成人肾及其血管的CT影像解剖

目的:为影像学诊断及临床诊治提供解剖学影像资料.方法:对160例成人进行64排螺旋CT平扫加增强扫描,统计测量肾的体积、肾动静脉、副肾动脉.所得数值按年龄、性别、侧别进行分组统计处理并进行相关性分析.结果:肾平均体积左侧(148.88±26.397)cm3,右侧(141.25±29.09)cm3,左右侧别无差异,男性组大于女性组.两侧肾动脉起点右侧高于左侧占优.左肾动脉与腹主动脉夹角平均79.39°,右肾动脉与腹主动脉夹角平均71.14°.肾动脉长度:左侧43.08 mm,右侧52.56mm,左右侧差异有统计学意义.左右肾静脉与下腔静脉之间的夹角分别为69.93°、67.23°.肾静脉长度左侧长于右侧.副肾动脉出现率为28.75%,入肾上极者多于入肾下极和肾门;副肾动脉起始于腹主动脉者占26.27%,起源于同侧肾动脉者占73.73%.结论:肾体积大小男性略大于女性,左右侧无差异;肾动、静脉长度、内径左、右侧存在差异性,但无性别差异.     

断层影像解剖学的现状与未来：首届全国断层影像解剖学论坛总结

断层影像解剖学的现状与未来——首届全国断层影像解剖学论坛总结刘树伟①张绍祥②吴德昌③刘丰春④汪亚晴⑤赵斌⑥本世纪７０年代以来，超声、ＣＴ、ＭＲＩ、ＳＰＥＣＴ、ＰＥＴ、介入放射学及立体定向技术（γ—刀、Ｘ—刀）已成为医学影像学诊治的主流，是当代医学迈入...     

影像解剖学的研究现状与前景展望

影像解剖学是由现代影像技术与传统解剖学相结合而产生的一门新兴学科,是断层解剖学在活体上的应用。它着重于应用现代高科技的成像方法认识、研究人体的解剖结构,以断面形式揭示人体器官组织的形态结构与相互关系。而传统解剖学通过手术刀解剖和展示人体结构,让人们看到它的形状、     

肾上腺静脉MSCT影像解剖研究

目的　利用MSCT准确显示肾上腺静脉正常解剖结构及变异,为临床提供影像解剖数据。 方法　回顾分析上腹部CTA患者108例。薄层MIP/MPR评估测量肾上腺静脉管径、长度及走行路径。 结果　①右侧：显示率64.81%（70/108）,变异5.71%(4/70);汇入下腔静脉7点至8点间占优势42.42%;其管径Rr (2.19±0.56) mm,腺外段长度RD1 (5.02±1.82) mm,汇入下腔静脉距右肾静脉汇入距离RD2 (40.69±12.96) mm,汇入口开口向下角度RA (60.25±17.85)°。②左侧：显示率97.22%（105/108）;变异14.29%（15/105）;肾上腺静脉管径Lr (2.39±0.56) mm,腺外段长度LD1 (7.28±4.01) mm,膈-肾上腺静脉干管径LR (3.65±0.93) mm,膈-肾上腺静脉的共干段长度LD2 (14.07±6.77) mm,膈-肾上腺静脉汇入左肾静脉点至下腔静脉左侧缘距离LD3 (32.89±4.85) mm,膈-肾上腺静脉汇入左肾静脉开口向内的角度LA1 (118.06±18.49)°,肾上腺静脉与膈静脉共干段开口向下的角度LA2 (156.15±13.81)°。 结论　MSCT可显示大部分右侧肾上腺静脉及绝大部分左侧肾上腺静脉正常走行及变异,测量相关影像解剖数据,为AVS等手术方案提供影像数据。     

局部解剖学和断层影像解剖学二合一教学改革的实践和反思

为了适应当代医学影像技术发展的需要,培养出更具时代特色的影像医学人才。我们从1995年开始,逐步将断层影像解剖学的教学纳入影像专业的局部解剖学教学之中,并逐步形成局部解剖学和断层影像解剖学二合一的教学模式。教学效果是肯定的、显著的。随着超声成像、计算机X线体层摄影和磁共振成像等影像技术的发展和普及,断层影像解剖学已越来越显示出它的必要性和重要性,它对提高教学质量和培养适应时代所需的临床医生具有十分重要的理论意义和实用价值。在如何更有效地实施这一教学模式方面,我们进行了大胆的改革和尝试。在以下几个方面我们认为仍值得反思和探讨:1.如何使二者更加有机地融合和统一,使之成为一个整体。2.与之相适应的教材建设和使用。3.断层挂图的制作和使用。4.如何使断层标本和影像图片有机统一。5.如何在教学中使用现代的多媒体技术和数字化人体。6.非影像学专业的学生也应开设断层影像解剖学课程。总之,我们认为局部解剖学和断层影像解剖学二合一教学是必要的,已是可行的,二者有机地衔接和融合,不仅能提高学生学习的积极性和主动性,而且能提高他们分析问题和解决问题的能力。但它毕竟还是新生事物,在诸多方面仍有待进一步提高和完善。     

