正常人下颌下腺的多层螺旋CT影像解剖研究

目的 研究正常人下颌下腺的多层螺旋CT(MSCT)影像解剖,为临床判断有无异常提供依据.资料与方法 选择无颈部疾病和无下颌下腺疾病、无阻塞性睡眠呼吸暂停综合征(OSAS)的健康自愿者100名(男女各50名),对下颌下腺进行MSCT扫描,应用图像后处理工作站的多平面重组(MPR)软件测量下颌下腺轴位最大截面积及左右径的大小;冠状位最大截面积及上下径的大小;矢状位最大截面积及前后径的大小;测量左右两腺体间的最近距离(腺间距)、两侧下颌下腺后缘连线与颈椎前缘的距离(腺-椎间距)并检测腺体CT值,用SPSS l0.0统计分析软件包行统计学分析.结果 冠状位和矢状位最大截面积及最大径线男女间差异有统计学意义.腺-椎间距男女差异无统计学意义;腺间距男女差异有统计学意义.儿童上下径线和腺间距小于成人.CT值同体形者男性高于女性,儿童高于成人.结论 应用MSCT扫描和图像后处理技术测量下颌下腺各截面积及各径线长度简单、廉价、易行,是对头颈部影像学研究、测量的重要补充.     

优秀击剑运动员下肢三关节等速肌力测试分析

目的:研究我国优秀击剑运动员下肢髋、膝、踝三关节肌群等速肌力表现,找出薄弱肌群。方法:国家击剑队备战2008年奥运会重点队员26名,男女各13名,年龄23.1±2.36岁。在60°/s、240°/s速度下测定运动员双侧下肢髋、膝、踝屈伸肌群等速向心峰力矩。结果发现:(1)髋关节:在240°/s下双侧伸肌峰力矩均明显低于60°/s(P<0.05),60°/s和240°/s下双侧髋关节屈肌峰力矩无显著差异(P>0.05);男运动员两个速度下前腿伸肌峰力矩均显著高于后腿(P<0.05),女运动员无显著差异(P>0.05);两个速度下,运动员双腿屈伸肌峰力矩比值低于正常。(2)膝关节:60°/s时男运动员双腿屈伸肌峰力矩有显著差异(P<0.05),240°/s时双侧伸肌峰力矩有显著差异(P<0.05),女运动员两个速度下均无显著差异(P>0.05);60°/s时,女运动员前后腿屈伸肌峰力矩比值分别为0.56和0.54,男运动员分别为0.63和0.67;240/°s时男女前后腿屈伸肌峰力矩比值均在正常范围。(3)踝关节:60°/s时男运动员前腿踝关节屈伸肌峰力矩显著大于后腿(P<0.05),240°/s时无显著差异(P>0.05);两个速度下,女运动员踝关节屈伸肌峰力矩均无显著性差异(P>0.05);运动员踝关节屈伸峰力矩比值在两个速度下均低于正常。结论:优秀男子击剑运动员下肢关节等速肌力双侧不对称,女运动员不对称表现不明显;击剑运动员下肢薄弱肌群为后腿髋关节伸肌群、股后肌群、前腿股后肌群及踝关节背伸肌群。     

MSCTA在胸廓内动脉解剖学显示中的价值

目的 探讨多层螺旋CT血管成像(MSCTA)技术对于胸廓内动脉的显示效果，并分析其解剖学关系特征。方法 选取我院行CT胸腹部血管检查患者288例，观察胸廓内动脉的走行及分支状况、测量胸廓内动脉近、中、远各段内径及胸廓内动脉长度、胸骨间距，并进行对比分析。结果 288例患者双侧胸廓内动脉的显示率为100%(576条);肋间前动脉的显示率为88.72%,胸壁穿透支的显示率为30.73%;右侧末端两分支者245例(85.07%)、三分支者24例(8.33%)、四分支者19例(6.60%);左侧末端两分支者240例(83.33%)、三分支者27例(9.38%)、四分支者21例(7.29%),两侧均以两分支型为主。双侧胸廓内动脉内径，同侧近、中、远各段内径的差异有统计学意义(P<0.05),而双侧相同段的差异无统计学意义(P>0.05);男、女在相同段的差异无统计学意义(P>0.05);双侧胸廓内动脉长度、胸骨间距的差异均无统计学意义(P>0.05);男性的胸廓内动脉长度较女性长差异有统计学意义(P<0.05),而男、女患者胸廓内动脉胸骨间距差异无统计学意义(P&g...     

