脑血管畸形的MRI诊断：与CT,脑血管造影对比分析

报道了６４例脑动静脉畸型和８例脑海绵状血管瘤的ＭＲＩ表现，并对ＭＲＩ、ＣＴ及脑血管造影在脑血管畸形诊断中的应用价值进行了对比分析。６４例脑动静脉畸形的ＭＲＩ均见到典型征象──流空信号簇。２９例见到粗大的供应动脉或／和引流静脉，１４例见到扩大的静脉窦。结果表明，ＭＲＩ对于脑动静脉畸形及其并发症的诊断优于ＣＴ，并可弥补脑血管造影的不足。ＭＲＩ与ＣＴ的联合应用对脑海绵状血管瘤的定性诊断很有意义。     

颅内海绵状血管瘤的影像诊断

目的：分析颅内海绵状血管瘤的ＣＴ和ＭＲＩ征象，以提高对其的认识。材料和方法：经病理证实的海绵状血管瘤３２例，２６例作ＣＴ检查，３０例作ＭＲＩ检查。结果：颅内海绵状血管瘤多为单发，脑内海绵状血管瘤多于脑外。ＣＴ平扫病灶呈高密度或稍高密度，增强扫描病灶呈轻至中度强化。ＭＲＩＴ２ＷＩ常显示海绵状血管瘤核心为混杂高信号，周边有一圈环状低信号。结论：ＭＲＩ对微小病灶的显示较ＣＴ优越，ＣＴ和ＭＲＩ结合是诊断海绵状血管瘤的有效方法，能全面提供诊断资料。     

眼眶海绵状血管瘤的影像学表现及其意义

目的 研究眼眶海绵状血管瘤的ＣＴ和ＭＲＩ征象,并着重探讨海绵状血管瘤的特异性征象即“渐进性强化”,及其在诊断和鉴别诊断海绵状血管瘤中的价值。方法 对经手术病理证实的眼眶海绵状血管瘤５８例进行回顾性分析。所有病例均行Ｂ超检查,其中ＣＴ检查４８例,ＣＴ增强扫描４３例,动态增强扫描１０例;ＭＲＩ检查２７例,动态增强扫描２４例。结果 ＣＴ增强后３６例（８３．７％）显示不同程度的片状强化,１０例ＣＴ动态增强     

胸腔入口区肿瘤影像诊断的评价

目的：评价Ｘ线、ＣＴ及ＭＲＩ等影像检查在胸腔入口区肿瘤的诊断价值。材料与方法：回顾性分析４４例经病理证实的神经源性肿瘤、肺上沟癌、甲状腺瘤、支气管囊肿、脂肪瘤等肿瘤。所有病人均有正侧位Ｘ线平片检查；２８例行ＣＴ检查；４０例行ＭＲＩ检查。结果：４２例经Ｘ线发现肿瘤阴影。２８例行ＣＴ检查，定位正确者２７例；定性正确者２５例，定性诊断正确率为８９％。４０例ＭＲＩ定位均正确；定性正确者３６例，定性诊断正确率为９０％。结论：Ｘ线平片仍是首选方法，是发现肿瘤的重要手段。ＣＴ检查对组织成分的显示优于Ｘ线检查，显示钙化、骨质破坏、坏死及脂肪等均较满意。非侵袭性的ＭＲＩ检查对胸腔入口区肿瘤诊断准确性高，是最佳的影像学检查方法，但不应列为首选检查。ＭＲＩ显示血管及臂丛神经受侵是其特有表现，显示钙化及骨质受侵不如ＣＴ扫描。     

