椎动脉颅内段重复变异MR血管成像的观察分析

目的:探讨椎动脉颅内段重复变异的发生率、磁共振血管成像（MRA）表现特点及其临床意义。方法:回顾性研究。纳入2011年1月—2020年12月聊城市人民医院38 503例患者和体检者的头颈联合或颅脑三维（3D）时间飞跃法（TOF）MRA扫描及最大密度重建（MIP）资料,其中男21 048例、女17 455 例,年龄2～9...     

Magnetic resonance arthrographic dissection of posterolateral corner of the knee: revealing the meniscofibular ligament

Purpose

To evaluate meniscofibular ligament (MFibL) at the posterolateral corner of the knee joint on the magnetic resonance arthrography (MRA) with 70° knee flexion.

Materials and Methods

The MRA of the knee joint was performed at 70° knee flexion. Eighteen patients (19 knee joints) underwent scanning of sagittal, coronal, and axial fat-suppressed T1 weighted images (T1FS), and coronal fat-suppressed T2 weighted images. Sagittal three-dimensional (3D) gradient echo (GRE) images were also obtained. Retrospective review of 19 knee MRA studies was independently performed by two musculoskeletal radiologists. The statistical significance was proved by chi-square test.

Results

The MFibL ligament was optimally demonstrated on the far lateral sagittal 3D GRE and T1FS MRA images. The MFibL appeared as a curvilinear or straight hypointense band of variable thickness, extended from the posterolateral meniscus to upper anteromedial aspect of the fibular head. The MFibL was demonstrated with scale 2 (more than a half length of the ligament) by both reviewers in 73.68% (n=14/19) of the knee 3D GRE images and 89.47% (n=17/19) of the knee T1FS images. The visualization on T1FS and that on GRE were not statistically different from each other (p>0.05). The interobserver agreements were significantly good on both 3D GRE and T1FS images in detecting the ligament (kappa values, 0.642 and 0.683, respectively).

Conclusion

The MFibL is well visualized on the far lateral sagittal MRA at 70° knee flexion, which could potentially be useful in recognizing structures in the posterolateral corner of the knee, including the MFibL.     

磁共振增强三维短时反转恢复变角激发T2WI快速自旋回波序列在成人精道解剖结构显示中的应用价值

目的 探讨MR增强三维短时反转恢复变角激发T₂加权成像(T₂WI)快速自旋回波(3D STIR T₂WI SPACE)序列对成人精道解剖结构显示的可行性及应用价值。方法 回顾性研究。收集2016 年11 月—2019 年3 月复旦大学附属华东医院MR室58 例成年男性腹盆腔MRI资料,年龄29~87 岁,按年龄分为低龄组(≤60岁,22 例)和高龄组(＞60岁, 36例)两组。所有患者均在德国西门子Syngo Via数据后处理工作站3D Viewer薄层最大强度投影(MIP)后行多平面重组(MPR)及曲面重组(CPR)。用3D Viewer行薄层MIP,获得冠状位、轴位、矢状位薄层MIP重建图。观察输精管壶腹段、后腹膜段和精囊腺的形态、走行、信号强度、背景抑制情况,参照日本Oh-Oka团队的评分标准,分别在MPR轴位和CPR 图像对输精管壶腹段、后腹膜段和精囊腺进行图像质量评分。采用Wilcoxon符号秩检验对比分析MPR轴位与CPR图像分别在输精管壶腹段、后腹膜段和精囊腺的图像质量评分,Wilcoxon秩和检验对比分析低龄组和高龄组在CPR图像上的图像质量评分。统计前列腺小囊检出率,并在3D Viewer获得的冠状位、轴位、矢状位三个方位薄层MIP重建图上测量前列腺小囊三个方位的径线值。结果 58例男性腰腿痛患者116侧输精管后腹膜段、壶腹段和精囊腺MR增强3D STIR T₂WI SPACE序列 MPR轴位和CPR图像质量评分分别为3(3,3)、2(2,2)、2(1,2)分和2(2,2)、2(1,2)、2(1,2)分,差异均有统计学意义(Z=10.232、5.196、2.000, P值均＜0.05)。22例(44侧)低龄组和36例(72侧)高龄组腰腿痛患者输精管后腹膜段、壶腹段和精囊腺MR增强3D STIR T₂WI SPACE序列CPR图像在的图像质量评分分别为2(1,2)、2(1,2)、1(1,2)分和2(2,2)、2(2,2)、2(1,2)分,组间比较差异均有统计学意义(Z=2.673、2.249、3.042, P值均＜0.05)。58例患者前列腺小囊检出率为27.58%(16/58),前列腺小囊冠、横、矢三个方位径线值分别为5.35(4.33,6.88)、7.50(5.90,9.00)、8.00(6.43,10.78)mm。结论 MR增强3D STIR T₂WI SPACE序列能较清晰显示精囊腺、输精管壶腹段、后腹膜段以及前列腺小囊等精道精细结构解剖,可为指导临床提供影像学参考。     

