ABSTRACT
Objective To explore the applicability of the three commonly used CT examination decision rules in Chinese head injured children. Methods This prospective observational study included 1538 children and adolescents (aged < 18 years), who were treated at the Emergency Department of First Hospital of Shanxi Medical University after head injuries. The three clinical decision rules include the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE; UK); the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury, that was developed by the Pediatric Emergency Care Applied Research Network (PECARN; USA), and the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule. Diagnostic accuracy had been evaluated by using the rule-specific predictor variables to predict each rule-specific outcome measure in populations who met inclusion and exclusion criteria for each rule. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and ROC curve were referred to the diagnostic accuracy. Indicators were characterized by 95％ CI. Results Of the 1538 patients, CTs were obtained for 339 patients (22.04％). Forty-nine patients (3.19％) had positive CT results, 8 patients (0.52％) underwent neurosurgery, 2 patients (0.13％) died, and 1 patient (0.07％) may be missed. In this study, CHALICE was applied for 1394 children (90.70％; 95％ CI: 89.24％-92.15％), PECARN for 801 children (52.11％; 95％ CI: 49.62％-54.61％), and CATCH for 325 patients (21.15％; 95％CI: 19.10％-23.19％). The validation sensitivities of CHALICE, PECARN, and CATCH rules were 92.6％(74.2％-98.7％), 100％ (56.1％-100％), and 85.7％ (42.0％-99.2％), respectively; the specificities were 78.1％(75.7％-80.2％), 48.0％ (44.5％-51.5％) and 70.8％ (65.4％-75.6％); positive predictive value were 7.7％ (5.1％-11.3％), 0.9％ (0.4％-1.9％) and 6.1％ (2.5％-13.2％); and negative predictive value were 99.8％ (99.2％-100％), 99.1％ (98.1％-99.6％), and 99.6％ (97.2％-100％), respectively. Conclusions The clinical decision rules of CHALICE, PECARN and CATCH have high sensitivities. The specificity of PECARN rule is lower than those of CHALICE and CATCH rules. The above three clinical decision rules can be used for the decision of CT examination in Chinese children with head injury in practice.
ABSTRACT
Objective To assess the diagnostic performance of real-time contrast-enhanced ultra-sound Sonovuein diagnosing minute rabbit liver VX 2 tumors with diameter ≤10.0 mm.Methods Thir-ty New Zealand white rabbits inoculated with VX 2 tumor ( left, right lobe of each ) were examined by two-di-mensional ultrasound and CEUS .The contrast enhanced mode of small rabbit liver VX 2 tumors in different phase was observed and tumor in the rabbit's liver was pathologically verified .The diagnostic performances of two-dimensional US and CEUS in detecting the rabbit VX 2 tumors were analyzed and compared .Results Thirty-nine tumors were pathologically verified .The detection rates of small tumors by CEUS and two-di-mensional US were 12.8% and 79.5%, respectively , yielded significantly higher than that of 2-D US. Conclusion Real-time CEUS significantly improves the detection rates of small rabbit VX 2 liver tumors less than 10.0 mm in diameter .
ABSTRACT
BACKGROUND: Splenic autotransplantation has been presently involved in the treatment of traumatic splenic rupture. Yhere have been retoorts regarding nuclein examination and immunologic test used to monitor splenic autotransplant. But little is known about ultrasonic visualization for follow up of splenic autotransplant. OBJECTIVE: To investigate the value of ultrasonography in monitoring splenic autotransplant survival and growth. DESIGN, TIME AND SETTING: The present retrospective case analysis Was performed at the Department of Ultrasonography. Shenzhen Second People's Hospital between January 2000 and December 2004.PARTICIPANTS:Eighteen patients undergoing splenectomy and suffering from traumatic splenic rupture,13 males and 5 females. aged 20-42 years, were included for this study. METHODS: Non-injured autologous splenic tissue was prepared into thin sections with an area of(2-4)cm×(1-3)cm and a thickness of≤0.5 cm. And transplanted into the greater omentum with abundant vessels in patients undergoing splenectomy.A1118 patients received ultrasonography at 3,6,and 12 months after splenic transplantation, and were subjected to spleen imaging with99Tcm-heat damaged red blood cells. MAIN OUTCOME MEASURES: Nuclein examination of splenic autotransplant survival and growth. RESULTS: Splenic autotransplants survived and gradually grew in 14 of 18 patients. Splenic autotransplants exhibited low level echo similar to normal spleen, regular contour, clear boundary, and visible internal blood flow signal. Splenic autotransplants were not found growing in 4 patients with accessory spleen. CONCLUSION: Ultrasonography can precisely monitor splenic autotransplant survival and growth.