影像学在四肢骨肿瘤诊断中的应用

影像学检查方法对四肢骨肿瘤的定位和定性诊断给临床治疗提供了重要信息。常规Ｘ线诊断已积累了相当丰富的经验，并成为定性诊断中的主要依据；ＣＴ可进一步提高软组织的分辨率，其显示肿瘤范围和其内部结构能力明显优于Ｘ线平片；磁共振成像（ＭＲＩ）问世后，因其三维多平面的成像能力及良好的软组织对比能力，使之对骨肿瘤的显示有独到之处，ＣＴ与ＭＲＩ对四肢骨肿瘤的诊断价值日益受到重视。本综述ＣＴ与ＭＲＩ在四肢骨肿瘤检     

侧脑室肿瘤的CT和MRI诊断

目的：评价ＣＴ和ＭＲＩ对侧脑室肿瘤的诊断价值。材料和方法：经手术病理证实的侧脑室肿瘤共５６例，回顾性分析其ＣＴ和ＭＲＩ表现，病变按部位分为侧脑室三角区、侧脑室体部、室间孔区３个部分，按年龄分为＜１０岁、１０～３９岁、＞４０岁３个年龄组。结果：（１）大多数侧脑室肿瘤如脑膜瘤、星形胶质细胞瘤、少枝胶质瘤、脉络丛乳头状瘤等具有特征性的ＣＴ和ＭＲＩ表现；（２）部分肿瘤具有其好发部位，如脑膜瘤、脉络丛乳头状瘤、海绵状血管瘤好发于三角区，少枝胶质瘤好发于体部，室管膜下巨细胞型星形胶质瘤、室管膜下瘤好发于室间孔区；（３）某些肿瘤具有年龄学特征，如脉络丛乳头状瘤均＜１０岁，脑膜瘤３０岁以上者占８２．３５％，室管膜下瘤均超过４０岁。结论：侧脑室肿瘤的诊断主要依据其ＣＴ和ＭＲＩ表现，结合发生部位和年龄特征，可进一步提高诊断正确率。     

颅内多发原发性肿瘤的CT与MRI诊断

目的：报道１５例颅内多发原发性肿瘤的ＣＴ和ＭＲＩ表现，并评价ＣＴ与ＭＲＩ的诊断价值。方法：１５例颅内多发原发性肿瘤均行ＣＴ检查，其中４例行ＭＲＩ检查，均经手术病理证实。结果：多发胶质瘤４例，其中恶性室宫膜瘤３例，表现为脑室内及额顶叶脑实质内实质性肿块或囊性病变，多发星形细胞瘤１例，病变分别位于额叶及小脑蚓部；双侧听神经瘤及多发脑膜瘤各３例、ＣＴ和ＭＲＩ表现均较典型；脑膜瘤合并胶质瘤３例、脑膜瘤合并听神经瘤１例和垂体瘤合并胶质瘤１例。结论：结合肿瘤的ＣＴ和ＭＲＩ表现特点，可对大多数颅内多发原发性肿瘤作出正确诊断，ＭＲＩ对脑膜瘤的诊断优于ＣＴ。     

垂体瘤的CT和MRI增强

目的：分析垂体瘤的ＣＴ和ＭＲＩ增强表现，探讨增强后ＣＴ和ＭＲＩ对诊断垂体瘤的价值。材料和方法：对手术和病理证实的２４２例垂体瘤，回顾性分析ＣＴ和ＭＲＩ增强前后表现。结果：２４２例中微腺瘤（≤１０ｍｍ）８１例，大腺瘤（＞１０ｍｍ）１６１例。微腺瘤直接征象为垂体内的ＣＴ低密度或ＭＲＩ（Ｔ１ＷＩ）低信号。增强后ＣＴ和ＭＲＩ显著提高低密度或低信号的显示率（Ｐ＜０．０１）。大腺瘤增强后扫描肿瘤均有不同程度的强化。ＣＴ和ＭＲＩ增强对于显示肿瘤的部位、大小、范围、鞍旁结构如海绵窦和颈内动脉的受侵情况以及显示残存正常垂体均有很高的价值。介绍了一种新的ＭＲＩ垂体瘤分级方法－ＳＩＰＡＰ分级系统。结论：ＣＴ和ＭＲＩ增强对垂体瘤的定位、定性、定量和定级诊断均具有至关重要的作用。     