A1 segment hypoplasia accompanied by AcomA aneurysms assessed with magnetic resonance angiography

Purpose

This study is to evaluate the use of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) at 3.0 T for the detection and classification of A1 segment hypoplasia based on a large case series and investigates the potential links with AcomA aneurysm occurrence.

Methods

Between January 2009 and June 2012, 8,013 patients underwent MRA examination at 3.0 T in our hospital. MRA was performed using 3D-TOF with volume rendering technique. The presence and location of A1 segment hypoplasia and AcomA aneurysm was reviewed.

Results

Among the 8,013 patients examined, 138 patients were identified with AcomA aneurysms. 425 patients were defined with A1 segment hypoplasia, among whom 303 right-sided A1 hypoplasia and 122 left-sided A1 hypoplasia. 60 of these 425 patients were confirmed with AcomA aneurysms, among them were 49 right-sided A1 hypoplasia. The prevalence of AcomA aneurysm with A1 segment hypoplasia was 14.1 %, which was much higher compared with that (1.0 %) of AcomA aneurysm without A1 segment hypoplasia (P < 0.001).

Conclusions

The incidence of right-sided A1 segment hypoplasia either accompanied with AcomA aneurysm or not was much greater than that of left-sided. Intracranial AcomA aneurysm development appeared to be associated with A1 segment hypoplasia.     

Ramification pattern and topographical relationship between the portal and hepatic veins in the left anatomical lobe of the human liver.

Sixty-one human livers obtained from donated Japanese adult cadavers were dissected to reveal the ramification pattern of the portal and hepatic veins, and their topographical relationship in the left anatomical lobe. The segmental portal vein supplying S2 (P2) tended to form a single stem, whereas that of S3 (P3) was usually double. An intermediate branch between P2 and P3 was observed in 23.0% of livers. In spite of variation between livers, definite P2 and P3 were identified in 47 specimens. One tributary of the left hepatic vein (LHV) was usually present for drainage of S2, and two tributaries were present for S3 (sometimes also for S2 and/or S4). The latter two tributaries of the LHV and the two subsegmental branches of S3 showed three patterns of three-dimensional interdigitations. From these results, the portal vein system did not seem to have a two segmental composition (i.e., S2 and S3) in 23.0% of specimens, whereas the hepatic vein system did not have an intersegmental course in 23.4%. Thus, there were obvious limitations in using each system to determine the liver segment. Taking the overlapping cases into consideration, the left anatomical lobe of 41.0% of specimens did not seem to fit the definition of Couinaud's liver segment. In addition, four patterns of fissure vein (or scissural vein), > 5 mm in diameter at its terminal, were identified: (1) middle hepatic vein type (left median vein, 9.8%); (2) LHV type (left medial vein, 41.0%); (3) true fissure vein (3.3%); and (4) absent cases (45.9%). The former two types also suggested limitations of the hepatic vein system as an indicator of the segmental border.     

多层螺旋CT三维重建研究猪肾动脉和集合系统的解剖关系

目的　探讨多层螺旋CT（MVCT）三维成像在研究猪肾动脉和集合系统解剖关系中的可行性。 方法　使用MVCT扫描机对81例猪肾行螺旋CT扫描, 采用多平面重建(MPR)、最大密度投影（MIP）和容积再现技术(VR)进行猪肾动脉和集合系统的三维成像,以观察肾动脉和集合系统的解剖关系。 结果　全部81例猪肾标本均能显示肾动脉和集合系统的解剖关系。每个猪肾均只有一条动脉,肾动脉的一级分支有2支型和3支型两种,其中2支型占97.53%（79例）,3支型占2.47%（2例）;2支型中91.14% (72例)分为上极支和下极支,8.86% (7例)主分支为背侧支和腹侧支;所有标本中这2条动脉(背侧支和腹侧支)均供应肾上盏群;肾脏背侧中央区由1条起源于上极支的背侧动脉供应的占48.15%;供应肾脏腹侧中央区的动脉由水平分布在肾盂腹侧表面的分支血管组成的占82.72%;肾动脉下极支供应肾下盏群腹侧和背侧表面的占85.19%,而14.81%的背侧表面由来源于上极支的背侧动脉供应。 结论　MVCT三维成像可以作为研究猪肾动脉和集合系统解剖关系的有效方法。     

