小儿支气管异物CT冠状位扫描的诊断价值

目的探讨CT冠状位扫描对小儿支气管异物的诊断价值.方法分析30例小儿支气管异物CT冠状位扫描的表现,并在部分病例中与CT轴位扫描及X线检查对照.结果CT冠状位清晰显示支气管腔内异物及异物周围炎性肉芽肿共30例,其中阻塞性肺气肿28例,阻塞性肺炎13例,阻塞性肺不张3例,横膈双边征16例,纵隔双边征11例.结论CT冠状位扫描可显示绝大多数支气管异物的直接和间接征象,可作为小儿支气管异物的首选检查.     

多层CT图像后处理技术在小儿气管支气管异物的应用价值

目的:探讨多层CT图像后处理技术在小儿气管支气管异物的应用价值。方法:搜集经临床病史及硬支气管镜钳取证实的小儿气管支气管异物40例。所有病例摄胸部X线片及CT薄层扫描,将容积数据进行多平面重建(MPR)、最小密度投影(MinP)、仿真内窥镜(VE)及容积漫游技术(VRT)成像,评价两种检查方法及CT图像后处理技术在小儿气管支气管异物的诊断优势及局限性。结果:①异物位于右主支气管13例,左主9例,并发肺气肿33例,肺不张6例,阻塞性肺炎17例,纵隔疝8例;②)除X线不能显示不透光异物外,CT轴位、各图像后处理技术在异物显示率之间比较无统计学差异(P>0.05);除CT与MPR、X线与VRT、VRT与MinP在肺部并发征象显示率之间比较无统计学差异外(P>0.05),其余各成像方法(CTVE除外)之间比较有统计学差异(P<0.05),CT及MPR优于X线、MinP及VRT;③MPR能多角度清晰显示叶以上气管支气管异物及肺部并发征象;CTVE较好地显示叶及以上气管支气管腔内异物,所见类似纤维支气管镜;VRT直观立体显示叶以上气管支气管异物、阻塞性肺气肿及纵隔疝,可弥补纵向范围显示不足。结论:X线、多层CT扫描及图像后处理技术对于气管支气管异物及其并发征象的显示各有优劣,诊断时应综合分析;多层CT图像后处理技术对叶支气管远端及以下支气管异物、局限性肺不张及阻塞性肺炎的显示有一定限度,诊断时应结合CT轴位像,以避免假阳性发生。     

儿童气管透光异物冠状位扫描的CT表现与气管镜下病理对照

目的 探讨儿童气管透光异物冠状位扫描的CT特点及其对气管镜手术的指导价值.方法 收集66例经气管镜证实为气管透光异物的病例,将其冠状位扫描的CT特点与气管镜检查结果进行回顾性分析.所有病例冠状位扫描前行常规普通X线检查(透视及呼吸相胸片).结果 66例中异物位于气管11例,支气管55例;右侧34例,左侧21例.异物形态:柱状铸型22例,类圆形15例,不规则形29例.异物引起支气管腔狭窄34例,气管镜下对应的病理改变为炎性水肿、肉芽组织及纤维瘢痕形成.结论 冠状位CT扫描可准确而直观地显示气管内透光异物以及气管腔改变,与支气管镜所见异物比较,两者在位置、大小及形态上可有不同,而支气管腔的改变与异物存留的时间及性质有关.     

胸部冠状面CT扫描诊断气管、支气管异物

目的:确定诊断气管、支气管异物时CT扫描的最佳位置。材料与方法:利用作者自行设计的一个可调节角度的倾斜木架,对16例疑有气管、支气管异物的患儿行半坐卧式胸部冠状面CT扫描。结果:气管、左右主支气管、上下叶支气管,以及部分段支气管呈树枝状被显示在同一层面上。在所有16例患儿中,6例为正常,而另10例则见异物附着于其气管、支气管的管壁上,或嵌顿于气管、支气管的管腔内。结论:本项研究取得了较满意的诊断效果。作者认为,选择CT扫描的最佳位置,是诊断气管、支气管异物的关键性因素。     

小儿支气管异物冠状面CT诊断

目的:探讨小儿支气管异物的冠状面CT扫描特征。方法:22例患者进行冠状面CT扫描,6 例同时加轴扫。所有患者在CT扫描后进行支气管镜检查。将CT扫描结果和纤支镜结果进行对比分析。结果:CT冠扫诊断气管支气管异物17例,支气管肿瘤2例,另3例未见异常。纤支镜诊断异物14例,支气管肿瘤2例,痰栓1例,另5例未见明显异常。气管支气管异物的冠状面CT表现为支气管腔内高密度影(17/22),异物边缘呈线样异常密度(15/17),纵隔及膈肌“双边征”(21/22)。结论:小儿支气管异物在冠状面CT扫描上有较为特征性表现。冠状面CT扫描能部分了解小儿大气道梗阻原因,对支气管异物和支气管肿瘤鉴别诊断有重要意义。     

