C型臂X线机引导下经皮双侧骶髂拉力螺钉固定治疗骶骨H形骨折

目的探讨骶骨H形骨折可行的治疗方法。方法运用C型臂X线机引导下经皮双侧骶髂拉力螺钉固定治疗骶骨H形骨折15例。结果15例患者均获随访，随访时间7—34个月，骨折临床愈合时间3～5个月，术后均未留下明显行走障碍，下蹲等活动接近正常。结论在C型臂X线机精确引导下，经皮双侧骶髂拉力螺钉固定技术能有效地固定骶骨H形骨折中的垂直骨折，纠正骨盆垂直方向移位，操作简洁安全，疗效可靠。     

Clinico-Radio-Histopathological Correlation by C-Arm Image-Guided Biopsy in Spinal Tuberculosis

Background/Purpose of the StudyC-arm-guided biopsy is a safe and effective technique for evaluating TB spine and is useful in planning therapy. The purpose of this study was to find a correlation between clinically and radiologically suspected TB spine and C-arm image-guided biopsy-proven cases and to study the complications encountered.MethodsAfter evaluating the clinical, laboratory, X-ray and MRI findings, 92 patients with provisionally diagnosed tubercular spine were subjected to C-arm image-guided biopsy.ResultsAmong our 92 cases, histopathology was positive in 55 cases (59.78%). Out of these 55 histologically positive cases, CBNAAT was positive in 42 cases and negative in the rest 13 cases. Overall, among the 92 cases, CBNAAT was positive in 51(55.43%) of cases, and out of these, histopathology turned out to be positive in 42 of cases. Out of 41 cases with negative CBNAAT, histopathology was suggestive of tuberculosis in 13. The strength of agreement between CBNAAT and histopathology was statistically significant (p < 0.0001; kappa = 0.511). No complication such as bleeding, nerve/cord injury, infection, injury to aorta or pneumothorax was encountered during and after the C-arm biopsy in any case.ConclusionC-arm image-guided biopsy is reasonably accurate and should be used as a tool for diagnosis of TB spine. We recommend histopathological examination as a key component for the diagnosis of TB spine, as it is precise and consumes relatively shorter time. CBNAAT is more rapid but is not a substitute for histopathology for spine TB diagnosis.     

半月神经节射频热凝治疗难治性三叉神经痛

目的探讨半月神经节射频热凝治疗难治性三叉神经痛效果和安全性。方法对三叉神经第Ⅱ支合并第Ⅰ、Ⅲ支或Ⅰ、Ⅱ、Ⅲ支并存疼痛者应用改良的前入路卵圆孔穿刺法行射频热凝毁损术。应用C型臂定位下行卵圆孔穿刺。射频温度控制在75-90℃。结果优良46例，良好1例，总有效率为100％。无严重并发症，随访42例3～18个月，无复发患者。结论在C型臂引导下射频热凝半月神经节毁损术治疗难治性三叉神经痛疗效可靠、定位准确，时患者更安全。     

C臂CT在颅内动脉瘤诊疗中研究进展

C臂CT在血管内介入治疗中的应用越来越广泛,其较高的空间分辨率和术中影像即时采集,为临床提供了更多选择。颅内动脉瘤诊断金标准仍为DSA,C臂CT可提供更多信息辅助动脉瘤诊断。术中即刻获取影像可为支架置放提供参考,较为清晰地显示支架、动脉瘤、弹簧圈等相对位置,这在术后随访中也有相当大的价值。现就C臂CT在颅内动脉瘤诊断、治疗和随访复查中的应用研究进展作一综述。     

DG3310 C型C臂X线机两例故障维修分析

本文通过DG3310 C型C臂X线机术中透视无图像显示和"灯丝板错误"两例故障现象的案例进行分析,简述DG3310 C型C臂机相关工作原理,结合厂家手册和维修经验,详细分析故障产生的可能原因,并逐一排查,最后精准定位故障点,更换MC7812T稳压管和LM358集成块后,C臂机工作正常,故障排除.通过对C臂机故障原因分析...     

C形臂CT在急性缺血性脑血管病介入治疗中的应用

目的 探讨C形臂CT技术在急性缺血性脑血管病介入治疗中的应用价值.方法 C形臂CT成像技术应用于152例急性缺血性脑血管病患者血管内介入治疗前后图像获取和处理,静脉注射对比剂经VasoCT获取类似CTA的脑血管图像,评估脑血管再通后脑出血或梗死风险.结果 C形臂CT能够在短时间内快速诊断血管缺血病变;152例血管内接触溶栓治疗后发现脑血管再通高灌注引发脑出血17例(前循环出血11例,后循环出血6例),经积极抢救治疗12例痊愈;可清晰显示颅内血管植入支架信息.结论 C臂CT应用于急性缺血性脑血管病介入治疗,有利于及时快速诊断脑缺血病变,迅速发现脑出血等严重并发症,及时有效抢救患者.     

自制简易脊柱手术床结合C型臂X线机粘贴标尺在基层医院行PKP术中的应用

目的 观察自制简易脊柱手术床结合C型臂X线机粘贴标尺在基层医院行经皮穿刺椎体后凸成形术(Percutaneous Kyphoplasty,PKP)中的运用效果.方法 回顾性分析2017年1月至2019年7月收治的46例行PKP术治疗的胸腰椎骨质疏松性椎体压缩性骨折患者资料.其中26例在普通手术床上进行手术,运用C型臂X...     

