磁共振对腹部巨大囊性病变的诊断价值分析

目的探讨磁共振(MRI)对腹部巨大囊性病变的诊断价值。方法搜集21例腹部巨大囊性病变的磁共振(MRI)资料进行总结分析,所有病例全部经手术病理证实。结果 21例中肾重度积水3例,肾囊肿3例,输尿管囊肿1例,卵巢囊肿3例,卵巢黏液性囊腺瘤1例,脾脏囊肿2例,胰腺假性囊肿2例,肝脏囊肿2例,先天性胆总管囊肿1例,腹膜后脂肪肉瘤囊性变1例,肠系膜囊肿1例,囊性转移癌1例。腹部囊性病变90.5%为良性,每种囊性病变的发病部位和MRI表现具有一定的特征性。结论 MRI对腹部巨大囊性病变的定位定性诊断具有重要价值。     

小儿先天性肺囊肿的临床X线诊断

分析经手术病理证实的先天性肺囊肿13例。右肺4例,左肺9例。根据囊肿是否多发及囊内容物,X线表现可分为液囊肿(1例),气液囊肿(3例),气囊肿(2例),多发性肺囊肿(7例)4型。当肺内发现壁不完全的囊腔时,不能排除先天性肺囊肿的诊断。CT检查有助于先天性肺囊肿的确诊及定位。重点讨论其诊断、发病部位及X线鉴别诊断。     

超声在颈部囊性病变诊断中的价值

目的 探讨超声在颈部囊性病变诊断及鉴别诊断中的价值.方法 回顾性分析92例经手术病理证实的颈部囊性病变的超声表现及其发病部位,总结不同病理类型囊性病变的声像图特征.结果 92例颈部囊性病变中,甲状舌管囊肿48例(52%),颈部淋巴管瘤31例(34%),腮裂囊肿10例(11%),表皮囊肿3例(3%),其发病部位及超声表现均具有一定的特异性.结论 不同病理类型的颈部囊性病变的发病部位、超声表现不同,对鉴别诊断具有重要价值.     

肝囊性病变的CT诊断

<正>肝脏CT表现为囊性病变时,可能为许多种疾病的病理反应。按病因可分为:(1)先天性:如肝囊肿;(2)创伤性;(3)炎症性:如肝脓肿;(4)寄生虫性:如肝包虫囊肿;(5)肿瘤性:如肝囊性转移瘤;(6)其他:如肝梗死等。现将肝囊性病变的CT表现分为7组加以讨论如下。1囊肿呈均一的水样密度性病变:先天性肝囊肿属于此类病变。CT表现为单发或多发圆形、椭圆形均质水样密度影,边缘光滑锐利,CT值约为0～15Hu之间。由于部分容枳效应的影响,小囊肿的CT值常偏高,应薄层扫描以确诊。增强扫     

多排螺旋CT在小儿腹部囊性占位诊断中的价值探讨

目的 探讨小儿腹部囊性占位的多排螺旋CT诊断价值.方法 收集我院近年来经手术病理证实的小儿腹部囊性占位病例共18例,分析其影像学表现,归纳特征.结果 肠系膜囊肿6例,卵巢囊肿1例、肠重复畸形1例(囊肿型)、肝囊肿1例、大网膜囊肿3例、胆总管囊肿5例、囊性畸胎瘤1例.结论 小儿腹部巨大囊性占位定位困难,多排螺旋CT对小儿腹部囊性占位的检出及确诊具有较高价值,是小儿腹部囊性占位诊断的最佳检查择之一.     

囊性淋巴管瘤的声像图表现探讨

目的:探讨囊性淋巴管瘤的声像图表现特征。方法:回顾分析了我院近年来经手术及病理结果证实的25例囊性淋巴管瘤声像图资料。结果:本组25例声像图均表现为囊性肿块,其中单房囊肿7例(占28%),多房囊肿15例(占60%),混合性肿块3例(占12%)。彩超检查13例(占52%)肿块未检出血流信号,12例(占48%)在囊壁和间隔可见彩色血流信号,混合性肿块者3例囊内实质性部分均可见少许血流信号,频谱多普勒检测到低速动脉血流频谱。结论:超声检查对囊性淋巴管瘤的诊断和随访有较高实用价值。     

