多层螺旋CT对主动脉夹层动脉瘤的诊断价值

目的探讨多层螺旋CT对主动脉动脉瘤的诊断价值。方法对25例主动脉瘤患者于临床症状出现后进行多层螺旋CT平扫加增强扫描并利用原始数据在AW4．3工作站进行MPR及VR后处理。结果横轴位图像上可观察到真假腔形态、大小、剥脱的内膜片、破口位置及内膜和主动脉壁钙化,MPR重建图像能观察主动脉弓受累情况,确定内膜剥离范围,显示内膜与各分支血管之间的关系,按DeBakey分型,本组患者表现为Ⅰ型4例,Ⅱ型2例,Ⅲ型19例。结论多层螺旋CT能直观、立体显示真、假腔的形态、大小,破口位置及其与大分支血管的关系,因而它应是诊断夹层动脉瘤的首选检查方法。     

螺旋CT在主动脉夹层动脉瘤诊断中应用（附13例报告）

目的：探讨主动脉夹层动脉瘤的螺旋CT扫描技术及三维重建技术在诊断中的应用。方法：主动脉夹层动脉瘤患者13例行螺旋CT增强扫描．原始图像在工作站进行MPR或三维重建。结果：横轴位图像上可以观察到真假腔内膜片、破口位置及主动脉壁钙化。MPR及三维重建图像能观察主动脉弓受累情况，确定内膜剥离范围，显示内膜与血管之间的关系．按DeBaKey分类法，Ⅰ型5例，Ⅱ型3例，Ⅲ型2例。结论：多层螺旋CT是诊断主动脉夹层较好的影像方法，其多种后处理方法对临床诊断及治疗帮助较大。     

CT MPR技术在主动脉夹层动脉瘤术前评价中的价值

目的:探讨多层螺旋CT多平面重组(multi-planar reformation,MPR)技术在主动脉夹层动脉瘤(DAA)术前评价中的价值。方法:术前对21例主动脉夹层动脉瘤患者行多层螺旋CT检查并利用原始数据行MPR重组,比较原始横轴位图像与MPR图像显示DAA的情况。结果:横轴位图像上均可显示真假腔形态、大小,显示剥脱的内膜瓣片破口位置9例。MPR图像上也均可显示真假腔形态、大小,显示剥脱的内膜瓣片破口位置18例。21例均能显示内膜与各分支血管之间的关系。结论:多层螺旋CT MPR能显示DAA剥脱的内膜瓣片破口位置,可对夹层动脉瘤明确分型,是术前评价DAA有效的影像学检查方法。     

多层螺旋CT血管成像技术对主动脉夹层的诊断价值

目的探讨多层螺旋CT血管成像技术对主动脉夹层的诊断价值。方法主动脉夹层(AD)患者17例全部经螺旋CT平扫加增强扫描,并结合二维三维图像重建技术观察。结果本组17例按DeBakey分型,Ⅰ型3例,Ⅱ型1例,Ⅲ型13例。多层螺旋CT血管成像技术的敏感性,特异性较高,能直观、立体地显示真假腔、破裂口、内膜瓣、夹层累及范围和主动脉各分支情况。结论多层螺旋CT血管成像技术可以迅速准确诊断主动脉夹层,是最实用的并值得首选的影像检查方法。     

CTA在主动脉夹层诊断及临床分型中的应用

目的 探讨多层螺旋CT血管成像（CTA）对主动脉夹层的诊断及临床分型中的价值。方法回顾分析20例主动脉夹层患者均行多层螺旋CT胸腹主动脉联合扫描并进行最大密度投影（MIP）、多平面重建（MPR）、容积重建（VRT）等后处理。结果20例均较好地显示了真假腔和主动脉夹层内膜瓣,显示破121位置18例,显示分支血管受累情况16例,按DeBakey分型：Ⅰ型8例,Ⅱ型1例,Ⅲ型11例。出现胸腔积液9例,出现心包积液1例。结论多层螺旋CTA是诊断主动脉夹层首选的无创性检查方法,并能提供准确的临床分型,对临床治疗具有重要的指导意义。     

