目的:探讨C T灌注成像在脑卒中患者侧支循环定量评价中的应用价值。方法:选取上海普陀区中心医院2019年4月—2020年4月收治的68例缺血性脑卒中患者,所有患者均接受常规C T平扫和C T灌注成像(C T P)检查。分析患者的脑血容量(CBV)、脑血...目的:探讨C T灌注成像在脑卒中患者侧支循环定量评价中的应用价值。方法:选取上海普陀区中心医院2019年4月—2020年4月收治的68例缺血性脑卒中患者,所有患者均接受常规C T平扫和C T灌注成像(C T P)检查。分析患者的脑血容量(CBV)、脑血流量(CBF)、达峰时间(TTP)和平均通过时间(MTT),分析侧支循环良好和不良的患者的C T P相关定量参数。结果:68例缺血性脑卒中患者中,有45例患者存在血管狭窄或闭塞。其中,侧支循环良好的21例,侧支循环不良的为24例。侧支循环良好患者C B V、C B F大于侧支循环不良患者,且梗死体积小于侧支循环不良患者。侧支循环良好患者的病灶侧CBF低于健侧,差异有统计学意义(P<0.05);平均通过时间,侧支循环良好患者病灶侧MTT、TTP长于健侧,差异有统计学意义(P<0.05)。侧支循环不良患者病灶侧CBV、CBF低于健侧,病灶侧M T T、T T P长于健侧,差异均有统计学意义(P<0.05)。结论:C T P检查可获取到患者的C T P相关参数,这些参数可评价侧支循环情况,继而帮助医师制定临床治疗方案,预测患者结局。展开更多
Radiographic changes consisting of al- terations in mineral content, osteopaenia or destructive neuropathy that occur following successful finger replantation have already been described. We report our experience abou...Radiographic changes consisting of al- terations in mineral content, osteopaenia or destructive neuropathy that occur following successful finger replantation have already been described. We report our experience about four fingers in three individuals in whom bone changes developed in the first three months postoperatively with complete ＂restitution ad integrum＂. Three patients, 21-49 years old （average 36 years） sustained a clean-cut amputation of four fingers. The first patient had an amputation at the base of the middle phalanx of the index finger and the second patient at the base of the proximal phalanx of the ring finger. The third had an amputation at the base of the first metacarpal bone and the proxi- mal phalanx of the small finger in a five finger amputation. In the first case, two dorsal veins and two palmar digital arteries and nerves were repaired. In the second case, one pal- mar artery and one dorsal vein were reanastomosed. In the third case at the thumb, two dorsal veins and two palmar digital arteries and nerves were reconstructed. At the small finger, one dorsal vein, one palmar digital artery and twodigital nerves were reconstructed. Bone fixation was achieved with two and three K-wires or tension-band wiring. Replantation was successful in all cases. Three weeks after replantation, the X-rays showed rapid development of osteopaenia in the juxtaarticular region and metaphyses of the bone. These changes were followed by subperiosteal, intracortical and endosteal bone resorption. No further surgical procedures or splintage were needed and hand therapy was not discontinued. At 10-13 weeks （average 12 weeks） postoperatively, the X-rays showed a complete recovery with new periosteal bone formation. We suggest that the radiographic changes after finger replantation are transient, first evident subperiosteally and progressing centrally. They may reflect small-vessel compromise and microinfarction and transient hyperemia secondary to neurovascular damage or to sympathetic progressive recovery.展开更多
文摘目的:探讨C T灌注成像在脑卒中患者侧支循环定量评价中的应用价值。方法:选取上海普陀区中心医院2019年4月—2020年4月收治的68例缺血性脑卒中患者,所有患者均接受常规C T平扫和C T灌注成像(C T P)检查。分析患者的脑血容量(CBV)、脑血流量(CBF)、达峰时间(TTP)和平均通过时间(MTT),分析侧支循环良好和不良的患者的C T P相关定量参数。结果:68例缺血性脑卒中患者中,有45例患者存在血管狭窄或闭塞。其中,侧支循环良好的21例,侧支循环不良的为24例。侧支循环良好患者C B V、C B F大于侧支循环不良患者,且梗死体积小于侧支循环不良患者。侧支循环良好患者的病灶侧CBF低于健侧,差异有统计学意义(P<0.05);平均通过时间,侧支循环良好患者病灶侧MTT、TTP长于健侧,差异有统计学意义(P<0.05)。侧支循环不良患者病灶侧CBV、CBF低于健侧,病灶侧M T T、T T P长于健侧,差异均有统计学意义(P<0.05)。结论:C T P检查可获取到患者的C T P相关参数,这些参数可评价侧支循环情况,继而帮助医师制定临床治疗方案,预测患者结局。
文摘Radiographic changes consisting of al- terations in mineral content, osteopaenia or destructive neuropathy that occur following successful finger replantation have already been described. We report our experience about four fingers in three individuals in whom bone changes developed in the first three months postoperatively with complete ＂restitution ad integrum＂. Three patients, 21-49 years old （average 36 years） sustained a clean-cut amputation of four fingers. The first patient had an amputation at the base of the middle phalanx of the index finger and the second patient at the base of the proximal phalanx of the ring finger. The third had an amputation at the base of the first metacarpal bone and the proxi- mal phalanx of the small finger in a five finger amputation. In the first case, two dorsal veins and two palmar digital arteries and nerves were repaired. In the second case, one pal- mar artery and one dorsal vein were reanastomosed. In the third case at the thumb, two dorsal veins and two palmar digital arteries and nerves were reconstructed. At the small finger, one dorsal vein, one palmar digital artery and twodigital nerves were reconstructed. Bone fixation was achieved with two and three K-wires or tension-band wiring. Replantation was successful in all cases. Three weeks after replantation, the X-rays showed rapid development of osteopaenia in the juxtaarticular region and metaphyses of the bone. These changes were followed by subperiosteal, intracortical and endosteal bone resorption. No further surgical procedures or splintage were needed and hand therapy was not discontinued. At 10-13 weeks （average 12 weeks） postoperatively, the X-rays showed a complete recovery with new periosteal bone formation. We suggest that the radiographic changes after finger replantation are transient, first evident subperiosteally and progressing centrally. They may reflect small-vessel compromise and microinfarction and transient hyperemia secondary to neurovascular damage or to sympathetic progressive recovery.
