外伤性脑梗塞(附12例分析)

目的：旨在提高对本病的诊断水平。方法：儿童６例，成人６例，均有外伤史，都作头颅ＣＴ平扫。结果：１２例头颅ＣＴ平扫先后都示低密度梗塞灶；其中５例在复查时发现。结论：①ＣＴ是外伤性脑梗塞的首选检查手段。②首次检查未见脑梗塞，应作ＣＴ复查。③当发现有其它颅内损伤时，还应注意有无外伤性脑梗塞。④外伤性脑梗塞好发于儿童，而儿童又好发于基底节区。⑤ＣＴ追踪观察对了解病情的进展情况有帮助     

重症肝炎,肝炎后肝硬变118例的肾脏病理改变

为了解重症肝炎、肝炎后肝硬变的肾脏病理改变，我们对本院1980～1992年重症肝炎、肝炎后肝硬变死亡患者的尸检结果进行分析，结果报告如下。1临床资料与结果1．1一般情况118例患者中，男92例，女26例。年龄1～77岁，其中小儿11例，老年患者28例。1．2诊断标准重症肝炎患者均符合1990年全国病毒性肝炎会议诊断标准，包括急性重症肝炎8例，亚急性重症肝炎21例，慢性重症肝炎55例。肝硬变患者34例，均尸检证实。1．3临床与实验室检查本组患者生前有明确泌尿系病史者仅4例，其中1例为慢性肾小球肾炎，1例输尿管结石，2例慢性肾盂肾炎。118例患…     

婴幼儿外伤性脑梗塞的CT诊断(附6例分析)

婴幼儿外伤性脑梗塞的ＣＴ诊断（附６例分析）唐承富张善撰郑晓林外伤性脑梗塞是颅脑外伤的并发症之一。发生于婴幼儿的外伤性脑梗塞比较少见，并具有一定的临床、ＣＴ表现及发病机理上的特点。本文就１９９２年～１９９６年经ＣＴ检查发现的６例作一回顾性分析。１材料与...     

出血性脑梗塞（28例CT分析）

本文对２８例出血性脑梗塞的ＣＴ资料做了详细分析。其中１９例作过２￣７次ＣＴ扫描。本文首次发现，部分病例其梗塞灶内出血是反复发生的，呈逐渐增多或此起彼伏的形式。结合文献对出血性脑梗塞的有关问题进行了讨论。     

脑梗塞患者SPECT脑血流灌注显像的表现

脑梗塞患者ＳＰＥＣＴ脑血流灌注显像的表现任艳，聂迎雪，梁亦邓，李亚明，刘浩，罗锡圭对４２例脑梗塞病人进行９９ｍＴｃ-ＥＣＤ脑血流灌注断层显像，并与同期ＣＴ结果作对比分析，现报告如下．一、资料与方法脑梗塞患者４２例，男３５例，女７例，年龄２８～７３（平?..     

重症肝炎的观察体会

重症肝炎的观察体会李雅琴黄应迅速上升，消化道症状加重，尿量减少，精神出现异常，鼻尬等都是重症肝炎的早期表现。病例资料：自１９９０年９月至１９９２年３月共护理了７６例急性黄疽型肝炎病人。男４９例，女２７例，年龄吕岁至６１岁。其中２例发展成重症肝炎，３例...     

小儿外伤性脑血管闭塞(附10例报告)

目的：研究小儿外伤性脑血管闭塞的临床与ＣＴ表现。探讨其形成的机理及ＣＴ诊断价值。方法：对１０例有明确颅外伤及伤后肢体偏瘫等体征的幼儿进行了ＣＴ扫描观察并记录。结果：２例正常，１例大面积脑梗塞、７例腔隙性脑梗塞（１例于丘脑、６例于内囊）。结论：外伤性腔隙性脑梗塞在幼儿中常见，而且大部分病变都发生在内囊（６∶１）。其产生的机理可能是脑外伤引起脑血管痉挛性闭塞所致脑缺血性坏死。ＣＴ扫描对其诊断的确立具有重要价值     

大脑中动脉狭窄相关的脑梗塞20例临床分析

目的：分析了２０例大脑中动脉（ＭＣＡ）狭窄相关的脑梗塞患者的临床中风模式与神经影像（ＣＴ／ＭＲＩ）特点。方法；对经颅多普勒超声（ＴＣＤ）等确诊的２０例ＭＣＡ狭窄的脑梗塞患者进行临床与神经影像的对比分析，结果：２０例中，腔隙综合征１０例（５０％），ＣＴ／ＭＲＩ显示无病灶２例（１０％），基底节和内囊腔隙性脑梗塞８例（４０％）非腔隙综合征１０例（５０％），ＣＴ／ＭＲＩ显示ＭＣＡ皮层无梗塞９例（４５％），     

脑梗塞同侧功能障碍的CT分析

脑梗塞是急性脑血管闭塞引起脑缺血所造成的脑组织坏死，自ＣＴ问世以来，此病诊断准确率明显提高。文献报道脑梗塞对侧功能障碍多见，同侧功能障碍较少见［１，２］。本文分析２６例脑梗塞引起同侧功能障碍的ＣＴ表现，并讨论其发病有关因素。１材料与方法搜集我院１９９...     

