OBJECTIVE: To study the effect of color doppler flow imaging(CDFI) technique in the design of axial pattern flap. METHODS: From April 1996 to June 1999, 10 patients with residual wound were adopted in this study. Among them, there were seven males and three females, the area of wounds ranged from 6 cm x 8 cm to 15 cm x 20 cm. Before operation, the axial pattern flaps were designed by traditional method, then CDFI technique with high frequency(5.0-7.5 MHz) was used for examining the major supply artery of the flap. At last, the modified flaps were transferred to cover the wounds. RESULTS: All the patients except one case completed the operation successfully. The cosmetic and function of the flaps were excellent. CONCLUSION: CDFI is a simple, direct and accurate method for detecting the supply artery of axial pattern flap. This technique should be popularized to avoid the blindness of flap design.
Objective To study the characteristics of optic al coherence tomography (OCT) in idiopathic macular epiretinal membranes (IMEM) and the relationship between the thickness of fovea and the vision of affected eyes. Methods Total of 67 cases (73 eyes) with clinica l diagnosis of IMEM by direct, indirect ophthalmoscopy, three mirror contact len s, fundus color photography or fundus fluorescein angiography(FFA）were examined with OCT. Results Epiretinal membranes(ERMs) with macular edema were found in 32 eyes, proliferative ERMs in 20 eyes, ERMs with macular pseudoholes in 14 eyes and ERMs with laminar macular holes in 7 eyes. Based on OCT, the ERMs were clearly and partially seperated from the retina (27 eyes, 38.36%), the retinal thickness of the fovea was the thickest in proliferative ERMs and the thinnest in ERMs with laminar macular holes. The statistical an alysis showed there was a negative correlation between the thickness of fovea an d visual acuity (r=－0.454, P= 0.000 ). Conclusion There were four types of image of OCT in IMEM: ERMs with macularedema, proliferative ERMs, ERMs with macular pseudohole and ERMs with laminar macular hole；and the thicker the fovea under the OCT, the poorer th e visual acnity in the affected eyes with ERMs. (Chin J Ocul Fundus Dis, 2001,17:115-118)
摘要:目的: 探讨臂丛神经磁共振成像的技术方法及其可行性。 方法 :对15例正常志愿者行双侧臂丛神经成像:包括常规快速自旋回波序列T1加权(T1W/TSE)、快速自旋回波序列T2加权(T2W/TSE)、快速自旋回波序列T2加权加SPIR脂肪抑制(T2W/SPIR)冠状位扫描以及弥散加权背景抑制成像序列(DWIBS)轴位扫描。 结果 :T1W/TSE、T2W/TSE、及T2W/SPIR对臂丛节后神经同层显示率分别为533%、567%和833%;DWIBS MIP重建图像对臂丛神经的全貌显示较为完整、清晰、直观;T1W/TSE、T2W/TSE、T2W/SPIR及DWIBS MIP重建图像的对比噪声比分别为109±09、107±13、185±68和299±133,T2W/SPIR序列和DWIBS MIP重建图像的对比噪声比明显高于T1W/TSE和T2W/TSE序列。 结论 :T2W/SPIR序列对臂丛神经的同层显示率及图像的对比噪声比明显高于常规T1W/TSE、T2W/TSE序列, DWIBS MIP重建图像能够显示臂丛神经的全貌,两者为臂丛神经成像较为有效的技术方法,对于臂丛神经病变的诊断即具有十分重要的意义。Abstract: Objective: To determine the optimal sequences of brachial plexus with MRI. Methods : Fifteen volunteers were underwent MRI on 15T scanner, the Sequences of T1W/TSE/COR, T2W/TSE/COR, T2W/SPIR/COR and Diffusionweighted imaging with background body signal suppression were performed. Results : The display rates of brachial plexus postganglionic segment nerve showing at the same slice were 533%, 567% and 833% on T1W/TSE/COR, T2W/TSE/COR, T2W/SPIR/COR. Brachial plexus on DWIBS MIP were clear and complete. Contrastnoise ratio of four sequences was 109±09, 107±13, 185±68 and 299±133,respectively. Contrastnoise ratio of T2W/SPIR/COR and DWIBS MIP was significantly higher than that of the other two sequences. Conclusion : Display rate of brachial plexus and contrastnoise ratio of images on T2W/SPIR/COR were higher than those of routine sequences. Image of DWIBS MIP can show the outline of brachial plexus clearly. The two sequences were reliable and effetive techoniquic in diagnosis of brachial plexus lesion.
