CT 诊断脾脏淋巴管瘤的应用价值

目的：通过分析脾脏淋巴管瘤的C T表现特征,探讨其影像诊断价值。方法搜集15例经病理证实的脾脏淋巴管瘤的CT资料,对其CT表现进行回顾性分析。结果脾脏囊状淋巴管瘤6例,海绵状淋巴管瘤9例。单发病灶7例,多发病灶8例。3例边缘清晰,12例边缘模糊。除单发单房病灶及多发单房病灶中1个病灶无分叶状轮廓改变外,余病灶轮廓均显示形态不规则,呈分叶状改变。病灶内呈稍高密度网格状分隔（除单发单房及多发单房中一个病灶外）及低密度之液性区（除1例出现分层征象,下层为稍高密度影）。增强后动脉期、门静脉期囊壁及分隔13例轻中度强化,2例延迟期轻度强化。结论脾脏淋巴管瘤的CT表现具有一定特征性,CT是临床正确诊断的重要影像学检查方法。     

脾弥漫性血管淋巴管瘤1例

病人,女,44岁。右下肢水肿1年。查体：腹平坦,无腹壁静脉曲张及胃肠蠕动波。腹软,全腹无压痛,无反跳痛及肌紧张,莫菲征（-）,肝脾未触及。全身皮肤无黄染,未见出血点、淤斑及皮疹,周身浅表淋巴结未触及。血常规、生化及肝功均正常。B超示：脾脏厚约3．5cm,形态正常,实质回声不均质,强弱不等,似呈结节状,较大者约1．1cm×0．9cm×0．8cm,实质内也可见多个囊性暗区,较大者约2．1cm×1．9cm×1．4cm,边界清,透声好,     

小儿淋巴管瘤的CT诊断

目的：探讨小儿淋巴管瘤CT表现及CT诊断价值。方法：对经手术(7例)、穿刺(2例)病理证实的9例小儿淋巴管瘤进行回顾性分析，5例行平扫加增强CT扫描，4例仅行平扫。结果：9例淋巴管瘤，6例位于颈部，其中1例向纵隔内生长、3例向肩背部生长，2例位于肠系膜，1例位于后腹膜，CT表现为多房(8例)或单房(1例)、薄壁囊肿，7例囊内密度均匀，呈水样密度，2例囊内密度不均匀，其中1例是囊状合并海绵状淋巴管瘤伴囊内出血，1例是囊内有出血，CT值4—50HU。5例强增扫描，3例囊壁及间隔有强化。结论：CT检查能清楚显示淋巴管瘤的部位、范围及内部特征，指导临床治疗。     

脾囊性淋巴管瘤1例

患者，男性，45岁。左腹胀痛不适2月余入院。查体：一般情况尚好，左上腹轻度压痛，反跳痛（-），末有肿块，脾区叩痛（＋）。血常规、血生化均正常。B超：用兵脏厚约51mm，脾实质可探及多发圆形、类圆形大小不一无回声暗区，边界清晰。     

淋巴管瘤的CT诊断

目的:探讨淋巴管瘤的CT表现及诊断价值.方法:回顾性分析32例经病理学证实的淋巴管瘤的CT资料,并与病理结果对照.结果:根据淋巴管瘤的发生部位将其分为疏松的间隙组(25例,颈部、腋窝、纵隔、腹腔)、内脏组(1例)和体表软组织组(6例,包括胸壁3例、四肢2例和臀部1例).最常见的CT表现为边缘光整的囊性肿块,内有分隔,囊壁菲薄,壁与分隔可强化.结论:淋巴管瘤的CT表现多种多样,主要依赖于其生长部位及内容物的成分.CT对大多数病例定位定性诊断均具重要价值.     

