B超、CT与MRI诊断胆管结石对比分析

对比分析B超、CT与MRI各成像序列对胆管结石的诊断。选择收治的胆管结石患者25例,所有患者均行B超和MRI检查,其中12例行同期CT扫描。 MRI检出率达84%,CT检出率75%,B超检出率56%。 MRI检出率明显高于CT诊断,差异有统计学意义（P＜0.05）。对胆管结石进行诊断时,B超作为初步筛查法,而CT与MRI的诊断准确率较高。     

B超诊断胆囊及胆管结石合并胆管癌2例

例1,女性,49岁。因发热40天,体温39℃,无其他不适,经消炎治疗后可缓解,以后间隔一周左右发作一次。入院前20天起,发热较为频繁,达38.5℃～     

B超在诊断肝外胆管结石中的应用

目的探讨B超在肝外胆管结石诊断中的价值。方法对54例术前临床拟诊为肝外胆管结石行肝外胆道手术病人的超声诊断结果与手术结果进行对照。结果54例中B超检查诊断为肝外胆管结石并肝外胆管扩张47例,未显示结石回声7例。超声误诊2例。B超诊断正确率为83.3%(45/54)。漏诊例结石均位于胆总管下段,直径<2cm。结论B超是一种无损伤,无痛性检查在肝外胆管结石诊断中具有重要价值,但对胆总管下段的小结石较易漏诊,对伴有钙化的胆管癌与结石相鉴别有困难。     

分析B超、腹部CT联合诊断肝外胆管结石的结果

目的:研究肝外胆管结石患者行B超+腹部CT诊断的效果。方法:数据选取我院收治80例肝外胆管结石患者,根据“诊断差异性”分单一组(B超,n=40)、联用组(B超+腹部CT,n=40),2组诊断结果比较分析。结果:联用组确诊率(95.00%)高于单一组(80.00%),联用组误诊率(2.50%)、漏诊率(2.50%)低于单一组(15.00%)、(5.00%),联合组灵敏度、特异度、阳性预测值、阴性预测值分别为59.09%、83.33%、81.25%、62.50%,均高于单一组的41.67%、56.25%、58.82%、60.87%,差异具有统计学意义(P<0.05)。结论:B超+腹部CT诊断肝外胆管结石可提高确诊率、诊断效能,值得临床推广和应用。     

肝内胆管结石合并肝癌的B超诊断分析

本文回顾性分析由超声检查诊断 ,并经手术病理证实的肝内胆管结石合并肝癌 2 0例。现将结果报告如下。资料与方法2 0例均为我院 1993年 6月至 2 0 0 1年 9月的住院病人 ,男 8例 ,女 12例 ,年龄 3 8～ 80岁。临床表现为上腹部疼痛。有 16例曾确诊为肝内胆管结石 ,有 14例出现黄疸。 2 0例中术前确诊为肝内胆管结石合并肝癌 15例 ,肝癌漏诊 5例。采用ＥＵＢ 3 0 5、海鹰 2 2 0 0及ＨＰ尖端影像超声诊断仪 ,探头频率 3 5ＭＨｚ ,按常规方法扫查 ,详细记录和图像摄片 ,并将手术及病理结果与术前Ｂ超检查对比分析。结　　果本组 2 0例肝内胆管结…     

B超诊断肝内巨大胆管结石伴胆管囊状扩张1例

患者男。因肝区阵发性疼痛 9月余 ,再发加重伴发热 39℃以上 ,腹胀 3个月而入院治疗。患者呈进行性消瘦面容 ,无黄疸。实验室检查示 :WBC 1 3.6×1 0 9/ L;淋巴细胞 1 .3× 1 0 9/ L;中性细胞 1 1 .9× 1 0 9/ L;肝功能示 A/ G比值倒置。患者于 1 2年前曾患阿米巴肝脓肿。超声检查 ,所用超声仪为 Siemens versa plus,探头频率为 4 .0 MHz。超声所见 :右肝上下斜径 1 9.0cm,肝形态失常 ,体积增大。肝包膜欠光滑 ,实质回声不均匀 ,增粗、增强 ,肝内见数十个大小不等的强光团回声 ,后方伴声影 ,全肝内 (左肝明显 )见多个大小不等的不规则…     

CT、MRI及MRCP诊断胆总管结石临床价值评价

胆道结石是国人常见病、多发病,超声检查可以诊断肝内胆管结石,而肝外胆管结石由于受肠道气体干扰,超声诊断价值有限。CT可以明确诊断高密度结石,对各种等密度或低密度结石CT诊断也有困难,往往需要MRI或MRCP进一步检查,为评价CT、MRI或MRCP诊断胆总管结石的临床价值,分析3种检查方法的优势与限度,笔者对50例临床、超声疑诊胆总管结石同时经CT、MRI和MRCP检查的患者行回顾性评价,根据手术所见对比分析CT、MRI和MRCP的诊断能力和价值。1资料与方法1.1临床资料临床、超声疑诊胆总管结石患者共50例,其中男21例,女29例,平均49.5…     

