自身免疫性胰腺炎的影像特征

目的探求自身免疫性胰腺炎（AIP）的影像特征。方法12例经病理检查或类固醇激素治疗证实的AIP患者接受MRI检查，10例接受了CT检查，3例进行了经内镜逆行胰胆管造影（ERCP）检查，对所有影像资料进行回顾性分析。结果9例AIP表现为胰腺弥漫性肿大，3例为局限性肿大。病变区在T1WI上信号明显降低，在T2WI上信号轻度升高，动脉期强化减弱但出现明显的延时强化。11例在胰腺病变区周围环绕包膜样结构。9例AIP伴有胰腺段胆总管的狭窄，3例ERCP均示胰管不规则狭窄。经类固醇激素治疗的7例AIP，影像表现都有明显的好转。结论AIP的影像表现具有特征性，影像检查是诊断AIP的重要方法。     

自身免疫性胰腺炎的影像诊断

目的探讨自身免疫性胰腺炎(AIP)的动态增强CT及内镜逆行胰胆管造影(ERCP)影像学表现。方法收集并分析经组织病理学证实的7例AIP患者,治疗前的动态对比增强CT、ERCP检查资料及相关临床资料。结果 7例患者中,2例为弥漫型,5例为局限型AIP。治疗前增强CT检查显示受累胰腺早期强化程度弱于正常胰腺,呈延迟期轻中度强化;1例弥漫型AIP伴有肾脏低密度结节状病变。ERCP示各例AIP示主胰管弥漫或节段性狭窄,1例弥漫型和2例局限型AIP伴有胆管狭窄。类固醇激素治疗半年后CT复查显示,各例AIP胰腺炎症明显减轻,胰胆管狭窄改善。结论 AIP的影像表现具有一定特征性,类固醇治疗前影像学检查及治疗后随访有助于其明确诊断。     

Imaging rheumatic diseases

Currently, more than 100 rheumatic diseases affect nearly 46 million Americans. Some of the most common rheumatic diseases include rheumatoid arthritis, osteoarthritis, lupus, psoriatic arthritis, ankylosing spondylitis, gout, and Sj?gren syndrome. Rheumatic diseases are characterized by inflammation and lack of function in the joints and connective tissue. Early diagnosis and treatment of rheumatic disease is paramount in preventing damage and disability. Many radiologic modalities are used for diagnosing and monitoring these diseases, but for many, radiography remains the gold standard. Furthermore, imaging biomarkers may play an important role in diagnosis and treatment of rheumatic diseases in the future.     

Imaging of prion diseases

Prion diseases are caused by self-replicating proteins that induce lethal neurodegenerative disorders. In the last decade, the understanding of the different clinical, pathological, and neuroimaging phenotypes of this group of disorders has evolved paralleling the advances in prion molecular biology. From an imaging standpoint, the implementation of diffusion-weighted imaging in routine practice has markedly facilitated the detection of prion diseases, especially Creutzfeldt-Jakob. Less frequent prion-related disorders, including genetic diseases, may also benefit from progresses in the field of quantitative diffusion-weighted imaging, MR spectroscopy or molecular imaging. Herein, we present a review of the neuroimaging features of the prion disorders known to affect humans emphasizing the important contribution of MRI in the diagnosis of this group of disorders.     

Imaging of cardiopulmonary diseases

Clear physiologic adaptations to endurance and resistance training occur in the myocardium. These morphologic changes have been identified primarily by echocardiography. In the evaluation of the symptomatic athlete, imaging is a valuable tool. To differentiate athletic hypertrophy from hypertrophic cardiomyopathy, echocardiography, or MRI may be used, although the latter may be superior in the accurate assessment of wall thickness. Either imaging modality may be used to differentiate athletic dilatation from dilated cardiomyopathy in which systolic dysfunction always accompanies the dilatation. To exclude anomalous coronary arteries, either MRI or CT is a reasonable examination, although the latter requires x-ray exposure and iodinated contrast dye. Chest radiograph continues to be the standard imaging modality for athletic lung disease, whereas fluoroscopy and laryngoscopy are useful for identifying vocal cord dysfunction. Knowledge of the utility of these different imaging modalities is crucial to the practitioner of sports medicine.     

