多排螺旋CT对咯血患者肺部血管和实质的综合评价

目的 应用16 排螺旋CT 行肺动脉与支气管动脉血管成像,对咯血患者肺部体-肺循环血管结构和肺实质进行综合评价,来进一步探讨其临床应用价值.方法 对39 例咯血患者行16 排螺旋CT 肺动脉与支气管动脉血管成像,经图像后处理获得容积显示(VR)、最大密度投影(MIP)、多平面重组(MPR)以及曲面重组(CPR)图像,通过观察薄层轴位图像和重组图像,对肺实质、肺动脉、肺静脉、支气管动脉以及肺内的非支气管体循环动脉进行评估,对比分析图像中肺动脉、肺静脉、主动脉、支气管动脉的强化程度以及肺动脉、肺静脉、支气管动脉的显示效果.结果 肺动脉期的肺动脉干、上肺及下肺外周肺动脉之间的强化程度比较无统计学差异;支气管动脉期的主动脉、肺动脉干、上肺及下肺外周肺动脉、中心肺静脉、上肺及下肺外周肺静脉、支气管动脉之间的强化程度相比无统计学差异;肺动脉期的肺动脉干与支气管动脉期的主动脉、肺动脉干、中心肺静脉及支气管动脉之间的强化程度相比无统计学差异.CT 发现支气管扩张22 例、肺间质纤维化3 例、肺动脉栓塞3 例、支气管动脉增粗19 例以及炎性病灶伴空洞形成2 例,其中7 例支气管扩张伴支气管动脉增粗、1 例支气管扩张无支气管动脉增粗、1 例肺间质纤维化伴支气管动脉增粗和1 例肺部恶性肿瘤无支气管动脉增粗的咯血患者经支气管动脉栓塞治疗后好转.结论 16 排螺旋CT 血管成像能够较好地显示咯血患者肺动脉、肺静脉、支气管动脉和肺实质的情况,能够为临床提供较详细的影像学信息,有着较好的应用和推广价值.

Study on the epidemic and ecologic characteristic of plague focuses in western areas from 2000 to 2008

Objective To describe and understand the plague＇s development in the western area of China by systematically evaluating the literatures about the epidemic of plague and ecologic characteristic of focuses from 2000 to 2008.Methods All related literatures,which were evaluated strictly by means of system qualitative analysis,were searched from the database of PubMed,ScienceDirect and Chinese periodical full-text articles and the official network station of WHO,USA CDC and other organizations. The epidemic trend,characteristics of geographical landscapes,animal reservoirs and media characters of plague were analyzed systematically. Results Thirteen original literatures and one review were identified. The southwest region,which selected Yunnan,Guizhou and Sichuan province as the observation place was covered and surrounded by five styles of plague foci. In 2000,the epidemic situation of plague reached the peak,and then declined year by year to a steady tendency. It was revealed that the plague foci in Sichuan province activated slightly,but no cases were reported. The geographical landscape type and animals species of the same types of focuses in different areas were very similar. Conclusions In recent years,the epidemic situation of plague in the western region keep stable on the whole,however,some of the focuses tend to activate mildly,the threatens of spreading of focuses＇ port don＇t disappear. It was suggested that the spreading of focuses＇ port must be controlled and the monitoring should be strengthened.