双侧肾上腺非霍杰金淋巴瘤CT、MRI动态增强诊断价值

目的:探讨双侧肾上腺淋巴瘤CT、MRI动态增强影像特征。方法:回顾性分析经手术病理证实的双侧肾上腺非霍杰金淋巴瘤6例。其中继发性非霍杰金淋巴瘤5例,原发性非霍杰金淋巴瘤1例。男4人,女2。年龄35～75岁,平均63岁。全部病例均行CT平扫和动态增强检查。1例行MR平扫和增强检查。所有病例影像资料均经2名高年医师在不知道病理结果的情况下分析阅片,分别确定病变大小、形态、边缘、密度以及强化程度,以及是否伴腹膜后淋巴结肿大。结果:12个病灶中,6个病灶呈椭圆形,肿块形4个,2个病灶呈肾上腺增生改变。肿瘤直径3.9～8.0cm。10个病灶CT平扫密度均匀,2个病灶密度不均匀,其中一个病灶内可见坏死。平扫CT值为24.1～35.2HU,平均25.5HU;CT动态增强动脉期病灶轻度强化,10个病灶均匀强化,2个病灶不均匀强化,其内可见条状、网格状强化。动脉期CT值28.3～44.7HU,平均31.6HU。门静脉期继续强化,门静脉期CT值36.4～64.6HU,平均48.7HU。MR扫描T1WI信号为均匀稍低信号,T2WI扫描信号为稍高信号,增强扫描可见动脉期轻度强化,静脉期持续强化。3例伴腹膜后淋巴结肿大。2名医师诊断正确4例,2例误诊。结论:双侧肾上腺非霍杰金淋巴瘤密度相对均匀,坏死少见或范围较小,CT、MR动态增强呈轻～中等程度进行性延迟强化,强化较均匀。肾上腺淋巴瘤具有一定的影像学特点,术前CT、MR动态增强扫描有利于确诊。     

孤立性纤维瘤的影像学诊断和鉴别

目的:分析孤立性纤维瘤CT、MR平扫和增强的影像学表现,探导其影像学诊断价值.方法:回顾性分析8例经手术病理证实的孤立性纤维瘤病例,7例术前经螺旋CT或多层螺旋CT平扫或增强检查,1例经MR动态增强检查.所有病例影像资料均经3名高年医师分析阅片,分别确定病灶境界、大小、密度和强化程度等,并与手术病理进行对照.结果:8例孤立性纤维瘤病例中,位于胸部4例,四肢2例,腹腔1例,盆腔1例.肿瘤直径4.0～22.5cm,<5cm 1例,5～10cm 3例,>10cm 4例,平均9.3cm.边缘光滑,境界清楚.瘤体呈圆形或椭圆形5例,梭形3例;5例肿瘤密度相对均匀或略不均匀,内可见两种明显不同密度的实质成分.3例可见不规则坏死区,坏死面积相对很小.较小病灶形态规则,巨大病灶多呈分叶状.CT增强病灶呈地图样强化和匐形线条样强化,动脉期轻微强化～显著强化,门脉期持续强化,强化趋于均匀.MR SE T1WI呈等信号,T2WI为略高信号,T2WI脂肪抑制为高信号,MR动态增强强化显著.结论:SFT典型影像学表现包括:肿瘤密度相对均匀,境界清楚,瘤内常见两种不同密度的实质成分,MR T2WI多表现为略高信号中夹杂片状低信号区,动态增强强化差异大.     

肌肉原发非霍奇金淋巴瘤的MRI表现

目的 分析肌肉原发非霍奇金淋巴瘤的MRI表现,探讨MR诊断价值.方法 回顾性分析6例经手术病理证实的肌肉原发非霍奇金淋巴瘤6例,初诊时均无明确淋巴瘤病史,术前分别经MRT_1WI、T_2WI和T_2WI增强检查.仔细复习MR扫描结果并和手术病理作回顾性对照分析.结果 6例肌肉原发非霍奇金淋巴瘤中,位于颈部2例、上肢1例、下肢3例.6个病灶皆起源于深部肌肉并累及多个肌群,5例病灶侵犯到皮下脂肪间隙,1例累及皮肤,3例肿瘤沿着神经血管束浸润.病灶呈不规则形5例,卵圆形1例.病灶直径7.3～22.5 cm,平均13.9 cm.境界不清楚5例,清楚1例.MR T_1WI略高信号2例,略低信号4例,信号均匀;T_2WI呈略高信号2例,中等程度高信号3例,高信号1例,信号略不均匀5例,均匀1例.5例瘤内可见固有解剖结构(增粗的肌纤维、肌腱和肌间脂肪)残留.MR动态增强扫描5例,动脉期呈中等程度强化,强化较均匀2例,略不均匀3例;实质期持续强化,强化较均匀3例,略不均匀2例.结论 原发肌肉淋巴瘤在T_1WI多呈等低均匀信号,T2WI信号强度低于绝大多数软组织恶性肿瘤,也有一定的参考价值.     

