第九组作业
1 膝横韧带与半月板损伤间关系的MRI 研究
【摘要】目的： 探讨MRI 上膝横韧带与半月板损伤程度及位置的关系，进一步认识膝横韧带的临床意义，并为半月板损伤的诊断和治疗提供新的信息。方法： 收集288例于本院2009年1月至2010年3月行膝关节MRI 检查的病例，在MRI 上观察膝横韧带的出现情况及半月板损伤的情况，并分析膝横韧带出现率与半月板损伤程度及位置的相关性。结果： 膝横韧带在MRI 上的出现率约43.1%（124/288），其平均长度（37.5±2.75）mm ，平均宽度（2.5±1.5）mm 。膝横韧带出现率与半月板损伤程度无关（P >0.05），但与半月板损伤位置有关（P
关键词：膝关节；膝横韧带；半月板损伤；磁共振成像
MRI Study on Relationship between Transverse Ligament of Knee and Meniscus Injury
Abstract
Objective ：To explore the relationship of transverse ligament of knee and degree and position of meniscus injury on MRI.To further understand clinical significance of transverse ligament of knee and provide new information on diagnosis and treatment of meniscus injury.
Methods ：288 patients with MRI examination of knee joints between January 2009 and March 2010 was collected in our institution. Situations of transverse ligament of knee and meniscus injury were observed on MRI, the relationship between occurrence rate of transverse ligaments of knee and the degree and position of the meniscus injury was analyzed
Results ：Occurrence rate of transverse ligament of knee was about 43.1%(124/288),and the mean length was 37.5±
2..75mm, the mean width was 2.5±1.5mm. there was no relationship between occurrence rate of transverse ligament of knee and the degree of the meniscus injury(P＞0.05﹚,but there was relationship between occurrence rate of transverse ligament of knee and position of the meniscus injury(P
Conclusions ：Transverse ligament of knee are the normal anatomy connecting bilateral anterior horn of meniscuses , which helps maintaining the stability of knee joints in the movement ¸and has certain function for protecting anterior horn of meniscuses.
Keywords: knee joint; transverse ligament of knee; meniscus injury;MRI
2枕大孔区脑膜瘤的显微手术治疗
[摘要] 目的： 探讨枕大孔区脑膜瘤的临床特点、手术入路选择及手术技巧。方法： 采用显微手术治疗枕骨大孔区脑膜瘤21例，其中，肿瘤位于背侧4例、腹侧3例、腹外侧14例，背侧者选择后正中入路，腹侧或腹外侧者选择远外侧入路；在腹外侧肿瘤中根据与椎动
脉关系分为肿瘤在椎动脉下方（7例）、椎动脉上方（4例）、椎动脉上下（3例）。结果： 本组资料全切肿瘤17例（81%），次全切除1例（椎动脉上下型）、部分切除3例（2例为椎动脉上下型、1例为椎动脉上型）；不全切除者术后行 -刀治疗；无手术死亡，随访期内无肿瘤复发；临床症状改善的16例，保持原有症状的3例，加重的2例。结论： 枕大孔区脑膜瘤的临床症状无特征性，术前的分型有助于手术入路的选择和判断手术效果。
[关键词] 枕大孔； 肿瘤 ；正中入路 ；外侧入路
Foramen magnum area of meningiomas microsurgery treatment
[Abstract]Objective: explore foramen magnum area of clinical characteristics, surgical approach choice and surgical techniques
Method: adopt microsurgery for foramen magnum area 21 cases among them this is located in dorsal 4 cases, the ventral 3cases, abdominal lateral 14 cases. After selecting the right in the middle of the dorsal into road, the ventral or those who are outside the abdominal choose far lateral approaches; In the abdomen lateral tumor according to the relationship with vertebral artery into tumor in vertebral artery below (7cases), vertebral artery above (4cases), vertebral artery side (3 cases)
Result: the material total resection of the tumor 17 cases (81%) and subtotal resection is partial resection in 3 cases (2 cases of vertebral artery side and 1 case of vertebral artery above).TVSH of patients after the γ–knife therapy. Clinical symptoms improved patients(16cases), and maintain the original symptom patients 3 cases, symptom aggravating patients in 2 cases.
Conclusion: magnum area of clinical symptoms no marked, preoperative parting help surgical approach choice and judgment operation effect.
Keywords: foramen magnum tumor, midline approaches, lateral approaches.
