改变与脑梗塞密切相关，可作为临床早期发现脑梗塞的诊断参考指标，具有重要临床价值。     

肝硬化肺部血流动力学改变的影像学研究

肝硬化常并发全身各脏器的损害,而肝肺综合征和门脉性肺动脉高压是肝硬化肺部严重并发症.主要病理机制是不同程度的肺部血流动力学改变,而且这种改变可能贯穿于肝硬化整个病理进程中.就血流动力学改变机制的影像学研究进展予以综述.     

下肢血管畸形的MRI、彩超、DSA——影像学探讨

目的：探讨下肢血管畸形的影像学检查及临床应用价值。方法：对30例行MRI、彩超检查的病人．其中12例同时进行DSA检查所产生的不同影像特征进行比较。结果：MRI对各种血管畸形都有意义，具有良好的多方位成像特点和软组织分辨力。DSA在显示高流速及混合性血管畸形的供应动脉及回流静脉方面优于MRI。结论：MRI下肢血管畸形的最佳影像学检查方法，彩超是下肢血管疾病的初步检查和随访的无创、简便手段，在高流速及混合血管畸形中应结合应用DSA。     

结缔组织病胸部病理与X线诊断的相关研究

作者分析了１７例尸检结缔组织病患者的胸部病理改变及有关的临床和Ｘ线诊断，并分析９６例四种常见结缔组织病患者胸片改变。结论：胸部Ｘ线诊断在胸部受累的结缔组织病诊断中具有重要作用；胸片改变的非特异性是临床衰诊的重要原因。     

创伤性湿肺的X线诊断（附100例分析）

本文报告１００例创伤性湿肺的临床资料。结合文献，探讨了创伤性湿肺的形成原因，Ｘ线表现、Ｘ线分型及鉴别诊断。认为其形成原因系多种因素并存。Ｘ线表现是肺挫伤和肺裂伤的复合改变。“面纱症”是创伤性湿肺的特征性Ｘ线表现     

Pulmonary arteriovenous fistulas in Osler's disease]

In a retrospective study over a period of 10 years we found 16 patients with Osler's disease and associated pulmonary arteriovenous fistulas in the hospital of the University of Heidelberg and the Thoraxklinik Heidelberg-Rohrbach. We report about the radiologic diagnostic findings and the clinical manifestations of this defined pulmonary malformation. Radiologic findings are round or oval lobulated homogeneous masses. The size ranges from < 1 to several centimeters in diameter, most fistulas were located in the lower lobes. Feeding and draining vessels can be identified frequently on plain radiographs or tomograms/CT. Best procedure to recognize these malformations is the selective pulmonary arterial angiography.     

Osteopathia striata with cranial sclerosis

Osteopathia striata with cranial sclerosis is a rare disease: fewer than 100 cases have been reported. The radiologic findings of osteopathia striata are characteristic, and once they are identified, they lead to the correct diagnosis. Longitudinal sclerotic striation in long bones and osteosclerosis in facial bones should raise suspicion of osteopathia striata with cranial sclerosis. This is not a serious disease, although it is often associated with other kinds of disorders and extraskeletal malformations that can affect the prognosis. Involvement of cranial and facial bones can lead to facial deformity and marked functional incapacity when the cranial nerves are affected. We present a case of osteopathia striata with cranial sclerosis discovered incidentally in a young woman studied for clinical manifestations unrelated to this disease.     

Structural changes of the substantia nigra in Parkinson's disease as revealed by MR imaging

BACKGROUND AND PURPOSE: The possibility of using MR imaging as a sensitive marker of the structural changes in Parkinson's disease has been a long-sought goal. We describe a new method for imaging and quantifying the morphologic changes of the substantia nigra in Parkinson's disease and compare radiologic findings with clinical evaluation. METHODS: Using a combination of two MR imaging inversion-recovery pulse sequences, the substantia nigra was imaged in six patients with Parkinson's disease and six age-related control participants. A radiologic index was defined and used to quantify the signal changes that were observed in the patients. The radiologic index was compared with clinical scores obtained from the Unified Parkinson's Disease Rating Scale. RESULTS: The images showed loss of signal in a lateral-to-medial gradient in cases of Parkinson's disease, corresponding to the known neuropathologic pattern of degeneration. The radiologic index was highly correlated with the Unified Parkinson's Disease Rating Scale score, and there was no overlap in radiologic indices between the patient and the control groups (P < .00005). CONCLUSION: This study suggests that MR imaging is sensitive to structural changes in even the earliest cases of Parkinson's disease, thereby indicating the potential for detecting presymptomatic disease. Furthermore, a radiologic measure has been defined that correlates with the conventional clinical measure of disease severity. Therefore, MR imaging could prove to be a sensitive biological marker for objective staging of the disease.     

