Objective To analyze the status of applying diagnostic test in imaging scientific study internationally and domestically, and to compare the application of the image diagnostic studies of our country with that of abroad. Method We hand-searched the diagnosis tests published in the "Chinese Journal of Radiology", the most influential in China, and in "Radiology’’, the most influential abroad, from 1998 to 1999 respectively. Then we evaluated each of the diagnosis tests according to the international standards. Results We searched 408 original articles in "Chinese Journal of Radiology" in which the diagnostic test articles were 12%, and 796 original articles in "Radiology" with the diagnostic test articles 23% from 1998 to 1999 respectively. In these diagnosis tests, by comparing the "Chinese journal of radiology" with the "Radiology", it was found that 19% applied blind comparison with Gold Standard, 28% calculated sensitivity, specificity and accuracy, 9% both calculated negative predictive value and positive predictive value and none calculated likelihood ratios in the former versus 64%, 57%, 33% and 26% and 3% respectivdy in the latter. Conclusions Compared with the international level, both the quality and the quantity of the diagnosis tests applied in the specialty of imaging scientific study in China are much lower and far from meeting the clinical requirement. Improving the methods of scientific study and carrying on more diagnosis tests with high qualities are of important significance in improving the diagnostic level of imaging.
【摘要】 目的 探讨青海玉树地震伤员损伤影像学表现及其诊断价值。 方法 2010年4月15-16日，对83例玉树地震伤员进行影像学表现分析。 结果 胸部损伤33例，四肢损伤32例，脊柱损伤22例，骨盆损伤15例，头颅及颌面部损伤12例，腹部损伤7例，仅软组织挫伤13例。 结论 影像学检查结合患者临床表现能快速、准确、有效对地震性损伤进行临床诊治。【Abstract】 Objective To observe and investigate the manifestations and diagnostic value of radiological features for the injured in Yushu earthquake. Methods From 15th to 16th April, 2010, 83 patients who were injured in Yushu Earthquake underwent CT or DR examinations. Results In 83 patients, chest injury was found in 33, limb injury was in 32, spinal injury was in 22, pelvic injury was in 15, head and maxillofacial injuries were in 12, abdominal injury was in seven,and single soft tissue injury was in 13. Conclusion Radiological examination can exactly, quickly and effectually diagnose the injuries caused by the earthquake.
摘要:目的:探讨5·12汶川8.0级地震中颅面部外伤的影像学表现特点。方法: 回顾性分析自2008年5月12~31日因地震颅面部外伤在我院行CT、MRI检查的伤员251例,其中CT检查248例,MRI检查16例。结果:放射检查阳性162例,阳性率为64.54%,以40～49岁年龄组最多,为53例,其中男性41例。在放射检查阳性中,多发伤112例(约69.13%),多类型颅面部外伤同时并存103例(约63.58%)。主要损伤发生率依次为软组织损伤(35.50%),骨折(22.94%),脑挫裂伤(21.21%),硬膜下及硬膜外血肿(10.40%),其它(共约9.92%)。结论: 地震造成颅面部外伤人群主要为40～49岁中年男性,多发伤、多类型颅面部外伤多见,并以软组织损伤、骨折、脑挫裂伤、硬膜下及硬膜外血肿较常见。Abstract: Objective: To describe the imaging features of head and face injured patients after the Wenchuan earthquake. Methods: The radiological information of 251 victims who were suspicious of head and face injury and underwent CT or MRI examinations from 12 May to 31 May 2008 was analysed retrospectively. There were 248 and 16 cases underwent CT or MRI examinations respectively. Results: One hundred and sixtytwo cases(64.54% )were positive. There were 53 cases in the 4049 years old age group, of which 41 were male. In patients with positive findings, 112 cases (about 63.58%) were comprised of several types of head and face injury. The incidence of the main injury type included: soft tissue injury (35.50%), fracture (22.94%), cerebral contusion (21.21%), subdural and epidural hematoma (12.40%), others (9.92%). Conclusions: The males with head and face injury in 4049 years old group were the major injured people in this earthquake. Head and face injury accompanied by multiple system injuries, the existence of several types of head and face injury at the same time were common. Among all the injury types, soft tissue injury, fracture, contusion, subdural and epidural hematoma were relatively commom.
