影像学评估晚期无功能性肾结核的比较研究

目的 探讨影像学评估晚期无功能性肾结核的价值。方法 搜集经手术病理证实的晚期肾结核72例，分析并比较腹部平片（KUB）、静脉肾盂造影（IVP）、逆行尿路造影（RGP）、B超、CT的诊断价值。结果 多种影像学手段不同程度显示了晚期肾结核的形态学、病理学改变或肾功能情况，对于晚期肾结核的诊断符合率：KUB＋IVP为50％，RGP为27％，B超为72％，CT为89％。结论 B超和CT对晚期无功能性肾结核的诊断及肾功能评估有重要价值。     

综合影像诊断诊断输尿管下段结石4例分析

目的 探讨输尿管下段结石综合影像诊断的价值。方法 分析4例输尿管下段结石的临床表现，B超、X线(KUB、IVP)及CT影像表现。结果 4例输尿管下段结石均由综合影像确诊。结论 综合影像诊断对诊断输尿管下段结石有很强的实用价值。     

肾积水IVP与B超检查对照分析

65例B超诊断肾积水患者,行经X线静脉肾盂造影检查(IVP),分析二者影像表现。结果65例中IVP检查诊断肾积水为46例,符合率为70.8%;21例B超诊断肾积水伴输尿管扩张,IVP检查符合15例(71.4%)。B超诊断肾积水及输尿管扩张有较高的临床价值,但存在一定的假阳性,如与X线IVP检查相结合,可提高诊断率。     

上尿路梗阻的影像学诊断评价

目的　探讨和评价影像检查对上尿路梗阻的诊断价值。方法　对经临床治疗和手术病理证实的 13 5例上尿路梗阻进行了回顾性分析 ,重点分析B超、X线和CT对上尿路梗阻的检出、定位和病因的诊断。结果　上尿路梗阻的检出率 :B超明显高于X线和CT(P <0 .0 1)。定位正确率 :X线、CT明显高于B超 (P <0 .0 1)。三项联合检查定位正确率高达10 0 %。病因确诊率 :CT明显高于B超、X线 (P <0 .0 1) ,三者联合检查的确诊率 97.8%。结论　影像学检查对上尿路梗阻诊断起决定性作用。三种检查方法各有所长 ,三项联合检查最佳 ,临床应注意联合检查方法的应用     

静脉肾盂造影、CT及磁共振尿路成像在肾结核的诊断价值及对比分析

目的探讨静脉肾盂造影（IVP）、CT及磁共振尿路成像（MRU）的对肾结核的诊断价值。方法21例肾结核患者均行IVP和CT检查,其中14例患者行MRU检查,分别从肾脏形态改变、肾实质、肾盂肾盏、输尿管、肾功能、有无钙化等方面对肾结核做出诊断;并与手术及病理结果对照。结果IVP、CT及MRU诊断肾结核的准确率分别为61.8%,80.9%和85.7%。3种影像学方法联合诊断准确率为92%。结论IVP仍为肾结核诊断的首选检查方法,CT和MRU对中晚期肾结核肾皮质改变,肾实质内脓腔或空洞形成、肾盂输尿管壁增厚等征象显示有特异性,MRU可作为IVP检查的辅助手段用于肾结核诊断。因此肾结核的影像学表现具有多样性,必须综合多种检查技术,从而提高对肾结核诊断的正确率。     

结肠绒毛状腺瘤影像诊断的价值

目的：探讨结肠绒毛状腺瘤影像诊断的意义和价值。方法：通过重点分析98例结肠绒毛状腺瘤的X线表现,并包括其中4例B超检查,6例CT检查和7例MRI检查的结果。观察其影像学表现,对照其诊断符合率。结果;结肠绒毛状腺瘤,特别是地毯型及菜花型在X线钡灌肠造影中有较特异的表现,X线检查对本组的诊断符合率较高,B超、CT、MRI对本病的特异性较低。结论：X线钡灌肠造影检查是诊断结肠绒毛状腺瘤重要而有效的手段。     