肾上腺肿块磁共振成像初步评价

目的：探讨肾上腺肿块ＭＲＩ信号产生机制，初步评价ＭＲＩ在其诊断中的作用。方法：对５３例患者６７只肾上腺肿块进行ＭＲＩ检查，同时行手术病理或活检病理检查。结果：ＭＲＩ对肿块的检出率为１００％，定位精确；可对大多数肿块作出定性诊断；可以明确肿块与邻近组织结构的关系。结论：肾上腺肿块病理结构是其ＭＲＩ信号变化的基础，ＭＲＩ对肾上腺肿块的定位、定性诊断均有重要作用。     

咀嚼间隙疾病的MRI和CT诊断

目的：评价ＭＲＩ和ＣＴ对咀嚼间隙病变的诊断价值。材料和方法：回顾性分析４２例咀嚼间隙病变的ＭＲＩ和ＣＴ表现。除５例感染经抗炎治疗好转外，均经手术病理证实。结果：５例蜂窝织炎病变弥漫，累及间隙内脂肪、咀嚼肌和周围间隙及其皮下脂肪，无明确肿块和骨质破坏，ＭＲＩ和ＣＴ均具特征，１例炎性肉芽肿有明确肿块和骨质破坏，术前误诊；５例原发性肿瘤均有明确肿块、间隙内脂肪受压消失、翼内肌受压向后内移位和骨质受压或破坏，除软骨瘤外均缺乏组织学特征；３１例累及咀嚼间隙的继发性肿瘤ＭＲＩ和ＣＴ均能显示其侵入的途径和范围。结论：ＭＲＩ和ＣＴ对显示病变的范围、鉴别感染类型、判断肿瘤位置、性质和来源具有重要价值，可帮助临床制定治疗计划     

Immuno-endocrine and metabolic responses to long distance ski racing in world-class male and female cross-country skiers

The purpose of this study was to characterize the extent of immune, endocrine, substrate and metabolic changes during a long-distance cross-country ski race in extremely well-trained athletes and evaluate if the blood perturbations would indicate signs of health risk. Ten male (M) and six female (F) national team skiers were investigated as they followed their usual routines of race preparations. Blood samples were drawn before and immediately after a World Cup 50-km M and 30-km F ski race with a mean finish time of 142 and 104 min, respectively. Hemoglobin, electrolytes, and C-reactive protein remained unchanged for both M and F. Serum testosterone remained unchanged in M, but doubled in F. Significant increases were observed in concentrations of granulocytes (F: 5 x, M: 5 x), natural killer cells (F: 2 x, M: 1.5 x), adrenaline (F: 12 x, M:10 x), noradrenaline (F: 7 x, M:5 x), growth hormone (F: 30 x, M: 2 x), cortisol (F: 1.5 x, M:2 x), glucose (F: 2 x, M:1.5 x), creatine kinase (F: 2 x, M:2 x), uric acid (F: 1.5 x, M: 1.5 x) and non-organic phosphate (F:2 x, M:2 x), while insulin concentration decreased (F: 0.5x, M: 0.8 x). Free fatty acid (FFA) concentration increased (F:2 x, M: 3 x). In conclusion, we observed substantial changes in several immuno-endocrine, substrate and metabolic measurements after long distance cross-country ski racing and suggest that some of these marked changes may reflect the large amount of muscle mass involved during skiing.     

