1.The Features of Crush Maxillofacial Fractures in the 5·12 Massive Wenchuan Earthquake: Evaluation with Multi-slice Spiral CT
Zhigang CHU ; Jianqun YU ; Zhigang YANG ; Zhihui DONG
Journal of Practical Radiology 2010;26(2):168-171
Objective To investigate the multi-slice spiral computed tomography (MSCT) features of crush maxillofacial frac-tures in the massive Wenchuan earthquake. Methods MSCT data of 85 patients with crush maxillofacial fractures caused by earth-quake were retrospectively analyzed. The anatomic distribution of fractures was evaluated. Results In 85 patients, single bone frac-tures (59 patients) were more common than multiple bone fractures (26 patients) (P<0.05). The fractures involved isolated mid-face, isolated mandible, and both were found in 49 patients (57.6%), 24(28.2%), and 12(14.2%), respectively. Midface frac-tures were most frequent (P<0.05). The fractures of condyle, posterolateral and anterior wall of maxillary sinus, zygomatic arch and lateral orbital wall accounted for 47.1%(24/51) ,41.5%(22/53) , 37.7%(20/53),71.9% (23/32) and 63.2%(24/38) of the total fractures of the corresponding maxillofacial bones. Conclusion Isolated bone fracture and midface factures are the main fea-tures of crush maxillofacial fractures resulted from the massive earthquake. MSCT and three-dimensional reconstruction images can demonstrate maxillofacial fractures well.
2.Clinical value of ECG-gated dual-source computed tomography and angiography in assessing coarctation of aorta.
Liqing PENG ; Zhigang YANG ; Jianqun YU ; Zhigang CHU ; Dongdong CHEN ; Yi LUO
Journal of Biomedical Engineering 2013;30(1):89-94
The purpose of this study was to explore the clinical value of ECG-gated dual-source CT angiography (DSCTA) in evaluating coarctation of aorta (CoA). 23 patients suspected with CoA underwent DSCTA and transthoracic echocardiography (TTE). Surgical results were taken as reference standard. 23 patients were diagnosed with CoA, 12 cases had focal stenosis of aorta, while 11 had tubular stenosis. 19 cases were associated with other cardiovascular malformations, including 5 cases of hypoplastic aortic arch, 5 of patent ductus arteriosus, 10 of ventricular septal defect, 2 of bicuspid aortic valve, 4 of collateral arteries, 2 of aberrant left subclavian artery and 2 of persistent left superior vena cava, respectively. The mean diameter of stenotic segment of aorta was (7.0 +/- 3.7) mm. In 9 patients with tubular CoA, the diameter and length of stenotic segment of aorta were (6.2 +/- 7. 3) mm and (29.2 +/- 5.9) mm, respectively. The accuracies of DSCTA and TTE in the diagnosis of CoA were 100% and 91.3% (P > 0.05), respectively. It is well concluded that ECG-gated DSCTA could accurately evaluate CoA and associated cardiovascular malformations, and provide detailed anatomic information before surgery.
Adolescent
;
Adult
;
Angiography
;
methods
;
Aortic Coarctation
;
diagnostic imaging
;
surgery
;
Cardiac-Gated Imaging Techniques
;
methods
;
Child
;
Child, Preschool
;
Contrast Media
;
Echocardiography
;
Electrocardiography
;
methods
;
Female
;
Humans
;
Infant
;
Male
;
Tomography, X-Ray Computed
;
methods
;
Young Adult
3.Auricle reconstruction with prefabricated expanded fascial flap covered on Medpor support
Benshou ZHANG ; Zihao LIN ; Yaozhong ZHAO ; Yi SUN ; Xiangbin SHUI ; Jiale HU ; Zhigang YANG ; Hui CHU ; Zhiming XU ; Zhijiu XU
Chinese Journal of Medical Aesthetics and Cosmetology 2010;16(3):155-157
Objective To study the methodology and effect of auricle reconstruction with prefabricated expanded fascial flap in temporal and parietal area and skin flap in mastoid area, covered on the Medpor support. Methods Thirty cases of congenital vestigial auricle were involved in this study. The operations were divided into two stages: in the stage I,the temporal and parietal superficial fascia flap was cut with a vascular pedicle in the parietal and temporal superficial area, which was implanted under the skin of mastoid, and then both layers of those were expanded at the same time; in the stage II, this fascial skin flap was cut down and covered on the whole Medpor support to rebuild the man-made auricle. Results Thirty cases were successful after following-up for 6 months to 3 years. Their auricle shapes were vivid; their skin color was normal, and it had no any difference from all around skins, or no any appearance of the support. Conclusions With best understanding the biological characteristics of the Medpor support and choosing the suitable procedures and using the prefabricated expanded support, we could minimize the surgical complications in this operation. The results show that this procedure is satisfactory, without any necrosis of flap, swelling of contour, or appearance of the support. The combination of two flaps is the best method for the auricle reconstruction.
