目的 探讨强直性脊柱炎（AS）受累骶髂关节、腰椎小关节及髋关节的病变CT表现特点，以提高诊断与鉴别诊断水平。 方法 2011年1月－10月对临床确诊的强直性脊柱炎患者44例骶髂关节、28例腰椎及14例髋关节行CT扫描，回顾性分析骶髂关节、腰椎小关节及髋关节的CT表现。 结果 AS患者的CT表现特点为病变主要累及骶髂关节滑膜部的髂骨侧，腰椎小关节及髋关节则表现为关节间隙改变、关节面毛糙及囊状破坏、面下骨硬化或吸收等改变。 结论 AS骶髂关节、腰椎小关节及髋关节的CT表现具有一定特征，CT具有重要的诊断及鉴别诊断价值。
【Abstract】Objective To investigate the features of gallbladder carcinoma in two-phase spiral CT, and to analysis the values of two-phase spiral CT for the differential diagnosis between gallbladder carcinoma and chronic cholecystitis. Methods The two-phase spiral CT manifestations of 30 cases of gallbladder carcinoma, proved by surgery and pathology, and 30 cases of chronic cholecystitis were analyzed. Results According to the CT findings, the gallbladder carcinoma was categorized into 3 types: intraluminal mass of gallbladder in 6 out of 30 (20.0%）， thickening of the gallbladder wall in 11 (33.7%), and mass replacing the normal gallbladder in 13(43.4%). The most common enhancement patterns of the wall in gallbladder carcinoma were hyperattenuation during the arterial phase, while isoattenuation with the adjacent hepatic parenchyma during the venous phase; or hyperattenuation during both phases. The most common enhancement pattern of the wall in chronic cholecystitis was isoattenuation during both phases, with clear hypoattenuation linear shadow in the gallbladder fossa. Other ancillary features of gallbladder carcinomas included: infiltration of the adjacent parenchyma, local lymphadenopathy and intrahepatic metastasis. Conclusion Two-phase spiral CT scan can identify the features of the gallbladder carcinoma and is helpful for the differential diagnosis of these two different disease entities.
目的 探讨多层螺旋CT血管造影（CTA）在主动脉夹层中的诊断价值及临床应用。 方法 回顾性分析2010年2月－2011年4月35例行CTA检查的主动脉夹层患者，所有患者原始数据在图像后处理工作站采用多平面重建、容积再重建、最大密度投影等方法进行主动脉成像。由2名有经验的放射科副主任医师进行诊断。 结果 35例均可明确显示主动脉夹层的真假腔、内膜片及破裂口部位。Ⅰ型12例，Ⅱ型3例，Ⅲ型20例；累及左锁骨下动脉5例，左颈总动脉2例，无名动脉2例，腹腔干3例，肠系膜上动脉4例，左肾动脉3例，右肾动脉2例，右髂总动脉受累6例，左髂总动脉受累8例，其中双侧髂总动脉均受累4例；合并动脉瘤3例；壁内血肿4例；所有患者均显示了单一或多发破口。 结论 CTA及图像后处理技术能快速、准确地诊断主动脉夹层，为临床治疗方案选择提供重要的影像学依据。
摘要:目的:研究一种能够显示颈椎关节突关节及关节间隙的最佳投照摄影位置的方法。方法:观察50例非脊柱疾病患者,在透视下利用传统颈椎斜位的基础上,继续增大角度20°～25°,使人体冠状面与床面的夹角逐渐增大至65°～70°角的范围,此时颈椎(C3～C7)关节突关节在电视上显示最佳时,然后进行点片获取C3~C7关节突关节X线照片。结果: 经透视点片获取422个关节突关节,其中C3显示48个,C4 为96个,C5 为98个,C6 为98个,C7为82个;经统计学χ2检验,颈C3~C7关节突关节在同一椎体的不同侧面及性别间显示率无差异(Pgt;0.05)。在摄影时,笔者设计将躯干冠状面与胶片成65°～70°角的范围,颈椎略呈屈曲位,头部略向对侧外旋,使头部冠状面与胶片成45°角,中心线下移至第五椎体下缘平行射入,经透视确定位置后点片,可得到清晰的关节突关节影像,此摄影位置称可视颈椎关节突关节投照位。结论:可视的颈椎节突关节投照位置能清晰显示颈椎关节突关节及关节间隙。Abstract: Objective: To study the best projection position of cervical articular facet. Methods:The cervical facet angle which was the join angle between sagittal plane of body and the continual line of cervical facet was measured on cervical Xrayed images showed and to the film in 50 healthy people. Results: The facet angle was 65°70°,during projection, the coronal plane of body in the form of 65°70° to the film, this projection position was called cervical facet position. Conclusion: seeingredients cervical facet and its interspaces of join can be showed clearly in the cervical facet position of projection.
