CT对腹部创伤的诊断价值

目的 探讨CT对腹部创伤的诊断价值。方法 应用CT扫描对38例腹部外伤病人进行检查。结果 CT扫描诊断肾外伤12例，肝外伤5例，肠系膜血肿1例，肠穿孔2例，脾外伤18例，其中有7例为复合伤。CT扫描能清楚地显示脏器损伤及腹膜出血的程度、范围。结论 CT能快速、准确地检出腹腔脏器损伤的程度，为临床选择治疗方法提供重要依据。     

茎突CT薄层冠状扫描在诊断茎突过长综合征中的价值

目的 探讨“一点一线垂直法”茎突CT薄层冠状扫描在诊断茎突过长中的价值。方法测量72例双侧茎突的长度、方位、形态、厚度、尖端与咽侧壁距离,总结茎突过长病人的临床症状与诊断。 结果 ①41例67侧长度超过3.0cm,符合茎突过长的诊断;②12例12侧茎突虽未超过3.0cm(均在2.5～2.9cm),且茎突方位角>20°、末端与咽侧壁的距离<20mm,并有临床症状的应考虑茎突过长综合征;③按茎突的形态进行分型:锥型(分直锥、弧锥),束状型,分节型,发育不良型。其中分节型与临床症状有密切关系。结论 ①茎突CT薄层冠状扫描能清晰显示茎突的长度、形态、厚度、末端与咽侧壁距离,是诊断茎突过长的一种可靠方法;②“一点一线垂直法”茎突CT薄层冠状扫描无需进行图像重建,可操作性强、简捷易行、便于推广。     

迟发性颅内血肿诊治体会

<正> 迟发性外伤性颅内血肿(DTICH)是指头部外伤后首次头颅CT检查未发现血肿,经过一段时间后再次行CT检查或经手术、尸检发现的血肿;或在初次头颅CT检查证实的在不同部位出现的血肿。其病死率及致死率较高,应予以重视。现将我科收治的11例DTICH患者资料总结如下。     

CT引导下经肋间隙穿刺活检12例临床报告

目的　对 12例患者的CT引导下经肋间隙穿刺活检操作方法和临床价值进行总结。方法　选择 2 0 0 0年 1月至 2 0 0 2年 6月 12例CT引导下经肋间隙穿刺患者 ,并经病理细胞学及组织学证实。结果　所有 12例患者在CT引导下穿刺均获得成功 ,11例取得较满意的细胞学及组织学材料 ;有 1例发生并发症。结论　CT引导下经肋间隙穿刺活检准确率较高 ,并发症较低 ,安全、可靠 ,是一种先进科学的检查方法     

实验性脑脓肿影像学改变的病理基础研究

目的：明确不同时期动物脑脓肿的影像学特征及其相应的病理学改变。方法：制备脑脓肿狗动物模型１４只，采用ＣＴ、ＭＲＩ检查结合多项病理学观测进行动态分析。结果：脑炎期ＭＲＩ对炎症坏死区及水肿范围的显示较ＣＴ扫描更为清晰准确。包膜形成期：ＣＴ上脑脓肿包膜强化是炎症区血脑屏障破坏和新生血管形成所致；ＭＲＩＴ２加权成像上包膜的低信号“暗带”与包膜上的巨噬细胞堆积有关，延迟扫描和ＭＲＩ均能有效地区分脑脓肿的急性脑炎期和包膜形成期，但ＭＲＩ更加准确、迅速。结论：脑脓肿的ＭＲＩ特征与其临床分期及病理学变化的相关性较好，能更加准确、简便、迅速地区别脓肿的脑炎期和包膜形成期，可作为临床诊治脑脓肿的有力参考。     

Increased expression of α2-6 linked sialic acids by nasal mucins in allergic rhinitis