3 双源CT 血管成像在Willis 环区动脉瘤诊断及治疗中的应用
[摘 要] 目的：探讨双源CT 血管成像（DSCTA ）在Willis 环区动脉瘤的诊断、分型及介入栓塞治疗中的临床应用价值。方法：术前采用DSCTA 检查筛选颅内动脉瘤患者26例（33个）。采用Seldinger 技术，在DSA 引导下行全脑血管造影，了解动脉瘤位置、形态、大小，测量瘤颈及瘤体直径；再根据不同的解剖学形态选用不同的介入栓塞方法治疗。结果：术前DSCAT 和DSA 检查对颅内动脉瘤的大小、位置、形状显示一致。26例患者共33个动脉
瘤均成功栓塞，完全栓塞18个，占54.54％；栓塞程度在95％以上12个，占36.36％；不完全栓塞3个，占9.09％。结论：DSCTA 检查和DSA 全脑血管检查可提供颅内动脉瘤的位置、形态、大小等影像解剖学资料，为动脉瘤的临床分类和治疗方法的选择提供依据。
Application of Dual-source CT vascular imaging in willis circle area aneurysm diagnosis and treatment
[Abstract] objective : discuss dual-source CT vascular imaging (DSCTA) in the diagnosis of Willis thering area aneurysm、classification and intervention embolization in the value of clinical applications. Methods: using preoperative screening intracranial aneurysm patients DSCTA check 26 patients (33). Using Seldinger technology, in whole cerebral angiogram guide DSA downward, understanding the aneurysm position, morphology and size, measuring tumor neck and occluded arterials diameter, then depending on the anatomical shape choose different intervention embolization therapy. Results: preoperative DSCAT and DSA check for the size of intracranial aneurysms、 position and shape shows consistent. 26 patients were 33 aneurysms are successful embolization, completely embolization 18, accounting for 54.54%; embolization degree in 12, accounts for above 95%; incomplete embolization 3, accounting for 9.09%. Conclusion: DSCTA inspection and DSA all cerebrovascular examination can provide image anatomy material of intracranial aneurysm position, morphology and size , is aneurism clinical classification and the selection of treatment, provides the basis.
第九组作业
1 膝横韧带与半月板损伤间关系的MRI 研究
【摘要】目的： 探讨MRI 上膝横韧带与半月板损伤程度及位置的关系，进一步认识膝横韧带的临床意义，并为半月板损伤的诊断和治疗提供新的信息。方法： 收集288例于本院2009年1月至2010年3月行膝关节MRI 检查的病例，在MRI 上观察膝横韧带的出现情况及半月板损伤的情况，并分析膝横韧带出现率与半月板损伤程度及位置的相关性。结果： 膝横韧带在MRI 上的出现率约43.1%（124/288），其平均长度（37.5±2.75）mm ，平均宽度（2.5±1.5）mm 。膝横韧带出现率与半月板损伤程度无关（P >0.05），但与半月板损伤位置有关（P
关键词：膝关节；膝横韧带；半月板损伤；磁共振成像
MRI Study on Relationship between Transverse Ligament of Knee and Meniscus Injury
Abstract
Objective ：To explore the relationship of transverse ligament of knee and degree and position of meniscus injury on MRI.To further understand clinical significance of transverse ligament of knee and provide new information on diagnosis and treatment of meniscus injury.
Methods ：288 patients with MRI examination of knee joints between January 2009 and March 2010 was collected in our institution. Situations of transverse ligament of knee and meniscus injury were observed on MRI, the relationship between occurrence rate of transverse ligaments of knee and the degree and position of the meniscus injury was analyzed
Results ：Occurrence rate of transverse ligament of knee was about 43.1%(124/288),and the mean length was 37.5±
2..75mm, the mean width was 2.5±1.5mm. there was no relationship between occurrence rate of transverse ligament of knee and the degree of the meniscus injury(P＞0.05﹚,but there was relationship between occurrence rate of transverse ligament of knee and position of the meniscus injury(P
Conclusions ：Transverse ligament of knee are the normal anatomy connecting bilateral anterior horn of meniscuses , which helps maintaining the stability of knee joints in the movement ¸and has certain function for protecting anterior horn of meniscuses.
