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Problems Of Diseases Manifested By X-ray Local Opacity Syndrome, And Differential Diagnostic Algorithm For Its Solution 以x线局部混浊综合征为表现的疾病问题及其鉴别诊断算法
Pub Date : 2008-12-31 DOI: 10.5580/1af5
L. B. Naumov
Objective: Efficiency of traditional and algorithmic diagnostics comparison; Differential Diagnostic Algorithm creation for effective X-ray differential diagnostics of diseases accompanied with local opacity. Methods: Comparative evaluation of X-ray traditional and algorithmic diagnostics has been performed by principle of other equal conditions. The first stage of independent diagnostics has reflected the results of traditional medical education. The same radiograms have been used by the same examinees in the same time for repeated diagnostics with original innovative diagnostic algorithm on the second stage.Results: X-ray diagnostic algorithm significantly decreased of errors obtained at independent diagnostics. Conclusion: Traditional X-ray diagnostics based on nosological thinking is ineffective. Syndromic algorithmic X-ray diagnostics used innovative the most effective intellectual activity, therefore, optimized results radically.Definition: Differential Diagnostic Algorithm or diagnostic algorithm is the exact comprehensible to all determination about step-by-step of elementary intellectual operations and actions in the certain sequence for establishment of a diagnosis of each of all diseases manifested by the given leading
目的:比较传统诊断与算法诊断的效率;为局部混浊疾病的x线鉴别诊断建立有效的鉴别诊断算法。方法:在其他条件相等的原则下,对x线传统诊断和算法诊断进行比较评价。第一阶段的独立诊断体现了传统医学教育的成果。在第二阶段,同一考生在同一时间使用相同的x线片,采用独创的创新诊断算法进行重复诊断。结果:x线诊断算法显著降低了独立诊断的误差。结论:基于病分学思维的传统x线诊断是无效的。综合征算法x射线诊断采用创新的最有效的智力活动,因此,从根本上优化了结果。定义:微分诊断算法(Differential Diagnostic Algorithm)或诊断算法(Diagnostic Algorithm)是所有人都能准确理解的,为了建立对所有疾病的诊断,而按照一定的顺序逐步进行的基本智力操作和动作
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引用次数: 0
Cranial and Spinal involvement in Neurofibromatosis type 2 2型神经纤维瘤病累及头颅和脊柱
Pub Date : 2008-12-31 DOI: 10.5580/1b85
S. Aneja, Rishu Sangal, M. Murthy, S. Sethi
Neurofibromatosis type 2(NF-2) is an often devastating autosomal dominant disorder which, until relatively recently, was confused with its more common namesake neurofibromatosis type 1. NF2 is a distinct disease which must be separated clinically & radiologically from neurofibromatosis1. Subjects who inherit a mutated allele of the NF2 gene inevitably develop schwannomas, affecting particularly the superior vestibular branch of the 8th cranial nerve, usually bilaterally. Meningiomas and other benign central nervous system tumours such as ependymomas are other common features. Much of the morbidity from these tumours results from their treatment. As a classical tumour suppressor, inactivation of the NF2 gene product, merlin/schwannomin, leads to the development of both NF2 associated and sporadic tumours. Merlin/schwannomin associates with proteins at the cell cytoskeleton near the plasma membrane and it inhibits cell proliferation, adhesion, and migration.
2型神经纤维瘤病(NF-2)是一种常染色体显性遗传病,直到最近才与1型神经纤维瘤病混淆。NF2是一种独特的疾病,必须从临床和影像学上将其与神经纤维瘤病区分开来。遗传NF2基因突变等位基因的受试者不可避免地会发生神经鞘瘤,特别是影响第八脑神经前庭上支,通常是双侧。脑膜瘤和其他良性中枢神经系统肿瘤如室管膜瘤是其他常见特征。这些肿瘤的发病大多是由治疗引起的。作为一种经典的肿瘤抑制因子,NF2基因产物梅林/神经鞘蛋白的失活可导致NF2相关肿瘤和散发性肿瘤的发展。Merlin/schwannomin与细胞质膜附近的细胞骨架蛋白结合,抑制细胞增殖、粘附和迁移。
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引用次数: 0
Normal variants of the bicipitolabral complex in MRI of the shoulder 肩关节MRI中双头肌复合体的正常变异
Pub Date : 2008-12-31 DOI: 10.5580/2911
P. Chatterjee, J. Sureka
Variants of the bicipitolabral complex in MR imaging of the shoulder are important to recognise due to their close simulation of labral tears. Three types of the same are described.
