多层CT作肺血管分期造影对肺癌侵犯中央肺动脉的评估

目的 探索多层螺旋CT作肺血管分期造影的可能性和评价肺癌侵犯中央肺动脉的临床价值。方法 用多层螺旋CT对73例肺门区肺癌患者进行研究。分两段对比剂注射，结合三个扫描程序作肺血管分期造影，根据肺动脉被侵犯的不同部位和程度分为三度。按盲法评价图像并与手术和病理对照。结果 肺动脉分期造影成功的共68例(93.15％，68/73)。肺动脉I度侵犯者4例(5．88％，4／68)，Ⅱ度侵犯者9例(13．23％，9/68)，Ⅲ度侵犯者55例(80．88％，55/68)。I度者全部作肺叶切除;Ⅱ度与Ⅲ度者的肺叶切除率有显著性差异(x^2＝64．03，P＜0.005)；Ⅲa度与Ⅲb度者的肺叶切除率也有显著性差异(x^2＝68．69，P＜0.005)，Ⅲc度全部放弃手术。结论 多层螺旋CT作肺血管分期造影能更好地显示肺癌侵犯中央肺动脉的部位和程度，为选择外科治疗方案提供更多的影像学依据。     

术前IADSA和栓塞术在鼻咽纤维血管瘤治疗中的应用

目的：研究分析术前经动脉数字减影血管造影（ＩＡＤＳＡ）和栓塞术在鼻咽纤维血管瘤治疗中的价值。方法：分析本院２１例鼻咽纤维血管瘤患者的临床分析治疗资料，１主后１年复发，再次手术治疗。２２次手术中，术前行及未行ＩＡＤＳＡ和栓塞术的各１１次。 术前示行和行ＩＡＤＳＡ和栓塞术的要中平均出血量和输血量。结果：术前未行和行ＩＡＤＳＡ和栓塞术的术中出量量和输血量分别为１１３６ｍｌ、８３６ｍｌ、６７７ｍｌ、４００     

TUMORS INVADING PARAPHARYNGEAL SPACE : REFINED IMAGING DIAGNOSIS

ＴＵＭＯＲＳＩＮＶＡＤＩＮＧＰＡＲＡＰＨＡＲＹＮＧＥＡＬＳＰＡＣＥ：ＲＥＦＩＮＥＤＩＭＡＧＩＮＧＤＩＡＧＮＯＳＩＳＺｈｕａｎｇＱｉｘｉｎ庄奇新ＣｈｅｎｇＹｉｎｇｓｈｅｎｇ程英升ＹａｎｇＳｈｉｘｕｎ杨世埙Ｓｈａｎｇｋｅｚｈｏｎｇ尚克中ＹａｎＸｉｎｈｕａ...     

Hepatic hemangiosarcoma: imaging findings and differential diagnosis

Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous liver biopsy is hazardous. Received: 20 November 1998; Revised: 2 March 1999; Accepted: 12 April 1999     

Angiomyolipoma arising in the thigh

A 41-year-old man presented with an asymptomatic mass in the right medial thigh. Magnetic resonance imaging (MRI) revealed a well-demarcated, 10-cm mass in the right adductor muscles. The margins of the mass exhibited high signal intensity and the rest showed low or iso signal intensity on T1-weighted MR images. However, the high signal intensity was decreased on T2-weighted images with fat suppression. The central part of the tumor was of inhomogeneous high signal intensity on T2-weighted images; after Gd-DTPA injection it enhanced inhomogeneously on T1-weighted images with fat suppression. On dynamic computed tomography (CT) in the arterial phase, there were strongly enhancing spotty areas in the tumor. At surgery, a yellow-whitish tumor was resected and a pathological diagnosis of angiomyolipoma (AML) in the thigh was made. Received: 21 June 1999 Revision requested: 28 July 1999 Revision received: 13 December 1999 Accepted: 15 December 1999     

