The roentgenologic investigation of congenital subglottic stenosis.

Congenital subglottic stenosis, which is life-threatening to the infant, can be diagnosed by the correlation of the clinical and the roentgenologic findings. The main clinical sign is the persistence of stridor from birth. The indicative roentgenologic finding is a symmetrical narrowing of the subglottic segment which is constant in form and length during the various phases of the respiratory cycle. Two cases are presented, one confirmed by postmortem examination and the other by endoscopy. The etiology of this condition and the differential diagnosis are discussed.     

环状软骨前裂开对兔环状软骨生长发育的影响

目的:观察环状软骨前裂开对环状软骨生长发育的影响。方法:将幼兔环状软骨前正中裂开,8月后测量环状软骨内径,计算其管腔面积。结果:(1)与对照组比较,实验组兔环状软骨管腔面积无显著性差异(P>0.05)。(2)裂开处均由软组织连接,未形成过多瘢痕。结论:环状软骨前裂开对环状软骨及动物的生长发育无明显影响。     

Sonographic appearance of cricoid cartilage calcification in healthy children

OBJECTIVE: The purpose of this study was to determine the distribution pattern of calcification in cricoid cartilage of healthy children. SUBJECTS AND METHODS: Sonography of the neck was performed with a high-resolution linear array transducer to show the sides of the cricoid cartilage ring in both the sagittal and transverse planes. Twenty-three boys and 33 girls, who ranged in age from 6 to 17 years, were examined. Calcifications in the cartilage were characterized by number and size, distribution pattern, and side-to-side symmetry. RESULTS: Calcifications were seen either as small echogenic, nonshadowing foci or as larger irregular, echogenic areas with acoustic shadowing. Calcifications were found in 19 of the 23 boys and 26 of the 33 girls. The earliest cases were in three 7-year-old children. The incidence and number of echogenic foci generally increased with age. Most calcifications were in the center of the cartilage or distributed diffusely throughout. Side-to-side comparison of the number, size, and distribution pattern of the calcifications showed considerable variation. CONCLUSION: The sides of the cricoid cartilage ring could be seen on sonography in both the sagittal and transverse planes. Calcifications within the cartilage were readily shown and were found in children at an earlier age than previously reported.     

成人环状软骨水平的下咽部正常CT表现及临床意义

目的 探讨CT图像上环状软骨水平的下咽部的正常表现及其临床意义.方法 回顾性分析84名正常成人下咽部的CT图像,将下咽部分成梨状窝区、咽后壁区和环后区,把下咽部的环后区划分为如下3个层面,即环状软骨上缘层面(经环杓关节水平);环状软骨中部层面;环状软骨下缘层面.分别测量环后区的前后径、横径及其前、后壁的厚度;观察黏膜下脂肪层的变化,并对周围相毗邻的其他结构和脂肪组织进行观察、分析.测量数据采用t检验和x2检验进行统计学分析.结果 环后区的后壁较同层面的前壁厚(0.9±0.4)mm.男性环后区的横径较女性宽(4.5±0.3)mm;横径在性别上差异有统计学意义[在环状软骨上缘层面,男性的横径为(38.6±3.3)mm,女性的为(34.4 4-2.5)nun,t=6.26,P<0.05;在环状软骨中部层面,男性的横径为(33.6±3.6)mm,女性的为(28.9±2.8)mm,t=6.36,P<0.01;在环状软骨下缘层面,男性的横径为(28.6 4-3.1)111111,女性的为(24.0±2.1)mm,t=7.52,P<0.01].环状软骨上缘水平的环后区的横径较环状软骨下缘水平的横径宽(10.1±2.4)mm.黏膜下的脂肪层从环状软骨上缘[显示率为81.0%(68/84)]至环状软骨下缘[显示率为23.8%(20/84)]逐渐减少.在环后区周围毗邻的脂肪组织中,每一层面环后区后侧的脂肪组织显示的概率最小,而其左侧的脂肪组织最易显示,这种差异具有统计学意义[在环状软骨上缘层面,环后区左、右、后方毗邻脂肪组织的显示率分别为77.4%(65/84)、72.6%(61/84)、28.6%(24/84),x2=24.64,中部层面,各显示率分别为89.3%(75/84)、75.0%(63/84)、34.5%(29/84),x2=24.76,在环状软骨下缘层面,各显示率分别为95.2%(80/84)、88.1%(74/84)、52.4%(44/84),x2=13.59,P值均<0.01].结论 环状软骨水平的下咽部的正常CT表现及变化在对下咽部疾病的诊查中起着重要作用.     

