原发乳腺黏液纤维肉瘤1例

本文报道了1例经手术病理证实的乳腺黏液纤维肉瘤。患者女, 69岁, 因乳房发现无痛性肿块3个月余就诊。乳腺X线摄影示右侧乳腺外上象限高密度肿物, 边缘浅分叶, 病灶大部分边界清晰, 前缘略模糊, 未见钙化。超声示右侧乳腺9点位低回声肿物, 边界清晰, 形态欠规则, 内部回声欠均匀, 可见点状强回声及索条状增强回声;彩色多普勒超声示肿物内部及周边探及点条状血流信号。MRI示右侧乳腺外上象限肿块, 浅分叶, T1WI呈低信号, T2WI短时间反转恢复序列呈高信号, DWI呈不均匀高信号, 增强后呈早期花环样至弥漫强化方式, 肿块外侧缘及胸大肌前缘网格状强化, 信号强度曲线呈平台/流出型, 表观扩散系数为1.5×10-3～1.8 ×10-3 mm2/s。术后病理:乳腺黏液纤维肉瘤(中度分化)。     

腹壁外韧带样瘤MRI诊断探讨

目的：讨论腹壁外韧带样瘤的MRI平扫及增强扫描的表现，评价MRI对该病的诊断价值。方法：回顾分析5例经手术切除及病理证实的腹壁外韧带样瘤的术前MRI平扫及增强扫描表现，其中2例同时行CT平扫，3例同时行血管造影。结果：5例腹壁外韧带样瘤均位于四肢肌肉及软组织，年龄11岁～28岁，其病灶MRI表现为在T1WI上，肿物呈中等信号，其间可见条片状及斑点状低信号，在T2WI上则呈高信号，其间夹杂中等、稍低及更低的条片状、斑点状信号，后与在T1WI上所见的低信号相吻合。增强扫描后在平扫中呈等T1、长T2或长T1、长T2信号改变的区域均强化非常明显，而在T1WI及T2WI上均呈条片状、斑点状低信号区域则未见强化，5例病灶周围组织均未见水肿，3例邻近骨出现压迫性改变，2例CT显示病灶密度欠均匀，边界清晰，3例血管造影可见肿瘤染色明显。结论：MRI可以较为精确的显示腹壁外韧带样瘤的病灶形态及范围，对韧带样瘤的诊断与鉴别诊断有重要价值，是目前最好的影像学检查方法。     

乳腺良性病变的钼靶X线、磁共振表现对照分析

目的 探讨乳腺良性病变的钼靶X线、MRI表现与病理结果的关系.方法 回顾性分析48例乳腺良性病变的钼靶X线、MRI表现特征,并与病理结果对比研究.结果 48例中乳腺纤维腺瘤18例,乳腺增生症12例,双乳多发囊肿8例,乳腺腺病伴慢性炎症8例,2例脂肪瘤.乳腺良性病变乳腺结构及局部血管多正常,边缘清晰而光滑,密度均匀.钙化点形态较规则,边缘光滑,颗粒稍大,清晰,数量少,可成簇生长,也可弥散在腺体的一个区内.MRI T1WI表现多为边缘光滑的圆形、卵圆形或片状均匀等或低异常信号,T2WI等或稍高信号.4例增强扫描病变呈明显均一强化.结论 乳腺钼靶摄影是乳腺良性病变检查的首选方法,而磁共振成像可提高诊断准确率.     

乳腺泌乳腺瘤影像学表现1例

该文报道了1例乳腺泌乳腺瘤患者的临床及影像学表现。患者于妊娠早期无意扪及左乳肿物, 无痛, 不伴乳头溢液, 产后10 d肿物增大至10 cm×7 cm, 触诊质硬, 活动度可。超声表现为团块状低回声区, 边界清, 内部回声欠均匀, 彩色多普勒超声示分支状血流信号。乳腺X线摄影表现为边界清晰的巨大肿块, 呈等腺体密度。MRI表现为椭圆形巨大肿块, 边界清晰, T1WI呈等低信号, T2WI呈不均匀高信号, 扩散加权成像表观扩散系数图显示扩散受限不显著, 增强扫描内部强化不均匀, 时间-信号强度曲线呈流入型。肿物切除术后病理结果证实为泌乳腺瘤。     

