支气管扩张症的CT诊断价值

支气管扩张(Bronchiectasis)是指支气管及其周围肺组织的慢性炎症损坏管壁,以致支气管树不可恢复性的变形扩张的一种肺内基本病变[1].本文对我院CT诊断的40例资料完整的支气管扩张病例进行回顾总结,结合文献对其CT检查价值及诊断进行评价和探讨.     

螺旋CT在支气管扩张症诊断中的应用研究

目的：评价螺旋CT在肺段水平诊断支气管扩张症（支护）的价值。方法：对30例临床和X线疑为支扩的患者共540个肺段分别进行10mm层厚和薄层（1－3mm）螺旋CT扫描,其中10例共180个肺段与支气管造影进行了比较。两位观察者用盲法对不同层厚的螺旋CT扫描和支气管造影进行评价。结果：根据诊断标准并计算kappa值,两位观察者对支扩评价的一致性很好（k值分别为0．96,0．98）。以支气管造影为金标准,螺旋CT10mm层厚扫描诊断支扩的敏感性,特异性,准确性HRCT相比,薄层螺旋CT扫描对诊断支扩有更大的优越性,对临床疑支扩的患者,应首选螺旋CT检查。     

支气管扩张的CT诊断(附46例分析)

本文收集我院1993年～2001年期间46例支气管扩张的CT资料，现报告并分析如下。     

Differential diagnosis of bronchiectasis: high-resolution CT as a valuable aide

Bronchiectasis is defined as localized irreversible dilatation of the bronchial tree. Brochiectasis has been associated with a wide variety of causes, but it is mostly caused by acute, chronic or recurrent infections. This paper should give a review about the manifestation of bronchiectasis and bronchioloectasis in HR-CT and discuss the causing entities. However, integration of bronchiectasis and other HR-CT findings may enable a narrower differential diagnosis, in some cases it is possible to give the correct diagnose directly.     

CT 对腮腺区肿块的诊断价值

评价ＣＴ对腮腺肿瘤的诊断价值。方法８８例腮腺区肿瘤进行ＣＴ平扫,ＣＴ增强扫描和／或腮腺造影ＣＴ扫描。结果：７８例为腺内肿瘤,其中７例为恶性;１０例为腺肿瘤。对ＣＴ肋腺区肿瘤定位准确,能准确显示肿瘤的范围,大小,数目及浸润情况。     

肝脏淋巴瘤的CT诊断(附9例报告)

目的:提高对肝脏淋巴瘤CT表现的认识.方法:回顾性分析经病理证实9例肝脏淋巴瘤的CT表现,原发性2例,继发性7例,采用螺旋CT平扫与增强检查.结果:原发性肝脏淋巴瘤2例(均为单发),继发性肝脏淋巴瘤7例(单发1例、多发4例、肝弥漫性浸润2例).CT平扫肝脏病灶大多呈低密度,增强后病灶不强化、轻度强化或边缘强化.原发性肝脏淋巴瘤以单发多见,继发性肝脏淋巴瘤以多发或弥漫浸润多见.结论:原发或继发性肝脏淋巴瘤CT表现具有一定特征.     

Value of CT in the diagnosis of adrenal ganglioneuroma

目的:分析肾上腺节细胞神经瘤的CT特征,提高CT对本病的诊断准确性.方法:回顾性分析6例经手术病理证实的肾上腺节细胞神经瘤的CT表现,并结合相关文献,探讨其影像学特征.结果:6例中4例病灶位于右侧,2例位于左侧.病灶呈圆形、椭圆形(5例)或不规则形(1例),边界清晰,无周围软组织和血管受侵犯征象.6例病灶密度均匀,其中2例病灶内有沙粒状钙化.增强扫描动脉期5例肿块无强化,1例无强化,静脉期及延迟期6例均呈轻度线条样或云絮样强化.结论:肾上腺节细胞神经瘤的CT表现有一定特征性,CT平扫和动态增强扫描对本病有重要诊断价值.     

