Goal: This study aims to evaluate the contribution of the whole body scanner in the management of severe traumas. Patient and Method: It is a retrospective analytical study, carried out at the Armentieres Hospital Cen...Goal: This study aims to evaluate the contribution of the whole body scanner in the management of severe traumas. Patient and Method: It is a retrospective analytical study, carried out at the Armentieres Hospital Centre (France) over a period of 14 months. It analyzes computed tomography reports and emergency department results of severe trauma patients immediately stabled at the entrance or stabilized after benefiting from a full body scanner according to Vittel criteria. Results: One hundred eighty patients were included in the study with an average age of 32.71 years old. One hundred and twelve patients (62.2%) had at least one clinical sign and only 48 patients presented a lesion on the computed tomography (26.7%). Sixty-two patients (34.4%) showed neither clinical signs nor damage in scan. The radio-clinical correlation was bad at spinal and abdominal level, mediocre at brain and chest level, but it was medium in the pelvis. The average radiation dose per patient was 3319.21 mGy⋅cm. Conclusion: The whole body computed tomography or scanning allows fast images acquisition compatible with emergency situation and with a satisfactory diagnostic reliability, but still remains an irradiating exam. The results of this study lead to reflect on the use of Vittel criteria that could be improved to reduce the number of normal tests carried out.展开更多
Objective： To evaluate the roles of radiograph, magnetic resonance imaging （MRI）, three-dimensional computed tomography （3-D CT） in early diagnosis of femoro-acetabular impingement （FAI） in 17 cases. Methods：...Objective： To evaluate the roles of radiograph, magnetic resonance imaging （MRI）, three-dimensional computed tomography （3-D CT） in early diagnosis of femoro-acetabular impingement （FAI） in 17 cases. Methods： Plain radiographs of the pelvis, 3-D CT, and MRI of the hip were made on 17 patients with groin pain, which was worse with prolonged sitting （i.e. hip flexion）. There was no history of trauma or childhood hip disorders in the patients who did not complain of any other joint problems or neurologic symptoms. All patients had positive anterior or posterior impingement test. Plain radiographs included an antero-posterior （AP） view of the hip and a cross table lateral view with slight internal rotation of the hip. CT scan was performed with the Lightspeed 16 row spiral （General Electric Company, USA） at 1.25 mm slice reconstruction. MRI scan was performed on the Siemens Avanto （Siemens Company, Germany）1.5T supraconduction magnetic resonance meter. The CT and MRI scans were taken from 1 cm above the acetabulum to the lesser trochanter in 5 series. Results： The plain radiographs of the pelvis showed that among the 17 patients, 12 （70.59%） had ＂Cam＂ change of the femoral head, 6 （35.29%） had positive ＂cross-over＂ sign, and 17 （100%） had positive ＂Pincer＂ change of the acetabulum. The 16 row spiral CT noncontrast enhanced scan and 3-D reconstruction could discover minus femoral offset and ossification and osteophyte of the acetabulum labrum in all the 17 cases （100%）. The MRI noncontrast enhanced scan could discover more fluid in the hip joint in 15 cases （88.33%）, subchondral ossification in 3 cases （17.6%）, and labrum tears in 3 cases （17.6%）. Conclusions： Plain radiographs can provide the initial mainstay for the diagnosis of FAI, 3-D CT can tell us the femoral offset, while MRI can show labrum tears in the very early stage of FAI. Basically, X-ray examination is enough for the early diagnosis of FAI, but 3-D CT and MRI may be useful for the treatment.展开更多
Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique i n diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for e...Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique i n diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for experiment. The menisci , anterior and posterior cruciate ligaments and cartilage of these 10 bovine kne es were injured with a hook. Each of the joints was injected with 100 ml air, th en soon scanned with a PQ6000 spiral computed tomography scanner. The data obtai ned was input into the work station, and multiplanar reconstruction technique wa s used to illustrate lesions in the knees. The results of CT diagnosis were comp ared to those found by gross inspection of the specimens. Clinically, 10 knees o f 9 patients diagnosed as internal derangement were evaluated with the same meth od after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results we re compared with intraoperative findings. Results:Experimentally, the sensitivity and specificity were 88.9 % and 93.9 % by detection of meniscal abnormalities, 85.7 % and 10 0% by detection of cruciate ligament lesions, and 72.7 % and 100% by detectio n of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90.0 % and 95.0 % by detection of meniscal lesion. As to ligament, t he figures were 85.7 % and 100% respectively. Images of virtual arthroscopy s imulated the images of real arthroscopy. Conclusions:Spiral CT arthrography of multiplanar reconstructi on technique offers fine images of internal structures of the knee, with clear b order and internal structure. It is an accurate method for detecting meniscal, cruciate and collateral ligament and cartilaginous lesions that cause internal d erangement of the knee. Virtual arthroscopy technique is a hopeful method for de tecting reasons of derangement of the knee.展开更多
文摘Goal: This study aims to evaluate the contribution of the whole body scanner in the management of severe traumas. Patient and Method: It is a retrospective analytical study, carried out at the Armentieres Hospital Centre (France) over a period of 14 months. It analyzes computed tomography reports and emergency department results of severe trauma patients immediately stabled at the entrance or stabilized after benefiting from a full body scanner according to Vittel criteria. Results: One hundred eighty patients were included in the study with an average age of 32.71 years old. One hundred and twelve patients (62.2%) had at least one clinical sign and only 48 patients presented a lesion on the computed tomography (26.7%). Sixty-two patients (34.4%) showed neither clinical signs nor damage in scan. The radio-clinical correlation was bad at spinal and abdominal level, mediocre at brain and chest level, but it was medium in the pelvis. The average radiation dose per patient was 3319.21 mGy⋅cm. Conclusion: The whole body computed tomography or scanning allows fast images acquisition compatible with emergency situation and with a satisfactory diagnostic reliability, but still remains an irradiating exam. The results of this study lead to reflect on the use of Vittel criteria that could be improved to reduce the number of normal tests carried out.
