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Methods: 1. Experimental laparoscopic liver resection: We selected pigs as experimental models aiming to approach human beings physiological and anatomical condition. After CO2 pneumoperitoneum was established, the ligaments around liver were dissociated. Livers were cut off by the methods such as clamp dissection, microwave tissue coagulator, ultrasound dissector, Ligsure dissection, hand-assisted, short abdominal incision laparoscopy-assisted, and Endo-GIA switcher. The operation time and bleeding volume were compared between different methods of laparoscopic liver resection. The advantages and limitations of different methods were summarized. 2. Clinical laparoscopic liver resection: 15 cases with tumors in segment V of anterior right lobe or segments II, III of left lateral lobe or segment IV of left internal lobe were selected in this study. The liver diseases included hepatocellular cancer, hepatic cavernous hemangioma and hepatic focal nodular hyperplasia. The ligaments around liver were dissociated after CO2 pneumoperitoneum established. Laparoscopic liver resection were carried out by some of the methods combined such as clamp dissection, microwave tissue coagulator, hand-assisted, short abdominal incision laparoscopy-assisted, ultrasound dissector, rotation and suction dissector.

1、实验性腹腔镜肝切除:以猪为实验动物,旨在接近人体的生理、解剖环境下进行实验,建立操作空间后游离肝脏周围韧带,采用钳夹分离切肝法、微波刀切肝法、超声刀切肝法、Ligsure切肝法、手辅助腹腔镜肝切除法、小切口腹腔镜辅助切肝法、Endo-GIA切肝法等方法实施腹腔镜下肝切除,比较不同切肝方法的手术时间、出血量,总结各种方法的优越性及其局限性。2、临床腹腔镜肝切除:选择肿瘤位于肝右前叶第Ⅴ段、肝左外叶第Ⅱ、Ⅲ段及左内叶第Ⅳ段的15例患者,病种包括原发性肝癌、肝海绵状血管瘤、肝脏局灶性增生,建立气腹后游离肝脏周围韧带,采用钳夹分离断肝、微波刀固化后断肝、手辅助腹腔镜肝切除、小切口腹腔镜辅助肝切除、超声刀断肝、旋吸断肝等多种方法分离切线肝组织,暴露管道结构,再采用高频电凝、钛夹夹闭、缝扎止血、止血纱布覆盖、氩气刀止血、生物胶止血、Endo-GIA处理等多种方法相结合处理肝断面,统计手术完成情况、手术时间、手术出血量、术后并发症及术后住院时间等,评价腹腔镜肝切除的可行性及安全性。

objective to evaluate the role of mr perfusion weighted imaging in preoperation diagnosis of meningiomas.methods mr perfusion weighted images was performed in 47 patients with meningiomas followed by conventional imaging.results the mean rcbv values of angioblastic was the highest in the parenchyma of tumor.the mean rcbv values of malignant group was the lowest.the biggest mean rcbv values among different type meningiomas was statistically significant.the biggest mean rcbv values between benign and malignant group meningiomas was statistically significant,but not in the peri-tumor edema.conclusion the rcbv values were useful in the preoperative differentiation diagnosis of different types of meningiomas.those in the peri-tumor edema were useless in the preoperative differentiation diagnosis of different types of meningiomas.

目的 探讨磁共振灌注成像技术对脑膜瘤术前分型及良恶性鉴别的临床应用价值。方法对47例脑膜瘤病人行mr灌注成像检查,对5种亚型的良性脑膜瘤的mr灌注成像进行分析,并与非典型性及恶性脑膜瘤进行比较。结果血管瘤型脑膜瘤实质部分的rcbv值均数最高,恶性组脑膜瘤的rcbv值均数最低。各亚型间瘤体实质最大rcbv值均数间差异有统计学意义(p<0.05),良恶性脑膜瘤实质部分最大rcbv值均数间差异有统计学意义(p<0.05)。瘤周水肿区的rcbv值均数间差异无统计学意义(p>0.05)。结论 rcbv值对脑膜瘤术前分型及良恶性鉴别有所帮助,而瘤周水肿区的rcbv值对脑膜瘤分型及良恶性鉴别未显示临床实用价值。

Aims: to assess prospectively the extent of, and predictive factors for recanalization of acute non-cirrhotic, non-malignant PVT. Between 2003 and 2006, patients were prospectively enrolled in 9 European countries, if there was radiographic evidence for a recent thrombus in the portal vein trunk or one of its main branches, and absence of cavernoma.

目的:前瞻性的估计急性非硬化非恶性门静脉血栓形成的程度和血管再通的预测因子。2003-2006年期间,前瞻性的纳入9个欧洲国家的患者,要求其在门静脉主干或一个主要分支有新近血栓的X射线证据并且无海绵状血管瘤。

Results There were 8 angiomyolipomas, 2 leiomyomas, 2 multilocular cystic nephromas, 1 hemangioma and 1 mesoblastic nephroma. Only multilocular cystic nephroma and leiomyoma have special characteristics that can be determined from RCC.

典型的平滑肌瘤和多囊性肾瘤在CT上有可与肾癌鉴别的特征性表现:平滑肌瘤为规则圆形,边界清楚,密度均匀,CT值略高于肾实质,无钙化,弱强化;多囊性肾瘤为边界清楚的包块,可见边缘锐利含多个分隔的肿块,分隔之间为囊腔,囊内容物的CT值与水相似或稍高,而错构瘤、海绵状血管瘤、慢性肾脓肿、中胚层肾瘤在CT上无法与肾癌鉴别。

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