Screening applications for MRI in the detection of upper abdominal disease: comparative study of non-contrast-enhanced single-shot MRI and contrast-enhanced helical CT

Purpose: To compare the value of ’push-button' singe-shot non-contrast-enhanced MRI and contrast-enhanced helical CT for detection of upper abdominal disease. Methods: In 120 patients, images obtained with non contrast-enhanced single-shot MRI (T2: double echo HASTE, and T1: turbo FLASH) and contrast-enhanced helical CT were compared. Lesions or abnormalities were divided in 8 anatomical categories (1: liver; 2: pancreatobiliary; 3: kidney/adrenal gland; 4: retroperitoneum; 5: vascular; 6: spleen; 7: gastrointestinal tract and peritoneum; 8: base of thorax) and classified as follows: 2: seen at MRI only; 1: better seen at MRI; 0: no difference; −1: better seen at CT; −2: seen at CT only. Also recorded were the 'door-to-door’ examination times. Results: Of a total of 629 abnormalities, 594 were detected at MRI (94 %) and 536 at CT (85 %). CT offered better results in two categories only: retroperitoneum (mean score: −0.68) and vascular (mean score −0.87). Mean examination times were 19 min for CT and 14.8 min for MRI. Conclusion: Unenhanced single-shot MRI is a valuable first step of a comprehensive upper abdominal MR exam and may even be the final step in many patients. Received: 3 April 1998; Revision received: 13 July 1998; Accepted: 18 August 1998     

Enhanced multidetector-row computed tomography (MDCT) in the diagnosis of acute appendicitis and its severity

PURPOSE: To examine the accuracy of enhanced multidetector-row computed tomography (MDCT) in diagnosing acute appendicitis and its severity. MATERIALS AND METHODS: Contrast-enhanced MD-CT 3.5 mm thick images of 23 control patients (A), and 64 patients with surgically proven acute appendicitis including 8 catarrhal (B), 28 phlegmonous (C), and 28 gangrenous (D) appendicitis patients were respectively analyzed. RESULTS: The number of observed major computed tomography (CT) findings for each patient group were as follows: enlarged (> or = 6 mm in maximum diameter) appendix (A: 5, B: 8, C: 28, D: 28), enhancement of the appendiceal wall; hyper (A: 3, B: 8, C: 27, D: 20), iso (A: 15, B: 0, C: 1, D: 2), hypo (A-C: 0, D: 4), and patched (A-C: 0, D: 2) enhancement, appendicolith (A, B: 0, C: 7, D: 13), dirty fat sign (A: 3, B: 1, C: 21, D: 28), localized ascites (A: 2, B: 0, C: 2, D: 11), and abscess formation (A-C: 0, D: 5). From the combinations of these findings, we could differentiate acute appendicitis from the control normal appendix with an accuracy of 99% and could diagnose the severity of acute appendicitis with accuracies of 92% for catarrhal appendicitis, 84% for phlegmonous appendicitis, and 92% for gangrenous appendicitis. We could also visually reconstruct the entire forms and positions of the appendices from the successive CT findings because of the high-resolution thin-slice MDCT images. CONCLUSION: MDCT is highly accurate in the diagnosis of acute appendicitis and its severity.     

Reproducibility and biological basis of in vivo T2* magnetic resonance imaging of liver metastasis of colorectal cancer

In this study, the reproducibility of MR imaging in colorectal liver metastases was assessed and values were correlated with the expression of the hypoxia‐related markers GLUT‐1 and CA‐IX as well as the relative vascular area, and the vessel density in resected tumors. The reproducibility of was analyzed in 18 patients with in total 22 colorectal liver metastases using the Bland and Altman method for the 16th, 50th, and 84th percentile values. Immunohistochemical staining was performed on 17 resected tumors obtained from 16 patients. The median of all liver metastases was 25.0 ± 5.6 ms vs. 23.0 ± 4.1 ms (median ± st.dev.) in normal liver. The coefficient of repeatability was 11.2 ms and the limits of agreement were ?13.2 ms and 9.1 ms for median values. On average, showed fair reproducibility. No correlations between values, hypoxia‐ and vascularity‐related markers were observed. Magn Reson Med, 70:1145–1152, 2013. © 2012 Wiley Periodicals, Inc.     

