CT对腮腺肿瘤的诊断价值

目的：评价ＣＴ在腺肿瘤中诊断及鉴别诊断的价值。方法：通过回顾性分析４２例经术后病理证实的腮腺肿瘤的ＣＴ表现及其术前诊断,并与病理诊断进行对照分析。结果：２７例良性肿瘤中,有２４例ＣＴ表现为类圆形肿块,边界清楚,密度均匀,有３例密度欠均匀,边界模糊;１５例恶性肿瘤中,１２例ＣＴ为边界不清,密度不均匀,３例密度均匀,边界较清晰。术前ＣＴ诊断对８５．７１％腮腺肿瘤可作出定性诊断,但对其组织类型不能确认。     

肝局灶性结节增生的不典型螺旋CT征象分析

目的探讨肝局灶性结节增生（FNH）不典型的螺旋CT征象。方法对病理证实或临床确诊的32例FNH患者37个病灶的螺旋CT征象进行回顾性分析。结果37个病灶中,有14个病灶直径≤3cm,23个病灶直径〉3cm;7个病灶周边存在假包膜;22个病灶存在中央瘢痕。其中有20个病灶直径〉3cm;所有病灶在动脉期均呈高密度,其中31个病灶肿瘤实质均匀强化。结论多发病灶、存在假包膜、无中央瘢痕、动脉期不均匀强化是FNH不典型的CT征象。征象的多样性与病灶的病理类型和病灶的直径相关。     

鼻咽非霍奇金淋巴瘤的MRI表现与侵犯特点

目的 探讨鼻咽非霍奇金淋巴瘤(NHL)的MRI表现特征及鉴别诊断.方法 回顾性分析41例经病理证实的鼻咽NHL的MRI表现.评价病灶的大小、分布、侵犯范围及淋巴结累及情况.对B细胞型和T或NK/T细胞型2组NHL的侵犯生长方式比较采用Fisher确切概率法或Pearson卡方检验.结果 41例患者中,成熟B淋巴细胞肿瘤26例,成熟T淋巴细胞肿瘤2例,NK/T细胞瘤13例.病灶以鼻咽黏膜增厚或形成软组织肿块为主要表现,在T2WI上呈稍高信号,T1WI呈等信号,增强后均匀轻到中度强化.均匀累及鼻咽各壁24例,伴溃疡形成5例,超腔生长9例,累及舌或腭扁桃体共23例,邻近肌肉受侵20例,颅底骨质破坏12例.41例患者中,25例合并咽后淋巴结受侵,27例合并颈部淋巴结受侵.NK/T淋巴细胞型鼻咽NHL更易超腔生长、咽旁结构侵犯、溃疡形成(T或NK/T淋巴细胞型鼻咽NHL分别为8、11、4例,B淋巴细胞型鼻咽NHL分别为4、10、1例),B淋巴细胞型鼻咽NHL扁桃体侵犯更常见(B淋巴细胞型鼻咽NHL为18例,NK/T淋巴细胞型鼻咽NHL为5例).结论 鼻咽NHL在MRI上表现具有一些特点,鼻咽各壁均匀增厚多见,常累及鼻腔或扁桃体,当肿瘤体积较大但没有或仅有少许深度侵犯时要考虑NHL.不同病理类型鼻咽NHL其MRI表现有一定差异.

