下肢静脉曲张骨改变的X线征象

本文对103侧下肢静脉曲张患者的骨骼X线片进行观察,其中85％伴有不同程度的骨改变。据其X线改变特点,可归为五个方面:骨质疏松、骨膜反应、骨质增生硬化、骨梗死及骨轮廓改变,并对骨改变的机理及与下肢静脉曲张类型的关系进行探讨。     

健康成年人骨性半规管和椭圆囊的MSCT显微解剖研究

目的:利用MSCT测量骨性半规管的径线、相互间的角度,椭圆囊的径线及体积,并估算健康成年人前庭器官参考值。方法:对60例健康成人行颞骨MSCT靶扫描及双斜位MPR,以显示各骨性半规管的全程和椭圆囊的全貌,并测量骨性半规管的径线、半规管间夹角以及椭圆囊的长径、短径和体积。用SPSS v16软件进行差异性t检验和参考值估算。结果:①前骨性半规管的内径、高度、跨度的测量值分别为(1.82±0.16)mm、(5.34±0.32)mm、(4.90±0.62)mm;后骨性半规管分别为:(1.57±0.14)mm、(4.89±0.50)mm、(3.06±0.47)mm;外骨性半规管分别为:(2.32±0.31)mm、(2.11±0.46)mm、(3.74±0.44)mm;椭圆囊的长径、短径分别为:(5.01±0.34)mm、(3.51±0.43)mm,体积为(56.7±7.71)mm3。②相应骨性半规管的径线及椭圆囊的体积比较在性别及侧别上差异均无统计学意义(P>0.05);不同半规管间的径线比较差异有统计学意义(P<0.05)。③骨性半规管间夹角测量值:前骨性半规管和后骨性半规管间91.80°±7.18°,前骨性半规管和外骨性半规管间89.71°±4.95°,后骨性半规管和外骨性半规管间91.19°±1.46°。④骨性半规管间夹角比较在性别及侧别上差异均无统计学意义(P>0.05)。结论:①利用MSCT靶扫描结合双斜位MPR可以很好地显示骨性半规管的全程和椭圆囊的全貌。②本组骨性半规管的径线和椭圆囊的测量值处于95%的置信区间内,可以作为正常参考值。③外骨性半规管的内径最大,前骨半规管最小;前骨半规管的高度和跨度最大,外骨半规管最小。骨性半规管间的相互夹角并非严格相互垂直。     

中耳炎继发面神经骨管破坏的HRCT诊断

目的 :探讨 HRCT在中耳炎继发面神经骨管破坏诊断中的应用价值。方法 :采用高分辨率骨算法薄层连续扫描后行中耳重建放大 ,显示面神经骨管各段的解剖结构。回顾性分析 2 3例经手术证实的中耳炎继发面神经骨管破坏的 HRCT表现。结果 :1.胆脂瘤型中耳炎继发的面神经骨管破坏最多 (91% ) ;2 .面神经骨管破坏以鼓室段和迷路段为主 (73% ) ;3.发生于上鼓室和鼓窦区的病变易继发面神经骨管破坏 ;4.面神经骨管破坏大部分合并面神经损伤而致面瘫。结论 :HRCT对中耳炎继发面神经骨管破坏的诊断 ,对临床制定正确的手术方案 ,避免面神经损伤 ,提高手术成功率具有重要价值。     

颞骨鼓部发育不良所致外耳道畸形的CT分析

目的 分析84耳外耳道畸形的高分辨率CT（HRCT）表现，探讨颞骨鼓部发育畸形与外耳道畸形的关系。资料与方法 临床诊断84耳外、中耳畸形患者均行HRCT检查，重点观察骨性外耳道鼓部发育的形态。结果 鼓部完全未发育、骨性外耳道未形成43耳(43／84)；鼓部重度发育不良、鼓部为不规则形态、未形成骨性外耳道27耳(27／84)；鼓部中度发育不良、鼓部形成不典型的“U”结构、外耳道形态不良14耳(14／84)。结论 骨性外耳道发育不良与颞骨鼓部发育不全有重要关系。     

Ultrasound of the elbow: a systematic approach using bony landmarks

The use of bony landmarks can be helpful in performing an ultrasound study of the elbow. We discuss bony landmarks that can be used for evaluation of the common extensor tendon, ulnar collateral ligament and common flexor tendon, coronoid and olecranon fossa, ulnar nerve, and biceps tendon. We discuss bony landmarks for each of these structures.     

