共查询到20条相似文献,搜索用时 31 毫秒
1.
PURPOSE: To characterize the imaging features of thoracic hemangioma, including findings on computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) using 18F-fluoro-2-deoxy-D-glucose (FDG). METHODS: Six patients with thoracic wall hemangioma and 2 patients with mediastinal hemangioma were included in this study. Preoperative evaluation was performed using CT (n=7), MRI (n=8), and FDG-PET (n=2). Five cases were pathologically confirmed by surgery and the remaining 3 cases were diagnosed clinically. RESULTS: On CT, characteristic finding of phleboliths were depicted in 5 of 7 cases (71%). Fat component was demonstrated in 3 of 7 cases with CT (3/7-43%) and 5 of 8 cases with MRI (5/8-63%). On MRI, characteristic finding of high intensity on T2-weighted images was demonstrated in all 8 cases and the high signal intensity was emphasized in all 4 cases on fat-suppression T2-weighted images. Both of two PET scans showed mildly elevated accumulation of FDG. CONCLUSIONS: Phleboliths, fat component, and high intensity on T2-weighted and fat-suppression T2-weighted image were thought to be characteristic findings reflecting the histologic findings. It might be useful to recognize these findings for differentiating hemangiomas from other soft tissue tumors, particularly malignant neoplasms. 相似文献
2.
单光子发射计算机断层扫描在系统性红斑狼疮中枢神经系统病变中的诊断价值 总被引:3,自引:1,他引:3
目的 评价单光子发射计算机断层扫描(single photon emission computed tomography,SPECT)在系统性红斑狼疮中枢神经系统病变(CNS-SLE)诊断中的应用价值。方法 对21例SLE患者进行SPECT检查,并由2名以上经过训练且不知晓患者病情的核医学医师进行独立读片,明确脑血流灌注异常部位。对10例CNS-SLE患者同时行头颅CT和,或核磁共振(MRI)检查。结果 10例CNS-SLE中9例头颅SPECT阳性(阳性率90%),同时行头颅CT/MRI检查仅4例阳性(阳性率40%)。9例均为中~重度血流灌注减低,9例均有额叶和,或顶叶受累(6例额叶受累,4例顶叶受累,5例基底节受累,1例颞叶受累,0例枕叶受累,7例为多个区域受累)。对其中3例CNS-SLE患者治疗前后SPECT表现进行比较,发现经有效治疗临床症状改善后,SPECT异常随之明显改善甚至完全消失。11例非CNS-SLE中,仅2例SPECT阳性(阳性率18%),且均为轻度单一区域血流灌注减低(1例枕叶,1例基底节),无一例有额叶或顶叶受累。结论 SPECT对于CNS-SLE是一种敏感的检测手段,对监测病情变化、指导治疗有重要的参考价值;SLE患者头颅SPECT表现多发病灶、有额叶和(或)顶叶受累及中~重度血流灌注减低提示有CNS受累。 相似文献
3.
OBJECTIVE: To evaluate the diagnostic value of single-photon-emission computed tomography (SPECT) in severe central nervous system (CNS) involvement of systemic lupus erythematosus (SLE). METHODS: Forty-three patients with SLE, including 22 with CNS-SLE and 21 with non-CNS-SLE, underwent SPECT and magnetic resonance imaging (MRI) examinations. SPECT was repeated 1-2 months after treatment in patients with abnormal findings. RESULTS: SPECT and MRI abnormalities were detected in 20 (90.9%) and 10 (45.5%) of the 22 patients with CNS-SLE, respectively (P < 0.01). For 4 patients with cerebral infarction or hemorrhage, SPECT was equally as sensitive as MRI (100%). For the patients with CNS-SLE with diffuse presentations, SPECT was more sensitive than MRI in revealing abnormalities (16 [88.9%] of 18 patients versus 6 [33.3%] of 18 patients; P < 0.01). In 19 (95.0%) patients, the abnormal SPECT finding manifested as moderate to severe perfusion defect (15 in frontal lobe, 11 in parietal lobe, 11 in basal ganglia, 3 in temporal lobe, and 17 in multiple regions). Although mild perfusion defect was also detected in 4 (19.0%) of the patients with non-CNS-SLE, it only involved a single region and spared the frontal and parietal lobes. Repeated SPECT after treatment showed that perfusion defect had improved significantly or even disappeared in 11 (84.6%) of 13 patients with diffuse CNS-SLE with abnormal findings before treatment. CONCLUSION: Moderate to severe perfusion defect in SPECT involving multiple regions, especially in the frontal and parietal lobes and basal ganglia, in patients with lupus suggests CNS involvement. SPECT is more sensitive than MRI in revealing damage in diffuse CNS-SLE, and is useful in followup, especially for monitoring disease severity and guiding treatment. 相似文献
4.
