目的 探讨基于单个最大层面(2D)及体积(3D)感兴趣区(ROI)的ADC直方图参数在区分肺良性及恶性孤立性实性病灶的价值。方法 本回顾性研究共纳入69例肺部孤立性实性病变患者,其中恶性56例,良性13例。所有患者术前均采用MRI、DWI(b=600 mm/s²)检查,使用OK软件获取病灶最大截面面积(2D)及体积(3D)ADC直方图特征参数值。运用ROC曲线比较两种测量方法的鉴别效能。结果 2D、3D直方图大部分参数在肺良恶性病变组间差异具有统计学意义(P＜0.05),其中以ADC 50分位数(50^th)、75分位数(75^th)、90分位数(90^th)为著(P＜0.001)。2D直方图中的ADC 75^th 及3D直方图中的ADC 50^th有较好诊断效能(AUC分别为0.891、0.894)。当3D ADC 50^th取1.41×10^-3 mm²/s时,诊断的准确性最高,敏感度为80.00%,特异度为92.86%。ADC 最大值(maximum)、ADC 25分位数(25^th)及峰度组间差异无统计学意义(P＞0.05)。结论 2D及3D ADC直方图在肺部病变鉴别有一定价值,其中以3D直方图的ADC 50^th最佳。

Objective To investigate the value of ADC histogram parameters measured by 2D and 3D ROI in distinguishing benign and malignant solitary solid pulmonary lesions (SPL). Methods A total of 69 patients with SPL were included in this retrospective study, including 56 patients with malignant disease and 13 patients with benign disease. All patients underwent preoperative MRI and DWI (b=600 mm/s²) examinations. The ADC histogram parameters of the lesion from 2D and 3D ROI were obtained by OK software. ROC curve was used to compare the discriminative efficacy of these two methods. Results Most parameters of 2D and 3D histogram showed a statistically significant difference between benign and malignant pulmonary lesions (P<0.05), especially ADC 50 quantiles (50^th), 75 quantiles (75^th) and 90 quantiles (90^th) (P<0.001). The ADC 75^th in 2D histogram and ADC 50^th in 3D histogram had better diagnostic efficiency (AUC were 0.891 and 0.894, respectively). When the ADC 50^th of 3D histogram was 1.41×10^-3 mm²/s, the accuracy of diagnosis was the highest, with a sensitivity of 80.00% and a specificity of 92.86%. There were no significant differences in ADC maximum, 25^th and kurtosis among groups (P>0.05). Conclusion Both 2D and 3D ADC histograms had a certain value in the diagnosis of SPL, and ADC 50^th of 3D histogram showed the best efficacy.

目的 基于防控要求,快速建立临时隔离病区,合理优化影像学检查,更好的加强病区的管理工作,控制新型肺炎、防止交叉感染。方法 基于我院现有条件、人员、检查设备,结合抗击SARS经验,合理调整病区布局,建立有效的就诊,分诊,转运机制,明确工作职责,优化检查流程,放射检查防控等。结果 自新型肺炎临时病区建立以来,无1例医护人员感染和院内交叉感染。结论 思想重视,认真落实分诊,就诊;转运措施得当,科学防控,一站式,一体化,快速有效的检查方式,快速建立临时隔离病区,防止交叉感染的发生。在防控COVID-19新型肺炎中可以发挥巨大作用。

Objective Based on prevention and control requirements, to establish temporary isolation of ward quickly, rationally optimize medical imaging examinations and strengthen the management of ward to control the novel pneumonia, and prevent cross infection. Methods Based on the existing materials conditions, personnels, and examination equipments of our hospital, combined with the experiences of fighting against SARS, we rationally adjust the layout of the ward, establish an effective consultation, triage, and transfer mechanism, clarify job responsibilities, optimize examination procedures, and take strict prevention and control measures of medical imaging examinations. Results Since the establishment of the COVID-19 temporary ward, there was no cases of medical staff infection and nosocomial infection. Conclusion Highly valued opinion, conscientiously implements triage-visit-transportation measures, scientific prevention and control, one-stop-integrated fast and effective examination procedures and quickly establishement of a temporary isolation ward have played a huge role in preventing and controlling COVID-19.

目的 分析睾丸非肿瘤性病变的超声与CT诊断价值。方法 回顾性分析58例经临床病史、超声、CT或病理证实的睾丸非肿瘤性病例,结合临床病史,分析其超声与CT表现,包括炎性(或感染性)病变、外伤性病变、先天性病变及扭转急症。结果 所有病例均行CT检查,睾丸炎症性病变共39例(包括一般性炎症,脓肿和结核),其中19例行超声检查;睾丸外伤8例,隐睾9例,睾丸扭转2例,均行超声检查。睾丸炎症性病变临床表现为患侧或双侧阴囊不同程度的红、肿、痛,或白细胞升高、其他脏器伴发结核,超声表现为睾丸体积不同程度增大,根据炎症坏死程度不同,回声表现为回声均质、回声减低、回声不均质,坏死灶内无血流信号;CT表现为睾丸体积增大,根据炎症性病变的不同可表现为睾丸轻度强化、环形强化,可伴有睾丸鞘膜积液、点状钙化或积气;睾丸外伤均有阴囊外伤史,根据受伤程度表现为白膜下血肿、实质出血、睾丸破裂;隐睾表现为睾丸位置异常或缺如;睾丸扭转表现为睾丸短时间内剧烈疼痛,并进行性加重,超声表现为“镯环征”,CT表现为精索扭转、水肿,睾丸实质水肿。结论 睾丸非肿瘤性病变超声与CT征象均具有特征性,结合患者病史可作出准确诊断。超声检查较为便捷,CT检查可免除受检者接触性疼痛、可对盆腔及腹腔进行更为全面的观察。

Objective: Discussion on diagnosis of testicular non-tumorous lesions by ultrasound and CT.Methods: Rretrospective analysis of 58 testicular non-tumor cases proved by clinical history, Ultrasound, CT or pathologically,combined with the clinical history, and analysis of the Ultrasound and CT features,including inflammatory or infectious disease, traumatic disease, congenital disease and acute torsion.Results: All cases were examined by CT,the testicular inflammatory lesions were 39 cases, 19 of them were examined by ultrasound; testicular trauma 8 cases,cryptorchidism 9 cases, testicular torsion in 2 cases, all of them were examined by ultrasound. The clinical symptom of the inflammatory lesions of the ipsilateral or bilateral scrotum with different degrees of red, swollen, painful, or leukocytosis, other organs associated with TB, Ultrasound showed the testicular volume increased to varying degrees,according to the degree of inflammation and necrosis, the echo showed homogeneous echo, echo reduction, echo heterogeneity, and no blood flow signal in the necrotic area.CT showed an increase in testicular volume, according to the different inflammatory lesions showed mild enhancement of testis, ring enhancement, with a hydrocele, calcification or gas; testicular trauma had scrotal trauma history, according to the severity of injury showed subcapsular hematoma, hemorrhage and rupture of testis; testicular cryptorchidism showed abnormal position or absent; testicular torsion showed testicular short time severe pain, and progressive, Ultrasound showed “bracelet ring sign”, CT showed testicular torsion, edema, testicular parenchyma edema.Conclusion: Ultrasound and CT features of testicular non-tumorous lesions are characteristic, and the accurate diagnosis can be made with the combination of the patient's clinical history. Ultrasound examination is more convenient, CT examination can relieve the patient's contact pain, can be more comprehensive observation of the pelvic and abdominal.