Objective To investigate the CT manifestations of acute pancreatitis (AP) and its complications and to evaluate the imaging modalities for staging the severity of AP. Methods Literatures on CT manifestations of AP and its complications and severity staging of AP were reviewed.Results CT has shown an early overall detection rate of 90% for pancreatic necrosis with close to 100% sensitivity 4 days after episode. The CT severity index has shown a bly positive correlation with the development of local complications and mortality of AP.Conclusion Contrastenhanced CT is the imaging modality of choice to help detect pancreatic necrosis, stage the severity of the inflammatory processes, and depict local complications.
ObjectiveTo investigate the X-ray diagnostic significance of calcification of the breast tumor without mass. MethodsMammograms of 90 cases of breast tumor without mass confirmed pathologically were retrospectively analyzed. There were 55 cases confirmed benign breast tumor, and the rest cases were breast cancer. The shape, distribution, total number, location of calcifications in the breast, and asymmetric dense of the breast were recorded and watched. Results①The X-ray findings of calcification in benign breast tumors always presented as coarse granular (31), scattered shape (35) with small number, less with the asymmetric dense of the breast (7), and the change of side with axillary lymph node (2). ②Meanwhile, fine sand-like (32), showing the cluster-like distribution (24) with larger number, with the asymmetric dense of the breast (24) and the change of side with axillary lymph node (10). Both of the differences of the calcifications (the shape, the distribution, and the total number) were statistically significant (Plt;0.05). ConclusionsThe calcifications of benign and malignant breast tumors have their unique X-ray characteristics. And there is a great value in differentiating early benign and malignant breast tumor.
ObjectiveTo investigate the relation between mammographic density (MD) and the efficacy of neoadjuvant chemotherapy (NACT) for patients with breast cancer. MethodsThe clinicopathologic data of patients diagnosed with breast cancer in the Affiliated Hospital of Southwest Medical University from January 2019 to December 2021 and met the inclusion and exclusion criteria of this study were collected. According to the 5th edition of the Breast Imaging-Reporting and Data System, the MD was classified into 4 categories: a, b, c, and d. Based on the pathological evaluation systems of Miller-Payne and Residual Cancer Burden, the new and improved pathological criteria was structured including the residual cancer cell and lymph node statuses to evaluate the pathological changes of breast cancer after NACT. After adjusting the factors affecting MD, the original model (only including MD categories as independent variables), the minimum adjustment model (adding age, body mass index, and menopausal status as independent variables), and the fully adjusted model (further including estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, axillary lymph node status at the initial diagnosis, and NACT regimen) were used to analyze the relation between MD and NACT effect. In the 3 models, the MD category a was used as the reference. ResultsA total of 287 patients with breast cancer were enrolled in this study. Thirty-eight, 76, 114, and 59 of whom with MD category a, b, c, and d respectively, and 14, 74, 117, and 82 of whom with grade L1, L2, L3, and L4 of NACT effect respectively. No matter in integrated patients or premenopausal patients, the results of the fully adjusted model showed that, the regression coefficient of MD classification was negative, and with the increase of MD classification, the odds ratio was <1 and showed a decreasing trend. ConclusionsFrom the results of this study, the increase of MD classification may have a negative impact on the effect of NACT. Namely, effect of NACT is poor in integrated patients or premenopausal patients of whom with higher MD. MD can be used as a predictor of NACT effect, so as to guide doctors in the selection and individual management of neoadjuvant therapy, and improve the prognosis of patients with breast cancer.
Objective To verify the effect of palatoplasty with or without velopharyngeal muscular reconstruction on the velar movement through the lateral radiography. Methods From October 1988 to October 2000, 62 patients with cleft palate and velopharyngeal insufficiency were treated. Of them, 32 were repaired by velopharyngeal muscular reconstruction (group A) and 30 by modified von Langenbeck’s procedure (group B). The lateral radiographs and cephalometric analysis were taken. The velopharyngeal closure, velar extensibility, the angle changes of velar elevation, the distance changes of velar levator eminence based on anatomy (LEA) to velopharyngeal closure line (VCL), the varieties in LEA, the comparison of LEA and velar levator eminence based on phonation (LEP), the distance comparison between posterior nasal spine (PNS) to LEA and LEP through soft palate line (SPL) were measured. Results During the phonation, group A was significantly greater than group B in the velopharyngeal closure rate(Plt;0.01)， the velar extensibility(Plt;0.05) and the location comparison between LEA and LEP(Plt;0.01); group B was significantly greater than group A in velar elevation angle (Plt;0.05), the varieties in LEA(Plt;0.05). In velar rest position, the distance of LEA to VCL was greater inB group than in A group(Plt;0.01). There was significant difference in thedistance comparison between LEA and LEP(Plt;0.05), difference between LEA and LEP(Plt;0.01) and the distance PNS-SPL-LEA and PNSSPL-LEP(Plt;0.05) within group B; contrary to the results within group A(P＞0.05). Conclusion The velopharyngeal muscular reconstruction in palatoplasty can result in a near normalizationof anatomic measurement of velar levator muscles and improve the velar functionand velopharyngeal competence. Repositioning of velar muscles in a more anatomic correct, transverse position is more important to improve the velar length andaccordant velar movement with velopharyngeal muscles in functional palatoplasty. The velar angle change and velar elevation during phonation are not determinative factors for velopharyngeal competence.