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 Adverse reactions to Gd-DTPA contrast media should be noticed enough.Methods Three cases of adverse reactions to Gd-DTPA contrast media were studied, and literatures were reviewed.Results The rate of adverse reactions to Gd-DTPA contrast media in our hospital was 0.206%.Conclusion Although the rate of adverse reactions to Gd-DTPA contrast media is very low, this problem must be noticed enough with the medical quality’s developement.

Objective To observe and measure the facial nerve canal(FNC) in curved planar reformation by multislice spiral CT.Methods High resolution computed tomography (HRCT)of temporal bone was performed in 40 cases (80 ears) by multislice spiral CT. Curved planar reformation of FNC was performed separately in axial, coronal and sagittal plane of multiplanar reconstruction. The morphology and measurement of FNC were studied.Results The mean length of FNC was (29.73?1.07)mm. The mean length of the labyrinthine, tympanic and mastoid segment was (5.6?0.74)mm, (10.66?0.79)mm and (13.47?1.01)mm respectively. The mean diameter of the l-abyrinthine, geniculate fossa, tympanic and mastoid segment was (0.76?0.16)mm, (2.37?0.63)mm, (1.03?0.16)mm and (1.57?0.31)mm respectively. The mean angle of first and second genu was 67.04??9.41? and 114.25??8.44? respectively. The distance between the tympanic segment and ampulla of the lateral semicircular canal was (0.57?0.19)mm. The distance between the tympanic segment and arch of the lateral semicircular canal was (1.59?0.61)mm. The mean angle between the tympanic segment of the facial nerve canal and the lateral semicircular canal was 10.63??3.60?. The tympanic course of the facial nerve canal formed an angle of 34.65??5.39? with the sagittal plane. Dehiscences was found in 89% FNC, 73.7% of them only located in the tympanic portion and 26.3% both in the mastoid and tympanic portions. Conclusion Curved planar reformation of FNC by multislice spiral CT is the good method to study the anatomy of FNC,and in combination with HRCT axial scan and multiplanar reconstrution can obtain more valuable information.

Objective To investigate the diagnostic value comparatively of CT and radiography in pneumoconiosis.Methods Chest radiographic and CT images were analyzed retrospectively in 52 cases with pneumoconiosis.Results The pulmonary disseminated small shadowes (diameter 10 mm),13 cases and 9 cases were detected by CT and radiography respectively.20 cases (5 pneumonia,3 pulmonary tuberculosis,1 lung cancer,6 pneumothorax,4 pulmonary emphysema) and 10 cases (1 pneumonia,1 pulmonary tuberculosis,6 pneumothorax,2 pulmonary emphysema) with complications were showed by CT and radiography respectively.Conclusion CT is not superior to radiography in diagnosis of simple pneumoconiosis,but CT is superior to radiography detecting the big shadow of lung and complications,and it can help radiologists to avoid mistakes.

Objective To study the facial nerve canal (FNC) abnormalities of the congenital external auditory canal (EAC) atresia by MSCT curved planar reformation (CPR).Methods 15 cases(17 ears) of congenital EAC atresia were scanned by MSCT. Post-processing images were completed by Philips Mx8000 workstation.Results In 17 ears, there were 2 ears with stenosis of EAC, 2 ears with membranous atresia of EAC and 13 ears with bony atresia of EAC.There were 1 ear with congenital cholesteatoma, 3 ears with malformation of tympanum, 7 ears with malformation of the ossicular chain and 1ear with malformation of inner ear. In 17 ears with abnormalities of FNC, included 11 ears with the shortness of FNC general length, 5 ears with the anomalous course of FNC, 9 ears with the displacement of FNC, 1 ear with the narrowing of FNC and 1 ear with the branch of FNC.Conclusion MSCT CPR of FNC, combined with HRCT axial scan, can clearly show the FNC abnormalities of the congenital EAC atresia and provide valuable information for surgery.