泪腺良性上皮性肿瘤及肿瘤样病变影像学分析

目的:总结分析泪腺良性上皮性肿瘤及肿瘤样病变的CT和MRI表现.方法:回顾性分析63例经病理学证实的泪腺良性上皮性肿瘤及肿瘤样病变的CT和MRI影像资料.结果:①60例良性混合瘤中,50例位于眼眶外上象限泪腺窝内,6例位于眶缘前,2例位于眼球外侧,1例位于眼球上方,1例为多发;53例呈类圆形,7例形态不规则;45例可见邻近眶壁骨质受压改变; MRI示T1WI呈低信号或等信号,T2WI呈高信号或等信号,增强扫描可见明显强化;②1例嗜酸细胞瘤CT示肿瘤呈类圆形,密度不均匀,中央密度略低,泪腺窝骨质受压;③2例上皮囊肿均位于眶缘前,CT呈均匀低密度,MRI T1WI呈低信号,T2WI呈等信号,增强后无强化.结论:CT及MRI可显示泪腺良性上皮性肿瘤及肿瘤样病变的特征,有助于病变的诊断及鉴别诊断.     

眼眶淋巴瘤多模态影像分析

【摘要】目的：探讨眼眶淋巴瘤多模态影像学特征。方法：回顾性分析27例经病理证实为眼眶淋巴瘤患者的治疗前MRI、CT增强扫描及18F-FDG PET/CT影像。评估内容包括病灶的MRI特征、CT增强扫描特征及最大标准摄取值（SUVmax）。结果：总共收集27例（34眶）患者,其中25例（31眶）行眼眶MR扫描,10例（13眶）行CT增强扫描及18F-FDG PET/CT扫描。病变多位于眶隔前区（15.38%）、泪腺区（23.08%）及肌锥区（21.54%）。病灶在压脂T2WI上,11例呈均匀稍高信号,13例呈等信号,1例呈混杂高信号;压脂T1WI上,24例呈等信号,1例呈稍低信号;压脂T1WI增强扫描上,15例呈中度均匀强化,8例为轻度均匀强化,2例为不均匀强化;7例可见骨质破坏。10例行CT增强扫描及18F-FDG PET/CT扫描患者中,病理组织类型为黏膜相关淋巴组织边缘区B细胞（MALT）淋巴瘤5例,弥漫大B细胞淋巴瘤（DLBCL）5例,其中1例DLBCL患者在CT上表现为不均匀密度,其余9例表现为均匀密度。两种病理类型病灶的△CT值差异无统计学意义（统计值0.60,P>0.05）。DLBCL与MALT淋巴瘤病灶的SUVmax差异具有统计学意义［6.40（5.40～7.10） vs. 11.40（9.63～25.60）,P=0.009］。结论：眼眶淋巴瘤病变多位于眶隔前区、泪腺区及肌锥区。MRI上病灶压脂T1WI多呈等信号,压脂T2WI呈等或稍高信号,增强扫描呈轻到中度强化;在CT上表现为均匀密度,增强扫描呈轻到中度强化,病灶的强化程度对鉴别DLBCL和MALT淋巴瘤无帮助。在18F-FDG PET/CT中,DLBCL的SUVmax较高,病灶的SUVmax 有助于鉴别DLBCL和MALT淋巴瘤。     

眼眶静脉性血管瘤的MRI和CT表现

目的 分析眼眶静脉性血管瘤的MRI、CT表现,提高对眼眶静脉性血管瘤的影像学认识.资料与方法 对49例经手术病理证实的眼眶静脉性血管瘤患者的MRI、CT资料进行回顾性分析.结果 49例中,位于眼眶前部1例,肌锥内间隙18例,肌锥外间隙3例,肌锥内外间隙同时受累27例.MRI扫描41例显示为边界清楚但不光滑,形状不规则的不均质肿块.6例肿物边界不清.与眼外肌相比,T1WI呈低或等信号,T2WI呈高信号,肿瘤内部或周边可见血管流空信号.T2WI脂肪抑制序列高信号不被抑制.46例眼球明显向前突出,7例显示眼球受压变形.29例显示病变沿眼球壁生长呈铸形.15例显示眶尖脂肪间隙消失.7例可见肿物向颅内蔓延.14例具有急性突眼病史者显示出血信号,7例可见液.液平面.CT扫描显示为不均匀的较高密度.5例显示单个或多个的静脉石.26例眶骨受压,眼眶扩大.10例显示眶上裂扩大.结论 眼眶静脉性血管瘤在MRI、CT上分别具有其特征性征象.CT对展示骨性结构及钙化有优势,而MRI对肿瘤的内部形态及其与周围组织结构关系的进一步判断更具意义.MRI在定位和定性诊断上优于CT.     

