112例脑动脉系统微栓子监测的临床研究

目的　研究脑动脉系统微栓子 (MES)的产生机制及其相关因素。方法　将 112例 MES监测的临床资料进行总结分析。结果　本组微栓子检出率为 33.93% ,且全部见于有明显脑卒中症状者 ;脑梗死 MES检出率为35 .87%且以原发性大面积梗死为主 ;MES阳性与病程有明显相关 ,病程 <72 h易检出微栓子 ,阳性率为 4 7.72 % ;颅内血管狭窄是微栓子产生的主要原因 ;颈动脉异常与正常组微栓子出现率无明显差异 ,但发现本组病例中微栓子出现以左侧为主 ,与颈动脉病变部位一致率为 5 5 .5 5 % ;确定微栓子来源于有病变的颅外颈动脉 2例 ,来源于有病变的颅内颈动脉系 5例 ,来源于同时伴有颅内外血管病变 12例 ,表明颅内外动脉同时伴有病变时微栓子检出率增高 ;MES的阳性率与血液成分无相关性 ,但在血液成分异常组中血粘度增高以及血小板聚集降低 MES阳性率明显增高。结论　脑动脉系统中监测到微栓子说明患者有活动的栓子来源 ,易发生或复发脑梗死 ,TCD能正确的监测、判断脑循环中微栓子 ,确定其发生率、性质、来源以及与疾病的联系     

发育性髋脱位的影像学研究进展

发育性髋脱位是一种常见的小儿骨科疾病。临床表现较隐匿,影像学检查对其诊断有重要价值。本文对X线、造影、超声、CT、MRI等影像检查方法对发育性髋脱位的诊断应用进行综述,探讨各种方法的优缺点及对发育性髋脱位的诊断价值。     

Stereophotogrammetric measurement of the nasolabial fold in repose: a study of age and posture-related changes

The nasolabial fold is a significant facial landmark. Its size, shape, and symmetry are important in facial reanimation surgery, while effacement is an important goal in rejuvenation surgery. However, quantitative data for the nasolabial fold volume (NLFV) and depth is still unavailable. We present a new method of measurement using 3D color speckle stereophotogrammetry and its application in the assessment of NLFV. The VECTRA-3D system was validated to determine its minimum resolution and accuracy. Normal volunteers aged 13–84 years (n = 87) were imaged in repose. Mother–daughter pairs (n = 15, aged 13–61) were imaged in the upright and supine positions. All data were processed using custom software and analyzed by linear regression and nonparametric tests as appropriate. NLFV varied from 0.0026 to 0.2306 ml. There was significant correlation between NLFV and age (r = 0.7269, p < 0.0001). Men had significantly higher NLFV than women across all ages. There was no significant difference between the left and right NLFV. NLFV altered significantly from upright to supine in all subjects (p = 0.0012). However, the mothers increased their NLFV by 32% from supine to upright postures, which was a greater change than observed in their daughters. We have demonstrated a rapid, objective, and non-invasive assessment tool for facial reanimation and rejuvenation surgery. We have quantified the effects of age and posture on NLFV, and the efficacy and longevity of rejuvenation procedures are currently under investigation.     

支气管肺癌伴其它部位多原发癌的影像诊断(附25例报告)

经病理确诊的527例原发性支气管肺癌(PBC)(1972～1987)中,PBC伴其它部位多原发癌(MPC)25例(4.7％)。其中双原发肺癌(DPBC)、12例(2.3％),PBC伴消化道癌6例(1.14％)。25例中共有原发癌灶52个,其中2例为3原发癌;同期组6例(其中DPBC 4例),后期组19例(其中14例间隔3年以上,内2例分别间隔14年及25年)。组织类型相同者8例,不同者4例。 25例MPC特点如下:1.55岁以上20例(80％);2.24例(96％)第2原发癌为1980年后发现;3.第2原发癌为肺癌者23例(92％);4.双原发肺癌12例(48％)。上述特点说明80年代老年人中MPC,尤其是肺癌发病率增高。 本文着重对第2原发肺癌的影像学表现和鉴别诊断进行讨论。     

经阴道超声及宫腔造影对鉴别子宫内膜息肉与其他病变的意义

目的分析子宫内膜病变的声像图和血流特征,并评价经阴道彩色多普勒超声宫腔造影对子宫内膜息肉的诊断价值。方法采用经阴道彩色多普勒加宫腔造影,分别对19例子宫内膜息肉和32例子宫内膜其他病变之声像图、彩色血流及频谱表现进行对比,全部病例经宫腔镜及手术后的病理证实。结果经阴道彩色多普勒超声检诊子宫内膜息肉,清晰显示了内膜与黏膜下肌层之界限和息肉的病变边界,还显示了息肉蒂基底的彩色血流或黏膜下肌瘤周边彩色血流环,适时加做宫腔造影则更有益于对细小病变的诊断。结论经阴道彩色多普勒超声加做宫腔造影可大大提高对子宫内膜息肉与子宫内膜其他病的鉴别诊断水平。     

