Endorectal surface coil MR imaging of prostatic carcinoma with the inversion-recovery sequence

The value of inversion-recovery (IR) sequences in the diagnosis and staging of prostatic carcinoma with magnetic resonance (MR) imaging was studied. Twenty-six patients with carcinoma of the prostate were imaged at 1.5 T with an endorectal surface coil and with a variety of IR sequences and a set of spin-echo (SE) sequences for comparison. Ex vivo prostate specimens were imaged again at the same field strength. The two images were correlated with histologic sections. Cancer was identified with MR imaging in 96% of patients. Of the tumors more than 4 mm in diameter, 87% were identified on T2-weighted SE images, whereas only 26% were identified on IR images. However, IR images may be more useful in local staging of carcinoma. Gross capsular infiltration was present in only two patients; however, it was detectable (and excluded in five other patients) by means of IR images. It was not detectable on SE images. The high quality of images obtained with the endorectal coil was confirmed. The authors conclude that addition of the IR sequence to MR imaging with the endorectal coil may improve the usefulness of this examination.     

经纤维支气管镜插管腔内放射治疗肺癌(附16例报告)

目的高剂量率腔内放射治疗肺癌腔内侵犯疗效观察。方法选择肺癌腔内侵犯患者１６例，经纤维支气管镇插入后装治疗管，与ＳＫ－Ⅱ型近距只后装治疗机连接进行放疗。剂量为每ｄ５Ｇｙ，每周１次，共照４次。结果纤维支气管镜检查示肿瘤消退，管腔通畅１２例，癌肿部分消退，管腔增宽４例。总有效率１００％。结论高剂量率腔内放射治疗肺癌腔内侵犯，可快速消除梗阻，缓解症状，是一种简单、安全、有效的治疗方法。     

主动脉夹层腔内修复术后逆行性A型主动脉夹层4例临床分析

【摘要】 目的 分析造成逆行性A型主动脉夹层的原因，为临床预防提供参考。方法 回顾性分析我院2005年1月至2017年6月收治的234例B型主动脉夹层腔内治疗的临床资料。结果 4例发生逆行性A型主动脉夹层，1例死亡，1例2017年3月行胸腹主动脉置换术，存活2例均采用保守治疗，并定期复查，目前病情无进展。结论 主动脉血管自身病变、近端锚定区不足、支架头端裸支架对血管壁的损伤是发生逆行性A型主动脉夹层的高危因素，值得我们关注     

Early outcomes and impact of a hybrid IC/IS applicator for a new MRI-based cervical brachytherapy program

PurposeThe purpose of this study was to report early outcomes and assess the learning curve in a new MRI-based cervical brachytherapy program.MethodsWe accrued 33 patients prospectively, and only patients with ≥3 months' followup (n = 27) were assessed for disease control and toxicity. Eras were defined as first half and second half for the intracavitary (IC)-only era (n = 13 each), and the intracavitary/interstitial (IC/IS) era was separated by difference in applicator availability (n = 7). Dose to 90% of the high-risk clinical target volume (D₉₀ HR-CTV) and minimum dose to the maximally irradiated 2 cubic centimeters (D_2cc) to organs at risk were used to assess dosimetry. Statistics were performed with t tests and Kaplan–Meier method.ResultsMedian followup was 14.7 months. Median treatment duration was 50.5 vs. 57 days for patients treated with external beam radiation therapy at our institution vs. an outside institution (p = 0.03). One-year local control, noncervical pelvic control, distant metastasis–free rate, and overall survival were 84.0%, 96.0%, 78.5%, and 91.3%, respectively. When comparing the first half and second half eras of IC only, there were no differences in median D₉₀ HR-CTV or D_2cc of the bladder, rectum, or sigmoid. Comparing the entire IC era to the IC/IS era, median D₉₀ HR-CTV trended higher from 88.0 Gy to 92.9 Gy (p = 0.11). D_2cc rectum decreased from 69.3 Gy to 62.6 Gy (p = 0.01), and D_2cc bladder trended lower from 87.5 Gy to 83.6 Gy (p = 0.09).ConclusionsThere was no significant difference between the first half and second half eras with IC-only MRI-based brachytherapy. Incorporation of an IC/IS applicator generated the greatest dosimetric improvement. Early results of the MRI-based brachytherapy program are favorable.     

