腹膜后纤维化的CT、MRI表现

目的：研究腹膜后纤维化的ＣＴ、ＭＲＩ表现。方法：本组经临床病理证实病例８例,其中男５例、女３例,平均年龄４８．０岁。特发性６例,非特发性２例。８例全部进行了ＣＴ扫描,其中２例作了强化扫描,１例进行了ＭＲＩ扫描。结果：８例中病变呈弥漫性３例,肿块性５例。ＣＴ平扫可呈低密度、不均匀密度或等密度,增强扫描显示不同程度强化。ＭＲＩ、Ｔ１ＷＩ、Ｔ２ＷＩ呈低信号强度。结论：本病为一种ＣＴ扫描表现多变的少见疾病,如腹膜后出现弥漫或肿块样病变合并肾及输尿管积水时应考虑到本病诊断。     

猪后肢枪弹伤前后肺血管容积CT与血生化指标变化趋势研究

目的 采用容积CT(VCT)评价猪后肢枪弹软组织贯通伤前后肺动脉血管容积与血浆生化指标变化特点.方法 12只普通家猪,雌性,4~5个月,35~40 kg.采用81-1自动步枪,子弹7.62 mm,致伤能量508.48～520.37 J,枪击猪后肢,制成下肢软组织贯通伤-肺损伤动物模型.分别于致伤前和致伤后3 min、10 min、25 min、40 min时间点,采用VCT行胸部常规及增强扫描,利用VCT AW4.2工作站自带软件进行后处理,测量各时间点两下肺外侧基底段动脉分支容积;同时在各时间点经耳缘静脉采血,检测血浆中内皮素(ET)、皮质醇(COR)、丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC)的浓度变化.对照分析各时间点肺动脉血管容积与血浆生化指标的变化特点与趋势.结果 (1)致伤后3 min两肺下叶外基底段动脉容积较致伤前增加(tR=-9.98,PR＜0.05;tL=-14,PL＜0.05);致伤后10 min较致伤前减少(tR=9.125、PR＝0.018;tL=11,PL＜0.05);致伤后25 min、40 min两肺下叶外基底段动脉容积恢复至致伤前水平.(2)血浆ET浓度致伤后10 min升至最高点与致伤前比 较(t=9.21,P＜0.05),血浆COR浓度致伤后10 min、25 min、40 min与致伤前比较均有统计学差异(t10 min=21,P＜0.05; t25 min=17,P＜0.05; t40 min=13,P＜0.05),在致伤后10 min达到最高峰.(3)致伤前后血浆SOD、MDA 、T-AOC浓度在各时间点变化无统计学差异.结论致伤能量为508.48～520.37 J的国产自动步枪所致的猪后肢软组织贯通伤可导致远隔肺损伤;损伤早期两肺下叶外基底段动脉容积增加,伤后10 min血浆ET、COR达到峰值,此时肺小动脉容积明显减小;血浆MDA、SOD、T-AOC浓度无特异性变化.     

医学影像学教学用PACS系统资源库的模式构建与管理

医学影像学数字化建设是当前医学影像学教学模式改革的热点,医学影像学实训课教学用医学影像存档与通信系统(Teaching-PACS,T-PACS),系统的应用作为推动医学影像学数字化建设的重要组成部分,在医学院校的日常教学活动中发挥着非常重要的作用。本文通过对医学影像教学用T-PACs系统资源库的模式构建和管理的原则和经验进行阐述,对取得的成效进行了评价。     

t-pacs在《医学影像学》结业考试中的应用

目前,医学图像存储与通信系统(Picture archiving and communication system,PACS)在国内大多数医疗机构都已普遍应用,基于PACS的医学影像教学模式已经成为必然趋势[1-3]。我院放射科作为国家重点学科培育学科,于2009年结合本科特色成功构     

恶性混合型苗勒氏瘤1例

患者女,29岁.无明显诱因自感左腰痛伴左股外侧放射痛1年,为持续性锐痛,夜间加重,向大腿外侧放射,躯干左倾时缓解,以后疼痛逐渐加重伴餐后上腹部不适,食纳差,体重减轻,闭经.体格检查:躯干部皮疹,舟状腹,未见肠型及蠕动波,腹壁皮肤无红肿无破溃,左侧腹肌较右侧紧张,左肋缘下深压痛,未触及包块及条索状物,左肾区叩痛,移动性浊音阴性,肠鸣音4次/min.     