Neurologic complications in the immediate postoperative period after cardiac surgery. Role of brain magnetic resonance imaging 总被引:1,自引:0,他引:1
Pérez-Vela JL Ramos-González A López-Almodóvar LF Renes-Carreño E Escribá-Bárcena A Rubio-Regidor M Ballenilla F Perales-Rodríguez de Viguri N Rufilanchas-Sánchez JJ 《Revista espa?ola de cardiología》2005,58(9):1014-1021
INTRODUCTION AND OBJECTIVES: Neurologic complications still cause significant morbidity and mortality in the immediate postoperative period following cardiac surgery. Our understanding of the pathogenesis, prevention, and management of these lesions is constantly developing. MATERIAL AND METHOD: We describe neurologic complications and their course in a cardiac surgery cohort and analyze the value of brain magnetic resonance imaging (MRI), using T1-weighted, T2-weighted, and FLAIR sequences, in patients with postoperative stroke or encephalopathy in whom CT scanning revealed no abnormalities explaining their clinical condition. RESULTS: In 688 patients studied postoperatively, we observed 57 neurologic complications (8.3%): 25 strokes, 24 encephalopathies, 5 seizure disorders, 2 brain deaths, and 1 intracranial hemorrhage. Initial CT scanning failed to show significant findings in 70%. 18 patients underwent brain MRI. In all but 1 of the 11 with stroke, MRI showed areas of acute or subacute infarction (i.e., hyperintensity in FLAIR or T2-weighted sequences) in different locations, mainly in a watershed distribution. In 3 of the 4 patients with mild-to-moderate encephalopathy, MRI showed lesions similar to those previously described for stroke. In the remaining 3 patients, who had severe encephalopathy, MRI showed diffuse cortical necrosis. CONCLUSIONS: The incidence of neurologic complications in the postoperative period following cardiac surgery is significant. In a high percentage of patients, brain CT scanning may not show pathologic findings. In selected patients, MRI could help identify areas of infarction not detected by CT. These images could improve clinicians' understanding of the pathogenic, pathophysiologic, clinical, and prognostic characteristics of such neurologic complications. 相似文献
5.
The aim was to examine whether clinical seizures and amplitude-integrated electroencephalogram (aEEG) patterns in infants with hypoxic ischemic encephalopathy (HIE) can predict the extent of brain injury on magnetic resonance images (MRI) and the long-term neurodevelopmental outcomes at 18∼24 months of age.HIE infants who underwent therapeutic hypothermia (TH) between June 2014 and March 2017 were included in this study. Infants with clinical seizure were analyzed for aEEG patterns and the extent of brain injury on MRI findings. Clinical seizure, aEEG, and brain MRI were assessed and compared with neurodevelopmental outcomes at 18∼24 months of age.Among the 97 HIE infants enrolled in this study with brain MRI scans, 78 (73.1%) TH-treated HIE infants exhibited clinical seizures. More abnormalities on a EEGs and more significant use of first and second antiepileptic drugs (AEDs) were significantly higher in the clinical-seizure group with longer hospitalized days. At a corrected 18 to 24 months of age, HIE infants in the clinical-seizure group with more extension of injury lesions on diffusion-weighted MRI scans exhibited significantly more delayed neurodevelopment. A risk factor analysis indicated that male infants who stayed in the hospital for more than 11 days were at a higher risk of having clinical seizures. The lesion size in MRI greater than 37 pixels was a risk factor with an 81.8% accuracy.Seizures in HIE infants may predict abnormal brain MRI scans and abnormal neurodevelopment at 18 to 24 months of age. 相似文献
6.
