MSCT diagnosis of intussusception caused by intestinal lipomas / 中华普通外科杂志

Objective To investigate the characteristics and diagnostic value of multislice spiral CT (MSCT) of intestinal lipomas causing intussusception.Methods The MSCT findings of 25 cases with intestinal lipomas causing intussusception were retrospectively analyzed,the tumor location,size,shape,density,enhancement patterns and shape and length of intussusception were also observed retrospectively.Results Tumors were 1.2-6.5 cm in diameter,round or oval in shape (n =18),irregular shape (n =4),tubular shape (n =3) with uniform density (n =19),or uneven density (n =6).Under CT enhancement tumor capsule was moderately intensified.Intussusception included ileum-ileum type (n =7),jejunum-jejunum type (n =5),jejunum-ileum type (n =2),ileum-colon type (n =4),and colon-colon type (n =7).Intussusception was 5.0-5l.0 cm in length;presenting as concentric circles (n =12),round target sign (n =7),orbanana (n =6).Conclusion Intestinal liporna complicating secondary intussusception has definite MSCT characteristics which can help establish diagnosis.

Radiological and clinical features of bone and joint disease in patients with congenital insensitivity to pain and anhidrosis / 中华放射学杂志

Objective To investigate the radiological and clinical features of osteoarthrosis in congenital insensitivity to pain with anhidrosis (CIPA).Methods The clinical and radiological features in 8 cases of CIPA diseases were retrospectively analyzed. There were five males and three females,age ranged from 11 to 18 years with a median age of (14±3) years. X-ray plain film findings in eight cases were analyzed for the location, extent and contour of the lesions, surrounding bony sclerosis, as well as joint and soft tissue changes. Results The main clinical presentations were insensitivity to pain, anhydrosis, fever, mental retardation and infection. In these eight cases, a total of 166 pieces of bone were involved, including the plantar and phalanges (n=115),phalanx (n=29).The radiological findings include dissolution of the entire bone or most of the bone (n=113), dissolution of a few small areas of the bone (n=40), dissolution of the bone with only residual punctate areas (n=7), the“pushpin sign”and“pencil tip sign”and“flat cut sign”of the finger osteolysis (n=6), sclerosis of peripheral bone (n=12), pathological fractures (n=2). Joint dislocation (n=3),joint deformity (n=3), and Charcot joint (n=3) were observed.Necrosis of soft tissue(n=4), complete absence of soft tissue in the finger or toe (n=4), dot-like calcification of the soft tissue(n=3) were also observed. Conclusion Osteoarthrosis in patients with CIPA had certain X-ray and clinical characteristic findings, which could facilitate its diagnosis.

Features of computed tomography examination of esophageal submucosal hematoma / 中华消化外科杂志

Esophageal submucosal hematoma is rarely seen in clinical practice and its clinical presentations are untypical.Gastroscopy might injure the esophageal mucosa and cause bleeding.Computed tomography had the advantages of quick examination and formation of imaging,as well as non-invasiveness,which is helpful for the diagnosis and differential diagnosis of the esophageal submucosal hematoma.The clinical data of 9 patients with esophageal submucosal hematoma who were admitted to the Yueqing People's Hospital,the First Affiliated Hospital of Wenzhou Medical University,the First Affiliated Hospital of the Zhengzhou University and the Third People's Hospital of Wenzhou from July 2005 to February 2014 were retrospectively analyzed.The features of computed tomography examination of esophageal submocosal hematoma include the range of the esophageal submucosal hematoma exceeds 2 parts of the esophagus,the rip of the esophageal mucosa begins and ends at the physiological narrowing of the esophagus,thickening of the esophageal wall,stricture of the esophagus,annular thickening and eccentric thickening of the esophageal wall,crescent,spot or gas shadows of the esophageal cavity,the density of the hematoma decreases as the time passed by.These features of computed tomography are of great importance for the diagnosis of esophageal submucosal hematoma.

Correlative study of subacromial space and acromial shoulder impingement syndrome / 中国基层医药

Objective To investigate the correlation between subacromial space and acromial shoulder impingement syndrome (SIS).Methods The clinical and imaging data of 40 patients with SIS were collected and retrospectively reviewed.The shape of acromion and tears of rotator cuff of all patients were classified.A cromion-Humerus (A-H) distance was measured.Results Among 40 patients,there were 9 cases of type Ⅰ,12 cases of type Ⅱ,19 cases of type Ⅲ.32 patients had subacromial space narrowing.7 cases had calcification in the supraspinatus tendon and 10 patients had acromioclavicular joint ostcoarthritis.There were 17 cases of type Ⅰ,15 cases of type Ⅱ,18 cases of type Ⅲ of tears of rotator cuff.6 patients had subacromial bursa thickening,5 patients had subacromial-deltoid sac fluid and 10 patients had the joint capsule fluid.2 patients had jointlabrum avulsion,3 patients had the supraspinatus muscle atrophy and 4 patients had Bankart Lesion.There was no significant difference was found in A-H distance measured with X-ray and MRI(P =0.137 0).There was positive correlation between the A-H distance and class of rotator cuff(r =0.545,P =0.000 1).Conclusion There exists some correlation between subacromial space and SIS.The diagnosis and class of SIS can be assessed according to narrowing range of subacromial space.

The correlation between anatomical measurement and CT measurement of the adult occipital thickness / 中华创伤骨科杂志

Objective To study the correlation between anatomical measurement and CT measurement of adult occipital thickness so as to provide anatomic evidence for the selection of screw length in occipital-cervical fusion. Methods The occipital thickness was measured on the occipital specimens of 10 normal adults in two ways: direct anatomic measurement and CT measurement. Measurements were made on the basis of the McRac' s line and according to a matrix of 66 points following a grid with one cm spacing. The results of both measurements were statistically analyzed using SPSS 10.0. Results The results of both measurements were highly correlated. The external occipital protuberance was the thickest while the region of cerebellar fossa was the thinnest. The regions two cm lateral to the midline between plane Five and plane Six, one cm lateral to the midline between plane Four and at plane Five, and median between plane Three and plane Four were found to have a thickness of more than eight mm. Conclusions The occipital thickness varies with individuals. CT measurement and direct anatomic measurement are highly correlated. Preoperative CT measurements can be reliable evidence for optimal screw placement before performing occipital-cervical fusions.