【摘要】 目的 探讨青海玉树地震伤员损伤影像学表现及其诊断价值。 方法 2010年4月15-16日，对83例玉树地震伤员进行影像学表现分析。 结果 胸部损伤33例，四肢损伤32例，脊柱损伤22例，骨盆损伤15例，头颅及颌面部损伤12例，腹部损伤7例，仅软组织挫伤13例。 结论 影像学检查结合患者临床表现能快速、准确、有效对地震性损伤进行临床诊治。【Abstract】 Objective To observe and investigate the manifestations and diagnostic value of radiological features for the injured in Yushu earthquake. Methods From 15th to 16th April, 2010, 83 patients who were injured in Yushu Earthquake underwent CT or DR examinations. Results In 83 patients, chest injury was found in 33, limb injury was in 32, spinal injury was in 22, pelvic injury was in 15, head and maxillofacial injuries were in 12, abdominal injury was in seven,and single soft tissue injury was in 13. Conclusion Radiological examination can exactly, quickly and effectually diagnose the injuries caused by the earthquake.
摘要:目的:探讨5·12汶川8.0级地震中颅面部外伤的影像学表现特点。方法: 回顾性分析自2008年5月12~31日因地震颅面部外伤在我院行CT、MRI检查的伤员251例,其中CT检查248例,MRI检查16例。结果:放射检查阳性162例,阳性率为64.54%,以40～49岁年龄组最多,为53例,其中男性41例。在放射检查阳性中,多发伤112例(约69.13%),多类型颅面部外伤同时并存103例(约63.58%)。主要损伤发生率依次为软组织损伤(35.50%),骨折(22.94%),脑挫裂伤(21.21%),硬膜下及硬膜外血肿(10.40%),其它(共约9.92%)。结论: 地震造成颅面部外伤人群主要为40～49岁中年男性,多发伤、多类型颅面部外伤多见,并以软组织损伤、骨折、脑挫裂伤、硬膜下及硬膜外血肿较常见。Abstract: Objective: To describe the imaging features of head and face injured patients after the Wenchuan earthquake. Methods: The radiological information of 251 victims who were suspicious of head and face injury and underwent CT or MRI examinations from 12 May to 31 May 2008 was analysed retrospectively. There were 248 and 16 cases underwent CT or MRI examinations respectively. Results: One hundred and sixtytwo cases(64.54% )were positive. There were 53 cases in the 4049 years old age group, of which 41 were male. In patients with positive findings, 112 cases (about 63.58%) were comprised of several types of head and face injury. The incidence of the main injury type included: soft tissue injury (35.50%), fracture (22.94%), cerebral contusion (21.21%), subdural and epidural hematoma (12.40%), others (9.92%). Conclusions: The males with head and face injury in 4049 years old group were the major injured people in this earthquake. Head and face injury accompanied by multiple system injuries, the existence of several types of head and face injury at the same time were common. Among all the injury types, soft tissue injury, fracture, contusion, subdural and epidural hematoma were relatively commom.
Objective To introduce the imaging modalities used for the evaluation of postoperative complications of orthotopic liver transplantation (OLT) and to present the imaging findings of these complications. Methods The literatures related to the imaging methods and imaging manifestations of OLT complications were reviewed. Results Ultrasound was the initial imaging technique used for the detection of complications in the early postoperative period. Spiral CT and MRI yielded more accurate and comprehensive evaluation of postoperative complications in later stage. So far, there had been no specific imaging findings to suggest rejection reaction. The spectrum of imaging manifestations of OLT complications, such as vascular complications, biliary complications, liver parenchymal complications, and so on, were summarized and illustrated. Conclusion Imaging examination (especially ultrasound, spiral CT and MRI ) plays an important role in the evaluation of postoperative complications of OLT.
