CT对脾脏结核的诊断价值(附12例报告)

目的探讨CT对脾脏结核的诊断价值。方法回顾性分析经病理证实或经抗结核治疗取得明显疗效而确诊的12例脾结核的CT表现。结果 (1)粟粒型脾结核2例,CT表现为脾脏弥漫性肿大,伴有多发粟粒状低密度灶,增强扫描病灶无明显强化;(2)结节型脾结核5例,CT表现为脾内单发或多发结节状低密度灶或混杂密度结节灶,增强后边缘轻度强化;(3)脓肿型脾结核3例,CT表现为多个干酪性结节灶相互融合,液化坏死形成较大的囊性病变,边缘轻度强化,周围可伴有卫星灶。(4)纤维钙化型:2例,表现为脾脏内散在点状钙化灶。腹腔、腹膜后淋巴结肿大6例,呈环形强化;其它脏器结核9例。结论脾结核的CT表现具有一定特征,CT对脾结核的诊断具有重要价值。     

散发性脑炎与脑CT检查(附40例分析)

本文对40例散发性脑炎病人脑CT检查进行回顾性分析。CT异常31例,正常9例。CT改变特点:1弥漫性,2局灶性,3弥漫性基础上局灶改变,4脑萎缩,5无异常发现。散发性脑炎病人通过脑CT检查对其诊断、鉴别诊断具有较大价值,能协助排除颅内占位性病变,缺血性及出血性脑血管病等。可进行动态观察、以评价疗效。     

肺实质性疾病的CT诊断

自1980年以来，CT对肺实质性疾病的评价起着越来越重要的作用。随着能在屏气期间观察肺组织的扫描设备的出现，随着高分辩力软件的开发，局灶性和弥漫性肺实质疾患现在已能正确评价。CT扫描机的不断应用使得CT在评价弥漫性肺实质病变方面有了惊人的进展。在这章里我们将介绍局灶性和弥漫性肺实质疾病的研究状况。二、局灶性肺疾患CT解释局处性肺疾患的病理改变是必不可少的。普通X线胸片无论何时都应做为CT研究的指导。作为一个总的原则，非增强扫描首先使用层厚为B～10n；nl的连续扫描，厚层面可有助于显示肺血管及其分支结构，使之容…     

脾脏良性肿瘤多层螺旋CT诊断（附13例报告）

目的 探讨碑脏艮性肿瘤CT表现及诊断价值，以提高诊断水平。方法 回顾性分析13例经病理证买脾脏良性肿瘤CT资料，其中海绵状血管瘤5例，脾囊肿6例，淋巴管瘤2例。结果 海绵状血管瘤增强扫描呈边缘强化并向中心充填，延期扫描痛灶可完全弥合与睥成等密度；脾囊肿呈圆形或椭圆形囊状占位，水样密度，边缘光滑，不强化为其特点：淋巴管瘤的典型表现是多发低密度灶，可有间隔状强化。结论 脾脏良性肿瘤具有比较特征性的螺旋CT表现，可作出较准确的定位．定性诊断。     

局灶性气管的CT表现

目的讨论局灶性气管和大支气管异常的CT表现。方法对患者进行CT检查并依据图像表现进行诊断。结论局灶性气管病变的症状常无特异性。     

Binswanger病临床特点与CT、MR分析

目的 :探讨Binswanger病 (BD)的病因、临床特点及CT、MR改变。方法 :对 5 7例BD患者的表现及CT、MR改变进行分析。结果 :BD伴有高血压病史 4 8例 (84 .2 % ) ,临床表现为渐进性痴呆、智能减退、假性延髓麻痹等 ,有神经系统局灶体征。常以脑卒中发作就诊。该病的头颅CT和MR均有局灶性或弥漫性改变 ,MR发现的病灶较CT明显增多。结论 :BD与高血压有密切关系 ,MR对BD的诊断率较高 ,早期控制高血压是治疗的关键。     

轻度脂肪肝的CT诊断

目的探讨轻度脂肪肝的CT特征,总结诊断经验。方法采用回顾性的分析方法,选取2011年2月-2012年4月某院收治确诊为脂肪肝患者共142例作为研究对象,行CT扫描,获得肝、脾CT值,并取比值,对比弥漫性脂肪肝与局灶性脂肪肝的CT特征,就轻度脂肪肝特征进行分析。结果共诊断出轻度脂肪肝74例占52.11%,其中弥漫性脂肪肝63例,无占位效应,病灶分布均匀,局灶性脂肪肝11例,病灶分布特异,有占位效应;轻度脂肪肝患者人均肝脏CT值（47.29±8.21）HU,肝、脾CT比值（0.75±0.11）。结论轻度脂肪肝患者其肝脏密度较中度、重度患者更高,弥漫性脂肪肝诊断较易,局灶性脂肪肝诊断,部分患者需进行增强扫描、增添对比剂或延时扫描,以排除肝癌、肝血管瘤等占位性病变的可能。     

