New Association between Idiopathic Scoliosis and Luckenschadel Skull (Lacunar Skull)

ObjectiveLuckenschadel skull is a skull that is radiologically characterized by lacunae in the cranial vault. To date, although the association between neurological abnormalities and scoliosis is well recognized, no relationship between idiopathic scoliosis and a lacunar skull has been defined. We explored the incidence and time courses of lacunar skulls in patients with idiopathic scoliosis.Materials and MethodsSpinal X-rays of 3,170 children aged 6–16 years with idiopathic scoliosis evaluated from October 2010 to August 2020 were examined for the presence of an irregular inner calvarial table indicative of a Luckenschadel skull. A total of 1,760 (55.5%) of the 3,170 images included the skull. We also explored the frequency of intraspinal abnormalities in children with lacunar skull images who underwent spinal magnetic resonance imaging.ResultsThe study population consisted of 1,760 children, 1,203 girls (68.4%) and 557 (31.6%) boys. A total of 268 (15.2%) clearly evidenced lacunar skulls in their radiographs; 186 (69.4%) girls (11.3 ± 4.3 years) and 82 (30.6%) boys (12.6 ± 3.3 years). Two of the 56 patients (3.6%) who underwent spinal MRI had intraspinal abnormalities (isolated Chiari malformation-I). No additional neurological problems were detected in children with lacunar skulls.ConclusionWe conclude that the lacunar skull is very common in children with idiopathic scoliosis who lack any other neurological pathology. The lacunar skull does not disappear even in adolescence. Although previous publications have stated that lacunar skull disappears over time in radiographic images, we observed that it became more noticeable over time in children with scoliosis.     

脑动静脉畸形出血的血管构筑学因素探讨

目的：探讨脑动静脉畸形（AVM）的相关血管构筑学因素与出血的关系,以期预测脑AVM出血的危险性。 方法：采用数字减影血管造影（DSA）为200例脑AVM患者进行全脑血管造影,分析脑AVM的供血动脉、畸形血管团和引流静脉等的情况,比较不同血管构筑的AVM患者出血的比率。 结果：穿支动脉供血、小病灶、位于基底节和后颅窝、单支静脉引流、深部引流、有静脉狭窄或闭塞及伴发动脉瘤者易出血。结论：与脑ＡＶＭ出血密切相关的危险因素是供血动脉的类型、ＡＶＭ的大小和部位、引流静脉的数目、引流静脉的类型和有无狭窄或闭塞、是否合并动脉瘤。     

动态四维彩超与二维彩超临床诊断价值比较--以筛查胎儿中枢神经畸形为例

目的:通过临床病例分析实时动态彩超在筛查胎儿中枢神经畸形中的诊断价值。方法:随机从在万年县中医院建档孕检实施彩超筛查病例300例,同一时间段先后实施二维彩超筛查及实时动态四维彩超筛查,定期随访至1周岁,观察胎儿降生后1年的神经发育表现,以比对两种筛查的准确率。结果:经实证研究得出,实时动态四维彩超诊断的准确率明显高于二维彩超,两者间差异显著(P<0.05)。结论:实时动态四维彩超在筛查胎儿中枢神经畸形中要优于二维彩超,可以作为应用实时动态四维彩超进行孕检的科学依据。     

老年患者脑血管储备功能的血管危险因素分析

目的调查研究老年患者脑血管储备功能的血管危险因素。方法对我院68例老年患者临床资料进行回顾性分析。按照是否存在血管危险因素均分成存在危险因素的观察组与正常因素的对照组。结果观察组屏气指数（BHI）为（0．56±0．17）与对照组的（1．33±0．32）相比具有显著性的差异（P〈0．05）。结论老年患者存在血管危险因素时脑血管储备功能便会下降,高血压、糖尿病、高血脂以及吸烟习惯对患者的血管储备功能产生较大影响,应对其产生高度重视。     

