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Image guidance allows safe passage of needles, often into small and otherwise inaccessible lesions, and into the portions of the lesion most likely to yield useful samples, while avoiding damage to important structures. This article hopes to provide a useful guide to image-guided musculoskeletal biopsy for radiologists in practice and in training. 相似文献
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目的评价超声血管增强技术(vascular enhancement technology,VET)在外周病变的临床应用价值。方法对90例外周血管病变的患者(52例颈动脉病变、16例下肢动脉病变及22例下肢深静脉病变)应用超声血管增强技术,显示病变的血管,并与传统二维谐波及彩色多普勒(CDFI)成像相对比。结果常规二维超声检查28例(31.11%)图像不能清晰显示,应用VET技术,86例(95.56%)外周血管病变患者的血管腔、血管壁及病灶(斑块、血栓)更清晰显示,图像质量评分VET高于传统二维超声,为2.91:2.09,(P<0.01)。结论 VET技术可提高能提高血管与周边组织对比分辨力,更清晰显示血管腔、管壁结构及病灶,具有较高的临床应用价值。 相似文献
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Schernthaner R Stadler A Lomoschitz F Weber M Fleischmann D Lammer J Loewe Ch 《European radiology》2008,18(4):665-671
The purpose was to evaluate the accuracy of multidetector CT angiography (MD-CTA) in the morphologic assessment of peripheral
arterial occlusive disease (PAOD) compared to digital subtraction angiography (DSA). Fifty consecutive patients referred for
DSA of the peripheral arteries due to PAOD were prospectively included in this study and underwent 16-row MD-CTA prior to
DSA. Maximum intensity projections and multipath curved planar reformations were created with a semi-automated toolbox. Twenty-one
vascular segments were defined in each leg and compared to DSA findings with regard to gradation, length, and number of lesions.
Mean sensitivity and specificity in the detection of significant stenoses (over 70%) were 100% and 99.5% in the iliac arteries,
97.4% and 99.0% in the femoro-popliteal arteries, and 98.3% and 99.8% in the infrapopliteal arteries, respectively. High kappa
values for exact stenoses gradation (0.74–1), lesion length (0.74–1), and number of lesions (0.71–1) were reached by MD-CTA,
indicating high agreement with DSA. Non-invasive MD-CTA is an accurate tool for the assessment of all treatment-relevant morphologic
information of PAOD (gradation, length, and number of stenoses) compared to DSA. 相似文献
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Aging-correlated pathologies are atherosclerosis, arterial hypertension, diabetes mellitus, bacterial infections, and malnutrition. The progressive impairment of renal function is the cause of the drug-induced renal pathologies: direct damage induced by nephrotoxic drugs or indirect damage induced by decreased renal excretion of serum molecules. In the elderly, an increase in different pathologies occurs in the genitourinary tract. Among these pathologies, an increase in neoplastic disorders is present; at the same time, several non-neoplastic pathologies are more frequent in old patients. This article considers first the neoplastic genitourinary pathologies and second the non-neoplastic genitourinary pathologies. 相似文献
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目的 通过与DSA比较评估64层螺旋CT血管成像诊断周围血管性疾病(peripheral vascular disease,PVD)的准确性及特异性.方法 30例PVD患者同时接受DSA及CT血管造影检查.血管狭窄程度分为5级:Ⅰ正常(无狭窄);Ⅱ轻度狭窄(1%~49%狭窄);Ⅲ中度狭窄(50%~74%狭窄);Ⅳ重度狭窄(75%~99%);Ⅴ闭塞.以DSA结果为金标准,分析64层螺旋CT的灵敏度、特异度等指标.结果 30例患者中,共有720支血管均有DSA及CTA成像.进行分析比较后发现,64层螺旋CT诊断下肢动脉有意义狭窄的灵敏度98.5%、特异度99.2%、阳性预测值99.1%、阴性预测值98.7%.结论 64层螺旋CT血管成像是诊断周围血管狭窄程度的一种准确、安全、无创的影像学诊断技术. 相似文献
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目的:探讨排泄性尿路造影(IVP)、CT尿路成像(CTU)、磁共振尿路成像(MRU)在泌尿系疾病中的诊断价值。方法:45例泌尿系疾病患者中,同时行IVP、CTU及MRU检查者31例,仅行IVP检查者5例,仅行CTU检查者6例,仅行MRU检查者3例,CTU采用的重组技术包括多平面重组、曲面重组、容积再现及最大密度投影。结果:经IVP检查的患者中,能够明确诊断者占82.69%;经CTU检查的患者中,能够明确诊断者占94%;经MRU检查的患者中,能够明确诊断者占78.57%。结论:IVP检查方法较简便,能大致了解肾脏功能,费用相对低廉,医生和患者易于接受,仍具有较重要的诊断价值;CTU具有较好的图像质量,对于肾尿路平片(KUB)和IVP不能显示或不能确诊的泌尿系肿瘤和结石,CT能从大小、形态、部位及梗阻以上空间的扩张上作出进一步评估;MRU后处理功能强大,重组图像清晰,可以发现很多IVP不能发现的细小病变,作为一种非侵袭性、无需对比剂的方法,对于某些泌尿系疾病具有十分重要的临床应用价值。 相似文献