ObjectiveTo observe the multimodal imaging characteristics of combined hamatoma of the retina and retinal pigment epithelium (CHRRPE).MethodsA retrospective case study. From January 2013 to December 2017, 6 CHRRPE patients (6 eyes) diagnosed in Department of Ophthalmology, Sun Yat-sen Memorial Hospital were included in the study. There were 4 males and 2 females, with the mean age of 12.0±8.10 years. There were 5 eyes with BCVA ≤0.1, 1 eye with BCVA＞1.0. Corneal fluoroscopy showed 1 eye with an external oblique 15°, and the remaining eye had no abnormalities in the anterior segment. All eyes underwent fundus color photography, FAF, FFA, ICGA, OCT and color Doppler flow imaging (CDFI). The multimodal imaging characteristics were observed.ResultsAll the affected eyes CHRRPE were located in the posterior pole and showed mild elevation. Most of the retinal neuroepithelial layers had different degrees of hyperplasia, vascular tortuosity and retinal folds. Of the 6 eyes, 4 eyes (66.7%) involving the macula and optic disc, only 2 eyes (33.3%) involving the macula. OCT showed that the structure of the neuroepithelial layer was unclear and the signal intensity was uneven; it involved 2 eyes of the whole retina (33.3%) and only 4 eyes of the neuroepithelial layer (66.7%). FFA and ICGA showed that the choroidal background fluorescence of the early lesions was weakened, and the lesions showed slightly weak fluorescence; the late telangiectasia fluorescein was obviously leaked, and the lesions were stained with fluorescence. FAF mainly appears as weak autofluorescence with a small amount of strong autofluorescence. CDFI has no characteristic performance.ConclusionsCHRRPE is mainly a membrane-like hyperplasia without angiogenesis, involving the retinal neuroepithelial layer, and may also involve the entire retina. OCT is dominated by strong reflection; AF, FFA and ICGA are mainly weak fluorescence.
Abstract： Objective To use tissue Doppler strain rate imaging to evaluate the impact of low dose dopamine and milrinone on systolic and diastolic function of the left ventricle of patients undergoing heart valve replacement. Methods Forty patients undergoing selective heart valve replacement in West China Hospital of Sichuan University between March and May 2011 were included in this study. All the patients were randomized into 2 groups with 20 patients in each group： milrione group and dopamine group. After anesthesia induction and before cardiopulmonary bypass setup， left ventricular ejection fraction （LVEF） was measured by echocardiography. Tissue Doppler strain rate imaging was used to measure the left ventricular lateral wall and midventricular segment from the four-chamber view， which was compared with Doppler parameters. Results LVEF， ratio of early-diastolic to end-diastolic velocity （E/A） of transmitral flow， ratio of mitral inflow velocity to early diastolic velocity in the annulus （E/Et） of both 2 groups were significantly different between before and after dopamine and milrinone administration （P＜0. 05）. In the milrinone group， 4 segments systolic peak velocity （Vs）， 1 segment early diastolic peak velocity （Ve）， 4 segments late diastolic peak velocity （Va）， 3 segments Ve/Va ratio， 2 segments systolic peak strain rate （SRs）， 2 segments late diastolic peak strain rate （SRa）， and 3 segments early diastolic peak strain rate SRe/SRa ratio after dopamine and milrinone administration were significantly higher than those before dopamine and milrinone administration （P＜0. 05）. In the dopamine group， 4 segments systolic peak velocity （Vs）， 1 segment Ve， 4 segments Va， 1 segment Ve/Va ratio， 2 segments SRs， 1 segment SRe， 1 segment SRa， and 1 segment SRe/SRa ratio after dopamine and milrinone administration were significantly higher than those before dopamine and milrinone administration （P＜0.05）. To compare the milrione group and dopamine group after medication administration， 2 segments Vs， 4 segments Va， 1 segment SRe， 1 segment SRa， 2 segments Ve/Va ratio， and 2 segments SRe/SRa ratio of the milrione group were significantly higher than those of the dopamine group （P＜0.05）， and 1 segment Vs， two segments SRs of the milrione group were significantly lower than those of the dopamine group （P＜0.05）. Conclusion Both milrinone and dopamine can improve left ventricular systolic function of perioperative patients undergoing heart valve replacement assessed by tissue Doppler strain rate imaging， while milrinone can improve the diastolic function of the left ventricle on the long axis more significantly.
