急性吸入性汞中毒胸部X线及CT表现

目的 分析急性吸入性汞中毒性肺炎胸部X线及CT表现.方法 23例急性吸入性汞中毒患者,拍摄胸部平片61次,其中11例行胸部CT扫描17次,分析其X线及CT表现.结果 23例入院时X线片示汞毒性实质性肺炎10例,表现为双肺野多发片状密度增高影,边缘模糊,散在分布,3例伴有泡性肺气肿.汞毒性肺间质性炎症7例,表现为肺纹理增重模糊及紊乱,呈斑团状、条索状、网格状致密影.中毒性泡性肺水肿6例,表现为双肺大片状密度增高阴影,4例合并间质性肺水肿,可见K氏A、B线.CT扫描显示汞毒性实质性肺炎为双肺野多发散在分布的片状高密度影,范围广泛,伴发的泡性肺气肿呈低密度大小不等薄壁泡状影.汞毒性肺间质性炎症CT表现为肺纹理增重模糊,局部呈斑团状、条索状、网格状高密度影,病灶周围伴较高密度渗出性改变.中毒性泡性肺水肿表现为双肺大片状或蝶翼状密度增高影,边界模糊、欠光整.结论 急性吸入性汞中毒性肺炎胸部X线及CT表现具有一定的特征性,结合临床病史和实验室检查可作出明确诊断.     

急性氯气中毒患者胸部影像学表现分析

目的 探讨急性氯气中毒患者胸部影像学表现及其诊断价值.方法 回顾性分析117例氯气中毒患者的胸部影像学表现,依据国家职业性急性氯气中毒诊断标准进行分类统计.结果 胸部影像学表现正常,临床表现为刺激反应者65例;胸部影像学表现为无异常或两肺肺纹理增多、增粗、模糊,临床表现为轻度中毒者31例;胸部影像学表现为局限性小斑片样模糊阴影,肺野有毛玻璃样改变、两肺散在点状和网状阴影,常可见水平裂增厚、单个或多个局限性片状阴影,临床表现为中度中毒者17例;胸部影像学表现为两肺广泛且密度均匀的实变阴影,临床表现为重度中毒者4例.结论 在有明确的氯气吸入史及出现相关临床表现的基础上,结合胸部影像学表现,能更准确地诊断氯气中毒以及判定病情的严重程度,为临床治疗原则的选择提供重要依据.     

阑尾黏液性囊腺瘤CT表现及文献复习

阑尾黏液性囊腺瘤临床少见,据文献报道其发生率占阑尾切除标本的0.43％[1-2].本病临床上无特异性症状,或主要表现为慢性非转移性右下腹疼痛以及右下腹包块,术前诊断困难,易误诊为阑尾炎、阑尾周围脓肿、回盲部肿瘤、卵巢囊肿等疾病.随着多层螺旋CT的广泛应用及普及,薄层扫描及多平面重组(multiplanar reconstruction,MPR)等重建技术能从不同角度整体观察阑尾及其周围情况,做到观察的连续性和完整性,大大提高阑尾疾病术前诊断准确率[3].现对本院经病理诊断的5例阑尾黏液性囊腺瘤进行回顾性分析,并对国内外相关文献进行复习,旨在提高对该病CT表现的认识及诊断能力.     

急性氰化物吸入中毒的胸部CT表现（附4例报告）

我院近期收治某矿厂车间生产过程中氰化物泄露导致急性氰化物中毒的患者6例。其中2例轻度中毒者,经过治疗6天、12天后恢复良好,顺利出院。现将4例重度中毒患者的胸部Cr表现分析总结如下。     

卵巢生殖细胞肿瘤的CT、MRI表现及其病理基础

卵巢生殖细胞肿瘤(ovarian germ cell tumors,OGCT)种类较多,可分为恶性和良性病变.目前多数OGCT定位诊断并不困难,但其术前定性诊断仍较困难,不同OGCT之间的鉴别诊断具有重要临床价值.笔者收集经临床病理证实的31例OGCT,结合国内外文献分析其CT和MRI表现,旨在进一步提高对其的认识和影像诊断水平.     

新型冠状病毒肺炎的临床表现及胸部高分辨率CT影像学表现分析

目的 探讨新型冠状病毒肺炎(COVID-19)患者的胸部CT影像学表现及其与临床表现之间的关系.方法 回顾性分析17例经病毒核酸检查确诊为COVID-19患者的临床症状、实验室检查和CT影像表现及CT评分,采用Spearman秩相关分析评估CT评分与临床资料间的关系.结果 高分辨率CT(HRCT)上,12例(70.6％...     

