目的 探讨成年人颅骨表面遮盖重建（SSD）的理想阈值设定，为利用SSD进行的头部CT血管成像（CTA）去骨成像提供阈值设定的依据。 方法 选取2012年8月，在成都市第一人民医院体检的、同一单位工作的86位体检对象，进行颅骨平均CT值、腰椎骨质密度、性别及年龄的两两对照及多重线性回归拟合，建立起预估颅骨平均CT值的多重线性回归方程，计算出18～80岁人群的理论平均颅骨CT值作为SSD的理想阈值。同时收集2012年10月－2013年2月在该院进行头部CTA检查的12例患者的相关资料以验证其可行性。 结果 18～80岁人群的理论平均颅骨CT值约为640 Hu。以该值作为SSD的阈值进行去骨成像，所有患者图像质量评分均为5分，可视为去骨成功。 结论 在利用理论颅骨平均CT值作为重建阈值的基础之上，通过简单的SSD图像质量再判断及修正，即可简便地完成后处理工作，具有可行性。
目的:探讨综合护理干预对头部伽玛刀治疗患者负性情绪的影响。方法: 将80例进行伽玛刀治疗的颅内病变患者随机分为干预组和对照组各40例,干预组实施综合性护理干预,包括心理护理、健康教育、社会家庭支持、伽玛刀专科护理等,对照组按伽玛刀治疗护理常规进行,分别与入院第1日及治疗前1h、治疗过程中用SAS焦虑自评量表和VAS恐惧测定量表进行评分。结果:干预组的负性情绪程度明显低于对照组,差异有统计学意义(Plt;0.01)。结论:头部伽玛刀治疗患者存在一定程度的情绪障碍,综合护理干预可明显缓解患者的负性情绪。
ObjectiveTo identify the clinical significance of epileptic eye movement for localization of posterior epileptic seizures. MethodsThere were 12 posterior epileptic patients, who were undertaken the detailed presurgical evaluation and ictal SEEG recording, and the epileptogenic zone of whom was confirmed restricted within posterior cortex through the boarder of epileptic cortical resection and the result of epileptic surgery, included in the research. ResultsThe cluster analysis of posterior cortical area of interest showed that parieto-occipital sulcus (POS) with the adjacent cortical areas belonged to the Medial Group; intraparietal sulcus (IPS) with the adjacent areas belonged to the Intermediate Group; and the Lateral Group included anterior occipital sulcus (AOS) and posterior temporal cortex. Eyes forced stare had the significant correlation with IPS, POS and related cortical group. Contraversive eye deviation had no significant correlation with cortical eye field with the related cortical areas. ConclusionsForced eye stare was significant eye movement in posterior epilepsy, and had significant correlation with IPS and POS. Ipsiversive eye deviation and convergence binocular movement were rare semiology in posterior epilepsy, and AOS had significant correlation with the two type of epileptic eyes movement.
ObjectiveTo investigate the value of head boneless CT angiography (CTA) for surface shaded display (SSD) (hereinafter referred to as the SSD-CTA technology) and volume computed tomographic digital subtraction angiography (VCTDSA) in diagnosing intracranial aneurysms. MethodsWe collected the clinical data of 35 patients diagnosed to have intracranial aneurysm by VCTDSA between April 2013 and November 2014 from the First Affiliated Hospital of Chongqing Medical University. The original data were imported into the CT workstation of the First People's Hospital of Chengdu. Then, SSD-CTA technology was performed for bone reconstruction. We compared the results of these two technologies. In addition, we selected another 27 patients diagnosed with intracranial aneurysm by SSDCTA and DSA examination at the same time between June 2012 and November 2014 in the First People's Hospital of Chengdu for comparison. ResultsThe quality score of SSD-CTA reconstructed image was lower than that of VCTDSA, but the diagnosis of the two technologies for intracranial aneurysm was not statistically different (P>0.05). Compared with DSA, the sensitivity and specificity of the diagnosis for intracranial aneurysms by SSD-CTA were both 100%. ConclusionSSD-CTA is valuable in diagnosing intracranial aneurysms.
