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Effect of Ageing on Midbrain to Pons Area Ratio Using MRI: A Cross-sectional Study 衰老对中脑-脑桥面积比影响的MRI横断面研究
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/58300.2847
Tukaram Rathod, KS Sachin, U. Joish, S. Vishnupriya, GM Vinutha
Introduction: There is brainstem atrophy with normal ageing. It is pertinent to determine, if this atrophy with ageing, is associated with significant alteration in the midbrain to pons ratio. Aim: To determine sizes and ratio of midbrain and pons area among adults and elderly. Materials and Methods: A cross-sectional, analytical study was done in a tertiary care hospital, S Nijalingappa Medical College, Bagalkot, Karnataka, India from January 2022 to March 2022, including 200 apparently healthy adult and elderly participants. They were divided into two groups, 100 men (M1≤50 years and M2>50 years) and 100 women (F1≤50 years and F2>50 years). Each underwent multiplanar T1 Magnetic Resonance Imaging (MRI) of the brain. An experienced Radiologist identified midsagittal image, and measured midbrain and pons areas on that image. Mean and standard deviations of midbrain and pons area and midbrain to pons area ratio were estimated for each of the groups. Independent Sample t-test was used to determine significance of differences between groups. Results: A total of 200 participants were included in the study with mean age of 51 years and 3 months. The midbrain to pons area ratio among M2 and F2 groups ranged from 0.20 to 0.39, and in M1 and F1 groups it ranged from 0.23 to 0.47. Midbrain areas and midbrain to pons area ratio were significantly more among participants aged less than 50 years among both males (p-value = 0.014 and 0.024) and females (p-value = 0.011 and 0.032) in comparison with participants aged more than 50 years. Conclusion: Midbrain to pons area ratio decreases significantly in older age, and hence, age needs to be accounted for, while interpreting the ratio.
导读:正常的衰老会导致脑干萎缩。确定这种萎缩与衰老是否与中脑与脑桥比例的显著改变有关是相关的。目的:探讨成人和老年人中脑和脑桥面积的大小及比例。材料和方法:于2022年1月至2022年3月在印度卡纳塔克邦巴加尔科特S Nijalingappa医学院三级保健医院进行了一项横断面分析研究,包括200名表面健康的成人和老年人参与者。男性100人(M1≤50岁,M2≤50岁),女性100人(F1≤50岁,F2≤50岁)。每个人都接受了多平面T1脑磁共振成像(MRI)。一位经验丰富的放射科医生确定了正中矢状面图像,并在该图像上测量了中脑和脑桥区域。估计各组中脑和脑桥面积及中脑与脑桥面积比值的平均值和标准差。采用独立样本t检验确定组间差异的显著性。结果:共纳入200例患者,平均年龄51岁零3个月。M2和F2组中脑与脑桥面积之比为0.20 ~ 0.39,M1和F1组中脑与脑桥面积之比为0.23 ~ 0.47。年龄小于50岁的男性(p值分别为0.014和0.024)和女性(p值分别为0.011和0.032)中脑面积和中脑与脑桥面积之比均显著高于50岁以上的参与者。结论:中脑与脑桥面积比值随年龄增大而明显下降,在解释中脑与脑桥面积比值时应考虑年龄因素。
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引用次数: 0
Comparison of Testicular Volume and Blood Flow in Children Before and After Surgery for Inguinoscrotal Diseases- A Prospective Cohort Study 腹股沟阴囊疾病手术前后儿童睾丸体积和血流量的比较——一项前瞻性队列研究
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/50452.2764
V. Virdi, Money Gupta, Abhishek Mahna
Introduction: Testicular diseases in children include hernia, hydrocele, undescended testis, epididymal cyst or torsion testis. Some of these like hernia and undescended testis will have affect on the testicular volume and blood flow. These are predictors for the future function of the testis. Manipulations during surgery can also affect blood flow to the testis. Aim: To compare testicular volume and blood flow in children undergoing surgery for inguinoscrotal diseases in both normal and diseased sides, before and after surgery. Materials and Methods: A prospective cohort study was conducted from March 2019 to December 2019 in which 30 children were selected from Surgery Outpatient Department (OPD), Department of Paediatrics, Gian Sagar Medical College, Rajpura, Punjab, India. For patients having inguinoscrotal disease, ultrasonography (US) and colour doppler was done preoperatively on all cases by an experienced radiologist, using the same machine settings on the seventh day and three months postsurgery. Preoperative and postoperative testicular volume and blood flow was recorded in all the patients. The Statistical Package for Social Sciences (SPSS) software was used to statistically analyse the data arising, p<0.05 was accepted as statistically significant. Results: Total of 30 children (10 months to 10 years of age) formed the total sample of the study. Pathology was found in 18 patients on the right side and 12 patients on the left side. When the right and left side pathology were compared, it was found that right testicular volume was less as compared to left side. This difference was statistically significant with the p-value 0.006. There was a significant difference in blood flow between the right and left testis, both before (p-value 0.007) and after surgery (p-value=0.004). Testicular volume increased three months postsurgery in all the patients. This difference was more evident in left side pathology (p<0.05) as compared to right side (p>0.05). The increase in mean blood flow of diseased testis was significant after seven days of surgery (p-value <0.05). But change in mean testicular volume and blood flow after three months of follow-up was found to be non-significant. Conclusion: Inguinal surgery does not affect the testicular volume and blood flow. But long term follow-up for children of inguinal surgery for its effect on fertility should be evaluated.