胸骨上突(附7例报告)

胸骨上突属少见的解剖变异，笔者自１９９２年至今共搜集到７例。其中男５例，女２例，均为摄胸片或透视时意外发现，据我们的统计，发生概率约１。Ｘ线表现：每例均摄胸部后前位片，部分加摄斜位片或点片。其中双侧胸骨柄外上方骨性突起３例，单侧４例，均与胸骨柄骨性...     

8—17岁儿童少年股外肌肌纤维组成最大等长伸膝力量、相对肌力及肌围的研究

本文用活检一组化方法对153名8～17岁儿童少年(男80人,女73人)做了股外肌快肌纤维%(FT%)的研究,并同时测定了最大等长伸膝力量(MVC)、相对肌力(RMVC)及肌围(活检处腿围,C)。实验发现男、女儿童及全体FT%均呈近似常态分布。且性别间也无显著差异(P>0.05)。还发现8～17岁儿童少年的MVC、RMVC及C均随年龄增长而增大。肌力(MVC及RMVC)与股外肌FT%间只有低度相关(r=0.23,r=0.30;P<0.05),而肌力(MVC)与肌围间却有密切相关(r=0.69,P<0.01)。     

MSCT对囊性肾瘤的诊断价值

目的：探讨囊性肾瘤(CN)的 MSCT表现及病理特点。方法回顾性分析7例经术后病理证实的肾脏 CN MSCT 表现及病理特点。结果7例均为单侧发病,男5例,女2例,MSCT表现均为囊性病变,边界清楚,囊壁及分隔厚度均匀无附壁结节,增强扫描囊壁及分隔均匀强化,而囊内密度不均,增强扫描无强化。结论肾脏CN的 MSCT表现具有特征性。     

MSCT 3D后处理技术在儿童肋骨及肋软骨发育异常诊断中的价值

目的:应用MSCT 3D后处理技术显示儿童肋骨及肋软骨发育异常及解剖变异,比较不同后处理方法的差异。方法:对92例胸廓异常患儿行MSCT扫描,利用3D后处理技术对图像进行后处理,包括多平面成像(MPR)、最大密度投影(MIP)、表面遮盖法(SSD)及容积成像(VR)技术,比较各种后处理方法对本病的诊断价值。结果:MSCT诊断部分肋骨融合畸形17例,叉状肋16例,肋骨膨大畸形9例,部分肋骨缺如8例,肋骨发育短小3例,颈肋1例,肋骨走行异常1例,肋软骨融合畸形18例,肋骨异常合并肋软骨异常(伴有脊柱、胸骨异常或胸壁软组织异常)19例。VR对肋软骨病变的诊断符合率为100%,各MSCT 3D后处理技术在显示儿童肋骨及肋软骨形态及走行方面各有特点。结论:不同MSCT3D后处理技术对于儿童肋骨及肋软骨异常的显示及诊断价值具有一定差异,其中以VR应用最为广泛,诊断符合率最高。     

股骨颈疝窝的X线表现及临床意义

目的 探讨股骨颈疝窝的发生率及其临床意义.方法 回顾性分析本院600例骨盆平片,其中男299例,女301例,年龄18～82岁,分析股骨颈疝窝的发生率、X线表现及临床意义.结果 1200侧髋关节中,股骨颈疝窝58例(64侧),发生率为5.3%,其中男39例(68.7%),女19例(31.3%),左侧25例(39.1%),右侧27例(42.2%),双侧6例(18.7%).男女性别组股骨疝窝的分布差异有统计学意义,各年龄组分布差异无统计学意义.X线表现为股骨颈外上侧的类圆形透亮区,边界清楚,部分周边有硬化缘.结论股骨颈疝窝的发生率为5.3%,有典型的X线表现,它的出现提示髋关节撞击综合征可能.     

