儿童正常垂体腺的MR研究

目的：通过ＭＲＩ研究儿童正常垂体腺形态、大小及信号强度。材料和方法：５２例非垂体腺疾病的颅脑ＭＢ资料。年龄３～１５岁。观察测量矢状面Ｔ１加权图像上垂体腺的形态、高径、垂体柄宽径及后叶信号特征。结果：儿童正常垂体腺形态分：平坦型２７例（５１．９％），凹陷型１５例（２８．８％），隆凸型１０例（１９．３％）。垂体腺高径：３～５岁３．９±０．３ｍｍ，５．１～１０岁４．２±０．５ｍｍ，１０．１～１５岁５．３±０．４ｍｍ。垂体柄宽径１．４±０．５ｍｍ。垂体后叶均呈高信号（１００％）。结论：１．儿童垂体腺形态以平坦型最常见。２．垂体腺高径与年龄呈正线性关系。３．垂体柄未见中断。     

高海拔地区成人正常垂体腺的MRI研究

目的通过MRI研究高海拔地区成人正常垂体腺形态、大小及信号强度,并将之与国内已报道的相关测量数据比较,以确定有无差异性。方法收集120例非鞍区疾病的颅脑MRI资料片测量。采用杨氏的测量方法,分别测量垂体腺的前后径、宽径,矢状位、冠状位高径;垂体后叶的高径、前后径;垂体柄的长径、宽径;同时观察垂体腺的形态及其信号特征。结果垂体腺形态呈平坦型86例（71%）,凹陷型20例（16%）,隆凸型14例（11%）。垂体腺的矢状位高径、前后径分别为5.4±1.3mm、10.3±1.7mm,冠状位的高径、宽径分别为5.0±1.2mm、13.8±2mm;垂体后叶的高径、前后径分别为3.9±1.2mm、2.1±0.5mm;垂体柄的长径和宽径分别为9.6±2.3mm、1.6±0.7mm。结论测得的结果显示高海拔地区垂体腺各径线数据与已报道的国内数据比较,无明显差异。     

正常鞍区MRI影像解剖学研究

目的研究１２０例正常鞍区ＭＲＩ断层影像解剖学表现。材料与方法用ＳＥ序列Ｔ１加权和Ｔ２加权进行冠、矢状面扫描,层厚２ｍｍ。结果正常垂体腺高度５．２±１．５ｍｍ,宽度１３．６±２．１ｍｍ,前后径８．９±１．６ｍｍ,５０岁以后垂体腺高度减低;在Ｔ２加权图像上,垂体信号与邻近脑组织相比,有４６％呈高信号,５４％呈等信号,注射造影剂后信号明显增高,３０％垂体信号不均匀。垂体上缘的形态４９％呈凹陷型,３４％呈平坦型,１７％呈隆起型。有１１２例垂体后鞍背前可见高信号影。垂体柄在矢状面可清晰显示,冠状面有８０％位置居中,２０％稍有偏斜。结论ＭＲＩ可清晰显示鞍区的解剖结构,并可准确测量鞍区结构的径线,正常垂体腺的大小、形态、信号有一定变化,须综合观察才能做出正确判断。     

正常成人垂体的磁共振测量研究

目的:观察正常垂体形态、测量其大小并探讨其与年龄、性别的变化关系。方法:选取300例非鞍区病变及内分泌症状的正常成年人。按性别、年龄分为5组:20~29岁组,30~39岁组,40~49岁组,50~59岁组及60岁以上组,每组男女各30例,MRI测量矢状位腺体及后叶前后径、高径以及垂体柄前后径;冠状位腺体宽径、高径及垂体柄宽径;比较分析不同性别、年龄段上述各径线MR测量值的变化特点。结果:成人男、女正常垂体冠状高径分别为(4.01±1.08)mm、(3.99±1.37)mm,冠状宽径分别为(9.75±1.63)mm(、10.17±1.59)mm;矢状高径分别为(4.46±1.24)mm(、4.68±1.61)mm;前后径分别为(10.15±1.51)mm(、10.24±0.90)mm;垂体后叶矢状高径分别为(4.01±1.43)mm(、4.59±1.17)mm,前后径分别为(2.01±0.66)mm、(1.98±0.70)mm;垂体柄冠状宽径分别为(1.56±0.21)mm、(1.59±0.21)mm,前后径分别为(1.50±0.23)mm、(1.52±0.22)mm。垂体高径在20~29年龄组最大,有随年龄增大而逐渐减小趋势;垂体宽径及前后垂体后叶及垂体柄各径线有先增大后减小趋势。结论:成人垂体各径线随年龄的变化有先变大后减小趋势。各径线与年龄有一定统计学差异而与性别无明显统计学差异。     

正常胎儿脑垂体的MRI与组织学对照研究

目的:MR成像观察正常胎儿垂体的大小、形态及信号强度,结合组织学对垂体信号进行研究.材料和方法:正常胎儿标本32例,胎龄16～39周.行MR T1WI扫描,对MR图像行计算机处理并行统计学分析.结果:胎儿垂体前后径、高度及宽度均与胎龄呈正相关;垂体形态为凸起型;前叶和后叶均为高信号,且前叶信号高于后叶信号,垂体形态及信号与胎龄不相关.垂体前叶的组织学特征为腺细胞密度大,细胞内内质网和分泌颗粒数量较多.结论:正常胎儿垂体各径线的持续性增加及其凸起的形态反映了妊娠阶段胎儿垂体迅速生长的特点,T1WI前叶高信号可能与垂体腺细胞内磷脂膜结构及蛋白质含量较高而导致结合水增加有关.     

