颈椎病与中医辨证关系的探讨(附100例分析)

目的:探讨颈椎病与中医分型的辨证关系。方法:对100例该病的影像表现与中医分型进行系统分析。结果:主要临床表现颈部活动受限,颈、肩、背部疼痛,常伴头痛、头晕、视物模糊、耳鸣等症状。风寒型以软组织所致颈曲改变为主。肝肾亏虚型、痰湿交阻型以骨质增生、椎间隙及椎间孔狭窄为主。结论:X线、CT是本病首选检查方法,能与中医辨证有机结合,对中西医治疗有重要意义。     

晚发性维生素K缺乏致颅内出血1例

1病历简介患儿,男,45天,呕吐抽搐5天伴发热2天。体检:体温38.5℃。前囟稍隆起,面色苍白,嘴角向左侧歪斜,两肺呼吸音粗未闻及罗音。实验室检查:凝血酶原时间30s,活化部分凝血活酶时间100s,白细胞11.2×109/L,血红蛋白72g/L。CT平扫:右额颞顶部颅骨内板下方见一新月形高低密度影,范围约11.0cm×1.0cm,边界清楚,前方呈低密度灶,CT值19Hu,后方呈高密度灶,CT值61Hu。右侧脑室及中线受压左移,后纵裂池内亦呈高密度铸形,CT值64Hu(图1),骨窗示颅骨结构完整,未见外伤性改变(图2)。CT诊断:右额颞顶部硬膜下血肿(亚急性期)并蛛网膜下腔出血。2讨…     

新生儿缺氧缺血性脑病143例颅脑CT分析

目的:评价CT检查对新生儿缺氧缺血性脑病(HIE)的诊断价值。方法:使用CT扫描仪,用OM基准线、0度角、层厚及层距5mm连续平扫至颅顶。结果:189例临床怀疑HIE的新生儿,CT阳性发现HIE143例,合并蛛网膜下腔出血22例,分别占受检者75·66%和11·64%。结论:对可疑HIE患儿行颅脑CT扫描,对临床上早期诊断HIE提供了可靠依据。它不但可以直观地提供病损部位与程度,而且对推测预后具有重要意义。     

CT在老年人硬膜下血肿诊断中的作用

老年人硬膜下血肿(SDH)系指60岁以上高龄人的SDH而言。由于近年来各国人口老年化率上升,老年人颅脑损伤的比例也随着增高,老年SDH也相应增多[1]。这类病人的临床表     

多层螺旋CT对胫骨平台骨折的诊断价值

目的:评价MSCT在胫骨平台骨折的分类及制定合理的治疗方案方面的价值。方法:对24例常规X线平片或临床诊断为胫骨平台骨折的患者进行MSCT扫描,并对图像进行MPR、SSD和VR重建,对骨折的部位、范围、碎骨片的数量或骨折程度、胫骨平台受累情况、手术入路、骨质疏松程度及骨组织的缺损等做出评价。骨折的分型根据Swiss AO-ASIF法。结果:24例患者中有19例进行了手术治疗,术中所见与轴位MSCT和MPR、SSD及VR重建图像综合做出的诊断一致。结论:MSCT及其MPR、SSD、VR重建技术对于胫骨平台的骨折分型及术前评价有重要意义。     

碘对比剂在CT检查中的应用

我院自 1994年使用CT检查以来 ,需增强检查者的比例越来越高。增强检查确实提供了CT平扫不可替代的诊断信息 ,但是碘对比剂的副作用却令人担忧 ,因此 ,CT室的护理人员应认真做好对患者的筛选、敏试工作 ,严格掌握禁忌证 ,加强对副反应的预防性措施及意外抢救工作 ,合理使用对比剂 ,现将我院应用碘对比剂的方法介绍如下。1　严格掌握禁忌证严重的甲状腺功能亢进、失代偿性心肌功能不全者禁忌。妊娠及急性盆腔炎症时禁行子宫输卵管造影。2　认真筛选高危因素有碘造影剂过敏、严重肝肾功能损害、心脏和循环功能不全、肺气肿、体质极差者 ,重…     

Interobserver Agreement for the Diagnosis of Venous Thromboembolism on Computed Tomography Chest Angiography and Indirect Venography of the Lower Extremities in Emergency Department Patients

Objectives: To determine interobserver agreement between radiologists for computed tomography (CT) angiography and venography. CT venography of the lower extremities combined with standard CT angiography of the chest may result in an increased overall diagnosis rate of venous thromboembolism (pulmonary embolism or deep venous thrombosis).
Methods: The study had a retrospective cohort design. The population consisted of emergency department patients who were evaluated for suspected pulmonary embolism. A random sample of 50 patients diagnosed and treated for venous thromboembolism and 50 age- and gender-matched patients whose CT angiograms and venograms were read as negative were enrolled. The original reading (R1) was compared with readings of two study radiologists: R2, a general radiologist, and R3, a radiologist with fellowship training in cross-sectional imaging. All readers were blinded to each other.
Results: Both R2 and R3 found both CT angiogram and venogram components technically adequate in 95% (95% CI = 89% to 98%) and 86% (95% CI = 78% to 92%) of studies, respectively. The agreement was very good for CT angiography (lowest agreement = 92%; lowest κ = 0.83) and was good for CT venography (85%, κ = 0.65). In nine cases, R1 read the CT angiogram as negative but the venogram as positive for DVT, whereas both R2 and R3 read both components as negative in four of these nine, suggesting a false-positive isolated DVT rate of 44% (95% CI = 19% to 73%). In no case did R1 read both scan components as negative when R2 and R3 agreed on presence of pulmonary embolism or DVT.
Conclusions: Diagnosis of pulmonary embolism on CT angiography is more reliable than diagnosis of isolated DVT on CT venography.     

胸壁病变的CT与X线诊断

目的:探讨CT、X线诊断胸壁病变的价值。材料和方法:回顾性分析53例胸壁病变的CT和X线表现,并评估其诊断价值。结果:53例中,CT确诊52例,X线平片确诊41例。正常7例,炎性和脓肿3例、骨折6例、胸膜病变12例(粘连4例、胸膜增厚3例、胸膜钙化3例、结核瘤2例)、良性肿瘤9例(脂肪瘤3例、神经纤维瘤3例、嗜酸性肉芽肿2例、间皮瘤1例)、恶性肿瘤16例(转移瘤13例、骨髓瘤3例)。结论:CT正确诊断率(98%)明显高于X线(77%),可以明确诊断胸壁病变,能发现X线平片不能发现的征象,具有较高的诊断价值。     

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.