应用MRA研究大脑前动脉A1段发育与交通动脉开放之间的关系

目的　探讨大脑前动脉A1段发育与前后交通动脉开放情况之间的关系。方法 回顾性分析了107例3.0T磁共振血管成像（MRA）无脑血管病的检查者和体检者。观察双侧大脑前动脉A1段发育、前交通动脉和双侧后交通动脉开放情况,测量双侧大脑前动脉A1段、前交通动脉及后交通动脉的管径,分析二者的相关性。  结果　①右侧大脑前动脉A1段发育不良占22.43%（24/107）,缺如占0.93%（1/107）,左侧大脑前动脉A1段发育不良占16.82%（18/107）,缺如占1.87%（2/107）。②前交通动脉开放占47.66%（51/107）。③单侧或双侧后交通动脉开放共有39例,其中双侧同时开放占21例,仅左侧开放占7例,仅右侧开放占11例。④大脑前动脉A1段发育不良与交通动脉开放相关（r=0.654,P＜0.01）。  结论 大脑前动脉A1段发育不良可引起交通动脉代偿性开放。     

上颌动脉翼腭段的应用解剖

目的 研究上颌动脉翼腭段的走行及分支规律,为翼腭窝内动脉结扎、肿瘤切除和颅面外科手术提供解剖学依据。方法 采用3种手术入路解剖21具成人尸头,观测上颌动脉翼腭段及分支的行程、管径、长度和毗邻关系。结果 上颌动脉翼腭段行于上颌骨颞下面后上区内,分为5型：Y型26.19%、中间型33.33%、T型21.43%、M型11.90%和其他型7.14%。上颌动脉翼腭段外径为（2.61±0.39）mm,总长为（19.44±3.62）mm;其分支有上牙槽后动脉、眶下动脉、圆孔动脉、翼管动脉、腭降动脉、蝶腭动脉、腭鞘动脉,分支走行变异常见;颞深前动脉可作为确定上颌动脉翼腭段的参考标志。结论 熟悉上颌动脉的分支、分型及走行对指导翼腭窝区手术及降低术后并发症具有重要意义。     

MRI depiction and 3D visualization of three anterior cruciate ligament bundles

The anterior cruciate ligament (ACL) is divided into three fiber bundles (AM‐M: anteromedial‐medial, AM‐L: anteromedial‐lateral, PL: posterolateral). We attempted to depict the three bundles of the human ACL on MRI images and to obtain 3‐dimensional visualization of them. Twenty‐four knees of healthy volunteers (14 males, 10 females) were scanned by 3T‐MRI using the fat suppression 3D coherent oscillatory state acquisition for the manipulation of imaging contrast (FS 3D‐COSMIC). The scanned images were reconstructed after the isotropic voxel data, which allows the images to be reconstructed in any plane, was acquired. We conducted statistical examination on the identification rate of the three ACL bundles by 2D planes. Segmentation and 3D visualization of the fiber bundles using volume rendering were performed. The triple‐bundle ACL was best depicted in the oblique axial plane. While the AM‐M and AM‐L bundles were clearly depicted in all cases, the PL bundle was not clearly visualized in two knees (8%). Therefore, the three ACL bundles were depicted in 22 knees (92%). The results of 3D visualization of the fiber arrangement agreed well with macroscopic findings of previous anatomical studies. 3T‐MRI and the isotropic voxel data from FS 3D‐COSMIC made it possible to demonstrate the identifiable depiction of three ACL bundles in nearly all cases. 3D visualization of the bundles could be a useful tool to understand the ACL fiber arrangement. Clin. Anat. 30:276–283, 2017. 2016 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.     

