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。     

Longitudinal stress fractures of the tibia: diagnosis with CT

In most cases, the diagnosis of stress fracture is straightforward with a history of physical activity; characteristic pain in a specific site; and plain radiographs that show sclerosis, periosteal or endosteal reaction, no abnormalities, or, rarely, a fracture. However, when any of the features above are atypical, further study is warranted. Most stress fractures of the tibia are transverse or oblique and involve the mid or proximal shaft. Two cases are presented in which the fracture line was seen on computed tomography scans as coursing longitudinally down the shaft of the distal tibia, which, to my knowledge, is an orientation and location not previously described in the literature.     

Distal tibial triplane fractures: diagnosis with CT

Distal tibial triplane features, which constitute 6%-10% of epiphyseal injuries, are most accurately delineated and analyzed with computed tomography (CT). This is directly related to the special geometry of these fractures that have important transverse components. CT, with its transaxial orientation, is the only radiographic technique that directly images the otherwise inaccessible, horizontally oriented tibial plafond, the integrity of which largely determines the prognosis. CT is the method of choice for preoperative and postoperative evaluation of these injuries.     

Complex fractures of the proximal humerus: role of CT in treatment

The authors reviewed the computed tomography (CT) scans, plain radiographs, and subsequent treatment of 17 patients with complex proximal humeral fractures. CT scans and radiographs were compared in the demonstration of fracture lines, displacement of fracture fragments, rotation of fragments relative to their normal positions, and status of the head and articular surface of the humerus. The impact of CT findings on the decision to treat with surgery versus closed reduction and on the choice of surgical procedure was assessed. Surgery was not performed in nine patients because CT scans showed no significant displacement of fragments previously judged displaced or "indeterminate" on radiographs. Surgery was performed in eight patients; CT demonstrated significant abnormalities not definitely shown with radiography. In six of these eight patients, CT scans demonstrated unsuspected abnormalities that directed the choice of surgical procedure. CT scans provide clinically useful information for the treatment of complex proximal humeral fractures when radiographs provide inadequate or indefinite information.     

Radiation induced fractures of sacrum: CT diagnosis

Sacral insufficiency fracture due to bone atrophy may develop as a complication of irradiation of pelvic malignancies. Pain is the presenting symptom and the clinical diagnoses most often considered are recurrence of the original malignancy and metastatic disease. Computed tomography provides the most specific information helpful for the detection of these fractures and for exclusion of recurrent malignancy.     

Monostotic fibrous dysplasia of the clivus: MRI and CT findings

Fibrous dysplasia is a developmental disorder caused by abnormal proliferation and maturation of fibroblasts resulting in replacement of mature bone by structurally weak, immature woven bone. Clival involvement in monostotic fibrous dysplasia is extremely unusual, and has rarely been reported previously. We report a case of monostotic fibrous dysplasia of the clivus with special emphasis on the imaging findings and differential diagnosis.     

Comparison of CT and MR features with clinical outcome in patients with Rocky Mountain spotted fever.

PURPOSETo compare neuroimaging findings and clinical features in patients with Rocky Mountain spotted fever and to determine the impact of imaging studies in the treatment of these patients.MATERIALSWe reviewed the brain CT scans (n = 44), MR images (n = 6), or both (n = 4), and one MR spinal study in 34 patients with Rocky Mountain spotted fever, proved by definitive serologic criteria. Records were reviewed with attention to clinical symptoms and therapeutic modifications based on neuroimaging; outcomes were compared with imaging findings.RESULTSAbnormalities, consisting of infarctions, cerebral edema, meningeal enhancement, and prominent perivascular spaces, were found on four of 44 CT scans and on four of six MR studies. The spinal MR study showed abnormal enhancement of the lower spinal cord and cauda equina. Nonspecific clinical symptoms were present in all patients in whom neuroimaging findings were abnormal and in 80% of patients whose CT and/or MR findings were normal. After treatment, return to baseline clinical status was documented in 67% of patients with abnormal imaging findings and in 93% with normal findings. Death occurred in 17% of patients with abnormal neuroimaging results and in none of those with normal results.CONCLUSIONSAbnormalities on neuroimaging studies were not common in patients with Rocky Mountain spotted fever. When present, they were subtle. Symptoms at presentation and unfavorable outcomes were more prevalent when CT or MR findings were abnormal. Abnormalities identified on neuroimaging studies did not alter clinical treatment in any patient.     

Cytomegalovirus pneumonia after stem cell transplantation: correlation of CT findings with clinical outcome in 30 patients

OBJECTIVE: The purpose of our study was to assess the correlation between early high-resolution CT findings of cytomegalovirus (CMV) pneumonia in patients with blood disorders and their clinical outcomes. CONCLUSION: The initial high-resolution CT findings in immunocompromised patients with CMV pneumonia seem to predict the patient's outcome being unfavorable in those forms of disease beginning mostly bilaterally as diffuse or patchy ground-glass opacity followed by progressive air-space consolidation. Also, a change in the CT morphology of pulmonary lesions toward diffuse ground-glass opacity seems to correlate with an unfavorable disease course.     

