目的:分析四川汶川地震顱腦損傷患者CT表現及其價值。方法:對地震發生后近2個月內陸續送至四川大學華西醫院治療，因地震致有顱腦損傷史的140名傷員進行顱腦CT分析總結。結果:在本組傷員中，頭皮損傷97例（69％）；顱骨骨折68例（49%）；腦挫裂傷66例（47%）；硬膜外和（或）硬膜下積血、積液44例（31％）；蛛網膜下腔出血36例（26％）；腦水腫、軟化灶29例（21％）；其他43例（31％）。結論:CT掃描能準確、快速、有效地對地震顱腦損傷患者進行判斷，可為臨床治療方案起指導作用。
目的:著重分析汶川地震中傷員下肢骨折的發生部位、類型及其產生機制和臨床意義。方法:對5·12汶川大地震發生后近2個月內先后送至四川大學華西醫院治療的496例下肢骨折傷員,按X線檢查結果對骨折部位及類型進行分析。結果:下肢多部位粉碎性骨折而截肢者29例(5.8％),其余467例傷員共584個部位發生骨折。按骨折部位分類:股骨162個(27.7％),脛腓骨275個(47.1％),髕骨19個(3.3％)以及足骨128個(21.9％)。按骨折類型分類:粉碎性骨折244個(41.8％),斜行骨折194個(33.2％),橫行骨折53個(9.1％),線性骨折35個(6.0％),螺旋形骨折33個(5.7％),嵌插骨折17個(2.9％),凹陷性骨折2個(0.3％),同一部位(脛腓骨骨干)的多種類型骨折6個(1.0％)。結論:本組汶川地震造成的下肢骨折,部位以脛腓骨為主;類型以粉碎性骨折為主。常規X線檢查對下肢骨折傷員具有簡便、快速和準確的診斷價值。
【摘要】 目的 探討青海玉樹地震傷員損傷影像學表現及其診斷價值。 方法 2010年4月15-16日，對83例玉樹地震傷員進行影像學表現分析。 結果 胸部損傷33例，四肢損傷32例，脊柱損傷22例，骨盆損傷15例，頭顱及頜面部損傷12例，腹部損傷7例，僅軟組織挫傷13例。 結論 影像學檢查結合患者臨床表現能快速、準確、有效對地震性損傷進行臨床診治。【Abstract】 Objective To observe and investigate the manifestations and diagnostic value of radiological features for the injured in Yushu earthquake. Methods From 15th to 16th April, 2010, 83 patients who were injured in Yushu Earthquake underwent CT or DR examinations. Results In 83 patients, chest injury was found in 33, limb injury was in 32, spinal injury was in 22, pelvic injury was in 15, head and maxillofacial injuries were in 12, abdominal injury was in seven,and single soft tissue injury was in 13. Conclusion Radiological examination can exactly, quickly and effectually diagnose the injuries caused by the earthquake.
目的 探討多層螺旋CT對下頜骨骨折的診斷價值。 方法 對2007年4月-2009年10月下頜骨不同部位骨折的45例患者進行多層螺旋CT軸位掃描，并行多平面、表面遮蓋法等三維重建，對下頜骨骨折CT表現特征作回顧性分析。 結果 45例下頜骨骨折中，位于下頜體骨折24例，下頜角骨折5例，下頜升支骨折6例，髁部骨折13例，冠突骨折2例；顳下頜關節脫位中，單側脫位3例，雙側脫位5例。 結論 多層螺旋CT能準確診斷下頜骨各部位骨折，對診治方案具有重要價值。
【摘要】 目的 探討汶川大地震傷員頜面損傷CT表現及其診斷價值。 方法 對2008年5月12日-7月23日就診的汶川大地震頜面部傷員51例的CT資料進行回顧性研究。 結果 頜面部骨折21例，多發骨折12例。眼部外傷性改變9例，鼻面部外傷性改變38例。 結論 地震頜面部損傷發生部位主要在鼻面部。CT掃描結合臨床檢查，能對地震性頜面部外傷的診斷提供幫助。【Abstract】 Objective To observe the features and diagnostic value of CT for maxillofacial injury in Wenchuan Earthquake. Methods The clinical data and CT images of 51 patients with maxillofacial injury in Wenchuan Earthquake from 12th May to 23rd July, 2008 were retrospectively analyzed. Results There were 21 patients (41.2%) with maxillofacial fracture, 12 with multiple fracture, 9 (17.6%) with eye injury, and 38 (74.5%) with facial and nasal injury. Conclusion The facial and nasal injury is the main injury in the maxillofacial trauma caused by the earthquake. CT is helpful to diagnose this kind of injury.
