肝吸虫病的CT表现特征

目的 :分析肝吸虫病导致肝胆管病变的CT表现特征。方法 :回顾性分析 12 8例肝吸虫病患者CT表现及临床资料。结果 :CT主要表现为肝边缘部小胆管小囊状、细枝状扩张 ( 65例 ) ;近肝门侧胆管树枝状扩张 ( 4 1例 ) ;肝实质结节或小斑片低密度灶 ( 6例 ) ;胆囊内条片状软组织影 ( 1例 )。结论 :肝边缘部细枝状、小囊状扩张为肝吸虫病CT表现特征 ;肝内结节、斑片低密度灶可能与炎性肉芽肿及胆管周围炎有关。肝吸虫病具有特征性CT表现 ,CT是肝吸虫病早期诊断有效的检查方法。     

肝结核的CT与MRI表现

目的 探讨肝结核的CT、MRI表现及其诊断价值。方法 回顾性分析经病理证实的12例肝结核的CT和MRI表现。结果 （1）12例 CT表现：肝浆膜型1例,为肝包膜下多发结节性病灶。肝实质型10例,其中多发粟粒小结节状低密度灶伴点状钙化2例,单发略低密度大结了伴斑点状钙化及聚集多个结节样病灶形成“成簇征”或融合成窝状改变各3例,多发囊样病变及发粟粒状钙化伴单发大结节低密度灶各1例。肝内胆管型1例,肝内胆管明显扩张及肝门部多发斑点状钙化灶。（2）4例MRI表现：T1WI、T2WI低信号灶1例,T1WI低信号、T2WI高信号灶3例,增强后为轻度边缘强化或呈多环状强化。结论 各种类型肝结核均有其特定的影像学表现,典型的CT、MRI表现可提示该病的诊断。     

肝外胆管细胞癌所致肝实质一过性密度差异研究

目的 探讨肝外胆管细胞癌所致胆系扩张的肝实质--过性密度差异(transient hepatic parenchyma)attenuation differences,THAD)的影像学表现.资料与方法 56例肝外胆管细胞癌致胆系扩张患者行肝脏三期动态扫描均可见THAD.分析THAD的影像学特征及THAD与胆系扩张程度的相关性.结果 56例共测量肝内胆管222段,其中轻度扩张46段,中度扩张98段,重度扩张78段.柱状或分枝状THAD(Ⅰ型)在胆管轻度扩张肝段的发生率明显低于胆管中、重度扩张肝段(X2=186.68,P<0.005).肝内胆管重度扩张时,扩张程度呈扇形或不规则片状THAD(Ⅱ型)发生率明显增高(t'=5.16,P<0.05)0 II型THAD阳性组95%可信区间下限为9.3mm.Ⅲ型THAD阳性组与阴性组胆囊横径均数存在差异,其差异具有统计学意义(t'=6.46,P<0.05).Ⅲ型THAD阳性组胆囊横径均数95%可信区间下限为28.2mm.结论 肝外胆管细胞癌所致胆系扩张的THAD的影像学表现主要有3种:(1) Ⅰ型.沿胆管分布的柱状或分枝状THAD,边界不清,肝内胆系扩张＞5mm时常见;(2) Ⅱ型.扇形或不规则片状THAD,边界清楚或不清楚,肝内胆系扩张＞9.3mm时常见;(3) Ⅲ型.胆囊旁肝实质内弧形片状THAD,边界不清,胆囊横径＞28.2mm时常见.     

肝华支睾吸虫病的CT表现

目的:探讨肝吸虫病的CT表现和诊断价值.方法:对经临床证实的肝吸虫病156例的CT表现进行分析和总结.结果:156例患者CT均表现为肝内胆管呈囊状及杵状扩张,特别是肝脏边缘部明显,胆总管无扩张.扩张胆管内见虫体呈点状软组织影58例.胆囊内见虫体软组织沉积43例,合并胆囊结石51例,合并胆管炎32例,并发肝脓肿8例.合并胆管癌8例.结论:肝吸虫病CT表现具有特征性,结合实验室检查可明确诊断.所以CT对肝吸虫病的诊治具有重要作用.     

外周型肝内胆管细胞癌CT表现

目的：探讨外周型肝内胆管细胞癌的CT表现及特征。方法：回顾性分析经手术及病理证实的33例IHPCC的CT表现。结果：33病例中29例CT平扫表现为低密度实质病灶．4例无明确肿块；肝内胆管扩张23例，扩张胆管合并肝内胆管结石15例。所在肝叶萎缩、肝包膜凹陷征25例，三期增强扫描：早期或动脉期明显强化1例；27例早期周边轻度强化，门脉期延迟期周边向中心明显强化呈片状、条状、分隔状；1例均无强化。结论：肝内胆管细胞癌的CT表现有一定的特征性。     

肝内胆管乳头状黏液性导管腺癌合并胰腺导管内乳头状黏液性肿瘤1例

导管内乳头状黏液性肿瘤多发生于胰管、胆管内。该文报道了1例肝内胆管乳头状黏液性导管腺癌合并胰腺导管内乳头状黏液性肿瘤。CT和MRI示肝内外胆管弥漫扩张, 肝左外叶扩张胆管内延迟强化小结节, 以及胰腺钩突囊性灶伴主胰管轻度扩张。病理结果为肝左叶胆管乳头状黏液性高-中分化导管腺癌, 胰腺导管内乳头状黏液性肿瘤伴上皮轻度异型。     