结核性脑膜炎的MRI和CT影像表现及其比较 总被引:1,自引:1,他引:0
目的 分析结核性脑膜炎的MRI和CT影像表现,并比较二者对结核性脑膜炎的诊断价值。方法 对42例结核性脑膜炎患者(其中男22例、女20例,年龄从16~45岁之间,平均年龄25岁)均行MRI与CT扫描。所有病例均行自旋回波T1WI、自旋回波或快速自旋回波T2WI及GdDTPA增强T1WI。结果 结核性脑膜炎的MRI和CT影像均可表现为基底池渗出、脑结核瘤,脑积水,脑梗塞等,但MRI尚能观察到脑干、颞叶、视交叉池周围等CT扫描不易显示部位的病变。此外,MRI还能明确显示基底池早期渗出及脑实质异常信号。结论 与CT相比,MRI能进一步提高结核性脑膜炎诊断的准确性及评价其疗效。 相似文献
7.
Kenji Hirai M.D. Yoshinori Aoki M.D. Yasuo Majima M.D. Hirohiko Abe M.D. Osamu Nakashima M.D. Masamichi Kojiro M.D. Kyuichi Tanikawa M.D. 《The American journal of gastroenterology》1991,86(2):205-209
Thirty-eight patients with small hepatocellular carcinomas (HCCs), size less than 20 mm, initially detected by ultrasound (US) and histologically confirmed, were examined by magnetic resonance (MR) imaging, computed tomographic (CT) scan, and angiography. MR imaging demonstrated HCC nodules in nine (75.0%) of 12 patients with tumors less than 10 mm in diameter and in 22 (84.6%) of 26 patients with tumors 10-20 mm in diameter. In total, HCC nodules were detected in 31 of 38 patients (81.6%) by MR imaging. On the other hand, HCC lesions were found on CT scan in 14 of 26 patients (53.8%) and in 27 of 35 patients (77.1%) by angiography. With MR imaging, HCC nodules were demonstrated in 21 of 31 patients on both T1 and T2 weighted images, and 13 of 21 patients (61.9%) were shown to have low intensity areas or iso intensity areas on T1 weighted image, whereas the other eight patients (38.1%) were shown to have high intensity areas. All 21 patients were shown to have high intensity areas on T2 weighted image. Among 15 resected cases, four patients had a high intensity area on T1 weighted image, and a significant fatty change was noted in HCC nodules by histological study of the resected specimen. We suggest that MR imaging is a useful diagnostic imaging modality, even in small HCC of less than 20 mm. 相似文献
8.
H Hoshino T Ohbuchi O Sakon G Suzuki K Shigehara H Takabatake A Fujita S Tagaki K Sekine S Abe 《Nihon Kokyūki Gakkai zasshi》2000,38(1):54-58
A 20-year-old man was admitted because of an abnormal mass shadow on chest X-ray film. Computed tomography (CT) and magnetic resonance imaging (MRI) disclosed a mass lesion in the superior portion of the left mediastinum. CT scans showed a well-defined mass with low density. Axial MRI rendered the mass lesion with intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. The preoperative diagnosis was bronchogenic cyst. Video-assisted thoracic surgery revealed that the tumor originated in the truncus of the left vagus nerve. The resected tumor was 90 x 24 x 18 mm in size. The postoperative course was uneventful and hoarseness did not develop. The pathologic diagnosis was benign mediastinal neurofibroma without von Recklinghausen's disease. Such cases are extremely rare in the Japanese literature. 相似文献
9.