Tietze综合征患者的X线摄影所见

作者报告13例Tetze综合征的体层摄影发现。女8例,男5例;初检时平均年龄39岁;4例有寻常型牛皮癣和/或掌跖部脓疱病,2例的家族中有牛皮癣患者。13例均摄了胸骨侧位片、胸骨和肋软骨后前位体层片、骶髋关节局部片及全脊柱与胸部平片。另将无前胸壁疾患的男女各5例的胸肋部体层片作为对照组。13例中仅2例X线表现正常。3例存在胸骨体上两节未融合、胸骨体关节移位等解剖变异。另3例的受累胸肋关节(SCJ)的边缘出现骨赘,犹如骨关节病的征象,1例同时有胸骨柄体关节(MSJ)的均匀性关节骨性强直。患皮损的6例分别显示有第1 SCJ的侵蚀伴软骨下硬化,胸锁关节侵蚀及毗连肋软骨的广泛钙化,1例有第1肋软骨广泛钙化和双侧第1 SCJ小关节面凹凸不     

椎弓峡部裂在腰腿疼痛患者中的患病率及其与椎体滑脱的相关性

目的研究椎弓峡部裂在腰腿疼痛患者中的实际患病率,并探讨其与椎体滑脱的相关性。资料与方法筛选行MSCT扫描的5301例腰腿疼痛病例作为研究对象,详细记录有无椎弓峡部裂及椎体滑脱。结果 5301例中,发现椎弓峡部裂221例,其中男112例,女109例,男、女之间差异有统计学意义(χ2=220,P<0.001);在221例中有236个腰椎有椎弓峡部裂,其中单侧22个(9.95%),双侧214个。按照Meyerding分级,椎体Ⅰ度滑脱116个,Ⅱ度滑脱4个,无Ⅲ、Ⅳ度滑脱。双侧、单侧椎弓峡部裂滑脱发生率分别为55.14%、9.09%,二者之间差异有统计学意义(χ2=19.621,P<0.001,rs=0.277)。结论椎弓峡部裂在腰腿疼痛患者中的实际发生率约是4.17%(男性4.61%,女性3.80%),椎弓峡部裂与椎体滑脱呈低度相关。     

The sternalis muscle: radiologic findings on MDCT

Purpose

The purpose of this study was to characterize and determine the prevalence of the sternalis muscle using 64-row multidetector computed tomography (MDCT).

Materials and methods

We retrospectively reviewed MDCT chest scans that were performed in a hospital during the course of a month. The study population consisted of 948 consecutive patients (511 males and 467 females). On the MDCT scans the sternalis muscle was defined as the longitudinal muscle lying on and superficial to the pectoralis major muscle.

Results

The prevalence of the sternalis muscle was 10.5?%. The muscle was present more frequently in females (13.0?%) compared to males (8.4?%) (P?=?0.02). In the majority of patients, the muscle was located longitudinally in the parasternal position; however, in two patients it was positioned across the sternum. One hundred twenty were flat types, while the remaining five had oblique shapes. The muscle mean height, width and depth were 77.9?±?25.1, 19.4?±?12.2 and 2.8?±?1.3?mm, respectively. The muscle was wider in males compared to females (P?<?0.001).

Conclusion

Using MDCT, its prevalence was shown to be 10.5?%. This variant muscle can be differentiated from other pathological structures using its specific characteristic appearance.     

Evaluation of the postnatal development of the sternum and sternal variations using multidetector CT

PURPOSE

We aimed to evaluate the postnatal development and the maturation of the sternum and sternal variations using multidetector computed tomography (MDCT). Additionally, we aimed to examine the roles of gender and age in sternal development.