16层螺旋CT血管成像在主动脉夹层动脉瘤诊断中的价值

目的：探讨多层螺旋CT血管成像（MSCTA）在主动脉夹层动脉瘤的诊断和临床治疗中的应用价值。方法：18例主动脉夹层动脉瘤患者均进行了16层螺旋CT胸腹联合增强扫描并将原始数据在Vitrea2工作站进行多平面重建（MPR）、容积重建（VR）、最大密度投影法（MIP）等后处理。结果：18例均很好地显示了主动脉全程及其分支，真腔、假腔、内膜片及夹层动脉瘤的部位、范围得到满意显示。结论：MSCTA是诊断主动脉夹层动脉瘤准确、快捷、有效的首选方法，具有较高的临床应用价值。     

16排CT对主动脉夹层动脉瘤的诊断价值

目的：探讨16排CT扫描和多平面重建技术（MPR）对主动脉夹层动脉瘤的诊断价值。方法：对7例主动脉夹层动脉瘤的CT征象进行分析，了解该病的特征性CT征象。结果：CT诊断的直接征象为不同密度的真、假两腔及剥离的内膜瓣、钙化内移的内膜，多平面重建技术（MPR）的运用使夹层动脉瘤的诊断更加准确、客观。结论：16排CT扫描和多平面重建技术（MPR）的运用是诊断主动脉夹层动脉瘤首选的影像学方法，具有准确、快速、无创伤的特点。对该病的诊断具有划时代意义。     

螺旋CT血管造影术在夹层动脉瘤诊断中的应用

目的评价螺旋CT血管造影技术在夹层动脉瘤诊断中的临床应用价值。方法21例夹层动脉瘤行螺旋CT连续容积增强扫描，并将获得的数据传至工作站行三维重建，结合横断面及三维重建图像进行分析。结果根据Debakey分型，De．bakeyⅠ型10例，DebakeyⅢ型11例，两型中不典型夹层各2例。典型夹层动脉瘤的CT征象主要是分离移位的内膜、真假腔、主动脉壁增厚、钙化、主动脉不规则扩张；不典型主动脉夹层动脉瘤的征象为主动脉壁呈半月状或环状增厚，伴或不伴有内膜钙化内移。结论螺旋CT血管造影检查在诊断主动脉夹层动脉瘤中是一种安全有效的便于治疗后观察对比的方法。     

多期CT扫描方法在诊断主动脉夹层中的应用

目的:探讨螺旋CT多期扫描方法在主动脉夹层诊断中的价值。方法:对63例主动脉夹层动脉瘤患者行多层螺旋CT平扫及增强扫描,其中增强采用22s、35～39s、60s的扫描模式。观察真假腔内造影剂浓度变化。结果:按DeBakey分型,本组病例中Ⅰ型18例,Ⅱ型6例,Ⅲ型39例。多期扫描真假腔诊断准确率93%。结论:多期CT扫描方法可以提高主动脉夹层病例真假腔的诊断准确率,有较高的应用价值。     

16层螺旋CT血管造影及后处理技术在诊断主动脉瘤及主动脉夹层中的应用

目的:探讨16层螺旋CT血管造影及后处理技术对主动脉瘤和主动脉夹层的显示能力及临床应用价值.方法:回顾性分析28例经手术或血管造影证实的主动脉瘤及主动脉夹层的螺旋CT血管造影资料,后处理技术包括最大密度投影(MIP)、表面遮盖成像(SSD )、多层面重建(MPR)、曲面重建、容积重建(VR)、CT仿真内镜(CTVE)及导航技术(n avigation),采用t检验进行统计学分析.结果: 多种后处理图像与轴位图像相结合能清晰显示主动脉瘤及主动脉夹层的解剖细节及毗邻关系,良好的显示了动脉瘤形态、内腔、附壁血栓、钙化斑块及主动脉夹层真假腔、撕裂的内膜及动脉瘤破裂口的形态. 结论:16层螺旋 CT血管造影及后处理技术对主动脉瘤及主动脉夹层的诊断具有多方面的优越性,对于选择治疗方法、指导临床手术、观察术后疗效及随访具有重要的应用价值.     

MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm.     

Mistakes in the diagnosis and treatment of the complete dislocation and fractures of the acromial end of the clavicle

The analysis of the mistakes in the operative treatment of the sick with such a trauma was conducted. Two typical examples were given. The mistakes were stipulated non-diagnosis of the simultaneous break of the coracoclavicular ligament and not taking measures for its recovery. The radiodiagnosis based on N. Z. Shmidt's method is considered to be inevitable for this category of the sick. After the confirmation of the diagnosis the operation of choice can be the operation of Yotkins-Leochuk for the sick with the complete dislocation of the acromial end of the clavicle, and the operation of Yotkins for the sick with fractures of the acromial end of the clavicle with the break of the coracoclavicular ligament. By means of these methods 43 sick men with the dislocation and 7 sick men with fractures of the acromial end of the clavicle have been operated since 1973. No cases had complications, relapses or unsatisfactory results.     