Abstract：

Objective To characterize the features of Nasopharyngeal non-Hodgkin's lymphoma (NHL) on MR imaging and find the main points to differentiate it from the other nasopharyngeal tumors.Methods The MR images of 41 patients with pathologically and immunohistochemically proven nasopharyngeal NHLs were reviewed retrospectively. Images were assessed by the size, invasive extent,signal intensity of primary nasopharyngeal tumor, and the distribution of cervical lymphadenopethy. The difference of regional tissues invasion and cervical lymphadenopathy distribution between the patients with B-cell NHLs and the patients with T-cell or NK/T-cell NHLs were analyzed by Pearson's Chi-Square test or Fisher's exact test Results Of the 41 patients, 26 patients had mature B-cell lymphoma, two patients with mature T-cell Iymphoma, and thirteen patients showed Nature killer/T-cell lymphoma in nasopharynx. MRI revealed that NHLs of nasopharynx can be showed as thickening of nasopharyngeal mucosa and (or) lumps in nasopharynx, which were slightly hyper-intensity on T2-weighted images, and intermediate signal intensity (similar to muscle) on T1 -weighted images, with mild or moderated enhancement following contrast medium administration. Twenty four cases had symmetrical disease of all walls of nasopharynx, and 17 cases had unsymmetrical tumor. Of all cases, 5 cases had superficial ulcerations, 9 cases had exceed nasoharynx invasion spreads superficially along the mucosa, 23 cases had invasion of lingual and (or) palatine tonsils,20 cases showed invasion of parapharygeal muscles, 12 cases suffered from skull base bone infiltration,25 cases had retropaharyngeal lymphadenopathy, and 27 cases had cervical lymhadenopathy. Patient with nasopharyngeal Nature killer/T-cell lymphoma had a higher incidence of exceed nasopharynx invasion,parapharyngeal structures invasion, and superficial ulcerations (the cases were 8, 11, 4 in patient with T-cell or N K/T-cell lymphoma, and 4, 10, 1 in patients with B-cell lymphoma, respectively). Patients with nasopharyngeal B-cell lymphoma had a higher incidence of inasion of lingual and (or) palatine tonsils.Conclusions Nasopharyngeal NHL is a homogeneous tumor that tends to diffusely involve all walls of the nasopharynx and spread in an exophytic fashion to fill the airway, rather than infiltrating into the deep tissues. Different pathological types of nasopharyngeal NHLs have some different appearance on MRI between each other. A large tumor in nasopharynx that fills the nasopharynx cavity, with no or minimal invasion into deep structures, but with invasion extend down into the lingual and(or)palatine tonsils, may suggest the diagnosis of nasopharyneal NHL.     

肝局灶性结节增生的不典型螺旋CT征象分析

目的探讨肝局灶性结节增生(FNH)不典型的螺旋CT征象。方法对病理证实或临床确诊的32例FNH患者37个病灶的螺旋CT征象进行回顾性分析。结果 37个病灶中,有 14个病灶直径≤3 cm,23个病灶直径>3 cm;7个病灶周边存在假包膜;22个病灶存在中央瘢痕, 其中有20个病灶直径>3 cm;所有病灶在动脉期均呈高密度,其中31个病灶肿瘤实质均匀强化。结论多发病灶、存在假包膜、无中央瘢痕、动脉期不均匀强化是FNH不典型的CT征象。征象的多样性与病灶的病理类型和病灶的直径相关。     

24例胰腺实性-假乳头状瘤的螺旋CT征象与临床病理分析

目的:分析胰腺实性-假乳头状瘤的螺旋CT征象及病理特点,提高术前诊断水平.方法:回顾性分析24例胰腺SP7的螺旋CT征象,包括肿瘤的部位、大小、形态、边界、密度、强化方式、强化程度、囊实比例、钙化、临近组织器官侵犯及淋巴结转移等,并与手术结果及病理对照分析.结果:1)肿瘤发生于胰头部10例,体部7例,尾部6例,体尾部1例,大部分呈圆形或类圆形,部分有分叶,边界清楚,有完整包膜.2)肿瘤内部可见实性及囊性成分,实性部CT平扫呈稍低或等密度,增强扫描动脉期轻至中度强化,门脉期进一步强化,与胰腺实质最大密度差出现在动脉期,囊性部分平扫及增强扫描均呈低密度.3)囊性为主型6例,实性为主型8例,囊实相仿型10例.4)8例肿瘤内部可见钙化,其中一例呈蛋壳状钙化,6例胰管轻度扩张,1例胆总管、肝内胆管可见扩张.5)9例患者CT征象见恶性倾向,1例呈弥漫性生长,5例推压、包绕脾血管,2例与肠系膜血管粘连,1例肿瘤包绕右肾静脉,其余15例CT表现为良性,包膜完整,与周围器官、组织分界清楚,术中所见有一定差异.结论:胰腺SPT病理学特点明显,螺旋CT征象有一定特征,肿瘤呈囊实性两部分,血供较为丰富,呈逐渐强化改变,与大多数胰腺癌缺乏血供有较大差别,血浆CEA阴性也有较大的参考价值,CT检查对胰腺SPT的术前诊断、良恶性判断、治疗方法的选择均有重要意义.     

