卷席法取材在胃良性溃疡标本中的应用

胃良、恶性疾病的术前诊断主要靠内窥镜检查和气钡双重对比造影。对术后胃切除标本,尤其对术前诊断为“良性溃疡”而行手术的胃标本进一步检查,对发现胃内其他病变有重要意义。1993～1996年,我们采用胃粘膜卷席法取材,对胃溃疡67例和十二指肠溃疡105例的标本进行检测。另外,还对126例术前已行胃粘膜活检的术后胃标本进行幽门螺杆菌(HP)的检测,取得了较有意义的结果。1　对象和方法1.1　对象　术后胃标本,沿胃大弯剪开(如病灶在大弯侧,则沿胃小弯剪开),铺平固定于木板上,用10%甲醛液固定。细致观察病灶周围粘膜的变化,如粘膜粗糙、隆起、出…     

胃后壁溃疡的双对比造影诊断：附46例X线分析

本文报告经胃镜、病理证实和具有典型X 线征象的46例胃后壁溃疡。龛影为其直接征象,表现为钡斑点(钡洼或钡池),环行线状影,龛口周围粘膜水肿及粘膜纹纠集;间接征象表现为胃轮廓变形。本文还讨论了胃良恶性溃疡的鉴别诊断。     

胃良恶性溃疡的X线诊断

目的：普通X线钡餐造影检查对胃良恶性溃疡的诊断。资料方法：14例胃溃疡患者，经手术及胃镜证实，其中恶性8例，良性6例。结果：胃的良恶性溃疡的临床表现及X线表现均有许多相似之处。不能只依靠单一X线征象就盲目诊断，而应综合考虑或借助于其他检查手段，才能做出正确诊断。     

中晚期胃癌的X线、CT和B超表现(附186例分析)

目的：探讨胃癌的X线、CT和B超特征性表现及意义。方法：186例胃癌均行气钡双重造影，其中63例行CT扫描，37例行B超检查，所有病例均经手术病理证实，分析全部病例的影像学表现。结果：1.X线气钡双重造影检出胃癌；蕈伞型65例，溃疡型82例，浸润型39例。2.CT检出胃癌：胃壁增厚37例，胃内肿块26例，胃周脂肪线消失32例，胃周及远处淋巴结肿大27例。3.B超检出胃癌：胃壁增厚17例，胃内肿块11例，25例显示第3、4、5层回声线消失、不清或中断，13例显示胃周脏器侵润及远处脏器转移，12例显示淋巴结转移。结论：X线气钡双重造影是诊断胃癌的首选检查方法，CT和B超对胃癌治疗方案的制定及预后估计有重要指导意义。     

克隆氏结肠炎的鹅口疮样溃疡

鹅口疮样溃疡是克隆氏结肠炎的有力证据和早期X线征象。作者从1970年开始,进行了109次双重对比钡灌肠,其中91例系克隆氏结肠炎。91例克隆氏结肠炎的诊断根据是:50例经直肠活检或切除标本证实;其余41例因病变未累及直肠,故由临床、乙状结肠镜及X线所见而成立诊断。 91例进行了双重对比钡灌肠的克隆氏病例中,40例(44％)发现有鹅口疮样溃疡。这种细小而散在的溃疡,可在双重对比钡灌肠造影中清晰显示出来。典型的鹅口疮样溃疡,直径由针尖大小至数毫     

微皱襞对胃良,恶性溃疡鉴别诊断的价值

胃微皱襞的诊断价值已受到人们重视。关于胃微皱襞对良、恶性溃疡的鉴别诊断价值,文献上尚缺少一致看法。为了确切地了解良、恶性溃疡龛周微皱襞的形态及分布规律,我们观察了良性及恶性胃溃疡术后标本微皱襞的X线表现,以冀从微皱襞水平对良、恶性胃溃疡的鉴别诊断有进一步认识。     

胃平滑肌肿瘤的X线气钡双对比造影与CT诊断

目的：探讨X线气钡双对比造影和CT检查对胃平滑肌肿瘤定位、定性的诊断价值。方法：对30例胃平滑肌肿瘤患者进行气钡双对比造影检查及CT强化检查并对其影像表现进行分析。结果：X线气钡双对比造影检查对腔内型肿瘤敏感，CT检查对非腔内型肿瘤诊断有优势，两种方法联合应用对各种胃平滑肌肿瘤定位诊断正确率达100％，定性准确率达84％。结论：X线气钡双对比造影和CT强化检查联合应用是诊断胃平滑肌肿瘤的有效影像检查方法。     

