牙周膜牵张成骨快速牙移动移动牙张力侧变化的X线观察

目的　观察移动牙快速移动时张力侧变化的X线表现 ,为牙周膜牵张成骨理论提供依据。方法　杂种犬 8只 ,拔除下颌两侧第二前磨牙 ,实验侧实施减阻 牵张措施 ,加力 1 4d后 ,停止加力固定 3 0d ;对照侧仅行拔牙术。 1、7、1 4、2 1、44d拍摄实验侧、对照侧咬合侧位片 ,观察移动牙张力侧的X线变化。结果　移动牙张力侧牙周膜加力期间有新骨迅速生成 ;停止加力 3 0d时 ,新生骨放射学特征与对照侧牙槽骨无显著差别。结论　移动牙快速移动时 ,张力侧牙周膜可以快速牵张成骨而不会造成龈下骨质缺损     

基于敏感编码技术磁共振水成像在胃肠道检查中的应用

目的探讨基于敏感编码(SENSE)技术单次激发放射状水成像技术对正常胃肠道解剖结构的显示能力,为水成像技术诊断胃肠道疾病提供正常解剖学基础,并探讨胃肠道疾病的影像学诊断新方法。方法健康自愿者共30例,其中男性19例,女性11例,年龄20-50岁,中位年龄35岁。检查前60 min口服饮用水1 000-1 500 mL,检查前20 min再口服500 mL,扫描前10 min肌注654-2 10 mg。MR水成像(MRH)检查使用PhilipsGyroscan Intera 1.5T超导型MRI,采用SENSE技术相匹配的相控阵线圈及呼吸门控,行单次激发放射状快速自旋回波序列进行胃肠道水成像检查。结果30例均能接受此检查,检查成功率100%。30例水成像图像经盲法评价,优良图像占93%,差图像占7%。其中胃显示率65%,胃黏膜显示清楚占80%;十二指肠显示率80%,空肠显示率59%,空肠直径2-2.5 cm,回肠显示率21%,回肠直径1.5-2.5 cm,小肠黏膜清楚显示占67%;结肠显示率10%,结肠黏膜清楚显示占6%。结论基于SENSE技术单次激发放射状水成像技术对胃、十二指肠及空肠轮廓和黏膜皱襞显示较为清楚,对回肠及结肠轮廓和黏膜皱襞显示较差。单次激发放射状水成像技术结合常规腹部MR检查可以清楚、方便地显示胃肠道的解剖特点,是胃肠道影像学检查的一种新的可供选择的方法。     

肝移植术后并发症的影像学诊断

目的系统分析肝移植术后正常及常见并发症的影像学表现。方法使用Philips Secura螺旋CT扫描仪对50例肝移植术后患者进行检查,CT扫描范围自膈顶至腰3椎体下缘水平,对比剂1.3mL/kg体质量,注药流率2.5mL/s,延迟时间30、60、120s。对拔除T管后出现胆管并发症患者使用Philips Gyroscan NT1.5T磁共振扫描仪检查。使用GE Advance Lp/Lc数字血管造影机,经股动脉穿刺进行肝动脉造影。结果27例肝移植术后患者出现移植肝下积液及右侧胸腔积液,门静脉伴行影像4例,肝动脉吻合口狭窄2例,肝动脉血栓1例,门静脉吻合口狭窄2例,胆管吻合口部位狭窄1例,非吻合口狭窄3例,胆瘘4例,肿瘤复发4例。结论CT、磁共振胆道水成像(MRCP)和数字减影(DSA)可以清晰显示肝移植术后血管、胆管并发症及其他少见并发症。     

贲门区癌可手术切除的相关X线征象

为探讨贲门癌的 X线征象在病变范围的确定及评估手术可能性中的价值 ,收集 10 6例采用双对比检查并经手术及病理证实的贲门癌 ,对其 X线表现与手术、病理所见进行对照分析。结果 :10 6例中 ,90例行开腹探查术 (其中病变切除 70例 ,未能手术切除 2 0例 ) ,16例因失去探查机会而采用非手术疗法。提示 :贲门癌的有些 X线征象在决定能否手术切除具有重要的意义。     

Classification decision tree algorithm assisting in diagnosing solitary pulmonary nodule by SPECT/CT fusion imaging

Objective To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78. 57e, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P=0.204), but greater than that of residents (P<0.001). Conclusion Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.     

基于Web平台孤立性肺结节影像计算机辅助诊断的研究

目的构建基于Web文本层面的孤立性肺结节(SPN)计算机辅助系统,探讨计算机帮助医生对SPN性质进行辅助诊断的可能性及价值。方法系统硬件设备包括1台路由器、1台交换机、2台服务器以及若干计算机和其他外部设备。Web服务器采用的操作系统为Windows 2000 Server,Web服务程序为Web Logic 8.1。数据库服务器采用的操作系统为RedHat Linux9.0,数据库系统为Oracle9i for Linux,在J2EE架构下开发SPN辅助诊断系统。SPN辅助诊断系统包括病例上传子系统、辅助诊断子系统以及维护和管理子系统。结果将待诊的SPN临床及CT图像原始文字信息录入辅助诊断子系统,该诊断模型依据输入的SPN属性,自动访问诊断规则数据库并提取相应SPN诊断规则进行比对分析,其诊断结果以报告的形式出现,包括典型层面的CT图像和诊断意见两部分,诊断意见分为5个层次:恶性、可能恶性、良性、可能良性、不能确定,并附有可信度值。结论基于Web的SPN计算机辅助诊断系统构建的方法是可行的,该系统可以辅助医师对SPN的良恶性做出辅助诊断。