放大内镜对胃黏膜幽门螺杆菌感染的可视性诊断价值

目的　探讨放大内镜用于胃黏膜幽门螺杆菌 (H .pylori)感染可视性诊断的可能性。方法　对 14 0例慢性胃炎患者应用OlympusGIFQ 2 4 0Z型放大内镜对胃黏膜微细结构形态进行观察和分型 ,以快速尿素酶试验和Warrthin Starry银染色检测H .pylori感染 ,分析两者之间的相互关系。结果　将胃窦黏膜小凹形态分为B型 (短棒状 )、C型 (树枝状 )、D型 (斑块状 )及E型 (绒毛状 ) 4种基本类型 ,C型小凹黏膜的H .pylori感染率 (5 8 3% ,2 1/ 36 )明显高于B型小凹黏膜 (36 3% ,2 9/ 80 ) (P <0 0 5 ) ,H .pylori阳性黏膜胃小凹常伴有开口扩张、表面发红等表现。胃体下部集合静脉形态可分为R(规则 )型、I(不规则 )型及D(消失 )型 ,3种类型的H .pylori感染率分别为12 2 % (9/ 74 )、6 0 % (9/ 15 )和 84 3% (4 3/ 5 1) ,R型与I型或D型比较有显著性差异 (P <0 0 1)。结论　放大内镜对胃黏膜H .pylori感染有一定可视性诊断价值     

内镜超声对上消化道黏膜下隆起病变的诊断价值

上消化道黏膜下隆起病变在临床上并不少见。X线上消化道钡餐检查和普通内镜常不能作出较准确诊断。近年开展的消化道超声技术介入内镜检查(EUS)，无疑提供了又一个重要的检查手段。我院应用EUS检查并就其对上消化道疾病的诊断价值作一比较。     

上消化道病变的双重造影和胃内镜的对照研究

上消化道的双重造影法已被普遍采用，胃内镜的问世不但能进行肉眼观察，而且能取活检进行组织学诊断，已显示了它在上消化道疾病诊断上的重要作用，为了了解双重造影与胃内镜的诊断能力及其优缺点，在国外已有不少对照研究的报道（1－3），对照研究的文章，常以胃内镜来核实X线的诊断正确性，本文试图通过手术病理证实的病例，客观对比两者的诊断能力，以提高认识，达到合理应用。     

放大色素内镜诊断早期胃癌及其癌前病变

目的研究放大色素内镜下胃黏膜萎缩、肠上皮化生、不典型增生和早期胃癌的小凹形态特点。方法利用Olympus GIF Q-240Z型电子放大内镜结合亚甲蓝染色对594例胃病患者的胃黏膜小凹进行观察,以黏膜红白色相间明显,白色区增多,白色区内小凹结构紊乱、消失为标准对黏膜萎缩进行内镜诊断,并在放大观察区域取活检送病理检查,与放大内镜下小凹形态进行对照。结果放大色素内镜对萎缩性胃炎诊断的敏感度为74．6％,特异度为90．4％,准确率为84．1％;轻度萎缩的黏膜白色区中心小凹稀疏、减少,周边的小凹无明显异常,萎缩较严重的区域小凹大面积消失,形成瘢痕样改变,周边小凹延长、迂曲明显;肠上皮化生黏膜亚甲蓝染色为淡染,小凹形态主要表现为绒毛状、斑块状和粗条纹状,其中绒毛状为最具有特征性的表现;不典型增生与早期胃癌都为亚甲蓝深染,小凹大小不等,形状不一,排列紊乱。结论胃黏膜萎缩、肠上皮化生、不典型增生和早期胃癌的小凹形态各有其特点,使用放大色素内镜有助于对病灶性质的判断和指导活检。     

电子线阵式超声内镜在上消化道黏膜下病变诊断中的作用

目的评估电子线阵式超声内镜（EUS）对上消化道黏膜下病变诊断价值。方法用电子线阵式超声内镜对138例上消化道黏膜下病变进行检查,并对其中17例行细针穿刺抽吸细胞学检查（EUS—FNA）。结果其中食管癌2例,胃淋巴瘤1例,黏膜下肿瘤113例,消化道壁外压迫22例。17例行细针穿刺抽吸细胞学检查（EUS—FNA）,其中14例取材成功可以进行病理诊断（82．5％）。结论电子线阵式超声内镜能满意的对上消化道黏膜下病变进行起源和初步定性诊断．结合细针穿刺抽吸细胞学检查能有效提高诊断的准确性。     

50例原发性胃淋巴瘤的内镜特征分析

目的:探讨原发性胃淋巴瘤(primary gastric lymphoma,PGL)胃镜下的特点,以期提高其在胃镜下诊断的准确率.方法:回顾性分析2010-04?2020-09经病理证实的50例PGL患者的病例资料,年龄10?81岁,平均(50.10士2.55)岁,患者均空腹≥6 h后口服盐酸达克罗宁胶浆后行白光内镜检...     