小儿淋巴管瘤的CT诊断

目的：分析小儿淋巴管瘤的CT表现和病理基础。方法：对6例经手术或临床治疗有效证实的小儿淋巴管瘤的CT表现进行研究。结果：6例CT平扫均为多房状、薄壁、水样密度肿块,沿疏松间隙弥漫性生长,其中3例密度均匀,3例伴较高密度区,其中1例有分层波面;增强后囊壁均有不同程度强化,2例于部分囊壁之间见斑点状强化影。3例位于颈部,其中1例累及上纵隔;1例位于腋窝;2例前胸壁及前上纵隔同时受累,其中1例病灶大部位于纵隔内。结论：CT检查能较准确地显示出淋巴管瘤的部位、范围、内部特征等,因而对其定位和定性有较大价值。     

脾脏淋巴管瘤的CT表现

目的探讨脾脏淋巴管瘤的CT表现特点。方法回顾性分析7例经手术和病理证实的脾淋巴管瘤的临床和CT检查资料。结果脾脏淋巴管瘤主要CT表现为单房或多房、边界清楚或不清楚,可有分隔及分叶,囊壁及间隔增强扫描呈轻-中度强化。结论脾脏淋巴管瘤CT表现具有一定的特征性,有利于定性诊断。     

眼眶淋巴管瘤的CT诊断价值

目的探讨眼眶淋巴管瘤的CT表现,提高术前诊断准确性。资料与方法回顾性分析经手术病理证实的8例眼眶淋巴管瘤的临床与CT表现,患者术前均行CT横断位扫描,其中5例加冠状位扫描,5例行增强扫描。结果8例中,3例表现为局限性肿块,呈椭圆形,位于肌圆锥外间隙;5例为弥漫性肿块,同时累及肌圆锥内外间隙及眼睑,形态不规则,边界不清楚。3例呈等密度（与眼外肌密度相比）,5例呈混杂密度,其中4例肿瘤内有囊性低密度,1例有高密度;增强的5例中,4例显示不均匀强化,1例不强化。结论常规CT扫描能清晰显示眼眶淋巴管瘤的部位、形态及内部结构,加上冠状位扫描能准确判断其位置与毗邻关系,为手术方案的制定提供可靠依据。     

淋巴管瘤影像学诊断

目的:探讨淋巴管瘤的影像学表现,评价影像学的诊断价值.方法:回顾性分析31例经手术及病理证实的淋巴管瘤影像学资料.结果:根据所合淋巴管扩张程度不同,组织学上将其分为3型:囊性淋巴管瘤18例、海绵状淋巴管瘤11例和血管瘤淋巴管瘤2例.结论:CT和MRI检查可清晰显示淋巴管瘤的大小、形态和范围,具有重要的诊断价值,MRI在...     

外伤性脾破裂的CT诊断

目的探讨外伤性脾破裂的CT表现及诊断价值. 资料与方法对48例成人闭合性钝性脾破裂的CT、B超表现与外科手术所见进行回顾性分析. 结果 48例中完全性脾破裂39例,中心破裂6例,3例包膜下破裂.48例均行CT检查, 46例确诊, 诊断符合率98.5%; 其中19例同时行B超检查, B超确诊17例, 诊断符合率89.4%.其CT表现为脾内血肿、脾撕裂伤、包膜下血肿、脾周血肿及腹腔积血,同时发现25例合并肝、肾、肋骨、脊柱等损伤. 结论 CT作为一种非损伤性检查手段,能迅速、准确评估脾损伤程度及出血的部位、大小以及腹腔伴随性损伤.肋骨及运动性伪影是CT诊断脾破裂过程中的主要误、漏诊原因,结合彩色多普勒超声检查,可减少运动性伪影造成的误漏诊;CT能为临床选择非手术病例提供重要帮助.     

肾上腺区副脾的CT表现

目的 探讨肾上腺区副脾的CT特征.方法 回顾性分析经手术病理证实的5例肾上腺区副脾术前CT资料.结果 病灶均位于左侧肾上腺区,单发,边界清晰,4例呈类圆形,1例椭圆形,最大径1.1 ～3.0 cm之间,平均(2.1±0.7)cm.CT平扫5例病灶密度均匀,与同层面的脾脏密度相近,均无囊变、坏死、出血及钙化,CT值41.9～55.3 HU,平均(47.7±5.4)HU;增强动脉期均明显不均匀或斑马纹样强化,CT值78.6～141.1 HU,平均(102.6±25.8) HU,静脉期2例进一步强化,3例强化程度略减低,强化程度均趋于均匀,CT值68.7 ～ 129.7 HU,平均(104.6±22.9) HU.5例病灶3期CT值与同层面脾脏的CT值相仿,5例中,病灶由脾动脉分支供血4例,合并其他部位的副脾2例.结论 肾上腺区副脾CT特征为平扫密度及强化程度均相近,多由脾动脉分支供血,易合并其他部位的副脾,这些特征有助于肾上腺区副脾的诊断.     

