腔外型胃平滑肌瘤的CT诊断

目的探讨腔外型胃平滑肌瘤的CT表现.方法对经手术病理证实的30例腔外型胃平滑肌瘤行CT平扫及增强扫描,分析其特点.结果 30例腔外型胃平滑肌瘤,病变位于胃体部27例,胃窦部3例,CT平扫表现为与胃壁关系密切的圆形或椭圆形软组织肿块,边缘光滑,病变与胃壁呈钝角或锐角,19例密度均匀,11例内见低密度灶,增强扫描14例无强化,16例轻至中度强化,右侧卧位扫描肿块出现牵拉征14例,抱球征12例.结论 CT在显示腔外型胃平滑肌瘤较其他检查方法有明显优势,对病变的正确诊断有重大意义.     

腔外型胃平滑肌瘤的CT诊断

目的 探讨腔外型胃平滑肌瘤的CT表现。方法 对经手术病理证实的30例腔外型胃平滑肌瘤行CT平扫及增强扫描，分析其特点。结果 30例腔外型胃平滑肌瘤，病变位于胃体部27例，胃窦都3例，CT平扫表现为与胃壁关系密切的圆形或椭圆形软组织肿块，边缘光滑，病变与胃壁呈钝角或锐角，19例密度均匀，11例内见低密度灶，增强扫描14例无强化，16例轻至中度强化，右侧卧位扫描肿块出现牵拉征14例，抱球征12例。结论 CT在显示腔外型胃平滑肌瘤较其他检查方法有明显优势，对病变的正确诊断有重大意义。     

上消化道结石的X线诊断及治疗

目的分析上消化道结石的钡餐造影表现及其治疗.分析36例上消化道结石的X线资料及治疗情况.结果上消化道结石钡餐造影主要表现胃内大小不等、数量不一的不规则性充盈缺损;病变随体位变化或推压,其位置亦发生改变.其中32例服产气粉后消失.结论钡餐造影对于诊断上消化道结石具有可靠价值.且用产气粉治疗结石,效果非常显著.     

肾血管平滑肌脂肪瘤的综合影像学诊断评价与病理

目的 结合手术病理结果,评价肾血管平滑肌脂肪瘤的影像学诊断.材料和方法 收治15例RAL患者其中11例经手术病理证实,4例由CT确诊.分析其腹平片、肾盂造影、B超、CT和病理资料,评价不同影像手段对本病诊断的价值和限度.结果 膜部平片和肾盂造影无特征性;B超典型表现为强回声光团,当肿瘤内含脂肪细胞较少或合并出血时可呈不典型的混合型或低回声型;CT发现肿块内脂肪低密度和低CT值为本病的特征.当表现为软组织密度时难与肾癌鉴别.结论 RAL的影像学表现与肿瘤的病理特点密切相关.B超和CT具有定性作用.不典型者仍须进一步检查.     

双对比消化道造影结合CT对胃间质瘤的诊断价值

目的探讨胃间质瘤的消化道造影和CT的表现,以提高诊断正确率。方法回顾性分析14例经病理学及免疫组化证实的胃间质细胞瘤患者的临床资料和消化道造影CT表现。14例均行双对比消化道造影和CT平扫＋增强扫描。结果肿瘤均为单发,腔内型4例,腔外型6例,哑铃型4例,圆形或类圆形10例,分叶形4例,良性偏小平均直径约3.2cm,恶性偏大,平均直径约7.5cm。CT平扫示肿瘤呈均匀等密度4例,肿块周边呈等密度,中间呈略低密度或低密度8例,呈高、低、等混杂密度2例。增强扫描示4例呈中度明显增强,5例中度不均匀增强,以静脉期明显。病灶内有大片低密度坏死,周边强化5例。病理检查8例恶性,6例良性。结论 GST的影像表现缺乏特异性,消化道钡餐造影是基础筛选检查,结合CT可对GST作出比较准确的定位、定性诊断,确诊还需要依靠病理和免疫组化。     

上消化道结石的X线诊断及治疗

目的：分析上消化道结石的钡餐造影表现及其治疗。分析36例上消化道结石的X线资料及治疗情况。结果：上消化道结石钡餐造影主要表现：胃内大小不等、数量不一的不规则性充盈缺损；病变随体位变化或推压，其位置亦发生改变。其中32例服产气粉后消失。结论：钡餐造影对于诊断上消化道结石具有可靠价值。且用产气粉治疗结石，效果非常显。     

小儿膀胱横纹肌肉瘤的影像诊断

目的探讨小儿膀胱横纹肌肉瘤(Rhabdomyosarcoma,RMS)的X线造影和CT表现特征,提高对本病的认识.方法回顾性分析14例经手术病理证实的膀胱RMS的临床影像资料,全部病例均行静脉尿路造影和/或膀胱造影检查,其中4例行CT扫描.结果造影显示葡萄簇状充盈缺损11例;膀胱三角区大的分叶状充盈缺损影3例,6例膀胱壁毛糙.4例CT均显示膀胱腔内典型葡萄簇状低于腹壁肌肉密度软组织肿块,膀胱壁增厚,增强呈轻中度强化.结论膀胱RMS影像表现具有一定特征,结合患儿年龄及临床特征多可做出正确诊断.     