Objective To investigate the relationship between Oxfordshire community stroke project (OCSP) classification and MRI classification in acute cerebral infarction. Methods A total of 282 patients with acute cerebral infarction were retrospectively evaluated with OCSP classification and imaging characteristics. Results According to OCSP classification, of all 282 patients with acute cerebral infarction, 32 (11.3%) experienced total anterior circulation infarction (TACI), 86 (30.5%) partial anterior circulation infarction (PACI), 111 (39.4%) lacunar infarction (LACI), and 53 (18.8%) posterior circulation infarction (POCI). The consistency was found in 201 cases (71.3%) between the OCSP classification and imaging classification, with the accuracy of 77% (27/35) for TACI, 79% (42/53) for PACI, 69% (95/137) for LACI and 65% (37/57) for POCI. Conclusion OCSP classification can predict the location and size of cerebral infarction with a high accuracy, and is well consistent with the MRI findings.
Macular choroidal macrovessel (MCM) is a recently reported rare choroidal vascular abnormality, characterized by a distinctly thickened choroidal vessel extending from the macular area to the temporal periphery area in fundus examinations. MCM may be an abnormal dilatation of the posterior ciliary artery. The diagnosis of MCM relies on multimodal imaging examinations, with indocyanine green angiography and optical coherence tomography being particularly critical, while optical coherence tomography angiography serves as an essential supplementary and non-invasive alternative. Due to its rarity, ophthalmologists generally have limited awareness of MCM. In clinical practice, it is essential to be familiar with the clinical manifestations and imaging characteristics of MCM, to improve diagnostic levels, enhance differentiation capabilities, and minimize the occurrence of misdiagnosis.
Through magnetic resonance electrical properties tomography (MR-EPT), electrical conductivity and permittivity of biological tissues could be reconstructed based on radio frequency field of magnetic resonance imaging (MRI) system. High precision and high resolution image could be obtained without current injection. In this study, XFDTD software was used to establish a finite element model of the human breast. Simulation was delivered at the Larmor frequency of 128 MHz by a 16-channel radio frequency coil. Conductivity and permittivity of the mammary tissue was reconstructed according to the B1+ field's amplitude and phase of forward problem. Anti-noise performance of the algorithm was studied by adding noise to B1+ field. The conductivity and permittivity's average relative error between simulation results and dielectric constant was 4.71% and 11.32%, respectively. With a signal-to-noise ratio of >30 dB, the noise added would not affect imaging results. This study demonstrated that high precision and high resolution image could be obtained by MR-EPT without excitation. MR-EPT had excellent feasibility and developing potential in early detection of diseases.