肝内胆管结石的CT诊断

目的探讨肝内胆管结石的CT表现及诊断价值。方法对26例肝内胆管结石患者进行常规1次屏气螺旋CT扫描，并分析其CT征象。结果（1）CT诊断肝内胆管结石的准确率达92．3％：（2）根据密度不同，结石分为高密度、等密度、低密度结石：（3）常伴有胆内胆管的柱状、囊状扩张；（4）CT可准确显示其并发症。结论CT对肝内胆管结石及其并发症有较好的诊断价值。     

B超诊断肝外胆管巨大结石1例

患者,女性,30岁。因中上腹反复发作性疼痛三 年,加重三天入院。体检:T38℃,巩膜及全身皮肤轻 度黄染,腹平软,剑下及右上腹胆囊区压痛(+),反 跳痛(-)。辅检:WBC4.2×109/L,N68％。B超检 查:取仰卧位+左侧卧位+胸膝位,必要时嘱患者吸 气后屏气,多角度扫查见:相当于肝总管部位显示一　10.2cm×4.8cm×8.7cm大小恒定不变形的增强光团 后伴声影,光团和管壁间有一窄无回声带,左肝内胆     

胆道镜联合B超诊治术后胆管残余结石

目的 为降低B超和胆道镜对术后胆管残余结石的漏诊，从而提高术后胆管残余结石的取净率。方法 总结58例胆管残余结石病人的B超、胆道镜及二者术中联合应用的诊断情况。结果 58例残余结石中，B超诊断准确率86．2％。胆道镜诊断准确率93．1％。二者术中联用准确率为100％。结论 B超和胆道镜是胆石术后诊断的常用方法，但由于受影响的因素较多而出现假阴性而造成漏诊，术中二者结合可有效预防结石漏诊并提高结石的取尽率。     

Comparative study between ultrasound,computed tomography,intra-arterial digital subtraction angiography,and magnetic resonance imaging in the differentiation of tumors of the liver

Forty-one patients with liver tumor have been evaluated with ultrasound (US), computed tomography (CT), intra-arterial digital subtraction angiography (IA-DSA), and magnetic resonance imaging (MRI) in order to establish the accuracy of each technique. In group A (24 patients), in which all four imaging modalities were performed, our results show that MRI detected all hemangiomas (25/25) compared to 22/25, 21/25, and 20/25 with US, CT, and IA-DSA, respectively. No difference between the various methods was seen in the case of hepatoma. Finally, in the patients with metastases, all four techniques had the same sensitivity (100%) but the specificity of MRI was also 100%, compared to 33% for IA-DSA and 66% for US and CT.     

背部弹力纤维瘤的多排螺旋CT及MRI诊断

目的探讨多排螺旋CT(multidetector spiral computed tomography,MSCT)及磁共振成像(magnetic resonance imaging,MRI)诊断背部弹力纤维瘤(elastofibroma dorsi,EFD)的影像学特点。材料与方法收集我院20例经手术病理证实的EFD患者资料,所有患者均行CT检查,其中8例行CT增强检查,4例行MRI检查,1例同时行MRI增强检查,3例MRI平扫检查,并分别测量EFD、前锯肌及周围脂肪CT平扫及增强后CT值进行比较,分析EFD的临床特点及CT、MRI表现。结果 20例患者中,13例病灶位于双侧,4例病灶位于右侧,3例病灶位于左侧,CT共发现33处病灶,并均位于背部肩胛下角肌肉深面,均呈扁丘状或半圆形肿块,主要以肌肉样密度为主,病灶内见条纹状脂肪密度沿病灶长轴间隔排列;病灶边缘毛糙不整,周围脂肪间隙模糊不清,CT增强扫描3例轻度强化,5例无强化;EFD与前锯肌、EFD与周围脂肪间平扫及增强CT值差异均存在统计学意义(P0.05);MRI平扫信号不均匀,呈等信号为主的肌组织与高信号的脂肪组织交错排列,MRI增强扫描1例呈不均匀中度强化。结论背部弹力纤维瘤具有典型的发病部位,根据CT及MRI影像表现均可做出明确诊断。     

Role of cardiac computed tomography and magnetic resonance imaging in the evaluation of acute chest pain in the emergency department

Evaluation of patients presenting with chest pain to the emergency department remains a challenging task because of a variety of etiologies that range from benign to potentially fatal. Although majority of patients do not have myocardial ischemia as the cause of their presentation, the clinical work up can be time consuming, costly and inconclusive. Recent technical advances in cardiac computed tomography and magnetic resonance imaging have led to better diagnostic accuracy in evaluating patients with chest pain. In this paper, we review the role of cardiac computed tomography and magnetic resonance imaging in evaluating patients with chest pain in the emergency department.     

