颅内胆脂瘤自发破裂CT表现一例

颅内胆脂瘤自发破裂ＣＴ表现一例阎敏纪祥齐波王小红患者男，２３岁。因突发性头痛伴呕吐５天入院。体检：无阳性所见。ＣＴ检查：右侧脑室前角旁见一６．０ｃｍ×５．６ｃｍ大小囊性低密度肿物影，边缘欠光滑并伴有壳样高密度钙化影，瘤内含有大量脂类密度影及少许软组织...     

颅内等密度和高密度胆脂瘤的CT诊断

ＣＴ对位于鞍区、桥脑小脑角表现为囊性低密度伴沿裂隙生长的胆脂瘤诊断不难。但对少数表现为等、高密度胆脂瘤，容易误诊为颅内其它肿瘤。为提高ＣＴ对于等、高密度胆脂瘤的认识，本文对４例病例进行总结分析。１资料与方法 收集我院１９８０～１９８８年间经ＣＴ检查４例，并经手术病理证实。病例应用ＨＦ型颅脑ＣＴ机和日立Ｗ－４型ＣＴ机检查。先平扫，后增强扫描。 病例１女，２１岁。闭经３年，左眼视力下降２年。蝶鞍正侧位片：鞍上偏右黄豆粒大小钙化影，蝶鞍扩大，鞍背上翘，提示鞍区颅咽管瘤。左侧脑血管造影提示左侧颅内未见占位…     

颅内胆脂瘤的CT诊断10例

颅内胆脂瘤又称表皮样囊肿，是一种少见良性肿瘤，约占颅内肿瘤的2.3％。可发生于任何年龄，以20—50岁最多见。肿瘤生长缓慢，病程长，临床症状不典型，以肿瘤位置不同而不同。现对我院发现的10例颅内胆脂瘤进行分析，旨在加深对本病的认识。     

颅内胆脂瘤的CT诊断

本文报告38例颅内胆脂瘤,总结了其CT表现,认为除胆脂瘤特征性的均匀低密度病灶,边缘光滑整齐,周围无水肿,增强后无强化等表现外,还可见到易引起误诊的其他CT表现:如密度混杂,增强后边缘强化等以及其癌变的可能,并结合有关文献的复习,对其进行分析,最后对其鉴别诊断进行了讨论。     

鼓室原发性胆脂瘤一例报告

原发性胆脂瘤系错位的胚胎上皮细胞所形成,为真性肿瘤,常发生于颅内,发生于耳部者少见。耳部者分二型:原发于中耳者称中耳型,原发于岩部者称岩部型。本例属中耳型。     

颅内原发性淋巴瘤一例

患者 女,46岁.脑瘤术后4年,间断性头痛1个月.4年前因间断头痛行CT扫描,发现左顶枕颅板下椭圆形等低混杂密度影,考虑肿瘤占位,手术完整切除.术后4年来病情平稳,近1个月来又出现症状.体检及实验室检查均未见异常.     

腹膜后肾母细胞瘤伴颅内转移一例

患儿男,５岁。间歇性发热伴腹痛５０余日。体检：右上腹饱满,有包块,肝边界不清。Ｂ超检查：腹膜后实质性不均质性病变,约５２ｃｍ×７２ｃｍ。考虑：（１）畸胎瘤;（２）肾上腺实质性病变。ＣＴ检查：右上腹实质包块,边界清,约６２ｃｍ×９０ｃｍ,ＣＴ值...     

颅内胆脂瘤的CT诊断（附72例分析）

胆脂瘤又称表皮样囊肿，为起源于外胚层的一种少见良性肿瘤，但在颅内先天性肿瘤中多见。多发生在脑外，也可位于脑内或脑室内。现将我院近７年经手术病理证实的７２例介绍如下。     

Intracranial epidermoid carcinoma: CT and MRI

We report a patient with an epidermoid carcinoma an extremely rare brain tumour, in the right cerebellopontine angle cistern. Contrast enhancement is the most important feature for differential diagnosis of epidermoid carcinomas from atypical benign epidermoid cysts.     

CT features of primary colorectal signet-ring cell carcinoma

PURPOSE: The purpose of this work was to evaluate the CT features of 15 patients with primary colorectal signet-ring cell carcinomas. METHOD: We retrospectively reviewed the CT scans of 15 patients (mean age 44 years) with pathologically proved colorectal signet-ring cell carcinoma. On CT, we evaluated the site and length of the tumor, bowel wall thickening patterns, perirectal or pericolic infiltration, the presence or absence of colonic obstruction, and metastasis to other organs. RESULTS: The tumors were located in the rectum in nine patients, the sigmoid colon in one, the hepatic flexure in one, the transverse colon in one, the ascending colon in two, and the cecum in one. The tumor length ranged from 4.0 to 10.0 cm (mean 6.1 cm) with mean thickness of 2.1 cm. CT showed concentric bowel wall thickening in all patients ("even" in 8 and "uneven" in 7), target appearance was noted in 4, perirectal or pericolic infiltrations were moderate to severe in 12, and colorectal obstruction was seen in 6. In the tumor spread patterns, lymphadenopathy was noted in 13, invasion to adjacent pelvic organs in 5, peritoneal carcinomatosis in 4, liver metastasis in 2, and periureteric metastasis in 1. CONCLUSION: Primary signet-ring cell colorectal carcinoma should be included for differential consideration when CT shows a long length of concentric bowel wall thickening and target sign, especially when such findings occur in the rectum and in young patients.     

