影像学诊断罕见发生于鼻咽部的颈部坏死性筋膜炎临床案例分析

本文介绍1例罕见的发生于鼻咽部的颈部坏死性筋膜炎（CNF）。该患者以顽固性慢性化脓性中耳炎就诊,进行包括CT、MRI及PET/CT在内的影像学检查,均误诊为鼻咽癌。最终该患者通过鼻咽肿物活检术确诊为CNF。本文通过回顾性分析该患者的影像学表现及误诊原因,总结出CT、MRI、PET/CT在CNF早期诊断中的特征和要点,为其临床精准诊断提供重要的帮助。      

小肠空气灌肠双源CT检查与胶囊内镜小肠检查对比研究

目的:探讨小肠空气灌肠双源CT检查对小肠疾病的诊断价值。方法:15例临床怀疑小肠病变的患者,行双源CT检查前或后3天内行胶囊内镜检查。其中,男8例,女7例,年龄最大者42岁,最小者23岁。症状主要为腹痛10例,脓血便4例,不明原因消瘦1例,病程最长4年,最短1月。结果:胶囊内镜未见异常8例,双源CT检查亦未见异常;双源CT诊断克罗恩病4例,与胶囊内镜及临床诊断一致;胶囊内镜可疑肿瘤3例,双源CT发现2例并作出良恶性诊断,其中1例为空肠间质瘤,1例为回肠腺癌,经手术病理证实;仅1例胶囊内镜可疑3cm大小肿瘤,双源CT未见异常,结合MRI检查及临床,证实为假阳性。结论:小肠空气灌肠双源CT检查,不仅可以显示小肠器质性病变范围、与邻近结构的关系,而且可以结合临床鉴别炎性病变与肿瘤性病变,并对肿瘤性病变做出良恶性鉴别;还可以为胶囊内镜所见病变定位及排除假阳性问题。     

CT与MRI诊断颅内孤立性纤维瘤临床案例分析

颅内孤立性纤维瘤（ISFT）是一种间叶组织来源的梭形细胞肿瘤,临床表现依据病程和肿瘤发生部位不同表现各异,发病罕见,影像及临床医生对其缺乏全面认识,术前误诊率高。本文报告1例颅内孤立性纤维瘤病例,52岁男性,临床表现为头痛及双下肢无力;CT及MRI影像学检查诊断为左侧听神经瘤。后经术后病理组织活检确诊为ISFT。患者术后1年半复查,左侧面神经麻痹,左侧面部憋胀,余无明显不适。本文回顾性分析该患者的影像学表现及临床资料,旨在总结此种罕见病的CT及MRI影像表现,以提高医生的术前诊断准确率,为临床精准治疗提供重要的帮助。     

慢性胰腺炎的影像检查方法及诊断进展

慢性胰腺炎（CP）是一种胰腺慢性进展性炎症,常导致胰腺功能持续性受损,其临床表现无特异性,一般需要结合影像表现综合诊断。影像检查不仅有助于该病的早期诊断、评估病变严重程度,而且对指导治疗有重要意义。本文就慢性胰腺炎的影像检查方法和诊断进展综述如下。      

自动推注碘水结肠造影术的应用价值

目的:探讨自动推注碘水结肠造影术在小儿结肠及小肠病变中的应用价值。方法:收集我院临床怀疑下消化道病变的55例患儿,均采用自动推注碘水结肠造影检查发现结肠及小肠病变。结果:自动推注碘水结肠造影直观显示病变所在部位。诊断为先天性空肠狭窄5例,先天性空肠闭锁并细小结肠10例,先天性回肠闭锁并细小结肠20例,先天性细小小肠2例,先天性肛门闭锁并直肠会阴瘘4例,先天性巨结肠12例,结肠息肉2例。结论:自动推注碘水结肠造影检查简单、安全、快速且有效,不仅是诊断小儿结肠及小肠病变最好的方法,而且可以减少患儿及陪护家属的放射性辐射损伤。      