MATERIALS AND METHODS

Two hundred and fifty patients who underwent thorax MDCT examinations were evaluated for sternal development and variations. Coronal curved planar reconstruction and maximum intensity projection images were used to better assess the ossification centers in the manubrium and the body of the sternum. Multiplanar images were used to accurately measure the thickness and the sagittal dimension of the manubrium, the sagittal dimension of the body, and the total sagittal dimension of the sternum in the sagittal plane.

RESULTS

No significant differences in the manubrium measurements were observed between the genders. The thickness and sagittal dimension of the manubrium, sagittal dimension of the body, and total sagittal dimension of the sternum in the sagittal plane were significantly different between the age groups. We evaluated the ossification centers; shape and developmental variations in the manubrium and body; direction, calcification, and termination of the xiphoid process; developmental variations in the xiphoid process; and manubriosternal and sternoxiphoidal fusion. Significant variations were observed from person to person.

CONCLUSION

The anatomy and the developmental properties of the sternum should be well understood in cases of potential chest and sternum injuries and in several surgical procedures. Therefore, knowledge of the development and the maturation of the sternum, and sternal variations and anomalies is important. We suggest that the postnatal development and the morphogenesis of the sternum can be adequately assessed using MDCT.The sternum is a flat bone that extends vertically through the middle of the anterior thoracic cage. The sternum consists of the following three parts: the manubrium, the body, and the xiphoid process (XP) (1, 2). The sternum develops over a long period of time, which begins during the prenatal period and continues through the third and fourth decades of the postnatal period (3–6). Ossification centers in the manubrium and the body form on cartilage plates that are located on both sides of the middle line during the prenatal period. The ossification centers in the manubrium generally merge before birth. Two or more ossification centers that develop on each segment of the mesosternum (body) are referred to as sternebrae, which are located on cartilage plates on both sides of the middle line. From 6–12 years of age, the ossification centers usually merge completely into a single ossification center. The calcification and the fusion of the sternebrae are usually complete by 25 years of age (6–8). Postnatal development, maturation, and ossification center development of the sternum differ significantly from person to person.Several radiographic studies in the literature have evaluated sternal development and its variations; however, few studies have used computed tomography (CT) to assess sternal development and sternal variations in pediatric and early adult groups. Multidetector CT (MDCT) has become the primary imaging method for assessing the sternum due to its higher image quality and its ability to perform a three-dimensional evaluation. In this study, we aimed to evaluate postnatal development, maturation, ossification centers and variations in the sternum using MDCT, and we aimed to examine the roles of gender and age in sternal development.     

多层螺旋CT造影在主动脉病变腔内修复术后随访的价值

目的:探讨多层螺旋CT血管造影(multi-detector rowspiral computed tomography angiography,MDCTA)及后处理技术在主动脉覆膜支架腔内修复术(transluminal stent-graft placement,TSGP)术后随访的临床应用价值。方法:21例接受TSGP主动脉疾病患者,包括:Stanford B型夹层13例,真性动脉瘤3例,假性动脉瘤2例,弓降部穿透性溃疡1例,胸主动脉瘤合并局限性夹层1例,胸主动脉瘤合并Stanford B型夹层1例,术后采用MDCTA进行随访,平均随访13个月(1~24个月)。采用轴位图像与多种重建图像相结合来显示支架形态、术前术后主动脉管腔情况的变化和有无并发症。结果:13例主动脉夹层覆膜支架置入后:所有患者均真腔扩大,假腔减小或消失并伴血栓形成,支架未发现移位或断裂;共3例(14%)随访中发现内漏,1例Ⅱ型内漏,建议随访观察;1例术后8个月复查新发现支架近端Ⅰ型内漏,密切随访2个月后患者出现胸痛,复查CT内漏增多,转外科治疗。1例腹主动脉瘤术后1月复查发现Ⅲ型内漏。所有患者介入术后CT随访图像均满足临床诊断需要。结论:MDCTA对主动脉覆膜支架置入术后随访较其他检查手段具有多方面的优越性,能及时观察术后疗效、发现并发症,对主动脉疾病覆膜支架腔内修复术后随访具有重要价值。     

