Objective To explore the value of HRCT and contrast-enhanced MRI in diagosis of facial nerve injuries.Methods HRCT and contrast-enhanced MRI were performed in 18 cases of facial nerve injuries.CPR of the facial nerve and canal was performed on the Philips EBW workstation,and the temporal bone involved location,fracture type and involvement of facial nerve and canal and its course were observed.The involved location,size,signal variation of facial nerve were analyzed compared with contralateral side on the GE AW 4.5 workstation.Results Among 18 cases,8 cases of longitudinal fractures,5 cases of transverse fractures and 5 cases of mixed fractures were found.HRCT axial scan and CPR of facial canal revealed that 18 cases had temporal bone fractures,including 1 case of labyrinthine segment,2 cases of geniculate fossa,4 cases of tympanic segment,2 cases of geniculate fossa,tympanic segment and hematoma of middle ear cavity,3 cases of tympanic segment with adjacent hematoma of middle ear cavity and 6 cases without obvious fracture of facial canal.Contrast-enhanced MRI and CPR of facial nerve revealed facial nerve injuries in all 18 cases,including 12 cases of internal auditory meatus segment,14 cases of labyrinthine segment,18 cases of geniculate ganglion,16 cases of tympanic segment and 15 cases of mastoid segment.Signal intensity ratio of affected internal auditory meatus segment,labyrinthine segment,geniculate ganglion,tympanic segment and mastoid segment were higher than those of contralateral side (all P＜ 0.001).Conclusion HRCT and contrast-enhanced MRI can clearly reveal the involvement of different segment of traumatic facial nerve,HRCT CPR and MR CPR are helpful to visualiz the involvement of traumatic facial nerve and canal.

Objective To explore the value of HRCT for the diagnosis of internal ear injuries caused by temporal bone trauma.Methods Totally 106 patients with temporal bone trauma were scanned by HRCT,and 12 patients with internal ear injuries were collected.MPR of temporal bone (cochlea,vestibule,horizontal semicircular canal,anterior semicircular canal and posterior semicircular canal) was performed on Philips workstation.The locations,types,and the involving structures were observed.Results Among the 106 cases of temporal bone trauma,12 cases were internal ear injuries,including 8 cases of fractures of inner ear,3 cases of pneumolabyrinth,and 1 case of foreign body in the cochlea,which 3 cases complicated with traumatic labyrinthine ossification.Conclusion HRCT and MPR can clearly reveal internal ear injuries,which are effective methods for diagnosis of internal ear injuries.

Objective To explore the application value of contrast-enhanced MRI and curved planar reformation (CPR) in diagnosis of facial neuritis.Methods Contrast-enhanced MRI scans were performed on 30 patients with facial neuritis.The involvement of intracranial facial nerve was observed,and the signal intensity of facial nerve and adjacent temporal lobe was measured with GE AW 4.5 workstation.While the signal intensity ratio (SIR) between facial nerve and adjacent temporal lobe was calculated.CPR of facial nerve was done with Philips EBW workstation,in order to observe the whole course and involvement of facial nerve.Results Among the 30 patients,SIR of affected geniculate ganglion,tympanic segment,labyrinthine segment,internal auditory meatus segment and mastoid segment was 1.59±0.28,1.16±0.16,1.38±0.20,1.30 ±0.19 and 0.96±0.14,respectively.While SIR of the relevant segment in contralateral side was 1.08±±0.19,0.74±0.13,0.81±0.13,0.83±0.08 and 0.69±0.12,respectively.There were significant differences of SIR between the affected and the contralateral segments (all P＜0.001).CPR could display the involved location and facilitate visualizing the whole course of facial nerve clearly.Conclusion Contrast-enhanced MRI and CPR are helpful to facilitate visualizing the whole course of facial nerve and clearly reveal the involvement.

OBJECTIVETo explore the anatomic basis and clinical application of the horn shaped perforator flap pedicled with the angular artery for the reconstruction of midface defect.

METHODS(1) 10 fresh cadavers were perfused with a modified guiding oxide gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise' s interactive medical image control system, MIMICS). The origin and distribution of the angular artery perforator were observed. (2) Between July 2012 and July 2014, twenty-one patients underwent operations for the reconstruction of midface defect. Ten patients had squamous cell carcinoma, nine patients had basal cell carcinoma and two patients had nevus. The flaps' size ranged from 1.5 cm x 3.5 cm to 2.5 cm x 5.0 cm.

RESULTSThe facial artery branches the lateral nasal artery 1 cm from the outside corner of the mouth, subsequently strenches to inner canthus continuing as the angular artery. The angular artery anastomoses extensively with the dorsal nasal artery and the infraorbital artery. All the flaps survived. The patients were satisfied with the final aesthetic and functional results.

CONCLUSIONSThe flap can be designed flexibly and simply with reliable blood supply. The donor sites could be closed directly without skin graft, it is a simple and fast method for the reconstruction of midface defect.