染色放大内镜下氩气凝固治疗直肠多发性息肉的护理体会

直肠息肉泛指直肠黏膜表面向肠腔突出的隆起性病变,包括有腺瘤、儿童型息肉、炎症息肉及息肉病等。从病理上来看,其内容不一,有的是良性肿瘤,有的是炎症增生的后果。但由于这些病变肉眼看来大体相似,很容易被忽视,且其癌变率较高,因此,积极诊治直肠多发性息肉,防止其癌变具有重要的临床意义。     

浅表型胃肿瘤的内镜形态学与病理学特征

目的探讨浅表型胃肿瘤的内镜形态学和术后病理结果的特征。方法回顾性分析38例浅表型胃肿瘤的内镜下形态、FICE和放大模式下及靛胭脂染色后病变黏膜结构的特点,结合病理结果进行归纳分析。结果 38例浅表型胃肿瘤表面结构、色泽、皱襞形态和组织学改变具有一定的特点,结合内镜染色及放大技术,有助于早期胃癌的诊断。结论充分认识浅表型胃肿瘤的形态学特点,结合组织学特征以及内镜不同诊断方法联合应用可提高早期胃癌检出率。     

胃小区、胃小沟形态改变的病理学基础及临床意义——X线、解剖镜及病理组织学对照研究

本文就210例胃双重造影,20例胃标本的解剖镜及显微镜观察与测量结果,讨论X线所示不同形态胃小区和小沟的病理组织学基础及临床意义。结果表明,X线所示胃小区和小沟形态变化的因素,主要有以下几个方面:胃小区增高扩大为小区部位粘膜增厚所致,引起粘膜增厚的原因为(1)胃粘膜重度肠化生,(2)腺体颈部增生,(3)粘膜肌锥形增生。胃小沟增宽的原因为(1)胃小区增高扩大时以中心部位较明显,当钡剂充填于小沟时,较低的小区周边部也被淹没,显示小沟增宽,(2)在部分胃粘膜的同一区域中的胃小区大小及高度极不相等,双重造影时,小而低的小区表面可能被钡剂掩盖而形成“小沟增宽”的假象。Ⅰ、Ⅱ型小区的病理改变主要表现为一般慢性浅表炎症,可称为炎性胃小区;Ⅲ、Ⅳ型小区的显示,可能是胃粘膜增生性病变的特点,以肠化生为主,可称为增生性胃小区。     

海水浸泡伤应激大鼠胃黏膜损伤与壁细胞泌酸的关系

目的　探讨应激状态下大鼠胃黏膜损伤与壁细胞泌酸状态的关系。方法　 32只SD大鼠随机分为 4组 ,即对照组、应激 1h组、应激 2h组、应激 3h组 (每组均为 8只 ) ,采用开放性腹部创伤并海水浸泡方法制作应激模型。检测胃液pH、胃黏膜溃疡指数 (UI) ,并取腺胃区胃黏膜制作光镜和电镜标本 ,观察胃黏膜的组织学改变和壁细胞的超微结构变化。结果　应激组大鼠胃黏膜损伤明显加重而胃液pH值明显降低 (P <0 0 1) ,二者之间呈明显负相关(r=- 0 70 0 35 ,P <0 0 1) ;电镜示对照组壁细胞呈静息状态 ,应激组壁细胞线粒体丰富 ,分泌小管扩张 ,绒毛密集 ,周围囊泡基本消失 ,呈明显分泌状态 ,尤以海水浸泡伤应激 3h组最明显。结论　海水浸泡伤可通过激活壁细胞促进胃酸分泌 ,从而加重急性胃黏膜病变的程度。     

Relationship between MR imaging and histopathologic findings of the brain in extremely sick preterm infants.

