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find Keyword "影像学特点" 4 results
  • CLINICAL MANIFESTATION AND QUANTITATIVE ANALYSIS ON ROENTGENOGRAPHY OF UNKNOWNETIOLOGY OSTEOARTHRITIC DISEASE IN CHONGZHOU CITY OF SICHUAN PROVINCE

    Objective To investigate the clinical manifestation and radiological features of unknownetiology ostearthritic disease in Shigeng village of Chongzhou city in Sichuan province so as to lay a basis for further study. Methods The data were analyzed retrospectively. The epidemiology investigation, physical examination, movement functional assessment, lab test and X-ray examination were performed on 116 villagers of 3 years and more than. Quantitative analysis on roentgenography was conducted. Results Sixty-four villagers had unknown ostearthritic disease,the prevalence was 55.2%;17 patients were limp, the prevalence of limp was 26.6%,onset age mainly focused under 40 years. Main manifestation of osteoarthritic disease was fixed pain of knee joint or hip joint, and bilateral pain was significantly more than single pain, but local fever and swelling were not obvious. Mild or moderate pain account for 73.5% of patients, and pain was aggravated after physical labor or movement and could be relieved after rest. Joint pain had no influence on joint movement function for long time, leading to a limp due to the joint functional disorders at late stage. Physical examination illustrated the flexion contracture of the hip and limitation of internal and external rotation. The Harris scores were 86.5±17.1(left hip) and 86.3±17.2. 46 (right hip), and the excellent or good result was achieved in 46 patients, fair and poor results in 18 patients. The average HSS scores were 88.4±9.3(left knee) and 88.2±11.0(right knee). The excellent or good result was achieved in 61 patients, fair and poor results in 3 patients. The X-ray films showed degenerative disorders of hip joint such as narrowing of the joint space (47.6%),articular surface sclerosis and deformation (30.2%), shallow and increased density acetabulum, increased obliquity and insuffi cient coverage of the femoral head by the acetabulum, and increased femoral neck-shaft angles. Radiological features of knee joint were bony spur or bony bridge,osteoporosis,incomplete and thickening articular surface with sclerosis and deformation,degenerative disorders. Conclusion Main clinical manifestation of unknown osteoarthritic disease in Chongzhou city was fixed pain of bilateral knee joint or combined with hip joint pain at early stage,and functional limitation in hip joint at late stage. Main radiological feature was hip joint degeneration. To effectively control the osteoarthritic disease ofthis area, much more etiology researches should be done.

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma Misdiagnosed as Pulmonary Tuberculosis:A Case Report and Literature Review

    Objective To improve the knowledge of pulmonary mucosa-associated lymphoid tissue (MALT)lymphoma. Methods A patient diagnosed as pulmonary MALT lymphoma was reported and related literatures were reviewed. Results The patient was a 58-year-old male,admitted due to intermittent fever,cough,sputum production,chest tightness and fatigue for 4 years.The patient was diagnosed as "pulmonary tuberculosis and tuberculous pleurisy" in other hospital and received anti-tuberculosis treatment for 3 years.The CT of the chest showed consolidation in the right middle lobe,right low lobe and left lower lobe with bronchial ventilation levy,miliary nodules in the right middle lobe,interstitial thickening,and right pleural effusion.Ultrasound guided lung biopsy pathology of the right lung showed diffuse small lymphocytes infiltration.The immunohistochemistry showed positive staining of CD20,CD79α and Vim,and weakly positive staining of Ki67(15%).Therefore,the patient was finally diagnosed pulmonary MALT lymphoma. Conclusions Pulmonary MALT lymphoma has no specific clinical manifestations,so is easy to be misdiagnosed as pulmonary tuberculosis,pneumonia or lung cancer.The patients with suspicious pulmonary MALT lymphoma should undergo percutaneous lung biopsy,transbronchial lung biopsy or open lung biopsy as soon as possible for immunohistochemistry staining to confirm the diagnosis.

