脑地型图和经颅多普勒对空勤人员偏头痛的诊断与评估

目的对患偏头痛的４１例空勤人员做脑地形图（ＢＥＡＭ）检查的同时又做经颅多普勒（ＴＣＤ）检查,以便作出诊断和评估。方法采用经颅多普勒血流诊断仪和脑电地形图仪进行检测。结果ＢＥＡＭ检测结果正常的４例（１０％）,异常３７例（９０％）;ＴＣＤ检测结果正常的５例（１２％）,异常的３６例（８８％）。ＢＥＡＭ与ＴＣＤ表现有相关性：ＢＥＡＭ表现α波功率值在局部不对称,ＴＣＤ表现相应部位血管血流速度的异常;ＢＥＡＭ表现前头部α波功率值高于后头部,ＴＣＤ表现后头部脑血流速度异常。ＢＥＡＭ表现全导联α波功率值降低,ＴＣＤ表现多根血管血流速度降低;ＢＥＡＭ局限性异常的,ＴＣＤ表现单根或数量很少的血管血流速度异常;ＢＥＡＭ表现阵发性异常趋势越明显,ＴＣＤ检查血流速度越不稳定。结论ＢＥＡＭ异常率与ＴＣＤ异常率很接近,两者之间有密切的相关性。对空勤人员的偏头痛患者做ＢＥＡＭ和ＴＣＤ检查,可以利用它们之间的相对特异性和敏感性,还可以弥补它们的不足和疏漏,做出较为完善的诊断与评估。     

动脉瘤样骨囊肿─CT和MR图像上的再认识

目的：评价ＣＴ和ＭＲＩ图像上液－液平面征象对诊断动脉瘤样骨囊肿（ＡＢＣ）的价值。材料和方法：回顾性分析１１例经病理证实的ＡＢＣ的平片、ＣＴ和ＭＲ表现，并用双盲法测试单纯平片和综合影像分析（平片、ＣＴ、ＭＲＩ）的诊断符合率。结果：１．单纯平片诊断符合率低于综合影像诊断；２．ＣＴ和ＭＲ有助于显示病变的范围、与周围组织的关系和病灶内的特征：３．在ＣＴ和ＭＲＩ上ＡＢＣ可见到液－液平面征。结论：ＣＴ和ＭＲＩ上的液－液平面征是ＡＢＣ较特征性的征象。综合性影像检查能提高ＡＢＣ的诊断准确率。     

细支气管肺泡癌的CT表现

目的：回顾性分析细支气管肺泡癌（ＢＡＣ）的ＣＴ表现：方法：４２例经病理证实的ＢＡＣ,根据ＣＴ表现分为结节型,实变型和多结节型,分别为２３,１６和３例;结合献资料分析各型肺泡癌的ＣＴ征角。结果;结节型ＢＡＣ主要表现为：肺外周（９５．７％）,分叶（６９．６％）,空泡征或细支气管气象（６５．２％）,密度不均（６５．２％）,胸膜牵引（６０．９％）和毛玻璃影（５２．２％）;     

海蛇乙醇浸出物灌胃对大鼠胶原性关节炎的防治作用(论著)

目的：探讨海蛇乙醇浸出物（ＡＥＢＦＳＳ）灌胃对大鼠胶原性关节炎（ＣＩＡ）的预防和治疗作用。方法：用自制的可溶性猪尾Ⅱ型胶原注入实验大鼠左后足造成胶原诱导性大鼠关节炎模型，观察用（预防性或治疗性）与不用ＡＥＢＦＳＳ对ＣＩＡ的影响。结果：在致炎前ＡＥＢＦＳＳ灌胃，当剂量达浸出蛋白４．０ｍｇ／ｋｇ，可明显推迟ＣＩＡ发病时间，降低ＣＩＡ患病率和减轻关节炎症状；在致炎后ＡＥＢＦＳＳ灌胃，可明显减轻关节炎症的程度，其作用在用药７天后开始表现明显。关节组织病理检查显示，ＡＥＢＦＳＳ显著减轻了患鼠关节的炎症程度。初步分析表明，ＡＥＢＦＳＳ灌胃既降低了ＣＩＡ患鼠血清抗ＣⅡ抗体水平，又对患鼠耳迟发型超敏反应（ＤＴＨ）产生了明显的抑制作用。结论：ＡＥＢＦＳＳ灌胃对大鼠胶原性关节炎有显著的防治作用；而其机理同时涉及Ｔ和Ｂ淋巴细胞免疫。     

颈部副神经节瘤的DSA诊断研究(附17例分析)

