CT扫描在骨肿瘤诊断中的应用价值

目的总结良、恶性骨肿瘤的CT征象特点。方法分析经手术病理证实的良性骨肿瘤19例、恶性骨肿瘤71例的CT、X线平片征象。结果骨肿瘤的基本CT征象有骨质破坏、肿瘤骨形成、骨膜反应及软组织肿块，良、恶性骨肿瘤各具有其CT特征，增强扫描更有利于显示肿瘤邻近的血管。结论CT扩展和加深了我们对骨肿瘤征象的认识，可为临床提供较平片更为准确、全面的影像学信息     

原发性跟骨骨肿瘤及肿瘤样病变的影像观察

目的 评价跟骨骨肿瘤及肿瘤样病变的影像学表现,鉴别病变的良恶性.方法 回顾性分析经穿刺和手术病理证实的22例跟骨病变的影像学表现,其中6例良性肿瘤,4恶性肿瘤,12例肿瘤样病变.22例中21例行X线检查,10例行CT检查,3例行MRI检查.结果 22例跟骨病变中,良性骨肿瘤包括4例成软骨细胞瘤、1例骨样骨瘤、1例骨巨细胞瘤;骨肿瘤样病变包括10例骨囊肿和2例动脉瘤样骨囊肿;恶性骨肿瘤包括2例骨肉瘤、1例软骨肉瘤和1例滑膜肉瘤.结论 X线平片、CT及MRI综合表现可做到对跟骨骨肿瘤及肿瘤样病变较为准确的定性分析,特别是良恶性鉴别.     

骨肉瘤的MRI诊断(附35例分析)

总结骨肉瘤NRI表现及其特点。方法：收集经手术病理或活检证实的35例骨肉瘤，分析其MRI、X线平片征象并与手术病理对照，总结NRI诊断骨肉瘤的特征。35例均进行NRI平扫，其中18例平扫后行增强扫描。结果：骨肉瘤MRI上可表现瘤骨、骨质破坏、骨膜反应、软组织肿块等征象。此外，NRI还可显示肿瘤坏死、出血，肿瘤侵犯骨骺、关节及“跳跃”病灶。增强扫描有利于骨肿瘤良恶性的鉴别。结论：NRI可以提供比X线平片更全面的影像学信息，并指导临床治疗。     

高频乳腺X线片对乳腺良恶性病变钙化的分析

目的研究高频乳腺X线片对鉴别乳腺良、恶性病变钙化的意义。方法152例经临床和病理证实的女性乳腺良、恶性病变患者（87例良性病变和65例恶性病变）均经高频乳腺X线摄影。回顾性分析了所有患者的乳腺X线表现，并着重鉴别了乳腺良、恶性病变钙化的X线特征。结果在乳腺X线片上，大多数良性病变的钙化表现为散在分布的粗颗粒状、环状或斑片状灶，形态规则，密度较高，而恶性病变的钙化多呈簇状分布的细颗粒与导管型，诸如泥沙状、短棒状、针尖状灶，形态不规则，密度较低。结论乳腺病变钙化的X线表现随病变性质而不同，因此，高频乳腺X线片对鉴别乳腺良、恶性病变起重要作用。     

长骨骨肿瘤良恶性X线评分系统的临床应用价值

目的:评估自创长骨骨肿瘤良恶性X线评分系统的临床诊断价值。方法:收集126例长骨骨肿瘤或者瘤样病变患者的术前X线平片,利用自创骨肿瘤良恶性X线评分系统进行病变良恶性判断,并与术后病理诊断对比,统计评分系统诊断恶性、侵袭性及良性骨肿瘤的敏感度、特异度及准确度。结果:骨肿瘤良恶性X线评分系统诊断恶性、侵袭性及良性骨肿瘤的敏感度分别为96.88%、56.76%和96.49%;特异度分别为100%、96.62%、76.81%;准确度分别为99.20%、84.92%、85.71%。结论:长骨骨肿瘤良恶性X线评分系统能定量评价骨肿瘤的良恶性,方法简便有效。     

恶性婴儿石骨症的临床及X线分析

目的:探讨恶性婴儿石骨症的临床影像学特点.方法:回顾性分析8例恶性婴儿石骨症临床、实验室检查及影像学资料,从临床影像学角度分析、归纳其临床病理特征及影像学特点.结果:本组患儿均呈贫血貌,肝脾肿大和生长发育迟缓,视神经受损2例.实验室检查异常指标:血红蛋白、红细胞、血小板均减少,2例患儿血钙浓度下降明显.影像学特征:①婴儿期全身性的骨质硬化,骨密度增高髓腔闭塞;②长骨塑形障碍显示棒球杆征,骨膜新骨形成;③长骨干骺端横行透亮带、见骨中骨征;④石骨症佝偻病改变及病理性骨折.结论:通过X线表现结合临床以及实验室检查通常能够明确恶性婴儿石骨症的诊断.     

