眼球钝挫伤眼底荧光血管造影61例临床分析

目的 探讨眼球挫伤眼底荧光素血管造影表现及临床意义.方法 回顾性分析2004年1月至2008年12月对61例眼球钝挫伤患者的眼底荧光素血管造影结果.结果 视网膜震荡18例,FFA:点状微弱荧光或未见异常荧光.视网膜挫伤15例,FFA:早期后极部点状荧光渗漏,晚期呈雾状荧光渗漏、出血为遮蔽荧光.脉络膜破裂伤10例,FFA:弧形高荧光.视神经挫伤8例,FFA:视盘高荧光.视网膜出血7例,FFA:视网膜前出血遮蔽脉络膜视网膜荧光,均遮挡血管;视网膜下出血遮蔽脉络膜荧光,位于血管水平下,可见血管于其上走行.黄斑裂孔3例,FFA:黄斑区圆形透见荧光.结论 眼钝挫伤眼底损伤的表现复杂,只要屈光间质清晰,都应进行荧先素眼底血管造影检查,以准确全面了解损伤的部位和程度.     

血管内淋巴瘤

目的：探讨血管内淋巴瘤的临床病理特征。方法：对1例血管内淋巴瘤进行免疫表型分析及原位杂交检测与EB病毒的关系，并文献复习，结果：女性，48岁，不明原因发热伴体重下降3个月，CT扫描示子宫肿块而行子宫加双侧附件切除，病理学检查发现瘤细胞位于血管内，伴少许管周浸润，瘤细胞免疫表型CD45（LCA）和CD20（L26）呈阳性表达，原位杂交显示E－BERs阴性，患者经CHOP联合化疗后获得完全缓解，结论：血管内淋巴瘤是一种极罕见的B细胞肿瘤，此瘤的诊断只能依赖病理学检查，治疗上应予以积极联合化疗。     

γ－干扰素样物质在肾上腺皮质腺肿瘤中的表达

为了检测γ－干扰素（ＩＦＮ－γ）是否在人肾上腺组织和肾上腺皮质腺肿瘤中有表达，我们对包括瘤旁肾上腺组织１４例；肾上腺皮质腺瘤１７例；皮质腺癌７例的组织标本，用抗大鼠ＩＦＮ－γ单克隆抗体ＤＢ－１做为一抗，采用ＡＢＣ法做免疫组化染色。结果：ＩＦＮ－γ样免疫反应阳性物可在１００％（７／７例）肾上腺皮质腺癌，４７％（８／１７例）皮质腺瘤细胞内和３０％腺癌（２／７例）和腺瘤（５／１７例）组织内毛细血管内皮细胞中检出，瘤旁肾上腺组织内未见阳性反应细胞。结论：（１）ＩＦＮ－γ的存在与肾上腺皮质肿瘤的分化有关，分化越低，ＩＦＮ－γ的阳性率越高。（２）肾上腺皮质肿瘤内的毛细血管内皮细胞可能具有ＩＦＮ－γ受体或能产生ＩＦＮ－γ。另外，在肿瘤组织内还发现一些树突状ＩＦＮ－γ阳性细胞，其存在意义尚待探讨。     

小儿异位神经母细胞瘤2例

小儿异位神经母细胞瘤２例林华奚政君△葛菁芳例１：患儿女，９岁。发热咳嗽胸闷４天入院。体检：心音低钝，肝右肋下１ｃｍ，余无异常。实验室检查正常。ＣＴ示心包肿瘤。Ｂ超示纵隔内实质性肿块伴钙化。临床诊断：前纵隔肿瘤。行手术切除。病理检查巨检：肿物１５ｃｍ×...     