Imaging of pericardial diseases

Traditionally echocardiography has been the method of choice for the evaluation of pericardial and cardiac lesions. However, computed tomography (CT) and magnetic resonance imaging (MRI) provide a large field of view and excellent images of anatomy not available with echocardiography. In addition, CT and MRI demonstrate high soft-tissue contrast as well as the exact localization of a lesion. Currently, CT and MRI are the preferred techniques for the recognition and characterization of pericardial disorders. In this review, the characteristic imaging appearances of a variety of pericardial diseases are discussed.     

Imaging of facet joint diseases

Facet joints are the important articular pillars of the spine. Several pathologies can occur in and around the facet joint, including extra ossicles, traumatic dislocation, osteoarthritis, synovial cyst, axial spondyloarthritis, rheumatoid arthritis, calcium pyrophosphate deposition disease, septic arthritis, and malignant and benign neoplasms. Imaging is the mainstay to detect and characterize these diseases. In this review, we discuss the anatomy and function of facet joints, imaging techniques, and the imaging findings of several facet joint diseases. This information may be helpful to radiologists to make the correct diagnosis and optimize the management of patients with facet joint diseases.     

Imaging of macrophage-related lung diseases

Macrophage-related pulmonary diseases are a heterogeneous group of disorders characterized by macrophage accumulation, activation or dysfunction. These conditions include smoking-related interstitial lung diseases, metabolic disorders such as Niemann–Pick or Gaucher disease, and rare primary lung tumors. High-resolution computed tomography abnormalities include pulmonary ground-glass opacification secondary to infiltration by macrophages, centrilobular nodules or interlobular septal thickening reflecting peribronchiolar or septal macrophage accumulation, respectively, emphysema caused by macrophage dysfunction, and honeycombing following macrophage-related lung matrix remodeling.     

Imaging of renal cystic diseases

The improved understanding of hereditary cystic diseases is changing the nomenclature used to describe these diseases. Detailed family studies of the inheritance of these conditions become possible as the genes involved, or their DNA markers, are identified. At the same time, ultrasonography allows cystic disease to be detected very early in life in some patients. The new information necessitates changes in the terminology, which was based previously on the patient's age at clinical presentation. Thus, because ultrasonography now sometimes identifies the cysts of adult polycystic kidney disease in utero or in neonates, the term autosomal dominant polycystic kidney disease is now more appropriate. Similarly, the term autosomal recessive polycystic kidney disease is replacing infantile polycystic kidney disease. Despite the success of ultrasonography in identifying the cysts of these and other inherited conditions very early, it is important to appreciate that precise definition of the type and heredity of the condition concerned requires detailed pathologic and genetic studies. The other renal cystic disease receiving considerable attention in the recent literature is acquired cystic disease, about which more data are accumulating. With increasing numbers of patients on long-term dialysis, the condition and its complications, especially renal adenocarcinoma but also hemorrhage, continue to cause concern. The evidence for an increased incidence of renal cell carcinoma has strengthened over recent years, and the debate on the need for CT screening of patients on long-term dialysis continues.     

Imaging of cystic liver diseases

The high frequency of benign and asymptomatic liver cysts must not underevaluate the potential diagnostic difficulties of liver cystic diseases. Complicated liver cyst or cystic mass of various origin, such as developmental, neoplastic or inflammatory, are important to be recognized by the radiologist. The diagnostic approach is depending on the number of lesions and their dissemination. The presence of a wall, the internal structure of the lesion, particularly the MR signal and the proximity of the biliary tree are the main diagnostic criteria. Some less frequent but characteristic unusual features need to be memorized.     

Imaging of metabolic bone diseases

Osteoporosis is a serious public health problem. The incidence of osteoporotic fractures increases with age. As life expectancy increases, social costs associated with osteoporotic fractures will multiply exponentially. The early diagnosis of osteoporosis, thanks to evermore precise devices, becomes, therefore, fundamental to prevent complications of disease and unnecessary suffering.     

