脊髓萎缩（附2例报告）

本文报告了两例脊髓萎缩，并结合文献复习讨论了该病的好发部位、病因、临床表现、诊断和治疗。脊髓萎缩的病因多为继发性，也可为特发性。根据临床表现结合脊髓ＣＴ造影及ＭＲＩ检查，可以明确诊断。     

Revisiting the prognostic role of gallium scintigraphy in low-grade Non-Hodgkin’s lymphoma

The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin’s lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the ⁶⁷Ga uptake by the tumour, and to establish the contribution of ⁶⁷Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic ⁶⁷Ga score at diagnosis. In addition to ⁶⁷Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host. Univariate and multivariate analyses were used. ⁶⁷Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with a dismal prognosis: with a mean follow-up of 47 months (range: 1–146 months) the median survival time was 28 months in patients with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27.4%±14.9% (mean ±SD) in the former and 8.9%±7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis. It is concluded that ⁶⁷Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other prognostic variables. Received 1 May and in revised form 6 August 1997     

MRI and CT in Krabbe's disease: case report

A case of infantile Krabbe's disease was first recognised as areas of relatively increased density on CT in the thalamus lateral geniculate body and dentate nucleus. These sites were subsequently shown on MRI to have a paramagnetic effect, being characterised by short T2 and T1. Subsequent examinations showed development of atrophy and high signal in white matter.     

Results of surgical treatment in patients with arachnoid cysts

Summary A retrospective study of 35 patients operated upon for arachnoid cysts during the last 10 years was carried out. In 19 patients treated by craniotomy, membrane resection and drainage into the basal cisterns, clinical improvement could be noted in 13 cases. Correspondingly on the CT-controls the cysts were found to have disappeared in two cases and were reduced in size in seven patients.In 11 patients, however, who were initially treated by a shunting procedure, seven patients became free of symptoms. Postoperative CT-controls showed in three cases a significant reduction of the size of the cyst, which remained unchanged in two other cases.In five patients with the combination of a nonspace-occupying arachnoid cyst and subdural effusions, drainage of the latter only was sufficient to relieve the clinical symptoms.The prominent Endings were the high complication rate of the primary or secondary shunting procedures (48%), as well as the close correlation between the clinical outcome and the postoperative CT-controls.     

Belt device for simplified CT-guided puncture and biopsy: A technical note

A new radiolucent device for increased accuracy of CT-guided fine-needle punctures permits precise determination of the optimum angle, depth, and position of the fine needle, which can be preset from the data supplied on the CT monitor. Puncture and repeat scans for controlling the tip of the needle can be performed with the patient in a stationary position. The device is designed as a belt that holds a needle holder sheath and a goniometric scale, both of which can be moved to varying positions around the patient.     

Imaging of thoracic aortic dissection

Acute thoracic aortic dissection has a high mortality if untreated, so the diagnosis must be rapidly made if mortality is to be lowered significantly. Multiple imaging techniques are often used. This retrospective study from 1988 to 1993 assesses the usefulness in diagnosis of chest X-rays, computed tomography (CT) scanning, aortography, magnetic resonance imaging (MRI), trans-thoracic (TTE) and trans-oesophageal (TOE) echocardiography. Forty-two patients with a final clinical diagnosis of dissection were studied. The diagnosis was confirmed in 16 (13 at surgery and three at autopsy). Three died with dissection given as the only cause for death. Chest X-ray abnormalities were seen in all 19 patients with surgery or death from dissection, with a widened mediastinum and/or dilated aorta being present in 17. In the group of 16 patients with surgery or autopsy proof, CT scans found dissections in 9 of 12 patients studied and correctly classified the type in only five. Aortography was performed in five, with accurate depiction of dissection and type in all. TTE found dissections in three of eight patients imaged by this method. MRI and TOE were performed each on two patients, with accurate depiction of dissection and type in each. Because of the relatively low sensitivity of CT scanning in defining aortic dissections Westmead Hospital is currently assessing the use of TOE as the prime imaging modality prior to surgical intervention.     

Local blood flow changes in malignant brain tumours under induced hypertension

Summary Changes in tumour blood flow under an induced hypertensive state were examined in malignant brain tumours to know if the precondition for the effectiveness of induced hypertensive chemotherapy — relative increase in tumour blood flow — are fulfilled. Tumour blood flow was measured under both a resting and an induced hypertensive state in 12 patients with various malignant brain tumours (6 gliomas, 6 metastatic brain tumours) using xenon-enhanced computed tomography. The blood pressure was elevated 40% above the systemic blood pressure of the resting state by the infusion of angiotensin II. Tumour blood flow increased 30% on average above the normal brain tissue blood flow after the induction of an induced hypertensive state (p < 0.05). The tumour blood flow increased in 11 cases of malignant tumours, but decreased in one case with massive brain oedema after induced hypertension. The increase in blood flow was higher in hypervascular tumours and less in hypovascular tumours. Therefore, induced hypertensive chemotherapy probably will be more effective in hypervascular malignant brain tumours with small mass effects.     

正常喉区的CT解剖研究

喉的解剖较复杂,从CT图象上分辨更为困难。木文通过比较尸体喉区的断层解剖标本,从4个不同的平面,描述了喉区各结构形态大小的变化,并讨论其分布特征,这将有助于临床CT的诊断。     

A Case of Pelvic Osteomyelitis

A patient presenting with osteomyelitis of the pelvis is described. In this case it was difficult to establish a correct diagnosis by use of scintigraphic scanning, in spite of clear roentgenographic evidence of osteomyelitis.     

胸部X线与CT诊断支气管结核的临床价值

目的分析胸部X线及CT影像征象在支气管结核临床诊断中的价值和意义。方法收集本院经病理及电子支气管镜证实为支气管结核105例，对照其胸部X线与CT表现进行回顾性分析。结果105例患者中，胸部X线显示伴有肺内结核灶77例，气管狭窄、肺叶不张分别为51例和49例，未见异常表现17例。胸部CT扫描对气管狭窄及肺叶不张检出率明显提高，分别为72例和61例，且能观察到气管内壁情况及狭窄或阻塞后肺野情况，伴肺内结核灶79例，无异常改变只有8例。结论提高对支气管结核的影像学认识，能有效地提高临床诊断准确率。