Keywords: knee joint; transverse ligament of knee; meniscus injury;MRI
2枕大孔区脑膜瘤的显微手术治疗
[摘要] 目的： 探讨枕大孔区脑膜瘤的临床特点、手术入路选择及手术技巧。方法： 采用显微手术治疗枕骨大孔区脑膜瘤21例，其中，肿瘤位于背侧4例、腹侧3例、腹外侧14例，背侧者选择后正中入路，腹侧或腹外侧者选择远外侧入路；在腹外侧肿瘤中根据与椎动
脉关系分为肿瘤在椎动脉下方（7例）、椎动脉上方（4例）、椎动脉上下（3例）。结果： 本组资料全切肿瘤17例（81%），次全切除1例（椎动脉上下型）、部分切除3例（2例为椎动脉上下型、1例为椎动脉上型）；不全切除者术后行 -刀治疗；无手术死亡，随访期内无肿瘤复发；临床症状改善的16例，保持原有症状的3例，加重的2例。结论： 枕大孔区脑膜瘤的临床症状无特征性，术前的分型有助于手术入路的选择和判断手术效果。
[关键词] 枕大孔； 肿瘤 ；正中入路 ；外侧入路
Foramen magnum area of meningiomas microsurgery treatment
[Abstract]Objective: explore foramen magnum area of clinical characteristics, surgical approach choice and surgical techniques
Method: adopt microsurgery for foramen magnum area 21 cases among them this is located in dorsal 4 cases, the ventral 3cases, abdominal lateral 14 cases. After selecting the right in the middle of the dorsal into road, the ventral or those who are outside the abdominal choose far lateral approaches; In the abdomen lateral tumor according to the relationship with vertebral artery into tumor in vertebral artery below (7cases), vertebral artery above (4cases), vertebral artery side (3 cases)
Result: the material total resection of the tumor 17 cases (81%) and subtotal resection is partial resection in 3 cases (2 cases of vertebral artery side and 1 case of vertebral artery above).TVSH of patients after the γ–knife therapy. Clinical symptoms improved patients(16cases), and maintain the original symptom patients 3 cases, symptom aggravating patients in 2 cases.
Conclusion: magnum area of clinical symptoms no marked, preoperative parting help surgical approach choice and judgment operation effect.
Keywords: foramen magnum tumor, midline approaches, lateral approaches.
3 双源CT 血管成像在Willis 环区动脉瘤诊断及治疗中的应用
[摘 要] 目的：探讨双源CT 血管成像（DSCTA ）在Willis 环区动脉瘤的诊断、分型及介入栓塞治疗中的临床应用价值。方法：术前采用DSCTA 检查筛选颅内动脉瘤患者26例（33个）。采用Seldinger 技术，在DSA 引导下行全脑血管造影，了解动脉瘤位置、形态、大小，测量瘤颈及瘤体直径；再根据不同的解剖学形态选用不同的介入栓塞方法治疗。结果：术前DSCAT 和DSA 检查对颅内动脉瘤的大小、位置、形状显示一致。26例患者共33个动脉
瘤均成功栓塞，完全栓塞18个，占54.54％；栓塞程度在95％以上12个，占36.36％；不完全栓塞3个，占9.09％。结论：DSCTA 检查和DSA 全脑血管检查可提供颅内动脉瘤的位置、形态、大小等影像解剖学资料，为动脉瘤的临床分类和治疗方法的选择提供依据。
Application of Dual-source CT vascular imaging in willis circle area aneurysm diagnosis and treatment
[Abstract] objective : discuss dual-source CT vascular imaging (DSCTA) in the diagnosis of Willis thering area aneurysm、classification and intervention embolization in the value of clinical applications. Methods: using preoperative screening intracranial aneurysm patients DSCTA check 26 patients (33). Using Seldinger technology, in whole cerebral angiogram guide DSA downward, understanding the aneurysm position, morphology and size, measuring tumor neck and occluded arterials diameter, then depending on the anatomical shape choose different intervention embolization therapy. Results: preoperative DSCAT and DSA check for the size of intracranial aneurysms、 position and shape shows consistent. 26 patients were 33 aneurysms are successful embolization, completely embolization 18, accounting for 54.54%; embolization degree in 12, accounts for above 95%; incomplete embolization 3, accounting for 9.09%. Conclusion: DSCTA inspection and DSA all cerebrovascular examination can provide image anatomy material of intracranial aneurysm position, morphology and size , is aneurism clinical classification and the selection of treatment, provides the basis.