Contrast of the therapeutic effect of CT/MRI image fusion technology and CT guided radiofrequency thermocoagulation of trigeminal semilunar ganglion / 安徽医科大学学报

Objective @#To evaluate the therapeutic effect of CT/MRI image fusion and usual CT guided percutaneous radiofrequency thermocoagulation of trigeminal semilunar ganglion . @*Methods @#The medical information of 88 patients diagnosed with primary trigeminal neuralgia were assembled . In accordance with different imaging guidance means , they were equally divided into the control group ( trigeminal semilunar ganglion radiofrequency thermo coagulation with CT guidance ) and the fusion group ( trigeminal semilunar ganglion radiofrequency thermocoagula tion with assistance of CT/MRI image fusion technology) at random. The puncture time , intraoperative discomfort rate , preoperative , intraoperative and postoperative visual analogue scale (VAS) score , Barrow neurological insti tute (BNI) pain score and postoperative complication rate were contrasted . @*Results @#The puncture operation time of the fusion group was shorter than that of the control group (P < 0 05) ; the intraoperative and postoperative VAS and BNI scores , occurrence rate of intraoperative discomfort and postoperative complications in the fusion group were lower than those in the control group (P < 0.05) .@*Conclusion @#In respect of improving therapeutic effect and diminishing intraoperative discomfort and postoperative complications , CT/MRI image fusion technique is superior to CT guidance .

Apport de l'imagerie dans les brèches ostéoméningées de l'étage antérieur de la base du crâne / Role of imaging in the osteo-dural defects of the anterior base of the skull

Décrire les caractéristiques radiologiques de la brèche ostéo-méningée (BOM) de l'étage antérieur de la base du crâne. Méthodes: Etude rétrospective, descriptive, monocentrique, colligeant les patients hospitalisés pour prise en charge d'une brèche ostéoméningée (BOM) et explorés par le couple TDM/IRM, du 1er janvier 2012 au 31 Décembre 2021. Résultats: Ont été retenu 23 patients avec un âge moyen de 48 ans et un sex ratio de 0,3. Des antécédents de chirurgie nasosinusienne ou de neurochirurgie ont été notés chez deux patients (9 %). Treize patients (57 %) étaient victimes de traumatisme crânien. Une rhinoliquorrhée était retrouvée dans 21 cas (persistante dans trois cas (12%) et intermittente dans 18 cas (76%)). La découverte de la BOM a été faite suite à une méningite dans quatre cas. Le dosage de la bêta trace a confirmé la présence de LCR chez deux patients. La TDM a confirmé le diagnostic chez 12 patients dont deux patients qui ne présentaient pas de rhinoliquorrhée à l'examen clinique. Elle a aussi permis d'établir le bilan topographique dans ces cas. Elle a suspecté une BOM dans 9 cas et était négative dans deux cas. L'IRM a confirmé le diagnostic dans tous les cas et a permis de: localiser le siège de la fuite de LCR dans les brèches multiples, confirmer le diagnostic deméningoencéphalocèle (trois cas) et objectiver des signes indirects d'hypertension intra-crânienne (HTIC) (quatre cas). Conclusion: L'imagerie en coupes permet de localiser la BOM mais nécessite souvent, une approche par étapes et son interprétation exige une connaissance approfondie de l'anatomie normale et des variantes de la base du crâne. Mots-clés: Liquorrhée, Brèche Ostéoméningée, Chirurgie, TDM, IRM

Aneurysm Formation of Cervical Aortic Arch Combined with Subaortic Left Innominate Vein: Case Report

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.

Prognostic Factors of Lumboperitoneal Shunt in Communicating Hydrocephalus

OBJECTIVE: A 10-year retrospective lumboperitoneal(LP) shunt surgery was reviewed in order to verify the several prognostic factors including the etiology, the findings of brain computed tomography(CT) and/or magnetic resonance imaging(MRI), and the effect of lumbar drainage which have been implicated in the result of LP shunt. PATIENTS AND MEHTODS: A series of 32 patients who underwent LP shunt surgery between March 1988 and May 1998 for the management of communicating hydrocephalus was reviewed. RESULTS: The etiology of communicating hydrocephalus was subarachnoid hemorrhage(SAH) in 19 cases(59.4%), head trauma in 10 cases(31.2%), intracerebral hemorrhage in 2 cases(6.3%), meningitis in 1 case(3.1%), tumor in 1 case(3.1%), and idiopathic in 2 cases(6.3%). The mean follow-up period was 1.2 years(range, 2 week to 8.5 year). Among them, twenty four patients(75%) were clinically improved after shunt operation. The result of LP shunt was not related to the etiologies and many findings of brain CT/MRI such as ventricular index, Evan's index, periventricular low density, obliteration of cerebral sulci and cortical atrophy. However, the result of LP shunt was significantly related to the effect of preoperative lumbar drainage(p=0.0184). CONCLUSION: This result suggests that the effect of preoperative lumbar drainage has a significant role in predicting the result of LP shunt in patients with communicating hydrocephalus.

Analysis of Inconclusive Diagnostic lesions in Stereotactic Biopsy: Review of Cases in 5 Years

While stereotactic biopsy increases the accuracy of obtaining appropriate tissue for precise diagnosis, inconclusive diagnostic lesions can still be observed frequently. We present a review of 43 patients with inconclusive diagnostic samples in stereotactic biopsy between June 1989 and June 1994. inconclusive diagnostic lesions were found in 43 patients(17.9%); the biopsy of these patients showed reactive gliosis in 22, foam cell infiltration and/or demyelination with coagulation necrosis in 8, chronic inflammatory cell infiltration with necrosis, fibrosis in 6, no evidence of tumor in 5, and ganglioglial lesion in 2. The final diagnosis was based on histological findings of permanent paraffin sections after rebiopsy or open surgery, close follow-up CT/MRI scan findings, clinical features and/or history, and serological studies;neoplasm 16, infarction/leukodystrophy 8, infection/inflammation 4, granuloma 1, and no confirmative diagnosis 4, In conclusion, rebiopsy or open surgery is recommended if the lesion is suspected to be a neoplasm, and the patient is closely observed with repeated radiological studies if the lesion is suspected to be benign. This study provides evidence that in some cases an accurate histopathological diagnosis can not be made with stereotactic biopsy and therefore, further investigations are needed in such inconclusive cases.