少量气胸影像特征及诊断方式选择的卫生经济学分析

目的:总结少量气胸的影像特征,并比较不同诊断方式的卫生经济学特点。方法:以我院2015年1月至2015年12月气胸待查的患者为研究对象,随机并结合患者或监护人意见要求分为胸片正位组、胸片正斜位组。比较两组患者影像学检查结果,统计检查费用,分析两种体位X线片诊断准确性并与其他影像诊断方式的经济性进行对比。结果:125例患者确诊为少量气胸,胸片正位组60例、胸片正斜位组65例。少量气胸的斜位胸片特点以轻微肺压缩为主,肺叶清晰、肺门密度结构正常,心脏外形、大小未见异常。胸片正位组诊断准确率为51.67%(31/60),低于胸片正斜位组的95.38%(62/65),差异有统计学意义(χ~2=6.245,P<0.05)。胸片正位检查的成本-效果比高于胸片正斜位,胸片正位、胸片正斜位、CT、MRI比较,胸片正斜位组卫生经济性更高。结论:正斜位胸片检查对于少量气胸的早期筛查有着较高参考价值,且相较于CT、MRI等技术而言经济性更佳,值得推荐。     

多层螺旋CT及灌注成像对尘肺合并肺结核的诊断效果

目的:探析多层螺旋CT及灌注成像对尘肺合并肺结核的诊断效果。方法:筛选2018年11月至2020年11月经本院收治尘肺疑似合并肺结核120例患者进行研究,均进行多层螺旋CT影像及肺结核CT灌注成像检查,观察患者CT征象表现,测定并分析灌注成像参数变化,通过比对病理组织学“金标准”,分析单一及联合检查诊断效能。结果:120例尘肺合并肺结核患者,经病理证实尘肺合并肺结核86例,34例仅为单纯性尘肺;采用多层螺旋CT检查,共计有诸如多发性小结节、多发空洞、磨玻璃影、肺实变、树芽征、团块状、管壁增厚、胸膜增厚、支气管扩张及大结节影等10大征象;经CT征型分析,尘肺合并肺结核以结核球型、浸润型及空洞型多见,依次为13例、38例及23例,其他类型共计12例,较少发生;经CT灌注成像,单纯尘肺患者PF、BF及PI参数均高于尘肺合并肺结核,差异有统计学意义(P<0.05);而不同类型肺结核中,浸润型PF、BF值最高,空洞型PF值最低,结核球型BF值最低,经单因素方差分析,差异有统计学意义(P<0.05);多层螺旋CT影像、肺结核CT灌注成像单一及联合诊断Kappa值依次为0.50、0.64及0.79,均具备中高度一致性,以联合诊断一致性最好。结论:多层螺旋CT影像及肺结核CT灌注成像均可获有良好诊断效能,以联合检查诊断效能最佳。且结合临床症状,实时性分析患者CT影响及灌注参数变化,更利于尘肺合并肺结核的检出。     

头孢菌素相关性尿路可逆性结石的CT表现

目的探讨头孢菌素相关性尿路可逆性结石的CT影像表现。方法回顾性分析本院7例近期使用头孢菌素后尿路出现可逆性结石患者的病例资料。所有患者均有静脉注射头孢菌素用药史,疗程1~3 d,用药后1~6 d全腹部CT平扫显示尿路多发高密度可逆性结石影,6例停药后7~16 d腹部CT随诊显示尿路可逆性结石消失(4例)或明显减少(2例),1例行手术治疗。在CT图像上,观察可逆性结石的部位、数量、形态、密度和伴随征象,并结合相关文献进行分析。结果7例患者中,肾结石7例,双侧发生5例,单侧2例,结石均为多发,呈结节状或泥沙状;输尿管结石6例,双侧发生1例,单侧5例,其中5条输尿管各发生2枚,2条单发,结石共12枚,2枚呈结节状,10枚呈圆柱状或条状;膀胱结石3例,单发2例,呈小结节状,多发1例,呈泥沙状;2枚结石密度不均匀,其他结石密度较均匀,各个结石之间密度不甚一致,全部结石CT值范围为47~667 HU;6例患者共7条输尿管发生梗阻性尿路轻度或中度积水。结论头孢菌素相关尿路可逆性结石由于其形成时间短,结构松散,在尿路中容易铸型,CT表现具有一定特点。在怀疑头孢菌素相关尿路可逆性结石时,应注意询问用药史并应在短期内影像学复查,以便明确诊断,避免不必要的治疗并选择适当的治疗方法。     

