This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
Abdominal Cavity ; anatomy & histology ; Adult ; Contrast Media ; Fascia ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Kidney ; anatomy & histology ; Multidetector Computed Tomography ; Pancreatitis ; pathology ; Pelvis ; anatomy & histology ; Tomography, X-Ray Computed

Objective To define the MRI features of biliary postoperative disoders,so as to find its exact causes.Methods MRI informations of 41 patients with biliary postoperative disoders were retrospectively evaluated to find whether there were such disorders as biliary dilatation,stricture,cholangeitis,remnant stones,remnant gallbladder,etc.Results The biliary abnormality was found in thirty-eight of the 41 patients,including ductal dilatation in 20,intraductal stones in 16,cholangietis in 13,ductal stricture in 7,tumors in hepatic hila in 3.The biliary dilatation commonly presented within 3 months after operation while the biliary stricture and cholangeitis presented commonly 6 months after operation.Conclusion The biliary postoperative disoders is mainly caused by biliary dilatation,stricture and remnant stone,MRI is the sensitive and effective method for diagnosis of biliary abnormalities.

In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly presented as a large solid, well-defined and hypervascular mass with necrosis or cystic changes at some extents together with the displacement of adjacent structures. The radial area with hypointensity on T2-weighted image and with progressive enhancement on enhanced magnetic resonance imaging is an important feature of SFT, which can be helpful for the diagnosis of this mass.
Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pelvis ; pathology ; Retrospective Studies ; Solitary Fibrous Tumors ; diagnosis ; pathology ; Tomography, X-Ray Computed

Objective The rate of post -operative complications has been increased with the changes in patients' age,prolonged duration, more severe and diffused lesions, and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit ( ICU ) after coronary artery bypass graft surgery (CABG). Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital Between June 1, 2006 and December 31,2007 were divided into two groups based on their stay duration in the ICU. Prolonged stay in ICU was defined as 5days or more. Univariate and multivariate analysis ( logistic regression) were used to identify the risk factors. The discrimination and calibration of the result were tested after the risk factors were determined. Results Fifty one patients had prolonged ICU stay, accounting for 3.14% of total cases. Multivariate logistic analysis showed that the age of patients, peripheral vascular diseases, critical status before operation, LVEF, operative status, mitral regurgitation, postoperative respiratory failure,postoperative renal failure, secondary thoracotomy for postoperative bleeding were associated risk factors. Conclusion Prolonged ICU stay after CABG surgery can be predicted based on the above factors. For patients with these risk factors, more pre-and postoperative care strategies are needed.

Although selective coronary angiography is a golden standard for diagnosing coronary artery diseases, it is expensive and may cause a little danger to the patient. With the advancement of space-resolution, time-resolution and various kinds of scan techniques, the sectional image methods such as electron beam CT, multislice spiral CT and magnetic resonance imaging will be prospective non-invasive techniques to diagnose coronary artery and other heart diseases.
Coronary Artery Disease ; diagnosis ; diagnostic imaging ; Electrons ; Humans ; Magnetic Resonance Imaging ; methods ; Tomography ; methods ; Tomography, Spiral Computed ; methods ; Ultrasonography

Objective:To evaluate the therapeutic efficacy of interposition urethroplasty on glandular hypospadias and severe penile curvature.Methods:A total of 9 cases of congenital glandular hypospadias and 2 cases of congenital severe penile curvature (>30°) treated with the interposition urethroplasty technique in the Shenzhen Children′s Hospital from November 2008 to December 2019 were retrospectively analyzed.The mean age of initial surgery was 40 (25-109) months.Two cases were surgically treated with one-staged interposition urethroplasty and the remaining were treated with two-staged interposition urethroplasty.They were followed up for 8 months to 12 years, including the penile morphology, urination, urethrocutaneous fistula, urethral stricture and uroflowmetry.Continuous variables were presented as ± s deviation, Student′s t-test was used for comparison between groups. Results:The median length of interposition urethra was 3.2 (2.2-4.2) cm.The cosmetic appearance of penis was good without residual chordee, urethral stricture or urethral diverticulum in all patients.Two cases had urethrocutaneous fistula(one-staged repair and two-staged repair were performed in one case respectively), which were successfully repaired by re-operation.The maximum of uroflowmetry in patients at 3 months [(8.3±1.0) mL/s] and 6 months [(6.7±1.9) mL/s] after surgery was significantly lower than that of children in healthy control group [(10.5±3.7) mL/s] ( t=3.221, 3.864, all P<0.05). However, there was no significant difference in 1-year maximum of uroflowmetry postoperatively between surgically treated patients [(10.5±3.7) mL/s] and healthy control group ( P>0.05). Conclusions:Interposition urethroplasty is an effective and safe treatment for glandular hypospadias and/or severe penile curvature in children.