儿童睾丸疾病包括疝气、鞘膜积液、隐睾、附睾囊肿或扭转睾丸。其中一些如疝气和隐睾会影响睾丸的体积和血流量。这些是睾丸未来功能的预测指标。手术过程中的操作也会影响睾丸的血流量。目的:比较正常侧和病变侧腹股沟阴囊疾病患儿手术前后睾丸体积和血流量的变化。材料与方法:于2019年3月至2019年12月在印度旁遮普省拉杰普拉吉安萨加尔医学院儿科外科门诊(OPD)选择30名儿童进行前瞻性队列研究。对于患有腹股沟阴囊疾病的患者,术前由经验丰富的放射科医生使用相同的机器设置对所有病例进行超声检查(US)和彩色多普勒检查,分别于术后第7天和3个月进行。所有患者术前、术后均记录睾丸体积和血流量。采用SPSS (Statistical Package for Social Sciences)软件对产生的数据进行统计分析,p0.05)。术后7 d病变睾丸平均血流量明显增加(p值<0.05)。但在三个月的随访后,平均睾丸体积和血流量的变化并不显著。结论:腹股沟手术对睾丸体积和血流量无影响。但对腹股沟手术患儿的长期随访对其生育能力的影响应进行评估。
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引用次数: 0
Subclavian Vein Cannulation and its Common Technical Errors, Failure Rates and Complications: A Cross-sectional Study 锁骨下静脉插管及其常见的技术错误、失败率和并发症:一项横断面研究
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/50466.2746
Pravinkumar Govande, Ankush Aasole, Sunil Bomble, Ravikumar Phad, K. Gupta
Introduction: Central Venous Catheter (CVC) is indicated when peripheral vein administration is not possible which can be inserted via different routes. CVC play a significant role in the therapeutic armamentarium of the surgeon and intensivist. The subclavian vein is the most frequently used access site but is associated with certain risks and failures. Aim: To study common technical errors, failure rate and complications associated with subclavian cannulation. Materials and Methods: This was a cross-sectional observational study carried out on 100 patients admitted from October 2017 to October 2020 for various surgical diseases in a Swami Ramanand Teerth Rural Government Medical College, Ambajogai, Maharashtra, India, requiring CVC placement. Subclavian vein cannulation (SVC) technique was done as standard method. Surgeon or anaesthetist who was performing the procedure noted the number of insertion attempts, failures and complications. Data was collected and analysed using Statistical Package for the Social Sciences (SPSS) version 21.0 and paired t-test. Level of significance was set at p-value <0.05. Results: Total of 100 patients included in the study, 57 (57%) were male with mean age of 61±14.2 years and 43 (43%) were female with mean age of 58±11.7 years. SVC was successfully done in all 100 cases but in 236 attempts. Thus, 136 attempts were failure and the overall failure rate was 57.62%. On an average there are 2.4 failed attempts per line. The most common technical error observed was improper site for needle insertion relative to the clavicle 27.94% followed by insertion of the needle through the clavicular periosteum 25.74%. The overall complication rate was 9% and most common complications was haematoma in 6%, catheter site infection 2% and pneumothorax in 1%. Conclusion: Subclavian vein catheterisation is an important invasive procedure often performed to administer drugs, haemodynamic monitoring and total parenteral nutrition. It is associated with high failure rate and complications due to technical errors of judgement leading to multiple attempts of needle insertion. They can be minimised with knowledge of anatomical landmarks, ultrasound guidance and Subclavian Vein Cannulation (SVC) personnel experience.