肾上腺节细胞神经瘤的螺旋CT诊断价值

目的:分析肾上腺节细胞神经瘤的CT特征,提高CT对本病的诊断准确性。方法:回顾性分析6例经手术病理证实的肾上腺节细胞神经瘤的CT表现,并结合相关文献,探讨其影像学特征。结果:6例中4例病灶位于右侧,2例位于左侧。病灶呈圆形、椭圆形(5例)或不规则形(1例),边界清晰,无周围软组织和血管受侵犯征象。6例病灶密度均匀,其中2例病灶内有沙粒状钙化。增强扫描动脉期5例肿块无强化,1例无强化,静脉期及延迟期6例均呈轻度线条样或云絮样强化。结论:肾上腺节细胞神经瘤的CT表现有一定特征性,CT平扫和动态增强扫描对本病有重要诊断价值。     

支气管扩张的HRCT诊断

支气管扩张的诊断,以往要根据典型临床症状、X线平片所见和支气管碘油造影检查确诊,但由于支气管造影是一种侵入性方法,病人痛苦、有一定危险性,在临床上已逐渐被淘汰.CT扫描作为一种无痛、无创伤的影像学检查方法,已日益受到重视.HRCT诊断支气管扩张,基本上可以完全替代支气管造影.有关HRCT诊断支气管扩张的报道较少,本文对15例经病理证实或经临床随访确诊的支气管扩张患者的HRCT表现进行回顾性分析,并就有关问题进行讨论.     

多层螺旋CT对咯血的诊断价值

咯血是指源于下呼吸道的出血并经口腔咯出，是一种严重的甚至危及生命的胸部疾病，因此对咯血的临床重要性评价，应考虑咯血量的多少和咯血对呼吸系统及心血管系统储备的影响。诊断应首先明确直接出血的来源，而且应当确定可能导致咯血的主要病因。近年来随着多层螺旋CT技术的迅速发展，将速度、分辨率和体轴覆盖面统一了起来，加上其强大的后处理功能，已可以有效评价胸部细小血管。     

MSCT对卵巢卵泡膜细胞瘤的诊断价值

目的：分析卵泡膜细胞瘤的多层螺旋CT（MSCT）表现,探讨其CT表现特征,提高对其认识。方法回顾性分析15例卵泡膜细胞瘤的临床资料和MSCT表现,所有病例均经手术病理证实。结果15例患者均为单发,肿瘤呈圆形或卵圆形12例,分叶状3例;肿瘤范围2．5cm×2．5cm-15．7cm×12．8cm;边界清楚9例,边界模糊6例;全部为实性者5例,内有囊变者10例。平扫肿瘤实性部分CT值与子宫肌层相似,增强后动脉期及实质期轻度强化,延时期进一步缓慢强化为轻度。肿瘤内坏死囊变区无强化,2例增强后肿瘤内见纤细血管影。7例合并盆腔少量积液。结论卵泡膜细胞瘤的MSCT表现在一定程度上能反映其大体形态及病理特征,对其诊断及鉴别诊断具有重要价值。     

CT/bronchographic correlations in bronchiectasis

Bronchiectasis is an irreversible bronchial dilation that may require surgery for successful treatment. Plain radiographic findings are usually not specific, and bronchography is often necessary for confirmation. We compared CT with bronchography to assess the utility of CT in diagnosing and determining the extent of bronchiectasis. Twenty-six bronchograms were performed in 14 patients. A segment-by-segment analysis of the presence, extent, and type of bronchiectasis was made. In 10 lungs, results of bronchography and CT were both negative, and in 10 other lungs results of CT and bronchography were both positive. In six lungs CT results were negative, but results of bronchography were positive. There were no false-positive CT diagnoses. In six of 10 lungs in which CT and bronchography demonstrated bronchiectasis the extent of disease was underestimated by CT. False-negative CT occurred when there were small foci of cystic bronchiectasis (minimal degrees of cylindrical bronchiectasis), or when pulmonary opacities obscured the bronchi. In three cases, thin section (1.5 mm) CT demonstrated improved definition of bronchi but did not alter the estimated extent of bronchiectasis. We conclude that, although in 77% (20/26) of the lungs CT correctly detected or excluded bronchiectasis, CT was less sensitive than bronchography and underestimated the number of diseased segments.     

