螺旋CT多平面重建在小儿可疑气道异物诊断中的应用

目的：探讨多层螺旋CT多平面重建（MPR）在不典型X线穿透性异物的诊断价值。方法:对71例可疑呼吸道异物患儿行螺旋CT扫描多平面重建。结果：35例MPR直观显示异物的位置、大小、形态及与周围组织关系,其中气管异物6例、右主支气管异物16例、右下支气管异物5例、左主支气管异物7例、左下支气管异物1例、双侧主支气管异物1例;排除异物35例,手术未证实异物1例。结论:MPR对气管支气管异物显示率高、定位准确,在可疑气道异物诊断及鉴别诊断中有重要意义。     

CT低剂量扫描及后处理技术在婴幼儿气管非金属异物中的应用探讨

目的　探讨多层螺旋CT低剂量扫描及其后处理技术在婴幼儿气管非金属异物中的诊断价值。方法　分析我院收治的48例被确诊为婴幼儿气管非金属异物患者的CT影像学资料。128层螺旋CT扫描参数为100 kV,30～40 mA,层厚0.9 mm,螺距1.4,对获得的数据进行多平面重建（multiplanar reconstruction,MPR）、最小密度投影（minimum intensity projection,Min-IP）及CT仿真内镜（CT virtual endoscopy,CTVE）与支气管内镜结果对比分析。结果　48例CT低剂量扫描图像全部符合诊断要求。CT对异物的检出率和支气管内镜无统计学差异,3种后处理技术中MPR与Min-IP无统计学差异,MPR、Min-IP分别与CTVE比较有显著性差异,MPR和Min-IP诊断的准确性高于CTVE。结论　螺旋CT及后处理技术能准确诊断及定位婴幼儿气管内的非金属异物,清楚显示出异物的大小和位置,具有很高的实用价值。     

小儿不典型支气管异物的螺旋CT诊断价值

目的探讨螺旋CT成像技术在诊断小儿不典型支气管异物中的价值。方法对31例不典型支气管异物的患儿,其中男18例,女13例,年龄10个月～3岁,平均1岁3月,均无明确异物吸入史,采用128层螺旋CT进行扫描(层厚0.6mm,电压120kv,电流83mA),并应用图像分析软件进行图像后处理:包括多平面重建(MPR)、曲面重建(CPR)、最小密度投影(MinP)、表面阴影显示(SDD)和CT仿真内窥镜(CTVB)等,以多平面重建为主。结果 28例患儿螺旋CT诊断有支气管异物,其中左侧支气管内19例,右侧支气管内9例。均在全麻下行支气管镜检查、取异物术,术中证实均有异物,且异物位置皆与CT检查结果一致,异物均顺利取出。3例CT诊断无异物者,病史较短,均为4天以内,经抗炎等治疗后痊愈。结论螺旋CT是一种无创、安全的检查方法,能直观显示支气管异物的位置、大小、多少及与周围组织的关系,大大提高了术前诊断的准确性,在不典型支气管异物的诊断中有重要价值。     

螺旋CT对气管支气管异物和狭窄的诊断价值

目的：探讨螺旋CT（MSCT）对气管、支气管异物和狭窄的诊断价值。方法：对18例可疑支气管异物的患儿进行MSCT检查。将获得的轴位扫描图像行Minp及MPR重建,并与支气管镜检查结果对照。结果：MSCT显示异物15例,21枚,其中1例异物CT值为278HU,其余14例CT值为-10．6～31．0HU;位于主支气管6例,叶支气管9例,其中并发段支气管异物4例。支气管炎性狭窄2例,异物取出后气道狭窄1例。异物及气管狭窄的显示以MPR和Minp图像最好。支气管镜所见与MSCT一致,但4例并发段支气管异物者未发现。MSCT所见不仅与支气管镜吻合,而且可准确显示段支气管以下的异物。结论：MSCT可准确显示气管、支气管异物与狭窄的直接和间接征象,并较准确地判定异物性质,对小儿支气管异物的诊断有重要参考价值。     

螺旋CT在小儿气管支气管异物诊断中的临床应用

目的探讨螺旋CT（64排）重建技术对小儿气管或支气管异物的诊断价值。方法 对24例疑有气管、支气管异物患儿行64排螺旋CT扫描,后处理技术采用多平面重建（MPR）、最小密度投影（MinIP）、表面阴影显示法（SSD）、透明成像（Raysum）、CT仿真内镜（CTVE）、容积再现（VR）对病例进行分析。结果 21例气管支气管异物均获得满意的后处理图像,异物诊断定位与支气管镜检相符100%,3例未见异物,经抗炎治愈。结论螺旋CT（64排）成像技术诊断气管或支气管异物符合率明显高于普通X线,是一种非常有价值的检查方法。     