On the Importance of the Level of Glutathione and the Activity of the Pentose Phosphate Pathway in Heat Sensitivity and Thermotolerance

Summary

Heating of Ehrlich ascites tumour (EAT) cells and mouse fibroblast LM cells to 43 or 44°C respectively, results in an increased level of reduced gluthathione (GSH). The maximum elevation in GSH was to 140 per cent for LM cells and to 120 per cent for EAT cells. No increase of GSH in EAT cells was observed after heating at 44°C. LM cells were treated with diethylmaleate (DEM) and the EAT cells with buthionine-sulphoximine (BSO) at non-toxic doses to deplete the levels of GSH. No effect on thermosensitivity or on the development of thermotolerance was observed when the DEM and BSO treatments were chosen such that the lowering of GSH was just down to the level of detection (about 5 per cent of control). When higher concentrations of DEM were used, thermal sensitization was observed. The activity of the pentose phosphate pathway (PPP) was also investigated because of its importance in supplying NADPH for the regeneration of GSH from GSSG and for the endogenous production of polyols. Hyperthermia was found to enhance markedly the flux of glucose through the PPP. While the DEM treatment inhibited glucose oxidation through the PPP, BSO addition to the cells resulted in a slightly increased activity of the PPP. The PPP activity of thermotolerant cells was lower (fibroblasts) or hardly affected (EAT cells) compared to control cells. The extent of PPP activation by hyperthermia was comparable for thermotolerant and control cells. For the two cell lines studied neither a high level of GSH nor an active PPP is a prerequisite for the development of thermotolerance.     

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Objectives

Musculoskeletal structures often appear brighter on imaging in the elderly, which makes it difficult to accurately delineate a peripheral nerve during ultrasound-guided regional anaesthetic procedures. The echo intensity of skeletal muscles is significantly increased in the elderly. However, there are no data comparing the echo intensity of peripheral nerves in the young and the elderly, which this study was designed to evaluate.

Methods

13 healthy, young volunteers (aged <30 years) and 11 elderly patients (aged >60 years) who were scheduled to undergo orthopaedic lower limb surgery were recruited. The settings of the ultrasound system were standardised and a high-frequency linear array transducer was used for the scan. A transverse scan of the median nerve (MN) and the flexor muscles (FMs) at the left mid-forearm was performed and three video loops of the ultrasound scan were recorded for each subject. Still images were captured from the video loops and normalised. Computer-assisted greyscale analysis was then performed on these images to determine the echo intensity of the MN and the FMs of the forearm.

Results

The echo intensity of the MN and FMs of the mid-forearm was significantly increased in the elderly (p<0.005). There was also a reduction in contrast between the MN and the adjoining FM in the elderly (p=0.04).

Conclusion

Under the conditions of this study, the MN and the FMs in the forearm appeared significantly brighter than those in the young, and there was a loss of contrast between these structures in sonograms of the elderly.Recently, there has been an increase in interest in the use of ultrasound to guide peripheral nerve blocks [1-3]. We have observed during such procedures that musculoskeletal structures often appear significantly brighter and that there is loss of contrast between the nerve and its adjoining muscles in the elderly, which often makes it difficult to accurately delineate a peripheral nerve using ultrasound in this age group. There are published data showing that the echo intensity (EI) of skeletal muscles is significantly increased in the elderly [4]. However, there are no data comparing the EI of a peripheral nerve in the young and the elderly, which this study was designed to evaluate.     

Sonography of the wrist and the hand

Sonographic examination of the hand requires high-frequency linear transducers. As the relevant structures are located very close to the surface, water stand-off pads are mandatory. Owing to the high sensitivity of sonography in the detection of fluid, exudative synovitis, tenosynovitis and ganglia can be easily diagnosed. Sonographic information on muscle atrophy and alterations of the shape and echogenicity of the median nerve in patients with carpal tunnel syndrome may be useful in evaluating the extent of disease. Further indications for the sonographic examination of the hand include suspected tumors, foreign bodies and synovial proliferation. Osseous destruction can be visualized in patients with rheumatoid disease, but the precise extent is hard to determine.     

