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Objective To investigate the diagnostic value of prenatal ultrasonography and magnatic resonance imaging in the fetal intracranial hemorrhage. Methods The 20 antenatal diagnosed ICH cases was collected from 31 200 prenatal diagnosis units in Guangzhou Women and Children′s Medical Center from July 2012 to June 2014. Maternal characteristics, ultrasound, and magnetic resonance imaging findings, clinical course, and postnatal outcome were reviewed. Results Twenty consecutive cases of fetal ICH were evaluated. All cases were diagnosed at mid or third trimester. Transabdominal ultrasound showed 9 cases of hyper echoic lesions in the lateral ventricle, 2 cases of hypoechonic lesions, 2 cases of irregular mixed echo in the parenchyma, 1 case of hyperechoic cerebellar hemisphere with infarction, and 1 case of abnormal choroid plexus. Seventeen cases were associated with ventriculomegaly, brain compression or brain midline displacement. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. Some cases were combined with cortex lesions or abnormal parenchyma. ICH was complicated with other structural abnormalities:1 case of cleft palate, 2 cases of spinal deformity and 3 cases of other cerebral cortical malformations. Prenatal diagnosis results were:2 cases diagnosed as positive cytomegalovirus infection and no chromosome abnormalities found in all cases. The follow up results were:1 case was lost, 16 cases were terminated after prenatal diagnosis. Among the 3 survival cases, 1 case has the neurological complication and the other two were normal till now. Conclusions Fetal intracranial hemorrhage has some image features on ultrasound and magnetic resonance. Ultrasound showed hyper echoic lesions with ventriculomegaly. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. MRI may contribute to the accuracy of diagnosis, particularly in bleeding site. The regular ultrasonic monitoring is helpful to improve the detection rate.
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Objective To analyze the Doppler indices of uterine artery at 11-16 weeks normal gestation. Methods Two hundred and ninty-seven normal pregnant women were consecutively recruited to take routine ultrasound examination at 11-16 weeks' gestation. According to gestational week, they were divided into 6 groups (11-11+6 weeks, 12-12+6 weeks, 13-13+6 weeks, 14-14+6 weeks, 15-15+6 weeks, 16-16+6 weeks). According to the location of placenta, they were divided into 3 groups (central placenta, right placenta, left placenta). Finally, the pregnant women were divided into 5 groups (RI<0.60 group, 0.60-0.69 group, 0.70-0.79 group, 0.80-0.85 group and ≥ 0.85 group) according to resistance index (RI). Doppler indices of uterine artery were measured in each case. Results (1) The PIm, RIm, S/Dm values (the mean PI, RI, S/D values of bilateral uterine artery) were decreased with the progress of pregnancy, but the difference of the RIm, S/Dm were not significant. Only the decrease of PIm after 15 weeks was significant (P<0.05). The mean PIm of each group was:11 weeks 1.96±0.39, 12 weeks 1.94±0.45, 13 weeks 1.79±0.43, 14 weeks 1.79±0.36, 15 weeks 1.51±0.43, 16 weeks 1.50±0.30. (2) The PI, RI, S/D values of uterine artery with placenta attached were lower than the other side. In the left placenta group, bilateral RI difference was-0.04 (t=-3.095, P=0.005), bilateral PI difference was -0.24 (t=-3.232, P=0.004), bilateral S/D difference was-1.00 (t=-2.965, P=0.007);in the right placenta group, bilateral RI difference was 0.04 (t=6.159, P=0.000), bilateral PI difference was 0.43 (t=6.614, P=0.000), bilateral S/D difference was 2.05 (t=6.378, P=0.000);in the middle placenta group, bilateral RI difference was 0.02 (t=4.150, P=0.000), bilateral PI difference was 0.14 (t=4.475, P=0.000), bilateral S/D differencewas 0.54 (t=4.376, P=0.000). (3) According to the RI, incidence rates ofα-notch detected:in<0.60 group both sides were 0;in 0.60-0.69 group, left uterine artery was 0.08, right uterine artery was 0.08;in 0.70-0.79 group, left uterine artery was 0.34, right uterine artery was 0.31;in 0.80-0.85 group, left uterine artery was 0.65, right uterine artery was 0.72;in≥0.85 group, left uterine artery was 0.81, right uterine artery was 0.87. Conclusion The uterine artery Doppler indices of 11-16 weeks maybe a reliable and non-invasive method for examining uteroplacental perfusion.