脾脏囊性占位性病变的螺旋CT诊断价值

目的:探讨脾脏囊性占位性病变的螺旋CT表现及其诊断价值。方法:回顾性分析经手术病理或穿刺活检证 实19例脾脏囊性占位性病变的CT表现。19例均行CT平扫,16例行动态增强扫描。结果:19例中脾囊肿10例,脾转移 瘤4例,脾脏淋巴管瘤2例,脾海绵状血管瘤2例及脾原发性淋巴瘤1例。CT对脾脏囊性占位性病变的检出率极高,能 明确肿块性质、范围及其与周围组织的关系。结论:平扫和动态增强螺旋CT检查对脾脏囊性占位性病变有较高的定性 诊断价值。     

Spleen volume on CT and the effect of abdominal trauma

The aim of this study is to determine the magnitude of change in spleen volume on CT in subjects sustaining blunt abdominal trauma without hemorrhage relative to patients without disease and how the spleen volumes are distributed. Sixty-seven subjects with blunt abdominal trauma and 101 control subjects were included in this retrospective single-center, IRB-approved, and HIPAA-compliant study. Patients with an injured spleen were excluded. Using a semiautomatic segmentation program, two readers computed spleen volumes from CT. Spleen volume distribution in male and female trauma and control cohorts were compared nonparametrically. Spleen volume plotted against height, weight, and age were analyzed by linear regression. The number of females and males are, respectively, 35 and 32 in trauma subjects and 69 and 32 among controls. Female trauma patients (49.6 years) were older than males (39.8 years) (p?=?0.02). Distributions of spleen volume were not normal, skewed above their means, requiring a nonparametric comparison. Spleen volumes in trauma patients were smaller than those in controls with medians of 230 vs 294 mL in males(p?<?0.006) and 163 vs 191 mL in females(p?<?0.04). Spleen volume correlated positively with weight in females and with height in male controls, and negatively with age in male controls (p?<?0.01). Variation in reproducibility and repeatability was acceptable at 1.5 and 4.9 %, respectively. Reader variation was 1.7 and 4.6 % for readers 1 and 2, respectively. The mean spleen volume in controls was 245 mL, the largest ever reported. Spleen volume decreases in response to blunt abdominal trauma. Spleen volumes are not normally distributed. Our population has the largest spleen volume reported in the literature, perhaps a consequence of the obesity epidemic.     

高海拔地区成年人脾脏正常大小CT观测

本文测量了１１５例高海拔地区（２２６０—３０００ｍ）正常成人脾脏大小，提出其ｂ值上限不超过１２．６ｃｍ，ｔ值上限不超过６．２ｃｍ，Ｉ值上限不超过１２．１ｃｍ的标准。用肋单元计数以不超过７个为妥，高原居民脾脏增大为机体对缺氧所致的一种代偿性改变，并随海拔递增，脾有渐大的趋势。     

经皮穿刺脾脏门静脉造影CT（CTSP）的扫描技术

众所周知 ,经动脉门静脉造影ＣＴ(ＣＴＡＰ)是显示肝内占位病变最敏感的方法 ,但此项检查需在Ｘ线引导下行动脉插管后才能进行ＣＴ检查。张雪林等在此检查的基础上 ,认为经皮穿刺脾脏门静脉造影ＣＴ(ＣＴＳＰ)简便了操作设备 ,但显示肝内占位病变效果与ＣＴＡＰ一样[1] 。本文就我院行 30例ＣＴＳＰ检查的ＣＴ扫描技术及体会做一介绍。1　材料1.1　ＣＴ扫描机 ,用西门子公司生产的ＳＯＭＡＴＯＭＰＬＵＳ全身ＣＴ机。1.2　ＣＴ注射器用美国Ｍｅｄｒａｄ公司生产的ＭＣＴ310 - 2型 ,储存 6个程序 ,可遥控操作。1.3　造影剂用德国先灵公司生产…     

