前列腺超声显象

超声显象、X 线摄影、同位素成象已成为影象诊断的三大支柱。超声显象系利用组织对超声的反射和衰减,提供软组织的断层图。由于超声显象对软组织有较高的分辨力,图象清晰,易于辨认,而且操作方便,对病人无损伤、无痛苦,因此,深受医生和病人的欢迎。     

经颅超声显象的方法研究

目的：研究经颅超声显象的方法。方法：利用普通的超声仪器对成人颅脑进行经颅显象，并与ＣＴ的对照。结果：通过观察经颅显象的图象，证实了利用普通扇扫超声进行经颅显象的可能性，建立了一些标准切面，提出了一整套简便准确的颅内大动脉的探查方法。结论：认为利用普通超声进行经颅超声显象也是一种理想的检查手段。     

实时超声显象诊断闭合性脾损伤

本文分析了37例经手术证实的闭合性脾损伤超声显象结果。其定位定性诊断符合率为84％。文中提出了脾损伤的声象图类型及其特征,对估计脾损伤程度、脾损伤部位、损伤范围的大小等可为临床治疗提供有价值的资料。并对脾损伤超声显象产生假阴性可能发生的原因进行了阐述。超声显象诊断是腹部闭合性损伤中必要的检查方法。     

宫外孕的超声显象诊断

总结70例宫外孕超声显象图象资料。子宫增大附件区包块和腹腔积血是宫外孕超声显象常见的征象,结合临床资料多可作出诊断。忽视临床病之的采集是超声显象检查宫外孕漏诊的主要原因。     

超声显象诊断输尿管结石的临床价值探讨

本文在论述了输尿管结石的超声显象方法及其声象图特征的基础上,通过对93例输尿管结石的超声显象资料和临床结果对照分析,探讨了输尿管结石的超声显象诊断价值。全组病例中超声诊断了85例,其中72例显示了81粒结石(直接征象),另13例显示了肾盂和输尿管积水(间接征象),结合临床表现和实验室检查亦明确了诊断。漏诊8例。超声显象诊断输尿管结石的敏感性91.40％,特异性100％。同时,超声显象检查对输尿管结石的治疗也有一定的指导价值。     

肾上腺肿瘤的实时超声诊断

为探讨肾上腺肿瘤的超声图象特点,评价超声显象的诊断价值,作者报告了19例肾上腺肿瘤的超声显象结果,符合率为84.2%。其中嗜铬细胞瘤超声诊断正确者4/4,皮质腺瘤9/12,皮质腺癌3/3。结果表明,超声显象对嗜铬细胞瘤和皮质腺癌的诊断准确率高于皮质腺瘤。本文详述肾上腺肿瘤的超声检查改进方法、声象图特点及鉴别诊断方法。超声检查肾上腺肿瘤具有方法简便、病人无痛苦、符合率较高等优点,可做为诊断肾上腺肿瘤的首选方法。但对较小肿瘤的检出率还有待进一步提高。     

B型超声显象在围产期检查中的实用价值(附101例围产儿超声显象分析)

B型超声显象不仅可监测围产儿的生长发育,预测胎儿成熟度,亦可显示某些胎儿发育异常及胎盘的形态结构、羊水的量和质,其应用日趋广泛。本文分析101例围产儿的超声显象,以阐明B型超声显象在围产期检查中的实用价值。     

B型超声在肝、胆、胰疾病诊断中的应用——附115例分析

自七十年代采用灰阶显象以来,B型超声图象的清晰度大大提高,对软组织显象有了突破。随着实时显象的发展和记录方法的改进,使超声对肝、胆、胰疾病的诊断有了飞跃的发展。B型超声实时显象在国外已普遍开展,国内报告也日益增多,现将我院1982年2月至9月检查中资料较完整的肝、胆、胰疾病115例报告于后。     

