Traumatised ischial apophysis (report of six cases)

Six boys with traumatic ischial apophysis are reported. Two cases were diagnosed as stress apophysis and four as apophyseolysis. Two of our patients were referred to the hospital as malignant bone tumours--Ewing sarcoma and osteosarcoma.     

Primary rib tumours in children (report of 27 cases with short literature review)

27 cases of primary malignant and benign rib tumours are reported. The most common malignant rib tumour in childhood is Ewing sarcoma (20 cases). Some other rare bone tumours and tumorous conditions (reticulosarcoma, aneurysmal bone cyst, monostotic rib eosinophilic granuloma, osteoid osteoma and lymphangioma) are also described. In the authors' opinion Ewing sarcoma presents with characteristic clinico-radiographic findings in most of the cases. Other monostotic, primary rib tumours and tumorous conditions in childhood--with the exception of exchondroma and enchondroma--rarely show diagnostic radiographic features.     

耻骨区结核的影像学表现（附2例报告）

耻骨区结核国内少见报道,并且易误诊,本院收治2例,现报告如下。     

Primary sacral bone tumours in children (report of 16 cases with a short literature review)

16 cases of primary sacral bone tumours in children are reported. These include 13 patients with Ewing's sarcoma and 3 with very rare primary sacral bone tumours in childhood--chordoma, haemangiopericytoma and osteoblastoma. All sacral bone tumours, with the exception of Ewing's sarcoma are very rare in childhood. The possibility of a sacral tumour should be considered in a child with radiculopathy. CT and MR make the diagnosis of primary sacral bone tumours much easier with the added possibility of recognition of the true nature of the lesion in many instances. Reports of primary sacral bone tumours in children are scarce. Most of the patients are incorporated in adult series which do not specify the age of the child and the site of the tumour. The purpose of this paper is to describe 16 children with primary sacral bone tumours.     

Coexistence of primary bone tumours: report of 4 cases of collision tumours.

OBJECTIVE: To report, in 4 patients, the occurrence of 2 different primary tumours in proximity in the same bone. Three patients had osteosarcomas, and 1 had a giant cell tumour; all had coincident metaphyseal fibrous defect. METHODS: Four patients (2 women, 1 man and 1 boy; 18, 25, 24 and 10 years of age, respectively) presented with progressive pain in the knee and distal thigh. All were studied by radiography, magnetic resonance imaging was done in 3 patients, and diagnostic open biopsy was performed for all. RESULTS: Radiologic studies demonstrated tumours in the distal end of the femur in all 4 patients. Biopsy tissue showed a metaphyseal fibrous defect in all, with coexistence of an associated giant cell tumour in 1 patient and an osteosarcoma in each of the others. In all cases, the metaphyseal fibrous defect was penetrated by the adjacent tumour. CONCLUSIONS: Despite the relative prevalence of metaphyseal fibrous defect, giant cell tumour and osteosarcomas in the distal end of the femur and their occurrence in approximately the same age group, their association has rarely been reported. As both giant cell tumours and osteosarcomas are usually diagnosed late in their clinical course, they may outgrow and destroy any evidence of pre-existing metaphyseal fibrous defect. The rate of destruction is also influenced by the distance between the 2 lesions--the shorter the distance, the earlier the destruction.     

Preaortic iliac confluence (marsupial vena cava): report of 4 cases

Congenital anomalies of the inferior vena cava (IVC) can represent a difficult for abdominal surgeries, and the radiologist must be aware even of the less common of these anatomical variations. Preaortic iliac venous confluence, also known as marsupial vena cava, is a rare congenital anomaly of the development of the IVC in which the IVC or the left common iliac vein is located anterior to the aortic bifurcation or the right common iliac artery. We report 4 cases of marsupial vena cava detected on multidetector computed tomography examinations in asymptomatic patients and discuss that this congenital anomaly can be recognized more frequently with the use of this new technique based on thinner images.     

MRI of primary meningeal tumours in children

Childhood meningeal tumours are uncommon and mostly meningiomas. We reviewed the histological and radiological findings in meningeal tumours in six children aged 12 years or less (four benign meningiomas, one malignant meningioma and one haemangiopericytoma). Compared to the adult counterpart, childhood meningiomas showed atypical features: cysts, haemorrhage, aggressiveness and unusual location. MRI features varied according to the site of the tumour, histology, haemorrhage, and presence of intra- or peritumoral cysts. Diagnosis of the extra-axial tumour was relatively easy in two patients with meningiomas, one malignant meningioma and one haemangiopericytoma. MRI findings strongly suggested an intra-axial tumour in two patients with benign meningiomas, because of severe adjacent edema. Awareness of the variable findings of childhood meningiomas and similar tumours may help in differentiation from brain tumours. Received: 22 September 1998 Accepted: 18 November 1998     

肋骨原发性骨肿瘤的影像学诊断(附18例分析)