MSCT与食道吞钡棉絮检查在食道异物诊断中的价值比较

目的:比较多层螺旋CT(multi-slice spiral CT,MSCT)和食道吞钡棉絮检查在食管异物诊断中的价值。方法:回顾性分析38例经内窥镜或手术证实的食道异物患者资料,所有患者均先行食道吞钡棉絮检查,然后行64层螺旋CT扫描。结果:38例食道异物中食道吞钡棉絮检出29例(76.3%),漏诊9例,64层螺旋CT检出37例(97.4%),包括鱼刺22例,禽畜类碎骨13例,图钉1例,肉团1例,CT还发现4例异物引起食道穿孔。结论:MSCT能清晰显示食道异物的位置、大小、形态走行、与周围组织关系及有无并发症,且检查安全、快速、无痛苦,可作为食道异物的首选检查方法。     

应用电子束CT低剂量扫描在冠状动脉CT成像病人中筛查早期肺癌

目的:探讨新一代电子束CT(e-SPEED)在行冠状动脉CT成像检查病人中联合筛查早期肺癌的扫描方法及应用价值。方法:对104例健康查体者先行肺部低剂量电子束CT扫描,扫描参数为130kV,895mA,50ms,层厚6mm,层距3mm,重建层厚3mm。平扫后再经静脉注射对比剂进行CT冠状动脉成像检查,其中48例(心率≥70次/分)行电子束CT扫描,扫描参数为Multiphase Dual方式,140kV,1010mA,100ms,层厚1.5mm;57例(心率<70次/分行16排螺旋CT扫描,扫描参数为120kV,370mA,500ms,层厚0.625mm。对比剂选用非离子型Ommipaque 350mgI/mL。肺平扫图像采用肺算法及标准算法重建,由两位放射诊断医师在工作站显示器上进行观察,统计病变检出例数并观察肺叶、段支气管显示情况;并对冠状动脉CT增强图像以VR、MIP、CINE、CTVE方式重建后进行观察,利用其薄层扫描的优势重点观察肺门结构及支气管开口情况,并观察可疑病变的强化情况。所有图像存贮至图像存储与传输系统(PACS)。结果:100%肺叶、段支气管可显示,共检出3mm以上非钙化肺结节4例,其中1例经活检证实为I期周围型肺癌。结论:在冠状动脉CT成像检查同时配合电子束CT低剂量平扫,适于联合筛查早期肺癌,并有助于提高肺内非钙化小结节及支气管细微病变的检出。     

64排CT诊断肺隔离症1例

<正>1病例资料患者,男,54岁,既往身体检查,无不舒。因健康查体胸片示:左后下纵膈旁见欠规则形阴影,行胸部CT平扫及增强扫描。影像图像如图1~图3所示:左下肺见欠规则形密度增高影,其内部见分隔样囊状低密度区,局部肺野透亮度减低,邻近肺叶内肺纹理未见明显延伸病变内。注射造影剂后见左下肺病变呈较明显强化改变,内部分隔样囊状低密度区未见明显强化改变。病变血供来自于降主动脉左后壁一孤     

合理降低螺旋CT在儿童扫描中的剂量探讨

随着多层螺旋CT的快速发展,CT检查在儿科疾病诊断中的应用日益广泛,同时患儿接受X线照射剂量也日益上升。因此,在保证图像质量的前提下尽量减少螺旋CT扫描时的辐射剂量是每位放射人员责无旁贷的任务。低剂量CT扫描技术既可以减少患儿的照射剂量,又能满足临床诊断需求,是值得推广的应用技术。     

