血液病的胸部X线分析(附22例报告)

目的：讨论血液病主要胸部Ｘ线表现及病理基础，不同病程及化疗后的Ｘ线变化。方法：２２例血液病患者，其中白血病１７例，恶性组织细胞病３例，恶性淋巴瘤２例，均经骨穿或临床病理证实，摄取不同病程及化疗后不同时期的胸部Ｘ线正、侧位片进行分析。结果：１．血液病的胸部Ｘ线表现大多数为片状影，其次为纵隔及肺门淋巴结肿大；２．血液病患者出现典型临床症状或早期及时确诊２个月后，肺部才可能出现浸润征象；３．肺部浸润病灶化疗２～３周，近１／３患者好转或吸收，化疗１月者，有效率达６０％以上。结论：血液病的胸部Ｘ线表现无特征性，不同病程及化疗后Ｘ线变化复杂，必须结合病史，随诊观察才能确诊。     

胸部结节病的X线表现

本文报告经临床病理证实的胸部结节病25例,其主要X线表现为:(1)双侧肺门淋巴结肿大合并右侧气管旁淋巴结肿大或合并双侧气管旁淋巴结肿大,而以肺门淋巴结肿大为主是结节病的重要象征;(2)双侧肺门淋巴结肿大合并两肺间质性和肺泡性浸润是结节病的常见X线表现;(3)少数病例以肺部弥漫性病变为主要表现,而肺门淋巴结肿大不太明显时也应想到结节病的可能。     

蘑菇肺临床和X线分析

本文分析了３０例蘑菇肺的临床和Ｘ线表现，Ｘ线基本改变为两肺弥漫性网织状，结节状多发性大小不等斑片状影，双肺透亮度下降，有时出现蜂窝状改变，肺门淋巴结肿大，讨论了Ｘ线表现与临床症状之间的关系，提出了诊断的主要依据，同时探讨了其致病机理，认为主要与Ⅲ，Ⅳ型变态反应有关，Ｉ型变态反应亦有参与。     

纵隔淋巴瘤X线诊断(附70例)

纵隔淋巴瘤Ｘ线诊断（附７０例）高瑞仙纵隔淋巴瘤易发生肺门淋巴结浸润和肺内浸润，故其Ｘ线诊断易同肺门淋巴结结核、纵隔其他病变和肺癌合并肺门或纵隔淋巴结转移等混淆。１一般资料本文收集我院１９７４～１９９４间经浅表淋巴结活检证实，临床和Ｘ线资料完整者７０例...     

毛细支气管炎临床及X线表现

目的：探讨毛细支气管炎临床及X线表现。方法：收集我院于1999年10月至2005年10月间住院并确诊为毛细支气管炎患儿180例胸片进行分析。结果：毛细支气管炎的X线表现主要为弥漫性肺气肿，肺门周围问质浸润及支气管周围炎，肺门淋巴结肿大。结论：通过对毛细支气管炎患儿临床特点，胸部X线表现及病理基础的分析，提高对本病的认识，为早期诊断提供帮助。     

膝关节结核的早期X线诊断（附100例分析）

本文通过对１００例膝关节结核病例Ｘ线片的分析研究，详述了膝关节正常软组织的Ｘ线解剖及膝关节结核早期软组织改变的Ｘ线征象。并对关节囊积液、滑膜增厚、淋巴结肿大、骨骺增大及鉴别诊断等问题进行了讨论，从而提出了膝关节结核的早期Ｘ线诊断征象。     

肺静脉曲张X线表现如何？

肺静脉曲张Ｘ线表现如何？答：肺静脉曲张为一罕见的肺静脉局限性扩张，本身无临床意义，右上肺叶多见，其重要性是ｘ线表现类似“钱币”形病灶。应与支气管肺癌、肺动静脉瘘、肺静脉畸形引流、肺结核瘤及纵隔淋巴结肿大等鉴别。肺血管造影诊断指征：①肺动脉形态正常；②...     

肺淋巴增生性疾病的影像学表现

目的 研究肺淋巴增生性疾病（LPD）的影像表现及诊断价值。方法 分析25例肺淋巴增生性疾病（25例行X线胸片，腹部B超或CT检查，12例胸部CT检查，13例行气管分叉和肺内病灶体层检查，1例行胸部MR检查）的影像，临床与病理所见。结果 2例肺假性淋巴瘤表现为进展缓慢的含支气管气像的双肺多发大片浸润实变，无纵隔，肺门淋巴结肿大。4例肺淋巴交 肉芽肿（LYG）的胸部影像表现为双肺多发大小不等的结节和肿块，2例病变内可见低密度，1例可见支气管气像，3例无肺门，纵隔淋巴结肿大，1例初期未见，而在晚期出现肺门，纵隔淋巴结肿大及大量胸腔积液。16例血管免疫母细胞淋巴结病（AILD）均有肺门，纵隔多组淋巴结肿大，伴有双肺小结节网状改变10例，少，中量胸脸积液5例，双肺多发大小不等的结节2例，肺内单发或多发斑片或实变8例，其中4例证实有明确的继发感染。3例巨大淋巴结增生病的胸部表现为边界光滑的前纵隔肿块，1例表现为纵隔多发淋巴结肿大。15例AILD患者有肝脾肿大，8例AILD患者有明确的腹腔淋巴结肿大，1例LYG有肝脾肿大，1例巨大淋巴结增生病有肝脾及腹腔淋巴结肿大，其余患者腹部B超或CT正常。结论 虽然肺淋巴增生性疾病各类型的临床与影像表现各有特点，最终仍需依靠活检病理确诊。     

