肺部慢性炎症与原发性肺癌供血动脉CTA表现的影像比较

目的 探讨肺部慢性炎症与原发性肺癌供血动脉CT血管成像(CTA)表现差异及其鉴别诊断价值.资料与方法 搜集81例行64层螺旋CT胸部增强扫描,支气管动脉清晰显示的病例,包括原发性支气管肺癌38例,慢性炎症(含支气管扩张)21例,肺癌合并支气管扩张2例及正常对照20例,全部病例均采用容积显示(VR)、多平面重组(MPR)及最大密度投影(MIP)对支气管动脉等供血动脉行三维重组,测量支气管动脉内径并计算肺癌组与慢性炎症组肺外体循环动脉供血率,比较3组支气管动脉内径及肺癌组与慢性炎症组肺外体循环动脉供血率有无差异(2例肺癌合并支气管扩张者不纳入统计).结果 肺癌组38例中,支气管动脉内径平均值为1.87 mm,18.42%(7例)伴有肺外体循环动脉供血;慢性炎症组21例中,支气管动脉内径平均值为2.54 mm,47.62%(10例)伴有肺外体循环动脉供血;正常对照组20例中,支气管动脉内径平均值为1.49 mm,3组支气管动脉内径、肺癌组与慢性炎症组肺外体循环动脉供血率差异均有统计学意义(P<0.05).结论 肺癌与慢性炎症时支气管动脉均有扩张,慢性炎症时支气管动脉扩张较原发性肺癌更为明显,更能刺激肺外体循环动脉参与供血,两者供血动脉的CTA表现在相关鉴别诊断中有一定价值.     

HRCT在支气管扩张诊断中的价值分析

目的评价高分辨率CT（HRCT）诊断支气管扩张症的价值。方法对经胸科手术或呼吸科随访观察确诊支气管扩张症的38例患者的8mm层厚的螺旋CT扫描及1．5mm～2mm层厚的螺旋CT薄层扫描图像进行对比分析。结果38例患者中螺旋CT常规扫描（8mm层厚）诊断支气管扩张症20例43个肺段，2mm层厚薄层扫描诊断支气管扩张症38例78个肺段。结论螺旋CT薄层扫描对支气管扩张的检测具有更高的敏感性、特异性及准确性，可作为诊断支气管扩张症的首选检查方法。     

螺旋CT在支气管扩张症诊断中的应用研究

目的：评价螺旋CT在肺段水平诊断支气管扩张症（支护）的价值。方法：对30例临床和X线疑为支扩的患者共540个肺段分别进行10mm层厚和薄层（1－3mm）螺旋CT扫描,其中10例共180个肺段与支气管造影进行了比较。两位观察者用盲法对不同层厚的螺旋CT扫描和支气管造影进行评价。结果：根据诊断标准并计算kappa值,两位观察者对支扩评价的一致性很好（k值分别为0．96,0．98）。以支气管造影为金标准,螺旋CT10mm层厚扫描诊断支扩的敏感性,特异性,准确性HRCT相比,薄层螺旋CT扫描对诊断支扩有更大的优越性,对临床疑支扩的患者,应首选螺旋CT检查。     

16层螺旋CT支气管动脉成像在肺癌中的表现

目的利用多层螺旋CT（MSCT）探讨病灶最大径〈3和≥3cm肺癌患者及正常人的支气管动脉内径差异。方法对44例经手术病理证实的肺癌患者资料作回顾性分析，男27例，女17例，年龄19～82岁，中位年龄58岁。其中3cm以下的小肺癌15例，≥3cm的肺癌29例，所有患者均进行16层螺旋CT增强扫描，三维重组支气管动脉，测量支气管动脉的内径。正常对照组，男16例，女12例，年龄22～78岁，中位年龄53岁。对3组支气管动脉内径行方差分析。结果15例小肺癌支气管动脉内径平均值为（1．9±0．4）mm，29例大肺癌支气管动脉内径平均值为（2．5±0．5）mm，28例正常组支气管动脉内径的平均值为（1．6±0．4）mm，大、小肺癌及正常组之间支气管动脉内径差异有统计学意义（P〈0．05）。结论供应肺癌的支气管动脉均增粗，大肺癌较小肺癌显著。     

螺旋CT诊断支气管扩张症

目的评价螺旋CT在肺段水平诊断支扩的价值.材料与方法对30例疑为支扩的患者分别进行10mm层厚和薄层(1～3mm)螺旋CT扫描,其中10例共180个肺段与支气管造影进行了比较,用盲法对不同层厚的螺旋CT扫描和支气管造影进行评价.结果两位观察者在10mm层厚分别发现支扩肺段90个和94个,薄层CT分别发现支扩肺段108和110个.与支气管造影比较,螺旋CT1omm层厚诊断支扩的敏感性、特异性、准确性分别为64.6%、100%、90.1%;薄层螺旋CT诊断支扩的敏感性、特异性、准确性分别为93.8%、100%和98.3%.结论薄层螺旋CT扫描对诊断支扩比支气管造影有更大的优越性,对临床疑支扩的患者,应首选螺旋CT检查.     