The validated finite element head model (FEHM) of a 3-year-old child, a 6-year-old child and a 50th percentile adult were used to investigate the effects of head dimension and material parameters of brain tissues on the head rotational responses based on experimental design. Results showed that the effects of head dimension and directions of rotation on the head rotational responses were not significant under the same rotational loading condition, and the same results appeared in the viscoelastic material parameters of brain tissues. However, the head rotational responses were most sensitive to the shear modulus (G) of brain tissues relative to decay constant (β) and bulk modulus (K). Therefore, the selection of material parameters of brain tissues is most important to the accuracy of simulation results, especially in the study of brain injury criterion under the rotational loading conditions.
ObjectiveTo explore the value of duodenum-preserving pancreatic head resection for benign lesions in pancreatic head. MethodsClinical data of 14 patients with benign lesions in pancreatic head who were underwent duodenum-preserving pancreatic head resection from Jan. 1995 to Dec. 2012 were retrospectively analyzed, to explore the value of the surgery. ResultsAll surgeries of the 14 patients were success. The operation time were 4.0-6.5 hours (5.2 hours on average), the intraoperative blood loss were 100-1 000 mL (450 mL on average). Postoperative complications happened in 3 patients (21.4%), including pancreatic fistula in 2 patients and biliary fistula in 1 patient, which were cured with non-surgical treatment. No deaths happened during surgery and hospitalization. Of the 14 patients, 13 patients were followed-up for 6 months to 2 years with no recurrence, diabetes, postoperative gastric emptying disorders, and other long-term complications happened. ConclusionDuodenum-preserving pancreatic head resection is the safe and effective treatment of benign lesions in the head of pancreas.
ObjectiveTo explore the clinical value of SEEG-guided radiofrequency thermocoagulation therapy in patients with posterior cortex epilepsy.MethodsA case of epilepsy secondary to viral encephalitis was reported in this paper, SEEG implantation confirmed that the seizure began in bilateral posterior head, and the right posterior head was the main area of disabling lesion. After a series of complete preoperative neuropsychological assessment, the right posterior head was found to have functional retention. Therefore, we used a minimally invasive radiofrequency thermocoagulation therapy to damage epileptic foci.ResultsThe patient were followed up for 2 years after operation, the seizure frequency were significantly reduced, and the patients did not show symptoms of functional loss.ConclusionPosterior cortex epilepsy is common in neonates with brain injury. The localization and lateralization of operation is difficult because its EEG showed bilateral discharges, or the seizures start from both sides of posterior head, meanwhile, posterior head involves functional areas, which makes the operation even more difficult. This minimally invasive treatment destroys the lesion and maximizes the protection of the patient's functional areas, which provides a new surgical approach for bilateral posterior cortex epilepsy in the future, especially for symptomatic epilepsy caused by hypoxic-ischemic brain injury and encephalitis.
ObjectiveTo explored the accuracy and effectiveness of “swimming pool” sign in recognizing fluid attenuated inversion recovery sequence (FLAIR) compared with traditional methods, and to solve the difficulties in distinguishing T1 weighted image (TIWI) and FLAIR in clinical medical students and junior residents. Methods Using the observational research method, forty standardized training physicians who rotated in the Department of Neurology, West China hospital of Sichuan University were included as the research objects between September and November 2021. Standardized training physicians were randomly divided into “swimming pool” sign group and control group, with 20 persons in each group. In the same period, 100 patients with central nervous system infection, cerebral vascular disease, dementia syndrome, multiple sclerosis and no obvious intracranial lesions were selected from the Department of Neurology, West China Hospital of Sichuan University between September and November 2021. According to the diagnosis, the patients were divided into 5 groups with 20 cases in each group. Two groups were given the same 20 images respectively, including T1WI and FLAIR. Record the accuracy, total time-consuming and time-consuming per image of each standardized training physicians. Results Each patient had “swimming pool” sign. Under different backgrounds, the accuracy of the “swimming pool” sign group was higher than that of the control group (P<0.001), while the total time-consuming and time-consuming per image were lower than that of the control group (P<0.001). Conclusions In different nervous system diseases, “swimming pool” sign is stable on FLAIR. Compared with traditional methods, “swimming pool” sign can quickly and accurately distinguish T1WI and T2 FLAIR.