Relationship between intramuscular fat content in the quadriceps muscle and clinical severity in patients with knee osteoarthritis / 中国骨伤

OBJECTIVE@#To explore relationship between intramuscular fat content of quadriceps femoris and clinical severity of knee osteoarthritis (KOA).@*METHODS@#Totally 30 KOA patients were selected from February 2021 to June 2021, including 6 males and 24 females, aged with an average of (64.20±9.19) years old, and body mass index (BMI) was (24.92±3.35) kg·m-2. Patients were divided into relative severe leg (RSL) and relative moderate leg (RML) according to severity of pain on visual analogue scale(VAS). Musculoskeletal ultrasound was used to collect muscle images of quadriceps muscles on both sides of the patient, and Image J was used to analyze echo intensity (EI) of each muscle. Both VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess pain and function. Quadriceps muscle EI on both sides of patients was compared. Pearson correlation analysis was conducted to analyze correlation between quadriceps muscle EI value between RSL and RML, and linear regression was used to analyze relationship between each muscle EI and VAS and WOMA scores of patients.@*RESULTS@#The EI of RSL lateral vastus lateralis (VL) was 123.78±36.25 and RSL vastus medialis (VM) was 109.46±30.36 which were significantly higher than those of 108.03±31.34 and 93.32±26.04 of RML (P<0.05), but there was no statistical significance in EI values of rectus femoris (RF) on both sides (P>0.05). EI values of VL and VM on both sides were significantly correlated (P<0.05). There was a significant positive correlation between VM EI value and VAS score in RSL and RML (P<0.05). VM EI values in RSL were positively correlated with total WOMAC (P<0.05), and VM VL EI values in RML were positively correlated with total WOMAC score (P<0.05).@*CONCLUSION@#Intramuscular fat content of quadriceps is closely related to severity of clinical symptoms in KOA patients, and the most obvious one is VM. Therefore, the intramuscular fat content of quadriceps may be an objective indicator to evaluate severity of KOA patients. At the same time, reducing intramuscular fat content of the quadriceps muscle of KOA patients may be a new direction for the prevention and treatment of KOA.

Study on the diagnostic value of transient elastography, APRI and FIB-4 for liver fibrosis in children with non-alcoholic fatty liver disease / 中华肝脏病杂志

Objective: To evaluate the diagnostic value of transient elastography, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on 4 factors (FIB-4) for liver fibrosis in children with non-alcoholic fatty liver disease (NAFLD). Methods: A retrospective study was conducted on 100 cases of nonalcoholic fatty liver disease in Hunan Children's Hospital between August 2015 to October 2020 to collect liver tissue pathological and clinical data. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic value of liver stiffness measurement (LSM), APRI and FIB-4 in the diagnosis of different stages of liver fibrosis caused by NAFLD in children. Results: The area under the ROC curve (AUC) value of LSM, APRI and FIB-4 for diagnosing liver fibrosis (S≥1) were 0.701 [95% confidence interval (CI): 0.579 ~ 0.822, P = 0.011], 0.606 (95%CI: 0.436 ~ 0.775, P = 0.182), and 0.568 (95%CI: 0.397 ~ 0.740, P = 0.387), respectively. The best cut-off values were 6.65 kPa, 21.20, and 0.18, respectively. The AUCs value of LSM, APRI, and FIB-4 for diagnosing significant liver fibrosis (S≥ 2) were 0.660 (95% CI: 0.552 ~ 0.768, P = 0.006), 0.578 (95% CI: 0.464 ~ 0.691, P = 0.182) and 0.541 (95% CI: 0.427 ~ 0.655, P = 0.482), respectively. The best cut-off values were 7.35kpa, 24.78 and 0.22, respectively. The AUCs value of LSM, APRI and FIB-4 for the diagnosis of advanced liver fibrosis (S≥ 3) were 0.639 (95% CI: 0.446 ~ 0.832, P = 0.134), 0.613 (95% CI: 0.447 ~ 0.779, P = 0.223) and 0.587 (95% CI: 0.411 ~ 0.764, P = 0.346), respectively. The best cut-off values were 8.55kpa, 26.66 and 0.27, respectively. Conclusion: The transient elastography technique has a better diagnostic value than APRI and FIB-4 for liver fibrosis in children with NAFLD.