ObjectiveTo observe the morphologic characteristics of drusen in atrophic age-related macular degeneration (AMD) by spectral domain optical coherence tomography (SD-OCT). MethodsFifty-four patients (84 eyes) with macular drusen and atrophic AMD, and 56 age-matched control patients (56 eyes) with cataract were included in this study. Atrophic AMD patients were divided into two groups: D1 group with drusen involving the fovea (42 eyes) and D2 group with drusen not involving the fovea (42 eyes). The SD-OCT images in macular (6 mm×6 mm scans) were acquired, and the foveal retinal thickness (FRT) was measured. The size, morphology, inner reflection, homogeneity of drusen and its relationship with surrounding tissues were analyzed. ResultsThe FRT of D1 group, D2 group and control group were (160.90±38.47), (194.21±26.11), (222.42±19.29) μm respectively. The FRT of D1 group and D2 group were thinner than that of control group (F=57.08, P=0.00). Totally 1124 drusen were found by SD-OCT images in 84 eyes, with an average of 10.84 drusen in each eye. 3.0%, 12.5% and 84.5% of all 1124 drusen were small, medium and large sized respectively. 56.6%, 14.2%, 20.4% and 8.8% of all drusen were dome, pointed, saw-toothed and basal-shaped respectively. 17.1%, 57.5% and 25.4% of all drusen had low, medium and high internal reflectivity respectively. The internal reflectivity of 65.6%, 2.8% and 31.7% of all drusen were homogeneous, nonhomogeneous with core, and nonhomogeneous without core respectively. Overlying retinal pigment epithelium (RPE) damage and photoreceptor inner segment/outer segment (IS/OS) junction damage were presented in 34.5% and 24.8% drusen respectively. The most common type of drusen was dome-shape, homogeneous, with medium internal reflectivity, and without overlying RPE or IS/OS junction damage (81.0%). ConclusionsThe FRT becomes thinner in patients with drusen. The most common drusen types are dome-shaped, homogeneous, with medium internal reflectivity, and without overlying RPE or IS/OS junction damage.
ObjectiveTo investigate the application of high frequency color Doppler ultrasound (HFCDU) combined with wide-field imaging in the preoperative navigation of anterolateral thigh perforator flap graft.MethodsBetween January 2017 and March 2018, 28 patients with skin and soft tissue defects were treated, including 22 males and 6 females, with an average age of 33.5 years (range, 17-66 years). The causes of injury included 2 cases of scald scar, 7 cases of heavy object crushing injury, 12 cases of traffic accident injury, 4 cases of fall injury, 2 cases of machine injury, and 1 case of infection ulcer. Injury sites included 6 cases of hand and wrist, 12 cases of lower leg, 10 cases of foot. After debridement, the wound area ranged from 6.0 cm×3.5 cm to 24.0 cm×9.0 cm, and all patients were treated with free circumflex femoral artery perforator flap graft. Combo of HFCDU and wide-field imaging navigation were done preoperatively to detect the origin, quantity, course, surface location, hemodynamic characteristics, and the relationship with body area of perforator branch of lateral circumflex femoral artery. According to the perforator information displayed by wide-field imaging of source artery, the dominant perforator was determined to be a pedicle for designed flap. The flap size ranged from 7.0 cm×4.5 cm to 26.0 cm×7.0 cm. The flap donor area was sutured directly.ResultsThe dominant perforator was successfully detected by HFCDU combined with wide-field imaging in 28 patients before operation. The existence of the perforator was confirmed during operation, and the location was accurate. The course characteristics of the perforate were consistent with the results of wide-field imaging. The grafted flaps survived completely among 27 patients after operation. Necrosis at the edge of the flap was observed in 1 patient, which healed after dressing change. All patients were followed up 3-12 months, with an average of 9 months. All the flaps have good blood supply, good elasticity and shape. The donor areas healed perfectly.ConclusionUsing HFCDU and wide-field imaging navigation for designing of anterolateral thigh perforator flaps can clearly show the characteristics of perforators, hemodynamic information, and the relationship with body area, so that the surgeons can understand the perforators more accurately and intuitively, and improve the success and efficiency of flap graft surgery.