免疫损害患者肺结核的影像诊断

目的　探讨几种免疫损害疾病并发肺结核患者的X线和CT所见 ,包括糖尿病、肾移植术后及获得性免疫缺陷综合征 (AIDS)。方法　回顾分析合并有肺结核的 2 0例糖尿病患者的胸部CT所见、10例肾移植术后患者的胸部X线片及 2例AIDS患者的CT片。结果　糖尿病并发肺结核的CT表现为 :大片融合性肺实变 (10例 ) ,在单一病变区内有多发小空洞 (9例 ) ,病变不按肺段分布(2例 ) ,多数病变具有卫星灶。肾移植术后并发肺结核的胸部X线表现为 :斑片及大片融合实变(6例 )和粟粒型肺结核 (4例 )。AIDS病合并肺结核的CT表现为 :纵隔淋巴结肿大 (1例 ) ,肺内浸润(1例 )及胸部以外的结核病变 (2例 ) ,包括颈部及腹膜后淋巴结肿大。结论　 3种免疫损害病变患者并发肺结核的主要CT及X线表现为大片融合病变、单一病变内的多发小空洞、粟粒型肺结核、纵隔淋巴结肿大及胸部以外的淋巴结肿大     

纵隔淋巴结结核的CT表现

纵隔淋巴结结核的ＣＴ表现殷泽富，赵永碧，王振光传统Ｘ线对纵隔淋巴结结核诊断的敏感性、特异性及准确性等方面均有一定限度，而ＣＴ由于其高密度分辨力，能够提供比传统Ｘ线更有价值的信息。笔者通过对确诊病例ＣＴ表现的回顾性分析，旨在探讨ＣＴ对纵隔淋巴结结核的诊...     

Use of an artificial neural network to determine the diagnostic value of specific clinical and radiologic parameters in the diagnosis of interstitial lung disease on chest radiographs

RATIONALE AND OBJECTIVES: The authors investigated the diagnostic value of each of multiple clinical parameters and radiologic findings in differentiating between various interstitial lung diseases by using an artificial neural network (ANN). MATERIALS AND METHODS: The ANN was designed to differentiate between 11 interstitial lung diseases. The authors employed 10 clinical parameters and 16 radiologic findings that were divided into three groups (location, general appearance, specific findings). The performance of the ANN was evaluated with receiver operating characteristic analysis with amodified round-robin (leave-one-out) method and 370 cases (150 actual cases, 110 published cases, and 110 hypothetical cases). The Az values of ANNs were evaluated with various combinations of 10 clinical parameters and 16 radiologic findings. RESULTS: The Az value obtained with the complete set of clinical parameters and radiologic findings was 0.947. The Az value obtained with the 10 clinical parameters alone was 0.900, which was greater than 0.843 obtained with the 16 radiologic findings alone. There were statistically significant differences among Az values for some diseases when certain clinical parameters were removed from the input. Omission of specific findings among the three groups of radiologic findings decreased the Az value significantly. CONCLUSION: These results appear to confirm that clinical parameters can be equally as or more important than radiologic findings in the diagnosis of interstitial lung diseases. Among radiologic findings, certain specific findings can be more important than the location or general appearance of abnormal findings.     

MRI of anterior cruciate ligament autografts

The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy.     

CT finding of cerebral paragonimiasis in the chronic state

Summary The CT findings in 5 patients with cerebral paragonimiasis in the chronic state are presented. The findings were: 1) multiple, densely calcified areas with a variety of round or nodular shapes in the brain, 2) a large low density area surrounding or connecting with the calcified areas, and 3) cortical atrophy and ventricular dilatation. The relation between the CT findings and the previously reported plain skull X-ray findings or neuropathological findings are discussed.     

