Delineation of adrenal in controls and nontumorous adrenal disorders by real-time ultrasonic-scanner

In 90 control subjects, 90% of the right adrenal and 38% of the left were delineated by sector US scanner. A longitudinal scan from an intercostal space in the mid-axillary line and a right-anterior-transverse scan from the intercostal space were useful in displaying the right adrenal, and an anterior-transverse scan from the epigastrium was also useful in showing the left adrenal. The latter was not as clear as the right. Moreover, a transverse scan from the left flank did not fully display the whole image of the left adrenal. The sizes of both adrenal images were somewhat smaller than those made by computerized tomography (CT), as shown in our previous study. Although the left adrenal in one case of congenital adrenogenital syndrome and those in three cases of Cushing's disease could not be delineated, all of the enlarged right adrenals in these cases were demonstrated by ultrasonic scanning (US). These results suggest the clinical usefulness of US for the detection of affected, nontumorous right adrenals.     

64层螺旋CT多期相扫描诊断肾上腺常见肿瘤的临床研究

目的：探讨64层螺旋CT多期相扫描对临床常见的肾上腺腺瘤、嗜铬细胞瘤及转移瘤诊断和鉴别诊断的意义。材料和方法：64例肾上腺肿瘤患者行Siemens Sensation 64层螺旋CT平扫及增强检查。分析评价肾上腺肿块的动态增强CT表现特征（各期CT值、造影剂绝对廓清率和相对廓清率）。结果：肾上腺腺瘤37例，嗜铬细胞瘤17例，转移性肿瘤10例。腺瘤平扫、动脉期及静脉期CT值均低于嗜铬细胞瘤，以动脉期明显（P<0.01）；腺瘤平扫、动脉期及延迟期CT值低于转移瘤，以延迟期明显（P<0.01）；腺瘤造影剂廓清率大于嗜铬细胞瘤和转移瘤。嗜铬细胞瘤仅动脉期CT值大于转移瘤。结论：64层螺旋CT为肾上腺的显示和肾上腺肿瘤的定位诊断提供了保证；而肾上腺肿瘤不同CT扫描时相和不同参数的特点为肾上腺肿瘤的定性诊断提供较多依据。     

Comparison of computed tomography and ultrasound in the evaluation of abdominal neuroblastoma

A retrospective review of 15 cases of abdominal neuroblastoma was undertaken to determine the efficacy of ultrasound (US) in the evaluation of this disorder. Thirteen of the 15 cases were studied with both US and computed tomography (CT). It was found that US was accurate in all but two cases, where shadowing from bowel gas and dense tumor calcifications prevented accurate delineation of residual tumors. The CT scans were degraded by artifacts from surgical clips in three cases and by patient motion in one. A nonopacified loop of bowel was mistaken for tumor by CT in one case. We conclude that although both CT and US should be done initially, US alone is adequate in most cases for follow-up of abdominal neuroblastoma. When excessive bowel gas is encountered, or dense tumor calcifications are known to be present, CT is the modality of choice.     

双层探测器光谱CT碘密度值对不同功能状态下肾上腺的评估

目的 探讨双层探测器光谱CT碘密度定量对肾上腺不同功能状态的评估价值.方法 2018年6月～2020年8月间于我院完成肾上腺光谱CT增强扫描的检查者中,按照不同的肾上腺功能状态收集病例,分为三组:感染性休克(双侧肾上腺肿大)26例(A组);肾上腺增生(双侧或左侧)14例(B组);右侧功能性肾上腺皮质醇腺瘤(左侧肾上腺反...     

肾上腺髓样脂肪瘤的CT表现

目的 分析肾上腺髓样脂肪瘤的CT表现,提高CT诊断的准确性。方法 本文报道螺旋CT检出的7例肾上腺髓样脂肪瘤并分析其CT征象,包括男性1例,女6例,年龄30-76岁,平均56岁。其中5例肿瘤起源于右侧肾上腺,1例起源于左侧肾上腺,另外1例为双恻性髓样脂肪瘤。结果 CT检查显示所有病例均起源于肾上腺并检出瘤体内脂肪成分,所有瘤体均位于肾上腺内外侧肢夹角的后方。肿瘤中6个以脂肪成分为主,2个以软组织成分为主：3个肿瘤中见点状钙化;2个以软组织成分为主的肿瘤可见完整的包膜,而6个以脂肪成分为主的肿瘤根据CT图象未能显示肿瘤包膜。在3例患者的对侧正常肾上腺周围可见大量脂肪。结论 螺旋CT薄层扫描可提供肾上腺髓样脂肪瘤详细解剖细节,有较高的诊断正确性。     

