胃肠道阴性对比剂在磁共振胰胆管成像中的应用

目的：评价马根维显（Gd—DTPA）溶液作为胃肠道阴性对比剂对改善磁共振胰胆管成像（MRCP）质量的价值。方法：对30例疑有胰、胆管系统疾病的患者口服对比剂前后分别行常规腹部MR和MRCP检查,采用相同的扫描参数及定位。结果：所有病例口服对比剂后MRCP扫描,胃及十二指肠内液体高信号均较前有明显下降,图像质量明显提高。口服稀释的Gd—DTPA溶液前后,MRCP检查胆总管、胰管及胆囊结构的显示效果具有显著性意义（P〈0．05）。结论：口服稀释的Gd—DTPA溶液是一种安全有效降低胃肠道液体高信号强度、改善MRCP图像质量的方法。     

口服钆喷替酸葡甲胺溶液行MR胰胆管成像的初步临床应用

目的　应用口服钆喷替酸葡甲胺 (Gd DTPTA)溶液作为胃肠道阴性对比剂 ,以降低胃肠道背景高信号 ,提高磁共振胰胆管成像 (MRCP)的图像质量。方法　用 5 0ml药瓶将Gd DTPA溶液稀释成不同浓度 (分别稀释为 5倍、10倍、15倍、2 0倍 ) ,并设空白对照组 ,行常规及MRCP扫描 ,以选择最佳的对比剂浓度。对 15例疑有胰胆管系统疾病的病人行口服对比剂前后MRCP检查 ,对比剂为稀释 5倍的Gd DTPA溶液 ( 1 488g/L) 2 5 0ml,磁场强度为 1 5T。MRCP成像方法有二维单层快速自旋回波 (FSE)序列及半傅立叶单次激发快速自旋回波 (HASTE)序列。结果　实验部分结果表明稀释 5倍的Gd DTPA溶液T2 WI信号降低最明显 ,达 5 9 3 % ,HASTE序列信号强度降低 82 45 % ,单层MRCP时所有稀释倍数液体信号强度均下降达 90 %以上。所有病例口服对比剂后MRCP扫描胃及十二指肠内液体高信号均较前有明显下降 ,图像质量明显提高 ,以单层MRCP序列胃肠道液体高信号抑制最明显。口服Gd DTPA溶液前后 ,胆总管、胰管及胆囊结构的显示程度等级评分差异有显著性意义 (P <0 0 5 )。结论　稀释 5倍的口服Gd DTPA溶液是一种安全有效地降低胃肠道液体高信号强度、改善MRCP图像质量的胃肠道阴性对比剂     