原发性甲状旁腺机能亢进症的影像诊断

目的：评价X线、B超及CT在原发性甲状穷腺机能亢进症诊断中的作用。材料与方法：回顾分析经手术病理证实的15例原发性甲状旁腺机能力进症的X线、B超及CT检查资料。结果：X线检查15例均有明显的骨质改变；颈部B超检查5例中4例结果与手术病理相符；颈部CT扫描3例，结果均与手术病理相符。结论；X线检查是本病影像诊断的基本方法．B超及CT具有进一步明确诊断及术前定位诊断价值。     

CT尿路造影成像后行静脉肾孟造影对输尿管结石的诊断效果及ESWL术中结石定位分析

目的探讨CT尿路造影成像(CTU)后行静脉肾孟造影(IVP)对输尿管结石的诊断效果,及体外冲击波碎石术(ESWL)术中结石定位分析。方法选取2017年1月至12月B超检查结果示输尿管结石准备行ESWL者54例,均先于DR摄片室拍摄腹部X线平片(KUB),然后在CT室行CTU并三维重建,CTU检查结束后立即至造影室行IVP检查。记录诊断结石、梗阻积液及输尿管显影情况。结果 CTU诊断阳性结石50例,结石诊断率为92. 60%,梗阻积液诊断率为88. 89%,输尿管显影率为75. 93%; CTU后KUB+IVP检查诊断阳性结石38例,阴性结石8例,合计结石诊断率为85. 19%,CTU后KUB+IVP输尿管显影率高于CTU(P 0. 05)。CTU诊断中,部分患者输尿管显影延迟导致三维重建失败,而在延时IVP中相当一部分患者可见梗阻以上输尿管扩张显影。结论 CTU较IVP能更精确诊断输尿管结石,但对于输尿管显影延迟者,透视下IVP作为补充可依据个体情况安排时间复查,协助ESWL术中结石定位。     

肝血管瘤MRI的诊断价值

目的讨论肝血管瘤患者MRI检查的优越性,通过肝血管瘤的MR检查与CT、B超检查的对比,提高肝血管瘤的诊断准确率。方法随机选取2013年10月至2014年10月诊断82例肝血管瘤患者的临床资料进行回顾性分析。所有患者均行MRI与CT及B超检查。结果 MR与CT、B超检查对肝血管瘤的诊断分别出现不同的影像表现。与术后病理相比符合率分别为97.5%、80%、31%。结论在肝血管瘤的影像诊断中,MR的敏感性及确诊率明显高过CT及B超,但相对来说费用较高,检查时间较长,可在CT扫描表现不典型、B超不能确诊,或需要鉴别诊断时行MR进一步检查,提高诊断正确率。     

超声、静脉肾盂造影术及CT对肾结核的影像对比观察

目的探讨超声(US)、静脉肾盂造影(IVP)及CT(计算机断层摄影技术)对肾结核的诊断对比。方法回顾19例肾结核患者的影像检查,并与病理相比较。结果1.对早期肾结核的诊断,以IVP为优;2.US与CT结合可以提高中晚期肾结核诊断准确率;3.US对无功能肾及其他生殖器官结核有诊断优势。结论三种影像方法各有优点,可以互相弥补及提高诊断水平。     

未分化脊柱关节病的X线平片、CT及骨显像比较

目的：评价未分化脊柱关节病的SPECT全身骨显像及骶髂关节局部显像诊断价值。方法：对临床诊断为未分化脊柱关节病患者68例受检者的136个关节，进行X线、CT检查和SPECT全身骨显像及骶髂关节局部显像进行比较。结果：68例未分化脊柱关节病患者136个骶髂关节X线平片中有16个异常，CT检查有38个异常，骨显像有84个骶髂关节／骶骨放射性比值升高，36例患者有髋关节和（或）胸锁关节、腰椎等其他关节病变，无异常发现17例。结论：放射性核素骨显像诊断未分化脊柱关节病较X线及CT灵敏。     

