食管癌的X线CT检查分析

目的:探讨食管癌X线检查与术前CT检查的临床意义.方法:收集50例食管癌患者的X线CT检查进行分析.结果:食道吞钡均能发现食管癌,且已处于中晚期;术前CT检查基本能发现病变,同时还能发现有淋巴或周围软组织侵犯征象.结论:食道吞钡是食管癌首选的检查方法,术前CT检查可为临床治疗进一步提供科学依据.     

脊柱爆裂型骨折的CT扫描价值分析

目的:探讨脊柱爆裂型骨折的CT扫描价值. 资料与方法:随机抽取我院1988年至2001年骨科70例脊柱外伤患者的资料.其中男性54例,女性16例.年龄19岁～73岁,平均49岁.全部患者均摄取普通X线片,然后依据X线片提示的骨折部位作CT扫描,采用估算法重建图像,应用骨窗和软组织窗观察,部分病例进行矢状面重组.结果:70例受检者中受损椎体87个,C5损伤1例,T12～L1损伤1例,L1～2损伤1例,其他均为单椎体损伤.按Denis[1]三柱理论,63例病例为爆裂骨折,累及二柱和二柱以上,7例为椎体单纯压缩型骨折,1例伴有严重的脱位.结论:CT在显示椎体骨折尤其是脊柱后结构损伤方面优于X线平片,对判定脊柱稳定程度及损伤有否手术指征帮助最大.当X线摄片之后考虑为爆裂性骨折时,应抓紧作CT扫描检查.     

12例Dandy—Walker综合征的临床CT与MRI分析

目的分析Dandy—Walker综合征的临床及cT与MR!影像特征。方法采用cT与MRI常规扫描，对12例Dandy—Walker综合征的临床表现、CT与MRI征象进行回顾性分析；结果12例Dandy—Walker综合征的CT与MRI表现归纳为①小脑蚓部缺失，小脑半球发育不良、完全分离，分离的小脑半球可以不对称；②第四脑室呈囊状、扇形、三角形显著扩张或后颅窝巨大囊状阴影与第四脑室相通；③窦汇异常抬高，越过人字缝／天幕抬高；④幕上脑室对称性扩张，脑积水。结论对Dandy—Walker综合征的诊断，CT扫描能够显示后颅凹及天幕上下脑的形态与结构，其CT表现具特征性；MRI可多平面扫描，无骨质伪影，显示后颅凹优于CT，在矢状面上可显示小脑、第四脑室、导水管、后颅凹囊肿以及与天幕的关系。CT与MRI扫描对Dandy—Walker综合征能够做出定性诊断，是术前诊断的主要依据，检查无痛苦，有重要的诊断和鉴别诊断价值。     

血清P-选择素水平与冠脉病变严重度关系的研究

目的：探讨检测血清P-选择素水平与冠脉病变严重度的关系。方法：70冽冠D病患者，按临床诊断分为2组：急性冠脉综合症组32冽和稳定型冠心病组38例，对照组患者30例。ELISA检测各组患者血清中P-选择素水平．并比较各组间的差异；冠脉造影术对冠脉病变进行Gensini评分，并了解其与血清中P-选择素的相关性。结果：冠心病患者血清中的P-选择素水平显著高于正常对照组；在冠D病组内，急性冠脉综合症组的P-选择素水平显著高于稳定型冠心病患者，但两组冠脉病变Gemini评分无显著差别；而且冠脉病变Gemini评分与血清中P-选择素水平呈明显的相关性。结论：P-选择素可能参与了冠状动脉粥样硬化的发生和发展过程，血清P-选择素水平可能是冠脉病变严重度的一个预测指标。     

Platelet function in patients with acute coronary syndrome (ACS) predicts recurrent ACS

BACKGROUND: Platelet hyperfunction contributes to acute coronary syndromes (ACS). Thus, we hypothesized that platelet function under high shear stress predicts recurrent ACS during long-term follow-up of ACS patients. PATIENTS AND METHODS: Consecutive ACS patients (n = 208) were prospectively followed-up for an average of 28 months. Platelet function was measured with the platelet function analyzer (PFA-100; Dade Behring, Marburg, Germany) at baseline for collagen/adenosine diphosphate closure times (CADP-CT) and for collagen/epinephrine closure times (CEPI-CT) after infusion of a uniform dose of 250 mg aspirin. RESULTS: Of the conventional risk factors, only the prevalence of diabetes was higher in ACS patients with re-events. However, use of clopidogrel and use of beta blockers were also slightly lower in patients with re-events (P < 0.05). The unadjusted risk hazard ratio (HR) for re-events was 3.3 [95% confidence interval (95% CI): 1.4-7.4; P = 0.005] in those patients with the shortest CADP-CT values (lowest quartile). Similarly, the risk was 2.0-fold higher (95% CI: 1.1-3.6; P = 0.02) in ACS patients with CEPI-CT < 300 s as compared with CEPI-CT >or = 300 s. Inclusion of diabetes, clopidogrel and beta blockers in a multivariate Cox regression model enhanced the predictive value of CEPI-CT (HR: 2.7). Inclusion of von Willebrand factor levels did not alter the HR for recurrent ACS (HR: 2.1; 95% CI: 1.1-5.2; P = 0.03) for CEPI-CT < 300 s, but reduced the HR for CADP-CT (HR: 2.8, 95% CI: 0.8-9.8; P = 0.11). CONCLUSION: Shortened CT values reflect biologically relevant platelet hyperfunction in patients with ACS because they predict recurrent ACS.     