多排CT胆道成像诊断肝胆管结石的方法和技术

目的:多排CT胆道成像诊断肝内及肝外主胆管结石的价值。方法:采用临床流行病学诊断试验的方法,对经手术、病理或ERCP证实的40例多排CT胆道成像结果进行回顾分析。结果:多排CT胆道成像诊断肝胆管结石的特异度、敏感度、准确度均达到90%以上,明显优于B超。结论:多排CT胆道成像诊断肝胆管结石的特异度、敏感度、准确度基本与ERCP相近,该技术拓展了肝内外胆管结石的诊断途径,具有重要的临床应用价值。     

海洛因依赖者前额叶皮质及杏仁核1H-MR波谱研究

Objective To explore the characteristic findings of 1H-MR spectroscopy(1H-MRS) in the prefrontal cortex and amygdala of patients with heroine dependence(HD), and the relationship to total cumulative dose of inhaled heroine.Methods Fourteen male HD patients and 12 healthy controls (HC) underwent 1H-MRS at the prefrontal cortex and amygdala regions.The total cumulative in haled heroin dose was (852±341) g in HD.Ratios of N-acetylaspartate/creatine(NAA/Cr) and choline/creatine (Cho/Cr) were respectively measured in the prefrontal cortex and bilateral amygdale regions.The student's t test and the linear correlation were employed for statistical analysis.Results Compared to HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, t=1.77 ,P <0.05), left amygdala region (1.32±0.08 vs 1.42±0.08, t=3.41, P < 0.05), and right amygdala region (1.34±0.09 vs 1.44±0.10, t=2.63, P <0.05), the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, t=2.31, P < 0.05), left amygdala region (1.20+0.12 vs 1.07±0.04, t=3.60,P<0.05) and right amygdala region(1.26±0.15 vs 1.12±0.11,t=2.60,P <0.05).There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NKA/Cr in the prefrontal cortex (r=-0.9159, P < 0.01), left amygdala region (r=-0.8756, P < 0.01), and right amygdala region (r=-0.9399, P < 0.01) respectively.Conclusions The study indicates that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdala region, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exists between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.     

乳腺导管造影诊断乳腺囊性增生病13例

1　临床资料　乳头溢液的乳腺囊性增生病患者 13例 ,单侧乳头溢液 12例 ,双侧乳头溢液 1例 ,乳内肿块 6例 ,乳房胀痛8例 ,与月经有关 6例 ,溢液无色 1例 ,黄色 6例 ,暗红色 6例 ,年龄 2 7～ 6 1(平均 4 2 8)岁 ,病程 1～ 2 4 (平均 5 4 )ｍｏ ,13例均先行钼靶Ｘ线平片 ,然后再行选择性乳腺导管造影Ｘ线检查 ,7例经手术病理证实 .导管造影Ｘ线检查 ,囊肿型 7例(图 1) ,表现为与导管相连的较大的囊性扩张 ;小导管腺泡囊性增生型 1例 (图 2 ) ,表现为终末导管、腺泡呈较均匀的小囊状或串珠状扩张 ;囊肿伴导管硬化型 4例 (图 3,4 ) ,即既有较…     

海洛因依赖者前额叶皮质及杏仁核1H-MR波谱研究

Objective To explore the characteristic findings of 1H-MR spectroscopy(1H-MRS) in the prefrontal cortex and amygdala of patients with heroine dependence(HD), and the relationship to total cumulative dose of inhaled heroine.Methods Fourteen male HD patients and 12 healthy controls (HC) underwent 1H-MRS at the prefrontal cortex and amygdala regions.The total cumulative in haled heroin dose was (852±341) g in HD.Ratios of N-acetylaspartate/creatine(NAA/Cr) and choline/creatine (Cho/Cr) were respectively measured in the prefrontal cortex and bilateral amygdale regions.The student's t test and the linear correlation were employed for statistical analysis.Results Compared to HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, t=1.77 ,P <0.05), left amygdala region (1.32±0.08 vs 1.42±0.08, t=3.41, P < 0.05), and right amygdala region (1.34±0.09 vs 1.44±0.10, t=2.63, P <0.05), the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, t=2.31, P < 0.05), left amygdala region (1.20+0.12 vs 1.07±0.04, t=3.60,P<0.05) and right amygdala region(1.26±0.15 vs 1.12±0.11,t=2.60,P <0.05).There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NKA/Cr in the prefrontal cortex (r=-0.9159, P < 0.01), left amygdala region (r=-0.8756, P < 0.01), and right amygdala region (r=-0.9399, P < 0.01) respectively.Conclusions The study indicates that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdala region, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exists between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.     

现代医学影像学QA QC体系的探讨

本文通过对系统及系统工程的阐述,以及对系统工程中系统论、信息论、控制论的分析,指出了系统观念在现代医学影像学管理与控制中的作用、影响及意义。并着重分析了如何在系统论、信息论、控制论指导下完成对现代医学影像学的综合管理与控制,做到人尽其才、物尽其用,发挥整体优势,避免各种相关资源的损失和浪费。