BACKGROUND AND PURPOSE: MR imaging can now be used safely in extremely preterm infants. The aim of this study was to compare the MR imaging appearance of the immature brain with neuropathologic findings at postmortem examination. METHODS: Seven extremely sick preterm infants, born at a median of 24 weeks' gestation, were studied using T1- and T2-weighted MR sequences. Infants died at a median of 3 days after initial MR imaging, and postmortem examinations were carried out. RESULTS: The cortex and germinal matrix were seen as areas of low signal intensity on T2-weighted images, which corresponded to their highly cellular histologic appearance. The periventricular and subcortical layers of white matter had a high signal intensity, corresponding to high fiber and relatively low cellular density; the intermediate layer of low signal intensity corresponded to a dense band of migrating cells. Regions of acute hemorrhage were seen as low signal intensity and regions of infarction as high signal intensity on T2-weighted images. One infant with mild periventricular leukomalacia had some low signal intensity on T1-weighted images, but no focal changes on T2-weighted images. Regions of neuronal mineralization, seen in association with infarction and capillary proliferation, within the basal ganglia and thalami were characterized by very low signal intensity on T2-weighted images and by very high signal intensity on T1-weighted images. There were no imaging abnormalities detected in regions with more subtle histologic abnormalities, such as increased glial or apoptotic cells. CONCLUSION: MR imaging can be used to observe normal developing brain anatomy in extremely premature infants; it can detect areas of hemorrhage and infarction within the developing brain, but conventional MR imaging may not detect more subtle histologic abnormalities.     

Gorham disease: correlation of MR findings with histopathologic changes

Gorham disease is a rare disorder of unknown etiology characterized by bone destruction and abnormal proliferation of thin-walled vascular channels including lymphatic capillaries. Starting monocentrically in a single bone, the angiomatous masses in this disease extend to adjacent bones and soft tissues without respecting articular barriers. Herein we report a case of Gorham disease with its MR and histopathologic appearance. Received 26 May 1997; Revised 8 October 1997; Accepted 17 February 1998     

良恶性孤立性纤维瘤的影像诊断及病理对照

目的 探讨良恶性孤立性纤维瘤的影像学特征及其与病理改变的相关性.方法 收集经手术病理证实并有完整影像学资料的孤立性纤维瘤20 例,分析其X线、CT或MRI资料,并与病理学结果进行对照研究.结果 20例孤立性纤维瘤患者中,胸部5例,腹部3例,脑部7例,四肢及软组织5例,其中4例出现复发,2例病理学诊断为恶性.肿瘤直径1.5~11 cm,大多数瘤体呈实性.2例行X线扫描,表现为软组织结节影,边界清晰.12例行CT扫描,瘤体多呈现为类圆形或有轻度分叶,边缘均较清楚,多数瘤体密度欠均匀,强化程度不等.6例行MRI检查,T1WI及T2WI上均呈不均匀等或稍低信号,增强扫描可见强化.2例恶性肿瘤CT或MRI示大片坏死或富含黏液区域.结论 孤立性纤维瘤是一种可发生于全身各部位的梭形细胞肿瘤,病理学表现为致密区与稀疏区交替分布,影像学检查有特征性.     

Radiofrequency ablation in a porcine lung model: correlation between CT and histopathologic findings

OBJECTIVE: The objective of our study was to investigate the time course changes of the ablated lesion after radiofrequency ablation in the porcine lung and the correlation between CT and histopathologic findings. CONCLUSION: Ground-glass attenuation on CT led to overestimation of the size of necrotic lesions. The layered structural findings on CT were consistent with the histopathologic findings. Although CT findings reflect the histopathologic findings, attention should be paid to the dissociation of ablated lesions and high-density areas in clinical interpretation of CT images.     

Hyperoxia-induced diffuse alveolar damage in pigs: correlation between thin-section CT and histopathologic findings

PURPOSE: To determine whether lung abnormalities at thin-section computed tomography (CT) in experimental hyperoxic lung injury correlate with the pathologic phases of diffuse alveolar damage (DAD). MATERIALS AND METHODS: Eighteen juvenile pigs were exposed to more than 80% oxygen-for 24, 48, 72, 96, or 120 hours-or room air in sealed cages. Their removed lungs were inflated with air infused through the trachea and examined with thin-section CT. Two independent observers, without knowledge of the exposure times, compared 63 areas selected on the CT scans with the corresponding pathologic and histologic findings, which were evaluated independently by two pathologists. RESULTS: CT findings correlated well with histologic findings (rho = 0.86, P <.001), which corresponded to the pathologic phases of DAD. All areas of normal CT attenuation, eight of nine spared regions within areas of opacity, and two of 15 areas of ground-glass opacity corresponded to the early exudative pathologic phase of DAD. All areas that showed traction bronchiolectasis at CT corresponded to the early proliferative pathologic phase. There was good observer agreement regarding the interpretation of CT findings (kappa statistic, >0.60) and histologic results (>/=0.70). CONCLUSION: Thin-section CT findings reflect the pathologic phases of DAD, although the early exudative phase cannot be specifically depicted by thin-section CT. Traction bronchiolectasis on a CT scan suggests progression to the proliferative phase.     

