共查询到20条相似文献,搜索用时 15 毫秒
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Demaria RG Vernhet H Battistella P Frapier JM Rouvière P Albat B 《The heart surgery forum》2004,7(1):51-54
Abstract Background: Selective coronary angiography is the standard but invasive procedure for postoperative assessment of coronary artery bypass graft patency. The aim of this prospective study is to evaluate the multislice computed tomography (CT) as a means of postoperative patency assessment and anastomotic site control of arterial and venous coronary bypass grafts performed with off-pump coronary artery bypass techniques. Methods: Over a 6-month period, 20 patients underwent isolated coronary artery bypass (beating heart technique) and benefited, 7 days later, from a patency and anastomotic site control by multidetector angio multislice CT with cardiac gating. Results: Whole internal thoracic artery bypasses and venous grafts were visualized perfectly on their entire length, including the anastomotic site, and 3-dimensional reconstruction was possible. The relationship between cardiac cavities and the bypasses were well visualized, allowing quantification of bypass stenosis ensured by software analysis. Conclusions: Postoperative control of coronary bypasses is possible by multislice CT with a very satisfactory resolution, thus making it possible to check the patency of coronary bypasses and the quality of anastomosis with a noninvasive method. Three-dimensional reconstructions are very useful in the event of redo surgery. 相似文献
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Martin H. Hessmann Alexander Hofmann KarlFriedrich Kreitner Carsten Lott Pol Maria Rommens 《European Journal of Trauma》2005,31(3):231-238
Abstract
Reducing time requirements for the primary diagnostic
evaluation is a major concern in the early
phase of polytrauma management. Multislice computed
tomography (MSCT) is a quick and reliable
method for the initial diagnostic evaluation. CT provides
more detailed and more consistent information
than conventional radiography and it has the great
advantage of allowing rapid examination of the head,
vertebral column, chest, abdomen, and pelvis during
one single examination. The CT suite needs to be
adequately equipped for resuscitation and reanimation,
which is done parallel to the radiologic investigations.Since polytrauma management is based on a multidisciplinary
approach that is characterized by a coordinated
interaction between trauma surgeons, anesthesiologists
and radiologists, members of all involved
disciplines need adequate teaching. Guidelines and
algorithms contribute to optimize the early management. 相似文献
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目的 探讨多层螺旋CT血管造影(multislice spiral computed tomography angiography,MSCTA)在胃癌规范性根治术术前评估中的价值.方法 通过术前MSCTA了解86例胃癌患者腹腔干三大动脉分支及其属支(肝总动脉、肝右动脉、肝左动脉、脾动脉、胃左动脉)的解剖走行情况,并经术中验证;同时采用MSCTA对胃癌进行术前TNM分期,并将其与手术后病理结果 进行对照.结果 通过术中探查验证,86例患者术前MSCTA评估腹腔干三大动脉分支及其属支走行情况的准确率为100%.肝动脉解剖异常者22例,变异率为25.58%,其中异常肝右动脉11例(12.79%)、异常肝左动脉7例(8.14%)、同时存在异常肝左及异常肝右动脉1例(1.16%)、肝总动脉源自肠系膜上动脉3例(3.49%).脾动脉直型24例(27.91%),轻曲型44例(51.16%),显著曲型18例(20.93%).本组未发现胃左动脉变异情况.通过与术后病理对照,MSCTA对胃癌术前T、N、M分期的准确率分别为75.58%(65/86)、74.42%(64/86)和91.86%(79/86).结论 MSCTA能较客观地评估胃癌患者术前腹腔于三大动脉分支及其属支的解剖走行情况及较为准确地进行胃癌术前TNM分期,在制定手术方案、防止术中动脉损伤等方面有着重要的作用. 相似文献
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Ali Mofidi John S. ShieldsJosh S. Tan M.S. Gary G. PoehlingAllston J. Stubbs M.D. 《Arthroscopy》2011,27(7):1005-1013
Femoroacetabular impingement has recently become a recognized cause of disability and hip arthritis. Hip arthroscopy and femoroacetabular reshaping have been performed to treat this condition. Quantification of the excess femoral and acetabular bone requiring resection has been challenging with the less invasive arthroscopic technique. We describe the use of intraoperative computed tomography assessing osteochondroplasty during arthroscopic surgery to treat cam- and pincer-type femoroacetabular impingement. We also describe the technical steps and present the important radiologic findings we have been able to visualize. We found intraoperative computed tomography scanning to be a reliable and reproducible method of assessing the quality of femoroacetabular impingement surgery. We believe that femoroacetabular impingement surgery can be assessed intraoperatively by use of computed tomography scanning where corrections can be made if necessary. 相似文献
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Aim
The purpose of the study was to examine changes in splenic volume among recipients during the course of adult-to-adult living donor liver transplantation (LDLT) using multislice computed tomography (CT) scanning with a semiautomatic volumetry software.Materials and Methods
Forty-eight patients, including 33 males and a mean overall age of 54 ± 8 years), underwent liver transplantation for the primary disease of liver cirrhosis with or without hepatocellular carcinoma (n = 31/17, respectively). The mean MELD score was 14 ± 6. The liver graft mass compared with recipient weight was 74% ± 28%. Splenic artery embolization was not performed. Dynamic CT scans splenic volume, and platelet counts (103/cm3) were obtained pre, ≤50 day and ≥90 days postoperatively.Results