良性型石骨症的X线表现(附2例报告)

石骨症(osteopetrosis)较为少见,临床上将其分为恶性型(幼儿型)和良性型(成人型)[1]。前者发生于婴幼儿及儿童,易发生骨折,且预后欠佳。后者除并发骨折外常无任何不适,故极难发现而罕见。兹就偶尔发现的2例良性型石骨症患者的X线表现进行分析并着重描述其影像特征。1材料与方法2例均为男性,分别为28岁和51岁。因感冒做X线检查时发现有骨硬化,后在岛津800 mA X线机监控下分别对其全身进行透视,对胸部、颈椎、胸椎、腰椎、双肩关节、骨盆、双膝关节拍片检查。2患者均称既往体健,否认铅、磷、氟、铋等职业接触史。2结果2.1胸部后前位片两侧第…     

关于恶性胸膜间皮瘤X线诊断的讨论

目的：恶性胸膜间皮瘤在X线、CT检查中的特点。材料与方法：本病20例恶性胸膜间皮瘤患者均经过胸部平片检查及CT检查。结果：胸部X线平片表现为单发的肺内肿块4例，波浪状胸膜肥厚及多发胸膜结节8例。肺内转移及脑转移各1例，胸腔积液6例。结论：胸部X线平片和CT检查，在诊断恶性胸膜间皮瘤中具有相互补充作用。胸部X线平片仍是首选方法。CT在诊断胸部恶性间皮瘤肿瘤侵犯范围方面优干胸部X平片。因此合理的使用CT检查将会使恶性胸膜间皮瘤的诊断更准确。     

髋周骨肿瘤及肿瘤样病变影像学诊断

目的评价髋周骨肿瘤及肿瘤样病变的影像学表现。资料与方法回顾性分析82例经穿刺活检或手术病理证实的髋周骨肿瘤及肿瘤样病变的影像学表现。全部病例均行X线平片检查,42例行CT检查,24例行MRI检查。结果骨囊肿13例,动脉瘤样骨囊肿16例,骨巨细胞瘤6例,软骨母细胞瘤2例(合并动脉瘤样骨囊肿1例),骨母细胞瘤1例,骨样骨瘤3例,骨化性纤维瘤2例,非骨化性纤维瘤3例,骨纤维异常增殖症6例,嗜酸性肉芽肿3例,骨肉瘤4例,软骨肉瘤3例,恶性骨母细胞瘤1例,淋巴瘤2例,转移瘤17例。良性骨肿瘤17例(占20.7%),肿瘤样病变38例(占46.4%),原发恶性骨肿瘤10例(占12.2%),转移瘤17例(占20.7%)。结论髋周是良性骨肿瘤及肿瘤样病变的好发部位,X线平片+CT或X线平片+MRI是较好的综合检查手段。     

年轻士兵腰椎间盘突出症影像学诊断对比分析

目的总结年轻士兵腰椎间盘突出症（LDH）的X线平片、CT及MRI特点,进一步探讨影像学对诊断LDH的价值。方法收集我院32例经临床及影像学确诊的年轻士兵LDH的临床资料,分析其腰椎X线平片、CT及MRI影像特点。结果 32例中,X线平片表现为椎间盘病变8例,CT表现为椎间盘突出29例,MRI均表现为椎间盘突出。结论年轻士兵LDH较轻,X线平片阳性表现少,结合症状、体征可起筛查作用,而CT、MRI检查具有确诊价值,可为临床确诊提供重要的参考依据。     

Usefulness of barium studies for differentiating benign and malignant strictures of the esophagus

OBJECTIVE: The purpose of our investigation was to determine the usefulness of barium studies for differentiating benign and malignant strictures of the esophagus. MATERIALS AND METHODS: A search of radiology and endoscopy files revealed 100 patients with esophageal strictures on barium studies who underwent endoscopy (with endoscopic brushings or biopsy specimens in 57). The images from these barium studies were reviewed by two gastrointestinal radiologists who were unaware of the clinical, endoscopic, and pathologic findings; these observers classified the strictures as having a benign, malignant, or equivocal appearance. The radiographic data were correlated with the endoscopic and pathologic findings to determine the usefulness of barium studies for differentiating benign strictures from malignant tumor. RESULTS: Of the 100 esophageal strictures detected on barium studies, 75 (75%) had a benign radiographic appearance, 11 (11%) had a malignant appearance, and 14 (14%) had an equivocal appearance. None of the 75 patients with radiographically benign strictures had malignant tumor on endoscopy, which revealed benign strictures in 48 patients and no definite strictures in the remaining 27. Conversely, all 11 patients (100%) with radiographically malignant strictures had malignant tumor on endoscopy. Finally, 13 (93%) of 14 patients with radiographically equivocal strictures had benign strictures without tumor on endoscopy and one (7%) had esophageal carcinoma. CONCLUSION: Radiographically benign esophageal strictures are not found to be caused by malignant tumor on endoscopy, so these patients can be treated medically before endoscopy or endoscopic dilatation procedures are performed. However, radiographically malignant or equivocal strictures require early endoscopy and biopsy for a definitive diagnosis.     

