胰岛细胞瘤的螺旋CT诊断(附8例报告)

目的:探讨螺旋CT检查在胰岛细胞瘤诊断中的价值。方法:回顾性对照病理分析8例胰岛细胞瘤平扫加增强扫描的螺旋CT表现。结果:胰岛素瘤7例,直径为1.0~2.0 cm。CT平扫加增强扫描未发现肿瘤1例;6例CT平扫为等密度,增强扫描动脉期为高密度,门静脉期为略高密度。无功能性胰岛细胞瘤1例,直径为7.7 cm,CT平扫为略低密度,双期增强扫描呈周边明显强化,肿瘤内部不均匀略强化。结论:螺旋CT双期增强扫描在胰岛细胞瘤诊断中有较大价值。     

螺旋CT三期增强扫描在小胰岛细胞瘤(直径≤2 cm)诊断中的价值

目的探讨三期螺旋CT扫描在小胰岛细胞瘤(直径≤2cm)诊断中的价值。资料与方法回顾性分析经病理证实的12例小胰岛细胞瘤患者的螺旋CT平扫及三期螺旋CT检查表现。结果12例患者共发现13个胰岛细胞瘤,其中胃泌素瘤1个,胰岛素瘤11个,无功能胰岛细胞瘤1个。CT平扫仅发现少数病灶(1/13),三期螺旋CT检查发现绝大多数病灶(12/13)。7个病灶强化峰值出现在动脉期,6个病灶强化峰值出现在实质期。病灶CT值动脉期为(118.0±31.6)HU,实质期为(131.2±26.6)HU,门静脉期为(104.5±16.3)HU,实质期与门静脉期之间有统计学意义(P<0.05),动脉期与门静脉期之间无统计学意义(P>0.05)。所有的病灶在三期增强CT上均表现为中等度或明显强化。11个病灶表现为明显均匀强化,2个病灶表现为环形强化。1个非功能性胰岛细胞瘤螺旋CT表现与其余12个功能性胰岛细胞瘤无明显差别。结论小胰岛细胞瘤三期扫描均呈中等度或明显强化,大部分表现为均匀强化,动脉期和胰腺实质期能够检出绝大部分小胰岛细胞瘤;螺旋CT增强三期扫描对判断小胰岛细胞瘤是否具有功能性价值有限。     

64层螺旋CT在胰岛细胞瘤中的临床应用

目的 探讨64层螺旋CT三期增强扫描和三维重组在胰岛细胞瘤中的诊断价值.资料与方法 回顾性分析12例经手术病理证实的胰岛细胞瘤患者的64层螺旋CT表现,重点分析动脉期及静脉期强化特点.结果 12例胰岛细胞瘤均为单发,全部位于胰头,平扫8例与胰腺呈等密度,4例可见钙化,部分可见局限性隆起,但与正常胰腺分界不清.增强后动脉期呈明显均匀强化,CT值较正常胰腺平均高75～85 HU,静脉期强化程度较动脉期略下降,CT值较正常胰腺平均高47～57 HU.增强后瘤体边界与正常胰腺分界清晰.结论 64层螺旋CT三期增强扫描及三维重组在胰岛细胞瘤诊断中有重要价值.     

胰腺实性假乳头状瘤的CT及MRI诊断

目的:探讨胰腺实性假乳头状瘤(SPTP)的CT及MRI表现.方法:9例经外科手术后病理组织学证实的SPTP,术前5例进行CT及MRI平扫和增强扫描,4例只进行CT平扫和增强扫描.结果:肿瘤3例发生在胰头颈部,6例发生在胰尾部.直径2～11cm,均含有囊壁的囊实性肿块,囊性、实性成分比例各有不同,肿瘤内伴有不同程度的出血,囊壁与周围组织分界清楚,9例均未见钙化灶.增强扫描肿瘤实性部分及囊壁有强化,动脉期呈轻度强化,静脉期及延迟期呈轻中度强化,延迟期肿瘤实性部分强化体积及程度更大,囊性和实性结构变得清晰,但均低于正常胰腺.结论:SPTPCT及MRI表现具有一定的特征性.     

胰腺囊实性肿瘤的螺旋CT诊断

目的:探讨胰腺囊实性肿瘤(CSTP)的CT特征性表现。材料和方法:回顾性分析经术后病理证实的7例胰腺囊实性肿瘤的临床资料,以及术前螺旋CT平扫及增强扫描的影像学资料。病例均于注药后28及60s,分别获取增强动脉期和门静脉期扫描图像。7例CSTP均为女性,年龄13~41岁,平均24岁。结果:CT平扫见肿瘤发生在胰头部2例,胰体或胰尾部5例,肿瘤最大者为13.0cm×9.5cm,最小者为5.0cm×3.7cm,密度最低为17Hu,最高为51Hu。增强扫描示7例肿瘤的囊性部位均无增强,实性部分5例明显增强,2例无明显增强。4例可见钙化。结论:胰腺囊实性肿瘤多发生于年轻女性,肿瘤体积较大,呈囊实性改变,螺旋CT能做出正确诊断。     

