MR conventional sagittal-axial plane and coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation technique in diagnosis of extraforaminal lumbar disc herniation / 中国医学影像技术

Objective To compare the diagnostic value of MR conventional sagittal-axial plane and coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) technique in diagnosis of extraforaminal lumbar disc herniation (ELDH).Methods Totally 32 patients with ELDH confirmed by surgery underwent preoperative MR sagittal-axial plane and coronal IDEAL scanning.Disc herniation,nerve involvement,nerve angle,nerve deep impression,nerve thinning or truncation,nerve adhesion unsmooth and nerve swelling were analyzed between the two methods.Results Disc herniation,nerve involvement and number of reduction or disappearance of surrounding fat had no statistically significant differences between the two methods (all P＞0.05),while nerve angle,nerve deep impression,nerve thinning or truncation,nerve adhesion unsmooth and nerve swelling were significantly different between the two methods (all P＜0.05).Surgical operation confirmed that 32 patients with nerve compression were consistent with findings by IDEAL.Conclusion MR sagittal-axial plane and coronal IDEAL both can be used to diagnose ELDH,but their display ability of nerve compression is different.Coronal IDEAL is superior to conventional sagittal-axial plane and is an effective imaging method,being able to display nerve compression more intuitively,clearly and comprehensively.

Analysis of the Utilization of Narcotic Drugs and CategoryⅠPsychotropic Drugs in Our Hospital / 中国药房

OBJECTIVE:To provide reference for rational use of narcotic drugs and category Ⅰ psychotropic drugs. METH-ODS:The utilization of narcotic drugs and category Ⅰ psychotropic drugs in clinical wards of Zhengzhou People's Hospital during Jan.-Dec. in 2014 was analyzed statistically in respects of drug types,department distribution medication purpose,DDDs,DDC, DUI,etc. RESULTS:A total of 16 kinds of narcotic drugs and one kind of categoryⅠpsychotropic drugs were used in 28 981 pre-scriptions of narcotic drugs and category Ⅰ psychotropic drugs in our hospital in 2014;A total of 16 kinds of narcotic drugs and one categery Ⅰ psychotropic drugs were used,narcotic drugs mainly included Sufentanil citrate injection(7 816 prescriptions)and Fentanyl citrate injection (5 104 prescriptions),and category Ⅰ psychotropic drugs mainly was Ketamine hydrochloride injection (190 prescriptions). Narcotic drugs and category Ⅰ psychotropic drugs were mainly used in anesthesia department,pain depart-ment and medical oncology department. Main purpose of narcotic drugs and category Ⅰ psychotropic drugs were intraoperative an-esthesia,cancer pain and postoperative analgesia. Top 3 drugs in the list of DDDs were Sufentanil citrate injection,Fentanyl citrate injection(0.1 mg)and Remifentanil for injection. CONCLUSIONS:The utilization of narcotics and category Ⅰ psychotropic drugs are generally rational in the hospital;the doctors can grasp the indication and medication principle,and use drugs rationally accord-ing to disease condition.

Diagnostic value of MR coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation water imaging in the far later lumbar disc herniation / 中华放射学杂志