中枢神经系统郎罕细胞组织细胞增生症一例

郎罕细胞组织细胞增生症 (ＬＣＨ)是 1种罕见的反应性疾病 ,在儿童更为少见。笔者报道 1例累及垂体轴的儿童郎罕细胞组织细胞增生症。患者　女 ,3岁。 2年前出现多饮、多尿等症状 ,临床诊断为隐匿型糖尿病 ,同时发现左侧股骨病变 ,经活检诊断为ＬＣＨ。近 1个月来出现进行性视力缺损及生长激素缺乏等临床表现。ＭＲ矢状面和冠状面ＳＥＴ1ＷＩ示垂体柄呈棒状膨大 ,表现为等信号 ,其前后径 3 4ｍｍ ,左右径 2 6ｍｍ ,增强后呈明显均匀强化。未见垂体后叶 ,垂体前叶和视交叉正常(图 1,2 )。 1年后复查 ,轴面ＳＥＴ2 ＷＩ示鞍上池内类圆形等信…     

学龄前儿童原发垂体性生长激素缺乏症的MR影像学表现

目的：研究学龄前儿童原发垂体性生长激素缺乏症垂体的MRI特征。方法：回顾分析46例原发垂体性生长激素缺乏症儿童（病例组）垂体的MR影像特征,并与35例同龄健康儿童（对照组）作对照比较。结果：病例组腺垂体平均高度（2.32±0.78）mm,与脑干对比,34例T1WI信号低于脑干,12例信号与脑干相等;44例垂体柄完整连续,矢状面平均宽径（0.89±0.51）mm;2例垂体柄缺如;2例垂体后叶异位于下丘脑漏斗底部的正中隆起。4例合并中枢神经系统畸形。对照组腺垂体高度、垂体柄宽径分别为（3.76±1.21）mm、（1.64±0.59）mm。病例组腺垂体高度、垂体柄矢状宽径均比正常对照组小,差异具有显著性意义。结论：MRI能够清楚的显示原发垂体性生长激素缺乏症垂体的影像学特征,表现为垂体前叶变小,信号低于或等于脑干,垂体柄变细或缺如,大多数垂体后叶位置正常,少数病例后叶异位,以及合并的中枢神经系统畸形。     

低场强MRI在垂体微腺瘤诊断中的应用研究

目的评价低场强MRI在垂体微腺瘸的诊断中的价值，提高诊断准确性。方法回顾性分析我院经临床内分泌检查及手术病理证实的垂体微腺瘸57例的MRI表现，总结其表现特征。结果在57例微腺瘤病人中，51例在T1WI上呈低信号，34例上缘膨隆，34例高径大于8mm，31例垂体柄向对侧偏移，增强后相对低信号50例。结论依据磁共振表现，结合临床表现厦内分泌检查，能很好的诊断垂体微腺瘤，并指导临床治疗。     

青春前期儿童甲状腺功能减退致垂体增生的MRI表现

目的探讨青春前期儿童甲状腺功能减退（甲减）致垂体增生的MRI表现。资料与方法分别对10例临床已确诊为甲减的儿童和10名青春前期的正常儿童行垂体MRI平扫及增强检查并对照分析。结果10例甲减患者表现为垂体上缘呈对称性隆起,形态呈钟形,垂体明显均匀强化,垂体高9．4～16．0nm,垂体柄横径为1．4～1．7mm。结论甲减所致垂体增生具有一定的影像学特征,结合临床可明确诊断。     

垂体柄病变的MRI影像与临床特征分析

目的 探讨MRI在垂体柄病变影像诊断中的价值及限度。方法 选取并分析经病理证实的21例垂体柄病变的MRI特征和临床表现。结果 21例中生殖细胞瘤7例，朗格汉斯组织细胞增多症(langerhans cell histiocytosis, LCH)6例，淋巴细胞漏斗神经垂体炎(lymphocytic infundibuloneurohypophysitis, LINH)5例，颗粒细胞瘤2例，Erdheim-Chester病(ECD)1例。21例MRI表现为垂体柄不同程度增粗或肿块，以垂体柄上部为主，增强呈明显强化。病灶最大横径为(6.68±2.97) mm。17例垂体后叶高信号消失，1例神经垂体异位。21例患者均有中枢性尿崩症，其中13例患者出现垂体前叶功能减低，以继发性性腺功能减退最常见。结论 MRI可以早期发现垂体柄病变，但对肿瘤及炎性病变的定性诊断尚需进一步研究。     

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.