甲状旁腺功能减退脑部CT表现

目的 探讨甲状旁腺功能减退的临床表现及脑部影像学表现.方法 回顾分析16例甲状旁腺功能减退患者的临床特征和颅脑CT表现.结果 16例患者有不同程度的脑内钙质沉着.CT表现为两侧(豆状核及尾状核)钙化10例,丘脑钙化4例,额叶、顶叶、枕叶和颞叶内对称性或不对称性分布的斑点状、斑片状、条带状或半环状多发的不规则高密度钙化4例.在头部CT扫描片上,两侧小脑半球、大脑半球和基底节区的脑内钙质沉着也可更加广泛.结论 癫痫和癫痫发作性晕厥可能与钙的脑内沉着有关.颅脑CT对原发性甲状旁腺功能减退脑内钙质沉着的诊断与鉴别诊断很有价值.     

超声在小儿肾发育不良诊断中的应用

目的 :总结分析超声对小儿肾发育不良的诊断价值。方法 :回顾性分析我院近3年来20例经手术证实的小儿肾发育不良患者的临床及超声检查资料,分析小儿肾发育不良的超声特点。结果:本组中,超声诊断正确19例,诊断符合率为95%;其中合并异位肾15例,患侧肾脏结构异常3例,远端输尿管开口异位8例。结论:超声在小儿肾发育不良的诊断中具有很高的准确性,可为临床诊断提供帮助。     

多层螺旋CT重组技术对肿瘤样钙质沉着症诊断的价值

目的探讨多层螺旋CT(multi-slice spiral CT,MSCT)重组技术在肿瘤样钙质沉着症诊断中的应用价值。方法经手术病理证实的肿瘤样钙质沉着症7例,男性3例,女性4例,年龄20～54岁,平均30.5岁7,例行X线,6例行轴位CT检查并全部行图像后处理,3例行MRI检查。分析肿瘤样钙质沉着症的各种影像学表现,并与病理对照。结果 7例肿瘤样钙质沉着症均表现为软组织内不规则致密钙化斑。7例中X线平片明确诊断4例(57.14%),CT横轴位图像结合后处理图像明确诊断7例(100.00%),MRI均未作出明确诊断(0.00%)。结论 MSCT重组技术对钙质沉着症的定位、定性具有重要的临床诊断价值。     

伴有肾脏病变的原发性甲旁亢3例

伴有肾脏病变的原发性甲旁亢３例盖永浩１蔡世峰２李俊来３邵长清２王茜１我院１９９２～１９９５年收治的以肾结石、肾钙质沉着症为主要表现的原发性甲状旁腺机能亢进（以下简称甲旁亢）患者３例，均为腺瘤所致，行手术切除，病理证实。本文旨在结合肾脏影像学改变，提高...     

肿瘤样钙质沉着症的影像学表现

目的为进一步提高临床罕见的肿瘤样钙质沉着症的诊断正确率,探讨肿瘤样钙质沉着症的影像学表现和鉴别诊断。方法选取并分析7例术前经X线摄影、CT平扫、MRI+增强检查后,且经穿刺和/或外科手术后病理证实为肿瘤样钙质沉着症的临床资料及影像学表现。结果 7例均有慢性尿毒症、长期血液透析的病史,X线摄影及CT平扫表现为关节周围软组织内多发结节状、团块状高密度影,边界清晰,部分融合; MRI平扫显示为结节状、团块状长T_1低信号影,T_2WI表现混杂T_2信号影,病灶内部及边缘可见条索状高信号影; MRI增强扫描表现为条索状、网格状的轻-中度不均匀强化。结论肿瘤样钙质沉着症好发于慢性尿毒症、长期血液透析的患者,其影像学表现有一定特点,结合临床病史,有助于本病的诊断和鉴别诊断。     

肿瘤样钙质沉着症的临床和影像学分析

目的:探讨肿瘤样钙质沉着症的临床及影像学表现,提高本病的影像诊断水平.方法:回顾性分析6例经手术病理证实的肿瘤样钙质沉着症的临床及影像学资料.6例均行X线平片检查,2例行MRI检查.结果:6例患者主要临床表现为关节附近无痛性肿块,多发肿块2例,单发肿块4例.主要X线表现为关节周围团块状软组织钙化.MRI表现:T1WI上呈结节状不均匀低信号,T2WI上呈不均匀高信号.X线和MRI均显示邻近关节结构正常.结论:肿瘤样钙质沉着症的典型影像学表现为不侵及关节的软组织内多发钙化性肿块,平片和MRI有助于本病的诊断和鉴别诊断.     

