剖宫产术后子宫及盆腔的声像图改变

研究剖宫产术后子宫及盆腔的声像图改变。方法：对８０５例剖宫产术后患者术后常规进行了Ｂ超检查。结果声像图异常发生率为５．３％。结论术后常规Ｂ超检查可及时发现剖宫术后隐并发症,和杜绝重大并发症的发生。     

Coordination of trunk and pelvis in young and elderly individuals during axial trunk rotation

It has been well known that complex tasks such as walking and arm reaching can be achieved by the coordination of the trunk and pelvis. However, understanding of the effect of aging on the coordination of the trunk and pelvis during axial trunk rotation is still lacking. The present study examined relative phase of the trunk and pelvis during axial trunk rotation, and compared it between young and older groups. 22 healthy young (age: 23.9±4.6, gender: 11 male and 11 female) and 22 healthy elderly (age: 68.4±4.9, gender: 11 male and 11 female) individuals participated in the experiment and performed axial trunk rotation. Relative phase between the trunk and pelvis was calculated based on the angular displacements of the two segments. The results demonstrated age-related changes in coordination pattern of the trunk and pelvis during axial trunk rotation.     

Features of the hypointense solid lesions in the female pelvis on T2‐weighted MRI

Most solid lesions in the female pelvis appearing hyperintense on T2‐weighted images should be interpreted as malignant. In contrast, if the solid lesions in the female pelvis appear hypointense on T2‐weighted images they may be benign. The characteristic imaging features of hyperintense solid lesions in the female pelvis on T2‐weighted images are well known, but various unusual causes and imaging features of hypointense solid lesions in the female pelvis on T2‐weighted images can be particularly misleading. Therefore, careful assessment of hypointense solid lesions in the female pelvis on T2‐weighted images is warranted. In this article, we demonstrate a variety of hypointense solid lesions in the female pelvis on T2‐weighted images. Familiarity with the clinical setting and imaging features of hypointense solid lesions in the female pelvis on T2‐weighted images will facilitate prompt, accurate diagnosis and treatment. J. Magn. Reson. Imaging 2014;39:493–503 . © 2014 Wiley Periodicals, Inc .     

肾外型肾盂-1种正常肾盂形态

目的：进一步明确影像诊断中肾盂正常形态的影像表现及分型。方法：对1240例静脉肾盂造影患者影像中的肾盂形态，采用3人阅片的方式确立肾盂形态，其中120例又进行了B超和CT的对照检查。结果：按肾盂所处于的位置可分为肾内型肾盂和肾外型肾盂；就其形态可为常见型、分枝型、壶腹型和移行型。结论：肾外型肾盂是一种正常的肾盂形态，肾外型肾盂并不罕见。     

经直肠彩超对输尿管盆腔段梗阻的诊断价值

目的：提高经直肠彩色多普勒超声对输尿管盆段梗阻定位、定性的诊断水平。方法：回顾性分析了96例输尿管盆段梗阻的病因及诊断方法。结果：输尿管盆段结石85例，输尿管恶性肿瘤11例。结论：输尿管盆段结石和肿瘤是导致输尿管梗阻的主要病因，对于其病因的诊断，应采用经直肠超声检查。     

Commonly encountered foreign bodies and devices in the female pelvis: MDCT appearances

OBJECTIVE: The objective of this article is to illustrate the MDCT appearances of several commonly encountered foreign bodies and devices in the female pelvis. CONCLUSION: The presence of a foreign body or device in the female pelvis can be a potential source of confusion to radiologists, particularly to the inexperienced reader. Familiarity with the normal appearances and locations of these devices on MDCT allows their accurate identification and detection of associated complications.     

