肾脏不典型囊性病变的Bosniak分级CT评价

目的探讨依据Bosniak分级标准用CT评价肾脏不典型囊性病变的诊断及处理。方法由两位放射诊断医生通过协商按Bosniak分级标准对65个病灶进行分类,并与临床随访和手术结果比较,计算该标准对是否需要手术切除判断的敏感性、特异性、准确性及阳性预测值、阴性预测值。结果本组病变中,按Bosniak分级标准诊断为Ⅱ级34个,ⅡF7个,Ⅲ级15个,Ⅳ级9个。对是否需要手术治疗的判断敏感性、特异性、准确性、阳性预测值和阴性预测值分别是83．3％、92．7％、89．2％、87．0％和90．5％。结论按Bosniak分级标准的CT表现,能准确地将需手术治疗的肾脏不典型囊性病变与仅需随访的病变加以区分。     

肾脏囊性占位的MSCT表现与Bosniak分级的临床应用

目的：探讨肾脏囊性占位病变的MSCT表现与Bosniak分级的临床应用价值。方法：回顾性分析我院肾脏囊性占位病变的MSCT表现,选取经病理证实的32例病例,并按照Bosniak分级系统分级,进行病理对照。结果：Bosniak Ⅰ级10例均为良性,Ⅱ级6例均为良性,ⅡF级4例（3例良性,1例恶性）,Ⅲ级5例（3例良性,2例恶性）,Ⅳ级7例均为恶性。结论：肾脏囊性占位病变的MSCT影像特征对Bosniak分级系统有较高的应用价值,Bosniak分级为临床治疗提供有意义的参考。     

Estimation of split renal function using different volumetric methods: inter- and intraindividual comparison between MRI and CT

Abdominal Radiology - This study aims to determine whether contrast-enhanced (CE)-magnetic resonance imaging (MRI) is comparable to CE-computed tomography (CT) for estimation of split renal...     

Synovial cysts of the lumbar spine: CT evaluation

Seven cases of surgically proven intraspinal synovial cysts are reported. Computed tomographic (CT) scans demonstrated a series of low-density masses adjacent to the facet joints; in three cases, a dense rim indicated a calcified wall on the cyst; in one, the wall was partially calcified; and in three the mass appeared to be filled with gas. In all of these cases, there was severe degenerative facet disease at the same level as the synovial cyst. In six patients, the cysts were unilateral, while one was bilateral; seven cysts were located at the level of L4–L5, and one at L3-L4. We conclude from this study that the intraspinal synovial cyst can be identified reliably by the CT scan.     

椎管内肠源性囊肿的CT和MRI影像

椎管内肠源性囊肿是由胚胎发育时期的神经肠管残余和异位组织演变而来,临床比较少见,多无典型临床表现,其发现与诊断多依靠影像学检查,如CT、MRI等.本文介绍4例经CT、MRI诊断并经手术和病理证实的椎管内肠源性囊肿.     

超声造影结合Bosniak分级对肾囊性病变的诊断价值

目的 探讨超声造影结合Bosniak分级对肾囊性病变的诊断价值.方法 回顾性分析2015年8月至2020年8月于兰州大学第二医院诊断为肾囊性病变的62例患者(共62个病灶,均经手术病理证实)的超声造影图像,并结合Bosniak分级标准对其进行分类,评价超声造影技术结合Bosniak分级对肾囊性病变的诊断及鉴别诊断价值....     

Correction to: Multi-institutional analysis of CT and MRI reports evaluating indeterminate renal masses: comparison to a national survey investigating desired report elements

Abdominal Radiology - The original version of this article contained an error in author name. The co-author’s name was published as Ivan M. Pedrosa, instead it should be Ivan Pedrosa. The...     

