膈肌包虫囊肿

本文报告了２６例膈肌包虫囊肿的Ｘ线表现，均经手术病理证实，其Ｘ线表现分为单纯性包虫囊肿及破裂感染的包虫囊肿两类，单纯包虫囊肿表现为膈肌局限性膨出；带蒂的突向胸腔的卵园形阴影，及合并囊肿钙化。破裂感染的包虫囊肿表现为囊肿内“月牙征”，“水上百合”或“气液平”；合并胸膜及肺内感染或肺包虫囊肿，及类似单纯性胸腔积液。讨论了常规Ｘ线，ＣＴ，超声的影象诊断。并指出多数膈肌包虫囊肿位于右侧膈肌，约８倍于左膈，因此，左膈的一些病变，一般不应考虑包虫囊肿。     

CT对胸部淋巴瘤诊断价值的研究

复习７８例胸部淋巴瘤的ＣＴ扫描和同期的胸部Ｘ线片，观察ＣＴ扫描对胸部淋巴瘤的诊断、分期及随诊的价值。７８例中Ｈｏｄｇｋｉｎ病３７例，非Ｈｏｄｇｋｉｎ淋巴瘤４０例，未分类１例。初诊时做治疗前ＣＴ扫描１８例，复诊做ＣＴ扫描７３例（１２０次）。ＣＴ扫描对５７例（７３％）增添了有价值的信息，特别是对检出位于胸膜、胸壁、隐匿在纵隔旁和胸膜下的肺病变，以及内乳链、膈脚后、横膈心包组和纵膈大血管之间的淋巴结更有意义。     

膈肌包虫囊肿误诊1例报告

包虫病在新疆地区颇为常见,尤其近年来随着家庭农场的发展,与牛羊狗的接触频繁,发病率有所增高。其中以肝脏及肺脏寄生较多,寄生于脑、肾、肌肉、眼眶、输卵管卵巢已多次报导,此外,尚有胆道、纵隔及胸膜的包虫病例,最近,还有罕见的心脏包虫囊肿的报道,膈肌包虫囊肿实属少见,现将我院发现1例,报告如下:     

侵袭性胸腺瘤的CT诊断及评价

目的分析侵袭性胸腺瘤的ＣＴ表现以便于分期和计划治疗。材料与方法分析２６例手术及病理证实的侵袭性胸腺瘤的ＣＴ所见，着重观察病变的密度，对周围纵隔结构的侵犯、胸膜种植以及纵隔外转移情况。结果２６例侵袭性胸腺瘤ＣＴ均显示为前纵隔软组织肿块，１６例密度不均，肿块不规则侵犯邻近器官２４例，主要表现在纵隔胸膜受侵７例，肺受侵９例，胸膜种植３例，心血管结构受侵２０例，以及心膈角区和腹腔受侵３例。结论ＣＴ在显示胸膜、心包和肺实质侵犯方面极其有效，对病变范围可进行可靠的评价，常规ＣＴ扫描可进行准确的分期和决定治疗方案。     

影响胸部CT导向穿刺活检准确性因素的探讨：（附100例分析）

目的：评价胸部ＣＴ导向穿刺活检中ＣＴ定位、取材方法、病变等因素对本项检查准确性的影响。材料与方法：回顾分析１００例资料完整的病例。分别计算用不同取材方法，对不同部位病灶检查的准确性，分析各因素对准确性的影响。结果：对肺部恶性病变细胞学和组织学诊断的正确率分别是９０％和８７％，对肺部良性病变细胞学和组织学诊断的正确率分别是６０％和８４％。对纵隔和胸膜病变组织学诊断准确性高。结论：细胞学诊断对肺部恶性病变的诊断准确性高，组织学诊断对肺部良性病变的准确性高，对肺部病变应根据影像学诊断决定取材方式。对纵隔、胸膜等处病灶应取得充分的组织学标本方易作出确切诊断。     

胸部疾病CT诊断的评价

本文通过２６１例Ｘ线与ＣＴ诊断比较，评价胸部ＣＴ在胸部疾病诊断中的价值。结果是（１）弥漫病变ＣＴ诊断正确率为８７．５％，Ｘ线为５８．９％；（２）纵隔肿块ＣＴ诊断正确率为６０．１％，Ｘ线为４８．０％；（３）胸膜肿块ＣＴ诊断正确率为７５．０％，Ｘ线为６６．６％；（４）肺段肺叶阴影ＣＴ诊断正确率为７１．０％，Ｘ线为６８．４％；（５）球块阴影ＣＴ诊断正确率为７３．０％，Ｘ线为７１．０％；（６）斑片阴影ＣＴ诊断正确率为６６．０％，Ｘ线为７２．０％。分析材料表明在Ｘ线检查基础上根据胸部疾病基本影像，在普遍胸部ＣＴ检查上附加高分辨、薄层及增强扫描可提高一些ＣＴ征象发现率，同时可以使胸部疾病ＣＴ诊断水平超过本文报道的水平。     