高机械指数灰阶谐波超声造影评价肾动脉狭窄的初步研究

目的 评价高机械指数实时灰阶谐波超声造影诊断肾动脉狭窄的临床价值.方法 怀疑肾动脉狭窄者21例,包括3例肾移植术后患者,行常规彩色多普勒超声和谐波造影检查.使用SonoVue造影剂,机械指数设置在1.0左右.超声检查结果与X线血管造影、CT血管成像、磁共振血管成像检查结果相对照.结果 常规超声诊断肾动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为85.7%,57.1%,80.0%,66.7%及76.2%;结合谐波造影可分别提高到100%,66.7%,88.2%,100%及90.5%.结论 高机械指数谐波超声造影能够明显提高肾动脉与周围组织的回声对比,直观显示肾动脉的流道变化,有助于对肾动脉狭窄的诊断.     

Thoracic sonography

Sonography has inherent limitations for thoracic imaging because sound waves are reflected by bone and air space (such as in lung parenchyma). However, sonography is less expensive and more convenient than computed tomography (CT) or magnetic resonance imaging (MRI); it provides immediate information with real-time imaging; and it can provide information not available from a standard radiograph. This review describes the utility and limitations of sonography and compares sonography to radiography, CT, and MRI with regard to diagnosing pleural, pulmonary, and aortic diseases, including pneumothorax, pleural effusions and masses, hemothorax, empyema, consolidated lung, pneumonia, pulmonary abscess, pulmonary embolism, mediastinal masses, aortic dissection, aortic intramural hematoma, and penetrating aortic ulcers.     

Diagnostic values of sonography for assessment of sternal fractures compared with conventional radiography and bone scans.

OBJECTIVE: This study was prospectively undertaken to evaluate the diagnostic value of sonography for detection of sternal fractures. We compared sonographic, conventional radiographic, and bone scan examinations of sternal fractures. METHODS: Fifty consecutive patients (26 male and 24 female; mean age, 45.2 years) were evaluated. Conventional radiography and sonography were performed in all patients, and bone scans were performed in 39 patients. All patients had acute pain and tenderness in anterior midline chest areas. Sonography was performed by 2 musculoskeletal radiologists within 1 to 2 days after admission. Patients underwent conventional radiography at admission and bone scans within 4 to 7 days after admission. Two radiologists reviewed all imaging findings by means of consensus. In addition, sonography was performed in 20 asymptomatic patients in a normal control group. RESULTS: Conventional radiography depicted sternal fractures in 12 of 50 patients. Sternal fractures were detected in 31 of 50 patients on sonography. Fractures on sonography were located in the manubrium (8 cases), upper sternal body (11 cases), mid sternal body (5 cases), and lower sternal body (7 cases). Bone scans showed sternal hot uptakes (accumulations of the radionuclide used) in 18 of 39 patients. In the control group, there were no bony defects or abnormal contours. CONCLUSIONS: We could detect sternal fractures more effectively with sonography than with conventional radiography and bone scans. In addition, sternal fracture locations showed relatively even distributions, and focal fractures in the manubrium were not easily detected on bone scans.     

Enterolith ileus in a patient with jejunal diverticulosis: sonographic findings

Jejunal diverticula are rare. Enterolith ileus, the least-encountered complication among patients with jejunal diverticula, is incidentally found at surgery or during imaging studies such as radiography, CT, or endoscopy. We report the case of a 71-year-old man with enterolith ileus involving the jejunum that was initially detected using abdominal sonography and subsequently confirmed with abdominal CT and surgery. Enterolith ileus should be considered in the differential diagnosis of small bowel obstruction. Abdominal sonography may contribute to the early diagnosis of this condition.     

Assessment of the therapeutic response of hepatocellular carcinoma treated with transcatheter arterial chemoembolization: comparison of contrast-enhanced sonography and 3-phase computed tomography.