中心静脉导管(CVC)是指外周静脉给药不可能时,可以通过不同的路径插入。CVC在外科医生和重症监护医生的治疗设备中起着重要的作用。锁骨下静脉是最常用的入路,但有一定的风险和失败。目的:探讨锁骨下插管术中常见的技术失误、失败率及并发症。材料和方法:本研究是一项横断面观察性研究,对2017年10月至2020年10月在印度马哈拉施特拉邦Ambajogai的Swami Ramanand Teerth农村政府医学院收治的100名患有各种外科疾病的患者进行研究,这些患者需要放置CVC。锁骨下静脉插管(SVC)技术作为标准方法。执行手术的外科医生或麻醉师记录了插入尝试、失败和并发症的次数。数据收集和分析使用社会科学统计软件包(SPSS)版本21.0和配对t检验。p <0.05为显著性水平。结果:共纳入100例患者,其中男性57例(57%),平均年龄61±14.2岁;女性43例(43%),平均年龄58±11.7岁。所有100例SVC均成功,但有236例尝试。136次尝试失败,总失败率为57.62%。平均每行有2.4次失败尝试。最常见的技术错误是相对于锁骨入针位置不当(27.94%),其次是穿过锁骨骨膜入针(25.74%)。总并发症发生率为9%,最常见的并发症是血肿(6%)、导管部位感染(2%)和气胸(1%)。结论:锁骨下静脉置管是一项重要的侵入性手术,常用于给药、血流动力学监测和全肠外营养。它与高失败率和由于技术判断错误导致多次尝试插入针的并发症有关。通过解剖标志知识、超声引导和锁骨下静脉插管(SVC)人员经验,可以将其最小化。
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引用次数: 0
Comparison of Plain Radiography with Spiral Computed Tomography and 3D Reformation in Tibial Plateau Fractures: A Cross-sectional Study 胫骨平台骨折的x线平片与螺旋ct及三维重建的比较:一项横断面研究
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/51518.2760
Nissy K Thomas, K. Anand, A. Rajaram
Introduction: Tibial plateau fractures may result in major disabilities if not diagnosed at the right time. Plain radiography is the first and foremost imaging modality of choice to evaluate trauma followed by Computed Tomography (CT). Aim: To evaluate tibial plateau fractures on CT and compare them with 3D reformations and plain radiography, and classify the fractures using Schatzker’s classification. Materials and Methods: The prospective cross-sectional study was conducted at a tertiary care centre in Bengaluru, Karnataka, India, between November 2016 to June 2018. The study sample comprised of 53 patients who presented with fracture of the tibial plateau. Demographic details and brief clinical history of the subjects were recorded. All patients underwent conventional radiography as well as CT of the knee, including three-Dimensional (3D) reconstruction. The region of interest was assessed for the presence, displacement, depression, extent and comminution of the fracture. Data was analysed using R version 4.0.3. Chi-square test was used to see the association between different variables. Cohen’s Kappa was employed to determine the agreement of plain radiograph and CT findings. Results: The mean age of patients was 44.01±13.23 years. The extent of the fracture line and communition of fracture were visible on all sections of CT for all samples, but 3D CT did not reveal the extent of the fracture line in 9.43% of the sample (p=0.003) and communition was visible only in 15.09% of the sample. On comparing the plain radiograph and CT findings for tibial plateau fractures, a close to perfect agreement in diagnosing the displacement of fracture (Cohen’s Kappa, 0.9618, p<0.001), followed by a fair agreement in diagnosing fracture communition (Cohen’s Kappa, 0.3748; p=0.0015) were noted. The positive predictive value of tibial plateau fracture detection rate by plain radiography and CT findings were 88.7% and 98.1%, respectively. These fractures assessed as per Schatzker’s classification revealed majority of the patients had bicondylar plateau with diaphyseal discontinuity 19 (35.85%) followed by bicondylar plateau 14 (26.42%). Conclusion: In this study, CT was observed to be an excellent modality for the evaluation of tibial plateau fractures including depression, displacement, comminution and extent of fractures when compared to plain radiography.