胸部冠状面CT扫描诊断气管支气管异物

作者自行设计一个可调节角度的倾斜木架，对１６例凝气管，支气管异物患儿作半坐卧式胸部冠状面ＣＴ扫描，以获取气管，支气管冠状面图象进行研究，结果，气管，主支气管、上下叶支气管及部分段支气管可呈树枝状显示在同一层面上。本组病例中６例正常，１０例气管，支气管异物患者均可直接显示异物附着在管壁上或嵌顿于管腔内。取得满意的诊断效果，对临床医师选择性纤维支气管镜取出异物有重要的指导意义。     

螺旋CT图像后处理技术诊断小儿气管、支气管非金属异物的价值

目的: 评价螺旋CT图像后处理技术诊断小儿气管、支气管非金属异物的价值.材料和方法: 109例气管、支气管非金属异物患儿,经螺旋CT扫描后分别进行多平面重建(MPR)、CT仿真内窥镜(CTVE)、表面遮盖显示(SSD)和最小密度投影(MinP)4种图像后处理成像技术,并根椐诊断行小儿支气管内窥镜异物摘取术.结果: 术中取出气管异物27例、右侧支气管异物53例、左侧支气管异物18例、双侧支气管异物1例、气管并左侧支气管异物2例、气管并双侧支气管异物2例;另有3例未见明确异物,1例异物位于Ⅲ级支气管无法取出,1例由于喉头水肿纤维支气管镜无法通过并手术,1例术前突然窒息死亡.螺旋CT 4种图像后处理技术对异物的显示率分别为MPR 97.2%、CTVE 94.4%、SSD 83.2%、MinP 70.1%.结论: 螺旋CT图像后处理技术结合原始轴位像对小儿气管、支气管非金属异物诊断迅速、准确,具有重要的诊断价值.     

螺旋CT图像后处理技术诊断小儿气管、支气管非金属异物的价值

目的：评价螺旋CT图像后处理技术诊断小儿气管、支气管非金属异物的价值。材料和方法：109例气管、支气管非金属异物患儿，经螺旋CT扫描后分别进行多平面重建（MPR）、CT仿真内窥镜（CTVE）、表面遮盖显示（SSD）和最小密度投影（MinP）4种图像后处理成像技术，并根椐诊断行小儿支气管内窥镜异物摘取术。结果：术中取出气管异物27例、右侧支气管异物53例、左侧支气管异物18例、双侧支气管异物1例、气管并左侧支气管异物2例、气管并双侧支气管异物2例；另有3例未见明确异物，1例异物位于Ⅲ级支气管无法取出，1例由于喉头水肿纤维支气管镜无法通过并手术，1例术前突然窒息死亡。螺旋CT4种图像后处理技术对异物的显示率分别为MPR97．2％、CTVE94．4％、SSD83．2％、MinP70．1％。结论：螺旋CT图像后处理技术结合原始轴位像对小儿气管、支气管非金属异物诊断迅速、准确，具有重要的诊断价值。     

16层CT低剂量成像诊断小儿气道异物

目的:评价16层螺旋CT低剂量扫描及运用多种重建技术对小儿气道异物的诊断价值。材料和方法:对48例气道异物患儿采用低剂量胸部扫描,参数为:120kV,30mAs,螺距0.75,重建层厚1mm,重建间隔0.5mm。轴位原始数据传至工作站分别行MPR、MinIP、VR及CTVE重建成像。结果:异物位于气管4例,支气管44例。其中金属异物5例,非金属异物43例,经气管镜取出异物49处。CT对气管异物诊断准确率为100%,对主支气管、叶及段支气管异物的诊断准确率为97.8%。结论:采用低剂量扫描可大幅度减少X线对小儿的辐射,而图像质量可达到常规剂量扫描的效果,多种成像技术结合运用,可清楚显示异物的部位、形态、大小及肺内的阻塞性病变,对临床治疗有重要的指导价值。     

螺旋CT多平面重建在小儿气道异物的临床应用

目的 回顾性分析螺旋CT多平面重建（MPR）对气道异物的临床应用价值。资料与方法 34例经纤维支气管镜证实的气道异物患儿行螺旋CT容积扫描，然后对CT薄层图像进行多平面重建，并分析其影像表现。结果 34例MPR均直接显示异物呈高密度影位于气管或支气管腔内，其中气管异物3例，右侧支气管异物15例（11例位于右主支气管，4例位于右中间段支气管），左侧支气管异物16例（11例位于左主支气管，5例位于左下叶支气管）。结论 MPR对气道异物的显示率高，定位准，具有重要诊断价值。     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].