儿童甲型H1N1流感病毒肺炎的胸部影像学特征

<正>2009年3月墨西哥暴发甲型HIN1流感疫情,随后出现了全球大流行。此次疫情的病原为变异后的新型甲型H1N1流感病毒,人类普遍易感[1-2]。甲型H1N1流感是一种急性呼吸系统传染病,多数病例临床表现温和,少数病例病情进展迅速,可出现病毒性肺炎,合并呼吸衰竭、多脏器功能损伤,严重者可导致死亡。据文献报道,甲型H1N1流感病毒性肺炎患者中71%为严重肺炎,发生年龄为5～59岁[3],     

基于影像学特征对骨质疏松性椎体压缩骨折病人经皮椎体成形术后同椎体再发骨折的预测研究

目的 探讨基于影像学特征对骨质疏松性椎体压缩骨折（OVCF）病人经皮椎体成形术（PVP）后的列线图模型预测术椎椎体再发骨折的价值。方法 回顾性纳入急性OVCF并行PVP后的病人93例。所有病人均行X线及MRI检查,根据椎体再发骨折诊断标准将病人分为再发骨折组（48例）和无再发骨折组（45例）。采用t检验和卡方检验比较2组间临床资料及影像特征的差异,对差异有统计学意义的指标进行多因素Logistic回归分析,获取再发骨折的独立危险因素,采用R软件建立列线图模型并绘制其校准曲线。采用受试者操作特征（ROC）曲线评估模型的预测效能,计算ROC曲线下面积（AUC）。应用校准曲线对列线图模型进行验证。结果 再发骨折组的椎体高度恢复率、延伸至终板的骨折线、椎体内裂隙（IVC）、骨水泥周围积液及骨水泥-终板未接触（NPEC）与无再发骨折组的差异均有统计学意义（均P<0.05）;多因素Logistic回归分析显示延伸至终板的骨折线[优势比（OR）=3.232]、存在IVC(OR=27.117)和NPEC(OR=1.993)及较高的椎体高度恢复率（OR=2.943）为同椎体再发骨折的独立危险因素（...     

Calcified tissue of fetal origin in utero

Hysteroscopic examination in a woman with secondary infertility revealed calcified tissue in the uterine cavity. Histopathological examination demonstrated mature bone. Genetic analysis supports its fetal origin.     

X线、MSCT和MRI对主动脉夹层的临床运用对比研究

目的对比分析X线、MSCT及MRI在主动脉夹层（AD）中影像学特征,并评价其临床运用价值。方法 30例经手术或行DSA造影证实的AD患者,对其X线、MSCT及MRI检查影像资料进行分析,总结归纳其影像特点。结果 X线仅见AD的间接征象,而MSCT和MRI均能不同程度地显示真假两腔、内膜破口、内膜片及附壁血栓。结论 X线对AD只能提示诊断,而MSCT和MRI可作特异性诊断,并且MRI在显示AD的破口位置、无钙化的内膜片及附壁血栓时均优于MSCT,但对内膜及主动脉壁钙化和急危重者的检查MSCT优于MRI。     

Can the patient pinpoint where the ingested fish bone is impacted?: A single-center,retrospective study

Among the plethora of foreign body impactions, fish bones are common examples that patients may struggle to properly disclose in clinical situations. This study investigated whether patients could pinpoint where the ingested fish bone was lodged. In addition, we investigated the differences between fish bone and other foreign bodies, the usefulness of computed tomography (CT), and the related risk factors for hospitalization. The cases of patients who underwent an endoscopic removal of fish bone between April 2008 and April 2020 were retrospectively reviewed. The clinical outcomes, X-ray scan, CT, and complications of each patient were investigated. A total of 96 patients were included in this study. The mean size of the impacted fish bone was 23.78 mm, and most were found in the upper esophagus (n = 38). There was a weak correlation between pain location and the actual lesion location (r = 0.419, P < .001). Compared to those of other foreign bodies, the location of impacted fish bones was different (P < .001), the X-ray detection rate of fish bones was lower (P < .001), and the complication incidence was higher (P = .030). CT (95.89%) showed higher sensitivity than X-ray scanning (11.24%) (P < .001). Foreign body size (P = .004) and door-to-endoscopy time (P = .029) were related to admission. Patients only managed to point out the approximate location of the ingested fish bone. CT detected fish bones well, but scans should include at least the entire esophagus instead of solely the area where pain is felt. Fish bone impaction has different clinical characteristics from other foreign bodies. Endoscopic removal without delay can reduce the admission rates.     

直接数字化摄影在尘肺病检查及诊断中的应用研究

目的：探讨直接数字化摄影（DR）技术在尘肺病检查和诊断方面的应用价值。方法选择来我院欲提交诊断的20世纪60～80年代参加国防施工的复退军人及部分经职业健康查体筛选的企业工人共计811例,同时拍摄高千伏（HkV）胸片及DR胸片,部分加照CT扫描胸片,并对二组胸片进行质量及尘肺病诊断一致性等方面的比较。结果二组胸片的质量对比发现：DR胸片总体质量优于高千伏胸片,尤其DR胸片的一级片率明显高于 HkV胸片,DR胸片的三级片率明显低于HkV胸片,且差异有统计学意义（ P ＜0．05）;DR胸片在图像清晰度及肺部微细结构显示方面较好,两组胸片的诊断结果基本一致,尘肺患者胸片在小阴影形态、总体密集度、分布范围方面无明显差别。结论 DR胸片质量好于HkV胸片,三级片率明显低于HkV胸片;DR摄影可用于尘肺病检查与分期诊断。     

房室间隔缺损的二维超声心动图临床及X线分析

本文报告运用二维超声心动图技术,结合临床和X线检查,诊断房室间隔缺损54例,手术证实15例。结果表明:二维超声心动图对诊断房室间隔缺损具有重要价值。在进行这项检查时,如结合做超声造影、临床和X线表现,对较小的房室间隔缺损也能得到明确诊断。     

骨关节放大相的临床应用（附133例病例分析）

１３３例骨关节放大相，其中肋骨６３例、胸腰椎１６例、骨关节及四肢管状骨３１例、手２３例。对骨放大相投照方法、诊断价值、优点和临床应用进行了探讨。     

The value of bedside Lung Ultrasonography in diagnosis of neonatal pneumonia

Purpose

The aim of this prospective study was to assess lung ultrasonography as an alternative to bedside radiography for the diagnosis of neonatal pneumonia.

Patients & methods

The study was performed on 75 neonates admitted during the period from October 2011 to October 2012 in the NICU of Cairo University Pediatric Hospital presenting with clinical picture of pneumonia. Chest X-rays and lung US were done.

Results

Chest X-ray findings denoting lung infections were present in 64 cases (85.3%), and the remaining 11 cases (14.6%) had a free chest X-ray. Ultrasonography revealed pneumonic patches in 68 patients (90.6%), 7 (9.3%) had free US scans. US and chest X-rays detected pneumonic patches in 64 cases (85.3%), US detected pneumonic patches in 18 cases (24%) with chest X-rays having signs of chest infections other than pneumonic patches and in 4 cases (5.3%) with clear chest X-rays.

Conclusion

Bedside lung ultrasonography is highly sensitive, specific, and reproducible for ruling out underlying pneumonic process as well as in early detection and follow up of possible complications and can be considered an attractive alternative to bedside chest radiography and thoracic computed tomography with minimal radiation exposure.