超声引导介入治疗肝包虫囊肿

外科手术一直是治疗肝囊型包虫病的主要方法〔1〕,其疗效肯定 ,治愈率高〔2～ 5〕,但也存在诸多问题 ,如创伤大、再次手术困难等。近 1 0多年来 ,苯丙咪唑类药物越来越多地应用于临床 ,但由于其吸收差、代谢快 ,血药、肝药及病灶内药物浓度低 ,实际治疗效果并不理想 ,治愈率仅为 30 %左右〔1 ,6〕。 2 0世纪80年代以来 ,随着医学影像学特别是介入治疗的迅速发展 ,人们开始尝试肝囊型包虫病的穿刺治疗〔7～ 9〕。 1 985年Ｍｕｅｌｌｅｒ等〔7〕首次穿刺治疗人类肝囊型包虫病获得成功 ,到目前为止 ,全球穿刺治疗的病例数已逾 2 0 0 0例〔1 0～…     

超声引导下介入治疗卵巢巧克力囊肿疗效观察

在妇科疾病中．超声介入治疗越来越受到重视及推广。本院从2000年6月至2004年12月．应用介入性超声技术对41例卵巢巧克力囊肿经阴道超声下囊肿穿刺抽液．并注入99．9％乙醇固定术治疗。术后随访．疗效确定，现将结果总结报告如下。     

隐性腕背腱鞘囊肿的超声诊断与治疗

目的初步探讨隐性腕背腱鞘囊肿超声诊断的准确性及手术疗效。方法对慢性腕关节背侧疼痛的患者,应用超声检查诊断出隐性腕背腱鞘囊肿7例,对其中5例采取手术治疗,2例保守治疗。结果5例手术患者中,其中4例术中发现舟月间隙有腱鞘囊肿,与术前超声诊断相符,1例未发现肿块。4例行囊肿切除,1例行腱鞘松解术;术后随访2～6个月,术后腕背疼痛症状完全消失,关节活动正常,握力较术前明显改善。2例保守治疗患者,经6～12个月的随访,腕背症状无明显缓解。结论隐性腕背腱鞘囊肿手术疗效可靠,超声诊断作为一种简便、无创的检查方法,对慢性腕关节背侧疼痛的临床诊断提供了新的检测手段。     

针刺治疗腱鞘囊肿

针刺治疗腱鞘囊肿福建省中医药研究院（３５０００３）蔡宗敏腱鞘囊肿（Ｔｈｅｃａｌｃｙｏｔ）是常见的关节囊或腱鞘附近所发生的粘液样病变，患者因长期劳损等因素，因手足等部位胀微痛，软弱乏力而影响工作，对生活带来痛苦与不便。国内有关针灸治疗本病的方法繁多，效...     

经直肠超声引导穿刺硬化与注药治疗 前列腺囊肿的疗效对比

目的探讨经直肠超声引导穿刺硬化与注药治疗前列腺囊肿的疗效及临床应用价值。方法将28例前列腺囊肿患者平均分为2组,分别进行经直肠超声引导穿刺硬化治疗（硬化组）和注药治疗（注药组）。比较两组的一次穿刺有效率及18个月后的复发率。结果硬化组12例患者一次穿刺硬化治疗后囊肿显著减小,症状消失,一次硬化治疗有效率为85.71%（12/14）;注药组11例一次穿刺注药治疗后囊肿显著减小,症状消失,一次注药治疗有效率为78.57%（11/14）,两组一次穿刺治疗有效率差异无统计学意义（P=0.648）。随访18个月,硬化组1例（7.14%,1/14）复发,注药组4例（28.57%,4/14）复发,两组复发率差异无统计学意义（P=0.328）。结论经直肠超声引导穿刺前列腺囊肿准确可靠,硬化治疗与注药治疗均具有较高的临床应用价值。     