Reliability and Validity of Foot Position Index for Foot Posture Assessment / 中国康复理论与实践

Objective:To explore the reliability and validity of Foot Posture Index (FPI) scoring system in evaluating foot posture in China. Methods:From September to October, 2019, two testers (tester 1, tester 2) evaluated the foot posture of 15 adult volunteers (30 legs) aged 20 to 40 years after mastering the FPI-6 scoring system. They were tested first by two testers on the same day, and after two weeks, they were retested by tester 1. The intra-group correlation coefficient (ICC) was calculated to evaluate the test-retest reliability and the inter-tester reliability, and the MedCalc was used to perform the Bland-Altman plot. The correlation between the scores of items and scale was analyzed with Spearman analysis, and the items were analyzed with factor analysis. Results:The ICC of the test-retest and inter-tester reliability of each item and total score of FPI were higher than 0.75. The mean difference in FPI scores between the testers was -0.133 and the limits of agreement was (-1.82, 1.55). All items scores were correlated with the total score (P < 0.05); three factors were extracted with the cumulative contribution more than 80%. Conclusion:The FPI-6 scoring system is reliable and valid, to evaluate foot posture for Chinese.

Vertebral Artery Dissection Probably Caused by Massage: A Case Report / 中国医学科学杂志(英文版)

MASSAGE has been recommended to more people as an adjunct to health care. We illustrate a case of vertebral artery dissection (VAD) probably caused by massage that almost resulted in the patient's death. The patient experienced sudden cardiac arrest and paralysis. After treatment with anticoagulation and antiplatelet, he finally discharged without any sequelae.

Design and application of medical clamp-type gloves / 医疗卫生装备

Objective To design a modified medical clamp-type restraining gloves for the agitated patient.Methods The gloves were composed of two parts for palm and wrist.The palm part had a layer of hardboard at each side,and the wrist part had a restraining belt at the outer surface and a layer of detachable circular pad at the internal surface.Totally 100 ICU patients were selected by random sampling and then divided into a control group and an observation group.The control group used the traditional restraining gloves,and the observation group applied the modified restraining gloves.The two groups were compared on the incidence rates for dropping off of the gloves,unplanned extubation and corresponding complications.Results The modified restraining gloves gained high application effects,and were easily acceptable for the patient dependents.The observation group had all the incidence rates for dropping off of the gloves,unplanned extubation and corresponding complications significantly lower than those of the control group (P＜0.05).Conclusion The modified restraining gloves have easy operation and high reliability,and thus are worthy promoting practically.

Design and application of medical clamp-type gloves / 医疗卫生装备

Objective To design a modified medical clamp-type restraining gloves for the agitated patient.Methods The gloves were composed of two parts for palm and wrist.The palm part had a layer of hardboard at each side,and the wrist part had a restraining belt at the outer surface and a layer of detachable circular pad at the internal surface.Totally 100 ICU patients were selected by random sampling and then divided into a control group and an observation group.The control group used the traditional restraining gloves,and the observation group applied the modified restraining gloves.The two groups were compared on the incidence rates for dropping off of the gloves,unplanned extubation and corresponding complications.Results The modified restraining gloves gained high application effects,and were easily acceptable for the patient dependents.The observation group had all the incidence rates for dropping off of the gloves,unplanned extubation and corresponding complications significantly lower than those of the control group (P＜0.05).Conclusion The modified restraining gloves have easy operation and high reliability,and thus are worthy promoting practically.

Chemical constituents from Metaplexis japonica / 中成药

AIM To study the chemical constituents from Metaplexis japonica (Thunb.) Makino.METHODS The dichloromethane fraction of 95％ ethanol extract from M.japonica was isolated and purified by silica and preparative HPLC column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Nine compounds were isolated and identified as dibutyl phthalate (1),(Z)-2-ethylidene-3-methylsuccinic acid (2),dehydrololiolide (3),medioresinol (4),isovanillin (5),vomifoliol (6),β-sitosterol (7),daucosterol (8),pregnenolone (9).CONCLUSION Compounds2-4 are isolated from genus Metaplexis for the first time,compounds 5-8 are first isolated from this plant.