目的 探讨颈部副神经节瘤的ＤＳＡ诊断价值。方法 总结经病理证实的动脉体瘤（ＣＢＴ）１２例、颈静脉瘤（ＣＪＴ）５例,研究ＤＳＡ表现,并与其他颈部肿块性病变进行对照。结果 副神经节瘤主富血供型（ＣＢＴ１１例,ＧＪＴ３例）,ＤＳＡ能清楚显示肿瘤血管细节及肿瘤与相邻血管的整体关系。ＣＢＴ颈总动脉分驻开大呈握球状（１２例）、枕动脉近段向前上推移（１２例）、咽升动脉肿瘤中心供血（１０例）具有特征性,３例恶变者     

肢体火器伤神经体液髓鞘碱性蛋白释放表达实验研究

目的：探讨肢体火器伤中枢神经系统（ＣＮＳ）应变内环境紊乱的病理生理基础．方法：借助犬双后肢低、高速投射物伤模型，采用ＲＮＡ斑点杂交、ＥＬＩＳＡ法，动态观察、定量分析脑组织、脑脊液（ＣＳＦ）、血清髓鞘碱性蛋白（ＭＢＰ）表达与释放．结果：伤后８小时血清、ＣＳＦ、脑组织ＭＢＰ含量增高（Ｐ＜０．０１），高速组尤甚；低速组下丘脑，高速组下丘脑、海马区ＭＢＰ－ｍＲＮＡ表达增强（Ｐ＜０．０５）．结论：肢体火器伤虽未直接伤及大脑，但提示下丘脑、海马区受损，可能为ＣＮＳ应变反应的重要病理生理基础之一．     

孤立型细支气管肺泡癌的CT研究

作者对４２例直径≤３ｃｍ的孤立型细支管肺泡癌（ＳＢＡＣ）进行了ＣＴ研究，并与其它类型的直径≤３ｃｍ的肺癌进行对照分析。在ＳＢＡＣ与其它类型的肺癌之间有显著性差异的ＣＴ表现包括胸膜皱缩、空泡征或／和空气支气管征。通过测量胸膜至结节中心的距离，以１．７ｃｍ作为区别标准，其诊断ＳＢＡＣ的精确性是７７％，作者认为，ＳＢＡＣ的ＣＴ表现虽与腺癌有不同程度的重叠，但其特点足以提示诊断     

累及胸部的Behcet‘s病：病理,临床和影像表现

本论述了累及胸部的Ｂｅｈｃｅｔ＇ｓ病的病理改变、临床特点和影像表现。胸部Ｘ线片是评价Ｂｅｈｃｅｔ＇ｓ病累及胸部的最佳诊断手段，ＣＴＡ和ＭＲＡ是可取代动静脉造影以评价血管并发症的影像技术。     

脑胶质增生的CT表现(附2例报告)

脑胶质增生的ＣＴ表现（附２例报告）ＣＴＡｐｐｅａｒａｎｃｅｓｏｆＢｒａｉｎＧｌｉｏｓｉｓ（ＡＲｅｐｏｒｔｏｆｔｗｏＣａｓｅｓ）李建军王兆熊海南省人民医院放射科５７０３１１有关脑胶质增生的ＣＴ表现，国内仅有２例报道［１］。现将我院２例经手术病理证实的脑...     

乙型肝炎病毒S基因插入和点突变株感染及其血清学特征

为探讨乙型肝炎病毒感染血清学不典型表现的分子病毒学基础,用聚合酶链反应产物直接序列分析测定中国人感染的ＨＢＶ Ｓ基因核苷酸序列。结果发现：１５例ＨＢｓＡｇ阴性ＨＢＶ感染者中,１例第５５２位碱基胸腺嘧啶被胞嘧啶,导致ＨＢｓＡｇ第１３３位蛋氨酸被氨酸替代;３例第５４６位碱基Ｃ被Ｔ替换,导致ＨＢｓＡｇ第１３１位苏氨酸被异亮氨酸替代。     

细支气管肺泡癌的CT分型及其临床意义

目的 评价细支气管肺泡癌（BAC）的CT分型及其临床意义。资料与方法 搜集经病理证实的BAC43例。按CT和HRCT的表现形式将其分为局限型和弥漫型,并分析局限型和弥漫型BAC的临床表现、CT特征、治疗方案和预后等特点。结果 （1）局限型26例。呈胸膜下区分布,含磨玻璃密度结节和实性密度结节,有分叶、毛刺、胸膜凹陷征、空泡征和细支气管充气征等。临床无症状者17例,咳嗽、痰中带血和胸痛9例。26例进行根治性肺叶切除,术后随访18例,其中死亡7例,生存期16～38个月,平均27．7个月。（2）弥漫型17例。肺实变16例,2个孤立病灶位于2个肺叶1例。实变内见“枯树枝征”11例,“峰窝征”4例,叶间裂膨隆7例;磨玻璃密度影12例,腺泡结节14例,分布于实变影的边缘和／或非实变的肺叶。4例X线胸片仅显示实变病灶而没有显示远离实变区的结节。咳嗽11例,咯大量泡沫痰8例,伴痰中带血3例;憋气7例。肺叶根治性切除3例。随访17例,死亡12例,生存期2～13个月,平均6．1个月。结论 根据CT和HRCT表现,BAC可分为局限型和弥漫型。两型BAC的临床表现、治疗方案和预后皆不同。     

