骶骨部原发性恶性黑色素瘤的CT与MRI表现4例报告

骶骨部原发性恶性黑色素瘤极为少见,且无明显特异影像学表现,最终诊断只有依靠手术后病理证实,作者对1990~2003年间4例临床资料的主要CT与MRI表现进行如下分析。     

骶骨部原发性恶性黑色素瘤的CT与MRI表现4例报告

骶骨部原发性恶性黑色素瘤极为少见，且无明显特异影像学表现。最终诊断只有依靠手术后痛理证实，作者对1990-2003年间4例临床资料的主要CT与MRI表现进行如下分析。     

儿童脱髓鞘病的临床及头颅磁共振特点(附38例报道)

目的: 探讨儿童脱髓鞘病临床及头颅磁共振特点。方法: 对38例儿童脱髓鞘病进行回顾性分析。结果: 多发性硬化20例,急性播散性脑脊髓炎18例;头颅MRI检查全部异常,表现为白质、基底核、脑干和小脑T₁W₁等信号、低信号病灶和T₂W₁高信号病灶。结论: 儿童脱髓鞘病临床表现多样化,MRI可作为早期诊断手段。     

病毒性脑炎的核磁共振成像、扩散加权成像和质子MR波谱表现

目的 探讨病毒性脑炎的核磁共振成像(magnetic resonance imaging,MRI)、扩散加权成像(diffusion weighted imaging,DWI)和质子MR波谱(1H magnetic resonance spectroscopy,1H-MRS)表现. 方法 36例病毒性脑炎在急性或亚急性阶段接受了常规MRI、DWI及2D 1H-MRS检查.总结病毒性脑炎常规MRI、DWI及 1H-MRS表现特点,比较病毒性脑炎和对侧正常脑组织的表观弥散系数值(ADC)、胆碱(Cho)、N-乙酰天门冬氨酸(NAA)、肌酸(Cr)差异有无统汁学意义.结果病灶表现多发22例,单发14例,可累及皮层、皮层下、侧脑室周围白质以及基底节-丘脑区.T1WI呈稍低信号,T2WI呈高信号,可有轻度斑片状强化.DWI上呈等或稍高信号11例,均匀高信号4例,不均匀高信号21例.ADC伪彩图上26例扩散加快,另外10例扩散加快与受限同时存在.病毒性脑炎ADC值[(0.93±0.29)×10-3 mm2/s]较对侧腑白质[(0.76±0.32)×10-3mm2/s]升高,差异有统计学意义(P=0.007).病毒性脑炎的Cho、Cr和NAA分别为(364.3±56.3)、(178.4±28.2)、(203.7±33.8),较对侧[分别为(440.2±52.8)、(269.3 ±37.5)、(386.5±68.5)]相应波峰降低,差异有统计学意义(P<0.01,P<0.05),有3例见Lac峰. 结论 DWI、1H-MRS反映了病毒性脑炎的组织及代谢特点,是常规MRI有益的补充.     

结外淋巴瘤的临床特点及治疗分析(附68例报告)

目的 探讨并评价结外淋巴瘤的临床特点及其治疗效果,为进一步提高临床疗效提供理论依据.方法 回顾性分析2012年1月至2014年3月我院收治的68例结外淋巴瘤患者的临床资料,分析患者的确诊时间、首发症状、发病部位、病理分型、临床分期和生存预后.结果 68例患者出现症状至病理检查确诊时间平均(7.63±1.25)个月.首发症状以胃肠道症状、咽喉和口鼻部症状、局部症状为主.发病部位前3位分别是胃肠道、咽和(或)扁桃体、鼻腔,分别占23.53％(16/68)、20.59％(14/68)、17.65％(12/68).病理分型:免疫分型,B细胞淋巴瘤44例,占64.71％(44/68);T细胞淋巴瘤24例,占35.29％(24/68).临床分期:Ⅰ期20例,占29.41％;Ⅱ期17例,占25.00％;Ⅲ期16例,占23.54％;Ⅳ期15例,占22.06％.68例患者经过治疗后,1年后生存率为79.42％(54/68),3年后生存率为51.47％(35/68).结论 临床对疑似结外淋巴瘤的患者应早期诊断,在诊疗过程中应该重视其临床特点以减少误诊率和漏诊率,应准确定位、分型、分期以尽早确定合理方案进行治疗,以期提高结外淋巴瘤患者的生存率.     

儿童癫痫54例临床特点及治疗体会

目的：探讨小儿癫痫的临床特点及治疗。方法：对经临床及脑电图诊断为癫痫的54例患儿进行临床观察，并根据发作类型选药；采用丙戊酸钠(VPA)或卡马西平(CBZ)单药治疗，并监测药物浓度及随访脑电图(EEG)。结果：临床表现为全身性发作37例，局灶性发作17例。37例单用VPA治疗，6个月后发作获完全控制，VPA平均血药浓度89．2mg/L；17例单用CBZ治疗，6个月后获完全控制，CBZ平均血药浓度6．37mg/L。治疗前EEG异常52例，治疗后恢复34例。结论：小儿癫痫的发作形式多种多样，具有反复发作、暂时性的特点。丙戊酸钠或卡马西平单药治疗小儿癫痫具有良好的疗效，血药浓度监测对治疗有指导作用，脑电图不能作为判定疗效的唯一指标。     

Sinonasal and nasopharyngeal adenoidcystic carcinoma: report of four cases

Four cases of sinonasal and nasopharyngeal adenoidcystic carcinoma that came to the RIMS Hospital, Imphal during the period of July, 2002 to March, 2003 are reported in this article. The age incidence ranged from 30 to 80 years and the mean age was 47.5 years; with male to female ratio of 1:1. The average duration from first sympton in the patient to the date of his medical consultation was 17.8 months. Nasal obstruction was the first symptom two cases; lump sensation in the throat and headache in the third and fourth cases respectively. Despite the evidence of rapid and extensive local spread there were definitely delays from the patients' end to consult a clinician. Whereas the tumour itself is not common, the usual sites, if it occurs, are palate and minor salivary glands and rarely mucous and seromucinous glands elsewhere.     

