ObjectiveTo observe the curative effect of temporal orbicularis oculi muscle transposition surgery for senile lower eyelid entropion. MethodsSeventy-eight patients including 93 eyes of senile lower eyelid entropion were treated with temporal orbicularis oculi muscle turn surgical treatment between May 2009 and January 2015. Six months after the operation, the rectification was evaluated. ResultsA total of 67 cases (72 eyes) finished the follow-up observation, among which 49 (51 eyes) had a good effect, 18 (21 eyes) had general effect, and 0 (0 eyes) had poor effect. No patients had such complications as infection or eyelid deformity. All the patients' corneal epithelial cell loss was cured after surgery. The skin of lower eyelid of these 67 cases (72 eyes) were raised to various degrees. ConclusionThe orbicularis oculi muscle temporal transposition surgery for the treatment of senile entropion can fulfill both clinical treatment and aesthetic need, and will prevent recurrence in a certain period.
Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes （one had chronic cholangitis with choledochal lithiasis）， another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.
Objective To investigate the CT imaging features of autoimmune pancreatitis (AIP) with report of 4 cases and literature review. Methods The CT imaging data of 4 AIP patients proved on the basis of clinical findings, laboratory tests, response to steroids therapy and follow-up observation were retrospectively collected. Plain CT and contrast-enhanced dual phase CT scan at arterial and portal venous phases were performed for all 4 patients. All imaging data were reviewed, focusing on the shape, size, parenchyma density and enhancement patterns of the pancreas, as well as the biliary and pancreatic ducts, peripancreatic fat, blood vessels, retroperitoneal spaces, lymph nodes, and other positive findings. Results Three patients showed diffuse swelling of the pancreas on CT and 1 had focal enlargement of pancreatic head. Swelled pancreas was hypodense on plain CT images, showed decreased enhancement on artery phase and moderate enhancement on portal venous phase images of contrast-enhanced CT. Capsule-like enhanced rim was found around swelled pancreas in 2 patients. Stricture of distal common bile duct was present in 2 patients, and ERCP showed irregular narrowing of the main pancreatic duct in 1 cases. After steroid therapy, all patients showed significant morphological improvement of the pancreas at follow-up CT examination. Conclusion CT scan reveals certain characteristic imaging findings of AIP, thus it is helpful for the diagnosis of AIP.
【Abstract】ObjectiveTo investigate the value of volumetric interpolated breathhold examination (3DVIBE) MRI sequence in the diagnosis of functional islet cell tumors of the pancreas. MethodsDedicated MRI scan was performed for 3 patients suspected to have functional islet cell tumors of the pancreas on clinical and laboratory basis. The MRI scan protocol included routine axial T1W and T2W, coronal true fast imaging with steady state procession (TrueFISP) and MRCP, gadoliniumenhanced 3DVIBE dynamic triphasic acquisitions and enhanced 2D GRE T1W scan. The three phases images of 3DVIBE sequence were acquired at 15 s, 40 s and 65 s after injection of contrast agent, corresponding to the early arterial, late arterial and portal venous phase respectively. The imaging features were compared with surgical and pathological findings. ResultsThe triphasic images of 3DVIBE sequence depicted clearly the morphology of small functional islet cell tumors of the pancreas and reflected accurately the characteristics of tumor blood supply, while other MRI sequences might miss these small lesions. ConclusionThinslice and fast dynamic MRI sequence, as exemplified by 3DVIBE sequence, is very useful in the detection and characterization of pancreatic functional islet cell tumors.
Objective To investigate the situation of MRI examination in children in outpatient and inpatient departments of the Sichuan Provincial People’s Hospital from 2010 to 2012, so as to provide favourable basis for the choice of imaging examination in children. Methods The materials of electronic reports of MRI examination in paediatric inpatient and outpatient departments from 2010 to 2012 were collected, categorized, and analyzed. Results a) 2 148 children underwent MRI examination in the Sichuan Provincial People’s Hospital from 2010 to 2012. The total number of patients increased with year. Boys were more than girls. The positive incidence was slightly decreased. The number of outpatients was more than inpatients, but the positive incidence was lower in outpatients. b) The total numbers of examination position were increased with year and the number of single position examination was the most (accounted for than 85% of the total numbers). The main examination positions included: head, MRA of the head, cervical column, knees, lumbar column, pituitary gland, thoracic column, and abdomen. The examination positions diversified gradually. The application of examination technique also increased gradually. c) The systemic disease spectrum of positive cases in MRI examination included 9 categories, which accounted for 42.86% of ICD-10. The nervous systematic disease, muscle, skeleton and connective tissue disease were the categories. The major disease types were stable during the recent 3 years. The increase was obvious in injuries of the knees, malacosis and atrophy of the brain, the deformity of the brain. Conclusion The total numbers of the patients and positions examined increased gradually with year in the Sichuan Provincial People’s Hospital from 2010 to 2012. The applications of MRI in the head, limbs and joints, and soft tissues were more extensive. Children diagnosed as positive results had diseases of the central nervous system, limbs and joints, and connective tissue disease.
