门静脉CTA在门静脉高压门体分流侧支血管显示中的应用

目的 研究多层螺旋CT血管成像(CTA)在门静脉高压患者上腹部分流侧支血管显示中的作用. 资料与方法 对126例门静脉高压患者行门静脉系统及侧支血管的CTA检查. 结果 126例中,CTA提示各类食管静脉曲张108例(85.7%),胃底静脉曲张117例(92.9%),单纯食管静脉曲张8例(6.3%),食管静脉曲张合并胃体部静脉曲张1例(0.8%),食管静脉曲张合并胃底静脉曲张99例(78.6%),单纯胃底静脉曲张18例(14.3%).胃左静脉显示120例(95.2%),附脐静脉显示26例(20.6%),胃网膜静脉显示10例(7.9%).发现脾肾分流道4例(3.2%),胃左肾分流道35例(27.8%). 结论 门静脉CTA可以清晰显示门静脉高压患者食管、胃底静脉曲张及主要侧支血管的走行、分布,为临床治疗方案的选择和疗效的观察评估提供有价值的影像学依据.     

MDCTP对肝硬化门脉高压侧支循环血管的显示价值

目的:评价16排螺旋CT门静脉血管成像(MDCTP)技术在显示肝硬化门脉高压侧支循环血管方面的应用价值。方法:对38例临床诊断肝硬化门脉高压的患者行上腹部MDCTP检查。采用MIP、MPR、VR等三维重组技术进行图像后处理,获得门静脉系统及侧支循环血管图像。结果:38例中显示食管胃底粘膜下静脉曲张31例,食管旁静脉曲张10例;胃左静脉曲张29例,胃短静脉曲张26例;脐静脉与腹壁静脉曲张7例;脾-肾或胃-肾分流6例;腹膜后分流2例。结论:MDCTP能显示肝硬化患者门-体侧支循环开放部位、范围及程度,有重要的临床应用价值。     

64层螺旋CT门静脉造影在显示肝硬化门静脉高压侧支循环中的价值

目的：评价64层螺旋CT门静脉造影对肝硬化门静脉高压侧支循环显示的价值.材料和方法：肝硬化患者28例,采用64层螺旋CT行动脉期、门脉期及平衡期扫描后,运用容积重建法（VR）、多层面重建法（MPR）和最大密度投影法（MIP）对门静脉及其分支进行重建,观察门静脉高压肝内门静脉、属支及侧支循环的影像学特征.结果：64层螺旋CT门静脉造影能准确显示侧支循环分布范围,初步评估病变程度;门静脉高压时,门静脉属支管径显著扩张（门静脉主干、脾静脉、肠系膜上静脉、胃冠状静脉）.胃冠状静脉曲张24例、食管胃底静脉曲张21例、食管周围静脉曲张17例、胃短静脉曲张10例、脾/胃-肾分流6例、脐静脉和腹壁静脉曲张5例、腹膜后静脉曲张2例和直肠上静脉曲张2例,门静脉海绵状变性1例.结论：64层螺旋CT门静脉造影能够多角度、准确地显示门静脉高压时侧支循环开放的情况,对判断病变程度、预测其并发症、选择治疗方案具有重要意义.     

多层螺旋CT门静脉成像对门脉高压侧支循环血管的研究

目的:评价多层螺旋CT门静脉成像(MDCTP)在门脉高压侧支循环血管显示中的价值。方法:31例经临床检查确诊的门静脉高压患者行MDCTP检查,采用MIP、MPR、VR等重建技术进行图像后处理,获得门静脉系统及侧支血管图像,两名医师分别判断侧支血管显示情况。结果:MDCTP不仅显示肝内门静脉3~4级分支,还显示了整个门脉侧支血管系统。31例患者中,胃左静脉曲张28例,食管或食管旁静脉曲张27例,脾静脉曲张21例,胃短/胃后静脉曲张7例,脾-肾分流血管1例,脐静脉曲张伴腹壁静脉曲张2例,门静脉栓塞4例,肠系膜上静脉血管闭塞2例。结论:MDCTP能显示门静脉高压侧支血管开放的部位、范围及程度,有助于对门脉高压患者治疗方案的选择,是一种有重要临床价值的无创性门脉检查方法。     

MSCTA容积再现对门静脉高压侧支循环检出的价值

目的 评价多层螺旋CT血管造影（MSCTA）容积再现（VR）重建对门静脉高压侧支循环检出的价值。方法 对40例门静脉高压侧支循环形成患者行MSCTA门静脉成像，工作站上采用VR进行血管重建。结果 40例中胃底-食道静脉曲张35例，脐静脉再通7例，脾-肾静脉交通11例，发生率分别为87．5％，17．5％，27．5％。其中，多发侧支循环：胃底-食道静脉曲张合并脐静脉再通、附脐静脉曲张1例，合并脾-肾静脉交通10例。脐静脉再通合并脾-肾静脉交通及胸廓静脉分流各1例。结论 MSCTAVR重建能清晰完整显示门静脉高压（PH）侧支循环的详细情况。     