下齿槽神经缺失对下颌骨骨折愈合影响的实验研究

目的观察兔下颌骨骨折愈合中下齿槽神经缺失对骨痂血管生成和矿化成骨的影响，探讨神经在颌骨骨折愈合的作用机制。方法40只新西兰白兔分作失神经下颌骨骨折的实验组和单纯下颌骨骨折的对照组，分别于术后4d、7d、14d和28d获取骨痂，通过HE染色、免疫组化对标本行形态学观察，对比两组CGRP、VIP表达情况；通过Ⅷ因子相关抗原染色检测骨痂早期新生血管密度，四环素免疫标记法检测骨痂后期矿化成骨量。结果实验组和对照组骨痂存在明显的形态学差异，实验组中CGRP、VIP表达低于对照组；实验组早期血管密度和后期矿化成骨量均低于对照组。结论下齿槽神经缺失影响骨痂的血管生成和矿化成骨量，不利于下颌骨骨折愈合。     

横纹肌肉瘤骨侵蚀X线表现（附4例报告并复习文献）

横纹肌肉瘤骨侵蚀较少见，本文报告４例并复习国内文献报告的８例，对其ｘ线表现进行了分析、总结。横纹肌肉瘤骨侵蚀的Ｘ线表现较为复杂，有骨质破坏，骨膜反应和软组织肿块。为便于认识，作者将骨质破坏分为广泛溶骨型、渗透状、虫蚀状和骨皮质外压吸收四型，这四型可混合存在。通过分析这１２例可见横纹肌肉瘤骨侵蚀多见于四肢骨和颅面骨，病理上以胚胎型、腺泡型为主者多见。     

A new “double-pulley” dual-row technique for arthroscopic fixation of bony Bankart lesion

The double-row technique is a new concept for arthroscopic treatment of bony Bankart lesion in shoulder instability. It presents a new and reproducible technique for arthroscopic fixation of bony Bankart fragments with suture anchors. This technique creates double-mattress sutures which compress the fragment against its bone bed and restores better bony anatomy of the anterior glenoid rim with stable and non-tilting fixation that may improve healing.     

Computerized tomography in the evaluation of the soft tissue component of bony lesions of the pelvis

Three cases are presented in which lesions of the bony pelvis with extraosseous soft tissue components are evaluated using computerized tomography. In each instance, computerized tomography provided precise anatomic localization of bony lesions and clearly depicted the extent of associated extraosseous masses. In all cases, the clarity of anatomic detail obtained suggests that computerized tomography represents an important new methodology for evaluation of the soft tissue component of bony lesions of the pelvis.     

Cystic expansile masses of the maxilla: differential diagnosis with CT and MR.

PURPOSETo describe the CT and MR findings of various entities causing cystic expansile masses in the maxilla and the significance of the cortical bony plate between the lesions and sinus cavities in the differential diagnosis.METHODSCT findings of 28 patients with cystic expansile masses of the maxilla, including 20 cases of maxillary mucoceles (17 postoperative mucoceles, 2 mucoceles of a septated compartment of the maxillary sinuses, and 1 maxillary antral mucocele with inflammatory ostial obstruction), 3 cases of fissural cyst, 4 cases of odontogenic cyst, and 1 case of maxillary cystic ameloblastoma, were reviewed. Six cases (4 postoperative mucoceles and 2 odontogenic cysts) were also examined with MR.RESULTSA thin bony plate between the lesion and antral cavity was demonstrated in every extraantral lesion (ameloblastoma, fissural cysts, and odontogenic cysts) and distinguishing these abnormalities from the antral lesions (mucoceles). All mucoceles showed findings of antral lesions except 2 cases of mucoceles at the septated compartments of the sinuses, in which thin bony septa were identified between the lesions and remaining sinus cavities. Postoperative mucoceles showed hyperostotic and retracted bony walls caused by previous surgery and localized erosion of bony walls with localized bulging of the cystic masses in every case.CONCLUSIONIn the differential diagnosis of cystic masses of the maxilla, careful identification of the bony walls of the antrum and bony septa may allow one to locate the origin of a mass as antral or extraantral. This is important to an appropriate differential diagnosis.     