The total time to generate volumetry and image postprocessing per examination was <10 minutes. One-factor analysis of variance (ANOVA) revealed that the average splenic volume tended to be reduced from pre- to post-LDLT, although not significantly: pre-LDLT, 469 ± 270 mL; ≤day 50, 369 ± 212 mL; and ≥day 90, 378 ± 210 mL (P = .066). One-factor ANOVA revealed that the average platelet count was significantly different in the 3 periods: pre-LDLT, 69 ± 32 × 103/cm3; ≤day 50, 181 ± 253 × 103/cm3; and ≥day 90, 126 ± 64 × 103/cm3 (P < .01). The post hoc Scheffé test revealed the statistical significance of the platelet counts between pre-LDLT and ≤day 50 (P < .01).Conclusion
Splenic volumetry with multislice CT and semiautomatic software, which is simple and not time consuming, was able to evaluate remission from hypersplenism during the course of LDLT. 相似文献9.
Zemel BS 《Current osteoporosis reports》2011,9(4):284-290
Quantitative computed tomography (QCT) methodologies have been instrumental in deepening our understanding of bone acquisition
and strength during childhood. Important publications in the last year have drawn attention to the functional muscle-bone
unit, showing that factors such as population ancestry, bone size, and muscle composition are additional dimensions of bone
strength that affect muscle-bone relationships. The role of adiposity in pediatric bone health is complex and may vary by
sex, puberty stage, and degree of obesity. Several new studies have demonstrated the association of peripheral QCT (pQCT)
outcomes with fracture, although pQCT outcomes are not superior to dual-energy x-ray absorptiometry measures in this regard.
New high-resolution pQCT studies document transient weakness in mid-puberty that coincides developmentally with the period
of peak fracture incidence. These new studies will ultimately help us understand the development of sex differences in bone
strength that emerge in adolescence. 相似文献
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Helical computed tomography with arterioportography (CTAP) and intraoperative sonography (IOUS) are both recognized to be
extremely sensitive in the detection of liver metastases measuring <2 cm in diameter. As sensitivity and specificity values
for both techniques differ significantly in the literature and in default of sufficient published data regarding this subject,
a lesion-by-lesion analysis was considered necessary. Accuracy of IOUS was compared with helical computed tomography (CT)
and portal-phase contrast enhancement (CTAP) in the preoperative detection of liver metastases from colorectal carcinoma projected
as a prospective blinded study. Cost efficiency should be determined. Liver CTAP and IOUS were evaluated in 33 patients with
colorectal carcinoma. Metastases were resected in 10 cases, and the remaining 23 patients were observed for follow-up with
CT investigations every 3 months for a period of 1 year. CTAP and IOUS detected all 13 lesions measuring 5–10 mm (13/13).
One metastasis measuring >10 mm was missed by IOUS. CTAP presented an ideal sensitivity of 100%, but specificity was as low
as 68%. IOUS sensitivity was 98% and specificity was 95%. IOUS and CTAP are of comparable value regarding the detection of
liver metastases <10 mm. Both techniques may be used if resections of synchronous or metachronous metastases are planned in
order not to miss limiting small lesions and to prevent superfluous liver surgery. Helical CT scan with dynamic intravenous
contrast enhancement is considered the most cost-effective preoperative staging method, although local staging may not be
achieved because of insufficient intraabdominal survey. 相似文献
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M. Özdemir R.S. Ökten F. Küçükay M. Ereren F.A.E. Özdemir M. Akdoğan S. Kaçar E.B. Bostancı 《Transplantation proceedings》2017,49(8):1806-1809
Purpose
The purposed of this study was to examine the incidence and multidetector computed tomography (MDCT) findings of splenic artery aneurysms (SAAs) in patients with liver involvement related to Wilson's disease.Methods
Eighteen patients with clinically and/or pathologically proven Wilson's disease underwent triphasic MDCT. Arterial, portal, and equilibrium phase images were obtained. The analysis of the CT features included the presence and characteristics of the SAA, splenic artery (SA) diameter, the presence and size of the portosystemic collateral vessels, and spleen volume.Results
SAAs were detected in 11 patients (61.1%). Eight (72.7%) patients had multiple aneurysms. In 6 (54.5%) patients, the SAAs were located in the distal third of the SA and the intraparenchymal part of the SA. In 3 (27.3%) patients, the SAAs were located only in the distal third of the SA. In 1 (9.1%) patient, the aneurysms were located in the intermediate, distal third, and intraparenchymal part of the SA; in another (9.1%) patient, the aneurysms were located only in the intraparenchymal part of the SA. There were significant differences between the patients with SAA and those without SAA with respect to SA diameter, portosystemic collateral vessel diameter, and spleen volume (P = .007, P < .001, and P = .006, respectively).Conclusions
The incidence of SAAs seems to be higher in patients with liver involvement related to Wilson's disease compared with patients with other causes of cirrhosis and portal hypertension. Large portosystemic collaterals, increased SA diameter, and spleen volume were significant factors for the presence of SAAs. 相似文献12.