先天性肥大性幽门狭窄的影像诊断

先天性肥大性幽门狭窄是新生儿常见的上消化道畸形之一,经手术做幽门环肌切开术,预后效果良好。本文回顾性的分析经我院手术证实的109例胃肠造影检查表现,介绍如下。1材料与方法1.1一般资料2004年~2005年的109例中,男94例,女15例,男:女为6.27:1;年龄1天~70天;临床症状为患儿喂奶后即吐,呕吐物为乳汁,不含胆汁;98例上腹部可扪及橄榄样包块,45例有不同程度的营养不良,5例有吸入性肺炎。1.2检查方法采用机器为GE Prestige-Ⅱ型数字胃肠造影机,对比剂为北京北化康泰临床试剂有限公司生产的硫酸钡Ⅰ型混悬液(160%)或中国上海安盛药业生产的欧乃…     

先天性肥厚性幽门狭窄的影像分析

本文作者收集2000年2月~2010年6月经手术病理证实的先天性肥厚性幽门狭窄27例,现报告分析如下。1材料与方法27例经手术病理确诊的先天性肥厚性幽门狭窄患儿中,男21例,女6例,年龄13~65天。均为足月产儿,剖腹产19例,顺产8例。均以呕吐为首发症状,呕吐物为乳汁或     

超声诊断先天性肥厚性幽门狭窄1例

患儿男,1岁。每次喂奶后不久即吐奶、奶凝块和粘液,有酸味11个月,现逐渐加重而来院就诊。查体:患儿明显消瘦,皮肤干燥,皮下脂肪减少,皮肤轻度黄染,右上腹可扪及类圆形肿块。超声检查:右上腹幽门部显示长轴断面上幽门部胃壁增厚呈梭形,肌层厚约0.66cm,幽门管变为狭长的实性回声,长约1.8cm,幽门管内径0.16cm,短轴断面呈均匀性中等回声环,中心为高回声。嘱患儿喝牛奶后观察。胃内容物通过受阻,胃腔略变宽。超声诊断:先天性肥厚性幽门狭窄,经手术证实。讨论:本病为新生儿常见疾病,发病率在欧美约1/300~900新生儿,我国约为1/1000~3000新生儿。男…     

CT features of congenital nasal piriform aperture stenosis: initial experience.

PURPOSE: To describe the computed tomographic (CT) measurements and features that enable accurate diagnosis of congenital nasal piriform aperture stenosis (CNPAS). MATERIALS AND METHODS: The clinical and imaging features of six patients (age range, 0-11 months) with CNPAS were retrospectively evaluated and compared with those of 61 control subjects younger than 24 months. RESULTS: The average widths of the piriform aperture in patients aged 0-3, 4-6, and 10-12 months were 4.8, 7.0, and 6.0 mm, respectively, compared with 13.4 (P < .001), 14.9, and 15.6 mm, respectively, in the age-matched control subjects. The average areas of the piriform aperture in patients in the three age groups measured 0.24, 0.46, and 0.36 cm2, respectively, compared with 0.67 (P < .001), 0.86, and 1.11 cm2, respectively, in the age-matched control subjects. The width of the nasal cavity in patients with CNPAS was in the less than 5th percentile compard with that in the control subjects. Abnormal dentition and a midline bone ridge projecting from the inferior palate were present in all six patients. CONCLUSION: CT measurement of the piriform aperture width is a simple and accurate method for diagnosing CNPAS; a width less than 11 mm in a term infant is considered to be diagnostic. An abnormal dentition and a bone ridge along the underside of the palate are confirmatory imaging findings.     

先天性小肠狭窄及肠闭锁的X线检查与诊断

目的 探讨先天性小肠狭窄及肠闭锁X线检查与诊断价值.方法 回顾性分析15例经手术证实的先天性小肠狭窄及肠闭锁病例,15例均行立位腹部平片检查,其中6例行口服医用硫酸钡检查,9例行口服非离子型含碘对比剂检查.结果 立位腹部平片显示12例高位肠梗阻,3例低位肠梗阻,造影检查显示十二指肠闭锁2例,空肠狭窄7例,空肠闭锁3例,回肠闭锁3例.结论 X线检查先天性小肠狭窄及肠闭锁具有重要价值.     

先天性胃窦部隔膜型狭窄2例

先天性胃窦部隔膜型狭窄，又称胃窦蹼，在临床上以小儿呕吐为主要症状，是由胃窦部粘膜性隔膜造成胃出口部狭窄，X线钡餐造影可明确诊断。我们遇到的两例均为男性，年龄分别为4个月和1岁半。4个月婴儿以反复吐奶就诊。X线造影显示胃窦出口部狭窄（图1）。1岁半婴儿发育差，以进食后呕吐而就诊。X造影显示胃窦远端狭窄。     

Congenital subglottic hemangioma: frequency of symmetric subglottic narrowing on frontal radiographs of the neck.

