青少年癫痫患者颅脑CT脑萎缩的特点

有关青少年癫痫患者颅脑CT仅表现为不同范围脑萎缩的报道较少。作者从432例因癫痫行CT检查的病例中发现,青少年占380例,其中有85例青少年颅脑CT图像上表现脑萎缩征象,约占青少年癫痫患者总检查人数的22％。青少年癫痫患者的脑萎缩在其范围上与老年人不同,现报道如下。 1 资料与方法 1.1 患者组 85例,男性58例,女性:27例;年龄最小4岁,最大35岁,平均17.4岁。根据诊断癫痫的金标准,其中76例由一位神经科副主任医师诊断。其余9例由神经科主治医生诊断。癫痫病史最长20年,最短3周。有35例行脑电图检查,重度与中度异常各11例,轻度异常13例。 1.2 对照组 60岁以上老年人颅脑CT脑萎缩100例,临床上表现头痛、头昏32例;高血压Ⅲ期43例;过性偏身麻木或肢体无力25例。     

CT对慢性酒精中毒所致弥漫性脑萎缩10例分析

本文对10例慢性酒精中毒的病人进行系统回顾,均有连续、长期大量饮酒史,就诊前已有不同程度的人格、情感异常,不能胜任原工作。后因停饮、感冒、急性酒精中毒、精神刺激等因素,出现酒精中毒、幻觉症、酒精性遗忘障碍、癫痫大发作等而急诊入院。患者有多组神经精神症状,10例病人经CT扫描均有脑萎缩。     

定量CT技术评估化疗对肺癌患者骨密度的价值

目的 应用定量CT(quantitative CT,QCT)技术观察肺癌患者化疗后骨密度变化,探讨化疗对肺癌患者骨密度的影响.方法 64例肺癌患者(肺癌组)均行肺癌根治术,术后行含铂双药方案辅助化疗4个周期;同期体检健康者59例为对照组.比较肺癌组与对照组性别、年龄、体质量指数.肺癌组于化疗前及化疗1、2、3个月时,对...     

CT及MRI特征对皮质下动脉硬化性脑病患者的评估价值

目的:探讨皮质下动脉硬化性脑病(Binswangerdisease,BD)的危险因素、临床特征及影像学改变。方法:回顾性分析26例BD住院患者的临床资料和脑CT,MRI的影像变化。结果:①24例(92.3%)患者有5～35年不等的原发性高血压病史,8例(30.8%)有糖尿病史,长期高血压伴有糖尿病或伴有多年饮酒史、吸烟史者病情较重。②BD临床特征:进行性加重的智能衰退,定向力障碍及人格改变,假性延髓麻痹征,锥体系及锥体外系损害的表现。③脑CT及MRI特点:白质疏松和深部白质的小梗死,表现为双侧侧脑室周围包括半卵圆中心对称性慢性缺血病灶,从侧脑室后角及前角向外方延伸,呈毛糙状边缘不清,侧脑室对称性扩大,同时可伴有基底核-内囊区、脑干的腔隙梗死。结论:原发性高血压是BD最重要的危险因素。对有长期高血压和进展性痴呆,伴有多发性腔隙性梗死者,结合脑CT及MRI改变可诊断为BD,及时合理的治疗可延缓病程。     

CT及MRI特征对皮质下动脉硬化性脑病患者的评估价值

目的：探讨皮质下动脉硬化性脑病(Binswanger disease，BD)的危险因素、临床特征及影像学改变。方法：回顾性分析26例BD住院患的临床资料和脑CT，MRI的影像变化。结果：①24例(92．3％)患有5—35年不等的原发性高血压病史，8例(30．8％)有糖尿病史，长期高血压伴有糖尿病或伴有多年饮酒史、吸烟史病情较重。②BD临床特征：进行性加重的智能衰退，定向力障碍及人格改变，假性延髓麻痹征，锥体系及锥体外系损害的表现。③脑CT及MRI特点：白质疏松和深部白质的小梗死，表现为双侧侧脑室周围包括半卵圆中心对称性慢性缺血病灶，从侧脑室后角及前角向外方延伸，呈毛糙状边缘不清，侧脑室对称性扩大，同时可伴有基底核-内囊区、脑干的腔隙梗死。结论：原发性高血压是BD最重要的危险因素。对有长期高血压和进展性痴呆，伴有多发性腔隙性梗死，结合脑CT及MRI改变可诊断为BD，及时合理的治疗可延缓病程。     

