结节性筋膜炎的CT和MRI表现

目的：探讨结节性筋膜炎的CT和MRI表现。方法：回顾性分析10例经病理证实的结节性筋膜炎的CT和MRI表现。结果：10例中4例位于上肢,4例位于下肢,2例位于腹壁。病灶均表现为单发实性软组织肿块（肌内型6例,肌间型2例,皮下型2例）,CT平扫示肿块密度稍低于肌肉密度,增强扫描有明显强化。MRI检查：病灶于T1WI呈等或稍低信号,T2WI呈不均匀高信号,其中1例病灶边缘可见囊变区,3例病灶中央可见低信号,增强扫描肿块呈均匀或不均匀中度一重度强化,边界清。结论：结节性筋膜炎的CT和MRI表现有一定特征性,两种方法均有助于本病的诊断及鉴别诊断。     

脊柱色素沉着绒毛结节性滑膜炎的影像学表现

目的探讨脊柱色素沉着绒毛结节性滑膜炎的CT和MRI表现,提高术前诊断的准确性。资料与方法回顾性分析7例经手术和病理证实的脊柱色素沉着绒毛结节性滑膜炎的CT和MRI征象,其中7例行CT扫描,5例行MRI扫描,分析其病变部位、肿块大小、形态、密度(信号)、骨质破坏情况及增强特点。结果 7例患者中,除1例病灶较小外,其余6例均出现分叶状软组织肿块,均以椎小关节区域为中心;1例病灶较小、无明显骨质破坏,6例均出现以椎小关节为中心的骨质破坏,均呈溶骨性、膨胀性骨质破坏。7例均行CT扫描,3例软组织肿块密度与周围肌肉类似,4例密度比周围肌肉稍低。5例行MRI扫描,1例病灶较小,边缘可见低信号;1例信号均匀,未见明显低信号结节;3例软组织肿块内部可见特异性的多发散在低信号结节。结论脊柱病变的骨质破坏以椎小关节为中心且软组织肿块呈特征性MRI信号时,应考虑脊柱色素沉着绒毛结节性滑膜炎的可能。     

眼眶内炎性病变的CT分析

目的：提高对眼眶内炎性病变CT表现的认识.方法：29例眼眶内炎性病变均行眼眶CT扫描,比较分析炎性病变的CT影像表现.结果：炎性假瘤22例,肿块游离缘锐利,其中9例累及泪腺,7例绕眼球生长,2例表现为眶尖部视神经及眼外肌增粗,4例主要表现为眼肌弥漫性增粗;肉芽肿性炎症4例,在眶内呈铸形生长;慢性泪囊炎1例表现为内眦部泪囊区囊性肿块;慢性泪囊周围炎1例表现为内眦部泪囊区中央可见液性密度的小肿物;蜂窝织炎1例表现为右侧眶内眼球外侧密度增高,边缘模糊不清.结论：眼眶内炎性病变CT表现有一定特征性可做出初步诊断.     

MSCT对原发性肠脂垂炎的检查价值

目的 探讨原发性肠脂垂炎（PEA）的CT特征,MSCT的检查价值.方法 对12例具有完整MSCT扫描资料并随访证实的原发性肠脂垂炎病例进行回顾性分析.12例均行全腹平扫,其中2例行增强扫描.结果 10例病灶位于直乙状结肠转折处,1例位于回盲部,1例位于降结肠;12例卵圆形脂肪密度病灶均可见边缘高密度环,11例病灶中心可见高密度影;9例病灶周围可见继发性炎性改变,其中5例可见邻近腹膜增厚,但均未见邻近肠壁增厚及周围积液;2例增强扫描病灶边缘的高密度环及邻近增厚的腹膜可见强化.4～10周后CT随访,12例病灶均自行消退.结论 边缘高密度环征、中心高密度影和周围继发性炎性改变为原发性肠脂垂炎的特征性CT表现,MSCT能清楚显示病灶细节特征及毗邻结构,对原发性肠脂垂炎的诊断有决定性意义.     

硬纤维瘤12例影像学表现

目的：探讨不同部位硬纤维瘤的影像学特征。方法：回顾性分析12例经病理确诊的硬纤维瘤的影像学特点。结果：12例硬纤维瘤均为单发,其中发生于腹直肌3例（右侧2例,左侧1例）,右腹外斜肌2例,左腹内斜肌2例,腹腔内1例,四肢肌肉软组织4例（2例位于前臂,2例位于小腿）。大部分病灶呈梭形（9／12）,少数呈类圆形或不规则形（3／12）。肿块截面大小不等1．4cm×3．5cm～2．8cm×6．4cm,平均2．8cm×4．6cm,长径3～8cm,平均约5．8cm。其中,5例边界较清晰,7例边界不清。B超表现为肌肉内低回声软组织肿块影,边界清楚或不清,内见血流信号。CT平扫表现为肌肉等密度或稍低密度软组织肿块影,与肌肉分界不清,密度均匀或不均匀,增强后病灶中等度或显著强化。MRI表现为肌肉内占位性病变,T1W1呈等信号或稍高信号,T2WI呈高信号。结论：影像学检查可以较为精确的显示硬纤维瘤的病灶部位、形态以及范围,对该病的诊断及鉴别诊断具有重要价值,术前影像学检出有助于病理取材及临床预后的正确评估。     