MSCTU成像技术在小儿先天性肾输尿管发育异常中的临床应用

目的:探讨三聚氰胺奶粉事件超声普查发现肾输尿管不明原因积水扩张后,经多层螺旋CT尿路造影检查后找到积水原因,得出影像诊断分析结论。方法:超声筛查均无尿路结石,但肾输尿管不明原因积水扩张,所有病例行多层螺旋CT尿路造影成像技术诊断分析,15例经手术证实。结果:多层螺旋CT尿路造影成像技术诊断,60例小儿主要为先天性肾输尿管发育异常致肾输尿管积水扩张及一侧肾缺如、异位。分析CT表现,多层螺旋CT尿路造影对泌尿系发育异常的诊断正确率为98.3%(59/60),优于传统静脉肾盂造影及超声检查(p0.05)。结论:超声检查应作为一种泌尿系统先天性疾病的筛查手段,而多层螺旋CT尿路造影作为泌尿系统先天性疾病的重要检查方法。多层螺旋CT尿路造影具有快速、无创、分辨率高等优点,结合多种图像后处理技术,能直观、立体显示泌尿系的全过程,是诊断泌尿系先天发育异常的理想方法,具有极高的临床应用价值。     

CT冠状动脉造影应用于急性胸痛临床实践研究进展

急性胸痛是一个重要的公共卫生问题,它可以造成高昂的医疗成本支出,并显著影响人民健康。急性冠脉综合征是急性胸痛血管性病变的主要原因,影像学检查可以快速、有效地对血管性病变进行排查诊断。本文主要就CT冠状动脉造影在急性胸痛中的临床实践做一综述。      

3种不同肠道准备方法在CT小肠造影中的应用研究

目的:探讨3种不同肠道准备方法在CT小肠造影（CTE）中的应用价值。方法:对156例临床怀疑为小肠病变而行CTE的病例进行前瞻性研究。156例随机分为A、B和C组各52例,肠道造影剂均采用口服法。A和B两组在扫描前16h进食半流质饮食,并均以番泻叶6g导泄,扫描前12h禁食,扫描前1h起每隔15min A组尽量口服等渗甘露醇、B组同法尽量口服引用水。C组扫描前6h禁食,扫描前1h起每隔15min尽量口服饮用水。3组均在口服对比剂10min后进行CTE检查。统计比较3组小肠的充盈效果及对小肠病变的诊断价值。结果:小肠充盈效果比较A组最佳,B组次之,C组最差;对小肠病变的诊断结果显示A组对小肠各段病变的诊断价值均较显著;B组对十二指肠、空肠病变诊断价值较大,对回肠的细小病变诊断效果较差;C组对十二指肠及空肠上段病变诊断效果较好,但不利于空肠上段以远细小病变的诊断。结论:充分的肠道准备是CTE的重要技术因素,分次口服等渗甘露醇尽量充盈小肠有利于小肠病变的显示,是一种安全可靠、经济方便的肠道准备方法。      

CT在新型冠状病毒肺炎诊断与鉴别诊断中的应用价值

新型冠状病毒肺炎已在全世界多个国家暴发,如何提升早期筛查率成为疫情防控的重点。计算机断层扫描（CT）在中国新冠肺炎的早期筛查及疾病监测中发挥了重要作用,因此,提升广大影像医生对肺炎诊断的准确性尤其重要。本文旨在述评CT在新冠肺炎筛查中的应用价值、诊断及鉴别诊断要点,比较新冠肺炎与其他病毒性肺炎、细菌性肺炎等的CT表现差别,以期在今后的疫情防控中CT可以发挥更好的作用,帮助即早发现并隔离病患。      