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ObjectiveTo explore puncture point and angle of skin for unipedicular vertebroplasty by imaging measurement and combining clinical practice in order to pr vide reference for clinical work.MethodsCT images of thoracic and lumbar vertebrae of imaged with multislice helical CT were random chosen.From high to low position vertebrae of easy fracture T6 to -L5,its angle between vertebraI pedfcle stalk line and 1/3 of vertebraI body stalk line fore and median of point of intersection was measured.The angle of sternocostal joints route was also measured.At the same time the distance between site of skin puncture and spinous process was measured.ResultsThe angle between the thoracic vertebraI pedicle and sagittal section was (28.2 ± 3.8) °,the lateral distance of the spinous process was ( 31.6 ± 5.4) mm.The angle of thoracic vertebraI pedicle lateral route was (35 ± 3.4) °,the distance was ( 55.2 ± 5.3 ) mm.In the lumbar vertebrae pedicle route,the angle of L1 -L4 was (29.3 ± 5.6 ) °,the distance was (38.4 ± 4.5 )mm.Ls was (39.2 ± 3.3) °,the distance was ( 71.6 ± 6.2) mm.Combining clinical practice,the lateral distance of the spinous process in thoracic vertebraIpedicle route,the best puncture point was 30 mm,in thoracic vertebraI pedicle lateral route it was 40 mm,in L1-L4 it was 45 mm,in L5 it was 60 mm.ConclusionsThe unipedicular vertebroplasty can be performed rapidly,accurately and safely,and it reduces complications,cost and time.
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Objective To investigate the independent factors influencing the efficacy of pre-hospital CPR effect. Method The data base with 1376 cases was set up with EpiData software by means of questionnaires and the information was provided by the survivals from cardiopulmonary arrest( CA)saved with cardiopulmonary resuscitation(CPR), and the data were analyzed with SPSS 13.0 software to carry out binary logistic regression. Through single factor analysis, the factors with emerged statistical significance were chosen as variances. Results With regard to the restoration of spontaneous circulation(ROSC), the rescue did by the first witness was the protective factor(PF)( OR = 2.21, P = 0.001, 95.0% CI=1.356-3.602); the male was the risk factor(RF) contrasted with the female( OR = 0. 515, P =0. 006, 95.0%0 CI = 0.320 - 0. 26) ; ages between 20 and 29 years old had higher likelihood of ROSC than group ≥81 years old( OR = 3.241, P = 0.026, 95.0%CI = 1.146 -9.138); the length of CA time before CPR was RF(OR = 0.913, P = 0.000, 95.0%CI = 0.887-0.948);ventricular fibrillation(VF) was PF compared with asystole( OR = 5.092, P = 0.000, 95.0%CI=2.927 -8.861); electric shock was PF(OR = 3.384, P = 0.000, 95.0%CI = 2.033 - 5.635); epinephrine dosage 0 - 4 mg had higher likelihood of ROSC than > 5 nag dosage( OR = 3. 255, P = 0. 001, 95.0% CI = 1. 606 -6.597). In respect of probability about victims at the tittle reached hospital alive, ages of 2- 12 and 13 - 19 years old had higher rations than ≥81 years old( OR = 12.818, P = 0.029, 95.0% CI = 1.299 - 126.508)( OR = 10.505, P = 0.036, 95.0% CI = 1.161-95.058); the length of CA time before CPR was RF(OR =0.862, P = 0.000, 95.0%CI = 0.821-0.906); VF was PF compared with asystole(OR = 7.330, P =0.000, 95.0%CI = 3.962 - 13.560). Conclusions ECG change before CPR, rescue by the first witness,electric shock, the length of CA time before CPR, epinephrine dosage, gender and age were independent influencing factors of pre-hospital CPR for the emergency of ROSC. Age, the length of CA time before CPR and ECG before CPR were influencing factors of pre-hospital CPR for patients at the time transferred to hospital alive.