眼眶继发性肿瘤的CT表现：附68例分析

目的：观察眼眶继发性肿瘤的ＣＴ表现。材料和方法：对６８例经病理学证实的眼眶继发性肿瘤的ＣＴ表现进行回顾性分析。结果：继发于邻近鼻窦的肿瘤占８２．３５％，继发于颅内、颞下窝等邻近结构的肿瘤占１１．７５％，全身恶性肿瘤的眼眶转移占５．８９％。继发于鼻窦、颅内、颞下窝等邻近结构的肿瘤，其形成有眶壁骨质破坏、增生、受压移位以及眼眶裂孔扩大等四种侵入方式，恶性肿瘤以眶壁破坏多见，良性肿瘤各种侵入方式均可见到。ＣＴ表现特征为眶内肿瘤与眶外肿瘤连续，肿瘤中心位于眶外，伴有眼眶骨质改变。结论：ＣＴ检查有助于明确肿瘤来源、范围、性质，具有重要临床意义     

Risk factors associated with self-reported injury history in female youth soccer players

Background: studies that investigate risk factors for musculoskeletal injuries in female youth athletes are limited, especially related to training attributes and position status.

Objective: to determine risk factors including training attributes and position status for a self-reported musculoskeletal injury history in female youth soccer players.

Methods: we conducted a cross-sectional study of young female soccer players (mean age: 13.6 ± 2.3 years). we asked about their history of musculoskeletal injuries using an electronic questionnaire. the proportion of young female soccer players with and without a history of soccer-related musculoskeletal injuries were compared based on physical characteristics, training attributes, position status (single vs. multiple), lower extremity strength, and joint laxity. a binary logistic regression analysis was used to generate, and adjusted odds ratios adjusted for potential co-variates (aor). a 95% confidence interval (95%ci) that did not cross one or p < 0.05 were considered statistically significant.

Results: a total of 160 young female soccer players (mean age: 13.6 ± 2.3 years) participated in the study. an independent association was found between prior musculoskeletal injuries and older ages (aor: 1.60, 95%ci: 1.17, 2.20, p = 0.004), higher weight (aor: 1.10, 95%ci: 1.01, 1.20, p = 0.026), and greater bmi (aor: 1.43, 95%ci: 1.07, 1.90, p = 0.014).

Conclusions: musculoskeletal injuries were associated with age, weight, and bmi in female youth players. the current study indicates that maintaining proper body composition may be beneficial to reduce musculoskeletal injuries among female youth soccer players.     

Myocardial T measurements in iron‐overloaded thalassemia: An in vivo study to investigate optimal methods of quantification

Reproducible and accurate myocardial T measurements are required for the quantification of iron in heart tissue in transfused thalassemia. The aim of this study was to determine the best method to measure the myocardial T from multi‐gradient‐echo data acquired both with and without black‐blood preparation. Sixteen thalassemia patients from six centers were scanned twice locally, within 1 week, using an optimized bright‐blood T sequence and then subsequently scanned at the standardization center in London within 4 weeks, using a T sequence both with and without black‐blood preparation. Different curve‐fitting models (monoexponential, truncation, and offset) were applied to the data and the results were compared by means of reproducibility. T measurements obtained using the bright‐ and black‐blood techniques. The black‐blood data were well fitted by the monoexponential model, which suggests that a more accurate measure of T can be obtained by removing the main source of errors in the bright‐blood data. For bright‐blood data, the offset model appeared to underestimate T values substantially and was less reproducible. The truncation model gave rise to more reproducible T measurements, which were also closer to the values obtained from the black‐blood data. Magn Reson Med 60:1082–1089, 2008. © 2008 Wiley‐Liss, Inc.     

