肺部弥漫性病变的X线、CR和CT诊断分析（附80例报告）

目的：探讨肺部弥漫性病变的X线和CR诊断。方法：回顾分析80例肺部弥漫性病变的X线和CR表现。结果：根据X线和CR征象分析为：(1)主质病变，包括腺泡结节，小片及大片阴影，支气管充气征；(2)问质病变，包括间质结节，网状及网状结节阴影，支气管血管束的增粗；(3)主间质病变，包括毛玻璃影，多发肿块及蜂窝状改变。同时对肺弥漫性病变做进一步探讨。结论：常规胸片目前仍是诊断肺弥漫性病变的首选方法，而CT则是重要的辅助手段。     

肺部空洞性病变的影像学诊断(附75例分析)

目的　提高对肺部空洞病变的诊断及鉴别诊断水平。方法　对本院近 8年来资料完整 ,诊断明确的肺部结核性、癌性及炎症性空洞性病变 75例的胸部X线平片及CT表现进行回顾性分析。结果　肺结核病灶边缘多数光滑 ,密度普遍较高 ,可见斑点状钙化灶 ,可见引流支气管影像 ;肺癌病灶外缘分叶 ,有毛刺 ,洞壁厚 ,内缘凹凸不平 ;肺脓肿空洞内缘光滑整齐 ,可见液平面 ,洞壁厚 ,外缘模糊。结论　明确空洞的密度、整体形态及周围组织的变化是确定诊断和鉴别诊断的关键     

肺弥漫性病变X线、CT及HRCT影像分析

本文报告肺弥漫病变(DLD)74例,对16种DLD的X线、CT及1.2mm薄层HRCT表现进行详细分析。X线平片影像重叠,对DLD的诊断和鉴别诊断有很大限度。普通CT克服了平片的缺点,可发现平片不能显示的轻微改变、隐避部位病变及早期病变。HRCT可显示肺小叶及其微细结构,显示叶间胸膜,可对粟粒点及网状结构进行详细分析获得更多信息,为DLD的诊断及鉴别诊断提供重要依据。     

喉结核的影像学表现(附10例报道)

目的: 分析喉结核的影像学表现,旨在提高对喉结核的认识,以利于更好的诊断。材料与方法: 10 例喉结核病例摄取常规颈侧位X 线平片8 例,CT 扫描检查5 例,分析其影像学表现。结果: 8 例颈侧位X 线平片有7 例显示喉部有病变,1 例未显示。5 例CT 扫描检查均显示喉部有病变。结论: 喉结核的影像学表现可分为弥漫型和局灶型2 种,都无特征性表现。喉部双侧弥漫性不对称肿胀增厚,如会厌前间隙和喉旁间隙无明显肿块侵及,且喉支架保持完整者为弥漫型喉结核的特征,可与喉癌鉴别     

脾脏囊性病变的CT诊断(附10例报告)

脾脏囊性病变少见,笔者回顾性分析我院从1992年12月～1999年11月间经CT检查、手术和病理证实的脾脏囊性病变10例,探讨其CT表现及诊断价值.     

肺部弥漫病变的X线诊断

肺部弥漫性病变，系广泛散布于两肺的多发性病变，病灶可均匀对称地分布于两肺，也可两下野多于两上肺野或两上肺野多于两下肺野，可较多的集中在两肺中野，形成“蝶翼状”，阴影，有时互相融合成大片状，现结合我们的日常工作中常见的疾病，以X线表现为主，参考一些临床资料，作以下简要介绍。     

支气管肺类癌的影像学诊断(附13例分析)

目的：研究肺类癌的影像学特点。方法：回顾性分析本组１３例手术病理证实的支气管肺类癌的Ｘ线平片,体层摄影及ＣＴ的表现。结果：肺类癌为单发类圆形或多角形肿块,边界清晰,密度均匀,多有分叶改变,转移少见,无钙化。ＣＴ像上肿块密度、边缘与相邻组织关系更为清晰。结论：肺类癌缺乏影像学特征,难与肺癌相鉴别,最后诊断需要病理证实。     

颅内生殖细胞瘤的X线分析－附17例报告

生殖细胞瘤是一种较少见的颅内肿瘤，约占颅内肿瘤的1．27％（1），本文报告我院自1982－1987年间，经手术，病理证实的生殖细胞瘤17例，就生殖细胞瘤的X线平片，Conray脑空造影，CT扫描的表现，结合文献探讨如下。     

