Vascular emergencies of the head and neck

The clinical manifestations of vascular lesions of the head and neck may be variable (hemorrhagic, ischemic, compressive). Diagnosis often is made at the time of acute presentation, but delayed manifestations, sometimes long after the initial presentation, should not be overlooked. Hemorrhagic manifestations are characterized by epistaxis, corresponding mainly to lesions of the nasal cavities but involvement of the internal carotid artery should be excluded (life threatening). In addition, some vascular malformations may lead to severe hemorrhage. Ischemic manifestations typically result from arterial dissection. A venous origin is also possible. Carotid-cavernous fistulas rarely lead to hemorrhagic or ischemic manifestations and tend to result in ocular manifestations, typically delayed and sometimes misleading.     

Review of COVID-19, part 2: Musculoskeletal and neuroimaging manifestations including vascular involvement of the aorta and extremities

The coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) has affected almost every country in the world resulting in severe morbidity, mortality and economic hardship, altering the landscape of healthcare forever. Its devastating and most frequent thoracic and cardiac manifestations have been well reported since the start of the pandemic. Its extra-thoracic manifestations are myriad and understanding them is critical in diagnosis and disease management. The role of radiology is growing in the second wave and second year of the pandemic as the multiorgan manifestations of COVID-19 continue to unfold. Musculoskeletal, neurologic and vascular disease processes account for a significant number of COVID-19 complications and understanding their frequency, clinical sequelae and imaging manifestations is vital in guiding management and improving overall survival. The authors aim to provide a comprehensive overview of the pathophysiology of the virus along with a detailed and systematic imaging review of the extra-thoracic manifestation of COVID-19. In Part I, abdominal manifestations of COVID-19 in adults and multisystem inflammatory syndrome in children will be reviewed. In Part II, manifestations of COVID-19 in the musculoskeletal, central nervous and vascular systems will be reviewed.     

乳腺错构瘤X线与病理分析

目的探讨乳腺错构瘤的X线表现与病理基础。方法收集经手术病理证实的乳腺错构瘤19例,分析其X线表现与病理学基础,全部病例均采用全数字化乳腺X线摄影。结果X线表现脂肪型5例,致密型4例,混合型10例。病理上本病均有完整的包膜,由数量不等、杂乱无章的乳腺导管、小叶和成熟的脂肪及纤维组织混杂组成。结论乳腺错构瘤的X线表现因其病灶内脂肪组织、腺体和纤维组织的比例不同而不同,混杂密度肿块为本病的特征性X线表现。     

艾滋病并发卡氏肺孢子虫肺炎的X线和CT诊断

目的 :探讨艾滋病 (AIDS)并发卡氏肺孢子虫肺炎 (PCP)的胸部X线和CT表现。材料和方法 :对 6例经证实的艾滋病并发卡氏肺孢子虫肺炎患者的胸部X线照片 ( 6例 )和CT扫描 ( 2例 )进行回顾性分析。结果 :典型表现为双侧肺门周围以及中、下肺野弥漫性网状阴影 ,部分渗出性病变可以相互融合 ,呈斑片样或磨玻璃样改变。少见表现有肺囊性改变、肺实变、肺门淋巴结增大、胸腔积液及气胸等。结论 :艾滋病并发卡氏肺孢子虫肺炎的特异性诊断是找到病原体 ,但是HIV抗体检测阳性者出现典型胸部影像表现结合临床症状 ,并排除其他免疫低下所致的细菌性感染或肿瘤 ,复方新诺明治疗有效 ,诊断AIDS并PCP可以成立。     

Extrapulmonary manifestations of COVID-19: Radiologic and clinical overview

COVID-19 is principally a respiratory illness and pulmonary manifestations constitute main presentations of the disease. According to the reported studies, SARS-CoV-2 infection is not limited to the respiratory system and other organs can be also affected. Renal dysfunction, gastrointestinal complications, liver dysfunction, cardiac manifestations, mediastinal findings, neurological abnormalities, and hematological manifestations are among the reported extrapulmonary features. Considering the broad spectrum of clinical manifestations and the increasing worldwide burden of the disease, there is an urgent need to rapidly scale up the diagnostic capacity to detect COVID-19 and its complications. This paper focuses on the most common extrapulmonary manifestations in patients with COVID-19 pneumonia. Further studies are needed to elaborate and confirm the causative relationship between SARS-CoV-2 and the reported extrapulmonary manifestations of COVID-19.     

