新生儿呕吐性疾病的消化道造影研究

目的:研究新生儿呕吐性疾病的造影技术,探讨其影像特征。方法:对比剂引入方式采用吸吮法和插胃管抽液后再注入对比剂两种方法;选用对比剂有6 0 %～80 % (W/V)的硫酸钡混悬液30～4 0ml或30 %泛影葡胺30ml;采用不同体位多轴位观察摄片,并对5 4例造影表现进行分析。结果:5 4例新生儿消化道造影均满足诊断要求,其中先天性幽门狭窄11例(19 6 % ) ,胃食管反流34例(6 3 0 % ) ,环形胰腺9例(16 .7% )。经手术治疗2 0例均与术前X线诊断相一致。结论:传统的上消化道造影是诊断新生儿呕吐病因的有效方法,熟练掌握造影技术和特有的造影征像能够及时地明确诊断。     

对比剂稀释法在低体重新生儿先天性心脏病CT血管成像中的应用

目的 探讨对比剂稀释法在低体重新生儿先天性心脏病CT血管成像(CTA)中的应用可行性.方法 前瞻性选取来本院行心脏CTA检查3～28天患有先天性心脏病新生儿100例,随机分为研究组、对照组(每组50例);对照组患儿使用未稀释对比剂威视派克(2 ml/kg体重);研究组患儿使用稀释浓度为60％对比剂威视派克(3 ml/k...     

先天性肥大性幽门狭窄的影像诊断

先天性肥大性幽门狭窄是新生儿常见的上消化道畸形之一,经手术做幽门环肌切开术,预后效果良好。本文回顾性的分析经我院手术证实的109例胃肠造影检查表现,介绍如下。1材料与方法1.1一般资料2004年~2005年的109例中,男94例,女15例,男:女为6.27:1;年龄1天~70天;临床症状为患儿喂奶后即吐,呕吐物为乳汁,不含胆汁;98例上腹部可扪及橄榄样包块,45例有不同程度的营养不良,5例有吸入性肺炎。1.2检查方法采用机器为GE Prestige-Ⅱ型数字胃肠造影机,对比剂为北京北化康泰临床试剂有限公司生产的硫酸钡Ⅰ型混悬液(160%)或中国上海安盛药业生产的欧乃…     

硫酸钡混悬剂用作MRI胃肠腔造影剂的研究——（I）实验研究

目的：探讨硫酸钡混悬剂用作MRI胃肠腔造影剂的可行性，提出一种适宜用于MRI胃肠造影的硫酸钡混悬剂配方．材科和方法：从硫酸钡粒径的大小，助悬剂的性能与混悬剂的粘度、辅剂的MRI信号、硫酸钡混悬液的浓度等方面进行了实验研究，确定了硫酸钡用于MRI胃肠造影适宜的粒径范围，提出了一种新的硫酸钡干混悬剂配方，其助悬剂使钡粒有良好的悬浮稳定性，其辅剂对MRI信号无明显影响．180％(w，v)浓度时有良好的MRI阴性造影效果，理化性状符合中国药典要求。结果：本研究提出了一种适宜用于MRI胃肠造影的硫酸钡混悬剂配方，初步确定了造影浓度．结论：硫酸钡混悬剂有良好的阴性MRI造影效果，本研究提出的硫酸钡混悬剂可望用于临床造影。     

硫酸钡混悬剂用作MRI胃肠腔造影剂的研究──（Ⅰ）实验研究

探讨硫酸钡混悬剂用作ＭＲＩ胃肠腔造影剂的可行性，提出一种适宜用于ＭＲＩ胃肠造影的硫酸钡混悬剂配方。材料和方法：从硫酸钡粒径的大小、助悬剂的性能与混悬剂的粘度、辅剂的ＭＲＩ信号、硫酸钡混悬液的浓度等方面进行了实验研究，确定了硫酸钡用于ＭＲＩ胃肠造影适宜的粒径范围，提出了一种新的硫酸钡干混悬剂配方，其助悬剂使钡粒有良好的悬浮稳定性，其辅剂对ＭＲＩ信号无明显影响，１８０％（ｗ／ｖ）浓度时有良好的ＭＲＩ阴性造影效果，理化性状符合中国药典要求。结果：本研究提出了一种适宜用于ＭＲＩ胃肠造影的硫酸钡混悬剂配方，初步确定了造影浓度。结论：硫酸钡混悬剂有良好的阴性ＭＲＩ造影效果，本研究提出的硫酸钡混悬剂可望用于临床造影。     

非新生儿小儿肠旋转不良的影像诊断价值

目的探讨非新生儿小儿肠旋转不良(malrotation of intestine)的影像表现,提高对本病的认识及诊断水平。方法回顾分析18例经手术证实的非新生儿小儿肠旋转不良的X线及CT表现,18例均行CT检查,其中10例行上消化道造影,11例行钡剂灌肠,另有8例行增强CT扫描。结果上消化道造影示十二指肠不完全梗阻6例;钡灌肠示回盲部位于右上腹2例,中上腹4例,左上腹3例;CT显示肠系膜根部类团块影,5例增强扫描可见典型"漩涡征",提示伴有中肠扭转,毗邻肠袢扩张,肠系膜静脉不同程度淤积扩张,18例患儿术前及术后均诊断为肠旋转不良,诊断准确率为100%。结论上消化道造影、CT平扫及增强扫描对非新生儿小儿肠旋转不良的诊断具有重要价值,对于不明原因的反复呕吐及腹痛的患儿应及时对其进行上述影像学检查。     

