Ebstein氏畸形X线诊断(附4例分析)

现将我院造影证实的4例Ebstein氏畸形,其中2例为手术验证报告如下,并着重讨论其X线诊断问题。 X线表现 平片表现:本文4例均摄有心脏远     

先天性输尿管梗阻影像表现与手术病理对照分析(附36例分析)

目的：探讨先天性输尿管梗阻的影像表现与手术病理结果的相互关系。方法：总结36例经手术病理证实的输尿管梗阻，就其尿路造影征象及B型超声图像表现与手术所见病理结果进行比较。结果：输尿管先天性狭窄发病率最高，共27例，且多发生在输尿管上段。瓣膜状狭窄4例，以输尿管粘膜皱折多见。外来血管压迫2例，输尿管囊肿并狭窄2例，重复肾盂输尿管畸形并狭窄1例，以上各类输尿管梗阻的影像表现与手术结果大致相符。结论：B超与静脉尿路造影相结合为本病术前确诊的最佳方法。     

不明原因小肠出血数字减影血管造影价值

目的探讨DSA血管造影对不明原因小肠出血的诊断价值。方法25例小肠出血患者,均经Seldinger法行肠系膜上动脉插管造影。结果显示出血直接征象11例,出血间接征象12例,其中5例同时具有直接征象和间接征象。直接诊断出血18例,阳性率72%。病变性质为:肿瘤性病变10例,其中平滑肌瘤6例,平滑肌肉瘤2例,间质瘤1例,小肠癌1例。梅克尔憩室4例,血管畸形3例,炎症1例。阳性病例与手术病理诊断的符合率为75%,定位诊断符合率100%。结论DSA血管造影对不明原因的小肠出血的定位、定性诊断有肯定的价值。     

自内向外顺序染色征象在血管造影和CT诊断小肝癌中的作用

目的:描写自内向外顺序染色征象以有助于血管造影和CT对小肝癌的诊断.材料和方法:14例直径3cm以下的小肝癌(手术病理证实10例,符合全国诊断标准4例).均行CT检查,行血管造影和CTA检查者分别是9例和3例.结果:9例血管造影者中8例富血管性者均呈自内向外顺序染色;3例CTA者亦呈上述征象;呈此征象的首例因对其认识不足而误诊,认识此征后其余7例诊断均正确.结论:自内向外顺序染色征象在血管造影和CT对小肝癌的诊断中有很大价值.     

腰间盘突出症脊髓造影诊断及鉴别诊断

脊髓造影是腰间盘突出症常用影像检查之一。本文报道经手术和病理证实的１７２例腰间突出脊髓造影。腰间盘突出症脊髓造影表现可分为直接征象，间接征象和腰骶骨质异常。本组病例脊髓造影诊断准确率为９５．９％，与Ｋｉｅｆｆｅｒ报道接近。游离骨块是腰间盘突出的直接征象，本文着重讨论了它的脊髓造影表现和形成原因。还讨论了腰５～骶１，间盘突出症脊髓造影诊断体会。最后，提出本症的鉴别诊断。     

成人多囊肾的影像学诊断

目的 :探讨影像学对成人多囊肾的诊断价值。方法 :本组 6 8例均经肾穿刺、手术、病理和较完整的临床资料证实 ,其中 5例合并肾钙乳。对其各种主要影像学征象、发病机理及病理基础进行了分析和讨论。结果 :成人多囊肾的主要影像学征象 :腹部平片 (4 6例 )显示肾影呈分叶状增大 ;囊壁钙化 (14例 ) ;多囊肾合并肾钙乳 (5例 ) ;肾盂造影 (6 0例 ) ,表现为肾盂、肾盏相互分离、变形、拉长 ;腹膜后充气造影 (5例 ) :表现为肾影增大肾影与邻近器官之间的关系 ,其界限清晰可辨 ;CT扫描 (2 5例 ) :表现为肾内多数大小不等的薄壁圆形低密度区 ;B型超声 (4 7例 )表现为肾内多个类圆形无回声的液性暗区。结论 :成人多囊肾均有一定特征性影像学征象 ,B型超声及 CT对诊断非常有帮助 ,紧密结合临床有助于提高诊断的准确性     

左侧三房心的X线诊断和评价

作者分析了２２例左侧三房心的临床资料，其中２０例经手术证实，经尸检或造影证实各１例。１０例为单纯左侧三房心，１２例俣并其他心血管畸形，描述了本病的胸部平片和心血管造影征象，左房真腔、假腔和异常纤维肌性隔膜的形态和运动特征。评价了不同检查方法的诊断价值，讨论了手术、病理、造影所见和临床征象间的相互关系以及本病的发病机理，分析表明，左房假腔排血受阻程度及合并畸形与发病年龄和临床症状密切相关。     

碘水剂椎管造影误入硬膜下腔的影像学分析

目的：观察碘水剂椎管造影误入硬膜下腔的Ｘ线造影表现,并分析了其误入原因和鉴别诊断方法。方法：从２８１例椎管造影中发现７例经脊髓造影ＣＴ（ＣＴＭ）证实有造影剂误入硬膜下腔者,进行Ｘ线征象分析,结果：发现其造影呈多样化影像表现,可产生多种假象,７例椎管造影中,假性硬膜外梗阻征５例,假性血管畸形４例,马尾神经不显影者５例等。结论：碘水剂椎管造影误入硬膜下的Ｘ线造影表现极易误诊硬膜外梗阻和血管畸形,充分认     

成人左冠状动脉异位起源于肺动脉

起源于肺动脉的冠状动脉先天性畸形,可为:1)左枝,2)右枝,3)双枝和4)一枝副冠状动脉起源于肺动脉。以第一型最为多见,本文报导成人病例二例,并复习文献和讨论造影技术。此畸形多见于婴幼儿。出生初期由于肺循环的压力仍然接近体循环水平,因此异位的左冠状动脉仍可获得血供。出生数周后,由于肺循环的压力下降,减少了异位的左枝冠状动脉的血供,迅速导致死亡。在此时期,如能建立足够右向左分流的吻合枝,左枝冠状动脉的血供得以维持,则可继续生存。但常于第2～4个月期间出现以消化系统、呼吸系统为主并伴有心绞痛样的临床征象。临床常无特征性表现。体检可有心脏收缩期杂音。由于左心室受损害,X 线表现为明显的心脏增大。心电图检查,80%的病例可在L_1、AVL、V_5、V_6导联出现大的Q 波,伴有ST 段的下移,T 波倒置、变尖但对称等。此时右心造影不能获得诊断资料,须作主动脉窦下造影才能明确诊断。病儿于此期多因心力衰竭而死亡,仅有13%的病例能建立足够的吻合枝而     

乳腺错构瘤X线病理对照分析

目的探讨乳腺错构瘤X线平片、导管造影、注气造影表现及其病理基础.方法分析X线检查并经病理证实的26例,其中26例投照X线平片,13例行导管造影,5例行注气造影,12例行标本X线摄影,并进行X线病理对照分析.结果全部病例均为良性、局限性生长,有完整包膜.X线表现因瘤体内所含脂肪和纤维腺体成分的数量不同而异,可分为三型脂肪为主型、纤维(纤维腺体)为主型和脂肪纤维混合型.结论X线可清晰显示脂肪和纤维腺体成分分布的区域,形成特征性"香肠切片”样征象.导管造影和注气造影有助于鉴别诊断.     

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.