Objective To study the diagnostic value of MR coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL) water imaging in the far later lumbar disc herniation(FLLDH).Methods A retrospective analysis of pre-operative routine CT axial imaging and MPR post-processing,conventional MR axial plane,sagittal plane and IDEAL imaging was performed in 10 patients with pathologically FLLDH.The above images were observed to find whether it could clearly show the spatial relationship outline of the nucleus pulposus and the nerve root,including the number of affected nerve root(1 or 2),and the compressed part(dorsal root ganglion,postganglionic nerve root or preganglionic nerve root),and the morphological changes of the compressed nerve root(distortion,thinning,enlargement),and were compared with surgical results.Results Surgery showed 2 cases with extra-intervertebral foramen herniation,2 cases with intra-intervertebral foramen herniation,6 cases with mixed herniation.Nine cases involved 1 nerve root,and 1 case involved 2 nerve roots.The conventional CT axial plane could roughly show the local relationship between nucleus pulposus and the nerve root.On conventional CT axial plane,9 cases were diagnosed correctly but 1 case of herniation of extra-intervertebral foramen shifting cephalic to the lower vertebral level was missed.Seven cases of the compressed nerve root were identified with difficulty,2 cases showed obliteration of the fat space and displacement of the nerve root.The spatial relationship of the nucleus pulposus and the nerve root was more visualized by CT MPR images than conventional CT images,but the image was less clear and it could not display the full view.Ten cases on CT MPR images were diagnosed correctly.Nine cases involved 1 nerve root,and 1 case involved 2 nerve roots,the image finding was obliteration of the fat space.Eight cases involved distortion of the compressed nerve root,3 cases involved thinning of the compressed nerve root,1 case involved thickening of the nerve root,6 cases were with no change or no confirmed diagnosis.MR regular scans could roughly show the local relationship of the nucleus pulposus and the nerve root and it is superior to the conventional CT axial scanning.On the conventional axial plane,7 cases of the compressed nerve root were identified with difficulty,3 cases showed obliteration of the fat space and displacement of the compressed nerve root.On the sagittal plane through the intervertebral foramen:5 cases of mixed herniation and 2 cases herniation of intra-intervertebral foramen showed intervertebral disc into the intervertebral foramen,with displacement or annihilation of the compressed nerve root.Two cases of extra-intervertebral foramen herniation were without positive findings.On MR coronal IDEAL water imaging,it could clearly and accurately show the spatial relationship of the nucleus pulposus and the nerve root.It is superior to the conventional CT axial image,CT MPR image and the conventional MR scanning.Ten cases were diagnosed correctly.Four cases were identified as compressed DRG,5 cases were identified as compressed postganglionic nerve root,1 case was identified with compressed L4 postganglionic nerve root and compressed L5 preganglionic nerve root.Ten cases were all identified with distortion of the compressed nerve root,6 cases were identified with the compressed thinning nerve root,and 2 cases with the compressed thickening nerve root.The other nerve roots were not compressed.Conclusion MR coronal IDEAL water imaging is a good tool to show the spatial relationship of nucleus pulposus and the nerve root in FLLDH patients,and it possesses diagnostic value.

Comparison study of four imaging modalities in diagnosis of primary synovial osteochondromatosis / 中华放射学杂志

ObjectiveTo compare the diagnostic value of X-ray, CT, MRI, and ultrasound in primary synovial osteochondromatosis ( PSO ).Methods The imaging data of X-ray, CT, MRI, and ultrasound of 42 patients with 44 knees with PSO proved by surgery and pathology were retrospectively collected and analyzed. ResultsThe Plain X-ray demonstrated 197 calcific nodules in 28 joints, 96 ossific nodules in 24 joints, and 5 mixed type nodules in 3 joints. Compared with the data of surgery and pathology,36 joints (81.8 ％, 36/44) were diagnosed correctly by X-ray. The CT showed 8 big cartilaginous nodules in 5 joints, 255 calcific nodules in 30 joints, 146 ossific nodules in 28 joints, and 16 mixed type nodules in 7 joints.Twenty-four knees underwent volume rendering technique reconstruction which displayed the quantity, size, shape, and position of non-cartilaginous nodules clearly. Compared with the data of surgery and pathology, 40 joints (90. 9％ , 40/44)were diagnosed correctly by CT. The MRI demonstrated 8 big cartilaginous nodules in 5 joints, 70 small cartilaginous nodules in 4 joints, 248 calcific nodules in 29 joints,146 ossific nodules in 28 joints, and 16 mixed type nodules in 7 joints. All nodules displayed low signal in DWI and there was no enhancement. Compared with the data of surgery and pathology, 43 joints (97.7％,43/44) were diagnosed correctly by MRI. The ultrasound showed 8 big cartilaginous nodules in 5 joints,70 small cartilaginous nodules in 4 joints, 232 calcific nodules in 30 joints, 142 ossific nodules in 28 joints,and 16 mixed type nodules in 7 joints. Compared with the data of surgery and pathology, 43 joints (97. 7％,43/44) were diagnosed correctly by ultrasound. ConclusionsThe less common manifestations of the PSO require multimodality imaging to make the diagnosis. Multimodalities (X-ray,CT, MRI and ultrasound) are particularly useful in fully characterising PSO and to allow for appropriate clinical planning.