文摘Objective： To evaluate the roles of radiograph, magnetic resonance imaging （MRI）, three-dimensional computed tomography （3-D CT） in early diagnosis of femoro-acetabular impingement （FAI） in 17 cases. Methods： Plain radiographs of the pelvis, 3-D CT, and MRI of the hip were made on 17 patients with groin pain, which was worse with prolonged sitting （i.e. hip flexion）. There was no history of trauma or childhood hip disorders in the patients who did not complain of any other joint problems or neurologic symptoms. All patients had positive anterior or posterior impingement test. Plain radiographs included an antero-posterior （AP） view of the hip and a cross table lateral view with slight internal rotation of the hip. CT scan was performed with the Lightspeed 16 row spiral （General Electric Company, USA） at 1.25 mm slice reconstruction. MRI scan was performed on the Siemens Avanto （Siemens Company, Germany）1.5T supraconduction magnetic resonance meter. The CT and MRI scans were taken from 1 cm above the acetabulum to the lesser trochanter in 5 series. Results： The plain radiographs of the pelvis showed that among the 17 patients, 12 （70.59%） had ＂Cam＂ change of the femoral head, 6 （35.29%） had positive ＂cross-over＂ sign, and 17 （100%） had positive ＂Pincer＂ change of the acetabulum. The 16 row spiral CT noncontrast enhanced scan and 3-D reconstruction could discover minus femoral offset and ossification and osteophyte of the acetabulum labrum in all the 17 cases （100%）. The MRI noncontrast enhanced scan could discover more fluid in the hip joint in 15 cases （88.33%）, subchondral ossification in 3 cases （17.6%）, and labrum tears in 3 cases （17.6%）. Conclusions： Plain radiographs can provide the initial mainstay for the diagnosis of FAI, 3-D CT can tell us the femoral offset, while MRI can show labrum tears in the very early stage of FAI. Basically, X-ray examination is enough for the early diagnosis of FAI, but 3-D CT and MRI may be useful for the treatment.
文摘Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique i n diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for experiment. The menisci , anterior and posterior cruciate ligaments and cartilage of these 10 bovine kne es were injured with a hook. Each of the joints was injected with 100 ml air, th en soon scanned with a PQ6000 spiral computed tomography scanner. The data obtai ned was input into the work station, and multiplanar reconstruction technique wa s used to illustrate lesions in the knees. The results of CT diagnosis were comp ared to those found by gross inspection of the specimens. Clinically, 10 knees o f 9 patients diagnosed as internal derangement were evaluated with the same meth od after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results we re compared with intraoperative findings. Results:Experimentally, the sensitivity and specificity were 88.9 % and 93.9 % by detection of meniscal abnormalities, 85.7 % and 10 0% by detection of cruciate ligament lesions, and 72.7 % and 100% by detectio n of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90.0 % and 95.0 % by detection of meniscal lesion. As to ligament, t he figures were 85.7 % and 100% respectively. Images of virtual arthroscopy s imulated the images of real arthroscopy. Conclusions:Spiral CT arthrography of multiplanar reconstructi on technique offers fine images of internal structures of the knee, with clear b order and internal structure. It is an accurate method for detecting meniscal, cruciate and collateral ligament and cartilaginous lesions that cause internal d erangement of the knee. Virtual arthroscopy technique is a hopeful method for de tecting reasons of derangement of the knee.
