三叉神经痛患者血管压迫MRI表现与手术结果对照研究

目的 分析三叉神经痛患者ＭＲＩ表现,探讨ＭＲＩ对三叉神经痛神经血管压迫的诊断价值。材料与方法 回顾性分析８５例三叉神经痛患者ＭＲＩ表现及手术结果。结果 ８５例三叉神经痛患者共１７０侧脑池段三叉神经ＭＲＩ检查中,５９侧存在三叉神经血管压迫或接触,可疑接触３５侧,其中症状侧有神经血管压迫、接触或可疑接触者为７５例,经统计学分析,三叉神经痛患者症状有无与是否存在血管压迫或接触有显著意义（Ｐ〈０．００１）     

3D-TOF磁共振血管成像诊断血管压迫性三叉神经痛的价值

目的　探讨增强薄层三维体积扫描时间飞跃法磁共振血管成像 ( 3D -TOFMRA)诊断血管压迫性三叉神经痛的价值。方法　回顾性分析 37例临床拟诊为血管压迫性三叉神经痛患者的常规颅脑MRI及增强薄层 3D -TOF磁共振血管成像资料。结果　增强薄层 3D -TOFMRA发现 37例中 2 4例共 2 7侧三叉神经存在血管压迫或接触 ,其中症状侧三叉神经有血管压迫或接触 2 4例 ,无症状侧三叉神经有血管压迫或接触 3例 ,本组病例统计学分析表明 ,三叉神经痛患者症状的出现与三叉神经存在血管压迫或接触有显著相关关系 (Ρ <0 .0 0 5 )。 13例为非血管压迫性三叉神经痛。压迫三叉神经的血管为小脑上动脉 (SCA) 14例 ,小脑前下动脉(AICA) 5例 ,起源不清的血管 3例 ,扭曲的椎动脉 1例 ,血管畸形 1例。结论　增强薄层 3D -TOFMRA可清楚显示三叉神经脑池段与毗邻血管的关系 ,明显优于常规颅脑MRI,是目前检测血管压迫性三叉神经痛最佳的影像学检查方法 ,对明确诊断和指导治疗三叉神经痛具有重大意义。     

三维时间飞跃-扰相梯度回波和三维快速高级自旋回波对颅神经与邻近血管关系的对比研究

目的探讨面肌痉挛及三叉神经痛的神经与周围血管显示的最佳MR扫描序列。方法对40例面肌痉挛及三叉神经痛病人的脑池段面神经和二叉神经用三维时间飞跃-扰相梯度回波(3DTOF-SPGR)和三维快速高级自旋回波(3DFASE)2种扫描序列进行扫描，并对其与周围血管的关系显示进行分析。结果38例经手术证实，3DTOF-SPGR序列图像显示其中33例面神经和三叉神经单侧存在邻近血管压迫或接触，5例无接触，3DFASE序列图像显示其中26例面神经和三叉神经单侧存在邻近血管压迫或接触，12例无接触。统计学分析结果表明2种扫描序列显示面神经和三叉神经对邻近血管的压迫或接触差异有显著性意义(X^2=5．14，P：0．016)。结论就显示神经与邻近血管的关系而言，3DTOF-SPGR序列明显优于3DFASE序列，是临床上面肌痉挛和三义神经痛病人行MR检查首选的扫描序列。     

3.0T磁共振断层血管成像对三叉神经痛和面肌痉挛血管神经压迫的诊断价值

目的 探讨3.0T磁共振断层血管成像(magnetic resonance tomographic angiography, MRTA )对三叉神经痛和面肌痉挛血管神经压迫的诊断价值. 方法 临床诊断的三叉神经痛52例,面肌痉挛9例,共61例.61例均行3.0T磁共振断层血管造影成像( MRTA),利用原始图像进行斜矢状位和冠状位重建,从3个方位观测血管神经的关系,并与手术结果进行对照. 结果 52例三叉神经痛中,MRTA显示46例存在三叉神经血管压迫或接触,6例无压迫.9例面肌痉挛MRTA显示面神经均有微血管跨越或压迫.手术结果显示52例三叉神经痛中45例存在三叉神经血管压迫或接触,6例无压迫,1例为囊肿;9例面肌痉挛均有微血管压迫.MRTA诊断阳性率为90.2%、敏感性为 96.4%、特异性为80%. 结论 3.0T超高场强下进行MRTA,对发现三叉神经痛和面肌痉挛血管神经压迫有重要诊断价值.     