Cerebral CT scan abnormalities in cholestatic and hepatocellular disease and their relationship to neuropsychologic test performance 总被引:2,自引:0,他引:2
P Bernthal A Hays R E Tarter D Van Thiel J Lecky A Hegedus 《Hepatology (Baltimore, Md.)》1987,7(1):107-114
Forty-nine nonalcoholic cirrhotic patients, on whom cranial CT scans were available, were administered a battery of neuropsychological tests. Although none of the subjects exhibited clinical signs or symptoms of hepatic encephalopathy, quantification of the CT scan image implicated cerebral edema and cortical atrophy. In addition numerous significant correlations were observed between the CT variables and neuropsychological test performance. The findings are conjectured to reflect previously unrecognized cerebral morphologic changes associated with chronic subclinical portal-systemic encephalopathy. 相似文献
10.
T Niimi Y Hasegawa Y Sugiura N Iijima K Yoshikawa M Kato M Morishita 《Kekkaku : [Tuberculosis]》1992,67(1):27-32
We report a case of cerebral tuberculosis following miliary tuberculosis. A 54-year-old man was admitted to our hospital in October 1990 because of fever and general fatigue. Chest x-ray film on admission showed diffuse granular shadows in both lungs. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl Neelsen's staining, and anti-tuberculous therapy was quickly started. But a few days after admission, the disturbance of consciousness, neck stiffness, and headache appeared. The examination of cerebrospinal fluid disclosed that leucocytes was increased in number, and that ADA was elevated to 14.6 IU/l. Tubercle bacilli were detected from cerebrospinal fluid by culture. Although CT scan of the brain was normal at first week of admission, brain CT at eighth week of admission showed several nodulus enhanced with contrast medium. The findings were confirmed by T2 weighted magnetic resonance images (MRI) as high intense areas. Although T1 weighted MRI showed isointensity of the gray matter, T1 weighted MRI enhanced by Gd-DTPA revealed abnormal enhancement. At twenty-ninth week of admission CT showed no abnormality even by contrast enhancement, but enhanced T1 weighted MRI revealed a small lesion with enhancement which was not shown by CT. MRI enhanced by Gd-DTPA was more useful for evaluating cerebral tuberculosis than brain CT. 相似文献
11.
Nontuberculous mycobacterial infection: CT scan findings, genotype, and treatment responsiveness 总被引:3,自引:0,他引:3
STUDY OBJECTIVE: The purpose of this study was to compare the imaging findings of nontuberculous mycobacterial (NTM) infection in patients with normal and abnormal cystic fibrosis (CF) genotypes, and normal and abnormal alpha1-antitrypsin (AAT) phenotypes. DESIGN: A retrospective review of medical records and chest CT scans from 85 patients with microbiologically proven NTM infection was performed. All patients had undergone genotype analysis for CF mutations, and phenotypic evaluation for AAT status. Patients with homozygous CF or AAT were not included. Two independent observers assessed the patterns and distribution of disease, according to a standardized score sheet. In 52 patients, follow-up CT scans were obtained 1 to 46 months (mean duration, 8 months) following the initial CT scan. The CT scan findings on the follow-up scan were visually compared with those on the initial CT scan for progression or regression of abnormalities. Statistical analysis was performed to evaluate the relationship between the dominant CT scan pattern and CF/AAT status, and between CT scan pattern and radiologic change on follow-up. RESULTS: Fifteen patients (18%) were found to carry a single CF mutation, and an abnormal AAT phenotype was seen in 13 patients (15%). Three patients (3%) were found to have both a heterozygous CF mutation and a heterozygous AAT phenotype. On the initial CT scans, bronchiectasis and nodules were the most frequent findings of NTM infection in all three groups (p > 0.05). The prevalence of nodules was slightly lower in the CF group, and the prevalence of linear scarring was greater in the AAT group than in the normal group (p < 0.05). Among the 52 patients who had a follow-up CT scan, 8 (15%) had a CF mutation and 6 (12%) had an abnormal AAT phenotype. The extent and pattern of abnormality seen on the initial CT scan did not predict change on follow-up evaluation. After treatment, 40 patients (56%) with a normal CF genotype had decrease in disease extent, compared with 4 patients (25%) with a CF mutation (p < 0.05). Bronchiectasis was improved in approximately 35% of those with normal genotype, but in none of those with a CF mutation. CONCLUSION: In patients with NTM infection, the CT scan findings show only minor differences according to phenotype and genotype. Initial CT scan findings do not predict change on follow-up CT scan evaluation. However, on follow-up CT scan, patients with CF mutations are less likely to improve, while those with AAT phenotype appear to have a radiographic outcome similar to those with normal phenotype. 相似文献
12.