男性病人冠状动脉病变与吸烟关系的研究

[目的]探讨吸烟对病人冠状动脉病变的影响。[方法]对吸烟组(5 0例)与不吸烟组(3 0例)进行冠状动脉造影,观察记录冠状动脉病变情况并进行统计学分析。[结果]两组冠状动脉病变记分、每日不同吸烟量与冠状动脉病变记分、不同的吸烟年限与冠状动脉病变记分比较均有统计学意义(P <0 .0 1)。[结论]长期吸烟可使冠状动脉病变程度加重,应加强对长期吸烟及冠状动脉介入术后病人的健康教育,有效预防和控制冠心病,提高人群的健康水平。     

多层螺旋CT肺密度测定对结缔组织病肺问质病变的早期诊断

目的探讨多层螺旋CT(MSCT)肺密度测定对结缔组织病(CTD)肺间质病变(ILL)早期诊断的临床意义。方法对222例CTD患者及50名正常对照者，应用MSCT附带的Pulmo自动评估软件进行上、中、下肺区的密度测定，并同时进行肺高分辨扫描(}-IR(_1、)，分析二者的变化与CTD伴ILL的关系。结果222例cm患者中197例平均肺密度有不同程度的增高，25例平均肺密度正常。157例HRCT有不同程度的肺间质病变，65例HRCT正常。50名正常对照者HRCT均正常，8名平均肺密度有不同程度的增高，42名平均肺密度正常。结论采用MSCT与HRCT对CTD伴ILL的检测结果差异有统计学意义，P=0．000(双侧)，因此MSCT平均肺密度测定对早期诊断CTD伴ILL比HRCT更敏感，更有临床意义。     

Alveolar hydatid disease of the liver: Brief review and spectrum of adjacent organ invasion

The purpose of this study is to show the spectrum of adjacent organ invasion and to make a brief review of hepatic alveolar hydatid disease (AHD), using CT and MR imaging. We retrospectively reviewed CT and MR images of three patients with various adjacent organ invasions surgically and histologically proven to be AHD. Local invasion to right kidney and adrenal, right hemidiaphragm and lung were detected in one patient, right adrenal in another patient and gall bladder, duodenum, gastric wall and pancreas invasion in the other. AHD may rarely extend to the gall bladder, stomach, duodenum, pancreas, right adrenal and kidney, diaphragm, pleura and lung. The extension of the disease outside the liver is usually encountered in patients with large, peripherally located masses in the advanced stage of the disease.     

Vascular Centerline Extraction in 3D MR Angiograms for Phase Contrast MRI Blood Flow Measurement

The accuracy of 2D phase contrast (PC) magnetic resonance angiography (MRA) depends on the alignment between the vessels and the imaging plane. PC MRA imaging of blood flow is challenging when the flow in several vessels is to be evaluated with one acquisition. For this purpose, semi-automatic determination of the plane most perpendicular to several vessels is proposed based on centerlines extracted from 3D MRA. Arterial centerlines are extracted from 3D MRA based on iterative estimation-prediction, multi-scale analysis of image moments, and a second-order shape model. The optimal plane is determined by minimizing misalignment between its normal vector and the centerlines’ tangent vectors. The method was evaluated on a phantom and on 35 patients, by seeking the optimal plane for cerebral blood flow quantification simultaneously in internal carotids and vertebral arteries. In the phantom, difference of orientation and of height between known and calculated planes was 1.2° and 2.5 mm, respectively. In the patients, all but one centerline were correctly extracted and the misalignment of the plane was within 12° per artery. Semi-automatic centerline extraction simplifies and automates determination of the plane orthogonal to one vessel, thereby permitting automatic simultaneous minimization of the misalignment with several vessels in PC MRA.     

Automatic algorithm for correcting motion artifacts in time-resolved two-dimensional magnetic resonance angiography using convex projections.

Time-resolved contrast enhanced magnetic resonance angiography (MRA) may suffer from involuntary patient motion. It is noted that while MR signal change associated with motion is large in magnitude and has smooth phase variation in k-phase, signal change associated with vascular enhancement is small in magnitude and has rapid phase variation in k-space. Based upon this observation, a novel projection onto convex sets (POCS) algorithm is developed as an automatic iterative method to remove motion artifacts. The presented POCS algorithm consists of high-pass phase filtering and convex projections in both k-space and image space. Without input of detailed motion knowledge, motion effects are filtered out, while vasculature information is preserved. The proposed method can be effective for a large class of nonrigid motions, including through-plane motion. The algorithm is stable and converges quickly, usually within five iterations. A double-blind evaluation on a set of clinical MRA cases shows that a completely unsupervised version of the algorithm produces significantly better rank scores (P=0.038) when compared to angiograms produced manually by an experienced radiologist.