CT血管成像对星点与静脉窦关系的研究

目的 利用CT血管成像(CTA)技术观察星点的位置,为临床手术操作提供解剖依据,同时评价减影CTA 技术在观察星点与横窦和乙状窦连接部(transverse and sigmoid sinus transition,TSST)关系的价值.资料与方法 回顾性重建100例行头部CTA检查患者的星点影像资料,观察星点与体表骨性标志及静脉窦位置的关系.结果 星点到乳突尖、颧弓根、颞鳞-顶乳缝交点、外耳道口的距离分别为(49.6±4.3)mm,(55.6±4.6)mm、(24.6±4.1)mm,(44.1±3.6)mm,横窦和乙状窦连接部内角到乳突尖、颧弓根、星点、外耳道口、颞鳞-顶乳缝交点的距离分别为(35.4±4.9)mm,(41.4±4.7)mm,(17.6±4.2)mm,(27.8±3.8)mm,(15.2±3.9)mm,星点及TSST位置男性高于女性,左侧TSST位置较右侧靠后.星点主要位于横窦末段,右侧星点3%位于TSST前上方,83%恰好位于TSST水平,14%位于TSST后下方,左侧分别为5%,79%,16%.结论 减影CTA可以清楚显示TSST与星点的关系,乙状窦后人路手术第一钻孔点应选在星点后下＞17mm以上位置,减影CTA术前检查获得个体解剖资料与传统定位TSST方法结合,对减少手术并发症及缩短手术进程具有重要价值.     

Tomographic findings of the inner ears of 24 patients with Waardenburg's syndrome.

The tomographic findings in the Stenvers' projection of inner ears of 24 patients with Waardenburg's syndrome are described. In 12 of these 48 inner ears deafness was found. The roentgenographic examination did not show any malformation of the inner ears of these patients. In the literature on this subject, the tomographic findings of the inner ears of 12 deaf patients with Waardenburg's syndrome have been described. In 8 of them malformations were reported, especially of the semicircular canals. These findings in the literature could not be confirmed by our study.     

The internal acoustic meatus. Anatomic variations and relations to other temporal bone structures

The internal acoustic meatus was evaluated in 97 temporal bone specimens, half of which were radiographed in different projections. Part of the material was also examined by multidirectional and computed tomography. Casts of the specimens were prepared and the meatuses were measured in different planes. The anatomic variations, especially in the transverse plane, and their relations to other structures in the petrous bone, were assessed. The meatus varied in shape, being mainly either long and thin, short and broad, funnel-shaped or pear-shaped. The pear-shaped meatus was practically always broad. The angle formed by the long axis of the meatus and the posterior wall of the pyramid varied inversely with the meatal length, a long meatus forming a small angle and vice versa. Large anteroposterior diameters were correlated to large meatal angles, but there was no direct correlation between meatal length and width. In addition, the meatal length was correlated to the perilabyrinthine and mastoid pneumatization and also to the dimensions of the pyramid.     

硒对动物生理机能的影响及缺硒预防

本文主要综述了近年来国内外对微量元素硒的研究进展．以及硒对动物生理机能的影响,动物因缺硒引起的疾病与缺硒预防。对于畜禽养殖的饲料营养元素配制,提高畜禽养殖的经济效益具有一定的指导意义。     

功能解剖图像同机融合在胸腹部肿瘤病变诊断中的价值

目的 初步评价氟代脱氧葡萄糖功能图像与X线断层解剖图像同机融合在胸腹部肿瘤病变诊断中的价值。方法 回顾性分析了39例疑为胸腹部肿瘤或肿瘤术后复发而行^18F-氟代脱氧葡萄糖功能显像与X线断层联合扫描同机图像融合患者的资料。结果 在27例肿瘤或肿瘤术后复发的患者中，氟代脱氧葡萄糖显像全部阳性。在72个病灶中共检出69个病灶（69／72，95.8%)。功能解剖影像可更加直观清晰地显示占位性病变或肿大淋巴结的代谢活性。其中8例（8／27，29.6%)患者位于邻近膈肌上下及胸椎体、前列腺的12个病灶（12／72，16.7%)必须借助融合图像才能精确定位。结论 氟代脱氧葡萄糖功能图像与X线断层解剖图像同机融合可明显提高胸腹部肿瘤病变定性及定位诊断的准确性。     