高频彩色多普勒超声对甲状旁腺腺瘤13例的诊断价值

目的探讨高频彩色多普勒超声对甲状旁腺腺瘤的诊断价值及超声声像图特征,以提高超声对该病的认识。方法回顾性分析经病理证实的13例甲状旁腺腺瘤的临床资料及超声声像图特征。结果 13例甲状旁腺腺瘤位于上甲状旁腺的4例,下甲状旁腺的9例,位于上极的超声诊断2例,误诊为淋巴结1例,漏诊1例,位于下极的超声诊断6例,误诊甲状腺结节1例,误诊为淋巴结1例,漏诊1例。13例甲状旁腺腺瘤均伴不同程度的骨质疏松,其中伴纤维囊性骨炎2例,伴肾结石10例。发现的11例甲状旁腺瘤的超声声像图特征为:均位于甲状腺背侧,其中低回声结节9例,高回声结节2例,结节多呈类圆形或椭圆形,边界清晰;彩色多普勒超声表现为结节内有较丰富的低阻血流。结论掌握甲状旁腺腺瘤的解剖及毗邻位置关系,熟悉其临床特征,认识甲状旁腺腺瘤的二维及高频彩色超声多普勒特征,有助于提高超声诊断率,减免漏误诊。     

肿瘤样钙质沉着症影像表现（附1例报告并文献复习）

目的：认识肿瘤样钙质沉着症X线及CT特征表现,提高影像诊断正确率。方法回顾分析1例双下肢肿瘤样钙质沉着症患者的X线、CT影像表现及临床资料,并复习相关文献。结果患者双髋关节、双膝关节周围及大腿肌群软组织内见“卵石样”、“桑葚状”大小不一分叶状、团块状钙化灶,病灶未累及相邻骨质及关节。结论肿瘤样钙质沉着症具有影像学特征表现,结合临床表现可对其作出准确的诊断。     

小儿腹部肿瘤临床表现及二维与彩色多普勒超声诊断价值比较

目的 :探讨小儿腹部肿瘤临床表现及彩色多普勒超声诊断价值。方法 :选择2013年1月至2014年12月我院收治的49例腹部肿瘤患儿,均行彩色多普勒超声及二维超声检查,观察患儿的年龄分布、肿瘤类型,比较彩色多普勒超声与二维超声检查的确诊率。结果:本组49例中,肾母细胞瘤、神经母细胞瘤、卵巢畸胎瘤及肝母细胞瘤中男患儿居多,腹膜后畸胎瘤以女患儿居多;肾母细胞瘤、腹膜后畸胎瘤及肝母细胞瘤多见于婴幼儿,神经母细胞瘤与卵巢畸胎瘤则发病年龄偏大。彩色多普勒超声准确诊断48例,确诊率为97.96%;二维超声准确诊断37例,确诊率为75.51%,两者比较差异有统计学意义(P0.05)。结论:不同类型的小儿腹部肿瘤性别及年龄均存在差异,彩色多普勒超声检查可显著提高小儿腹部肿瘤的诊断准确率,值得临床推广。     

彩色多普勒超声诊断继发性甲状旁腺功能亢进症的应用价值

 目的 评价彩色多普勒超声对继发性甲状旁腺功能亢进时甲状旁腺增生的诊断价值.方法 肾衰竭并伴有不同程度的血中全段甲状旁腺激素水平增高的患者36例,比较分析其术前彩色多普勒超声检查与手术和病理学诊断结果 ,并与核素检查对比观察.结果 36例中检出增生的甲状旁腺51枚.增生的甲状旁腺边界清晰,形态多样,呈极低回声改变,内部回声欠均匀,可见不同程度的钙化;分析后反映出增生的甲状旁腺个数、大小与血中全段甲状旁腺激素水平呈正相关,与血中肌酐、尿素氮无明显相关性.结论 彩色多普勒超声是继发性甲状旁腺功能亢进症术前定位诊断的有效手段.     

