巨大脊索瘤CT诊断一例

巨大脊索瘤ＣＴ诊断一例孙国超，李焕义，刘洪霞，高国政患者男，３９岁。大小便困难１年，加重５个月。查体：骶尾部隆起，外界大小９ｃｍ×８ｃｍ，质硬，有轻压痛，表面尚平整。直肠指诊骶前有一肿物，质较硬、压痛，下缘清楚，表面平整，直肠受压前移。ＣＴ检查：平扫...     

颅内脊索瘤的影像学诊断

颅内脊索瘤的影像学诊断杜金梁解中福孙桂琴郝志杨光雯对我院１９８９～１９９６年经手术病理证实的１５例颅内脊索瘤进行回顾性分析，并就不同影像学检查方法对本病的检出率加以比较，对如Ｆ何提高颅内脊索瘤的影像学诊断及鉴别诊断等问题进行了讨论。１一般资料１５例中...     

小儿颅底脊索瘤的CT诊断

目的：探讨小儿颅底脊索瘤的ＣＴ表现和鉴别诊断。材料和方法：分析经活检或手术病理证实的８例小儿颅底脊索瘤的ＣＴ平扫和增强扫描表现。结果：发现肿瘤均起源于蝶枕软骨结合区，破坏斜坡和蝶骨，形成颅底鼻咽部肿块，肿块密度不均，内有散在营养不良性钙化。增强后肿块呈轻度非均匀性强化。结论：ＣＴ检查能够准确地发现肿块的起源，了解骨破坏和肿块内的钙化情况，从而能够作出正确的诊断和鉴别诊断     

斜坡脊索瘤的CT和MRI表现

目的：分析斜坡脊索瘤的CT和MRI表现。材料和方法：经病理证实的斜坡脊索瘤16例，7例作CT检查，11例作MRI捡查。结果：CT扫描7例均显示软组织肿块、骨质破坏和钙化，MRI图像上11例显示骨质破坏，10例显示软组织肿块。结论：CT和MRI是诊断斜坡脊索瘤有效的检查方法，斜坡脊索瘤必须与颅底骨软骨肉瘤、斜坡脑膜癌和鼻咽部肿瘤鉴别。     

8例斜坡脊索瘤的CT和MRI表现

脊索瘤是罕见的先天性肿瘤，约占颅内肿瘤1％以下，起源于残余的脊索。颅内脊索瘤占所有脊索瘤的35％-40％，且通常位于斜坡中线附近和蝶骨后部，少数可起源于岩骨尖。本文报道8例经病理证实的斜坡脊索瘤的CT和MRI表现，以期提高对它的认识，从而提高诊断水平。     

脊索瘤MRI诊断

目的　了解脊索瘤的MRI表现特征。方法　分析 3 9例脊索瘤的MRI表现。结果　颅底部脊索瘤 16例 ,15例破坏颅底并有硬膜外软组织肿块 ,1例位于颅内右侧桥前池区 ,骨质无破坏。骶尾部脊索瘤 2 3例 ,椎体均有破坏 ,2 2例伴骶前较大软组织肿块。肿瘤边界清楚 ,T1WI呈低～等信号 ,T2 WI呈较高～高信号 ;3 6例信号不均匀 ,14例有条状低信号纤维间隔和高信号粘液基质。结论　MRI可清楚地显示肿瘤的部位和范围 ,根据肿瘤侵犯特点和信号特征 ,多数肿瘤可以定性诊断     

CT and MRI appearances of a thoracic chordoma

A case of a chordoma in the thoracic spine is presented. This is a very rare tumour in this location and should be considered in the differential diagnosis of any posterior mediastinal mass. The appearances on CT and MRI were similar to chordomas described in other locations. On T2-weighted images septae of low signal intensity radiated throughout the large high-signal mass. This feature may be of use in differentiating chordomas from other posterior mediastinal masses. Received 12 September 1997; Revision received 2 April 1998; Accepted 29 April 1998     

腰椎峡部裂的CT诊断

腰椎峡部裂是腰椎一侧或两侧椎弓上下关节突之间的峡部有骨质缺失,失去连续性。是引起腰腿疼痛的常见原因之一。过去主要依靠X线平片诊断,CT扫描可以显示腰椎平片所不及的征象。笔者就38例腰椎峡部裂CT资料作回顾性分析。     

