体部CT扫描诊断乳癌的应用（附42例分析）

用体部ＣＴ对７５例乳房肿块进行了检查，其中４２例为乳癌，增强扫描癌灶有显著增强，绝大部分病例比平ＣＴ值增加３０ＨＵ以上，因此可显示常规Ｘ线摄影中未显示出的或与周围乳腺增生病变不能分辨癌灶，本组乳癌ＣＴ诊断的敏感性９５．２４％，特异性８９．３９％，准确率９２．６６５，与干板摄影互补准确率达９６％。讨论了乳癌ＣＴ检查的鉴别诊断及其难点，作者认为ＣＴ扫描可补常规乳房Ｘ线摄影之不足。     

乳腺肿块的动态CT扫描

目的：应用动态ＣＴ检查乳腺肿块，分析各种乳腺病变的时间－密度曲线，探讨其诊断价值。材料与方法：对３６例乳腺肿块患者作了前瞻性动态ＣＴ扫描，其中经手术病理证实者３２例（乳癌１５例，纤维腺瘤９例，增生性乳腺病７例，脂肪坏死１例）。结果：根据肿块的增强密度在时间上的变化，得出３种时间－密度曲线：Ｉ型：速升－平台－缓降型；Ⅱ型：渐进上升型；Ⅲ型：曲线起伏较小型。Ｉ型曲线为乳癌所特有，Ⅱ型多见于纤维腺瘤和Ⅲ     

肝脏螺旋CT动脉造影

目的：评价肝脏螺旋ＣＴ动脉造影（ＳＣＴＡＬ）对肝肿瘤的诊断价值。方法：对２０例肝细胞性肝癌（ＨＣＣ）和１０例肝内转移癌患者作ＳＣＴＡＬ：经皮穿刺肱动脉，将５－ＦＣｏｂｒａ导管送入肝动脉，以０．３～１．５ｍｌ／ｓ的速度经导管注入浓度为３００ｍｇＩ／ｍｌ的造影剂１５～３０ｍｌ，在开始注入造影剂６～１０ｓ后用螺旋ＣＴ行全肝扫描。结果：所有肿瘤病灶均显著增强，肿瘤的实体部分ＣＴ值为１０５～４１３ＨＵ，明显高于邻近肝组织。ＨＣＣ灶多呈不均匀增强，转移灶多呈环形增强，而直径为３～１０ｍｍ的病灶呈均匀增强。结论：与常规肝脏ＣＴ增强扫描相比，ＳＣＴＡＬ可发现更多的多血供病灶，能真实显示肝肿瘤的肝动脉血供情况。     

小肾癌的CT诊断(附11例报告)

目的：评价ＣＴ扫描在小肾癌诊断中的应用价值。方法：回顾性分析１１例经手术病理证实为小肾癌（直径＜ ３．０ ｃｍ ）的Ｂ超和ＣＴ资料。结果：１１ 例小肾癌病人中Ｂ超诊断肾囊肿２例、肾良性肿瘤１ 例、肾实性占位８例;ＣＴ诊断畸胎瘤１例、肾脏恶性肿瘤１０例。ＣＴ表现：①ＣＴ平扫为软组织密度结节、无钙化及脂肪组织１０例;②增强扫描显著强化１０例（△ＣＴ值＞ ４０ ＨＵ）;③肿瘤—肾实质界面模糊不清６例、清晰而不锐利４例。结论：ＣＴ检出小肾癌优于Ｂ超,根据小病灶的密度、边缘及强化程度等特征性ＣＴ表现术前能诊断为小肾癌。     

肝泡型包虫病的CT诊断及对阿苯达唑治疗效果的评价

目的分析２１例肝泡型包虫病的ＣＴ征象，评价阿苯达唑治疗效果。方法全部病例包虫抗原皮试、血清酶联免疫吸附试验（ＥＬＩＳＡ）与包虫免疫印迹试验（Ｗｅｓｔｅｒｎｂｌｏｔｉｎｇ，ＷＢ）检测均为阳性，全部做ＣＴ扫描检查。阿苯达唑治疗后ＣＴ随访２０例。结果ＣＴ表现最常见特征为轮廓不规则，边界不清，密度不均的以低密度区为主的混合密度灶（ＣＴ值：－２５～＋４０ＨＵ），病灶区出现多少不一的钙化（ＣＴ值：＋９０～＋５５６ＨＵ）是本病突出的表现。ＣＴ影像分三型：实质型７例；假囊型６例；混合型８例。３例增强ＣＴ中２例病灶无强化，１例病灶周边呈轻度环形强化。ＣＴ随访２０例（时间１～９年，平均３．９年）中４例治愈，５例好转，５例稳定，６例恶化。结论ＣＴ扫描不但可用作肝泡型包虫病的诊断，而且可用于阿苯达唑等药物的疗效观察。     