超声造影结合Bosniak分级在肾脏囊性病变诊断中的应用价值

目的探讨超声造影（CEUS）结合Bosniak分级在肾脏囊性病变诊断中的应用价值。 方法选取2010年8月至2016年8月在上海交通大学附属第一人民医院确诊的75个肾脏囊性病灶的超声造影声像图特征，并结合Bosniak分级标准对75个病灶进行分类，手术病例以术后病理结果为"金标准"，非手术病例临床随访2年以上（超声造影、增强CT等）。采用四格表计算用超声造影结合Bosniak分级标准对是否需要手术判断的准确性、敏感度、特异度、阳性预测值、阴性预测值。采用配对资料的χ²检验对Bosniak阳性诊断率和手术病理结果阳性诊断率进行比较。 结果75个肾脏囊性病灶中，超声造影结合Bosniak分级标准诊断为Ⅰ级2个，Ⅱ级33个，ⅡF级8个，Ⅲ级19个，Ⅳ级13个。超声造影结合Bosniak分级检查阳性率与手术病理检查阳性率，差异无统计学意义（χ²=0.243，P=0.622）。对是否需要手术治疗的判断的敏感度为85.71%、特异度为95.00%、准确性为90.67%、阳性预测值为93.75%、阴性预测值为88.37%。 结论超声造影结合Bosniak分级标准在肾脏囊性病变良恶性鉴别诊断中有较高的应用价值，有助于临床医师制订准确的临床治疗方案。     

超声造影结合Bosniak分级诊断囊性肾癌的可行性

目的 探讨超声造影结合Bosniak分级诊断囊性肾癌的可行性.方法 回顾性分析经手术病理证实的24例囊性肾癌的常规超声及超声造影表现,评估指标包括囊隔数目、囊隔或囊壁厚度、有无实性结节以及囊壁、囊隔或结节处血供情况.根据超声造影声像图特征进行Bosniak分级并统计其诊断符合率.结果 常规超声声像图表现:2个病灶内未见分隔,8个见少量分隔,14个见多条分隔;5个囊壁或囊隔厚度≤1 mm,19个＞1 mm;7个病灶内见实性结节;11个病灶的囊壁、囊隔或结节处可见彩色血流信号.超声造影声像图表现:8个病灶内见少量分隔,16个见多条分隔;1个囊壁或囊隔厚度≤1 mm,23个＞1 mm;9个病灶内见实性结节;所有病灶的囊壁、囊隔或结节处均可见造影剂灌注增强.Bosniak分级示Ⅲ级15个,Ⅳ级9个,诊断符合率为100%.结论 与常规超声相比,超声造影能清晰显示囊性肾癌的血供和复杂的内部结构,超声造影结合Bosniak分级可用于诊断囊性肾癌.     

Preoperative evaluation of potential renal donors using multidetector CT

Preoperative knowledge of vascular anatomy and parenchymal disease is critical in patients undergoing laparoscopic donor nephrectomy. Multidetector computed tomography represents a substantial improvement in technology that lends itself to the comprehensive evaluation of renal donors. We describe and illustrate our computed tomographic technique in patients considering a donor nephrectomy. Received: 31 May 2001/Accepted: 22 August 2001     

无对比增强MR血管成像与CT血管成像对肾动脉狭窄评价的对照研究

目的探讨结合时间-空间双重标记反翻转恢复脉冲（Time-SLIP）序列的无对比增强（non-contrast-enhanced）MR血管造影（MRA）技术在评价肾动脉狭窄（RAS）中的应用,并与CT血管造影（CTA）比较。材料与方法对22例怀疑RAS的患者同期进行MRA和CTA检查。在1.5 T MR扫描仪上,运用结合Time-SLIP技术的冠状面和轴面采集真实稳态自由进动序列（true SSFP）进行肾动脉MRA成像。评价肾动脉MRA图像质量和狭窄程度,并与CTA进行比较。结果共46支肾动脉列入统计,MRA图像质量优秀29例（63%）,良好13例（28%）,一般4例（9%）。无对比增强MRA与CTA对诊断肾动脉狭窄程度分级结果具有相关性（r=0.991,（P〈0.01）。以CTA为参照标准,MRA诊断明显RAS（狭窄程度≥50%）的敏感度为100%,特异度为97.1%。结论结合Time-SLIP的无对比增强MRA技术可有效用于评价肾动脉狭窄。     

