目的:研究对膝关节外伤性损伤患者采用1.5T MR检查的诊断价值.方法:选取2019年7月—2021年6月在东部战区总医院秦淮医疗区医学影像科进行检查的膝关节外伤性损伤患者共计84例,所有患者均进行膝关节M R检查,检查结束后统计检查结果并分析M R检查的相关特点.结果:M R检查结果显示,84例患者中存在半月板撕裂的有43例,占比为51.19％(43/84),韧带损伤或断裂的有26例,占比为30.95％(26/84),两种损伤都存在的有15例,占比为17.86％(15/84).分析后发现,两种损伤在M R的图像表现上有着明显的差异.结论:MR检查可明确膝关节损伤的具体位置和损伤的程度,可为临床的诊断与治疗奠定基础,可以作为膝关节外伤性损伤患者的首选检查方式.

目的 探讨胫骨平台后外侧髁骨折治疗的难点及改良方法的临床优势.方法 回顾性分析2016年3月—2018年8月无锡市惠山区人民医院收治单纯胫骨平台后外侧髁骨折24例,根据治疗方法不同分为改良组和对照组,各12例.改良组男性8例,女性4例;年龄23～66岁,平均48.5岁;对照组男性7例,女性5例;年龄21～68岁,平均47.1岁.改良组采用腓骨头上方入路联合自制环抱支撑解剖钢板进行显露复位固定,对照组采用腓骨头上方入路联合普通L形钢板进行复位固定,术后定期复查,指导膝关节功能锻炼.比较两组相关指标,包括术中出血量、手术时间、骨折愈合时间、未次随访的Rasmussen放射评分、纽约特种外科医院(Hospital for Special Surgery,HSS)功能评分以及术后膝关节功能优良率.结果 术中出血量改良组(42.92±15.44)mL与对照组(51.25±14.64)mL比较差异无统计学意义(P>0.05),改良组与对照组手术时间(51.00±6.80)min vs.(63.58±7.79)min、骨折愈合时间[(10.75±1.48)周vs.(12.75±1.96)周]、末次随访的膝关节Rasmussen评分[(17.08±2.11)分vs.(12.58±4.38)分]和HSS评分[(88.42±7.69)分vs.(74.83±13.27)分]比较,差异有统计学意义(P<0.05).按膝关节HSS评分评定膝关节功能,改良组优10例,良1例,可1例,优良率为91.7％;对照组优4例,良2例,可4例,差2例,优良率为50.0％,两组差异有统计学意义(P<0.05).结论 腓骨头上方入路联合自制环抱支撑解剖钢板治疗胫骨平台后外侧髁骨折,具有简单安全、手术时间短、骨折固定可靠、术后功能恢复满意等优点,是一种值得推广应用的改良方法.

目的 探究血液循环速度与冠状动脉CT血管造影(CTA)增强效果的相关性,并分析对比剂优化方案.方法 选取2020年1月～2021年4月于我院行冠状动脉CT血管造影患者161例,按照血液循环速度分为快速组(n=32)、中等组(n=35)和缓慢组(n=94),分析血液循环速度与增强效果关系,并将缓慢组分为A、B、C 3个亚组,A组与快速组、中等组使用的对比剂浓度和注射速率相同(均为碘浓度320 mgI/mL,速率5 mL/s);B组采用对比剂的碘浓度为350 mgI/mL,速率5.5 mL/s;C组采用对比剂的碘浓度为370 mgI/mL,速率5.5 mL/s,比较各组伪影发生、室间隔显示、冠脉CT值及图像质量情况.结果 快速组、中等组、B组、C组产生伪影概率均低于A组,且快速组低于中等组,C组低于B组(P<0.05);快速组、中等组、B组、C组主动脉根部CT值、图像质量评分、室间隔显示评分均高于A组,且快速组高于中等组,C组高于B组(P<0.05).结论 血液循环速度能增加冠脉CTA增强效果,清晰显示室间隔,对于血液循环较慢者可适当增加对比剂浓度和注射速率以保证图像质量.