肌肉原发非霍奇金淋巴瘤的MRI表现

目的 分析肌肉原发非霍奇金淋巴瘤的MRI表现,探讨MR诊断价值.方法 回顾性分析6例经手术病理证实的肌肉原发非霍奇金淋巴瘤6例,初诊时均无明确淋巴瘤病史,术前分别经MRT1WI、T2WI和T2WI增强检查.仔细复习MR扫描结果并和手术病理作回顾性对照分析.结果 6例肌肉原发非霍奇金淋巴瘤中,位于颈部2例、上肢1例、下肢3例.6个病灶皆起源于深部肌肉并累及多个肌群,5例病灶侵犯到皮下脂肪间隙,1例累及皮肤,3例肿瘤沿着神经血管束浸润.病灶呈不规则形5例,卵圆形1例.病灶直径7.3～22.5 cm,平均13.9 cm.境界不清楚5例,清楚1例.MR T1WI略高信号2例,略低信号4例,信号均匀;T2WI呈略高信号2例,中等程度高信号3例,高信号1例,信号略不均匀5例,均匀1例.5例瘤内可见固有解剖结构(增粗的肌纤维、肌腱和肌间脂肪)残留.MR动态增强扫描5例,动脉期呈中等程度强化,强化较均匀2例,略不均匀3例;实质期持续强化,强化较均匀3例,略不均匀2例.结论 原发肌肉淋巴瘤在T1WI多呈等低均匀信号,T2WI信号强度低于绝大多数软组织恶性肿瘤,也有一定的参考价值.     

肝脏局灶性结节增生影像分析

目的 :分析肝脏局灶性结节增生 (FNH )的CT、MR及DSA表现 ,提高对本病的认识。方法 :6例经证实的FNH ,均行CT、MR及DSA检查。结果 :6例病灶CT平扫低密度者 4例 ,均匀或不均匀 ,2例为等密度。增强动脉期所有病灶均有明显强化 ,除中心瘢痕外病灶强化均匀一致 ,3例可见到中心或周边增粗、扭曲的动脉。门脉期和延迟期扫描 4例病灶为等密度 ,2例为略高密度。 3例伴有中心瘢痕 ,1例无强化 ,2例延迟强化。 2例行DSA检查 ,病灶内分布较均匀的新生血管团。MR检查 4例 ,T1 WI呈等信号或略低信号 ,T2 WI呈略高信号。 1例行Gd DTPA增强延迟期呈略高信号 ,中心瘢痕无明显强化。结论 :CT、MR及DSA检查可充分反映FNH的血供特点和病理特征 ,动态增强是诊断FNH最有效的影像学手段 ,在诊断和鉴别诊断中具有很大价值     

钙化上皮瘤的影像表现及病理基础

【摘要】目的：分析钙化上皮瘤的CT及MRI表现,并探讨其病理基础。方法：回顾性分析17例经手术病理证实的钙化上皮瘤患者影像学资料并复习相关文献,其中8例行CT平扫及增强扫描,6例行MR平扫及增强检查,2例仅行CT平扫,1例先行X线片,后行MR平扫加增强检查。结果：10例CT共13个病灶。8个病灶见钙化,其中5个病灶完全钙化。2个病灶见坏死。10个病灶边界清清楚,3个瘤周见絮状稍高密度影。8例CT增强扫描共11个病灶,其中3个轻度强化,5个不均匀中度强化,3个病灶完全钙化无强化。6例MR均为单发,2例T1WI呈等信号,T2WI呈外周高中央低信号,DWI呈环状高信号,增强呈“环靶征”。2例T1WI呈等或稍高信号,T2WI呈高信号,内见微囊状更高信号,灶周可见斑片状高信号,增强不均匀强化。2例T1WI呈稍低信号,T2WI均呈稍高信号,增强不均匀强化。1例X线片呈高密度,T1WI呈低信号,T1WI压脂呈不均匀稍高信号,T2WI压脂呈高低混杂信号,增强扫描不均匀强化,以中央强化较为明显。结论：钙化上皮瘤的影像表现有一定特征,当病灶位于皮下,边界清楚,CT见广泛泥沙样或致密的局灶性钙化,MR上见微囊状改变,增强扫描轻至中度强化,尤其呈“环靶征”表现时,应考虑到PM的诊断。     

