肺转移瘤早期X线征象的探讨

肺是转移性肿瘤的好发器官，Ｘ线检查是诊断此病的简便有效方法。作者回顾性分析了本院７９例确诊为肺转移瘤病例，经动态观察对比，找出早期Ｘ线征象，并从机理上进行了探讨，以提高对本病的早期诊断。资料与方法本组７９例肺转移均经手术病理证实原发瘤为恶性肿瘤。男４...     

肺错构瘤的临床诊断(附16例报告)

目的：肺错构瘤是肺内最常见的良性肿瘤。但因临床表现无特异性而容易误诊。为提高对本病的诊治水平，我们从临床表现、胸部Ｘ线、手术及病理等方面探讨肺错构瘤的诊断与鉴别诊断。方法与结果：采用回顾性资料分析发现，本组肺错构瘤肺内型１５例，腔内型１２例；平均年龄４９９岁，男女比例为１６７∶１。临床症状少而轻。Ｘ线表现为圆形、类圆形阴影，肿块直径≤４ｃｍ者占８７５％，位于肺周边部位者占７５％。结论：肺错构瘤可经影像学检查提示诊断，确诊有赖于手术切除病理证实。     

肺错构瘤的临床诊断

目的：肺错构瘤是肺内最常见的良性肿瘤，但因临床表现无特异性而容易误诊。为提高地本病的诊治水平，我们从临床表现、胸部Ｘ线、手术及病理等方面探讨肺错构瘤的诊断与鉴别诊断。方法与结果：采用呃生资料分析发现，本组肺错构瘤肺内型１５例，腔内型１２例；平均年龄４９．９岁，男女比例为１．６７：１。临床症状少而轻。Ｘ线表现为圆形、类圆形阴影，肺块直径≤４ｃｍ者占８７．５％，位于肺周边部位才占７５％。结论：肺错构瘤     

肺部慢性间质性病变的CT 诊断

肺部慢性间质性病变是一组主要累及肺的支持结构,即肺泡壁、小叶间隔、支气管血管周围组织的疾病。胸部Ｘ线平片依然是本病最初的、重要的影像检查方法。由于ＣＴ可以消除影像的重叠,能够比Ｘ线平片更好地显示病变的表现及分布。它比胸部Ｘ线平片更灵敏,当胸部Ｘ线平片看不到异常时,它能证实广泛的肺间质病变;当胸部Ｘ线平片征象是非特异性的时候,它能有把握地做出诊断。因此,ＣＴ常用于本组疾病的检查。本文根据收集到的文献对肺部慢性间质性病变的ＣＴ诊断作一介绍。1　慢性间质肺炎11　普通型间质肺炎(ｕｓｕａｌｉｎｔｅｒｓｔｉｔｉａ…     

肺错构瘤的X线诊断——附103例分析

本文通过对103例手术后病理证实为肺错构瘤病例的X线征象分析,讨论了肺错构瘤的X线征象与临床、病理的关系,诊断及鉴别诊断要点,以及各种K线检查方法在本病的诊断及鉴别诊断中的作用。     

石工尘肺的临床X线诊断

临床工作中对石工尘肺的诊断常被忽视。现将作者收集的 32例Ｘ线资料进行分析 ,以提高对本病的认识。1　一般资料32例患者均为在露天用手锤、錾子进行石料开采或建筑安砌作业石工。全为男性 ,年龄 40～ 6 2岁之间。职业史 :10～ 15年者 2例 ,16～ 2 0年者 7例 ,2 1～ 30年者 14例 ,30年以上 9例。32例都以长期反复咳嗽、气紧等慢性呼吸道症状就诊。无 1例临床拟诊石工尘肺 ,Ｘ线诊断为慢性支气管炎、肺气肿 5例 ,浸润型肺结核 4例。2　Ｘ线表现本组 32例按尘肺Ｘ线诊断及分期标准〔1〕,1期矽肺 9例 ,Ⅱ期矽肺 2 3例。Ｘ线胸片表现 :双肺纹理…     

如何正确判断肺门病变浅析

在我们日常Ｘ线工作中 ,经常会遇到肺门淋巴结是否增大的争议 ,误诊、漏诊的现象时有发生 ,常常不能正确判断肺门淋巴结是否增大。虽然近年来多种影像技术如ＣＴ及磁共振成像在胸部疾病诊断中的应用 ,突破了Ｘ线诊断的限度 ,提高了肺门病变的检出率和鉴别诊断能力 ,但胸片仍是基本检查方法。几年来 ,我们在教训中反复重温了有关肺门病变的胸部平片资料 ,结合临床实践 ,现总结如下。1　正常肺门解剖及Ｘ线表现肺门阴影主要由肺动静脉、主支气管及淋巴结、神经组织及周围结缔组织构成。肺血管和支气管是形成正常肺门阴影的主要解剖结构。右肺…     

