先天性支气管桥的多层螺旋CT诊断

目的 探讨MSCT重组图像在诊断先天性支气管桥(BB)中的临床应用价值.方法 回顾性分析12例经MSCT重组图像诊断的先天性支气管桥畸形的影像表现.图像后处理方法包括MPR、MinIP、MIP、VR.结果 12例支气管桥中,Ⅰ型支气管桥6例,表现为正常隆突位于T2～3平面,存在右肺支气管分支,隆突角平均59.2°,支气管桥起源于隆突下左主支气管,该位置称为假隆突,位于T4～5平面,夹角平均108.80°,支气管桥起源以前的左主支气管明显狭窄,宽约1～2mm,长约17 mm.Ⅱ型支气管桥6例,表现为正常隆突位置平面无右肺支气管分支,支气管桥起源于气管更远端,供应整个右肺,假隆突位于T4～5平面,角度平均131 °,均伴气管下段狭窄,宽约2～3 mm,长约30 mm,4例气管下段向左侧倾斜,2例伴肺动脉吊带.结论 MSCT可以对先天性支气管桥进行定性诊断,重组图像可以直观地观察气管、支气管、隆突的形态、走行、管径及与周围组织的关系.     

多层螺旋CT重组图像诊断先天性气管支气管发育异常

目的:探讨多层螺旋CT(MSCT)图像重组在诊断先天性气管支气管发育异常中的临床应用价值,提高对气管支气管发育异常的影像学表现的认识.方法:回顾性分析32例经多层螺旋CT图像重组诊断的先天性气管支气管发育异常影像学表现.结果:本组32例中食管-气管瘘13例,气管支气管壁发育异常11例,先天性气管支气管分支异常8例,其中25例合并其它部位的畸形.结论:多层螺旋CT图像重组可以多方位全面观察气管、主支气管、段及亚段支气管的形态、走行、管径及与周围组织的关系,明显提高了本病的诊断准确性,并能明确胸部合并的其它畸形,已成为本病的首选检查方法.     

小儿支气管桥的多层螺旋CT诊断

目的:探讨多层螺旋CT(MSCT)对小儿支气管桥的诊断价值.方法:回顾性分析18例支气管桥患儿的计算机X线摄影(DR)、MSCT扫描图像资料,MSCT肺部常规扫描后,在16层MSCT机上进行1.25mm层厚、1.25mm层间隔重组,获得最小密度投影(MIP)、容积重组(VR)、表面遮盖显示(SSD)、仿真支气管内镜(VB)图像,记录病变的部位及与周围组织的关系和伴发异常.结果:18例病变经CT三维重建处理后全部清晰显示,15例伴有先天性心脏病,其中8例伴有左肺动脉吊带;8例伴有左主支气管起始部狭窄,5例左、右支气管均有狭窄,1例伴有气管下段及右侧支气管起始部狭窄,仅1例未见明显气道狭窄.结论:MSCT对于支气管桥的诊断、气道及周围组织的显示有良好价值.     

多层螺旋CT及其后处理技术对肺部先天性病变的诊断价值

目的 探讨多层螺旋CT(MSCT)及各种图像后处理技术对肺、支气管及肺血管先天性病变的诊断价值. 资料与方法 回顾性分析34例肺部先天性病变的MSCT表现,所有病例均行MSCT平扫,19例行增强扫描,常规行多平面重组(MPR)、最大密度投影(MIP)及容积再现(VR)等技术重组图像.结合手术和临床资料评价其作用. 结果 34例中,肺发育异常3例,支气管囊肿15例,囊性腺瘤样畸形2例,支气管闭锁3例,气管支气管1例,肺动静脉瘘6例,一侧肺动脉近端缺如1例,肺隔离症3例.MSCT轴位及后处理图像能清楚显示病变的部位、与相应支气管及血管的关系,血管性病变均清楚显示供血动脉及引流静脉. 结论 MSCT常规检查结合各种后处理技术能获得肺部先天性病变诊断的足够信息,对肺血管先天性疾病多能作出定性诊断.     

MSCT诊断气管支气管的价值

目的:探讨多层螺旋CT对气管支气管的表现和诊断价值.方法:总结分析8例气管支气管的影像特点,6例行平扫检查,2例行增强扫描,4例行平片检查.CT后处理包括多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)、曲面重组(CURED)和三维重组(3D),重点对气管、主和段支气管的开口、分叉及行径采取追踪观察,并全面重建此种变异.结果:8例气管支气管中3例直接开口于气管,1例从隆突发出.4例起源于主支气管,并且5例为移位型气管支气管(移位的右上尖段支气管3例,移位的右肺上叶支气管2例),3例为额外型气管支气管(额外的右上叶尖段支气管),从CT冠状位重组图像中测得气管支气管与隆突平均间距约为1.52cm,与气管或主支气管的平均夹角约为62.,开口处的管腔径均值约为0.38cm.男5例,女3例,平均年龄37.6岁.仅有2例呼吸道症状与此直接有关.其中1例为气管支气管肺癌,1例合并右肺发育不良.同时,4例有胸片对照者中均无阳性表现.结论:MSCT扫描便捷、安全、准确,对其分型和观察明显优于其他检查手段,采用多平面重组是诊断气管支气管的最有效的方法.     

