BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can c...BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.展开更多
Objective: To explore the characteristics of the primary ureteral carcinoma (PUC) and discuss the value of spiral CT (SCT) in the diagnosis of PUC. Methods: The SCT findings of the primary ureteral carcinoma in 16 cas...Objective: To explore the characteristics of the primary ureteral carcinoma (PUC) and discuss the value of spiral CT (SCT) in the diagnosis of PUC. Methods: The SCT findings of the primary ureteral carcinoma in 16 cases were analyzed and compared with the histopathological diagnosis and staging. Results: The transverse diameters of the lesions were 1.0–2.1 cm, and the longitudinal lengths were 1.5–15.2 cm. There were no statistically significant differences (P>0.1) in diam- eters and lengths among the low staging group (pT0–T2) and the high staging group (pT3–T4). The average CT value of the lesions was 43 HU on plain scanning, and 73 HU on CE scanning. The increment was 30 HU. The lesions were clearer on CE scanning. Curved planar reconstruction (CPR) could show the entire course of the urinary tract. Among 6 cases of pT3 stage, CT gave a correct diagnosis in 1 case. For 2 cases of pT4 stage, CT gave correct diagnoses in both cases. Conclusion: The carcinomatous lesions spread along the ureter. The longitudinal length of each lesion is longer than its transverse diameter. Tumor cannot be staged merely according to its diameter and length. CT is difficult to differentiate stage T0–T3, while for stage T4, CT diagnosis is accurate. Contrast enhancement CT scanning has the confirming and differentiating roles. CPR offers direct and easy observing images for clinical doctors.展开更多
Summary: The diagnostic value of 16-slices spiral computed tomography (CT) for portal vein disorders was evaluated. Forty-one patients were scanned by the 16-slices spiral-CT. The celiac trunk, portal vein and their ...Summary: The diagnostic value of 16-slices spiral computed tomography (CT) for portal vein disorders was evaluated. Forty-one patients were scanned by the 16-slices spiral-CT. The celiac trunk, portal vein and their branches were reconstructed by volume rendering (VR), multiplanar volume reconstruction (MPVR) and maximum intensity projection (MIP) technique, and the results were compared with digital subtraction angiography (DSA). VR, MPVR and MIP could display celiac trunk, portal vein, inferior vena cava and their branches and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery-portal vein. The results from 16-slices CT were better than DSA and identical with pathologic ones. The vessel three-dimension reconstruction technique of 16-slices spiral CT is valuable for evaluating the portal systemic disorders.展开更多
文摘BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.
文摘Objective: To explore the characteristics of the primary ureteral carcinoma (PUC) and discuss the value of spiral CT (SCT) in the diagnosis of PUC. Methods: The SCT findings of the primary ureteral carcinoma in 16 cases were analyzed and compared with the histopathological diagnosis and staging. Results: The transverse diameters of the lesions were 1.0–2.1 cm, and the longitudinal lengths were 1.5–15.2 cm. There were no statistically significant differences (P>0.1) in diam- eters and lengths among the low staging group (pT0–T2) and the high staging group (pT3–T4). The average CT value of the lesions was 43 HU on plain scanning, and 73 HU on CE scanning. The increment was 30 HU. The lesions were clearer on CE scanning. Curved planar reconstruction (CPR) could show the entire course of the urinary tract. Among 6 cases of pT3 stage, CT gave a correct diagnosis in 1 case. For 2 cases of pT4 stage, CT gave correct diagnoses in both cases. Conclusion: The carcinomatous lesions spread along the ureter. The longitudinal length of each lesion is longer than its transverse diameter. Tumor cannot be staged merely according to its diameter and length. CT is difficult to differentiate stage T0–T3, while for stage T4, CT diagnosis is accurate. Contrast enhancement CT scanning has the confirming and differentiating roles. CPR offers direct and easy observing images for clinical doctors.
基金ThisprojectwassupportedbyagrantfromtheNaturalSci encesFoundationofHubeiProvince (No .2 0 0 2AB130 ) .
文摘Summary: The diagnostic value of 16-slices spiral computed tomography (CT) for portal vein disorders was evaluated. Forty-one patients were scanned by the 16-slices spiral-CT. The celiac trunk, portal vein and their branches were reconstructed by volume rendering (VR), multiplanar volume reconstruction (MPVR) and maximum intensity projection (MIP) technique, and the results were compared with digital subtraction angiography (DSA). VR, MPVR and MIP could display celiac trunk, portal vein, inferior vena cava and their branches and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery-portal vein. The results from 16-slices CT were better than DSA and identical with pathologic ones. The vessel three-dimension reconstruction technique of 16-slices spiral CT is valuable for evaluating the portal systemic disorders.
