软骨黏液样纤维瘤的影像分析

目的:探讨软骨黏液样纤维瘤（CMF）的影像学特征。资料与方法:回顾分析18例经手术病理证实的软骨黏液样纤维瘤的影像资料，女性12例，男性6例，平均年龄30岁，范围9岁～78岁。分析其平片（15例），CT（8例）及MRI（10例）表现特征。结果:发生于股骨3例，胫骨3例，肱骨2例，掌骨2例，颞骨2例，额骨2例，尺骨1例，腓骨1例，跟骨1例和胸椎1例；10例位于长骨，其中干骺端7例，骨端2例，骨干1例；11例呈类圆形或椭圆形，4例呈分叶多房状，3例呈不规则形，均呈不同程度膨胀。CMF在平片及CT上病灶均为溶骨破坏，平片显示4例（26.67%）钙化，CT显示6例（75%）钙化；在MRI的T1WI表现为低至中等信号，T2WI表现为不均匀中高信号，其中80%（8/10）为外周中高信号，中央区高信号，增强后呈不规则环形强化，20%（2/10）呈弥漫性不均匀中高信号，增强后呈弥漫不均匀强化。结论:CMF影像表现具有一定的特征，其MRI信号及强化特点在CMF诊断及鉴别诊断中有重要作用。      

子宫癌肉瘤的MRI表现

目的:探讨子宫癌肉瘤的MRI表现特点,提高其MRI诊断的正确率。方法:回顾性分析我院2017年1月至2017年12月经病理证实的7例子宫癌肉瘤患者的MRI表现。结果:子宫体积增大,宫腔内肿块。病灶体积较大（6例最大径大于5 cm）,形态不规则,呈分叶状,边界不清晰。磁共振成像（MRI）特征:平扫T₁WI呈等低或混杂信号,T₂WI呈等、稍高混杂信号,部分合并出血。病灶实性部分DWI呈高信号,ADC图呈低信号,平均ADC值为（1.105±0.136）×10-3mm2/s。增强扫描不均匀强化,静脉期及延迟期持续强化,内部出血、囊变坏死区无强化。部分肿瘤侵犯宫颈,并向颈管内脱出。部分病灶合并盆腔和腹膜后淋巴结肿大。结论:病灶的大小形态、DWI高信号、较高的ADC值、早期及持续强化有助于子宫癌肉瘤的诊断及鉴别诊断,MRI对肿瘤浸润的深度和范围有较重要的意义。      

原发于骨上皮样血管内皮瘤的影像对比分析

目的:提高对骨上皮样血管内皮瘤(EHE)的认识和影像诊断水平。方法:回顾性分析经手术病理证实的6例骨上皮样血管内皮瘤的X线平片、CT、MR和临床病理,结合文献对比分析各检查方法的影像特征。结果:3个病例表现为多发病灶,分别位于股骨下段、胫腓骨及足部;2个病例病灶位于胫骨下段;1例病灶位于股骨近端。X线平片及CT平扫示多灶性溶骨性骨破坏、硬化边,部分病灶内见“栅栏样”骨嵴,MR上病灶呈稍长T1、长T2信号,增强后呈明显强化。免疫组化提示肿瘤细胞表达血管内皮细胞标记如CD3l、CD34、Vimentin、CK呈阳性。结论:骨上皮样血管内皮瘤有一定的影像学特征,X线平片、CT和MR检查能为临床诊断及鉴别诊断提供有价值的信息。      

非典型部位骨巨细胞瘤的影像学分析

目的:探讨X线平片、CT及MRI对非典型部位骨巨细胞瘤的诊断价值。方法:回顾性分析19例经手术病理证实的非典型部位的骨巨细胞瘤的X线平片、CT及MRI表现。其中,19例行X线平片检查,19例行CT检查,16例行MRI检查。结果:骶椎9例,坐骨4例,跖骨2例,掌骨、腕骨、肩胛骨,腰椎各1例。X线平片及CT表现:膨胀性、溶骨性骨质破坏区,无硬化边;MRI表现:病灶在T1WI常呈等-低信号,T2WI呈不均匀高信号。结论:运用多种影像检查方法,可提高对非典型部位骨巨细胞瘤的认识,做出准确的诊断。     

