超声及CT对肝脏炎性假瘤的诊断价值

目的研究肝脏炎性假瘤的影像学表现。方法回顾性分析27例肝脏炎性假瘤的超声与CT诊断,并将两种相结合的影像检查结果进行对比分析。结果肝脏炎性假瘤超声多表现为肝实质内的哑铃状、花生节及类圆形低回声结节,结节外周的强回声边,内见条状及条管强回声及极少显示血流。CT平扫呈低密度类圆形结节,强化后门脉期及延迟期结节周边部分呈不同程度环形强化等。以术后及超声引导下穿刺活检病理结果对CT、超声及超声联合CT检查结果对比显示:超声诊断符合率66.67%(18/27),CT诊断符合率77.78%(21/27),超声联合CT诊断符合率92.59%(25/27)。结论单一的超声及CT检查其诊断结果难以令人满意,两者联合对肝脏炎性假瘤的影像诊断具有较高的准确性。     

高频超声诊断睾丸附件扭转的价值

目的探讨高频超声对睾丸附件扭转的诊断价值。资料与方法对近4年睾丸附件扭转32例睾丸附件扭转的超声声像图进行回顾性分析。结果睾丸附件扭转早期直接征象表现为睾丸与附睾间出现类圆形结节,较正常明显增大,回声减低、不均匀,呈"网状",CDFI显示类圆形结节内无血流信号,但同侧附睾头和睾丸血流信号较丰富。后期表现为类圆形结节明显缩小,回声增高。结论高频超声对睾丸附件扭转有较高的诊断价值,成为目前诊断睾丸附件扭转的首选检查方法。     

卵巢癌肝周转移灶的CT特征分析

目的探讨卵巢癌肝周转移的多层螺旋CT影像特点。方法回顾性分析63例卵巢癌患者的临床及影像学资料,术前或术后随访观察明确诊断肝脏转移瘤。观察分析肝脏及肝周转移灶的部位、密度及强化特点以及与邻近肝包膜的关系。结果 63例卵巢癌患者中,其中61例共155个肝脏转移瘤:肝内转移灶87个,肝周转移转移灶68个(24个病灶侵及肝实质,44个病灶未侵及肝实质)。2例呈肝内弥漫性转移(未纳入统计)。155个转移病灶:36个实性结节,20个囊实性结节,99个低密度影;2例转移性钙化,5例病灶周围异常高灌注。同期收集其他器官源性恶性病变肝脏转移瘤各30例(胃癌、结肠癌、肺癌、乳腺癌、胰腺癌),共822个肝脏转移灶,其中肝内765个,肝周55个,结果显示卵巢癌与其他器官来源肝转移瘤病灶分布之间的差异具有统计学意义(X~2=166.9,P=0.0000.05)。结论卵巢癌肝脏转移瘤的肝周分布是其重要影像特征。     

肝结核的影像诊断

肝结核较少见,本文报告4例由影像学检查和病理证实.所见征象包括:1例腹部X线平片及超声表现为肝内钙化团块,2例超声检查分别表现为肝内弥漫粟粒结节状较强回声灶及低回声区,1例经CT 扫描呈现轻度强化低密度肿块。作者认为影像学检查必须与临床相结合,才能获得正确诊断.     

甲状腺转移瘤超声表现

目的探讨甲状腺转移瘤的超声影像特征。方法对11例甲状腺转移瘤病人[男8例,女3例;年龄49~73岁,平均年龄(62.3±6.3)岁]的临床、病理及超声表现进行回顾性分析,观察超声影像特征,并进行超声分型。结果 11例甲状腺转移瘤病人中6例单侧甲状腺受累,5例双侧甲状腺均受累。11例病例中5例呈单结节型(来源于肺2例,食管、肾脏、直肠各1例),最大径3.0~5.6 cm(平均3.9 cm);4例呈多结节型(来源于食管、肾脏、直肠、舌各1例),最大径1.5~3.8 cm(平均2.5 cm);2例呈弥漫性病变型(来源于肺、乳腺各1例)。实性结节或肿块病灶超声表现为低回声,形态不规则,边界不清,无晕环,内回声不均,无囊变、钙化,丰富血流信号,伴颈部淋巴结肿大。弥漫性病变超声均表现为双侧甲状腺弥漫性体积增大,回声减低不均,内探及丰富血流信号,伴颈部淋巴结肿大。结论甲状腺转移瘤具有一定的超声影像特征,结合病史有助于甲状腺转移瘤的诊断。     