初论影像断层解剖学的教学设计

随着电子计算机X线连续断层图(CT)和磁共振成像(MRI)的应用,从而开拓了在活体上研究人体断层或器官内部结构的广阔前景,也新辟了断层解剖学。当代临床工作者不仅要掌握系统解剖学和局部解剖学,而且还要熟悉影像断层解剖学,才能适应现代医学的     

断层影像解剖学标本的制作与封装

随着各种影像诊断技术的飞速发展及临床的广泛应用 ,作为形态学基础的断层影像解剖学已形成一门新的学科。为适应临床影像诊断、治疗的需要 ,近年来我室开展了断层影像解剖学的教学和科研工作 ,我们在标本制作和封装方面进行了有益的探索。1　标本制作1.1　材料选择　制作断层影像解剖学教学标本 ,选用传统防腐固定的成人尸体 ,以中青年为好 ,外观体态均称 ,皮下脂肪少 ,无特殊疾病与生理缺陷 ,淹死或中毒死亡的尸体是制作标本的最佳材料[1] 。如进行正常断层影像解剖学研究 ,则选用新鲜尸体 ,按正常解剖位置放置 ,进行灌注固定 ,固定 2～ 3…     

努力开拓断层影像解剖学研究的新局面

断层解剖虽然在16世纪就已有记载,断层解剖学的专著和图谱亦始见于19世纪,但大规模的断层解剖学的研究是近几十年来才得到开展。特别是自70年代以后,由于Ｂ超、ＣＴ、ＭＲＩ等影像技术的临床应用,对断层解剖学的研究提出了急迫的需求,于是,断层影像解剖学便应运而生。我国的断层影像解剖学研究,由于具有标本来源比较方便的有利条件,居于世界先进行列。特别是近年来,在钟世镇院士、刘玉清院士等不少德高望重的老一辈科学家的亲切关怀和大力扶持下,在刘树伟教授为首的一批有识之士的带动下,经过全国许多志同道合的学者们的共同奋斗,我国的断层…     

顺应现代医学发展加强断层影像解剖学

断层影像解剖学是断层解剖学与影像解剖学的合称，是针对影像诊断学和介入放射学等学科的需要而研究人体形态结构及其基本功能变化规律的科学。７０年代以来，随着四大影像医学、介入医学、立体超声、磁共振血管造影等现代化诊治手段在临床上的应用和飞速发展，带来了临床...     

浅谈如何开设影像断层解剖学

随着现代科学技术的发展,各种先进的影像诊断、治疗设备在临床中得到广泛应用。目前国内大多数地县级医院已配置了CT和MRI等影像诊断仪器,而操作和使用这些仪器的影像诊断工作者,尚缺乏与之相适应的系统的影像断层解剖学知识。并且高等医学院校现培养的学生都是二十一世纪的实用型人才,为了适应影像诊断技术的快速发展,他们均需具备影     

Lipoma of the adrenal gland

A rare case of a lipoma of the adrenal gland is reported with a review of the literature. The tumor was incidentally found at autopsy in a 50-year-old man who died from severe head trauma after a traffic injury. At autopsy, an oval-shaped, soft yellow nodule measuring 1.1 cm in diameter was found in the right adrenal cortex. Histological examination revealed a lesion consisting of mature adipose tissue partially surrounded by a thin fibrous capsule. On serial sections there was no evidence of hematopoiesis nor of adrenal medulla cells. To the best of our knowledge, this is the eighth case described in the English literature. With the increasing use and the high resolution of modern imaging techniques, these unsuspected adrenal masses may become more prevalent.     

Adenomatoid tumor of the adrenal gland with micronodular adrenal cortical hyperplasia

We report a case of an adenomatoid tumor (AT) of an adrenal gland with micronodular adrenal cortical hyperplasia (ACH). A 51-year-old man was found to have newly developed hypertension with clinical evidence of primary aldosteronism. A computerized tomogram of the abdomen revealed a solitary mass in the right adrenal gland. He underwent a right adrenalectomy for a presumptive clinical diagnosis of a solitary aldosterone-producing adrenal cortical adenoma. On histopathologic examination, the adrenal gland demonstrated an AT, diagnosed by the characteristic histological features, immunohistochemical stain results, and electron microscopic findings. The surrounding adrenal cortex showed multiple small hyperplastic cortical nodules. After the adrenalectomy, the patient's blood pressure normalized. Primary AT of the adrenal gland coexisting with micronodular ACH associated with hypertension has not been previously reported.     

Myelolipoma in adenoma of accessory adrenal gland.

A tumor was incidentally found at autopsy in the vicinity of the right adrenal gland of a 69-year-old man who had died of liver cirrhosis with hepatoma. Microscopic examination disclosed a myelolipoma associated with a cortical adenoma occurring in an accessory adrenal gland. No evidence of hormonal abnormalities was found in the clinical record of the patient. The association of myelolipoma with cortical adenoma occurring in an accessory adrenal gland seems very unusual, and the present case is believed to be the first reported of this type of association.     