胃肠道的双重对比放射学

在胃肠道造影中常规的或称简单对比的钡餐检查为腔内显影技术而双重对比的检查法则为粘膜显影技术——即粘膜表面为薄层而致密的硫酸钡混悬液所均匀涂布,并使胃壁充气膨胀。兹将有关使用原则和方法介绍如下:     

一种新剂型硫酸钡上市

北京化工厂是国家大型二级企业，其临床诊断试剂分厂在解放军301医院、北京同仁医院、北京电力医院等单位有关专家的指导帮助下，参照国外临床目前广泛使用硫酸钡的剂型和方法研制出肠道造影专用的X线双对比造影硫酸钡混悬液，其特点一是将目前临床肠道造影所采用的钡粉现场配制改为厂配制并精加工。方便临床操作，缩短检查时间。其二．可使用一次性专用密器，避免了交叉感染，也可用瓶装混悬液。     

胃双对比造影数字化成像的应用价值(附1000例报告分析)

目的：了解数字化成像Ｘ线机的性能、特点及其对胃双对比造影的应用价值。方法：使用日立１１０ＸＦ １０００ｍＡ数字化成像Ｘ线机,采用青岛东风化工厂生产的ＱＤ－３Ⅱ型硫酸钡干混悬剂及产气粉。选择１０００例患者进行胃低张气钡双对比造影检查。结果：１０００例患者,检出阳性率占６９．４％,其中胃炎５６３例,胃溃疡７２例,胃息肉１３例,胃癌４６例,其中早期胃癌６例,小于５ｍｍ以下病灶胃溃疡１２例,胃息肉４例。所     

植物性消化道结石的X线诊断(附39例分析)

目的分析植物性消化道结石的X线特征。材料与方法采用青岛东风化工厂产QD-3Ⅱ型硫酸钡干混悬剂,常规行胃肠道低张气钡双对比造影方法检查,对39例植物性消化道结石进行了胃肠钡餐造影并加照点片。结果39例中食管结石一例,胃结石37例,十二指肠结石一例。结论传统的胃肠道X线钡餐造影检查植物性消化道结石是目前最好的检查方法,它能显示结石的发生部位、大小、形态,为临床治疗提供了可靠的依据。     

Optimizing lesion contrast without using contrast agents.

The essence of optimizing lesion detection is increasing the signal-to-noise (S/N) for the lesion while decreasing the S/N of the background. Maneuvers which improve one aspect of lesion detection may have a deleterious effect on another. For example, thinner slices decrease partial volume averaging (important for detection of small lesions) but also decrease S/N. Attempts to increase S/N by lowering the bandwidth may increase the TE, decreasing the degree of T1-weighting. Fast spin echo (FSE) generally offers the best T2-weighting for detection of long T2 lesions. However, lesions with short T2s (due to magnetic susceptibility effects) are better detected with gradient echo techniques. Strategies which decrease background S/N include those based on chemical shift differences (ie, spectroscopic techniques like FatSat) and those based on differences in T1 (ie, inversion recovery [IR] techniques like STIR and FLAIR).     

Introduction: The controversy air contrast or double contrast techniques

With experience, air contrast examination of the esophagus, stomach, and duodenum can be performed routinely as quickly and easily as the standard UGI. The air contrast examination is superior for detection of small gastric polyps and the Japanese have found it superior for detection of early carcinoma. The post-operative stomach and the fundus and cardia are most easily examined by air contrast. Clear superiority in the diagnosis of peptic ulcers and peptic esophagitis has not been proved. The most accurate routine examination may be a multiphasic or combined approach utilizing air contrast views as well as filled compression views and careful fluoroscopy.With respect to the colon, we do not suggest that air contrast BE must be done exclusively. However, it is superior for the detection of polyps and small carcinomas. The technique should be available in all radiology departments and should be an integral part of the evaluation of patients at increased risk of developing carcinoma. This includes patients over 40 years of age, with chronic ulcerative colitis, familial multiple polyposis or Gardner's syndrome, family history of inherited cancer, and medical history of adenomatous polyps, colorectal cancer, or female genital cancer. In addition, air contrast enema should be utilized for the sensitive and accurate evaluation of early inflammatory bowel disease.Finally, with respect to the colon examination one fact must be stressed. Irregardless of full column or air contrast method, most missed lesions are due to poor bowel preparation, poor technique, or perceptive error by the radiologist. There can be no substitute for a clean colon, meticulous attention to technical details, and careful review of the radiographs.     

Effects of computed tomography contrast medium factors on contrast enhancement

The various nonionic iodinated contrast media used in contrast computed tomography (CT) studies differ in terms of their composition, characteristics, and iodine concentration (mgI/ml), as well as the volume injected (ml). Compared with ionic iodinated contrast media, nonionic iodinated contrast media are low-osmolar agents, with different agents having different osmotic pressures. Using a custom-made phantom incorporating a semipermeable membrane, the osmotic flow rate (HU/s) could easily be measured based on the observed increase in CT numbers, and the relationship between the osmotic pressure and the osmotic flow rate could be obtained (r(2)=0.84). In addition, taking the effects of patient size into consideration, the levels of contrast enhancement in the abdominal aorta (AA) and inferior vena cava (IVC) were compared among four types of CT contrast medium. The results showed differences in contrast enhancement in the IVC during the equilibrium phase depending on the type of contrast medium used. It was found that the factors responsible for the differences observed in enhancement in the IVC were the osmotic flow rate and the volume of the blood flow pathways in the circulatory system. It is therefore considered that the reproducibility of contrast enhancement is likely to be reduced in the examination of parenchymal organs, in which scanning must be performed during the equilibrium phase, even if the amount of iodine injected per unit body weight (mgI/kg) is maintained at a specified level.