重症颅脑损伤患者CT检查的护理

我院自 1997～ 2 0 0 1年以来 ,CT扫描诊断检查重症颅脑外伤 (GCS评分 3～ 8分 ) 16 4例 ,其中 16 1例平稳度过扫描期 ,3例因伤势严重在扫描过程中呼吸心跳停止 ,经抢救无效死亡。1　临床资料　　 16 4例重症颅脑损伤中 ,单纯颅内血肿 6 3例占 38% ;血肿伴脑挫裂伤 38例占 2 3%     

小脑出血的临床、CT及预后评估

目的探讨小脑出血的原因、临床特点、CT表现、治疗及预后情况。方法回顾分析32例患者的临床及CT影像资料。结果本病多见于60岁以上,以高血压动脉硬化为主要原因,以突发性眩晕、呕吐为发病的主要症状,头颅CT检查可确诊。预后与患者年龄、出血量、出血部位、意识状态等多种因素密切相关。结论CT扫描可及时准确诊断,避免误诊漏诊,临床上根据患者的综合情况采取不同的救治策略有助于提高疗效,改善预后。     

CT在老年人硬膜下血肿诊断中的作用

老年人硬膜下血肿(SDH)系指60岁以上高龄人的SDH而言。由于近年来各国人口老年化率上升,老年人颅脑损伤的比例也随着增高,老年SDH也相应增多[1]。这类病人的临床表     

碘对比剂在CT检查中的应用

我院自 1994年使用CT检查以来 ,需增强检查者的比例越来越高。增强检查确实提供了CT平扫不可替代的诊断信息 ,但是碘对比剂的副作用却令人担忧 ,因此 ,CT室的护理人员应认真做好对患者的筛选、敏试工作 ,严格掌握禁忌证 ,加强对副反应的预防性措施及意外抢救工作 ,合理使用对比剂 ,现将我院应用碘对比剂的方法介绍如下。1　严格掌握禁忌证严重的甲状腺功能亢进、失代偿性心肌功能不全者禁忌。妊娠及急性盆腔炎症时禁行子宫输卵管造影。2　认真筛选高危因素有碘造影剂过敏、严重肝肾功能损害、心脏和循环功能不全、肺气肿、体质极差者 ,重…     

脊柱爆裂型骨折的CT扫描价值分析

目的:探讨脊柱爆裂型骨折的CT扫描价值. 资料与方法:随机抽取我院1988年至2001年骨科70例脊柱外伤患者的资料.其中男性54例,女性16例.年龄19岁～73岁,平均49岁.全部患者均摄取普通X线片,然后依据X线片提示的骨折部位作CT扫描,采用估算法重建图像,应用骨窗和软组织窗观察,部分病例进行矢状面重组.结果:70例受检者中受损椎体87个,C5损伤1例,T12～L1损伤1例,L1～2损伤1例,其他均为单椎体损伤.按Denis[1]三柱理论,63例病例为爆裂骨折,累及二柱和二柱以上,7例为椎体单纯压缩型骨折,1例伴有严重的脱位.结论:CT在显示椎体骨折尤其是脊柱后结构损伤方面优于X线平片,对判定脊柱稳定程度及损伤有否手术指征帮助最大.当X线摄片之后考虑为爆裂性骨折时,应抓紧作CT扫描检查.     

12例Dandy—Walker综合征的临床CT与MRI分析

目的分析Dandy—Walker综合征的临床及cT与MR!影像特征。方法采用cT与MRI常规扫描，对12例Dandy—Walker综合征的临床表现、CT与MRI征象进行回顾性分析；结果12例Dandy—Walker综合征的CT与MRI表现归纳为①小脑蚓部缺失，小脑半球发育不良、完全分离，分离的小脑半球可以不对称；②第四脑室呈囊状、扇形、三角形显著扩张或后颅窝巨大囊状阴影与第四脑室相通；③窦汇异常抬高，越过人字缝／天幕抬高；④幕上脑室对称性扩张，脑积水。结论对Dandy—Walker综合征的诊断，CT扫描能够显示后颅凹及天幕上下脑的形态与结构，其CT表现具特征性；MRI可多平面扫描，无骨质伪影，显示后颅凹优于CT，在矢状面上可显示小脑、第四脑室、导水管、后颅凹囊肿以及与天幕的关系。CT与MRI扫描对Dandy—Walker综合征能够做出定性诊断，是术前诊断的主要依据，检查无痛苦，有重要的诊断和鉴别诊断价值。     

Alveolar hydatid disease of the liver: Brief review and spectrum of adjacent organ invasion

The purpose of this study is to show the spectrum of adjacent organ invasion and to make a brief review of hepatic alveolar hydatid disease (AHD), using CT and MR imaging. We retrospectively reviewed CT and MR images of three patients with various adjacent organ invasions surgically and histologically proven to be AHD. Local invasion to right kidney and adrenal, right hemidiaphragm and lung were detected in one patient, right adrenal in another patient and gall bladder, duodenum, gastric wall and pancreas invasion in the other. AHD may rarely extend to the gall bladder, stomach, duodenum, pancreas, right adrenal and kidney, diaphragm, pleura and lung. The extension of the disease outside the liver is usually encountered in patients with large, peripherally located masses in the advanced stage of the disease.     

CT scan and threshold vibrometry in the diagnosis of spinocerebellar degenerations

45 patients with spinocerebellar degeneration (SCD) underwent through quantitative investigation of the ventricular and cisternal systems by CT scanning and threshold vibrometry in the limbs to find out whether these parameters could be used for distinguishing mainly spinal from cerebellar forms or from olivopontoce-rebellar atrophy. The increase in the vibration sense threshold and the mild atrophy in the posterior cranial fossa proved typical of spinal forms and the reverse for cerebellar forms. In olivopontocerebellar atrophy enlargement of the cisterns and dilatation of the ventricles always exceeded 85% of normal values.

---

Sommario 45 pazienti affetti da degenerazione spinocerebellare (SCD) sono stati sottoposti ad uno studio approfondito di esplorazione quantitativa del sistema ventricolare e cisternale alla TAC e della soglia di percezione vibratoria agli arti per valutare la possibilità di distinguere con questi parametri le forme prevalentemente spinali da quelle cerebellari o delle atrofie olivopontocerebellari. L'aumento della soglia vibratoria e la modesta atrofia in fossa posteriore è risultata tipica delle forme spinali, mentre l'inverso si verifica per le forme cerebellari. Nelle atrofie olivopontocerebellari l'allargamento delle cisterne e la dilatazione dei ventricoli supera quasi sempre l'85% rispetto ai casi normali.

     

False positive-false negative CT scan in late epileptic seizure: a meningioma-glioblastoma association

Summary A false-negative finding on initial CT is reported in a case of supratentorial glioma. This observation was peculiar because the first CT revealed a meningioma which might initially have been related to the clinical symptoms. The term false positive-false negative CT is proposed. The reasons for such CT failures are discussed. The accuracy of clues as to the localization of the glioma provided by EEG is emphasized.     

Successful embolization of a large superior gluteal artery pseudoaneurysm emerging during anticoagulant therapy

Gross hemorrhage is the most serious complication of anticoagulant therapy. We report the discovery and treatment of a large pseudoaneurysm of the superior gluteal artery in one patient who had been receiving oral anticoagulant therapy. We diagnosed the pseudoaneurysm by contrast-enhanced computed tomography, and embolized the artery with stainless steel coils. The exact cause of the pseudoaneurysm remains unclear, however, minor trauma appears most likely.