【Abstract】 Objective Using 16-slice multi-detector row helical CT (16-slice MDCT) to investigate the value of multiplanar reformation technique (MPR) in the diagnosis of bowel obstruction. Methods Thirty patients with surgically (27 cases) or clinically (3 cases) proofed diagnosis of bowel obstruction underwent 16-slice MDCT examination of the entire abdomen. All cases had plain CT scan, while 20 cases had additional contrast-enhanced CT scan at portal venous phase. In addition to the conventional axial images, the original CT raw data were then reconstructed into both coronal and sagittal images using MPR technique. Imaging findings were analyzed on axial, MPR coronal and sagittal images. Results Among the 30 patients with bowel obstruction, there were 8 cases caused by adhesion, 7 by simple intestinal tumor, 5 by intussusception (including caused by instestinal tumor), 4 by abdominal hernia, 2 by volvulus, 1 by ileocecal abscess, 1 by stenosis of mesenteric artery，1 by retroperitoneal cyst, and 1 by carcinoma in pancreatic tail. Six patients developed intestinal ischemia or strangulation. Both axial and MPR images correctly depicted the presence of bowel obstruction. Based on CT axial view （AV）, the site and the underlying etiology of bowel obstruction were determined in 26 (86.7%) and 22 (73.3%) patients respectively, while the combination with MPR coronal and sagittal images improved the diagnostic performance to 29 (96.7%) and 27 (90.0%) patients respectively. Both axial and MPR images correctly revealed the presence of intestinal ischemia or strangulation in 5 （83.3%）patients. Conclusion MPR technique of MDCT is very useful for evaluating the site and etiology of bowel obstruction, as well as the circulation status of involved bowel loop.
目的 比較更昔洛韋聯合甲潑尼龍綜合療法和甲潑尼龍綜合療法治療病毒性視神經炎的療效。 方法 將2008年10月－2010年3月入院41例（60只眼）病毒抗體檢測陽性的病毒性視神經炎患者隨機分為治療組，21例30只眼）和對照組（20例30只眼）。于治療前和治療第3、7、14、30、90、180天觀察兩組患者的視力、視野。 結果 兩組患者的視力、平均視野缺損治療組采用更昔洛韋聯合甲潑尼龍綜合療法，對照組采用甲潑尼龍綜合療法。均隨時間得到改善（P＜0.001）。兩組患者視力在治療的第3天開始恢復，30 d治療組視力明顯優于對照組（P＜0.05），治療180 d時兩組視力改善無差異（P＞0.05）；治療組與對照組分別在第7天和第14天平均視野缺損開始恢復（P＜0.001）。 結論 更昔洛韋聯合甲潑尼龍綜合療法較單純甲潑尼龍綜合療法治療病毒性視神經炎能更快提高患者視力、恢復視野、改善患者視覺質量。
ObjectiveTo investigate the MRI manifestations of internal carotid artery dissection (ICAD) before and after treatment. MethodsMRI materials of 20 patients with ICAD between November 2007 and February 2013 were collected for analysis. ResultsMRI manifestations of ICAD showed 17 cases of artery stenosis, 16 cases of mural hematoma or thrombus, 3 cases of aneurysmal dilatation, and 2 cases of lines of intimal flap. The treatment outcome MRI manifestations showed that 18 patients had effective response, including disappeared (n=9) and lessened (n=8) artery stenosis, disappeared (n=13) and diminished (n=3) hematoma and thrombus, and shrunken aneurysmal dilatation (n=1); and there were 2 cases of unchanged aneurysmal dilatation, and another 2 patients had aneurysmal dilatation while stenosis lessened. ConclusionMRI manifestations of internal carotid artery dissection mainly include stenosis, mural hematoma or thrombus, and aneurysmal dilatation. Stenosis, mural hematoma or thrombus usually disappear and lessen in the treatment, and all MRI findings may vary among each other.