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Objective To investigate the diagnostic value of 64-slice CT and MRI in detection of abnormal sacroiliac joint changes in patients with early stage of ankylosing spodylitis (AS).Methods The 64-slice CT and MRI imaging data of the sacroiliac joint early diseases(grade 0 ～ Ⅱ lesion) for the 66 patients with clinical confirmed were reviewed retrospectively,of which MRI contrast enhanced was performed in 6 patients.Results CT showed grade zero lesion 15 cases,grade Ⅰ lesion in 20 cases and grade Ⅱ lesion in 31 cases.MRI revealed bilateral articular bone marrow edema in 52 cases,articular cartilage erosive destruction in 48 cases,fat accumulation of bilateral articular bone in 36 cases,articular bone erosive destruction in 31 cases.Bilateral synovial membrane enhancement was showed in all patients who underwent contrast enhanced.Conclusions MRI can detect acute inflammatory changes which can not display by MSCT.Compared with MSCT,MRI is more useful in detection of abnormal sacroiliac joint changes in patients with early stage of AS.
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Objective To explore the appropriate pneumoperitoneum pressure in different surface area children during pediatric laparoscopic surgery,so as to attenuate the intederence with physiological function and avoid pneumoperitoneum correlative complications.Methods 120 patients underwent laparoscopic surgery were divided into three groups by different surface area:A(0.43～0.67m2),B(0.68～0.92m2),C(0.93～1.17m2).Each group was divided into two subgroups again by different pneumoperitoneum pressure:A1(4 mm Hg),A2(6mm Hg),B1(7mm Hg),B2(9mm Hg),C1(10mm Hg),C2(12 mm Hg).The cardiorespiratory function and blood gas analysis in different time point before and after pneumoperitoneum were monitored.Results The increase of PET CO2,Paw,HR,MAP and PaCO2 in A2,B2,C2 were more obvious than in A1,B1,C1(P ＜ 0.01).The eligible pneumoperitoneum pressure for A,B,C were 4,7,10mmHg respectively.The complications of gastric contents back-streaming and respiratory acidosis were 7 cases in A2,B2,C2 in all,and 3 cases in A1,B1,C1.Conclusion Using a compatible pneumoperitoneum pressure for different surface area children could attenuate the interference of physiological function and avoid pneumoperitoneum correlative complications.
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Objective To assess the diagnostic value of DR,SCT,MSCT and MRI in diagnosis of osteoid osteoma.Methods Nineteen cases of osteoid ostcoma proved by surgical pathology were collected,Among the 19 cases,all patients had DR and CT scanning,8 with MR imaging.All the DR image processing were performed to display the nidus.Ten patients were examined by SCT axial scanning and 9 cases were performed by MSCT using isotropic parameters,then multi-direction MPR were performed.The ability of DR,SCT,MSCT and MKI in demonstrating the nidus and the surrounding reaction were analyzed.Results Among 19 cases.only 6 cases showed nidus on DR before image processing and 12 showed nldus after image processing.All cases with CT scanning showed nidus.Among 8 cases with MRI.only 6 eases could be diagnosed correedy.The nldns could be ariarmed in only 4 cases.and the nidus was affirmed by comparing with DR or CT in 2 eases,the other 2 cases were misdiagnosis.Among 10 eases with SCT,only 6 cases showed calcification of nidus.Whereas among 9 cases with MSCT,8 cases showed calcification of nidus.There were also soft tissue and bone marrow edema around the nidus on MR imaging in all 8 cases.Conclusion Nidm is the key in diagnosing the osteoid osteoma correctly.DR is a basic checking method for osteoid osteoma.DR image processing con improve the display rates of nidus.CT scan is the best method to demonstrate the nidus.MSCT is better than SCT in demonstrating the nidus and the surrounding reaction.MRI can demonstrate the soft tissue and bone marrow edema around the nidus sensitively.but probably lead to an incorrect diagnosis.Combining with DR or CT.MRI can make an accurate diagnosis.
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Objective To study preoperative nursing intervention mode for thyroid surgery and its effect.Methods 78 patients were randomly divided into two groups.39 patients in the intervention group received psychological care 30 minutes before operation besides preoperative interview 24 hours before operation,while 39 patients in the control group received routine visit 24 hours before operation.Indexes including the values of blood pressure,heart rate and the SCOre of anxiety of the two group patients were measured and recorded before interview and before anesthesia.Results There were no difference in the observational indexes between the two groups before interview(P＞0.05),while after intervention(before anesthesia),the values of blood pressure and heart rate and the Score of anxiety in the intervention group were lower than those in control group (P＜0.01).Conclusion Preoperative systematic interview combined psychological care before operation is an effective nursing intervention mode,it can help patients who will receive thyroid surgery reduce the fluctuation of blood pressure and heart rate,and it can also relieve the preoperative anxiety.
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Objective To investigate the diagnostic value of MSCT with multi-planar reconstruction(MPR)and maximum intensity projection(MIP)in diagnosis of spinal burst fracture.Methods 45 patients(53 vertebras)with vertebral burst fracture were examined by MSCT and processed with MPR and MIP.The imaging features were analyzed comparatively.Results The axial images clearly demonstrated the vertebral body vertically or transversely burst crack in 49 vertebras(92.5%),bony fragment inserted into the spinal canal and stenosis of spinal canal in 34 vertebras(64.2%).The sagittal images showed kyphosis in 28 vertebras(62.2%).The sagittal and coronal images showed decreased height of the vertebral body in 37 vertebras(69.8%)and depressed fracture of vertebral end plate in 19 vertebras(35.8%).Total 44 fractures were located at spinal appendix,39 were showed by axial images,35 by sagittal images and 33 by coronal images.MIP displayed the space changes of bone structures in all cases and rotary dislocation fracture in 6 cases(11.3%).Conclusion MPR and MIP are of significant values in diagnosis and clinical treatment of spinal burst fracture.