Magnetic resonance imaging with computed tomography of a renal leiomyoma

Renal leiomyoma are rare, benign tumors of the kidney. There is little information about the imaging of these tumors with modern modalities. We present a case of computed tomographic (CT) and magnetic resonance (MR) imaging of a large renal leiomyoma.     

HASTE法磁共振胰胆管造影诊断胆道病变的应用价值

目的：探讨HASTE法单次屏气磁共振胰胆管造影（HASTE－MRCP）诊断胆道病变的应用价值。方法：对照分析75例胆道病变患者的HASTE－MRCP影像和手术结果，并与经皮肝穿刺胆管造影（PTC）比较。结果：HASTE－MRCP诊断胆道病变，正确率96％（72／75）；诊断胆管恶性梗阻灵敏度97．1％，特异率95％，阳性预测值94．4％，阴性预测值97．4％。35例恶性胆管梗阻中，HASTE－MRCP显示癌肿32例，其癌肿发现率高于PTC（8／35）。结论：HASTE－MRCP在胆道病变诊断中具有准确的定性诊断价值。     

Application value analysis of magnetic resonance imaging and computed tomography in the diagnosis of intracranial infection after craniocerebral surgery

BACKGROUNDIntracranial infection is a common clinical disease. Computed tomography (CT) and magnetic resonance imaging (MRI) have certain sensitivity and have good diagnostic efficacy.AIMTo study the application value of MRI and CT in the diagnosis of intracranial infection after craniocerebral surgery. METHODSWe selected 82 patients who underwent craniocerebral surgery (including 40 patients with intracranial infection and 42 patients without infection) during the period from April 2016 to June 2019 in our hospital. All 82 patients received CT and MRI examinations, and their clinical data were reviewed. A retrospective analysis was performed, and the coincidence rate of positive diagnosis and the overall diagnosis coincidence rate of different pathogenic infection types were measured with the two examination methods. The diagnostic sensitivity and specificity as well as the positive and negative predictive values of the two examination methods were compared.RESULTSFor all types of pathogenic infections (Staphylococcus aureus, Staphylococcus hemolyticus, Staphylococcus epidermidis, and others), MRI scans had higher positive diagnostic coincidence rates than CT scans; the overall diagnostic coincidence rate, sensitivity, specificity, positive predictive value, and negative predictive values were significantly higher with MRI examinations than with CT examinations, and the differences were statistically significant (P < 0.05). CONCLUSIONMRI examination can accurately diagnose intracranial infection after clinical craniocerebral surgery. Compared with CT, MRI had higher diagnostic efficiency. The diagnostic sensitivity and specificity, the diagnostic coincidence rate, and the positive and negative predictive values were significantly higher with MRI than with conventional CT, which can be actively promoted.     

磁共振成像在肝病的应用及进展

我国是肝病大国.除慢性病毒性肝炎外,非酒精性脂肪肝及酒精性肝病的发生比率亦逐年上升,其中一部分人将最终发展为重症肝炎、肝硬化甚至肝癌.降低慢性肝病死亡率、改善预后是广大医务工作者的一项重大课题.近年来,随着MR软硬件的更新及脉冲序列的改进,MRI已成为肝脏疾病诊断不可替代的检查手段,在定量肝脂肪、肝纤维化及肝硬化、肝肿瘤的鉴别等领域有了长足的发展.本文就MRI在肝脏疾病中的应用现状及研究进展进行阐述.     

Liver metastases from colorectal cancer: imaging with superparamagnetic iron oxide (SPIO)-enhanced MR imaging,computed tomography and positron emission tomography

The literature about superparamagnetic iron oxide-enhanced MR imaging, computed tomography (CT) and PET (positron emission tomography using fluorine-18 labelled fluoro-deoxy-glucose) in detection of liver metastases (LM) from colorectal cancer is reviewed in this update. Special emphasis is given to studies with surgical standard of reference allowing for the lesion-by-lesion sensitivity to be determined. Based on the review, it is concluded that state-of-the-art anatomical imaging, e.g., SPIO-enhanced MR imaging and multidetector CT (MDCT), must be considered more sensitive than PET in detection of individual LM, due to technical developments in MR imaging, such as liver specific contrast agents, modern sequences and high performance gradients, and in modern MDCT have increased the performance of these modalities. MR imaging with a liver specific contrast agent is recommended for the preoperative evaluation before liver surgery for LM because of high sensitivity and better discrimination between small LM and cysts compared to MDCT. PET or PET/CT can be used for detection of extra-hepatic tumor before liver surgery.