Ultrasound diagnosis of primary synovial osteochondromtosis of the knee / 中华超声影像学杂志

Objective To explore the ultrasound appearance of primary synovial osteochondromatosis (PSO) of the knee. Methods Thirty-eight cases with PSO were confirmed by pathology, their ultrasound features were analyzed retrospective. Results Two hundred and sixty calcify nodules showed medium echo and several motting or bolus strong echo. Two hundred and eighty-nine ossify nodules showed slightly strong echo or strong echo,or only showed arc strong echo with rear sound shadow near nodules. Twenty-six mixed type nodules showed promiscuity moderately strong echo or with rear sound shadow. Forty introsynovium cartilage lesser nodules showed synovium thickening and similar round low echo nodules,30 sursynovium lesser nodules showed high echo, with a pedicel connected to synovium, can shift deform or sway because of the pressure from transducer, often concomitance other type nodules. Ten cartilage greater nodules showed similar round or lobulated low or medium echo tuberculum. Conclusions Ultrasound can show multiple nodules of PSO of the knee, especially noncalcific nonage smaller cartilage nodules. It is helpful for clinicians to decide more reasonable operation strategy.

Observation on the optimal brakingtime for ultrasonography of traumatic lipohemarthosis / 中华超声影像学杂志

Objective To investigate the braking time in diagnosis of lipohemarthrosis by ultrasound. Methods Experiment group:After 20 tubes containing fresh blood and pig marrow were uniformly mixed, they were instantly continuously detected by high-frequency linear array transducer in fixed-area at short-interval.Clinical group: Ten walking patients with lipohemarthrosis were examined with continuous detection by ultrasound,CT and MR before operation.Results Experiment group: Cloudy echo and slowly floating up of lipoids were detected at the beginning.After 2.7 to 3.7 minutes (average 3.17 minutes), the liquid was divided into two layers with vague boundary.After 5.3 to 8.0 minutes (average 6.75 minutes) ,the liquid was divided into 3 layers with thickening serum laye.Clinical group: Ultrasound findings: Cloudy medium echo was detected at first.After 2.0 to 4.0 minutes (average 3.08 minutes),the liquid was divided into two layers.After 4.4 to 10.0 minutes (average 6.92 minutes) , the liquid was divided into 3 layers with thickening serum layers.Three knees showed fracture line and 2 knees with occult fracture were diagnosed as lipohemarthrosis.CT and MR findings: Ten knees showed fracture line in CT examination,of which 7 knees showed double liquid-liquid layer and 3 knees showed single liquid-liquid layer in the suprapatellar bursa.Ten knees showed fracture line in MR examination,6 knees showed double liquid-liquid layer and 4 knees showed single liquid-liquid layer in the suprapatellar bursa. Conclusions The best braking time in diagnosing lipohemarthrosis by ultrasound can be shorten to 10 minutes and the necessary braking time is 2 to 4 minutes.

Comparison of X-ray, CT, MRI and ultrasonography in diagnosis of knee joint lipohemarthrosis / 中华全科医师杂志

Forty eight patients with knee joint lipohemarthrosis underwent X-ray, CT, MRI and ultrasonography examinations, the diagnosis was confirmed by knee operation or puncture.The findings of 4 imaging methods were compared.Plain radiographs displayed fracture lines in 39 cases and fat-liquid layer of suprapatellar bursa in 40 cases, it displayed suprapatellar fat-liquid layer in 5 out of 9 occult fracture cases.CT displayed fracture lines in 48 cases and joint lipohemarthrosis in 48 cases; 3D imaging showed fracture lines better.MRI displayed fracture lines in 45 cases and joints lipohemarthrosis in 48 cases, and also showed the intracapsular structure injury.Ultrasonography revealed fracture lines in 15 cases and joint lipohemarthrosis in 48 cases, lipohemarthrosis was displayed in 7 out of 9 occult fracture cases.All 4 diagnostic imaging methods have advantages and disadvantages for diagnosis of lipohemarthrosis, and should be chosen on the basis of clinical needs.

Correlation between ultrasonography and relevant techniques in traumatic lipohemarthrosis / 中国医学影像技术

Objective To explore the correlation between ultrasonographic findings and relevant technical factors in traumatic lipohemarthrosis. Methods Fifty-two patients with traumatic lipohemarthrosis underwent ultrasonic examination in supine position (26 in unbent, 16 in external rotary position, 10 in unbent and 45° rotation) before operation, and 22 of them underwent dynamic examination. Findings of ultrasography were compared with manifestations of MRI and CT regarded as gold standard.Results Fifty-two patients with traumatic lipohemarthrosis were diagnosed correctly. The best effect of ultrasonic examination of lipohemarthrosis was observed on suprapatellar bursa. Superior border of patella were showed well in supine straight position, then turned to the level of patella, and the structure below patella were showed badly. The best posture was in supine genuflex position with 45° rotation when the joint effusion presented, by which thicker layer liquids could be displayed than in straight position. Three layer liquids could not be displayed synchronously in mild external rotary rest position of lower extremity, and the combination of findings at internal and external side were favorable to the diagnosis. Liquids bed changed from one layer to two layers and then to three layers, from fuzzy to clear gradually in dynamic examination.Conclusion Ultrasonic manifestations of traumatic lipohemarthrosis are closely correlated to the position, posture and arresting time during examination.