螺旋CT对非小细胞肺癌纵隔淋巴结分期的诊断价值

目的：评价螺旋CT对非小细胞肺癌纵隔淋巴结分期的诊断价值。方法：对89例病理确诊NSCLC的患者进行CT纵隔淋巴结分期，并同淋巴结最后病理分期做一一对照。结果：CT对纵隔淋巴结转移总的敏感性为58．9％，特异性为70．o％，阳性预测值60．5％，阴性预测值68．6％，总的准确率为65-2％。CT对4R、5、6,7组淋巴结的准确率和特异性偏低。4R组和7组淋巴结的假阳性和假阴性较高。结论：CT是评价肺癌患者纵隔淋巴结转移的重要检查手段，能提供有效的纵隔淋巴结转移信息，但存在一定的假阳性和假阴性，应结合其他检查手段达到更精确的分期。     

CT和MRI在单椎体转移瘤中的应用

目的:探讨单椎体转移瘤(vertebral metastases)CT与MBI的表现.方法:搜集恶性肿瘤合并脊柱转移病例66例,行常规CT扫描及MBI(T1WI,T2WI,STIR,MB增强扫描),其中45例行增强扫描,分析CT,MRI表现,并加以总结.结果:单椎体转移瘤的CT表现:由于脊椎骨血源性转移,多发生于椎体中后部,少有死骨及边缘硬化,椎旁肿块内少有钙化,强化明显;MRI扫描均显示单个椎体异常信号病灶,表现为均匀或略不均匀的TIWI低信号或等、低混杂信号,T2WI等、高或低、高混杂信号,以矢状位显示最佳.结论:CT和MRI对于单椎体转移瘤有一定的诊断价值,具有重要的临床意义.     

Kimura病的CT、MRI表现

Objective To study the imaging features of Kimura disease to improve diagnostic ability prior to surgery.Methods The clinical manifestations and CT and MR findings of 11 patients with histologically confirmed Kimura disease were retrospectively analyzed.All 11 tumors originated from (or involved)the parotid region in 7 cases, the maxillofacial region in 2 cases, the palate in one case and the groin in one case.Clinically, the lesions showed asymptomatic tumors with the mean clinical course over 2 years.The increase of cosinophilic granulocyte was found in all 11 cases.Results On CT and MRI,5 patients were single masses and others were muhi-nodular masses.The smallest lesion was 6 mm×3 mm,and the largest lesion was 60 mm × 34 mm.The lesions were almost ill-defined in the subcutaneous tissue,especially 10 locating underlying superficialfascia in head and neck.On CT,the lesions showed homogeneous hypodense to the muscle in 9 patients.The lesions appeared isointeuse signal or slightly hypointense on MR T1WI and slightly hyperinteuse on T2WI in 3 patients.All lesions revealed moderate or marked, and homogeneous or inhomngeneous enhancement.Regional lymph nodes (eight cases in the maxillofacial region and one in the groin) enlarged without necrosis and fusion, and with marked enhancement.Conclusion The clinical and imaging findings of Kimura disease have some characteristics, the diagnosis can be made combined with the laboratory examination.     

腕骨骨内腱鞘囊肿的影像学表现

目的:评价腕骨骨内腱鞘囊肿的影像学特征.方法:分析8例经手术病理证实的发生于近排腕骨的骨内腱鞘囊肿的X线(7例)、CT(5例)和MRI(2例)表现,其中男性5例,女性3例,平均年龄28岁,发生于月骨6例,舟骨2例.结果:8例患者均表现为腕关节的慢性疼痛和不适.X线平片显示为月骨或舟骨内囊状溶骨性病变,边缘光滑,有硬化边包绕,病灶内无骨性分隔和钙化.CT图像上2例病灶可见骨皮质小缺损与关节腔相通.2例MRI显示T_1WI为低信号,T_2WI为高信号,信号均匀.结论:腕骨骨内腱鞘囊肿好发中青年,有腕关节慢性疼痛和不适病史,典型X线表现为发生于近排腕骨的边界清楚囊状病变,有硬化边.CT可清楚显示病灶是否与关节腔相通.病灶在MRI T_1WI为低信号,T_2WI为高信号.     

经皮射频消融术在肝脏肿瘤治疗中的临床价值

目的；对44例原发性肝癌和肝转移瘤行射频消融（radiofrequency ablation,RFA)治疗，研究其近期局部治疗效果、不良反应和副作用。方法：原发性肝癌和肝转移瘤共44例，病灶总数共67个。经RFA治疗后随访2－6个月，运用螺旋CT三期扫描评价肿瘤治疗效果。结果：肝脏肿瘤直径≤3．0cm者26个、3．1－4．0cm者21个、4．1－5．0cm者11个，≥5.1cm者9个，经RFA治疗后肿瘤完全坏死分别为24个、19个、9个、6个。螺旋CT增强扫描表现为肿瘤去血管化征象，或并有体积缩小。结论：RFA治疗是效果好、副作用小、安全可靠的局部治疗肝脏肿瘤的方法。