Nodular sarcoidosis of the liver and spleen: Appearance on MR images

Small nodular lesions in the liver and spleen have been reported as an infrequent manifestation of sarcoidosis. Five patients with this appearance on either dynamic contrast material—enhanced computed tomographic (CT) or ultrasound scans underwent magnetic resonance (MR) imaging with and without dynamic gadolinium enhancement. The lesions were relatively uniform in size, ranging from 0.5 to 1.5 cm. On CT scans, they were hypoattenuating relative to surrounding parenchyma. On MR images, the lesions were hypointense relative to background parenchyma with all sequences. No substantial enhancement was observed in the lesions, although lesion conspicuity decreased over time on serial postcontrast images. Lesion conspicuity was greatest on either T2-weighted fat-suppressed (T2FS) images or early-phase dynamic contrast-enhanced images. Abdominal adenopathy was seen in three of the five patients and was hyperintense relative to liver on T2FS images in two and intermediate in intensity in one patient.     

迟发性脾破裂32例诊治分析

目的 探讨迟发性脾破裂(DRS)的诊断和治疗方法。方法 对1978-1999年间收治的32例DRS进行回顾性分析，比较CT、B超、腹腔灌洗等检查手段在DRS诊断中的作用及不同治疗方法的效果。结果 26例行脾切除术，其中1例因合并脑损伤于脾切术后4d死亡；6例严密观察下保守治疗出院，平均住院18．5d。结论 联合腹腔灌洗可提高腹腔穿刺的阳性率。B超是诊断DRS和对保守治疗患者进行严密观察的重要手段。     

32例卫氏肺吸虫病的胸部CT分析

目的：探讨肺吸虫病的胸部CT表现。方法：对32例经临床证实的卫氏肺吸虫病的临床与胸部CT所见进行回顾分析。结果：根据本组资料,肺吸虫病的胸部CT表现可为5类,浸润性改变10例,支气管周围炎样改变8例,囊状阴影6例,附壁结节空洞5例,胸腔积液3例。结论：肺吸虫病的胸部CT表现与一般感染性病变不易区别,应结合临床相关检查,但是附壁结节空洞内的“瓜子”状附壁结节影有助于诊断。     

不典型肝脓肿超声诊断的应用(附32例分析)

目的:探讨不典型肝脓肿的超声表现及超声诊断技术临床应用价值。方法:回顾性分析32例不典型肝脓肿的超声表现,其中3例超声造影检查。全部病例经临床随访及穿刺活检后经病理证实。结果:不典型肝脓肿随病理过程的变化超声表现各不相同,可表现为实性低回声、等回声及偏高回声,与周围肝组织分界不清,内回声强弱不等,分布极不均匀,可见形态不规则的小片状液区。部分病灶内可见正常肝内门脉血管穿行。注射对比剂后整个过程病灶内部未见增强,均呈低回声,病灶边界较造影前清晰。结论:不典型肝脓肿声像图复杂多变,超声检查仍为可靠方法,超声造影更具诊断意义。     

Aspiration biopsy of the spleen in patients with sarcoidosis

Fine-needle aspiration biopsy of the spleen was performed on 101 patients with suggested sarcoidosis; it was the final diagnosis in 79. Adequate specimens were obtained in all cases with a 0.8 X 80 mm or 0.7 X 40 mm disposable needle. Fine-needle biopsy specimens of the spleen showed a granulomatous reaction in 19 out of the 79 cases with sarcoidosis (24%). There were three minor biopsy complications that required no treatment.     

外伤性基底节区血肿32例分析

回顾分析32例外伤性基底节区血肿患者的临床资料,其中行开颅血肿清除术者6例,非手术治疗26例。伤后6个月格拉斯哥预后评分（ GOS）：恢复良好12例,中残10例,重残7例,植物状态3例。     

胸部结节病36例临床医学影像征象分析

目的:探讨临床影像检查对胸部结节病的诊断价值。方法:回顾性分析胸部结节病36例患者临床影像资料,病例均经手术病理和临床治疗随访证实。结果:患者女性略多于男性,可发生于任何年龄,但半数以上见于40~50岁患者,临床症状多较轻微;胸部淋巴结增大具有特征性,多表现为纵隔与双侧肺门对称性淋巴结增大,增大淋巴结多不融合,境界较清晰,强化CT扫描,增大淋巴结多呈中度强化。肺内表现呈多样化,可为间质性肺改变、多发粟粒结节或肿块,肺门增大模糊症也较常见,胸膜腔积液较少见。结论:胸部结节病临床表现无特异性,医学影像检查对胸部结节病的诊断具有重要临床价值。     

腺样囊性癌的影像学诊断(附32例分析)

