螺旋CT在跟骨关节内骨折各关节面受累诊断中的应用研究

目的：通过螺旋CT多平面及表面重建来探讨跟骨骨折的特征及其在跟骨各关节面骨折诊断中的临床应用价值。材料与方法：经CR或临床检查可疑或确诊跟骨骨折的患者，应用Light SpeedQ／iGE4层扫描机进行检查，对35例47侧跟骨关节内骨折行多平面及表面重建。对骨折进行分型，同时分析各关节面受累情况。结果：跟骨结节位扫描是显示各关节受累总数最多的一种方法（95／101），在准确显示后关节骨折（46／47）与轴位（39／47）间有统计学差别。冠状位重建是显示距下中（14／14）、后（47，47）关节面受累的较佳方法，但11侧（11／47）骨折后关节面压缩及旋转移位在冠状位上没有被准确的反映出来，而在矢状重建中则准确的被显示。约60％的患者未发现独立的前关节。跟骰关节的骨折在轴位（32／32）、结节位（32／32）得到较准确的显示。三维重建是观察骨折整体空间改变的一种方法。结论：螺旋CT重建在跟骨各关节面骨折诊断中具有很高的临床价值。     

Biophotonic methods in microcirculation imaging

Visible and near-infrared light, particularly in the wavelength region of 600–1100 nm, offer a window into human and animal tissues due to reduced scattering and absorption. We review the main biophotonic methods applied to visualisation and assessment of the microcirculation and document the progress made over the past 10 years in particular. Applications, particularly in human skin, are of special topical importance due to an improved knowledge of its role and its value as a surrogate for other organs in drug testing at a time when drug development is under severe pressure.     

肺部钝性伤的CT征象分析

目的:分析肺部钝性伤的CT征象。材料与方法:对45例肺部钝性伤的病人胸部CT表现进行分析。结果:表现为肺挫伤36例,4例表现为肺撕裂伤及肺血肿,5例表现为创伤性湿肺伴有气胸、血胸。结论:CT能良好地反映肺部钝性伤的病情。对早期诊断及评估预后有重要意义。     

Straight leg elevation to rule out pelvic injury

ObjectivePelvic x-ray is frequently used as a screening tool during initial assessment of injured patients. However routine use in the awake and alert blunt trauma patient may be questioned due to low yield. We propose a clinical tool that may avoid unnecessary imaging by examining whether the ability to straight leg raise, without pain, can rule out pelvic injury.MethodsWe conducted a prospective cohort study with the exposure variables of ability to straight leg raise and presence of pain on doing so, and presence of pelvic fracture on x-ray as the primary outcome variable.ResultsOf the 328 participants, 35 had pelvic fractures, and of these 32 were either unable to straight leg raise, or had pain on doing so, with a sensitivity of 91.43% (95% CI: 76.94–98.2%) and a negative predictive value of 98.57% (95% CI: 95.88–99.70%). The 3 participants with a pelvic fracture who could straight leg raise with no pain, all had a GCS of less than 15, and therefore, among the sub-group of patients with GCS15, a 100% sensitivity and 100% negative predictive value for straight leg raise with no pain to rule out pelvic fracture was demonstrated.ConclusionAmong awake, alert patients, painless straight leg raise can exclude pelvic fractures and be incorporated into initial examination during reception and resuscitation of injured patients.     

Comparison of biliary atresia with and without intracranial hemorrhage

Background/Purpose

Intracranial hemorrhage (ICH) is a severe complication of biliary atresia (BA). We aimed to compare the clinical data of BA patients with and without ICH.

Treatment of corneal chemical alkali burns with a crosslinked thiolated hyaluronic acid film

Purpose

The study objective was to test the utilization of a crosslinked, thiolated hyaluronic acid (CMHA-S) film for treating corneal chemical burns.

深度学习重建对增强CT胆系图像质量的影响

目的 通过比较多种重建算法,探讨深度学习重建(DLR)对增强CT上胆道系统图像质量的影响。方法 回顾性纳入30例本院进行增强CT检查并伴有胆总管或肝外胆管扩张的患者,分别采用滤波反投影算法(FBP)、三维自适应迭代(AIDR 3D)、全模型迭代算法(FIRST)和DLR对门脉期图像进行重建。比较4组图像信号噪声比(SNR)、对比噪声比(CNR)及噪声,对4组图像质量进行主观评价排序并比较。结果 除AIDR 3D肝实质CNR外,DLR图像的CNR(胆管:4.42±0.87,肝实质:3.78±1.47)显著高于FBP[胆管:2.21±1.02(P<0.001),肝实质:1.43±1.29(P<0.001)]、AIDR 3D[胆管:2.81±0.91(P=0.024),肝实质:2.39±1.94(P=0.278)]及FIRST[胆管:2.51±1.24(P<0.001),肝实质:2.45±1.81(P=0.003)],DLR图像的SNR(胆管:1.39±0.85,肝实质:9.75±1.90)显著高于FBP[胆管:0.86±0.63 (P<0.001),肝实质:3.31±1.12 (P<0.001)]和 FIRST[胆管:1.01±0.61(P=0.013),肝实质:5.73±1.37 (P<0.001)],DLR图像的噪声(10.51±3.53)显著低于FBP[24.10±3.92 (P<0.001)]、AIDR 3D[15.72±2.41 (P=0.032)]和 FIRST[17.20±3.82 (P<0.001)]。DLR图像的主观评价排序[4(4,4)分]显著高于FPB[1(1,1)分](P<0.001)、AIDR 3D[3(2,3)分](P=0.029)和FIRST[2(2,3)分](P<0.001)。结论 深度学习重建可提高增强CT图像质量,有助于更好地观察胆道系统。