两种方法解决介入治疗术后排尿困难效果的比较

冠状动脉造影术,使冠心病的诊断、治疗水平明显提高。但床上排尿困难是术后常见的护理问题,采用常规的方法,效果不佳,常需导尿术解决,既增加了患者的痛苦,又增加了护理工作量。我科2003年3月~2006年10月采取开塞露肛注刺激直肠诱发排便-排尿反射,较好地解决了床上排尿困难的问题。并与常规诱导排尿的方法进行了比较,现报告如下。临床资料对象选择冠状动脉造影术后排尿困难者60例,其中男性42例,女性18例,年龄20~78岁,平均53岁,随机分为对照组和观察组各30例,两组年龄、性别差异无显著性,具有可比性。方法(1)观察组:给予开塞露肛注排便以诱导…     

MR monitoring of MR-guided radiofrequency thermal ablation of normal liver in an animal model

The purpose of this study was to determine the suitability of MRI to accurately detect radiofrequency (RF) thermoablative lesions created under MR guidance. In vivo RF lesions were created in the livers of six New Zealand White rabbits using a 2-mm-diameter titanium alloy RF electrode with a 20-mm exposed tip and a 50-W RF generator. This was performed using a 0.2T clinical C-arm MR imager for guidance and monitoring. Each animal was sacrificed and gross evaluation was performed. Histologic correlation was performed on the first two animals. The MR-compatible RF electrode was easily identified on rapid gradient-echo images used to guide electrode placement. A single lesion was created in each rabbit liver. Lesions ranged from approximately 10 to 17 mm in diameter (mean, 13.5 mm). T2-weighted and short T1 inversion recovery (STIR) images demonstrated lesions ranging in diameter from 12 to 18 mm (mean, 14.6 mm). Lesion dimensions determined from images closely correlated with those determined at gross examination with the discrepancy never exceeding 2 mm, for an r² value of .87. MRI performed at the time of MR-guided RF ablation accurately demonstrated created lesions. This modality may provide a new option for the treatment of local and regional neoplastic disease.     

Intestinal plethora: An early sign of acute posttraumatic hepatic artery-portal vein arteriovenous fistula

Traumatic communications between the hepatic artery or its branches and the portal vein or its tributaries usually are clinically occult until the late sequelae of portal hypertension, such as esophageal and mesenteric varices, ascites, or congestive heart failure, become manifest. The authors describe the early diagnosis of such a lesion by computed tomography. The CT findings included a hepatic hematoma and, more significantly, diffuse thickening of the small and large bowel wall. This thickening represents vascular congestion of the bowel caused by acute portal hypertension prior to the development of decompressing portal collateral circuits. When this CT finding is not associated with other signs of intestinal ischemia or infarction, it should suggest portal hypertension and lead to arteriography for diagnosis and therapy of arterioportal fistula.     

A Novel Application of the MIRC Repository in Medical Education

Medical students on the radiology elective in our institution create electronic presentations to present to each other as part of the requirements for the rotation. Access was given to previous students presentations via the web-based system, Medical Imaging Resource Center (MIRC) project, created and supported by the Radiological Society of North America (RSNA). RadPix Power 2 MIRC (Weadock Software, LLC, Ann Arbor, MI) software converted the Microsoft PowerPoint (Redmond, WA) presentations to a MIRC-compatible format. The textual information on each slide is searchable across the entire MIRC database. Future students will be able to benefit from the work of their predecessors.     

Pulmonary hypertension due to tumor emboli: A report of three autopsy cases with morphological correlations to radiological findings

Three cases of pulmonary hypertension caused by tumor emboli to the lungs are described. Two of the three cases had a clinical diagnosis of pulmonary thromboembolism until surgical embolectomy, and the other had a diagnosis of primary pulmonary hypertension. Autopsy disclosed chondrosarcoma, choriocarcinoma and gastric cancer as the primary tumors, respectively. Pulmonary vascular obstruction due to tumor embolism leading to pulmonary hypertension is a previously rare clinical entity, and obstructed pulmonary vessels are believed to tend to be small vessels. We compared the autopsy and radiological findings and concluded that pulmonary tumor embolism involved not only the small peripheral arteries but also the segmental and/or lobar arteries.     