人体罕少见部位包虫病的X线诊断

目的 探讨人体罕少见部位包虫病的X线表现及其诊断价值.方法 回顾性分析经X线诊断及手术证实的6例罕少见部位包虫病患者的X线表现.结果 6例均为囊性包虫病,肱骨骨包虫1例,坐骨骨包虫1例,乳腺包虫1例,心包包虫2例,肾脏包虫合并肝包虫1例.囊性包虫病在X线上可表现为囊型和钙化等.结论 罕少见部位包虫病具有一定的特征性X线表现,结合临床流行病学特点可提高诊断准确率.     

肺包虫病的X线诊断（附32例分析）

目的：分析肺包虫病的X线表现特点，以提高其诊断及鉴别诊断能力。方法：回顾性分析32例经手术病理证实的肺包虫病的X线表现，全部病例均摄有胸部X线正侧位平片。结果：单囊型29例，多囊型3例、8例合并感染，X线表现为气液平面及内外囊分离。单纯性肺包虫病及部分有合并症的包虫囊肿具有典型的X线征象，结合临床诊断容易明确。合并破裂感染及有复杂合并症的肺包虫病有时缺乏特征性表现，大多数诊断较为困难。结论：X线检杏对肺包电病的诊断有重要价值．仍为首诜方法．     

颅内包虫病的CT诊断：附四例报告

颅内包虫病的ＣＴ诊断（附四例报告）张玉珂，董兆虎，赵辉，巴吐尔包虫病（细粒状棘球蚴）绝大多数寄生于肝、肺，发生在颅内者少见。据统计脑包虫仅占包虫病的０．２％～１．５９％［１］。而颅内硬膜外包虫则罕见。我院１９８８年以来经ＣＴ检查发现脑包虫３例，硬膜外...     

人体少见部位包虫病的CT表现

目的：探讨人体少见部位包虫病的CT表现及其诊断价值。方法：回顾性分析经CT诊断及手术病理证实的35例少见部位包虫病的CT表现。结果：所有病例均为囊型包虫病,腹腔包虫21例,心脏包虫1例,肾脏包虫4例,脾脏包虫5例,胫骨包虫1例,髂骨包虫3例,其中合并肝包虫19例、肺包虫4例。囊型包虫病在CT上因病程和病理的不同可表现为单囊型、多子囊型、钙化等;骨包虫CT表现为病骨呈类多房状膨胀性骨质破坏及周围包囊性病灶,内可见子囊及小碎骨片。结论：少见部位包虫病具有一定的特征性CT表现,结合临床流行病学特点可提高诊断准确率。     

CT findings in pulmonary hydatid disease.

PURPOSE: The purpose of this study was to present the CT findings of complicated pulmonary hydatid cysts on the basis of the CT appearances. MATERIAL AND METHODS: Preoperative CT examinations of 19 cases with hydatid cysts were evaluated retrospectively for the number and various features of the cysts and secondary changes in adjacent structures. The results were compared with surgical findings. RESULTS: While 7 patients had multiple pulmonary hydatid cysts, 12 patients had solitary cyst. The total number of the cysts was 29. Eleven of them were intact cysts. Two of the 18 complicated cysts were only ruptured, while the remaining 16 complicated cysts were ruptured and infected. The endocyst was separated from a pericyst in a local area in one ruptured cyst. Air-bubbles were seen within 14 infected cysts. Nine of the infected cysts had characteristic appearances of hydatid disease. The other 2 infected cysts showed soft tissue density. CONCLUSION: CT can provide the specific diagnosis of pulmonary hydatid cysts by demonstrating the number and features of the cysts, characteristic appearances of complicated cysts, and secondary changes in adjacent structures. Whether there are characteristic signs or not, the demonstration of air-bubbles within the cyst, together with ring enhancement, are strong indicators for infected hydatid cysts.     

Computed tomography of pulmonary hydatid disease

The CT findings in 20 patients with pulmonary hydatid disease were reviewed. Sixty-four intrapulmonary cysts were imaged, 22% of which were ruptured or complicated. Simple hydatid cysts and water-density lung cysts of other etiology may have a similar CT appearance; however, the demonstration of the cystic nature of a lung lesion in endemic areas makes hydatid disease the primary consideration. Pathognomonic features in ruptured or complicated hydatid cysts that can be visualized better by CT than by conventional radiography include detached or collapsed endocyst membrane(s), collapsed daughter cyst membranes, and intact daughter cysts.     