脾结核的CT征象

目的 评价脾结核的CT表现在诊断中的价值。方法 对11例脾结核的影像资料和临床资料进行回顾性分析。结合有关文献进行了深入讨论。结果 9例CT表现为脾内多发性大小不等的类圆形，低密度灶，8例伴有脾门，胰周及邻近大血管周围多数低密度结节影，少数有融合，增强扫描脾，胰，肝及肾等脏器内病变无强化，腹腔淋巴结表现为周边环状强化而中央无强化，仅1例表现为肝，脾，腹腔多发钙化影，1例肝，脾内多发钙化，结论 脾结核通常不是孤立性病变，是全身结核的一部分，脾脏病灶，CT表现为脾内单发或多发不被强化的低密度区，钙化，肝脾肿大等，影像学表现不具有特异性，但是淋巴结结核的CT表现具有特征性，发现脾外结核的证据常能确立诊断。     

超声造影与CT对脾结核的诊断价值

目的观察脾结核在超声造影及计算机断层扫描(CT)中的影像学表现,并探讨两种影像学方法在脾结核中的诊断价值。方法回顾性分析2009年1月-2014年3月我院门诊部收治的经手术病理证实26例脾结核患者的临床资料,对所有病例患者的超声造影及CT影像学表现进行分析比较,并对两种诊断方法的应用价值进行评估。结果脾结核患者经超声造影检查有低回声型、混合回声型及强回声型,超声造影表现基本相同,无增强型为其最常见超声造影表现;CT平扫脾脏内多发大小不等结节状稍低密度影,边缘不清,而CT增强扫描边缘及内部分隔明显不强化,与周围脾脏相较呈明显低密度影,类似囊性病灶征象及钙化灶征象是脾结核相对典型的表现,超声造影与CT对脾结核患者诊断准确率无显著差异(P0.05)。结论超声造影和CT对脾结核诊断均具有特异性,两种诊断方法均值得临床推广应用。     

256排螺旋CT灌注成像对局灶性结节增生的诊断价值

目的:探讨CT灌注成像对局灶性结节增生的诊断价值。方法:选出将经256排螺旋CT及临床资料初步诊断为局灶性结节增生患者,将病理结果确诊为局灶性结节增生患者筛选出来,行CT灌注扫描。最后得到10例病例,比较10例局灶性结节增生病灶实性成分与远处肝组织的CT灌注值。结果:局灶性结节增生病灶实性部分的肝动脉灌注量(HAP)、肝动脉灌注指数(HPI)、总肝灌注量(TLP)高于远处肝组织,门静脉灌注量(PVP)低于远处肝组织,其中HAP、HPI及PVP存在统计学差异。结论:CT灌注成像对局灶性结节增生的诊断具有重要临床意义。     

Abdominal subcutaneous fat aspiration--an alternative method to diagnose amyloidosis

A middle aged lady presented with clinical manifestations of primary amyloidosis which included amyloid cardiomyopathy. There was failure to confirm the diagnosis of amyloidosis with biopsies from rectal and tongue tissues. Fat tissue obtained from abdominal subcutaneous fat aspiration eventually demonstrated the presence of amyloid.     

Experimental murine amyloidosis: a model system for studying amyloid formation.

Myeloma-associated and casein-induced murine amyloidosis were used as models to study the role of lymphocytes and macrophages in amyloid formation. Amyloidosis occurred rarely and in small amounts in Balb/C mice with immunoglobulin (Ig)-producing myeloma tumours but large amounts could be induced by injections of casein. Fluorescent staining of both forms of amyloid deposits by means of anti-casein- and anti-myeloma-amyloid antibodies indicated that they either crossreacted or coexisted. Nor abnormality of Ig biosynthesis was detected in amyloidosis, suggesting that abnormal degradation was responsible for production of the Ig form of amyloid. Although spleen lymphocytes of casein-injected mice with amyloidosis demonstrated diminished cellular immunologic responses, this did not indicate generalized immunologic incompetence. The non-Ig form of amyloid in casein-injected mice was shown to be produced by macrophages, and a technique was developed for increasing the yield of amyloid-containing cells.     

原发性支气管肺淀粉样变9例临床分析

目的：探讨原发性支气管肺淀粉样变的临床表现、影像学特征和治疗措施。方法回顾分析我院1994-2012年收治的9例原发性支气管肺淀粉样变患者的临床资料并结合文献进行分析。结果9例中男6例,女3例,平均年龄54岁。肺实质结节型和气管支气管淀粉样变主要表现为咳嗽、咳痰,可伴咯血或无症状。肺间质弥漫型主要表现为胸痛、痰中带血。肺实质结节型胸部CT均表现为肺部结节影,气管支气管淀粉样变表现为气管、支气管管壁增厚,可伴有钙化,肺间质弥漫性淀粉样变表现为双肺弥漫分布小结节影、斑片影。肺实质结节型通常预后较好。气管支气管型病变者常反复感染加重,需间断气管镜下介入治疗,抗炎、止咳化痰、平喘等综合治疗有一定疗效。呈肺间质弥漫型病变者预后较差。结论原发性支气管肺淀粉样变临床和影像学表现无特异性,确诊依据病理学检查,抗炎等对症治疗可以缓解症状。     

Pattern of renal amyloidosis in Indian patients.