Objective To investigate the value of contrast-enhanced ultrasonography in detection and diagnosis of small primary liver cancer. Methods SonoVue-enhanced ultrasonography were performed on 353 patients with 378 primary liver cancer, less than 3 cm in diameter. Enhancement patterns and enhancement phases of hepatic lesions on contrast-enhanced ultrasonography were analyzed and compared with the results of histopathology. Results In all hepatic tumors, 96.6% （365/378） lesions enhanced in the arterial phase. Among them, 317 (83.9%) tumors enhanced earlier than liver parenchyma and 48 (12.7%) tumors enhanced synchronously with liver parenchyma, and 342 (90.5%) tumors showed early wash-out in the portal and late phases. With regard to the enhancement pattern, 329 (87.0%) tumors presented whole-lesion enhancement, 35 (9.3%) to be mosaic enhancement and 14 (3.7%) to be rim-like enhancement. If taking the whole-lesion enhancement and mosaic enhancement in arterial phase as diagnotic standard for primary liver cancer on contrast-enhanced ultrasonography, the sensitivity was 92.9%(351/378), and if the earlier or synchronous enhancement of the tumor compared with liver parenchyma in arterial phase and the wash-out in portal phase were regarded as the stardand, the sensitivity was 87.3%(330/378). Conclusion Contrast-enhanced ultrasonography could display real-time enhancement patterns as well as the wash-out processes both in hepatic tumors and the liver parenchyma. It might be of clinical value in diagnosis of primary liver cancer based on the hemodynamics of hepatic tumors on contrast-enhanced ultrasonography.
Objective To review the principles and techniques of CT perfusion imaging and its applications in the imaging diagnosis of abdominal disorders. Methods All the relevant literatures were reviewed. The principles and techniques of CT perfusion imaging were described and summarized in detail. The functional information of a target abdominal organ (e.g. the liver and pancreas) revealed by CT perfusion imaging, such as hemodynamics and microcirculation status, was also evaluated. Results In addition to the morphologic information, CT perfusion imaging can also provide functional information about the circulation parameters of target abdominal organs. Moreover, such functional information can be generated for the neovasculature and microcirculation of tumor lesions of abdominal organs, which is very helpful for not only the diagnosis, but also the evaluation of tumor invasiveness and response to treatment. Conclusion CT perfusion imaging offers an effective method for studying abdominal disorders by providing functional information that is quite useful for the differential diagnosis and assessment of therapeutic response.
Objective To introduce the imaging modalities used for the evaluation of postoperative complications of orthotopic liver transplantation (OLT) and to present the imaging findings of these complications. Methods The literatures related to the imaging methods and imaging manifestations of OLT complications were reviewed. Results Ultrasound was the initial imaging technique used for the detection of complications in the early postoperative period. Spiral CT and MRI yielded more accurate and comprehensive evaluation of postoperative complications in later stage. So far, there had been no specific imaging findings to suggest rejection reaction. The spectrum of imaging manifestations of OLT complications, such as vascular complications, biliary complications, liver parenchymal complications, and so on, were summarized and illustrated. Conclusion Imaging examination (especially ultrasound, spiral CT and MRI ) plays an important role in the evaluation of postoperative complications of OLT.
医学影像学是临床医学科学中发展较快的学科之一。为了将影像检查技术合理、高效、及时地应用于临床，为患者服务，需要影像医师与临床医师的密切合作。在具有一定学术地位和雄厚技术力量的本院放射科的鼎力支持与合作下，本刊自2003年第1期起增设“腹部影像”专栏，旨在为腹部外科医师和腹部影像医师搭建起一个学术交流的桥梁，促进相互了解、认识、渗透与合作，使腹部外科医师能及时了解到影像学检查手段的进展和影像医学的发展，又能使影像医师了解到腹部外科医师对影像检查的具体要求，从而一方面使影像学检查技术更好地为腹部外科服务，另一方面又使腹部外科促进影像学检查的合理化和提高影像诊断水平。基于这一宗旨，本栏目将着重推出一些具有特色、图文并茂的综述性文章，作为让腹部外科医师了解腹部影像学现状与进展的的窗口。同时，我们也将选登一些与腹部外科密切相关、临床实用性比较强的腹部影像学方面的原著介绍给腹部外科医师。此外，有关影像学检查的新技术、新方法以及它们在腹部疾病诊治中的临床应用的短篇文章或报道也将是我们选稿的重点。我们殷切希望，本刊增设的这一新栏目能够得到外科医师和影像医师的认可和支持，并让大家从中获得有用的信息。我们相信，在主编、各位编委和杂志编辑部的共同努力下，特别是有广大读者的支持和鼓励，背靠华西放射的雄厚技术力量，我们有信心把腹部影像专栏办好，实现它的宗旨，更好地为临床工作服务。
近年胰腺癌的发病率明显增加，过去10年，美国及欧洲的发病率已达到8/10万～12/10万，我国与其相近似。胰腺癌的治疗效果至今却难以令人满意，5年生存率无显著提高。主要的原因是由于胰腺的位置深在，胰腺癌又缺乏特异性的临床表现，早期诊断非常困难，大多数患者到医院就诊时已属于Ⅱ、Ⅲ、Ⅳ期肿瘤。治愈的唯一可能性是肿瘤的外科切除，但根治性手术切除率仅为18.6%，5年生存率在0～24%。未治疗者中位生存期为6～8个月。目前，随着影像学技术、内窥镜和腹腔镜超声等多项检查手段的应用与普及，对胰腺癌能否切除可以做出较准确的术前评估，这对合理地选择治疗方法，提高手术切除率，避免不必要的“开腹探查”有着重要的意义。
Liver transplantation；Imaging evaluation；Donor；Recipient