Radiographical diagnosis of posttraumatic knee joints hemarthrosis and lipohemarthrosis / 中华放射学杂志

Objective To explore the imaging findings and diagnostic values of X-ray, CT, MR,and ultrasonography in traumatic knee joints hemarthrosis and lipohemarthrosis. Methods Traumatic knee joints hemarthrosis (12 knees) and lipohemarthrosis (18 knees) proved by operation (27 knees) or puncturation (3 knees) were included in the study. Horizontal-beam plain radiographs (16 knees), CT (30 knees), MRI (30 knees) and ultrasonography (24 knees) in supine position were investigated. Results (1)supine position horizontal-beam plain radiographs: Fat-liquid layer was found in 8 cases of lipohemarthrosis. Dense supragenual bursa was found in 1 case of lipohemarthrosis and 7 cases of hemarthrosis. Fracture (13 knees) was diagnosed correctly. (2) CT findings: double fluid-fluid layer was found in 11 of all 18 cases, and single fluid-fluid layer was found in 7 of 11 cases of lipohemarthrosis. Single fluid-fluid layer was found in 3 of 12 cases of hemarthrosis. Isodensity was detected in 9 cases, and high-density blood clot was found in 4 cases. Fracture (30 knees) was diagnosed correctly. (3) MRI findings: in 12 of 18 cases of lipohemarthrosis, double fluid-fluid layer was shown including supernatant layer as short T1, long T2signal and low signal after fat-suppression, middle layer as long T1, long T2 signal and high signal after fat-suppression, and dependent layer as iso-T1, iso-T2 and slight high signal after fat-suppression. Single fluid-fluid layer was seen in 6 cases, only had aforementioned upper and under layer.Only aforementioned supernatant layer and dependent layer were seen in 12 cases of hemarthrosis. 4 cases showed entire blood clot in fluid, T1WI showed middle signal or center iso-signal accompanied with peripheral high signal ring, and fat-suppression imaging showed high signal. T2WI and fat-suppressionimaging showed middling or high signal accompanied with peripheral low signal ring. Fracture (30 knees) was diagnosed correctly. (4) Ultrasound findings: In 10 of 14 cases of lipohemarthrosis, double fluid-fluid level was shown, supernatant layer as equal echo, middle layer as echoless, and dependent layer as cloudy echo. Four cases with single fluid-fluid level only showed aforementioned upper and under layer. Three of 10 cases of hemarthrosis showed single fluid-fluid level, only showing aforementioned upper and under layer,and 7 cases showed cloudy echo and float. In 3 cases the fluid blood clot showed irregular shape low-equal echo bolus. No fracture hne was found. Conclusions CT can clearly detect fracture line, hemarthrosis and lipohemarthresis, and can substitute plain radiography. MRI is the best way to diagnose hemarthresis and lipohemarthrosis. Ultrasonography can be used in diagnosing hemarthresis and lipohemarthrosis but not helpful in the diagnosis of fracture.

CT Evaluation of Spinal Median Sagittal Diameter at the Intervertebral Space and the Pedicel Level / 实用放射学杂志

0.05).However,the difference between DIV and DV was statistically significant(P

Aneurysmal Bone Cyst:CT and MRI Diagnosis:A Report of 21 Cases / 实用放射学杂志

Objective To analyze CT and MRI manifestations of the aneurysmal bone cyst and to evaluate the value of its imaging diagnosis.Methods The manifestations of CT and MRI of the aneurysmal bone cyst confirmed by operation or puncture were analysed retrospectively.Results On CT images,there were obvious liqued-liqued level within the lesions in 16 cases,in which,the CT values in up part was lower than that in low part,and there were obvious soft tissue mass in secondary aneurysmal bone cyst.While,on MRI,all lesions appeared obvious liqued-liqued level except one secondary example,and the soft tissue mass of secondary aneurysmal bone cyst was clear showed.Conclusion Most of aneurysmal bone cyst appear liqued-liqued level within the lesions on CT and MRI,it is a characteristic sign,but not the only one.