Coronary Angiography in Isolated Hearts and Its Forensic Application / 法医学杂志

OBJECTIVES@#To check the isolated heart by coronary angiography to discover the location, nature and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease.@*METHODS@#Ten fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimensional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results.@*RESULTS@#The imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳ coronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed.@*CONCLUSIONS@#Isolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.

Clinical application of single-balloon enteroscopy in children with small intestinal bleeding / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value and safety of single-balloon electronic enteroscopy in children with small intestinal bleeding.</p><p><b>METHODS</b>Seventy children with clinically suspected small intestinal bleeding, including 38 males and 32 females aged 4-13 years, underwent single-balloon enteroscopy under general anesthesia. Twenty-six cases underwent the procedure through the mouth, 32 cases through the anus, and 12 cases through both.</p><p><b>RESULTS</b>Of the 70 children, 58 (83%) had small bowel disease according to the single-balloon enteroscopy results, including 24 cases of non-specific inflammation, 12 cases of allergic purpura, 8 cases of Crohn's disease, 8 cases of Meckel's diverticulum, and 6 cases of Peutz-Jeghers syndrome.</p><p><b>CONCLUSIONS</b>Single-balloon enteroscopy is a safe, effective means for the diagnosis of small intestinal bleeding among children.</p>

The study of pedicle imaging and reformation with the multi-slice spiral CT in the surgical treatment of lumbar spondylolisthesis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the value of pedicle parameter obtained by the reformation images on multi-slice spiral CT (MSCT) in the surgical treatment of lumbar spondylolisthesis.</p><p><b>METHODS</b>From January 2009 to March 2010, 60 patients with lumbar spondylolisthesis failing in conservative treatment were enrolled into the study and divided into experimental and control group randomly (each group with 30 patients). There were 26 males and 34 females ranging in age from 18 to 59 years with an average of (42.60 +/- 9.36) years. The experimental group was examined with volumetric scanning on MSCT before operation. Reformation such as multiplanar reconstruction (MPR) and volume rendering (VR) were carried out at the work station. Transverse section angle (TSA), sagittal section angle (SSA), pedicle length (PL), pedicle width (PW) and pedicle height (PH) were measured on different images and pedicle screws were implanted according pedicle parameter. In control group, the pedicle screws were implanted according to conventional anatomic landmark. Preparative time of screw canal and accuracy of screw were compared between two groups.</p><p><b>RESULTS</b>A hundred fifty-six screws were inserted in experiment group,143 screws were excellent, 11 good, and 2 poor. A hundred fifty screws were inserted in control group, 101 screws were excellent, 26 good, and 23 poor. There was significant difference in accuracy of screw between two groups (P < 0.001). The preparative time of screw canal in experiment group was (66.20 +/- 7.31) s, and was shorter than that of control group [(104.11 +/- 9.51) s, P < 0.001)].</p><p><b>CONCLUSION</b>Abundant information and parameter could be obtained with the MSCT reconstruction images. The images and parameters could make a perfect operative strategy before operation, adjust the direction of pedicle screws during operation, avoid and decrease operative complications effectively.</p>

Analysis of 13 critically ill children complicated with pancreatic damages / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the pathological reports and clinical data of the cases with pancreatic damage in critically ill children, and summarize the clinical features and biological markers of critically ill children with pancreatic damage or pancreatic necrosis so as to provide the basis for early diagnosis and treatment in children complicated with pancreatic damage.</p><p><b>METHODS</b>The clinical data of 13 patients treated in our hospital from 2003 to 2009 whose autopsy confirmed pancreatic damage existed and the pathological results of all organs were collected and analyzed.</p><p><b>RESULTS</b>All the cases had acute onset; 7 cases had fever, 2 had abdominal pain, the other cases had abdominal distention, hepatosplenomegaly, hypoactive bowel sounds, ascites, intestinal obstruction and gastrointestinal bleeding, etc. All these cases had abnormal liver function, especially elevated ALT or AST level and significantly decreased albumin, 9 cases had abnormal blood glucose, 5 cases had elevated C-reactive protein (CRP). In abdominal B-mode ultrasonography, no case showed abnormal pancreas acoustic image. Autopsy confirmed that 7 cases had varying degrees of necrosis of the pancreas, other 6 cases showed edematous, hemorrhagic or inflammatory changes, which may be associated with adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other damage. All these children died within 36 hours after the patients' conditions worsened.</p><p><b>CONCLUSIONS</b>Pancreatic damage or necrosis in critically ill children had acute and ferocious onset, short course and were prone to multiple organ damage or failure to which all pediatric clinicians should have high alert.</p>