CT Evaluation of Laryngotracheal Trauma

Laryngotracheal injuries are rare, and typically associated with multisystem trauma. They may be blunt or penetrating in nature, and are in the great majority of cases related to motor vehicle accidents or òclotheslineó injuries with a small percentage due to direct blows sustained during assaults or athletic contests, hanging or manual strangulation, or other less common etiologies including iatrogenic causes. Missed diagnoses or mismanagement may result in the patient's death or significant long-term morbidity. The radiologist must be familiar with the normal computed tomographic (CT) appearance of laryngotracheal anatomy to correctly interpret CT studies following injury, and must also be aware of the central role that CT plays in diagnosis, management, and selection of therapy. This should include an understanding of the Shaefer classification of laryngeal injuries that is based on a combination of the CT and endoscopic findings. Although an acceptable evaluation of the traumatized larynx is obtainable with most commercially available CT scanners, optimal studies are produced by CT devices capable of spiral technique and subsecond scan times, particularly in regard to their ability to generate thin retrospectively reconstructed two-dimensional (2D) axial sections, 2D coronal and sagittal images, and three-dimensional (3D) images. Our discussion of laryngotracheal injuries is divided into four parts. Part 1 deals with injuries to the endolaryngeal soft tissues structures, including the mucosa, vocal cords, and deep compartments. The ability of CT to demonstrate endolaryngeal edema and hematoma, vocal cord injuries, subcutaneous emphysema, and aspirated radiopaque foreign bodies is discussed along with its inability to demonstrate the site of mucosal perforations or degloving injuries. Part II deals with fractures of the hyoid bone, epiglottis, and thyroid and cricoid cartilages, while Part III discusses dislocations of the cricoarytenoid and cricothyroid joints. Finally, Part IV discusses laryngotracheal separation, the most immediately life-threatening laryngotracheal injury, and the difficulties inherent in making this diagnosis prospectively by CT.     

结核性脑膜炎的CT评价

目的　评价结核性脑膜炎（TBM）的CT表现和诊断作用。方法　对40例临床诊断为TBM的CT平扫和增强扫描进行了回顾性研究。结果　CT扫描36例（90%）显示异常,其他4例正常。CT扫描异常表现包括脑底渗出22例,脑积水36例,脑梗塞11例和结核瘤9例。结论　TBM的特征性CT表现为脑底池和外侧裂的炎性渗出,CT扫描对于观察TBM的脑积水、脑梗死和结核瘤等并发症也很重要,这些因素都和治疗计划相关。经过内科治疗以后,CT显示结核瘤持续存在或者进行性脑室扩张,应当考虑手术治疗。     

多层螺旋CT对周围肺动脉显示能力的研究

目的比较多层螺旋CT肺动脉造影不同层厚重建对周围肺动脉的显示能力. 资料与方法 21例无肺部疾患和血栓病史的患者行CT肺动脉造影检查,均用0.75 mm准直扫描,分别用0.75 mm/0.5 mm（层厚/层间距）（A组）、1.0 mm/0.6 mm（B组）、1.5 mm/1.0 mm（C组）重建,记录每例患者3种不同重建层厚对段肺动脉、亚段肺动脉、5级和6级肺动脉的显示情况及血管不能显示的原因. 结果 3组人均肺段动脉的显示率均为96.45%（19.29/20）;人均亚段动脉显示率分别为94.42%、93.44%、91.13%,3组间均无显著性差异;A、B、C组对第5级肺动脉的人均显示率分别为80.44%、73.47%、59.02%,A组与C组有显著性差异（P＜0.01）,B组与C组间有显著性差异（P＜0.05）;6级肺动脉3组人均显示率分别为33.75%、31.69%、23.56%,A组与C组有显著性差异（P＜0.01）.段肺动脉不能分析的主要原因是解剖变异（53.33%）和心脏搏动伪影（40%）;A、B组亚段肺动脉不能分析的主要原因是解剖变异和心脏搏动伪影,C组的主要原因是部分容积效应（43.84%）与A组比较有显著性差异（10.87%）（P=0.015）;3组对5级和6级肺动脉不能分析的主要原因均为部分容积效应. 结论多层螺旋CT肺动脉造影0.75 mm、1.0 mm、1.5 mm重建层厚对段肺动脉和亚段肺动脉均有很好的显示率,A、B组对5级肺动脉的显示率也较好.影响亚段肺动脉显示的主要原因是解剖变异和心脏搏动伪影.1.0 mm重建层厚可满足肺动脉的观察和图像处理的需要.