Radiological characteristics of pulmonary hydatid disease in children: less common radiological appearances

OBJECTIVE: To evaluate the chest roentgenogram and CT characteristics of pulmonary hydatid disease (PHD). MATERIAL AND METHODS: Forty-seven (27 male and 20 female, aged between 3 and 11 years) consecutive pediatric patients with surgically proven pulmonary hydatid cysts were enrolled for the study. Posteroanterior and lateral chest roentgenograms, CT of the chest, and laboratory findings (latex agglutination, Casoni skin test, and eosinophil count) were obtained from all of the patients. The radiological features (localization, internal architecture, number, diameter) were determined. RESULTS: On CT examination, a total of 79 cysts were determined. On chest roentgenogram, 57 of 79 cysts were detected in all patients. Single cysts were seen in 33 patients, while multiple cysts were seen in 14. Median CT density of the cysts was 21 Hounsfield units (HU) (0-80). There were six giant cysts (>10 cm of cyst diameter). The crescent sign, water lily sign, and air-fluid level were seen in two, five and eight of the cysts, respectively. Apart from the classically described features of pulmonary hydatid cysts of the lung, a crescent-shaped rim of air at the lower end of the cyst (inverse crescent sign) was detected in three cysts. All of the liquid content of the cyst was expelled to the bronchial system (dry cyst sign) was observed in seven cysts. There were two infected cysts. Heavily calcified curvilinear cyst wall was present in one cyst. Pericystic reaction in the lung tissue was observed in five patients. Other features included pleural effusion (n=2), mediastinal shift (n=6) and atelectasis (n=7). CONCLUSIONS: Chest roentgenogram is helpful for diagnosis of intact cysts but, it is impossible to define entire morphology of the complicated cysts. CT imaging recognize certain details of the lesions and discover others that are not visible by conventional radiography. In conclusion, CT examination should be done to elucidate cystic nature of the lung mass and for accurate localization in the preoperative period. In addition, inverse crescent sign should be recognized as feature of pulmonary hydatid cysts on CT.     

New diagnostic signs in hydatid disease; radiography, ultrasound, CT and MRI correlated to pathology

Seventeen of 70 patients with hydatid disease had verified Echinococcus granulosus infection of the chest. In 14 patients (20%), the primary location was the lung parenchyma. Two patients had primary and one secondary mediastinal hydatid cysts, and one patient a primary hydatid cyst of the chest wall. In three above-mentioned patients, secondary pleural involvement occurred, of which two were due to ruptured pulmonary cysts and one due to an hydatid cyst arising in the liver and having prolapsed into the chest. In all cases, clinical findings, radiography, ultrasound (US), computed tomography (CT) and/or magnetic resonance imaging (MRI) were correlated to macroscopic and microscopic pathology. Characteristic signs made recognition of hydatid disease possible, sometimes even when serologic tests had been non-conclusive. Assessment of other cysts throughout the body with or without involvement of neighbouring organs or tissues allowed appropriate therapeutic management. CT and MRI also played a key role in recognizing complications (e.g., rupture, infection of cysts).     

An unusual cause of pulmonary hypertension: Mediastinal hydatid cyst

Hydatid disease is a parasitic zoonosis prevalent in sheep-rearing areas. The lung is the second most commonly involved organ following the liver. Intra-thoracic and extra-pulmonary hydatid disease is rare and can affect the mediastinum, heart, diaphragm, pleura, and chest wall. Uncommon locations represent a diagnostic challenge. We report clinical and imaging manifestations of a compressive mediastinal hydatid cyst revealed by pulmonary hypertension. Radiologists must be familiar with the imaging features of hydatid disease and contemplate the diagnosis when facing atypical chest cystic lesions, especially in patients from endemic regions or with evidence of hydatidosis in a different anatomical location.     

Radiographic,CT and MRI spectrum of hydatid disease of the chest: a pictorial essay

Thirty patients with thoracic hydatidosis (Echinococcus granulosus) were studied. The hydatid cysts were located in the lung parenchyma (70%), mediastinum (6.7%), inside the heart (10%), the pleurae (10%) and the chest wall (3.3%). complications of thoracic hydatid cysts, such as rupture, infection, pleural involvement, spread and calcifications are presented. Computed tomography (CT) without and/or with contrast enhancement was performed in all patients (30). Findings from conventional chest radiographs were compared with CT and confirmed by pathology (30). In 10 cases (33.3%), magnetic resonance imaging was also performed. The diagnostic spectrum of hydatid cysts, including variations and developmental stages, is presented in this pictorial essay.     