甲状腺肿瘤的MRI诊断探讨

目的:评价MRI对甲状腺肿瘤诊断的价值。材料和方法:回顾分析经手术病理证实的28例甲状腺肿瘤,均采用飞利蒲T5MRI成像仪检查,术前28例均做过同位素检查,25例做过超声检查。结果:28例甲状腺肿瘤中,甲状腺癌13例,腺瘤15例。MRI表现恶性肿瘤多形态不规则、边缘模糊不整,淋巴结转移较常见(9/13),良性肿瘤边缘光滑,无淋巴结转移。结论:MRI在甲状腺肿瘤的定性方面优于B超和同位素,与CT相比无质的飞跃。但在观察淋巴结肿大和肿瘤与周围组织关系方面有优势。     

Primary aldosteronism: computerized tomography in preoperative evaluation

We reviewed the value of computerized tomography (CT) in the preoperative evaluation of 34 patients with primary aldosteronism. All 34 patients entered a standard protocol including saline suppression testing, abdominal CT scanning, and adrenal venous sampling. Surgical pathologic findings, biochemical determinations, and clinical response to adrenalectomy were the criteria used to evaluate 68 adrenals in 34 patients. Of 36 diseased glands 17 were correctly identified by CT (48%). Of the 32 normal glands, 29 were identified correctly by CT (91%). Thus, CT is not sensitive (0.48), but very specific (0.91) in Conn's syndrome. Our patients were divided into two groups: group 1 were those scanned between 1977 and 1980, group 2 were those scanned from 1981 to 1983 with a high-resolution GE-8800 scanner. CT results in group 2 showed no significant improvement in specificity (0.92), but improvement in sensitivity (0.58) over group 1 (specificity 0.90, sensitivity 0.42). Furthermore, CT is less sensitive in patients with smaller tumors than in those with larger tumors.     

几种影像学检查对肾上腺醛固酮瘤定位诊断的互补作用研究

目的：探讨Ｂ型超声、ＣＴ及（或）同位素检查对肾上腺醛固酮瘤定位诊断的互补作用。方法：对疑醛固酮瘤者作Ｂ超检查２３８例,其中１４１例同时作过ＣＴ检查,２７例作为核素检查。将各种检查与病理对照,再把其中的假阴性与假阳性病例分别与其他两种检查相对照。结果：发现三种检查对漏诊（假阴性）单瘤具用很强的互补性,而对同侧双瘤则均未能幸免漏检其中之一。对误诊（假阳性）亦有很好的互补性,且本组核素无假阳性,但其样本嫌小（仅２７例）。结论：通过对比研究可以明确采用何种检查方法属最佳选择。     

儿童神经母细胞瘤的CT检查价值

目的:评价儿童神经母细胞瘤的CT检查价值。方法:回顾性分析24例手术病理证实神经母细胞瘤患者的临床资料,分析肿瘤的CT直接征象和间接征象。结果:神经母细胞瘤起源于肾上腺19例,腹部交感神经链3例,后纵隔交感神经链2例。CT特点:肿瘤呈类圆形或不规则形软组织密度肿块,部分跨中线生长,多数肿瘤体积较大,肿瘤密度多不均匀,可见斑片状低密度坏死区及斑块、沙砾状高密度钙化影;肿瘤易侵犯邻近结构,可包埋大血管,淋巴结转移多见,可见骨转移及硬脑膜转移,可见主动脉壁密度明显高于其内血液。化疗后肿瘤有不同程度缩小,其内钙化影浓聚并增大。结论:CT在儿童神经母细胞瘤治疗前的诊断、治疗方法的选择及治疗后随访均有重要价值。     

Giant adrenal myelolipomas: CT and MRI findings

The computed tomographic (CT) and magnetic resonance imaging (MRI) features of three giant myelolipomas of the adrenal gland are presented in two patients. CT demonstrates large, fatty retroperitoneal tumors that may be confused with retroperitoneal liposarcoma or very large renal angiomyolipoma. MRI with coronal and sagittal imaging is more sensitive than CT in defining the most likely origin of these tumors as the adrenal gland.     

Preoperative evaluation of periampullary tumors by endoscopic sonography, transabdominal sonography, and computed tomography.