M Tanno M Nakayama Y Kyomatsu M Kawakami Y Mashima S Tanno H Kasahara K Chiba K Endo H Yamada 《Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics》1992,29(3):190-197
Findings in patients in whom brain stem lesions were suspected were studied by a high-field-strength (1.5 T) MR imager. MR scans were obtained in 97 patients over a 10-month period. The mean age was 71 years (range, 39-94 years). A high incidence of infarction and lesions showing a high signal on T2-weighted image, but an almost normal signal on the T1-weighted image were observed at the pons in elderly cases. Furthermore, cases in which these two findings were observed, had a high incidence of lesion at other regions than pons. Cases with a past history of hypertension had higher incidence of lesions at the pons than normotensive patients (alpha less than 0.01). These findings suggest that MRI examination in the elderly could detect a high incidence abnormal lesions at the brain stem as well as in basal ganglia. 相似文献
13.
Ten cases of syringomyelia confirmed by magnetic resonance imaging (MRI) were presented. The cavities in the spinal cord were of low signal on T1 weighted image (T1WI) and high signal on T2 weighted image (T2WI). The segments of the spinal cord with involved lesion resembled "bamboo joints" or were of "beaded" shape on sagittal section image and of "necklace" shape on cross section image. Size of the lesions in the spinal cord shown by MRI was larger than that judged by clinical symptoms. MRI can clearly show the position, size and shape of the cavities and other abnormal conditions. Results of this study show that MRI is the most useful diagnostic tool for syringomyelia. It should be emphasized that there was no dissociated impairment of pain and temperature and touch sensation in 40% of the patients and chronic spontaneous segmental pain was one of the important clinical characteristics of syringomyelia. 相似文献
14.
J P Hauzeur S Hanquinet P A Gevenois T Appelboom J Bentin N Perlmutter 《The Journal of rheumatology》1991,18(8):1211-1217
To better define the magnetic resonance imaging (MRI) features during transient osteoporosis of the hip, we carried out sequential MRI of 8 patients with transient osteoporosis of the hip showing the typical radiographic pattern of diffuse osteoporosis of the femoral head. These cases displayed the same MRI changes in the femoral head and neck characterized by low signal intensity on the T1 weighted images and high signal intensity on the T2 weighted images. The MRI signal became normal within 11 months, but surprisingly, migration of the MRI abnormalities was observed during the course of the disease in 5 cases: abnormal MRI signals were first observed in the anterior area, then migrated to the posterior part, while a normal MRI signal reappeared in the anterior part. We conclude that MRI seems to show some particular features in transient osteoporosis of the hip, which normalize after a few months of evolution; this could represent a migration of MRI abnormalities. Such findings could help in the differential diagnosis of hip diseases such as aseptic bone necrosis. 相似文献
15.
M Nakanishi Y Demura Y Totani S Amesima F Sasaki T Ishizaki I Miyamori 《Nihon Kokyūki Gakkai zasshi》2000,38(2):107-112
We report 2 cases of lung metastasis of malignant melanoma. Patient 1 was a 71-year-old woman who had undergone an operation for enucleation of her left eye 13 years earlier. Chest magnetic resonance imaging (MRI) demonstrated intermediate intensity including partially high intensity on T 1 weighted images, and high intensity including partially low intensity on T 2 weighted images. Microscopic findings from a transbronchial lung biopsy specimen disclosed melanotic melanoma. Patient 2 was a 54-year-old man who had undergone surgery for malignant melanoma in the left upper arm 4 years earlier. Chest MRI films demonstrated low intensity on T 1 weighted images, and high intensity on T 2 weighted images. Microscopic findings from specimens of the primary lesion in the left upper arm revealed melanotic melanoma, but the findings from the lower right lobectomy disclosed amelanotic melanoma. It has been reported that MRI is useful in the diagnosis of malignant melanoma, and that melanin content reflects MRI signal intensity. The MRI findings were consistent with the histopathologic findings in each of the 2 cases we reported. 相似文献
16.