引言:胫骨平台骨折可能导致严重残疾,如果没有在正确的时间诊断。x线平片是评估创伤的首选成像方式,其次是计算机断层扫描(CT)。目的:评价胫骨平台骨折的CT表现,并与三维重建及x线平片进行比较,采用Schatzker分型法对骨折进行分类。材料和方法:前瞻性横断面研究于2016年11月至2018年6月在印度卡纳塔克邦班加罗尔的一家三级医疗中心进行。研究样本包括53例表现为胫骨平台骨折的患者。记录受试者的人口学细节和简短的临床病史。所有患者都接受了常规的膝关节x线摄影和CT检查,包括三维重建。对感兴趣的区域进行了评估,包括骨折的存在、位移、凹陷、程度和粉碎程度。数据分析使用R版本4.0.3。采用卡方检验检验不同变量之间的相关性。采用Cohen 's Kappa来确定平片和CT表现的一致性。结果:患者平均年龄44.01±13.23岁。所有样本的CT各切片均可见骨折线范围和骨折通讯,但9.43%的样本在3D CT上未显示骨折线范围(p=0.003),仅15.09%的样本可见通讯。对比胫骨平台骨折的平片和CT表现,对骨折移位的诊断接近完全一致(Cohen’s Kappa, 0.9618, p<0.001),其次是对骨折通讯的诊断较为一致(Cohen’s Kappa, 0.3748;P =0.0015)。平片和CT表现对胫骨平台骨折检出率的阳性预测值分别为88.7%和98.1%。这些骨折根据Schatzker的分类评估显示,大多数患者为双髁平台伴骨干不连续19(35.85%),其次为双髁平台14(26.42%)。结论:在本研究中,与平片相比,CT是评估胫骨平台骨折的一种很好的方式,包括骨折的凹陷、移位、粉碎和程度。
{"title":"Comparison of Plain Radiography with Spiral Computed Tomography and 3D Reformation in Tibial Plateau Fractures: A Cross-sectional Study","authors":"Nissy K Thomas, K. Anand, A. Rajaram","doi":"10.7860/ijars/2022/51518.2760","DOIUrl":"https://doi.org/10.7860/ijars/2022/51518.2760","url":null,"abstract":"Introduction: Tibial plateau fractures may result in major disabilities if not diagnosed at the right time. Plain radiography is the first and foremost imaging modality of choice to evaluate trauma followed by Computed Tomography (CT). Aim: To evaluate tibial plateau fractures on CT and compare them with 3D reformations and plain radiography, and classify the fractures using Schatzker’s classification. Materials and Methods: The prospective cross-sectional study was conducted at a tertiary care centre in Bengaluru, Karnataka, India, between November 2016 to June 2018. The study sample comprised of 53 patients who presented with fracture of the tibial plateau. Demographic details and brief clinical history of the subjects were recorded. All patients underwent conventional radiography as well as CT of the knee, including three-Dimensional (3D) reconstruction. The region of interest was assessed for the presence, displacement, depression, extent and comminution of the fracture. Data was analysed using R version 4.0.3. Chi-square test was used to see the association between different variables. Cohen’s Kappa was employed to determine the agreement of plain radiograph and CT findings. Results: The mean age of patients was 44.01±13.23 years. The extent of the fracture line and communition of fracture were visible on all sections of CT for all samples, but 3D CT did not reveal the extent of the fracture line in 9.43% of the sample (p=0.003) and communition was visible only in 15.09% of the sample. On comparing the plain radiograph and CT findings for tibial plateau fractures, a close to perfect agreement in diagnosing the displacement of fracture (Cohen’s Kappa, 0.9618, p<0.001), followed by a fair agreement in diagnosing fracture communition (Cohen’s Kappa, 0.3748; p=0.0015) were noted. The positive predictive value of tibial plateau fracture detection rate by plain radiography and CT findings were 88.7% and 98.1%, respectively. These fractures assessed as per Schatzker’s classification revealed majority of the patients had bicondylar plateau with diaphyseal discontinuity 19 (35.85%) followed by bicondylar plateau 14 (26.42%). Conclusion: In this study, CT was observed to be an excellent modality for the evaluation of tibial plateau fractures including depression, displacement, comminution and extent of fractures when compared to plain radiography.","PeriodicalId":56235,"journal":{"name":"International Journal of Anatomy Radiology and Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71261246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Measurements of Corpus Callosum in Formalin Fixed Brain and in Magnetic Resonance Imaging Scan 福尔马林固定脑与磁共振成像扫描胼胝体测量值的比较
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/50648.2739
P. Choudhury, Purujit Choudhury, P. Baruah, K. Biswas
Introduction: Corpus callosum is the collection of white fibres situated in the longitudinal fissure of brain connecting the two halves of the brain. Different methodologies may yield different results in the measurement of diameters of corpus callosum. Aim: To find out any difference in corpus callosum diameters when these diameters were measured in formalin fixed brain specimens and in Magnetic Resonance Imaging (MRI) scans. Materials and Methods: This was a cross-sectional study carried out in the Department of Anatomy, Silchar Medical College and Hospital, Silchar, Assam, India from April 2014 to March 2019. A total of 107 formalin fixed cadaveric brain specimens were used to measure length, height and thickness of corpus callosum and MRI scans of 43 patients were used to measure the same diameters. The mean value of all the diameters of corpus callosum measured in formalin fixed brain specimens and in MRI scans were compared. Statistical significance was calculated with student’s t-test and p-value <0.05 was considered significant. Results: Total data collected from 107 brain specimens (66 were males and 41 were females) and MRI scans of 43 subjects (30 were males and 13 were females), all in age range of 10- 70 years, were analysed. Mean values of length, height, mid- body, rostrum and splenium thickness of corpus callosum in cadaveric brain specimens were recorded 70.85 mm, 23.37 mm, 5.46 mm, 5.91 mm and 8.40 mm, respectively and same diameters in MRI scans were 74.61 mm, 25.85 mm, 5.84 mm, 6.68mm, 10.46 mm, respectively. Difference of these diameters of corpus callosum measured in cadaveric brain specimens and in MRI scans was statistically significant with p-value=0.0001 for length, 0.0006 for height and 0.0001 for thickness. Conclusion: Significant difference was observed when the same diameters of corpus callosum were measured in MRI and in formalin fixed cadaveric brain specimens.