口服百草枯中毒肺损伤的胸部CT表现与预后关系分析

【摘要】目的：分析口服百草枯中毒患者肺损伤的胸部CT表现,探讨百草枯中毒患者CT征象与临床预后的关系。方法：回顾性分析78例口服百草枯中毒患者的临床及胸部CT影像资料,将78例患者根据预后分为生存组（40例）和死亡组（38例）,分析两组百草枯中毒患者的胸部CT征象的差异,探讨影响临床预后的重要CT征象。 结果：死亡组患者出现肺纹理增多、磨玻璃影、实变影、肺纤维化、肺过度充气等CT征象,以及纵隔/皮下气肿等并发症的比例高于生存组,差异有统计学意义（P<0.05）;两组患者的肺部CT征象中,以肺纹理增多、胸膜下线、磨玻璃影等早期渗出性征象的诊断效能较高,曲线下面积（AUC）达0.87～0.93。结论：在口服百草枯中毒患者的胸部CT征象中,尤以磨玻璃影的范围及肺过度充气、纵隔/皮下气肿的有无与临床预后的关系最为密切,能为临床预后的判断提供重要的影像学依据。     

严重急性呼吸综合征患者肺内残留病变CT表现的随访观察

目的 探讨严重急件呼吸综合征（SARS）患者临床治疗后，CT复查肺内残留病变的动态变化情况。方法 对124例治疗后的SARS患者进行CT复查随访，失访13例，资料完整111例，对平均病程第3、6、12及18个月行螺旋CT检杏的结果进行对比分析，总结其影像动态变化的特征。结果 病程18个月内，相继有70例（占63．1％）患者肺内CT表现恢复止常。6、12、18个月时CT主要征象：（1）磨玻璃样病变残留率分别为33．3％（37／111）、24．3％（27／111）、20．7％（23／111）。（2）小叶间隔或小叶内间质增厚残留率分别为37．8％（42／111）、28．8％（32／111）、25．2％（28／111）。以上2种主要病变在随访期内的总体变化经对比分析X^2检验，差异有统计学意义（P〈0．01）。（3）胸膜下弧线影15例，随访期内病变有不同程度的吸收，但无一例病变消失。（4）不规则纤维条索影18个月时残留率17．1％（19／111）。少见征象：（1）实变病灶1例，病程第12个月完全吸收。（2）空洞病灶2例，1例于病程第12个月基本吸收，1例随访期内末完全吸收。（3）牵拉性支气管扩张1例，随访期内无明显变化。（4）小结节灶3例，1例病程第12个月基本吸收，2例无明显变化。结论 病程第18个月SARS患者肺内磨玻璃样病变残留率为20．7％。17．1％的患者残留局限性肺间质纤维化改变。对肺内残留磨玻璃样病变的患者继续定期随访间隔6～12个月为宜，其他患者可以延长随访间隔时间至12个月以上。     

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.     

亚低温治疗重度弥漫性轴索伤的临床研究

目的 旨在探讨亚低温对重度弥漫性轴索伤（DAI）的治疗作用及患者颅内压、预后的关系。方法 本组观察了80例重度弥漫性轴索伤,在常规治疗的同时,对60例亚低温治疗。80例重度DAI患者分为亚低温和常温两组,所有患者均行颅内压监护5－7天。全部患者于伤后3个月行GOS评分判断预后。结果 在亚低温组,其颅内压明显低于对照组（P＜0．05）;亚低温组的死亡率为26．7％,而常温治疗组为55％（P＜0．05）。结论 重度DAI后,不仅应及时诊断,而且要尽早应用亚低温治疗、尽早降温。亚低温治疗有明显降低颅内压的疗效。亚低温治疗可以明显提高重度DAI患者的生存率和生存质量,降低DAI的死亡率和伤残率。     

Extrarenal manifestations of severe acute pyelonephritis: CT findings in 21 cases

The aim of this study is to report the extrarenal computerized tomography (CT) findings in patients with acute pyelonephritis (APN). Twenty-one CT examinations of 20 patients [19 women and one man, with ages ranging from 18 to 57 years (mean —35.2 years)], presenting either with a clinical diagnosis of APN (n=17) or with a suspected acute appendicitis, fever of unknown origin, and adult respiratory distress syndrome, one in each, were retrospectively reviewed. None had a known preexisting systemic disease. Results showed that renal abnormalities were seen on CT in all patients. In addition, ascites was detected in all women patients associated with subcutaneous edema in five of them. A thickened gallbladder wall was found in 19 cases, all were women, and periportal tracking and a dilated inferior vena cava in 17 CTs. Pleural effusion and thickened interlobular septa were present in 16 and 15 studies, respectively. Relevant laboratory findings included hypoalbuminemia in 14, elevated liver enzymes in 11, hypocholesterolemia in nine, and elevated LDH levels in six cases. In conclusion, radiologists should be familiar with the extrarenal imaging features of APN that may be seen on CT, and on ultrasonography as well, and should look for renal abnormalities to diagnose a clinically unsuspected APN. Alternatively, APN should be included in the differential diagnosis of systemic diseases that cause gallbladder wall thickening to avoid misdiagnosing it as acute cholecystitis.     