左心功能不全的临床X线诊断72例分析

左心功能不全的临床Ｘ线诊断７２例分析包礼杰，蔡广义，孙臣义，赵虹，吴华民，孙丽，丁丽荣左心功能不全Ｘ线征象有肺静脉扩张、肺郁血、间质性或肺泡性肺水肿及肺叶间裂增宽和胸腔积液等。因Ｘ线改变常早于临床征象，所以Ｘ级诊断对估计病情的发展和了解心脏功能有重要...     

新生儿肺透明膜病36例X线诊断分析

目的：探讨新生儿肺透明膜病（HMD）的X线诊断及临床意义。方法：回顾性分析临床与病理证实的36例HMD的X线表现。结果：胸片显示的网格状、颗粒状、两肺野透亮度减低和支气管充气征为本病主要X线征象。结论：胸部X线检查是诊断肺透明膜病的主要方法,对其诊断及治疗有重要意义。     

14例肺曲菌病临床,X线与纤支镜检

１４例肺曲菌病临床、Ｘ线与纤支镜检湖南省湘乡市人民医院内科（４１１４００）胡清平湖南医科大学湘雅医院呼吸科瞿素洁肺曲菌病过去认为是一种少见病，近年来本病的发病率有所增加，本文报告近５年来经纤维支气管镜刷检、活检确诊为肺曲菌病１４例，分析临床、Ｘ线与纤...     

新生儿肺透明膜病的X线分析

目的：提高对新生儿肺透明膜病的X线影像学诊断的认识。材料与方法：选择临床确诊,X线表现典型37例进行分析。结果：胸片显示的网状、颗粒状影、两肺野透亮度减低和支气管充气征为本病的主X线征象。结论：X线检查对本病的诊断、预后及发现并发症具有重要的价值。     

骨外骨肉瘤的X线诊断(附4例报告)

目的:提高对骨外骨肉瘤的X线表现的认识。材料与方法:选择临床确诊、X线表现典型4例病例进行分析。结果:其X线主要表现是大的软组织肿块及斑片状或小结节状的瘤骨、临近骨骼无变化。结论:X线照片对该病变的显示、诊断及判断预后具有重要的价值。     

Endobronchial tuberculosis manifested as obstructive airway disease in a 4-month-old infant

Tuberculosis is becoming a more prominent pediatric disease, but there are few recent reports of endobronchial involvement. We have presented the case of a 4-month-old infant with symptomatic obstructive airway disease due to Mycobacterium tuberculosis. Endobronchial tuberculosis usually follows 2 to 3 months of antituberculous therapy. This case is especially unusual because the endobronchial disease developed before diagnosis or therapy. Endobronchial tuberculosis should be considered in any patient with symptoms or roentgenographic findings of obstructive airway disease. Bronchoscopy is the best technique for diagnosis and follow-up of endobronchial tuberculosis.     

气管、支气管结核误诊原因及早期诊断方法的探讨

目的探讨气管、支气管结核的误诊原因及其早期正确诊断的方法。方法回顾性分析150例被误诊的气管、支气管结核患者的临床资料、误诊原因和诊断方法。结果临床症状缺乏特征性,以刺激性干咳为主(75.0%),其次为间断性咯血、发热、胸闷、气促等,结核中毒表现不明显或缺如;临床影像学无典型性,可表现为正常、斑片状阴影、肺不张、阻塞性肺炎、肺门影增大和肺门肿块等;误诊疾病主要为肺癌并肺不张(49.0%)、肺炎(23.3%)和支气管炎(17.3%),其他依次为肺结核、支气管扩张症、结核性胸膜炎和哮喘等;支气管镜下表现为肉芽增殖型(36.7%)、炎症浸润型(28.0%)、溃疡坏死型(24.0%)、瘢痕狭窄型(11.3%)。病变部位以左肺(49.4%)多于右肺(37.2%),左支气管受累比例最大(22.7%),病变遍及所有叶段支气管;150例中经支气管镜活检诊断131例(87.3%),毛刷涂片抗酸染色细菌学诊断41例(27.3%)。结论气管、支气管结核在临床症状、影像学和结核菌痰检学方面缺乏特征性,极易误诊。误诊的主要原因是临床医师对该病认识不足和不重视或放弃支气管镜检查。支气管镜活检和刷检是目前诊断气管、支气管结核最可靠和最准确的方法,值得临床医师推广应用。     

