MR动态强化在小肝癌的灌注表现

目的分析原发性小肝细胞癌<3cm(SHCC)动态强化MR肿瘤灌注表现。方法经手术病理证实SHCC18例,21个病灶。采用2DT1-Turbo-FLASH序列对18个肿瘤进行了动态强化灌注观察,通过检测正常肝组织及肿瘤组织的信号强度随时间的变化,研究肿瘤组织的血流动力学信息。结果18个SHCC中17例见动态强化,1例未见强化。17例强化肿瘤中,2例最大峰值强化(SImp)在第1期扫描(6～23s),15例出现第2期扫描(33～51s)。平均峰值强化时间(SImt)为42.5s(23～50.5s),平均最大峰值强化信号强度增加30.5(19.5～45.0)。18例中17例时间-信号强度曲线为速升速降型,1例未见明显时间-信号强度曲线变化。结论动态强化MR在研究及诊断SHCC中有重要作用。     

平扫和动态增强MR诊断肝脏增生性结节

目的 总结增生性结节(DN)在MRI平扫及动态增强扫描中的特征. 资料与方法 回顾性分析行Gd-DTPA动态增强MR检查并经手术病理证实的DN共11例16个病灶,观察病灶的大小、信号强度、强化方式和时间,测量各序列病灶及周围肝组织的信号强度和背景噪声标准差,计算信噪比及其差值.绘制病灶和周围肝组织的时间-信号强度曲线. 结果 16个病灶中有4个表现为"结中结",中央结节为T1WI低、T2WI等或高信号,动态增强为速升速降或速升缓降型,周围为T1WI高、T2WI等或高信号,动态增强为缓慢上升型;余12个病灶在T1WI上高、等和低信号均有,在T2WI上为等信号和稍高信号,动态增强过程中动脉期强化较明显,门静脉期以等信号为主,延迟期为等及稍高信号, 未见呈低信号者.时间-信号强度曲线显示病灶为速升缓降型. 结论 "结中结"征象和动态增强早期强化、后期与周围肝组织类似信号的表现是DN的MRI特征.     

动态CT增强扫描对甲状腺结节诊断价值的初步研究

目的：探讨动态CT增强扫描对甲状腺结节的鉴别诊断价值。方法：选择经病理证实甲状腺结节患者55例进行动态增强扫描,将病灶强化方式分成无强化、不均匀强化和均匀强化3种类型,测量病灶增强前后各时间点的CT值,并根据增强后CT增加值绘制动态曲线。结果：甲状腺癌9例,7例表现为均匀性强化,2例不均匀强化;腺瘤19例,6例呈均匀强化,8例不均匀强化,5例无强化;结节性甲状腺肿27例,9例均匀强化,15例不均匀强化,3例无强化。强化方式在良恶性结节间有显著差异（χ2=6.682,P〈0.05）。多数（7/9）甲状腺癌的动态曲线呈速升缓降型,2例速升速降型,达峰时间为50s;大部分（12/19）腺瘤动态曲线呈速升缓降型,达峰时间约50s,小部分为速升速降型（3/18）或平稳型（4/18）;多数（16/27）结节性甲状腺肿动态曲线呈速升速降型,小部分呈速升缓降型（6/27）或平稳型（5/27）。结论：动态增强扫描就甲状腺结节的强化方式和动态曲线提供更多的信息,对甲状腺结节的鉴别诊断有重要价值。     

肾脏肿瘤的MR动态增强扫描研究

目的:探讨MR动态增强扫描在肾脏肿瘤诊断和鉴别诊断中的价值。方法:对21例肾细胞癌、11例肾错构瘤和6例肾囊肿行MR常规检查及动态增强和延迟增强扫描,测量病灶的信号强度,绘制时间-对比增强率曲线并对动态增强的类型及血液动力学改变进行分析。结果:肾脏肿瘤动态增强后的时间-对比增强率曲线不同,富血供肾癌在早期强化并逐渐上升,但其时间-对比增强率曲线无明显峰值;乏血供肾癌早期轻度强化,缓慢上升至60s后趋于稳定;肾错构瘤早期即明显强化,于30s达到强化高峰后快速下降;肾囊肿则无明显强化。结论:通过定量分析肾脏肿瘤的信号强度,动态增强MRI可以提供肿瘤的血供信息,有助于肾脏肿瘤的诊断和鉴别诊断。     