急性脑外伤CT、MRI敏感性,特异性比较分析

目的：比较急性脑外伤CT、MRI的敏感性和特异性。方法：选取1998年1月－1999年12月122例均进行CT、MRI检查的脑外伤病例,且这些病例的CT、MRI诊断均得到复查或手术核实。把所获得的数据进行列表,分别计算敏感性和特异性。为了减少主观因素的影响,我们采用了ROC曲线图来评价此组资料。结果：在ROC曲线图中发现MR曲线位于CT曲线的左上方。结论：检测急性脑外伤MR比CT更具有优越性。     

Electrocardiographic findings and cardiac manifestations in acute aluminum phosphide poisoning

Aluminium phosphide (AlP) poisoning has a high mortality due to cardiovascular involvement. In this study, we evaluated the frequency of cardiac manifestations and electrocardiographic (ECG) findings in 20 patients with acute AlP poisoning, who were admitted to the intensive care unit (ICU) in Tehran, Iran, over a period of 6 months (between October 2008 and April 2009). The sex, age, cause and manner of ingestion, number of ingested AlP tablets, cardiac and ECG manifestations, creatine phosphokinase (CPK), CPK-myocardial band (CPK-mb) and troponin-T (TnT) were extracted from the patients' files. All data were analysed with Statistical Package for the Social Sciences (SPSS) software.The majority (60%) of patients were male. The mean age was 27 ± 8.7 years. The mortality rate was 40%. In all of the patients, the cause of poisoning was intentional suicide and ingestion was the route of exposure. The mean number of ingested AlP tablets per patient was 2.2 ± 1.1. The average time interval between admission and cardiovascular manifestations or ECG findings was 168.8 ± 116.2 min. The range of systolic (SBP) and diastolic blood pressure was 60–130 mmHg and 40–70 mmHg, respectively. Dysrhythmia was observed in nine (45%) cases. Elevation of the ST segment was seen in nine cases (45%). Seven patients (35%) had prolonged QTc intervals. Bundle branch block (BBB) was observed in four (20%) patients. In nine (45%) patients, the serum cardiac TnT qualitative assay was positive. There were no significant differences between normal and abnormal ECG groups according to sex, age, number and manner of ingested AlP tablets and SBP. There was a significant correlation between cardiac manifestations and ECG findings and TnT-positive results with mortality in acute AlP poisoning.     

Paraquat poisoning: findings on chest radiography and CT in 42 patients

The purpose of this study is to describe the radiologic manifestations of paraquat-induced pulmonary damage, with special emphasis on the sequential changes seen with this condition. Paraquat is a herbicide that has toxic effects on the lungs, liver, and kidneys. Progressive respiratory failure is a frequent cause of death. We analyzed retrospectively 42 patients with a history of paraquat ingestion and abnormal findings on chest radiographs. Radiographic changes during the first week after ingestion included diffuse consolidation (26/39), pneumomediastinum with or without pneumothorax (15/39), and cardiomegaly with widening of the superior mediastinum (8/39). Small cystic and linear shadows began to appear at the end of the first week and were the preponderant parenchymal abnormality after 2-4 weeks. Focal honeycombing was the major parenchymal abnormality after 4 weeks. High-resolution CT of the lung 9 months after paraquat exposure revealed localized fibrosis containing small cysts. Our study shows that the pulmonary manifestations of paraquat poisoning begin with air-space consolidation, which then leads to end-stage lung.     

急性缺氧家猫颅脑CT表现与毛细血管面积密度的关系

目的研究急性高原病和（或）高原性脑水肿的颅脑CT表现及其病理学基础。方法采用低压缺氧模型在模拟7000m海拔高度条件下观察家猫缺氧24、48和72小时的颅脑CT表现、脑组织毛细血管面积密度的变化及病理改变。结果CT显示脑室脑池变小或消失、脑沟变窄，大脑、基底节、脑干和小脑的密度不同程度地普遍增高；脑组织毛细血管面积密度明显增加，并与CT值呈显著直线正相关。病理学上见微血管扩张，大脑皮层神经细胞肿胀，细胞和血管周围间隙增宽，脑实质内散在广泛点状出血。结论脑肿胀可能是急性高原病和（或）高原性脑水肿的一种颅脑CT表现。     

64层CT一站式血管造影检查在急重症胸痛诊断中的应用

目的 探讨64层螺旋CT一站式血管造影检查在心胸部血管性病变所致急重症胸痛诊断中的应用价值.方法 对28例临床高度怀疑血管性病变所致急重症胸痛行一站式血管造影检查,利用多种后处理技术进行重建,分别观察胸主动脉、肺动脉及冠状动脉,从而找出引起急重症胸痛的病因.结果 急性主动脉夹层10例,急性肺动脉栓塞7例,急性冠状动脉综合征6例,胸膜炎2例,自发性气胸1例,肋骨病理性骨折1例,1例未发现明显异常,所有病例最终经过临床证实.结论 64层螺旋CT一站式血管造影检查在血管性病变引起的急重症胸痛诊断中有非常重要的意义和实际应用价值,可以明确引起急重症胸痛的责任血管,可以作为急重症胸痛重要检查手段之一.