锌对镉所致胚胎毒性的保护作用研究

实验用Ｗｉｓｔａｒ大鼠，分为正常组、低锌组、低锌染镉组、正常染镉组和染镉高锌保护组，分别饲养，其中三组在孕８和１０天注射镉（２．０ｍｇ／ｋｇ）。妊娠第２０天处死动物，取血，并剖腹检查孕鼠内脏和胎鼠畸形情况。研究发现：与正常对照组相比，单纯缺锌即可引起胎鼠的吸收率增高和畸形的发生；而染镉（２．０ｍｇ／ｋｇ）也可引起胎鼠的吸收胎和迟死胎显著增加，并可引起皮下水肿、卷尾等外观畸形。在孕期缺锌的同时，给予孕鼠２．０ｍｇ／ｋｇ体重的镉，孕鼠在整个孕期体重呈负增长，胚胎不能形成；如给予孕鼠高锌饲养（２２７ｍｇ／ｋｇ），胎鼠可得到较好的保护，其吸收胎、死胎率明显下降，存活率显著上升，且胎鼠体重、身长也与对照组相差无几。提示孕鼠缺锌可引发胎儿畸形，缺锌染镉加重胚胎毒作用，而高锌膳食能拮抗镉所造成的胚胎毒作用。     

血液流变学在缺血性脑血管病中的研究进展(综述)

缺血性脑血管病是一种常见病,其具有发病率高、复发率高、致残率高的特点,该文就血液流变学在缺血性脑管病的研究进展进行探讨,以期为临床及药物研究提供指导.     

血管瘤与脉管畸形的鉴别诊断研究进展

血管瘤和脉管畸形是婴幼儿比较常见的血管疾病,过去由于对两者的分类和诊断比较混乱,给临床治疗带来诸多不便,也给患者增加了不必要的痛苦。1982年,Mulliken和Glowacki提出了脉管性疾病的生物学新分类,将血管瘤和脉管畸形归类为2种性质完全不同的病变。血管瘤是多发于婴幼儿的良性肿瘤,大多数可以自行消退;而脉管畸形是血管结构的发育异常,不会自行消退,随患者的生长发育持续增长。因此,对于确诊的脉管畸形,应尽早采取干预措施。这就要求临床医师能及时、准确、有效地鉴别诊断血管瘤和脉管畸形。本文就目前关于血管瘤和脉管畸形的鉴别诊断进展作一综述。     

Feasibility of Single-Shot Whole Thoracic Time-Resolved MR Angiography to Evaluate Patients with Multiple Pulmonary Arteriovenous Malformations

ObjectiveTo evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs.Materials and MethodsNine patients (8 females and 1 male; age range, 23–65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics.ResultsFeeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions). TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers.ConclusionSingle-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.     

Secondary arteriovenous malformation due to subclavian vein occlusion

An 80-year-old man underwent rectal resection and insertion of a central venous catheter through the left subclavian vein 16 years earlier. Following surgery, he developed edema of his left upper limb that became exacerbated and infected. Computed tomography showed occlusion of the subclavian vein and multiple arteriovenous shunts from the branches of the axillary artery to the venous sac of the axillary vein. Angiography confirmed numerous shunts between the branches of the axillary artery and vein and dilated collateral veins. Embolization of the venous sac was performed using coils, alcohol, and glue. Postprocedural angiography showed complete eradication of the nidus.     

脑血管狭窄患者狭窄分布及筛查模型的建立

目的 构建基于Logistic回归的脑血管狭窄筛查模型。 方法 在体检者中选取经核磁共振血管成像(MRA)检查的1 118例脑血管狭窄阴性者,在体检者中经MRA检查高度怀疑有脑血管狭窄并住院的患者中选取经数字减影脑血管造影(DSA)检查确诊的1 329例脑血管狭窄者。将1 118例脑血管狭窄阴性者作为对照组,将1 329例脑血管狭窄者作为病例组,采用病例-对照研究分析。通过描述脑血管狭窄部位的分布特点,进而使用经济廉价的常规检查指标在男女中构建脑血管狭窄Logistic筛查模型,用ROC曲线下面积(AUC)等指标进行模型评价。 结果 1 329例脑血管狭窄者中,男性有985例,女性有344例。调整年龄后的脑血管狭窄Logistic筛查模型中,男性共纳入8个变量:年龄、谷草转氨酶、白蛋白、高密度脂蛋白、中性粒细胞值、高血压、吸烟和饮酒,女性共纳入5个变量:白蛋白、高密度脂蛋白、空腹血糖、中性粒细胞值和高血压。其中高密度脂蛋白、白蛋白、高血压和中性粒细胞值为男女共同纳入的变量。AUC男女分别为0.927和0.888,经十折交叉验证后AUC男女分别为0.928和0.885。 结论 该模型具有较好的筛查能力,可用来识别脑血管狭窄高风险个体。