5. Optimal rotation time and pitch study of CT angiography for arterial occlusive diseases of lower limbs
Academic Journal of Second Military Medical University 2010;31(2):165-168
Objective: To identify the optimal rotation time and pitch of 64-slice spiral CT angiography for arterial occlusive diseases (AOD) of the lower limbs. Methods: We performed test-bolus in eighty patients with AOD of the lower limbs (48 with intermittent claudication and 32 with ischemic rest pain or ulceration) to confirm the aortic peak time, popliteal artery peak time and aortopopliteal bolus transit time. The patients were randomly assigned to receive two sets of scan protocols for lower limb arterial 64-slice spiral CT angiography (CTA) examination (n = 40), protocol A, with a gantry rotation time of 330 ms and a pitch of 1.0; protocol B, with a gantry rotation time of 500 ms and a pitch of 0. 85. Two experienced radiologists independently evaluated the image quality of the lower limb artery. Results: Great differences in the time to peak enhancement in the aorta (14-33 s) and popliteal arteries (20-48 s) and the aortopopliteal bolus transit time (4-24 s) were found between different AOD patients. Wide overlap of the time to peak enhancement and transit time was observed between intermittent claudication patients and ischemic rest pain or ulceration patients. The qualities of segment images were rated as excellent 63.3% (152/240), good 30.0% (72/240), and poor 30.0% (72/240) for protocol A, and excellent 98. 3% (234/238) and good 1. 7% (4/238) for protocol B, with no poor images in protocol B. Conclusion: 64-slice CTA with a gantry rotation time of 500 ms, a pitch of 0. 85, scan time>30 s, and with the contrast agent injection time maintained at 35 s, can obtain better image of lower limb arteries in patients with AOD of the lower limbs.
7.Manual reduction of children's Monteggia fractures associated with anterior interosseous nerve injury.
China Journal of Orthopaedics and Traumatology 2014;27(10):862-865
OBJECTIVETo study clinical results of the manual reduction in treatment.
METHODSFrom October 2010 to April 2013,39 children with Monteggia fracture associated with anterior interosseous nerve injury were treated by manual reduction and fixation on buckling rotation backward,including 17 females and 22 males with an average age of 6.3 years old ranging from 3.2 to 11 years old. Among them, 15 cases were on the right side and 24 cases on the left. The course of disease was 40 minutes to 8 days (averaged 1.5 days). There were 7 cases with skateboard injured, 13 cases with stumble injured, 11 cases with falling injured,8 cases with air bed injured. According to Bado classification, 13 cases were type II, 22 cases were type III, 4 cases were type IV.
RESULTSThe distal forefinger showed exercise normally in 34 cases at 3 weeks after treatment, and the patients restored normal activities at 6 weeks after treatment. All patients were follow-up from 54 days to 6 months (averaged 67 days. According to Mayo elbow functional evaluation standard,the scoring result was 19.62±1.35 in activity, 45.00 ± 0.00 in pain, 9.87 ± 0.80 in stability, 25.00±0.00 in strength, 99.49 ±1.92 in total. The outcome of all patients was excellent and good evaluation results.
CONCLUSIONIf the anterior interosseous nerve injury could be identified early and treated timely, patients could gradually restore reasonable function and recover with satisfactory results. Raising understanding of anterior interosseous nerve injury can effectively reduce misdiagnosis.
Arm Bones ; injuries ; innervation ; surgery ; Child ; Child, Preschool ; Female ; Forearm Injuries ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Median Nerve ; injuries ; Monteggia's Fracture ; surgery
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