Utility of dark-lumen MR colonography for the assessment of extra-colonic organs

The aim of the study was to evaluate the utility of dark-lumen MR colonography (MRC) for the assessment of extra-colonic organs. Three hundred seventy-five subjects with suspected colonic disease underwent a complete MRC examination. MRC data were evaluated by two radiologists in a blinded fashion. In addition to the large bowel, the extra-intestinal organs from the lung bases to the pelvis were assessed for the presence of pathologies. All findings were divided into known or unknown findings and therapeutically relevant or irrelevant findings. If deemed necessary, other diagnostic imaging tests to further assess those findings were performed. In total, 510 extra-colonic findings were found in 260 (69%) of the 375 subjects. Known extra-colonic findings were found in 140 subjects (54%) and unknown findings in 120 subjects (46%). Thirty-one (12%) of the 260 subjects had therapeutically relevant findings (45 findings); 229 patients (88%) had irrelevant findings (465 findings). Dark-lumen MRC is a useful tool not only for the assessment of the entire colon, but also for the evaluation of extra-colonic organs. Thus, intra- and extra-colonic pathologies can be diagnosed within the same examination.     

Computer tomography diagnosis of space-occupying lesions in the area of the base of the skull

119 CT findings of examinations of the base of the skull conducted over a period of 52 months in 63 patients, were checked for their informative value. The CT findings were compared with clinical signs and symptoms and--if available--with findings from operations, biopsies and/or postmortem examinations (55 of 63 patients). For 42 CT findings, a total of 88 comparable findings obtained via conventional x-ray methods were available. This comparison showed a 66% superiority of CT over conventional radiography. The results point to a considerable superiority of CT both in the imaging of structures and in the detection of bony changes in the region of the base of the skull.     

胃癌CT检查价值的分析

目的：通过对进展期胃癌术前ＣＴ表现的ＴＮＭ分期,确定胃癌的治疗方案,避免盲目地４手术探查。方法：对８８例胃癌患者进行普通ＣＴ扫描,对无周围器官和远处转移者进行手术,手术所见和ＣＴ表现进行对照。结果：ＣＴ扫描对进展期胃癌的检出率为１００％,ＴＮＭ分期的准确率达８４．６％,民见与ＣＴ表现的符合率为９０．６％。结论：进展期胃癌的术前ＣＴ检查能够准确地对胃癌进行ＣＴ分期。     

Budd-Chiari syndrome: spectrum of imaging findings

OBJECTIVE: The objective of our study was to illustrate the imaging findings of Budd-Chiari syndrome, including CT, MRI, sonographic, and angiographic findings. CONCLUSION: The key imaging findings in Budd-Chiari syndrome are occlusion of the hepatic veins, inferior vena cava, or both; caudate lobe enlargement; inhomogeneous liver enhancement; and the presence of intrahepatic collateral vessels and hypervascular nodules. Awareness of these findings is important for early diagnosis and appropriate treatment.     

The MR evaluation of pachygyria and associated syndromes

A retrospective study of 40 children with some form of pachygyria was performed at the Children's Memorial Hospital in Chicago. All 40 children had MR brain scans. We analyzed the MR findings, and correlated these findings with the clinical symptoms and course in all the children. We have autopsy findings in 15% these children. Based on our clinical, MR and autopsy findings, in conjunction with the medical literature, we found the following: (1) Pachygyria can occur as an isolated entity without an association with lissencephaly. The MR findings in these children consisted of a brain that demonstrated normal opercularization with either focal or diffuse areas of pachygyria without areas of agyria. These children live longer and have less severity of symptoms than the children with lissencephaly. (2) The MR findings in children with lissencephaly consisted of a brain that demonstrated abnormal opercularization with areas of total agyria or areas of agyria with pachygyria. (3) The MR findings in 25% of our children with polymicrogyria simulated pachygyria. The MR findings of the brain in these children consisted of a 'nubby' appearance to the outer surface of these abnormal gyri which resembled pachygyria but on histologic exam was polymicrogyria.     

脓毒性肺栓塞的高分辨CT表现初探

目的探讨脓毒性肺栓塞(SPE)的高分辨CT(HRCT)表现。资料与方法回顾分析11例SPE患者的胸部HRCT表现。结果11例SPE的HRCT表现为实变及磨玻璃影、结节、楔形阴影、空洞、胸膜改变(如胸腔积液)等征象。其中52%结节影及37%楔形阴影可见滋养血管。7例经治疗后肺部改变消失。结论周围性分布的结节影、楔形阴影,结节影、楔形阴影内空洞形成以及与结节影及楔形阴影相连的血管影是SPE较为特征性的HRCT表现,对早期诊断及指导临床治疗有重要意义。     

MRI findings of osteochondritis dissecans of the capitellum with surgical correlation

OBJECTIVE: Few studies have described the MRI findings of osteochondritis dissecans of the capitellum. Our objective was to describe the MRI findings of 10 patients with osteochondritis dissecans of the capitellum and to correlate the imaging findings with surgical findings of stability and instability. CONCLUSION: The MRI findings of unstable and stable osteochondritis dissecans of the capitellum are similar to the findings described for osteochondritis dissecans of the femoral condyles and talar dome. Unstable osteochondritis dissecans lesions are surrounded by a rim of high signal intensity or a fluid-filled cyst on T2-weighted images. Stable osteochondritis dissecans lesions show no surrounding signal abnormality on T2-weighted images.