超声引导下经皮穿刺硬化治疗子宫内膜异位性囊肿

目的探讨超声引导下经皮穿刺硬化治疗子宫内膜异位性囊肿的临床应用价值。方法回顾性分析接受超声引导下经皮穿刺硬化治疗的113例子宫内膜异位性囊肿患者资料,观察超声引导下经皮穿刺硬化治疗子宫内膜异位性囊肿的方法及疗效。结果 113例患者120个囊肿中治愈113个,囊肿缩小7个,无无效病例,首次治愈率94.17%,总有效率100%。结论超声引导下经皮穿刺硬化治疗可作为子宫内膜异位性囊肿的首选治疗方法 。     

超声引导下经皮肝穿抽吸硬化介入治疗肝包虫囊肿

目的探讨超声引导下经皮肝穿抽吸硬化治疗肝包虫囊肿的应用价值。方法在超声引导下对38例肝包虫囊肿患者行经皮肝囊肿穿刺抽吸囊液,抽尽后向囊内注入20%～25%无菌高渗盐水或95%无水乙醇,注入量约为抽出量的25%～50%,保留5～15 min后全部抽出,再注入5～10 ml予以保留,术前术后结合口服抗包虫药阿苯达唑30～50mg/kg治疗。术后定期行超声随访,1年内3个月复查1次,1年后每年复查1次。结果治疗中1次穿刺成功率100%,6个月后16例囊肿缩小50%、22例缩小30%。1年后34例治愈,3例显效,1例好转。其后囊肿逐渐缩小,直至钙化,治愈率达100%。结论超声引导下经皮肝穿抽吸硬化治疗肝包虫囊肿是一种安全、有效、可靠的方法。     

对比X线与经阴道超声引导下介入治疗输卵管妊娠

目的探讨X线与经阴道超声引导下介入治疗输卵管妊娠的方法与疗效,并分析两种介入治疗方法的优、缺点。方法将30例输卵管妊娠患者随机分为两组,分别接受X线引导下局部注入氨甲蝶呤介入治疗和经阴道超声引导下局部注入高渗葡萄糖介入治疗。所有患者均于治疗前后测量血HCG、病灶大小及彩色血流阻力指数,并于术后接受输卵管造影检查。结果 X线引导下局部注入氨甲蝶呤对血HCG高、输卵管妊娠孕囊型的患者疗效较好,患者疼痛感较轻,且术后输卵管复通率高;经阴道超声引导下局部注入高渗葡萄糖对血HCG低、输卵管妊娠流产型患者的疗效较好,但患者痛疼感较强。结论两种介入治疗方法各有其优缺点,丰富了输卵管妊娠的非手术治疗方法。     

椎管内滑膜囊肿及腱鞘囊肿

滑膜囊肿和腱鞘囊肿为起自关节旁组织的囊肿,常见于腕、膝、踝、足等关节附近,起自脊椎关节突关节旁的滑膜囊肿和腱鞘囊肿较为少见[1-15]。虽然本病在国内外文献中的报道较少,但考虑到每位神经外科、骨科和放射科医生都可能会遇到,故我们对最近几年的医学文献进行了检索,对本病作一介绍。一、病理改变滑膜囊肿有蒂附着于关节囊内,囊内充满草黄色清亮的滑液,也可见含铁血黄素,有时还含有气体。囊壁由含有血管的多层绒毛结节状增生的结缔组织、疏松的粘液样结缔组织或胶原纤维以及弹力纤维构成。囊肿内壁被覆假复层柱状滑膜上皮细胞,…     

超声引导肝肾囊肿介入治疗的方法再探

目的对超声引导乙醇治疗肝肾囊肿的方法进行进一步的探讨,使乙醇治疗肝肾囊肿疗效更好,安全性更高。方法采用超声引导下的直接乙醇冲洗疗法和置管引流冲洗疗法,乙醇总量不予控制为主要方法改进。注重术前认真谈话和彩超引导。结果肝肾囊肿共306个,治愈249个,明显有效48个,有效6个,无效3个。治愈率81.37%,有效率99.02%。其中,肾囊肿189例241个囊肿,有效率100%,治愈率87.55%;肝囊肿59例65个囊肿,有效率95.38%,治愈率58.46%。无一例出现明显的过敏反应、出血等并发症。结论①超声引导下的直接乙醇冲洗疗法和置管引流冲洗疗法,疗效确切,不良反应少。②肾囊肿的治愈率明显高于肝囊肿(P<0.01);大于10mm的肝囊肿疗效差(P<0.01)。③术前认真谈话和彩超引导也很重要。     

