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Goldberg HI; Grossman RI; Gomori JM; Asbury AK; Bilaniuk LT; Zimmerman RA 《Radiology》1986,158(1):157-161
Two men underwent high-resolution magnetic resonance (MR) imaging of the internal carotid artery (ICA) 12 and 16 days after spontaneous dissection of this vessel. One underwent follow-up MR imaging 7 weeks later. T1-weighted images were obtained in both cases, and T2-weighted images were obtained in one patient. In both cases, the MR findings corresponded to the angiographic abnormalities. On both the T1- and T2-weighted images, there was a hyperintense lesion expanding the wall and narrowing the lumen of the ICAs. Follow-up MR imaging showed complete resolution of the mural lesion. Axial images best demonstrated the anatomic and MR signal alterations. The hyperintensity of the lesion on both T1- and T2-weighted images indicated a short T1 and a long T2 as expected in a subacute hematoma. High-resolution MR imaging, therefore, can specifically demonstrate a thrombosed carotid dissection noninvasively at least as early as 12 days. The potential to diagnose carotid dissection in the acute phase using high-field-strength MR imaging and its importance for the prevention of embolic strokes are also discussed. 相似文献
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The ability of diagnostic intravenous digital subtraction angiography (IVDSA) to demonstrate the degree of renal artery stenosis was compared with that of intraarterial angiography in 45 patients with 92 arteries. Stenotic lesions on both IVDSA and intraarterial studies were classified as normal (0% stenosis), minor (less than 50%), low grade (50%-80%), and high grade (80%-99%). There was agreement about the degree of stenosis in 90% of the cases. IVDSA grading was correct in 94% of atheromatous lesions and in 56% of the fibromuscular dysplastic lesions. In the high-grade atheromatous lesions, the degree of stenosis was slightly overestimated on IVDSA studies in 22.5% of the cases. In fibromuscular dysplasia, stenosis was underestimated in 33% of the cases. 相似文献
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Acetazolamide, which reversibly inhibits carbonic anhydrase, is a useful diuretic in alkalotic and over-hydrated patients. In two earlier investigations we have consistently found increases in the arterial and venous oxygen saturation and tension when patients were treated with acetazolamide 15 mg·kg-1. A plausible explanation of this phenomenon is that acetazolamide diminishes oxygen consumption. In the present study we measured oxygen uptake in 10 critically ill patients. We found a minor and statistically insignificant decrease in oxygen consumption. Nevertheless SvO2 increased from 0.77 to 0.83 and PvO2 from 5.9 kPa to 6.8 kPa. It is still not possible from this investigation to determine the origin of the improvement in blood oxygenation. The inhibition of carbonic anhydrase caused a CO2 retention of 5.8% of the total CO2 production. An increase in body stores of CO2 of this magnitude is without clinical significance. 相似文献
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The Indian Armed Forces Medical Services has been engaged in providing medical to the soldiers serving on Siachen Glacier for the last 25 years. This paper attempts to highlight the medical problems faced by troops on the world's highest battlefield as perceived by a medical officer located on the forward most medical echelon on Siachen Glacier. The medical problems on the glacier include high altitude pulmonary oedema, acute mountain sickness, frost bite chilblains, hypothermia, snow blindness, injury non enemy action due to avalanches, crevasses and fires, carbon monoxide poisoning and problems in disposal of nightsoil. A large number of problems are taken care of by following a well documented acclimatisation drill. However under such conditions providing medical support is a difficult task and requires innovations and improvisations entailing a high degree of mental mobility on the part of medical commanders and the Regimental Medical Officers located on the forward posts. 相似文献
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