64层螺旋CT与磁共振成像评价左心功能的比较研究

目的以磁共振为对照,应用64层螺旋CT(MSCT)定量评价左心功能,探讨MSCT成像技术和屏气法MRI电影技术心功能评价指标的相关性及MSCT在冠心病左心功能评价中的应用价值。方法临床拟诊冠心病的患者20例,均自愿参加。全部病例均行心脏MSCT和MRI检查。结果MSCT和MRI两种方法的心功能指标无显著性差异,两种方法的心功能指标舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、左室射血分数(EF)、心肌质量(MM)相关性高,r值=0.72~0.92。MSCT所测EDV、ESV、SV和MM值较MRI偏大,MSCT所测EF值较MRI偏小。结论本研究显示64层螺旋CT在左心功能定量评价方面准确、可靠,与3.0T磁共振两种方法各指标之间相关性高。一次MSCT冠状动脉成像检查,可以同时评估冠状动脉狭窄情况和左心室功能。     

超声造影应用Bosniak分级诊断肾囊性病灶的价值

目的 探讨CEUS应用Bosniak分级诊断肾囊性病灶的价值,并与增强CT比较。方法 收集同期接受CEUS和增强CT检查的52例患者共68个肾囊性病灶,观察病灶的形态、边壁、分隔、实性结节及血流灌注情况,评价2种方法分级诊断肾囊性病灶的价值。结果 良性组中,25个病灶(25/31,80.65%)CEUS和增强CT均表现为单房或多房囊性病灶,内无分隔或伴纤细分隔,分隔无强化或轻度强化,仅3个病灶(3/31,9.68%)表现为多房囊性病灶伴多个实性结节,2个病灶(2/31,6.45%)表现为花瓣样增强,分隔不规则增厚,1个病灶(1/31,3.23%)表现为网状增强;恶性组中,32个病灶(32/37,86.49%)CEUS和增强CT均表现为多房囊性病灶伴多个实性结节或不规则实性增强区,4个病灶(4/37,10.81%)表现为分隔较厚的多房性囊性病灶,1个病灶(1/37,2.70%)表现为边壁不规则增厚的单房囊性病灶;以Ⅳ级为诊断标准,CEUS和增强CT诊断囊性肾癌的敏感度、特异度、准确率分别为67.57%和70.27%,93.55%和96.77%,79.41%和82.35%。以Ⅲ级及以上为诊断标准,CEUS和增强CT诊断囊性肾癌的敏感度、特异度、准确率分别为97.30%和100%,74.19%和 80.65%,86.76% 和91.18%。分隔数目≥3条及分隔厚度≥1.75 mm可作为诊断肾囊性病灶良恶性的最佳诊断界值。结论 CEUS结合Bosniak标准鉴别诊断肾囊性病灶的良恶性具有较高的价值。     

Complications of renal angiomyolipomas: CT evaluation

Complications from angiomyolipomas are rare but often severe depending on the size and content of the angiomyolipoma. In this study, we describe 10 cases from 63 patients with renal angiomyolipomas in whom computed tomography revealed the following complications: compression of pyelocalyceal system in three cases, intratumoral bleeding in two cases, rupture in four cases with subcapsular, perirenal, or pararenal hematoma and extensive intrarenal/parapelvic hematoma, cystic degeneration in one case. Received: 10 April 1995/Accepted after revision: 2 June 1995     

