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Objective To discuss clinical value of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma.Methods A retrospective study was carried out on data of 72 multiple trauma patients diagnosed with systemic 64-slice spiral CT scanning in our hospital from January 2006 to June 2008.Of all,28 patients with traffic injuries,24 with falling injuries,10 with blunt injuries,6 with stab injuries and 4 with explosive injuries.Results There were 72 multiple trauma patients with mean scanning time of 10.2 seconds.The CT scanning showed both craniocerebral and thoracic injuries in 30 patients,brain injuries in 16,thoracoabdominal injuries plus pelvic injuries in 10,extremity and brain injuries in 14 and systemic soft tissue injuries in 2.Isotropic characteristics and postprocessing function of 64-slice spiral CT scanning could accurately diagnose and evaluate injury severity of multiple trauma.Conclusions 64-slice spiral CT scanning is a fast and effective method for fast evaluating injury severity of multiple trauma,for it can not only shorten checking time,reduce movements of the patients and relieve the pain of the patients,but also can avoid defects induced by respiratory movement and provide fairly integrated imaging materials by its isotropic characteristics and pestprecessing function.
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Objective To detect the total colon transit time (CTT) and segmental CTT of patients with chronic constipation and explore the clinical significance. Methods Colon transit study and defecography(DFG) were performed on 60 patients with chronic constipation. These patients were divided into 3 groups: group Ⅰ, 19 patients with slow transit constipation based on low stool frequency and normal DFG, group Ⅱ, 22 patients with rectal intussusception diagnosed by DFG and group Ⅲ, 19 patients with external rectal prolapse or puborectal muscle syndrome based on the results of DFG. Results Group Ⅰ showed increased total CTT (mean, 96.2 h) and segmental CTT, right colon, 35.3 h (36.7%), left colon, 30.8 h (32.0%), rectosigmoid, 30.1 h (31.3%). Group Ⅱ had normal mean total CTT (57.8 h) and a relative decrease in rectosigmoid CTT [mean, 13.8 h (23.9%)]. In group Ⅲ, patients showed elevated total CTT(mean, 175.1 h) and rectosigmoidal CTT [mean, 115.8 h(66.1%)]. There were significant differences in mean total CTT and rectosigmoidal CTT among the 3 groups ( P
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Objective To study the morphologic and structural changes of the pelvic floor and corresponding visceras in patients with outlet obstructive constipation (OOC). Methods We used simultaneous pelvicography and colpocystodefecography (PCCD), including pelvicography, vaginal opacification, voiding cystography and defecography in 38 patients with OCC and 12 healthy volunteers. Anorectal angle, the level of perineum, and bladder were measured. Results Internal rectal prolapse (IRP) in 37 cases, rectocele (RC) in 5 cases and spastic pelvic floor syndrome (SPFS) in 5 cases were diagnosed by PCCD. While common physical examination alone detected only 12 cases, 4 RC cases and one SPFS case, which were confirmed by PCCD. Moreover, PCCD found 9 cases of pelvic floor hernia or peritoneoceles, 6 cases of cystoceles, 3 cases of descending perineum syndromes, and 10 cases of uterine prolapses. Compared with controls, OOC patients had a larger anorectal angle during defecation, abnormal descending of perineum at rest and defecation, and a deep pouch of Douglas during defecation. Some patients with urinary system symptoms have an abnormal descent of bladder during rest and defecation. Conclusion PCCD has a higher detection rate than common physical examination in diagnosing IRP and RC, and provides information for diagnosis of pelvic floor hernia or peritoneocele, cystocele or uterine prolapse. PCCD helps in the selection of a proper surgical procedure for OOC patients.
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Objective To evaluate the effects of meglumine diatrizoate mucilage (MDC) used as contrast medium in bronchography. Methods A total of 500 patients undergoing bronchography were reviewed, including male 346, female 154, with an average age of 42 (ranged 5～71). Among them, 415 were examined with bilateral bronchography in a dose of 20～30 ml, 85 with unilateral bronchography in 10～15 ml of MDC. Results In 487 cases (97.4%), the lobes, segments, subsegment bronchi were revealed very well, and 456 cases (91.2%) had no cough. Conclusion MDC is regarded as an ideal bronchial contrast medium, and may replace dionosil and iodized oil.
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Objective To study the MRI features of normal and abnormal axillary lymph nodes so as to explore the evaluation of MR breast coil on metastasis of axillary lymph nodes in patients with breast cancer before operation.Methods MR scanning was made on 119 axillas from 24 healthy volunteers,23 patients with benign breast disease and 43 patients with breast cancer with MR breast coil.The shape,border,size,number and signal intensity of axillary lymph nodes in every group were comparatively studied.The features of the axillary lymph nodes of the patients with breast cancer were compared with the histopathologic results.Results Axillary lymph nodes were detected in 15 out of the 48 healty volunteer axillas (31.25%).The shape,border,size,number and signal intensity of axillary lymph nodes had no significant difference between the patients with benign breast disease and the patients with breast cancer with no metastasis lymph nodes (LN-)and the healthy volunteers.The shape,border,size,and enhancement pattern of the patients with axillary lymph nodes metastasis(LN+)were statistically different from that of the above mentioned three groups.Conclusion MRI is an effective method to evaluate the status of axillary lymph nodes before operation.It provides useful evidences for clinical operation and treatment.
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Objective To evaluate operative effect on internal rectal prolapse. Methods Sixty-two patients with internal rectal prolapse who underwent operation were studied by retrospectively analyzing the treatment and followed up results. Results The total success rate of surgical treatment for internal rectal prolapse is 73%. The rate of symptoms improvement as difficulty in defecation,anal aboating, incomplete defecation,asistation with fingers,and defecating dependent on laxatives were 77%,80%,71%,86%,97% respectively. Conclusion the operative indications of internal rectal prolapse should be strictly controlled. Only those who received standard conservative treatment and failed to improve should be a candidate for surgery.
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Defecography was performed in 110 patients without any anorectal symptoms which included 57 male and 53 female with an average age of 43. 15. Normal defecography was found in 82 cases and abnormal one in 28. The normal features of defecography in 82 patients were as follows;1.There was an increase of anorectal angle during defecation. The increase was 21. 27 degrees measured-with precise axis method and 36. 72 degrees with approximate axis method.2. Reduction or obliteration of the impression of the puborectal muscle.3. There was a shortening of the anal canal by 1. 20 cm and a widening of the caliber of the anal canal to an average of 2. 23 cm.4. The resistance of the pelvic floor was good and the decending of the perineum was smaller than 3 cm during straining. The rectovaginal septum of female subjects was not deformed during straining.5. The barium paste in the distal rectum was largely or totally evacuated with an average e-vacuation rate of 90. 55%.