Steno-Occlusive Changes in the External Carotid System in Moyamoya Disease

To evaluate the steno-occlusive changes in the external carotid system in moyamoya disease, cerebral angiograms of 39 moyamoya patients were retrospectively reviewed. There were 26 females and 13 males, age ranged from 4 to 62 years with a mean of 26 years. Initial symptoms were ischaemia in 27 patients, haemorrhage in 9, and none in 3. Stenosis, occlusion, and dilatation in the external carotid system were analysed angiographically. No stenosis or occlusion of the superficial temporal artery, middle meningeal artery, or occipital artery was observed in either preoperative or postoperative follow-up angiograms in any patients. Steno-occlusive changes do not occur in the external carotid system, but are confined in the internal carotid system in moyamoya disease.     

RDSA在颅内动脉瘤成像中的技术探讨

目的:探讨旋转数字减影血管造影(RDSA)在颅内动脉瘤成像中的应用。方法:对疑有颅内动脉瘤的43例患者首先进行常规DSA检查,对其中27例进行RDSA检查,研究RDSA的技术参数及应用价值。结果:43例中,16例常规DSA能清楚显示,其余27例在常规DSA基础上加RDSA,动脉瘤的形态、位置及毗邻关系得到清楚显示。结论:常规DSA是诊断颅内动脉瘤的必要检查方法,RDSA是常规DSA的重要补充,对颅内动脉瘤的成像、治疗及复查有重要的价值。     

Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing carotid stenosis

We compared three angiographic methods for grading of carotid stenosis and examined the correlation between angiographic and ultrasound findings. Two observers independently measured 111 carotid stenoses on arteriographic films of 84 patients. The stenoses were graded according to the European Carotid Surgery Trial (ECST), North American Symptomatic Carotid Endarterectomy Trial (NASCET), and Common Carotid (CC) methods. The results obtained by these methods were compared, and the interobserver reproducibility of the measurements was calculated. In addition, all angiographic results were compared to ultrasound findings obtained before angiography. Measurements using the CC method were the most reproducible and those using the NASCET method the least. The NASCET method underestimated the degree of stenosis compared to the other methods. The ECST and CC methods yielded almost identical results (97% agreement). Ultrasound provided an accuracy of 94% compared to ECST and CC methods and 84% compared to the NASCET method. Interobserver reproducibility of angiographic quantification of carotid stenoses was best for the CC and ECST methods and least for the NASCET method. Ultrasound demonstrated better accuracy than the ECST and CC methods. Received: 7 April 1999/Received in revised form: 5 October 1999/Accepted: 11 April 2000     

CTA在主动脉夹层诊断中的应用

目的 探讨CT血管造影（CTA）在主动脉夹层诊断中的临床应用价值。方法 对35例主动脉夹层患者行CTA成像，层厚3mm，重建间距1．5。并与手术对照。结果 CTA能清楚显示主动脉夹层病变及其复杂的解剖关系，如双腔、内膜片及累及的范围等。与手术对照，CTA的诊断符合率达100％。结论 CTA有助于主动脉夹层的诊断并可指导手术，并有望取代传统血管造影。     

MSCTA在静脉窦旁脑膜瘤手术中的应用价值

目的探讨多排螺旋CT血管造影(MSCTA)在颅内静脉窦旁脑膜瘤手术中的应用价值。方法对两所医院60例窦旁脑膜瘤患者术前行MSCTA检查,利用三维重建图像技术进行模拟手术入路及肿块与血窦之间的关系研判。结果通过三维后处理后60例患者皆合理的设计和选择了手术入路和术式,有效地避免了颅内静脉窦的损伤,其中5例改变了常规手术入路,7例改变了常规手术方式,6例术前早期制定了次全切手术方案及放疗计划。结论 MSCTA在颅内静脉窦旁脑膜瘤术前制定手术入路及手术方式方面具有重要参考价值。