胸腺囊肿的CT、MRI诊断

目的:总结胸腺囊肿的CT和MRI影像表现。材料和方法:回顾分析12例胸腺囊肿的胸部平片、CT和MRI表现并与手术病理对照。结果:12例胸腺囊肿直径1~12cm,平均3.6cm;圆形或类圆形10例,长圆或圆柱形2例;位于前上纵隔9例,前下纵隔1例,从主动脉弓至横膈2例;边缘光整12例;境界清楚9例,与心脏大血管或心包联系紧密3例;未突出纵隔轮廓5例,突出纵隔轮廓7例;薄壁10例,厚壁2例;单房11例,多房1例;均匀水样密度9例,接近肌肉密度3例;7例增强扫描囊内容物均无增强。结论:大多数胸腺囊肿根据其CT和MRI表现,术前可作出正确诊断,并与其他纵隔囊性肿块相鉴别。     

CT and MRI findings of cardiac echinococcosis

Fifteen patients (8 males and 7 females, 15–56 years old) with primary or secondary hydatid disease involving the heart were examined by radiography, CT and/or MRI. MRI was done with a 1.5 T machine (Picker) in 11 cases and a 0.5 T machine (Philips) in 4 cases using ECG-gated T1- and T2-weighted spin-echo pulse sequences. Transaxial sections were combined with at least one mr more plane (coronal and/or sagittal) and intermediate views if the need for further information was anticipated. In 4 patients primary cardiac echinococcal cysts were found, localised to the left ventricle/pericardium/interventricular septum in 2 cases and to the left atrium/percardium and right atrium/pericardium in 1 case each. In 11 of 15 cases there was secondary involvement of the heart by echinococcal cysts primarily arising in the lung parenchyma (n = 6), mediastinum (n = 3) and by transdiaphragmatic extension from the liver and abdomen (n = 2). CT was superior to MRI in visualising calcifications. However, ECG-gated MRI of cardiac hydatid disease appears to be the method of choice for specific diagnosis and exact assessment of hydatid cysts and their correlation with cardiac structures. Correspondence to: W. N. von Sinner     

Isolated hydatid disease of the spleen: CT findings in 4 patients and differential diagnosis

AIM: To report our experience with four cases of isolated hydatid disease of the spleen studied by spiral Computed Tomography (CT) and to review the literature with special attention to the differential diagnosis with other focal lesions of the spleen. MATERIALS AND METHODS: The spiral CT images and clinical records of four patients (1 man, 3 women; age range 26-45 yrs) affected by isolated hydatid disease of the spleen were retrospectively evaluated. None of the patients had a history of hydatid disease. All the patients were evaluated by plain and enhanced spiral CT of the abdomen. All patients underwent preoperative chest X-ray and surgery; all surgical specimens were studied by histology. RESULTS: Spiral CT depicted all the hydatid lesions of the spleen. It showed the location, size, low density of their content without enhancement after iv contrast medium injection, the possible presence of daughter cysts, the appearance of the wall with calcifications, and excluded the presence of complications. The preoperative chest X-ray was negative for focal pulmonary lesions in all cases. Pathology confirmed the diagnosis of hydatid disease in all cases. CONCLUSIONS: According to our results and to the literature, spiral CT plays an important role in the pre-surgical evaluation of patients with hydatid disease of the spleen, and provides useful information for differentiating the disease from other isolated cyst-like lesions of the spleen.     

肺淋巴管肌瘤病的HRCT诊断（附17例报告）

目的：探讨肺淋巴管肌瘤病的高分辨率C T （H RC T ）表现,以提高对该病的认识。方法回顾性分析17例经病理证实的肺淋巴管肌瘤病胸部HRCT表现及临床资料,所有病例肺活检前均行胸部 HRCT扫描及腹部B超检查,腹部B超发现异常病例者行腹部C T检查6例。结果17例患者均为育龄期女性,胸部H RC T均表现为两肺弥漫、大小不等圆形薄壁囊状影（17/17,100％）,2例部分融合成肺大泡（2/17,11．8％）,4例合并气胸（4/17,23．5％）,2例伴乳糜胸（2/17,11．8％）。腹部C T检查发现2例伴双侧肾错构瘤（2/17,11．8％）,1例伴右侧肾错构瘤（1/17,5．9％）,1例伴子宫错构瘤（1/17,5．9％）,2例伴肝脏错构瘤（2/17,11．8％）,3例伴腹膜后囊性淋巴管瘤（3/17,17．6％）。结论育龄期女性,胸部HRCT表现为两肺弥漫、均匀分布的圆形薄壁囊状影,应考虑肺淋巴管肌瘤病可能。应常规行腹部CT检查,腹部CT检查发现肝肾错构瘤,腹膜后囊性淋巴管瘤可协助诊断。