肝脏海绵状血管瘤的磁共振成像诊断

目的 分析６７例肝海绵状血管瘤的ＭＲＩ表现，探讨磁共振成像（ＭＲＩ）对肝海绵状血管瘤的诊断价值。方法 ６７例病人均应用德国西门子公司生产的１．０Ｔ超导ＭＲ机（Ｉｍｐａｃｔ）行肝脏扫描，选用ＳＥ序列横断面成像，分别施行Ｔ１ＷＩ、ＰＤＷ１和Ｔ２ＷＩ，扫描层厚１０ｍｍ，间隔０．２ｍｍ。１８例施行了静脉团注Ｇｄ－ＤＴＰＡ增强扫描。结果 ６７例病人肝脏ＭＲＩ共检出１２７个病灶，单发者４７例，多发者２０例，病     

核磁共振成像在直肠癌术后复发诊断中的应用价值

目的探讨核磁共振成像（ＭＲＩ）在直肠癌术后复发诊断中的应用价值。方法复习资料完整的直肠癌术后疑复发而行ＭＲＩ检查的病例３４例,应用标准ＳＥ序列,行轴位Ｔ１ＷＩ、Ｔ２ＷＩ及矢状位Ｔ１ＷＩ序列扫描盆腔。２例行静脉ＧｄＤＴＰＡ增强扫描。结果肿瘤复发２７例,主要表现为骶前及会阴区肿物,Ｔ１ＷＩ呈低信号,Ｔ２ＷＩ呈混杂稍高信号,矢状位Ｔ１ＷＩ骶前脂肪间隙不连续或消失。复发肿瘤侵犯膀胱８例,侵犯前列腺６例,明确骶尾骨转移６例,盆腔淋巴结肿大３例。３４例中,７例未见复发。结论ＭＲＩ对发现直肠癌术后复发并确定病变侵犯范围有重要价值。     

磁共振成像诊断原发性肝癌评价

本文分析了１６５例原发性肝癌的磁共振成像（ＭＲＩ）价值。ＳＥ序列为Ｔ１加权成像（Ｔ１ＷＩ）；ＲＡＲＥ序列为Ｔ２加权成像（Ｔ２ＷＩ）。在Ｔ１ＷＩ上对肝脏结构显著显示清楚，而Ｔ２ＷＩ上主要对肝癌信号异常敏感性高，故对肝癌的范围、大小显示较为清楚。两处序列联合应用以及多层多平面横断加冠状切层可以精楚构画肝癌的部位、大小和范围。本研究提示，其敏感性ＭＲＩ比ＣＴ略高，但无统计学意义。ＭＲＩ优于Ｂ超，但不及Ｂ     

鼻咽癌放疗后的MRI表现

目的：探讨ＭＲＩ在评价ＮＰＣ放疗后改变中的作用。方法;对４２例ＮＰＣ放疗后患者行ＭＲＩ检查,其中１５例为ＲＦ,２１例ＲＮＰＣ,３例ＲＦ及３例ＲＮＰＣ伴有局部淋巴结转移,病例经病一活检或针吸收细胞学检查或随访追踪证实。ＭＲＩ扫描使用０．５Ｔ超导型磁共振成像仪。常规ＳＥ序列Ｔ１,Ｔ２加权横断,冠状,矢状位成像,其中３４例加行Ｇｄ－ＤＴＰＡＴ１Ｗ增强扫描。     

COMP和PBM化疗方案治疗晚期鼻咽癌的疗效分析

我们以ＣＴＸ＋ＶＣＲ＋ＭＴＸ＋ＤＤＰ（ＣＯＭＰ）和ＤＤＰ＋ＢＬＭ＋ＭＴＸ（ＰＢＭ）两种化疗方案治疗复发和转移的晚期鼻咽癌５８例。４９例可评价客观疗效。结果ＣＯＭＰ组取得ＣＲ３例、ＰＲ９例，有效率（ＣＲ＋ＰＲ）为５２．２％；ＰＢＭ组ＣＲ１例、ＰＲ９例，有效率（ＣＲ＋ＰＲ）为３８．５％。两者无显著性差异（Ｐ＞０．０５）．治疗后有效病例缓解期为５～５６月，中位缓解期为２５月。两种方案对鼻咽癌肺转移均较好，对肝转移疗效最差。ＣＯＭＰ方案对鼻咽癌远处转移疗效较好，对肺转移有效率为５８．３％（７／１２）．可作为鼻咽癌远处转移尤其是肺转移的首选。ＰＢＭ方案对鼻咽癌原灶复发疗效较好，对鼻咽癌复发有效率为４２．９％（３／７），可作为鼻咽癌原灶复发或放射治疗后辅助化疗首选方案。     