左肺动脉吊带伴随气管畸形的多层螺旋CT诊断价值

目的 评价MSCT在诊断左肺动脉吊带及伴随气管畸形中的价值.方法 回顾性分析MSCT诊断的肺动脉吊带伴随气管畸形及气管狭窄患儿9例.结果 根据Wells分型,分为2种主型和2种亚型,其中1A型2例,1B型3例,2A型2例,2B型2例.9例患儿全部存在不同程度的气管支气管狭窄.4例(1型)局限或短段气管支气管狭窄,5例(1型1例,2型4例)长段气管狭窄或支气管狭窄.结论 MSCT成为同时显示左肺动脉吊带畸形和伴随气管畸形的最佳成像方法.Wells分型对制定手术方案非常有帮助.     

多层螺旋CT对小儿气管、支气管非金属异物的诊断价值

目的:探讨多层螺旋CT(MSCT)对气管、支气管非金属异物的诊断价值。方法:50例临床可疑气管、支气管异物病例行MSCT检查,并结合MSCT多模式重组如多平面重建(MPR)、表面遮盖显示法(SSD)、CT仿真支气管镜(CTVB)图像分析诊断,全部病例均经纤维支气管镜或临床证实。结果:50例可疑病例中,有气管、支气管非金属异物30例,MSCT能显示这些支气管异物的位置、形态、大小及异物所致气管、支气管狭窄和堵塞情况,无异物20例,其中18例与临床相一致,2例误诊。结论:利用MSCT的多模式重组,结合轴位图像能提高诊断气管、支气管非金属异物的准确性,具有重要的诊断价值。     

MSCT气道后处理技术在先天性气管性支气管疾病中的诊断价值

目的:探讨MSCT气道后处理技术对先天性气管性支气管(TB)的诊断及应用价值.方法:回顾性分析12例TB患儿的MSCT原始图像及各种后处理重组图像,气道重组技术包括多平面重组(MPR)、最小密度投影(MinIP)、容积再现(VR)及仿真支气管内镜(VB),获得支气管树的三维重组图像根据conacher分型法进行归类.结...     

小儿先天性气管性支气管的多层螺旋CT诊断

目的：介绍小儿先天性气管性支气管的分类及意义，探讨多层螺旋CT（MSCT）在该病中的诊断价值。方法：回顾性分析43例先天性气管性支气管患儿的计算机X线摄影（CR）、MSCT扫描影像资料，MSCT肺部常规10mm层厚扫描，在16层MSCT机进行1．25mm层厚、1．25mm层间隔重组，获得最小密度投影（minIP）、容积重组（VR）、表面遮盖技术（SSD）、仿真支气管内镜（VB）图像，记录病变的部位及与周围组织的关系和伴发异常。结果：43例病变经CT后处理技术全部清晰显示，CT横断面扫描显示37例，CR仅显示1例；43例中38例有先天性心血管病变，40例为右侧气管性支气管，3例为双侧气管性支气管，共有9例伴随气道狭窄，2例气管插管过深引起右肺上叶节段性肺不张。结论：MSCT对于诊断先天性气管性支气管，显示气道及其周围伴随组织有良好的价值。     

儿童冠状动脉异常起源肺动脉的16层螺旋CT诊断

目的 评价儿童冠状动脉异常起源肺动脉的多层螺旋CT(MSCT)诊断价值.资料与方法 MSCT应用于8例冠状动脉异常起源肺动脉患儿检查中,平均年龄4.12岁(5个月～10岁),其中4例采用无心电门控CT血管成像,MSCT参数:准直0.625～1.25mm,层厚0.625～1.25mm,螺距为0.562,旋转速度0.5s/r,床进5.62mm/r,0.31～0.625mm重建间隔,4例采用回顾性心电门控.结果 8例冠状动脉起始、右冠状动脉近端、左冠状动脉主干、左前降支及左回旋支近端显示率100%.7例左冠状动脉异常起源于肺动脉瓣窦上的肺动脉总干,1例右冠状动脉异常起源于肺动脉总干右后壁,1例伴右上肺静脉异位引流入上腔静脉,1例伴右冠状动脉高位开口.结论 冠状动脉异常起源肺动脉为少见的先天性心脏病,MSCT可作为一种可靠的,有潜力的无创伤性诊断方法 应用于其诊断中.     

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.     

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.     

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）