眼眶内血管外皮细胞瘤影像诊断及鉴别诊断

目的：探讨眼眶内血管外皮细胞瘤影像学表现,提高对本病影像学特征的认识。方法：报道1例经手术、病理证实的右侧眼眶内血管外皮细胞瘤,对其CT平扫、MRI平扫及强化表现进行分析。结果：肿瘤CT表现为右侧眶内上方球后团块状软组织密度影。MRI表现为右侧眼眶内上方球后团块状T1WI等及稍低信号,T2WI稍高信号影,动态增强扫描,动脉期及实质期有明显强化。结论：运用多种影像学检查方法,可提高对眼眶内血管外皮细胞瘤的认识,做出准确的诊断。     

项型纤维瘤的CT和MRI诊断

目的:探讨项型纤维瘤的CT和MRI特征。方法:回顾性分析8例NTF的影像学表现,病变均经外科切除和病理证实,其中2例行CT平扫检查,6例行MRI扫描,2例同时行MRI增强扫描,分析NTF的临床表现和CT、MRI征象。结果:8例肿物位于骶尾部皮下,质韧;CT和MRI显示病灶局部皮肤增厚,皮下脂肪内见片状、条索状影;CT呈稍高密度,T1WI呈低信号,T1WI压脂呈低-等信号,T2WI压脂呈低信号,DWI呈等信号,内见交错脂肪样密度或信号影;形态不规则,边界不清,无明确包膜。2例行增强扫描,均呈轻度强化。结论:项型纤维瘤的MRI和CT表现具有特征性,结合病史、症状及体征,有助于项型纤维瘤的诊断。      

成人肝脏未分化胚胎性肉瘤影像学表现

目的:探讨成人肝脏未分化胚胎性肉瘤（UESL）的CT/MRI表现及病理对照分析。资料与方法:回顾性分析经手术切除并病理证实的UESL 5例患者临床和影像学资料。结果:5例病灶均单发,4例位于肝右叶,1例同时累及肝左右叶。CT/MRI表现为边界模糊的囊实性肿块,囊壁见结节状、不规则软组织密度/信号影,内见厚壁不均分隔,CT平扫呈低密度,内见大片状液化、坏死,MRI平扫呈长T1长T2信号改变,CT/MRI增强扫描壁结节、软组织成分及囊内分隔呈轻度渐进性强化。结论:成人UESL影像表现有一定的诊断价值,有助于提高术前诊断准确率。      

CT与MR诊断鞍区原发性小圆细胞性未分化肉瘤的临床案例分析

目的：探讨鞍区原发性小圆细胞性未分化肉瘤的临床表现、病理特征及影像特点,以提高对该病的影像诊断及鉴别诊断能力。方法：回顾性分析1例经手术病理证实为鞍区原发性小圆细胞性未分化肉瘤的临床病理特征、CT及MR表现,并复习文献。结果：CT平扫示鞍区偏右侧呈稍低密度影,增强欠均匀强化,并累及邻近颅骨;MRI示T1WI呈低信号,T2WI、液体衰减反转恢复（FLAIR）呈略高信号,扩散加权成像（DWI）序列上呈高信号,信号欠均匀;增强病灶较明显强化,边缘较光整,邻近蝶鞍后床突可见骨质破坏。结论：鞍区原发性小圆细胞未分化肉瘤罕见,其临床和影像表现无明显特异性,确诊仍需依靠病理组织学检查。     