长骨血管瘤的影像诊断

目的 分析长骨血管瘤的影像特征,旨在提高其诊断水平.方法 回顾性分析经手术病理证实的18例长骨血管瘤患者的X线平片(14例)、CT(9例)及MRI(6例).结果 18例长骨血管瘤中髓型10例、骨膜型5例、皮质内型3例.X线表现:髓型8例,其中3例表现为典型的蜂窝状,3例为溶骨性病灶周围骨质硬化明显,单纯溶骨、毛玻璃样密度各1例;骨膜型3例,表现为骨皮质增厚、硬化;皮质内型3例,表现为边界清晰的溶骨性病灶.CT表现:髓型6例,表现为溶骨膨胀型病灶5例,其中3例可见薄厚不一的硬化边,蜂窝状骨嵴影2例,骨皮质呈筛孔状1例,垂直于骨皮质的放射状骨膜增生2例;毛玻璃样密度1例.2例骨膜型表现为骨皮质均匀增厚1例,不规则骨膜增厚1例,局部髓腔狭窄消失.1例皮质内病变表现为病灶呈均匀软组织密度,局部皮质膨胀、增厚.MRI表现:2例显示髓腔内斑片状T1WI稍低信号,T2WI均呈稍高信号,边界清晰;1例T1WI及T2WI均呈等或稍低信号,病灶与正常组织分界不清;1例显示病灶突破局部骨皮质,肿物向外突出,外突肿物及相连髓腔部分T1WI呈稍低信号,T2WI呈高信号;2例显示骨膜增厚,其中1例呈等信号,1例无信号;2例周围肌肉组织内可见不均匀斑片状长T2信号,T1WI与肌肉组织呈等信号.结论 长骨血管瘤的囊性蜂窝状X线表现较为特征型;CT及MRI有助于长骨血管瘤的诊断.     

长骨血管瘤的影像诊断

目的 分析长骨血管瘤的影像特征,旨在提高其诊断水平.方法 回顾性分析经手术病理证实的18例长骨血管瘤患者的X线平片(14例)、CT(9例)及MRI(6例).结果 18例长骨血管瘤中髓型10例、骨膜型5例、皮质内型3例.X线表现:髓型8例,其中3例表现为典型的蜂窝状,3例为溶骨性病灶周围骨质硬化明显,单纯溶骨、毛玻璃样密度各1例;骨膜型3例,表现为骨皮质增厚、硬化;皮质内型3例,表现为边界清晰的溶骨性病灶.CT表现:髓型6例,表现为溶骨膨胀型病灶5例,其中3例可见薄厚不一的硬化边,蜂窝状骨嵴影2例,骨皮质呈筛孔状1例,垂直于骨皮质的放射状骨膜增生2例;毛玻璃样密度1例.2例骨膜型表现为骨皮质均匀增厚1例,不规则骨膜增厚1例,局部髓腔狭窄消失.1例皮质内病变表现为病灶呈均匀软组织密度,局部皮质膨胀、增厚.MRI表现:2例显示髓腔内斑片状T1WI稍低信号,T2WI均呈稍高信号,边界清晰;1例T1WI及T2WI均呈等或稍低信号,病灶与正常组织分界不清;1例显示病灶突破局部骨皮质,肿物向外突出,外突肿物及相连髓腔部分T1WI呈稍低信号,T2WI呈高信号;2例显示骨膜增厚,其中1例呈等信号,1例无信号;2例周围肌肉组织内可见不均匀斑片状长T2信号,T1WI与肌肉组织呈等信号.结论 长骨血管瘤的囊性蜂窝状X线表现较为特征型;CT及MRI有助于长骨血管瘤的诊断.     

颅底软骨肉瘤的CT和MRI诊断

目的 分析颅底软骨肉瘤的CT和MRI表现，探讨CT和MRI的诊断价值和限度。资料与方法搜集经病理组织学证实的12例颅底软骨肉瘤，均行CT及MRI平扫。其中8例行MRI增强扫描。结果 11例CT上可见不同程度的钙化，MRTlWI呈低等信号，T2WI呈不均匀高信号；1例CT表现为囊性低密度，伴有高密度点状出血灶，T1WI呈以低信号为主夹杂高信号出血灶，T2WI呈均匀高信号，边界清晰。8例MRI增强扫描均表现为不均匀强化，信号及密度改变与病理相符。结论 颅底软骨肉瘤的CT和MRI表现与病理相符。CT和MRI是诊断颅底软骨肉瘤的有效方法。     