K空间中心部分采集技术肝脏局灶性病变动态增强扫描

目的：探讨Ｋ空间中心部分采集技术肝脏局灶性病变ＭＲ动态增强扫描方法及临床意义。材料与方法：前瞻性研究１１７例肝脏局灶性病变,包括肝细胞性肝癌、肝细胞性肝癌介入治疗后、周围型肝内胆管细胞性肝癌、转移瘤、海绵状血管瘤及肝囊肿。轴位常规自旋回波Ｔ１加权成像及快速自旋回波Ｔ２加权成像后,采用平静呼吸状态下梯度回波Ｋ空间中心部分采集技术、７个连续层面８个时相动态增强扫描。结果：各例均动态增强扫描成功。动态扫描显示时间信号强度曲线在肝细胞性肝癌及肝细胞肝癌介入治疗后活癌组织部分呈速升速降型;胆管细胞癌呈渐升型;转移瘤呈环形强化,缓慢升高型;海绵状血管瘤呈速升平台型;肝囊肿无强化。结论：Ｋ空间中心部分采集技术肝脏局灶性病灶动态扫描,可以在平静呼吸下成像,显示肝脏局灶病变的血供状态特征,有助于术前病灶定性诊断。     

肝内再生性结节、增生性结节和小肝癌的磁共振征象与鉴别

目的 分析肝内再生性结节(RN)、增生性结节(DN)和小肝癌(SHCC)的磁共振成像特点及鉴别诊断.方法 磁共振平扫及动态增强检查并经病理证实的RN中大结节17个病灶, DN 16个病灶及SHCC 45个病灶,观察病灶的大小、信号强度、强化的方式和时间、包膜等,并绘制时间信号强度曲线.结果 (1)RN: 平扫呈T1W高、T2W低的信号,10个病灶压脂后信号增高,时间-信号强度曲线显示为缓慢上升型.(2)DN: 4个病灶表现为"结中结",中央结节为T1W低、T2W等或高信号,动态增强为速升速降或速升缓降型,周围为T1W高、T2W等或低信号,动态增强为缓慢上升型;余12个病灶T2W为等和稍高信号,动态增强为速升缓降型.(3)SHCC: T1W低信号(35/45)、T2W高信号(42/45)为主,动态增强为速升速降型占71.1%;62.2%病灶可见包膜,3个病灶压脂后信号减低,3个病灶可见镶嵌征.结论 磁共振平扫结合动态增强可对肝内不同性质的结节(RN,DN和SHCC)鉴别.     

3.0T MR对肾透明细胞癌和血管平滑肌脂肪瘤的鉴别诊断价值

目的 探讨结合MR平扫及增强参数、动态增强特征在肾透明细胞癌（clear cell renal cell carcinoma,CCRCC）及血管平滑肌脂肪瘤（renal angiomyolipoma,AML）鉴别诊断中的价值.方法 回顾性分析行3.0T MR平扫及增强扫描并经手术病理证实的肾透明细胞癌17例和血管平滑肌脂肪瘤12例,对压脂T2 WI（T2 WI-FS）信号、正反相位T1WI信号、强化程度进行定量测量.绘制ROC曲线,根据敏感性、特异性、Youden指数确定肿瘤与肾实质T2 WI信号强度（signal intensity,SI）比值阈值、正反相位信号强度比值百分比（SII）阈值、增强动脉-延迟期信号强度比值阈值.根据动态强化特征,绘制动态强化时间-信号曲线.结果 CCRCC的T2 WI SI比值、动脉-延迟期信号强度比值均大于AML,AML的SII大于CCRCC.CCRCC增强动脉期信号强度大于延迟期信号强度,而AML增强动脉期信号强度与延迟期信号强度相近.动态强化曲线显示为两型,一为流出型,其中CCRCC 16例,AML6例;二为平台型,其中CCRCC 1例,AML 2例.结论 在本研究中,CCRCC、AML T2 WI SI比值、SII、动脉-延迟信号强度比值有显著差异,动态增强扫描强化曲线各有不同.根据T2WI SI比值、SII、动脉-延迟信号强度比值可区分CCRCC和AML,其阈值分别为0.738、9.170％、1.224.     

