髓质海绵肾的CT诊断(附8例分析)

目的:探讨髓质海绵肾的CT表现及其诊断价值。方法:回顾性分析8例髓质海绵肾CT的表现,结合文献复习分析其诊断价值。结果:髓质海绵肾的CT平扫表现为肾盏旁锥体内多发小斑点状结石,成扇形排列。增强扫描后扩张的肾集合管内结石周围有造影剂充盈,无结石的肾锥体集合管呈条纹状或小囊状造影剂积聚,肾功能正常。结论:髓质海绵肾的CT具有特征性表现,诊断价值较高。     

髓质海绵肾的影像学表现

目的分析髓质海绵肾（MSK）的影像学表现,以期提高对该病诊断的正确性。方法回顾性分析8例MSK在腹部X线平片I、VP、CT及MRI上的影像表现,并进行文献复习。结果 8例中累及右肾4例,左肾2例,双侧肾2例。腹部X线平片5例见肾内多发小结石呈散在或簇状排列,3例未见异常。静脉肾盂造影6例肾功能正常,肾盏外围扩张的集合管内见造影剂充盈,使肾锥体呈花蕾状或葡萄串状致密影,结石位于扩张的集合管内;2例肾盂肾盏扩张,造影剂显影延迟。CT检查可以发现腹部X线平片未能显示的细小结石,增强扫描见肾锥体呈条纹状或小囊状扩张。MRI检查见肾锥体内结石在T1WI及T2WI均呈低信号,T2WI及MRU成像肾锥体内可见条纹状、放射状及小囊状高信号影,大小不等。结论 MSK有其特征性影像表现I,VP、CT、MRI都有助于MSK的诊断,但以IVP检查为首选。     

髓质海绵肾的MRI表现

目的:探讨MRI对髓质海绵肾的诊断价值。方法:回顾性分析9例髓质海绵肾患者的MRI表现,全部病例均行常规T1WI、T2WI及磁共振尿路成像(MRU)扫描,分析患肾的形态、大小及髓质内集合管囊变、小结石的MRI信号特点,并与患者同期CT图像作对比分析。结果:9例髓质海绵肾中3例双肾体积增大且边缘凹凸不平,2例单侧体积增大且边缘光滑,另4例双肾大小、形态正常;肾髓质内集合管呈多发小囊状及条管状扩张,T1WI呈低信号,T2WI呈高信号;5例在小结石较集中的部位T2WI序列可见呈低信号改变的小结石,对小结石稀少的部位T2WI序列显示不清,所有髓质海绵肾小结石在T1WI序列上均无法显示;1例患者同时合并先天性肝内胆管扩张及双侧肾盂结石。结论:MRI对髓质海绵肾的诊断具有重要价值,可清晰显示髓质集合管的囊变情况,但对结石显示较差。     

MSCT在诊断髓质海绵肾中的应用

目的:探讨MSCT容积扫描在诊断髓质海绵肾中的临床应用价值,以提高髓质海绵肾的临床诊断水平。方法:回顾性分析17例髓质海绵肾的临床表现、MSCT资料,并复习相关文献。所有患者均采用荷兰飞利浦公司Brilliance 6层CT机行容积扫描,常规行腹部平扫及肾脏3期增强扫描。结果:髓质海绵肾的MSCT表现为肾盏旁锥体内多发小斑点状结石,呈散在、簇状或扇形排列;增强扫描扩张的集合管内结石周围有对比剂充盈,无结石的扩张集合管呈条纹状或小囊状对比剂积聚,肾功能正常。结论:髓质海绵肾的MSCT表现具有特征性,多期扫描对髓质海绵肾的诊断敏感、准确,且能够作出定性诊断;容积扫描数据后处理图像直观,有利于指导临床制定治疗方案。     

髓质海绵肾9例声像图分析

肾髓质海绵肾是一种先天性发育异常的髓质囊肿病变，其特征为肾锥体部的乳头管和集合系统呈梭形或小囊状扩张，于扩张的囊腔内可充满钙盐形成沙粒样小结石，貌似海绵而得名。本研究对超声诊断为髓质海绵。肾9例的超声声像图进行回顾分析，现报告如下。     

髓质海绵肾的CT表现及其临床意义

目的分析髓质海绵肾的CT表现及其临床意义。方法回顾性分析18例髓质海绵肾的CT表现。结果髓质海绵肾的CT表现为沿肾锥体排列呈放射状或簇状多发小斑点状结石或钙化影及周围有小囊状或梭形低密度影。双侧病变见于13例,单发右侧3例,左侧2例。结论CT有利于髓质海绵。肾早期诊断并对发症的检出有重要的意义。     

髓质海绵肾的CT诊断(附12例分析)

髓质海绵肾(medullary sponge kidney、简称MSK)其特征是一个肾或两个肾的肾锥体的集合管呈梭形或囊状扩张,致肾脏似海绵状,故称海绵肾.以往海绵肾的影像诊断主要依靠B超,肾静脉尿路造影等检查.近年来随着CT的普及应用,海绵肾的诊断率不断提高.本文对12例海绵肾的CT征像进行回顾性分析,并复习相关文献,以加深对海绵肾的认识,探讨海绵肾的CT表现及诊断价值.     

髓质海绵肾(附16例报告)

本文综合报道16例髓质海绵肾,就本病的命名、发病年龄、性别、合并症、X线诊断和鉴别诊断等问题进行了探讨。主要X线表现是:(1)平片显示成簇的小结石,分布的范围相当于肾乳头;(2)分泌性造影显示肾小管扩张常为早期充盈,锥体内可见粗的条纹影;(3)肾小盏变大并向外展开,或变扁;(4)肾影轻度增大;(5)病变常为双侧。     

髓质海绵肾的影像学诊断（附13例报告）

目的研究髓质海绵肾（MSK）的影像学表现，并提高其诊断准确性。方法临床疑诊MSK的13例患者中，起先8例经X线平片检查，11例经超声检查，7例经CT平扫，其中，3例又经CT增强扫描，随后，11例经静脉肾盂造影（IVP）证实，2例经手术病理证实。对所有患者的影像表现进行了回顾性分析。结果IVP显示集合管呈线状、囊状扩张。X线平片显示肾乳头、髓质区簇状排列的圆形、椭圆形致密影。超声显示围绕肾髓质放射状分布的小回声区和强回声光点。CT平扫示环绕肾小盏分布的点状或簇状结石影，髓质区饱满、明显增大，呈低密度影，增强后，结石影周围的集合管内造影剂蓄积，造成结石影增大的假象。结论IVP是诊断本病例的金标准，但它属于有创性检查，X线平片可作为本病的首选检查方法，而CT能清楚显示肾内结石的形态、大小及分布状况，尤其是髓质增大且呈低密度是本病一新的重要征象之一。     

原发性输尿管癌的影像学诊断

目的：分析２７例输尿管癌的临床和影像学资料，提出其影橡学检查的程序和鉴别诊断。方法：男２７例，女７例；年龄２８～７０岁。２７例均有腹平片及排泄性尿路造影，其中１６例逆行尿路造影，８例ＣＴ检查。结果：９例腹平片患侧肾影增大，２０例患侧肾不显影。７例排泄性和１５例逆行尿路造影显示充盈缺损。８例ＣＴ检查显示输尿管壁不规则增厚３例，结节状２例，３例凸入膀胱形成肿块。结论：排泄性尿路造影能发现患侧肾功能异常或显示肿瘤，逆行尿路造影是诊断输尿管肿瘤的有效方法，ＣＴ扫描能显示肿瘤及与邻近结构的关系     

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.     

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).     

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.     

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.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）