螺旋CT三维重建在气道异物定位诊断中的应用

目的探讨螺旋CT三维重建在气道异物定位诊断中的临床意义。方法 2007年1月~2012年7月经螺旋CT气管支气管三维重建定位诊断气道异物140例,根据异物存在位置、形态及其与气道管壁的空间关系制定取出方案,行气管镜检查＋异物取出术。结果全部病例气管镜检查发现气道异物存在,其中139例异物嵌顿位置、形态与CT三维重建检查结果相符;1例右支气管异物术中见异物移位于主气管内。全部病例顺利取出异物。结论螺旋CT三维重建定位诊断气道异物有较大价值;为制定手术方案提供直接依据。     

多层螺旋CT三维重建在诊断气管支气管异物中的应用

目的 评价多层螺旋CT(multilayer spiral computed tomography,MSCT)三维 重建对气管支气管异物诊断的价值。方法 对30例怀疑为气管支气管异物的患 者,实施肺螺旋CT平扫及三维重建,与硬性支气管镜下手术情况对比,分析各种重建方法对支气管异物的显示情况及诊断价值。结果 30例患者均获清晰图像,23例异物部位与术中所见一致,出现位移1例,假阴性1例,异物咳出后检查3例, 左主支气管狭窄1例,吸入性肺炎1例,均未见异物。各种重建方法均可清楚显示气管、支气管异物的位置、形状、大小及异物所致气管、支气管狭窄的部位、程度和外形改变。结论 螺旋CT及图像后处理技术在气管支气管异物诊断中具有重要的临床应用价值。     

冠状位CT扫描对小儿支气管异物的诊断价值

目的 :探讨气管、支气管冠状位CT扫描诊断小儿支气管异物敏感性、特异性及临床应用价值。方法 :对 30例支气管异物患儿摄X线胸片及胸透检查 ,同时行气管、支气管冠状位CT扫描 ,其中 18例患儿行CT轴位扫描进行对照。结果 :30例CT冠状位扫描均清晰显示支气管腔内异物及异物周围炎性肉芽肿 ,其中阻塞性肺气肿 2 8例、阻塞性肺炎 5例、阻塞性肺不张 3例。结论 :气管、支气管冠状位CT扫描可以显示小儿支气管异物的直接征像和间接征像 ,其显示异物所在的位置对指导手术有重要意义。     

多层螺旋CT在闭合性甲状软骨损伤诊断中的价值

目的 探讨多层螺旋CT(multi-slice spiral computed tomography,MSCT)扫描在闭合性甲状软骨损伤诊断中的成像方法及应用价值.方法 对闭合性甲状软骨损伤5例患者进行MSCT扫描,重建数据在Advantage Workstation 4.0工作站进行二维、三维图像处理.其中联合应用多平面重组(multi-planar reconstruction,MPR)4例次,容积重建(3D-volume reconstruction,3D-VR)3例次,仿真喉镜成像(computed tomography virtual laryngoscope,CTVL)1例次.结果 5例患者中发现甲状软骨左板骨折4例,右板骨折1例;其中合并环状软骨骨折1例,合并上气道狭窄1例.利用窄窗宽低窗位技术有助于显示软骨结构,本组4例利用MPR图像进行多角度观察,对显示骨折线的走行及移位能取得满意的效果.3例利用3D-VR图像显示软骨结构的空间改变,其立体效果能为临床医牛选择治疗方案提供依据.1例运用CTVL技术对上气道狭窄及狭窄程度做出明确诊断.结论 MSCT扫描能够清晰地显示闭合性甲状软骨骨折及上气道狭窄,选择合适的后处理技术或多种技术联合运用能够提供准确、直观的图像.     

