骨样骨瘤的影像学特征

目的:探讨骨样骨瘤的影像学特征。方法:对我院近年来就诊的22例骨样骨髓患者进行回顾性分析,所有病例均行X线检查,与此同时行CT检查者16例,行MR检查者7例,三种检查方法均检查者7例。结果:22例病灶周围均有不同程度的骨质硬化,经CT检查者有4例周围可见骨膜反应,行MR检查者5例都可见瘤巢周围的软组织或骨髓水肿。结论:瘤巢是骨样骨瘤的特征性表现,了解骨样骨瘤的病理变化和影像学表现,对术前诊断及鉴别诊断、确定治疗方案具有重要意义。     

骨髓纤维化在中轴骨和四肢长骨中的影像学表现

目的 探讨骨髓纤维化在中轴骨和四肢长骨中的影像学特点.方法 收集2007-2011年经活检病理证实,并有完整影像学资料的骨髓纤维化患者共8例.根据其中轴骨和四肢长骨的X线、CT及MRI表现,分析其影像学特点,并对比三者的优缺点.结果 8例骨髓纤维化患者X线检查3例诸骨骨质未见阳性表现;2例广泛骨质密度增高,骨小梁增粗、致密及融合,呈骨质硬化改变,长骨骨髓腔分辨不清;3例骨小梁模糊,呈磨玻璃样密度增高.5例CT检查中2例可见不同程度骨质硬化及多发囊状透亮影;3例髓腔密度不均匀,其内见散在斑片状或条状密度增高影.8例MRI均发现异常,4例表现为T1WI和T2WI不同程度减低的弥漫均匀低信号,4例表现为等信号背景下数目、大小不等的多发斑点或斑片状低信号灶,分布不均匀;T2WI STIR呈低信号,增强扫描未见强化.结论 骨髓纤维化有较特征性的MRI表现,CT对骨髓纤维化的诊断有一定帮助,X线对骨髓纤维化的诊断有明显的局限性.     

脾错构瘤的影像学诊断

目的 探讨脾错构瘤的影像学诊断特点,提高对本病的诊断能力.方法 回顾性分析经手术病理证实的4例脾错构瘤的影像学资料.4例均做了CT扫描,其中3例做了超声检查,2例做了MRI检查.结果 本组4例均为单发.超声声像图表现为脾内边界较清楚的实质性圆形或类圆形团块,中等偏高回声、内部回声欠均匀;CT平扫表现为无明确界限之等密度或稍低密度灶,增强后呈持续性强化,其中1例呈"星芒"状不强化区;MRI平扫上,1例灶内呈"星芒"状、"漩涡"状低信号,另1例在T2WI上呈低信号.结论 脾错构瘤的影像学表现比较多样,综合影像学检查,尤其是CT、MRI两者的诊断信息,有助于本病的诊断与鉴别诊断.     

长管状骨骨梗死的影像学对比

目的探讨骨梗死的影像学诊断要点。方法病人均行X线平片、CT、MRI检查,病灶累及股骨下段、胫骨上段、胫骨下段、股骨颈和胫骨粗隆。结果早期骨梗死,X线平片无明显异常;中期,CT表现为髓腔不均匀钙化;晚期,MRI显示为典型的地图样表现。结论MRI是检查诊断早期骨梗死最为有效的方法,X线平片对中晚期病变有帮助,CT较平片敏感。     

数字化影像技术联合应用诊断骨肿瘤的临床价值

目的探讨三种数字化影像技术联合应用(包括DR、CT、MRI)在骨肿瘤诊断中的临床价值。方法回顾分析96例经临床病理证实的影像学资料,其中96例行DR,46例行CT扫描,50例行MRI检查,40例联合应用DR、CT及MRI检查。结果 96例DR片中8,7例显示骨质改变,20例显示软组织肿块,40例显示骨膜反应,28例显示钙化或骨化。46例行CT扫描均显示骨质改变4,0例显示软组织肿块,21例显示骨膜反应3,4例显示钙化或骨化。50例行MRI检查中40例显示骨质改变,49例显示软组织肿块,19例显示骨膜反应,15例显示钙化或骨化4,7例显示骨髓水肿。40例联合应用DR、CT及MRI检查中40例显示骨质改变,39例显示软组织肿块,19例显示骨膜反应,30例显示钙化或骨化,38例显示相应骨髓水肿。结论三种数字化影像技术联合应用能全面、准确显示骨肿瘤征象,诊断符合率高于单一或两种技术联合应用。     