静脉脑栓塞临床表现及CT与MRI影像学分析

目的:探讨静脉脑栓塞患者的发病原因、临床表现及CT、磁共振成像(MRI)的影像表现。方法:回顾性分析8例(12处病灶)经临床及影像学联合检查确诊的静脉性脑栓塞患者临床资料。其中6例接受MRI增强扫描,部分患者接受外科手术治疗。分析其治疗前后CT平扫及MRI序列检查结果,评估其影像表现。结果:8例确诊患者中浅表型静脉性栓塞6例(单侧5例、双侧1例),临床表现为头痛、恶心、呕吐、局灶性神经功能缺损或癫痫发作;深部中央型静脉性栓塞者2例(单侧/双侧基底节丘脑静脉梗死各1例),临床表现均较轻且病情进展缓慢,预后效果较理想。12处病灶CT平扫均呈低密度影;T1WI图像呈低信号,DWI图像则呈高信号,T2WI图像呈高信号9处,混杂信号3处;6例行MRI增强扫8处病灶强化环厚薄均匀,但形态欠规则。结论:MRI相较于CT检查,能帮助医师更直观、清晰地了解静脉脑栓塞患者的病灶信息,对针对性治疗方案的拟定和预后效果的准确评估具有积极影响。      

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。     

自身免疫性胰腺炎CT及MRI表现

目的:探讨自身免疫性胰腺炎(AIP)CT及MRI表现特点,加深对此少见病的认识,提高对AIP的诊断水平。方法:回顾性分析11例经手术及临床证实为AIP的CT及MRI影像学资料,总结其影像学特征。11例全部行CT检查,其中有7例同时行MRI检查。结果:全部病例中有7例AIP表现为胰腺弥漫性肿大,4例为局限性肿大。病变胰腺CT平扫表现为等密度或稍低密度,MRI扫描在T2WI上信号轻度升高,T1WI上信号降低;增强扫描胰腺实质在动脉期强化减弱,门脉期及延迟期呈渐进性强化且强化均匀。MRI有5例显示包膜样环,CT有4例显示包膜样环,CT不能显示胰管狭窄段,MRCP有4例显示胰管狭窄段。胰腺外表现主要为:胆管壁增厚并管腔狭窄5例,脾血管包埋变细4例,肾脏受累3例,腹膜后淋巴结肿大6例,肠系膜血管周围及腹膜后纤维化各1例。经类固醇激素治疗后影像学复查显示胰腺内外病变均有不同程度好转。结论:AIP患者胰腺内、外CT及MRI表现均具有一定特征。其影像学表现结合类固醇激素治疗有效,可做出正确诊断,避免患者不必要的手术治疗。      

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。     

外伤性肝内胆汁瘤的CT与MRI表现

目的:探讨外伤性肝内胆汁瘤的CT与MRI表现特征。方法:回顾性分析10例临床证实的外伤性肝内胆汁瘤的影像资料。结果:全部病例有CT检查资料,2例病程中行MRI检查。全部病例伴肝实质挫裂伤,外伤后短期内CT或MRI检查提示肝内大片状低密度或长T1长T2信号影,随访中很快出现水样密度或信号影。其中囊状单发7例,多发3例。多发者沿胆管树呈囊袋状排列。除7例随访中渐小外,其余3例均经手术或超声或CT引导下引流治愈,其内容物均为胆汁成分。结论:认识外伤性肝内胆汁瘤CT与MRI表现特征对于诊断及进一步治疗具有重要意义。     

头颈部结外淋巴瘤的影像诊断

目的:探讨头颈部结外淋巴瘤的CT、MRI表现及临床病理特点。方法:回顾性对照分析51例经外科手术或病理证实的头颈部结外淋巴瘤患者的临床病理及CT、MRI影像资料,评价头颈部结外淋巴瘤的影像及临床病理特点。结果:51例全部为非何杰金淋巴瘤(NHL),其中来源于B细胞32例(62.75%),T细胞19例(37.25%)。原发部位最常见于鼻腔及咽环,其中鼻腔23例(45.10%),咽环(Waldeyer环)20例(39.22%),其余部位共8例(15.69%),包括眼眶3例,喉部、甲状腺各2例,腮腺1例。18例(35.29%)伴淋巴结转移。根据肿瘤形态分为3型,其中单发肿块型31例(60.78%),弥漫肿胀型17例(33.33%),溃疡坏死型3例(5.89%)。结论:头颈部结外淋巴瘤的临床病理及CT、MRI影像表现有一定特征性,影像检查可以显示病变形态、范围及淋巴结转移,结合临床特点对头颈部结外淋巴瘤的诊断、分期及指导治疗有一定价值。     