Primary sclerosing cholangitis

Primary sclerosing cholangitis is a chronic, cholestatic disease affecting the biliary tree. Recent data suggest an autoimmune etiology. Clinical findings, roentgenographic characteristics, and compatible liver histology will help in establishing the diagnosis. There is no known treatment for cure, though relief of symptoms may be accomplished with certain drugs, such as antibiotics for cholangitis and cholestyramine for pruritus. Death usually ensues within five to seven years after diagnosis, as a consequence of liver failure, cholangitis, and cholangiocarcinoma.     

Oriental cholangiohepatitis: Preoperative radiographic and ultrasonographic diagnosis

The recent influx of immigrants from Southeast Asia into the United States has increased the likelihood of encountering unusual diseases heretofore rarely seen in this country. Among these disorders is Oriental cholangiohepatitis, a potentially life-threatening process whose early diagnosis is facilitated by roentgenographic findings. Ultrasonography can also provide useful information, although potential pitfalls in diagnosis should be recognized.     

The diagnosis of cor triatriatum sinistrum in children: a continuing dilemma

Cor triatriatum (CT) is a rare congenital cardiac anomaly. The salient clinical, roentgenographic, electrocardiographic, echocardiographic, and hemodynamic findings are presented in two asymptomatic children and one with nonspecific dyspnea on exertion. Two male children had a classical form of cor triatriatum with normal physical and inconsequential roentgenographic and electrocardiographic findings. One of the male patients had surgery for a large atrial septal defect ostium secundum (ASD 2 degrees) and pulmonary hypertension in infancy. The female patient had CT with a communicating accessory chamber to right atrium and a rare patent foramen ovale. Her clinical findings confirmed an atrial level shunt. All patients had excision of the fibromuscular membrane from the right and left atrial transseptal approach with excellent results and with no recurrence during 2 to 4 year follow-up. We report the dilemma encountered in the clinical diagnosis of CT in children and the pivotal role played by echocardiography in the diagnosis of this anomaly.     

A reappraisal of clinical, roentgenographic, and endoscopic features of the Zollinger-Ellison syndrome

Recent experience with 40 patients with the Zollinger-Ellison syndrome at all Mayo Clinic suggests that traditional clinical criteria for diagnosis are often absent or invalid. Patients are younger have a shorter duration of symptoms, and often present without prior gastric surgery. Clinical, roentgenographic, and endoscopic findings indistinguishable from those of idiopathic duodenal ulcer or erosive duodenitis were the only presenting features in half of the patients in this series. Therefore, increased diagnostic use of serum levels of gastrin and gastric analysis appears desirable, particularly in patients selected for elective surgical treatment of duodenal ulcer disease, because specific therapeutic approaches may be required.     

Extrapleural hematoma: A recognizable complication of central venous pressure monitoring

Variations in the roentgenographic appearance of an extrapleural hematoma are discussed using an illustrative case. Information for making the diagnosis based on radiographic findings is provided.     

地方性氟骨症X线征象

目的分析地方性氟中毒骨骼改变的X线表现特点,探讨氟骨症相关影响因素.方法 88例地方性氟骨症患者和45例健康人作为研究对象,全部拍摄了头颅、胸部、腰椎、骨盆、前臂、双手及下肢平片.分析其X线平片所见,进行诊断及分型和分度.结果 88例地方性氟骨症患者X线平片可见不同程度的骨质异常改变,57例表现为骨小梁粗大,骨小梁呈纱布状或粗网状,严重者骨小梁融合而消失,代之以骨质硬化,为硬化型,占64.8%.26例表现为骨小梁稀疏、模糊,骨密度普遍减低甚至椎体呈双凹、楔形变和骨盆变形,分为疏松型及软化型,占29.6%.混合型5例,占5.6%.病变以头颅和骨盆的损害最常见,各个部位的损害不平行且各有特点.骨骼损害的程度与年龄和当地氟含量有关.结论地方性氟骨症的X线表现有骨硬化、骨疏松、骨软化和骨旁软组织骨化等多样性改变,掌握其基本X线特征并结合流行病学史是诊断和鉴别诊断的关键.