MSCTA在支气管扩张并大咯血介入治疗中的作用

目的：评价多层螺旋CT血管成像（multi-slice computed tomographic angiography,MSCTA）在支气管扩张并大咯血患者介入治疗中的作用。方法：16例支气管扩张并大咯血的患者,采用16层螺旋CT增强薄层扫描,经最大密度投影（MIP）及容积重建（VR）处理显示罪犯血管,然后行支气管动脉栓塞（bronchial artery embolization,BAE）治疗。结果：16例患者胸部CT血管成像共显示28条罪犯血管,包括21条支气管动脉（左13、右8）、3条肋间动脉、2条膈动脉、1条胸廓内动脉及1条自主动脉弓部下缘来源。栓塞后随访6—13个月（平均9个月）,15例（93．7％）未发生再咯血。结论：MSCrA能客观地评价咯血相关血管特征,指导支气管扩张并大咯血的介入治疗。     

咯血患者的胸部16层CT血管造影

目的:利用CT血管造影研究咯血患者相关血管影像学.材料和方法:回顾性分析46例因反复或大量咯血行胸部增强的病例,包括支扩或慢性炎症31例,原发性肺癌11例,肺内血管畸形4例,采用16层螺旋CT胸部增强扫描,容积显示、多平面重建和最大强度投影进行CTA重建观察与分析,其中10例有同期DSA对照.结果:肺癌和支气管扩张或慢性炎症均显示支气管动脉异常,其中13例表现为支气管动脉主干明显扩张、迂曲,19例支气管动脉主干及分支均扩张增粗,多支支气管动脉供血时远端相互吻合成丰富的血管网,10例支气管动脉与肺外体循环动脉向同一病灶供血.血管畸形表现为瘤样扩张的血管团并见供血动脉和引流静脉(3例)或丰富的支气管动脉血管网(1例).结论:咯血患者常见支气管动脉异常,并有不少合并肺外体循环动脉异常供血,少数为肺内血管畸形,16层CTA能安全、清晰地评价咯血相关血管特征,指导相关介入治疗.     

肺癌16层螺旋CT支气管动脉血管成像与DSA对比分析

目的:探讨16层螺旋CT血管三维重组对诊断与评价肺癌支气管动脉供血血管和血供的临床应用价值.方法:10例肺癌同时行16层螺旋CT支气管动脉血管三维重组和DsA检查,并对16层螺旋cT支气管动脉血管三维重组和DSA资料进行对比分析.结果:10例肺癌16层螺旋CT血管成像显示11支支气管动脉,其中图像质量优5支、良好6支;DSA显示10支支气管动脉.10例肺癌16层螺旋CT血管成像显示肿瘤供血支气管动脉起源、形态及分支状况与DSA一致.10例肺癌16层螺旋CT血管VR彩色成像与DSA显示肿瘤染色及肿瘤内血供状况一致率为90%.结论:16层螺旋CT血管成像可克服DSA一次检查不能显示其全部供血血管的缺点;对诊断和评价肺癌供血血管和血供状况有较大临床价值.     

MSCT支气管动脉三维成像对中心型肺癌的血供研究

目的：探讨多层螺旋CT(MSCT)三维支气管动脉成像在中心型肺癌中的影像学表现．为显示中心型肺癌的血供来源及介入治疗提供理论依据。方法：对18例中心型肺癌的患者行MSCT造影增强检查，采用实时螺旋薄层CT扫描，在独立工作站行支气管动脉三维重建，使用不同的旋转轴观察支气管动脉的空间解剖细节。结果：其中6例(33．33％)中心型肺癌的支气管动脉三维图像能够清晰显示出支气管动脉的起源、走行的路径(肺内段和纵隔段)和血管直径等。有肺动脉明显狭窄截断的病例支气管动脉显示率最高，且明显增粗，表明此类肺癌的血供来源主要以支气管动脉为主。三维成像中以容积再现(VR)技术显示最佳。结论：MscT三维支气管动脉成像能够准确、直观地显示支气管动脉的空间解剖特点，为中心型肺癌的血供研究及介入治疗提供理论基础。     

多层螺旋CT低剂量扫描对肺门区段支气管显示率的评估

目的　比较低剂量与标准剂量的多层螺旋CT扫描对肺门区段支气管的显示情况 ,以决定多层螺旋CT低剂量扫描是否适合用于早期中央型肺癌的普查。方法　 5 0名健康自愿者分成 2组 ,2 0例行胸部低剂量多层螺旋CT平扫 ,扫描参数为 :12 0kV、17mAs、Pitch 1:7,8mm层厚。 3 0例行胸部标准剂量多层螺旋CT平扫 ,扫描参数均为 :12 0kV、80mAs、Pitch 1:7,8mm层厚。比较 2种剂量的CT图像上肺门区段支气管的显示情况。结果　双肺段支气管总显示率 :低剂量扫描为 84% ,标准剂量为 86% ,两者无统计学差别 (Ρ >0 .0 5 )。右肺低剂量与标准剂量多层螺旋CT扫描的各叶段支气管总显示率分别为 :上叶 91%和 95 % ;中叶均为 88% ;下叶 91%和 93 %。右肺各段支气管的总显示率分别为 90 %和 92 % ,两者无统计学差别 (Ρ >0 .0 5 )。左肺低剂量与标准剂量多层螺旋CT扫描的各叶段支气管显示率分别为 :上叶 97%和 98% ;舌叶 47%和 5 0 % ;下叶 91%和 95 %。左肺各段支气管的总显示率分别为 78%和 80 % ,两者无统计学差别 (Ρ >0 .0 5 )。结论　低剂量多层螺旋CT扫描并不降低肺门区段支气管的显示率 ,它适合用于肺部普查 ,检出肺门区段支气管壁上的小肿瘤。     

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.