可逆性后部白质脑病综合征影像学与临床分析

目的 探讨可逆性后部白质脑病综合征(RPLS)影像学与临床特点.方法 回顾性分析2004年6月至2007年10月6例RPLS患者的影像学及临床资料.结果 6例均行MRI及CT检查,4例双侧对称性枕叶白质受累,4例双侧额顶叶皮质下白质广泛受累,1例同时累及中脑和丘脑,1例累及尾状核头部;病灶形态不规则,表现为皮质及皮质下白质脑回样异常信号,2例妊娠高血压综合征磁共振静脉造影显示未发现静脉窦血栓形成.所有患者均给予积极治疗原发病、控制血压、控制癫痫发作、脱水减轻脑水肿及对症支持治疗.5例患者症状基本消失,1例遗留右侧肢体轻偏瘫.无一例死亡.结论 只要结合临床病史,特别是具有高血压、子痫及肾功能不全的患者出现典型的临床四联征,影像学为后部脑白质损害为主的表现,RPLS的诊断并不困难.     

脑胶质瘤病的影像学表现与临床及病理诊断

目的 探讨脑胶质瘤病的影像学表现与临床及病理诊断,提高对该病的认识.方法 回顾性分析26例脑胶质瘤病患者的影像学所见.结果 手术部分切除8例,立体定向穿刺活检18例.影像学检查包括CT和MRI平扫及增强,12例行1H磁共振波谱分析(MRS)检查.所有患者病变都至少累及2个脑叶,其中22例CT和MRI表现为脑内大片状对称性低密度影和略长T1、长T2异常信号,增强扫描20例无明显强化,2例轻度强化,4例表现为大片状病灶不对称,增强扫描无强化.12例行1H MRS检查,表现为胆碱(CHO)/肌酸(Cr)、CHO/N-乙酰基天冬氨酸(NAA)升高,NAA/Cr不同程度降低,8例出现乳酸峰.结论 MRI是诊断脑胶质瘤病的首选检查方法;1H MRS 对该病的诊断及病理分级有重要帮助;MRI和活检相结合可明确诊断.     

化脓性脊柱炎的影像学诊断

目的探讨化脓性脊柱炎的影像学表现，提高对化脓性脊柱炎的影像学认识和诊断水平。方法回顾性分析20例经手术病理或临床证实的化脓性脊柱炎患者的X线、CT和MRI表现。所有病例均行X线检查，其中CT检查13例，MRI检查15例。结果X线显示14例椎体边缘不同程度骨质增生、硬化，其中2例形成骨桥，3例椎体骨质破坏。CT能清晰显示椎体骨质破坏、小的死骨、椎间盘密度减低、椎旁软组织肿胀增厚。MRI示15例33个椎体表现为相邻椎体终板下局限或全椎体弥漫性长T。、长T2信号改变，受累椎间盘及椎旁软组织也以长T1、长T2信号为主。2例Gd—DTPA增强扫描病变椎体、椎间盘、椎旁软组织明显异常强化。结论CT与MRI对化脓性脊柱炎均可做出正确诊断。MRI对化脓性脊柱炎的早期诊断及显示椎管内累及范围更有优势。     

胆管囊肿的影像学诊断（附6例分析）

目的探讨B超、CT、经皮肝穿刺胆管造影（PT℃）及磁共振成像（MRI）在胆管囊肿及其合并症中的诊断价值。方法回顾性分析6例胆管囊肿患者的B超、CT、PTC及MRI的影像学资料。结果B超和CT能清晰显示肝内较大的胆管囊肿，对肝内细小胆管囊肿及肝外胆管囊肿的显示不如MRI；PTC能较好地显示胆管树及胆管扩张情况，但操作复杂，有创伤，对某些合并症易漏诊；MRI能无创、多方位、多序列地显示胆管囊肿及其合并症的影像学特点，其中磁共振胰胆管造影（MRCP）能无创、直观地显示肝内外胆道情况，可与PTC相媲美。结论对于胆管囊肿及其合并症的诊断，MRI较其他检查方法更具有优势。     