肾上腺少见病变的CT表现 (附12例报告)

目的探讨肾上腺少见病变的CT表现特点。方法2003年1月至2006年7月肾上腺少见占位性病变12例,其中男性7例,女性5例,年龄14～76岁,中位年龄42岁。回顾性分析12例经手术病理证实的肾上腺少见病变的CT资料。结果12例中,右肾上腺皮质癌2例,右肾上腺神经鞘瘤1例,左肾上腺节细胞神经瘤1例,多发内分泌肿瘤MEN-Ⅰ型1例,左肾上腺区巨淋巴结增生症1例,肾上腺髓样脂肪瘤4例5个病灶,肾上腺囊肿2例。囊肿及髓样脂肪瘤易于诊断;肾上腺皮质癌CT表现提示其为恶性;其他少见病变定性诊断困难。结论肾上腺少见病变均有一些CT表现特点;CT平扫加动态增强扫描对诊断有重要价值。     

Mesothelial cyst of the adrenal gland

A case of mesothelium-lined cyst of the adrenal gland is reported. Although more than 300 adrenal cysts have been reported in the literature, epithelial cell-lined cysts are rare and comprise only 9% of the cases. An adrenal cyst was found, the lining cells of which had features consistent with mesothelial cells. The inner surtace of the cyst was lined by a single layer of cuboidal cells, which showed alcian blue positive cellular outline. Immunohistochemically, the lining cells were positively stained for keratin, epithelial membrane antigen and CA-125. Electron microscopic examination revealed many long complex microvilli and desmosomes in the lining cells. There was a basal lamina beneath the cell layer. These morphological and immunohistochemical findings indicated that the lining cell is derived from mesothelium.     

活体肾上腺血管的解剖观测及临床意义

目的：研究活体肾上腺血管的应用解剖。方法：对１８例２４侧肾上腺手术时分离出血管，测量血管外径及长度，对６个完整肾上腺灌注染色。结果：右膈下动脉从下腔静脉右缘至末支肾上腺上动脉长８．５（７．５～１１．０）ｃｍ，外径２．５～３．０ｍｍ；左膈下动脉从腹主动脉左缘至末支肾上腺上动脉长８．０（７．０～９．０）ｃｍ，外径２．５～３．１ｍｍ；肾上腺上动脉１～６支，均源于膈下动脉。肾上腺中动脉右侧长１．７～２．２ｃｍ，外径１．０～１．５ｍｍ；左侧长１．５～２．０ｃｍ，外径１．０～１．５ｍｍ。肾上腺下动脉两侧基本相同，长１．５～２．０ｃｍ，外径１．０～２．０ｍｍ。肾上腺中心静脉右侧长０．４～０．８ｃｍ，左侧长３．０～４．０ｃｍ，外径３．０～４．０ｍｍ。结论：肾上腺血管加部分膈下血管的长度可供带血管蒂肾上腺转位治疗柯兴氏病；活体切取供移植的肾上腺；选择性肾上腺血管造影等。     

Adenomatoid tumor of the adrenal gland: case report with immunohistochemical study

Adrenal adenomatoid tumor (AT) is a recently recognized disease with marked male predominance. Herein is presented a case of adrenal AT incidentally found in a 30-year-old man and results of immunohistochemical examination of the tumor. The left adrenal gland, weighing 17 g, contained a mass measuring 3 x 2.5 x 2.5 cm in the cortical tissue. Cut surface showed a relatively well-circumscribed firm tumor with a white solid appearance. Histologically, the tumor had the typical appearance of AT described in the genital tract. Immunohistochemically, the tumor cells were positive for calretinin, D2-40, WT1, mesothelial cell antigen, CA125, thrombomodulin, vimentin and cytokeratins (stained by AE1 + AE3, OV-TL 12/30, CAM5.2 and MNF116), and negative for endothelial markers (CD31, CD34 and factor VIII-related antigen) and CD56. CD56-positive adrenocortical cells were diffusely scattered in the tumor, especially in its periphery. Immunohistochemistry of estrogen, progesterone and androgen receptors was negative. These findings confirm mesothelial origin of the tumor and suggest that this tumor has little relation to sex hormone despite male predominance.     

Lipoadenoma of the adrenal gland: report of a rare entity and review of literature

Adrenal lipoadenoma is an extremely rare tumor. Only four cases have been reported so far. The authors reported a case of adrenal lipoadenoma in a 46-year-old man with the history of abdominal pain. The present case, manifesting as a nonfunctional adrenal tumor, is characteristically comprised of a mixture of mature adipocytes and adrenocortical cells. We also reviewed this tumor in different organs which have been published in the literature.     

肾上腺髓性脂肪瘤的诊断和治疗

目的总结肾上腺髓性脂肪瘤的诊断及治疗经验。方法分析21例肾上腺髓性脂肪瘤的临床特点、诊断、治疗及随访情况。患者术前均行内分泌、B超及CT检查;部分患者行MRI及131I-MIBG检查。结果21例患者均行肾上腺髓性脂肪瘤切除术,肿物直径4.5-12 cm,平均6.7 cm。病理诊断均为肾上腺髓性脂肪瘤。随访1-15年,未见复发。结论肾上腺髓性脂肪瘤是肾上腺的少见良性病变,多偶然发现,预后良好。