4.MDCT and MRI findings of localized Castleman's disease and its pathological basis.
Xueming LI ; Jianqun YU ; Dongdong CHEN ; Yi LAO ; Liqing PENG ; Zhigang CHU
Journal of Biomedical Engineering 2012;29(1):70-96
To evaluated the multi-detector CT (MDCT) and magnetic resonance imaging (MRI) features of localized Castleman's disease (CD), we retrospectively analyzed the clinical data, MDCT and MRI findings of 13 patients with CD proved pathologically. All patients underwent plain MDCT scan, 11 underwent enhanced CT, and 2 MRI. 14 lesions were detected in the 13 patients, and all of them were hyaline-vascular type (HV-CD) histopathologically. On plain MDCT scans, all lesions were homogeneously attenuated soft tissue mass; intra-tumoral calcification with punctate and "arborizing" patterns was detected in the center of 2 lesions each. Of the patients with enhanced MDCT, all lesions showed obvious enhancement homogeneously except two lesions with central stellate and 1 lesion with dotted low attenuation. Tortuous vessels could be revealed at the periphery of 8 lesions. Of the 2 patients with MRI, the lesions showed slightly hyper-intensity on T1WI, hyper-intensity on T2WI and marked homogenous enhancement. In addition, one of them showed signal void appearance in the center on unenhanced MRI and large supplying artery with tortuous vessels at the periphery on enhanced MRI. In a word, Localized HV-CD usually demonstrated as soft tissue mass with obvious enhancement on MDCT and MRI. Central stellate area of low attenuation and calcification with punctate or "arborizing" pattern may also be present.
Adolescent
;
Adult
;
Castleman Disease
;
diagnosis
;
diagnostic imaging
;
pathology
;
Female
;
Humans
;
Image Enhancement
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Multidetector Computed Tomography
;
Retrospective Studies
;
Young Adult
5.Percutaneous occlusion of left atrial appendage in experimental canine models:the establishment of the delivery pathway
Zhigang ZHANG ; Changyong LI ; Hongwen TAN ; Guojun CHU ; Yufeng ZHU ; Yuan BAI ; Xudong XU ; Wenfeng XIONG ; Xinmiao HUANG ; Xianxian ZHAO ; Hong WU ; Yongwen QIN
Journal of Interventional Radiology 2014;23(10):897-900
Objective To evaluate the feasibility and safety of a delivery pathway for the performance of percutaneous left atrial appendage (LAA) occlusion in experimental canine models. Methods Transseptal puncture was performed via femoral vein approach under fluoroscopic and angiographic guidance in 12 experimental dogs. A pigtail catheter was advanced into the left atrium (LA), which was followed by LA angiography. The diameters of the neck of LAA were measured on LAA angiogram obtained in appropriate projection. After the delivery sheath was advanced along the wire into LA, a pigtail catheter was inserted into the ostium of the LAA and the sheath was then advanced over the pigtail into the LAA. LAA angiography was then performed through the delivery sheath to confirm the position of the delivery sheath. One hour after the procedure both electrocardiography (ECG) and transthoracic echocardiography (TTE) were carried out in five dogs to check the results, immediately after which the five dogs were sacrificed to macroscopically observe the damages of the puncture site of inter-atrial septum as well as inside the LA and LAA. One hour and 2 weeks after the procedure TTE was conducted in the remaining 7 dogs and these dogs were followed up for one month. Results One dog died of pericardial tamponade during the operation. In 8 dogs the LAA was clearly displayed in the projection position of right anterior oblique (RAO) 30°/cranial (CRA) 20°,while in 3 dogs the LAA was well visualized in the