LREX型B型超声诊断早孕

超声诊断在国内外已较广泛应用于临床,近年来用于妇产科临床进展较大。尤其是B型超声切面显象仪诊断价值更高。超声诊断早孕简便、迅速、准确。对50天以前的妊娠实用价值更大,现将我院1981年11月至82年8月用LREX型超声显象仪对70例早孕病人进行了探查,经临床证实B型超声显象仪对早孕是一种操作简便、诊断准确及时的辅助方法。     

外伤性脾破裂出血B型超声的应用

近年来超声显象诊断在临床迅速普及应用,但是有关脾脏疾病在超超声上的报导尚少。本文报告用实时超声显象诊断5例外伤性的、经手术证实的脾破裂出血的病例,并     

艾滋病合并非结核分枝杆菌感染的腹部CT表现

目的研究艾滋病(Acquired immuno deficiency syndrome,AIDS)合并非结核分枝杆菌感染的腹部CT表现。方法回顾性分析11例经病原学证实的艾滋病合并非结核分枝杆菌感染的腹部CT表现。结果 11例艾滋病合并非结核分枝杆菌感染腹部CT示腹部淋巴结肿大6例(54.5%,6/11);肝脾肿大6例(54.5%,6/11);肝内胆管扩张1例(9.1%,1/11);腹水2例(18.2%,2/11);2例(18.2%,2/11)腹部CT影像未见异常。结论艾滋病合并非结核分枝杆菌感染腹部CT常见表现为腹部淋巴结肿大及肝脾肿大,肿大淋巴结中央坏死及环形强化少见。     

Hepatic hydatid cyst presenting as cutaneous abscess

Hydatidosis is a parasitic zoonotic echinococcal infection that affects both humans and other mammals. These diseases are common worldwide but particularly common in sheep and cattle farming regions. Anaphylaxis mediated by IgE is a serious complication of surgery or trauma which necessitates more aware of its clinical features, diagnosis and management. It is important to make a preoperative diagnosis based on the typical image findings, so that particular precaution can be taken not to rupture the lesion. A woman presented with a right upper quadrant cutaneous abscess. USG reveals multiple cystic lesions in the liver arranged in cartwheel appearance, CT disclosed a cystic lesions having daughter cysts, marginal calcifications, marginal enhancement and contiguous abdominal wall abscess, which led to a diagnosis of complicated hepatic hydatid cysts with abdominal wall abscess formation. FNAC showed scolices surrounded by chronic inflammatory cells. Abdominal wall abscess may be a presentation of hydatid liver disease.     

原发性胃恶性淋巴瘤17例胃镜表现及临床分析

目的:探讨原发性胃恶性淋巴瘤(primary gastricmalignant lymphoma,PGML)的临床及内镜表现特征,以提高早期诊断水平。方法:总结17例经手术和(或)病理证实的原发性胃恶性淋巴瘤患者的临床及内镜表现资料。结果:临床表现以上腹部不适及黑便、腹胀、贫血为主。病变多见于远端胃部,表现为溃疡型、肿块型及小结节或息肉型。3例为大B细胞淋巴瘤,13例为黏膜相关淋巴瘤,检出1例套细胞淋巴瘤。13例(76.5%)幽门螺杆菌(H pylori)阳性。结论:原发性胃恶性淋巴瘤临床表现无特异性,内镜下病变形态多样、范围广。内镜下多点、深凿取材结合免疫组织化学检查,必要时及时复查、多次活检可提高内镜诊断准确率。     

Bilateral primary adrenal non-Hodgkin's lymphoma - a case report and review of the literature

Primary adrenal non-Hodgkin's lymphoma (PAL) is a rare neoplastic disease. Clinical symptoms are often related to the presence of lymphoma or adrenal insufficieny. Diagnostic strategies include endocrine evaluation, imaging studies and histopathological examination. In case of suspicious PAL, percutaneous CT or US-guided needle biopsy is recommended to rapidly establish diagnosis before starting chemotherapy. We report about an 84-year-old male who presented with significant weight loss and chronic lumbar pain. Abdominal CT scans revealed bilateral masses highly suggestive of malignancy. After open bilateral adrenalectomy with abdominal lymphadenectomy, histological examination showed bilateral PAL. Five months after surgery, the patient died due to progressive tumor disease.     