脑萎缩认知正常患者MRI特征及对阿尔茨海默病发生风险的预测价值

目的 探析脑萎缩认知正常患者磁共振成像(MRI)的特征及对阿尔茨海默病(AD)发生风险的预测价值。方法 选择90例认知正常受检者作为研究对象,均行脑MRI检查,根据是否发生脑萎缩分为脑萎缩组(38例)和对照组(52例)。比较两组AD患病情况,以及不同感兴趣区域脑区MRI图像厚度。采用受试者工作特征曲线(ROC)分析脑萎缩AD的预测价值。结果 脑萎缩组AD发生率高于对照组,差异有统计学意义(χ²=18.19,P<0.05)。脑萎缩组在左脑半球的内嗅皮层(EC)、眶额叶皮层(OFC)、后扣带皮层(PCC)的ROI图像厚度均小于对照组,差异均有统计学意义(t分别=3.46、16.30、9.26,P均<0.05),ROC结果显示,MRI技术中左脑半球EC、OFC、PCC对脑萎缩认知正常患者发生AD的曲线下面积(AUC)分别为0.88、0.80、0.81,灵敏度分别为86.75%、77.44%、80.43%,特异度分别为90.56%、84.29%、89.25%。结论 脑萎缩认知正常患者AD患病率极高,且风险呈现左右脑半球特异度,而MRI技术测量左脑半球感兴趣区域...     

23例心肌淀粉样变性临床分析

目的:探讨临床早期识别与诊断心肌淀粉样变性的方法与依据。方法:回顾性分析23例心肌淀粉样变性患者临床表现、心电图及心脏超声、冠状动脉造影等特点,分析研究与病理诊断的一致性。结果:23例(100%)患者均有心功能不全表现,17例(73.9%)表现为限制性充盈障碍(E/A>1.5和DT<140 ms);蛋白尿15例(65.2%);超声心动图检查心肌回声增强、呈颗粒闪光点回声("闪耀症")22例(95.7%);心脏M超检查左心室增厚("质"),23例(100%)均有不同程度室间隔增厚(>12 mm),20例(86.9%)左心室后壁增厚(>12 mm),而心电图肢体导联呈低电压("电")21例(91.3%)("质/电"矛盾现象);住院期间死亡13例(56.5%),随访死亡6例(26.1%),从诊断至死亡时间1～19个月。结论:心力衰竭+心室壁"质/电"矛盾现象+心肌间"闪耀症"诊断心肌淀粉样变性敏感性高,可作为临床早期识别与诊断的方法和依据。     

Wilson‘s病53例功能障碍评估

目的 对Ｗｉｌｓｏｎ’ｓ病（ＷＤ）所致功能障碍进行分析和评估。方法 采用我科制定的ＷＤ功能障碍评估标准，对５３例住院患的功能进行临床分析和评估。结果 （１）患具有运动、言语、精神心理、智能４个方面的功能障碍，本组中发生率依次为９８．１％、７７．４％、５６．６％、４５．３％；（２）ＷＤ所具有的功能障碍往往是复合性障碍，本组中具有两种以上障碍中８８．７％；（３）ＷＤ的功能障碍与性别无关。结论 ＷＤ     

Wilson病的脑CT表现与临床(附45例分析)

本文分析了45例wilson病患者脑部CT表现,认为双侧豆状核区及丘脑区对称性低密度灶对Wilson病具有特征性意义,与年龄不相符的脑萎缩改变亦很多见。1例Wilson病颅脑CT改变被尸解证实,铜的异常沉积是其病理基础。丘脑区病变与患者精神症状关系密切,豆状核区的改变则与椎体外系症状关系紧密。CT对本病的作用除证实临床诊断和确定病变部位及范围外,还可以在临床未疑及本病时及本病症状前期提示本病可能。     

Assessment of the Hallmarks of Wilson Disease in CT Scan Imaging

IntroductionOwing to nonspecific clinical symptoms, Wilson disease (WD) diagnosis is often missed or delayed; hence, many patients reach end-stage liver disease. When cirrhosis takes place, it is difficult to distinguish between WD and other causes of cirrhosis by imaging alone. This study outlines abdominal computed tomography (CT) imaging findings that occur more frequently in patients with WD cirrhosis.Material and MethodsFifty-seven patients with WD who had referred for liver transplantation took part in this study and underwent dynamic liver CT examination before transplantation. Qualitative and quantitative parameters including liver density, contour irregularity, dysmorphia, hypertrophy of caudate lobe, presence of focal parenchymal lesion, thickness of perihepatic fat layer, periportal thickness, lymphadenopathy, and other associated findings were recorded and evaluated.ResultsAmong these patients, 85.9% had contour irregularity, 28% had hepatic dysmorphia, and periportal thickening and cholelithiasis were found in 25.5% and 12.3% of patients, respectively. Splenomegaly, lymphadenopathy, and portosystemic shunting were observed in all patients. Also, hyperdense nodules (>20 mm) and honeycomb pattern were detected in 65.2% and 15.2% of patients, respectively, in the arterial phase. In the portal phase, these findings were detected only in 13% and 4.3% of patients. Hypertrophy of caudate lobe was seen only in 12.2% of patients.ConclusionWD-associated cirrhosis has many CT imaging findings, although most of them are nonspecific. Some findings, such as hyperdense nodules and honeycomb pattern in non–contrast-enhanced CT scan and arterial phase of triphasic CT scan with lack of hypertrophy of caudate lobes, are hallmarks of WD.     