细支气管肺泡癌的CT主要征象探讨

目的:探讨细支气管肺泡癌CT表现特点与组织病理的相关性。方法:收集经手术或穿刺活检病理证实的细支气管肺泡癌30例,男14例,女16例,年龄40~75岁,平均62岁。采用螺旋CT增强17例,平扫13例。CT图像上观察病灶的部位、大小、密度分布、内部结构及边缘特征,并评价其征象与组织病理的相关性。结果:单发结节型18例,实变型9例,弥漫小结节型3例。单发结节型主要征象:胸膜牵引征9例(50%),磨玻璃征16例(88.8%),支气管征10例(55.5%),空泡征14例(77.7%)。实变型主要征象:枯树枝征6例(66.6%),蜂房征4例(44.4%),碎路石征3例(33.3%),血管造影征2例(22.2%),弥漫小结节型主要征象:两肺不对称、不均匀弥漫分布大小不等结节,结节融合倾向,伴有母瘤2例(66.6%)。结论:细支气管肺泡癌的影像表现复杂,对各型的征象深入细致地分析,可提高本病的诊断符合率。     

细支气管肺泡癌的X线CT诊断

目的提高细支气管肺泡癌(BAC)的X线、CT诊断水平.材料与方法回顾性分析24例BAC的X线、CT表现,将其分为结节型、炎症型和弥漫型.结果结节型7例,均为单发结节.炎症型6例,两肺多发斑片状影4例,大叶实变2例.弥漫型11例,两肺呈细小结节影10例,网状结节影1例.单侧或双侧胸腔少量积液8例,心包大量积液5例,双侧肺门淋巴结增大3例.胸部及远处骨质破坏6例.结论BAC影像表现多种多样,炎症型需与肺结核、肺炎等鉴别.仔细观察、分析X线、CT征象并结合临床表现与治疗情况,可提高BAC的诊断正确率.     

肺泡蛋白沉积症的CT诊断

目的：探讨肺泡蛋白沉积症的ＣＴ表现和诊断价值。方法：４例均有完整的临床、实验室以及胸片和高分辩率ＣＴ（ＨＲＣＴ）检查资料,４例均经肺泡灌洗术,其中３例经纤支镜检、１例经肺穿刺活检病理证实。对其ＣＴ表现进行回顾性分析。结果：本病在ＨＲＣＴ象上呈多样化改变：从弥散分布的较模糊的结节影到弥漫性斑片云雾状肺实变阴影与磨玻璃影,呈地图样分布;多见蜂窝状、网状间质性表现,同时伴有病变范围内光滑的小叶间隔增厚。     

Pictorial review of the many faces of bronchioloalveolar cell carcinoma

Bronchioloalveolar cell carcinoma (BAC) has a varied appearance on CT that often leads to an incorrect or delayed diagnosis. The purpose of this pictorial review is to define common CT characteristics that are specific to BAC. A retrospective review was undertaken of 20 CT scans of pathologically proven cases of BAC; tumours were categorized as focal or diffuse, single or multiple, and infiltrative or well defined. Additional radiological features noted include the density (solid, part solid, non-solid), the presence of unaffected vessels within the tumour(s), and the presence of internal air bronchograms. We illustrate cases of localized and diffuse BAC presenting as (i) solitary or multiple pulmonary nodules, with and without air bronchograms, (ii) bubble-like lucencies of pseudocavitation associated with nodules of varying density, (iii) unifocal or multifocal ground-glass opacities, (iv) crazy paving, (v) nodules and airspace opacities with unaffected vessels coursing through them and (vi) lobar or multilobar consolidation and cavitating nodules. In conclusion, BAC may present with a variety of CT appearances. However, there are typical features such as the CT-angiogram sign or air-brochochograms in solitary nodules and in the periphery of larger consolidations, persisting pure ground-glass opacities, unresolving consolidation and the combination of diffuse nodules and consolidation. These features should alert the radiologist to the diagnosis of BAC.     

CT differentiation of pneumonic-type bronchioloalveolar cell carcinoma and infectious pneumonia.