肝结核的CT诊断价值

目的:探讨肝结核的CT表现及其诊断价值.方法:回顾性分析经病理证实的8例肝结核的CT表现.结果:肝结核分为以下四种亚型:①肝浆膜型1例,为肝包膜增厚及胞膜下多发低密度病灶.②肝实质型5例,其中又分为粟粒型1例、结节型3例、肝囊肿型1例.粟粒型表现为肝弥漫肿大、密度减低并伴有多发粟粒状低密度灶,增强扫描无明显强化;结节型表现为肝内局灶性低密度区,增强扫描部分有周边性强化,有1例表现为肝内结节状混杂密度灶,特点为病灶中心密度高,周围密度低,增强扫描有轻至中度的环形强化;肝囊肿型表现为肝内单纯囊肿样改变.③混合型1例,同时具有肝浆膜型和结节型(肝实质型)的表现.④结核性胆管炎1例,仅表现胆管内积气、胆管扩张,沿胆管壁走行的钙化、管型结石均未见.结论:粟粒型肝结核、肝囊肿型肝结核及早期结核性胆管炎的CT表现缺乏特征性,除非有结核病史或活检证实,CT诊断价值有限.结节型肝结核和晚期结核性胆管炎的CT表现有一定的特征性,可提示肝结核的诊断.     

肝内外胆管及胆囊扩张程度和低位梗阻性黄疸病变的相关性

目的探讨肝内、外胆管及胆囊扩张程度、形式对低位梗阻性黄疸的诊断价值。方法回顾性分析105例低位阻塞性黄疸患者的CT和内窥镜逆行胰胆管造影（ERCP）的影像资料，将胆系扩张分为下列7种类型：Ⅰ型为肝内、外胆管及胆囊均重度扩张；Ⅱ型为肝外胆管、胆囊重度扩张伴肝内胆管轻度扩张；Ⅲ型为肝内、外胆管重度扩张伴胆囊不扩张或轻、中度扩张；Ⅳ型为肝外胆管重度扩张伴肝内胆管和胆囊不扩张或轻、中度扩张；Ⅴ型为肝内胆管重度扩张伴肝外胆管及胆囊不扩张或轻、中度扩张；Ⅵ型胆囊重度扩张伴肝内、外胆管不扩张或轻、中度扩张；Ⅶ型为肝内、外胆管及胆囊均不扩张或轻、中度扩张。结合手术和病理结果，分析各类型胆系扩展和其低位阻塞性黄疸病变的相关性。结果105例低位阻塞性黄疸中33例为肿瘤性病变，72例为非肿瘤性病变。肿瘤性病变中．Ⅰ型16例，Ⅱ型10例，Ⅲ型4例，Ⅳ型1例，Ⅶ型2例。非肿瘤性病变中，Ⅰ型4例，Ⅱ型4例，Ⅲ型9例，Ⅳ型33例，Ⅴ型2例，Ⅵ型11例，Ⅶ型9例。Ⅰ、Ⅱ型扩张和Ⅲ～Ⅶ型扩张在肿瘤和非肿瘤病变中差异有统计学意义（χ^2=47．33，P〈0．01）。结论低位阻塞性黄疸病变性质和肝内、外胆管及胆囊扩张程度密切相关：（1）Ⅰ型和Ⅱ型扩张提示绝大多数为肿瘤性病变，少数为嵌顿性结石。（2）Ⅲ～Ⅶ型扩张常为胆管、胆囊结石及炎症。     

药物性肝损害的多层螺旋CT影像表现

目的 探讨药物性肝损伤的MSCT表现.方法 回顾性分析2008年5月至2010年1月间经临床及病理证实的40例药物性肝损伤患者的MSCT影像及临床资料,总结其影像表现特征.结果 药物性肝损伤的MSCT影像表现主要有3种类型.(1)弥漫性肝脏损害2例:平扫肝脏密度均匀性减低,增强扫描肝实质轻度均匀强化.病理表现为肝细胞脂肪变性;混合炎性细胞浸润,点状坏死,毛细胆管淤胆.(2)灶性肝脏损害6例:肝内大片或多发小片状坏死灶5例.平扫肝脏密度不均匀,病变区为低密度改变;增强后病变区强化,特别是静脉期与平扫图像比较呈反转表现.另1例病程20 d的移植肝显示肝内弥漫的结节样再生.CT平扫可见肝内弥漫分布的稍高密度结节灶,增强后动脉期病灶强化,静脉期及延迟期近似于肝实质密度.5例患者病理表现为肝细胞片状及桥接坏死,大量混合炎性细胞浸润;1例重度淤胆,假小叶形成,肝细胞羽毛变性.(3)肝硬化表现2例:平扫肝脏表面呈结节状,肝叶比例失调,肝裂增宽.增强后肝脏强化一致,同时伴有脾大、腹水、侧支循环.病理为纤维组织增生,点状坏死和毛细胆管淤胆.结论 药物性肝损伤的MSCT影像表现具有一定的特征性,对临床诊断具有重要的参考价值.     

100例脑囊虫病临床及CT分析

分析讨论了100例脑囊虫病的临床和 CT 表现,其中脑实质型54例,脑膜型4例,脑室型6例,混合型36例。CT 主要表现为1.多发小囊状低密度灶和较大的囊状低密度灶,囊壁上显示高密度点状或结节造影。2.多发结节或环形强化灶。3.脑实质内广泛密度减低,病灶分辨不清或脑实质内可见散在小片状低密度灶,边缘不清,多无强化效应。其它征象有脑积水等。     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.