后交通动脉开放与椎动脉颅内段发育间关系的MRA研究

目的　探讨后交通开放情况与椎动脉颅内段发育之间的关系。 方法　回顾性分析了115例3.0T磁共振血管成像（MRA）体检者。观察双侧椎动脉发育与双侧后交通动脉开放情况,测量椎动脉颅内段管径及后交通动脉的长度与管径,分析二者的相关性。 结果　 ①右侧椎动脉发育不良占39.13%（45/115）,缺如占0.87%（1/115）,左侧椎动脉发育不良占15.65%（18/115）,双侧椎动脉同时发育不良占2.61%(3/115)。②单侧或双侧后交通动脉开放72例,双侧同时开放35例,仅左侧开放23例,仅右侧开放14例。③椎动脉颅内段发育不良与后交通动脉开放相关（r=0.677,P=0.000）。 结论　椎动脉颅内段发育不良可引起后交通动脉代偿性开放。     

肺内血管的影像解剖学在肺段切除术的临床应用

目的 对肺内血管予以三维重建后探讨其解剖结构的走形变异对肺段切除术术式的影响,为临床肺段切除术提供影像解剖学基础。 方法 随机抽取中南大学湘雅医院2019～2020年100例肺部增强CT未见明显异常的成年人样本,分别予以三维重建后进行肺血管主干及分支走行的全方位观察。 结果 左肺动脉主干变异率为1%;尖后段、前段动脉变异率为18%,舌段动脉变异率为10%,背段动脉无变异,基底段动脉变异率为1%。右肺动脉主干变异率为1%,尖后段、前段动脉变异率为17%,舌段动脉变异率为22%,背段动脉无变异,基底段动脉变异率为13%。左肺静脉主干变异率为3%,尖后段、前段静脉变异率为20%,舌段静脉变异率为16%,背段静脉变异率1%,基底段静脉变异率为19%;右肺静脉主干无变异,尖后段、前段静脉变异率为25%,内侧段、外侧段静脉变异率为16%,背段静脉变异率1%,基底段静脉变异率为28%。 结论 肺内血管解剖结构复杂多样,尤以尖后段与前段、各基底段的组合较为多样化,内侧段与外侧段不符解剖位置关系,背段走形较为固定。影像三维重建技术能准确清晰地反映肺内血管走行,为临床影像学定位诊断及肺段切除术前评估血管解剖提供了影像学资料。     

Fine mapping of probes in the adenomatous polyposis coli region of chromosome 5 by in situ hybridization.

The gene for adenomatous polyposis coli has been localized to 5q21-22. We have mapped six probes from this region using isotopic or nonisotopic in situ hybridization. Using tritium-labeled probes we localized II227 (D5S37) to 5q14-15 and ECB27 (D5S98) to 5q21. Following hybridization with biotin-labeled probes, the positions of signals along the chromosomes were measured as fractional length relative to the length of the chromosome arm from centromere to qter (FLcen-qter). Ninety-five percent confidence limits, compared with standard karyotypes, provided the corresponding band localization. By this method we localized Cllpll (D5S71) to FLcen-qter 0.407-0.452 (5q21.1-21.3), ECB27 to FLcen-qter 0.426-0.473 (5q21.3), YN5.48 (D5S81) to FLcen-qter 0.459-0.496 (5q21.3-22.2), and ECB134 (D5S97) to FLcen-qter 0.509-0.533 (5q22.3-23.1). ECB220 had three sites of hybridization, a major site at FLcen-qter 0.460-0.492 (5q21.3-22.1) and minor sites at FLcen-qter 0.299-0.339 (5q14.3-15) and FLcen-qter 0.629-0.691 (5q23.3-31.2). We have shown that the chromosome 5 breakpoint in a t(5;15) translocation from a patient with Gardner's syndrome (GM03314) is between Cllpll and ECB27. Linkage data are presented suggesting that ECB27 is located on the same side of the APC locus as II227. These and published results including data on several constitutional deletions (M, SD, and brothers PW and ND) give a probable order of [cen] - [II227, proximal SD breakpoint] - [Cllpll] - [proximal PW/ND, M breakpoint(s), GM03314 breakpoint] - [ECB27] - [APC] - [YN5.48] - [distal PW/ND breakpoint] - [ECB134] - [distal M breakpoint] - [qter]. The major site of ECB220 appears to be between ECB27 and the distal PW/ND breakpoint; the distal SD breakpoint is distal to YN5.48.     