早期宫颈癌3.0T MRI术前评估与术后病理对照研究

目的:探讨早期宫颈癌3.0 T高场强磁共振成像（MRI）术前评估的临床应用价值。方法:回顾性分析我院20例经手术证实的早期宫颈癌（临床分期为Ⅰb和Ⅱa期）的3.0 T高场强MRI影像资料,并将其与术后病理结果对照,分析3.0 T高场强MRI对早期宫颈癌术前评估的准确率。结果:早期宫颈癌表现为宫颈部实性肿物T₁WI低信号14例（14/18）、T₂WI高信号10例（10/18）,15例（15/18）肿瘤病灶比正常宫颈肌层强化时间早（4±2.1）s,13例（13/18）肿瘤病灶时间-信号曲线（TIC）呈快速上升-缓慢下降型,术前评估分期准确率约为88.3%。结论:3.0 T高场强MRI对早期宫颈癌的诊断具有明显的临床应用价值,为选择最佳治疗方案提供参考。      

良恶性滋养细胞疾病的影像诊断与鉴别诊断

目的:探讨MRI对良恶性滋养细胞疾病（GTD）的诊断价值。方法:回顾性分析55例（良性15例,恶性40例）经临床手术病理证实GTD的MRI表现。结果:15例良性病灶均位于宫腔,子宫肌层无受累;40例恶性病灶位于宫腔26例,宫颈管2例,均伴有子宫肌层浸润;位于子宫肌层12例,位于肌层的病灶,子宫结合带连续。MRI表现为病灶呈混杂信号影,T₁WI于低信号中夹杂高信号者良性3例、恶性20例;增强扫描后40例恶性病变中10例呈动脉期强化,15例病灶分隔及实性部分中度以上强化,15例囊性病灶中央可见“暴风雪”样强化。良性均呈分隔状、渐进性持续性强化。31例恶性病变周围及肌层、宫旁可见增多增粗迂曲的流空血管影,5例良性病变宫旁见增多血管影,MR增强扫描显示清晰。结论:良恶性GTD的MRI表现具有一定特征性,可以很好的显示肿瘤侵及范围,早期有助于提示良恶性,为临床诊断及治疗提供依据。      

神经节细胞瘤的影像诊断与分析

目的:探讨神经节细胞瘤的CT及MRI表现,提高对该病的影像诊断水平。方法:收集33例经手术病理证实的神经节细胞瘤的影像学和临床资料,对其影像学表现进行回顾性分析。结果:30例单发病灶中:9例位于后纵隔（右侧5例,左侧4例）;9例位于肾上腺（右侧4例,左侧5例）;腹膜后8例;盆腔1例;咽旁间隙1例,椎管内单发2例。椎管内外多发3例,其中2例伴腹膜后、枕部及腰背部皮下多发结节。CT平扫11例为均匀低密度,平均CT值（26.1±7.2）HU,密度低于同层面肌肉,9例表现为斑点、斑片状钙化,位于病灶边缘处,2例含有脂肪密度。在19例CT增强扫描中,动脉期有6例轻度强化,静脉期有4例轻中度强化,静脉期及延迟期呈轻中度渐进性强化4例,三期呈渐进性强化4例,各期均无强化1例。MRI平扫T1WI呈低或等信号,T2WI呈高或混杂高信号,STIR多呈高信号。10例MRI增强扫描,3例均匀强化,6例呈絮状或斑片状不均匀强化,其中1例为明显不均匀渐进性强化,1例无明显强化。结论:神经节细胞瘤的影像学表现具有一定的特征性,若在肾上腺、后纵隔、椎管内外及腹膜后见,境界清楚,存在伪足或嵌入式生长,包绕大血管,增强无强化或轻度强化,在MRI T2序列见“漩涡征”的低信号病灶时,应首先考虑神经节细胞瘤。      