Effects of human urinary tissue kallikreins on vasodilation of basilar artery in rabbits with symptomatic cerebral vasospasm / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effects of urinary kallidinogenase on subarachnoid hemorrhage (SAH) in rabbits.</p><p><b>METHODS</b>Rabbits symptomatic cerebral vasospasm model was built though Endo method, among the 40 rabbits, 8 died or had severe nervous system syndrome, the other 32 were randomly divided into 4 groups:group A, control group, injection of normal saline to the cisterna magna;group B, subarachnoid hemorrhage;group C, injection of human urinary tissue kallikreins;group D, treated with Nimodipine. The behavior scores, neurological scores and cerebral angiography changes were observed.</p><p><b>RESULTS</b>Food intake obviously decreased and neurological deficit were seen in group B, while which were attenuated in group C and group D, and group A was normal. Comparing the diameter of basilar artery was (1.9 +/- 0.3) mm before SAH, the diameter of group B 4 d later was (1.5 +/- 0.3) mm, 7 d later (1.4 +/- 0.3) mm, the difference was significant (P < 0.05). Comparing with group C on the day 4th and 7th, the diameters of basilar artery were significantly different (P < 0.001). Comparing with group D on the day 4th, 7th and 14th, there was no obvious improvement.</p><p><b>CONCLUSION</b>Urinary kallidinogenase and Nimodipine can obviously alleviate symptomatic cerebral vasospasm in rabbits remarkably, but the former's effect of attenuating vasospasm is better than that of Nimodipine.</p>

Study on combined transplantation of rabbit's marrow stroma cells and hematomas in bone healing / 中国骨伤

<p><b>OBJECTIVE</b>To study the potentiality of osteanagenesis of the hematomas formed around the fractures and that of the marrow stroma cells, evaluate the effect of the combined trans-plantation of the hematoma and the marrow stroma cells, to explore a new method to accelerate the union of fracture.</p><p><b>METHODS</b>The bone defect models were made on the tibias of the New-Zealand's rabbits. The hematomas formed around the fracture were taken out 3 days latter after the operation, the marrow stroma cells were abstracted from the femoral marrow simultaneously. And then the mixture of the hematoma and the marrow stroma cells were transplanted to the defects of the tibias in the experiment group, and the hematoma transplanted simply to the same place in the control group. The radio-graph and the histological observation of the osteotylus were carried out regularly post-operation.</p><p><b>RESULTS</b>1) There was a significant difference in osteotylus quantity between the two groups: more osteotylus and obvious periosteal proliferation were found in the experiment group than that in the control group which accepted the transplantation of the hematomas alone. 2) There was a significant difference in osteoblast number between the two groups: more sclerotomal-like cells were observed under the microscope in the experiment group than that in the control group.</p><p><b>CONCLUSION</b>Marrow stroma cells have great potentiality of osteoanagenesis. The result of combined transplantation of the marrow stroma cells and the hematomas is more effective than that of simple transplantation of the bone hematoma.</p>

Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction.</p><p><b>METHODS</b>MSCTA was performed on 10 patients who were initially diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained.</p><p><b>RESULTS</b>Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from stenosis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA.</p><p><b>CONCLUSION</b>The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral hemodynamic information of traumatic cerebral infarction.</p>