Takeshi Tanaka Gohta Masuda Akiko Takechi Hiroyuki Kobayashi Satoshi Tanaka Morio Koike Nobu Hattori 《Journal of gastroenterology》1995,30(2):268-272
In Japan, Kaposi's sarcoma (KS) is a very rare neoplasm. However, it does occur as one of the complications in patients with acquired immunodeficiency syndrome (AIDS). AIDS-related KS commonly involves the skin, lymph nodes, and gastrointestinal tract. Hepatic KS is sometimes observed in AIDS patients at autopsy, but it is very rarely diagnosed during life. We report a case of hepatic KS in an AIDS patient, detected by ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) during life and proven at autopsy. Abdominal US revealed multiple hyperechoic tumors along the portal vein. CT scan showed low density and delayed enhancement by contrast material. These tumors were revealed as a low intensity area on a T1-weighted image of MRI and as a high intensity area on T2-weighted and proton density images. US, CT scan, and MRI revealed characteristic findings of hepatic KS. These procedures are very useful for the diagnosis of hepatic KS. To our knowledge, this is the first report of hepatic KS in Japan. 相似文献
17.
目的探讨并殖吸虫病肝损害的CT及MR特征性表现。方法对18例经临床治疗奏效或病理证实的并殖吸虫病肝损害的CT及MRI征象进行回顾性分析。经CT检查10例,MRI检查2例,同时行CT及MRI检查6例。结果单发病灶4例,多发病灶14例。病灶均分布在肝包膜下或门脉分支周围肝实质内,呈楔形、不规则形或条形,部分病例可见“隧道征”及“围管征”;16例CT平扫病灶呈稍低密度12例,等密度4例,边缘模糊;动态增强动脉期大部分病变轻度强化或周边轻度强化,少数无强化;门脉期病灶显示最多,边界清晰,呈相对低密度;延迟期病灶强化消失。MRI检查8例中,呈等T1、稍长T2信号2例,呈稍长T1、稍长T2信号6例;动态增强扫描,多发病灶在动脉期可见斑片状强化;门脉期呈多发低信号,边缘清晰;延迟期病灶强化呈等信号改变。肝内单发病灶表现为环状及分隔样强化,门脉期显示最清。结论并殖吸虫病肝损害白}『CT蜃MRT嘉瑚有一事特征.对该病有赫高的诊断价倌. 相似文献
18.
Sleep disorders and brain MRI as early indicators of subclinical hepatic encephalopathy 总被引:3,自引:0,他引:3
Velissaris D Solomou E Kalogeropoulos A Georgiopoulou V Thomopoulos C Karatza C 《Hepato-gastroenterology》2006,53(67):51-54
BACKGROUND/AIMS: Cirrhotic patients with hepatic encephalopathy have significant impairment of their daily activities. Sleep disturbances and increased signal on T1-weighted brain Magnetic Resonance Imaging (MRI) are commonly encountered in this clinical entity. The prevalence of these abnormalities in patients with subclinical encephalopathy is unknown. METHODOLOGY: Sleep history and brain MRI were evaluated in 26 cirrhotic individuals with no evidence of encephalopathy. Thirteen patients without liver dysfunction or signs of neurological impairment served as a control group. RESULTS: Sleep disturbances were found in 24 of 26 cirrhotic patients (92.3%), whereas 18 of them (69.2%) had brain MRI abnormalities (p<0.05 by McNemar's test). Among the control group, 1 of 13 patients had sleep disorders, whereas none exhibited abnormal MRI (both p<0.001 by chi2 compared to study group). Increased bilirubin and globulin levels, and decreased albumin levels were found to have a significant correlation to brain MRI abnormalities among cirrhotic patients. CONCLUSIONS: Sleep disturbances are emerging as a sensitive sign of subclinical encephalopathy in cirrhotic patients. A major role of brain MRI is also recognized, as abnormal images are highly prevalent in this clinical entity. Furthermore, the level of MRI abnormalities appears to be in concordance with the abnormal liver function tests. 相似文献
19.