磁共振成像对颅内脑膜瘤水肿分析

目的：探讨脑膜瘤周围脑水肿的程度和肿瘤的生长部位．质地．组织学亚型的相关性．研究其瘤周水肿的形成原因．材料和方法：使用经手术和病理证实的65例脑膜瘤MRI和临床病理资料．观察分析脑膜瘤的瘤周水肿的程度．肿瘤的质地，组织学亚型等．结果：发生于大脑颅盖部或／和有矢状窦受累的脑膜瘤有明显的脑水肿．而发生于其它部位(颅底，丘脑、小脑、脑池等)无或只有轻度脑水肿．结论：轻度脑水肿主要是脑膜瘤对脑组织的直接压迫，而中，重度脑水肿主要是脑膜瘤对大脑表面引流静脉尤其是矢状窦的压迫或阻塞．脑水肿和肿瘤的发生部位有关，面和肿瘤的质地、组织学亚型无关．     

Changes in the levels of neuropeptide Y-LI in the external jugular vein in connection with vasoconstriction following subarachnoid haemorrhage in man

Summary NPY is a putative neurotransmitter mainly co-localized with noradrenaline in sympathetic fibers which innervate the cerebral vasculature. The origin of most of the perivascular NPY fibers seems to be in the superior cervical ganglion. To investigate involvement of Neuropeptide Y (NPY) mechanisms in subarachnoid haemorrhage (SAH), twenty patients with SAH were investigated. NPY-LI (-like immunoreactivity) levels in the external jugular vein were assessed using radioimmunoassay in blood samples collected postoperatively (or after SAH in non-surgical patients) on days 1, 2, 3, 5, 7 and 9. These levels were compared with the clinical course and blood flow velocity changes monitored with ultrasonic Doppler equipment from both middle cerebral arteries (MCA) and both internal carotid arteries (ICA).Compared to NPY-LI levels in 14 controls (mean 116±3 pmol/ l), increased levels (up to 253 pmol/l) and a close relationship between velocities and NPY-LI levels were found in a subpopulation of the SAH patients. When comparing the mean haemodynamic index (V MCA/ipsilateral V ICA) and mean NPY-LI levels in each of the 20 patients, a correlation of r=0.75, p=0.0001 was found. Increased NPY-LI were found (131±8 pmol/l) when simultaneous Doppler velocity recordings showed vasoconstriction (Haemodynamic index >5) compared with samples taken when the haemodynamic index was <5, p<0.05. When MCA velocity exceeded 120 cm/sec, increased levels were found (129±9 pmol/l) compared with the conditions when MCA velocity was less than 120 cm/sec (113±5 pmol/ l), p=0.06. The results indicate a possible NPY involvement in cerebral vasoconstriction after SAH.     

The Doppler guide wire: clinical applications in neuroendovascular treatment

The application of Doppler-tipped guide wires to measure blood flow velocity in coronary and peripheral arteries has been described previously as a valuable means of functional assessment in interventional cardiological procedures. In animal studies intravascular Doppler has been used in the cerebrovascular system, and this appears to be an important field of application for this new technique. We used intravascular haemodynamic monitoring by the Doppler guide wire during neuroendovascular procedures in patients with different cerebrovascular diseases and evaluated the clinical feasibility of the method. We found it a safe technique which complements morphological angiographic information with valuable functional data. Further studies may be expected to demonstrate the relation of flow parameters to clinical outcome. Received: 16 January 1996 Accepted: 30 January 1996     

A study of blood supply of liver tumors using duplex Doppler ultrasound and color Doppler flow imaging

Summary With the use of duplex Doppler ultrasound and color Doppler flow imaging(CDFI), the characteristics of blood supply in neoplasma were studied in 51 cases of 60 liver tumors, and compared with the results of surgery, pathological examination and hepatic anerial angiography. The result showed that: 1. Doppler blood flow signals could be detected in all hepatic carcinomas, and in 10 cases of 18 hemangiomas, significant difference was observed (P<0.001); 2. Doppler blood flow spectra showed pulsatile pattern in 41 of 42 hepatic carcinomas, and in 6 of 10 hemangiomas (P<0.01); and 3. the peak flow velocity was obviously lower in hemangioma group than in hepatic carcinoma group (20.34±23.93 vs 64.74±30.18 cm,P<0.001). The characteristics of CDFI show that hemangiomas and hepatocellular carcinomas are different. It can, therefore, be concluded that the blood supply of hepatic carcinomas mainly comes from hepatic arterial system, and is of value in duplex Doppler ultrasound and CDFI.