颌骨囊性病变CT及临床分析

目的对颌骨囊性病变CT表现进行分析,探讨病变的病理学表现,并且明确该种病变的治疗与疗效。方法选择该院50例上颌骨囊性病变病例,对其进行回顾性分析,了解其CT表现。结果在这50例颌骨囊性病变中有根端囊肿15例,孤立性颌骨囊肿6例,含牙囊肿7例,角化囊肿4例,造釉细胞瘤5例,骨纤维异常增殖症3例,鼻腭囊肿7例,球上颌囊肿3例。结论通过对于颌骨囊性病变各种类型CT表现的分析,对了解其病理特点和提高治疗效果的意义很重大。     

卵巢囊性病变的CT诊断

目的:评价CT对卵巢囊性病变的诊断价值.方法:分析经病理证实的67例共82个卵巢囊性病变CT资料,讨论其CT表现及病理基础.结果:囊肿22例,4例囊肿CT值偏高,病理标本上均有不同程度的出血,7例子宫内膜异位囊肿有分隔;24例囊腺瘤均表现为边缘光整的囊性肿块,9例有分隔,3例囊壁见结节,其中6例黏液性囊腺瘤表现为不同密度的多房性肿块;7例卵巢畸胎瘤,均含钙化和(或)脂肪密度;1例卵泡膜细胞瘤和3例脓肿,后者边缘模糊;10例恶性肿瘤,CT表现均以囊性密度为主,伴不同程度实质成分或囊实性混合密度影.结论:卵巢囊性病变CT表现颇为相似;CT对其定位诊断敏感性高,定性诊断需结合临床.     

外围性子宫内膜异位症的CT表现及其病理学基础

目的 探讨外围性子官内膜异位症(EEM)的CT表现及其病理基础,评价CT对EEM的诊断能力.材料与方法回顾分析24例EEM临床、CT和术后病理资料,全组病例均行平扫及增强检查.结果 24例EEM,共发现病灶51个,其中实块型3个,囊实混合型4个,囊肿型44个.实块型EEM CT表现为软组织肿块,其病理为大量增生的纤维组织夹杂微量的子宫内膜细胞、含铁血黄素和少量淋巴细胞、浆细胞;囊肿型EEM囊壁厚、毛糙,与周围结构粘连,囊液呈高密度或高低混杂密度,囊液分层征.囊壁病理为纤维组织,内衬宫内膜组织,囊液为新旧不一的异位内膜经血;囊实混合型具有囊肿型和实块型CT表现及病理基础.结论 囊肿型,囊实混合型EEM CT表现具有特异性,实块型CT表现缺乏特异性,但结合与经期相关的临床表现,术前亦能明确诊断.     

外围性子宫内膜异位症的CT表现及其病理学基础

目的 探讨外围性子宫内膜异位症(EEM)的CT表现及其病理基础,评价CT对EEM的诊断能力.材料与方法回顾分析24例EEM临床、CT和术后病理资料,全组病例均行平扫及增强检查.结果 24例EEM,共发现病灶51个,其中实块型3个,囊实混合型4个,囊肿型44个.实块型EEM CT表现为软组织肿块,其病理为大量增生的纤维组织夹杂微量的子宫内膜细胞、含铁血黄素和少量淋巴细胞、浆细胞,囊肿型EEM囊壁厚、毛糙,与周围结构粘连,囊液呈高密度或高低混杂密度,囊液分层征.囊壁病理为纤维组织,内衬宫内膜组织,囊液为新旧不一的异位内膜经血;囊实混合型具有囊肿型和实块型CT表现及病理基础.结论 囊肿型、囊实混合型EEM CT表现具有特异性,实块型CT表现缺乏特异性,但结合与经期相关的临床表现,术前亦能明确诊断.     

Clinics in diagnostic imaging (102)

A 19-year-old man presented with cough and haemoptysis of ten days duration. He also had mild right hypochondrial pain. Chest radiograph and computed tomography (CT) showed a rounded soft tissue density opacity with an air crescent sign. CT showed multiple cystic lesions in the liver with a daughter cyst in its lateral wall. Diagnosis of hydatid disease of lung and liver was made. The contents of the liver cyst were aspirated, hypertonic saline instilled, re-aspirated, and absolute alcohol injected. Hydatid disease is endemic in certain parts of the world. Although the lungs and liver are most frequently affected, the disease can arise in any part of the body and should be kept in differential diagnosis whenever a cystic lesion is encountered. Hydatid cysts typically demonstrate characteristic imaging findings, however, the appearances may become complicated due to cyst rupture or secondary infection. Ultrasonography is the imaging modality of choice particularly in hepatic disease. CT best demonstrates cyst wall calcification and cyst infection.     