眼眶淋巴瘤的MRI征象

目的探讨眼眶淋巴瘤的MRI特点,提高对本病的认识和术前诊断准确率。资料与方法回顾性分析8例经手术病理证实的眼眶淋巴瘤的MRI表现,包括病变部位、数量、形态、大小、MRI信号及对邻近结构的侵犯。结果 8例患者中,6例为单侧,2例为双侧。4例位于眼眶前部,包括眼睑、泪腺及眼球周围,1例位于肌锥外间隙,4例呈弥漫性,位于眼眶前部及肌锥内外间隙,并不同程度地包绕眼球;1例可见眼眶骨质破坏,并突破眶骨向颅内外蔓延;8例均未见囊变、坏死。6例平扫T1WI呈等信号,2例呈稍低信号;6例T2WI呈均匀稍高信号,2例呈等信号;增强扫描后6例呈与眼外肌信号一致的中度均匀强化,2例为轻度均匀强化。结论眼眶淋巴瘤的MRI表现有一定的特征性,好发于眶隔前部,并向眶内侵犯;单侧多见,也可以双侧多发;呈多形性、塑形性、浸润性生长,信号多均匀,增强扫描多呈轻中度强化,少见骨质破坏,掌握其MRI表现有助于术前定性诊断。     

眼眶孤立性纤维瘤的MRI诊断

目的 探讨眼眶孤立性纤维瘤的特征性MRI表现.方法 网顾性分析7例经手术病理证实的眼眶孤立性纤维瘤的MRI资料,7例均行MR平扫、增强及动态增强检查.扫描序列包括T1WI、T2WI及三维快速扰相梯度回波(FSPGR)动态增强扫描序列.结果 肿瘤发生于右侧眼眶5例,左侧2例;位于泪腺周围肌锥外间隙6例(内上方5例、外下方1例),眼球后肌锥内间隙颞侧1例.病变边界均清楚,呈椭圆形6例,分叶状1例;病变最大径18 ～40 mm,平均31mm.与脑实质相比,MR T1 WI呈较均匀等信号6例;T2 WI呈不均匀低信号5例,等信号1例,高信号(多发囊变)1例;增强后病变呈较均匀显著强化6例,不均匀显著强化1例.7例动态增强扫描的时间-信号强度曲线(TIC)均为速升缓降型.结论 T2WI呈低信号、增强扫描明显强化、动态增强扫描TIC显示速升流出型为眼眶孤立性纤维瘤的典型MR1征象.     

泪腺良性混合瘤的CT和MRI诊断

目的 探讨CT和MRI对泪腺良性混合瘤的诊断价值. 资料与方法 回顾性分析45例经病理证实的泪腺良性混合瘤的临床和影像学资料,30例行CT检查,35例行MRI检查. 结果 45例中,起源于泪腺眶部43例,泪腺睑部2例.肿瘤呈椭圆形29例,圆形10例,不规则形6例;边缘光滑30例,边缘不规则呈分叶状或结节状15例.CT表现为等密度,大多数密度均匀.眶壁骨质受压、凹陷或缺损22例,骨质破坏伴眶壁硬化、肥厚6例,骨质增生硬化14例.MR T1WI上呈低信号25例,等信号10例,T2WI上呈高信号21例,等信号14例,增强后肿瘤呈中度至明显强化,大多数强化均匀. 结论 泪腺良性混合瘤的CT和MRI表现有一定特征,CT和MRI结合可以提高病变诊断的准确性.     

酷似海绵状血管瘤的眼眶海绵状淋巴管瘤的影像学表现

目的 探讨酷似海绵状血管瘤的眼眶海绵状淋巴管瘤的影像学表现.资料与方法 回顾性分析7例经手术病理证实的眼眶海绵状淋巴管瘤的CT和MRI表现以及MR动态增强扫描的特点.结果 7例均表现为眼眶椭圆形肿块,其中4例累及眼眶后部和眶尖,视神经明显受压移位.7例CT表现均呈等密度,密度均匀.MRI显示7例均呈略长T1长T2信号,信号不均匀,T2WI显示肿块内有散在的条状和小片状低信号.7例MR动态增强扫描都表现为"渐进性强化"征象,其中5例肿块强化范围扩大较快.结论 表现为眼眶内椭圆形肿块的海绵状淋巴管瘤与海绵状血管瘤非常相似,但肿块累及眼眶后部和眶尖及动态增强扫描显示肿瘤强化范围扩大较快高度提示肿瘤为海绵状淋巴管瘤.     