脑梗塞的MR诊断

目的：分析脑梗塞的ＭＲ表现，部分与ＣＴ对比，以探讨ＦＭＲ在诊断该上的价值，材料与方法；对５例脑梗塞病例的ＭＲ片进行回顾性分析。结果：４４例表现为侧脑室旁、基底节及内囊区单个或多个塞灶，直径约５－２０ｍｍ，脑干梗塞４例，发生于脑叶的大片状梗塞４例，小脑半球梗塞２例，出血性梗塞１例，伴脑萎缩１０例，室旁水肿５例。结论：ＭＲ能较ＣＴ更早发现脑梗塞，能较好显示皮质受累程度及脑干，小脑梗塞，由于多方位成像。     

CT and MR imaging of postnecrotic liver scars

Four cases of postnecrotic liver scar were examined by dynamic CT or MR imaging or both. Postnecrotic scars appeared as low-density areas on plain CT, showed marked and prolonged enhancement on single level dynamic CT, and became isodense on postcontrast scan. On T2-weighted images, postnecrotic scar were as hyperintense as the spleen. Postnecrotic liver scar is an example of localized attenuation or intensity difference not corresponding to mass lesion. It should be distinguished from mass lesions associated with lobar or segmental attenuation (or intensity) difference of the liver as well as nonmass lesions such as irregular fatty infiltration, radiation hepatitis, and hepatic infarction.     

Nuclear magnetic resonance imaging of the liver: initial experience

Nuclear magnetic resonance (NMR) scans of the liver were obtained in 12 normal volunteers and 32 patients using a whole-body machine developed by Thorn-EMI Ltd., and the results were compared with x-ray computed tomography (CT). Two types of NMR scan, saturation-recovery and inversion-recovery, were performed in order to obtain values for the spin-lattice relaxation time, T1. Although the saturation-recovery scans show little soft-tissue detail, the inversion-recovery scans demonstrated the interlobar fissure, hepatic veins, portal veins, bile ducts, and gallbladder. In comparison with CT (Siemens Somatom 2), both types of NMR scan showed some blurring due to respiratory movement but much less linear artifact across the liver from the air-fluid interface in the stomach. Focal disease within the liver was demonstrated by both CT and NMR, although an area of focal atrophy and another of hepatic infarction were only recognized with NMR. In diffuse disease the pattern varied. In steatosis CT was virtually diagnostic, while NMR showed no specific features. In hemochromatosis, hepatitis, eight cases of cirrhosis, and one of Wilson disease, both techniques showed abnormalities of varying specificity. In two cases of cirrhosis and one of primary biliary cirrhosis, only the NMR scan was abnormal. Nuclear magnetic resonance images are now sufficiently anatomically detailed to permit serious comparisons with technically advanced computed tomography. The information revealed is fundamentally different and can be expected to have some diagnostic utility.     

70例急性酒精性肝炎的CT影像分析

目的：探讨急性酒精性肝炎的CT影像特征。方法：回顾性分析经临床、化验、CT综合诊断的70例急性酒精性肝炎病例的CT影像资料;本组病例肝功能化验均无甲、乙肝炎表现。结果：急性酒精性肝炎CT影像表现为：点状、片状低密度急性肝损害征象以及胆汁淤积、肝内胆管扩张,重者可出现肝组织坏死液化、肝肿大。急性酒精性肝炎的并发症有：肝硬化、脾大、脂肪肝、腹水。根据急性肝损害的严重程度,分为轻度39例,中度23例,重度8例。治疗后复查CT,除2例死亡外,其他所有病例的急性肝损害征象可恢复。其并发症酒精性肝硬化为不可逆病变。结论：CT能够显示急性酒精性肝炎的影像学特征。     

大脑中动脉高密度征的动态CT表现与临床

目的探讨大脑中动脉高密度征(HMCAS)在大脑中动脉(MCA)供血区超急性期梗死的诊断价值。方法对46例MCA供血区超急性期脑梗死(发病6h内)的CT征象及临床表现进行分析,并定期复查CT观察其动态变化。结果MCA供血区超急性期脑梗死46例中表现为HMCAS者32例(71.1%),临床均为完全前循环梗死(TACI),25例死亡(78.1%),其中HMCAS进展且合并MCA点状征的14例中12例(85.7%)死亡,其余均遗留严重神经功能缺损;而无HMCAS的14例中8例为部分前循环梗死(PACI),6例为TACI,仅2例(14.3%)死亡,两者差异具有统计学意义(P<0.01)。3例HMCAS在复查随访时消失,病人病情好转且均转化为出血性脑梗死。结论大脑中动脉高密度征的动态CT变化有助于MCA供血区超急性期脑梗死的诊断及预后判断。     

