肾巨大错构瘤破裂出血的CT诊断

目的:探讨肾巨大错构瘤破裂出血的CT表现。方法:回顾性分析6例经手术病理证实的肾巨大错构瘤破裂出血患者的临床及影像资料,6例均行CT平扫及增强扫描。结果:肾巨大错构瘤破裂后呈高、等、低混杂密度;脂肪密度是诊断的关键依据,增强扫描脂肪和血肿无强化。结论:依据CT特征性表现可对肾巨大错构瘤破裂出血作出定性诊断。     

腹膜后软组织肉瘤的CT诊断

目的 探讨腹膜后软组织肉瘤的CT表现和诊断价值.资料与方法 搜集经手术病理证实的36例腹膜后软组织肉瘤患者的CT影像资料,对其大小、形态、边界、密度、肿瘤与周围组织的关系及增强扫描特征进行回顾性分析,并探讨这些征象在诊断与鉴别诊断中的价值.结果 36例中,CT正确定位31例(86%).全组病例瘤体平均体积为6.3 cm×9.7 cm×11.2 cm.32例形态不规则或呈分叶状.29例密度不均匀,可见坏死、出血或钙化.所有病灶均不同程度推压周围组织器官,28例与周围组织器官不同程度粘连,部分边界不清晰,其中17例累及周围组织.增强扫描脂肪肉瘤内部的条状分隔及软组织肿块、结节可见轻度强化,恶性纤维组织细胞瘤、平滑肌肉瘤及横纹肌肉瘤呈中等程度或显著不均匀强化.结论 CT能准确定位腹膜后软组织肉瘤,明确肿瘤的特征、范围以及肿瘤与周围组织的关系,在腹膜后软组织肉瘤的诊断与鉴别诊断中具有重要的价值.     

肾血管平滑肌脂肪瘤的CT诊断

目的探讨肾血管平滑肌脂肪瘤（AML）的CT表现,提高术前CT诊断水平。方法回顾性分析21例（女性12例,男性9例）经手术、病理证实的肾血管平滑肌脂肪瘤临床和CT资料。结果本组21例中．15例CT表现为含脂肪成分的混杂密度肿块,5例表现为稍低密度或混杂密度肿块,1例表现为高密度肿块;18例为单发病变（左侧11例,右侧7例）,3例多发病灶。结论CT对肾血管平滑脂肪瘤的确诊取决于病灶中的脂肪成分,对含较多脂肪成分的肾AML能明确定性诊断,对少脂肪成分的肾AML散在点状低密度影有助于定性诊断。     

肾上腺髓质脂肪瘤

目的总结肾上腺髓质脂肪瘤(AML)的影像学表现及临床特征。资料与方法回顾性分析经手术病理证实的10例AML的影像学和临床病理特点,并复习文献。结果10例AML中,右侧7例,左侧3例,CT表现为含脂肪组织的混杂密度肿块,增强扫描无强化。术前CT诊断准确率为100％。B超检查,8例诊断为AML,1例诊断为左肾上极肾血管平滑肌脂肪瘤,另1例诊断为右腹膜后肿块占位。结论AML的CT表现为含脂肪组织的混杂密度肿块,增强扫描无强化,CT检查可以明确诊断。     

腹部外周性原始神经外胚层肿瘤的CT与MRI表现

目的探讨外周性原始神经外胚层肿瘤(peripheral primitive neuroectodermal tumors,p PNET)临床特点,CT与MRI表现。方法对24例腹部外周性原始神经外胚层肿瘤患者行CT和MR扫描检查。结果原始神经外胚层肿瘤患者发生部位:13例位于腹膜腔,5例位于腹膜后间隙,左肾、右肾上腺及胰腺各2例;其中发生在胰腺部位的p PNET患者伴有黄疸、恶心、呕吐。CT平扫表现为不均匀软组织密度肿块,浸润性生长,与周围组织分界不清,肿块直径3~15cm,CT平扫示等或低密度,MR T1WI多为等、低混杂信号,肿瘤呈与肌肉等或略低信号;T2WI及其抑脂像呈不均匀高信号或混杂信号,肿瘤大多为不均匀的高信号,少数肿瘤有出血。CT、MR增强扫描肿瘤均呈不均匀强化,均有不同程度坏死,常见囊变,瘤内多见多房间隔样改变及网格状强化,肿瘤侵蚀临近骨质时,可见明显的相邻骨质破坏,1例可见骨膜反应。结论CT与MRI能较准确描述肿瘤内部结构、毗邻关系及转移情况。     