近年胰腺癌的发病率明显增加，过去10年，美国及欧洲的发病率已达到8/10万～12/10万，我国与其相近似。胰腺癌的治疗效果至今却难以令人满意，5年生存率无显著提高。主要的原因是由于胰腺的位置深在，胰腺癌又缺乏特异性的临床表现，早期诊断非常困难，大多数患者到医院就诊时已属于Ⅱ、Ⅲ、Ⅳ期肿瘤。治愈的唯一可能性是肿瘤的外科切除，但根治性手术切除率仅为18.6%，5年生存率在0～24%。未治疗者中位生存期为6～8个月。目前，随着影像学技术、内窥镜和腹腔镜超声等多项检查手段的应用与普及，对胰腺癌能否切除可以做出较准确的术前评估，这对合理地选择治疗方法，提高手术切除率，避免不必要的“开腹探查”有着重要的意义。
Liver transplantation；Imaging evaluation；Donor；Recipient
ObjectiveTo evaluate the imaging examination in the diagnosis of periampullary carcinoma. MethodsA retrospective analysis of 125 patients with pathologically proven periampullary carcinomas enrolled in Zhongshan hospital between Jan. 1991 and Dec. 2000. ResultsThe accuracy of BUS or CT was higher than that of ERCP in patients with pancreatic head carcinoma (P=0.044,P=0.029, respectively). The accuracy of ERCP was higher than that of BUS or CT in patients with duodenal papillary carcinoma (P=0.005,P=0.03, respectively). The accuracy of ERCP was higher than that of BUS or CT in patients with ampullary carcinoma (P=0.157,P=0.282, respectively). The accurary of MRCP was 8/8,8/9 respectively in patients with duodenal papillary carcinoma and ampullary carcinoma. ConclusionBUS+CT is the manner of choice in the diagnosis of pancreatic head carcinoma, ERCP is suitable for nonpancreatic periampullary cancer. MRCP should be applied widely in the near future.
ObjectiveTo study the diagnostic value of imaging examinations and their accuracy in evaluating the malignant obstructive jaundice and their resectability. MethodsThe clinical data of 674 malignant obstructive jaundice within 10 years were collected and analyzed.ResultsFor BUS, CT, PTC, ERCP and MRCP, the preoperative accuracy in malignant obstructive jaundice were 74.0%, 86.5%, 88.4%, 92.9% and 94.0%, while the ratio of actual removals in those who had been assessed removable preoperatively were 63.4%, 68.5%, 86.8%, 87.3% and 93.9%, respectively. Conclusion MRCP， PTC, CT and ERCP are better than BUS in the diagnosis of malignant obstructive jaundice (P＜0.05 vs. P＜0.01), while MRCP，ERCP and PTC are much better than BUS and CT in evaluating resectability (P＜0.01). Combination of two or more imaging examinations can improve the accuracy of preoperative diagnosis and assessing resectability.
Objective To investigate the value of different imageology methods in the diagnosis of acute pulmonary thromboembolism (PTE).Methods 22 cases diagnosed acute PTE in the last two years were retrospectively analysed，including 4 cases diagnosed by clinical signs and symptoms who did not perform further examinations due to severity of the disease (2 cases confirmed by autopsy)，18 cases diagnosed by either two methods of computed tomographic pulmonary angiography (CTPA)，ultrasound，radioisotope scanning of lung and pulmonary arteriography.The diagnostic positive rate of different methods were measured.Results 15 of the 18 subjects were performed CTPA，with a positive rate of 80.0% (12/15).Nuclide detection was performed in 14 cases，in which 5 cases were performed simple pulmonary infusion scanning，9 cases by lung ventilation/perfusion scanning，resulted in a positive rate of 92.9% (13/14).10 cases were performed nuclide phlebography on the low extremity simultaneously，deep phlebothrombosis was found in 5 subjects，and unnormal formation of collateral circulation，blocked blood circulation，stenosis of lumens，and valve disfunction et al were found in other 5 cases.16 cases were performed heart color ultrasound detection，in which 2 were found normal，one was directly found thrombus，and the other 8 cases were found indirect manifestations of acute PTE，including right ventricular enlargement，pulmonary artery hypertension，tricuspid backstreaming et al，with a diagnosing rate of 56% (9/16).Deep phlebothrombosis was found in 6 of the 10 cases who were performed color Doppler ultrasonography on the lower extremity，and one was found with valve function impaired.Conclusions CTPA possesses high positive rate in diagnosing acute PTE with promptness，convenience and reliability，thus can be taken as the front-line detection device.Radioisotope scanning of lung associated with same-time phlebography on the low extremity also has fairly high positive rate to diagnosing acute PTE and make it easy.
Objective To analyze the clinical presentations and radiological characteristics of pathologically proved cases of cryptogenic organizing pneumonia(COP).Methods The clinical and radiological features of 8 patients with COP confirmed by open lung biopsy were analyzed.Treatment and follow-up data were also recorded.Results There were 5 male an 3 female patients aged 37 to 68 years.Dyspnea，cough and inspiratory crackles were the most common symptoms and signs.Various computed tomography findings including ground glass opacities,pathy consolidation with air bronchograms，nodules and reticulation were simultaneously observed in the same patient.The diagnostic imaging features of COP were patchy or lobar consolidation，often by a predominantly subpleural distribution，and irregular band-like opacities distributed along the bronchovascular bundle or located in the subpleural area.All patients were treated with corticosteroids and yielded significant improvement in seven cases.Conclusions COP could be diagnosed by clinical and radiological findings and histopathological examination was needed for confirmed diagnosis.In general，COP responds well to glucocorticoid therapy and has a benign prognosis.