创伤性脑损伤后继发脑萎缩CT动态分析

目的探讨创伤性脑损伤(TBI)后继发的脑容量改变、脑萎缩CT表现特征和治疗效果。方法回顾性分析127例轻中度(GCS≥9)TBI患者伤后1年内动态CT,利用脑容积计算机自动定量检测法,测定脑实质容量分数(VBP)变化,并对29例脑室扩大患者进行脑室-腹腔分流手术。与正常人群29例的CT表现比较。结果TBI组两个时间点患者的VBP变化显著大于对照组,分别为(-5.19±1.78)%和(-1.18±1.62)%,P=0.022。脑萎缩CT表现为脑室扩大而脑室周围无低密度区,脑室扩大分流术前后脑实质容量变化差异无显著性意义(P>0.05)。结论轻中度脑损伤后脑萎缩发生率增高,发生的脑萎缩为全脑性的,手术治疗对脑实质容量和神经功能障碍改善的效果不佳。     

Pediatric Wilson disease presenting as acute liver failure: Prognostic indices

BACKGROUNDAcute liver failure (ALF) can be a primary presentation of Wilson disease (WD). Mortality rates are high in WD with ALF (WDALF). Predictions of mortality in WDALF vary by model and are sometimes contradictory, perhaps because few patients are studied or WD diagnoses are questionable. AIMTo determine the outcomes among well-documented WDALF patients and assess mortality model performance in this cohort.METHODSWe reviewed the medical records of our pediatric WDALF patients (n = 41 over 6-years-old, single-center retrospective study) and compared seven prognostic models (King’s College Hospital Criteria, model for end-stage liver disease/pediatric end-stage liver disease scoring systems, Liver Injury Unit [LIU] using prothrombin time [PT] or international normalized ratio [INR], admission LIU using PT or INR, and Devarbhavi model) with one another.RESULTSAmong the 41 Han Chinese patients with ALF, WD was established by demonstrating ATP7B variants in 36. In 5 others, Kayser-Fleischer rings and Coombs-negative hemolytic anemia permitted diagnosis. Three died during hospitalization and three underwent liver transplantation (LT) within 1 mo of presentation and survived (7.3% each); 35 (85.4%) survived without LT when given enteral D-penicillamine and zinc-salt therapy with or without urgent plasmapheresis. Parameters significantly correlated with mortality included encephalopathy, coagulopathy, and gamma-glutamyl transpeptidase activity, bilirubin, ammonia, and serum sodium levels. Area under the receiver operating curves varied among seven prognostic models from 0.981 to 0.748 with positive predictive values from 0.214 to 0.429.CONCLUSIONWDALF children can survive and recover without LT when given D-penicillamine and Zn with or without plasmapheresis, even after enlisting for LT.     

Cowden disease: CT findings in three patients

Cowden disease, also known as multiple hamartoma syndromes, is an autosomal dominant disease characterized by numerous benign mucocutaneous tumors, hamartomas of multiple organs, and malignancies of the breast and thyroid. In this report, we present the computed tomographic findings in three patients with Cowden disease. In addition to the classic findings, the patients were diagnosed with spinal neurinoma (n=1), meningioma (n=1), and hepatic hemangioma (n=3). We also review current clinical and genetic concepts that unify Cowden disease.     

电子束CT与CT在诊断肝脏疾病的比较研究

目的 :分析普通CT和电子束CT在肝脏疾病辅助性诊断中的意义。方法 :收集 35例有临床症状和生化改变的各种肝脏疾病的患者 ,分别行普通CT和电子束CT(EBCT)扫描 ,帮助确诊并分析其结果。结果 :EBCT对上述35例肝脏疾病的确诊率为 10 0 % ,优于CT(77.1% )。结论 :EBCT不仅在心血管疾病应用方面有独特的优势 ,在肝脏疾病应用方面也优于普通CT。