Echographic aspects of fused kidneys. Apropos of 2 cases

Coalescent kidney is a rare variety of fused kidneys, clinical manifestations observed with the greatest frequency being a more or less painful abdominal mass, digestive disturbances and a complicating infection, calculus, renal failure or hematuria. Straight abdominal films (SAF), ultrasound tomography, SAF after colon insufflation and IVU can usually establish the diagnosis. Results of ultrasound imaging of this rare variety of ectopic kidney have apparently not been published. Apart from any complicating factor, the coalescent kidney corresponds to a discoid shaped subumbilical prespinal mass of oblong section. It appears as two highly echogenic central zones encircled by a less dense zone. No separation exists between the right and left portion, and furthermore a kidney cannot be identified in either lumbar fossa. These findings are useful for identification of a retroperitoneal mass, ultrasound imaging being of importance when IVU supplies insufficient data.     

MR灌注成像在正常肾和肾脏疾病中的应用价值

目的 探讨正常肾脏及常见肾脏疾病MR灌注加权成像(PWI)的主要表现特征和临床应用价值.方法 搜集共31例患者行MR PWI,其中9例非泌尿系统疾病患者作为正常肾对照组,肾癌14例,肾囊肿6例,肾结核2例.31例均行冠状面常规T1WI、T2WI与PWI.原始图像经工作站处理后获得灌注曲线及各功能图像,比较正常肾脏及病变部位的时间-信号强度曲线、血容量(RBV)、血流量(RBF)、平均通过时间(MTT)、达峰值时间(TTP)及相应灌注功能图像.正常肾脏灌注参数(RBV、RBF、MTT和TTP)的相对值通过左肾/右肾获得,异常肾脏灌注参数通过病变组织/对侧同一部位肾组织获得.观察两组肾脏的血流灌注参数变化,并结合灌注图像对其病变组织的血流变化进行分析.对正常对照组左、右肾和正常肾皮、髓质各灌注参数的比较采用t检验;对异常肾与正常肾各灌注参数的比较行q检验.结果 正常肾脏皮质的相对RBV(1.33±0.08)和RBF(1.44 ±0.09)均明显大于髓质相对RBV(0.58 ±0.05)和相对RBF(0.78 ±0.13),差异均有统计学意义(t值分别为9.2241和5.0336,P值均＜0.01);肾脏皮质相对MTT(1.11±0.08)和相对TTP(1.04 ±0.06)与髓质相对MTT(0.97±0.04)和相对TTP(0.94±0.03)差异无统计学意义(t值分别为2.2551和2.2613,P值均＞0.05).肾癌相对RBF(1.35±0.34)明显高于正常肾脏组织相对RBF(1.02±0.06)(q=3.0882,P＜0.01).结论 PWI可以测量正常肾组织与病理情况的血液动力学变化,在肾功状态变化和疾病的鉴别诊断方面具有较高的应用价值.     

The value of tomodensitometric studies in the diagnosis of the herniated lumbar disk. Apropos of 155 operated disks

Correlation of radiological and pathological findings in 155 cases of operated herniated discs emphasizes the value of a CT scan in the diagnosis of these lesions. Imaging by the scanner is a safe and relatively low-cost procedure and its reliability is identical to that of other conventional exploratory methods. It should, therefore, become the initial examination conducted during investigation of sciatica thought to be of discal origin. Reliability of results has varied between 85 and 90 p. 100, according to the author, for this essentially simple and atraumatic method. Confirmation of the presence of a hernia requires the observance of clear signs: material of discal density amputating the spinal canal and spreading over the dural sheath. False negatives or positives usually occur in borderline cases or in previously operated patients. Differences in clinical and computed tomography findings, with undoubted absence of signs on the scan image, require further investigation by radiculography.     