胸腰椎骨折的CT诊断及与X线平片对照分析(附72例报告)

目的：提高ＣＴ诊断脊柱损伤价值的认识。方法：对照分析７２例胸腰椎骨折的Ｘ线平片与ＣＴ表现。结果：７２例９５节胸腰椎骨折中,单椎体骨折者５４例,多椎体骨折者１８例。单纯屈曲压缩型２１例,爆裂型４１例,骨折脱位型１０例。结论：Ｘ线平片是脊柱损伤的基本检查手段。有时仅凭Ｘ线平片表现较难区分单纯屈曲压缩型和爆裂型。椎体后缘线异常是Ｘ线平片诊断爆裂骨折的重要指征。ＣＴ是检查脊柱损伤必要的补充手段,能明确区分单纯屈曲压缩型和爆裂型骨折;对骨折分型、判断脊柱失稳、椎管受累程度以及制定治疗方案均有重要价值。     

A practical approach to high-resolution CT of diffuse lung disease

Diffuse lung disease presents a variety of high-resolution CT findings reflecting its complex pathology, and provides diagnostic challenge to radiologists. Frequent modification of detailed pathological classification makes it difficult to keep up with the latest understanding. In this review, we describe a practical approach to high-resolution CT diagnosis of diffuse lung disease, emphasizing (1) analysis of “distribution” of the abnormalities, (2) interpretation of “pattern” in relation to distribution, (3) utilization of associated imaging findings and clinical information, and (4) chronicity of the findings. This practical approach will help radiologists establish a way to interpret high-resolution CT, leading to pin-point diagnosis or narrower differential diagnoses of diffuse lung diseases.     

Computed tomography of diffuse lung disease: functional correlates

An appreciation of functional and morphological characteristics is fundamental to the understanding of diffuse lung disease. The detailed information available from high-resolution computed tomography (HRCT) and the facility to subjectively or objectively quantify disease has elucidated the sometimes complex pulmonary function profiles of several diffuse lung diseases. The many reasons why correlations between the extent of HRCT abnormalities and physiological measures of disease may be less strong than expected and are considered in this review.     

Nothing but lung and bones: Longitudinal evolution and quantitative analysis in a case of idiopathic diffuse pulmonary ossification

A 77-year-old Caucasian man, a former surveyor in a chemical company, underwent a chest X-ray (CXR) as a follow-up exam for a melanoma of the back, surgically removed.CXR showed interstitial thickening in both lower lobes; then, a high-resolution computed tomography of the chest (HRCT) was performed to further investigate these findings, revealing multiple small, calcified nodules with branching appearance at both lung bases.Clinical examination and exposure history were negative, except for a decrease in diffusing capacity for carbon monoxide resulting from pulmonary function tests.Surgical lung biopsy was performed; histology revealed numerous nodules and branching tubules of bone tissue, some of which with marrow elements.After multidisciplinary discussion of the case, a diagnosis of idiopathic diffuse pulmonary ossification (DPO) was considered.Clinical status of the patient was stable over time, despite the increase in extent of calcifications.DPO is an uncommon condition that should be considered in different clinical-radiological settings; multidisciplinary discussion is essential for the final diagnosis.     

弥漫性间质性肺疾病130例

 目的 分析总结我院弥漫性间质性肺疾病(ILDs)的病种概率、临床特点,以期提高对ILDs的认识,加强对ILDs病因和基础疾病的分析,更好地治疗ILDs患者.[HTH〗方法 对我院自1995年1月～2006年12月临床诊断为ILDs病例进行临床回顾性分析研究,对比分析其病程、症状、体征及影像学[胸片、胸部高分辨 CT和(或)HRCT]、肺功能及血气分析结果 ,试图从中发现共性及各自的特点.结果 (1)11年间共收治130例ILDs患者,其中特发性肺纤维化(IPF)发病率最高(55/130,42.31%),其余发病率较多的依次为:慢性阻塞性肺气肿(COPD)、结缔组织病、充血性心力衰竭和肺癌合并ILDs, 分别占19.23%,10.77%,7.69%和7.69%.(2)不同病因的ILDs患者有ILDs的共同表现, 但在其临床发病年龄、病程、症状、体征、影像学征象和肺功能检查等方面又有各自的一些特点 .结论 认识ILDs的共性和个性对ILDs的病因诊断和针对性治疗,减少ILD s的漏诊和误诊大有裨益.     