EB病毒LMP1在鼻咽癌细胞系中通过TRAF2活化NF-kB

目的：为了探讨ＥＢ病毒（ＥＢＶ）中ＬＭＰ１的致瘤机制,对鼻咽癌ＬＭＰ１激活重要的核转录因子ＮＦ－_ＫＢ的机制进行了研究。方法：①以ＬＭＰ１阴性的鼻咽癌细胞系ＨＮＥ２及表达载体（ｐＳＧ５）的鼻咽癌细胞系ＨＮＥ２－ｐＳＧＳ为对照,采用免疫共沉淀－Ｗｅｓｔｅｒｎ－ｂｌｏｔｔｉｎｇ方法在稳定表达ＬＭＰ１的鼻咽癌细胞系ＨＮＥ２－ＬＭＰ１中证实ＬＭＰ１与ＴＲＡＦ２是否直接结合形成免疫共沉淀复合物;②在ＨＮＥ２－ＬＭＰ１细胞系导入ＴＲＡＦ２表达质粒或不同剂量ＴＲＡＦ２显性负性突变体（ＴＲＡＦ２Ａ６－ ８６）表达质粒,以 ＮＦ－ｋＢ报道基因方法确定 ＬＭＰ1是否通过 ＴＲＡＦ2活化 ＮＦ－ｋＢ ;③将ＬＭＰ１（１－２３１）（ＣＴＡＲ２缺失区）或ＬＭＰ１△１８７－３５１（ＣＴＡＲＩ缺失区）及不同剂量ＴＲＡＦ２Ａ６－８６瞬时导入ＨＮＥ２中以证实ＬＭＰ１ ＣＴＡＲ１或ＣＴＡＲ２是否介导了这种效应;④以转染或未转染ＴＲＡＦ２６－８６的ＨＮＥ２－ＬＭＰ１细胞系为材料,应用免疫共沉淀－Ｗｅｓｔｅｒｎ－ｂｌｏｔｔｉｎｇ方法,确定ＴＲＡＦ２△６－８６是否竞争性抑制ＴＲＡＦ２与ＬＭＰ１结合。结果：①在ＨＮＥ２－ＬＭＰ１中ＬＭＰ１与ＴＲＡＦ２形成复合物     

鼻咽癌组织中bcl—2及EB病毒潜伏膜蛋白表达与放射诱发细胞？…

目的：探讨鼻咽癌（ＮＰＣ）组织ｂｃｌ－２及ＥＢ病毒潜伏膜蛋白（ＬＭＰ）表达与放射诱发细胞凋亡的关系。方法采用免疫组化Ｓ－Ｐ法及ＴｄＴ酶介导的生物素化ｄＵＴＰ缺口要端标记技术（ＴＵＮＥＬ法）,分别检测３５例ＮＰＣ组中ｂｃｌ－２及ＥＢ病毒ＬＭＰ的表达,以及放疗总量为１０Ｇｙ时ＮＰＣ组织的细胞凋亡率（ＡＲ）。结果ＮＰＣ组织ｂｃｌ－２及ＬＭＰ的表达率分别为７１．４％（２５／３５）、４５．７％（１６／３５）     

^153Sm—EDTMP对鼻咽癌骨转移患者免疫状态影响的初探

１５３Ｓｍ－ＥＤＴＭＰ对鼻咽癌骨转移患者免疫状态影响的初探樊卫曾宗渊关键词鼻咽肿瘤骨转移瘤１５３Ｓｍ－ＥＤＴＭＰ核素治疗Ｔ细胞亚群中图号Ｒ７３９．６３Ｒ７３８．１钐－１５３乙二胺四甲撑膦酸（１５３Ｓｍ－ＥＤＴＭＰ）治疗鼻咽癌（ＮＰＣ）骨转移已成为一种...     