PURPOSE: The purpose of this retrospective study was to compare the sensitivity of endoscopic sonography (EUS), transabdominal sonography (US), and CT in the detection of, local staging of, and prediction of vascular involvement by or distant metastasis from periampullary tumors. METHODS: Seventy-four consecutive patients with presumed periampullary tumors were evaluated by EUS, US, and CT during a 3.25-year period. The local staging accuracy of the modalities was assessed in the 36 patients with solid tumors who underwent surgery. The sensitivity of the modalities in predicting vascular involvement and distant metastasis was assessed in the 56 patients with carcinomas. RESULTS: EUS was the most sensitive modality in the detection (EUS, 97%; US, 24%; and CT, 39%; p < 0.001 for EUS versus US or CT) and T classification (EUS, 72%; US, 11%; CT, 22%; p < 0.001 for EUS versus US or CT) of periampullary tumors. EUS also had better sensitivity than US in detecting lymph node metastasis from periampullary cancers (EUS, 47%; US, 7%; and CT, 33%; p = 0.02 for EUS versus US; p = 0.7 for EUS versus CT). The accuracy of EUS in determining the T classification (without stent, 81%; with stent, 65%) and N classification (without stent, 80%; with stent, 70%) tended to decrease in the presence of an endobiliary stent, but the differences were not significant. EUS was the most sensitive modality in demonstrating vascular involvement (EUS, 100%; US, 0%; and CT, 33%; p = 0.002 for EUS versus US; p = 0.03 for EUS versus CT) but was not significantly different in detecting distant metastasis (EUS, 11%; US, 44%; and CT, 44%). CONCLUSIONS: EUS is superior to US and CT in the local assessment of periampullary tumors. The staging accuracy of EUS is minimally but not significantly affected by the presence of an endobiliary stent.     

Sonography of the adrenal glands in chronic disseminated histoplasmosis

In this retrospective study, the findings on abdominal sonograms in six patients newly diagnosed as having chronic disseminated histoplasmosis are reported. Five of six patients showed bilateral adrenal gland enlargement that was similar in degree from side to side. The most characteristic feature was the maintenance of a triangular shape in five glands and a cylindrical shape in two glands. Four glands had a nonspecific round or oval shape. All sonographic findings correlated well with the computed tomographic (CT) findings on each patient except that CT detected the one enlarged right adrenal gland not demonstrated sonographically. Abdominal sonography may provide the initial important clue to the diagnosis of chronic disseminated histoplasmosis.     

US和CT对甲状腺癌定性和淋巴结转移的比较

目的：评价超声（US）和CT检查对甲状腺癌的诊断价值。方法：我们回顾性分析42例甲状腺癌的US和CT表现。42例均行US和CT检查，CT都用对比增强扫描和多平面重建（MPR）来鉴别原发性肿瘤和颈部转移淋巴结。结果：US和CT诊断结果与病理结果进行对比分析。US诊断甲状腺癌的符合率为64．3％，CT为83．3％。对于颈部淋巴结转移诊断US的符合率为75．0％，CT为50．0％。结论：CT对甲状腺癌定性诊断正确率高于US检查，但是US对于怀疑颈部淋巴结转移的晚期病人评价要优于CT。US和CT结合可以提高诊断甲状腺癌的准确性。     

Adrenal and pseudoadrenal masses: CT and US findings

Computed tomography (CT) is currently the imaging modality of choice for assessing the morphology of the adrenal glands in adult patients. Much useful information can be gained using CT in disease processes which primarily involve one or both of the adrenal glands, such as adenomas, as well as in entities which secondarily affect the adrenals, such as pituitary or metastatic disease. The size and configuration of the glands can be readily determined, and masses may be detected. We discuss CT of normal and abnormal adrenal glands with sonographic (US) and pathological correlation, when available. Entities which may mimic adrenal abnormalities are emphasized. Relative advantages of US over CT in the pediatric patient are discussed.     

11C-胆碱PET/CT在脑肿瘤放疗计划制定中的应用

目的：探讨¹¹C-Choline PET/CT显像用于立体定向放射治疗的治疗计划制定的可行性，并分析其对放疗目标靶区所造成的改变。方法：34例脑肿瘤患者进行¹¹C-Choline PET/CT的图像采集，由放疗物理师和医师根据PET和CT两组资料应用计划系统的图像融合软件分别根据单纯CT及¹¹C-Choline PET/CT融合图像勾划肿瘤的外形轮廓并计算相应肿瘤总体积（GTV）及计划靶区体积（PTV），所得结果使用SPSS统计软件分别进行统计计算以了解应用PET/CT以后GTV及PTV增加或减少的差异情况。结果：34例患者中，有67.65%（23/34）患者的GTV有显著性改变，其中增加23.53%（8/34）（P=0.025），减少44.12%（15/34）（P=0.015）。有58.82%（20/34）患者的PTV有显著改变，其中增加20.59%（7/34）（P=0.022），减少38.24%（13/34）（P=0.007）。3例患者因发现颅内多发转移而由根治性治疗改为姑息性治疗；5例患者因未发现明显活性肿瘤组织存在依据而取消了放疗计划改为密切随访观察。结论：¹¹C-Choline PET/CT融合图像方法学在脑肿瘤三维适形/调强放疗的应用可提高对脑肿瘤生物靶区体积制定的精确性，减少正常脑组织的照射量及遗漏病灶的可能性，使临床缓解的可能增加。实际的临床效果还有待进一步的随访及研究证实。     