先天性骨梅毒的X线表现(附5例报告)

目的:探讨先天性骨梅毒的X线表现。方法:回顾性分析5例先天性骨梅毒患儿的骨骼X线平片及临床表现。结果:先天性骨梅毒的X线表现主要包括:①干骺端炎,呈多发、对称性分布,可为先天性骨梅毒最早出现的征象;②骨干炎(骨髓炎);③骨膜炎,是最常见的征象。结论:X线检查对发现和诊断婴幼儿骨梅毒病变有非常重要的意义,有时可以在临床症状出现之前显示骨梅毒的改变,为临床早期诊断提供线索。     

肺栓塞诊断:单层、多层螺旋CT的对比研究

目的:研究并对比分析多层、单层螺旋CT肺动脉造影(multi-slice and single-slice spiral CT pulmonary angiography,MSCTPA and SSCTPA)对肺栓塞(pulmonary embolism,PE)诊断的临床价值。方法:回顾性分析临床明确诊断的83例PE患者的螺旋CT肺动脉造影表现,其中行16层MSCTPA及SCTPA检查者各为23和60例。结果:分析83例PE患者的3548支肺动脉,MSCTPA、SCTPA共显示759支PE直接征象(包括中心型充盈缺损95支、部分型充盈缺损230支、完全性阻塞251支、附壁性充盈缺损183支),约占23.3%;其中1885支段以上肺动脉中,MSCTPA、SCTPA分别检出157支和371支PE直接征象,各占32.6%(157支/481支)和26.4%(371支/1404支),经过t检验,t=1.3220.1,两者检出率无明显差别;1663支亚段肺动脉中,MSCTPA、SCTPA分别检出123支和108支PE直接征象,各占25.0%(123支/492支)和9.2%(108/1171支),t=3.125>t0.01(81)=2.374,P<0.01,前者检出率明显高于后者。平扫示间接征象共160例次。结论:作为一种快速、无创的检查方法,MSCTPA、SCTPA对段以上PE的诊断均有效、准确、可靠,而MSCTPA对亚段PE的显示更为敏感,适用于临床对PE的全面评价。     

肋骨血管瘤骨显像一例

笔者报道了1例肋骨血管瘤患者,即从临床症状、影像学表现、临床诊断、组织病理学检查诊断及预后等方面介绍并分析了该病的特点,并通过文献复习加深了对肋骨血管瘤的认识。该病为肋骨的血管瘤病变,其进展相对较缓慢,虽然在影像学上无明显的特异性表现,但并非只能通过组织病理学检查诊断,影像学表现在该病的诊断上仍有一定的参考价值。该病的影像学表现多种多样,易与恶性骨肿瘤及骨肿瘤样病变混淆。因该病极易误诊,所以需结合临床表现、影像学检查及术后组织病理学检查综合考虑。     

艾滋病并发隐球菌脑膜炎15例临床分析

目的分析艾滋病并发隐球菌脑膜炎临床特征、诊断方法。方法在临床表现、诊断方面就作者在非洲工作2年间，收治的艾滋病并发隐球菌脑膜炎病人15例进行回顾性分析。结果所有病人均有发热、神经系统症状如：头痛、惊厥等。不同程度存在艾滋病相关表现。全部病例HIV，CSF墨汁染色法查隐球菌均阳性。结论艾滋病并发隐球菌脑膜炎临床表现没有特异性，目前脑脊液墨汁染色法，仍不失为简单、可靠的手段。血隐球菌多糖夹膜抗原测定，具有较高诊断价值。     

儿童后肾腺瘤的临床及CT表现

目的:分析儿童后肾腺瘤的临床、病理及影像学特征。方法:对2例经病理证实的儿童后肾腺瘤结合文献中临床及影像学资料较完全的患者10例进行综合分析。结果:儿童后肾腺瘤临床伴有红细胞增多症较多见,B超多为高回声,CT平扫以相对高密度伴钙化多见,但可为囊性病灶伴壁结节,实质部分增强后强化程度不等,本院1例新病例为含大量脂肪成分的多囊性病灶,表现特殊。虽然后肾腺瘤为良性肿瘤,但是可有转移。结论:儿童后肾腺瘤的临床及影像学特征并不显著,但是综合分析其表现有助于做出正确诊断,最终诊断有赖病理学检查。     

Thoracic manifestations of inflammatory bowel disease

OBJECTIVE: The purpose of this article is to present the spectrum of inflammatory bowel disease manifestations in the chest, including the airways, lung parenchyma, pulmonary vasculature, and serosal surfaces. CONCLUSION: The spectrum of inflammatory bowel disease manifestations in the chest is broad, and the manifestations may mimic other diseases. Knowledge of these manifestations in conjunction with pertinent clinical data is essential for establishing the correct diagnosis and treatment.     

