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Objective:To explore the efficacy of Matas test combined with endovascular intervention on patients with traumatic internal carotid-cavernous fistula.Methods:A retrospective case study was performed on 144 patients with traumatic internal carotid-cavernous fistula treated in our department from August 2012 to June 2018. The clinical symptoms, intraocular pressure and visual acuity data before and after surgery were counted, and the paired t test was used for statistical analysis. Logistic regression was performed to analyze factors affecting recurrence.Results:The main symptoms of traumatic internal carotid-cavernous fistula were proptosis, bulbar conjunctival hyperemia and cranial sound. Postoperative intraocular pressure was significantly lower than preoperative intraocular pressure [(11.13±2.97) mmHg vs. (22.37±6.64) mmHg] and postoperative visual acuity was significantly higher than preoperative visual acuity [(0.69±0.36) vs. (0.47±0.25)] and (both P<0.05). Postoperative intraocular pressure was an independent risk factor for recurrence within 3 months ( OR=0.357, 95% CI: 0.135-0.944, P=0.037), and the recurrence rate was 10.42%. Conclusions:Matas test combined with endovascular intervention in the treatment of traumatic internal carotid-cavernous fistula can effectively reduce intraocular pressure, improve visual acuity, and has a definite curative effect. It is one of the effective treatment methods for traumatic internal carotid-cavernous fistula.
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Objective To evaluate the occurrence and prevention of pinch-off syndrome in post-operative complications of totally implantable central venous port.Methods From October 2003 to September 2016,628 cases underwent implantable central venous port via the subclavian vein using the landmark venipuncture technique.From February 2014 to September 2016,106 cases underwent implantable central venous port gaining subclavian venous access.Retrospective analysis of two groups of pinch-off syndrome after totally implantable central venous port.Results pinch-off syndromne were not found in the uhrasound-guided group,pinch-off syndrome occurred in 9 patients of 628 cases underwent implantable central venous port via the subclavian vein using the landmark venipuncture technique during follow-up period.Conclusions Subclavian venous access cannulation on the lateral side of mid-clavicular line by ultrasound guidance was found to be associated with absence of pinch-off syndrome.This method appears to reduce or prevent pinch-off syndrome occurrence after implantable central venous port,therefore improving the safety of the long-term management of implantable central venous port.
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OBJECTIVE@#Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA).@*METHOD@#Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used.@*RESULT@#Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P<0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process.@*CONCLUSION@#Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.
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Adolescent , Adult , Child , Humans , Male , Middle Aged , Young Adult , Angiofibroma , Diagnosis , Pathology , General Surgery , Endoscopy , Nasopharyngeal Neoplasms , Diagnosis , Pathology , General Surgery , Prognosis , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To study a rare CT finding of pulsatile tinnitus(FT)caused by sigmoid sinus abnormalities.Methods The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients(15 female).The median age was 45 years(24 to 63 years).The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years(median time,2.0 years).The tinnitus was at left side in 5 patients and right side in 10 patients.Fifteen patients underwent HRCT of the temporal bone.Of them,12 patients underwent cerebral CT angiography and CT venogram(CTA/CTV),and 9 patients underwent cerebral digital subtraction angiography(DSA).Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus.Of them,the tinnitus was at left side in 2 patients and right side in 7 patients.Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results On HRCT,focal bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients.On CTA/CTV,the sigmoid sinus focally protruded into the adjacent mastoid air cells and formed diverticulum in 10 patients.The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients.The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6(41.5-96.2)mm~2,it was 77.0(92.1-122.4)mm~2 in the nonmal side(Z=2.158,P=0.031).Conclusion Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus,which can be easily identified by imaging examination.
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Objective To observe imaging characteristics of carotid body tumor and schwannoma in carotid space. Methods CT, MRI and digital subtraction angiography (DSA) appearances of 16 patients with carotid body tumors and schwannomas in carotid space confirmed pathologically were retrospectively analyzed. There were 8 patients with carotid body tumors and 8 patients with schwannomas. Six patients with carotid body tumors and 5 patients with schwannomas underwent CT plain scan. All the patients underwent MR plain and contrast-enhanced scan. Four patients with carotid body tumors and 2 patients with schwannomas underwent DSA examination. Results CT: Six carotid body tumors were lobulated soft tissue masses. The density of the tumors was similar to neck muscles. Two carotid body tumors involving jugular foramen expanded jugular foramen, and the margin was irregular and erosion-destructive. Five schwannomas were ovoid or fusiform soft tissue masses. The density of the tumors was mixed. Two schwannomas involved jugular foramen expanded jugular foramen, and the margin was smooth. MRI: Eight carotid body tumors were lobulated, well-defined, longitudinal growth masses with characteristic high-velocity flow voids. The tumor splayed and surrounded internal carotid artery and external carotid artery. The diameters of the arteries were normal. The tumors intensely enhanced on contrast-enhanced MRI. Eight schwannomas were ovoid or fusiform, well-defined, longitudinal growth masses with heterogeneous signal, splaying carotid artery and jugular vein. The diameters of the vessels were narrow. The tumors nonuniformly enhanced on contrast-enhanced MRI. DSA: Four carotid body tumors showed intense tumor blush, while 2 schwannomas showed slight tumor blush. Conclusion According to the imaging characteristic of the tumors, carotid body tumor and schwannoma in carotid space can be accurately differentiated.
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Objective To discuss the diagnostic value of MR in carotid-cavernous sinus fistulae(CCF). Methods Conventional MRI and 3D TOF MRA were performed in 23 cases of CCF confirmed by DSA. The MRI and MRA appearances of CCF were reviewed. Results The main MRI and MRA findings of CCF included enlargement of cavernous sinus, distortion and dilatation of the superior ophthalmic vein in the involved side in all cases.Dilatation of the inferior ophthalmic vein in 3 cases, superficial cerebral veins in 5 cases,dilatation of pterygoid venous plexus in 2 cases, superior petrosal sinus in 3 cases, and inferior pertrosal sinus in 2 cases. In the counterside, dilatation of cavernous sinus were found in 3 cases. Opening of posterior communicating artery in the circle of Willis happened in 17 cases. Conclusion MRI combined with MRA is able to make a reliable diagnosis of CCF, and is also able to demonstrate the condition of compensatory blood supply in brain, which is useful in the decision of the theraputic plan.
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Objective To determine serum vascular endothelial growth factor (s-VEGF) and serum endostatin (s-endostatin) levels in patients with colorectal cancer after preoperative regional intraarterial chemotherapy (PRAC). Methods Peripheral venous blood was sampled preoperatively and postoperatively, and was assayed for VEGF and endostatin by ELISA. Results Patients' preoperative level of s-VEGF and s-endostatin elevated significantly, which was in close correlation with Dukes' stage. The level of s-VEGF and s-endostatin before chemotherapy elevated significantly compared with that on day 7 after chemotherapy and on postoperational day 1 and 14 after operation. In patients undergoing palliative resection, only the level of s-endostatin before chemotherapy was significantly higher than that on day 1 after operation. Conclusions PRAC, inhibiting angiogenesis, is of antitumor effect, the decrease of s-endostatin after chemotherapy may suggest the combination of chemotherapy and antiangiogenesis for a better antitumor effect.