胰腺神经内分泌肿瘤的CT、MRI、^18F-FDG PET/CT表现与鉴别诊断

目的:探讨胰腺神经内分泌肿瘤(NETP)的CT、MRI、18F-FDGPET/CT表现及其鉴别诊断价值.材料和方法:回顾性分析经手术病理证实的20例胰腺神经内分泌肿瘤(功能性7例,无功能性13例)的影像学资料,均行CT平扫及增强扫描,5例行MRI平扫及增强扫描,2例行PET/CT检查.结果:功能性NETP1例CT平扫、增强扫描及PET/CT均未显示;其余6例为等密度(5例)或略低密度(1例);2例MRI均呈长T1长T2信号;动脉期(5例)或门静脉期(1例)明显增强,高于胰实质,且境界清楚.无功能NETP呈实性4例、囊实性7例、囊性2例;3例MRIT1WI呈低信号、T2WI呈高信号(2例)和稍高信号(1例);1例PET/CT呈均匀高代谢的等密度结节;11例境界清晰;2例囊性肿瘤未见增强,实性和囊实性在动脉期(7例)或门静脉期(4例)显著增强,高于胰实质.结论:境界清晰和显著增强是胰腺神经内分泌肿瘤的CT、MRI特点,18F-FDGPET/CT对鉴别其性质有帮助.     

非功能性胰内分泌肿瘤的螺旋CT表现

目的　了解非功能性胰内分泌肿瘤的螺旋CT双期增强扫描的表现。方法　回顾性分析 1 8例经手术病理证实的非功能性胰内分泌肿瘤的螺旋CT表现。螺旋CT采用平扫和双期 (动脉和门静脉 )增强扫描 ,层厚 1 0mm、螺距 1 0 ,非离子型碘对比剂总量 90ml,注射流率 3ml/s,动脉、门脉期扫描分别为 30s和 70s。结果　 1 8例肿瘤平均大小 5 3cm× 5 9cm× 6 2cm ,其中位于胰头9例、胰颈 4例、胰体尾 3例和胰尾 2例。平扫呈稍低密度 7例、低密度 3例、水样密度 2例和等密度6例 ,其中 4例可见肿瘤内有钙化。增强扫描动脉期肿瘤呈中等至明显强化 1 3例 ,其中均匀和不均匀强化各占 5例、环状强化为 3例。 9例胰头肿瘤中 ,1例胆管轻度扩张、3例胰腺管轻度扩张和 1例胰体尾轻度萎缩。本组病例中 5例胰腺周围血管受累。结论　非功能性胰内分泌肿瘤螺旋CT动脉期扫描呈中等或明显强化为其特征 ,同时具有较少侵犯胰腺管和 (或 )胆总管及邻近血管的特征     

胰腺实性假乳头状瘤的多层螺旋CT表现

目的探讨胰腺实性假乳头状瘤的多层螺旋CT特征性表现。方法回顾性分析经手术病理证实的5例胰腺实性假乳头状瘤的螺旋CT平扫和增强扫描影像资料。本组5例均于静脉注射造影剂后25s和55s分别获得动脉期和胰腺实质期CT扫描图像。结果患者中1例为19岁男性,其余为年轻女性,无黄疸。肿瘤呈囊实性肿块,实质与囊性部分呈相间分布,1例有病灶内钙化。肿瘤最长径4～12cm,平均8cm。CT增强扫描动脉期肿块轻度强化,门静脉期肿瘤强化略高于动脉期,但其强化程度均低于正常胰腺组织。结论胰腺实性假乳头状瘤的螺旋CT表现虽有一定特征,但在术前作出正确诊断仍较难,应行胰腺活检确诊。     

非功能性胰岛细胞瘤的多层CT表现

目的:探讨CT诊断非功能性胰岛细胞瘤的多排CT表现。方法:对12例病理证实的非功能胰岛细胞瘤的CT平扫及增强图像进行分析。结果:12例患者检出13个病灶。11个为实性病灶,2例为囊性,动脉期,7个病灶明显强化,3例轻度强化,1例与正常胰腺强化程度相似。门静脉期,4例为明显强化,7例位轻度强化。2例病灶始终为低密度。结论:多排CT对于非功能性胰岛细胞瘤的病灶检出及分期有很要得价值,可为手术提供重要的信息。     

胰腺实性-假乳头状瘤的CT诊断和鉴别诊断

目的 描述胰腺实性-假乳头状瘤的CT表现，探讨CT对该肿瘤的诊断价值。方法 回顾分析经手术、病理证实的11例胰腺实性-假乳头状瘤的CT表现和诊断。结果 (1)肿瘤内有实性和囊性结构，CT平扫实性结构呈低或等密度，造影后动脉期呈轻度强化，门静脉期呈明显强化，囊性部分在增强前后扫描均呈低密度。(2)囊实性结构比例相仿的肿瘤7例，囊性结构为主者3例，其CT表现分别为囊实部分相间分布或实质部分呈附壁结节。(3)实性结构为主的肿瘤1例，其CT表现为囊性部分位于包膜下。(4)肿瘤绝大多数来源于胰腺，呈圆形、椭圆形，多有完整包膜，增强后强化明显，与胰腺分界清晰。(5)不伴有胆总管和胰管扩张。(6)8例术前诊断为良性、3例诊断为低度恶性肿瘤。结论胰腺实性-假乳头状瘤CT表现有一定特征，且CT诊断有其重要价值，需与黏液性或浆液性囊腺瘤、囊腺癌、胰腺癌囊变、胰性假性囊肿等进行鉴别。     

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.