64排螺旋CT低剂量筛查肾上腺肿瘤的实验研究

目的探索适用于64层螺旋CT肾上腺成像筛查肾上腺肿瘤的低剂量扫描参数,以有利于该技术在临床上更广泛应用。方法选择2009年6月至2010年6月吉化集团公司总医院确诊的肾上腺肿瘤30例,男15例,女15例。平均年龄38岁,年龄范围在28岁-67岁之间。肾上腺肿瘤共36个,其中所有病例均经手术病理证实。对照组：健康自愿者10例。一同使用64层螺旋CT在自动管电流模式下以不同的扫描参数组合扫描：噪声指数（NI）分别采用8、121、5、18、21、24、273、0、33;管电压（TV）分别采用140 kV、120 kV、100 kV8、0 kV;球管旋转时间（RT）分别采用0.4 s和0.5 s。将所得数据经0.625 mm重建后传至GE ADW4.3工作站。运用肾上腺成像专用软件重组出肾上腺的图像,由1名有20年放射经验的医师对各扫描参数组合所得图像进行评分,记录各扫描参数组合的放射剂量（DLP）,采用偏相关分析探讨放射剂量及图像质量与噪声指数、管电压、球管旋转时间的关系。结果 DLP与NI的偏相关系数为-0.613,P〈0.0l;DLP与TV的偏相关系数为0.198,P〉0.05;DLP与RT的偏相关系数为-0.054,P〉0.05。结论自动管电流法模式下扫描,NI取值21,管电压120 KV,球管旋转时间0.4 s为64层螺旋CT筛查肾上腺肿瘤的最优剂量扫描参数组合,其放射剂量约为固定管电流法CT肾上腺成像的18.6%。上述扫描参数可作为64层螺旋CT筛查肾上腺肿瘤的低剂量扫描参数。     

Pre-operative Detection of Thyroid Pyramidal Lobes by Ultrasound and Computed Tomography

This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). A single radiologist prospectively performed thyroid US and retrospectively reviewed neck CT to detect TPLs in 135 consecutive patients scheduled for thyroid surgery. The location, size and superior extent of each TPL and its separation or continuity with the main thyroid gland were assessed by thyroid US, neck CT and surgery. The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.     

Absence of the left lobe of the liver: US and CT appearance

We report five cases of absence of the left liver lobe diagnosed by ultrasonography (US) and/or computed tomography (CT). There were four men and one woman, with an average age of 62.8 years. The right lobe was normal in four patients and enlarged in one. A tongue-like hypertrophy of the caudate lobe was present in two patients. The gallbladder was located at the left portion of the liver. Elevation of the antrum of the stomach was also seen.     

肾上腺髓样脂肪瘤的CT诊断

目的分析和探讨肾上腺髓样脂肪瘤的CT表现特征及其诊断价值。方法回顾性分析21例经手术病理证实的肾上腺髓样脂肪瘤的CT表现。分析病变位置、形状、大小和病变内有无钙化、出血、脂肪和假包膜及增强后的表现特征等。结果本组共21例,均为单发,15例位于右侧。肾上腺,6例位于左侧。肿瘤最大径线为1．7—11cm,肿瘤多呈圆形或类圆形,病灶内部含有脂肪和髓样成分,CT表现因病灶内所含成分的比例不同而有所差异,其中16例呈脂肪与软组织混合密度,3例以脂肪密度为主,2例以软组织密度为主,无1例肿瘤内部有出血。3例肿瘤边缘可见钙化,所有病例假包膜完整,CT增强后脂肪成分未见明显强化,软组织成分轻度强化。结论肾上腺髓样脂肪瘤有比较典型的CT表现,通过CT平扫及增强扫描一般能做到术前诊断,部分不典型病变术前诊断比较困难,确诊仍依靠病理。     

肺癌肾上腺转移的超声诊断

目的探讨超声对肺癌肾上腺转移的诊断价值和肿瘤声像图特征。方法应用超声检查肺癌肾上腺转移患者71例。结果超声对肾上腺转移癌的检出率为91．55％（65／71）。声像图特征表现为低回声，形态可呈圆形、椭圆形或不规则性分叶状。结论超声检查对肺癌肾上腺转移的诊断有重要价值，可作为肾上腺转移癌的较佳检查方法。