垂体脓肿的CT诊断（附8例报告）

本文分析了８例经手术证实的垂体脓肿的临床及ＣＴ表现，特点如下：１．常有垂体功能亢进或低下；２．多呈环状强化灶；３．可呈实质性病灶；４．病灶密度常高于脑脊液，多在４０ＨＵ左右，提出单层动态ＣＴ扫描有助于垂体脓肿与垂体瘤的鉴别诊断。     

肝细胞癌胆管内生长的MRI、CT表现及病理基础

目的探讨肝细胞癌（ＨＣＣ）胆管内生长的影像学检查方法及其表现。方法经手术和病理证实为本病１８例，其中ＭＲＩ检查１７例，ＣＴ增强扫描１１例。结果ＭＲＩ检查均显示ＨＣＣ肝内原发病变和胆管内生长的癌栓；ＣＴ检查除１例肝内原发病变未检出外其余病变均显示。结论ＨＣＣ胆管内生长影像学上可见二类：一是原发病灶直接侵犯相邻胆管，二是原发病灶癌细胞种植在较远的胆管内形成癌栓。ＭＲＩ、ＣＴ检出本病和确定诊断优于直接法胆系造影     

大脑半球室管膜瘤一例

患者女，１７岁。主诉头痛１月，加重伴呕吐１周，无发热、抽搐及精神障碍。ＣＴ扫描见左枕顶区３．８ｃｍ×４．０ｃｍ×６．５ｃｍ的囊状占位病灶，中央为均匀的水样密度，ＣＴ值１９．７ＨＵ，增强扫描无变化，周边为厚薄均匀的软组织密度，平扫ＣＴ值３３ＨＵ，增强后...     

X线照片、B超、红外线扫描同期乳腺普查对比分析（附940例病例）

总结９４０例妇女Ｘ线照片、Ｂ超、红外线扫描普查资料，共发现乳腺癌２例，乳腺腺瘤９例。在所发现的２例乳腺癌患者中，１例临床可扪及－２．５ｃｍ×２．０ｃｍ大肿块，Ｘ线照片、Ｂ超、红外线扫描术前均予以较明确诊断。另１例，有乳头血性溢液６＋月，临床未扪及肿块，红外线扫描可见乳晕上方血管增粗，突然中断，诊断为乳癌。手术所见病灶０．２ｃｍ×０．３ｃｍ大，病理报告为：浸润性导管癌。Ｘ线照片，Ｂ超均漏诊。Ｘ线照片，红外线扫描各发现乳腺腺瘤６例，Ｂ超发现８例。我们认为：红外线扫描无损害、简便、早期乳癌灵敏度高，适应于乳腺肿块的鉴别诊断及乳癌大面积人群普查筛选，是目前临床较为理想的乳腺检查设备。     

螺旋CT动脉门脉造影在小肝癌诊断中的价值

目的：用螺旋ＣＴ动脉门脉造影（ＳＣＴＡＰ）评价肝癌并与超声（ＵＳ）及螺旋ＣＴ双期扫描进行检出敏感性和定性准确性比较研究。方法：肝癌４１例,行ＳＣＴＡＰ后分析病灶灌注特征,统计各种方法病灶检出数,计算检出敏感性及定性准确性并行统计学处理。结果：４１例共检出≤３ｃｍ病灶４５个,ＳＣＴＡＰ检出敏感性为９５．５％,双期扫描肝动脉期、门静脉期及双期合计的检出敏感性分别为：８８．８％、６８．８％、９１．１％,ＳＣＴＡＰ与ＵＳ（６６．６％）和双期扫描门脉期相比有显著性差异（ｐ＜０．０１）。其定性准确性为（９５．３％）,明显高于ＵＳ（８０．０％）。结论：ＳＣＴＡＰ能可靠反映小肝癌、肝实质血流灌注特征,明显提高病灶检出敏感性及定性准确性。螺旋ＣＴ动脉造影（ＳＣＴＡ）显示病变动脉血管最佳,两者结合可增加诊断特异性。     

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.