多层螺旋CT三维重建技术在踝关节骨折诊断中临床价值

踝关节骨折是足部常见骨折之一[1],临床常用的诊断方法有普通X线片、常规横轴位CT等,由于踝关节解剖结构较为复杂,且重叠较多,传统诊断手段均不能全面完整的显示骨折、骨折碎片、关节面塌陷及移位程度等,容易漏诊[2,3]。近年来,随着影像学技术的不断发展,多层螺旋CT三维重建技术已越来越多的应用于骨折的诊断[4,5],不仅图     

隐匿性骨折CT诊断的临床价值（附23例分析）

目的：探讨CT对隐匿性骨折的诊断价值。方法：采用轴位CT扫描。部分病例加薄层高分辨率CT扫描。结果：23例中,眼眶骨折4例,脊柱骨折7例,髋关节骨折7例,胫骨平台骨折5例。结论：CT对隐匿性骨折的诊断是可靠的,凡临床怀疑骨折而X线平片阴性者,应进一步做CT检查。     

11C-蛋氨酸PET/CT显像在脑胶质瘤中的初步应用

目的探讨11C-蛋氨酸(MET)PET/CT显像对脑胶质瘤的应用价值.方法2例正常对照者、2例脑胶质瘤初诊患者和23例脑胶质瘤术后患者行11C-MET PET/CT显像;25例患者中有17例同时行18F-脱氧葡萄糖(FDG)PET/CT显像.临床随访时间3～17个月.结果4例脑胶质瘤术后无肿瘤残余或复发者11C-MET显像为阴性,其中3例同时行18F-FDG显像也为阴性.2例胶质瘤Ⅱ级初诊者和19例脑胶质瘤术后残余、复发者中,20例11C-MET显像阳性(肿瘤/灰质、肿瘤/白质比值分别为2.02±0.96、3.01±1.79),其中14例同时行18F-FDG显像中12例为阳性.11C-MET显像所见病灶远较18F-FDG显像清晰.14例患者11C-MET、18F-FDG显像的肿瘤/灰质、肿瘤/白质比值分别为2.15±1.16比0.97±0.43(P＜0.01)、3.31±2.16比1.90±0.67(P＜0.05).结论11C-MET对脑胶质瘤的显像、定位优于18F-FDG.     

Orbital "blow-in" fractures: clinical and CT features

During a 16 month period, seven patients were admitted to our trauma center with "blow-in" fractures of the orbital roof. This injury results from a significant direct blunt force applied to the supraorbital region of the frontal bone with transmission of energy to the thin orbital plate of this bone and displacement of bone fragments downward into the superior orbit. High resolution CT with multiplanar reformation and three-dimensional display proved very useful in identifying and characterizing the bone and soft tissue abnormalities found in our patients. Our experience suggests that CT demonstration of supraorbital frontal bone fractures and/or frontal lobe cerebral contusions is an indication for thin section CT of the entire orbit, even when there is no evidence of a superior orbital rim fracture. Demonstration of an orbital blow-in fracture should prompt careful clinical assessment of the globe, optic nerve, and extraocular muscles to identify and appropriately manage underlying injuries to these structures.     

Idiopathic inflammatory pseudotumour of the orbit: CT features correlated with clinical outcome.

Idiopathic orbital pseudotumour is an inflammatory condition which usually presents as an orbital mass. The response to treatment is variable and often unpredictable. In this study we have assessed the spectrum of computed tomographic (CT) appearances in 17 patients. Four categories of orbital pseudotumour were identified by CT based on the location and extent of the inflammatory process within the orbit. Patients within each of the four categories had broadly similar clinical outcomes. CT was valuable in identifying certain prognostic features enabling better clinical and therapeutic planning.     

脊柱爆裂骨折的X线与CT诊断及评价

目的 :分析脊柱爆裂骨折的X线、CT表现 ,并评价其诊断价值和限度以及对临床治疗中的指导作用。方法 :回顾性分析 98例脊柱爆裂骨折的影像表现和临床资料 ,其中颈椎 12例 ,胸椎 16例 ,胸腰椎交界 5 0例 ,腰椎 2 0例 ;男 65例 ,女 3 3例 ,平均年龄 3 5岁。外伤后全部摄取X线正侧位片 ;73例行CT平扫 ,其中 3 4例行CT多平面重建。结果 :X线、CT表现为椎体高度减低、终板骨折移位突入椎管内、椎板骨折、椎体侧突成角后移、椎管狭窄、小关节脱位 ,棘突间或椎弓根间距增大、脊髓受压改变、椎间盘突出及椎旁软组织变化。结论 :投照质量良好的平片对脊柱爆裂骨折的诊断有一定价值 ,但需与单纯性压缩骨折鉴别 ,明确诊断需CT证实。CT能较清楚显示脊柱的三柱结构 ,对脊柱爆裂性骨折能做出较全面准确的诊断 ,尤其是对骨折线显示、小关节脱位、椎管损伤及稳定性的判断CT有着明显的优越性。平片对脊柱爆裂骨折的指导治疗作用不大 ,CT对其有一定的价值。但由于对椎间盘损伤、脊髓受损及椎旁软组织显示的局限性 ,其对治疗指导有一定的限度。     

螺旋CT三维成像对髋臼骨折的诊断价值

目的探讨螺旋CT三维成像埘髋F1骨折的诊断价值。方法州顾性分析68例患者共75侧髋臼骨折的X线平片、轴位cT平扫和CT三维成像资料．比较3种检查方法检测骨折线和关节内骨碎片的能力和在Letournel—Judet分型中的价值。各组数据进行X^2检验。结果对髋臼骨折线的检出,轴位CT组（134处,97．1％）和三维CT组（138处,100％）优于x线组（99处,71．7％）;对于骨折分型的价值,三维CT组（75处,100％）〉轴位CT组（69处,92．0％）〉X线组（48处,64．0％）;经X^2检验,差异具有统计学意义。34侧髋臼骨折合并关节内骨碎片,X线组检出19例,轴位CT组和三维CT组无漏诊。结论螺旋CT三维成像能立体直观地观察髋臼骨折并准确进行分型．从而指导临床治疗．