目的：著重探討鼻腔及鼻竇內翻性乳突狀瘤CT表現特征及診斷價值。材料和方法：收集經手術和病理確診的鼻腔及鼻竇內翻性乳突狀瘤65例CT資料，進行回顧性研究。結果：65例IP的CT表現特征，以鼻中道為中心的一側鼻竇和/或鼻腔內不規則軟組織腫塊。其中，僅鼻腔受累者18例，一側鼻腔及鼻竇均受累者47例。鼻腔及鼻竇有膨大并骨質破壞者43例。軟組織腫塊強化者23例。術后IP復發者13例（20%）；惡變者9例（14.3%）。結論：CT檢查對IP的病變部位、范圍、程度等能準確確定，可為手術治療提供重要依據。
摘要:目的:分析汶川大地震傷員中上肢骨折的發生部位、類型及其產生機制和臨床意義。方法:對地震發生后近2個月內先后送至四川大學華西醫院治療的140例上肢骨折傷員,按X線檢查結果對骨折部位及類型進行分析。結果:140例傷員共183個部位發生骨折。按骨折部位分類:即肱骨60個(32.8％),橈骨51個(27.9％),尺骨41個(22.4％)及手骨骨折31個(16.9％)。按骨折類型分類:橫行骨折46個(251％),斜行骨折31個(16.9％),螺旋形骨折11個(6.0％),粉碎性骨折64個(35.0％),嵌插骨折8個(4.4％),線行骨折13個(7.1％),撕脫骨折10個(5.5％)。結論:本組汶川大地震性的上肢骨折,部位以肱骨骨折為主;類型以粉碎性骨折為主。常規X線檢查對上肢骨折傷員具有簡便、快速和準確的診斷價值。
摘要:目的:探討16層螺旋CT圖像后處理技術對青少年特發性脊柱側凸的胸椎旋轉和椎弓根徑線變化特點及臨床價值。 方法:收集經臨床診治的青少年特發性脊柱側凸20例,運用16層螺旋CT掃描及圖像后處理技術,進行相關CT數據測量統計。結果:(1)脊柱胸椎側凸的頂椎及鄰近椎體均向凸側旋轉、后份向凹側旋轉,以頂椎旋轉最重,且凹側椎弓根徑線小于凸側,與側凸程度及方向具有相關性。(2)上、下終椎椎體旋轉及椎弓根徑線變化則較復雜,其椎體無旋轉或向相反方向旋轉,椎弓根徑線可凸側小于凹側,以上終椎明顯。結論:16層螺旋CT及圖像后處理技術,對顯示青少年特發性脊柱側凸胸椎旋轉及椎弓根徑線變化特征,可提供臨床擬訂手術方案的重要影像學依據。
【摘要】 目的 探討用視頻腦電圖和MRI診斷藥物難治性癲癇的臨床價值。 方法 收集2006年12月-2010年5月間經手術和病理證實的藥物難治性癲癇患者38例。其中，海馬硬化25例，顳葉萎縮伴腦發育不良2例，腦灰質移位及巨腦回4例，血管畸形3例，膠質瘤2例，腦內囊腫1例，外傷性癲癇1例。用視頻腦電圖監測癲癇發作期及發作間期癇樣放電的來源部位及腦電活動特點，用MRI掃描顯示癇灶區的表現特征，并與手術、病理改變對照，進行回顧性分析。 結果 視頻腦電圖對癲癇發作期的致癇灶來源定位準確率為100%（38/38），發作間期定位準確率為53%（20/38）。MRI對發作間期的致癇灶及相關病變定位診斷準確率為89%（34/38），病變定性準確率為79%（30/38）。 結論 視頻腦電圖和MRI檢查有機結合，對藥物難治性癲癇，能更有效檢出致癇灶的部位及性質，為藥物難治性癲癇患者的手術治療，提供重要信息。【Abstract】 Objective To study the clinical diagnosis value of video-electroencephalography (EEG) and MRI on pharmacal intractable epilepsy. Methods From December 2006 to May 2010, 38 cases of pharmacal intractable epilepsy were confirmed through operation and pathologic examination. Among them, there were 25 cases of hippocampal sclerosis, 2 cases of temporal lobe atrophy combined with brain dysplasia, 4 cases of heterotopic gray matter and macrogyria, 3 cases of vascular malformation, 2 cases of glioma, 1 case of cyst in brain, and 1 case of traumatic epilepsy. Video-EEG was applied to monitor the source of epileptoid discharge and the features of brain electrical activity during and between the occurrences of epilepsy. MRI was used to detect the manifestation characteristics of the epilepsy focus, and retrospective analysis was done to compare these findings with operational and pathological results. Results The accuracy rate of Video-EEG in locating the epilepsy focus was 100% (38/38) during the occurrence of epilepsy, and 53% (20/38) between the occurrences of epilepsy. The accuracy rate of MRI in diagnosing the epilepsy focus and relevant abnormalities during the occurrence of epilepsy was 89% (34/38), and 79% (30/38) in characterizing the abnormalities. Conclusion Video-EEG combined with MRI examination is effective in locating and characterizing the epilepsy focus, which can provide more useful information for the surgery in treating pharmacal intractable epilepsy.