Web-based Diagnostic Imaging Service Using XML Forms

Traditionally, radiology has been conceived as a support department providing patient scanning services to the other clinical departments in a hospital. However, recent advancements in networking technology and related information systems such as picture archiving and communication system (PACS) and radiology information system (RIS) provide new opportunities for inventing different types of diagnostic imaging businesses such as teleradiology. In this article, we examined the business processes of currently operating imaging centers and proposed a prototype of an information system that can facilitate their workflows in a more efficient way. The principal component of our proposed system is a report management module built on extensible markup language (XML) technologies that allows much flexibility and convenience for both imaging technicians and radiologists.     

Fluid and solid mechanical implications of vascular stenting

Vascular stents have emerged as an effective treatment for occlusive vascular disease. Despite their success and widespread use, outcomes for patients receiving stents are still hampered by thrombosis and restensosis. As arteries attempt to adapt to the mechanical changes created by stents, they may in fact create a new flow-limiting situation similar to that which they were intended to correct. In vitro fluid mechanics and solid mechanics studies of stented vessels have revealed important information about how stents alter the mechanical environment in the arteries into which they are placed. Adverse nonlaminar flow patterns have been demonstrated as well as remarkably high stress concentrations in the vessel wall. In vivo studies of stented vessels have also shown a strong relationship between stent design and their dynamic performance within arteries. Alterations in pressure and flow pulses distal to the stent have been observed, as well as regional changes in vascular compliance. Considering the influence of flow and stress on the vascular response and the suboptimal clinical outcomes associated with stenting, knowledge gained from stent/artery mechanics studies should play an increasingly important role in improving the long-term patency of these devices. © 2002 Biomedical Engineering Society. PAC2002: 8719Rr, 8780-y, 8719Uv     

标准位X线片上胸腰椎椎弓根轴线的放射学研究

目的:研究标准正位X线片上T9～L5椎弓根轴线的放射学表现。方法:10具T9～L5脊柱标本,解剖成单个椎体。直视下沿椎弓根轴线置入导针。测量分析下列数据:标准侧位X线片显示导针达到椎体后壁及椎弓根中段时,标准正位X线片导针在椎弓根投影内的距离与椎弓根投影最大横径的百分比。另选4具T9～L5脊柱标本,根据上述数据,X线分步监测椎弓根螺钉植入。结果:标准正位X线片导针位于椎弓根中段时的百分比为(49.16±1.84)%～(51.83±2.53)%,各节段及左右侧椎弓根差异无统计学意义(P>0.05);导针位于椎体后壁时的百分比为(61.13±6.09)%～(74.68±6.13)%,左右椎弓根之间、T10￣T12之间、T9与L1￣L5之间差异分别无统计学意义(P>0.05),T10￣12与T9、L1￣5差异有统计学意义(P<0.001)。植入72枚螺钉,68枚位于椎弓根中心,4枚穿破椎弓根,穿破率5.56%。结论:标准正位X线片导针在椎弓根投影内的比值能间接表达椎弓根轴线,可为经椎弓根手术确定正确的进针轨道提供一种参考。     

CT导向下^125I粒子植入治疗肺转移癌15例疗效观察

目的观察CT导向下125I粒子植入治疗肺转移癌的临床疗效。方法15例肺转移癌患者,男8例,女7例,15例病灶数为58个,平均每人3.9个病灶,病灶平均直径为2.5cm。在CT导向下将125I粒子植入肺转移瘤灶内,采用治疗计划系统计算布源;对残留厚度≤1.0cm的肿瘤选择平面植入方法,采用18.5~29.6MBq活度的125I粒子相隔1.0~1.5cm平面播植。结果15例58个病灶,完全缓解31个;部分缓解14个;无变化8个;进展5个。总有效率77.6%。结论放射性粒子植入治疗肺部转移癌临床疗效好,创伤小,并发症发生率低。     

选择腰椎椎弓根螺钉长度的放射解剖学研究

目的 :探讨在腰椎侧位片及CT片上推算椎弓根螺钉长度的方法 ,为临床提供参考。方法 :随机在 3 0个腰椎骨标本上用 1mm软钢丝在椎弓根最狭窄处缠绕 ,按人字嵴进钉方法打入椎弓根直钢丝 ,拍正侧位片、横断面片及椎弓根CT扫描 ,分别在标本、CT及侧位片上测量椎弓根螺钉长度 ,三组数据比较。结果 :腰椎侧位片上测量的自关节突关节间隙下缘至椎体前缘距离乘以 0 .83即是螺钉长度 ,椎弓根CT扫描测量其长度更为准确。结论 :正常拍照条件下 ,用腰椎侧位片和椎弓根CT片可准确地推算螺钉长度 ,具有临床实用意义。