多层螺旋CT多平面及三维重建对骨盆骨折的诊断价值

目的:讨论MSCT多平面重建(MPR)及三维容积再现(VR)诊断骨盆骨折的临床价值。方法:MSCT行骨盆扫描32例,重建层厚1.25mm,间隔0.6mm,将数据传至工作站,行MPR及VR处理,并对横断面图像及重建图像进行回顾性分析。结果:32例骨盆骨折患者共发现骨折59处。MPR图像可清楚显示骨折线及细小骨碎片,但不能显示三维空间关系,VR图像可以从各个方位准确显示表面骨结构的空间改变,但对细小无移位的骨折线显示不佳。结论:多层螺旋CT多平面及三维重建相结合能够清晰立体地显示骨盆骨折的全部细节,对临床制定治疗方案具有重要的参考价值。     

利用深度学习实现腹盆部CT图像范围及期相分类:临床验证研究

目的:探讨基于深度学习的分类模型对腹盆部CT图像范围及期相进行自动分类的可行性。方法:回顾性搜集本院2019年10月14日-2019年10月18日PACS中连续416例患者的腹盆部CT图像(数据集A)。按照扫描范围分为腹部、腹盆部、盆部三类,按照扫描期相分为平扫、动脉期、门静脉期、延迟期和排泄期五类。以3D-ResNet为基础架构,训练CT图像范围及期相的分类模型。利用该模型预测2020年1月1日-2020年1月3日本院连续657例患者的腹盆部CT图像(数据集B)。以影像医师的分类结果为金标准,采用混淆矩阵评价模型的分类效能。结果:在数据集B中,扫描范围分类模型在腹部、腹盆部和盆部的符合率分别为95.7%(243/254)、98.4%(362/368)和94.3%(33/35)。对数据集B中的腹部图像进行分析,扫描期相分类模型在平扫、动脉期和门静脉期的符合率分别为100.0%(77/77)、97.6%(82/84)和100.0%(11/11);对数据集B中腹盆部图像进行分析,扫描期相分类模型在平扫、动脉期、门静脉期、延迟期和排泄期的符合率分别为96.6%(144/149)、100.0%(9/9)、100.0%(106/106)、66.7%(44/66)和100.0%(32/32);对数据集B中盆部图像分析,扫描期相分类模型在平扫、门静脉期、延迟期和排泄期的符合率分别为100.0%(13/13)、70.0%(7/10)、88.9%(8/9)和100.0%(1/1)。结论:通过深度学习模型建立腹盆部CT图像性质分类模型的准确性基本可达到临床要求。     

肾盂移行上皮细胞癌MRI诊断

目的：探讨肾盂移行上皮细胞癌MRI特点。方法：回顾性分析经手术和病理证实的26例肾盂移行上皮细胞癌MRI表现。结果：肿瘤位于肾盂19例,位于肾盏7例。MR信号在T2WI上为均匀略高信号15例,混杂等高信号8例,均匀等信号2例,等低信号1例;在T1WI上为均匀低信号16例,混杂信号8例,均匀等信号2例;增强18例中10例轻度均匀强化,8例轻度不均匀强化。MRI明确诊断肾盂移行上皮细胞癌18例,可疑肾盂移行上皮细胞癌5例,误诊2例,漏诊1例。结论：MRI对肾盂移行上皮细胞癌病灶的发现,观察生长方式和侵犯范围均具有较高价值。     

女性盆腔囊实性病变的CT诊断

目的:探讨女性盆腔囊实性病变的CT特征,为鉴别诊断提供依据。方法:回顾性分析有完整的CT、临床及病理资料的女性盆腔囊实性病变116例。结果:病变直接来源于妇科器官(子宫及附件)108例,妇科器官外的8例。其中良性74例,恶性42例。囊实性病变CT平扫表现为高低不一的混杂密度,增强后实性部分强化明显,囊性部分无强化。结论:CT对女性盆腔囊实性病变的定位准确率高,密切结合临床病史对定性诊断亦具有重要价值。     

A case of totally cystic fibroepithelial polyp of the renal pelvis

Fibroepithelial polyps are the most frequently observed mesenchymal tumors of the renal pelvis. We report on one case of fibroepithelial polyp of the renal pelvis with unusual CT findings of totally cystic structure with septations. Received: 27 July 1998; Revised: 6 January 1999; Accepted: 8 February 1999     

