小儿膀胱横纹肌肉瘤的影像诊断

目的探讨小儿膀胱横纹肌肉瘤(Rhabdomyosarcoma,RMS)的X线造影和CT表现特征,提高对本病的认识.方法回顾性分析14例经手术病理证实的膀胱RMS的临床影像资料,全部病例均行静脉尿路造影和/或膀胱造影检查,其中4例行CT扫描.结果造影显示葡萄簇状充盈缺损11例;膀胱三角区大的分叶状充盈缺损影3例,6例膀胱壁毛糙.4例CT均显示膀胱腔内典型葡萄簇状低于腹壁肌肉密度软组织肿块,膀胱壁增厚,增强呈轻中度强化.结论膀胱RMS影像表现具有一定特征,结合患儿年龄及临床特征多可做出正确诊断.     

眼底荧光影像对原发性视网膜色素变性病情严重性的评估作用

目的：探讨眼底荧光影像对原发性视网膜色素变性严重性的评估作用。方法:按准入和排除标准选择患者20名,按国际通用方法进行眼底荧光血管造影,对造影图像的表现及临床病理意义进行分析。结果:全部病例的造影图像均显示斑驳状透见荧光,其它较多的特征有色素斑块所致的荧光遮蔽、因视网膜色素上皮细胞脱离所致的荧光渗漏和沉积,较少表现的还有毛细血管无灌注所致的充盈缺损以及黄斑荧光积存等。结论:眼底荧光影像对原发性视网膜色素变性病情严重性的预示性从轻向重依次为：弥漫性斑驳状透见荧光;荧光遮蔽;充盈缺损;视网膜荧光素池样积存;黄斑荧光积存。     

颈腰椎磁共振脊髓造影技术及临床应用

目的探讨颈腰椎磁共振脊髓造影(MRM)扫描技术及其临床应用价值.方法 46例患有腰腿疼痛,颈部疼痛,肢体麻木的颈腰椎疾病患者行MRM检查,均行矢状位T1WI,T2WI,横断位T2WI扫描,随后行MRM扫描,所有MRM均以冠、矢状位及斜位显示.结果正常颈腰椎MRM12例,硬膜囊、脊髓、神经根和神经根鞘袖显示清晰.椎间盘突出31例,中央型间盘突出的硬膜囊正中有弧形压迹,侧突型表现一侧神经根受压移位.髓核脱出表现为充盈缺损.1例转移瘤,2 例神经鞘瘤各有其MR特征.结论 MRM是诊断颈腰椎疾患可靠的、无创性的技术,能代替传统的脊髓造影.     

螺旋CT血管造影对肺动脉栓塞的诊断价值

目的评价螺旋CT血管造影(SCTA)对肺动脉栓塞(PE)的诊断价值.方法对临床疑诊PE的20例患者进行螺旋CT血管造影成像(SCTA).结果 20例患者中确诊 PE 7例.7例PE SCTA 直接征象:肺动脉主干或分支内混合性、附壁性、中心性充盈缺损.间接征象:局限性肺纹理稀疏,肺动脉高压,右心室增大,胸腔积液等.结论螺旋CT血管造影具有准确、快速、无创性的优点,对肺动脉栓塞的诊断具有广泛应用价值.     

直肠充盈对直肠壁CT影像组学特征的影响

目的：探讨直肠充盈对直肠壁CT影像组学特征的影响。方法：收集95例宫颈癌后装治疗定位CT扫描图像,患者在直肠填充苦参凝胶前后分别进行CT扫描,手动勾画直肠壁,计算提取7类共计851个特征,包括形态、统计、灰度相关矩阵、灰度游程矩阵、灰度共生矩阵、灰度区域矩阵及邻域灰度差分矩阵特征,采用一致性相关系数评估特征稳定性,威尔科克森符号秩检验分析直肠充盈对直肠壁CT影像组学特征的影响。结果：直肠充盈前后较稳定（一致性相关系数值小于0.8）的特征占总数的13%(113/851),有显著性差异（P<0.05）的特征占总数的92%(782/851)。结论：直肠充盈对直肠壁CT影像组学特征影响较大,应予以关注。     

膀胱肿瘤的超声图像与病理35例报告

就我院1994年～1997年经手术、病理证实为膀胱肿瘤35例的B超图像与病理进行分析,以提高诊断水平．膀胱肿瘤的回声基本上分为向膀胱腔突起和向膀胱壁浸润两部分．充盈的膀胱无回声暗区内有明亮的菜花样或乳头状凸起,肿瘤生长部位膀胱壁回声零乱不清．部分可见侵及肌层．35例均具有上述声像．其中31例为移行上皮癌．着重分析了4例膀胱肿瘤超声误诊为前列腺不规则增生、血块机化、输尿管癌、膀胱壁增生的超声声像及误诊原因,对照手术及病理所见,提出注意事项及检查手法,对原因不明血尿或膀胱刺激症状者,均应进行超声检查,其与CT、膀胱镜、膀胱造影等有很好的互补性．     