多层螺旋CT双斜位MPR对骨半规管的全程显示研究

目的:利用多层螺旋CT各向同性扫描进行双斜位多平面重组(multiplanarreformation,MPR)后处理,重建出各半规管全貌。方法:搜集观察对象105例(男52,女53),210耳,年龄范围为9个月至71岁,利用多层螺旋CT各向同性扫描对颞骨进行检查,然后对所得图像进行双斜位多平面重组(multiplanarreformation,MPR)后处理,重建出各半规管全貌。结果:通过双斜位多平面重组(MPR)后骨半规管和外骨半规管均能在一个平面上显示其全貌,部分前骨半规管(105例中6例,5.7%)未能显示全貌。结论:多层螺旋CT各向同性扫描后双斜位多平面重组(MPR)后处理能够很好的显示各骨半规管的全貌。     

A combined transglenoid and suture anchor technique for bony Bankart lesions

We present a modified hybrid technique that is a combination of a transglenoid and suture anchor technique. Three-dimensional CT reconstruction is indicated for patients with bony fragments larger than 10 mm. First, a transglenoid technique is performed to reduce the bony fragment and then a suture anchor technique is performed to achieve a stable fixation. This combined technique is a useful arthroscopic procedure for the easy reduction and stable fixation of bony Bankart lesions.     

Computed tomographic features of the bony canal of the cochlear nerve in pediatric patients with unilateral sensorineural hearing loss

Purpose The aim of this study was to evaluate the diameters of the various bony canals of the inner ear in patients with sensorineural hearing loss (SNHL) and establish criteria for detecting hypoplasia of the bony canal of the cochlear nerve. Materials and methods Measurements obtained in 118 patients without inner ear malformations among 160 patients with unilateral SNHL were analyzed. The diameters of the internal auditory canal and the bony canals of the cochlear, vestibular, and facial nerves were measured on transverse or coronal computed tomographic images. Mean values (± SD) were compared between the affected and unaffected ears, and statistical analysis was done. Results The diameter of the bony canal of the cochlear nerve was significantly smaller in affected ears than in unaffected ears (P < 0.01). The affected ears could be divided into groups with (72 ears) and without (46 ears) bony canal stenosis. Conclusions Most (60%) of the patients with unilateral SNHL showed a significant difference in the diameters of the bony canals of the cochlear nerve between the affected and unaffected sides; moreover, the mean value was significantly smaller in affected ears. The diameter of <1.7 mm on transverse images or <1.8 mm on coronal images suggests hypoplasia.     

Bony inlet stenosis as a cause of nasal airway obstruction

Two cases of congenital bony stenosis of the nasal piriform aperture (anterior nares) are presented. Both patients experienced episodes of respiratory distress and clinical symptoms similar to those seen in patients with posterior choanal atresia. The underlying anatomic abnormalities in congenital bony inlet stenosis are quite different from those in choanal atresia and require different surgical approaches for correction. Computed tomography demonstrates in detail the underlying anatomic abnormality and allows differentiation of bony inlet stenosis from choanal atresia.     

Ilizarov's method. Histological and radiological aspects

The Ilizarov method is an original technique of surgical lengthening of long bones. The constraints in compression and distraction obtained with this method favor the bony healing. The straining of extension induces stimulating consequences on the bone. The healing process is different from that of the fractures because the bony regeneration is accomplished by a membranous bony mechanism without intermediate fibrous or cartilaginous medium. The maturation occurs when the lamellated bone is present, at the end of the 4th month.     

外伤性眶底骨缺损的重建

目的介绍重建外伤性眶底骨缺损的方法与疗效。方法在眶周骨折复位同期，对24例眶底骨缺损经下睑缘下途径重建，使用微型钛板重建12例，钛网6例，自体骨6例(上颌窦壁3例、喙突1例、髂骨2例)。结果全部患者颧部塌陷与眼球外观畸形矫正满意，下睑缘切口瘢痕不明显。术前15例眼与眶下神经功能障碍者中，术后半年仅1例复视、2例眶下神经麻痹未消失，均为伤后6～8周后期治疗者。影像检查植入物位置理想。结论早期重建眶底骨缺损有利于功能恢复，减少并发症。重建材料应根据骨缺损程度与眼球位置选择，缺损范围较小且眼球位置正常者可使用微型钛板、钛网重建，反之应使用自体骨重建以缩小眶腔容积并支撑眼球。     

