螺旋CT诊断迟发性维生素K缺乏症颅内出血的价值

目的:探讨迟发性维生素K缺乏症颅内出血的螺旋CT表现.材料和方法:回顾性分析两个医院2002-07 ～2005-09临床资料比较完整的迟发性维生素K缺乏症颅内出血12例的螺旋CT表现.结果:12例迟发性维生素K缺乏症颅内出血中,蛛网膜下腔出血2例、脑实质出血3例、硬膜下出血4例、脑室内出血2例和混合性出血1例.结论:螺旋CT能准确诊断维生素K缺乏症颅内出血,并能检查出极少量出血灶,确定出血的部位、出血量、范围、周围情况以及是否并发有脑梗塞等.     

外伤性颅内出血患者开颅术后并发迟发性脑出血危险因素分析

目的探讨外伤性颅内出血患者开颅术后并发迟发性脑出血的危险因素。方法将2015年1月至2017年12月首都医科大学附属北京潞河医院收治的外伤性颅内出血开颅术后并发迟发性脑出血的58例患者设为B组,并将同期收治的外伤性颅内出血开颅术后未出现迟发性脑出血的60例患者设为A组。比较两组患者的临床资料,并利用Logostic回归分析引发再出血的危险因素。结果 B组患者的年龄、既往脑血管病史比例、高血压病史比例、发病至手术时间、格拉斯哥昏迷指数评分3～8分患者比例、典型CT图像患者比例、脑疝发生率均高于A组,组间比较,差异均有统计学意义(P<0.05)。Logostic回归分析结果显示,年龄、既往脑血管病史、高血压病史、发病至手术时间、典型CT图像、脑疝、格拉斯哥昏迷指数评分(3～8分)是外伤性颅内出血患者术后并发迟发性脑出血的危险因素(P<0.05)。结论外伤性颅内出血患者术后并发迟发性脑出血与年龄、既往脑血管病史、高血压病史、发病至手术时间、典型CT图像、脑疝及格拉斯哥昏迷指数评分密切相关。     

婴儿期迟发性维生素K缺乏致颅内出血的CT表现

目的探讨婴儿期迟发性维生素K缺乏性颅内出血的CT影像特点。方法选择临床确诊为迟发性维生素K缺乏性颅内出血的23例患儿的头颅CT资料进行回顾性分析。结果蛛网膜下腔出血8例,脑实质出血10例,硬膜下出血5例,脑室内出血3例,其中60%为多部位出血,脑梗死1例。结论结合临床特点,CT检查不仅可以明确具体的出血部位,还可以辅助作出出血的病因诊断。     

3.0T磁敏感加权成像在新生儿颅内出血中的应用价值

目的 探讨磁敏感加权成像(SWI)在诊断新生儿颅内出血中的应用价值.资料与方法 搜集新生儿重症监护病房的97例患儿头颅MRI常规序列(T1WI、T2WI)和SWI序列的扫描资料.结果 97例新生儿SWI共检出46例颅内出血,MRI常规序列仅检出其中的36例;SWI共检出脑内出血灶104个,MRI常规序列仅检出19个.结论 较常规MRI序列,SWI在检出新生儿颅内出血的阳性率、数目、体积大小方面有着明显的优势,是探查新生儿颅内出血一种非常好的MR新技术.     

迟发性外伤性颞叶脑内血肿的早期诊治

目的总结迟发性外伤性颞叶脑内血肿的早期诊治经验,以提高疗效.方法对本组首次CT检查无血肿者,严密观察,及时CT复查,对血肿量≥25ml伴脑干周围池受压变窄者,积极手术治疗,其余行保守治疗.结果本组16例中,手术治疗9例,保守治疗7例.恢复良好11例,中残2例,重残2例,死亡1例,总死亡率6.25%.结论迟发性外伤性颞叶脑内血肿的救治关键在于早诊早治,早期手术者多预后良好.     

脑卒中细胞凋亡的活体成像进展

脑卒中是全球第二大常见死因,是我国第一大死亡和致残原因.缺血脑卒中急性期及迟发性神经元死亡期均存在神经元细胞的凋亡,凋亡决定了脑卒中最终的梗死体积.应用活体成像技术能够无创地检测脑内的细胞凋亡信息,为脑卒中的早期诊断、病程及治疗效果监测提供了新的方向.     

基于电阻抗断层成像的非均匀电导率颅骨物理模型研究

目的 用非均匀电导率分布的颅骨模型进行电阻抗断层成像(EIT)实验,分析颅骨电导率非均匀分布对成像结果的影响.方法 选用石膏材料制作非均匀电导率的颅骨模型,用此模型模拟头颅进行EIT目标成像,并将结果与均匀电导率颅骨模型的成像结果进行比较.结果 相对于均匀电导率模型,在非均匀电导率模型内成像目标更加远离电导率较低一侧,且所在位置边界电压扰动量降低.结论 颅骨模型的电导率非均匀分布对成像定位有明显影响,需要在成像算法上做进一步改进.     

电阻抗监护小猪腹膜后注血模型的研究

目的 使用小猪腹膜后注血模型来研究电阻抗成像监测创伤导致的腹膜后出血的可行性,为电阻抗成像的临床应用提供必要的理论和现实依据.方法 5头小猪行腹膜后穿刺置管,经导管持续注入血液,模拟创伤性腹膜后出血,应用电阻抗成像临测小猪注血部位的阻抗和图像变化情况.结果 5头腹膜后注血小猪电阻抗监护图像成像清晰,稳定.注血部位的阻抗值随注血量的增加而持续降低,图像灰度变化明显.经CT及解剖验证,后腹膜完整,血液局限于腹膜后间隙内.结论 在小猪腹膜后注血模型的基础上,使用电阻抗监护腹膜后出血成像清晰,对比明显.     

放射性脑损伤的MRI分析

目的：分析放射性脑损伤的MRI表现及MRI诊断的意义。方法：回顾性分析25例放射性脑损伤患者的MRI资料,观察并比较病变的部位、范围及增强表现。结果：急性放射性脑损伤1例,深部脑白质及胼胝体压部对称性长T2信号,脑白质和胼胝体压部肿胀,增强扫描无强化;早期迟发性放射性脑损伤18例,深部脑白质对称性长T2信号,增强扫描无强化;晚期迟发性放射性脑损伤6例,双侧颞叶不均匀长T1长T2信号,增强扫描呈明显花环样强化。结论：放射性脑损伤具有特征性MRI表现,MRI对诊断放射性脑损伤具有重要价值。     

急性一氧化碳中毒后迟发性脑病的MR扩散张量表现一例

急性一氧化碳中毒后迟发性脑病是指急性一氧化碳中毒后 ,患者经过 1～ 2周左右的“假愈期”又出现一系列神经精神症状。其发病率约为一氧化碳中毒的 9% [1] 。由于其预后较差 ,常导致患者出现痴呆、智力及记忆力下降、生活不能自理和其他神经系统功能障碍 ,故早期诊断对本病的治疗具有重要意义。本科近来通过ＭＲＩ和扩散张量成像 (ｄｉｆｆｕ ｓｉｏｎｔｅｎｓｏｒｉｍａｇｉｎｇ ,ＤＴＩ)诊断 1例急性一氧化碳中毒后迟发性脑病患者 ,报道如下。患者　男 ,75岁。于 2 0 0 1年 10月 2 6日晨起出现头晕、神志不清、呕吐等症状入院 ,5小时后神…     

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.