Resection and repair of large abdominal wall lesions in gynecologic patients

Background The techniques of resection and repair of large lesions in the abdominal wall are very challenging in the area of gynecology.We explored the techniques of resection and plastic surgical repair of large abdominal wall lesions in gynecologic patients.Methods Twenty-six patients with large lesions in the abdominal wall underwent resection by the gynecologists and repair through abdominal plasty and V-Y plasty with or without fascia patch grafting by the gynecologists or plastic surgeons from March 2003 to October 2010.Results All patients had a history of cesarean section.One patient had an infected sinus tract after cesarean section,one patient had an inflammatory nodule,and the others had lesions of endometriosis,including one cancer.The average largest lesion diameter was (4.79 ± 4.18) cm according to the ultrasonography results.The lesions of all patients were completely resected with pretty abdominal contour.A polypropylene biological mesh was added to the fascia in 20 patients.One patient underwent groin flap repair,and one underwent V-Y advanced skin flap repair on the left of the incision to relieve the suture tension.Conclusions Multi-department cooperation involving the gynecology and plastic surgery departments,and even the general surgery department,is essential for patients with large lesions in the abdominal wall.This cooperative effort enabled surgeons to completely resect large lesions.Abdominal wall plastic surgical repair can ameliorate large wounds of the abdominal wall.     

Evaluation of 35 cases of abdominal lymphoma

Abdominal lymphoma is not a common clinical entity in Bangladesh. Still, in our Clinical practice we come across such problem occasionally. Because of their rarity and variable unusual behaviour, such case may present a major challenge even to experienced clinicians. Thirty five cases are reported in this series of which 29 were male and 6 were female (M:F = 4.8:1). Cases were collected from BSMMU, DMCH, MMCH, different clinics of Dhaka. Mean age was 36.7 years. Out of 35 cases 20(57.15%) had primary abdominal lymphoma, 08(22.85%) had secondary lymphomatous involvement, 07(20%) were cases of nodal lymphomas with or without superficial lymphnode involvement. All patients presented with gastrointestinal symptoms with or without an abdominal lump. Duration of symptoms of these patients ranged from 03 months to 02 years. In only 02 patients a clinical diagnosis of lymphoma was made pre-operatively. Various operative procedures were performed according to circumstances. Most common site of involvement was small intestine followed by large intestine, mesenteric lymphnodes, rectum and stomach. Among 35 cases, 28(80%) were Non-Hodgkin's, lymphoma 05(14.28%) were Hodgkin's and lymphoma 2(5.71%) were unclassified. All of the patients were referred to oncologist. Some of the patients received chemotherapy. The patients were followed up for a variable period. This study showed that abdominal lymphoma has a good prognosis provided diagnosed and treated early.     

Ultrasonographic findings and differentiation of benign and malignant focal splenic lesions

The purpose of this study was to analyse the sonographic findings of focal splenic lesions with an attempt to differentiate benign lesions from malignancies. The sonographic findings of 53 cases of verified focal splenic lesions, excluding post-traumatic haematomas and phleboliths, were retrospectively analysed. Of the 53 cases, 30 cases (57%) were benign and 23 cases (43%) were malignant. The malignancies included lymphoma (n=13), metastases (n=10); while the benign lesions included cysts (n=17), infarcts (n=3), and abscesses (n=5), and one case each of haemangioma, hamartoma, spontaneous rupture, tuberculosis, and lymphangioma. Significant differences were noted between the benign and malignant groups with respect to the presence of solitary lesions (p<0.0001), anechoic mass (p<0. 0001), lesions with highly echogenic foci due to gas or calcification (p = 0.0303), hyperechoic/mixed echoic lesions (p<0. 0001), presence of extrasplenic abdominal masses (p<0.0001), and nodules with the target sign (p<0.0001). Solitary lesions, anechoic mass, and lesions with highly echogenic foci due to gas or calcification each had a positive predictive value of 85%, 100%, and 100%, respectively, for the lesions to be benign. The multifocal/diffuse lesions, presence of extrasplenic abdominal masses, hyperechoic/mixed echoic lesions, and nodules with the target sign each had a positive predictive value of 70%, 100%, 70%, and 100%, respectively, for the lesions to be malignant. In summary, focal lesions with anechoic pattern or echogenic foci due to gas or calcification are suggestive signs of benign process. The sonographic observations of multifocal or diffuse solid lesions, especially those associated with target sign or extrasplenic abdominal masses are suggestive of malignancy.     