瘤体内注射IL—2基因后肿瘤细胞和肿瘤浸润性淋巴细胞的功能分析

将脂质体包裹的ＩＬ－２基因直接注射至Ｂ１６Ｆ１０黑色素瘤瘤体内，研究肿瘤细胞和肿瘤浸润性淋巴细胞（ＴＩＬ）的功能变化。１０ｄ后，Ｎｏｒｔｈｅｒｎ ｂｌｏｔ鉴定显示瘤体内注射ＩＬ－２基因后肿瘤细胞及ＴＩＬ中ＩＬ－２ｍＲＮＡ表达阳性；经Ｇ４１８筛选后的肿瘤细胞培养上清中可检测出ＩＬ－２；肿瘤细胞表面表达了较高水平的ＭＨＣＩ类抗原（Ｈ２Ｋ＾ｂＤ＾ｂ）；ＴＩＬ表面粘附分子ＬＡＦ－１表达也明显高于对照组，其     

口服避孕药对女性局灶性肝内结节增生的影响

局灶性肝内结节增生被认为是肝细胞对血管异常的一种局部增生性反应，是一种良性病变。这种病变通常见于年轻女性，常被影像检查发现。虽然口服避孕药与肝细胞腺瘤的产生和恶化有关，但其对于局灶性肝内结节增生（ＦＮＨ）的产生及恶变还有争论。从１９８９～１９９８年，作者研究２１６例患ＦＮＨ的女性，中位年龄３６．２（１４～１７）岁，其中１４４例按照以前文献标准用ＭＲＩ诊断。另外７２例在ＭＲＩ上有典型特征，经手术活检（Ｎ＝３６），切除（Ｎ＝３６）分别证实。作者将其分为５组：不服用避孕药（ｎ＝２８）；高剂量服用组（炔…     

超声检查对眼球内恶性肿瘤的诊断价值

视网膜母细胞瘤(retinoblastoma，RB)、脉络膜恶性黑色素瘤(choroidal melignant melanoma，CMM)、脉络膜转移癌(choroidal metastatic carcinoma，CMC)等是常见的眼球内恶性肿瘤。本文通过一组病例在诊疗过程中不同阶段诊断情况进行对照研究，探讨超声波的诊断价值。     

原始神经外胚层肿瘤（PNET）1例光镜,免疫组化和电镜观察 …

研究原始性神经外胚层肿瘤的特征。方法：采用光镜，电镜和免疫组化对１例颈部原始生神经外胚层肿瘤进行观察。结果；肿瘤组织由小圆形细胞构成，肿瘤细胞胞膜示ＭＩＣ２强阳性，肿瘤细胞胞浆内含有微和及神经内分泌颗粒。     

多项肿瘤标志物在鼻咽癌诊疗中的意义

本文应用放射免疫分析法对１２４例鼻咽癌患者血清ＣＥＡ、ＳＦ、β２－ｍ和ＣＧ水平进行了分析，以探讨其在鼻咽癌发病和诊疗中的临床意义。 资料和对象 一、对象： （一）病例组：１２４例（男９５，女２９），均为我院近年来放化疗住院患者，且全部经病理学检查确诊。年龄３１－７２岁，平均５２岁。 （二）正常对照组：系本院健康职工和体检人员，共４１人（男２４，女１７）。年龄２６－７０岁。 二、方法：空腹血３ｍｌ，分离血清进行放免测定。ＳＦ、β２－ｍ和ＣＧ试剂盒由中国原子能研究院提供，正常参考值分别为１５－２４０ｎｇ…     

肝内原发性血管内皮肉瘤一例

肝内原发性血管内皮肉瘤一例陈壬寅，陈俊峰，许恒昌，王春林，张玮，谢海泓患者男，３０岁。二个月前无明显诱因上腹部不适。胃镜示“慢性浅表性胃炎”；Ｂ超、ＣＴ示“肝内胆管占位性病变”。门诊以“肝内胆管占位并胆囊炎”于１９９３年２月２日收治入院。查体：全身粘...     

恶性蝾螈瘤MR影像分析（附1例报道）

目的：探讨恶性蝾螈瘤（MTT）的MRI表现和临床病理特点,提高临床对MTT的认识.方法：手术切除辅以放疗治疗右前臂MTT 1例.结合文献复习,分析MTT的MRI表现及病理特征.结果：MTT的MRI表现为T1WI稍低信号、T2WI高信号的软组织肿块,肿瘤信号不均、T2WI上高信号肿块影内环形或线样低信号分隔影或许是MTT的特征性MRI表现之一.MTT的恶性度高,其治疗以手术切除为主,疗效及预后不佳,易在短期内复发及转移.结论：深入了解MTT的MRI表现,对MTT的早期诊断、早期治疗具有重要价值.     