超声造影诊断肝脏局灶性结节状增生的价值

目的：探讨超声造影诊断肝脏局灶性结节状增生的价值。材料和方法：回顾分析了11例肝脏局灶性结节状增生的超声造影表现。9例于造影后经超声引导穿刺确诊,2例经手术确诊。结果：11例病灶动脉期均快速显著增强。9例病灶动脉早期呈轮辐状增强,造影三期回声强于周边肝实质,实质期可见轮辐状低回声；2例病灶动脉早期快速增强,动脉期及门脉期回声强于周边肝实质,实质期回声与肝实质等同,未见轮辐状低回声。结论：超声造影所显示的肝脏局灶性结节状增生的增强特征,有助于临床诊断。部分病灶超声造影表现缺乏特异性,确诊仍需要结合其他影像学方法和穿刺活检。     

肝脏单发性囊性转移瘤的影像学表现

目的探讨肝脏单发囊性转移瘤的CT和MRI表现。方法回顾分析14例肝脏单发囊性转移瘤的CT（5例）和MRI（9例）表现。结果肝左叶5例，右叶9例。2例包膜下转移瘤呈扁丘形，其余12例呈圆形或类圆形。肿瘤直径0．7～5．5cm，平均2．7cm。病灶表现为均匀薄壁型2例，均匀厚壁型2例，不均匀厚壁型7例和分隔型3例。病灶的囊壁和分隔CT平扫呈低密度，MRI T1WI呈低信号，MRI T2WI呈高信号、无钙化。12例有强化，3例延迟增强MR扫描呈现外周冲洗现象。病灶囊内部分为水样密度或信号、无强化，3例有液平。病灶通常不伴肝硬化、门静脉栓子以及胆道扩张，但有时同时显示肝外原发肿瘤或者腹部他处转移灶。结论肝脏单发囊性转移瘤具有一定的CT和MRI特征，了解这些特征有助于此类病变的诊断与鉴别诊断。     

甲状腺转移癌的超声影像表现

目的:探讨甲状腺转移癌的超声表现及诊断价值.方法:对10例经超声引导下穿刺活检证实为甲状腺转移癌的超声图像特点进行分析.结果:本组甲状腺转移癌超声图像表现为甲状腺内多结节型、孤立结节型、弥漫钙化灶型、回声不均型,7例合并钙化灶,3例无钙化灶,9例病变区血流信号异常增多.结论:甲状腺转移癌超声表现多样,无特征性,确诊需依靠穿刺活检.     

肺癌颅内转移的CT诊断与临床分析（附45例报告）

回顾性分析经ＣＴ诊断为颅内转移瘤,均经手术、纤支镜检和胸部平片证实原发肿瘤为肺癌者４５例。其中２６例颅内转移症状先于肺部原发症状,称之为脑先行型。通过分析肺癌细胞的血流途径及大脑内血流的分布,提出了肺癌较易发生颅内转移并多见幕上。转移灶与其他原发癌颅内转移瘤相似,为多发类圆形、结节状等密度、低密度或略高密度影,增强扫描后呈结节状或环状强化,周围水肿带明显并不规则,呈＂岛征＂。     

急性睾丸疾病的超声诊断与鉴别诊断

目的:探讨超声诊断和鉴别诊断急性睾丸疾病的价值.材料和方法:回顾性分析78例急性睾丸疾病患者的睾丸超声表现,并与临床、手术及病理结果进行对照分析. 结果:12例睾丸肿瘤瘤体较大,内部回声杂乱不均匀,病灶区血管走行不规则或呈"树枝状"分布,5例伴有钙化灶;26例睾丸外伤阴囊壁水肿增厚,病变部位回声减弱并与液性暗区混杂分布,彩色血流减少,周围组织彩色血流增强;21例急性睾丸炎患侧睾丸肿大,实质血流分布异常丰富呈五彩镶嵌的"彩球样"; 18例睾丸扭转患侧睾丸血流明显少于健侧或血流消失;1例睾丸结核病侧睾丸回声极不均匀,多种回声混杂分布. 结论:超声能够对各种急性睾丸疾病做出快速、准确的诊断和鉴别诊断.     