放大内镜及实体显微镜对结肠肿瘤性病变检查的意义

目的 探讨如何通过放大内镜和实体显微镜观察分析大肠息肉腺管开口类型,从而发现早期大肠癌及癌前病变。方法 2001年8月-2002年2月结肠镜检查139例大肠病变。采用内镜下黏膜染色技术,结合放大内镜、实体显微镜观察腺管开口分型(pit pattem)并与病理诊断对照。结果 139例患者中发现大肠息肉124例,进展期癌9例,LST型病变5例。5例LST的直径为10-50mm,其中ⅢL型1个,Ⅳ型4个。本组采用放大内镜与病理、实体显微镜诊断的符合率高。结论 大肠腺管开口对于判断肿瘤性、非肿瘤性病变以及早期大肠癌具有重要意义,如发现有V型腺管开口则高度提示早期癌的可能。     

Leiomyosarcoma of sacrum: imaging and histopathologic findings

European Radiology - A rare case of low-grade primary leiomyosarcoma of the sacrum is described in a young woman who suffered from pain in the right sacroiliac region. A lytic sacral mass was...     

Metabolic lung disease: imaging and histopathologic findings

Metabolic lung disease includes pulmonary alveolar proteinosis (PAP), pulmonary amyloidosis, metastatic pulmonary calcification, dendritic pulmonary ossification, pulmonary alveolar microlithiasis, and storage diseases. In pulmonary alveolar proteinosis, CT demonstrates air-space consolidation with thickened interlobular septa, producing the so-called "crazy paving" appearance. Pulmonary amyloidosis can appear as parenchymal nodules (nodular parenchymal form), diffuse interstitial deposit (diffuse interstitial form), or submucosal deposits in the airways (tracheobronchial form). Metastatic pulmonary calcification may appear on high-resolution CT as numerous 3- to 10-mm diameter calcified nodules or, more commonly as fluffy and poorly defined nodular opacities. In pulmonary microlithiasis, high-resolution CT demonstrates diffuse punctuate micronodules showing slight perilobular predominance resulting in apparent calcification of interlobular septa. Niemann-Pick disease appears as ground-glass attenuation in the upper lung zone and thickening of the interlobular septa in the lower lung zone. Radiologic study including high-resolution CT will be helpful for the diagnosis and follow-up of these diseases.     

Metastatic myxoid liposarcomas: imaging and histopathologic findings

Objective The objective was to describe the imaging and histopathologic characteristics of metastatic myxoid liposarcomas. Materials and methods This retrospective study was approved by the institutional review board and complied with HIPAA guidelines. The study group comprised 12 patients with metastatic myxoid liposarcoma who underwent MRI, CT, or FDG-PET. The location and imaging characteristics of the metastatic lesions were recorded, and the histopathology of all metastatic lesions was reviewed. Results There were 23 histologically proven metastases in 12 patients. Based on imaging criteria, there were 41 metastases. The mean time from the diagnosis of primary tumor to the first metastasis was 4.4 years. Sixty-seven percent of patients had bone and soft tissue metastases, 33% had pulmonary metastases, 33% had liver metastases, 25% had intra-abdominal, and 16% retroperitoneal metastases. CT demonstrated well-defined lobulated masses with soft tissue attenuation in all cases, without macroscopic fat component. In cases of osseous metastases, CT showed mixed lytic and sclerotic foci, with bone destruction in advanced cases. MRI demonstrated fluid-like signal intensity with mild heterogeneous enhancement in cases of soft tissue metastases. In osseous metastases, MRI showed avid heterogeneous enhancement. FDG-PET showed no significant FDG uptake for all metastases. MRI was the most useful imaging modality for osseous and soft tissue metastases. Conclusion Myxoid liposarcomas are soft tissue sarcomas, with a high prevalence of extrapulmonary metastases. The bones and soft tissues were the most common site of involvement, followed by the lungs and liver. MRI was the most sensitive modality in the detection of osseous and soft tissue metastases, and is the recommended modality for the diagnosis and follow-up of bone and soft tissue involvement.