肾盂移行细胞癌MSCT及MRI诊断

目的：探讨不同类型肾盂移行细胞癌MSCT和MR表现特点,以提高诊断符合率。方法：38例手术病理证实的肾盂移行细胞癌,32例术前行MSCT双期增强扫描,15例行MR扫描,9例同时进行CT和MR扫描,并与病理结果对照。结果：肾盂内肿块型19例,CT见肾盂内软组织肿块,增强轻中度强化11例,明显强化5例。MR大多数为稍长T1稍长T2信号,增强轻中度强化。肿块浸润型13例,CT见不均匀软组织肿块,增强不均匀强化,外周强化要明显高于内部。MR见T1WI混杂低信号,T2WI混杂高信号,增强见伴坏死囊变的不均匀强化。肾盂壁增厚型6例,CT为肾盂壁不规则增厚影,增强少许强化。MR为轻度强化。结论：肾盂移行细胞癌的CT和MR表现有一定特征性,MSCT和MR均能较为准确地诊断并进行分型分期。     

Definition of a reproducible method for acetabular anteversion measurement at CT

PURPOSE: To demonstrate the variability of acetabular anteversion angle measurement at CT and suggest a new and reproducible method of measurement. MATERIAL AND METHODS: Sawbone pelvis based study: We first realized a series of helical CT of the pelvis, with gradual increase in tilt angle, and measured acetabular anteversion angles on axial sections, then on sections parallel to the superior S1 endplate. Then, we made a series of radial sections centered at the acetabulum, and the anteversion angle was measured on each section. Finally, a test series of five in vivo pelvis was performed to evaluate the feasability of our method. RESULTS: The acetabular anteversion angle varies with pelvis tilt, whereas measurements obtained from sections parallel to the S1 endplate are constant. CONCLUSION: Acetabular anteversion angle should be measured from sections parallel to the S1 endplate, in order to minimize errors during total hip arthroplasties.     

双侧肾外型肾盂伴左肾盂重度积水99Tcm-DTPA肾动态显像一例

笔者报道了双侧肾外型肾盂伴左肾盂重度积水99Tcm-DTPA肾动态显像一例。肾外型肾盂临床上通常无症状,常为健康体检或其他原因行腹部超声或CT等影像学检查时偶然发现,可伴有肾结石、肾积水等。因肾盂位于肾外,肾盂积水对肾皮质一般无压迫,故患者早期血尿素、血肌酐水平正常或轻度增高。临床为评估分肾功能,将9Tcm-DTPA肾动态显像作为首选检查,肾外型肾盂伴一侧肾盂重度积水表现为患侧肾影外异常显像剂浓聚影,需与尿漏、肾旋转不良等鉴别。故笔者通过病例及文献复习加深了对肾外型肾盂伴肾盂积水9Tcm-DTPA肾动态显像特点及鉴别诊断的认识。认识这种解剖变异和提供肾功能相关信息可以帮助临床医师做出决策,并降低术中损伤肾盏肾盂的风险。     

彩色多普勒超声对预测胎儿肾盂分离转归的应用价值

目的应用彩色多普勒超声动态观察胎儿肾盂分离状态,为预测胎儿肾盂分离的转归、避免不必要的终止妊娠、及早治疗泌尿系统先天畸形,提供有价值的信息。方法选择2008年10月—2010年1月在我院就诊的单胎孕妇,符合纳入排除标准者,首次超声提示胎儿肾盂分离[采用Stocks等[1]标准,孕33周以前肾盂前后径(APD)≥4 mm,孕33周以后APD≥7 mm作为肾盂分离的标准]共119例。从首次发现胎儿肾盂分离开始,孕妇每隔4周进行1次超声检查复查;出生后1年内,每月复查1次超声,观察胎儿的转归。将所有数据录入计算机,用SPSS11.5软件处理。结果 (1)可复组与不可复组胎儿肾脏APD值差异有统计学意义。(2)通过绘制受试者工作特征曲线(ROC曲线),得出对于妊娠≥33周孕妇预测其胎儿肾盂分离转归有意义的APD界值为15.5 mm。结论 APD值≥15.5 mm时,发展为不可复性肾积水的可能性大。     

Inflammatory pseudotumor (myoblastic tumor) of the genitourinary tract

OBJECTIVE: The purpose of this article is to describe imaging features of the following genitourinary tract locations that can involve inflammatory pseudotumor: kidney, adrenal gland, retroperitoneum or pelvis, bladder, and other rare locations. CONCLUSION: Although definite radiologic differentiation from malignancy is not clearly possible, we suggest that familiarity with the manifestations of inflammatory pseudotumor can help avoid unnecessary radical surgery before histopathologic proof of malignancy is obtained.     