肩关节磁共振成像中的双肩关节复合体的变异是很重要的,因为它们非常接近唇裂的模拟。描述了三种类型的相同。
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引用次数: 0
Periadrenal Bronchogenic Cyst with Intracystic Milk of Calcium 肾上腺周支气管源性囊肿伴囊内钙乳
Pub Date : 2008-12-31 DOI: 10.5580/1268
Soo-Youn Park, S. Hwang
Retroperitoneal bronchogenic cyst containing intracystic milk of calcium is extremely rare and only one case of retroperitoneal bronchogenic cyst with a small amount of milk of calcium has ever been reported. We report a case of periadrenal retroperitoneal bronchogenic cyst with intracystic milk of calciumn and its serial change into the nodular cyst wall calcifications over the course of two year. The patient was treated with laparoscopic resection of retroperitoneal bronchogenic cyst.
含有囊内钙乳的腹膜后支气管源性囊肿极为罕见,仅报道一例含有少量钙乳的腹膜后支气管源性囊肿。我们报告一例肾上腺周围腹膜后支气管源性囊肿伴囊内钙乳,并在两年内连续转变为结节性囊肿壁钙化。患者行腹腔镜腹膜后支气管源性囊肿切除术。
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引用次数: 0
Swyer-James Syndrome: X-ray and MDCT findings 斯威-詹姆斯综合征:x线和多层螺旋ct表现
Pub Date : 2008-12-31 DOI: 10.5580/96e
M. Rinaldi, T. Bartalena, G. Giannelli, L. Braccaioli
A case of Swyer-James syndrome is described with emphasis on multidetector CT (MDCT) findings and the diagnostic value of post-processing techniques. CASE REPORT A 53-year-old woman was referred to our radiology department for the onset of exertional dyspnea since 3 months. Chest X-rays showed reduced left lung volume with diminished vascular markings and hyperinflation of the right lung which was see herniating beyond the midline (Fig.1a) Contrast enhanced MDCT of the thorax was performed on a 16-slice scanner. Review of the axial images and of the multiplanar post-processed reconstructions (Fig. 1b,c) confirmed lung asymmetry and showed increased lucency of the left lung relative to the right. Left bronchial tree was patent with diffuse peripheral bronchiectasis. Left-sided pulmonary arteries were present but showed significantly decreased caliber (Fig. 1d). Radiologic findings were consistent with Swyer-James syndrome (SJS). DISCUSSION SJS is believed to represent the result of postinfectious bronchiolitis obliterans in infancy or early childhood that damages the terminal and respiratory bronchioles preventing the normal development of alveolar buds. [1] This lead to reduced lung volumes in adulthood and air-trapping. Patients may be asymptomatic or may experience cough, chronic pulmonary infections, decreased exercise tolerance, and hemoptysis. Chest x-ray findings consist of a unilateral small lung with hyperlucency and air trapping. CT aids in the differential diagnosis between SJS, bronchial obstruction and congenital vascular anomalies like unilateral pulmonary artery agenesis or scimitar syndrome, showing preserved anatomy of tracheobronchial tree and pulmonary arteries. [23] Currently available post-processing tools improve MDCT diagnostic performances; in particular the combination of multiplanar reformatted images with maximum intensity projection (MIP) is most effective in vascular imaging while minimum intensity projection (minIP) reconstructions help to disclose differences in lung attenuation and depiction of bronchial structures. [4] Figure 1 Figure 1 a. Chest X-rays showing reduced left lung volume and herniation of hyperinflated right lung (arrow) b, c. Axial CT scan and minIP coronal reconstruction