Diagnosis and management of hepatic hydatidosis complicated with biliary fistula.

A total of 1,204 patients with liver hydatidosis were treated by operations in our hospital from 1953 to 1990. Of these 74 had biliary fistulae. Growth of echinococcus cyst causes displacement, distortion and stenosis of the hepatic ductules with impaired bile drainage. Biliary effusion may occur between the endo- and ecto-cyst walls. Long term compression renders the hepatic ductule atrophic, and liable to rupture, forming a hydatid cyst-biliary fistula. The hydatid cyst can rupture into the biliary tract, and cyst fluid escapes into the biliary tract with daughter cysts discharged into the common bile duct, causing biliary colic, obstructive jaundice and possibly liver abscess. For acute obstructive and suppurative cholangitis, drainage of purulent bile and daughter cysts and management of the infected hydatid cyst are indicated. After removal of the echinococcus cyst, the fistulous opening on the hepatic duct must be sutured, but a small biliary fistula may be left alone. According to the thickness of the ectocyst wall, size of the cavity, severity of the infection, and degree of bile leakage, one of the following operative procedures for obliteration of the residual cavity can be selected: (1) closure by inversion suture of ectocyst; (2) omental or muscle flap obliteration; (3) closed catheter drainage.

     

肝包虫病的螺旋CT诊断

目的:提高对肝包虫病的螺旋CT表现的认识。方法:回顾分析经本院螺旋CT检查及手术病理证实的21例肝包虫病螺旋CT表现。结果:囊型包虫病18例,其中单纯囊肿8例,表现为圆形水样密度区。多子囊型10例,表现为在一个大囊内可见数量不等的更低密度小圆形低密度区,边界清晰。钙化14例,为囊壁壳状钙化囊内不定形条片状钙化。包虫囊肿合并感染4例,表现为囊壁增厚,强化明显。泡型包虫病3例,呈不规则及不均匀密度影,所有病灶内均有钙化灶,其中1例病灶边缘有晕样改变区。所有病例CT均诊断正确。结论:螺旋CT可以很好显示肝包虫病病灶,对肝包虫病具有较高的诊断率。     

肝脏及肺部泡状棘球蚴病CT表现（附11例肝肺病例报告）

目的分析肝脏及肺部泡状棘球蚴病的CT表现，探讨肝脏及肺部泡状棘球蚴痛的CT诊断及鉴别方法分析临床及手术病理证实的9例肝脏及2例肺脏泡状棘球蚴病螺旋CT表现。结果2例肺泡状棘球蚴病CT均表现为实性病灶，边缘清楚，未见钙化影。9例肝脏泡状棘球蚴病中5例表现为中心以实性为主周围伴有多发性小空泡征的圆形、椭圆形阴影，边缘光滑，其中3例囊肿壁有不同程度环形钙化。2例为实性病灶，部分囊壁环形钙化，囊内无小空泡征（小囊肿）。2例CT表现为斑块状低密度影，分界不清，中间散在分布斑点钙化影。结论螺旋CT可以很好显示肝肺泡状包虫病病灶，对肝肺泡状包虫病具有较高的诊断率。     

肺包虫囊肿的影像学诊断

本文总结了４５８例肺包虫囊肿影像学诊断经验。典型Ｘ线征除罕见的环形囊壁鲈化外,只有破裂后形成液平面,上有漂浮膜或内囊周围有液体及气体形成双液平面。ＣＴ扫描包虫囊肿密度均匀,ＣＴ值２０Ｈｕ以下,偶见囊中之囊。Ｂ超声囊肿呈圆形或椭圆形无回声区。     