自身免疫性胰腺炎的临床进展及影像学评价

自身免疫性胰腺炎(AIP)是慢性胰腺炎中的一种特殊类型,是与IgG4相关的系统硬化性疾病,其主要影像学检查手段包括B超检查、超声内镜、CT、MRI、磁共振胆胰管成像、经内镜逆行胰胆管造影等。AIP在影像学上表现为胰腺弥漫性或局灶性肿大,伴不同程度胰管或胆管的狭窄,但经超声引导下的细针穿刺活检诊断的敏感性与特异性均不高,正确的诊断对其治疗方案的选择和预后具有重要意义,现就AIP的临床进展及影像学表现予以综述。     

自身免疫性胰腺炎的临床进展及影像学评价

自身免疫性胰腺炎（AIP）是慢性胰腺炎中的一种特殊类型,是与IgG4相关的系统硬化性疾病,其主要影像学检查手段包括B超检查、超声内镜、CT、MRI、磁共振胆胰管成像、经内镜逆行胰胆管造影等。AIP在影像学上表现为胰腺弥漫性或局灶性肿大,伴不同程度胰管或胆管的狭窄,但经超声引导下的细针穿刺活检诊断的敏感性与特异性均不高,正确的诊断对其治疗方案的选择和预后具有重要意义,现就AIP的临床进展及影像学表现予以综述。     

腮腺少见病变的影像学表现分析

目的:探讨腮腺少见病变的影像学表现,提高对其认识水平。方法:回顾性分析经临床及病理证实的38例腮腺少见病变的CT或MRI资料。结果:嗜酸细胞腺瘤向咽旁间隙生长是其特征性表现;基底细胞腺瘤有双期持续强化特点;肌上皮瘤和肌上皮癌影像表现无特异性;脂肪瘤可见脂肪成分;婴儿毛细血管瘤有血管流空信号;木村病表现为腮腺弥漫性肿大,累及皮肤及皮下组织;表皮样囊肿、皮样囊肿、潴留囊肿病灶内均无强化;钙化性上皮瘤常位于腮腺区外侧皮下,发生部位有一定特点;良性淋巴上皮病变表现为双侧腮腺弥漫性肿大伴多发囊性肿块或小结节;淋巴上皮癌表现为多发囊性肿块时与良性淋巴结上皮病变及转移性鳞癌鉴别困难;腮腺癌2例均为腺泡细胞癌;淋巴瘤常有原发淋巴瘤病史,伴全身多发淋巴结肿大;转移瘤有原发恶性肿瘤病史,影像学表现与原发肿瘤密切相关。结论:部分腮腺少见病变具有一定的影像学特点,有助于鉴别诊断,确诊仍依靠组织病理学和免疫组化。     

泌尿系疾病的影像学诊断

目的：探讨排泄性尿路造影（IVP）、CT尿路成像（CTU）、磁共振尿路成像（MRU）在泌尿系疾病中的诊断价值。方法：45例泌尿系疾病患者中,同时行IVP、CTU及MRU检查者31例,仅行IVP检查者5例,仅行CTU检查者6例,仅行MRU检查者3例,CTU采用的重组技术包括多平面重组、曲面重组、容积再现及最大密度投影。结果：经IVP检查的患者中,能够明确诊断者占82.69%;经CTU检查的患者中,能够明确诊断者占94%;经MRU检查的患者中,能够明确诊断者占78.57%。结论：IVP检查方法较简便,能大致了解肾脏功能,费用相对低廉,医生和患者易于接受,仍具有较重要的诊断价值;CTU具有较好的图像质量,对于肾尿路平片（KUB）和IVP不能显示或不能确诊的泌尿系肿瘤和结石,CT能从大小、形态、部位及梗阻以上空间的扩张上作出进一步评估;MRU后处理功能强大,重组图像清晰,可以发现很多IVP不能发现的细小病变,作为一种非侵袭性、无需对比剂的方法,对于某些泌尿系疾病具有十分重要的临床应用价值。     

自身免疫性胰腺炎影像特征的显示:MRI与CT对照

R/的显示率高于CT(X2值分别为17.05、7.11、9.09、6.12,P值均<0.01).在显示增强扫描动脉期灌注降低(分别显示16和21例)和胆总管胰腺段狭窄(分别显示14和18例)方面,两者差异无统计学意义(X2值分别为3.20、2.25,P值均>0.05).结论 在显示病变区平扫密度或信号异常、病变区延迟强化、病变周围假包膜结构、胰管弥漫性不规则狭窄等方面,MRI的显示率高于CT.而对于AIP的其他影像特征的显示,尤其是对于胰腺肿大的显示,MRI的显示率与CT相似.