reveal hyperlucency of left lung and airways patency. d. Left pulmonary arteries have strikingly decreased caliber on contrast enhanced MIP coronal reconstruction CORRESPONDENCE TO Dr. Tommaso Bartalena. Radiologia III – Pol. S.OrsolaSwyer-James Syndrome: X-ray and MDCT findings 2 of 3 Malpighi, Bologna, Italy. Via Massarenti 9, Bologna, Italy. Phone: +390516363384 Fax: +39051349797 E-mail: t.bartalena@email.it References 1. Swyer PR, James GCW. A case of unilateral pulmonary emphysema. Thorax 1953;8:133-136. 2. Marti-Bonmati L, Ruiz Perales F, Catala F, Mata JM, Calonge E. CT Findings in Swyer-James Syndrome. Radiology 1989;172:477-480. 3. Moore ADA, Godwin JD, Dietrich PA, Verschakelen JA, Henderson WR Jr. Swyer-James Syndrome: CT
本文报告一例Swyer-James综合征,重点介绍多层螺旋CT (multidetector CT, MDCT)的表现和后处理技术的诊断价值。病例报告一名53岁女性因3个月以来的用力性呼吸困难而被转介到我们的放射科。胸部x线片显示左肺体积缩小,血管标记减少,右肺过度膨胀,突出中线(图1a)在16层扫描仪上对胸部进行对比度增强MDCT扫描。回顾轴向图像和多平面后处理重建(图1b,c)证实肺不对称,显示左肺相对于右肺透明度增加。左侧支气管树未闭伴弥漫性周围性支气管扩张。左侧肺动脉存在,但直径明显减小(图1d)。影像学表现符合斯威-詹姆斯综合征(SJS)。SJS被认为是婴儿期或幼儿期感染后闭塞性细支气管炎的结果,这种疾病会损害终末和呼吸性细支气管,阻止肺泡芽的正常发育。这导致成年期肺容量减少和空气潴留。患者可能无症状,也可能出现咳嗽、慢性肺部感染、运动耐受性降低和咯血。胸部x线表现为单侧小肺透光性高、气陷。CT有助于SJS、支气管梗阻及先天性血管异常如单侧肺动脉发育不全或弯刀综合征的鉴别诊断,显示保存完好的气管支气管树和肺动脉解剖结构。[23]目前可用的后处理工具提高了MDCT诊断性能;特别是多平面重构图像与最大强度投影(MIP)的结合在血管成像中最有效,而最小强度投影(minIP)重建有助于揭示肺衰减和支气管结构描绘的差异。a.胸部x线片显示左肺体积缩小,右肺过度充气突出(箭头)b, c.轴位CT扫描和minIP冠状面重建显示左肺透光高,气道通畅。d.与Tommaso Bartalena博士一致,增强MIP冠状重建显示左肺动脉直径明显减小。放射学ⅲ- Pol。s . orsolaswyyer - james综合征:x线和多层螺旋ct表现,3 Malpighi,博洛尼亚,意大利。Via Massarenti 9,博洛尼亚,意大利。电话:+390516363384传真:+39051349797邮箱:t.bartalena@email.itSwyer公关,James GCW。单侧肺气肿1例。胸腔8:133 1953;136年。2. Marti-Bonmati L, Ruiz Perales F, Catala F, Mata JM, Calonge E. Swyer-James综合征的CT表现。放射学1989;172:477 - 480。3.Moore ADA, Godwin JD, Dietrich PA, Verschakelen JA, Henderson WR Jr.。Swyer-James综合征:8例患者的CT表现。学杂志1992;158:1211 - 1215。4. 格鲁登摩根富林明。多探测器时代的胸部CT表现与解读。[J]中华胸外科杂志,2005;20(3):563 - 564。斯威-詹姆斯综合征:x线和多层螺旋ct表现3 / 3作者信息Maria Francesca Rinaldi, MD Radiologia III, Pol。s.o orsola - malpighi Tommaso Bartalena,医学博士放射学III,波尔。s.o orsola - malpighi Giovanni Giannelli,医学博士放射学III,波尔。中华放射学杂志(3);S.Orsola-Malpighi
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引用次数: 0
Subacute Combined Degeneration Of The Cord: Lateral Column Involvement Seen On Mri –An Uncommon Finding 亚急性合并脊髓变性:Mri上见外侧柱受累-罕见的发现
Pub Date : 2008-12-31 DOI: 10.5580/2023
L. Malhotra, S. Sethi, Jaya Shankar, T. Mehta
A 46 year old man, a vegetarian, presented with acute onset of paresthesia (“pins and needles” sensation) involving both hands and feet of 15 days duration. He also complained of difficulty in walking and inability to feel the ground for the same period. There was no history of trauma, fever, vomiting, diarrhea, upper respiratory tract infection, visual disturbances, and bladder or bowel incontinence. On examination, the patient was restless and agitated but his higher mental functions were normal. There was impairment of sensation of fine touch, pin prick, joint position and vibration in both hands and feet bilaterally. All the deep tendon reflexes were exaggerated and symmetric, more so in the lower limbs; Plantars were extensor. Romberg's sign was positive. There was no evidence of motor weakness. His cranial nerves were normal. Spine was normal. Vision was normal. Other systemic examination did not reveal any abnormality.