锁骨朗格汉斯组织细胞增生症的影像诊断及鉴别

目的:总结锁骨朗格汉斯组织细胞增生症（LCH）的影像表现。材料与方法:收集2005年7月至2018年12月9例（男女比4︰5,平均年龄10.5岁）手术病理证实的锁骨LCH的术前X线、CT、MRI资料进行回顾性分析。结果:有4例位于锁骨中段,2例位于锁骨外1/3段,3例位于锁骨内1/3段或中内2/3段。6例表现为纯溶骨性骨质破坏,骨皮质断裂,破坏区边缘见反应性骨质增生及层状骨痂;1例表现为虫蚀状骨质破坏,病灶膨胀不明显,边界模糊。2例病灶膨胀性生长,其内见多发骨间隔,骨包壳完整,周围无软组织肿块。4例病灶在T₁WI上呈不均匀低信号,T₂WI上呈不均匀高信号,增强扫描中度不均匀强化。结论:锁骨LCH好发于儿童,不同分期和锁骨的不同部位影像表现均不同,需和尤文肉瘤、慢性骨髓炎、浆细胞骨髓瘤等疾病鉴别。      

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。      

利用SE求取SNMR横向弛豫时间方法研究

自旋回波作为测量T₂时间的重要脉冲序列,由该脉冲系列交变磁场激发而获得的核磁共振信号不受磁场不均匀性的影响,这对于以地磁场作为稳定磁场的SNMR方法来说,可以减小地磁场不均匀对NMR信号的影响,得到真实、可信的T₂值,提高信噪比。将自旋回波信号应用到地面核磁共振找水方法中求取T₂分布,在国内尚属首例,本文借鉴核磁共振测井中的多指数反演方法,采用奇异值分解算法编程,反演得到T₂分布,并与SNMR反演软件的结果T₂*对比。结果证明,用SE信号提取T₂时间,可以减少地磁场不均匀对NMR信号的影响,更真实地反映T₂分布,提高信噪比。      

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.     

基于无人机航测的天景山断裂孟家湾地貌精细解译及活动构造定量参数提取

利用无人机摄影测量技术航测天景山断裂孟家湾的地表地形地貌数据,以获取的数字高程模型为基础,通过构造地貌精细解译进一步提取地震断层的水平位移量及垂直位错量,计算断层的平均水平滑动速率,并分析判识了古地震事件。结果表明:①研究区发育3期河流阶地T₃、T₂、T₁,且均被断错,最新的冲沟T₀未见错动;②在T₁阶地面上提取水平位移量为(7.77±0.98)m,计算得到全新世中期以来的平均水平滑动速率为0.86~0.91 mm/a;③在T₁阶地面上跨陡坎提取垂直位错量为(0.61±0.11)m,其坡度存在2个明显拐点,代表2次地表破裂型地震事件,推测在12000 a前,即晚更新世末期或全新世初期以来至少发生过2次地表破裂型地震。     

ANALYSIS OF THE LATE QUATERNARY ACTIVITY ALONG THE WENCHUAN-MAOXIAN FAULT -MIDDLE OF THE BACK-RANGE FAULT AT THE LONGMENSHAN FAULT ZONE