非潜水性骨梗死影像学诊断

目的 探讨非潜水性骨梗死的影像学表现。方法 7例患中，平片 CT MRI ECT检查、平片 CT、平片 MRI检查各2例；单纯拍平片1例。结果 7例共累及14骨。早期平片、CT可无异常发现，亦可见病变区密度不均或轻度骨膜反应。MRI示病灶中心T1WI呈等骨髓脂肪信号，边缘呈迂曲的低信号带；该带T2WI可分2层。整个坏死区呈地图样改变。ECT显示为中央放射性缺损，边缘放射性浓聚。晚期平片、CT扫描病灶呈类环形、花边状或条状致密影。MRI、ECT此期表现无特征。结论 对早期病例，MRI是最好的检查手段。晚期病例检查应首选平片和CT。     

超急性脑梗死首诊的多层螺旋CT表现

目的 探讨超急性期脑梗死的多层螺旋CT(multislice spiral computed tomography, MSCT)平扫表现.方法 回顾分析确诊的 19例超急性脑梗死病例,所有病例发病后1～6 h内进行第1次MSCT平扫检查,经发病后3 h～5 d复查MSCT或MRI确诊,观察分析MSCT平扫征象.结果 首次诊断超急性脑梗死17例,可疑诊断2例.MSCT平扫阳性表现主要有脑实质低密度征19例,局部脑肿胀征13例,脑动脉高密度征3例.结论 MSCT平扫对超急性脑梗死具有较高诊断价值.     

CT and MR imaging of radiation hepatitis

The authors describe two cases of radiation hepatitis evaluated by magnetic resonance imaging and CT with CT angiography (CTA) additionally performed in one patient. On CT the radiation hepatitis appeared as sharply demarcated region of lower attenuation than the adjacent normal liver. The region of radiation hepatitis demonstrated decreased perfusion in the portal venous phase of CTA, and 4 min delayed images following CTA showed increased density or relative increased accumulation of contrast. Magnetic resonance in both cases showed that the area of low density on CT had high signal on the T2-weighted image and had increased water content as determined by proton spectroscopic imaging method.     

成人外伤性脑梗死的CT诊断

目的 探讨成人外伤性脑梗死的影像特点.方法 分析30例成人外伤性脑梗死的临床与CT资料.结果 脑叶梗死17例,基底节-内囊区梗死13例,伴蛛网膜下腔出血15例,硬膜下血肿9例,硬膜外血肿3例,脑内血肿3例,脑疝5例,出血性脑梗死2例.结论 CT发现成人外伤性脑梗死的最佳时间是外伤后24 h～6 d,梗死多伴有颅脑损伤的其他CT表现,临床结合动态CT观察是诊断成人外伤性脑梗死的有效方法.     

妊娠子痫并发脑血管病的CT诊断

目的：妊娠子痫并脑血管病并非少见，且脑水肿与脑梗塞的早期CT表现极为相似，早期诊断，及时治疗至关重要，本旨在分析各并发症的CT特点，重点讨论脑水肿与早期脑梗塞的鉴别诊断。材料与方法：妊娠子痫合并脑血管病共23例，其中脑水肿12例，脑梗塞7例，脑内血肿4例，所有病人发病后急诊作CT平扫，3例行增强扫描，15例病人复查CT。结果：脑水肿CT表现为双侧顶、额、枕叶较为对称的片状低密度区，以顶叶为甚，脑梗塞CT表现类似脑水肿，脑内血肿CT表现均为皮层下血肿。结论：CT检查妊娠子痫并脑血管病具有迅速、准确的诊断价值。     

The relationship between cerebral infarction and angiographic characteristics in childhood moyamoya disease

BACKGROUND AND PURPOSE: In childhood-onset moyamoya disease, the angiographic disease process of stenoocclusive lesions is progressive, and cerebral infarctions often develop as a result of ischemia. Our purpose was to determine how the severity of stenoocclusive lesions in the anterior and posterior circulations affects the distribution of cerebral infarction in patients with childhood-onset moyamoya disease. METHODS: In 69 patients with childhood-onset moyamoya disease, angiograms were reviewed for stenoocclusive lesions, and CT scans, MR images, or both were reviewed for the sites and extent of cerebral infarction. The relationship between the angiographic and CT/MR findings was examined. RESULTS: The prevalence and degree of stenoocclusive lesions of the posterior cerebral artery (PCA) significantly correlated with the extent of lesions around the terminal portion of the internal carotid artery (ICA). The prevalence of infarction significantly correlated with the degree of stenoocclusive changes of both the ICA and PCA. Infarctions tended to be distributed in the anterior borderzone in less-advanced cases, while in more advanced cases lesions were additionally found posteriorly in the territory of the middle cerebral artery, the posterior borderzone, and the PCA territory. CONCLUSION: Our results indicate that progressive changes of the anterior and posterior circulations are associated with the distribution of cerebral infarction, culminating in a patchily disseminated or honeycomb pattern of infarction on CT and MR studies in late stages of the disease.