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41.
脑血管畸形的CT、MRI及MRA诊断(附16例报告) 总被引:1,自引:0,他引:1
目的 探讨CT、MRI及MRA在脑血管畸形中的诊断价值。方法 搜集经血管造影和手术病理证实的脑血管畸形16例,包括动静脉畸形(AVM)12例,海绵状血管瘤4例。所有病例均行CT、MRI平扫及MRA检查,MRA采用3D-TOF法。结果 AVM的CT平扫主要表现为低、等或高混杂密度,部分伴钙化,合并急性出血者呈高密度。MRI扫描T 相似文献
42.
IntroductionThe initial management of urethral trauma remains disputed, and there are several suitable techniques, including delayed repair and suprapubic urinary diversion as well as primary endoscopic or open alignments. The treatment choice used depends on the rupture’s location and length as well as the accompanying trauma.Case presentationA 33-year-old male patient was referred to the department of emergency, with the chief complaint of inability to void experienced 1 day before being admitted, after falling from a height of approximately three meters. There was a laceration to the perineum 3 cm long to the rectum, with no active bleeding. After the incident, the patient could not void, but the lower abdomen was not painful. Upon retrograde urethrography examination, contrast extravasation of the bulbous urethra was seen through the anorectal laceration. Immediate debridement and repair for the anorectal wound, then primary anastomosis for the bulbous urethra, was performed.DiscussionThe likelihood of an injury to the anterior urethra increases with certain clinical features, including blood in the urethral meatus, palpable bladder distention, and a butterfly appearance on the perineum. Immediate exploration and reconstruction of the urethra is recommended in urethral traumas associated with penile fractures and non-life-threatening penetrating injuries. Furthermore, small lacerations are repaired primarily, while total ruptures are treated with anastomosis.ConclusionProper identification and management of urethral rupture determines the outcome. Initial urethral trauma management is disputed; however, a bulbous urethra rupture with anorectal lacerations can be treated safely and effectively with primary anastomosis. 相似文献
43.
Vaginal agenesis with anorectal malformations is a complex pediatric condition that adversely affects various physiological processes in the body. It may cause disturbances in defecation and urination, abnormalities in the urinary and gastrointestinal tract, dysfunction of the genital and reproductive organs, and sexual function disorders. The complexity in the surgical management of vaginal agenesis includes the selection of a functional reconstruction technique for anal and vaginal formation, timing of the reconstruction, and management of complications in the associated organ system.Herein, we describe a patient with Mayer–Rokitansky–Küster–Hauser syndrome accompanied by a rectovesical fistula. Other abnormalities, such as microcephaly, polydactyly, long urethral abnormalities resembling the male urethra, and complications in the kidney and urinary tract, were observed in the patient. The associated complications included recurrent urinary tract infections, urinary overflow incontinence, vesicoureteric reflux, hydroureter, and left renal hydronephrosis. The patient underwent posterior sagittal anorectoplasty surgery and vaginal reconstruction. The long-term vaginal physiological development of patients with this condition remains unknown. 相似文献
44.
K. M. Goebel W. D. Gassel F. D. Goebel H. Kaffarnik 《Journal of molecular medicine (Berlin, Germany)》1972,50(17):849-851
Summary Hexokinase deficiency in the red cells caused a hemolytic anemia in a 28 y. old woman who revealed multiple malformations and a latent diabetes mellitus.Supported by Deutsche Forschungsgemeinschaft (Grant Go 236/2). 相似文献
45.
46.
目的:总结胼胝体动脉脉畸形(AVM)的显微手术治疗经验。方法:回顾分析1990年1月至1998年12月治疗8例胼胝体AVM的结果。结果:7例行显微手术切除,其中1例行术中AVM栓塞加手术切除。全切5例,次分切除2例,无手术死亡。1例扭绝手术,半年后死于再出血。随访5例,平均随访26月,均恢复良好。绫:胼胝体AV-经诊断明确,应积极行显微手术切除。对难以全切者可行栓塞治疗或栓塞后切除。对深部术后部分 相似文献
47.