Objective To measure the radiological data of the fibular capitellum which can be used for design of a surgical approach and an anatomical plate for the fibular capitellum.Methods Enrolled in the present study were 38 healthy volunteers (60 normal knees),including 22 males (38 knees) and 16 females (22 knees).They were aged from 18 to 60 years (average,44.8 years).They were divided into 2 groups twice according to gender and body height.Group A1 was males while group A2 females; group B1 included subjects of 156 to 170 cm in height while B2 subjects of 171 to 185 cm in height.The 60 knees were subjected to CT scan before three-dimensional (3-D) reconstruction for measurements of the bony region from the articular surface of the capitellum to the articular surface of the lateral tibial plateau.The 3-D CT images of the lateral tibial plateau were divided into 3 categories:division Ⅰ covering the posterolateral condyle of the tibial plateau,division Ⅱ covering the superior region of the capitellum and division Ⅲ covering the anterolateral region of the tibia.At the same time,the 60 knees were examined by MRI scanning to measure the bone-ligament region from the lateral tibial plateau to the lateral collateral ligaments.All the data were analyzed and compared.Results The narrowest width of the bony region was 11.13 ± 1.43 mm; the narrowest width of the bone-ligament region was 5.35 ± 0.78 mm.In division Ⅱ,the narrowest width of the bony region in group A1 (11.45 ± 1.48 mm) was significantly longer than in group A2 (10.58 ± 1.34 mm),but that in group B1 (10.32 ± 1.40 mm) was significantly shorter than in group B2 (11.63 ± 1.45 mm) (P ＜ 0.05).The narrowest width of the bone-ligament region in division Ⅱ was 5.45 ± 0.82 mm in group A1,showing no significant difference from that in group A2 (5.18 ±0.71 mm),B1 (5.11 ±0.74 mm) and B2 (5.50 ±0.80 mm) (P ＞ 0.05).Conclusions The bony space and bone-ligament space in the superior region of the fibular capitellum provide an anatomic basis for design of a superior fibular capitellum approach.The 3-D CT divisions of the lateral tibial plateau and their anatomic measurements are very important for development of an anatomical plate via the superior fibular capitellum approach.

Objective To explore the clinical application of the whole leg radiograph using CT by weight-bearing simulation in total knee arthroplasty.Methods Totally 35 patients desired to undergo total knee arthoplasty were examined by weightbearing whole leg radiograph with GE 64-slice spiral CT.CT localization scanning program and frontal localization mode were used for the single continuous exposure with the scanning range from the hips to the ankles.The acquired images were transmitted to AW4.4 workstation,quantitative measurement and analyses were carried out with the workstation software for the force lines and angles of the lower limbs.Results The hip joint,femoral bone,knee joint,tibiofibula and ankle joint could be displayed clearly with the consistent contrast.Of the 35 patients,there were 32 ones of knee joint bowleg and 2ones of valgus,who went through the operation with the success rate of 100%.Conclusion The whole leg radiograph using CT by weight-bearing simulation is of great significance for the pre-operation plan and post-operation evaluation of otal knee arthroplasty.

Objective To discuss the value of three-dimensional(3D) reconstruction technique of 64-slice spiral CT in the diagnosis of impacted teeth within the jaw bone.Methods Thirty-three suspected cases of impacted teeth were examined by 64 -slice CT volume scan.The acquired data were processed by multi -planar reconstruction(MPR),volume rendering technique(VRT) using GEAW4.4 workstation.Results Impacted teeth consisted of 8 central incisors,5 lateral incisors,11 canine teeth,5 cranters and 9 accessory teeth were detected from all the 33 patients.Conclusion The 3D reconstruction technique of 64-slice spiral CT could display the details of impacted teeth,including the shape,location and eruption orientation.It can provide valuable information for diagnosis.

BACKGROUND:The adjacent data between clavicle and the subclavian vessels mostly come from human observation and measurement of anatomical specimens.The measurement results slightly differ from the actual body.OBJECTIVE:To observe and analyze the relationship between the clavicle peripheral vascular in vivo and anatomy of collarbone for finding the safe area and hazardous area of screw external fixation.METHODS:Totally 44 patients were conducted chest and neck enhanced CT scanning to examine coronary angiography.The collected CT image of clavicle area were used to reconstruct three-dimensional images of intact clavicle and clavicle peripheral vascular using ADW4.4 workstation.The adjacent relationship between the clavicle and clavicle peripheral vascular was observed and measured on the images.RESULTS AND CONCLUSION:Subclavian vein and artery near the clavicle,clavicle angle formed between the lower edge of the left was (53.75°±10.64°),the right side was (52.85±11.41)°.If the length of the clavicle was divided into five equal parts,the clavicle artery and vein at the surface of the clavicle in its projected range from the inside out about the second 1/5 of the left brachiocephalic vein from the clavicle shortest average distance (4.81±1.66) mm,the right innominate artery shortest distance from the average of the clavicle was (5.09±2.60) mm.In vivo imaging measurements are closer to the normal human body,clavicle surgery is likely to damage the site of the subclavian vessels from the inside out of the second 1/5 of the sternum and clavicle end,to grasp the anatomical characteristics of the source can be maximum avoided health peripheral vascular injuries of the clavicle.

1 故障现象 Ⅰ管透视工作正常.Ⅰ、Ⅱ管在正常曝光条件下点片时,按下曝光手闸第一档,旋转阳极工作正常;按下手闸第2档,无X线发生.

1病历简介 患者,男,16岁.因发作性意识不清,四肢抽搐及言语不清10天入院.查体:两侧瞳孔等大,等圆,对光反射灵敏,颈软.四肢肌力正常,生理反射存在.余全身检查未发现异常.腰穿颅内压高37.3kPa.脑脊液常规、生化未发现异常.