    Release date:2016-10-12 10:17 Export PDF Favorites Scan
  • 肺放线菌病一例报告

    目的 通过分析1例肺放线菌病患者的临床特征及诊治过程,结合文献复习,加强临床医生对本病的认识,以期早期诊断、规范治疗,改善患者预后。方法 回顾性分析1例肺放线菌病患者的临床资料,以“肺放线菌病”、“放线菌肺炎”为关键词在万方数据库、中国知网数据库、中国期刊全文数据库,以“pulmonary”和“actinomycosis”为关键词在PubMed数据库检索相关文献进行文献复习,总结肺放线菌病的临床特征、影像学特点、诊断手段、治疗及预后不良相关因素。结果 患者男,53岁,因“反复咳嗽、咳痰4-个月,伴咯血15 d”入院。患者无明显肺外临床表现,内科查体未见明显异常,外院胸部CT提示左下肺团片影,两次痰液送检二代测序,均检出放线菌菌属(检出最多序列数4393),革兰阳性格雷文尼放线菌多(检出最多序列数4258)。入院后予头孢哌酮舒巴坦针静脉滴注抗感染19 d,出院后继续复方磺胺口服,随访至2021年3月患者胸部影像学提示病变已明显吸收好转。结合本例及国内外文献报道的肺放线菌病相关资料,结果显示该病中老年男性多见,口腔卫生条件不良是该病的主要危险因素,临床症状无特异性,主要表现为咳嗽、咳痰、咯血,胸部CT典型表现为团块影并空洞形成,增强后不均匀强化,病灶内见稍低密度或气体密度,经支气管活检、经皮肺穿刺或手术标本病理为主要确诊手段,近年二代测序技术已成为诊断该病的重要工具。放线菌对多种抗菌药物敏感,但抗菌药物治疗疗程长,推荐6~12个月。内科及介入无法控制的大咯血以及抗菌药物治疗长疗程前提下临床症状无缓解、胸部影像学肺部病灶无明显吸收的患者,手术可能是一种治疗选择。结论 肺放线菌病的临床特征及影像学表现均不典型,影像学上常表现为巨大团块,临床上常被误诊为肿瘤。痰液、纤维支气管镜灌洗液标本及经皮肺穿刺组织标本病原微生物二代基因测序有助于确诊。经抗菌药物治疗预后良好,对于止血药物及介入无法控制的大咯血、使用长疗程抗菌药物后临床症状仍缓解不明显或胸部影像学病变未见明显吸收的患者,手术可能是一种治疗选择。

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  • 恶性颈动脉体瘤肺转移一例并文献复习

    目的 探讨恶性颈动脉体瘤(malignant carotid body tumor,MCBT)的发病机制、临床表现、影像学特点及治疗。方法 回顾 1 例确诊 MCBT 的患者资料并结合相关文献进行复习,以“颈动脉体瘤”、“肺转移”以及“carotid body tumor”、“lung metastasis”和“pulmonary metastasis”为检索词检索中国知网、万方、Pubmed 等数据库,对相关文献进行分析。结果 患者女,20 岁,以“头晕、伴咳嗽”为首发症状,胸部 CT 示两肺多发粟粒结节,在外院诊断“肺结核”,抗结核治疗 10 d 因出现胃肠道反应停用。入院查体发现左侧下颌角无痛性肿块,结合颈动脉 CT 血管成像(CT angiography,CTA)和正电子发射计算机体层显像联合计算机体层摄影检查结果,考虑 MCBT。文献复习共纳入 36 篇文献,合计 42 例患者。患者临床表现不典型。颈动脉CTA 病变征象呈“破杯征”,典型“抱球征”消失。手术是主要治疗方法,放射治疗、化学治疗作为辅助手段,基因检测和分子靶向治疗是近年来的研究方向。结论 MCBT 临床上缺乏特征性表现,当 CT 表现为粟粒结节样肺转移瘤时,易误诊为肺结核。应对入院患者进行细致查体,可疑患者行颈动脉 CTA 等检查,诊断后尽早彻底切除肿瘤以改善患者预后。

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