颈腰椎磁共振脊髓造影技术及临床应用

目的探讨颈腰椎磁共振脊髓造影（MRM）扫描技术及其临床应用价值．方法46例患有腰腿疼痛，颈部疼痛，肢体麻木的颈腰椎疾病患者行MRM检查，均行矢状位TIWI，T2WI，横断位T2WI扫描，随后行MRM扫描，所有MRM均以冠、矢状位及斜位显示．结果正常颈腰椎MRM12例，硬膜囊、脊髓、神经根和神经根鞘袖显示清晰．椎间盘突出3l例，中央型间盘突出的硬膜囊正中有弧形压迹，侧突型表现一侧神经根受压移位．髓核脱出表现为充盈缺损．1例转移瘤，2例神经鞘瘤各有其MR特征．结论MRM是诊断颈腰椎疾患可靠的、无创性的技术，能代替传统的脊髓造影．     

对比分析超声与CT诊断膀胱尿路上皮癌

目的比较超声与CT对膀胱尿路上皮癌的影像表现及诊断价值。方法选择45例膀胱尿路上皮癌患者,其中男性36例,女性9例;年龄27~83岁,平均年龄62.7岁。术前行超声和CT检查,分析其诊断结果。结果 45例膀胱尿路上皮癌中,超声检查发现43例,多表现为中等回声结节,回声较均匀,形态较规则,边缘较平滑,血液供应较丰富,超声诊断符合率为95.6%。45例膀胱尿路上皮癌行CT检查均发现病灶,多表现为膀胱壁较规则的乳头状突起,边缘较规整,36例行增强扫描均见较明显强化,CT诊断符合率为91.1%。结论超声和CT均为诊断膀胱癌的重要影像方法,而超声检查操作方便,无辐射,可作为首选检查方法。     

侵袭型肺曲霉菌病的CT影像诊断特征

目的 探讨侵袭型肺曲霉菌病的CT影像表现特征，为侵袭型肺曲霉菌病的临床诊断提供参考依据。方法 搜集经病理活检、手术证实的10例侵袭型肺曲霉菌病的CT影像表现特征进行回顾性分析，其中4例行5mm层厚和5mm层距的CT扫描，进行CT影像诊断学观察。结果 10例CT表现中均不同程度地出现了结节状阴影，伴有晕征或空气半月征。结论 晕征、空气半月征是侵袭型肺曲霉菌病的CT特征性表现，结合原发病史，对侵袭型肺曲霉菌病诊断或早期提示性具有重要意义。     

脐尿管癌的CT影像学分析

目的探讨脐尿管癌的CT表现特点及鉴别诊断要点。方法回顾性分析经病理证实的9例脐尿管癌及4例其他脐尿管病变患者的临床资料和CT表现。结果9例脐尿管癌患者的病变部位均在腹中线Retzius间隙脐尿管走行区,其中6例位于脐尿管膀胱交界区的膀胱顶壁或前壁,3例位于脐尿管上端。9例脐尿管癌中6例呈囊实性,3例为实性,4例可见病灶中心或周边斑点状钙化。增强扫描后均有不同程度强化。随诊复查腹膜转移者1例．肝转移者1例。结论脐尿管癌的CT表现具有特征性,CT扫描能提供较为准确的定位和定性。同时也是脐尿管癌术前明确诊断和鉴别诊断的重要措施之一。     

The value of cystoscopy and intravenous urography after magnetic resonance imaging or computed tomography in the staging of cervical carcinoma.

The clinical staging system for cervical carcinoma presently recommended by the International Federation of Gynecology and Obstetrics (FIGO) does not include MRI or CT findings and thus suffers limited accuracy. Recently however, the positive contributions of MRI and CT to preoperative staging have been reported. This study involves a determination of the value of routine cystoscopy and intravenous urography, in the detection of bladder invasion or hydronephrosis resulting from cervical carcinoma, among patients who had undergone MRI or CT. Among a total 296 patients with cervical carcinoma, 271 patients (92%) had undergone MRI and 25 (8%) CT. Bladder invasion was identified pathologically by cystoscopic biopsy in 8 (57%) of the 14 patients with suspected bladder invasion on MRI or CT. There was no bladder invasion in any of the other cases lacking in bladder invasion evidence on MRI or CT. Hydronephrosis was identified by intravenous urography in 18 patients, as it also was in all of these cases on MRI or CT, confirming a negative predictive value for MRI or CT, in detecting bladder invasion or hydronephrosis from cervical carcinoma, of 100%. Therefore, although MRI or CT cannot totally replace cystoscopy, the latter is unnecessary in the absence of bladder invasion evidence on MRI or CT. Intravenous urography, however, can be safely omitted whenever MRI or CT is performed.     