Continuous long-term albendazole therapy in intraabdominal cystic echinococcosis

Ａｌｂｅｎｄａｚｏｌｅｈａｓｂｅｅｎｗｉｄｅｌｙｕｓｅｄｉｎｔｈｅｔｒｅａｔｍｅｎｔｏｆｃｙｓｔｉｃｅｃｈｉｎｏｃｏｃｃｏｓｉｓ ,ｂｕｔｒｅｌａｔｉｖｅｌｙｆｅｗｌｏｎｇ ｔｅｒｍｆｏｌｌｏｗ ｕｐｒｅｓｕｌｔｓａｒｅａｖａｉｌａｂｌｅｔｏｅｖａｌｕａｔｅｌｏｎｇ ｔｅｒｍｅｆｆｉｃａｃｙａｎｄｓａｆｅｔｙ Ｉｎｔｈｉｓｓｔｕｄｙ ,ｗｅｆｏｌｌｏｗｅｄｕｐ 15ｐａｔｉｅｎｔｓｗｈｏｒｅｃｅｉｖｅｄｃｏｎｔｉｎｕｏｕｓｌｏｎｇ ｔｅｒｍａｌｂｅｎｄａｚｏｌｅｔｈｅｒａｐｙ ;ｃｌｉｎｉｃａｌｔｈｅｒａｐｅ…     

囊性肾癌的CT表现

目的:分析囊性肾癌的CT表现,提高术前确诊率。方法:分析6例经手术病理证实的囊性肾癌CT表现。结果:6例单发肾癌均呈多房囊性,囊壁、分隔厚薄不均,其中5例伴壁结节,2例伴钙化外软组织成分;增强扫描:囊壁、分隔及结节于肾皮期明显强化,肾实质期及肾盂期密度降低,呈"快进快出"的强化模式。6例囊液不均,4例伴片絮状物。结论:囊性肾癌的CT表现具有一定特征,正确认识可及早确诊。     

Pericyst may be a new pharmacological and therapeutic target for hydatid disease

Background  Most hydatid cysts with calcified walls are biologically and clinically silent and inactive. Transforming growth factor-beta 1 (TGF-β1) plays a critical role in the calcification process of cells. The aim of this study was to assess the effect of modulating TGF-β1 signaling on the calcification of hydatid cysts.

Methods  Pericyst cells isolated from hepatic hydatid cysts were cultured with osteogenic media. These cells were assessed for alkaline phosphatase activity and mineralization capacity using Alizarin Red staining. Cells were also treated with recombinant human TGF-β1 and TGF-β inhibitor, and the expression profiles of osteoblast markers (RUNX2, osterix, and osteocalcin) were analyzed using Western blotting. The effects of inhibiting TGF-β1 signaling on calcification of pericyst walls were assessed using different doses of TGF-β inhibitor for 7 weeks in a preclinical disease model of liver cystic echinococcosis.

Results  Cells within the pericyst displayed high levels of alkaline phosphatase activity and mineralized nodule formation, as induced by osteogenic media. These activities, as well as expression profiles of osteoblast markers (RUNX2, osterix, and osteocalcin) could be inhibited by addition of recombinant human TGF-β1 (rhTGF-β1) and enhanced by TGF-β inhibitor. In the animal model of cystic echinococcosis, inhibition of TGF-β1 signaling increased calcification of the pericyst wall, which was associated with decreased cyst load index and lower viability of protoscoleces.

Conclusions  Cells within the pericysts adopt an osteoblast-like phenotype and have osteogenic potential. Inhibition of TGF-β1 signaling increases hydatid cyst calcification. Pharmacological modulation of calcification in pericysts may be a new therapeutic target in the treatment of hydatid disease.

     

肝脏泡状棘球蚴病的CT MRI表现

目的 分析肝脏泡状棘球蚴病CTMRI表现，评价CTMRI对肝包虫病的诊断价值。方法 回顾分析15例经CTMRJ诊断及手术病理证实的肝包虫病影像学资料。结果 15例共发现肝包虫囊肿17个。CT表现边界清晰或稍模糊的圆形或椭圆形不均匀密度减低区；大部分病灶可见钙化。MRI表现在T1加权像上边界清晰或稍模糊的圆形或椭圆形不均匀的低信号影，其内散在分布不规则的更低信号影。在T2加权像上，病灶呈不均匀高信号。病灶内的钙化在T1和T2加权像上呈条状、点状、斑片状无信号区（钙化）。增强扫描强化不明显。结论 CTMRI对肝包虫病有较高的诊断价值。     

出血性肾囊肿的CT诊断

分析经手术和病理证实的 19例出血性肾囊肿的CT征象。结果发现高密度出血灶 8例 ,可见特征性的低密度环征、囊肿隐没征、肾周筋膜增厚等 ;低密度出血灶 11例 ,见囊壁增厚 ,囊内容物密度不均匀。出血灶的CT值与病程相关。提示CT对高密度出血性肾囊肿有较大的诊断价值 ,对低密度出血性肾囊肿能提示诊断