目的探讨C臂CT引导下经皮三叉神经半月节球囊压迫术治疗三叉神经痛的应用价值。方法回顾性分析采用C臂CT(Xper-CT)引导下经皮三叉神经半月节球襄压迫术治疗三叉神经痛患者40例,所有患者均进行C臂CT程序扫描,并通过X-travision工作站进...目的探讨C臂CT引导下经皮三叉神经半月节球囊压迫术治疗三叉神经痛的应用价值。方法回顾性分析采用C臂CT(Xper-CT)引导下经皮三叉神经半月节球襄压迫术治疗三叉神经痛患者40例,所有患者均进行C臂CT程序扫描,并通过X-travision工作站进行颅骨后处理重建,引导穿刺针进入卵圆孔及球囊到位,确定球囊头端位于Meckel’s腔,充盈球囊。术后记录手术剂量面积乘积(dose area product,DAP)、空气比释动能(cumulative air kerma,CAK)、曝光时间(fluo time,FT),分析辐射剂量。结果40例患者均通过C臂CT后处理重建技术引导卵圆孔穿刺成功(其中小卵圆孔2例);40例患者中通过C臂CT后处理重建技术确定球囊一次性到位并获得满意梨形21例(52%),通过C臂CT后处理重建技术分析后多次调整球囊位置及方向,使球囊头端位于岩骨切迹,并获得满意梨形12例(30%),7例(18%)患者未获得满意梨形。术后40例患者疼痛完全消失17例(42%),疼痛满意缓解21例(53%);疼痛缓解不满意2例(5%);总有效率95%。术后伴面部麻木26例(65%),咀嚼肌无力9例(23%)。40例患者DAP、CAK、FT分别为(79.39±23.15)Gycm^(2)、(245.07±84.04)mGy、(5.20±1.30)min。结论C臂CT引导下经皮三叉神经半月节球囊压迫术直观准确显示穿刺针、卵圆孔、球囊、岩骨脊的三维结构及其相互位置关系,尤其对解剖变异或异常增生的显示更具优势。展开更多
Branchial arch anomalies can arise from the four first branchial arches, but the most encountered cases are from the second one. Second branchial arch cysts and abscesses occur mainly in older children or young adults...Branchial arch anomalies can arise from the four first branchial arches, but the most encountered cases are from the second one. Second branchial arch cysts and abscesses occur mainly in older children or young adults while fistulae are discovered in young children. We report a case of complete second branchial arch fistula of Bailey III type with adult complaints of painful swelling and local reddishness followed by spontaneous discharge and disappearance of complaints. Diagnosis was based on ultrasound and confirmed by CT scan, with the classic “beak sign” visible on both exams. Three cases were encountered in the family, with no otologic or kidney symptoms, which is quite different from the classical branchiootorenal syndrome which associates severe inner ear and kidney congenital anomalies.展开更多
文摘目的探讨C臂CT引导下经皮三叉神经半月节球囊压迫术治疗三叉神经痛的应用价值。方法回顾性分析采用C臂CT(Xper-CT)引导下经皮三叉神经半月节球襄压迫术治疗三叉神经痛患者40例,所有患者均进行C臂CT程序扫描,并通过X-travision工作站进行颅骨后处理重建,引导穿刺针进入卵圆孔及球囊到位,确定球囊头端位于Meckel’s腔,充盈球囊。术后记录手术剂量面积乘积(dose area product,DAP)、空气比释动能(cumulative air kerma,CAK)、曝光时间(fluo time,FT),分析辐射剂量。结果40例患者均通过C臂CT后处理重建技术引导卵圆孔穿刺成功(其中小卵圆孔2例);40例患者中通过C臂CT后处理重建技术确定球囊一次性到位并获得满意梨形21例(52%),通过C臂CT后处理重建技术分析后多次调整球囊位置及方向,使球囊头端位于岩骨切迹,并获得满意梨形12例(30%),7例(18%)患者未获得满意梨形。术后40例患者疼痛完全消失17例(42%),疼痛满意缓解21例(53%);疼痛缓解不满意2例(5%);总有效率95%。术后伴面部麻木26例(65%),咀嚼肌无力9例(23%)。40例患者DAP、CAK、FT分别为(79.39±23.15)Gycm^(2)、(245.07±84.04)mGy、(5.20±1.30)min。结论C臂CT引导下经皮三叉神经半月节球囊压迫术直观准确显示穿刺针、卵圆孔、球囊、岩骨脊的三维结构及其相互位置关系,尤其对解剖变异或异常增生的显示更具优势。
文摘Branchial arch anomalies can arise from the four first branchial arches, but the most encountered cases are from the second one. Second branchial arch cysts and abscesses occur mainly in older children or young adults while fistulae are discovered in young children. We report a case of complete second branchial arch fistula of Bailey III type with adult complaints of painful swelling and local reddishness followed by spontaneous discharge and disappearance of complaints. Diagnosis was based on ultrasound and confirmed by CT scan, with the classic “beak sign” visible on both exams. Three cases were encountered in the family, with no otologic or kidney symptoms, which is quite different from the classical branchiootorenal syndrome which associates severe inner ear and kidney congenital anomalies.