返流性食管炎孤立性溃疡:X线表现

为了研究返流引起的食管孤立性溃疡的特征,确定有无好发于食管后壁的倾向,作者复习29例有明显的返流症状或吞咽困难,而无免疫损害或引起食管溃疡的其他情况病人的食管X线表现。男性21例,女性8例。年龄25～86岁。均进行食管双相X线检查,即站立左后斜位(LPO)高密度混悬钡双重对比检查和俯卧右前斜位(RAO)低密度混悬钡单对比检查。观察X线片确定溃疡的大小、部位以及与胃食管交界处的距离,还观察有无胃食管返流性病     

气钡双重造影在上消化道疾病诊断中的应用

目的：探讨气钡双重造影X线检查在上消化道疾病诊断中的价值。方法对2014年5月～2015年4月收治的79例上消化道疾病患者的医学影像资料进行分析探讨。结果经检查，发现黏膜病变（炎症、癌症和溃疡）共38例；发现黏膜下病变（间质瘤、淋巴瘤、硬皮病）20例；器官结构改变（食管裂孔疝、憩室）16例。结论气钡双重造影X线检查是一种有效诊断手段，精度高，患者不适感少，可在临床进行推广。     

胃小区X线分型及其病理基础

胃双重造影能清楚显示胃小区，有效地提高了细微粘膜病变的诊断水平，但对胃小区的正常与异常表现，X线分型及其临床意义尚有争论，本文就60例胃切除标本涂钡照片，进行X线－－病理对照，就其中一些问题作初步探讨。     

Intravasation of barium sulphate at barium enema examination

We report a case of venous intravasation of barium sulphate occurring during a routine barium enema examination for investigation of rectal bleeding. The patient suffered a cardiopulmonary arrest, but made a full recovery after organ support in intensive care. Review of radiographs from the examination showed intravasated barium in pelvic vessels. We review the literature on this rare, but serious, complication of barium enema examination and suggest measures by which intravasation can be prevented.     

Barium peritonitis: experimental study using barium sulfate and radioactive barium

Barium peritonites are known to be a serious complication of barium enema examinations, being accompanied by a high mortality rate. The authors made their study injecting barium and radioactive 133Ba in the peritoneum of 68 rats without causing damages to the colon, in order to verify the toxicity of barium if injected in the peritoneum, and to evaluate the various extraperitoneal locations. Moreover, they compared the alterations caused by this agent with those consequent to a similar agent, such as talcum. The results show that barium is not toxic on its own: it gives in fact origin to granulomas similar to those caused by talcum; a particular tropism for the lymphatic tissues is present as well.     

MR colonography with fecal tagging: barium vs. barium ferumoxsil

RATIONALE AND OBJECTIVES: Both magnetic resonance (MR) and computed tomographic (CT) colonography are useful for colon examination. With sensitivities close to those for conventional colonoscopy (CC) for polyps, colonography has been proposed as an alternative to diagnostic CC. MR colonography (MRC) with fecal tagging may be a method of gaining further patient acceptance and widespread use, but the method has to be optimized. The aim of our study was to evaluate the quality of a new contrast agent mixture and to validate a new method for evaluating the tagging efficiency of contrast agents. MATERIALS AND METHODS: Twenty patients referred to CC underwent dark lumen MRC prior to the colonoscopy. Two groups of patients received two different oral contrast agents (barium sulfate and barium sulfate/ferumoxsil) as a laxative-free fecal tagging prior to the MRC. After MRC, the contrast agent was rated qualitatively (with the standard method using contrast-to-wall ratio) and subjectively (using a visual analog scale [VAS]) by three different blinded observers. RESULTS: Evaluated both qualitatively and subjectively, the tagging efficiency of barium sulfate/ferumoxsil was significantly better (P < .05) than barium sulfate alone. The VAS method for evaluating the tagging efficiency of contrast agents showed a high correlation (observer II, r = 0.91) to the standard method using contrast-to-wall ratio and also a high interclass correlation (observer II and III = 0.89/0.85). MRC found 1 of 22 (5%) polyps <6 mm, 2 of 3 (67%) polyps 6-10 mm, and 2 of 2 (100%) polyps >10 mm. CONCLUSION: MRC with fecal tagging using barium sulfate/ferumoxsil as contrast agent will give better overall assessment of the colon wall compared to barium sulfate alone. Furthermore, the VAS method of evaluating fecal tagging efficiency correlated with the standard method of calculating the contrast-to-wall ratio.