R. Deruty I. Pelissou-Guyotat C. Mottolese D. Amat Y. Bascoulergue 《Acta neurochirurgica》1994,131(3-4):169-175
Summary The prognostic value of the Spetzler's grading system is studied in a series of 52 AVMs treated by a combined management, using one or several of the 3 available techniques: surgical resection, endovascular embolization, radiosurgery.The symptoms at the time of treatment were haemorrhage 50%, seizures 31%, headache and deficit 19%. Three grade groups were considered: I and II (31%), III (33%), IV and V (36%). Overall, AVMs were managed as follows: resection alone 25%, embolization plus resection 23%, embolization alone 23%, radiosurgery with various combinations 29%. According to the grade groups, the most frequently used technique was resection alone for grade I–II AVMs (44%), radiosurgery for grade III AVMs (41%) and embolization alone for grade IV–V AVMs (42%).The clinical outcome was evaluated in terms of deterioration due to treatment. The best results were obtained in grade I–II AVMs (81% with no deterioration) then in grade III AVMs (65%) and in grade IV–V (58%). However, when we consider the outcome in terms of favourable results (no or only minor deterioration) we obtained a similar outcome for grade I–II and grade III AVMs (94% each), and only 79% for grade IV–V malformations. The angiographic outcome showed a better eradication rate in grade III AVMs (88% complete eradication), than in grade I–II AVMs (75%) and in grade IV–V (47%).Our conclusion is that the Spetzler's grading system in this series was well correlated with both the clinical and the angiographic outcome. However, we found no real difference between grade I–II and grade III AVMs. So, in terms of prognostic value, the grade I, II, and III AVMs could be considered together as low-grade malformations, with a better prognosis than the high-grade malformations (grade IV and V). 相似文献
48.
49.
目的评价数字减影血管造影(DSA)、磁共振成像(MRI)及磁共振血管造影(MRA)在脑动静脉畸形(AVM)诊断中的价值。②方法对病理证实的113例AVM病人皆行DSA及MRI检查,其中67例行MRA检查。③结果DSA表现为密集成球、相互交叉缠绕的血管团或块状血管;MRI表现为蜂窝状、葡萄状和条索状流空血管,无明显占位效应;MRA显示局部纡曲的血管团,血管分支增多,缠绕在一起。DSA及MRI对AVM的诊断率远高于MRA(χ2=106.7,P<0.01)。④结论DSA与MRI结合使用,对AVM的诊断及治疗有重要价值。MRA可作为MRI的补充用于筛选及AVM切除术后随访检查。 相似文献
50.
Laparoscopic rectopexy for complete rectal prolapse 总被引:5,自引:0,他引:5
A. C. Poen M. de Brauw R. J. F. Felt-Bersma D. de Jong M. A. Cuesta 《Surgical endoscopy》1996,10(9):904-908
Background: The purpose of this study was to evaluate the clinical outcome of laparoscopic rectopexy and its effect on anorectal function investigations.
Methods: Twelve patients with complete rectal prolapse without constipation underwent laparoscopic rectopexy. Pre- and postoperative evaluation included scoring of incontinence, anorectal manometry, and anal endosonography.
Results: No recurrences of rectal prolapse were seen (median follow-up 19 months). Continence improved in eight of nine preoperatively incontinent patients. Two patients had mild constipation after surgery. Median maximum basal pressure measured by anorectal manometry increased from 20 to 25 mmHg (p=0.005) and the rectoanal inhibitory reflex improved in seven patients (p=0.03). Rectal sensitivity did not change significantly. Endosonography showed asymmetry and thickening of the internal anal sphincter and submucosa preoperatively. After surgery the maximum internal anal sphincter thickness decreased from 3.0 mm to 2.6 mm (p=0.02).
Conclusions: Laparoscopic rectopexy improved continence in our patients. Anorectal function tests show a partial recovery of the internal anal sphincter. Laparoscopic rectopexy combines the low morbidity of minimal invasive surgery with the good outcome of abdominal rectopexy.Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Orlando, Florida, USA, 11–14 March 1995 相似文献