胼胝体是位于连接大脑两半的纵向裂缝中的白色纤维的集合。在测量胼胝体直径时,不同的方法可能产生不同的结果。目的:探讨福尔马林固定脑标本与磁共振成像(MRI)扫描时胼胝体直径的差异。材料和方法:这是一项横断面研究,于2014年4月至2019年3月在印度阿萨姆邦西尔查尔西尔查尔医学院和医院解剖学系进行。采用107个福尔马林固定的尸体脑标本测量胼胝体的长度、高度和厚度,43例患者的MRI扫描测量相同的直径。比较福尔马林固定脑标本和MRI扫描测量的胼胝体所有直径的平均值。采用学生t检验计算差异有统计学意义,p值<0.05被认为是显著的。结果:分析了107例脑标本(男性66例,女性41例)和43例(男性30例,女性13例)的MRI扫描数据,年龄在10- 70岁之间。尸体脑标本胼胝体的长度、高度、体中部、喙部和脾部厚度的平均值分别为70.85 mm、23.37 mm、5.46 mm、5.91 mm和8.40 mm,相同直径的MRI扫描值分别为74.61 mm、25.85 mm、5.84 mm、6.68mm、10.46 mm。在尸体脑标本和MRI扫描中测量的胼胝体直径差异具有统计学意义,长度p值=0.0001,高度p值= 0.0006,厚度p值=0.0001。结论:MRI测量相同直径的胼胝体与福尔马林固定的尸体脑标本测量胼胝体有显著差异。
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引用次数: 0
Role of Sonoelastography for Differentiating Benign and Malignant Cervical Lymph Nodes: A Cross-sectional Study 超声弹性成像在鉴别颈淋巴结良恶性中的作用:一项横断面研究
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/50838.2729
M. Seetharam, Muralidhara Chennagiri Prakash, Hagalahalli Nagarajegowda Pradeep, C. Nanjaraj, M. Narayana, Raksha Alalasandra Ramakrishnaiah, Archana Rao Kerekoppa, Tanuja Ponnappa Chandura
Introduction: Cervical nodes form one of the major groups of Lymph Nodes (LN) that are frequently involved in inflammatory and neoplastic diseases. Metastasis causes the most apparent change in consistency of the node among the various nodal pathologies. Ultrasound elastography provides an estimate of tissue consistency by measuring the degree of distortion under the application of an external force. Aim: To estimate the diagnostic accuracy of sonoelastography in the differentiation of malignant and benign cervical LN with fine needle aspiration cytology/biopsy considered as a gold standard. Materials and Methods: A cross-sectional study was carried out from March 2020 to January 2021 in a tertiary care hospital in south India, a total of 50 patients with cervical lymphadenopathy underwent ultrasonography followed by elastography of superficial neck LN using high frequency linear transducer by freehand technique. The ultrasound characteristics of selected LN were determined and colour elastogram pattern was assessed using colour mapping elastography. The chi-square test was performed. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were obtained. The results were then compared to the fine needle aspiration cytology. Results: A total of 50 subjects(median age of 40.5±18.71 years ; 19 (38%) males and 31 (62%) females). The grayscale and colour Doppler features of cervical LN which helped predict malignancy were short axis ≥8 mm, S:L axis ratio ≥0.5, absence of normal central fatty hilum, abnormal echogenicity, lobulated border, presence of calcification and peripheral/mixed vascularity. With reference to the above variables of cervical LN characterisation on grayscale, colour doppler ultrasound and sonoelastography findings, elastography pattern was the most promising variable to differentiate malignant from benign cervical LN with 95.2% sensitivity, 75.0% specificity, 95.2% PPV, 75.0% NPV and 92.0% accuracy. Conclusion: Sonoelastography is useful in the assessment of elastic properties of cervical LN with short examination time required, real-time display, immediate interpretation and limited cost. Sonoelastography had higher diagnostic accuracy than gray scale and doppler ultrasound in differentiating benign from malignant cervical LN. Sonoelastography is an effective supplement to conventional gray scale and colour doppler ultrasound and that the combination is clinically recommended for a more accurate diagnosis of metastatic LN.
