结节性硬化的影像学诊断

目的总结结节性硬化的影像学表现特征。方法回顾分析20例经临床、影像及病理证实的结节性硬化患者的脑部CT和MRI表现。结果20例中CT表现为沿侧脑室壁分布的多发室管膜下钙化结节16例,其中多发结节14例,单发结节2例,室管膜下等密度未钙化结节2例,结节大小介于2~12mm。未见明确异常2例。MRI显示多发室管膜下结节19例,单发结节1例,T1WI结节呈等信号或低信号,T2WI呈低信号、等信号或稍高信号。MRI显示脑皮质及皮质下病变19例,呈局限脑回样异常信号;脑白质异常信号7例,分别呈线状、楔形及不规则形。9例MRI增强扫描室管膜下结节多呈轻中度强化,脑实质内结节多不强化。结论结节性硬化的CT和MRI表现均具有特征性。     

结节性硬化的影像诊断

目的:探讨结节性硬化的CT和MRI影像学特征表现。方法:回顾性分析10例结节性硬化的CT和MRI表现,10例均行头部CT平扫,CT增强1例,膝关节CT平扫1例,2例行头部MRI平扫。结果:CT表现中,所有病例均见双侧侧脑室室管膜下多发高密度钙化结节,1例并有室管膜下巨细胞星形细胞瘤,1例有皮肤血管纤维瘤。2例MRI均见双侧侧脑室室管膜下多发结节,T1WI呈稍高信号或等信号,T2WI则为低信号。结论:CT和MRI检查对结节性硬化的诊断具有重要价值,其CT和MRI影像学表现具有特征性。     

磁共振增强梯度回波T2*加权血管成像对结节性硬化症的诊断价值

目的 探讨磁共振增强梯度回波T2*加权血管成像 (enhanced gradient echo T2-star weighted angiography,ESWAN) 序列对结节性硬化症(tuberous sclerosis,TS)的诊断价值.方法 回顾性分析经临床证实的9例TS患者的CT、常规MRI及ESWAN的资料(9例均行颅脑CT、MRI平扫及ESWAN扫描,其中CT增强2例,MRI增强3例).结果 CT表现为脑室管膜下或周围的多发钙化灶;MRI表现双侧大脑白质、皮层和室管膜下区多发结节样、斑片状异常信号影,室壁呈波浪状改变,T1WI呈低或等信号,T2WI为等或略高信号;ESWAN显示钙化性病灶呈斑点状低信号,灶周环绕斑片状高信号,而未钙化的病灶呈斑片状高信号,边界清楚.ESWAN与常规MRI、CT对病变结节的显示率具有显著性差异(χ2值分别为9.35和13.75,P＜0.005＝.结论 ESWAN是常规MRI及CT诊断TS的有力补充.     

CT和MRI对结节性硬化的诊断价值(附32例报告)

目的：探讨CT及MRI对结节性硬化的诊断价值。方法：回顾分析经临床病理证实的32例结节性硬化（TS）的CT、MRI资料。结果：CT表现为脑室周围的结节状钙化，脑实质错构瘤，室管膜下巨细胞星形细胞瘤。MRI表现为脑实质多发异常信号灶，T1WI呈低信号，T2WI呈高信号。结论：结节性硬化的CT表现有一定特征性，对临床疑TS的患者，CT检查很有必要。MRI检查能发现更多病变，对非钙化性病变比较敏感，两者起互补作用。     

肝结核的CT与MRI表现

目的 探讨肝结核的CT、MRI表现及其诊断价值。方法 回顾性分析经病理证实的12例肝结核的CT和MRI表现。结果 （1）12例 CT表现：肝浆膜型1例,为肝包膜下多发结节性病灶。肝实质型10例,其中多发粟粒小结节状低密度灶伴点状钙化2例,单发略低密度大结了伴斑点状钙化及聚集多个结节样病灶形成“成簇征”或融合成窝状改变各3例,多发囊样病变及发粟粒状钙化伴单发大结节低密度灶各1例。肝内胆管型1例,肝内胆管明显扩张及肝门部多发斑点状钙化灶。（2）4例MRI表现：T1WI、T2WI低信号灶1例,T1WI低信号、T2WI高信号灶3例,增强后为轻度边缘强化或呈多环状强化。结论 各种类型肝结核均有其特定的影像学表现,典型的CT、MRI表现可提示该病的诊断。     

结节性硬化症的CT和磁共振成像诊断价值

目的评价cT及磁共振成像（MRI）检查对结节性硬化症的诊断价值。方法采用64排cT及1．5T磁共振扫描仪,回顾性分析18例结节性硬化症的颅脑cT及MRI表现。结果结节性硬化症的cT与MRI表现为室管膜下结节,脑皮质及皮质下病变,脑白质异常,室管膜下巨细胞星形细胞瘤。cT显示钙化结节敏感,而非钙化结节、皮质及白质病变的显示MRI比cT有显著优越性。MRI增强扫描室管膜下结节多呈轻中度强化。结论结节性硬化症的cT和MRI表现均具有一定特征性,cT和MRI在结节性硬化的诊断中具有十分重要的价值。     