乳腺慢性炎症X线、MRI影像分析

目的 :分析乳腺慢性炎症的X线、MRI表现,提高其诊断正确率。方法:回顾性分析26例病理或临床证实为乳腺炎患者的临床资料、乳腺X线和MR资料。结果:慢性乳腺炎主要发生在乳晕后方及周围,X线表现可分为致密型、结节型、肿块型及混合型四型。MRI病灶于T1WI呈低或等信号,T2WI呈高或等高信号,增强后病灶全部明确显示,其中区域样强化42.3%(l1/26),局灶性强化11.5%(3/26),肿块样强化7.7%(2/26),弥漫性强化7.7%(2/26),集簇环状强化30.8%(8/26);26例中,时间-信号强度曲线呈I型、Ⅱ型和Ⅲ型的百分比依次为73.1%、19.2%和7.7%;MRI诊断乳腺炎的误诊率为7.7%(2/26)。结论:区域样分布的病变呈多发簇环状强化和增强后动态曲线呈I型或II型是乳腺慢性炎症较常见的MRI表现,对乳腺炎的检出和定位诊断具有较大的临床价值,诊断需密切结合临床。     

纵隔支气管源性囊肿的CT特征及鉴别诊断

目的:分析纵隔支气管源性囊肿(Mediastinal bronchogenic cyst,MBC)的CT特征及鉴别诊断依据。方法:分析18例经病理检查确诊的MBC患者临床及影像资料,分析病变部位、CT平扫及增强扫描表现、误诊情况,据此总结MBC的CT特征与鉴别诊断依据。结果:误诊13例,误诊率为72.22%。MBC病灶最大径19~85 mm,平均(36.02±10.81)mm,均为单发病变,其中7例位于前纵膈,4例位于中纵膈,7例位于后纵膈。内部密度分型:液性密度4例,软组织密度14例(球灶型8例,不确定型6例)。增强扫描示:仅1例可见囊壁强化。18例病灶中,13例边缘清晰、完整,其余5例边缘欠光滑;不确定型病灶中,6例CT值超过60 Hu,其CT值分布范围为65~137 Hu,1例CT值未超过60 Hu的病灶可见囊壁与周围实变肺组织紧密相连,囊内密度不均匀并可见点状钙化,囊壁强化呈条片状。结论:MBC的术前误诊率较高,根据囊肿边缘光滑、密度均匀及增强扫描一般无强化的CT特征,综合与周围解剖结构的关系及临床表现,一般可达到定性诊断。     

99mTc-MDP SPECT/CT显像在原发性骨肿瘤及肿瘤样病变良恶性鉴别诊断中的应用价值

目的 探讨^99mTc-MDP SPECT/CT显像对原发性骨肿瘤及肿瘤样病变良恶性鉴别诊断的应用价值。方法 回顾性分析2014年5月—2023年5月在康复大学青岛中心医院行^99mTc-MDP全身骨显像和SPECT/CT显像的原发性骨肿瘤及肿瘤样病变患者75例,共128个病灶,所有病灶均经手术病理或活体组织检查或影像随诊获得最终诊断,对比同机SPECT、CT和SPECT/CT三种断层扫描对原发性骨肿瘤及肿瘤样病变的诊断效能。结果 128个病灶最终诊断良性病变88个,恶性病变40个,其中1例侵袭性骨巨细胞瘤,2例内生软骨瘤和1例骨软骨瘤局部恶变获得早期诊断。SPECT、CT和SPECT/CT显像对原发性骨肿瘤及肿瘤样病变良恶性的诊断灵敏度分别为70.6%(36/51)、87.2%(34/39)和97.4%(38/39),特异度分别为94.8%(73/77)、93.3%(83/89)和97.8%(87/89),阳性预测值分别为90.0%(36/40)、85.0%(34/40)和98.9%(87/89),阴性预测值分别为82.9%(73/88)、94...     