口服静脉用钆喷替酸葡甲胺对MR胰胆管成像质量影响的研究

目的 选择出静脉用钆喷替酸葡甲胺(Gd-DTPA)作为MR胰胆管成像(MRCP)口服胃肠道阴性对比剂的最佳浓度及容量;评价口服Gd-DTPA对比剂在抑制胃肠道高信号、改善MRCP图像质量中的作用.方法 (1)体外实验:对不同浓度Gd-DTPA稀释液及温开水空白对照组行T1WI、T2WI、二维单层快速自旋回波(FSE)序列及三维半傅立叶单次激发快速自旋回波(HASTE)序列扫描,测量不同成像序列上的信号强度并计算增强率,选择出最佳浓度;(2)临床实验:分别配制不同容量的最佳浓度Gd-DTPA稀释液作为MRCP口服胃肠道阴性对比剂,选择出最佳容量;以最佳浓度和容量Gd-DTPA对比剂对24例临床疑有胰胆管病变的患者行口服前及口服后5～10、10～15 minMRCP扫描,分析图像质量.统计方法采用计算机软件包SPSS 10.0版,对实验结果进行方差分析.结果 T1WI上对照组均为低信号,Gd-DTPA浓度≤0.01 mol/L时为完全高信号;T2WI上对照组为明亮高信号,Gd-DTPA浓度≥0.015 mol/L为完全低信号;2D FSE单层MRCP图像上对照组为明亮高信号,Gd-DTPA浓度在0.0025～0.0300 mol/L之间均为低信号;3D HASTE MRCP图像上对照组为明亮高信号,Gd-DTPA浓度≥0.01 mol/L时为完全低信号;容量≥100 ml浓度为0.01 mol/L的Gd-DTPA对比剂对胃及十二指肠内液体高信号的抑制效果完全;24例患者口服100 ml浓度为0.01 mol/LGd-DTPA对比剂10～15 min后MRCP图像上肝内1、2、3级胆管、肝总管、胆囊、胆总管、胰管头、体、尾的平均等级分数(分别为3.63、3.46、3.08、3.71、3.87、3.88、3.79、3.71、3.50)略高于5～10 min的图像(分别为3.54、3.46、3.00、3.79、3.96、3.87、3.71、3.67、3.54),差异无统计学意义(P值均>0.05),而口服对比剂后肝内3级胆管、胆总管、胰管的等级分数明显高于口服对比剂前(分别为2.79、3.71、3.50、3.42、3.25),差异有统计学意义(F值分别为4.36、4.75、7.86、8.05、7.55,P值均<0.05).结论 100 ml浓度0.01 mol/L的Gd-DTPA对比剂能使胃及十二指肠内潴留液高信号抑制完全,可作为MRCP理想的胃肠道阴性对比剂;口服对比剂后5～10 min行MRCP扫描,图像质量效果最佳.     

口服超顺磁性氧化铁在MRCP中的应用

目的：研究超顺磁性氧化铁(SPIO)作为胃肠道阴性对比剂在改善磁共根胰胆管成像(MRCP)质量的应用。方法：30例受检者口服2mmol/Fe／1的SPIO液100m1后进行TSE MRCP检查，采用西门子1．5T MRI扫描机，服药前后常规行单层和多层扫描，原始图像经工作站处理后，采用最大信号强度投影技术重建获得新图像。结果：口服SPIO溶液可以完全抑制胃及十二指肠内液体信号，排除其干扰，使MRCP时胰胆管显影更加清晰。结论：口服SPIO，行MRCP检查，能抑制胃肠道内液体信号，使胰胆管显影更加清晰，特别是在TSEMRCP成像时效果更佳。     

口服枸橼酸铁铵在梗阻性黄疸MRCP检查中的应用价值评估

目的评价采用枸橼酸铁铵作为胃肠道口服阴性对比剂对提高梗阻性黄疸患者磁共振胰胆管成像(MRCP)检查质量的作用。方法对50例临床怀疑梗阻性黄疸的患者行MRCP检查,将患者随机分为2组:试验组25例患者,在检查前30min时口服枸橼酸铁铵冲剂;对照组25例患者,不服用任何对比剂。观察患者对口服对比剂的耐受性;对所有患者进行冠状位厚层的半傅立叶单次激励快速自旋回波序列(HASTE)和呼吸触发的3D快速自旋回波序列(RT-3D-TSE)扫描。由2位放射科医师单盲阅片,对2组患者MRCP图像的对比效果和图像质量作评估和分级。结果所有患者对枸橼酸铁铵溶液都有很好的耐受性。口服枸橼酸铁铵溶液后所有试验组MRCP图像上的胃肠道高信号都有很大程度的抑制,对比效果和图像质量有明显改善,胆道解剖结构显示的清晰性明显提高。结论口服枸橼酸铁铵溶液作为安全的胃肠道阴性对比剂在梗阻性黄疸患者的MRCP检查中可以有效降低胃肠道高信号所造成的影响及假象,改善胆道系统的显示情况,便于诊断。     

茶为口服负对比剂在磁共振胰胆管造影中的应用评估

目的 探讨以茶叶(中国日照绿茶)为原料研制的磁共振口服胃肠道对比剂的作用机制,评估茶对比剂在磁共振胰胆管造影(MRCP)中的可行性及应用价值.方法 经体外试验确定适宜的茶对比剂浓度为(12.04±0.22) mg/L(锰含量).选择30例志愿者对口服茶对比剂前后MRCP图像自身对照,观测胃肠道信噪比变化及以胰胆管解剖结构为对象的MRCP图像质量的改善情况.采用配对t检验,使用SPSS 18.0软件进行统计学分析.结果 30例受检者服用对比剂后,胃十二指肠充盈达100％.行MRCP时,可有效抑制胃肠道高信号伪影.结论 口服茶对比剂易于接受,安全性好,性能稳定,有助于改善MRCP图像质量,是一种安全有效的胃肠道阴性对比剂.     