Decompression sickness in Miskito Indian lobster divers: review of 229 cases

BACKGROUND: The Miskito Indian lobster divers of Central America employ very provocative diving profiles and experience severe neurological decompression sickness (DCS) and/or arterial gas embolism (AGE). Scientific data are scarce regarding the clinical patterns of injury, response to treatment, and functional outcomes for such cases. METHODS: A retrospective review of 229 cases of DCS and/or AGE was conducted at 2 hyperbaric units in Central America. RESULTS: The following deficits were recorded on presentation: any neurological deficit: 94%; motor: 79%; sensory: 60%; urinary: 48%; reflex: 45%; and loss of consciousness: 20%. The patterns of weakness (n = 182) were as follows: paraparesis: 27%; paraplegia: 26%; lower extremity monoparesis: 14%; lower extremity monoplegia: 6%; quadriparesis: 4%; hemiparesis: 4%; hemiplegia: 3%; and quadriplegia: 2%. Treatment was delayed by a mean and median of 5 and 2 d, respectively. The majority received hyperbaric oxygen and systemic steroids. Motor function on discharge (n = 182) was as follows: normal: 30%; paraparesis: 15%; lower extremity monoparesis: 15%; paraplegia: 3%; quadriparesis: 2%; hemiparesis: 2%; and missing data/other: 33%. Gait on discharge (n = 182) was as follows: normal: 19%; abnormal: 19%; required one crutch: 10%; required two crutches: 16%; not ambulatory: 5%; and missing data: 31%. DISCUSSION: The majority of severe injuries could be localized to the thoracolumbar spinal cord. One-fifth had bilateral cerebral dysfunction manifested by loss of consciousness. Despite long delays to treatment, divers responded to hyperbaric oxygen. At the time of discharge, almost a third had complete recovery of strength and the majority were ambulatory.     

X线片图像分析骨折后股骨头坏死的病理改变

目的：探讨Ｘ线片图像分析股骨颈骨折、头缺血坏死的病理基础。方法：对１０例股骨颈骨折（７例新鲜，３例陈旧）术前Ｘ线片股骨头进行图像分析，然后行人工关节置换，将取出之头行病理检查。结果：（１）１０例骨折Ｘ线片股骨头图像分析均为异常图像。（２）７例新鲜骨折的头内有出血，缺血坏死；陈旧３例骨折，除缺血坏死外，有不同程度血管增生及修复改变。结论：股骨头Ｘ线片图像分析异常图像的病理基础为头缺血坏死及髓腔出血     

Regional variations of T2* in healthy and pathologic achilles tendon in vivo at 7 Tesla: Preliminary results

The aim of this study was to investigate T in the Achilles tendon (AT), in vivo, using a three‐dimensional ultrashort time echo (3D‐UTE) sequence, to compare field strength differences (3 and 7 T) and to evaluate a regional variation of T in healthy and pathologic tendon. Ten volunteers with no history of pain in the AT and five patients with chronic Achilles tendinopathy were recruited. 3D‐UTE images were measured with the following echo times, at echo time = [0.07, 0.2, 0.33, 0.46, 0.59, 0.74, 1.0, 1.5, 2.0, 4.0, 6.0, and 9.0 ms]. T values in the AT were calculated by fitting the signal decay to biexponential function. Comparing volunteers between 3 and 7 T, short component T was 0.71 ± 0.17 ms and 0.34 ± 0.09 ms (P < 0.05); bulk long component T was 12.85 ± 1.87 ms and 10.28 ± 2.28 ms (P < 0.05). In patients at 7 T, bulk T was 0.53 ± 0.17 ms (P = 0.045, compared to volunteers), T was 11.49 ± 4.28 ms (P = 0.99, compared to volunteers). The results of this study suggest that the regional variability of AT can be quantified by T in in vivo conditions. Advanced quantitative imaging of the human AT using a 3D‐UTE sequence may provide additional information to standard clinical imaging. Finally, as the preliminary patient data suggest, T may be a promising marker for the diagnosis of pathological changes in the AT. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.