Two hundred and thirty-three patients with renal amyloidosis were studied in an attempt to identify the incidence and pattern of the disease in northern India. The incidence of amyloidosis was 1.01% of 6431 post-mortems and 8.4% of 1980 renal biopsies from patients who presented with clinical evidence of glomerular disease. Two hundred and three patients (87.1%) had secondary amyloidosis, 22 (9.4%) had primary amyloid and 8 patients (3.5%) had amyloidosis associated with multiple myeloma. Tuberculosis of various organs was the commonest predisposing disease accounting for 59.1% of secondary amyloidosis, followed by chronic suppurative lung disease in 24.1%. Rheumatoid arthritis, chronic osteomyelitis and lepromatous leprosy were seen in a small percentage of patients (2 to 8%). Proteinuria of varying degree was present in all the 233 patients and 12.9% of them had a daily protein excretion of more than 10 g. Post-mortem examination of 65 patients with renal amyloidosis showed that 75.3% also had amyloid deposit in the spleen, 63% in the liver, and 50.8% in the adrenals. Clinical evidence of disappearance of proteinuria was observed in 3 patients with secondary amyloidosis; in 2 of them, the regression of amyloidosis was confirmed by serial renal biopsy performed 3 and 5 years after the initial diagnosis.     

Impaired splenic function in systemic amyloidosis

In four cases of biopsy proven amyloidosis there was evidence of impaired splenic function. All had absent or grossly reduced splenic uptake on colloid isotope scans and three had haematological changes consistent with hyposplenism. Poor splenic function with a normal sized or enlarged spleen may be a clue to underlying amyloid.     

从“虚”论治肾淀粉样变性病初探

结合现代科技,西医对肾淀粉样变性病的认知取得较大进展。中医对该病论述相对较少,但据其临床症状,结合诸多学者对该病所累积脏腑的认识及经验,认为本病多责之于脏腑虚衰,以脾肾亏虚为本,兼夹寒、痰、瘀等致病因素,进而形成复杂多变的临床表现。治疗上运用中医理论,从“虚”论治,审察病机,扶正祛邪,标本兼治。     

脾外伤的CT诊断与损伤分级的临床意义

目的探讨脾外伤的CT诊断及分级的临床意义。方法回顾分析12例经手术证实脾外伤患者,术前均行CT检查。结果脾外伤性破裂的常见CT表现有脾周新月形密度异常区、脾内类圆形或斑片状高密度影、脾实质内线状不规则低密度影等;增强扫描脾实质明显强化,而血肿不强化或强化密度明显低于正常脾脏或肝脏密度。结论 CT平扫及增强扫描能显示脾外伤性破裂的部位及范围,并能明确脾脏损伤程度分级。     

Whole-body MRI including diffusion-weighted imaging compared to CT for staging of malignant melanoma

Abstract

The relationship between the degree of amyloidosis in pancreatic islet tissue and the frequency of islets containing amyloid was studied in an autopsy material. A very strong positive correlation was found between these two variables in both the head and the tail of the pancreas. There was also a positive correlation between the degree of amyloidosis in islets containing amyloid and their frequency. This may indicate that the deposition of amyloid in the islets of Langerhans is a continuous process affecting progressively increasing numbers of islets. It is probable that the amyloid formation in the islets is influenced by some factor or factors that affect the different islets to different degrees. It is conceivable that one such factor may be vascular changes. The strong correlation between the frequency of islets containing amyloid and the degree of amyloidosis can be utilized as a simple and rapid method of determining the latter.     

局限性淀粉样物沉积症的组织化学及免疫组织化学的研究

应用组织化学和免疫组织化学的方法对18例局限性淀粉样物沉积症进行了分析和研究,探讨不同类型病变的形态学特征和发病机理,并提出诊断该病的可靠方法。     

脾脏创伤的CT表现

目的 :总结脾脏创伤的 CT征象及诊断价值。材料与方法 :笔者分析了 30例脾创伤病人的 CT资料 ,其中男 2 6例 ,女 4例 ,平均年龄 38岁 ,CT平扫 8例 ,平扫加增强 2 2例。结果 :12例呈“新月形改变”,6例呈线形低密度影 ,6例为类圆形低密度影 ,6例表现为“前哨血凝块”征象 ,2 2例行增强扫描 ,其中 2 0例表现为血肿密度较正常脾实质强化密度低 ,2例显示血肿密度与主动脉密度相同。结论 :CT能准确地显示脾脏创伤的存在及其损伤范围 ,在临床应用中具有重要价值