The Longmenshan fault zone is located in eastern margin of Tibetan plateau and bounded on the east by Sichuan Basin, and tectonically the location is very important. It has a deep impact on the topography, geomorphology, geological structure and seismicity of southwestern China. It is primarily composed of multiple parallel thrust faults, namely, from northwest to southeast, the back-range, the central, the front-range and the piedmont hidden faults, respectively. The M_S8.0 Wenchuan earthquake of 12^th May 2008 ruptured the central and the front-range faults. But the earthquake didn't rupture the back-range fault. This shows that these two faults are both active in Holocene. But until now, we don't know exactly the activity of the back-range fault. The back-range fault consists of the Pingwu-Qingchuan Fault, the Wenchuan-Maoxian Fault and the Gengda-Longdong Fault. Through satellite image(Google Earth)interpretation, combining with field investigation, we preliminarily found out that five steps of alluvial platforms or terraces have been developed in Minjiang region along the Wenchuan-Maoxian Fault. T₁ and T₂ terraces are more continuous than T₃, T₄ and T₅ terraces. Combining with the previous work, we discuss the formation ages of the terraces and conclude, analyze and summarize the existing researches about the terraces of Minjiang River. We constrain the ages of T₁, T₂, T₃, T₄ and T₅ surfaces to 3~10ka BP,~20ka BP, 40~50ka BP, 60ka BP and 80ka BP, respectively. Combining with geomorphologic structural interpretation, measurements of the cross sections of the terraces by differential GPS and detailed site visits including terraces, gullies and other geologic landforms along the fault, we have reason to consider that the Wenchuan-Maoxian Fault was active between the formation age of T₃ and T₂ terrace, but inactive since T₂ terrace formed. Its latest active period should be the middle and late time of late Pleistocene, and there is no activity since the Holocene. Combining with the knowledge that the central and the front-range faults are both Quaternary active faults, the activity of Longmenshan fault zone should have shifted to the central and the front-range faults which are closer to the basin, this indicates that the Longmenshan thrust belt fits the "Piggyback Type" to some extent.     

叁期尘肺CT表现与肺内二氧化硅含量的关系分析

目的:应用双源CT双能量扫描技术测量叁期尘肺患者肺组织内二氧化硅（SiO₂）含量及混合能量CT值,探讨SiO₂含量与其沉积部位及叁期尘肺主要CT表现的关系。结果:①尘肺组肺组织内SiO₂含量为（0.57±0.49）mg/mL,健康对照组为（0.26±0.20）mg/mL;尘肺组混合能量CT值为（-777.72±111.33）HU,健康对照组为（-829.95±112.31）HU。尘肺组SiO₂含量和混合能量CT值均高于健康对照组,组间差异均有统计学意义（P=0.00）。②比较尘肺组患者肺组织不同沉积部位间SiO₂含量和混合能量CT值,发现气管分叉下3cm层面SiO₂含量和混合能量CT值均最高,气管分叉下缘层面次之,主动脉弓上缘层面最低,提示叁期尘肺患者肺组织内SiO₂主要分布在两下肺野,由下而上其SiO₂含量逐渐减低。③比较尘肺组CT影像表现的复杂程度与SiO₂含量和混合能量CT值关系,含有5种CT征象者SiO₂含量及混合能量CT值最高,均值分别为（0.72±0.58）mg/mL及（-719.30±154.68）HU;仅含1种CT征象者SiO₂含量及混合能量CT值最低,均值分别为（0.49±0.40）mg/mL及（-809.74±105.60）HU。提示叁期尘肺患者CT表现越复杂,其肺组织SiO₂含量及混合能量CT值越高。结论:双源CT双能量扫描技术可以量化叁期尘肺患者肺组织内SiO₂含量及混合能量CT值,其混合能量CT值与SiO₂含量有关,SiO₂含量与其沉积部位的CT影像表现有关。      

致密油储层核磁共振测井响应机理研究

中国西部某盆地致密油储层孔隙结构差,而核磁共振测井T2谱宽,其复杂的核磁测井响应认识不清,且响应机理也不明确.本文基于致密油储层的特性,通过对三组岩样不同系列的实验测量,包括核磁共振、毛管压力曲线、X衍射矿物分析和润湿性实验,主要研究了碳酸盐岩矿物含量对T2谱的影响和由润湿性引起的T2弛豫机制.根据实验结果分析和讨论,明确了致密油岩石核磁共振响应的影响因素及孔隙流体的弛豫机制.综合分析认为,所述的核磁测井响应特征是由两方面因素综合作用的结果,一是水的T2信号主要取决于表面弛豫,低表面弛豫率的碳酸盐岩矿物导致水的T2信号的长弛豫分量增多;二是由于岩石亲油孔隙表面的存在且其弛豫率低于亲水孔隙表面的弛豫率,使得油的T2信号由表面弛豫和体弛豫贡献.