化脓性脊柱炎的影像学诊断

目的 探讨化脓性脊柱炎的影像学表现,提高对化脓性脊柱炎的影像学认识和诊断水平.方法 回顾性分析20例经手术病理或临床证实的化脓性脊柱炎患者的X线、CT和MRI表现.所有病例均行X线检查,其中CT检查13例,MRI检查15例.结果 X线显示14例椎体边缘不同程度骨质增生、硬化,其中2例形成骨桥,3例椎体骨质破坏.CT能清晰显示椎体骨质破坏、小的死骨、椎间盘密度减低、椎旁软组织肿胀增厚.MRI示15例33个椎体表现为相邻椎体终板下局限或全椎体弥漫性长T1、长T2信号改变,受累椎间盘及椎旁软组织也以长T1、长T2信号为主.2例Gd-DTPA增强扫描病变椎体、椎间盘、椎旁软组织明显异常强化.结论 CT与MRI对化脓性脊柱炎均可做出正确诊断.MRI对化脓性脊柱炎的早期诊断及显示椎管内累及范围更有优势.     

中日传染病防制管理体系的比较

为了解一些先进国家应对突发公共卫生事件,特别是对SARS一类传染病的管理措施,本文以SARS防治为例对北京和日本东京的传染病防治体系进行比较,寻找二者的异同和存在的问题,为防病体系的建设提供建议.     

Bronchoalveolar inflammation after exposure to diesel exhaust: comparison between unfiltered and particle trap filtered exhaust

OBJECTIVES: Air pollution particulates have been identified as having adverse effects on respiratory health. The present study was undertaken to further clarify the effects of diesel exhaust on bronchoalveolar cells and soluble components in normal healthy subjects. The study was also designed to evaluate whether a ceramic particle trap at the end of the tail pipe, from an idling engine, would reduce indices of airway inflammation. METHODS: The study comprised three exposures in all 10 healthy never smoking subjects; air, diluted diesel exhaust, and diluted diesel exhaust filtered with a ceramic particle trap. The exposures were given for 1 hour in randomised order about 3 weeks apart. The diesel exhaust exposure apperatus has previously been carefully developed and evaluated. Bronchoalveolar lavage was performed 24 hours after exposures and the lavage fluids from the bronchial and bronchoalveolar region were analysed for cells and soluble components. RESULTS: The particle trap reduced the mean steady state number of particles by 50%, but the concentrations of the other measured compounds were almost unchanged. It was found that diesel exhaust caused an increase in neutrophils in airway lavage, together with an adverse influence on the phagocytosis by alveolar macrophages in vitro. Furthermore, the diesel exhaust was found to be able to induce a migration of alveolar macrophages into the airspaces, together with reduction in CD3+CD25+ cells. (CD = cluster of differentiation) The use of the specific ceramic particle trap at the end of the tail pipe was not sufficient to completely abolish these effects when interacting with the exhaust from an idling vehicle. CONCLUSIONS: The current study showed that exposure to diesel exhaust may induce neutrophil and alveolar macrophage recruitment into the airways and suppress alveolar macrophage function. The particle trap did not cause significant reduction of effects induced by diesel exhaust compared with unfiltered diesel exhaust. Further studies are warranted to evaluate more efficient treatment devices to reduce adverse reactions to diesel exhaust in the airways.

 

     

Imaging techniques for measuring adipose-tissue distribution--a comparison between computed tomography and 1.5-T magnetic resonance

We developed a method for calculating adipose-tissue areas from transverse body scans by magnetic-resonance imaging (MRI). The method is based on an inversion recovery experiment (repetition time 820 ms, inversion delay time 300 ms, and echo time 20 ms). Total-fat areas and subcutaneous-fat areas were calculated by this method and by computed tomography (CT) from abdominal scans taken in seven male volunteers. The SEE ranged from 4.4 cm2 (CV 4.4%) for subcutaneous-fat areas to 8.3 cm2 (CV 12.8%) for visceral-fat areas. The reproducibility of measuring fat areas with MRI was assessed in seven other volunteers (four males, three females). The average errors of the method for different fat areas were 5.4%, 10.6%, and 10.1% for total-, visceral-, and subcutaneous-fat areas, respectively. We conclude that CT and MRI may yield different absolute values of fat areas (especially visceral fat) but that the ranking of individuals on the basis of their fat areas will be similar by both methods.     