CT对急性胰腺炎的诊断价值

目的评价CT在急性胰腺炎诊断和分型中的作用。方法95例经临床与手术证实的急性胰腺炎患者均进行屏气CT扫描,其中,14例进行增强扫描,30例患者进行多次扫描。结果本组95例中,80例诊断为急性水肿型胰腺炎,表现为胰腺肿大水肿,胰周间隙和肾旁前间隙蜂窝织炎,实质密度不均匀,另15例诊断为出血坏死型胰腺炎,除有上述表现外,还可见出血坏死区域。结论CT对急性胰腺炎的诊断和分型具有重要作用。     

等密度硬膜下血肿的CT诊断

探讨CT对等密度硬膜下血肿的诊断价值，认为CT诊断硬膜下血肿的准确率非常高，目前CT已成为该疾病的首选检查手段。     

急性胃肠道穿孔的CT诊断

目的分析急性胃肠道穿孔的CT表现及其诊断价值。方法收集17例急性胃肠道穿孔患者术前腹部CT检查资料,与手术结果对照。结果胃窦前壁穿孔4例,幽门前壁穿孔1例,胃小弯前壁穿孔5例,十二指肠球部穿孔4例,肠穿孔3例。胃肠道穿孔的CT表现:直接征象有管壁不规则,周围脂肪层模糊;间接征象为腹腔内散在游离气体,以及穿孔引起的一系列并发症。结论CT对临床症状较轻,X线透视膈下无游离气体的胃肠道穿孔患者有较高的诊断价值。     

7例外伤性支气管断裂的CT诊断

回顾性分析7例外伤性支气管断裂的cT表现,探讨外伤性支气管断裂CT检查的临床诊断价值。     

斜坡脊索瘤螺旋CT表现及鉴别诊断

目的探讨螺旋CT在斜坡脊索瘤诊断及鉴别诊断中的价值。方法分析11例经手术病理证实斜坡脊索瘤的螺旋CT资料。结果 11例中,肿瘤位于上斜坡区3例,同时累及上、中斜坡区7例,累及中、下斜坡区仅1例。肿瘤形态以不规则、分叶状为主,大小不一。肿瘤骨质破坏区,边缘较清晰,但不锐利,骨质破坏旁软组织肿块侵及、压迫颅内组织时,与颅内正常组织交界不清。肿瘤密度混杂,11例均见斜坡不同程度的骨质破坏,邻近可见软组织肿块形成,7例肿瘤内见钙化或残存骨,对周围正常结构均产生不同程度的侵及、压迫、包绕表现。结论螺旋CT对斜坡脊索瘤的诊断及鉴别诊断有着重要的价值。     

梗阻性黄疸的CT诊断分析

目的：探讨梗阻性黄疸的CT表现。方法：对50例梗阻性黄疸患者进行CT腹部平扫和增强扫描,检查结果与病理诊断、临床结果进行比较。结果：15例肝内梗阻性黄疸中,肝门部肿瘤10例,肝内胆管结石5例;35例肝外梗阻性黄疸中,胆总管结石10例,胰头癌14例（其中包括6例合并胆系结石）,胆管癌5例,壶腹部癌2例,胆总管炎性狭窄4例。结论：CT检查是梗阻性黄疸定性诊断的有效方法。     

Sacrococcygeal chordoma

Sixty patients with sacrococcygeal chordoma, who were seen at this center between 1946 and 1985, were studied with particular attention to the radiographic findings. This study was undertaken because of the large number of these cases and comparison was made between the plain films available in 39 patients and the computed tomography CT studies in 22. Bone destruction was found in 78% on plain films but in 90% on CT. A soft tissue mass was identified in plain films in 60% but in 90% on CT. Calcific debris was found in plain films in 44% but in 87% on CT. Mostly the debris consisted of coarse irregular fragments and probably represented sequestrated necrotic bone. Myelography was performed in only 15 patients. Angiography was studied in 10 cases. Of the 60 patients 88% underwent surgical resection. The tumor recurred in 80% and in only 20% was there no evidence of recurrence. Distant metastases occurred in 24% of patients. Fifty percent survived 5 years; 28% survived 10 years; mean survival 7.5 years.     

CT diagnosis of ureteral fibroepithelial polyps

We report a case of fibroepithelial polyp of the ureter with serial CT examinations. Progressive growth of the fibroepithelial polyp was documented by CT within a period of 62 months. Excretory phase contrast-enhanced CT images accurately contributed to the diagnosis of ureteral fibroepithelial polyp and allowed limited surgical resection. Accurate imaging assessment of ureteral fibroepithelial polyps is essential for a conservative surgical approach and/or observation alone.