胎盘植入的影像学表现及介入治疗临床研究

目的探讨胎盘植入的影像学表现及介入治疗方法和疗效。资料与方法本组11例患者,术前作CT平扫、术前术后作超声检查、查血绒毛膜促性腺激素(HCG),行双侧子宫动脉造影。治疗采用改良式Seldinger技术穿刺插管行盆腔动脉造影,明确出血血管后将5 F Cobra导管超选择插入出血侧子宫动脉,立即用明胶海绵颗粒和明胶海绵条栓塞。栓塞前经导管注入甲氨喋呤(MTX)200 mg。结果 CT发现11例患者均有盆腔软组织包块,造影示子宫动脉异常增粗、迂曲,并见粗条状血窦及包块染色;11例患者栓塞治疗后植入性胎盘均在3～28天(平均12.3天)内自行剥离、脱落,其中3例1年后自然怀孕。结论胎盘植入通过CT、超声及子宫动脉造影可明确诊断,经导管超选择性子宫动脉栓塞术是治疗胎盘植入安全性高、疗效肯定的方法。     

子宫动脉栓塞术治疗胎盘植入的临床应用

目的 探讨子宫动脉栓塞术(UAE)治疗胎盘植入及引起的产后出血的临床应用. 方法对26例经保守治疗无效的胎盘植入患者及引起的出血进行UAE治疗,采用Seldinger技术选插两侧子宫动脉后分别灌注氨甲喋呤(MTX),然后进行两侧子宫动脉栓塞. 结果 26例经介入治疗后达到快速止血且保留子宫的效果.结论 介入治疗是胎盘植入及所致产后出血有效的新治疗方法.     

肺动静脉畸形的影像诊断及介入治疗分析

目的 探讨肺动静脉畸形的影像学诊断及介入治疗的应用价值.方法 回顾性分析2007年10月至2013年11月在本院行介入治疗的15例肺动静脉畸形患者的临床资料,分析总结其临床表现、影像特征及介入治疗的方法与疗效.结果 15例患者均行CT血管造影(CTA)检查,显示病灶的供血动脉、引流静脉及不同形状的瘤囊,提示肺部动静脉畸形病灶,并将病灶分型,其中简单型12例,复杂型3例.15例患者均行介入栓塞治疗,其中13例患者临床症状逐渐好转,2例复杂型患者症状得到缓解,所有患者介入治疗效果良好,术后均未发生严重并发症.结论 对可疑肺动静脉畸形患者应及时行CTA明确诊断,介入栓塞是一种安全有效的治疗方法.     

Budd—Chiari综合征的影象诊断与介入治疗：附168例分析

本文报告１６８例经Ｂ超检出，下腔静脉造影证实的Ｂｕｄｄ－Ｃｈｉａｒｉ综合征，其中６５例行下腔静脉或肝静脉ＰＴＡ或血管内支架置入。对Ｂｕｄｄ－Ｃｈｉａｒｉ综合征的临床表现。Ｂ超声象、下腔静脉或静脉造影、ＣＴ和其它Ｘ线征象进行了回顾性分析。１６８便中，下腔静脉隔膜型７６例（４５．２％），下腔静脉节段性狭窄或闭塞６５例（３８．７％），肝静脉开口闭塞１０例（６．１％），下腔静脉＋肝静脉闭塞１７例（１０％）     

肝癌介入治疗的影像评估价值--着重CT平扫及双期动态增强与DSA的影像对比分析

目的　探讨肝癌介入治疗后CT平扫及双期增强的评估价值及其意义。材料与方法　搜集 3 7例碘油栓塞及 7例微球栓塞患者复查CT平扫及双期增强图像 ,并与血管造影对比分析 ,了解栓塞区非坏死低密度灶的强化规律与供应血管的关系。结果CT平扫可分辨碘油沉积区、液化坏死区、非坏死低密度区。血管造影发现非坏死低密度区有残存肿瘤血管或 /和侧支供血。双期增强CT显示 :动脉期 ( 2 5～ 40秒 )明显强化时 ,该区肿瘤血管部分再通或 /和大量侧支循环形成 ;若门静脉期 ( 60～ 75秒 )进一步强化 ,可能还有门静脉参与供血 ;双期增强无明显强化者 ,该区供血动脉不丰富 ,门静脉很少参与供血。结论　CT应作为肝癌介入治疗后影像学复查的首选检查方法 ,其平扫及双期增强表现可反映栓后瘤体的组织学及供血变化 ,及时发现新病灶 ,据此制订新的治疗方案 ,有望提高疗效。     

肝癌介入治疗的影像评估价值：着重CT平扫及双期动态增强与D …

探讨肝癌介入治疗后ＣＴ平扫及双期增强的评估价值及其意义。材料与方法，搜集３７例碘油栓塞及７例微球栓塞患者复查ＣＴ平扫及双期增强图像，并与血管造影对比分析，了解栓塞区非坏死低密度灶的强化规律与供应血管的关系。     