宫颈淋巴结是淋巴结(LN)的主要类群之一,常与炎症性和肿瘤性疾病有关。在各种淋巴结病理中,转移引起的淋巴结一致性变化最为明显。超声弹性成像通过测量在外力作用下的变形程度来估计组织的一致性。目的:以细针穿刺细胞学/活检为金标准,评价超声弹性成像对颈淋巴结良恶性鉴别的诊断准确性。材料与方法:本研究于2020年3月至2021年1月在印度南部的一家三级医院进行横断面研究,共50例颈部淋巴结病患者接受超声检查,然后使用高频线性换能器采用手绘技术对颈部浅淋巴结进行弹性成像。确定所选LN的超声特征,并使用彩色映射弹性图评估彩色弹性图模式。进行卡方检验。获得敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)。然后将结果与细针抽吸细胞学进行比较。结果:共纳入50例受试者(中位年龄40.5±18.71岁;男性19人(38%),女性31人(62%)。颈LN的灰度和彩色多普勒特征为短轴≥8mm, S:L轴比值≥0.5,无正常的中央脂肪门,回声异常,分叶状边界,存在钙化和周围/混合血管。结合上述灰度、彩色多普勒超声和超声弹性图的颈淋巴结特征变量,弹性图是鉴别颈淋巴结良恶性最有希望的变量,灵敏度为95.2%,特异度为75.0%,PPV为95.2%,NPV为75.0%,准确率为92.0%。结论:超声弹性成像具有检查时间短、实时显示、即时判据、成本低等优点,可用于颈椎LN弹性特性的评估。超声弹性成像对颈淋巴结良恶性鉴别的诊断准确率高于灰度和多普勒超声。超声弹性成像是传统灰度和彩色多普勒超声的有效补充,临床推荐两者结合用于更准确地诊断转移性淋巴结。
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引用次数: 0
Morphological Study of Nutrient Foramina in Long Bones of Upper Limb among North Gujarat Population 古吉拉特邦北部人群上肢长骨营养孔的形态学研究
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/53550.2818
Hetal Modi, H. Chauhan, Yogesh N Umrania, Himanshu Kantibhai Prajapapati
Introduction: Main source of nutrition to long bone during growth and ossification is nutrient artery. Nutrient canal opens as nutrient foramen on the surface of shaft which conducts the nutrient artery and the peripheral nerves to bones. Nutrient artery provides more than 60-70% of blood supply to long bone, 30- 40% through periosteal, metaphyseal and epiphyseal blood vessels. Aim: To determine number of nutrient foramina, its position on surface of shaft, size and direction of nutrient foramina either towards proximal end or distal end and find out foraminal index from the position of nutrient foramina. Materials And Methods: A cross-sectional study was performed in 177 dry bones (60 humerus, 60 radius, 57 ulna) of upper limb, available at Anatomy Department, GMERS Medical College Himmatnagar, during September 2021. All bones were observed for number, position and direction of nutrient foramina. Size of foramen was measured by needles of different size. Mean Foraminal index was calculated for each long bone of upper limb by using Epi Info™ for windows, CDC, Atlanta, version 7.2. Results: Majority of bones had single nutrient foramina, all foramina were directed towards the elbow joint. All nutrient foramina were on flexor surfaces of bone, except one bone (radius). Majority of nutrient foramina were situated on middle 3rd of the shaft. Size of nutrient foramen was range from 22 to 28 gauge of needle. Conclusion: Information on nutrient foramina of long bones of upper limb will be useful in many orthopedic surgeries like microvascular bone grafting and many plastic reconstructive surgeries. During surgeries like fracture repair, bone graft or muscle graft care should be taken, not to damage these nutrient vessels to keep intact blood supply of bone.
简介:长骨在生长和骨化过程中的主要营养来源是营养动脉。营养管作为骨轴表面的营养孔打开,将营养动脉和周围神经输送到骨骼。营养动脉向长骨提供60-70%以上的血液供应,30- 40%通过骨膜、干骺血管和骨骺血管。目的:测定营养孔的数量、在椎体表面的位置、营养孔的大小和向近端或远端方向,并从营养孔的位置求出营养孔指数。材料与方法:研究人员于2021年9月在Himmatnagar GMERS医学院解剖学系对177块上肢干骨(60块肱骨、60块桡骨、57块尺骨)进行了横断面研究。观察各骨营养孔的数量、位置和方向。用不同大小的针测量孔的大小。使用Epi Info™for windows软件,CDC, Atlanta, version 7.2计算上肢各长骨的平均椎间孔指数。结果:多数骨为单个营养孔,所有营养孔均指向肘关节。除一个骨(桡骨)外,所有营养孔均位于骨屈肌表面。大部分营养孔位于茎中部的3 / 3处。营养孔大小为22 ~ 28针。结论:上肢长骨营养孔的信息在微血管植骨和整形重建等骨科手术中具有重要的应用价值。在进行骨折修复、植骨或植肌等手术时,应注意不损伤这些营养血管,以保持骨血供的完整。
{"title":"Morphological Study of Nutrient Foramina in Long Bones of Upper Limb among North Gujarat Population","authors":"Hetal Modi, H. Chauhan, Yogesh N Umrania, Himanshu Kantibhai Prajapapati","doi":"10.7860/ijars/2022/53550.2818","DOIUrl":"https://doi.org/10.7860/ijars/2022/53550.2818","url":null,"abstract":"Introduction: Main source of nutrition to long bone during growth and ossification is nutrient artery. Nutrient canal opens as nutrient foramen on the surface of shaft which conducts the nutrient artery and the peripheral nerves to bones. Nutrient artery provides more than 60-70% of blood supply to long bone, 30- 40% through periosteal, metaphyseal and epiphyseal blood vessels. Aim: To determine number of nutrient foramina, its position on surface of shaft, size and direction of nutrient foramina either towards proximal end or distal end and find out foraminal index from the position of nutrient foramina. Materials And Methods: A cross-sectional study was performed in 177 dry bones (60 humerus, 60 radius, 57 ulna) of upper limb, available at Anatomy Department, GMERS Medical College Himmatnagar, during September 2021. All bones were observed for number, position and direction of nutrient foramina. Size of foramen was measured by needles of different size. Mean Foraminal index was calculated for each long bone of upper limb by using Epi Info™ for windows, CDC, Atlanta, version 7.2. Results: Majority of bones had single nutrient foramina, all foramina were