OBJECTIVE: The purpose of this study was to compare contrast-enhanced sonography with 3-phase computed tomography (CT) in assessing the therapeutic response of hepatocellular carcinomas (HCCs) treated with transcatheter arterial chemoembolization (TACE). METHODS: Twenty-nine nodular HCCs treated with TACE were examined with contrast-enhanced sonography, 3-phase helical CT, and conventional angiography. Contrast-enhanced sonographic and CT findings were interpreted separately and prospectively for the presence or absence of contrast enhancement in the treated HCCs. Conventional angiography served as the reference standard. RESULTS: Intratumoral enhancement was seen in 19 HCCs (61%) on contrast-enhanced sonography and 12 HCCs (39%) on CT. Enhancement patterns on sonography were blush in 8 (42%), branching in 2 (11%), nodular in 4 (21%), and stippled in 5 (26%). Of the 19 HCCs with intratumoral enhancement on contrast-enhanced sonography, 13 (68%) showed tumor staining on angiography. Of the 12 HCCs without intratumoral enhancement on sonography, 1 (8%) showed tumor staining on angiography. The sensitivity and specificity of contrast-enhanced sonography in depicting flow in HCCs treated with TACE were 93% and 65%, respectively. The sensitivity and specificity of 3-phase CT were 64% and 100%. CONCLUSIONS: Contrast-enhanced sonography is a more sensitive imaging method than 3-phase CT in depicting vascularity in HCCs treated with TACE.     

Segmental cystic renal disease: sonographic and CT findings

Segmental cystic renal disease is a unique benign condition that requires no treatment. It can be confused on imaging, especially on sonography, with other more common cystic renal diseases and sometimes cystic malignancy. We report a case of segmental cystic renal disease with typical imaging features on sonography and CT for which nephrectomy was avoided.     

肾结核的CT征象和病理关系

目的：探讨肾结核的CT征象和病理之间的关系。方法：肾结核26例，分别经手术（16例）和尿培养（10例）证实，综合其CT征象、手术和病理结果，结合文献资料予以分析。结果：26例肾结核，22例呈大小数量不一的囊状低密度区；2例呈实质性肿块；2例以肾盂肾盏壁增厚伴肾功能下降为主。16例有钙化，2例平扫呈均匀的囊状高密度影。共20例有肾盂和输尿管壁增厚，其中2例部分膀胱壁增厚。结论：肾结核是肾脏的慢性炎症性病变，各期的CT表现差异较大，但仍有相对的特征性，CT能客观地显示各期肾结核的病理特征，是目前肾结核最佳的影像诊断方法之一。     

Contrast-enhanced power Doppler sonography for the differentiation of cystic renal lesions: preliminary study.

The objective of this study was to investigate the potential usefulness of contrast-enhanced power Doppler ultrasonography in the differentiation of benign and malignant cystic renal lesions. Our study group was limited to patients who had complex cystic renal lesions of uncertain malignancy at screening ultrasonography. During the previous 6 months, 485 patients have been referred to ultrasonography for evaluation of renal cystic lesions, but only 13 patients participated in this study. Focusing on tumor vascularity in the intracystic septa or solid component, we analyzed power Doppler sonographic images before and after intravenous injection of contrast agent and compared them with contrast-enhanced CT scans or MR images and pathologic results. The visualization of vascularity was best on contrast-enhanced power Doppler sonography (n = 7). The use of contrast agent with power Doppler sonography showed improved diagnostic accuracy (77%) that was superior to non-contrast-enhanced power Doppler sonography or contrast-enhanced CT. In conclusion, contrast-enhanced power Doppler sonography provides better visualization of tumor vascularity in complicated cystic renal lesions than other imaging modalities, leading to more exact differential diagnosis. We therefore expect that this imaging modality might be very useful in differential diagnosis of problematic cystic renal lesions, benign or malignant.