临近胸膜周围型肺癌的CT表现

目的:探讨临近胸膜周围型肺癌的CT征象,提高对临近胸膜周围型肺癌的诊断符合率。方法:对43例经病理证实的临近胸膜周围型肺癌患者的CT征象进行分析。结果:15例结节型临近胸膜周围型肺癌具有典型的周围型肺癌的CT表现,23例实变型临近胸膜周围型肺癌以临近胸膜实变影、胸膜改变、纤维条索聚集及肺大泡为主要CT征象,5例渗出型临近胸膜周围型肺癌表现为炎症CT征象。结论:全面分析CT征象可提高结节型与实变型临近胸膜周围型肺癌的诊断符合率,渗出型临近胸膜周围型肺癌应进行动态观察提高诊断符合率。     

21例胸膜结核瘤的外科治疗

目的：探讨胸膜结核瘤的诊断和外科治疗经验。方法：回顾 性分析21例胸膜结核瘤的X线表现和手术治疗方法，其中胸壁型27例，膈上型2例，叶间型2例。单发16例，多发5例。完整切除18例，病灶清除3列。结论：21例全部治愈，随访1－8年无复发。结论：外科手术是治疗胸膜结核瘤的有效方法，具有疗效确切、并发症少等优点。     

胸腔孤立性纤维瘤伴阵发性低血糖症1例报道并文献复习

目的 研究胸腔孤立性纤维性肿瘤(PSFT)伴阵发性低血糖的病理特点和鉴别诊断。方法 通过组织形态学和免疫组化对胸腔孤立性纤维性肿瘤进行病理分析并复习文献。结果 肿瘤细胞由纤维母细胞样梭形细胞构成，束状交错排列及片状分布，局部呈血管外皮瘤形态。间质内有大量胶原纤维，部分区域黏液变性。在细胞密集区，可见核分裂象3个／10HPF。CD34、vimentin、somatotastin和insulin( )；CK、HBME-1，calvetinin、EMA、AE1／AE3、Cam5．2和p53(-)表达。结论 PSFT确能合成和分泌胰岛素样物质及生长抑素，但低血糖症则由多种因素造成。vimentin和CD34阳性以及上皮性标记阴性有助于诊断。     

磁共振成像对胸膜外脂肪显示的研究

目的：研究MRI对正常及异常胸膜外脂肪显示的价值。材料和方法：对21例健康志愿者进行了MRI化学位移同相位成像、反相位成像、T1WI、T2WI及STIR序列扫描，并对胸膜外脂肪的绝对信号强度及信号强度比进行比较分析，同时还对20例累及胸膜外脂肪的病人进行检查。结果：在MRI各序列中，化学位移反相位成像显示胸膜外脂肪最佳，各序列绝对信号强度没有差别，而信号强度比存在差异。异常的胸膜外脂肪可以表现为移位、受压、中断、增厚及信号改变。结论：MRI可以作为观察正常及异常胸膜外脂肪的有效检查方法。     

Radiologic anatomy of the inferior lung margins as demonstrated on computed radiography with enhancement of low frequencies

The aim of this work was to describe the radiologic anatomy of the inferior lung margins (ILMs). The method was to enhance the low frequencies of 50 normal chest computed radiographs. On each side, the anterior and posterior ILMs were divided into two halves. The frequency of visibility of each half of each ILM was calculated as their shape, lateral and medial continuities, depth, and vertebral level. The differences were compared by a paired Student t-test. The right posterior ILM was always visible and usually concave upward (94%). Its height was 8.7 ± 1.6 cm. Its most inferior part faced L1 or L2 in 92% of cases. It was continuous medially inside with the azygo-esophageal recess in 96% of cases. The left posterior ILM was not visible laterally in 34% of cases and medially in 60% of cases. It was most often concave upward (82% of cases). Its height was 6.9 ± 1.5 cm. Its most inferior part was at the level of L1 or L2. It was continuous medially with either the left paraspinal line or the paraaortic line. The right anterior ILM was visible in 76% of cases. It was most often oblique upward and medially (46%) or concave upward (33%) and often notched (38%). The left anterior ILM was visible in 64% of cases and more often oblique inward and upward (58%). It was continuous medially with the left inferior precardiac recess. The anterior ILMs were more variable than the posterior. The posterior ILMs were very similar in shape and inferior level and differed in depth only by the difference of height of the diaphragmatic cupolas.     

支气管镜诊断胸腔积液27例护理体会

目的探讨支气管镜诊断不明原因胸腔积液中的护理措施。方法回顾性分析2012年1月2013年6月鞍山市中心医院以电子或纤维支气管镜代替胸腔镜对27例不明原因的胸腔积液进行检查诊断的临床护理资料。结果27例胸腔积液患者中支气管镜诊断为胸膜转移癌19例,结核病4例、胸膜问皮细胞瘤3例、类风湿性胸膜炎1例,经与病理确诊结果比较,敏感性100.0％,特异性为84.1％。结论加强心理疏导,密切观察,做好术中配合有利于顺利完成支气管镜检查,提高诊断准确率。