磁共振断层血管成像对原发性三叉神经痛的诊断价值

目的：探讨磁共振断层血管成像(MRTA)对原发性三叉神经痛(ITN)患者神经血管关系的诊断价值及可靠性。方法回顾性分析280例 ITN 患者的临床及 MR 资料,并与手术结果进行盲法对照。结果280例 ITN 患侧神经血管接触、可疑接触或压迫共267例(阳性率95.3%),健侧有66例(假阳性率23.6%);120例手术者,术中发现神经血管接触或压迫118例。患侧与健侧神经血管接触或压迫比较差异有统计学意义(P <0.05)。以手术结果为金标准,MRTA 诊断神经血管接触或压迫的特异度、灵敏度、诊断符合率分别为100%,96.6%,96.7%。结论MRTA 能可靠地显示 ITN 神经血管的关系,其诊断灵敏度和准确率高,对ITN 病因诊断和手术治疗提供客观的依据。     

三叉神经痛和面肌痉挛MR断层血管成像表现与手术对照分析

目的 探讨磁共振断层血管成像(magnetic resonance tomographic angiography,MRTA)在诊断三叉神经痛和面肌痉挛血管神经压迫中的价值.方法 经临床诊断三叉神经痛23例,面肌痉挛22例,行三维时间飞越稳态梯度回波序列(3D-TOF-SPGR)采集图像,利用原始图像对两侧三叉神经和面神经进行轴位、矢状位和冠状位重建,观察血管与神经的关系,并与手术结果进行对照分析.结果 23例三叉神经痛中,MRTA显示19例存在三叉神经血管压迫或接触,阳性率为82.6%(19/23),可疑接触4例.22例面肌痉挛中有20例MRTA显示了面神经起始段有微血管跨越或对面神经有轻微的推压改变,阳性率为95.5%(21/22),与手术结果有较高的一致性.结论 MRTA对发现三叉神经痛和面肌痉挛血管神经压迫具有重要价值.     

3D-TOF-SPGR磁共振血管成像在三叉神经痛神经血管压迫诊断中的价值

目的 探讨3D-TOF-SPGR磁共振血管成像(MRA)在三叉神经痛(TN)神经血管压迫临床诊断中的应用价值.方法 三叉神经痛患侧组23例(23侧神经)、正常对照组31例(39侧神经),利用SE-T1WI、FSE-T2WI、MR三维时间飞跃稳态梯度回波序列(3D-TOF-SPGR)MRA图像及MPR斜矢状位、冠状位重组图像,盲法观察3个方位图像,以判定三叉神经与局部微小血管的关系.结果 三叉神经痛患侧组23侧神经,19侧表现为神经血管压迫阳性,占82.6%;正常对照组39侧神经,11侧表现为阳性,占28.2%,TN患者组与正常对照组χ2=17.15,P＜0.005,具有统计学差异.在MRA图像中,TN患者组阳性者微小血管与三叉神经的关系密切,有13侧表现为受压三叉神经不同程度弯曲、变形;正常对照组阳性者微小血管与三叉神经仅表现为横过、平行或密贴,相应三叉神经形态及信号均无明显异常表现.结论 3D-TOF-SPGR序列MRA对神经血管压迫三叉神经痛具有很高的临床诊断价值,并可为微血管减压术提供术前指导.     

磁共振3D-FIESTA在原发性三叉神经痛诊断中的应用

目的 研究MR三维稳态进动快速成像(3D-FIESTA)序列对原发性三叉神经痛的诊断价值.方法 对23例三叉神经痛患者行3D-FIESTA序列成像并多平面重建,分析患侧组与健侧组三叉神经与邻近血管关系.结果 患侧组与健侧组神经血管接触阳性比例分别为20/23与11/23,神经受压推移比例分别为6/23与0/23,经统计学分析,2组间的差异均有统计学意义(P<0.05).结论 MR 3D-FIESTA序列可以清晰显示三叉神经与邻近血管的关系,对原发性三叉神经痛的诊断具有重要价值.     

磁共振3D FIESTA-C联合3D-TOF序列对原发性三叉神经痛的诊断价值

目的探讨磁共振3D FIESTA-C联合3D-TOF序列对原发性三叉神经痛的诊断价值。方法分析磁共振3D FIESTA-C及3D-TOF序列扫描的45例三叉神经痛患者,观察正常侧及三叉神经痛侧的神经与周围血管的关系。结果 45侧三叉神经痛侧中,神经与周围血管表现为压迫及接触关系共36侧;正常侧表现为压迫及接触关系12侧。两组间差异有统计学意义(P0.05)。结论 3D FIESTA-C联合3D-TOF序列可清晰显示三叉神经与周围血管的关系,对原发性三叉神经痛具有很高的诊断价值,以指导临床治疗。     

3D-TOF法MRA图像后处理技术在血管压迫性三叉神经痛中的正确应用

目的：探讨三维时间飞跃法磁共振血管成像（3D—TOFMRA）及其后处理技术在血管压迫性三又神经痛的正确应用。方法：两名神经放射医师盲法分析38例临床诊断为三叉神经痛的患者3D—TOF法MRA基础图及MPR技术后处理图像。结果：（1）38例三叉神经患者中MRl诊断为血管接触或压迫的31例，其中有症状侧血管接触或压迫26例。经统计学分析，三叉神经痛患者症状的出现与三叉神经存在血管接触或压迫有显著相关关系（P〈0．005）。（2）14例以V2分布区域疼痛为主要症状的患者中，85．7％（12例）能清楚显示血管压迫神经的中间部位；10例以V3分布区域疼痛为主要症状的患者中，70％（7例）能清晰显示血管压迫神经的侧方（P〈0．005）。结论：3D-TOF法MRA及图像后处理技术可清晰地显示三叉神经脑池段与毗邻血管的关系，血管压迫神经的部位与疼痛的区域有一定的相关性。为临床治疗三又神经痛提供影像学上的支持。     

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.