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Objective To explore the predictive value of different CT signs in surgical treatment in patients with acute closed intestinal and mesenteric injury.Methods The CT data and follow-up results of 120 patients with acute closed intestinal and mesenteric injury(including 58 cases of surgical treatment and 62 cases of conservative treatment)were analyzed retrospectively.The diagnostic value and prognostic value in surgical treatment of different CT signs were analyzed.Results There were significant differences between the operation group and the conservative treatment group in mesenteric vascular amputation,mesenteric hematoma,vascular contrast agent extravasation, intestinal wall defect,pneumoperitoneum and peritoneal effusion (χ2＝4.69,P＝0.03;χ2＝21.40,P＜0.001;χ2＝13.95,P＜0.001 ;χ2＝11.34,P＝0.001;χ2＝80.65,P＜0.001).The CT signs of intraperitoneal effusion had the highest sensitivity for intestinal and mesenteric injury,and vascular contrast agent extravasation and intestinal wall defect had the highest specificity for surgical predictability of intestinal and mesenteric injury.ROC curves showed that abdominal gas accumulation had the highest predictive value for intestinal and mesenteric injuries (AUC＝0.92,95%CI:0.87－0.97),followed by mesenteric hematoma (AUC＝0.73,95%CI:0.64－0.82).Conclusion Intraperitoneal effusion has the highest sensitivity for intestinal and mesenteric inj ury,and vascular contrast agent extravasation and intestinal wall defect have the highest specificity for surgical predictability of intestinal and mesenteric injury.The overall value of intraperitoneal gas in predicting intestinal and mesenteric injury is highest.Combining different CT signs can improve the accuracy of clinical intervention for acute closed intestinal and mesenteric injury.
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Objective To study the value of MRI in the diagnosis of diabetic foot(DF)ulcer.Methods MRI data of 29 cases with DF ulcer were analyzed retrospectively,among which 8 showed neuropathic osteoarthropathy (Charcot’s joint)on X-ray radiographs. To analyze the correlation of MRI features and MRA results of DF ulcer patients.Results All patients displayed with soft tissue cellulitis,and 1 6 cases suffered with osteomyelitis as well.8 cases were Charcot’s joint,and 2 cases were confirmed by biopsy for false positive osteomyelitis.8 cases of MRA could not meet the diagnostic requirements due to the contamination of the inferior genicular vein.There were no obvious difference among the incidence of Charcot’s joint,sinus,abscess and tenosynovitis between lower extremity artery stenosis and not(P=0.06;χ2=0.07, P=0.79;χ2=2.15,P=0.14;χ2=2.29,P=0.13),but the difference of incidence of osteomyelitis was obvious(χ2=4.88,P=0.03). Conclusion MRI can display osteomyelitis,neuropathic osteoarthropathy,cellulitis of the tissue,sinus,abscess,tenosynovitis and lower extremities arterial disease (LEAD)of the DF ulcer patients,and the incidence of osteomyelitis was associated with LEAD.
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Objective To research X-ray and CT findings and diagnosis of primary non-Hodgkin lymphoma of the bone.Methods The X-ray and CT findings of primary non-Hodgkin lymphoma in 8 patients (B-cell origin in 7,T-cell origin in 1) confirmed by the clinic and pathology were retrospectively analysed. Results The simple bone involved in 6 and multiple bone involved in 2. Radiographic findings were:invasive in 4 , osteolytic, sclerosed, combination and cystiform expansion in each one. All lesions had soft-tissue mass,two cases had periosteal reaction, and two cases had pathologic fracture. Conclusion Primary non-Hodgkin lymphoma of the bone usually involve simple bone. moth-eaten,invasive and osteolytic destruction with soft-tissue masses are most common seen. The diagnose is necessary to combine with clinic and pathological data.
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Objective To research the radiodiagnosis of fat embolism sydrome in the chest.Methods The clinic and X-ray manifestation of 12 cases fat embolism after long bone fracture were analysed.Results After wounded 19 to 70 hours later,all of the patients showed dyspneic respiration,symptoms of central nervous system,dermorrhagia,partly thrombocy topenia,fat drop in the urine or blood.There were diffuse maculate and tablet shadow of the pulmones on the chest X-ray film.Conclusion The X-ray character of fat embolism is difuse maculate and tablet consolidation shadow in the pulmones.
