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Objective@#To analyze the ultrasound examination and computed tomography angiography (CTA) features of carotid web(CAW), and compare with the pathology after carotid endarterectomy, and then compare diagnostic efficacies of the two methods.@*Methods@#From June 2018 to July 2019, 159 patients underwent carotid endarterectomy(CEA) in Beijing Tian Tan Hospital were collected, ultrasound examination and CTA were performed preoperatively. The presence or absence of CAW and whether there were thrombosis or atherosclerotic plaques associated with it were identified. The location length, thickness, direction in the lumen, echo characteristics of CAW, and complicated with or without thrombosis or atherosclerotic plaques were recorded. The postoperative specimens were observed, and the pathological analysis was performed.@*Results@#Among the 159 cases of CEA, 22 cases were confirmed to have CAW structure by pathology, and HE staining showed extensive intimal fibrohyperplasia and mucoid degeneration, among which 18 cases had plaque formation at the bottom of the carotid web, and 4 cases associated with thrombosis. There were 17 cases of CAW structure diagnosed by ultrasound, 5 cases were misdiagnosed or missed, the sensitivity and specificity of ultrasound in the diagnosis of CAW were 77% (17/22) and 98% (135/137), and the accuracy was 75%. Eleven cases of CAW were diagnosed by preoperative CTA, and 11 cases were misdiagnosed and missed diagnosis, the sensitivity and specificity of CTA in the diagnosis of CAW were 50%(11/22) and 97%(134/137), and the accuracy was 47%.@*Conclusions@#The sensitivity of ultrasound in the diagnosis of CAW is higher than that of CTA, which can better display the structure of CAW and whether it is associated with plaque or thrombosis.
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Objective:To analyze the ultrasound examination and computed tomography angiography (CTA) features of carotid web(CAW), and compare with the pathology after carotid endarterectomy, and then compare diagnostic efficacies of the two methods.Methods:From June 2018 to July 2019, 159 patients underwent carotid endarterectomy(CEA) in Beijing Tian Tan Hospital were collected, ultrasound examination and CTA were performed preoperatively. The presence or absence of CAW and whether there were thrombosis or atherosclerotic plaques associated with it were identified. The location length, thickness, direction in the lumen, echo characteristics of CAW, and complicated with or without thrombosis or atherosclerotic plaques were recorded. The postoperative specimens were observed, and the pathological analysis was performed.Results:Among the 159 cases of CEA, 22 cases were confirmed to have CAW structure by pathology, and HE staining showed extensive intimal fibrohyperplasia and mucoid degeneration, among which 18 cases had plaque formation at the bottom of the carotid web, and 4 cases associated with thrombosis. There were 17 cases of CAW structure diagnosed by ultrasound, 5 cases were misdiagnosed or missed, the sensitivity and specificity of ultrasound in the diagnosis of CAW were 77% (17/22) and 98% (135/137), and the accuracy was 75%. Eleven cases of CAW were diagnosed by preoperative CTA, and 11 cases were misdiagnosed and missed diagnosis, the sensitivity and specificity of CTA in the diagnosis of CAW were 50%(11/22) and 97%(134/137), and the accuracy was 47%.Conclusions:The sensitivity of ultrasound in the diagnosis of CAW is higher than that of CTA, which can better display the structure of CAW and whether it is associated with plaque or thrombosis.
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Objective To investigate the value of multiple sequential MRI in the differential diagnosis of vater ampulla carcinoma (VPC).Methods MRI data of 53 patients with VPC confirmed by surgery and pathology were analyzed retrospectively,which included 17ampullary carcinomas,15 pancreatic head carcinomas,10 duodenal papillary carcinomas and 11 distal common bile duct carcinomas.All patients underwent routine MRI plain scan,MRCP and multi-phase dynamic enhancement scan for the upper abdomen.The morphological characteristics and model of multi-phase dynamic enhancement of the tumor,and the morphological changes of pancreaticobiliary duct were focused,and relevant data were also measured.Results The differences of tumor size,central location,and signal homogeneity among the four different histological types showed statistical significance(P＜0.05),and their patterns of multi-phase dynamic enhancement also had differences.Double-segment sign was most found in VPC (26/53),four-segment sign was easy showed in pancreatic head carcinoma (8/15)and three-segment sign in distal common bile duct carcinoma (8/11).Beak sign was common seen in ampullary carcinoma(10/17),rat-tail sign was easy discovered in pancreatic head carcinoma (7/15) and truncated sign in distal common bile duct carcinoma(10/11).Diameter of major pancreatic duct in pancreatic head carcinoma was maximum and minimum in distal common bile duct carcinoma,and their difference had statistical significance(P＜0.05).Distance between obstructive end of bile common duct and major papilla of duodenum,and between obstructive end of major pancreatic duct and major papilla of duodenum as well as the pancreaticobiliary conjunction angle in pancreatic head carcinoma and distal common bile duct carcinoma were greater than that in ampullary carcinoma and duodenal papillary carcinoma.Conclusion MRI can prominently demonstrate various imaging characteristics of VPC with different histological origins.It is very valuable in the differential diagnosis of VPC with different histological types by comprehensive analysis of these findings.
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@#Objective To investigate the risk factors of cerebral palsy(CP)in children.Methods 1∶2 matched case-control study was carried out in 100 CP children and 200 controls individually matched for sex and age were selected for each case.The data were analyzed with Logistic regression.Results 9 risk factors were suggested from univariate analysis,namely hospital level,educational level of mother and father,premature birth,neonatal asphyxia,ABO hemolysis,lower birth weight,hypoxic-ischemic encephalopathy(HIE)and kernicterus.The risk factors confirmed by multivariate analysis were hospital level,educational level of father,premature birth,neonatal asphyxia,ABO hemolysis,lower birth weight and HIE.Conclusion Relevant risk factors of CP are various.
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The results of the determination of SACE activity in recent four years were reported. It was found that the levels were 33.5?5.1, 41.6?8.6, 33.4?8.6, 37.2?4.5, 53.6?7.3 and 31.4?13.0 in the healthy persons (37 cases), silicosis (40 cases), lung cancer (30 cases), pulmonary tuberculosis (18 cases), active sarcoidosis (4 cases) and inactive sarcoidosis (3 cases), respectively. The clinical value of the SACE measurement in sarcoidosis was discussed. The results showed that the SACE measurement is helpful to the diagnosis and monitoring of sarcoidosis, because the SACE activity was significantly elevated in most cases of active sarcoidosis, decreased during the stage of remission and elevated again during exacerbation. However, sarcoidosis can not be ruled out even though a normal SACE activity is measured. In addition, the SACE activity can also be elevated in the other pulmonary or systemic diseases, but the differentiation of these diseases from sarcoidosis is not difficult clinically. The SACE measurement can not be taken as a predictor of the prognosis of sarcoidosis.