儿童急性鼻窦炎颅眶并发症的CT和MRI表现

目的 探讨儿童急性鼻窦炎颅眶并发症的CT和MRI表现,提高对其影像学表现的认识.方法 回顾性分析26例经临床证实的儿童急性鼻窦炎颅眶并发症的影像资料,16例行CT平扫检查,所有病例均行MRI检查.结果 26例患者中眼眶并发症23例,颅内并发症3例.根据Chandler对儿童急性鼻窦炎眼眶并发症的分型,眶隔前蜂窝织炎2例,CT表现为眼睑、面颊部肿胀,MRI肿胀的软组织T1 WI呈等信号,T2WI呈高信号,眶隔后肌锥内外间隙清晰;眶隔后蜂窝织炎5例,CT表现为眼睑、面颊部肿胀并眶隔后肌锥内外间隙模糊不清,MRI炎性水肿组织表现为T1WI呈等信号,T2WI呈高信号,肌锥内外间隙脂肪信号存在,增强后,病变累及范围内有强化;骨膜下脓肿16例,CT表现为眼眶内下象限肌锥外间隙软组织密度影,多呈梭形,11例眼眶内壁、下壁骨质有不同程度破坏,MRI表现为T1WI低信号,T2WI高信号,增强后脓肿壁明显强化.儿童急性鼻窦炎颅内并发症主要为脑膜炎及硬膜下脓肿,CT表现为前颅底、额部颅板下新月形低密度影,MRI脓腔T1WI低信号,T2WI高信号,增强扫描脓肿内外壁均明显强化,脑表面见脑沟回样强化.结论 CT和MRI的联合检查可明确儿童急性鼻窦炎颅眶并发症的类型、范围、部位,对临床治疗方案的制定以及随访观察具有重要的指导意义.     

儿童颅面骨转移性神经母细胞瘤的CT和MRI诊断

目的 探讨儿童颅面骨转移性神经母细胞瘤的CT和MRI特征.方法 分析7例经病理证实的颅面骨转移性神经母细胞瘤患儿的CT和MRI资料,7例患儿均行眼眶CT平扫、MRI平扫和增强扫描,其中5例行上腹部平扫,3例行腹部增强扫描.结果 7例患儿中6例多发,1例单发;多发病灶以颅眶骨交界为著.CT均表现为受累骨质呈虫蚀状破坏,骨皮质毛糙不整,骨膜下可见垂直针状高密度影,受累骨质周围见梭形稍高密度肿块,内见斑点、斑片、不规则高密度影;7例MRI平扫表现为正常骨髓信号被软组织肿块替代,肿块呈等T1、不均匀等、稍长T2信号;MRI增强扫描显示病变不均匀强化,其中4例伴相邻脑膜增厚、异常强化、破坏中断.5例上腹部CT平扫表现为单侧肾上腺区或腹膜后软组织肿块伴腹膜后多发淋巴结肿大,肿瘤密度不均;3例上腹部CT增强扫描显示病变不均匀强化.结论 儿童颅面骨转移性神经母细胞瘤的CT和MRI表现具特征性,CT对针状骨膜反应和肿块内钙化斑的显示较MRI更具鉴别诊断价值,而MRI对病变范围及脑膜转移的显示优于CT.     

神经纤维瘤病眼眶受累影像学诊断(附12例分析)

目的：探讨神经纤维瘤病眼眶受累的影像学表现。方法：回顾性分析12例经病理或临床表现和影像学证实的神经纤维瘤病眼眶受累患者的影像学资料,12例均行眼眶CT检查,其中5例行CT增强,6例行MRI或增强检查。结果：12例神经纤维瘤病病例中,Ⅰ型8例,Ⅱ型4例。眼眶内受累10例,视神经受累2例,眼球内受累3例,眼环增厚伴点状钙化1例,泪腺2例,视神经孔2例,海绵窦2例,眼睑部6例。CT表现为眶内不规则形等密度影,眼球内半月形等密度影,视神经孔开大,邻近骨质缺损或增生硬化。T1WI上病灶呈等信号,T2WI上呈高信号,增强后中度增强。MRI增强后脂肪抑制序列更能清晰显示病变。结论：神经纤维瘤病眼眶受累的CT和MRI表现多种多样,结合临床和其他部位影像学资料,可提高其诊断符合率。     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.