婴幼儿肾脏肿瘤的CT表现

目的：探讨婴幼儿肾脏肿瘤的CT表现及其诊断价值。方法：回顾性分析经病理证实的24例婴幼儿肾脏肿瘤的临床及CT资料,总结分析肿瘤的类型及CT表现。结果：24例中,肾母细胞瘤17例,CT表现为单侧肾脏内混杂密度肿块伴较明显囊变坏死,强化不均匀;2例伴钙化,1例肿块内见脂肪密度;2例伴肾静脉或下腔静脉癌栓,3例伴远处转移（肺、肝脏、骨、胸壁及淋巴结转移）。中胚层肾瘤2例,CT表现为肾脏内软组织密度结节,密度欠均匀,中度强化。透明细胞肉瘤1例,CT表现类似肾母细胞瘤,坏死更显著。乳头状淋巴管内血管内皮瘤1例,CT表现为肾脏内类圆形低密度灶不均质轻度渐进性强化。XP11.2易位性肾癌1例,CT表现为单侧肾脏混杂密度肿块,内有点状钙化,轻度不规则强化,伴腹膜后转移。淋巴瘤2例,其中Burkitt瘤1例,CT表现为双肾多发等密度结节,轻度强化;肝脏内多发低密度灶,轻度强化;急性髓系白血病侵犯肾脏1例,CT表现为单侧肾脏、腹腔、腹膜后、肠系膜及胸壁多发巨大不规则软组织密度肿块。结论：肾母细胞瘤多发于1岁以上的婴幼儿;中胚层肾瘤多发生在1岁内。婴幼儿肾脏肿瘤的诊断参考临床资料结合CT表现,可提高术前诊断准确率。     

自发性眶内出血的CT及MRI表现

目的：分析总结自发性眶内出血的CT及MRI表现。方法：回顾性分析13例经手术病理证实或临床影像随访诊断为自发性眶内出血病例的CT及MRI表现。结果：13例均为单侧,右眼5例,左眼8例。4例经手术证实,9通过临床随访诊断为自发性眶内出血。出血形成的血肿形态上呈前宽后窄的锥形,边界光滑清晰,均位于球后,与外直肌或下直肌关系密切,向后可达眶尖部。CT图像上出血表现为较高密度,MR信号特点符合出血信号,增强CT及MR均无强化。9例通过CT复查的病例中,4例出血完全吸收,4例遗留外直肌稍增厚,1例眶尖部内下方软组织影稍增多。结论：自发性眶内出血CT和MRI表现具有一定的特征性,大多数能够自行吸收,CT及MR可对其诊断、随访提供可靠依据。     

腹膜后神经源性肿瘤的CT诊断

目的:分析腹膜后神经源性肿瘤的CT表现,提高对良、恶性腹膜后神经源性肿瘤的鉴别诊断能力。方法:对23例经手术病理证实的腹膜后神经源性肿瘤的CT征象进行回顾性分析。结果:良性13例、恶性10例。13例良性神经源肿瘤CT大多表现为圆形、类圆形软组织肿块,密度均匀,轮廓光滑,其中神经鞘瘤和节细胞神经瘤可见斑点状钙化。10例恶性神经源性肿瘤,CT显示瘤体大而不规则,混杂密度,边缘不光滑,肿瘤可液化坏死、融合或侵蚀周围组织。CT增强扫描肿瘤表现为均匀或不均匀强化。CT对其良、恶性的诊断符合率为78%,组织类型诊断符合率为60.9%。结论:腹膜后神经源性肿瘤的好发部位有一定特征性,结合CT表现有助于良、恶性的鉴别,但对病理组织类型诊断有局限。     

泡状棘球蚴病肝外转移的CT影像特点

目的 探讨肝外泡状棘球蚴病(AE)的CT诊断及鉴别诊断.资科与方法回顾性分析31例经手术或活检病理证实的肝外AE的CT表现. 结果肺AE 24例,CT表现为以肺野外带和肺底分布为主的单发或多发肿块结节,内见钙化灶、小空泡征或空洞;脑AE 17例,平扫呈均质实性肿块或实性肿块伴多发囊泡,增强扫描呈靶样环状强化,6例病灶周围显示小囊泡征;骨AE 4例,CT表现为溶骨性骨质破坏,内见结节样或小圈状钙化灶,病变突破骨皮质后形成软组织肿块;肾上腺AE 14例,CT表现为混杂密度肿块内多发的结节样钙化灶或小囊泡征;肾AE 2例;累及腹膜后和背部软组织AE 4例.结论 CT检查能够明确AE肝外转移部位和侵犯范围,其表现有一定特征,结合流行病史有助于诊断.     

颅底骨巨细胞瘤的CT、MRI表现

目的:探讨颅底骨巨细胞瘤的CT、MRI表现。方法:回顾性分析11例经手术病理证实的颅底骨巨细胞瘤的临床表现及CT、MRI表现。结果:11例病变均位于颞骨和蝶骨,CT表现为不规则混杂密度软组织肿块,相应颅骨呈溶骨性和膨胀性骨质破坏,肿块外周多有骨性包壳存在。肿瘤MRI信号不具特征性,但MRI检查有助于观察病灶与周围软组织、血管、神经的关系。CT、MRI增强扫描后肿块均表现为不均匀强化。结论:CT和MRI表现有助于颅底骨巨细胞瘤的诊断和鉴别诊断,并为制定治疗方案提供详细资料。     

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 role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

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.