Effect of interleukin-6 on the chondrocytes in the cartilage endplate of rabbits in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of interleukin-6 (IL-6) on the biological behaviors of the chondrocytes in the cartilage endplate of rabbits.</p><p><b>METHODS</b>Chondrocytes isolated from the cartilage endplate of New Zealand rabbits, verified for their biological characteristics by such means as toluidine blue staining for type II collagen, were treated with IL-6 at different concentrations. The proliferation of the chondrocytes was evaluated by MTT assay at different time points following the treatment, the cell cycle changes were determined by flow cytometry and the changes of aggrecan and type II collagen mRNAs detected by RT-PCR.</p><p><b>RESULTS</b>At the concentrations of 10, 50 and 100 ng/ml, IL-6 did not obviously affect the rate of chondrocyte proliferation. IL-6 at 50 ng/ml resulted in no obvious changes of the cell cycle of the chondrocytes, but significantly decreased the expression of collagen IIa mRNA.</p><p><b>CONCLUSION</b>IL-6 has no effect on the proliferation and cell cycle of the chondrocytes, but at higher concentrations, it inhibits matrix synthesis of the chondrocytes to promote intervertebral disc degeneration.</p>

Expression change of interleukin-8 gene in rabbit basilar artery after subarachnoid hemorrhage / 神经科学通报·英文版

<p><b>OBJECTIVE</b>To study the expression change of interleukin-8 (IL-8) gene in the basilar artery of rabbit and the effect of IL-8 on the development of cerebral vasospasm induced by experimental subarachnoid hemorrhage (SAH).</p><p><b>METHODS</b>Thirty five healthy Japanese White Rabbits were randomly divided into saline-control group and experimental group. The experimental group was subdivided into four groups, representing day 1, 4, 7 and 14 after the first blood injection of SAH. The delayed cerebral vasospasm (DCVS) model was established by double injection of autologous blood into the cisterna magna. The expression change of cytokine IL-8 mRNA in the basilar artery was analyzed by RTPCR.</p><p><b>RESULTS</b>The expression of IL-8 gene increased on day 4-7 after the first blood injection of SAH compared with control (P< 0.001), and decreased to normal on day 14. The expression of IL-8 gene in the SAH groups were positively correlated with the degree of basilar artery stenosis (r = 0.642, P< 0.01).</p><p><b>CONCLUSION</b>The expression level of IL-8 gene in basilar arteries was intimately associated with the degree of cerebral vasospasm, suggesting that IL-8 may play an important role in the DCVS after SAH as an immunological inflammatory factor.</p>

The vitamin D receptor gene Tru I polymorphisms and its effect on the detection of Bsm I polymorphisms in Han nationality / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the polymorphisms of vitamin D receptor (VDR) gene Tru I polymorphisms and the influence of this variation on Bsm I polymorphisms in Han nationality.</p><p><b>METHODS</b>Venous blood samples from 80 healthy individuals of Han nationality were collected and genomic DNA was extracted, VDR Bsm I and Tru I were tested by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to analyze the polymorphisms of VDR gene; After using another primers to test VDR Bsm I in the same samples, the consistence of each method was assessed.</p><p><b>RESULTS</b>The frequencies of the VDR Tru I genotype in the groups were: TT 68.7%, Tt 26.3%, tt 5.0%; VDR Bsm I were: BB 6.2%, Bb 52.5%, bb 41.3%; Both polymorphisms were under Hardy-Weinberg equilibrium. After using another pair of primer, the frequencies of Bsm I genotype were BB 20.0%, Bb 26.2%, bb 53.8%, 22 genotype Bb changed to genotype BB or genotype bb in comparison with the result of first detection.</p><p><b>CONCLUSION</b>The VDR Tru I polymorphism is found in the Han nationality, the distribution of this site's polymorphism is different from that of other nationalities. The presence of Tru I variation can result in some allele of Bsm I genotype drop-out in some study.</p>