Radiography of successful bone marrow transplantation for osteopetrosis

Hematopoietic stem cell transplantation (HSCT) is the only curative therapy for autosomal recessive infantile malignant osteopetrosis, an otherwise fatal disease. HSCT has also been utilized in patients with the less severe autosomal recessive intermediate form in an attempt to correct hematologic abnormalities and halt cranial nerve deficits caused by progressive cranial foraminal stenosis. Successful engraftment is accompanied by rapid normalization of radiographic signs of osteopetrosis.     

Vertebral-body collapse in focal and diffuse disease: patterns of pathologic processes

The radiographic patterns of vertebral-body collapse and/or endplate deformity were examined in 99 autopsy specimens of the thoracolumbar spine with benign and malignant disease. Angling of endplates was found to be highly predictive of underlying malignancy, whereas concavity was more suggestive of benign disease, for both individual vertebral bodies and intact spines (P less than .001). Diffuse-concave, diffuse-angled, and focal-angled patterns were more useful (P less than .001) than the focal-concave pattern (P = .07) in distinguishing between benign and malignant disease for superior endplates, whereas all were equally useful (P less than .025) in inferior endplates. Condition of the adjacent disks, location within the spine, and position of the apex of collapse were not predictive. Although these results and subsequent blinded testing suggest that reliable distinction between benign and malignant vertebral collapse is possible, extrapolation to clinical practice may be inappropriate because of population bias in the study and differences in radiographic quality between autopsy specimens and live subjects.     

良恶性肿瘤18F-FDG符合线路显像的临床价值

目的 评价18F-FDG符合线路显像检测良恶性肿瘤的诊断价值.方法 回顾性分析135例病变性质不明患者的18F-FDG符合线路显像结果,并与常规影像学检查结果进行对比分析.病变的确诊依据手术病理检查和临床随诊.结果 135例患者经病理学检查及随访结果最终确诊为恶性病变者86例(病灶数:95个),良性病变者49例(病灶数...     

基于MR早期动态增强的影像组学标签鉴别乳腺良恶性病变的价值

目的:探讨基于MR早期动态增强的影像组学标签鉴别乳腺良恶性病变的价值.方法:回顾性搜集通过乳腺动态对比增强MRI(DCE-MRI)检查,发现乳腺结节或肿块的144例患者(146个病变),146个病变按照样本量7:3随机抽样选取良性病变与恶性病变(102个作为训练组,44个作为验证组).所有病例基于病变的三维图像对影像组...     

50例SARS患者的X线分析

目的 分析总结SARS的X线表现。方法回顾性分析50例确诊为SARS患者的X线表现及其发展过程。结果 (1)SARS的X线主要表现为早期即可出现大小不一、边界模糊的片状阴影，以下肺及肺野外周多见。可单发或多发，可单侧肺受累或双侧同时受累，形态多样，变化迅速。随病情进展，单发病灶多发展为单侧多发或双侧多发病灶。空洞(1例）、结节状病灶(1例)、胸腔积液(2例)及胸膜肥厚粘连(1例)改变少见，未见有钙化灶。X线的进展睛况可分为4种：X线改变严重程度加重，出现1个高峰后，病灶逐渐改善，共32例(占64％)；X线改变波动，共9例(占18％)；X线改变较平稳，共7例(占14％)；X线表现进行性恶化，共2例(4％)。(2)50例SARS患者的肺部X线表现可初步分为三型：实质型36例(占72％)，间质型4例(占8％)，混合型10例(占20％)。(3)转归48例X线胸片有明显吸收，多在接受治疗后6～39d吸收消散(平均为15．9d)，1例治疗期间死亡，1例病危，其X线表现加重。结论 胸部X线检查可以协助临床早期发现SARS，并可了解其进展及转归，为临床诊断及治疗提供重要依据。     

The radiographic manifestations of pseudolymphoma of the stomach.

