OBJECTIVE: To study the effect of color doppler flow imaging(CDFI) technique in the design of axial pattern flap. METHODS: From April 1996 to June 1999, 10 patients with residual wound were adopted in this study. Among them, there were seven males and three females, the area of wounds ranged from 6 cm x 8 cm to 15 cm x 20 cm. Before operation, the axial pattern flaps were designed by traditional method, then CDFI technique with high frequency(5.0-7.5 MHz) was used for examining the major supply artery of the flap. At last, the modified flaps were transferred to cover the wounds. RESULTS: All the patients except one case completed the operation successfully. The cosmetic and function of the flaps were excellent. CONCLUSION: CDFI is a simple, direct and accurate method for detecting the supply artery of axial pattern flap. This technique should be popularized to avoid the blindness of flap design.
【Abstract】Objective To study the surgical therapy and staging investigation about stage Ⅳ breast carcinoma. Methods The clinical data of 38 patients with stage Ⅳ breast carcinoma were summarized, and the patients were followed up. Results The stage Ⅳ patients who had isolated metastasis and removable primary tumor were treated by radical surgery with good effect. On the other hand, the stage Ⅳ patients who had extensive metastasis and primary tumor unresectable were treated by palliative operation with the living quality of patients becoming better and chemotherapy load cutting down. Conclusion The stage Ⅳ patients should be divided into stage Ⅳa and stage Ⅳb. And the stage Ⅳa patients should be treated by radical operation, and the stage Ⅳb by palliative operation.
Objective
To study the characteristics of optic al coherence tomography (OCT) in idiopathic macular epiretinal membranes (IMEM) and the relationship between the thickness of fovea and the vision of affected eyes.
Methods
Total of 67 cases (73 eyes) with clinica l diagnosis of IMEM by direct, indirect ophthalmoscopy, three mirror contact len s, fundus color photography or fundus fluorescein angiography(FFA）were examined with OCT.
Results
Epiretinal membranes(ERMs) with macular edema were found in 32 eyes, proliferative ERMs in 20 eyes, ERMs with macular pseudoholes in 14 eyes and ERMs with laminar macular holes in 7 eyes. Based on OCT, the ERMs were clearly and partially seperated from the retina (27 eyes, 38.36%), the retinal thickness of the fovea was the thickest in proliferative ERMs and the thinnest in ERMs with laminar macular holes. The statistical an alysis showed there was a negative correlation between the thickness of fovea an d visual acuity (r=－0.454, P= 0.000 ).
Conclusion
There were four types of image of OCT in IMEM: ERMs with macularedema, proliferative ERMs, ERMs with macular pseudohole and ERMs with laminar macular hole；and the thicker the fovea under the OCT, the poorer th e visual acnity in the affected eyes with ERMs.
(Chin J Ocul Fundus Dis, 2001,17:115-118)
摘要:目的: 探討臂叢神經磁共振成像的技術方法及其可行性。 方法 :對15例正常志愿者行雙側臂叢神經成像:包括常規快速自旋回波序列T1加權(T1W/TSE)、快速自旋回波序列T2加權(T2W/TSE)、快速自旋回波序列T2加權加SPIR脂肪抑制(T2W/SPIR)冠狀位掃描以及彌散加權背景抑制成像序列(DWIBS)軸位掃描。 結果 :T1W/TSE、T2W/TSE、及T2W/SPIR對臂叢節后神經同層顯示率分別為533%、567%和833%;DWIBS MIP重建圖像對臂叢神經的全貌顯示較為完整、清晰、直觀;T1W/TSE、T2W/TSE、T2W/SPIR及DWIBS MIP重建圖像的對比噪聲比分別為109±09、107±13、185±68和299±133,T2W/SPIR序列和DWIBS MIP重建圖像的對比噪聲比明顯高于T1W/TSE和T2W/TSE序列。 結論 :T2W/SPIR序列對臂叢神經的同層顯示率及圖像的對比噪聲比明顯高于常規T1W/TSE、T2W/TSE序列, DWIBS MIP重建圖像能夠顯示臂叢神經的全貌,兩者為臂叢神經成像較為有效的技術方法,對于臂叢神經病變的診斷即具有十分重要的意義。Abstract: Objective: To determine the optimal sequences of brachial plexus with MRI. Methods : Fifteen volunteers were underwent MRI on 15T scanner, the Sequences of T1W/TSE/COR, T2W/TSE/COR, T2W/SPIR/COR and Diffusionweighted imaging with background body signal suppression were performed. Results : The display rates of brachial plexus postganglionic segment nerve showing at the same slice were 533%, 567% and 833% on T1W/TSE/COR, T2W/TSE/COR, T2W/SPIR/COR. Brachial plexus on DWIBS MIP were clear and complete. Contrastnoise ratio of four sequences was 109±09, 107±13, 185±68 and 299±133,respectively. Contrastnoise ratio of T2W/SPIR/COR and DWIBS MIP was significantly higher than that of the other two sequences. Conclusion : Display rate of brachial plexus and contrastnoise ratio of images on T2W/SPIR/COR were higher than those of routine sequences. Image of DWIBS MIP can show the outline of brachial plexus clearly. The two sequences were reliable and effetive techoniquic in diagnosis of brachial plexus lesion.