增强CT成像对肝窦阻塞综合征的诊断价值

目的:探讨增强CT成像对肝窦阻塞综合征（HSOS）的诊断价值。材料和方法:收集临床和影像诊断为HSOS的6例（男2例,女4例）纳入本研究,所有患者均行增强CT检查,观察分析增强CT成像上肝实质、肝脏相关血管及其他扫描范围相关影像变化,并参考肝脏血管超声、血管造影或增强MR检查结果,总结分析HSOS增强CT的特征。结果:CT平扫6例均表现肝脏肿大,肝实质密度不均匀减低。增强后6例均表现为“斑片状”或“地图样”异常强化,1例除此之外还可见特征性的以第二肝门为中心沿三支肝静脉周围“放射状”异常强化。5例三支肝静脉均未见显示,1例肝左静脉未显影,肝中静脉和肝右静脉变细成线样改变。下腔静脉肝段3例重度狭窄,3例稍受压,但所有病例经肝脏血管超声、血管造影或增强MR检查均证实肝静脉及下腔静脉血流通畅。结论:CT平扫所显示肝脏肿大、密度不均匀减低和增强扫描所显示肝实质“斑片状”或“地图样”异常强化或特征性的以第二肝门为中心沿三支肝静脉周围“放射状”异常强化特点有助于HSOS的诊断。但增强CT对诊断肝静脉和下腔静脉肝段是否狭窄或闭塞有一定的局限性。      

Chert–clastic sequence in the Cretaceous Shimanto Accretionary Complex on the central Kii Peninsula,SW Japan

Ocean plate stratigraphy (OPS) within an ancient accretionary complex provides important information for understanding the history of an oceanic plate from its origin at a mid‐ocean ridge to its subduction at a trench. Here, we report a recently discovered chert–clastic sequence (CCS) that comprises a continuous succession from pelagic sediments to terrigenous clastics and which constitutes part of the OPS in the Akataki Complex within the Cretaceous Shimanto Accretionary Complex on the central Kii Peninsula, SW Japan. As well as describing this sequence, we present U–Pb ages of detrital zircons from terrigenous clastic rocks in the CCS, results for which show that the youngest single grain and youngest cluster ages belong to the Santonian–Campanian and are younger than the radiolarian age from the underlying pelagic sedimentary rock (late Albian–Cenomanian). Thus, the CCS records the movement history of the oceanic plate from pelagic sedimentation (until the late Albian–Cenomanian) to a terrigenous sediment supply (Santonian–Campanian).     

Leatherback turtles: The menace of plastic

The leatherback, Dermochelyscoriacea, is a large sea turtle that feeds primarily on jellyfish. Floating plastic garbage could be mistaken for such prey. Autopsy records of 408 leatherback turtles, spanning 123 years (1885-2007), were studied for the presence or absence of plastic in the GI tract. Plastic was reported in 34% of these cases. If only cases from our first report (1968) of plastic were considered, the figure was 37%. Blockage of the gut by plastic was mentioned in some accounts. These findings are discussed in the context of removal of top predators from poorly understood food chains.     

Lagrangian coherent structures in the California Current System – sensitivities and limitations

We report on numerical experiments to test the sensitivity of Lagrangian coherent structures (LCSs), found by identifying ridges of the finite-time Lyapunov exponent (FTLE), to errors in two systems representing the California Current System (CCS). First, we consider a synthetic mesoscale eddy field generated from Fourier filtering satellite altimetry observations of the CCS. Second, we consider the full observational satellite altimetry field in the same region. LCS are found to be relatively insensitive to both sparse spatial and temporal resolution and to the velocity field interpolation method. Strongly attracting and repelling LCS are robust to perturbations of the velocity field of over 20% of the maximum regional velocity. Contours of the Okubo–Weiss (OW) parameter are found to be consistent with LCS in large mature eddies in the unperturbed systems. The OW parameter is unable to identify eddies at the uncertainty level expected for altimetry observations of the CCS. At this expected error level, the FTLE method is reliable for locating boundaries of large eddies and strong jets. Small LCS features such as lobes are not well resolved even at low error levels, suggesting that reliable determination of lobe dynamics from altimetry will be problematic.     