目的探讨影像学对肋骨原发性骨肿瘤的诊断价值及临床应用的意义。材料与方法本组中18例摄取正侧位平片,8例加摄斜位片,2例加体层摄影,2例行CT检查。结果12例良性病变平片显示与肋骨长轴一致的囊性破坏者10例,4例伴有砂粒状钙化,6例恶性肿瘤均显示边界清楚的溶骨性破坏,CT显示软组织肿块突人胸腔。结论分析本组病例,表明X线平片对肋骨肿瘤多数可判断良恶性,CT在显示肿瘤骨质破坏及软组织肿块与邻近组织的关系方面优于X线平片。     

儿童胡桃夹征CT表现(附2例报告)

“胡桃夹征”(nutcracker sign)又称“左肾静脉压迫综合征”,本文对经CT证实的2例分析如下。1材料与方法2例中,男女各1例,年龄7~10岁。临床症状主要为反复血尿,直立或剧烈活动明显。症状持续时间为10天~1年2个月,为肉眼或镜下血悄,伴有或不伴蛋白尿,无高血压及水肿。2例患者实验室检查:肝功、肾功、抗PPD抗体、抗“O”均正常。2结果2例患者重组图像均显示肠系膜上动脉(SMA)与腹主动脉夹角变小,为23°~25°,SMA向后挤压左肾静脉,以矢状面重组图像较为直观(图1);左肾静脉于SMA后方与腹主动脉之间明显狭窄,其远侧段管腔扩张(图2)。CTA…     

儿童眼外伤的临床特点(附103例病例报告)

探讨儿童眼外伤的伤因、临床特点和并发症,以提高其防治率.     

儿童滤泡性膀胱炎的超声诊断(附2例报告)

小儿滤泡性膀胱炎是慢性非特异性膀胱炎的一种类型，临床超声报道罕见。我院发现较典型的2例。现报告如下。     

儿童肾癌的CT诊断(附七例报告)

目的探讨儿童肾癌的ＣＴ诊断。方法回顾性分析７例经手术病理证实为儿童肾癌的ＣＴ表现。男４例，女３例；年龄３～１３岁，平均年龄９岁。全部病例行平扫与增强检查。结果儿童肾癌具有学龄期发病优势，这有别于Ｗｉｌｍｓ瘤好发于学龄前期。儿童肾癌的ＣＴ表现与Ｗｉｌｍｓ瘤极为相似而难以区分者３例；２例小肾癌表现颇具特征，ＣＴ平扫呈轻度高密度影，增强后轻度强化；表现为巨大类囊性低密度肿块（直径＞１０ｃｍ）２例。结论临床特点与ＣＴ表现相结合，可对部分儿童肾癌做出明确诊断     

原发性腹膜后肿瘤诊断与外科治疗体会（附58例报告）

目的探讨原发性腹膜后肿瘤诊断和外科治疗经验。方法回顾性分析本院2000年1月～2010年3月58例经手术治疗的原发性腹膜后肿瘤的临床资料。结果 58例中,临床症状主要表现为腹部肿块33例（56.9%）,腹痛21例（36.2%）,腹胀13例（22.4%）;术后病理检查结果良性肿瘤19例,恶性肿瘤39例;肿瘤完整切除41例,姑息性切除16例,剖腹探查肿瘤活检术1例。58例患者围手术期无死亡,肿瘤完全切除组中位生存时间59个月,其l、3、5年生存率分别为88.2%、68.7%、35.8%;肿瘤姑息性切除组中位生存期35.3个月,其1、3、5年生存率分别为82.9%、53.8%、9.2%。结论手术切除是腹膜后肿瘤的最有效治疗方法,积极的外科治疗、争取完整切除可以延长患者的生存期,降低复发率。对于复发患者,应争取再次手术切除。     

胸膜原发性肿瘤的影像学诊断(附26例分析)

目的：分析胸膜原发性肿瘤的影像学特点，探讨胸膜原发性肿瘤与肺内肿块鉴别诊断的要点。方法：回顾性分析26例经手术病理证实的原发性胸膜肿瘤的影偈学资料，其中，胸膜间皮瘤20例，胸膜神经鞘瘤4例，神经纤维瘤1例及胸膜纤维脂肪瘤1例。结果：胸膜间皮瘤影偈学表现为3种类型；单发胸膜肿块型，多发胸膜肿块及结节状胸膜增厚型，胸膜积液为主型，单发肿块良，恶性均有，多发性肿块或结节状胸膜增厚伴胸腔积液时，多见于恶性弥漫型胸膜间皮瘤，胸膜神经鞘瘤，神经纤维瘤及胸膜纤维脂肪瘤均具有良性肿瘤的特征。结论：胸膜原发性肿瘤虽无特征性影像学表现，仔细综合分析各种影像学征象特点，对提高本病的诊断具有重要价值。