髂腰肌病变的影像特点及临床特征

目的探讨髂腰肌疾病的影像表现及临床特征。方法回顾性分析96例经手术或病理证实的髂腰肌病变并复习文献。结果 35例恶性病变包括原发性肿瘤2例,转移性髂腰肌肿瘤33例。动脉期可见转移性肿瘤中75%(25/33)的病变强化低于周边肌肉,16%(5/33)的病灶强化高于周边肌肉,9%(3/33)的病灶可见环形强化。髂腰肌结核40例,其中2例合并髋关节结核,3例合并骶髂关节结核。非特异性髂腰肌脓肿11例,3例可见气液平面。腰大肌外伤5例及退行性病变5例。结论髂腰肌病变具有一定的影像学及临床特征,认识其有助于正确诊断。     

Estimation of age from human sternum: an autopsy study on a sample from South India

Age estimation is one of the main parameters in the evaluation of skeletal remains in forensic anthropology casework. The present investigation is an attempt to study the fusion of manubrium and xiphoid process with mesosternum in 118 sterna (67 males and 51 females) of known age obtained during autopsy in South Indian population. The male samples were aged between 25 and 74?years and the females between 20 and 80?years. The fusion is studied to derive standards for the estimation of age from sternum. The results indicate that, with advancing age, the proportion of sternum with fusion of manubrio-mesosternal and mesosterno-xiphisternal junctions increases in males and females. A larger proportion of sterna showed fusion of mesosterno-xiphisternal junction than manubrio-mesosternal junction in different age groups. Fusion of manubrio-mesosternal and mesosterno-xiphisternal junctions was proportionately commoner in males than females. None of the sterna aged below 30?years showed fusion of mesosterno-xiphisternal junction. Nonfusion of mesosterno-xiphisternal junction was reported till the age of 48?years in males and 46?years in females. Manubrio-mesosternal junction was observed to be very variable with regard to fusion status as the joint remained unfused even in the elderly ages. Based on the variability of the fusion of manubrio-mesosternal and mesosterno-xiphisternal junctions observed in the study, it can be concluded that the sternum alone is not reliable for estimation of age in South Indian population.     

螺旋CT及三维成像在诊断胸骨肋软骨骨折中的价值

目的:探讨多层螺旋CT(MSCT)图像后处理技术在胸骨及肋软骨骨折中的诊断价值。方法:回顾性分析9例胸骨骨折和6例7条肋软骨骨折患者,在工作站进行多平面重建(MPR)、最大密度投影(MIP)、容积再现(VRT)等三维后处理对获得图像进行观察。结果:9例胸骨骨折中,在CT平扫轴位图像上显示6例骨折,而1例胸骨柄骨折、2例胸骨体骨折漏诊,在6例7条肋软骨骨折中1条肋软骨骨折漏诊,三维重建图明确显示9例胸骨骨折和6例7条肋软骨骨折,其中以MPR图显示骨折线最佳,MIP、VRT图显示骨折部位胸骨和肋软骨整体观较佳。结论:MSCT通过MPR、MIP、VRT不同技术相结合多角度观察能够更加完整清晰地显示胸骨骨折和肋软骨骨折部分、形态,提高对细微骨折的显示效果,可为临床提供可靠的诊断依据。     

Sexual dimorphism of sternum using computed tomography – volume rendering technique images of Western Chinese

Previous studies have revealed that the sternum can provide a method for assessing sex in diverse population groups. In the current study, sternal measurements were recorded from three-dimensional multidetector-computed tomographic images of 255 individuals (112 females and 143 males) in Western China. Results demonstrated that the difference between male and female mean values for all linear dimensions and manubrium index was highly significant. The stepwise analysis of four linear sterna dimensions and manubrium index, in which the sternum index, total length and manubrium width were selected, yielded a sex classification accuracy rate of 81.6% and a sex bias of 2.6%. Furthermore, multivariate discriminant function equations incorporating dimensions of the manubrium and individual sternal dimensions, such as the total length of the sternum and the sternum body, may also be of value in the estimation of sex. The results of the present study with osteometric equations provide an effective method for assessing sex in Western Chinese, particularly in situations where the pelvis or bones of the extremities are not preserved, and the CT-VRT may be a practical method for estimation of sexual dimorphism.     