OBJECTIVE. This study was undertaken to determine how often symmetric subglottic airway narrowing is present in cases of infantile subglottic stenosis and to determine if the radiographic finding has any association with the anatomic location of the hemangioma. MATERIALS AND METHODS. All cases (n = 12) of endoscopically proved subglottic hemangioma from 1976 to 1991 were collected from the records at Children's Hospital of Michigan. In 10 cases, high-kilovoltage magnification studies or frontal radiographs of the neck were available for review by two observers who classified the subglottic narrowing as either symmetric or asymmetric. The radiographic findings in these 10 cases were then compared with the location and extent of the lesion as described endoscopically. RESULTS. In 50% of cases (n = 5), narrowing of the subglottic airway was symmetric. In four of these the hemangioma was either situated on the posterior wall or was circumferential, and in the remaining one an associated marked fibrotic reaction to a lateral wall lesion was present. All other lesions were on the lateral wall, and asymmetric subglottic airway narrowing was consistently shown on radiographs. CONCLUSION. Our results show that subglottic hemangioma often manifests as a symmetric subglottic airway narrowing and that the anatomic location of the hemangioma appears to be associated with the appearance on radiographs.     

Superficial neurofibroma: a lesion with unique MRI characteristics in patients with neurofibromatosis type 1

OBJECTIVE: Our aim was to test the hypothesis that in neurofibromatosis type 1 (NF1), superficial plexiform neurofibromas have different MRI characteristics than deep plexiform neurofibromas. SUBJECTS AND METHODS: Sixty-six patients (median age, 15 years) with superficial plexiform neurofibromas were compared with 56 patients with deep plexiform neurofibromas (median age, 12 years). All patients underwent axial STIR and coronal or sagittal STIR images. RESULTS: Superficial neurofibromas were more likely to be asymmetric (p = 0.004) and extend to the skin surface (p < 0.001). Lesion borders were poorly defined with similar frequency in both superficial and deep groups (77% vs 68%, p = 0.31). The morphology of superficial neurofibromas was more likely diffuse (64% vs 11%, p < 0.001), whereas deep neurofibromas were more likely nodular or fascicular. Of neurofibromas that were nodular or fascicular in morphology, superficial lesions had a smaller maximal fascicle-nodule diameter (mean, 10.3 mm) than deep lesions (mean, 13.4 mm) (p = 0.013). Signal characteristics of deep neurofibromas were more likely to be targetlike (75%) compared with superficial neurofibromas (21%) (p < 0.001). Superficial neurofibromas had a smaller mean volume than deep neurofibromas (180 vs 444 cm(3), p = 0.002). CONCLUSION: Unlike the typical targetlike lesions along the course of major nerves seen in deep plexiform lesions, superficial plexiform neurofibromas in NF1 tend to be asymmetric, have nontargetlike signal intensity, lack nodular or fascicular morphology, and are likely to involve skin.     

飞行员先天性大脑中动脉狭窄一例

一、临床资料患者男性 ,30岁 ,轰炸机飞行员 ,飞行时间 10 0 0 h。因发作性头晕、视物模糊 9年 ,加重 1个月入院。患者近 9年来在飞行强度较大时出现发作性头晕、视物模糊及看不清仪表 ,每次持续数秒。入院时查体 :一般状况好 ,神经系统检查无阳性体征。经颅多普勒提示 :右侧大脑中动脉狭窄 ,血流量减少 ,右侧大脑前、后动脉血流量稍减少。脑 MRI示 :右侧大脑中动脉膝段狭窄。双侧颈动脉造影示 :右侧大脑中动脉第 1段及第 1、2段交界处狭窄。入院后给予尼莫地平、维生素等药物治疗 ,症状稍有好转 ,但仍有发作。结论 :飞行暂不合格。经地面…     

飞行员先天性左侧椎动脉狭窄一例

一、临床资料 患者男性，38岁，歼-6飞行员，飞行时间1900h。主诉飞行中发作性短暂意识蒙胧入院。患者2004年10月始，飞行中曾3次无明显诱因出现短暂一过性意识朦胧，伴有出汗、乏力，操作能力下降，但无意识丧失，自觉与飞行载荷等因素无关，持续10s左右症状消失。平时易于劳累、睡眠差时出现发作性头晕和视物模糊。停止活动休息后症状可缓解，无晕厥、抽搐、尿便失禁等情况。