彩色多普勒超声和多层螺旋CT在肾脏良恶性肿瘤诊断中的应用比较简

目的：比较彩色多普勒超声（US）和多层螺旋CT（MSCT）在诊断肾脏良恶性肿瘤中的临床应用价值。方法对35例肾肿瘤患者分别行超声和螺旋CT检查,将两者检查结果与手术后病理结果进行对比,比较两种检查方法的诊断准确率。结果肾良性肿瘤及病变25例,超声诊断准确率为84％,CT为88％;肾癌10例,超声诊断准确率为80％,CT检查为90％。结论 US和MSCT在诊断肾脏良恶性肿瘤中,超声是筛查肾脏肿瘤首选检查方法,其价格低廉,无电离辐射,简单易行,患者容易接受。MSCT检查在特异性和准确性方面要高于超声,但在敏感性方面超声要优于CT,两者都能较准确地判断肾脏肿瘤及病变的良恶性。     

肾结核的CT诊断与误诊分析

目的 探讨CT诊断肾结核的临床效果,并对引起CT误诊的相关因素进行分析.方法 选取经病理组织学证实为肾结核的32例患者分别行B超及CT检查,并与病理组织学结果进行对比.结果 经病理组织学证实Ⅰ型肾结核 7例,Ⅱ型肾结核 8例,Ⅲ型肾结核 6例,Ⅳ型肾结核 6例,Ⅴ型 5例.CT诊断中Ⅰ型肾结核7例,Ⅱ型肾结核 6例,Ⅲ型肾结核 6例,Ⅳ型肾结核 6例,Ⅴ型7例,符合率为93.75%（30例）.B超诊断证实Ⅰ型肾结核6例,Ⅱ型肾结核 8例,Ⅲ型肾结核 7例,Ⅳ型肾结核 7例,Ⅴ型 4例,符合率为81.25%（26例）.与B超诊断相比,CT诊断符合率较高,差异有统计学意义（P〈0.05）.CT诊断中有2例（6.25%）患者出现误诊,1例将其诊断为肾囊肿,1例为假性动脉瘤合并脓肿误诊为结核.结论 对肾结核患者应用CT诊断具有较高的诊断价值,可作为临床诊断肾结核的重要手段.     

Normal renal variations as a cause of sonographically suspect tumors

106 cases of 470 computed tomographic studies of suspected renal tumors were referred to us because a tumor was expected by ultrasound examination. 67 suspected renal tumors proved to be physiological variations, in 39 cases tumor suspicion was confirmed by computed tomography. Since ultrasound findings frequently seem to be false positive, criteria for the diagnosis of renal tumors were reviewed. Our experience is that the combination of inhomogeneity in echo pattern, irregularity of the outer contour and/or the inner parenchymal border seems to be relevant for ultrasound diagnosis of renal tumors whereas isolated widening of parenchyma does not seem to be suspicious by itself.     

Cystic kidney disease presenting in infancy.

AIM: The clinical, histological and imaging findings of 12 children with ultrasound features of severe renal cystic disease presenting in the first year of life were reviewed. METHODS AND RESULTS: Two children had cystic dysplasia and four had autosomal dominant polycystic disease. Two had a malformation syndrome, one a variant of Meckel syndrome and the other Bardet Biedl syndrome. One had autosomal recessive polycystic disease and in three there was no final diagnosis. Intravenous urography gave non-specific information. In six cases clinical findings combined with imaging established a diagnosis. Diagnosis was established by biopsy in two and gave supportive evidence in one. Outlook for renal function is variable. One child has had a transplant and one is on dialysis awaiting a transplant. Three have a degree of renal failure and one has died. Six have normal renal function. Renal cystic disease is the common pathway for a heterogeneous group of disorders as shown in these children. CONCLUSION: It is emphasized that a specific diagnosis could not be made from the renal sonographic appearances alone, nor could any prognostic implications for renal function be made. Contrast retention on intravenous urography was also insufficiently specific to be of value. Ultrasound of the parents was the most useful imaging procedure and should be done in all cases.     