小儿膀胱横纹肌肉瘤的影像诊断

目的探讨小儿膀胱横纹肌肉瘤(Rhabdomyosarcoma,RMS)的X线造影和CT表现特征,提高对本病的认识.方法回顾性分析14例经手术病理证实的膀胱RMS的临床影像资料,全部病例均行静脉尿路造影和/或膀胱造影检查,其中4例行CT扫描.结果造影显示葡萄簇状充盈缺损11例;膀胱三角区大的分叶状充盈缺损影3例,6例膀胱壁毛糙.4例CT均显示膀胱腔内典型葡萄簇状低于腹壁肌肉密度软组织肿块,膀胱壁增厚,增强呈轻中度强化.结论膀胱RMS影像表现具有一定特征,结合患儿年龄及临床特征多可做出正确诊断.     

2.26 食管裂孔疝伴反流性食管炎患者X线钡餐与内镜检查动力学对比研究

目的探讨了X线钡餐与内镜检查在反流性食管炎合并食管裂孔疝患者中的诊断价值以及两者在临床应用的优选问题.方法对50例确诊为反流性食管炎伴食管裂孔疝患者,在1周内行X线钡餐与内镜检查,并将结果进行对照分析.结果 X线钡餐检查中,合并胃食管反流的患者占100%,反流方式以抽吸式为主(80%),间断式次之(15%).内镜检查均可见食管粘膜炎症表现,出现明显反流患者较少(3 0%),食管裂孔疝疝囊内黏膜改变以充血水肿为主(60%),而食管下段黏膜则以糜烂、溃疡为主(40%).对短食管性食管裂孔疝诊断意义较大.X线钡餐与内镜检查诊断符合率为70%.结论两种检查方法均适用于食管裂孔疝诊断,X线钡餐简便、痛苦少,可动态监测食管运动功能,常为首选.但对于合并反流性食管炎或其他并发症时以内镜检查为宜 .     

胃平滑肌肉瘤7例误诊分析

胃平滑肌肉瘤是源于胃平滑肌的恶性肿瘤,较少见,一般占胃恶性肿瘤的1.5%~5%,约占胃间叶组织肿瘤的20%[1]。由于临床症状、X线检查等与胃癌难以鉴别,常常误诊为胃癌。为了提高对本病的认识,明确术前诊断,现将我院近年胃切除的恶性肿瘤中被病理证实的7例胃平滑肌肉瘤,结合文献进行分析讨论。1资料与方法1.1临床资料本组共7例,其中男4例,女3例,年龄37~59岁,平均年龄49岁。病程3~7个月,早期症状不明显,仅有胃痛,晚期出现上腹压痛,触及上腹包块,甚至伴有消化道出血。4例诊断为胃癌,3例诊断为胃内或腹腔内肿物,临床全部误诊。1.2病理资料肿物部位…     

腹茧症的影像学表现

目的 探讨腹茧症的影像学表现,提高对腹茧症的认识和诊断水平.方法 回顾性分析经手术病理证实的10例腹茧症患者的影像及临床资料.结果 临床主要表现为肠梗阻症状,X线平片可表现为肠梗阻,消化道造影表现为小肠聚集成团,呈"菜花状"或"拧麻花状"改变,CT表现为盘曲成团的肠管被增厚的纤维膜包裹或分隔.结论 腹茧症临床表现无特异...     

胃肠道肿瘤诊断中彩色多普勒超声的应用价值

目的了解彩色多普勒超声在诊断胃肠道肿瘤中的应用价值，提高术前正确诊断率。方法临床彩色多普勒超声所见腹腔或盆腔占位，后经手术或超声引导下活检病理诊断进一步证实。结果临床彩超所见腹腔或盆腔占位，后经手术或超声引导下活检病理证实来源为胃、小肠或结肠良恶性肿瘤27例，其中小肠及胃平滑肌肉瘤各3例，空结肠恶性间质瘤5例，胃及结肠腺癌14例，胃淋巴瘤2例。27例病人中26例行纤维内窥镜检查，15例病理活检为恶性肿瘤（15／27），1例病理回报炎症（1／27），10例未见明显占位（10／27）。结论临床彩超在诊断腹腔或盆腔占位中的价值应得到临床医师的重视，在某些病例中甚至优于经典的纤维内窥镜和钡餐及气钡剂双重造影。     

Gastric Schwannoma

Schwannomas, also known as neurinomas or neurilemmomas, are generally benign, slow-growing neoplasms originating in any nerve that has a Schwann cell sheath. These neoplasms are rare among the spindle cell mesenchymal tumors of the gastrointestinal tract, but develop most commonly in the stomach representing 0.2% of all gastric tumors. We present the case of a 57-year-old female patient with a large schwannoma in the stomach that was palpable in the abdomen. She underwent subtotal gastrectomy under suspicion of gastrointestinal stromal tumor (GIST), but post-operative histopathological and immunohistochemical findings showed a fascicular arrangement of spindle cell with pallisading nuclei, and positive for S-100 protein with negative smooth muscle actin (SMA). These results confirmed schwannoma as the diagnosis.     