Atypical incarcerated abdominal wall hernia mimicking acute diverticulitis

An 89-year-old female presented with typical symptoms of acute diverticulitis. Abdominal CT revealed an abdominal wall hernia with signs of acute incarceration in the lateral part of the transverse abdominis muscle and rupture of the transversalis fascia. The findings were confirmed intraoperatively. The present case underlines the diagnostic importance of abdominal CT, especially in patients with acute abdomen, allowing for selection of appropriate therapy options.     

骨淋巴瘤的CT、MRI表现

研究原发性骨淋巴瘤及继发性淋巴瘤骨浸润的CT、MRI表现,探讨CT、MRI对骨淋巴瘤的诊断价值。方法经病理证实的骨淋巴瘤23例,其中原发性骨淋巴瘤5例,全身淋巴瘤伴发骨浸润18例,回顾性分析各类病例CT、MRI表现。结果 5例原发性骨淋巴瘤均为单发,分别位于股骨、髂骨、肱骨、胸骨和上颌骨,均为浸润性骨质破坏,可伴有少许硬化;18例继发性骨淋巴瘤单骨发生10例,8例为多发骨浸润,其中溶骨型5例,浸润型6例,硬化型2例,混合型5例,病变MRI表现为T1WI呈等或稍低信号,T2WI脂肪抑脂序列呈高信号,增强扫描肿瘤可呈明显均匀或不均匀强化。结论骨淋巴瘤浸润具有一定的影像学特点,CT、MRI在骨淋巴瘤诊断和鉴别上有着重要价值。     

原发性肠淋巴瘤的18F-FDG PET/CT影像学表现

目的探讨原发性肠淋巴瘤（PIL）的18F-氟代葡萄糖（FDG）PET/CT的影像学表现。方法收集2005年1月~2016年1月间 23例原发性肠淋巴瘤患者的临床及18F-FDG PET/CT资料,对病灶的分布、形态、代谢表现进行回顾性分析及总结。结果23例 PIL以弥漫性大B细胞淋巴瘤（DLBCL）与肠病相关性T细胞淋巴瘤（EATL）为主要病理学类型,分别占47.8%和43.4%。回肠、 回盲部及升结肠为PIL常见发病部位,共占57.0%。所有42个肠道病灶均呈18F-FDG浓聚,最大标准摄取值（SUVmax）为15.2±8.1 （3.6~33.7）,其中DLBCL组与EATL组间SUVmax差异无统计学意义,（t=1.851,P=0.073）。肠壁呈弥漫性均匀性或不均匀性增厚 是PIL 肠道病灶的主要形态学表现,DLBCL组与EATL 组在肠道病灶形态学上的差异无统计学意义（χ2=0.426,P=0.514）。 26.2%的患者存在病灶处肠腔瘤样扩张,DLBCL组其发生率高于EATL组（χ2=8.101,P=0.004）。56.5%患者存在腹部淋巴结侵 犯,30.4%见少量腹腔积液。结论原发性肠淋巴瘤在18F-FDG PET/CT显像上具有一定特点,同时,18F-FDG PET/CT是检测原 发性肠淋巴瘤的肠内外病灶并显示该病影像学征象的灵敏影像学技术,对该病的诊断有重要价值。