MRI在腮腺上皮性良性肿瘤定性诊断价值及其病理基础

目的　探讨MRI在腮腺上皮性良性肿瘤定性诊断中的作用 .方法　收集腮腺上皮性良性肿瘤 72例 80个病灶的MRI资料 ,其中 70例经手术病理证实 ,2例活检证实 .77个手术切除病灶行病理逐层切片检查并与MRI影像进行对照分析 .MRI平扫采用T1WI、T2WI,其中 6 1例共 6 7个病灶同时行平扫和增强扫描 .结果　超过一半的腺淋巴瘤瘤灶 (2 6个 )T2WI表现为低、等信号 ,所有经过增强的 4 2个腺淋巴瘤均轻度增强 ;31例混合瘤T2WI表现为高而不均匀信号 ,经过增强的 2 4例混合瘤均中等或显著强化 .结论　常见腮腺上皮性良性肿瘤在MRI表现上各有特点 ,对大多数病例进行定性诊断是可能的     

颅内生殖细胞瘤的MRI影像表现及诊断

目的 探讨颅内生殖细胞瘤的MRI表现,旨在提高对本病的影像诊断准确率。方法 回顾性分析2014年12月~2019年5月我院经手术病理或临床诊断性放射治疗确诊的13例颅内生殖细胞瘤患者的MRI影像资料,分析其临床表现、影像表现及诊断。结果 病变位于松果体区患者9例,MRI检查肿瘤实质部分T1WI呈稍低信号,T2WI和FLAIR 呈高或稍高信号,DWI呈等或稍高信号,增强扫描呈明显强化;肿瘤伴有囊变者1例,伴有钙化者3例,4例患者伴脑积水;3例患者出现转移灶,累及三脑室、侧脑室等,其MRI信号及强化方式与原发灶相似。病变位于鞍区患者3例,肿瘤形态、大小不一,T1WI 呈稍低信号,T2WI和FLAIR 呈稍高信号,增强扫描呈明显强化。1例患者的病变位于右侧基底节区,形态不规则,T1WI呈等信号,T2WI、FLAIR及DWI均呈稍高信号,增强扫描无强化,同侧大脑脚较对侧萎缩。结论 MRI对颅内生殖细胞瘤的影像诊断与鉴别诊断具有重要价值。     

Clinical characteristics and treatment of angiomatous meningiomas: a report of 27 cases

Angiomatous meningioma (AM) is a rare histological variant of meningioma. Twenty seven patients (14 male and 13 female) with angiomatous meningioma were treated in our institution. Their clinical presentation, neuroimaging studies, treatment and follow-up were investigated. The age of patients ranged from 24 to 72 years with a mean of 51.8 years. The clinical presentation was non-specific and depended on the location of the tumor and was mainly due to the mass effect. On computed tomography (CT) scanning, AMs showed slightly hyperintensity. On magnetic resonance imaging (MRI), AMs demonstrated hypointensity on T1-weighted images (T1WI), hyperintensity on T2-weighted images (T2WI), slight hypointensity on diffusion-weighted images (DWI), enhancement on postcontrast T1WI, peritumoral edema, and rich signal voids of vessels in the tumor. On histology, all tumors exhibited abundant blood vessels with at least focal classic meningothelial differentiation. Thirteen, eight, and six cases were achieved Simpson grade I, II and III-IV resection respectively. Nineteen cases were followed for 8 to 125 months with a mean of 47.9 months. Four patients with residual tumor were treated with postoperative radiation therapy and all of them had stable disease. One patient with Simpson grade II resection was not treated with radiation therapy and developed recurrent tumor in 5 years. In conclusion, angiomatous meningiomas have relative high male to female ratio, more frequent peritumoral edema, and rich blood vessels. Gross total resection is still the treatment of choice. These patients with residual tumor after surgery can benefit from radiation therapy. Overall, the prognosis of AMs are as good as other benign meningiomas.     