Estimation of stature from the length of the sternum in South Indian females

Estimation of stature is one of the principal elements in practical forensic casework involving examination of skeletal remains. The present study was undertaken to estimate stature from the length of the sternum in South Indian females using a linear regression equation. The material for the present study consisted of intact sternums belonging to adult females of South Indian origin aged between 25 and 35 years of age obtained during medico-legal autopsies. The length of the sternum was measured as the combined length of the manubrium and the mesosternum (body of the sternum) from the incisura jugularis (central suprasternal notch) to the mesoxiphoid junction along the mid-sagittal plane using vernier calipers. A linear regression equation [Stature?=?111.599?+?(3.316?×?Length of the sternum)] was derived to estimate stature from the length of the sternum. The correlation coefficient was 0.639. The standard error of the estimate was 4.11?cm. The present study concludes that the length of the sternum is a reliable predictor of stature in adult South Indian females and can be used as a tool for stature estimation when better predictors of stature like the long bones of the limbs are not available when examining skeletal remains.     

MSCT重组技术对气管破裂的诊断价值

目的:探讨MSCT重组技术对气管破裂的诊断及临床应用价值。方法:回顾性分析7例气管破裂患者的CT资料,病因分别为颈胸部严重外伤、医源性损伤、自发性因素。采用128层螺旋CT对7例患者行颈胸部平扫,原始数据行减薄重组,将减薄重组后的图像传输到工作站进行多平面重组及CT仿真内窥镜(CTVE)观察。结果:气管破口以及溢出的气体均表现为低密度影,气管壁连续性中断,MPR重组可以完整显示破裂口形态和大小、距气管隆突、会厌或胸骨柄上缘等重要解剖标志的距离;2例严重患者在双侧颜面部、颈部、颞下窝、咽旁组织间隙、前后胸壁皮下、纵隔内均有广泛分布的低密度气影;最轻的1例仅见裂口附近的后纵隔内有少量、散在低密度气影;2例喉癌患者因肿块占据喉腔而行气管切开术,植入的导管显示通畅;5例外伤或自主破裂者通过CTVE均能识别破口,边界显示较MPR稍模糊,CTVE成像时附加的一幅虚拟三维VR图像,对溢出的气体自动着色,可立体地显示从破口溢出的气体在组织间的分布情况。结论:MSCT重组技术对气管破裂的诊断、治疗具有重要意义。     

Stature estimation from sternum length using computed tomography–volume rendering technique images of western Chinese

The objective of the present investigation was to generate linear regression models for stature estimation on the basis of sternum length derived from computed tomography–volume rendering technique (CT–VRT) images for Western Chinese. The study sample comprised 288 individuals of Western Chinese, including 124 females and 164 males, with documented ages between 19 and 78 years, and was randomly divided into two subgroups. The linear regression analysis for the calibration sample data yielded the following formulae: male stature (cm) = 137.28 + 1.99*combined length of manubrium and mesosternum and female stature (cm) = 111.59 + 3.51* combined length of manubrium and mesosternum. Pearson's correlation coefficients for the regression models were r = 0.459 and r = 0.541 for the male and female formulae, respectively. The standard errors of the estimate (SEE) were 4.76 cm for the male equation and 6.73 cm for the female equation. The 95% confidence intervals of the predicted values encompassed the correct stature of all specimen in the validation sample. The regression equations derived from the sternum length in the present study can be used for stature estimation and the length of the sternum is a reliable predictor of stature in Chinese when better predictors of stature like the long bones are not available, and the CT–VRT method may be a practical method for stature estimation.