口服复锐明在MRCP检查中的应用价值

目的探讨口服复锐明溶液作为阴性对比剂在进行MRCP检查时,通过抑制胃肠道液体信号,提高胰胆管系统显示质量的价值。方法从139例进行MRCP的患者中,选择胃肠道液体高信号干扰胆管系统显示质量的患者40例,服用复锐明后再次进行MRCP检查,对服药前后的图像质量进行评价及对比。结果 40例患者中,服用复锐明前MRCP图像质量为3、4级的患者有25%,服用复锐明后,升为92.5%,在显示解剖结构及病变细节方面,诊断价值均优于未服复锐明组(P<0.005)。结论口服复锐明溶液可不同程度的抑制胃十二指肠道内液体信号,明显改善MRCP图像质量,特别是提高对于胆总管、胰管的显示质量,可进一步提高胰胆管疾病的正确诊断水平。     

口服红氧化铁混悬液用于胃部MRI的研究

目的评价红氧化铁超顺磁性口服磁共振对比剂在胃部MR I诊断中的应用价值。方法采用扫描前口服红氧化铁对比剂,对36例年龄21~60岁受检者行胃部MR检查,对图像进行影像学分析。结果36例受检者服用对比剂后,胃充盈达100%。在各序列扫描中,均呈阴性对比,胃部病变及毗邻关系显示清晰。行MRCP时,可有效抑制胃肠道高信号伪影。结论在胃部MR检查中,口服红氧化铁对比剂易于接受,安全性好,性能稳定,成像浓度范围宽,是一种优良的胃肠阴性对比剂。     

口服枸橼酸铁铵对MRCP的影响

目的: 探讨口服枸橼酸铁铵前后MRCP的临床应用价值.材料和方法: 对43例可疑胰胆管病变者行常规MRI及口服枸橼酸铁铵前后MRCP,并根据术后病理诊断,对照研究口服枸橼酸铁铵前后MRCP的诊断准确率.结果: 口服对比剂后图像质量明显改善;常规MRI,综合口服对比剂后前后MRCP定位、定性诊断的准确率明显提高,分别达到100%及95.4%.结论: 口服枸橼酸铁铵后能有效抑制胃、十二指肠内液体高信号,明显改善胰胆管的显像效果,综合口服对比剂前后MRCP对胆胰系统病变具有重要的临床应用价值.     

口服枸橼酸铁铵在磁共振胰胆管成像中的价值

目的　研究枸橼酸铁铵作为胃肠道阴性对比剂对改善磁共振胰胆管成像 (MRCP)质量的价值。方法　 6 0例受检者归入本次研究 ,其中 30例受检者口服枸橼酸铁铵溶液 (内含 6 0 0mg枸橼酸铁铵 )后进行MRCP检查 ,30例则直接进行MRCP检查 ,均采用GE 1 5TMR扫描仪 ,冠状面常规薄层成像 ,原始图像经工作站处理 ,采用最大信号强度投影 (MIP)技术获得新图像。资深放射科医生对2组图像进行评估后行统计学分析。结果　采用非参数检验Raddit分析 ,未服用枸橼酸铁铵溶液组Raddit值的均数为 0 2 75 ,服用枸橼酸铁铵组Raddit值的均数为 0 72 5 ,计算U值为 6 0 37,P <0 0 0 1。结论　口服枸橼酸铁铵溶液可完全抑制胃及十二指肠内液体 ,排除其干扰 ,使MRCP更能清楚地显示胰胆管     

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.     

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.     

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).     

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).     

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.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.