肋骨原发性软骨肉瘤的影像表现

目的:探讨肋骨原发性软骨肉瘤的影像学特点。方法:收集经手术病理证实的12例肋骨原发性软骨肉瘤,回顾性分析其X线、CT及MRI表现。结果:12例肋骨原发性软骨肉瘤(男性6例,女性6例)。12例肋骨原发性软骨肉瘤位于肋骨前缘肋软骨连接处7例,位于肋骨头近胸椎处4例,肋骨腋段1例。X线检查均表现为境界清楚/密度均匀的胸部肿块(左侧7例,右侧5例),邻近肋骨骨质结构变模糊。CT平扫病变处均呈溶骨性、膨胀性骨质破坏,局部软组织肿块边缘清晰伴有条状、结节状及环状钙化。CT增强扫描病变(11例)强化不明显,邻近椎体和附件表现为骨质侵蚀破坏。10例肋骨原发性软骨肉瘤接受了MRI检查,病变均表现为边界清楚的长T1、长T2混杂信号肿块,增强后不均匀环状强化。结论:钙化为肋骨原发性软骨肉瘤的特征性表现,边界清楚的软组织肿块为重要征象,环状强化为其增强CT/MRI表现特点,完善影像学检查,能明显提高诊断的准确性,指导临床手术。      

颅骨板障型脑膜瘤的影像诊断

目的：探讨颅骨板障型脑膜瘤的CT和MRI影像表现。方法：收集2012年1月至2013年6月经病理及免疫组化证实的颅骨板障型脑膜瘤病例共2例,分析其临床、病理及CT表现。结果：发生于额颞顶骨交界部1例、顶骨1例,病理证实前者为透明细胞型、后者为上皮型。前者为成骨性骨质破坏,CT表现为颅骨骨质明显增厚,边缘毛糙,内外板界限不清,部分病变内侧可见弧形钙化;后者为溶骨性骨质破坏,MRI表现为T1WI等低信号,T2WI等信号,增强扫描强化明显、均匀。结论：CT和MRI能对不同骨质破坏方式的板障型脑膜瘤的大小、形态和周围组织的侵犯程度作出较准确的诊断。     

膝关节痛风性关节炎的CT与MRI分析

目的：探讨膝关节痛风性关节炎的CT和MRI影像特征。方法：回顾分析经手术病理证实的21例膝关节痛风性关节炎的CT和MRI表现,其中12例CT,14例MRI。结果：所有病例均能发现痛风结节,CT显示45个,MRI显示48个,痛风结节位于肌腱和韧带共58个,滑膜或关节腔内15个,骨内11个,其他软组织9个。形态呈条块状31个,结节状31个,线状4个,不规则形27个。骨质破坏CT共发现21处,MRI发现24处,位于骨边缘共30处;MRI显示5处骨质破坏周围骨髓水肿。痛风结节在T1WI均呈低至中等信号;T2WI上39个呈混杂信号,6个呈高信号,3个呈低信号。在5例均行CT及MRI检查膝关节比较中：CT显示痛风结节21个,MRI显示痛风结节18个;CT和MRI在显示骨质破坏的部位均为12处,MRI显示骨髓水肿4处;MRI显示软骨异常共5处。结论：膝关节痛风性关节炎在影像上有一定的特征性,CT更容易发现痛风结节,而MRI更合适于评估软组织情况及炎性改变,综合分析两种影像资料有助于准确诊断痛风性关节炎。     

软骨母细胞型骨肉瘤的影像诊断

目的:探究软骨母细胞型骨肉瘤的X线平片、CT及MRI表现和诊断要点。方法:回顾性分析2010年1月至2020年6月我院经病理证实的软骨母细胞型骨肉瘤18例患者的病历资料,分析其X线平片、CT及MRI表现。结果:X线平片和CT显示肿瘤骨（棉絮样瘤骨12例,象牙质样瘤骨3例,针样瘤骨3例）、瘤软骨钙化（沙粒状、斑点状钙化8例,环状、半环状钙化6例）、骨膜新生骨（葱皮状9例、线状5例、层状4例,其中形成Codman三角10例）、软组织肿块18例;全部病例均出现不规则形骨质破坏,边界模糊。14例MRI增强扫描显示肿瘤病灶呈边缘强化4例,不均匀的间隔强化6例,边缘强化及间隔强化4例。结论:肿瘤骨、瘤软骨钙化、肿瘤边缘强化及间隔强化,是软骨母细胞型骨肉瘤的影像特点。合理利用影像学检查,有助于提高软骨母细胞型骨肉瘤的诊断准确率。      