支气管肺泡灌洗在弥漫性肺实质疾病预后评估中的价值

目的探讨支气管肺泡灌洗（BALF）在弥漫性肺实质疾病（DPLD）预后评估中的价值。方法回顾分析27例弥漫性肺实质疾病患者临床资料及BALF结果,对该组患者进行随访,观察BALF中细胞成分与预后的关系。结果 IPF5例,COP4例,NSIP7例,HP5例,CVD-ILD6例,病情缓解13例,加重3例,死亡11例;淋巴细胞比例与中性粒细胞比例与生存时间的COX回归分析显示淋巴细胞百分比为保护因素（OR=0.950,95%可信区间0.913～0.990,P=0.018）。中性粒细胞百分比为危险因素（OR=1.023,95%可信区间0.998～1.042,P=0.064）。结论 BALF在DPLD诊断及预后评估中具有重要价值,淋巴细胞增高为保护因素,中性粒细胞增高为危险因素。     

High-resolution CT of diffuse interstitial lung disease: key findings in common disorders

High-resolution CT (HRCT) is the radiological imaging technique that most closely reflects changes in lung structure. It represents the radiological method of choice for the diagnostic work-up of patients with known or suspected diffuse interstitial lung disease. A single HRCT finding is frequently nonspecific, but the combination of the various HRCT findings together with their anatomic distribution can suggest the most probable diagnosis. The purpose of this article is to summarize the classic HRCT features of the most common diffuse interstitial lung diseases. Lists of differential diagnoses and distinguishing key features are provided to improve diagnostic confidence. The presence of classic HRCT features often obviates the need for biopsy. In patients with atypical findings, HRCT can be used to determine the most appropriate biopsy site. Received: 29 May 2000 Accepted: 1 August 2000     

影像诊断颅骨表皮样囊肿四例

目的探讨颅骨表皮样囊肿（SEC）的CT及MRI特征。方法回顾性分析经手术病理证实的4例颅骨表皮样囊肿患者的CT及MRI表现。结果SEC的影像特征表现为：（1）CT显示颅骨火山口或扇贝样骨质缺损，周围骨质增生硬化，病灶内可出现脂性密度；（2）MRT1WI示肿瘤呈等、低信号，T2WI呈显著高信号，扩散加权成像（DWI）呈轻、中度高信号，表观扩散系数（ADC）图像病灶呈等、低信号氢质子MR波谱（^1H—MRS）肿瘤区出现乳酸（Lac）、氨基酸（AA）等波；（3）CT、MR增强扫描，病灶实质无强化。结论SEC的CT及MR／表现具有特征性，影像检查有助于其定性诊断。     

双能量CT在肝实质弥漫性疾病中的应用进展

双能量CT是一种采用2种不同能量进行数据采集的成像技术,可选择多种算法进行影像后处理。基于物质分离算法的双能量CT可以定量分析肝实质内的脂肪、铁、碘等物质,有助于早期评估肝实质弥漫性疾病及其严重程度,为肝实质弥漫性疾病的早期诊断及其发展的监测提供了一种新的影像学方法。综述近年来双能量CT在脂肪肝、肝铁沉积症、肝硬化等肝实质弥漫性疾病方面的应用进展。     

Contemporary perspectives on pediatric diffuse lung disease

It is much more challenging in children than in adults to obtain computed tomography images of the lung parenchyma at optimal lung volumes without motion artifact. Some of the more common forms of diffuse lung disease in adults rarely occur in children, and several forms of diffuse lung disease are unique to children. Recognition of these differences has led to the development of a new classification scheme for pediatric diffuse lung disease. Knowledge of this classification and recognition of characteristic imaging findings of specific disorders will lead to accurate diagnosis and guide appropriate treatment of children with diffuse lung disease.     

成人型肺母细胞瘤临床及平片、CT诊断

目的 探讨肺母细胞瘤的平片与CT表现，并进行对比分析。方法 搜集经手术、病理，针吸活检证实的肺母细胞瘤7例，男5例，女2例，年龄29～70岁，平均46例，均行平片和CT检查，对比其平片与CT表现。结果 肿瘤发生于段以上支气管腔内（中央型）1例，位于周边肺胸膜下（周围型）6例；7例中右肺6例（上叶5例，下叶1例），左肺上叶1例。肿瘤体积多较大，瘤体中心易发生液化坏死。结论 CT在成人型肺母细胞瘤诊断上能显示平片上看不到的病变，因而它明显优于平片。