Imaging of pulmonary viral pneumonia

Imaging and clinical manifestations of viral pneumonia are protean and not reliably predictive of its origin. All patients with neutropenic fever and normal findings at chest radiography should undergo thin-section computed tomography to determine whether parenchyma abnormalities are present. Although the radiologic manifestations of viral pneumonia are nonspecific and difficult to differentiate from those of other infections, it is important to consider viral infection when confronted with a rapidly progressive pneumonia in patients with risk factors for infection. Although definitive diagnosis cannot be made on the basis of imaging features alone, the use of a combination of clinical and radiographic findings can substantially improve the accuracy of diagnosis in this disease.     

假性甲状旁腺机能减退症(附一家系六例报告)

目的 提高对假性甲状旁腺机能减退症（PHP）的认识和诊断。方法 发现PHP先证者后,对其家族进行了调查。该家族共4代6例患者,男4例（死亡2例）,女2例。现存4例年龄最大者55岁,最小者8岁。6例均经生化证实,选择2例摄取手平片和头颅CT片。结果 6例均有典型的Albright遗传性骨营养不良症体型、短指（趾）畸形。2例行X线检查者表现为掌、指骨粗短,骨增厚、基底节区呈对称性钙化。结论 影像学表现与临床特点相结合,可对PHP做出明显诊断。     

Enfermedad hepática crónica asociada a la cirugía de Fontan

ObjectiveTo review the pathophysiology of Fontan-associated liver disease, its histologic changes, and its radiologic manifestations.ConclusionsFontan-associated liver disease is the result of a set of structural and functional changes in the liver that occur secondary to hemodynamic changes brought about by Fontan surgery. The radiologic manifestations of Fontan-associated liver disease consist of changes in the size and shape of the liver, alterations in the signal intensity or pattern of enhancement, abnormalities in the vascular structures, and focal lesions, which include benign nodules with intense uptake in the arterial phase and hepatocellular carcinoma. Radiologists need to be familiar with this disease and its complications, because the number of patients who undergo Fontan surgery continues to increase, and these patients undergo an increasing number of imaging tests.     

颌面部骨纤维结构不良的X线诊断和鉴别诊断

A radiologic-pathologic correlative study was carried out on 43 cases with fibrous dysplasia of the facial bones with emphasis on basis for radiological diagnosis. The x-ray manifestations according to density changes are classified into three types: sclerotic, osteolytic and mixed. The lesion extends along the longitudinal axis in the mandible whereas in the maxilla, the lesion spreads in a diffuse pattern along the wall of the maxillary antrum with preservation of maxillary contour. The authors considered that fibrodysplasia and ossifying fibroma are different disease entities and should be distinguished by combination of clinical, radiologic and pathologic evidences.     

MR of CNS sarcoidosis: correlation of imaging features to clinical symptoms and response to treatment.

BACKGROUND AND PURPOSE: Sarcoidosis is an idiopathic systemic granulomatous disease, recognized in a patient when clinical and radiologic findings are confirmed by histopathologic analysis. The objective was to identify a relationship between MR imaging and clinical findings in CNS sarcoidosis. METHODS: The clinical charts of 461 patients with biopsy-proved sarcoidosis were reviewed retrospectively. Criteria for including patients in the study included those with symptoms referable to the CNS, excluding those with another explanation for their symptoms, those with headaches or other subjective complaints without accompanying objective findings, and those with peripheral neuropathy other than cranial nerve involvement or myopathy without CNS manifestations. Thirty-four of 38 patients whose conditions met the criteria for CNS sarcoidosis underwent a total of 82 MR examinations. The positive imaging findings were divided into categories as follows: pachymeningeal, leptomeningeal, nonenhancing brain parenchymal, enhancing brain parenchymal, cranial nerve, and spinal cord and nerve root involvement. Treatment response, clinical symptomatology, and any available histopathologic studies were analyzed with respect to imaging manifestations in each of the categories. RESULTS: Eighty-two percent of the patients with sarcoidosis with neurologic symptoms referable to the CNS had findings revealed by MR imaging. However, eight (40%) of 20 cranial nerve deficits seen at clinical examination of 13 patients were not seen at contrast-enhanced MR imaging, and 50% of the patients with symptoms referable to the pituitary axis had no abnormal findings on routine contrast-enhanced MR images. In contradistinction, 44% of 18 cranial nerves in nine patients with MR evidence of involvement had no symptoms referable to the involved cranial nerve. Clinical and radiologic deterioration occurred more commonly with leptomeningeal and enhancing brain parenchymal lesions. CONCLUSION: MR imaging can be used to confirm clinical suspicion and to show subclinical disease and the response of pathologic lesions to treatment.