彩色多普勒超声高频浅表小器官联合腔内探头对肛周脓肿的诊断价值

目的：研究联合应用彩色多普勒超声高频浅表小器官及腔内探头对肛周脓肿的诊断价值。方法选取2013年8月~2014年8月本院收治的78例经病理证实为肛周脓肿患者的临床资料,根据数字随机分组法原则,将患者分为两组,每组各39例。对照组给予常规专科检查(彩超检测),观察组联合应用高频浅表小器官及腔内探头检查,比较两种检测方式的检测结果。结果①观察组患者与括<肌关系符合、支管符合、主管符合、内口符合率均高于对照组,差异均有统计学意义(均P<0.05)。②观察组肛周脓肿检出率为97.44%,对照组肛周脓肿检出率为82.05%,观察组肛周脓肿检出率较对照组升高,差异有统计学意义(P<0.05)。③观察组肛瘘检出率为94.44%,高于对照组(75.00%),差异有统计学意义(P<0.05)。结论联合使用高频浅表小器官与腔内探头检查,能够提高肛周脓肿的检出率,诊断价值非常高,便于为疾病的治疗提供依据,值得临床推广应用。     

The impact of rectal/bladder filling and applicator positioning on in vivo rectal dosimetry in vaginal cuff brachytherapy using an enhanced therapy setting

PurposeThe impact of rectal filling and bladder volume on in vivo rectal dosimetry (IVD) in vaginal cuff brachytherapy (VCBT) is unknown. The purpose of this study was to compare rectal doses from IVD with those calculated from treatment planning and to identify influencing factors.Materials and MethodsWe collected data of 80 VCBT sessions, four for each of 20 patients. Each was retrospectively compared with doses determined by the treatment planning system. Factors potentially predicting the IVD rectum dose were analyzed.ResultsFor a series of 80 brachytherapy applications, the calculated mean dose to the rectum was 2.52 Gy. The mean difference between all calculated and measured doses for the 80 applications with five probe positions each was 0.09 Gy (p = 0.952) proving high overall accordance between IVD and calculated doses at the rectum. The mean volume of the rectum was 119 ± 57 cm³. The rectal volume was not statistically significantly associated with the IVD or the calculated rectum doses. At the third and fourth rectal probe position in craniocaudal ordering, increased filling of the urinary bladder resulted in decreased measured and calculated doses (p < 0.05 for both). A rectum pointing position of the applicator significantly increased the maximum rectum dose compared with a bladder-oriented position (p < 0.05).ConclusionsIVD provided valuable data for rectal exposure in VCBT. Increased bladder filling and vaginal applicator positioning off the rectum elicited related with less rectal radiation exposure, whereas rectal filling did not. Further confirmation including assessment of IVD in bladder is pending to define optimal dosimetric conditions in VCBT.     

腔内心电图定位技术在儿童PICC置管中的应用进展

本文报告了腔内心电图(EKG)定位技术在儿童PICC置管中应用的重要意义,从国内外儿童患者PICC置管过程中EKG的应用情况、EKG定位工具的选择、引导方式、如何通过P波变化判断导管尖端位置,并分析了影响儿童EKG稳定性的相关因素,展望了EKG定位技术在儿童PICC置管中的应用前景,并提出了建议,便于对临床提供指导。     

腹腔置管腹水引流联合腹腔内灌注化疗治疗恶性腹水（附10例报告）

目的分析腹腔置管腹水引流联合腹腔内灌注化疗治疗恶性腹水的疗效。方法采用14G深静脉导管腹腔置入，腹水引流后，腹腔内灌注地塞米松10mg、顺铂60mg。结果患者近期自觉症状均得到改善。结论对于晚期癌症合并大量腹水患者，腹腔置管引流、腔内灌注化疗，能够减轻患者痛苦，提高生活质量，延长存活期。     

吻合口狭窄的食管腔内冷冻术及扩张治疗

吻合口狭窄是食管癌，贲门癌术后较严重的并发症之一，发生率为０．５％～５．９％，造成狭窄的原因是多方面的我们应用纤维内镜引导下的食管腔内冷冻术和食管扩张综合治疗吻合口狭窄６７例，取得明显的疗效，腔内冷冻４０例，局部狭窄珠平均直径由０．３０ｃｍ增加到冷冻后的１．０３ｃｍ扩张术２７例狭窄处的平均直径由０．２７ｃｍ增加到１．０２ｃｍ。