directed towards the elbow joint. All nutrient foramina were on flexor surfaces of bone, except one bone (radius). Majority of nutrient foramina were situated on middle 3rd of the shaft. Size of nutrient foramen was range from 22 to 28 gauge of needle. Conclusion: Information on nutrient foramina of long bones of upper limb will be useful in many orthopedic surgeries like microvascular bone grafting and many plastic reconstructive surgeries. During surgeries like fracture repair, bone graft or muscle graft care should be taken, not to damage these nutrient vessels to keep intact blood supply of bone.","PeriodicalId":56235,"journal":{"name":"International Journal of Anatomy Radiology and Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71262282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Stomach Full of Hair-Trichobezoar 胃里满是毛毛虫
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/52792.2799
Raghav Yelamanchi, Gayathri Dharma Teja Manda, Gautam Kumar Chukka, M. Dokania
Trichobezoars are rare masses of hair resulting from hair plucking (trichotillomania) and hair eating (trichophagia). Few of the hair may also be carried by peristalsis into the duodenum. This condition is known as Rapunzel syndrome. Complications include gastric perforation, small bowel obstruction and pancreatitis. Here the authors present a case of 20-year old female patient who presented with complaints of abdominal pain, early satiety and non-bilious vomiting. On examination, there was a swelling of size 10×5 cm predominantly in the epigastric and umbilical regions. Contrast Enhanced Computed Tomography (CECT) of the abdomen revealed a grossly dilated stomach with a heterogeneous mass in the lumen obstructing the pylorus. Upper gastrointestinal endoscopy confirmed the diagnosis of trichobezoar. Trichobezoar was removed by laparotomy and the patient had an uneventful recovery. Treatment is mainly laparotomy and minimally invasive methods can be used for small lesions with limited success rate. Psychiatric consultation is a must in all cases.
拔毛癖是一种罕见的毛发肿块,由拔毛癖和食毛癖引起。少数毛也可通过肠蠕动进入十二指肠。这种情况被称为长发公主综合征。并发症包括胃穿孔、小肠梗阻和胰腺炎。在这里,作者提出了一个20岁的女性患者谁提出抱怨腹痛,早期饱腹感和非胆汁性呕吐。检查发现,主要在上腹部和脐部有一个大小为10×5 cm的肿胀。腹部增强计算机断层扫描(CECT)显示胃明显扩张,管腔内有不均匀肿块阻塞幽门。上消化道内窥镜证实诊断为毛粪。经剖腹手术切除毛痂,患者顺利康复。治疗方法以剖腹手术为主,病灶小可采用微创方法,但成功率有限。心理咨询在任何情况下都是必须的。
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引用次数: 0
Postcaeserean Surgical Site Infection at a Tertiary Care Centre in Southern Rajasthan, India 印度拉贾斯坦邦南部三级保健中心剖腹产术后部位感染
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/52891.2839
Gulshan Bano, Mohammad Mishal, Meera Jindal, Anubha Manu Prasad
Introduction: Surgical Site Infection (SSI) is one of the most common complications of postcaeserean section, which is mainly associated with increase morbidity and mortality. This is also an important cause of prolonged hospital stay, patient dissatisfaction and higher treatment cost. There is very limited data available on the incidence, outcome and clinical spectrum of postcaeserean SSI from Southern Rajasthan. Aim: The aim was to find out the frequency of SSI and variables contributing to it in women who have a caesarean section in a tertiary care centre in Rajasthan, India. Materials and Methods: This was a prospective observational study conducted over a duration of six months from June 2019 to November 2019 at SHKBM, Jhalawar Hospital and Medical College, Jhalawar, Rajasthan, India. All the women who developed postcaeserean SSI during hospital stay or within 30 days following surgery were included in the study. Demographic data and all the potential risk factors were noted. Pus samples from the infected wound were sent for culture and sensitivity. Data was presented as frequencies and percentages. Statistical Package for Social Sciences software (SPSS) version 26.0 and Epi Info Software were used for the statistical analysis. Results: A total of 1157 cases underwent caeserean section during study period, among them 53 cases had postcaeserean SSI, which gives an incidence rate of 4.5%. In present study, majority of women belonged to 21-25 years of age group 33 (62.26%), 31 (58.49%) cases were unbooked, 47 (88.67%) of SSI was seen in emergency caeserean section, and 48 (90.56%) of SSI cases had pfannenstiel incision. Anaemia (81.13%), hypertensive disorder (13.2%) and urinary tract infection (3.77%) were associated medical risk factors for SSI. There were other obstetrics and intraoperative risk factors found to be associated with postcaeserean SSI, out of them previous caesarean section was most common (56.6%). Klebsiella was the most common organism isolated. Conclusion: Infrequent antenatal visits, emergency caeserean sections, anaemia and history of previous caeserean section are the most common risk factors for SSI.