侵袭性纤维瘤病的影像分析及组织病理学分析

目的 分析侵袭性纤维瘤病的影像特点,以及组织病理学特征。方法 回顾性分析2013年1月～2018年3月湖北省荆门市第一人民医院经术后病理证实的 15例AF患者的 CT 和 MRI表现,及MR与组织病理对照分析。结果 15 例患者全部行 CT 平扫,8例行CT增强;9例行 MRI平扫,6例行MRI增强。CT 平扫示13 例呈不均匀等、低密度,2 例呈较均匀稍低密度;12例边界不清,3例边界清楚;CT 增强8例均呈渐进性不均匀明显强化。MRI平扫提示T1WI、T2WI、压脂、DWI等序列肿瘤均为不均匀信号,夹杂不规则低信号,肿块边缘呈爪形浸润或边缘不清。MRI增强 6例均呈不均匀明显强化。结论 CT和MRI 都能从不同方面为AF的诊断提供信息,MRI能更好地显示肿瘤的形态、范围及边缘,且可推断肿瘤的大致成分,对AF的诊断更有帮助。     

副鼻窦腺泡型横纹肌肉瘤4例CT和MRI表现

目的分析副鼻窦腺泡型横纹肌肉瘤(ARMS)的CT、MRI表现,探讨其诊断要点。方法经手术病理证实的4例ARMS患者,其中男性3例,女性1例;年龄分别为3、9、15、17岁,平均年龄11岁。所有患者均行MRI平扫及增强扫描,同时行CT平扫扫描。分析其影像特点。结果肿瘤位于蝶窦1例,筛窦2例,上颌窦1例。3例骨破坏呈膨胀性、吸收性,1例骨破坏呈溶骨性。累及翼腭窝1例,颞下窝2例,眼下直肌受累3例,鼻腔受累3例。直径5 cm呈椭圆形,直径6 cm呈不规则分叶状。2例有囊变密度或信号,无钙化,1例含有黏液蛋白成分。T1WI以稍低信号为主,近似或低于正常脑实质信号,T2WI以不均匀高信号为主,与脑脊液信号近似,增强扫描呈中等~明显强化,强化不均匀,但程度较轻,可见线环状及菊花瓣样强化。结论 ARMS的CT和MRI有一定的特征性表现,在鉴别诊断上有着较高的临床应用价值。     

促纤维组织增生性小圆细胞肿瘤^18F-FDG PET-CT影像学表现及文献复习

目的探讨促纤维组织增生性小圆细胞肿瘤（DSRCT）的正电子发射体层摄影术（PET）-CT影像表现、诊断、鉴别诊断。方法经病理组织证实的2例DSRCT患者,男性,年龄均为27岁。回顾性分析其PET-CT影像学特点,并文献复习。结果PET影像表现为广泛腹、盆腔内不均质性葡萄糖代谢异常活跃灶,肿块内坏死区葡萄糖代谢呈缺失表现。CT表现为腹、盆腔内分叶状结节或团块状肿块,广泛侵及腹膜、网膜、浆膜面;内可见坏死区,伴点状钙化;增强CT呈轻中度不均质性强化,病灶对周围组织、器官呈推挤、包绕、侵犯倾向,边界不清,但与周围器官无明显起源关系。MRI显示：T1加权像病灶呈不均质性等、低信号,T2加权像病灶呈不均质性等、稍高信号,坏死区呈高信号,增强扫描呈不均质性轻中度强化。结论DSRCT罕见,临床表现复杂,病灶与浆膜关系密切,但也可发生在其他部位;PET-CT可以同机融合结构及功能显像行全身扫描,对DSRCT的诊断、分期、定位活组织检查及疗效评价有很高价值。     

3D MRI-based tumor delineation of ocular melanoma and its comparison with conventional techniques