盆腔脂肪增多症的影像学观察

目的通过分析2例盆腔脂肪增多症的影像和临床特点,以提供临床对盆腔脂肪增多症诊断的参考。方法分析2例盆腔脂肪增多症患者的临床表现以及静脉尿路造影（IVtl）、X线、CT、膀胱造影等表现。结果盆腔脂肪增多症患者的腹部X线片、CT、IVU均可见“骨盆透明”征;肾盂和输尿管上段有不同程度扩张积水;膀胱抬高呈“梨”形;直肠和乙状结肠向上及外侧推挤移位;病理诊断均伴有腺性膀胱炎。结论盆腔脂肪增多症行X线、CT和IVU检查有其特征性的表现,合理运用影像学检查手段可减少对本病的误诊,认识这些影像学特点有助于提高对本病的诊断。     

中、晚期肾结核40例临床分析

目的探讨中晚期肾结核的临床表现特征及其有效治疗方法。方法对40例中晚期肾结核患者的临床资料进行回顾性分析。对所有患者进行尿常规、红细胞沉降率、尿抗酸杆菌、尿结核杆菌-PCR（Tb—PCR）、B超、静脉尿路造影（IVU）、CT等检查，8例患者行药物治疗，32例患者行手术治疗。结果临床表现为腰痛18例（45％），膀胱刺激症24例（60％），血尿28例（70％）。尿常规检查异常38例（95％），红细胞沉降率异常升高36例（90％），尿抗酸杆菌阳性11例（27．5％），尿结核杆菌-PCR（Tb—PCR）阳性18例（45％）。B超检查肾积水、肾结石或／和肾结构异常40例（100％）；静脉尿路造影（IVU）确诊肾结核23例（57．5％），患肾不显影17例（42．5％）；CT确诊肾结核31例（77．5％）。肾结核合并膀胱结核16例，肺结核5例，附睾结核8例。8例患者药物治疗治愈，32例患者手术后经病理确诊为肾结核。结论中晚期肾结核的临床表现多不典型，其诊断应在结合临床表现的前提下以实验室检查与影像学诊断为主。尿沉渣染色查抗酸杆菌仍重要，尿Tb-PCR检查是术前确诊肾结核的主要手段．IVU和B超可作为泌尿系结核诊断首选的影像学检查，治疗仍以手术切除肾脏为主，应尽可能切除患侧全程输尿管。     

Absolute and relative dose-surface and dose-volume histograms of the bladder: which one is the most representative for the actual treatment?

The purpose of this study was to quantify to what extent relative and absolute bladder dose-volume and dose-surface histograms of the planning CT scan were representative for the actual treatment. We used data of 17 patients, who each received 11 repeat CT scans and a planning CT scan. The repeat CT scans were matched on the planning CT scan by the bony anatomy. Clinical treatment plans were used to evaluate the impact of bladder filling changes on the four histogram types. The impact was quantified by calculating for this patient group the correlation coefficient between the planning histogram and the treatment histogram. We found that the absolute dose-surface histogram was the most representative one for the actual treatment.     

多层螺旋CT后处理技术在泌尿系结石诊断中的应用价值

目的 探讨多层螺旋CT后处理技术在泌尿系结石诊断中的应用价值。方法 11例泌尿系结石患者中,7例直接行泌尿系CT平扫后+三维重建,4例先行CT平扫,后进行尿路造影检查（CTU）,两种方法扫描后应用容积重建（VR）、多层面重建（MPR）及曲面重建（CPR）等技术来分析观察结石的形态、大小、密度、数目以及发病部位。结果 11例结石患者中,阳性结石10例（CT值约500 Hu~1100 Hu）,阴性结石1例（CT值约40 Hu）,共35枚结石,鹿角状9枚,结节状26枚。单纯肾结石3例,单纯输尿管结石1例,肾结石合并输尿管结石6例。合并不同程度肾积水7例,合并肾周筋膜炎和输尿管周围炎1例。结论 多层螺旋CT后处理技术在治疗前可准确评估泌尿系结石的状态,有助于临床泌尿系结石的诊断。     

Phytobezoar: an unusual cause of intestinal obstruction

Small bowel phytobezoars are rare and almost always obstructive. There have been previously reported cases of phytobezoars in the literature, however there are few reports on radiological findings for small bowel bezoars. Barium studies characteristically show an intraluminal filling defect of variable size that is not fixed to the bowel wall with barium filling the interstices giving a mottled appearance. On CT scan, the presence of a round or ovoid intraluminal mass with a 'mottled gas' pattern is believed to be pathognomonic. Since features on CT scans are characteristics and physical findings are of little assistance in the diagnosis of bezoar, the diagnostic value of CT needs to be emphasised.     