18 F-FDG PET/CT显像探测原发肿瘤病灶的临床价值

目的探讨^18F-脱氧葡萄糖(FDG)PET/CT显像寻找原发肿瘤病灶的价值。方法对临床诊断转移瘤患者31例行唧CT显像，将其诊断结果与手术、活组织检查及临床随访结果对照。结果29例患者唧CT显像准确显示其原发灶，分别为结、直肠癌7例，肺癌13例，甲状腺癌3例，子宫恶性肿瘤4例，胰腺癌和鼻咽癌各1例。1例PET/CT检查未能确定其原发灶。另1例临床诊断为肾上腺转移瘤的患者，PET/CT显像为良性肿瘤，经CT动态增强检查及实验室检查证实。结论PET／CT显像对寻找转移瘤原发灶有重要价值。     

3.0T MR THRIVE技术在腹部疾病中应用价值

目的探讨3.0TMR THRIVE(T1high resolution isotropic volume examination)技术在腹部疾病中应用价值。方法采用THRIVE序列对67例腹部疾病进行扫描,分析其应用价值。结果THRIVE技术发现肝、胆、胰、脾病变45例,肾及肾上腺病变10例,腹主动脉瘤2例,原发性腹膜后肿瘤5例,盆腔内卵巢及阴囊肿瘤各1例,胃癌和结肠癌各1例,腹腔脓肿1例。阳性率约为97.1%。有2例在THRIVE技术中病灶没能显示,阴性率约为2.9%。结论MRI THRIVE技术在腹部疾病检查中能够满足临床的诊断需要。     

6. 18F-FDG Whole Body Positron Emission Tomography (PET) in the Detection of Unknown Primary Tumors

Purpose: To evaluate the utility of FDG-PET in detecting primary tumors in patients with metastatic disease from unknown primary tumors.Methods: 12 patients with metastases from unknown origin after unsuccessful conventional diagnostic procedures were studied. 5 had lymph node metastases (2 axillary, 2 cervical, 1 mediastinal), 3 multiple metastases, 1 in the lung, 1 in the cava vein, 1 in the brain and 1 in adrenal glands. Patients received 400MBq FDG intravenously, and whole body images were acquired 60 min. after injection with an ECAT EXACT HR+. PET results were compared with histological and clinical findings.Results: All but one metastatic lesion was identified by PET. Additional metastases were visualized in 4 patients. In one helped to guide biopsy for histological diagnosis. In 4/11 patients FDG-PET did not reveal lesions suspected to be primary tumor. FDG-PET identified primary tumor in 8/11 patients (breast: 2, pancreas: 2, base of tongue: 1, adrenal gland: 1, lung: 1, stomach: 1). In 4 of them (33% of total) primary tumor was confirmed either histologically or by the clinical evolution (breast: 2, lung: 1, pancreas: 1). In 1 patient FDG-PET was false positive (base of tongue). 3 patients positive FDG-PET have not yet been confirmed. FDG-PET influenced therapeutic procedures in 4 patients (33% of total). 2 underwent surgery (breast), 1 received specific chemotherapy (lung) and 1 palliative chemotherapy (pancreas).Conclusions: Our preliminary results suggest that FDG-PET is a non-invasive technique useful in the detection of unknown primary tumors, can influence in selecting appropriate therapeutic management and could guide biopsies for histologic analysis.     

Congenital bilateral cystic neuroblastoma with liver metastases and massive intracystic haemorrhage.

A case of bilateral cystic neuroblastoma with liver metastases in a newborn is reported. CT showed a 10 cm right suprarenal multicystic mass and numerous hepatic cystic masses with intracystic fluid-fluid levels. Multiple smaller cystic lesions were also present in the left adrenal gland. To our knowledge, the CT findings of neonatal bilateral cystic neuroblastoma with liver metastasis and massive acute intracystic haemorrhage has not been previously documented.     

增强CT诊断肝细胞癌肾上腺腺瘤与转移瘤的价值分析

目的 探讨增强CT对肝细胞癌肾上腺腺瘤与转移瘤的鉴别价值,以期为临床诊治提供参考依据.方法 回顾性分析2017年10月至2019年11月于我院接受治疗的41例肝细胞癌患者的临床资料,所有入选者均接受增强CT扫描,分析肝细胞癌肾上腺瘤与转移瘤的增强CT影像学特征及三期扫描CT值.结果 ①肾上腺腺瘤:瘤体为较小的圆形或卵圆...     