螺旋CT容积再现技术在椎管内骨嵴形态学研究中的应用

目的:显示椎管内骨嵴三维立体结构,测量其大小、形态。方法:63例脊髓纵裂合并椎管内骨嵴患者行螺旋CT容积扫描,共发现79个骨嵴,将其原始数据减薄行容积再现技术(volume rendering technique,VRT)重建。结果:骨嵴可分为不分叉型及分叉型,不分叉型65个,分叉型14个,不分叉型明显多于分叉型(P<0.05);不分叉型有多种形态,在胸腰段形态多为前后粗中间细前端径线大于后端径线且前中部上下径大于宽径形(P<0.05);上腰段骨嵴前端宽径明显大于其它节段(P<0.05);分叉型多为后方分叉型,总共14个分叉型中有7个位于腰1节段。结论:VRT图像可以清晰显示椎管内骨嵴的三维解剖学形态,其在椎管内骨嵴诊断及术前评估中具有重要的应用价值。     

The relationship of transverse sinus stenosis to bony groove dimensions provides an insight into the aetiology of idiopathic intracranial hypertension

Introduction  Transverse sinus tapered narrowings are frequently identified in patients with idiopathic intracranial hypertension (IIH); however, it remains unclear whether they are primary stenoses or whether they occur secondary to raised cerebrospinal fluid pressure. Computed tomographic venography demonstrates both the morphology of the venous system and the adjacent bony grooves so it may provide an insight into the aetiology of these transverse sinus stenoses. Materials and methods  Tapered transverse sinus narrowings (>50%) were studied in 19 patients without IIH and 14 patients with IIH. Computed tomography vascular studies were reviewed and the dimensions of the venous sinuses and bony grooves at the sites of maximum and minimum transverse sinus area dimensions were recorded. Results  There was demonstrated to be a strong correlation of bony groove height with venous sinus height at the largest portions of the transverse sinus in both IIH patients and non-IIH subjects as well as at the transverse sinus narrowing in non-IIH subjects. There was a discordant relationship between bony groove height and venous sinus height at the site of transverse sinus stenoses in IIH patients. In 5/23 IIH transverse sinus stenoses, the bony groove height was proportionate to that seen in non-IIH subjects. There were a further 8/23 cases where the small or absent sinus was associated with an absent bony groove. Conclusion  Transverse sinus tapered narrowings in subjects without IIH and in the majority of patients with IIH were associated with proportionately small or absent grooves, and these are postulated to be primary or fixed. Some patients with IIH demonstrate tapered transverse sinus stenoses with disproportionately large bony grooves, suggesting a secondary or acquired narrowing. This implies a varied aetiology for the transverse sinus stenoses of IIH.     

Superficial bone metastases: report of two cases from colonic origin

Two cases of superficial bony metastases from colonic adenocarcinoma are reported. The plain film, CT and MR features are presented. The diagnostic imaging features and differential diagnosis are discussed. Superficial bony metastases are rare (2% of bony metastases) and only the characteristics of cortical bone vascularization allow to understand the superficial origin at the level of the cortex or subperiosteum. Magnetic resonance imaging is the modality of choice to characterize the tumor site and local extension. Diagnosis is suspected by clinical history and confirmed at biopsy.     

中耳炎侵犯迷路的影像表现

目的:探讨中耳炎侵犯迷路的HRCT和MRI表现及其诊断价值与局限。方法:回顾性分析24例(24耳),经临床综合诊断为中耳炎侵犯迷路患者的HRCT和MRI表现。结果:骨迷路破坏8耳,HRCT诊断7耳,表现为骨迷路破坏,中耳内病变与迷路腔相通。迷路腔淋巴液受侵14耳,HRCT显示骨迷路破坏9耳,骨迷路完好5耳。MRI示8耳迷路腔淋巴液于T1WI上信号升高,T2WI信号无变化,其中7耳增强扫描有明显强化,1耳轻度强化;5耳迷路腔淋巴液于T1WI信号升高,T2WI信号减低,其中4耳明显强化,1耳轻度强化;1耳迷路腔淋巴液于T1WI和T2WI信号无变化,增强后明显强化。迷路增生、硬化1耳,HRCT显示耳蜗骨迷路骨质增厚、硬化,迷路腔变窄;MRI上表现为蜗腔变细。骨迷路广泛破坏1耳,位于耳蜗后部骨迷路内,HRCT显示骨迷路内大片软组织密度影,周围骨质破坏,内部可见形态不规则死骨;MRIT1WI和T2WI显示骨迷路内均呈混杂信号,增强后有不均匀强化。结论:HRCT和MRI可显示中耳炎侵犯迷路的程度,能为临床制定治疗方案提供重要信息。