螺旋CT对急性胰腺炎诊断的应用价值

目的:探讨螺旋CT在急性胰腺炎诊断中的应用价值。方法:回顾分析60例经临床确诊急性胰腺炎病例的CT影像学改变。结果:临床诊断水肿型胰腺炎52例;急性坏死型胰腺炎8例。CT检查表现为胰腺肿大46例,密度改变8例,胰周积液35例,并发假性囊肿5例,并发蜂窝织炎16例,并发脓肿2例,合并少量胸腔积液18例,两下肺炎症22例等影像学改变。结论:螺旋CT是诊断急性胰腺炎简便而有效的影像学检查方法,对指导临床正确诊断及制订治疗方案具有重要意义。     

CT在机械性肠梗阻诊断中的作用

目的：探讨CT对临床或（和）X线平片疑为肠梗阻疾病的诊断价值。方法：回顾性分析临床或（和）X线平片疑为肠梗阻疾病的52例患者的平扫及增强CT检查表现，并与手术病理结果比较。结果：52例手术治疗患者中，48例（92%）手术结果与CT表面相符，包括肠肿瘤12例，肠粘连10例，肠套叠9例（含5例肿瘤），肠扭转及腹外疝各5例，胆石3例，回盲部感染3例，Crohn病1例。肠肿瘤和肠粘连各误诊2例；5例肠壁缺血（提示肠绞窄）4例CT诊断明确，主要表现为洱壁增厚及肠壁强化减弱。结论：CT能区分机械性肠梗阻和其他原因引起的肠管扩张，快速显示梗阻的部位和病因，提示肠绞窄，有助于临床及时制定正确的治疗方案，因此，对疑为肠梗阻的病人只要条件允许宜尽快作CT检查。     

CT在腮腺肿块性病变的诊断与鉴别诊断中的价值

目的:探讨CT对腮腺肿块性病变的诊断与鉴别诊断价值,提高术前定性诊断准确性。方法:回顾性分析经手术病理证实的52例原发性腮腺肿块性病变,所有病例均行平扫,其中39例行CT增强扫描,将CT诊断结果与病理结果进行对照研究。结果:35例良性肿瘤CT表现为圆形或类圆形边界清楚肿块22例,浅分叶13例,多形性腺瘤病灶内密度较均匀,腺淋巴瘤(6/9)易出现囊性变;14例恶性肿瘤CT表现为分叶状或不规则肿块影,边界毛糙模糊,其内密度欠均匀,发生坏死囊变(7/14),与邻近咬肌及胸锁乳突肌分界欠清楚(8/14);3例嗜酸性淋巴肉芽肿CT表现为单侧或双侧腮腺浅叶弥漫性增大,并颌下和颈部淋巴结大。CT均能对52例腮腺肿瘤准确定位,多数病变CT能准确定性,但对低度恶性肿瘤与良性肿瘤,囊变淋巴瘤与淋巴上皮癌,深叶嗜酸性腺瘤与恶性肿瘤难以鉴别。结论:肿块的形态、边缘、内部低密度灶分布以及与邻近咬肌及胸锁乳突肌分界情况是腮腺良恶性肿瘤的重要鉴别点,CT对大多数腮腺良、恶性肿瘤能做出正确诊断。     

小儿卵巢肿瘤的CT诊断价值

目的：利用多层螺旋CT分析小儿卵巢肿瘤的影像特点。方法：经手术病理确诊的27例女性患儿共34个卵巢肿瘤病例资料,年龄1.1-18.0岁,平均（11.7±5.1）岁;使用Philips Brilliance 6层螺旋CT进行平扫和增强扫描;1例肿瘤扭转的急腹症患儿仅行平扫。结果：CT表现为单纯囊性肿瘤11个（11/34,占32.35%）,实性肿瘤有9个（9/34,占26.47%）,囊实性肿块14个（14/34,占41.18%）。增强扫描后有29个卵巢肿瘤可见卵巢血管蒂征,占87.88%。12例可见腹水,4例有腹膜种植。9例淋巴结肿大,5例出现肝肺等远处转移。钙化15个,13个畸胎瘤均见钙化,同时可见钙化及脂肪成分者11个,2个畸胎瘤未见确切脂肪成分。结论：CT扫描易于显示肿瘤囊实性、钙化及脂肪成分以及卵巢静脉的走行等征象,对于小儿卵巢肿瘤的定位、定性及协助分期等有重要价值。     

CT of airways disease and bronchiectasis

High-resolution CT is accepted as an accurate noninvasive means of diagnosing bronchiectasis. A wide spectrum of abnormalities may be identified at HRCT in patients with airway disease, including various distinctive patterns of bronchiectasis in specific clinical settings, such as ABPA, MAC infection, AIDS, and CF. Characteristic CT findings occasionally suggest a specific diagnosis that may not have been under clinical consideration. HRCT also provides significant clinical use in assessing the degree and extent of airway disease, and allows noninvasive monitoring of disease progression, regression, or response to therapy.