projection position of RAO 30° , and in one dog in the projection position of RAO 30°/caudal (CAU) 20°. The diameter of LAA neck was (13.6 ± 5.2) mm. The delivery sheath was safely advanced into the LAA along the pigtail catheter in all dogs, and no air embolism, thrombus or pericardial tamponade occurred. Hematoma at puncture point of groin occurred in 2 dogs, which was absorbed through pressure dressing. Macroscopic examination of the heart performed immediately after the operation showed that no bloody pericardial effusion was found, and mild hematoma at posterior wall of LA was seen in one dog and mild damage of the upper-margin intima of LAA was noted in 2 dogs. The mean fluoroscopy time was (10.1 ± 2.5) minutes and the mean operation time was (58 ± 12) minutes. TEE showed no pericardial effusion 2 weeks after the procedure. During the follow-up period of one month no sudden death, stroke or infection occurred. Conclusion This method of placing the delivery sheath into the LAA is clinically safe and effective, and it can reliably establish a pathway to advance the LAA occluder into LAA.
6. Observation on clinical effects of recombinant human growth hormone on the treatment of children with severe burn
Zhigang CHU ; Ze LI ; Aihua WANG ; Qiongfang RUAN ; Hong WU ; Jingjing RUAN ; Weiguo XIE
Chinese Journal of Burns 2018;34(8):522-525
Objective:
To observe the clinical effects of recombinant human growth hormone (rhGH) on children with severe burn.
Methods:
Clinical data of 94 children with severe burn, hospitalized in our burn unit from April 2012 to December 2016, conforming to the study criteria, were retrospectively analyzed. According to the use of rhGH, children were divided into rhGH group (
7.CT diagnosis of isolated pulmonary nodules in patients with a history of malignant tumor
Wangjia LI ; Fajin LYU ; Yan ZHANG ; Yineng ZHENG ; Zhigang CHU
Chinese Journal of Thoracic and Cardiovascular Surgery 2019;35(7):390-395
Objective To analyze the CT features of solitary pulmonary nodules(SPN) in patients with malignant tumor with the aim of improving its diagnosis and differential diagnosis in this special background .Methods From May 2014 to De-cember 2018, the CT data of 76 pathologically confirmed SPNs in patients with malignant tumor were retrospectively analyzed . The CT features of SPNs, including density, morphology and change of peripheral lung field and adjacent structures, were mainly analyzed.The characteristics of different types of nodules and their differences were summarized .Results Among the 76 SPNs, there were 41(53.9%) primary lung cancers, 14(18.5%) metastatic tumors, and 21(27.6%) benign lesions(in-cluding 12 inflammatory nodules, 7 tuberculous nodules and 2 benign tumors).Of all nodules, there were 57(75%) solid nodules, including 23(40.4%) primary lung cancers which mainly manifested as nodules with rough margin , close to adjacent vessel and bronchus and usually had internal or edge features(19, 82.6%), 14(24.6%) metastatic tumors which mainly showed as round or oval, homogeneous density, smooth margin nodules(12, 85.7%), and 18(31.6%) inflammatory nodules which mainly showed as lesions with rough and blurred margin accompanied by peripheral patch or fibrosis (14, 77.8%). There were 19(25%) sub-solid nodules, including 18(94.7%) primary lung cancers, which mainly manifested as nodules with heterogeneous density and clear border(14, 77.8%).There was only 1(5.3%) sub-solid inflammatory nodule.Conclu-sion The pathological nature of SPNs in patients with malignant tumors is various .Understanding their CT characteristics is helpful for diagnosing and differentiating and providing useful information for further treatment .
