快速MRI检出前列腺癌的前列腺成像报告和数据系统指南解读

前列腺MRI的诊断需求稳步增长, 解决方案必须在保证前列腺MRI的诊断效能的前提下增强其运营效益, 其中的一种解决方案是快速MRI检出前列腺癌, 联合临床风险信息, 来决定前列腺癌诊疗方案的选择。为此, 前列腺成像报告和数据系统指导委员会对快速MRI检出前列腺癌提出了指导性建议, 让临床怀疑前列腺癌并且未接受过活检的患者受益。     

快速MRI检出前列腺癌的前列腺成像报告和数据系统指南解读

前列腺MRI的诊断需求稳步增长,解决方案必须在保证前列腺MRI的诊断效能的前提下增强其运营效益,其中的一种解决方案是快速MRI检出前列腺癌,联合临床风险信息,来决定前列腺癌诊疗方案的选择。为此,前列腺成像报告和数据系统指导委员会对快速MRI检出前列腺癌提出了指导性建议,让临床怀疑前列腺癌并且未接受过活检的患者受益。     

前列腺癌的磁共振诊断

前列腺癌是欧美老年男性的最常见恶性肿瘤之一,其预后及治疗主要取决于早期诊断和准确的术前分期,正确处理的情况下前列腺癌的死亡率相对较低[1～6]。随着我国人口老龄化的进程和男性人口预期寿命的延长,我国前列腺癌的发病率日益上升,其术前诊断与分期的方法成为倍受关注的研究热点。磁共振成像（MRI）以其优异的软组织分辨率及多方位、多序列成像能力成为目前前列腺癌术前诊断、分期的最主要、最准确的方法。前列腺癌的磁共振成像包括常规MRI及功能MRI两个部分。     

前列腺癌的MR诊断

前列腺癌是男性泌尿生殖道最常见的恶性肿瘤之一,介绍了常规MRI、动态增强磁共振成像及磁共振波谱成像在前列腺癌诊断中的应用,以及前列腺癌影像学表现、分期及鉴别诊断.     

功能MRI在前列腺癌治疗后评估中的临床应用与进展

前列腺癌治疗后临床多采用前列腺特异抗原水平进行评价,但其受多种因素影响。目前肿瘤的评价主要以肿瘤体积的改变为评价指标,但滞后于肿瘤微循环改变及肿瘤细胞坏死等功能性改变。如何在前列腺癌治疗后早期准确评估其治疗疗效并早期发现肿瘤残存或复发是非常重要的。动态增强MRI、扩散加权成像、体素内不相干运动成像、磁共振波谱等多种功能MRI技术已在前列腺癌早期诊断中发挥重要的作用。就多种功能MRI技术应用于前列腺癌治疗后评估及随访的价值进行综述。     

前列腺扩散加权成像超高b值优化及其在前列腺癌诊断的初步研究

目的 探讨前列腺超高b值扩散加权成像(DWI)b值优化方案,并分析其在诊断前列腺癌(PCa)不同级别ISUP分组上的应用价值.方法 选取超声引导下前列腺靶点穿刺、临床病理确诊并于穿刺前后1个月内完成前列腺MRI检查的35例患者350处穿刺靶区MRI资料.所有患者均完成3.0T前列腺常规MRI扫描并完成超高b值DWI,b...     

前列腺癌MRI诊断技术研究进展

前列腺癌是世界上第二常见的男性恶性肿瘤, 我国前列腺癌的发病率亦呈逐年上升趋势。MRI有着良好的软组织分辨率及多方位成像优势, 能较好地显示前列腺的解剖结构及相邻的组织结构, 随着MRI技术的不断发展, 其对前列腺癌的诊断发挥着越来越重要的作用。该文从前列腺癌MRI常规序列的影像表现着手, 对各种功能MRI在前列腺癌的诊断和鉴别诊断中的应用进行了详细地论述, 如MR灌注加权成像、MR波谱、MR扩散加权成像、MR扩散张量成像、体素内不相干运动扩散加权成像、MR磁敏感加权成像等, 介绍了功能MRI相对于常规扫描的优势及其所能提供的更多的影像学资料, 通过系列半定量和定量数据, 能进一步提供前列腺癌的血流灌注、水分子扩散、微循环状态、物质代谢及生化成分变化等信息。     

MR功能成像在子宫内膜癌的术前分期中的价值

子宫内膜癌术前准确分期对治疗方案的选择,尤其是手术方案的选择有很重要的影响,MRI是目前最准确的术前分期方法之一.综述MR动态增强成像及扩散加权成像在子宫内膜癌术前分期中的价值,并就其各自的适用范围、技术优势和局限性进行探讨.     

MRI与经直肠超声融合导航技术引导前列腺靶向穿刺研究

经直肠超声(TRUS)引导下的前列腺穿刺已成为目前临床诊断前列腺癌最常用的穿刺方法.由于前列腺癌特殊的生物学特性,目前临床常用的系统穿刺联合TRUS目标靶向穿刺的方法仍存在一定的漏诊率等不足.多参数磁共振成像(MRI)是近年来逐渐被公认的诊断前列腺癌最佳影像学方法.本文以MRI-TRUS融合导航技术为主题,围绕前列腺穿刺活检现状、多参数MRI诊断前列腺癌的价值、MRI TRUS融合导航技术引导前列腺靶向穿刺的应用价值、MRI-TRUS融合导航技术目前尚存在的问题及最新进展4个方面,阐述MRI-TRUS融合导航技术在引导前列腺靶向穿刺中的价值.     

前列腺癌MRI新技术进展

前列腺癌是威胁中老年男性身体健康的重要杀手之一,早期筛查诊断对降低前列腺癌患者临床病死率,提高患者生活质量具有重要意义。MRI是目前临床前列腺疾病检查的首选方法,近年来随着MRI技术的发展,一些MRI功能成像新技术不断涌现,如DCE-MRI、MRPWI、DWI、MRS、SWI等在前列腺癌诊断、鉴别诊断中的应用。本文对以上的研究现状进行综述,旨在提高对前列腺癌磁共振成像研究的新认识。     

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.     

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）     

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.