188例脊柱转移瘤磁共振成像分析

（目的）分析１８８例脊柱转移瘤的ＭＲ表现，探讨其转移途径，生长方式和ＭＲＩ诊断价值，（方法）１８８例脊柱转移瘤患者均有脊柱病变区或原发肿瘤组织学证实，ＭＲ成像采用自旋回波序列，所有病例作了Ｔ１加权成像，质子密度成像和Ｔ２加权成像，４９例作了静脉注射Ｇｄ－ＤＴＰＡ后Ｔ１加权成像，（结果）１８８例共检出椎体转移７５６只，其中５９８只椎体呈现信号／形态异常，１５８例只仅呈现信号异常，９６例伴附件异常，１     

GD—DTPA、MRI增强在脑转移瘤诊断中的价值

目的：探讨ＧＤ－ＤＴＰＡ在脑转移瘤中的诊断及鉴别诊断价值。方法：对２５例经手术及临床证实的脑转移瘤患者,行ＭＲＩ平扫及增强扫描,其中９例行ＣＴ平扫及增强。结果：脑单发转移瘤５例,多发转移瘤２０例,幕上转移１５例,幕下转移３例,兼有７例,３例合并脑膜转移。Ｔ１ＷＩ发现病灶３５个,Ｔ２ＷＩ发现病灶４５个,增强扫描发现病灶１２５个,增强扫描发现病灶是非增强的近２．８倍。结论：增强扫描ＭＲＩ对脑转移瘤的检出率明显高于非增强扫描,尤其对肿瘤与水肿的区分、脑膜转移以及鉴别诊断等方面起着重要作用。     

鼻咽癌放射治疗后放射性脑病的临床分析

目的 :探讨鼻咽癌放射治疗后放射性脑病的临床特点、治疗及预后。方法 :对我院收治的 4 6 9例鼻咽癌患者中 ,采用面颈联合野 36～ 4 0Gy后缩野改耳前野加鼻前野或耳后野 ,常规放疗 4 0 6例 ,中位剂量 70 (6 6～ 74 )Gy ,后程加速超分割 32例 ,中位剂量 76 (70～ 80 )Gy ,超分割 31例 ,剂量 76 8Gy。 结果 :18例发生放射性脑病病变部位 :颞叶 15例 ,双侧 4例 ,单侧 11例 ,脑桥 3例。潜伏期 :单程放射治疗中位潜伏期 33(2 2～ 77)个月 ;再程放射治疗中位潜伏期 8 5 (6～ 2 8)个月。全组随访率 10 0 % ,16例仍存活 ,2例死于放射性脑病。结论 :鼻咽癌放射性脑病与剂量及照射野设计有关。MRI为其重要的诊断方法 ,PET可作为鉴别诊断的方法之一。尽早进行激素、脱水、扩血管和脑细胞营养药等治疗可有一定效果 ,但对病情反复 ,且有手术指征的患者尽早切除病灶可获良效     

The sequence of histological changes in mouse lungs after single doses of X-rays

Histological changes in mouse lungs have been quantified up to one year after irradiation of both lungs with a range of single X-ray doses. Three lesions characteristic of the acute, intermediate, or late phase of lung response were scored separately according to the area of the miscroscopic section involved. An “average score” was obtained for each lesion and plotted against time. Clearly separated peak response times were found for the acute phase (18 weeks) and intermediate phase (36 weeks). The peak response times of these 2 phases were independent of dose. Fibrosis was just detectable histologically at 36 weeks after 14 Gy and 13 Gy. The severity of each phase was dose related. The mice that died did so mostly between 14 and 24 weeks (98 and 168 days), the normal time over which death occurs in lung LD₅₀ studies. The histological data indicated that the lung LD₅₀ assay is related to acute radiation pneumonitis rather than to late fibrosis.     

Radiation retinopathy.

The records were reviewed of all patients treated with irradiation to the eye at the University of California, San Francisco, between 1%0 and 1975. Eight patients were identified who had developed radiation retinopathy one to 3 years postirradiation. Lesions included retinal vascular occlusions, hemorrhages, microaneurysms, exudates, neovascularization, vitreous hemorrhage, retinal detachments, and optic atrophy with blindness. Four patients had received less than 5000 rad in 6 weeks to the retina, a dose usually considered within normal tissue tolerance.     

Barytes Board: A Cost Effective Radiation Barrier Material for use in Diagnostic X-Ray Suites

The need for cost saving in hospital construction is becoming acute. This paper describes the investigation of Barytes Board as an alternative to lead ply for use in diagnostic X-ray suites. Barytes Board when used on both sides of a protective wall will provide 2 mm lead equivalance at 100 kVp for approximately half the cost of lead ply.     