8.Clinical characteristics of elderly patients with coronavirus disease 2019
Zhigang CHANG ; Xin CHU ; Yongke ZHENG ; Yigang ZHONG ; Li WEN ; Ping ZENG ; Guifang ZHANG ; Chunyi FU ; Xunliang TONG ; Yunfei LONG ; Jing LI ; Aihua LIU ; Yalin LIU ; Huan XI
Chinese Journal of Geriatrics 2021;40(2):147-152
Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.
9.Exploration of the online and offline mixed teaching mode of Medical Imaging
Juan PENG ; Fajin LÜ ; Yongmei LI ; Zhigang CHU ; Haitao YANG
Chinese Journal of Medical Education Research 2022;21(2):168-171
Based on the online course of Medical Imaging, the online and offline mixed teaching mode is an important reform against the traditional teaching mode. Combining the teaching reform experience of Chongqing Medical University, this paper introduces the resource construction of the online teaching platform of Medical Imaging, the construction of the online and offline mixed teaching mode (including the overall reconstruction design of the online and offline teaching content, and the organic integration of the online and offline teaching content before, during and after class), the details of teaching implementation (taking ischemic cerebral infarction as an example), the teaching efficiency, the existing problems and related improvement measures. The preliminary practice shows that it has great significance in enhancing the teaching quality since it can break through time and space constraints, expand teaching space, effectively stimulate students' learning autonomy, enhance their practical skills, increase the communication and interaction between teachers and students, and improve the teaching effect.
10.Experimental study of transcatheter aortic valve implantation assisted with snare to fix the delivery system.
Xiang CHEN ; Yufeng ZHU ; Hongwen TAN ; Zhigang ZHANG ; Ben ZHANG ; Feiyu WANG ; Guojun CHU ; Li SHEN ; Liping MA ; Xianxian ZHAO ; Yongwen QIN ; Junbo GE
Chinese Journal of Cardiology 2014;42(10):873-877
OBJECTIVETo evaluate the feasibility and effectiveness of transcatheter aortic valve implantation assisted with snare to fix the delivery system.
METHODSThis study was made in 5 healthy goats. After the abdomen was opened and the abdominal aorta was exposed, a stiff guide wire was advanced into the apex of the left ventricle through abdominal arterial puncture points. The delivery catheter equipped with valved stent was inserted into the descending aorta under fluoroscopy along the stiff guide wire. A minimal thoracic surgery approach was used to access the apex of the heart. A J-type guidewire and 5 F multifunction catheter were placed transapically and across the aortic valve down to the descending aorta. The snare was introduced through the 5 F catheter into the ascending aorta and was controlled to seize the head of stent delivery catheter. Then the delivery catheter was advanced into the left ventricle. The valved stent was positioned in the desired position under aortography and then the balloon was dilated and the valved stent was deployed into the aortic annulus assisted with snare to fix the catheter to prevent stent dispositions. Aortic angiography and echocardiography were performed to evaluate of valve performance post procedure.
RESULTSThe interventional procedure was completed successfully in all 5 goats. The mean aortic annulus diameter was (23.8 ± 2.6) mm, two valved stent of 23 mm diameter and three valved stent of 26 mm in diameter were implanted. The operation duration and X-ray exposure time were (112.3 ± 19.5) min and (16.8 ± 5.2) min, respectively. Immediate observation after procedure showed that the valved stents were in the desired position after implantation by angiography and echocardiography. No moderate to severe aortic regurgitation was observed. All goats were alive at 1 month post procedure.
CONCLUSIONSThe procedure of transcatheter implantation of a balloon-expandable valved stent into the aortic valve position of goats assisted with snare to fix the delivery catheter is feasible and effective. This procedure might be suitable also for patients with noncalcified aortic stenosis.
Animals ; Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Catheterization ; Echocardiography ; Fluoroscopy ; Goats ; Stents ; Transcatheter Aortic Valve Replacement