Controlling factors on the submarine canyon system: A case study of the Central Canyon System in the Qiongdongnan Basin,northern South China Sea

Based on an integrated analysis of high-resolution 2D/3D seismic data and drilling results, this study analyzes the tectonic-sedimentary evolution of the Qiongdongnan Basin (QDNB) since the late Miocene, and discusses the controlling factors on the formation and development of the Central Canyon System (CCS). The sediment failures caused by the relative sea level falling might have discharged deposits from the slope to the canyon. The two suits of the infillings, i.e., turbidites and mass transport complex (MTC), were derived from the northwestern source and northern source, respectively. The sediment supplies, which differ significantly among different areas, might have led to the variations observed in the internal architectures. Tectonic transformation around 11.6 Ma had provided the tectonic setting for the CCS and formed an axial sub-basin in the central part of the Changchang Depression, which could be called the rudiment of the CCS. The tectonic activity of the Red River Fault (RRF) at about 5.7 Ma might have strengthened the hydrodynamics of the deposits at the junction of the Yinggehai Basin (YGHB) and the QDNB to trigger a high-energy turbidity current. The MTC from the northern continental slope system might have been constrained by the Southern Uplift, functioning as a barrier for the infillings of the CCS. Thanks to a sufficient sediment supply during the Holocene period and the paleo-seafloor morphology, the relief of modern central canyon with the starving landform in the eastern Changchang Depression might have been accentuated by deposition of sediments and vertical growth along the canyon flanks, where collapse deposits were widely developed. Corresponding to the segmentation of the CCS, the forming mechanisms of the canyon between the three segments would be different. The turbidite channel in the head area had likely been triggered by the abundant sediment supply from the northwestern source together with the fault activity at about 5.7 Ma of the RRF. The formation and evolution of the canyon in the western segment were caused by combined effects of the turbidite channel from the northwestern source, the MTC from the northern continental slope, and the paleo-seafloor geomorphology. In the eastern segment, the canyon was constrained by the tectonic transformation occurring at approximately 11.6 Ma and the insufficient sediment supply from the wide-gentle slope.     

Potential acidification impacts on zooplankton in CCS leakage scenarios

Carbon capture and storage (CCS) technologies involve localized acidification of significant volumes of seawater, inhabited mainly by planktonic species. Knowledge on potential impacts of these techniques on the survival and physiology of zooplankton, and subsequent consequences for ecosystem health in targeted areas, is scarce. The recent literature has a focus on anthropogenic greenhouse gas emissions into the atmosphere, leading to enhanced absorption of CO₂ by the oceans and a lowered seawater pH, termed ocean acidification. These studies explore the effects of changes in seawater chemistry, as predicted by climate models for the end of this century, on marine biota. Early studies have used unrealistically severe CO₂/pH values in this context, but are relevant for CCS leakage scenarios. Little studied meso- and bathypelagic species of the deep sea may be especially vulnerable, as well as vertically migrating zooplankton, which require significant residence times at great depths as part of their life cycle.     

MSCT对十二指肠憩室诊断价值的探讨

目的：探讨MSCT对十二指肠憩室的诊断价值。方法：对23例多层螺旋CT扫描发现的可疑十二指肠憩室患者,在一周内进行上消化道造影对照检查。结果：23例中CT与GI共同显示憩室22例,检出率95．6％（22／23）,CT表现为十二指肠窗内囊袋状含气结节影,突出于肠管小弯侧壁外,结节内可见气液平,残留内容物较多时呈网状阴影。结论：MSCT检查快速、安全性高,可提供更多的诊断信息。     

岱海水位下降原因分析

应用ＧＩＳ软件ＡＲＣ／ＩＮＦＯ,建立太湖流域海面－地面变化信息系统,并与数据采集系统,图像处理系统和计算机系统相结合,研究对本区人类社会经济发展,区域规划,工程建设和人民生活产生重大影响的气候,海面,地面变化和区域环境变迁。采用长江三角洲地区邻近海域２１世纪前半期地区性ＲＳＬ上升幅度预测方案进行研究,结果表明：随着海面的不断上升和太湖流域地面沉降的加剧,２０００年和２０５０年,太湖流域处于高潮位以