Study on the stability of the calibration and normalization in PET and the influence of drifts on the accuracy of quantification

With regard to the quality control of quantification in positron emission tomography some characteristics were examined, to develop a simple method for frequent monitoring. The stability and uniformity of the detector count rate was checked by plotting the RMS deviation of the non normalized count rate and the standard deviation of the normalized count rate, each normalized to its value after the calibration or normalization respectively. Switching off a single detector did not impair the image quality, but the normalized image pixel counts were reduced by 2%–3% when a detector block was switched off. Thus in case of need, a weak detector can still be used to perform a scan. A reduced count rate capability at specific activities above 5x10⁴ Bq/ml (1.5x10⁵ corrected true system counts/s or 1.5x10⁴/s for a plane) was found compared to the maximum usable activity of 8x10⁴Bq/ml obtained 1 year earlier, indicating a drift in the count loss corrections. A variation of the room temperature changes the temperature distribution inside the gantry by 5% per °C and the drift of the sensitivity (normalized image pixel counts) is 2% per °C.This article was presented at the 1st EEC workshop on accuracy determination in PET, January 19–20th. 1989 Pisa, Italy (COMAC-BME Concerted Project Characterization and Standardization of PET Instrumentation)     

Aspects of the venous drainage of the pons and the mesencephalon

Summary After a brief resumé of the morphology of the pontomesencephalic veins, the authors demonstrate the drainage dynamics of these veins in normal and pathlogical vertebral angio-seriograms. The repercussions of drainage impairment are illustrated.

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Untersuchungen über die Venen-Drainage von Pons und Mesencephalon

Zusammenfassung Nach kurzer Beschreibung der Morphologie der pontomesencephalen Venen wird die Drainagedynamik dieser Venen anhand normaler und pathologischer Vertebralisangiogramme demonstriert. Die unterschiedlichen Mechanismen einer Drainagebehinderung werden erläutert.

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A propos du drainage veineux du pont et du mésencéphale

Résumé Après un bref résumé de la morphologie des veines ponto-mésencéphalques, les auteurs décrivent les modalités de drainage de ces veines en sérioangiographie vertébrale normale et pathologique. Ils illustrent les répercussions de drainage défectueux.

     

高原彝汉成年人血红蛋白、红细胞值调查分析

目的了解高原地区彝汉成年人血红蛋白、红细胞及相关指标的基础水平，探讨其与国家参考值指标是否存在差异。方法选择健康成人规范采集静脉血，用美国COULTERAC·Tdiff2血球分析仪检测，对数据进行统计学处理。结果川西南高原彝汉成人的血红蛋白、红细胞水平及相关指标与国家参考值比较差异有非常显著的意义，P〈0．001；当地彝汉民族比较差异无显著意义，P〉0．05。结论有必要制定高原地区成人血红蛋白、红细胞及相关指标的正常参考值，为临床提供更科学实际的参考依据。     

四肢深部软组织血管瘤和血管畸形的X线及MRI表现

目的：探讨四肢深部软组织血管瘤和血管畸形的 X 线及 MRI 表现。方法回顾性分析经手术病理及 DSA 证实的89例四肢深部软组织血管瘤和血管畸形患者的临床、影像资料,其中89例均行 X 线平片检查,33例行 MRI 检查。结果 X 线检查中,骨质及软组织影未见异常者54例(60.7%),软组织异常者14例(15.7%),可见静脉石者30例(33.7%);骨质异常者32例(36.0%),其中伴骨膜反应者13例,皮质破坏16例,髓腔受累者10例,三者均受累者为7例弥漫性病灶。MRI 图像上,病灶呈蜂窝状或海绵状,T1 WI 上呈等低信号者25例(75.8%),低信号5例(15.2%),不均匀稍高信号3例(9.0%);T2 WI 上病灶为不均匀高信号伴低信号分隔,范围及边界显示清楚,其中9例内部可见低信号区伴血管流空影;检出静脉石10例(30.3%),呈低信号;增强后病变不均匀明显强化。骨质异常者18例(54.5%),均可见病灶紧邻骨质或呈半包绕、包绕改变,其中12例髓腔内可见异常信号影,3例为迂曲血管流空影。在15例(45.5%)骨质无改变患者中,3例病灶邻接骨质,余12例病灶与骨间隔以脂肪或肌肉组织。结论四肢深部软组织血管瘤和血管畸形可引起邻近骨质的异常,掌握其 X 线及 MRI 表现特征,有助于提高对本病的诊断与鉴别诊断能力。