脑内血肿机化的CT、MRI表现及误诊分析

目的：分析脑内血肿机化的CT及MRI表现，提高其影像学诊断正确率，减少误诊。方法：回顾性分析临床及手术证实的18例脑内血肿机化的影像学资料，18例均进行了CT平扫，10例同时进行了CT及MRI检查，15例均进行了MRI或CT增强扫描。结果：5例有脑出血史，通过随访复查确诊为血肿机化。另13例术前均诊断为胶质细胞瘤，术后证实为血肿机化。结论：脑内机化的血肿常表现为混杂密度（信号），伴周边水肿，增强扫描呈花环形强化，与胶质细胞瘤影像表现非常相似，有此影像学表现的应想到血肿机化的可能。

巨淋巴结增生的CT、MRI表现

目的研究经病理学检查证实的巨淋巴结增生(CD)的CT及MRI的影像特征,以期提高正确诊断率。方法回顾性分析9例巨淋巴结增生病例的CT及MRI表现,并与手术病理学检查结果对照,总结其CT及MRI表现特征。结果9例病变分布为颈部1例、胸壁1例、纵隔5例、腹部2例,其中,局限性8例。CT表现为中等密度、动脉期明显强化、静脉期及延迟期持续强化。3例行MRI检查,表现为平扫呈等T1长T2,动脉期病变明显强化,静脉期及延迟期呈持续强化及边缘环形强化;增强扫描病变周围可见迂曲血管影。6例透明血管型病变周围可见多个反应性淋巴结增生;浆细胞1例,纵隔内多发淋巴结肿大,腋窝淋巴结肿大,增强扫描呈中等度强化。结论透明血管型CD的CT及MRI有明显的特征性,并且MRI优于CT。浆细胞型CD病变无特征性影像表现。

Diagnosis of carotid body tumor by digital subtraction angiography

Objective: To make a further understanding of the features of the carotid body tumor (CBT) by digital subtraction angiography (DSA) so as to explore the clinical value of DSA diagnosis and interventional therapy for CBT. Methods: DSA data from 12 cases of CBT were analyzed retrospectively. A consensus interpretation of the DSA appearances in all of the patients was reached after dynamic observation by 2 experienced radiologists in a double blind manner. Results: Definite diagnosis in all cases could be made by DSA. The DSA features of the CBT included bigger bifurcation angles of the internal and external carotid arteries, displacement of internal and external carotid arteries, CBT supplied by external carotid arteries in most cases and the significant increase of tumor blood vessels in bifurcation. Invasion of internal or external carotid arteries was found in 6 cases. Smaller stained area of the tumor and significantly reduced intraoperative bleeding were found after embolization of the supplying arteria in 2 cases. Conclusion: DSA is the effective method for the diagnosis and preoperative assessment of CBT. Preoperative embolization of CBT may contribute to the reduced intraoperative bleeding.

听神经鞘瘤CT、MR诊断与鉴别诊断

目的回顾总结听神经鞘瘤临床表现及CT、MRI影像表现,旨在提高听神经鞘瘤术前诊断的准确性。方法对55例病理诊断为听神经鞘瘤病例的临床资料及CT、MRI影像表现进行回顾性分析。结果55例患者中,双侧发病1例,单侧发病有54例;肿瘤伴囊变出血3例,血栓形成1例,52例密度及信号均匀,3例密度及信号混杂;38例内听道受侵犯,表现为内听道不同程度增大,部分呈漏斗状,12例患侧岩骨骨质不同程度吸收破坏,54例听神经鞘瘤外缘灶性突起并伸入内听道内,55例瘤周未见明确水肿带。55例患侧桥脑小脑角池扩大,脑桥、桥臂及小脑半球不同程度受压,第四脑室不同程度受压变形,向健侧移位,40例出现梗阻性脑积水。结论听神经鞘瘤作为桥小脑角区最常见的良性肿瘤,根据该肿瘤发病部位、密度以及信号、生长方式以及对内听道形态的改变,我们能作出明确诊断,为临床手术方案的制定提供重要意见。