The aim of this study is to (1) compare the delineation of the tumor volume for ocular melanoma on high-resolution three-dimensional (3D) T2-weighted fast spin echo magnetic resonance imaging (MRI) images with conventional techniques of A- and B-scan ultrasound, transcleral illumination, and placement of tantalum markers around tumor base and (2) to evaluate whether the surgically placed marker ring tumor delineation can be replaced by 3D MRI based tumor delineation. High-resolution 3D T2-weighted fast spin echo (3D FSE) MRI scans were obtained for 60 consecutive ocular melanoma patients using a 1.5 T MRI (GE Medical Systems, Milwaukee, WI), in a standard head coil. These patients were subsequently treated with proton beam therapy at the UC Davis Cyclotron, Davis, CA. The tumor was delineated by placement of tantalum rings (radio-opaque markers) around the tumor periphery as defined by pupillary transillumination during surgery. A point light source, placed against the sclera, was also used to confirm ring agreement with indirect ophthalmoscopy. When necessary, intraoperative ultrasound was also performed. The patients were planned using EYEPLAN software and the tumor volumes were obtained. For analysis, the tumors were divided into four categories based on tumor height and basal diameter. In order to assess the impact of high-resolution 3D T2 FSE MRI, the tumor volumes were outlined on the MRI scans by two independent observers and the tumor volumes calculated for each patient. Six (10%) of 60 patients had tumors, which were not visible on 3D MRI images. These six patients had tumors with tumor heights < or = 3 mm. A small intraobserver variation with a mean of (-0.22 +/- 4)% was seen in tumor volumes delineated by 3D T2 FSE MR images. The ratio of tumor volumes measured on MRI to EYEPLAN for the largest to the smallest tumor volumes varied between 0.993 and 1.02 for 54 patients. The tumor volumes measured directly on 3D T2 FSE MRI ranged from 4.03 to 0.075 cm3. with a mean of 0.87 +/- 0.84 cm3. The tumor shapes obtained from 3D T2 FSE MR images were comparable to the tumor shapes obtained using EYEPLAN software. The demonstration of intraocular tumor volumes with the high-resolution 3D fast spin echo T2 weighted MRI is excellent and provides additional information on tumor shape. We found a high degree of accuracy for tumor volumes with direct MRI volumetric measurements in uveal melanoma patients. In some patients with extra large tumors, the tumor base and shape was modified, because of the additional information obtained from 3D T2 FSE MR images.     

MRI中T2WI高信号长度与急性颈脊髓损伤程度相关性研究

目的：探讨MRI中T2WI高信号长度与急性颈脊髓损伤程度的关系。方法：急性颈脊髓损伤患者37例,其中脊髓完全损伤19例,不完全损伤18例。全部病人均于伤后1～7天行MRI检查,于T2加权矢状位成像上选取高信号最长层面量取其长度,并分析其与颈脊髓损伤程度的关系。结果：急性颈脊髓损伤患者颈髓矢状面T2WI高信号长度,脊髓完全性损伤组明显高于不完全性损伤组（P〈0．01）。结论：MRI是临床诊断急性脊髓损害程度及评估其预后的良好的无创性检测方法。     

子宫内膜异位症的MRI影像病理学研究

目的 分析子宫内膜异位症的磁共振（MRI）影像特征。材料与方法 回顾性分析51例子宫内膜异位症的MRI影像特征，全部病例经手术及病理证实。结果 子宫增大48例；T2WI及T1WI显示子宫有弥散分布的片状低信号区内夹杂斑点状高信号30例；T2WI显示子宫低信号区内夹杂斑点状高信号，T1WI呈低信号21例，29个卵巢囊肿，T1WI及T2WI均呈高信号有15个，T1WI呈高信号而T2WI呈低或等信号5个，T1WI和T2WI均呈混杂信号9个。结论 子宫内膜异位症的主要MRI表现：（1）子宫内出现片状低信号区，同时夹杂斑点状高信号；（2）卵巢巧克力囊肿在T1WI和T2WI均为高信号或以高信号为主的混杂信号。