眼眶肌锥内血管外皮细胞瘤的CT及MRI诊断

目的:探讨眼眶肌锥内血管外皮细胞瘤(HPC)的CT及MRI表现和病理组织学特点,旨在提高对HPC的认识。方法:结合文献复习,回顾性分析1例经手术病理证实的HPC影像学表现、病理组织学特点、治疗及预后。结果:HPC的CT表现为眼眶内软组织密度;MRI表现以等T1信号、长T2信号为主,内见特征性多发细小流空信号,眼内肌及视神经明显受压,球后脂肪间隙存在。增强扫描:病变呈不均匀强化。结论:深入了解HPC的CT及MRI表现和病理组织学特点,对HPC的诊断、治疗和预后具有重要价值。      

LATE QUATERNARY FAULTED LANDFORMS AND FAULT ACTIVITY OF THE HUASHAN PIEDMONT FAULT

Based on the 1︰50000 active fault geological mapping, combining with high-precision remote imaging, field geological investigation and dating technique, the paper investigates the stratum, topography and faulted landforms of the Huashan Piedmont Fault. Research shows that the Huashan Piedmont Fault can be divided into Lantian to Huaxian section (the west section), Huaxian to Huayin section (the middle section) and Huayin to Lingbao section (the east section) according to the respective different fault activity. The fault in Lantian to Huaxian section is mainly contacted by loess and bedrock. Bedrock fault plane has already become unsmooth and mirror surfaces or striations can not be seen due to the erosion of running water and wind. 10~20m high fault scarps can be seen ahead of mountain in the north section near Mayu gully and Qiaoyu gully, and we can see Malan loess faulted profiles in some gully walls. In this section terraces are mainly composed of T₁ and T₂ which formed in the early stage of Holocene and late Pleistocene respectively. Field investigation shows that T₁ is continuous and T₂ is dislocated across the fault. These indicate that in this section the fault has been active in the late Pleistocene and its activity becomes weaker or no longer active after that. In the section between Huaxian and Huayin, neotectonics is very obvious, fault triangular facets are clearly visible and fault scarps are in linear distribution. Terrace T₁, T₂ and T₃ develop well on both sides of most gullies. Dating data shows that T₁ forms in 2~3ka BP, T₂ forms in 6~7ka BP, and T₃ forms in 60~70ka BP. All terraces are faulted in this section, combing with average ages and scarp heights of terraces, we calculate the average vertical slip rates during the period of T₃ to T₂, T₂ to T₁ and since the formation of T₁, which are 0.4mm/a, 1.1mm/a and 1.6mm/a, and among them, 1.1mm/a can roughly represent as the average vertical slip rate since the middle stage of Holocene. Fault has been active several times since the late period of late Pleistocene according to fault profiles, in addition, Tanyu west trench also reveals the dislocation of the culture layer of(0.31~0.27)a BP. 1~2m high scarps of floodplains which formed in(400~600)a BP can be seen at Shidiyu gully and Gouyu gully. In contrast with historical earthquake data, we consider that the faulted culture layer exposed by Tanyu west trench and the scarps of floodplains are the remains of Huanxian M_S8½ earthquake. The fault in Huayin to Lingbao section is also mainly contacted by loess and mountain bedrock. Malan loess faulted profiles can be seen at many river outlets of mountains. Terrace geomorphic feature is similar with that in the west section, T₁ is covered by thin incompact Holocene sand loam, and T₂ is covered by Malan loess. OSL dating shows that T₂ formed in the early to middle stage of late Pleistocene. Field investigation shows that T₁ is continuous and T₂ is dislocated across the fault. These also indicate that in this section fault was active in the late Pleistocene and its activity becomes weaker or no longer active since Holocene. According to this study combined with former researches, we incline to the view that the seismogenic structure of Huanxian M_S8½ earthquake is the Huashan Piedmont Fault and the Northern Margin Fault of Weinan Loess, as for whether there are other faults or not awaits further study.     

睾丸原发肿瘤的CT表现及鉴别诊断

目的:分析睾丸原发肿瘤的CT影像特征.方法:回顾性分析46例经病理证实的睾丸肿瘤CT影像资料,结合其他资料对病灶做综合评估.结果:所有肿瘤均为单侧发病.精原细胞瘤24例,其中16例可见不均匀轻度分隔样强化;内胚窦瘤10例,8例可见多发迂曲、增粗供血血管;畸胎瘤4例,可见斑点状、不规则钙化,2例可见脂肪;混合性生殖细胞肿...