Quantitative digital X-ray imaging using frozen hydrated and frozen dried tissue sections

Application of quantitative X-ray imaging to frozen hydrated tissue sections has presented a number of major problems including lack of a suitable algorithm which could deal effectively with mass loss due to radiation damage, problems of low characteristic X-ray signal to background ratios, and provide a means of analysis of the same location in both hydrated and dried states. This paper presents details of the application of our algorithm for analysis of frozen hydrated, then dried cryosections applied to quantitative X-ray imaging, which provides relatively high precision quantitative measurement of elemental content (related to both wet and dry weight) and water content of each pixel. This algorithm largely circumvents many of the problems of analysis of frozen hydrated tissue sections. Our algorithm for X-ray imaging obtains reasonably precise quantitative measurements coupled with morphological information by trading speed and image resolution.     

Soft-X-ray damage to biological samples

X-ray damage to biological samples was investigated in the wavelength region of 2.7–5 nm, which overlaps the so-called 'water window', the wavelength range of 2.4–4.3 nm usually used in X-ray microscopy. Yeast cells and myofibrils were chosen as representatives of whole cell samples and motile protein systems, respectively. The samples were exposed to X-rays using an apparatus composed mainly of a laser-plasma X-ray source, a Wolter mirror condenser, and a sample cell. The yeast cells lost their dye exclusion ability when the X-ray flux was higher than 1 × 10⁶ photons μm⁻², while the myofibrils lost contractility when the X-ray flux was higher than 4 × 10⁵ photons μm⁻². These X-ray fluxes are lower than the flux required for the X-ray microscope observation of biological samples at a resolution higher than that of light microscopes.     

使用平行束软X光透镜的深亚微米X射线光刻

使用本实验室研制的整体平行束软X光透镜作为准直器和电子枪软X光源相配,作成了平行束软X光源,用此平行束软X光源进行了深亚微米X射线光刻实验。刻出了1.0μm～0.2μm的线条。文中对实验装置和光刻结果作了简要的介绍。     

大高宽比、高线密度X射线透射光栅的制作

利用电子束光刻、X射线光刻和微电镀技术,成功制作了面积为1 mm × 1 mm,周期为300 nm,金吸收体厚度为1 μm的用于X射线显微成像技术的透射光栅。首先利用电子束光刻和微电镀技术在Si3N4薄膜上制作周期为300 nm,厚度为250 nm的高线密度光栅掩模。然后利用X射线光刻和微电镀技术复制厚度为1 μm,占空比接近1：1,高宽比为7的X射线透射光栅。整个工艺流程充分利用了电子束光刻技术制作高分辨率图形和X射线光刻技术制作大高宽比结构的优点     

3D in-vivo X-ray microtomography of living snails

In this paper we report the first in‐vivo scanning of living snails by desktop X‐ray microtomograph with a resolution up to 10 m. Consecutive cross‐sections were acquired without destroying the specimen. Subsequently, 3D images were reconstructed. The results clearly demonstrate the possibilities of in‐vivo scanning. Processes of growth and regeneration of living snails were visualized over a period of time.     

弯晶X射线光学

近年来,人们付出很大精力研制新的具有独特性能的同步辐射装置和自由电子激光器,而飞秒激光等离子源可提供具有高峰值亮度的超短X射线脉冲,用来作为波荡器辐射的补充X射线源。此外,所有最新型的X射线源的诊断和应用也都需要专用X射线光学元件或仪器。X射线光谱测量是激光聚变应用中最重要的等离子诊断方法之一,该方法根据实验目的,可获得单色X射线图像或与空间或时间分辨相组合的高分辨率图像。已经研制出拥有多达10个环状弯晶的高精单色成像仪,用以研究激光聚变实验中的内爆过程并通过获得的数据对等离子体参数的时间分辨图做出评估。大功率飞秒激光器可提供实用的相对价格不高的大功率X射线脉冲源,但需要有发光效率,能量分布,以及热电子传输方面的信息来实现理想K层辐射线或者连续X射线输出的最大化,以便得到相当于同步辐射输出的峰值亮度。把这些新的射线源与弯晶光学元件相组合,可完成亚皮秒时间量级的衍射实验。激光泵浦的X射线探针实验已经展示了若干晶体在250 fs内的结构变化。作者所在研究所使用光线追踪和布拉格反射方法设计了1D或2D或1D与2D结合的弯晶X射线光学仪器。在仪器制备过程中,非常注重晶体完整,反射选择的优化,弯曲精确,以及成像和反射特性的测量,还使用X射线形貌相机和衍射仪对分析器晶体的相关特性做了测试。     