胸椎椎间孔外韧带的解剖学观测

目的　对T1~12椎间孔外口区域的韧带进行解剖学研究并探讨其临床意义。 方法　对10具成人尸体标本的240个T1~12椎间孔进行解剖观测。鉴别所有出现的韧带，观察并记录T1~12椎间孔外口区域椎间孔外韧带的数量、形态、分布、起止位置和毗邻，并用游标卡尺分别测量每条韧带的长度、宽度和厚度。 结果　在229个胸椎椎间孔外口区域共发现564个椎间孔韧带，另11个椎间孔外口区域未发现韧带，椎间孔外韧带的出现率为95.42%。韧带有2种类型，放射型占24.11%（136个），横跨型占75.89%（428个）。放射型韧带在T1及T9~12节段较为常见，而在T2~8节段则相对较少。其中有43.44%（245个）韧带分布于椎间孔外口区域的前部，39.89%（225个）分布于后部，11.35%（64个）分布于上部，5.32%（30个）分布于下部。 结论　胸椎椎间孔外口区域存在2种类型的韧带；其中放射型韧带可能是一种脊神经抗牵拉的结构，对脊神经起到固定和保护作用，横跨型韧带可能是胸椎压缩性骨折后肋间神经痛的潜在原因之一。     

Angioimmunoblastic T-cell lymphoma with hyperplastic germinal centres (pattern 1) shows superior survival to patterns 2 and 3: a meta-analysis of 56 cases

Tan L H C, Tan S Y, Tang T, Lim S T, Tan D, Lim L C, Kam G L S, Loh T P, Tao M & Koay E S C
(2012) Histopathology  60, 570–585
Angioimmunoblastic T‐cell lymphoma with hyperplastic germinal centres (pattern 1) shows superior survival to patterns 2 and 3: a meta‐analysis of 56 cases Aims: Angioimmunoblastic T‐cell lymphoma (AITL) may present in patterns 1, 2 or 3, representing those with hyperplastic, regressed or effaced germinal centres (GCs), respectively, but the prognostic utility of this subclassification has not been previously validated. Methods and results: Twenty‐five cases of AITL were reviewed immunohistologically and with in‐situ hybridization for Epstein–Barr virus‐encoded RNA and polymerase chain reaction for T‐cell receptor gamma and immunoglobulin heavy chain clonality and followed for up to 120 months. Four cases had conventional hyperplastic GCs, two had floral GCs, and one had progressively transformed GCs, consistent with pattern 1 and one additional case had hyalinized GCs, consistent with pattern 2. The remaining 17 (pattern 3) cases lacked morphologically discernible GCs. The Kaplan–Meier survival distribution of pattern 1 cases (5‐year survival 83%) was superior to that of pattern 2 and 3 cases [5‐year‐survival 36% (P = 0.0417)] only when combined with the 31 cases, seven of which were pattern 1, that Attygalle et al. had followed for up to 247 months and previously published. Furthermore, the development of B‐lineage (classical Hodgkin or diffuse large‐cell) lymphoma was associated exclusively with pattern 3 (P = 0.0057). Conclusions: Pattern 1 represents an indolent phase/grade of AITL, unassociated with the development of secondary B‐lineage lymphoma and uninfluenced by treatment regimen.     

Microsurgical anatomy of intralaryngeal distribution of the inferior laryngeal nerve

The functional results of a partial laryngeal surgery or a laryngeal reinnervation depend on the precise knowledge of the intra laryngeal anatomy of the inferior laryngeal nerve (ILN). Ten human larynges without known laryngeal disorders were obtained from human cadavers for ILN microdissection. Intra laryngeal ILN branching patterns were determined bilaterally. The lengths of the vertical, genu and oblique segments of the anterior division of ILN and the distance between the nerve within the paraglottic space and the cricothyroid articulation (CTA) were measured with a digital microcaliper. The mean lengths of the vertical, genu and oblique segments were 10.82, 5.89 and 9.29 mm, respectively. The mean distance between the nerve in the paraglottic space and the CTA was 11.20 mm. Key anatomical landmarks of the abductor division (vertical and genu segments of ILN) were the lateral border of posterior cricoarytenoid (PCA) muscle and the superior ligament of the CTA. The two-branch pattern for the lateral border of the PCA muscle has been the most frequent (50%). A branch of interarytenoid muscle (IA) originated from the genu segment. One or two branches for the PCA muscle has been identified in 75% of cases from the IA neural plexus on the front side of PCA muscle. The adductor division for the thyroarytenoid muscle and the lateral cricoarytenoid muscle was the oblique segment of the nerve. We conclude that abductor and adductor divisions of intra laryngeal ILN can be readily identified and the knowledge of key landmarks allows preservation of the ILN during partial surgery of the larynx and possibly selective muscle reinnervation.     