基于特征融合和相关反馈的医学图像检索技术

目的 探索新型医学图像检索技术,以方便用户高效快速地查询到所需图像。方法 在分别研究基于颜色聚类、颜色纹理和形状等单一特征医学图像检索算法的基础上,提出了基于特征融合和相关反馈的医学图像检索算法。结果 通过对800幅标准临床内窥镜图像构成的数据库进行实验研究,分别给出了基于单一特征、特征融合以及相关反馈图像检索的查准率和查全率,并进行了比较分析。结论 利用特征融合和相关反馈逐步求精的方法,实现了更有效、更快捷的医学图像检索能力,     

血管造影CT在肝脏病变诊断中的应用

１９９０年１０月至１９９２年２月，我们对１４例病人作了ＣＴＡ检查，其中５例还行ＣＴＡＰ检查。经手术病理证实，１２例为ＳＨＣＣ，２例为肝内炎性假瘤。ＣＴＡ检查时ＳＨＣＣ表现为明显高密度，单层ＣＴＡ还可显示ＳＨＣＣ造影剂快进快出的典型表现。而炎性假瘤为无增强的低密度，ＣＴＡＰ检查时ＳＨＣＣ表现为边缘清楚的低密度灶。在ＣＴＡ图像上，病灶的ＣＴ值直方图分析有助于肝内小病灶的定性。另外我们在ＣＴＡ检查时还对     

Physiologic responses to maximal treadmill and deep water running in men and women.

Maximal physiologic responses to treadmill running and deep water running using a flotation device were compared in 12 trained men and 12 trained women. Although the men had significantly higher ventilation volumes, VO2max (liters of oxygen per minute and milliliters of oxygen per kilogram per minute), there were no significant differences in maximal heart rates or respiratory exchange ratios between the sexes. Significantly lower ventilation volumes, VO2max (LO2.min-1 and mlO2.kg-1.min-1), and heart rates were obtained in response to maximal water running compared to treadmill running, regardless of gender. Neither the men's nor women's maximal respiratory exchange ratios were significantly different between modes. The analysis of variance indicated that there were no significant interactions for any of the maximal responses to the tests between the sexes. The magnitude of these differences is similar to that found between treadmill running and cycling ergometry and should not preclude deep water running as a training technique. Caution, however, is advised if the training intensity is to be prescribed on the basis of land-determined heart rates.     

The Use of Dynamic Computed Tomographic Angiography Ancillary to the Diagnosis of Brain Death

Objective

Global absence of cerebral circulation is an important ancillary test for brain death when the diagnosis cannot be confirmed clinically. A number of imaging methods are available to assess cerebral circulation; however, new techniques are sought to improve on limitations of the current tests. Dynamic computed tomographic angiography (dCTA) is a novel technique that enables dynamic noninvasive imaging of cerebral blood flow.

Materials and Methods

We present the use of dCTA in 3 cases as a corroboratory tool to diagnose brain death. Analysis of our findings suggest that it is a reliable technique for demonstrating the lack of intracranial blood flow, with many advantages over other current methods.

Conclusion

A dCTA may be used to reliably demonstrate the lack of cerebral blood flow in patients with suspected brain death.     

本期读片窗答案

手术及病理所见 :术中切开增厚胸膜纤维板见一大小约 15cm× 13cm× 12 cm囊状包裹性肿物与右胸壁和右膈粘连 ,切开厚约 0 .4cm囊壁 ,从囊内取出 5 0 0 ml多暗红色液体和血块 ,以及大量絮状结晶物。囊内容物清除干净后 ,从膈面向上逐一剥离与囊壁粘连之胸膜脏层和壁层 ,剥离中见受压肺组织膨胀。壁层因不能完全剥离而有部分残留。肿块内容物送病理检查 ,结果为胆固醇结晶 ,未见癌细胞。讨论 :胆固醇性胸膜炎较少见 ,病因不太清楚。据文献报导 ,与慢性胸膜病变有关 [1 ,2 ] ,如继发于结核性病灶等 ,也有报导与矽肺、梅毒、糖尿病等并发者[3 ]…     

本期读片窗答案

术中证实:开腹后有气体扑出,继而大量血液涌出,探查见十二指肠球部横断及其上2支喷血的血管.实质性脏器正常.肝肾间隙内有大量血凝块.     