Miyakoshi M Kamoi K Takano T Nishihara M Kawashima T Sudo N Togashi K Emura I Williams D 《Endocrine journal》2007,54(2):205-210
We encountered an unusual case of hyperparathyroidism with both hemosiderin deposits on the ribs and low intensity on T2-weighted magnetic resonance imaging (MRI) caused by a parathyroid adenoma with multiple brown tumors that mimicked metastatic bone tumor due to false positive results on computed tomography (CT) and Tc-99m sestamibi (MIBI) imaging. The patient, a middle-aged woman, had very high serum levels of calcium (14.1 mg/dl), alkaline phosphatase (9,369 IU/l) and intact-PTH (12,400 pg/ml), and a large tumor (2.5 cm in diameter) in the lower portion of the left lobe of the thyroid. Plain X-ray revealed a soft tumor in the left chest wall. On CT scan, there were multiple destructive masses in the ribs, including large intramedullary masses on both 3rd ribs. On MIBI scintigraphy, there was strong late uptake in the lower portion of the left cervical region, both 3rd ribs, and the left 7th, 8th, and 10th ribs. T2-weighted image MRI scans showed that both 3rd ribs had a low intensity with hemosiderin deposits. These findings suggested that the patient had hyperparathyroidism with multiple bone metastases due to carcinoma of the parathyroid gland. However, on pathology, the resected tumor of lower portion of the left lobe of thyroid was diagnosed as a parathyroid adenoma, and the tumors of the left 3rd and 7th ribs, as well as the right 2nd rib, were shown to be brown tumors. After resection, the patient's serum levels of calcium, alkaline phosphatase, and intact-PTH normalized. At 1.5-years follow-up, CT, MIBI, and MRI scans showed no abnormal findings. It is necessary to determine whether MRI can be used to distinguish between brown tumors and metastases caused by carcinoma of the parathyroid gland. 相似文献
20.
目的探讨腹盆腔孤立性纤维瘤的影像学表现及病理学特征。
方法回顾性分析2015年3月至2021年3月江苏省苏北人民医院经手术病理证实的7例腹盆腔孤立性纤维瘤(SFT)患者的影像学资料,并与病理结果对照。
结果7例SFT患者中男性6例,女性1例;平均年龄57(27~71)岁。1例仅行CT腹部平扫、6例行CT或MRI平扫、增强扫描。1例发生于胰腺,2例位于腹腔,4例位于盆腔。7例中仅1例为多发病灶,其余均为单发,病灶最大径平均值90 mm。CT平扫呈等密度影或伴有稍低密度影,密度均匀或不均匀,其中伴小囊变2例,钙化灶1例。增强扫描仅1例表现为均匀轻微强化,5例动脉期见强化血管影,4例实质期呈"地图样"强化。MRI T1WI呈稍低信号,T2WI呈等低或稍高、稍低混杂信号影,1例病灶见T2WI低信号血管流空影,增强扫描延迟性强化。7例中有2例发生术后转移,1例邻近骨质受侵犯。组织学上SFT主要由梭形细胞和胶原纤维组成,免疫组化主要表现为CD34高表达阳性,Ki-67低表达阳性,恶性SFT表现为CD34表达减弱,而Ki-67高表达。
结论腹盆腔SFT较为少见,其影像学表现具有一定的特异性,且可反映其病理特征,有助于疾病的诊断及鉴别诊断。 相似文献