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目的 探讨扩散张量成像(DTI)及磁共振肌纤维束成像应用于骨肌系统肿瘤诊断的可行性及价值.资料与方法 38例骨肌系统肿瘤,均行常规MRI和DTI,计算并分析良、恶性肿瘤中心区、肿瘤周边区及邻近正常肌肉的部分各向异性值(FA)和体积比各向异性值(VrA),重组病变周围肌纤维束成像,并将MRI表现与手术病理学检查结果作对照研究.结果 良性肿瘤病变周围肌肉肌纤维束成像主要表现为肌肉推移征象.恶性肿瘤主要表现为浸润、破坏征象.良、恶性肿瘤周边区的FA值和VrA值相比差异均有统计学意义(P<0.01),良、恶性肿瘤中心区FA值和VrA值相比差异无统计学意义.结论 MR DTI能用于评价肌骨系统肿瘤的内部结构特征及与周围组织的关系,对良、恶性肌骨系统肿瘤的诊断及鉴别诊断有一定帮助. 相似文献
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髓鞘少突胶质细胞糖蛋白(MOG)抗体相关疾病(MOG-AD)是一种由MOG抗体导致的、以髓鞘脱失为主要病理表现的疾病,属于炎症性脱髓鞘疾病中一个新的疾病谱,其临床及影像表现形式多样,可类似多种其他疾病。目前MOG-AD影像表现尚不被熟知,诊断准确率低。就视神经、脑部及其他颅神经、脊髓等部位MOG-AD的MRI表现及目前研究中待解决的问题做一综述。 相似文献
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目的观察外周切割球囊(PCB)治疗外周血管狭窄的临床近期效果,评价其临床价值。方法回顾性分析应用PCB治疗的13例患者资料,包括4例血液透析患者上臂人工动静脉瘘狭窄段和9例下肢动脉狭窄患者,共13条肢体,33处狭窄。采用患肢同侧顺行穿刺,选择相应直径的PCB用8~10atm(1atm=10.108kPa)行扩张治疗,对于存在多个狭窄段的患肢血管,采用由远及近的顺序依次扩张。术后给予持续抗凝治疗。结果13例患者治疗均获成功,未出现明显并发症。血液透析患者动静脉瘘血流量增加。下肢动脉狭窄患者末端皮温升高,间歇性跛行及静息痛消失,症状、体征改善明显。随访时间15d至5个月,患者症状无反复,1例血液透析患者术后5个月上臂人工动静脉瘘造影证实未发生再狭窄。结论PCB治疗外周血管狭窄近期疗效满意,为处理外周血管狭窄提供了一个新的研究和治疗方法。 相似文献
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Imaging features of musculoskeletal tuberculosis 总被引:4,自引:0,他引:4
De Vuyst D Vanhoenacker F Gielen J Bernaerts A De Schepper AM 《European radiology》2003,13(8):1809-1819
The purpose of this article is to review the imaging characteristics of musculoskeletal tuberculosis. Skeletal tuberculosis
represents one-third of all cases of tuberculosis occurring in extrapulmonary sites. Hematogenous spread from a distant focus
elsewhere in the body is the cornerstone in the understanding of imaging features of musculoskeletal tuberculosis. The most
common presentations are tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue involvement. The diagnostic value
of the different imaging techniques, which include conventional radiography, CT, and MR imaging, are emphasized. Whereas conventional
radiography is the mainstay in the diagnosis of tuberculous arthritis and osteomyelitis, MR imaging may detect associated
bone marrow and soft tissue abnormalities. MR imaging is generally accepted as the imaging modality of choice for diagnosis,
demonstration of the extent of the disease of tuberculous spondylitis, and soft tissue tuberculosis. Moreover, it may be very
helpful in the differential diagnosis with pyogenic spondylodiscitis, as it may easily demonstrate anterior corner destruction,
the relative preservation of the intervertebral disk, multilevel involvement with or without skip lesions, and a large soft
tissue abscess, as these are all arguments in favor of a tuberculous spondylitis. On the other hand, CT is still superior
in the demonstration of calcifications, which are found in chronic tuberculous abscesses. 相似文献
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Ultrasonography (US) is a readily available non-invasive tool useful for the detection of musculoskeletal and soft tissue masses. Although X-Ray is often the first imaging study for evaluating both bone and soft tissue lesions, and magnetic resonance imaging and computed tomography are mandatory in lesions staging, US is increasingly used for the early assessment of musculoskeletal and soft-tissue masses and for guiding procedures and biopsies. Surgical biopsy or fine needle aspiration biopsy (FNAB) is needed to ascertain the nature of any lesion. FNAB is a low cost technique, safer and less traumatic than an open surgical biopsy. Significant complications are rare, mostly related to the site of biopsy. Knowledge of indications, limitations, anatomical and pathological access, adequate technical expertise in US imaging and in intervention skills are the critical factors of the appropriate and safe use of FNAB. By now, the role of FNAB in musculoskeletal diseases is controversial and there is still a heated debate in the scientific community. 相似文献