脑囊尾蚴病81例磁共振分析

目的: 探讨脑囊尾蚴病的临床及磁共振(MRI)特点。方法: 对81例脑囊尾蚴病患者的临床资料和头颅MRI进行回顾性分析。结果: 81例脑囊尾蚴病头颅MRI表现分为脑实质型73例、脑室型5例和混合型3例;活虫期、退变死亡期、非活动期及混杂期四期,以脑实质型和退变死亡期最常见。杀虫治疗一般需要3~5个疗程。结论: 头颅MRI可以对脑囊尾蚴病进行准确分型、分期,为用药及疗程的确定提供依据,还可用于CT检查阴性的脑囊尾蚴病的确诊。     

Pulmonary infections mimicking cancer: report of four cases

Lung infections infrequently simulate cancer, and their differentiation, based on imaging findings, can sometimes be difficult. The infections may be fungal, mycobacterial, parasitic or, rarely, viral. A biopsy is required to prove the infectious nature of the lesions. A specific diagnosis is necessary for initiation of appropriate therapy. We report four cases of chronic pulmonary infections, which were wrongly diagnosed as bronchogenic carcinoma based on radiological features. We also reviewed the existing literature.     

Pulmonary alveolar microlithiasis: report of four familial cases

Pulmonary alveolar microlithiasis (PAM) is a rare disease. There have been only about 400 cases reported internationally since it was first described by Feidirch in 1856 PAM has familial tendency, but there are few reports of four cases in one family.     

Secondary syphilis-related oral ulcers: report of four cases

Establishing a diagnosis of syphilis, whatever the stage of the disease, can be difficult because syphilis is a great mimic in clinical morphology and histology. Many patients infected with venereal diseases have oral manifestations, but very few dentists and physicians have the proper experience to diagnose syphilis or other STDs from oral lesions. Oral secondary syphilis appears to be very uncommon, and few cases have been reported over the recent past. We present 4 patients who developed secondary syphilis-related oral lesions of moist ulcers, irregular linear erosions termed 'snail-track' ulcers, or erythematous mucous patches on the labial mucosa, buccal mucosa, palate, or tongue. Concurrent human immunodeficiency virus (HIV) infection was diagnosed in 1 patient. The histological examination in 2 patients showed dense subepithelial inflammatory cell infiltration comprised predominantly of plasma cells, and it was of practical help in the diagnosis of syphilis. The diagnostic value of a histological examination, serologic tests, and treatment of syphilis are discussed. Obviously, coinfection with HIV will complicate the clinical presentation, diagnosis, and management of syphilis. Concurrent HIV infection should be considered in any patient with a sexually transmitted disease including syphilis.     

Myxoid adrenal cortical tumor: report of four cases

Myxoid adrenocortical neoplasms are rare. Surgical resection of the mass is the first-line therapy. Here we reported a total of four patients, aged 44–66 years, diagnosed with myxoid adrenocortical tumor. The clinical characteristics and immunohistochemical features of the tumor are discussed in the current literature.

     

4例心脏创伤的抢救体会

在各类外伤病人中，心脏创伤较为少见，多在现场或战场中死亡。我院自1982～1999年收治4例心脏创伤患均获痊愈，报告如下：     

地震伤226例救治特点与分析

我国是世界地震发生频繁国家，建国以来地震死亡人数高达27万余人。2008年5月12日，四川汶川发生8．0级特大地震。重创了四川山区十几个县，波及16个省，受灾面积覆盖了4571万人口。造成了历史罕见的重大人员伤亡，死亡及失踪人员近10万人。2008年5—7月我院收治226例地震伤员，现将救治特点分析如下。     

骶神经根囊肿的影像学特点及治疗

探讨骶神经根囊肿的临床表现及影像学特点。方法对６８例骶神经根囊肿的临床表现及ＭＲ、ＣＴ（１６例）、脊髓造影（２９例）和Ｘ线平片等影像学特征进行总结,分析。探讨了病因和治疗方法。结果本病的临床特点是腰骶部疼痛伴骶神经压迫症状;     

Superficial cervicovaginal myofibroblastoma: report of four cases and literature review

In 2001, Laskin et al firstly described a series of 14 seemly distinctive mesenchymal tumors that occurred exclusively in the superficial lamina propria of the vagina and cervix of middle to old-aged women. They proposed the term ＂superficial cervicovaginal myofibroblastoma （SCVM）＂ to highlight the unique features of this tumor： the superficial subepithelial location and myofibroblastic differentiation of the minor cells. SCVM appears less well recognized with only three additional reports have been documented in the English literatures.24 In this study, we described four new cases of SCVM to further characterize the clinical and pathological features of this rare entity.