The value of echography in the early diagnosis of renal lesions in the Laurence-Moon-Bardet-Biedl syndrome. Apropos of a case

The Laurence-Moon-Bardet-Biedl syndrome (LMBB) is characterized by the association of obesity, hypogonadism, polydactyly, mental retardation and pigmentary retinitis. Symptomatic or asymptomatic renal dysplasia (calyceal diverticula, precalyceal tubular ectasia, cysts) is frequently associated with LMBB. The authors consider renal sonography as the convenient investigation for an early detection of such dysplasia as in the case they reported here.     

Rectosigmoid hemangioma: diagnostic value of associated phleboliths. Apropos of a case

When confronted with rectorrhagia in a young patient, combining a straight abdominal examination with a barium enema investigation may reveal the presence of phleboliths, atypical by their large number and central localization, and orientate towards the rare diagnosis of a colorectal hemangioma.     

多层螺旋CT乳腺检查方法与应用价值探讨

目的:探讨多层螺旋CT(MSCT)在乳腺检查中的操作方法、应用价值及诊断优越性。方法:分析68例乳腺CT扫描病例的检查方法、CT表现,进行总结、归纳。所有病例均经MPR、MIP等多种后处理重建,寻找及确定最佳体位、最佳条件、最佳后处理方法。结果:俯卧位为最佳体位。年轻女性可以仰卧位扫描,年老体弱及术后病例可采用仰卧位加托垫固定。3.2mm扫描、1.6mm重建,90kV,200mA,为最佳扫描条件,原始图像加MPR重建为最佳后处理方法。结论:MSCT乳腺检查有望成为乳腺结节性病变及乳癌术后病人的首选检查方法,具有较好的诊断优越性和经济实用性,且操作简便、易行,费用较常规CR钼靶相近或更低。     

Cerebral cysticercosis. Diagnostic value of x-ray computed tomography. Apropos of 117 cases

117 cases of cerebral cysticercosis in La Réunion are reported. Different CT features are related and situated with the evolutive state of the parasite. CT scan provided accurate diagnostic information except in some intraventricular or subarachnoid location where NMR study seems already to be superior.     

Renal function and technetium-99m-dimercaptosuccinic acid uptake in single kidneys: the value of in vivo SPECT quantitation.

The ability to evaluate kidney function in each kidney separately by quantitative SPECT was tested in 20 patients with a single kidney and varying degrees of renal disease. Technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) uptake was compared with renal function measured by creatinine clearance and serum creatinine. There was a good correlation for both serum creatinine (r = 0.89, y = 24.6 *X -1.15, error = 5.6, p less than 0.001) and creatinine clearance (r = 0.76, y = 0.6 *X 0.84, error = 8.0, p less than 0.001). The results indicate that SPECT quantitation of 99mTc-DMSA uptake can be used as an indicator of the function of each kidney individually.     

CT引导经皮穿刺活检技术在肺部微结节诊断中的价值

【摘要】目的：评价CT引导经皮穿刺活检对肺部微结节（直径≤5mm）的诊断价值及安全性,另探索有效的穿刺方法。方法：在CT引导下对58例肺部微结节行经皮穿刺活检术,其中18例采用Angiotech 20G软组织活检针穿刺,40例采用Angiotech 17G同轴套管针配以 Biopince18G自动活检针,穿刺结果与手术或临床随访诊断结果进行对比,分析其准确性及并发症情况,比较采用不同穿刺针诊断的准确性及安全性。结果：经74次穿刺所有患者均获取足够的组织标本,其中对29例恶性微结节的诊断敏感性为89.7%（26/29）,特异性为100%（29/29）;对29例良性微结节的诊断敏感性为100%,特异性为89.7%（26/29）;总诊断符合率为94.8%（55/58）。两种穿刺针诊断的准确率无统计学差异（P=1.000）,第一次穿刺成功率差异具有统计学意义（χ2=5.038,P=0.025）,气胸发生率差异无统计学意义（χ2=1.987,P=0.159）,咳血发生率差异具有统计学意义（χ2=3.882,P=0.049）。结论：CT引导经皮穿刺活检术对微结节的诊断准确性高,并发症少,是一种安全可行的诊断技术,且同轴套管针配以自动活检针穿刺安全性更高。