骨盆原发性恶性肿瘤的影像学临床分析

目的:探讨骨盆原发性恶性肿瘤的病种分布及其影像学表现。方法:回顾本院11年间经活检和/或手术病理证实的骨盆原发性恶性肿瘤56例,分析其发病情况及影像学主要表现。结果:骨盆原发性恶性肿瘤共56例,按其发生比例依次为骨髓瘤(包括单发及多发性骨髓瘤)34例(占60.7%),软骨肉瘤、尤文氏肉瘤及原发性骨淋巴瘤各6例(分别占10.7%),骨肉瘤2例(占3.6%),恶性骨母细胞瘤及恶性纤维组织细胞瘤各1例(占1.8%)。主要影像表现为溶骨性骨质破坏(48例)或混合性骨质破坏(6例),软组织肿块或肿胀(22例),病灶边界清楚(35例),边界模糊(21例);出现瘤骨或钙、骨化(9例),少数可出现骨膜反应(4例)。结论:骨盆原发性恶性肿瘤种类较多,影像学表现缺乏特异性,综合影像检查可提高对各类病变的诊断及鉴别诊断准确率。     

骨盆肿瘤的MSCT术前评估

目的:探讨MSCT及其后处理技术对骨盆肿瘤术前评估及临床手术的指导价值。方法:对36例骨盆肿瘤患者进行薄层扫描,术前评估病变的性质、累及范围、肿瘤的血供状态和肿瘤周围的血管情况。结果:86.1%的病例术前诊断性质与病理结果一致;89.3%的手术病例的累及范围与手术所见基本一致;79.1%的手术病例肿瘤的血供状态和肿瘤周围的血管情况与手术所见基本一致。结论:MSCT及后处理技术在术前能够准确地评估骨盆肿瘤的性质、累及范围、肿瘤的血供和肿瘤周围的血管状况,对选择治疗方案、手术方式及术后重建具有重要意义。     

Evaluation of blunt abdominal trauma using PACS-based 2D and 3D MDCT reformations of the lumbar spine and pelvis

OBJECTIVE: The purpose of this study was to show the value of 2D and 3D reformations of CT data from abdominal and pelvic CT performed immediately at the workstation using a PACS-based software program to evaluate the lumbar spine and pelvis in patients with blunt abdominal trauma. MATERIALS AND METHODS: We reviewed the abdominopelvic CT scans and conventional radiographs of the lumbar spine or pelvis of 156 consecutive patients with blunt abdominal trauma. The CT data were compared with the radiographic findings and also with the findings of dedicated repeat CT of the spine or pelvis, when performed. RESULTS: CT depicted 80 fractures of the lumbar spine and 178 pelvic fractures. Radiography showed 40 fractures of the lumbar spine and 138 pelvic fractures. No additional fractures were identified on dedicated repeat CT. CONCLUSION: Conventional radiographs to clear the lumbar spine are no longer required when abdominopelvic CT data are available. CT and reformatted CT data show more fractures than radiography and miss no fractures compared with dedicated CT of the lumbar spine or pelvis. Having these images immediately available through the PACS workstation saves time for the trauma team in the management of critically ill patients.     

骨盆骨巨细胞瘤影像特征分析

目的:分析骨盆骨巨细胞瘤X线平片、CT及MRI征象,探讨其影像特征及鉴别诊断要点。方法:分析总结经手术及病理证实的29例(包括7例复发)骨盆骨巨细胞瘤患者的X线平片、CT、MRI表现。结果:①X线平片表现:囊状骨质破坏15例,单纯溶骨性破坏8例,"多房性"骨质破坏6例。②CT表现:18例呈囊样膨胀性骨质破坏,11例呈单纯溶骨性破坏,未见骨膨胀扩张征象;增强扫描肿瘤实质部分均出现轻度至中度的强化。③MRI表现:6例MRT1WI上均呈等信号、低信号,T2WI上呈低信号、等信号、高混杂信号。结论:骨盆巨细胞瘤的影学表现为膨胀性溶骨破坏,与长骨巨细胞瘤比较除膨胀更为显著外,余无明显差异;骨盆骨巨细胞瘤诊断需综合运用X线平片、CT及MRI并与临床表现相结合,且能够提高骨盆骨巨细胞瘤诊断及鉴别诊断的准确性。