Variability of the arterial system of the human pancreas

The basic feature related to survival and the ultimate functioning of a transplanted segment or whole pancreas is the preservation and continuation of an adequate blood flow. The current study examined the anatomical variability of the arterial vascularization in 126 pancreases following their removal form cadavers by the technique routinely used for transplantation. Arteriography was conducted initially by the injection of either 75% uropolin or barium sulfate in 70 specimens following removal of the specimen. All 126 specimens were injected with latex, and corrosion casts were prepared through maceration with either sodium hydroxide or hydrochloric acid. The dorsal pancreatic artery showed the greatest variability with respect to the mode of origin and division into branches. Also 42.1% of the cases were found to have poor anastomoses between the body and tail segments. These observations suggest that it is necessary to carefully assess the origins of the vascular supply of the donor organ 1) as resection at the celiac rather than the splenic artery can increase preservation of the dorsal pancreatic artery; 2) whole organ transplantation may be indicated to ensure adequate vascularization; and 3) the presence of a separate arterial supply to the caudal segment in 42.1 % of the cases allows the consideration of its use as an independent transplant from a live donor. © 1993 Wiley-Liss, Inc.     

正常引流肺静脉解剖变异的多层螺旋CT血管成像研究

目的 探讨正常引流肺静脉的解剖变异率及其变异形式。方法 回顾性分析2013年5月—2014年7月中山大学附属孙逸仙纪念医院220例两侧肺静脉均引流至左心房患者的胸部64层螺旋CT血管成像(MSCTA)资料,对肺静脉进行多平面重建(MPR)、最大强度投影(MIP)及VR重建,观察段以上肺静脉引流区域,以及双侧肺静脉与左心房连接模式。两侧肺静脉分别以上、下肺静脉独立开口于左房,右中叶肺静脉回流至上肺静脉者为正常肺静脉引流模式;一侧单支或多于两支肺静脉引流、跨叶引流者为肺静脉解剖变异。结果 220例正常引流肺静脉中,左右肺静脉总变异发生率22.7%(50/220)。右肺静脉解剖变异38例(17.3%,38/220),共见8种变异模式,分别为:(1)上、下叶肺静脉分别汇入左心房,中叶静脉汇入下叶肺静脉 4例(1.8%,4/220);(2)上、下叶肺静脉分别汇入左心房,上叶后段汇入下叶肺静脉2例(0.9%,2/220);(3)上、中、下叶静脉分别汇入左心房16例(7.3%,16/220);(4)上叶后段、尖前段、下叶肺静脉分别汇入左心房,中叶静脉汇入尖前段肺静脉4例(1.8%,4/220);(5)上叶、下叶背段、下叶基底段肺静脉分别汇入左心房,中叶静脉汇入上叶肺静脉2例(0.9%,2/220);(6)上叶、 中叶内段、中叶外段、下叶肺分别静脉汇入左心房6例(2.7%,6/220);(7)上叶后段、上叶尖前段、中叶、下叶肺静脉分别汇入左心房2例(0.9%,2/220);(8)上叶、中叶、下叶背段、下叶基底段肺静脉分别汇入左心房2例(0.9%,2/220)。左肺静脉变异12例(5.5%,12/220),共见2种变异模式,即上、下叶肺静脉组成共干汇入左心房8例(3.6%,8/220),上叶、舌叶、下叶肺静脉分别汇入左心房4例(1.8%,4/220)。220例患者中,左右肺静脉解剖变异率的差异有统计学意义(χ²＝13.533, P<0.01)。结论 MSCTA上正常引流肺静脉解剖变异常见,右肺静脉解剖变异发生率显著高于左肺静脉,且变异模式多样。     

Silencing and complementation of reovirus core protein mu2: functional correlations with mu2-microtubule association and differences between virus- and plasmid-derived mu2