Clinical manifestations and diagnosis of childhood mediastinal tumors

Mediastinal tumors make up as high as 7% of the malignant neoplasms in children and are encountered in all age groups, slightly more commonly in preschool children. Three main groups of common symptoms that are typical of mediastinal tumors are identified. These include 1) symptoms associated with tumor compression of thoracic organs; 2) neurological disorders associated with compression or destruction of ganglionary nodes; 3) general symptoms. Posterior mediastinal tumors are diagnosed by X-ray in 85% of cases. X-ray computed tomography makes it possible to judge of the initial site of a neoplasm, the presence of inclusions, the status of adjacent organs and tissues, the density of a pathological focus. Gallium-67 citrate radionuclide study allows one to make an early differential diagnosis between a solid formation and lymph proliferative disease. The lack of morphological verification of a diagnosis requires the use of transthoracic aspiration biopsy whose diagnostic value enhances when it is made under guidance of ultrasound or X-ray computed tomography.     

多发性食管炎性肌纤维母细胞瘤影像分析（附1例报道）

目的：提高对食管多发性炎性肌纤维母细胞瘤（inflammatory myofibroblastoma,IMF）影像表现的认识。方法和结果：临床诊治1例经手术病理证实的食管多发性IMF;通过分析其影像学表现并结合文献复习,总结IMF的影像学表现特点。结论：IMF的影像学表现缺乏特异性;胃肠钡餐检查及螺旋cT检查相互结合,对其诊断具有重要价值。     

脊柱原发骨质疏松性压缩骨折MRI特征及诊断价值

目的　分析脊柱原发性骨质疏松性压缩骨折MRI特点及其诊断价值 .方法　回顾性分析经X线诊断、临床证实的 4 8例脊椎原发骨质疏松性压缩骨折的MRI表现 .结果　共 82个椎体表现为压缩变形 ,其中凹陷形 4 1个 ,楔形 31个 ,扁平形 10个 .矢状位T1WI5 2个椎体表现不同类型的低信号 ,30个椎体未见异常信号 .结论　脊柱原发骨质疏松性骨折的MRI表现较具特征性 ,是临床诊断的一种可靠的检查手段 ,能准确地与恶性肿瘤所致的椎体病理性骨折鉴别     

Gastrointestinal stromal tumor presenting as a recurrent vaginal mass

Gastrointestinal stromal tumors are CD117 (c-Kit)-positive mesenchymal neoplasms with histologic and ultrastructural features of the interstitial cell of Cajal. While tumors outside of the gastrointestinal tract have been described, to our knowledge the case we present is the first such case in the vagina. We describe a 75-year-old woman with a recurrent vaginal gastrointestinal stromal tumor without apparent rectal involvement. This tumor was characterized by short intersecting fascicles of spindled cells, focal necrosis, and 12 to 15 mitoses per 50 high-power fields. Immunohistochemistry revealed diffuse cytoplasmic positivity for CD117 (c-Kit), CD34, vimentin, and h-caldesmon. Tumor cells were negative for S100, desmin, actin, and CAM 5.2. The differential diagnosis in this case included a vaginal smooth muscle tumor. While histologically similar to a smooth muscle neoplasm, the immunohistochemical profile ruled out smooth muscle differentiation. Gastrointestinal stromal tumor should be considered in the differential diagnosis of vaginal mesenchymal neoplasms.     

Renal angiomyoadenomatous tumor

We report a case of a 40-year-old woman with renal angiomyoadenomatous tumor, a rare neoplasm with only 6 previous cases reported in the literature. Unlike our case, most tumors have been identified in middle-aged males; they present as well-circumscribed, encapsulated tan-brown masses with variably prominent cystic areas. Microscopically, the tumors have a variably thick leiomyomatous capsule, which invaginates into the tumor and intermixes with tubules or solid nests of clear epithelial cells. The epithelial cells have low-grade basally oriented nuclei, and their basement membranes are intimately linked to a labyrinthine network of capillaries and pericytes. Microscopically, these tumors can be confused with clear cell carcinoma, papillary carcinoma, mixed epithelial and stromal tumors, and angiomyolipoma. This is also the first case report correlating the radiographic and morphological findings of this rare entity. The differentiating features of these neoplasms and a review of literature of are herein presented.