结外淋巴瘤:影像学共性特征与病理的关系

目的 分析结外淋巴瘤的影像学特征,探讨影像学对其诊断价值.资料与方法 回顾性分析57例经手术病理证实的结外淋巴瘤病例,非霍奇金病54例,霍奇金病3例,初诊时均无明确淋巴瘤病史,术前分别经常规X线、CT和MRI检查.结果 57例结外淋巴瘤中,消化道14例,骨骼9例,脑7例,肾5例,肺4例,脾4例,肾上腺4例,肝脏3例,肌肉3例,胰腺2例,睾丸1例,阴道1例.常规X线检查22例,术前诊断6例;CT检查39例,术前诊断17例;MRI检查19例,术前诊断12例.CT检查47个病灶中,41个病灶密度均匀,6个病灶有程度不等坏死.MRI检查26个病灶中,T1WI为低或等信号,25个病灶T2WI为低、等或略高信号,1个病灶为高信号;17个病灶信号均匀,9个病灶信号不均匀.动态CT和MR增强47例,除脑淋巴瘤为进行性显著持续强化外,其他部位淋巴瘤为进行性轻到中度延迟强化.结外淋巴瘤瘤内常可见脏器原有解剖结构,如血管、支气管、肾盂、肌间隙等残留.结论 结外淋巴瘤共性表现包括肿瘤密实,瘤内可见原有解剖结构残留,MR T2WI多为等或略高信号;一般轻度至中度延迟强化.掌握结外淋巴瘤的一些特征性影像学表现,有利于提高诊断准确率.     

原发性脑淋巴瘤的CT及MRI诊断

目的探讨原发性脑淋巴瘤的CT及MRI影像学特征。方法对20例经手术病理证实的脑淋巴瘤患者的CT及MRI影像学表现进行回顾性分析。结果20例脑淋巴瘤患者17例单发，3例多发，共有24个病灶。其中，CT及MRI图像有以下特点：a）瘤灶多为单发，幕上多见，多为圆形或不规则形；b）CT平扫多呈等或略高密度，无钙化，MR T1WI呈略低或等信号，T2WI呈等或略高信号，瘤周水肿及占位效应相对较轻；c）CT及MRI增强扫描病灶多呈均匀明显强化，亦可不均匀呈环形或花瓣样强化。结论脑原发性淋巴瘤影像表现缺少特征性，确诊主要依靠病理检查。     

鼻及鼻咽孤立性髓外浆细胞瘤的CT和MRI表现

目的探讨鼻及鼻咽孤立性髓外浆细胞瘤的CT和MRI表现,并评价两种影像学检查方法的临床应用价值。资料与方法回顾性分析8例经组织学证实鼻及鼻咽孤立性髓外浆细胞瘤患者的影像学资料。结果发生于鼻咽3例,上颌窦2例,鼻腔1例,鼻腔、筛窦及蝶窦1例,鼻腔、额窦、筛窦、蝶窦及上颌窦1例;病变边界较清楚,呈椭圆形3例,分叶状5例;病变最大径20～92mm,平均49mm。CT表现:鼻部病变造成周围骨质变形、变薄、移位、吸收,其中3例伴局部破坏;鼻咽病变位于黏膜下,黏膜表面光滑,邻近骨质未受累。与脑实质比较,平扫7例呈等密度,1例呈不均匀高密度;增强后2例呈中度、较均匀强化,1例呈不均匀高度强化。MRI表现:T1WI、T2WI均呈等信号,其中7例T1WI信号较均匀,T2WI散在细条状略高信号,另1例可见片状短T1、长T2出血信号;增强后病变中度强化6例,显著强化2例,其中7例病变内可见强化更明显的细条状间隔,对应T2WI所示略高信号。3例动态增强扫描的时间-信号强度曲线均为速升缓降型。MRI均清楚显示病变的范围、伴发的炎症及术后的复发。结论鼻部病变所致骨质变形和吸收、鼻咽病变黏膜下生长、MRI平扫等信号和增强后所示间隔强化是鼻及...     

肝脏假淋巴瘤的MRI表现

【摘要】目的：探讨肝脏假性淋巴瘤的MR表现及其相关病理基础。方法：回顾性分析6例经病理证实的肝脏假性淋巴瘤的MRI及其临床资料,MR图像分析内容包括病灶的数目、部位、大小、形态,边界,病灶平扫信号特点,动态增强特征等。结果：6个病例共7个病灶,5例单发,1例含2枚病灶;7枚病灶均呈类圆形结节,平均大小为1.9cm,MRI平扫T1WI均为低信号,T2WI 2枚略高信号、5枚呈中等高信号;DWI呈不均匀高信号;动态增强7枚病灶呈“快进快出”强化模式;6枚病灶表现为不规则厚环形强化;1枚病灶表现为不均匀强化;2枚病灶外见尖角状强化并向外延伸;1枚病灶内可见血管穿通征。6例病例肝门及腹膜后均未见淋巴结肿大、未见腹腔积液,未见远处转移。结论：肝脏假性淋巴瘤临床罕见,体积较小,多呈类圆形,MRI具有一定的特征性表现,有助于术前诊断及鉴别。     

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.     

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.     

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).     

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.