The objective was to analyse the potential of CT to distinguish pneumonic-type bronchioloalveolar cell carcinoma (BAC) from infectious pneumonia. The study consisted of 21 patients with pathologically proven BAC and 30 patients with infectious pneumonia. Both groups of patients had patchy or diffuse consolidation of more than half the area of a lobe or lobes on CT. CT findings in these two groups were compared with regard to morphological appearance, including CT angiogram, air bronchogram, mucous bronchogram, contrast enhancement pattern, pseudocavitation, cavity with air-fluid level, location, satellite lesion, ground-glass opacity and bulging of the interlobar fissure. Air-filled bronchi were morphologically analysed as dilatation, stretching, sweeping, widening of the branching angle, squeezing and crowding. Lymphadenopathy and pleural effusion were also analysed. CT findings favouring the diagnosis of BAC included an air-filled bronchus within the consolidation with stretching, squeezing, sweeping, widening of the branching angle and bulging of the interlobar fissure (p<0.05). It is concluded that CT may be helpful in differentiating pneumonic-type BAC from infectious pneumonia if the air-filled bronchus within the consolidation shows stretching, squeezing, widening of the branching angle or bulging of the interlobar fissure.     

实变型细支气管肺泡癌的CT表现及病理基础

目的:探讨实变型细支气管肺泡癌(BAC)的CT表现特点。方法:对13例经病理证实的实变型BAC的CT征像及其病理特征进行回顾性分析。结果:13例中,单发肺叶实变8例,多发肺叶或肺段实变3例,单发肺段实变2例;实变肺密度低于心肌8例,伴见血管造影征或血管高密度征7例、支气管气像征9例伴枯树枝征6例;实变肺周见蜂窝肺征9例,磨玻璃征7例,多发小结节2例;少量胸水1例,肺门淋巴结肿大及肺气囊腔各1例。13例中9例CT首诊误诊为肺炎,4例正确诊断。结论:实变肺密度低、蜂窝肺征、血管造影征尤其是血管高密度征、枯树枝征及多发腺泡结节是实变型BAC的主要CT表现特点;磨玻璃影是早期表现,但特异性不大;CT引导肺穿刺活检是较理想的确诊手段。     

CT-pathologic correlative study of interstitial pneumonia

A direct CT-pathologic correlative study of interstitial pneumonia was performed using inflated and fixed lungs. The specimens, which were obtained from 26 patients at the time of autopsy or during surgery, had pathologic findings of interstitial pneumonia (UIP and/or DAD). The specimens were fixed in distension and air dried. They were then scanned with a GE CT/T9800. HRCT images of the specimens could be correlated with two different types of pathologic processes. One was the chronic fibrotic change which was seen in the subpleural area of the specimens both from the autopsied and surgical cases, and the other was the acute alveolar change which was seen in the diffuse area of the specimens only from autopsied cases. HRCT images of the chronic fibrotic change showed nodular opacities, ring like opacities, increased density (high density), and air-bronchiologram in the subpleural area. These findings were correlated with patchy fibrotic lesions, honeycombing, mucus stasis in cysts of the honeycomb, and dilatation of the airways. HRCT images of the acute alveolar change showed mainly diffuse increased densities (hazy appearance and high density) and diffuse nodular opacities. These findings were correlated with a diffuse thickening of the alveolar walls, hyaline membranes in the alveoli and alveolar ducts, and their organization. Understanding of the difference between HRCT images of these chronic and acute pathologic processes is helpful for the evaluation of disease processes of interstitial pneumonia by HRCT. The abnormal patterns of HRCT images of the specimens were influenced by several technical factors of CT scanning, such as reconstruction algorithm, thickness of the slice, window level, and window width. It is, therefore, necessary to know the influence to HRCT images by these technical factors for a better understanding of HRCT images in interstitial pneumonia.     

Crazy-paving appearance at thin-section CT: spectrum of disease and pathologic findings

PURPOSE: To determine the spectrum of disease associated with a fine reticular pattern superimposed on areas of ground-glass opacity (i.e., "crazy-paving" appearance) at thin-section computed tomography (CT) and to determine the underlying pathologic features. MATERIALS AND METHODS: In the in vivo study, the cases of 46 patients (21 male, 25 female; age range, 13-82 years) were retrospectively reviewed, with special attention paid to the size and extent of the reticular network. In the in vitro study, the thin-section CT findings in 20 inflated and fixed lungs were precisely correlated with the gross appearance, contact radiograph findings, stereomicroscopic views, and histologic findings. RESULTS: In the in vivo study, 15 different diseases were identified, including alveolar proteinosis, adult respiratory distress syndrome, acute interstitial pneumonia, diffuse alveolar damage superimposed on usual interstitial pneumonia, and drug-induced pneumonitis. In the in vitro study, the fine networks at pathologic analysis were due to an alveolar filling process (n = 10), an interstitial fibrotic process (n = 7), or a combination of interstitial and intraalveolar processes (n = 3). Twelve (60%) cases did not have thickening of the interlobular septa within the areas of the crazy-paving appearance. CONCLUSION: The crazy-paving appearance is a nonspecific finding seen in a variety of interstitial and airspace lung diseases.