目的分析头部和气管腺样囊性癌（ＡＣＣ）的临床表现和影像学征象。方法对３２例经病理证实的腺样囊性癌进行回顾性分析。其中男２０例，女１２例，年龄范围２１～７３岁，平均年龄４６．２岁。结果ＡＣＣ具有浸润性生长的特点。ＣＴ有利于显示骨质破坏。ＭＲＩ可显示肿瘤边界及其侵犯范围。Ｔ２ＷＩ信号可反映组织类型，提示预后。结论ＡＣＣ缺乏特异性，确诊靠病理学诊断。本病具有明显沿神经扩展、少见淋巴转移的特点，有助于与其他肿瘤进行鉴别     

缺血性肠病32例结肠镜检查分析

目的：总结缺血性肠病的内镜检查特点。方法：2003年1月-2007年12月对32例缺血性肠病者行镜检分析，并做病理学检查。结果：32例缺血性肠病经结肠镜检显示以左半结肠好发，病变局限于黏膜及黏膜下层。结肠镜检查无并发症发生。结论：结肠镜是早期诊断和治疗缺血性肠病的有效手段，并能明确病变的范围和严重程度。     

腘动脉损伤32例临床分析

目的探讨腘动脉损伤的诊疗方法及临床疗效。方法回顾性分析2005年1月~2015年1月收治的32例腘动脉损伤患者临床资料,其中男性28例,女性4例;年龄25~56岁,平均35.5岁;左侧14例,右侧18例;开放性损伤12例,闭合性损伤20例;血管损伤分型:A型17例,B型5例,C型10例;腘静脉损伤17例,合并膝关节周围骨折26例。30例患者行急诊手术治疗,术中探查腘血管、神经,其中行腘动脉端端吻合11例,大隐静脉移植19例,2例一期截肢。对17例合并腘静脉损伤进行修复,骨折行外固定支架固定,同时行骨筋膜室切开减压,创面负压封闭引流技术覆盖。结果 32例患者无一例死亡,29例保肢成功;2例因受伤12h下肢肌肉坏死严重,全身并发症或急性肾衰竭予以一期截肢;1例保肢术后出现肌肉广泛坏死、急性肾衰竭予以截肢。30例获得随访,随访时间6~24个月,平均15个月。26例合并骨折患者中25例获骨性愈合,1例发生骨不连,二期行植骨及接骨板内固定后愈合。末次随访对29例保肢成功患者进行Hohl膝关节功能评分,优11例,良8例,可6例,差4例,优良率65.5%。结论早期诊断、急诊手术重建下肢血供、术后密切观察及护理可提高腘动脉损伤治疗的成功率。     

肝脏结节性再生性增生1例并文献复习

患者男,26岁.2月前体检超声发现肝占位,无自觉症状,CT提示肝左叶肿物.无肝炎、肝硬化及其他疾病病史.肝功能正常,甲胎蛋白(AFP)1.7 ng/mL. 影像检查:超声示肝左叶约4.3 cm×4.0 cm高回声肿物(图1),边界清楚,回声均匀;超声表现为“快进慢出”的强化方式.MRI示肝左内叶肿物T1WI呈稍低信号,反相位信号略降低,T2WI呈稍高信号,DWI轻度扩散受限(b值为600 s/mm2);Gd-DTPA增强扫描动脉期中度强化,静脉期及延迟期呈均匀低信号(图2～5).     

Computed tomography of liver sarcoidosis

A case of sarcoidosis revealed multiple low density areas in the liver on CT. One of these lesions was confirmed by laparoscopic liver biopsy to be a mass of noncaseating granulomas surrounded by necrotic or fibrotic tissues. These lesions disappeared rapidly after steroid therapy.     

Nodular hepatic and splenic sarcoidosis in a patient with normal chest radiograph.

Almost all the patients with sarcoidosis have an abnormal chest radiograph, while nodular lesions of both the liver and the spleen is an unusual manifestation of abdominal sarcoidosis. We report a case of a patient with numerous hypodense nodular hepato-splenic lesions on abdominal CT and a normal chest X-ray. Biopsy of an hepatic lesion revealed sarcoidosis.     

药物性肝损害35例临床分析

目的：提高对药物性肝损害的认识，减少药物性肝损害的发生。方法：对35例药物性肝损害的临床资料进行回顾性总结分析。结果：35例患者中，31例在2个月内肝功能恢复正常，其余4例3个月内恢复正常。结论：治疗药物性肝损害的关键是详细了解服药史，及时处理；提高对中药不良反应的认识，避免或减少病人自行超量长期服用。     

Pneumocystis carinii involvement of the liver and spleen: CT demonstration

Patients with acquired immunodeficiency syndrome (AIDS) are subject to a variety of infections, including Mycobacteria avium intracellulare, cytomegalovirus, Cryptosporidium, and Pneumocystis carinii. Pneumocystis is most commonly associated with a potentially fatal pneumonia in AIDS patients. Other organ involvement by Pneumocystis is rare. We present a patient with hepatic and presumed splenic infiltration by Pneumocystis.