肝硬化患者CT门静脉血管成像中门静脉侧支血管的表现

目的 分析肝硬化患者在16排螺旋CT门静脉血管成像(CTPV)上门静脉侧支血管的表现.方法 对36例经临床、肝功能和影像学检查诊断为肝硬化门静脉高压的患者行腹部CTPV检查,经图像后处理,获得门静脉系统及侧支血管三维重建图像.结果 CTPV可以直观地显示门静脉系统及整个门静脉侧支循环系统.36例病例中显示胃左静脉曲张29例(80.6%),食管下段静脉曲张18例(50.0%),胃短/W后静脉曲张15例(41.7%),食管旁静脉曲张9例(25.0%),胃-肾/脾-肾分流8例(22.2%),门静脉海绵样变7例(19.4%),脐静脉与腹壁静脉曲张6例(16.7%),椎旁静脉分流4例(11.1%).结论 CTPV能很好地显示肝硬化患者门脉高压侧支循环的开放部位、范围及严重程度,对判断病情、选择治疗方案及估计预后有重要的临床应用价值.     

胰源性区域性门静脉高压的多层螺旋CT诊断及其临床价值

目的 探讨多层螺旋CT（MSCT）及图像后处理技术对胰源性区域性门静脉高压的诊断及临床价值.方法 对胰源性区域性门静脉高压症患者28例使用16排多层螺旋CT机行腹部平扫及增强扫描,采用图像后处理技术,显示胰源性区域性门静脉高压异常的脾静脉及侧支血管情况.结果 CT显示脾静脉狭窄或闭塞28例,胃冠状静脉曲张14例（14/28）,胃短静脉曲张15例（15/28）,胃网膜静脉曲张25例（25/28）.结论 MSCT及图像后处理技术能很好地从不同方位显示胰源性区域性门静脉高压侧支循环血管,具有重要的临床指导价值.     

经自发性胃-肾静脉和脾-肾静脉分流道栓塞治疗胃底静脉曲张和肝性脑病

经自发性胃－肾静脉和脾－肾静脉分流道栓塞治疗胃底静脉曲张和肝性脑病崔进国周桂芬张书田田慧琴薛春华张丽丽在门静脉高压症患者中，通过侧支循环形成自发性胃－肾静脉分流（ｓｐｏｎｔａ－ｎｅｏｕｓｇａｓｔｒｏ－ｒｅｎａｌｓｈｕｎｔ）和自发性脾－肾静脉分流（ｓｐ...     

肝硬化门静脉高压侧枝血管的多层螺旋CT表现

目的用多层螺旋CT(MSCT)统计、分析肝硬化门静脉高压患者的侧枝循环表现。方法收集203例肝硬化门静脉高压患者MSCT上腹部检查的完整资料。结果共发现门静脉侧枝或异常血管612处:食管下段静脉曲张175处,食管旁静脉曲张49处(其中伴假肿瘤征13处),胃底静脉曲张119处,胃冠状静脉曲张105处,胃肾静脉分流34处,脾肾静脉分流15处,椎旁静脉丛曲张16处,脐静脉再通48处,副脐静脉再通22处,脐静脉、副脐静脉同时再通4处,腹壁静脉丛曲张呈蛇头征12处,门静脉海绵样变8处,门静脉右后支瘤样扩张并与下腔静脉分流4处,胃左静脉直接入肝与门静脉左支相连1处。结论MSCT可较好地显示各类门静脉高压侧枝,了解这些异常表现有助于作出正确诊断,避免误诊,对临床选择治疗方法有重要的意义。     

自发性脾-肾分流16排螺旋CT门静脉三维成像表现

目的探讨自发性脾-肾静脉分流16排螺旋CT门静脉三维成像表现及其在胃静脉曲张临床处理中的作用。资料与方法对211例疑有门静脉高压的患者行腹部门静脉期增强扫描,在后处理工作站进行三维重建。结果共检出63例自发性脾-肾静脉分流患者,其中,脾静脉主干或其大分支直接同左肾静脉分流14例,胃短静脉和／或胃后静脉在胃底后下方与左肾静脉交通9例,胃左静脉经左膈下、胰腺后小区与左肾静脉分流63例,其他类型分流2例。结论16排螺旋CT门静脉三维成像技术可多方位、多角度显示脾-肾静脉分流。根据自发性脾,肾静脉分流的血流路径可分成直接脾．肾分流、直接胃-肾分流、间接胃-肾分流和其他4种类型,从而为选择患者、优化治疗方案及评估疗效提供客观影像学依据。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.