3D(4D)超声成像技术在肝肾囊肿介入穿刺中的临床应用

目的评价3D（4D）超声成像技术在肝肾囊肿介入穿刺中的临床应用价值。方法分别用动态三维成像（即4D超声成像）、实时动态三维成像（即实时4D冠状面成像）和静态三维成像的条件进行肝肾囊肿的引导穿刺过程。结果①4D超声成像无法达到实时状态,显示的图像落后于针道的步进,图像平均采集时间较长。实时动态4D冠状面成像,引导穿刺过程效果最佳,能达到实时状态;②穿刺针在4D冠状面图像和融合平面上比正常情况要厚一些,这一现象增加了针在穿刺过程中的可视性;③静态3D只能穿刺结束后评价针的最终位置而不能引导穿刺的过程;④实时4D的最佳成像模式为表面质地模式50%和透明最大模式50%混合,动态4D以多平面成像和表面模式成像引导穿刺过程为最佳。结论3D（4D）超声成像技术为超声引导穿刺过程开辟了一条新的途径。     

Intraosseous ganglion cyst within the L4 lamina causing spinal stenosis

Background context

There are rare reports of intraosseous ganglion cysts in the cervical spine. However, to our knowledge, there are no previous reports of these cysts occurring in the lumbar spine.

Purpose

To report a case of symptomatic lumbar spinal stenosis caused by an intraosseous ganglion cyst of the L4 lamina that communicated with the spinal canal.

Study design

Case report.

Methods

An 86-year-old woman was referred to our spine service for a 2-year history of anterior thigh and leg pain. Magnetic resonance imaging revealed a benign-appearing intraosseous cyst in the left L4 lamina communicating with a posterior epidural cyst at L4–L5 causing marked spinal stenosis. The patient was treated successfully with a laminectomy and resection.

Results

The patient underwent partial laminectomies of L4 and L5 preserving the interspinous ligaments between L5–S1 and L3–L4. The cyst was removed en bloc without violation of the cyst wall. Histopathologic examination revealed focal myxoid changes without a cellular lining of the cyst wall, confirming the diagnosis of intraosseous ganglion cyst.

Conclusions

This is the first report to describe an intraosseous ganglion cyst occurring in the lumbar spine. Although spinal stenosis is commonly a result of degenerative joint or disc disease, it occasionally may result from more obscure causes. This case illustrates a patient with an intraosseous ganglion cyst within the spinal lamina resulting in spinal stenosis, treated successfully with a laminectomy and resection.     

Case report: intraneural ganglion cyst of the ulnar nerve at the wrist

We report a case of a 69-year-old male who presented with pain, weakness, and clumsiness of his right hand. Initial evaluation suggested possible neoplastic process affecting his cervical spine, which was fortunately ruled out by bone biopsy. Subsequent electrodiagnostic studies and magnetic resonance imaging confirmed a lesion of the deep ulnar motor branch. Exploration of Guyon’s canal was performed, and an intraneural ganglion involving the deep motor branch of the ulnar nerve was found and excised. Despite more than 14 months of symptomatic duration, the patient made a near-complete recovery with virtually no functional limitations. This provides supporting evidence for a functional benefit of intraneural ganglion excision and nerve decompression even in cases of chronic muscle atrophy.     