C型臂引导下关节腔冲洗联合臭氧注射治疗膝关节骨性关节炎疗效观察

目的比较在C型臂引导下单纯膝关节腔冲洗和关节腔冲洗联合臭氧注射治疗膝关节骨性关节炎的临床疗效。方法137例单侧膝关节骨性关节炎患者，完全随机分为单纯关节腔冲洗组（67例）及关节腔冲洗联合臭氧注射组（70例）。单纯关节腔冲洗组每周大量生理盐水＋庆大霉素冲洗1次，关节腔冲洗联合臭氧组每周大量生理盐水＋庆大霉素冲洗加臭氧注射1次，2组连续3次为1个疗程。结果1个疗程后，单纯关节腔冲洗组患者：疗效优27例，良23例，可14例，差3例，优良率为74．6％（50／67）；关节腔冲洗联合臭氧组患者：疗效优35例，良25例，可9例，差1例，优良率为85．7％（60／70），2组比较差异有统计学意义（P〈0．05）。单纯关节腔冲洗组：术后1、2、3个月优良率分别为71．6％（48／67）、68．7％（46／67）、61．2％（41／67）；关节腔冲洗联合臭氧注射组术后1、2、3个月优良率分别为84．2％（59／70）、81．4％（57／70）、80．0％（56／70）；2组各时段比较差异均有统计学意义（均P〈0．05）。2组患者在术中及术后均未见明显不良反应。结论单纯关节腔冲洗和关节腔冲洗联合臭氧注射均能有效治疗膝关节骨性关节炎，但关节腔冲洗联合臭氧注射相对于单纯关节腔冲洗治疗膝关节骨性关节炎，中远期疗效佳，值得临床推广。     

C臂CT引导经皮乙醇消融术在巨块型肝癌经肝动脉化疗栓塞后的近期疗效

目的 评价C臂CT引导经皮无水乙醇消融术(PEI)在巨块型肝癌经肝动脉化疗栓塞术(TACE)后的可行性及近期疗效.方法 回顾分析巨块型肝癌患者95例,其中40例行单纯TACE治疗(对照组),55例行TACE联合PEI治疗(联合组).对照组1个月后重复TACE治疗1次.联合组TACE1周后行PEI.术前经C臂CT扫描评估碘油沉积情况,定位穿刺路径及注入部位.2周后对碘油沉积缺损部分追加PEI.3个月后两组复查CT,对碘油沉积分布情况进行统计学分析.结果 联合组初次PEI术后显示碘油沉积为Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为41.8％ (23/55)、49.1％(27/55)、7.3％ (4/55)和1.8％(1/55);2周后分别为25.4％ (14/55)、50.9％(28/55)、16.4％(9/55)和7.3％(4/55).再次对除Ⅰ型病灶外的41例患者行PEI.3个月后复查CT,对照组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为7.5％ (3/40)、30％(12/40)、42.5％(17/40)、20％(8/40);联合组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为30.9％(17/55)、40％ (22/55)、23.6％(13/55)、5.5％(3/55).两组差异有统计学意义.结论 C臂CT成像技术在TACE术后联合PEI治疗巨块型肝癌的指导和评估中具有重要价值,保证了手术的安全性、准确性和有效性.     

Depression of the Thoracolumbar Posterior Vertebral Body on the Estimation of Cement Leakage in Vertebroplasty and Kyphoplasty Operations

Background:

The cross-section of thoracolumbar vertebral body is kidney-shaped with depressed posterior boundary. The anterior wall of the vertebral canal is separated from the posterior wall of the vertebral body on the lateral X-ray image. This study was designed to determine the sagittal distance between the anterior border of the vertebral canal and the posterior border of the vertebral body (DBCV) and to analyze the potential role of DBCV in the estimation of cement leakage during percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP).

Methods:

We retrospectively recruited 233 patients who had osteoporotic vertebral compression fractures and were treated with PVP or PKP. Computed tomography images of T11–L2 normal vertebrae were measured to obtain DBCV. The distance from cement to the posterior wall of the vertebral body (DCPW) of thoracolumbar vertebrae was measured from C-arm images. The selected vertebrae were divided into two groups according to DCPW, with the fracture levels, fracture grades and leakage rates of the two groups compared. A relative operating characteristic (ROC) curve was applied to determine whether the DCPW difference can be used to estimate the degree of cement leakage. The data were processed by statistical software SPSS version 21.0 using independent sample t-test and Chi-square tests.

Results:

The maximum DBCV was 6.40 mm and the average DBCV was 3.74 ± 0.95 mm. DBCV appeared to be longer in males than in females, but the difference was not statistically significant. The average DCPW of type-B leakage vertebrae (2.59 ± 1.20 mm) was shorter than that of other vertebrae (7.83 ± 2.38 mm, P < 0.001). The leakage rate of group DCPW ≤6.40 mm was lower than that of group DCPW >6.40 mm for type-C and type-S, but much higher for type-B. ROC curve revealed that DCPW only has a predictive value for type-B leakage (area under the curve: 0.98, 95% confidence interval: 0.95–0.99, P < 0.001), and when the cut-off value was 4.05 mm, the diagnostic sensitivity and the specificity were 94.87% and 93.02%, respectively.

Conclusions:

Depression of the thoracolumbar posterior vertebral body may be informative for the estimation of cement location on C-arm images. To reduce type-B leakage, DCPW should be made longer than DBCV on C-arm images for safety during PVP or PKP.