Desktop X-ray microscopy and microtomography

Recent developments in X-ray microtomography have made it possible to miniaturize a CT scanner into a versatile and cost-effective desktop system that fits into any laboratory environment. The possibilities of the technique are demonstrated for a range of applications. It is also shown how an existing scanning electron microscope with an X-ray detector can, with a specially developed attachment, be transformed into an X-ray microscope and microtomograph.     

非共轴掠入射X射线显微镜参数的误差分析

设计了一套由4个反射镜组成的非共轴掠入射X射线显微镜,分析了该系统的像差和成像质量。为了研制出高质量的设备,需要制定合理的加工和装配公差。研究了由于元件和结构参数(反射镜的半径,物距,掠入射角等)的误差而引起的高斯参数和像差的变化。首次用点列图和调制传递函数来定量评价图像质量降低的程度,并在此基础上制定了合理的加工和装配公差。在这些公差的约束下,研制成一套非共轴掠入射X射线显微镜,在激光引爆的惯性约束聚变的诊断实验中,用该系统获得了高质量的图像。     

Error analysis of the parameters for non-coaxial grazing X-ray microscope

A non-coaxial grazing X-ray microscope, consisting of four spherical mirrors, is designed for diagnosis of inertial confinement fusion (ICF). The aberrations and imaging quality of the microscope are analyzed. To acquire excellent imaging quality, suitable tolerances for manufacturing and assembling the microscope are necessary. This paper researches the changes of Gauss parameters and aberrations due to component and subsystem parameters (such as the radius of the mirror, angle between mirrors, grazing angle, object distance, etc.). Here, spot diagrams and modulation transfer function (MTF) are first adopted to quantitatively evaluate the imaging quality of the microscope. Suitable manufacturing tolerances of components and assembly tolerances of the system are established on the basis of the discussion and analysis. A set of non-coaxial grazing X-ray microscopes is manufactured based on the tolerances. In site tests of ICF, the images with high resolution are obtained by the microscope. __________ Translated from Optics and Precision Engineering, 2006, 14(1): 34–42 [译自: 光学精密工程]     

Quantitative X-ray imaging of labelled molecules in tissues and cells

Using cisplatin as a model system, we have been able to demonstrate the feasibility of studying the cellular and subcellular distribution of a labelled molecule containing a single atom of platinum per molecule in bone marrow. An X-ray imaging system consisting of a microcomputer, a 4pi system and a software package was interfaced with an electron microscope enabling the computer to control the beam movements as well as receive signals from the STEM and EDS X-ray detectors. X-ray imaging is useful for both tissue and samples in which the population of cells is not homogeneous. Imaging permits elemental distributions to be measured throughout the sample and not in just randomly selected areas as previously done in X-ray microanalysis. Images are created for not only the element labelling the molecule of interest but also other specified elements present.
Three types of maps for imaging labelled molecules are compared and discussed. When the original (collected) data are mapped, the elements of interest are obscured by the continuum. The maps calculated using an internal standard give a concentration distribution on the basis of volume (mmol L⁻¹ of packed cells). The maps calculated using the continuum normalization method according to Hall produces concentration distribution on the basis of mass (mmol kg⁻¹ dry weight). By recalculating using the 'Peak' or 'Hall' method the continuum problem is removed yielding quantitative images of the intracellular distribution of labelled molecules present in low concentrations.