手术部位感染(SSI)是剖宫产术后最常见的并发症之一,主要与发病率和死亡率增加有关。这也是导致住院时间延长、患者不满意、治疗费用增加的重要原因。关于拉贾斯坦邦南部术后SSI的发病率、结局和临床谱的数据非常有限。目的:目的是找出在印度拉贾斯坦邦三级保健中心剖腹产的妇女发生SSI的频率和导致SSI的变量。材料和方法:这是一项前瞻性观察性研究,于2019年6月至2019年11月在印度拉贾斯坦邦贾哈拉瓦尔贾哈拉瓦尔医院和医学院SHKBM进行,为期6个月。所有在住院期间或手术后30天内发生术后SSI的妇女都被纳入研究。记录了人口统计数据和所有潜在的危险因素。感染伤口脓液样本送去培养和敏感。数据以频率和百分比表示。采用SPSS 26.0版和Epi Info软件进行统计分析。结果:研究期间共剖宫产1157例,其中术后SSI 53例,发生率为4.5%。本组以21 ~ 25岁女性居多,33例(62.26%),31例(58.49%)未确诊,47例(88.67%)SSI在急诊剖宫产术中发现,48例(90.56%)SSI有膜膜切口。贫血(81.13%)、高血压疾病(13.2%)和尿路感染(3.77%)是SSI的相关医学危险因素。其他产科学及术中危险因素与剖宫产术后SSI相关,其中既往剖宫产最为常见(56.6%)。克雷伯菌是最常见的分离菌。结论:产前检查次数少、急诊剖宫产、贫血和既往剖宫产史是SSI最常见的危险因素。
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引用次数: 0
Imaging in Multisystem Complications of COVID-19 associated Coagulopathy: An Interesting Case Series 新冠肺炎相关凝血功能障碍多系统并发症的影像学研究:一个有趣的病例系列
Pub Date : 2022-01-01 DOI: 10.7860/ijars/2022/56258.2846
A. Bala, S. Venkataraman, Jenikar Paulraj, Sai Gopalakrishnan, H. Balaganesan
The ongoing global threat of Coronavirus Disease 2019 (COVID-19) has been an issue of escalating concern due to its propensity to cause increased morbidity and mortality. Extensive reports have emphasised chest imaging findings in patients with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection leading to a greater understanding of pathogenesis in the lung. There is also an added lurking pernicious propensity of the virus to cause a distinct coagulopathy attributing to the increased virulence. Further, radiologists should be aware of thromboembolic imaging findings in patients with SARS-CoV-2 infection. In this case series, authors present six cases of SARS-CoV-2 infection confirmed on nasopharyngeal Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests presenting with various systemic thromboembolic complications. The purpose of this case series is to explore diverse imaging findings in patients with COVID-19 coagulopathy.
2019年冠状病毒病(COVID-19)的持续全球威胁已成为一个日益令人担忧的问题,因为它有可能导致发病率和死亡率上升。大量报道强调了严重急性呼吸综合征冠状病毒-2 (SARS-CoV-2)感染患者的胸部影像学发现,从而更好地了解了肺部的发病机制。由于毒力的增加,该病毒还有一种潜在的有害倾向,即引起明显的凝血功能障碍。此外,放射科医生应了解SARS-CoV-2感染患者的血栓栓塞成像结果。在本病例系列中,作者报告了6例经鼻咽逆转录聚合酶链反应(RT-PCR)试验证实的SARS-CoV-2感染病例,并伴有各种系统性血栓栓塞并发症。本病例系列的目的是探讨COVID-19凝血病患者的各种影像学表现。
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引用次数: 0
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International Journal of Anatomy Radiology and Surgery
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