目的:着重分析汶川地震中伤员下肢骨折的发生部位、类型及其产生机制和临床意义。方法:对5·12汶川大地震发生后近2个月内先后送至四川大学华西医院治疗的496例下肢骨折伤员,按X线检查结果对骨折部位及类型进行分析。结果:下肢多部位粉碎性骨折而截肢者29例(5.8％),其余467例伤员共584个部位发生骨折。按骨折部位分类:股骨162个(27.7％),胫腓骨275个(47.1％),髌骨19个(3.3％)以及足骨128个(21.9％)。按骨折类型分类:粉碎性骨折244个(41.8％),斜行骨折194个(33.2％),横行骨折53个(9.1％),线性骨折35个(6.0％),螺旋形骨折33个(5.7％),嵌插骨折17个(2.9％),凹陷性骨折2个(0.3％),同一部位(胫腓骨骨干)的多种类型骨折6个(1.0％)。结论:本组汶川地震造成的下肢骨折,部位以胫腓骨为主;类型以粉碎性骨折为主。常规X线检查对下肢骨折伤员具有简便、快速和准确的诊断价值。
摘要:目的:分析汶川大地震伤员中上肢骨折的发生部位、类型及其产生机制和临床意义。方法:对地震发生后近2个月内先后送至四川大学华西医院治疗的140例上肢骨折伤员,按X线检查结果对骨折部位及类型进行分析。结果:140例伤员共183个部位发生骨折。按骨折部位分类:即肱骨60个(32.8％),桡骨51个(27.9％),尺骨41个(22.4％)及手骨骨折31个(16.9％)。按骨折类型分类:横行骨折46个(251％),斜行骨折31个(16.9％),螺旋形骨折11个(6.0％),粉碎性骨折64个(35.0％),嵌插骨折8个(4.4％),线行骨折13个(7.1％),撕脱骨折10个(5.5％)。结论:本组汶川大地震性的上肢骨折,部位以肱骨骨折为主;类型以粉碎性骨折为主。常规X线检查对上肢骨折伤员具有简便、快速和准确的诊断价值。
目的 探讨多层螺旋CT对下颌骨骨折的诊断价值。 方法 对2007年4月-2009年10月下颌骨不同部位骨折的45例患者进行多层螺旋CT轴位扫描，并行多平面、表面遮盖法等三维重建，对下颌骨骨折CT表现特征作回顾性分析。 结果 45例下颌骨骨折中，位于下颌体骨折24例，下颌角骨折5例，下颌升支骨折6例，髁部骨折13例，冠突骨折2例；颞下颌关节脱位中，单侧脱位3例，双侧脱位5例。 结论 多层螺旋CT能准确诊断下颌骨各部位骨折，对诊治方案具有重要价值。
目的:分析四川汶川大地震胸部损伤患者影像学表现及其价值。方法:对地震发生后近2个月余陆续送至四川大学华西医院治疗,因地震致有胸部损伤史的155名伤员进行影像学分析总结。结果:在本组伤员中,胸廓骨折139例,胸膜损伤160例,肺损伤55例,纵隔损伤28例,肺部慢性感染39例,肺部肿块2例。其中部分伤员为多处复合性损伤。结论:影像学检查能准确、快速、有效地对地震胸部损伤患者进行判断,可为临床治疗方案起指导作用。
ObjectiveTo discuss the MRI diagnostic criteria, classification and lesion characteristics of medial discoid meniscus of the knee. MethodsWe retrospectively analyzed the clinical data of all patients who accepted MRI examination of knee from November 2009 to March 2015.Twenty-six of them (28 knees) with medial discoid meniscus were screened out.We measured and analyzed in all cases the ratio of the width of meniscus to that of tibial plateau on coronal slice, and the thickest thickness of the meniscus posterior horn on sagittal slice.All cases were divided into complete and incomplete type according to MRI findings, and then we compared the lesion rate of the two types of medial discoid meniscus. ResultsTwenty-eight cases were divided into complete type (n=16) and incomplete type (n=12);there were 17 cases of medial discoid meniscal tears, with a lesion rate of 60.7%.The ratio of the width of meniscus to that of tibial plateau on coronal slice was 0.29±0.06, and the thickest thickness of the meniscus posterior horn was (5.31±0.92) mm.The lesion rate of complete type was 81.2%, and 33.3% of the incomplete type.The lesion rate of the complete type was higher than that of the incomplete type, and the difference was statistically significant (P < 0.05). ConclusionsThree MRI diagnostic criteria for medial discoid meniscus are 3 or more than 3 consecutive layers discoid meniscus "tie-like" change in sagittal slice, the ratio of the width of meniscus to that of tibial plateau≥0.20, and the thickest thickness of the meniscus posterior horn≥4.40 mm.Medial discoid meniscuses are divided into complete and incomplete type; the lesion rate of complete type of medial discoid meniscus is higher than that of the incomplete type.