A low-copy component of mammalian reovirus particles is mu2, an 83-kDa protein encoded by the M1 viral genome segment and packaged within the viral core. Previous studies have identified mu2 as a nucleoside triphosphate phosphohydrolase (NTPase) as well as an RNA 5'-triphosphate phosphohydrolase (RTPase), putatively involved in reovirus RNA synthesis and/or 5'-capping. Other studies have identified mu2 as a microtubule-binding protein, which also associates with the viral factory matrix protein muNS and thereby anchors the factories to cellular microtubules during infections by most reovirus strains. To extend studies of mu2 functions during infection, we tested a small interfering RNA (siRNA) directed against the M1 plus-strand RNAs of reovirus strains Type 1 Lang (T1L) and Type 3 Dearing (T3D). The siRNA strongly suppressed mu2 expression by either strain and reduced infectious yields in a strain-dependent manner. This first strain difference was genetically mapped to the M1 genome segment and tentatively assigned to a single mu2 sequence polymorphism, Pro/Ser208, which also determines a T1L-T3D strain difference in microtubule association. The siRNA-based defect in mu2 expression was rescued by plasmids, containing silent mutations in the siRNA-targeted sequence, which encoded either T1L or T3D mu2, but the growth defect was rescued only by T1L mu2. This second strain difference was also mapped to Pro/Ser208, in that swapping this one residue between T1L and T3D mu2 reversed the rescue phenotypes. Thus, the T1L-T3D strain difference in mu2-microtubule association was correlated not only with the extent of reduction in infectious yields by the siRNA but also with the extent of rescue by plasmid-derived mu2. In addition, the rescue capacity of T1L mu2 was abrogated by nocodazole treatment, providing independent evidence for the importance of mu2-microtubule association in plasmid-based rescue. In two separate cases, the results revealed functional differences between virus- and plasmid-derived mu2. Ala substitutions within the NTP-binding motif of T1L mu2 also abrogated its rescue capacity, suggesting that the NTPase or RTPase activity of mu2 is additionally required for effective viral growth.     

胫骨及胫骨远端CT影像解剖形态学研究

目的 探讨西南地区正常成人胫骨远端CT影像解剖学及形态学特征,为治疗胫骨干远端极限骨缺损新型保踝胫骨干假体的设计提供理论依据。方法 回顾性分析2014年1月—2017年10月于四川大学华西医院行CT检查的107例正常胫骨CT影像资料,其中男57例、女50例,年龄20~40(29.8±5.2)岁。应用Mimics软件测量胫骨上下关节面长度(L1)、胫骨平台最低点到髓腔最狭窄部位的长度(L2)、能保留下胫腓韧带的最短胫骨长度(L4)、狭窄段的长度(L5)、最狭部最薄皮质骨厚度(L6)、最狭窄部直径(D1)、胫骨远端关节面最高点上4 cm处胫骨截骨面最贴合髓腔椭圆长径(D2)、短径(D3)以及D2与胫骨冠状轴夹角(∠α)等参数;采用独立样本t检验分析上述参数在性别上是否有差异,并通过Pearson检验分析其与身高的相关性;通过CT影像进行解剖形态学观察,进而分析胫骨远端髓腔的大小和形态、上下截骨面髓腔的大小及相对位置关系。结果 L1为 (339.0±22.2) mm,L2为 (210.0±20.2) mm,L4为(27.0±4.3)mm,L5为(56.5±15.0)mm, L6为(3.6±0.6)mm,D1为(10.2±1.6)mm,D2为(22.2±2.5)mm,D3为(18.1±2.5)mm,∠α为32.8±24.7°(忽略成角方向)。L1、L2、L6、D1、D2、D3均与身高呈正相关(r=0.212~0.793, P值均＜0.05),且男性明显大于女性(P值均＜0.05);保留下胫腓韧带残留的最短胫骨长度占胫骨长度百分比(S1)与身高呈负相关(r=-0.199, P＜0.05),男女之间差异无统计学意义(P＞0.05); L4、L5、∠α、胫骨髓腔最狭窄部与胫骨的位置比例(S2)相对固定,与身高无相关性,且男女之间差异无统计学意义(P值均＞0.05)。当胫骨远端残留长度≤4 cm时,胫骨远端髓腔为近端窄小而远端宽大的“反漏斗”形状;胫骨机械轴相对于胫骨下关节面上4 cm处截面的髓腔解剖轴CT冠状面上偏内约18.5%±6.5%的位置,矢状面上偏后约34.5%±4.7%的位置,故假体远端柄位置设计应更贴合内后侧皮质。结论 胫骨有其固有的CT影像形态特征, 在假体设计时应据此确定假体基本形状,再根据变量设计不同梯度的型号。