W.J. Bush J.P. Davis M.A. Maluccio C.A. Kubal J.B. Salisbury R.S. Mangus 《Transplantation proceedings》2018,50(10):3501-3507
Background
Patients with cirrhosis and end-stage liver disease (ESLD) develop severe nutrition deficits that affect morbidity and mortality. Laboratory measures of nutrition fail to fully assess clinical deficits in muscle mass and fat stores. This study employs computed tomography imaging to assess muscle mass and subcutaneous and visceral fat stores in patients with ESLD.Methods
This 1:1 case-control study design compares ESLD patients with healthy controls. Study patients were selected from a database of ESLD patients using a stratified method to assure a representative sample based on age, body mass index (BMI), sex, and model for end-stage liver disease score (MELD). Control patients were trauma patients with a low injury severity score (<10) who had a computed tomography scan during evaluation. Cases and controls were matched for age ± 5 years, sex, and BMI ± 2.Results
There were 90 subjects and 90 controls. ESLD patients had lower albumin levels (P < .001), but similar total protein levels (P = .72). ESLD patients had a deficit in muscle mass (?19%, P < .001) and visceral fat (?13%, P < .001), but similar subcutaneous fat (?1%, P = .35). ESLD patients at highest risk for sarcopenia included those over age 60, BMI<25.0, and female sex. We found degree of sarcopenia to be independent of model for end-stage liver disease score.Conclusions
These results support previous research demonstrating substantial nutrition deficits in ESLD patients that are not adequately measured by laboratory testing. Patients with ESLD have significant deficits of muscle and visceral fat stores, but a similar amount of subcutaneous fat. 相似文献13.
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Melvin Korobkin 《Annals of surgery》1984,200(5):674-675
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近年来,冠心病(coronary artery disease,CAD)在我国的发病率明显增高,早期诊断、早期治疗尤为重要。随着计算机断层成像(CT)技术的迅速发展,多层螺旋CT(multidetector-row computed tomography,MDCT)逐步成为冠心病筛查和诊断的首选检查方法。现就MDCT的发展概况、钙化积分、检测冠状动脉狭窄程度、斑块评价、解剖变异显示、旁路血管评价、冠状动脉支架术后评价、心肌灌注、心功能分析等方面的临床应用进行综述 相似文献
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Phenotyping Chronic Lung Allograft Dysfunction Using Body Plethysmography and Computed Tomography 下载免费PDF全文
H. Suhling S. Dettmer M. Greer T. Fuehner M. Avsar A. Haverich T. Welte J. Gottlieb 《American journal of transplantation》2016,16(11):3163-3170
Restrictive subtype of chronic lung allograft dysfunction (CLAD) was recently described after lung transplantation. This study compares different definitions of a restrictive phenotype in CLAD patients and impact on survival. Eighty‐nine CLAD patients out of 1191 screened patients (September 1987 to July 2012) were included as complete longitudinal lung volume measurements and chest computed tomography (CT) after CLAD onset was available. CT findings and lung volumes were quantified and survival was calculated for distinctive groups and predictive factors for worse survival were investigated. Graft survival in patients with total lung capacity (TLC) between 90% and 81% of baseline (BL) (n = 13, 15%) in CLAD course was similar to those with TLC >90% BL (n = 64, 56%; log‐rank test p = 0.9). Twelve patients (13%) developed a TLC ≤80% BL and 10 (11%) had significant parenchymal changes on CT, of whom 6 (46%) also had TLC ≤80% BL. CT changes correlated with TLC ≤80% BL (Φ‐coefficient = 0.48, p = 0.001). Patients with either TLC ≤80% or significant CT changes (n = 16, 18%) had a significantly reduced survival (log‐rank p < 0.001). Forced vital capacity loss at CLAD onset was associated with poorer survival but did not correlate with the TLC or CT changes. A restrictive subtype of CLAD may be defined by either TLC ≤80% BL or severe parenchymal changes on chest CT. 相似文献
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K. Grąt M. Grąt O. Rowiński W. Patkowski K. Zieniewicz R. Pacho 《Transplantation proceedings》2018,50(7):2002-2005