本期读片窗答案

手术所见:取左顶枕区瓣状切口常规开颅,硬脑膜张力较高,脑组织沟回变平。于左枕区试穿抽出草黄色液体约100ｍｌ。电凝并切开脑皮层,见一分隔状囊腔与左侧脑室三角区相通,囊壁黄染,于左侧脑室三角区见一紫褐色肿物,直径约4.0ｃｍ,质韧,易出血,边界清楚,与侧脑室脉络丛相连。行肿物全切及囊壁部分切除术。病理:肿物呈紫褐色,质脆。镜下观见肿瘤细胞呈多角形或梭形,胞浆内含有大量黑色素颗粒,细胞排列紊乱,间质较少。病理诊断:黑色素瘤伴瘤周出血,中风囊形成。讨论:颅内原发性黑色素瘤是一种罕见的中枢神经系统恶性肿瘤,男性多于女性,以青壮年…     

本期读片窗答案

手术所见:胃体左下方,横结肠上方、胰腺前方有一囊性包块,如拳头大小,呈灰白色,表面凹凸不平。被大网膜包裹,其周围与肠管粘连,经分离包块,见与空肠近端肠壁紧密相连,压迫肿物与空肠近端相通。胃十二指肠及其它部位未见异常。术后剖开肿物呈多房状,腔内均充满含有钡剂的液...     

本期读片窗答案

手术所见 :肿块位于左肾周脂肪囊内 ,质硬 ,与肾前缘相连 ,行肿块及左肾切除。肿块切面见坏死灶 ,周边部为脂肪组织。术前诊断 :腹膜后错构瘤或畸胎瘤。术后病理诊断 :腹膜后恶性神经鞘瘤累及左肾。讨论 :神经鞘瘤是来自周围神经鞘膜雪旺氏细胞的肿瘤 ,可发生于全身任何具有雪旺氏细胞的周围神经。有良性及恶性之分 ,恶性少见。本例恶性神经鞘瘤发生部位特殊 ,容易导致误诊。该肿瘤密度不均匀 ,呈不均匀强化 ,边缘不规则及与肾脏前缘分界不清应考虑为恶性 ;肿块周围低密度脂肪组织并非来自肿瘤本身 ,而是肾周囊状脂肪层受到肿瘤不同程度的侵…     

本期读片窗答案

手术及病理所见:空肠上段屈氏韧带下约10 cm处见有高出浆膜面紫红色血管网,面积6 cm×5 cm.切开肠管见该部粘膜紊乱,呈灰白颗粒状,切面紫红色海绵状.血管瘤向内浸达粘膜,向外达浆膜,相应肠粘膜糜烂、坏死.病理诊断:空肠上段海绵状血管瘤.     

读片窗答案

手术所见 :肿块位于后下纵隔 ,病变与右肺下叶有粘连。大小约 10ｃｍ× 10ｃｍ× 7ｃｍ ,分离较易 ,分离后肿块来自脊柱旁沟 ,基底广。仔细分离后 ,将肿瘤完整切除。病理诊断 :(后上纵隔 )血管滤泡性淋巴结增生。讨论 :纵隔血管滤泡性淋巴结增生临床上较少见。一般无症状 ,常在体检中发现。部分病例可有免疫机能障碍表现。本例患者以全身皮肤多发扁平苔藓就诊而发现纵隔肿块。此病肿块常位于纵隔或肺门区 ,可生长很大 ,多为孤立性 ,钙化少见。按组织学特点可分为二型 :透明型占绝大多数 ,浆细胞型仅占 10 %。Ｘ线表现为孤立性肿块 ,边缘光滑…