多排螺旋CT诊断原发性肠脂垂炎的临床价值分析

目的探讨多排螺旋CT用于原发性肠脂垂炎诊断临床价值。方法对收集的原发性肠脂垂炎18例患者采用多排螺旋CT进行检查,观察病灶的形态、大小、密度、部位及周围表现。结果本组原发性肠脂垂炎病例中位于乙状结肠旁8例,回盲部6例,结肠肝曲4例。所有病灶边缘均可见包鞘样高密度环,厚度1~3mm,病程短者薄而光滑,病程长者厚而毛糙。3例表现为肠壁边缘圆形或卵圆形云絮状较周围脂肪比稍高密度影,其余15例表现为肠壁边缘戒指样或环形稍高密度影。结论原发性肠脂垂炎具有特征性CT表现,表现为脂肪垂区的特定病变部位,呈现椭圆形、圆形脂肪密度肿块,边缘高密度环征、中央见点状及线条状高密度影和周围继发性炎性改变,增强后周围环壁呈轻中度强化。     

结节性筋膜炎的影像学表现与病理所见(附1例报告并文献复习)

目的 提高对结节性筋膜炎的影像学表现及其与组织病理学相关性的认识。方法 报告1例经病理证实的结节性筋膜炎病例，并结合文献分析其X线，CT，MRI表现及其与病理学的相关性。结果 本例发生于上臂下段之深层肌间筋膜。X线显示肱骨下段外后缘不规则骨皮质缺损。XT除显示骨质改变外，还可见与周围组织密度相同的软组织肿块MRI显示TtWl上病变周边区呈稍高于肌肉信号、中央区不均匀低信号；TtWl病变周边稍高信号、中央区均匀高信号(明显高于脂肪信号)：病理所见符合黏液和细胞混合型筋膜炎。结论 本病为一良性病变，其MRI表现与组织病理学有相关性。应与纤维性骨皮质缺损、纤维肉瘤、恶性纤维组织细胞瘤、及韧带样纤维瘤相鉴别，     

结节性筋膜炎的影像表现

目的 分析结节性筋膜炎(NF)的CT及MRI表现,以提高影像诊断水平.方法 回顾性分析经手术病理证实的9例NF的影像表现,其中4例行CT检查,5例行MR检查.结果 9例NF中,5例位于下肢,2例位于腹壁,2例位于外耳道.病灶最大直径为1.1～9.5 cm,平均(3.7±0.3)cm.所有病灶均表现为单发实性软组织肿块,CT平扫显示肿块密度与肌肉密度相仿;病灶在MR T_1WI呈等低信号,在T_2WI呈混杂高信号,增强扫描肿块呈均匀或不均匀中、重度强化.结论 CT及MR检查能为临床诊断及鉴别诊断NF提供有价值的信息.     

多层螺旋CT对侵袭性纤维瘤病的诊断价值

目的:探讨侵袭性纤维瘤病的多层螺旋CT表现及诊断价值。方法:回顾性分析9例经病理证实的侵袭性纤维瘤病的多层螺旋CT表现。结果:9例病灶中7例发生于腹内,2例发生于腹外。发生于腹内者4例病灶呈类圆形、密度均匀、边缘光整;3例病灶略呈椭圆形或分叶状、混杂密度、侵犯周围组织,其中3例侵犯临近小肠,1例侵犯临近腹主动脉、右侧髂动脉及右侧腰大肌。发生于腹外的2例病灶表现为沿肌纤维浸润性生长的分叶状软组织肿块,累及多块肌肉。9例病灶中1例可见囊变,1例有点状钙化,9例均未见瘤周水肿。CT增强扫描,病灶以中等强化为主,其中2例可见小片状明显强化区。结论:侵袭性纤维瘤病的CT表现有一定的特征性,CT可以较好的显示肿瘤与周围组织结构关系,对诊断该病有重要价值。     

膝关节色素沉着绒毛结节性滑膜炎的影像学诊断

目的 探讨膝关节色素沉着绒毛结节性滑膜炎(PVNS)的影像学表现。方法 回顾分析9例经手术及病理证实的色素沉着绒毛结节性滑膜炎影像学资料并进行总结。9例膝关节病变均行MR检查，其中3例增强扫描；X线平片检查6例；CT平扫5例。结果 (1)X线表现：6例中关节间隙5例正常，1例增宽；股骨髁破坏1例；胫骨平台破坏4例；共9个病灶，其中7个病灶周围见硬化环。(2)CT表现：5例PVNS均显示关节腔积液；股骨髁合并胫骨平台破坏1例，胫骨平台单发或多发破坏4例，共12个病灶，所有病灶周围均见硬化环。2例合并胭窝内软组织密度肿块。(3)MRI表现：9例中弥漫型7例，局灶型2例。7例弥漫型PVNS均见关节腔积液，其中3例髌上囊积液中见低信号结节，3例前、后交叉韧带表面可见不规则增厚的低信号滑膜覆盖，6例伴有股骨髁或胫骨平台骨质破坏，共15个病灶，其中13个病灶周围绕以低信号硬化环。3例增强扫描显示增厚的滑膜和结节均明显强化。2例局灶型PVNS表现为单发性肿块伴关节腔积液。结论 膝关节色素沉着绒毛结节性滑膜炎的MRI表现较CT、X线表现具有特征性，能够作出正确诊断。     

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.