炎性乳癌的MRI表现特征及鉴别诊断

目的探讨炎性乳癌的MRI表现特征。方法临床触诊阳性在X线表现均呈非对称局限致密影的10例患者,行乳腺MR检查并经手术病理证实的炎性乳癌,依据乳腺影像报告和数据系统(BI-RADS)MRI标准,回顾性分析病变形态学,T1WI及T2WI信号强度,强化特征及动态增强曲线类型。结果 10例在MRI上表现为:肿块型4例,非肿块样强化6例,动态增强后呈大片及团片状不均匀强化,呈区域性分布3例,弥漫性分布3例,病变部位在中心区4例,在背侧2例,早期强化明显9例,T2WI信号呈低信号7例,等信号3例,动态增强后时间-信号呈流出型6例,平台型4例;间接征像:乳腺较健侧增大4例,乳头凹陷8例,弥漫性皮肤增厚10例,以乳晕后及乳腺内下侧明显6例,皮下脂肪层浑浊10例,凿突征6例,乳后间隙模糊或消失5例,胸大肌浸润(脂肪层中断3例,病理性增强3例),血管较健侧增多,增粗7例,腋下淋巴结病理性增大4例。结论 MR乳腺多参数成像和动态增强联合使用,可对炎性乳癌术前作出正确诊断。     

全数字化乳腺摄影与MRI对乳腺恶性病变诊断的对比分析

目的 探讨乳腺癌全数字化乳腺摄影(full-field digital mammography,FFDM)与乳腺MRI的影像学表现,评价其对乳腺癌的诊断价值.方法 收集68例经穿刺或手术病理证实的乳腺癌病例,对比分析其X线摄影及MRI表现.全数字化乳腺摄影采用常规方法摄片,MRI采用自旋回波T1WI,T2WI序列及动态增强扫描等.结果 68例乳腺恶性肿瘤中,浸润性导管癌57例,浸润性小叶癌3例,叶状囊肉瘤1例,血管肉瘤1例,导管内癌2例,炎性乳癌2例,印戒细胞癌1例,Paget's病1例.乳腺X线摄影诊断正确61例,诊断准确率89.7％.MRI诊断正确66例,诊断准确率97.1％.结论 乳腺X线摄影是乳腺恶性病变的首选检查方法,MRI能更多的显示乳腺病灶的内部特征,二者联合应用对乳腺癌的临床诊断具有重要意义.     

Imaging features of chondrosarcoma

目的:探讨软骨肉瘤的影像学表现,提高对本病诊断的准确性.方法:回顾性分析25例经手术病理证实的 软骨肉瘤的X线、CT和MRI资料.结果:25例软骨肉瘤中原发23例,其中普通型20例,去分化型、黏液型及透明细胞型 各1例;继发2例.X线及CT表现:原发的23例中溶骨性骨破坏5例,混合性骨破坏18例,形成软组织肿块20例.其中 表现为低密度19例,等密度1例.20例普通型及1例黏液型见散在钙化.MRI表现:普通型软骨肉瘤T1 WI呈等或稍低 信号,T2WI呈等或稍高信号;黏液型T1WI呈等、低混杂信号,T2WI呈稍高、低的混杂信号,钙化T2WI呈低信号;透明细 胞型病例T2WI及T2WI呈近乎等信号;去分化型T1WI呈等低混杂信号,T2WI呈不均匀高信号.6例普通型及1例继 发型出现环形、间隔样中等一明显强化,黏液型及去分化型呈不均匀中等一明显强化.结论:普通X线及CT是软骨肉瘤影 像诊断及鉴别诊断的主要手段,MRI显示软骨信号为重要提示.MRI显示病变范围更为清楚、准确.为临床治疗提供可 靠依据.     

补体受体1型的结构功能及sCR1基因克隆表达的策略

补体受体1型（Complement receptor type 1,CR1）具有外源性及内源性活性,既可灭活组装于非自身细胞膜上的C3/C5转化酶,也可灭活自身细胞膜上形成的C3/C5转化酶。CR1是唯一既对经典,替代及植物凝集素（MBL）3个补体激活途径的,对C3/C5转化酶拥有衰变加速活性,又有辅助1因子裂解C3b和C4b作用的补体调节蛋白。对补体分子的过度活化具有抑制和调节作用,在防治补体介导的缺血再灌注损伤以及异种器官移植超急性排斥反应等疾病具有广阔的应用前景。本文主要综述CR1的结构功能及生物学活性,sCR1基因的克隆与表达及在创伤、缺血再灌注损伤中的应用研究现状。     

Possibilities and limitations of radiology--CT and MRT in cases of tumors of the uterus and ovary

The author describes the present possibilities of computed tomography (CT) and of magnetic resonance (MR) tomography. MR is superior to CT in the visualisation of carcinomas of the cervix and endometrium, especially in the initial stages, whereas in the diagnosis of the spread of tumours (especially the advanced ones) CT yields results similar to those of MR. In carcinoma of the ovary, however, MR has so far not proved to be definitely superior to CT despite the multiplanar visualisation possibilities it offers. It is in fact inferior to CT especially in clarifying the extent of extrapelvic spread. In posttherapeutic diagnostics MR explores new avenues in respect of delineation between scar and recurrence, as initial investigations have shown.     