Pseudolymphoma of the stomach is a benign proliferation of lymphoid tissue which can be mistaken histologically for malignant lymphoma. The etiology is unknown but in most cases it is believed to be a reaction to chronic peptic ulcer disease. The clinical records and radiographs of 18 patients with pseudolymphoma of the stomach were reviewed. The radiographic findings fell into 3 relatively distinct groups: tumor masses, enlarged gastric rugae, and well-defined benign-appearing ulcers. All but 2 cases demonstrated ulcers radiographically and all cases had ulcers or erosions on pathological examination.     

Papillary lesions of the breast: evaluation with stereotactic directional vacuum-assisted biopsy.

PURPOSE: To evaluate the use of stereotactic directional vacuum-assisted biopsy (SDVAB) in diagnosing and managing papillary lesions of the breast. MATERIALS AND METHODS: The authors retrospectively reviewed the mammographic and histopathologic findings of 26 cases in which papillary lesions were diagnosed at SDVAB. In all cases, subsequent surgical excision (n = 20) or long-term imaging follow-up (n = 6) was performed and correlated with findings at SDVAB. RESULTS: SDVAB of 26 lesions yielded tissue that was classified as benign in 12, atypical in six, and malignant in eight. Of the 12 lesions that were diagnosed as histologically benign at SDVAB, six were surgically excised. Of these six lesions, five yielded benign correlative results. The sixth lesion was thought to be discordant with the imaging findings, and was surgically excised and determined to be malignant. Of the six benign lesions that were not surgically sampled for biopsy, five decreased in size and one was not seen at radiographic follow-up. Of the six lesions diagnosed as atypical at SDVAB that were surgically excised, one was benign and five were atypical. None proved to be malignant. Of the eight lesions diagnosed as malignant at SDVAB, surgical excision demonstrated ductal carcinoma in situ in all eight; two also had foci of invasive carcinoma. CONCLUSION: Benign and malignant papillary lesions of the breast can be reliably diagnosed at SDVAB when the SDVAB results correlate with the imaging findings. However, the extent of malignant papillary disease may be underestimated at SDVAB; in our study, invasive carcinoma was later discovered in 25% of patients with this diagnosis.     

Cranial MR imaging of osteopetrosis

BACKGROUND AND PURPOSE: The purpose of this study was to describe the cranial MR imaging manifestations of osteopetrosis. These features have not previously been reported in the literature. METHODS: Cranial MR studies, obtained with a uniform imaging protocol, were reviewed in 47 patients with osteopetrosis. Thirty-four patients had autosomal recessive (malignant) osteopetrosis (AROP), seven had intermediate osteopetrosis (IOP), and six had either type I or type II autosomal dominant osteopetrosis (ADOP I or II). The prevalence of abnormalities was tabulated and compared with the specific osteopetrosis variants. RESULTS: All patients with osteopetrosis had thickening and sclerosis of the calvaria. Ventriculomegaly, tonsillar herniation, proptosis, and dural venous sinus stenosis were observed in the majority of patients with AROP and ADOP I. Optic nerve sheath dilatation occurred in many of the patients with AROP and in all patients with ADOP I. Acquired cephaloceles were also observed only in these two groups. Optic nerve atrophy and optic canal stenosis were observed in a majority of patients with AROP, IOP, and ADOP II. Middle ear fluid was prevalent in AROP and IOP, present in over half the patients in each group. Features seen most prevalently, or exclusively, in AROP included stenosis of the internal carotid and vertebral arteries and extramedullary hematopoiesis. CONCLUSION: The cranial MR imaging features of osteopetrosis are both shared and unique among the various subtypes of the disease. The specific cranial and intracranial manifestations reflect the predominant calvarial or skull base patterns of bone thickening. The unique features seen in patients with AROP probably reflect the early age of onset and the greater severity of this form of the disease.     

The fate of ureteral endoprostheses

Fifty-five pyelovesical endoprostheses were inserted percutaneously in 56 patients. The indication for this procedure was a benign disease in 22 cases and a malignant disease in 34 cases. Early complications were haemorrhagic (3 haematomas) and infectious (septicaemic syndrome: 2 cases). 80.6% of the stents remained patent and most of the obstructions occurred before the second month in the benign indications (mean: 4.1 weeks) and later (mean: 13 weeks) in the malignant indications. Two-stage insertion (nephrostomy then insertion of the endoprosthesis under conditions of sterile and non-haemorrhagic urine) decreased the risk of early occlusion of the stent by urinary debris and clots. Abundant diuresis and control of urinary tract infection by prophylactic antiseptic treatment contribute to the maintenance of the patency of the prosthesis.