胸廓内动脉参与肝脏肿瘤供血的影像表现与介入治疗(附6例报告)

观察胸廓内动脉参与肝脏肿瘤供血的影像表现和介入治疗效果。材料与方法４年间发现ＩＴＡ参与肝癌供血６例，经血管造影证实，男性５例，女１例，年龄３６－５２岁，均有超声波与ＣＴ检查资料，３例曾做ＭＲＩ检查。既往均曾行肝动脉化疗栓塞。ＩＴＡ造影用５Ｆ眼镜蛇形导管，对向肿瘤供血的ＩＴＡ分支行栓塞治疗，２例用同轴微导管。     

肺动静脉瘘的影像综合诊断与介入治疗

归纳与分析肺动静脉瘘诊断中常用的胸部X线平片、造影对比超声心动图、胸部CT、磁共振血管造影、选择性肺动脉数字减影造影等影像学检查方法,探讨介入治疗中金属弹簧圈、可脱式球囊、Amplatzer血管封堵器、国产自制双伞型封堵器等栓塞材料的应用,操作技术与注意事项,并发症以及随访与复发等问题,为肺动静脉瘘的诊治提供参考。     

视网膜母细胞瘤的影像学表现及其临床价值

目的　探讨视网膜母细胞瘤的CT、MRI表现及其诊断、鉴别诊断价值。方法　回顾性分析 3 2例经手术病理 (2 9例 )和临床证实 (3例 )的视网膜母细胞瘤。所有病例均行CT检查 ,11例行MRI检查。结果　具有典型CT表现者 2 8例 :①眼球壁上软组织密度块影向球内隆起 ;②斑点状或团块状钙化。 3例视神经增粗 ,其中 1例伴鞍上肿块。 4例瘤内无钙化。MRI显示 11例球内肿块同时伴有视网膜下积液、出血 2例 ,显示有低信号钙化灶 2例 ,视神经增粗 2例。CT与MRI检查对视网膜母细胞瘤敏感性相同。定性诊断准确率 :CT 90 .63 % (2 9/3 2 ) ,MRI 81.82 % (9/11)。分期准确率 :CT 93 .10 % (2 7/2 9) ,MRI 10 0 % (9/9)。结论　CT对肿瘤定性诊断具有重要意义。MRI检查对肿瘤分期较优越。对无钙化肿瘤辅以MRI检查可提高定性诊断准确率     

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.     

自发性低颅压综合征的临床及影像学表现

目的 探讨自发性低颅压综合征(spontaneous intracranial hypotension,SIH)的临床及影像学特征,以提高对本病的认识.方法 回顾性分析35例SIH患者的临床、头部影像学资料.全部患者行头颅CT检查,22例行头颅MRI检查,其中6例行增强检查.结果 所有患者均有体位性头痛,常伴有恶心、呕吐、头晕,偶有颈肩疼痛、脑膜刺 激征阳性,脑脊液(CSF)压力均<70 mmH2O,其中蛋白升高12例,氯化物升高11例,白细胞(WBC)增多5例,红细胞(RBC)增多12例.2例CT表现为蛛网膜下腔出血.MRI检查常见脑下坠(14例)、静脉窦扩张(11例)、硬膜下积液(6例)、硬脑膜强化(5例).结论 体位性头痛是SIH的重要的特征性症状,头部影像学特别是MRI有助于该病的诊断.     

巨大淋巴结增生症的临床、病理及影像学表现

巨大淋巴结增生症是一种少见的良性淋巴结增生性疾病,195 6年由Castleman等[1] 首先报道此病,描述为类似胸腺瘤的局限型纵隔淋巴结增生性疾病,此后文献多有报道,并分别命名为Castleman病(Castle man’sdisease ,CD)、血管淋巴滤泡增生症和淋巴样错构瘤等[2 ] 。由于该病少见,对     

Biliary Complications in Living Donor Liver Transplantation: Imaging Findings and the Roles of Interventional Procedures

Purpose To describe the incidence, types, and findings of biliary complications in living donor liver transplantation (LDLT) and to determine the roles of interventional procedures. Materials and methods Twenty-four biliary complications among 161 LDLT patients (24/161, 14.9%) were identified. These complications were divided into two groups according to the initial manifestation time, i.e., “early” (<60 days) or “late”. The CT and cholangiographic findings were reviewed regarding the presence of a stricture or leak and the location, and length, shape, and degree of the stricture. Both groups were categorized into three subgroups: leak, stricture, and both. The type of interventional procedures used and their roles were determined. Results Early complications were identified in 14 of the 24 patients (58%) and late complications in 11 (46%). One patient showed both early and late complications. Biliary stricture was detected in 10 patients, leak in 10, and both in 5. By cholangiography, all strictures were irregular and short (mean length 15 ± 6 mm) at the anastomotic site and complete obstruction was observed in 2 patients with late stricture. Twenty-three of the 24 patients were treated using percutaneous and/or endoscopic drainage procedures with or without balloon dilatation. Seventeen (74%) showed a good response, but reoperations were inevitable in 6 (26%). All patients except those with complete obstruction showed a favorable outcome after interventional management. Conclusion Biliary leaks and strictures are predominant complications in LDLT. Most show good responses to interventional treatment. However, complete obstruction needs additional operative management.     