46岁男性,素食者,表现为急性发作的感觉异常(“针和针”的感觉),涉及双手和双脚,持续15天。他还抱怨在同一时期行走困难,无法触摸地面。患者无外伤、发热、呕吐、腹泻、上呼吸道感染、视力障碍、膀胱或肠道失禁等病史。经检查,病人坐立不安,情绪激动,但高级心理功能正常。双侧手脚细触觉、针刺感觉、关节位置、震动感觉受损。深肌腱反射均呈夸张对称分布,下肢更为明显;足底是伸肌。Romberg的迹象是积极的。没有运动无力的迹象。他的脑神经正常。脊柱正常。视力正常。其他全身检查未见异常。
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引用次数: 0
Macleod syndrome presenting as hemoptysis 麦克劳德综合征表现为咯血
Pub Date : 2008-12-31 DOI: 10.5580/726
M. Singhal, R. Mathur, G. P. Vashist, V. Nangia
Macleod syndrome is an important cause of unilateral luceny on chest radiograph and usually detected incidentally on imaging done for some other reason or sometimes with respiratory problems including infections or hemoptysis. We present a case of Macleod syndrome in an adult who presented with hemoptysis due to associated bronchiectatsis.
麦克劳德综合征是胸片单侧透光的重要原因,通常在影像学检查中偶然发现,因为一些其他原因,有时伴有呼吸系统疾病,包括感染或咯血。我们提出一例麦克劳德综合征在成人谁提出咯血由于相关支气管扩张。
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引用次数: 0
Standards of angiography & percutaneous transluminal angioplasty and their application to current practice 血管造影和经皮腔内血管成形术的标准及其在当前实践中的应用
Pub Date : 2008-12-31 DOI: 10.5580/6fd
N. Khandanpour, S. Girling, P. Wilson, F. Meyer, M. Armon, J. Cockburn
OBJECTIVES To review standards of angiography and angioplasty in the light of a study of post-intervention complications. METHODSData for early (24-hours) and 30-day complications after diagnostic angiography (DA) and percutaneous transluminal angioplasty (PTA) were prospectively examined over a 28-month period. Complication rates were compared with the published standards. RESULTS758 patients were included. Major complications occurred in 1.18%. The commonest complication was haematoma (n=16, 2.11%), of which two were major. Systemic problems (nausea, vomiting, vasovagal syncope, transient hypotension and transient arrhythmias) accounted for 1.45%. Arterial occlusion, minor vessel rupture, distal emboli and renal failure constituted the remainder with an incidence of 0.66%. No pseudoaneurysms or arteriovenous fistulae occurred. The 30day mortality rate was 1.82%.CONCLUSIONThis study demonstrated lower mortality and morbidity than published standards in 2001. Standards of DA developed by the Society of Cardiovascular and Interventional Radiology (2001SCVIR) could be extended to include PTA. Pseudoaneurysm appears to be avoidable.
目的根据介入后并发症的研究回顾血管造影和血管成形术的标准。方法对诊断性血管造影(DA)和经皮腔内血管成形术(PTA)术后早期(24小时)和30天并发症进行28个月的前瞻性研究。将并发症发生率与公布的标准进行比较。结果共纳入758例患者。发生严重并发症的占1.18%。最常见的并发症是血肿(16例,2.11%),其中2例为严重并发症。全身性问题(恶心、呕吐、血管迷走神经性晕厥、一过性低血压和一过性心律失常)占1.45%。其余为动脉闭塞、小血管破裂、远端栓塞和肾功能衰竭,发生率为0.66%。无假性动脉瘤或动静脉瘘发生。30天死亡率为1.82%。结论本研究的死亡率和发病率均低于2001年公布的标准。心血管与介入放射学会(2001SCVIR)制定的DA标准可以扩展到PTA。假性动脉瘤似乎是可以避免的。
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引用次数: 0
Steroid-induced Extensive Bilateral Femoral and Tibial Bone Infarcts in a Patient with Ulcerative Colitis 溃疡性结肠炎患者类固醇诱导的广泛双侧股骨和胫骨梗死
Pub Date : 2008-12-31 DOI: 10.5580/4a6
I. Chernev, K. Yan
Osteonecrosis is a common complication of chronic or repetitive steroid treatment.A 55 year-old black man with a history of ulcerative colitis for 30 years, treated with multiple courses of steroids is presented in this clinical vignette. Multifocal extensive osteonecrosis was detected on imaging studies.