骨质量与骨密度影像学检查及评价

2001年美国国立卫生院(NIH)提出骨质疏松是一种骨骼异常,特征是骨强度降低,导致骨折危险性增加的全身性骨病.骨强度反映骨密度和骨质量两个特征的整和.世界卫生组织(WHO)于1994年基于对高加索绝经后妇女骨量(骨密度)的测定提出的骨质疏松的定义更多的是工作定义.     

Relationship between inflammation biomarkers, antioxidant vitamins, and bone mineral density in patients with metabolic syndrome

Few studies have shown the correlation between metabolic syndrome and bone mineral density (BMD). The main pathogenic mechanisms of metabolic syndrome rely on chronic low-level inflammatory status and oxidative stress. There are few studies that examine the gender-specific effects of inflammation and antioxidants on BMD. In this study, we evaluated the relative contribution of these factors in patients with metabolic syndrome. We conducted a cross-sectional study of 67 men and 46 postmenopausal women with metabolic syndrome; metabolic syndrome was defined as having three or more metabolic syndrome risk factors. BMD, body fat mass, and lean body mass were evaluated. We also examined the levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), adiponectin, vitamin E, and C in serum. Log-transformed hs-CRP levels were significantly higher in lumbar spine osteoporotic subjects than in normal subjects for women but not for men. There was no significant difference between the normal group and the osteoporotic group in other inflammatory markers. Stepwise regression analyses for BMD of the lumbar spine showed that lean body mass and vitamin E were significant determinants in men. Lean body mass and log-transformed hs-CRP were significant determinants in women Analysis for BMD of the femoral neck showed that lean body mass was a significant determinant for both men and women. There was no significant factor among the inflammatory markers or antioxidant vitamins affecting the femoral neck BMD for either gender. In conclusion, while hs-CRP is an independent predictor of the BMD of the lumbar spine in women, vitamin E showed profound effects on BMD in men but not women with metabolic syndrome.     

炎症与子痫前期

过度炎症反应可能会导致子痫前期的发生。本文就炎症在子痫前期发生中作用的支持和反对方面的证据加以总结。已有大量研究证据表明血管生成因子失衡和全身炎症与子痫前期的发病有关,而子痫前期却缺乏炎症标记物,因此对子痫前期的炎症学说存有质疑。尚未完全证实炎症因子与子痫前期之间存在剂量-反应关系。此外,大剂量糖皮质激素治疗尽管能够控制炎症,但并不能改善子痫前期孕妇结局。研究显示,子痫前期患者经典补体途径和替代补体途径均过度激活。补体系统调节缺陷会导致补体过度激活,进而导致胎盘损伤、胎盘发育异常、全身内皮系统激活、以及抗血管生成因子的释放。炎症可能会加重由血管生成因子失衡导致的病理过程,而并非直接导致子痫前期。虽然子痫前期患者炎症反应增加,但炎症并非导致子痫前期发病的主要因素。     

动脉瘤样骨囊肿的影像诊断

目的：探讨动脉瘤样骨囊肿的影像特征,以提高诊断正确率方法：综合分析经病理证实的19例动脉瘤样骨囊肿的影像表现,除常规X线检查外,11例另行CT检查,7例另行MRI检查结果：囊肿发生于长管骨的13例、发生于扁骨及不规则骨的5倒、发生于短管骨的l例．均于X线上表现为嵌状嘭胀性骨质破坏其中11例见骨性分隔,CT表现为软组织密度,11例中4例见短小液一液平面,MRI除上述特点外,在显示液一液平面上更有优越性结论：动脉瘤样骨囊肿的X线典型表现,结合CT及MRI显示的内部结构,尤其是对液一液平面的显示,可大大提高诊断正确率,