寰枢关节退变性骨关节病的影像学表现及与临床的相关性

目的　探讨寰枢关节退变性骨关节病 (AAOA)的影像学表现及与临床的相关性。方法　对 164例主要接受头颅CT检查病人的寰枢 (AA)关节行CT扫描 ,部分加摄X线张口位片。结果　AAOA的影像表现为关节间隙变窄、骨赘及关节周围钙化。AA外侧关节退变与枕颈区痛有相关性。结论　CT较X线能更好地显示AAOA的病理改变 ,对于有单侧枕颈区痛的 5 0岁以上患者 ,应考虑是否有AA外侧关节骨关节病     

Uremic Encephalopathy: MR Imaging Findings and Clinical Correlation

BACKGROUND AND PURPOSE:Uremic encephalopathy is a metabolic disorder in patients with renal failure. The purpose of this study was to describe the MR imaging findings of uremic encephalopathy.MATERIALS AND METHODS:This study retrospectively reviewed MR imaging findings in 10 patients with clinically proved uremic encephalopathy between May 2005 and December 2014. Parameters evaluated were lesion location and appearance; MR signal intensity of the lesions on T1WI, T2WI, and T2 fluid-attenuated inversion recovery images; the presence or absence of restricted diffusion on diffusion-weighted images and apparent diffusion coefficient maps; and the reversibility of documented signal-intensity abnormalities on follow-up MR imaging.RESULTS:MR imaging abnormalities accompanying marked elevation of serum creatinine (range, 4.3–11.7 mg/dL) were evident in the 10 patients. Nine patients had a history of chronic renal failure with expansile bilateral basal ganglia lesions, and 1 patient with acute renal failure had reversible largely cortical lesions. Two of 6 patients with available arterial blood gas results had metabolic acidosis. All basal ganglia lesions showed expansile high signal intensity (lentiform fork sign) on T2WI. Varied levels of restricted diffusion and a range of signal intensities on DWI were evident and were not correlated with serum Cr levels. All cortical lesions demonstrated high signal intensity on T2WI. Four patients with follow-up MR imaging after hemodialysis showed complete resolution of all lesions.CONCLUSIONS:The lentiform fork sign is reliable in the early diagnosis of uremic encephalopathy, regardless of the presence of metabolic acidosis. Cytotoxic edema and/or vasogenic edema on DWI/ADC maps may be associated with uremic encephalopathy.

Uremic encephalopathy is a metabolic disorder that occurs in patients with acute or chronic renal failure. This toxic-metabolic encephalopathy is a complication resulting from endogenous uremic toxins in patients with severe renal failure. The pathogenesis is complex and unclear.Knowledge concerning a uremic encephalopathy (UE)-specific imaging feature, the so-called lentiform fork sign (LFS), is limited to case reports. The LFS may also be present in metabolic acidosis from any cause, including end-stage renal disease, methanol intoxication, and the dialysis disequilibrium syndrome.^1–6 This study was undertaken to describe the MR imaging features in the brains of 10 patients with UE, with the aim of identifying common imaging features and potentially clarifying the possible pathophysiology of UE.     

脑白质疏松MR成像与临床对照研究

目的；探讨脑白质疏松的ＭＲＩ表现并与临床对照分析。材料与方法：搜集资料完整经ＭＲＩ诊断为脑白质疏松者１００例，男７１例，女２９例，年龄４９￣８０岁，平均６６岁。根据ＭＲＩ所见和病壮部位，将脑白质疏松分为两大类、０￣Ⅲ级。比较临床症状、脑血管病变与脑白质 的关系。     

介入治疗子宫腺肌病的临床价值

子宫腺肌病所致的痛经、月经过多、子宫增大等临床症状,常常使患者生活质量大大降低。传统子宫切除的治疗方法使年轻的患者难以接受。寻找一种安全、有效,费用低的治疗手段是人们关注的问题。经导管子宫动脉栓塞是目前最新的治疗方法,有望成为替代子宫切除治疗子宫腺肌病的理想     

子痫颅脑CT表现及与临床关系

目的分析子痫颅脑CT表现及与临床相关性。方法18例子痫患者均行颅脑CT平扫,其中3例行增强扫描,8例进行CT复查。结果14例患者显示脑白质内广泛低密度水肿区,枕叶脑白质累及为主,并多伴有额叶、顶叶受侵。4例表现为脑内局限性低密度区,2例合并脑出血,呈散在小斑片状分布。结论CT是子痫脑内病灶较好的影像检查手段,既可发现早期病灶,又可评价预后。