CT demonstration of fat density in renal cell carcinoma.

The presence of fat in a renal mass is almost pathognomonic of angiomyolipoma. We report a rare instance of CT demonstration of foci of fat density in a renal cell carcinoma.     

透明细胞型原发性肝细胞癌CT表现

透明细胞型原发性肝细胞癌是肝细胞癌的一种少见类型,其病理特征与普通肝细胞癌明显不同,细胞内含大量中性糖原或脂肪,相关其影像诊断研究的报道较少[1].笔者回顾性分析经病理证实的透明细胞型原发性肝细胞癌8例,以提高对本病的认识和影像诊断水平.     

Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT

Purpose

The purpose of our study was 1) to evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 2) to assess the impact of FDG PET/CT on treatment decision-making, and 3) to estimate the prognostic value of FDG PET/CT in the restaging process among patients with renal cell carcinoma (RCC).

Methods

From the FDG PET/CT databases of San Raffaele Hospital in Milan, Italy, and the Veneto Institute of Oncology in Padua, Italy, we selected 104 patients with a certain diagnosis of RCC after surgery, and for whom at least 24 months of post-surgical FDG PET/CT, clinical, and instrumental follow-up data was available. The sensitivity and specificity of FDG PET/CT were assessed by histology and/or other imaging as standard of reference. Progression-free survival (PFS) and overall survival (OS) were computed using the Kaplan–Meier method. Univariate and multivariate Cox proportional hazards models were used to identify predictors of outcome.

Results

FDG PET/CT resulted in a positive diagnosis in 58 patients and a negative diagnosis in 46 patients. Sensitivity and specificity were 74 % and 80 %, respectively. FDG PET/CT findings influenced therapeutic management in 45/104 cases (43 %). After a median follow-up period of 37 months (± standard deviation 12.9), 51 (49 %) patients had recurrence of disease, and 26 (25 %) had died. In analysis of OS, positive versus negative FDG PET/CT was associated with worse cumulative survival rates over a 5-year period (19 % vs. 69 %, respectively; p <0.05). Similarly, a positive FDG PET/CT correlated with a lower 3-year PFS rate. In addition, univariate and multivariate analysis revealed that a positive scan, alone or in combination with disease stage III–IV or nuclear grading 3–4, was associated with high risk of progression (multivariate analysis = hazard ratios [HRs] of 4.01, 3.7, and 2.8, respectively; all p?<?0.05).

Conclusions

FDG PET/CT is a valuable tool both in treatment decision-making and for predicting survival and progression in patients affected by RCC.

     

原发性肺透明细胞癌的CT诊断

目的 探讨原发性肺透明细胞癌的CT表现.方法 回顾分析经手术和/或病理证实的7例患者的CT表现和临床病理的特点,并结合文献进行分析.结果 原发性肺透明细胞癌的CT主要表现为肺周围性肿块（5/7）,肿块常较大、形态不规则、密度均匀、有分叶、可见毛刺;1例为空洞性肿块,增强扫描呈中等度强化,无纵隔淋巴结肿大.2例左肺上叶中央型肿块合并肺不张,与其它类型中央型肺癌相似.结论 原发性肺透明细胞癌临床表现无特异性,CT上仅有相对的影像学特征,确诊仍需依赖病理学检查.     

Recurrent colorectal carcinoma: evaluation with barium enema examination and CT

The efficacy of the barium enema examination and abdominal computed tomography (CT) was investigated in 81 patients who had undergone operation for colorectal carcinoma. Recurrent disease was found in 52 patients and was divided into local (anastomotic and perianastomotic) and remote (distant and hepatic metastases) types. In 32 patients with locally recurrent carcinoma, the sensitivity of the barium enema examination was 88%; for CT it was 69%. Conversely, the barium enema examination was not useful for detecting remote metastases shown on CT, which disclosed disease at one or more sites in 47 (90%) of the 52 patients. CT best evaluated recurrences remote from the anastomosis, pelvic recurrences in patients with colostomies, and hepatic metastases. Barium enema examination and CT were therefore found to be complementary modalities.     

原发性肝透明细胞癌的 CT 及 MRI 表现

目的：评价 CT 和 MRI 对原发性透明细胞型肝癌(PCCCL)的诊断价值。方法回顾性分析38例经手术病理证实的PCCCL 的 CT 和 MRI 表现。26例行 CT 检查,23例行 MRI 检查,其中11例同时进行了 CT 及 MRI 检查。结果CT 平扫表现为低密度(n=24,92.3%)、稍高密度(n=2,7.7%)。MR T1 WI 呈低信号(n=19,82.6%)或混杂高信号(n=4,17.4%),脂肪抑制后信号均有不同程度下降。T2 WI 病灶为高或稍高信号(n=22,95.7%),1例为等低信号(n=1,4.3%),CT/MR 动态增强后动脉期所有病灶均强化(n=38),门静脉期病灶呈相对低密度(n=35,92.1%)或稍高密度/高信号(n=3,7.9%)。肿瘤内结节状强化共14例。环形包膜样强化26例(26/38,68.4%)。结论PCCCL 既有普通型肝癌“快进快出”的强化方式和包膜样强化的特征,又有自身特点即肿瘤内结节状强化和瘤内脂肪成分。