原发性肠脂垂炎的CT表现及鉴别诊断

目的:探讨原发性肠脂垂炎(PEA)的CT表现及鉴别诊断。方法:搜集我院9例经手术病理证实的PEA患者的临床及CT检查资料,并进行回顾性分析。结果:9例PEA中,病灶位于乙状结肠旁5例,回盲部1例,升结肠旁1例,降结肠旁2例;9例CT平扫表现为结肠旁卵圆形或分叶状脂肪密度病灶,边缘呈环形高密度影,周围脂肪间隙内均可见条索状高密度渗出影,3例病灶中央见点状高密度影,2例中央见线形高密度影,2例中央可见圆形高密度影,仅2例病灶可见相邻结肠壁的增厚;2例增强扫描病灶边缘呈环状强化。结论:PEA的CT表现具有一定的特征性,CT检查对本病的诊断及鉴别诊断具有重要价值。     

MSCT及多平面重建技术在柿石性小肠梗阻中的诊断价值

目的分析柿石性小肠梗阻的CT表现,提高对本病的诊断水平。方法回顾性分析经手术证实的26例柿石性小肠梗阻的CT图像,分析其CT特征。结果 26例柿石性小肠梗阻病例中,9例柿石位于空肠,17例位于回肠。病灶为圆形的6例,椭圆形20例。最小柿石为2.7cm×2.1cm,最大为6.2cm×3.3cm。所有小肠内的柿石均为单发,其中3例伴有胃内柿石。柿石含较多气体呈筛状或蜂窝状的21例,呈均匀软组织密度伴少部分气泡影的5例;边缘见薄环形高密度影呈"胶囊壁"改变的22例;所有病灶在MPR重建时均表现为"瓶塞"样改变,嵌顿于小肠肠腔内。所有行增强CT检查的病变均无强化;病灶远段肠管突然萎陷的23例。结论柿石性小肠梗阻的CT表现具有特征性,MSCT及MPR技术对柿石性小肠梗阻的诊断具有重要价值,结合进食柿子病史及季节性发病,可作出明确诊断。     

鼻结石CT诊断（附2例报告）

鼻结石 ,临床上较少见。由于对其缺乏足够的认识 ,极易漏误诊 ,以致不能得到及时诊断和正确治疗。我们曾遇 2例 ,现报告如下。例 1　男性 ,43岁。鼻塞、鼻衄、流脓涕 2 0年 ,嗅觉减退 ,分泌物有臭味。体查 ,全身情况好 ,心肺正常 ,鼻外观无畸形 ,鼻背无隆起。左鼻通气好 ,右鼻腔内见肿块 ,位于下鼻道及鼻底部 ,距鼻后孔约 1.5ｃｍ ,表面有黄色和血性分泌物 ,奇臭 ,鼻粘膜粗涩萎缩。ＣＴ扫描 ,发现右侧下鼻道内一鹿角形高密度影 ,约 2ｃｍ× 1.5ｃｍ大小 ,ＣＴ值 135 0ＨＵ ,轮廓不规则 ,鼻中隔向左弯曲 ,右侧上颌窦粘膜增厚 (图 1)。ＣＴ诊…     

冠状位CT扫描在霉菌性鼻窦炎术前诊断中的应用价值

目的 探讨冠状位CT扫描在霉菌性鼻窦炎术前诊断中的价值.资料与方法 回顾性分析34例经手术病理证实的霉菌性鼻窦炎患者的冠状位CT特征.结果 单窦或单侧鼻赛发病30例,双侧鼻窭发病4例.发现病灶38个,其中34个位于上颌窦.冠状位CT表现:窦腔内均可见软组织影充填,密度不均,其中28个病灶内可见点状、结节状、团片状钙化,29个窦壁增厚及窭腔变小,8个窦壁骨质破坏.合并窦口鼻道复合体阻塞34个;合并鼻腔、鼻窦息肉7个.34例中检出各种变异76个.结论 CT诊断霉菌性鼻窦炎主要特征是窦腔内软组织影充填,其内散在钙化并窦壁增厚.冠状位CT扫描能较好地显示鼻腔鼻窦的解剖结构和病变范围,对功能性内镜手术有一定指导意义.     