Anastomosis, Surgical ; methods ; Arteries ; anatomy & histology ; Cadaver ; Carcinoma, Basal Cell ; surgery ; Carcinoma, Squamous Cell ; surgery ; Face ; blood supply ; Facial Neoplasms ; surgery ; Humans ; Nevus ; surgery ; Nose ; blood supply ; Perforator Flap ; blood supply ; transplantation ; Skin Neoplasms ; surgery ; Skin Transplantation ; Software ; Tomography, Spiral Computed

OBJECTIVETo study the anatomy basis for the clinical application of the adjacent horn shaped perforator fasciocutaneous flap for the reconstruction of small and medium-sized defects in the trunk area.

METHODS(1) Ten adult antiseptic cadavers (20 sides) were perfused with red latex. The skin blood supply, line of the blood vessels, branches in accordance with the distribution and crossing were observed. (2) Fifteen cases with defects in the trunk were treated with the adjacent horn shaped perforator fasciocutaneous flaps. The defects size ranged from 5 cm x 5 cm to 13 cm x 13 cm with the size of the flaps ranging from 10 cm x 6 cm to 35 cm x 15 cm.

RESULTSThe trunk skin is supplied by mainly 17 groups arteries such as thyrocervical trunk, internal thoracic artery, posterior intercostal arteries, superior epigastric artery, arteria epigastrica inferior, lumbar arteries, and so on. The perforators (diameter > 0.5 mm) numbers are about 20, 40, 24, 6, on the chest, abdomen and perineum, upper back, waist, respectively. All the flaps survived completely with primary healing both on donor and recipient sites. The flaps color, texture, function and appearance were satisfactory during the follow-up period of 1-24 months.

CONCLUSIONSThe adjacent horn shaped perforator fasciocutaneous flap should be designed flexibly. The defects in the donor sites could be closed directly without skin graft. It is an effective, easy and ideal method for the reconstruction of large defects in the trunk.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Perforator Flap ; Skin Transplantation ; Torso ; surgery ; Young Adult

Objective To study MR imaging features of transient bone marrow edema syndrome of the hip so as to improve its diagnosis and differential diagnosis.Methods MR images of transient bone marrow edema syndrome of the hip in 13 patients were retrospectively analyzed in combination with literature review.Results The bilateral hips were affected in 4 patients.The single hip was affected in 9 patients,left hip in 6 and right hip in 3.The MR images demonstrated low signal intensity in all 13 patients on T1WI,and normal signal intensity in 2 patients,moderate or high signal intensity in 11 patients on T2WI,and high signal on T2 fat suppressed or STIR images in all 13 patients.The bone marrow edema pattern involved the femoral head and neck in 13 hips,the femoral head and neck and the intertrochanteric region in 4 hips.A small joint effusion was observed in 8 hips on T2WI.The configuration of femoral heads were normal.Conclusion Correct judgement of MRI manifestations of transient bone marrow edema syndrome of the hip can improve its diagnosis and differential diagnosis.

Objective To explore the high-resolution CT manifestation of chronic otitis media with cholesteatoma. Methods clinical and high-resolution CT manifestation of 31 cases of chronic otitis media with cholesteatoma were analyzed. All the cases were confirmed by operation and pathology. Results High-resolution CT can accurately show the signs of soft-tissue occupancy and bony-erosion of cholestcatoma in middle ear which originate from various sites and of various sizes.confirmed by operation, accuracy were as high as 93.5%-100% . Conclusion high-resolution CT is extremely accurate in diagnosis of chronic otitis media with cholesteatoma.

0.05).The values and ages were positive correlation before age 25(r=0.71～0.91,?0.05).Four main patterns of marrow distribution were identified in the proximal femur.Our data implied that there was progressive marrow fat distribution with age.The diaphyseal red marrow began to convert to yellow marrow after 5 years old and the conversion completed at age of 10.Foci of longer T 1 signals were found in the diaphysis in some of the subjects and the percentage increased with age.The femoral head and the greater trochanter showed yellow marrow signals after ossification.Conclusion Measurement of MRI signal intensity values could be used in evaluating the conversion of red to yellow marrow of the femur.Red and yellow marrow of femur may be distinguished by MRI.We should notice the different MRI feafure in different ages.

Objective To study the findings of CT and MRI in tongue cancer.Methods 21 cases of tongue cancer were examined by CT or MRI,CT examined 7 cases,MRI examined 14 cases.Results MRI could display the tongue cancer in all the cases,but CT only display 5 of 7 cases of the tumour.The value of CT and MRI was same in displaying soft tissue direct invasion.MRI and contrast enhanced CT could display cervical lymph node metastases.CT was superior to MRI in the diagnosis of mandible invasion.Conclusion MRI is superior to CT in the display soft tissue of tongue cancer and the metastases.CT is optimal in detection of cortical bone invasion.

Objective To measure the dimension and area of the brainstem on MR images in healthy adults and to study the relationship between age, sex and the size of the brainstem.Methods The dimensions and areas of the brainstem in 360 healthy volunteers on midsagittal MR images were measured. There were 180 males and 180 females, ranged in age from 20～87 years old. Results The average antero-posterior(AP) distances and areas of the midbrain were the largest at the 20～29 years old, and decreased slightly over 60 years. The average AP distance, vertical distance and area of the frontal pontine and pontine were no significant difference between different age groups, but there were significant difference in sex. The average upper diameter and area of the medulla oblongata were significant difference in partial age groups, and there was difference in sex (?