6例膀胱子宫内膜异位症的诊治体会

目的探讨膀胱子宫内膜异位症的诊断和治疗方法。方法对6例诊断膀胱子宫内膜异位症病例的临床表现和B超、CT、膀胱镜征象以及治疗方法进行分析,6例患者均行膀胱部分切除术。结果 6例患者术后病理检查均证实为膀胱子宫内膜异位症,术后无复发,疗效满意。结论确诊膀胱子宫内膜异位症需膀胱镜检查或手术探查。诊断应详细地询问、分析病史和临床症状,治疗方法的选择取决于患者的年龄、生育要求、病变的范围、泌尿系症状的程度以及是否合并盆腔其他部位的子宫内膜异位症病变等。腹腔镜下膀胱部分切除术是最有前途的术式之一。     

慢性硬膜下血肿影像学多形性表现及临床诊治

目的 探讨慢性硬膜下血肿的临床特征、多形性影像学表现与手术结果。 方法　对2014年1月~2017年12月我院收治的经过头部CT扫描证实的CSDH共78例,对患者的临床特征、影像学表现及手术结果进行分析。结果　经手术治疗治愈73 例（93.59%）,术后血肿量减少,中线结构复位明显,术后1月后复发5 例（6.41%）。结论 钻孔引流术治疗慢性硬膜下血肿安全、简单、疗效满意,CT扫描及CT增强扫描和MRI检查综合术前评估采用不同术式能提高手术质量。     

Inflammatory pseudotumor of the renal pelvis. A report of 2 cases with clinicopathologic and immunohistochemical study

We describe 2 cases of inflammatory pseudotumor of the renal pelvis. Case 1, the male patient, was 37 years old, and case 2, the female patient, was 54 years old. Both patients presented with macroscopic hematuria and flank pain. Computed tomographic (CT) scan and ureterocystoscopy revealed in case 1 a mass in the left renal pelvis and the calyces. In case 2, urography showed a lacuna of the renal pelvis, and CT scan showed an irregular thickening of the renal pelvis. In both cases, the preoperative clinical diagnosis was urothelial carcinoma, and both patients underwent nephrectomy. Microscopic examination revealed in case 1 a tumor of the renal pelvis composed of spindle cells with eosinophilic cytoplasm in a myxoid and vascular stroma with abundant inflammatory infiltrate. In case 2, the tumor was composed of densely basophilic spindle cells in a fascicular pattern intermingled with lymphocytes and plasma cells and involving the lamina propria of the renal pelvis. The spindle cells reacted strongly with antibody to vimentin and focally with antibodies to smooth muscle actin and muscle-specific actin. In the urogenital tract inflammatory pseudotumor involves preferentially the urinary bladder. Rare cases have been reported in the kidney. The 2 cases presented here are unusual due to the location in the renal pelvis, mimicking urothelial carcinoma.     

Ultrastructural Study of Tooth Enamel with Amelogenesis Imperfecta in Al-Nephrocalcinosis Syndrome

This paper describes the ultrastructure of the affected enamel and the clinical features in two siblings with the syndrome of nephrocalcinosis and amelogenesis imperfecta. Nephrocalcinosis was diagnosed by intravenous pyelography, and confirmed by ultrasonography and CT scan. Amelogenesis imperfecta AI was diagnosed clinically and histologically.

Light microscopy showed that the affected enamel surfaces were rough and the enamel was hypoplastic and mainly positively birefringent. Scanning electron microscopy revealed a rough and extensively cracked enamel surface covered with oval shaped blister-like protrusions. TEM snowed porous enamel consisting of loosely packed and randomly oriented thin ribbon-like crystals with little or no prismatic structure.

Observations showed that hypoplasia together with hypocalcification and/or hypomaturation defects were present in the same tooth, indicating the possibility of an abnormality in interstitial matrix, leading to dystrophic calcification in the kidney and abnormal tooth enamel formation, or alternatively an involvement of two separate but closely linked genes.