儿童神经母细胞瘤的CT表现

目的:描述儿童神经母细胞瘤的CT表现,以提高对本病的认识。方法:回顾性分析13例经病理证实的神经母细胞瘤的CT表现,研究肿瘤的CT特征。结果:13例中,原发在头部1例,颈部1例,纵隔3例,腹部6例(源于肾上腺4例,源于腹膜后交感神经链2例),盆腔2例。肿瘤形态,其中不规则形2例,圆或椭圆形11例。8例显示钙化,钙化呈散在或弥漫分布斑点样钙化6例,索条状1例,不规则形钙化1例。共10例进行CT增强,增强后均匀强化1例,不均匀强化9例。与血管、气管关系,包绕周围血管4例,推移血管2例,推移气管1例。结论:神经母细胞的CT表现有一定特征,可有助于临床诊断。     

Bilateral adrenal gland metastasis from malignant fibrous histiocytoma: Value of [F-18]FDG PET-CT for diagnosis of occult metastases

The vast majority of soft tissue sarcomas metastasize initially to the lungs. We report a 71-year-old woman with malignant fibrous histiocytoma of the right buttock and thigh that metastasized to the bilateral adrenal glands without development of pulmonary metastasis. Whole-body [F-18]FDG PET-CT showed abnormal tracer uptakes in the bilateral adrenal glands in addition to high accumulation in the primary soft tissue tumors. CT-guided needle biopsy revealed that both of the adrenal lesions were metastatic malignant fibrous histiocytoma. There was no pulmonary or other visceral metastasis. To the authors' knowledge, this is the first report of malignant fibrous histiocytoma metastatic to the bilateral adrenal glands without development of pulmonary metastases. This case illustrates the excellence of [F-18]FDG PET-CT scan for diagnosis of occult metastases from soft tissue sarcomas.     

肺大细胞神经内分泌癌的18F-FDG PET/CT表现

目的探讨肺大细胞神经内分泌癌（LCNEC）的18F-氟脱氧葡萄糖（FDG）PET/CT的影像学表现。方法回顾性分析2009年10月至2017年5月经病理证实的37例肺LCNEC患者的18F-FDG PET/CT影像学表现,包括病灶位置、形态特征、代谢和淋巴结转移情况,以及最大标准化摄取值（SUV_max）预测淋巴结转移的价值。SUV_max与肿瘤最大径的相关性采用Pearson相关性分析。结果37例肺LCNEC患者均为单发,其中周围型28例（28/37,75.7%）、中央型9例（9/37,24.3%）。30例病灶（30/37,81.1%）可见分叶征,多为浅分叶;10例病灶（10/37,27.0%）可见毛刺征。29例病灶（29/37,78.4%）边界清晰,9例病灶（9/37,24.3%）可见胸膜凹陷征,2例病灶可见液化坏死,1例病灶可见空洞形成,1例病灶内见点状钙化,1例病灶内见充气支气管征。37例病灶18F-FDG代谢程度均高于肝脏,SUV_max为11.7±5.2（3.3~25.3）,肿瘤最大径为（3.2±1.5）cm,SUV_max与肿瘤最大径呈正相关（r=0.569,P=0.000）。15例病灶伴有肺门和（或）纵隔淋巴结转移,8例可见远处转移,包括骨转移4例、肾上腺转移1例、肝脏及骨转移2例、肾上腺及骨转移1例。约登指数最大为0.573,所对应的SUV_max为11.9,诊断效率最高,灵敏度为80.0%,特异度为77.3%。结论肺LCNEC的18F-FDG PET/CT多表现为周围型类圆形软组织结节或肿块,边缘清晰,充气支气管征少见,18F-FDG摄取较高。原发肿瘤SUV_max是判断淋巴结转移的重要半定量指标。     

Cryptic cause of renal malrotation

An intravenous urogram in a child with left adrenal neuroblastoma and bone metastases deomonstrated malrotation of the left kidney but no visible mass. A bone scan showed uptake of 99mTc by the tumor which suggested the diagnosis, confirmed by an abdominal echogram.     

Computed tomography of adrenal metastases in hepatocellular carcinoma. Report of four cases

Four patients with adrenal metastases from hepatocellular carcinoma (HCC) diagnosed with computed tomography are described. In three, the metastases showed a central area of low density due to tumor necrosis, irregular contrast enhancement, and a well-defined margin. They measured 8 cm or more in diameter. In one, the adrenal metastasis was at first a relatively small homogeneously solid mass, but later, when it grew larger, a central low density developed. Since the adrenal gland is the second most common site of metastasis from HCC at autopsy, a combination of an adrenal tumor and a liver tumor should suggest this possibility.