胎儿及婴幼儿结节性硬化症伴有心脏横纹肌瘤的MRI表现

目的 分析胎儿及婴幼儿结节性硬化症(TSC)合并心脏横纹肌瘤(CRs)的影像表现,以提高对该病的认识.方法 回顾性分析2006年6月至2013年11月经MRI诊断的9例婴幼儿和4例胎儿TSC伴有CRs的临床和影像资料,总结其影像特征.所有胎儿及婴幼儿均接受颅脑和心脏MR平扫,9例婴幼儿还进行MR增强检查.结果 9例TSC患儿在头颅MRI上具有特征性的侧脑室室管膜下及双侧大脑皮层和皮层下多发异常结节信号.室管膜下结节在常规自旋回波T1WI表现为等或略低信号,T2WI为稍高或稍低信号.皮层及皮层下结节T1WI表现为低或者高信号,T2WI上为低或者高信号.增强后有不同程度强化.9例CRs患儿中,单发病灶3例、多发6例.心脏增强扫描CRs表现为室间隔、心室流出道或房室游离壁类圆形实质性占位,自旋回波T1WI及T2WI、平衡稳态快速梯度回波(B-TFE)序列均呈类似于心肌的等信号,增强后无或者轻度强化.4例胎儿快速序列MRI显示颅内双侧室管膜下多发小结节,T1WI呈等或稍高信号,单次激发快速自旋回波(SSTSE)或平衡稳态快速梯度回波(B-FFE)序列上呈等高或者低信号.心房或者心室内CRsB-FFE序列和SSTSE序列呈等或稍高圆形信号.结论 MRI在TSC合并CRs的颅内和心脏病灶的检出方面均具有独特的优势.MRI技术的发展可以提高本病诊断的及时性及准确性.     

结节性硬化的MRI诊断

目的:探讨结节性硬化的临床和MRI诊断价值。方法:回顾分析11例结节性硬化症病例的临床和MRI影像资料。结果:病灶表现为脑组织内多发性形态不规则结节,散布于脑皮质、皮质下和脑室室管膜下;结节在T2WI像呈高或低信号,T1WI呈等或低信号,增强后结节不强化。结论:结节性硬化的头颅MRI表现具一定特征性,对早期诊断具有一定价值。     

结节性硬化症的MRI和CT诊断

目的 探讨结节性硬化症的颅内影像学征象。材料和方法：对5例临床确诊为结节性硬化症的病例进行头颅CT和MRI检查,对其影像学征象进行分析。结果 所有病例均表现为两侧侧脑室室管膜下多发结节状异常信号和高密度,其内多同时有钙化。其余脑实质及皮层下亦可见散在结节状和片状异常信号,合并有钙化。增强扫描,室管膜下结节有轻度增强。结论 MRI和CT检查能全面反映结节性硬化症的颅内病理改变,对于其临床诊断和中枢系统损害程度的评价有意义。     

结节性硬化症的磁共振影像学表现

目的　分析结节性硬化症TSC的MRI表现。方法　 13例经临床证实的TSC病例 ,分析其头部MRI特征性改变。结果　MRI主要征象包括 :①室管膜下结节 :13例均发现病灶 ,T1WI发现 71个 ,T2 WI 39个 ,PDWI 5 6个 ;②皮层及皮层下结节 :11例有阳性发现 ,T2 WI和PDWI各发现 114个病灶 ,T1WI 72个 ;③脑白质异常信号 :5例发现白质病变 ,T2 WI和PDWI各发现 10个病灶 ,T1WI无明确显示 ;④室管膜下巨细胞星形细胞瘤 :仅 1例发现。结论　MRI对TSC的中枢神经系统改变敏感 ,是诊断此病的首选影像学检查方法 ,其中T1WI观察室管膜下结节敏感 ,T2 WI和PDWI观察皮层下及白质病变敏感     

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     

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.     

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.     

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.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

U50,488H对正常及缺氧心肌细胞L型钙电流的作用

目的 探讨心脏阿片受体和β-受体相互作用的机制。方法 采用全细胞膜片钳技术，观察U50，488H(β-阿片受体选择性激动剂)对正常和缺氧心肌细胞L型钙电流的作用。结果 U50，488H剂量依赖性(0．1～100μmol／L)抑制正常心肌细胞的L型钙电流及异丙肾上腺素(0．1μmol／L)激动的钙电流，而细胞缺氧后，这一抑制作用减弱；U50，488H对Forskolin(10μmol／L)激动的L型钙电流无明显影响。结论 β-阿片受体对β-受体信号的负性调节作用在细胞缺氧后减弱，其作用位点可能发生于β-受体与腺苷酸环化酶环节之间。     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

Prenatal detection of brain anomalies with ultrasonography

Ultrasound is the first-line imaging study of the fetal brain performed at 12, 22 and 32 weeks of gestation. The very structured evaluation of biometric and morphological data, facilitated by the use of a checklist, ensures a high quality examination. All patients where an anomaly of any key element is suspected should be referred to a center dedicated to prenatal diagnosis for confirmation irrespective of the gestational age. Prenatal diagnosis plays a significant role in France since medical interruption of pregnancy until term is authorized.