目的：着重探讨鼻腔及鼻窦内翻性乳突状瘤CT表现特征及诊断价值。材料和方法：收集经手术和病理确诊的鼻腔及鼻窦内翻性乳突状瘤65例CT资料，进行回顾性研究。结果：65例IP的CT表现特征，以鼻中道为中心的一侧鼻窦和/或鼻腔内不规则软组织肿块。其中，仅鼻腔受累者18例，一侧鼻腔及鼻窦均受累者47例。鼻腔及鼻窦有膨大并骨质破坏者43例。软组织肿块强化者23例。术后IP复发者13例（20%）；恶变者9例（14.3%）。结论：CT检查对IP的病变部位、范围、程度等能准确确定，可为手术治疗提供重要依据。
目的：分析四川汶川地震脊柱损伤患者CT表现及其价值。方法：对地震发生后近2个月内先后送至四川大学华西医院治疗的148名脊柱外伤伤员，进行脊柱骨折特点CT分析。结果：148例伤员共有341个椎骨骨折，其中颈椎骨折49个，胸椎骨折110个，腰椎骨折179个，骶椎骨折3个。压缩骨折43个，爆裂骨折41个，后柱断裂149个，压缩骨折合并后柱断裂6个，爆裂骨折合并后柱断裂102个，骨折脱位18个。148例脊柱伤员有84例伴发椎管狭窄。结论：CT能准确、快速地对地震脊柱损伤患者进行诊断，为临床治疗起到指导作用。
Objective To investigate the CT features and anatomic basis of peritoneal and retroperitoneal spread of primary acute duodenal inflammation. Methods Twenty-six cases of peritoneal and retroperitoneal spreading acute duodenum inflammation confirmed by gastroscopy and clinical diagnosis during January 2010 to December 2014 were collected. Then we analyzed the CT manifestations of their inflammatory features, and abdominal cavity and retroperitoneal diffusion rules. Results According to the inflammation location, in the 26 cases, there were 1 case of inflammation in the descending part of duodenum, 1 in the horizontal part of duodenum, 15 in both the descending and horizontal parts of duodenum, 7 in both the horizontal and ascending parts of duodenum, and 2 in all the descending, horizontal and ascending parts of duodenum. According to the peritoneal and retroperitoneal spreading locations of acute duodenum inflammation, there were 20 cases of transverse mesocolon and mesenteric root swelling, 17 cases of enlargement of the head of pancreas, 6 cases of ascending colon and ileocecal swelling, 5 cases of anterior and posterior renal fascia of right kidney and perinephric fascia of right kidney swelling, 3 cases of effusion between the anterior and posterior renal fascia and lateral cone fascia of right kidney, 1 case of transverse mesocolon, mesenteric root, and the right pelvic swelling, and 1 cases of abdominal pelvic effusion. Conclusions Acute duodenum inflammation is mainly located in the descending and horizontal parts of duodenum. Different duodenal segments have different degrees of inflammation, while the horizontal segment is the most obvious. Inflammation involving two segments and above can be combined with ulcers. The inflammation infiltrates through transverse mesocolon, mesenteric root, anterior and posterior renal fascia of the right kidney, and spreads to the abdominal and retroperitoneal space, which causes the ascending colon and ileocecal swelling. The effusion can be observed in retroperitoneal space, anterior and posterior renal fascia and abdominal cavity.