The avoidance of small intestine injury in gynecologic cancer

The evolution of systematized operative staging and radical surgical procedures in the management of gynecologic cancer has increased the complexities of integrating radiation therapy. High dose irradiation to large treatment volumes has been associated with an increased incidence of small intestine injury. This complication is morbid and often fatal. Although predisposing factors have been extensively studied, there has been a paucity of reports evaluating preventative measures. Between 1975 and 1980, 140 patients with gynecologic cancer were treated at the Valley Presbyterian Hospital in the Division of Radiation Therapy. Twenty-six patients with cervix cancer received definitive irradiation and seven received adjunct irradiation. Seventy-two with corpus cancer received adjunct irradiation, seven received definitive irradiation and three palliative irradiation. Eleven patients with ovarian cancer received adjunct irradiation and 15 palliative irradiation. Eight-five patients were at potential risk for small intestine injury and had treatment planning small intestine X rays. Fixation was observed in 7/39 (18%) without prior pelvic surgery and 30/46 (65%) with prior pelvic surgery. Information from the small intestine X rays were used in 41 patients to make 60 treatment modifications. Twenty-five of 140 (17%) had a reduction of total dose, 26/140 (18%) had exclusion of the small intestine by shrinking fields, or patient positioning and 13/140 (9%) had displacement of the small intestine by distention of the bladder. No patient developed small intestine injury. The disease free survival for cervix cancer was 27/33 (82%), corpus cancer 68/79 (86%) and ovarian cancer 5/11 (45%). Pelvic failure was observed in 19/123 patients who received definitive or adjunct irradiation. One patient with corpus cancer and three patients with ovarian cancer might have benefited from the use of a larger treatment volume or a higher total dose.     

Update of human spinal cord reirradiation tolerance based on additional data from 38 patients

PURPOSE: To update a combined analysis of all published clinical data. METHODS AND MATERIALS: We collected data from 38 additional patients treated in our department or published in four different reports and calculated the biologically effective dose (BED) according to the linear-quadratic model using an alpha/beta value of 2 Gy for cervical and thoracic cord and 4 Gy for lumbar cord. In this model, a dose of 50 Gy given in single daily fractions of 2 Gy is equivalent to a BED of 100 Gy(2) or 75 Gy(4). RESULTS: The 2005 risk score based on three variables (cumulative BED, highest BED of all treatment series in a particular individual, and interval), which discriminate three different risk groups, does not require modification. The low-risk group now contains 1 case of radiation myelopathy (RM) after hypofractionated stereotactic reirradiation. Therefore, the rate increased from 0% to 3%. Intermediate-risk patients developed RM in 25%, and high-risk patients in 90%. When the interval between the two treatment courses is not shorter than 6 months and the dose of each course is < or =98 Gy(2), the cumulative BED where no case of RM has yet been reported is 120 Gy(2). CONCLUSIONS: Based on these updated results, the risk of RM appears small after < or =135.5 Gy(2) when the interval is not shorter than 6 months and the dose of each course is < or =98 Gy(2). We would recommend limiting the dose to the lowest feasible level. The influence of very steep dose gradients from stereotactic and intensity-modulated approaches (i.e., a more complex volume-effect) requires further evaluation.     

Treatment planning for resected abdominal tumors: differences in organ position between diagnostic and radiation-planning computed tomography scans

PURPOSE: To evaluate whether organ location, determined from preoperative diagnostic computed tomography scans (CTs), accurately reflects organ location when patients are positioned for radiation therapy. METHODS AND MATERIALS: We identified patients with upper abdominal malignancies treated with surgery and/or radiation therapy. Comparisons of organ position relative to fixed bony landmarks were made among preoperative diagnostic CTs, postoperative diagnostic CTs, and radiation-planning CTs. We studied 18 patients who had CTs differing only in scanning technique, 11 patients who had CTs differing only in operative state, and 7 patients with CTs differing in both scanning technique and operative state. RESULTS: For patients with diagnostic CTs and radiation-planning CTs that were either both preoperative or both postoperative, mean organ position, measured relative to a fixed bony landmark, ranged from 1.9 to 3.2 cm superior on radiation-planning CTs compared with diagnostic CTs (p < 0.0001). Mean organ position ranged from 0.9 to 1.7 cm posterior on radiation-planning CTs compared with diagnostic CTs (p < or = 0.008). Shifts in the right-left direction were small and variable. For patients with pre- and postoperative diagnostic CTs, organ shifts were variable and not significant. Organ shifts for patients with preoperative diagnostic CTs and postoperative radiation-planning CTs were similar to shifts observed for the first group. CONCLUSIONS: Relative to bony landmarks, there are superior and posterior shifts in organ position for radiation-planning CTs compared with diagnostic CTs. These shifts should be considered during treatment planning for resected abdominal tumors.