【摘要】 目的 探討0.35 T MRI各方位各序列掃描對肩袖撕裂的診斷價值。 方法 對2010年3月-2011年4月就診的38例肩關節疼痛患者，分別在斜冠狀位、斜矢狀位及橫軸位行T1加權像（T1 weighted image，T1WI）、T2加權像（T2 weighted image，T2WI）、質子密度加權像（proton density weighted image，PWI）及脂肪抑制像（turbo inversion recovery magnitude，TIRM）掃描。將38例患者的岡上肌及岡下肌肌腱合并為A組、肩胛下肌及小圓肌肌腱合并為B組進行研究，分別比較A、B組采用各方位的掃描表現；再將A組患者分為斜冠狀位T1WI+T2WI組與斜冠狀位PWI+TIRM組，將B組患者分為橫軸位T1WI+T2WI組與橫軸位PWI+TIRM組，分別比較各序列組的掃描表現。 結果 A組患者在3個方位掃描像以及斜冠狀位T1WI+T2WI組與PWI+TIRM組之間診斷準確度差異有統計學意義（Plt;0.05），其斜冠狀位診斷肩袖撕裂的靈敏度為88.9%，特異度為81.8%，準確度為86.8%，為最佳掃描方位，而PWI+TIRM組診斷肩袖撕裂的靈敏度為88.9%，特異度為90.9%，準確度為89.5%，為優選掃描序列；B組患者在3個方位掃描像以及橫軸位T1WI+T2WI組與PWI+TIRM組之間診斷準確度差異有統計學意義（Plt;0.05），其橫軸位診斷肩袖撕裂的靈敏度為87.5%，特異度為86.4%，準確度為86.8%，為最佳掃描方位，而PWI+TIRM組診斷肩袖撕裂的靈敏度為100%，特異度為83.3%，準確度為94.7%，為優選掃描序列。 結論 低場MRI診斷岡上肌、岡下肌肌腱撕裂以斜冠狀位PWI及TIRM掃描序列為首選，診斷小圓肌、肩胛下肌肌腱撕裂則以橫軸位PWI及TIRM掃描序列為主。【Abstract】 Objective To explore the clinical value of 0.35 T MRI diagnosing rotator cuff tears with different scan sequence and patient position. Methods From March 2010 to April 2011, there were 38 patients with shoulder pain were separately scanned by MRI at the position of oblique coronal, oblique sagittal and transaxial planes. Otherwise, the MRI images completed with T1 weighted, T2 weighted, PDWI and TIRM technique. The 38 cases were divided into two groups (group A: to study the supraspinatus and infraspinous tendons of the 38 cases; group B: to study the musculus teres minor and musculus subscapularis tendons of the 38 cases). Afterwards, the diagnostic results were compared among images at different patient positions. Furthermore, the images at oblique coronal plane of T1WI+T2WI and PWI+TIRM technique in group A were compared; on the other hands, the images at transaxial plane of T1WI+T2WI and PWI+TIRM technique in group B were compared. Results The difference of diagnostic accuracy in group A at different patient positions and scan sequences were statistical significant (Plt;0.05), and oblique cornal plane was the best patient position with sensitivity of 88.9%, specificity of 81.8% and accuracy of 86.8%; at the same time, the PWI+TIRM sequence was better sequence with sensitivity of 88.9%, specificity of 90.9% and accuracy of 89.5%. The difference of diagnostic accuracy in group B at different patient positions and scan sequences were statistical significant (Plt;0.05), and transaxial plane was the best patient position with sensitivity of 87.5%, specificity of 86.4% and accuracy of 86.8%; at the same time, the PWI+TIRM sequence was better sequence with sensitivity of 100%, specificity of 83.3% and accuracy of 94.7%. Conclusion In low field MRI, the oblique cornal plane with PWI+TIRM sequence are a first-line method for diagnosing supraspinatus tendon tears or infraspinous tendon tears; on the other hands, the transaxial plane with PWI+TIRM sequence are a first-line method for diagnosing musculus teres minor hurt or musculus subscapularis hurt.