Real-time sonography to estimate muscle thickness: comparison with MRI and CT

PURPOSE: We investigated the feasibility of using real-time sonography to measure muscle thickness. Clinically, this technique would be used to measure the thickness of human muscles in which intramuscular microstimulators have been implanted to treat or prevent disuse atrophy. METHODS: Porcine muscles were implanted with microstimulators and imaged with sonography, MRI, and CT to assess image artifacts created by the microstimulators and to design protocols for image alignment between methods. Sonography and MRI were then used to image the deltoid and supraspinatus muscles of 6 healthy human subjects. RESULTS: Microstimulators could be imaged with all 3 methods, producing only small imaging artifacts. Muscle-thickness measurements agreed well between methods, particularly when external markers were used to precisely align the imaging planes. The correlation coefficients for sonographic and MRI measurements were 0.96 for the supraspinatus and 0.97 for the deltoid muscle. Repeated sonographic measurements had a low coefficient of variation: 2.3% for the supraspinatus and 3.1% for the deltoid muscle. CONCLUSIONS: Real-time sonography is a relatively simple and inexpensive method of accurately measuring muscle thickness as long as the operator adheres to a strict imaging protocol and avoids excessive pressure with the transducer.     

Tibial plateau fractures: CT evaluation and classification

Fractures of the tibial plateau consist of two important components. One is depression of the plateau surface and the other a detached and peripherally displaced component referred to as the split fragment. The classification of these fractures is based on the morphologic appearance as well as the location of the above components. The surgical treatment of these fractures is dependent upon several factors, including the type of fracture, the degree of the fracture depression, and fracture fragment separation as well as the patient's age and physical condition. The degree of the plateau depression is a particularly important criteria for surgical-treatment planning. However, the anatomic configuration of the proximal tibia is such that the fractures of these regions are not adequately visualized on conventional radiographs. In the past, conventional tomography was routinely employed for evaluation of tibial plateau fractures. Recently, computed tomography (CT) has shown to be a more accurate and easier method for evaluation of these fractures. CT can be performed without removal of the knee brace or cast and usually requires less than 12 axial images. Furthermore, the degree of fracture separation and depression can be measured by computerized technique. CT scanning is a reliable method for evaluation and an accurate classification of tibial plateau fractures.     

多层螺旋CT对活体肾移植供体术前综合评价的初步研究

目的评价MSCT在活体肾供体术前综合评价中的价值。方法11例供体术前进行了MSCT三期增强扫描,均进行VR及MIP重组,观察肾实质、肾动脉、肾静脉以及集尿系统,并与9例手术结果进行对照分析。结果MSCTA显示23支肾动脉,包括左肾副动脉1例;23支肾静脉,包括1例左双肾静脉;23支肾盂输尿管,包括1例右侧双肾盂双输尿管。此外,还检出副肝静脉2例,脾动脉瘤1例。2例放弃手术,1例因肾血管原因,1例为乙肝病毒携带者;9例手术结果与MSCT所见完全吻合,准确率为100%。结论MSCT作为术前活体肾供体的一站式检查技术,有重要的临床应用价值。     

颅内神经上皮囊肿的CT、MRI及DWI诊断

目的：通过分析47例颅内神经上皮囊肿CT、MRI和DWI表现,探讨神经上皮囊肿的影像学诊断和鉴别诊断。方法：对47例颅内神经上皮囊肿的CT、MRI及DWI表现进行回顾性分析。男21例,女26例。行CT平扫8例,其中6例加MR检查。行MR检查45例,16例加行DWI。结果：神经上皮囊肿位于侧脑室内17例,脉络膜裂内24例,脑实质内6例。外形规则的囊肿占93.6%;侧脑室内囊肿均可见患侧脑室内脉络膜丛移位,其中64.7%可见线样囊壁影。CT平扫囊肿均呈脑脊液样密度,MRI平扫95.6%囊肿呈脑脊液样信号,增强后85.7%不强化。DWI上87.5%囊肿呈低信号,ADC值高于脑实质。结论：形态规则、类似脑脊液信号、DWI呈低信号、不强化是神经上皮囊肿的影像学表现特点,不典型的神经上皮囊肿可通过DWI及增强扫描与颅内其他类似病变相鉴别。