Science and medicine of canoeing and kayaking

Canoeing and kayaking are upper-body sports that make varying demands on the body, depending on the type of contest and the distance covered. The shorter events (500 m) are primarily anaerobic (2 minutes of exercise), calling for powerful shoulder muscles with a high proportion of fast-twitch fibres. In contrast, 10,000 m events call for aerobic work to be performed by the arms. Such contestants need a high proportion of slow-twitch fibres, and an ability to develop close to 100% of their leg maximum oxygen intake when paddling. In slalom and whitewater contests, the value of physiological testing is somewhat limited, since performance is strongly influenced by experience and the ability to make precisely judged rapid paddling efforts under considerable emotional stress. Paddlers face dangers from their hostile cold water environment; causes of fatalities (drowning, cardiac arrest, ventricular fibrillation and hypothermia) are briefly reviewed. Medical problems include provision of adequate nutrition and a clean water supply, effects of repeated immersion (softening of the skin, blistering, paronychial infections, sinusitis, otitis), varicose veins (secondary to thoracic fixation) and hazards of exposure to fibreglass and polystyrene in the home workshop. Surgical problems include muscle sprains and mechanical injuries (haemotomas, lacerations, contusions, concussion, and fractures).     

Accuracy of digital and film panoramic radiographs for assessment of position and morphology of mandibular third molars and prevalence of dental anomalies and pathologies

OBJECTIVES: To compare the accuracy of digital and film panoramic radiographs for determining (1) the position and morphology of mandibular third molars before surgical removal and (2) the prevalence of dental anomalies and pathologies. METHODS: Three hundred and eighty-eight third mandibular molars were available for examination. Position and morphology of third molars observed on film radiographs and on digital panoramic images from five systems (DenOptix, DigiDent, Digora, Dimax2 and Orthophos Plus) were recorded by two observers and were compared with surgeons' findings at the time of the operation (gold standard). One observer further recorded the prevalence of dental anomalies and pathologies on both imaging modalities. RESULTS: Few differences were found between the digital and film-based panoramic systems in the assessment of accuracy of position and morphology of mandibular third molars. The prevalence of dental anomalies and pathologies determined with the two modalities was roughly similar. CONCLUSION: The five digital panoramic systems evaluated in this study were equally as useful for third molar treatment planning and diagnosis of dental anomalies and pathologies as conventional film-based panoramic radiographs.     

闭合性喉气管断裂伤的诊断与治疗

目的 提高对闭合性喉气管断裂伤的诊治水平.方法 报告38例闭合性喉气管断裂伤病例的临床资料,其中急性外伤16例,陈旧性外伤22例.对临床易发生的问题进行分析.结果 38例中16例急性喉外伤在24～48小时之间行手术治疗,22例陈旧性喉外伤因其它原因在32～129天后行手术治疗.35例手术成功拔管,3例因喉气管狭窄手术失败不能拔管,均为陈旧期手术患者.结论 对于急性闭合性喉气管断裂伤应根据其病情轻重程度进行早期处理,尽快恢复喉和气管通气功能,预防后遗症及并发症的发生,提高治愈率.     

快餐消费者的消费行为心理及对营养的认知调查

 目的 调查分析快餐消费者对快餐的营养认知、消费行为和消费心理情况,引导消费者正确处理快餐与日常正餐的关系。方法 采用随机抽样的方法,选择北京地区中、西式快餐各3个品牌,每个品牌选择4家分店,采用入店访问式现场调查方法,数据处理采用频数分析法。结果 共调查1722名,问卷合格率98.6%,选择中西式快餐的人群多为20～39岁者(68%),大多数消费者因为“口味喜欢”(66.4%)而选择快餐,且优选“优惠套餐”(48.2%),为了“省事方便”(64.3%)。消费快餐的频率多数是每月就餐1～2次(35.1%),多数优选“西式快餐店的中式食品”(60.3%),对中西式快餐店中的健康宣传语 “偶尔看看”(55.9%),但多数认为起到了“警示和营养宣教的作用”(64.1%)。大多数消费者认为,媒体对西式快餐的报道未影响他们对西式快餐的正常消费(44.9%);但中式快餐的负面报道却影响了消费者的正常消费(43.9%),理由多数是“影响健康”(37.9%)。快餐消费人群中体型正常者居多,但40岁以上者超重百分比大于20～39岁者。结论 中西式快餐消费人群为20～39岁者,消费频率不高,多数因为“口味喜欢”而选择中式或西式快餐,基本不存在对中式或西式快餐食品安全误解的问题,对快餐店的营养健康宣传语持赞同态度,但如何处理快餐与正常餐的搭配问题,存在误区。