Mucins have a polypeptide backbone, oligosaccharide side-chains and peripheral structures that include sialic acids. Several pathogens have specific receptors for sialic acids, including human strains of influenza A virus which preferentially recognise and bind α2-6 linked rather than α2-3 linked sialic acids.¹ 1 NElson J., COuceiro S.S., PAulson J.C. & BAum L. (1993) Influenza virus strains selectively recognise sialyloligosaccharides on human respiratory epithelium; the role of the host cell in selection of haemagglutinin receptor specificity. The aim of this study was to identify possible disease-related changes in the expression of sialic acids in nasal mucins. Nasal mucosal samples were placed in organ culture. Metabolically-labelled mucins were purified by gel filtration, blotted on to nitrocellulose membranes and probed with the sialic acid-binding lectins Sambucus nigra and Maackia amurensis. Ninety-five mucosal samples were collected (49 turbinates, 31 nasal polyps, 15 samples from FESS). Lectin binding, expressed as optical density, showed significantly increased binding of S. nigra to cellular (P = 0.02; Kruskal–Wallis) and secreted (P = 0.045) mucin from allergic mucosa compared to non-allergic mucosa. No significant differences were found in the binding patterns of M. amurensis. This study has demonstrated increased expression of α2-6 linked sialic acids in the mucins synthesised and secreted by allergic compared to non-allergic nasal mucosa. This may cause a change in the way mucins and pathogens interact in allergic rhinitis, leading to altered susceptibility to upper respiratory tract infection.     

Tunneling Schmorl’s nodes in an elderly woman treated for acute lymphoblastic leukemia

We present a 70-year-old woman with pre-B acute lymphoblastic leukemia in whom serial imaging studies showed the development of multiple vertebral collapse, and communicating superior and inferior Schmorl’s nodes creating a longitudinal channel (”tunneling” Schmorl’s nodes) through the anterior aspect of T12 to L3 vertebral bodies of her osteoporotic thoracolumbar spine. This was observed after achieving complete remission of the disease and during maintenance therapy. The finding is felt to be secondary to iatrogenic exacerbation of osteoporosis. Received: 26 May 2000 Revision requested: 23 June 2000 Revision received: 10 July 2000 Accepted: 13 July 2000     

基因CT120在胶质瘤中的表达及意义

目的：研究基因CT120在胶质瘤组织中的表达及其与胶质瘤组织病理学的关系。方法：应用免疫组织化学方法检测50例胶质瘤手术切除标本、3例正常脑组织中CT120蛋白的表达：应用半定量RT—PCR检测20例胶质瘤、3例正常脑组织中CT120mRNA的表达。结果：免疫组织化学检测发现正常脑组织中CT120蛋白无表达．50例胶质瘤组织中CT120蛋白表达阳性率为50．9％，不同级别胶质瘤中的表达无显著差异（χ^2=2．99，P〉0．05）；半定量RT—PCR检测正常脑组织中CT120 mRNA呈弱表达，不同病理级别胶质瘤CT120 mRNA表达无显著差异（χ^2=3．25．P〉0．05）。结论：基因120在胶质瘤有表达，但在胶质瘤发生发展中作用不明显。     

Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases

The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400–600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99 % in early and advanced gastric cancer, respectively, with overall detection rate of 96 % (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78 %. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20 % (3 of 15) and 87 % (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3–pT4 vs pT1–pT2) was 93, 90, and 91.6 %, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87 %, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5 % and specificity of 99 %. The sensitivity of peritoneal involvement was 30 % when ascites or peritoneal nodules were absent. Our findings show that dynamic CT can play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients. Received: 29 June 1999, Revised: 20 October 1999, Accepted: 22 May 2000     

Esophageal lipomatosis: another consequence of the use of steroids

After we incidentally found on CT extensive esophageal fat accumulations in a patient with long-term use of steroids, we prospectively evaluated during a 6-month period all CT studies of the chest for esophageal lipomatosis and related the findings to the possible use of steroids. The diagnosis of esophageal fat on CT was made by density measurements or if too small for reliable density measurements by comparison with mediastinal fat. In 21 of 1320 exclusively older male patients the diagnosis of esophageal lipomatosis was definite in 7 and likely in 14 patients. All fat accumulations were located in the upper third of the esophagus (mean length 22 ± 6 mm) and presented ring-like (n = 10), irregular (n = 3), or as a horseshoe sparing the posterior border (n = 8). In 20 patients there was an unequivocal history of steroid treatment. Associated centripetal fat infiltration was found in 11 patients. None of the patients had swallowing problems. Prolonged use of steroids, either orally or inhalationally administered, is associated with esophageal lipomatosis. The predisposition for the upper esophagus might be related to the presence of striated muscle cells in this part of the esophagus; moreover, inhalational steroid therapy may adversely affect the upper esophagus. Received: 3 April 2000; Accepted: 2 May 2000