Acute lumbosacral hemorrhagic ganglion cyst after transforaminal epidural steroid injection

Epidural steroid injection is one of the most commonly used non-surgical treatments for degenerative lumbar vertebral disease. Its use has increased as degenerative lumbar vertebral disease has increased in frequency. Concomitant complications are being reported more often. In this report, we report a rare case of iatrogenic hemorrhagic cyst following epidural steroid injection. The patient underwent operative treatment with complete resolution of his symptoms     

Intratendinous ganglion cyst of the extensor digitorum longus tendon: A case report

IntroductionGanglion cysts are benign lesions, common in the hand and wrist. Intratendinous ganglion, however, are rare. We present the first reported case of an intratendinous ganglion cyst in an extensor digitorum longus (EDL) tendon of the foot.Case reportA 35-year old presented with a left-sided painful dorsolateral foot swelling. Ultrasound suggested a ganglion cyst in proximity to the EDL tendon of the 5th toe. Two distinct swellings were identified on surgical exploration, including a 6 × 1 cm ganglion lying within the EDL tendon substance that had resulted in tendon splitting. The lesions were excised and EDL tendon repaired. Histological analysis confirmed that both lesions were ganglion cysts. Post-operative recovery was uneventful.DiscussionIntratendinous ganglion cysts are rare lesions that pose a unique set of diagnostic and treatment challenges. Unlike conventional ganglion, their diagnosis may not be possible until surgical exploration. They have been reported to increase the risk of spontaneous tendon rupture. As such, a lower operative threshold should be applied to prevent their progression. A high index of suspicion should be applied to any ganglion reported radiologically to be in close contact with tendons. If diagnosed upon surgical exploration, it is essential that the operating surgeon is prepared to appropriately modify the procedure to involve primary tendon repair, tendon transfer or tenodesis.     

Compression neuropathy of the peroneal nerve secondary to a ganglion cyst

Peripheral neuropathies caused by ganglion cysts are rare, particularly in the lower extremities. The case of a 45-year-old man with a two-month history of foot drop and swelling in the region of the right fibular head is presented. Physical examination and electromyogram studies verified a peroneal nerve palsy. Magnetic resonance imaging revealed a lobulated, multilocular, cystic-appearing mass extending around the fibular neck. Surgical decompression of the nerve with removal of the mass and careful articular branch ligation was performed. Surgical pathology reports confirmed the diagnosis of a ganglion cyst. The patient regained full function within four months of the decompression. Pertinent findings on physical examination are discussed, as well as electromyogram and magnetic resonance imaging results. If symptoms persist, early surgical decompression (between the third and fourth months) is recommended.     

高频超声对肘部囊肿的诊断价值与介入治疗研究

目的:分析研究高频超声对肘部囊肿的诊断价值与介入治疗的价值。方法:回顾性分析自2018年2月至2021年2月采用高频超声下介入疗法治疗60例肘部囊肿患者的资料,男30例,女30例;年龄20~54(30.93±5.32)岁;病程1~10(3.45±0.25)年。观察所有患者高频超声表现特征,分析治疗后临床疗效、不良事件发生情况以及治疗前后心理状态变化情况。结果:60例肘部囊肿中,囊肿大小6 mm×7 mm~111 mm×60 mm。超声图像特点:多数形态规则,呈圆形或椭圆形,少数形态不规则;边界清晰,存在囊壁,大部分囊内透声较好,呈无回声;伴有出血或感染时,可见细小密集点漂浮;病程较长受试者囊壁较为毛糙,且内部可见光带分隔,呈多房样;未见显著血流信号。最终检查结果:尺骨鹰嘴滑囊囊肿19例,桡骨环状韧带囊肿10例,肱二头肌桡骨囊囊肿9例,副韧带损伤囊肿7例,肘部表皮样囊肿4例,腱鞘囊肿6例,神经鞘囊肿5例。治疗后,痊愈33例,显效16例,好转11例,无效0例。治疗后发生轻度不良事件1例,中度不良事件1例,重度不良事件0例。治疗后患者正性情绪评分(38.04±1.74)分,高于治疗前的(35.92±2.34)分(P<0.05);而负性情绪评分(24.61±1.51)分,低于治疗前的(30.15±3.46)分(P<0.05)。结论:高频超声对肘部囊肿的诊断价值较高,应用于介入治疗中的效果较为理想。