Association of 86 bp variable number tandem repeat polymorphism of interleukin-1 receptor antagonist gene with lumbar disc disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the association of 86 bp variable number tandem repeat (VNTR) polymorphism of interleukin-1 receptor antagonist (IL-1Ra) gene with lumbar disc disease and intervertebral disc degeneration.</p><p><b>METHODS</b>The 86 bp VNTR polymorphism of IL-1Ra gene was analyzed with PCR and electrophoresis for 81 patients with lumbar disc disease and 101 volunteers without sciatica (control). The grade of intervertebral disc degeneration was determined with magnetic resonance imaging, and the association of 86 bp VNTR polymorphisms with lumbar disc disease and intervertebral disc degeneration in those younger than 45 years was assessed.</p><p><b>RESULTS</b>The presence of 86bp VNTR polymorphisms of IL-1Ra gene was detected in both patients with lumbar disc disease and the control subjects. The distribution of 86 bp VNTR polymorphisms of IL-1Ra gene showed no significant difference between the two groups, but the distributions of 1/1, 1/2 and 2/2 or 1, 2 genotypes differed significantly. The current data did not support a significant association between the distribution of IL-1Ra gene 86bp VNTR polymorphism and lumbar disc degeneration.</p><p><b>CONCLUSIONS</b>IL-1Ra gene 86bp VNTR polymorphism is present among Chinese population in association with lumbar disc disease, but not with lumbar disc degeneration.</p>

Diagnostic value of CTA and MRA in intracranial traumatic aneurysms / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the diagnostic value of computerized tomographic angiography (CTA) and magnetic resonance angiography (MRA) for intracranial traumatic aneurysms (TAs).</p><p><b>METHODS</b>CTA and MRA of six patients with intracranial TAs verified by digital subtraction angiography (DSA) and surgery were retrospectively analysed. All patients were examined by nonenhanced computerized tomography (CT) and two by CTA. The source data were reconstructed by volume rendering (VR) and multi-planar reconstruction (MPR) from CTA. Four of them had maximum intensity project (MIP) from MRA.</p><p><b>RESULTS</b>Of the six patients, a total of seven TAs were detected by CTA and MRA examinations. Five cases had only one TA and one case had two TAs. The average diameter was 2.3 cm (1.1-3.3 cm). CTA demonstrated two TAs appeared at the cavernous segment of the internal carotid artery (ICA) and the middle cerebral artery (MCA) respectively. MCA TA was definitely and clearly demonstrated on VR images, whereas VR images failed to depict the cavernous ICA TA, which was detected on MPR images. Two TAs were found irregular saccular shape, irregular margin of parent artery and wide neck on CTA. Four MRA examinations demonstrated five TAs, including the cavernous segment ICA TAs (2 cases), the supraclinoid segment ICA TA (1 case), and the cavernous segment associated with opposite side of the petrosal segment ICA TA (1 case). In a cavernous ICA TA, MRA only revealed aneurysm body, whereas aneurysm neck and distal segment of the parent artery were not revealed. In the remaining cases, MRA clearly depicted aneurysm body and parent artery, whereas the neck was not displayed. ICA TAs showed irregular capsule-like high signal intensity on MRA images. Four TAs exhibited irregular distal segment of the parent artery. TAs at the supraclinoid segment or MCA failed to find fracture signs on nonenhanced CT.</p><p><b>CONCLUSIONS</b>Both CTA and MRA examinations are the effective non-invasive method of imageology for diagnosing intracranial TAs, while CTA is more eligible for diagnosing TAs after nonenhanced CT has demonstrated skull base fractures.</p>

Application of MRI in indirect temporomandibular joint injury without condylar fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To discuss the application of MRI in indirect temporomandibular joint injury without condylar fracture.</p><p><b>METHODS</b>MRI examination on temporomandibular joint was conducted in 28 patients with indirect injury to temporomandibular joint without condylar fracture. The scanning sequence included T(1)WI, PDWI on oblique sagittal section at both open and closed mouth positions, and T(1)WI, T(2)WI on oblique coronal section. The MRI appearance was analyzed by 2 senior radiologists.</p><p><b>RESULTS</b>Among the 56 temporomandibular joints of 28 patients, 35 joints exhibited pathological changes on MRI, in which there were 9 bone injuries, 21 articular disc dislocation, 24 intracapsular hematocele and hydrops.</p><p><b>CONCLUSIONS</b>MRI can clearly reveal bone injury, articular disc dislocation as well as articular capsule abnormality in the indirect injury of temporomandibular joint without condylar fracture. It is highly advocated in clinical use.</p>