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ObjectiveTo discuss the incidence,treatment and effect of cryptogenic hemoptysis (CH).MethodsPatients with CH were selected from 231 patients with hemoptysis according to clinical evaluation,chest radiography,fiberoptic bronchoscopy and CT scan,and the clinical data and treatment methods were retrospectively analyzed.ResultsFifty-three of 231 patients referred for CH,the incidence of CH was 22.94 ％ (53/231),of which 45 (45/53,84.91％ ) received internal conservative treatment and 8 (8/53,15.09％) received bronchial artery embolization (BAE).High resolution CT (HRCT) showed ground-glass opacities in 20 CH patients after hemoptysis.Bronchial arteriography showed abnormalities,including arterial enlargement and localized hypervascularity in 8 patients and systemic to pulmonary shunting in 3 patients.No recurrence of hemoptysis was observed during 1 to 8-year follow-up.ConclusionBleeding can be controlled in most of CH patients by internal conservative treatment,only a few patients with massive hemoptysis need BAE,and both treatments have good short and long term results.
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Objective To explore the causes of hepatic perfusion disorders (HPD), and to analysis the CT features of this phenomenon. Methods Nine experimental pigs were randomly divided into three groups. In Group A, B and C, intrahepatic portal, arterial branches and hepatic vein were selectively embolized, respectively. Then all animals underwent contrast enhanced CT scans immediately and after one week. Results On CT images immediately after intervention, HPD were found in all animals. Multiple transient wedge-shaped hyperattenuation represented during the hepatic arterial phase and isoattenuating areas during the portal venous phase. In group A, the site of HPD was in correspondence with the area of embolization,whereas in group B, the embolized area displayed hypoattenuation and non-embolized area displayed hyerattenuation during arterial phase. In group C, the site of HPD was correspondence with the area of embolization in two pigs, but in one pig, the region of HPD was larger than the region of embolization. After one week, HPD disappeared due to sponges absorption and the vessels reopening in group A and B. In group C which hepatic vein was coagulated by laser, HPD remained partially. Conclusion Intrahepatic vascular occlusions of portal, hepatic arterial and hepatic venous branches are the main factors that cause HPD.
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Objective To assess the therapeutic value of CT guided percutaneous radiofrequency thermal ablation(RFA)for peripheral lung carcinoma(PLC).Methods Forty-three patients with PLC were treated with RFA under the CT guidance.The patients included 26 males and 17 females,and the age ranged from 52 to 76 years.The CT guided percutaneous biopsies were performed to obtain the pathology before the procedures.Results The operations in all cases were successful,little amount of pneumothorax was found in 3 cases,liquid-pneumothorax in 1 case,and large amount of pneumothorax was drainaged in 1 case.The volume of the lesion in 40 cases from 43 patients was diminished gradually at 3 and 6 months follow-up after the procedures.No change in the volume of lesion with peripheral enhancement was seen in 3 cases.Conclusion CT guided percutaneous RFA for PLC is a safe,effective,and minimal invasive procedure.
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Objective To study the correlation between MRI features and pathology of intraspinal neruilemmoma.Methods MRIfeatures of intraspinal neurilemmomas proved by operation and pathology in 16 cases were analysed retrospectively and in comparison with the results of pathology.Results All the tumors were intradural-extramedullary in location,including 6 in the cervical regions,5 in the upper thoracic regions,3 in the thoracic-lumbar junction and 2 in the lumbar regions.On MRI,the tumors were marginate elliptical heterogeneousisointense or slightly low intense with punctate or patchy more low intensity areas on T_1WI and heterogeneous slightly high intense orisointense with punctate or patchy more high intensity areas on T_2WI.Parts of the masses obviously enhanced with no enhancement of more low intensity areas on T_1WI.All of above imaging manifestations were corresponding to pathology of intraspinal neurilemmomas.Interlace of Antoni A and Antoni B was attributed to heterogeneous intensity.Antoni B that was no obviously enhancement was concentrated in bleeding and cystic areas and Antoni A that was obviously enhancement was concentrated in cellular area and collagen.Conclusion The imaging manifestations of intraspinal neurilemmoma is due to its varied pathologic changes,and this has guiding significance to the correct diagnosis.