肝脏局灶性病变MR动态增强扫描及临床意义

目的探讨肝脏局灶性病变ＭＲ动态增强扫描方法及临床意义。方法作者前瞻性研究了１３６例肝脏局灶性病变，包括肝细胞性肝癌、周围型肝内胆管细胞性肝癌、转移瘤及海绵状血管瘤。采用平静呼吸状态下梯度回波Ｋ空间中心部分采集技术、７个连续层面８个时相动态增强扫描。结果各例均动态增强扫描成功。动态扫描显示时间信号强度曲线在肝细胞性肝癌呈速升速降型；胆管细胞癌呈渐升型；转移瘤呈环形强化，缓慢升高型；海绵状血管瘤呈速升平台型。结论平静呼吸下Ｋ空间中心部分采集肝脏动态扫描，可以显示肝脏局灶病变的血供状态，而且不同病变具有不同的强化特征。     

3T MR动态增强对脊柱骨髓瘤和转移瘤鉴别诊断初步研究

目的探讨MR T1WI动态增强对脊柱骨髓瘤和转移瘤的鉴别诊断价值。资料与方法对12例脊柱骨髓瘤和19例转移瘤进行MR T1WI动态增强扫描,分析其动态增强信号强度-时间(SI-T)曲线的形态、曲线上升期信号强度增幅、达峰时间以及信号强度-时间曲线最大上升线性斜率。结果 12例骨髓瘤均为Ⅰ型动态增强曲线,19例转移瘤中10例为Ⅰ型曲线,9例为Ⅱ型曲线,骨髓瘤和转移瘤动态增强曲线Ⅰ、Ⅱ型之间差异有统计学意义(P<0.05)。骨髓瘤和转移瘤SI-T曲线上升期信号强度增幅分别为256.58%、206.48%,差异有统计学意义(Z=1.57,P<0.05);SI-T曲线最大上升线性斜率分别为29.70、16.97,差异有统计学意义(Z=2.20,P<0.05);达峰时间分别为24.33s、31.21s,差异有统计学意义(Z=1.81,P<0.05)。结论 MR T1WI动态增强对脊柱骨髓瘤和转移瘤的鉴别诊断有一定的价值,SI-T曲线类型、曲线上升期信号强度增幅、达峰时间和曲线最大上升斜率可以为二者的鉴别诊断提供一定的参考。     

乳腺良恶性病变的动态增强MR信号强度分析

目的:探讨动态增强MB信号强度在鉴别良恶性病变中的意义.方法:72例经手术及病理证实患者,观察和测量其MR信号强度,比较良恶件病变的MR平扫信号强度、动态增强时间-信号强度曲线和早期信号增强率、峰值信号增强率.结果:单以信号强度来说,平扫对于良恶性病变无统计学意义;动态增强时间-信号强度曲线中,良性病变以Ⅰ型曲线为主,占78.9%,而以乳腺痛为代表的恶性病变则以Ⅲ型曲线为主,占79.4%.乳腺癌诊断的敏感性为94.11%,特异性为79.41%,假阳性率为0.08%;早期信号强度增强率对于良恶性病变的鉴别具有统计学意义.结论:动态增强MR信号强度对于乳腺良恶性病变的诊断和鉴别诊断具有很高的临床价值,但本研究结果没有突破,对于定性困难的病灶,还需结合病灶形态学和临床表现及其他检查手段综合分析,以提高对乳腺疾病诊断的正确率.     

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.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

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     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

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).