ABSTRACT
The subclavian artery leaves the thoracic cage at the outer margin of the first rib, where it becomes the axillary artery. Rupture and hemorrhage of the subclavian artery may result in ischemia and necrosis of the upper limb, brachial plexus injury, and even hemorrhagic shock or mortality. A patient with an injury to the proximal segment of the axillary artery underwent emergency repair using a coated endovascular stent graft. The patient was followed up for 13 months and examined using CT imaging, B-mode ultrasonography and electromyography to evaluate stent function and brachial plexus recovery. The endovascular stent graft remained correctly positioned and patent, extending across the injured part of the vessel. Neurolysis at 3 months after injury was effective in restoring the majority of the brachial plexus function. The coated endovascular stent graft was effective in treating the acute injury to the great vessels in the clavicular region. Follow-up of brachial plexus function is important and secondary neurolysis should be performed if necessary.
ABSTRACT
OBJECTIVE: To investigate the diagnostic value of imageology of giant cell tumour of tendon sheath (GCTS) including X-ray, CT and MRI. METHODS: Thirty-five patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. There were 16 males and 19 females. The average age was 39.4 years, ranged from 7 to 66 years. All the patients underwent X-ray examination, 8 patients underwent CT examination, and 16 patients underwent MRI examination. RESULTS: There were 2 patients in knee joint, 6 patients in ankle joint, 1 patient in capitulum radius, 2 patients in wrist joint, 14 patients in hand and 10 patients in foot. Ten cases were the diffuse form, and 25 cases were the focal form. The X-ray results: the slightly high density soft tissue mass surrounding the bone were shown in 32 cases, 3 cases were normal. The bone erosion were shown in 9 cases, the obvious destruction of bone were shown in 5 cases. CT results: The soft tissue mass and the destruction of bone were shown clearly. MRI results: On T1WI, the signal intensity of GCTTS almost was similar to those of skeletal muscle in 9 cases and was slightly lower than those of skeletal muscle in 7 cases. On T2WI, the signal intensity presented mainly hypointensity with patchy isointensity or hyperintensity signal. A little of fluid was shown in 6 cases. CONCLUSION: X-ray can demonstrate the lesion and erosion of bone, destruction of bone can clearly be shown on CT. The low intensity signal on MRI T1WI and T2WI is the characteristic appearance of GCTTS. And it can clearly show the lesion range and type of GCTTS.