骨坏死是慢性或重复类固醇治疗的常见并发症。一个55岁的黑人男子溃疡性结肠炎的历史为30年,治疗了多个疗程的类固醇是在这个临床小特写。影像学检查发现多灶性广泛性骨坏死。
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引用次数: 0
Radiology in 2101: Future of a Radiologist or Radiology Practice 2101年的放射学:放射科医生或放射学实践的未来
Pub Date : 2008-12-31 DOI: 10.5580/1812
S. Sethi
A lot of people come up with queries on what would be the future role of radiologist. Will the role of the radiologist become more primary to the patient management than it is now or will the increasing clarity of images make him less useful, with images speaking for themselves. In my view radiologist will continue his role and probably will provide more and more information to the referring physician. His domain of knowledge will expand. In the past, the basis of radiology has resided primarily in knowledge of physics and anatomy. The future radiologist will have to provide functional and molecular imaging, as well as continued expansion of electronic imaging, computer applications, and interventional radiology. We will see an integration of functional and anatomical information and applications like MR-PET will be commonly used for brain pathologies. CT scans will become more and more faster and number of slices will increase with adaptations for radiation doses. We will do more and more endoluminal studies and seeing the inside of the blood vessels, bowel and bronchus will replace diagnostic endoscopy as we know today. May be with evolution of MR-microscopy we will encroach on the pathologists domains too. Radiologist of the future will be more efficient. Radiology volumes will increase tremendously. The average number of studies interpreted by each radiologist will be very high. Digital radiology and picture archiving and communication systems, or PACS, will offer newer more efficient solutions and will be more user friendly. Proper integration of advanced communication technology into radiology practices not only will improve our diagnostic accuracy and communication with our patients, colleagues, and referring physicians but will also provide efficiencies needed to meet the data overload that already exists. Subspecialization will become a norm, with some groups providing reports on only some subsets of patients and offer a level of expertise which referring specialists often demand. There will be an increasing role for a radiologist to participate in the globalization of medicine. The worldwide communication network or internet is making the world “Flat” and as experts in communications, radiologists should assume a leadership role in the globalization of medicine.. May be we will see some turf loss between surgeons and interventional radiologists. Already we see cardiologists and gynecologists giving some expertise into radiological procedures and diagnosis. However, this would be partly compensated by tremendous increase in the volume of such procedures. Concluding, what radiology in the 2101 will be like is a matter of opinion, I encourage all readers to send me their opinions at sumerdoc@yahoo.com
很多人都问放射科医生未来的角色是什么。在病人管理中,放射科医生的角色会比现在更重要吗?还是随着图像清晰度的提高,放射科医生的作用会越来越小,因为图像会自己说话。在我看来,放射科医生将继续发挥他的作用,可能会为转诊医生提供越来越多的信息。他的知识领域将会扩大。过去,放射学的基础主要是物理和解剖学知识。未来的放射科医生必须提供功能和分子成像,以及不断扩展的电子成像、计算机应用和介入放射学。我们将看到功能和解剖信息的整合,像mri - pet这样的应用将被广泛用于脑病理学。CT扫描将变得越来越快,切片数量将随着辐射剂量的适应而增加。我们将做越来越多的腔内研究,观察血管,肠和支气管的内部将取代我们今天所知道的诊断性内窥镜检查。也许随着核磁共振显微镜的发展,我们也将侵入病理学家的领域。未来的放射科医生会更有效率。放射学的数量将大大增加。每个放射科医生解释的研究的平均数量将非常高。数字放射学和图像存档和通信系统(PACS)将提供更新、更有效的解决方案,并将更加用户友好。将先进的通信技术适当地整合到放射学实践中,不仅可以提高我们的诊断准确性和与患者、同事和转诊医生的沟通,还可以提高效率,以满足已经存在的数据过载。专科会诊将成为一种规范,一些小组只提供某些亚组患者的报告,并提供转诊专家经常要求的专业水平。放射科医生将在医学全球化中扮演越来越重要的角色。全球通信网络或互联网正在使世界变得“平坦”,作为通信专家,放射科医生应该在医学全球化中发挥领导作用。也许我们会看到外科医生和介入放射科医生之间的一些地盘流失。我们已经看到心脏病专家和妇科医生在放射治疗和诊断方面提供了一些专业知识。然而,这将通过此类程序数量的大量增加而得到部分补偿。最后,21世纪的放射学会是什么样子是一个意见问题,我鼓励所有读者在sumerdoc@yahoo.com上给我发他们的意见
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引用次数: 0
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The Internet Journal of Radiology
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