Objective:To explore the prevalence of irritable bowel syndrome (IBS) based on a community population of Shanghai and the treatment of IBS by acupuncture therapy.Methods:A population of 1 685 subjects aged between 18-80 years were randomly selected by clustered sampling from the inhabitants in Changqiao Community of Shanghai to receive a questionnaire,for understanding the symptomatology and prevalence of IBS according to modified Manning and Rome II criteria,and the voluntary IBS patients were treated by acupuncture therapy.Results:The community- based prevalence of IBS was 11.45 % and 5.04% respectively according to modified Manning criteria and Rome II criteria.The ratio of male and female was 0.77:1 in IBS patients and the proportion was 10.62% and 12.19% respectively.But there were no significant difference in prevalence between different age groups (P＞0.05) .IBS is more common in subjects aged between 45-65 years (38.86%).Regarding the 62 IBS patients treated by electroacupuncture (EA),the total effective rate in Tianshu (ST 25) group (n=32) was 84.38%,and it was 56.67% in Daheng (SP 15) group (n=30),which showed a significant difference.(P＜0.05).Conclusion:IBS is a commonly encountered disorder in Changqiao Community of Shanghai and should be taken into consideration for human welfare,disease prevention and further epidemical investigation.Acupuncture treatment is recommended for treating IBS due to its satisfactory therapeutic effect.

The present paper is aimed to observe the lateral attachment of the renal fascia (RF) in vivo with multidetector computed tomography (MDCT) scanning, and to discuss its diagnostic value. 121 healthy adults were adopted into this experiment. All images were obtained with MDCT and double phase enhancement scanning. Then we observed the lateral attachment of RF. In addition, we mad a fresh body specimen as anatomical basis. The study found that above the renal hilar plane (RHP), the anterior renal fascia laterally fused with the peritoneum of the liver on the right and the peritoneum of the spleen on the left,and the posterior renal fascia fused with the subdiaphragmatic fascia. The lateral attachment of the RF at the RHP and the lower renal pole(LRP)is divided into three types. The RF in Type I is about 47.9% (58/121) at the left RHP, while about 33.9% (41/121) at the right RHP. At the LRP of the kidney is about 55.3% (67/121) on the left, and about 42.1% (51/121) on the right. The RF in Type I is about 38.8% (47/121) on the left side at the RHP, about 26.4% (32/121) on the right side. At the LRP, left side about 27.3% (33/121), right side about 13.3%(16/121). The RF in Type III at the RHP is 13.3% (16/121) on the left side, and on the right side is about 39.7% (48/121). At the LRP, it is about 17.4% (21/121) on the left side, and about 44.6% (54/121) on the right side. MDCT can display the lateral attachment of the RF better as well as the outside connection of the retroperitoneal space.
Adult ; Aged ; Aged, 80 and over ; Fascia ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Kidney ; anatomy & histology ; diagnostic imaging ; Male ; Middle Aged ; Multidetector Computed Tomography ; Retroperitoneal Space ; anatomy & histology ; diagnostic imaging ; Young Adult

The purpose of this study was to describe the 16-slice detector spiral computer tomography (SCT) technique and imaging features of aortic aneurysms. We analyzed 21 patients documented aortic aneurysms, that underwent unenhanced and contrast-enhanced spiral CT with a 16-slice scanner (Sensation 16), and three-dimensional reconstructions were performed for CT scan images. The results showed that: (1) Aortic dissection (11 cases), included the true and false lumen (11 cases, 100%), intimal flaps (11 cases, 100%), intimal tear (9 cases, 81.8%) and thrombosed false lumen (5 cases, 45.5%); (2) Intramural hematoma, unenhanced CT depicted crescent-shaped areas with high attenuation extending along the walls of the aorta, no definable intimal flap, while contrast-enhanced CT showed no enhancement of attenuation in the crescent-shaped areas; (3) True aortic aneurysms (7 cases), CT revealed the size, range, thrombosis and calcification of all aneurysms; (4) Pseudoaneurysms (2 cases), the enhanced part of the inhomogeneous masses beside the aorta connected with the aorta shown on contrast-enhanced CT. Therefore, 16-slice detector SCT axial and three-dimensional images can exactly reveal the pathological and anatomical features of aortic aneurysms, and provide detailed imaging information for clinical therapy.
Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; diagnostic imaging ; Aortic Aneurysm ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods ; Young Adult