小儿单纯性阑尾炎的超声诊断

目的探讨超声探头触诊结合超声图像诊断小儿单纯性阑尾炎的价值。方法利用三层触诊法和对比法对32例经病理证实的小儿单纯性阑尾炎和13例健康小儿对照组进行超声检查,观察并分析超声图像特征。结果健康对照组13例三层触诊和对比法未见异常,超声图像腹膜后可见增大的淋巴结,体积较小。32例小儿阑尾炎中典型阑尾炎声像图21例,深压痛28例,中层压痛18例,抵抗压痛处26例,肌紧张3例,患儿抵抗压痛处26例。结论超声探头触压痛结合超声图像能有效提高小儿阑尾炎的早期诊断准确率。     

Complementary use of ultrasound and computed tomography in studies of the pancreas and kidney

113 cases of pancreatic and renal disease studied by both ultrasound and computed tomography (CT) were analyzed retrospectively. CT provided a diagnosis when pancreatic ultrasound was unsuccessful due to overlying bowel gas or obesity and when renal ultrasound was unsuccessful due to obesity, reverberations from ribs, small lesions, or multiple lesions. Conversely, ultrasound provided a diagnosis when CT was unsuccessful due to lack of fat planes or respiratory motion. CT usualy distinguished carcinoma from pancreatitis when ultrasound showed a focal echogenic mass. CT resolved renal cyst from neoplasm when ultrasound showed a mixed echo pattern mass.     

Contrast-enhanced ultrasound in detection and follow-up of focal renal infections in children

Objective:Focal renal infections in children have to be diagnosed early in order to enable an appropriate antibiotic treatment. The purpose of this paper was to investigate the efficacy and clinical utility of intravenous renal contrast-enhanced ultrasound (CEUS) as an alternative imaging method for the diagnosis and follow-up of focal renal infections in children.Methods:Fourteen children aged from 6 months to 17 years (mean 6.5 years) in whom focal renal infection was suspected were included in this retrospective study. All data were obtained from medical and imaging records of the patients.Results:CEUS was performed for the diagnosis in all 14 children and then also for follow-up in seven children with renal abscess. In three children enhancement pattern was concordant with focal nephritis and in four children CEUS excluded focal renal infection and the diagnosis of pseudolesion was confirmed.Conclusion:Renal CEUS was proven to be an efficient and self-sufficient imaging in diagnosis and further follow-up of focal renal infections in children. CEUS patterns of focal renal infections are described as well as relevant CEUS enhancement patterns important for differential diagnosis. Renal abscess follow-up algorithm with CEUS is suggested.Advances in knowledge:All clinically relevant imaging data was obtained by CEUS and no other imaging was necessary for the diagnosis and follow-up.     

超声造影在移植肾排斥反应中的诊断价值

目的观测移植肾排斥反应的超声造影特点,分析造影图像,寻求超声造影诊断移植肾排斥反应的定量指标。方法选取患者30例,将患者分为A、B两组,A组20例肾功能异常和B组10例移植肾功能正常患者分别进行常规超声检查和超声造影检查,观察造影时微循环灌注情况并应用造影分析软件对感兴趣区域分析定量指标曲线下面积AUC(Area Under The Curve),然后进行统计分析。结果 A组移植肾微循环的灌注明显比B组差;A组与B组的分析指标AUC差异有统计学意义(P<0.05)。结论超声造影可以动态检测移植肾发生排斥反应时微循环灌注的改变;定量指标AUC为诊断移植肾排斥反应提供了较为可靠、客观的影像学依据。     

超声造影对肾脏小占位的诊断分析

目的:探讨不同病理类型肾脏肿瘤的造影特点,评价超声造影诊断肾脏良恶性肿瘤的应用价值,为临床诊断提供依据。方法:应用声学造影剂声诺维对27例超声诊断为肾脏占位病变或可疑肾脏占位病变的患者进行超声造影检查,分析其造影增强图像特点。结果:27例患者均满意获得清晰的肿瘤动态造影灌注图像,大部分与其正常肾组织回声等强,10例肾恶性肿瘤的造影显像比其正常肾组织快,3例肾良性肿瘤造影显像为"同进慢出";4例肾柱肥大造影后与正常肾组织造影剂显像一致;2例肾囊肿内无造影剂显示。结论:超声造影成像技术能清晰显示肾肿瘤的血流灌注特点,对肾脏肿瘤的诊断具有一定实用价值。     

Tumoral calcinosis causing bone erosion in a renal dialysis patient.

Tumoral calcinosis is a rare disorder manifest by large calcific periarticular masses. Associated bone destruction has been described previously only once. The radiographic and computed tomographic (CT) findings of bone erosion in a case of tumoral calcinosis in a renal dialysis patient are presented. Although the presence of bone destruction may suggest a neoplasm, it does not exclude the diagnosis of tumoral calcinosis.