鼻腔Stewart型恶性肉芽肿的CT诊断(附4例分析及文献复习)

目的探讨CT在鼻腔Stewart型恶性肉芽肿的诊断和鉴别诊断上的价值。方法对4例经手术或活检病理证实的Stewart型鼻腔恶性肉芽肿患者临床资料及CT表现进行回顾性分析。结果本病的早期CT表现主要表现为鼻中隔及下鼻甲的黏膜肥厚和鼻前庭的软组织肿块影,晚期以鼻为中心的面部骨质与软骨的破坏。结论CT扫描是诊断本病的有效方法。     

鼻息肉的CT表现与诊断价值

目的：总结分析鼻息肉的CT表现特点,评价CT扫描对鼻息肉的诊断价值。方法：97例均行轴位及冠状位扫描,其中轴位24例,冠状位73例,全部病例经鼻内窥镜手术及病理证实。结果：97例中双侧发病72例,单侧发病25例。鼻息肉主要发生在筛窦及中鼻道,部分累及上颌窦及下鼻道,在CT断面上表现为鼻腔内息肉样肿块,均合并不同程度的鼻窦炎,冠状位CT扫描比轴位显示清楚。结论：鼻息肉在CT断面上有比较特征性的表现,诊断明确,冠状位能提供与功能鼻内窥镜手术方位一致的解剖层面,能清楚显示鼻道解剖结构和病变特点,对指导纤维内窥镜手术进路及防止并发症有重要指导意义。     

MSCT对原发性肠脂垂炎的检查价值

目的 探讨原发性肠脂垂炎（PEA）的CT特征,MSCT的检查价值.方法 对12例具有完整MSCT扫描资料并随访证实的原发性肠脂垂炎病例进行回顾性分析.12例均行全腹平扫,其中2例行增强扫描.结果 10例病灶位于直乙状结肠转折处,1例位于回盲部,1例位于降结肠;12例卵圆形脂肪密度病灶均可见边缘高密度环,11例病灶中心可见高密度影;9例病灶周围可见继发性炎性改变,其中5例可见邻近腹膜增厚,但均未见邻近肠壁增厚及周围积液;2例增强扫描病灶边缘的高密度环及邻近增厚的腹膜可见强化.4～10周后CT随访,12例病灶均自行消退.结论 边缘高密度环征、中心高密度影和周围继发性炎性改变为原发性肠脂垂炎的特征性CT表现,MSCT能清楚显示病灶细节特征及毗邻结构,对原发性肠脂垂炎的诊断有决定性意义.     

CT诊断鼻腔鼻窦脑膜瘤的作用

目的：评价CT扫描在诊断鼻腔鼻窦脑膜瘤中的作用。方法：对4例经手术证实的脑膜瘤的CT特征进行回顾性分析。结果：本组病斧正累及范围均较广泛，CT平扫时呈等，低混杂密度灶，瘤周均有环形骨质硬化，其中3例瘤内有不规则的条片状钙化影和低密度的坯 煞费苦心区；病灶均累及鼻中隔和鼻窦，鼻中隔明显偏曲或破坏消失。筛窦和蝶窦受累4例，上颌窦2例，窦腔膨胀性扩大，并被混杂密度影填塞，窦壁骨质受压变薄，但未见明显骨质溶解破坏。结论：CT扫描可正确诊断鼻腔鼻窦脑膜瘤。     

变应性真菌性鼻窦炎的CT诊断

目的 探讨变应性真菌性鼻窦炎的CT表现及其诊断价值。方法 回顾性分析12例经术后组织病理证实的变应性真菌性鼻窦炎，均经过CT检查。主要临床表现包括奶酪状黏涕、鼻阻塞感及鼻区痛。鼻内镜检查：12例受累侧鼻腔内均可见息肉、黏膜水肿，鼻窦腔内均见真菌分泌物。结果 变应性真菌性鼻窦炎累及半组鼻窦3例，累及全组鼻窦9例。CT平扫12例表现为鼻窦黏膜增厚；窦腔内充满软组织影，伴有不规则条状、匍行性或斑片状高密度影(软组织窗)，边界清楚，也可伴有云雾状高密度影(骨窗)，边界模糊；CT值80～110HU，平均92．5HU。11例鼻窦膨胀，窦壁骨质变形、变薄10例，8例窦壁骨质侵蚀。8例病变延伸到邻近结构，其中4例累及眼眶，2例累及颅内，2例同时累及眼眶和颅内。结论 半组或全组鼻窦充满软组织影，伴有多发典型的高密度影是诊断本病的特征性CT征象，根据此征象可能首先提出本病的诊断。CT不但可以准确显示病变累及的范围，也能够帮助与其他病变进行鉴别。     

无症状小肾癌的CT诊断（附12例报告）

目的：探讨小肾癌的CT表现特点。方法：12例无症状小肾癌均经手术病理证实，癌块直径1.8-3．0cm，行CT平扫及增强扫描，分析其影像特征。结果：12例中病灶呈等密度影4例，稍低密度影6例，稍高密度影2例，5例病灶内见坏死区。增强扫描8例癌块明显强化，CT值升高30-75Hu。结论：小肾癌CT表现有一定的特征性，为其正确定性诊断提供依据，为临床手术提供指导。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.