手术后椎间盘炎的CT诊断

目的 探讨术后椎间盘炎的病因、临床表现及CT诊断。方法 总结并分析13例术后椎间盘炎的临床表现，治疗方法及CT诊断。结果 本组资料中术后椎问盘炎发生率为0．66％。从临床表现、术后病理检查到CT诊断都支持感染学说。结论 CT早期诊断困难但征象典型，对术后椎间盘炎的诊断与治疗有指导意义。     

22例怪异型心脏的X线平片诊断分析

目的：分析一组怪异型心脏的Ｘ线平片特异征象。材料和方法：２２例均行心脏正位及左侧位食道吞钡摄片,１９例经手术证实,２例经造影证实,１例经彩超证实。结果：心脏呈普大型伴弧弓９例,无法分型８例,其他型５例。结论：怪异型心脏病因复杂,其Ｘ线平片诊断及鉴别诊断有赖于肺循环改变并结合临床资料及其他Ｘ线征象。     

经埋置式给药装置肝肿瘤门静脉造影的价值

目的 探讨总结经埋置式给药装置肝脏肿瘤门静脉造影的影像学特征。方法 ５１例肝肿瘤患者,术中行门静脉插管,并将埋置式给药装置（ＩＤＤＳ）埋置于腹壁皮下,术后经ＩＤＤＳ进行直接门静脉造影及摄片,分析总结其影像学特点。结果 门静脉系统显影均良好,门静脉造影主要影像学表现有肿瘤染色,肝内门静脉主支附近的细小分支异常增多呈“树叶征”样改变、门静脉分支伸入肿瘤内参与其血液供应（４例）,门静脉主干被癌栓部分或完     

Computed tomography in Whipple disease

A case of Whipple disease demonstrated on computed tomography (CT) a large mesenteric mass of low density and thickened folds in the jejunum, which was confirmed by barium studies. Retroperitoneal manifestations were absent. The importance of CT in demonstrating the extraintestinal manifestations of Whipple disease is emphasized.     

The spectrum of pulmonary sarcoidosis: Variations of high-resolution CT findings and clues for specific diagnosis

Sarcoidosis is a systemic disease of unknown cause, characterized by widespread non-caseating granulomas. There is a wide spectrum of radiologic manifestations in pulmonary sarcoidosis, providing challenges to radiologists. However, recognition of the key features of sarcoidosis with knowledge of its pathologic background can often allow for specific diagnosis. In this review, we describe the variety of high-resolution CT findings in pulmonary sarcoidosis along with its pathologic features as the basis for radiographic manifestations, and discuss the key features on high-resolution CT for the specific diagnosis of pulmonary sarcoidosis.     

子宫腺肌病的MRI表现与临床的相关性研究

目的探讨子宫腺肌病MRI表现与临床的相关性。资料与方法搜集54例经病理证实为子宫腺肌病患者的MRI及临床资料,就其MRI表现与患者病程、疼痛程度及血清CA125情况进行分析统计,并对各组数据行Spearman秩相关检验。结果 54例中,20例弥漫型子宫腺肌病患者结合带厚度与CA125水平显著相关,病灶内点状长T2数目与CA125水平显著相关,但疼痛程度与结合带厚度、病灶内点状长T2数目无明显相关性;34例局灶型子宫腺肌病患者疼痛程度与病灶最长径显著相关,与病灶内点状长T2数目信号显著相关;CA125与病灶内点状长T2数目信号显著相关。各相关性均有统计学意义。结论局灶型及弥漫型子宫腺肌病的MRI表现与患者的临床表现存在相关性。     

骨肌系统淀粉样变性的MRI表现

淀粉样变性（AM）是由多种疾病引起的一组临床症候群,多见于肾衰而行透析治疗的病人或浆细胞骨髓瘤病人。该病是由于淀粉样物质沉积于器官或组织的细胞外间隙所引起。AM累及骨肌系统较为少见,病变的MRI表现不典型,容易误诊。就AM的概念、分类及其在骨关节及肌肉的MRI特点及鉴别诊断予以综述。     

The multiple faces of lymphoma of the musculoskeletal system

Musculoskeletal manifestations of lymphoma cover a broad spectrum of disease findings with varying degrees of involvement of bone and soft tissue. This pictorial essay will illustrate and review the range of manifestations of lymphoma of the musculoskeletal system. Several unique cases of soft tissue lymphoma will be included to aid with the less familiar and atypical imaging features. Knowledge of the multitude of radiographic manifestations of the disease is critical for enhanced detection, improved diagnostic accuracy and treatment planning, and avoidance of imaging pitfalls.