ObjectiveTo investigate the application of high frequency color Doppler ultrasound (HFCDU) combined with wide-field imaging in the preoperative navigation of anterolateral thigh perforator flap graft.MethodsBetween January 2017 and March 2018, 28 patients with skin and soft tissue defects were treated, including 22 males and 6 females, with an average age of 33.5 years (range, 17-66 years). The causes of injury included 2 cases of scald scar, 7 cases of heavy object crushing injury, 12 cases of traffic accident injury, 4 cases of fall injury, 2 cases of machine injury, and 1 case of infection ulcer. Injury sites included 6 cases of hand and wrist, 12 cases of lower leg, 10 cases of foot. After debridement, the wound area ranged from 6.0 cm×3.5 cm to 24.0 cm×9.0 cm, and all patients were treated with free circumflex femoral artery perforator flap graft. Combo of HFCDU and wide-field imaging navigation were done preoperatively to detect the origin, quantity, course, surface location, hemodynamic characteristics, and the relationship with body area of perforator branch of lateral circumflex femoral artery. According to the perforator information displayed by wide-field imaging of source artery, the dominant perforator was determined to be a pedicle for designed flap. The flap size ranged from 7.0 cm×4.5 cm to 26.0 cm×7.0 cm. The flap donor area was sutured directly.ResultsThe dominant perforator was successfully detected by HFCDU combined with wide-field imaging in 28 patients before operation. The existence of the perforator was confirmed during operation, and the location was accurate. The course characteristics of the perforate were consistent with the results of wide-field imaging. The grafted flaps survived completely among 27 patients after operation. Necrosis at the edge of the flap was observed in 1 patient, which healed after dressing change. All patients were followed up 3-12 months, with an average of 9 months. All the flaps have good blood supply, good elasticity and shape. The donor areas healed perfectly.ConclusionUsing HFCDU and wide-field imaging navigation for designing of anterolateral thigh perforator flaps can clearly show the characteristics of perforators, hemodynamic information, and the relationship with body area, so that the surgeons can understand the perforators more accurately and intuitively, and improve the success and efficiency of flap graft surgery.
Objective
To understand and analyze technique development of magnetic resonance elastography (MRE) and its application in chronic liver disease.
Method
The relevant literatures about the application of MRE in the field of chronic liver disease were reviewed.
Results
The liver fibrosis was a common pathway of chronic liver disease, which would progress to cirrhosis of the liver if untreated. The diagnosis and assessment of fibrosis was important in the treatment of patients with chronic liver disease. The liver biopsy was considered to be the reference standard for clinical assessment of liver fibrosis. However, this technique was invasive and still had inevitable drawbacks in the clinical practice. With the update of the imaging technology and equipment, the MRE had been developed as a safe and noninvasive examination method for the evaluation of liver fibrosis in the chronic liver disease, early diagnosis of nonalcoholic fatty liver disease, evaluation of focal liver lesions, and other clinical applications.
Conclusion
MRE is currently regarded as an attractive noninvasive technique in management of chronic liver disease.
Objective To summarize the principle and application of functional MR imaging of pancreatic carcinoma and chronic mass-forming type pancreatitis. Methods Articles about diffusion-weighted imaging (DWI), magnetic resonance spectrum imaging (MRSI) and dynamic contrast-enhanced MR imaging of pancreatic carcinoma and chronic pancreatitis were reviewed and analyzed. Results Functional MR imaging could reflected the differences in molecules diffusion, metabolism and tissue perfusion between pancreatic carcinoma and chronic pancreatitis. Conclusion As a non-invasive protocol, functional MR imaging can provide useful information in differential diagnosis between chronic mass-forming type pancreatitis and pancreatic carcinoma.
Objective To investigate the situation and prospect of local recurrence of rectal cancer by using CT and MRI. Method Relevant references about the imaging diagnosis of local recurrence of rectal cancer， which were published domestic and abroad in recent years， were collected and reviewed. Results In the diagnosis of local recurrence of rectal cancer， the sensitivity of CT was higher than that of MRI， while the specificity and accuracy were not. Perfusion CT， dynamic contrast-enhanced MRI， and diffusion weighted imaging were valuable in diagnosing local recurrence of rectal cancer， as new diagnostic techniques. Conclusion Both CT and MRI are important and valuable methods in diagnosing for local recurrence of rectal cancer.
Surgery has remained the cornerstone of lung cancer therapy. Sleeve lobectomy, which is featured by not only the maximal resection of tumors but also the maximal preservation of functional lung parenchyma, has been proved to be a valid therapeutic option for the treatment of some centrally located lung cancer . Evidence points toward equivalent oncologic outcomes with improved survival and quality of life after sleeve resections compared with pneumonectomy. However, the postoperative morbidities and the long-term results after sleeve lobectomy remain controversial, especially in relation to nodal involvement and after induction therapy. With the development of technology, minimally invasive procedures have been performed more and more widely.
Liver cancer is one of the world’s most prevalent malignancies, and is also the third leading cause of cancer death in China. Hepatitis and cirrhosis background is a major feature of liver cancer patients in China, which makes specific requirements that suits the national conditions in many aspects of prevention and control like screening diagnosis, treatment options, and prognosis follow-up. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition), which is based on China’s practice, proposes liver cancer staging in line with China’s national conditions and forms a multi-disciplinary joint diagnosis and treatment model based on surgical treatment. Liver transplantation is included in liver cancer as one of the surgical treatments option. It also emphasizes the support of evidence-based medicine. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) may have laid a solid foundation for future diagnosis and treatment of liver cancer in China.