64层螺旋CT三维重建在气管支气管异物诊断中的应用价值

目的：探讨64层螺旋CT三维重建成像技术在小儿气管、支气管异物诊断中的应用价值。方法对35例疑诊气管、支气管异物的患儿,行64层螺旋CT扫描后三维重建,与硬质支气管镜手术中情况比对,评价各种重建技术对支气管异物的位置、大小等情况判断及诊断价值。结果35例患儿经扫描后重建,均获清晰图像,其中32例诊断为气管、支气管异物,异物位于主气管5例、右侧支气管16例、左侧支气管11例,行硬质支气管镜检查与CT诊断异物部位一致,且均一次成功取出;异物咳出后CT检查1例未见异物,另2例重建成像未见异物,均未行硬质支气管镜检查,予抗炎治愈。螺旋CT多平面重建（MPR）、CT仿真内窥镜（CTVE）等技术均能明确异物的有无、位置、大小、形态等及异物所致气管、支气管狭窄的部位、严重程度等。结论螺旋CT多平面重建及后处理技术对明确气管、支气管异物的诊断以及是否需行硬质气管镜有创检查有重要指导意义。     

Results of an evaluation of clinical practice in orthognathic surgery in France in 2002

BACKGROUND: Over the years, orthognathic surgery has become a mainstay of maxillofacial surgery and is the object of many publications and oral communications. However, in spite of well-established methodology, disparities still exist in France basically concerning the way orthognathic surgery is performed. MATERIALS AND METHODS: In relation with the XXXIXth congress of Stomatology and Maxillofacial surgery, a questionnaire was mailed to 100 French maxillofacial surgeons. Questions dealing with some practical points of orthognathic surgery (condylar positioning, osteosynthesis technique, rate of condylar resorption.) were asked. RESULTS: Overall reply rate was 37%. Condylar positioning was performed empirically in 73% of the cases. Mandibular osteosynthesis was achieved by titanium miniplates alone in 70%. Post-operative condylar resorption rate was about 2%. This survey produced numerous astute comments. DISCUSSION: This survey highlighted the interest of maxillofacial surgeons for practical aspects of orthognathic surgery including the questions of condylar positioning or osteosynthesis technique. These points are instrumental in achieving high-quality surgical result.     

Use of ultrasound in detection of sinus disease in children

A prospective study utilizing a small, portable A-Mode ultrasound apparatus (Sinus-V 2500 Radionics Medical) was undertaken to screen children with signs and symptoms of sinusitis. Fifty-three children (age 2-16 years) were tested both by ultrasound and compared to standard radiographs of the paranasal sinuses. The sensitivity of the ultrasound to evaluate small, developing paranasal sinuses in children was low (22%). Sinus pathology, particularly mucosal thickening, was difficult to confirm. However, even opacified sinuses were only detectable in 58% of the time. Therefore, portable ultrasound devices to detect sinus disease in children, have limited usefulness for this particular population.     

Efficacy of Curcumin in the healing of paracentesis in rats

Objectives

The present study was designed to investigate the possible beneficial effect of Curcumin (CMN) in healing of paracentesis in terms of wound thickness, sclerosis and closure by histological evaluation. To evaluate the efficacy of CMN, paracentesis was performed experimentally in the rats; and the results were presented histologically.

Methods

Sixteen, each 270–310 g weighted, healthy Sprague-Dawley female rats were included into the study. In both groups, paracentesis was performed into the eardrum bilaterally. In Group 1 (Paracentesis + Saline Group), saline drop was applied; and in Group 2 (Paracentesis + Curcumin group), Curcumin drop treatment was applied. Paracentesis area did not healed bilaterally in two rats (one in Group 1 and one in Group 2). Therefore, these two rats were excluded from the study. Histological examination performed in 14 rats and 28 temporal bones on the 15th day after the completion of drop treatment and closure of the paracentesis-area and wound healing were evaluated according to the histological examination criteria: Thickening of the tympanic membrane (ThicTM); and sclerosis.

Results

Both tympanic membrane thickening and sclerosis values of Paracentesis + Curcumin Group (Group 2) were significantly lower than those of the Paracentesis + Saline Group's (median: 2.0) (p = 0.001). Histological examination by light microscopy showed that in Paracentesis + Curcumin Group (Group 2), the structure of the tympanic membrane is near to the normal and decreased sclerosis was observed in connective tissue. Whereas in Paracentesis + Saline Group (Group 1), tympanic membrane thickening and connective tissue sclerosis were observed.

Conclusions

Curcumin improves wound healing process in paracentesis of TM. By using Curcumin drops, the closured paracentesis area was observed near to the normal eardrum; and thickness of the TM and sclerosis were less than the control, showing the improved healing at 15th day. The possible mechanisms may be anti-inflammatory effect, improving collagen deposition, and increasing fibroblast and vascular density in wounds thereby enhancing impaired wound healing.