三维动态增强磁共振门静脉造影对门静脉癌栓的诊断价值

目的 :探讨三维动态增强磁共振门静脉造影 ( 3DDCE MRP)对门静脉癌栓的诊断价值。方法 :对 2 6例门静脉癌栓患者行 3DDCE MRP检查 ,观察其门静脉癌栓在 3DDCE MRP上的表现 ,并与常规MRI表现进行比较。结果 :所有 2 6例门静脉显示满意。 3DDCE MRP均显示了癌栓所致相应部位门脉阻塞征象 ,2 1例示肝门部侧支血管 ,形成门静脉海绵样变性。结论 :3DDCE MRP是诊断门静脉癌栓的有效方法 ,尤其在显示由此引起的侧支循环方面有很大优越性。不足在于不能显示癌栓近侧端的范围     

动态增强磁共振门静脉成像及临床应用

目的　探讨动态增强磁共振门静脉成像 (DCE -MRP)技术要点及临床应用优势。方法　 3 1例进行腹部常规扫描时疑有门静脉异常的患者接受了动态增强磁共振门静脉成像扫描 ,其中正常 8例 ,异常 2 3例。使用高压注射器将Gd -DTPA造影剂经手背静脉注入血管 ,应用透视触发造影技术确定扫描延迟时间 ,所有图像分别进行数字减影、最大信号强度投影 (MIP)重建。结果　3 1例患者均获得了清晰、立体的门静脉图像。 8例无肝脏疾患者 ,DCE -MRP均能完整显示门静脉主干及肝内 5级以上的分支。 2 3例异常 ,其中肝硬化门静脉高压 13例 ,均显示门静脉扩张迂曲 ,2例显示门静脉主干闭塞 ;肝癌 9例 ,其中门静脉主干和 (或 )其主分支闭塞 3例 ;肝右叶巨大血管瘤 1例。结论　动态增强磁共振门静脉成像为新的磁共振血管成像技术 ,成像效果与传统的血管造影相仿 ,具有明显的临床应用优势     

螺旋CT门静脉血管造影的成像技术及其临床应用价值

目的评价螺旋CT门静脉血管造影（CTP）的最佳成像技术及其临床应用价值。方法对60例正常和108例疑有肝脏疾病的患者作了最大强度投影（MIP）和表面遮盖法（SSD）CTP成像。使用不同的准直、延迟时间及扫描方向将正常组随机分为六组,定性和定量分析各组图像的差别。结果准直3.0～5.0mm,延迟时间45～50s,自足端方向扫描MIPCTP能同时显示4级以上门静脉分支和2级以上的肝静脉分支。CTP能直观地评价门静脉和肝静脉的位置、管径、有无门静脉受侵或癌栓形成,了解门静脉高压侧支循环的分布范围和程度。CTP有助于经颈静脉肝内门腔静脉分流术（TIPS）术前定位、Budd-Chiari综合症的诊断和术后随访。SSDCTP立体感强,但不利于细微结构和癌栓的显示。结论CTP是门静脉和肝静脉无创性检查的可靠方法,有较高的临床应用价值。     

三维DCE MRA在门静脉和肝脏静脉系统的应用

目的探讨门静脉和肝脏静脉系统三维动态增强磁共振血分成像（3DDCEMRM）检查的最佳技术，评价3DDCEMRA在该系统中的使用价值。方法门静脉和肝脏静脉系统行3DDCEMRA108次，二维（2D）DCEMRA10次。比较两种力法显示门静脉右支的能力，不同层厚对3DDCEMRA显示门静脉右支的影响，并对门静脉、肝静脉和下腔静脉在3DDCEMRA的显示情况以及各种病变的3DDCEMRA表现一分析。结果3DDCEMRA显示门静脉右支级数优于2DDCEMRA（P＜0.05），且层厚越薄，显示分支越细（p＜0.01）。3DDCEMRA能较好地显示门脉主干（显示率93％）、左右分支（88％．97％）、肝静脉（81％）和腔静脉（83％），并能显示多种疾病。结论3DDCEMRA能较好地同时显示门静脉、肝静脉和下腔静脉，在门静脉和肝脏静脉系统多种疾病的显示和诊断方面具有较高使用价值。     

无创伤性三维门静脉双螺旋CT造影

本文报到60例三维门静脉双螺旋CT造影结果.在所有的病人该方法均能显示肠系膜上静脉、脾静脉、门静脉主干及其分支、在3例肝癌.2例肝癌术后及4例门静脉高压病人,三维门静脉双螺旋CT造影结果与肠系膜上动脉门静脉造影和外科手术所见一致,表明三维门静脉双螺旋CT造影是一种安全而又可靠的显示门静脉系统的方法.     

螺旋CT门静脉血管造影的临床应用价值

目的 :评价螺旋CT门静脉血管造影 (CTP)的临床应用价值。材料和方法 :对 10 8例对疑有肝脏疾病的患者分别行最大强度投影 (MIP)和表面遮盖法 (SSD)CTP成像。结果 :MIPCTP能同时显示 4级以上门静脉分支和 2级以上的肝静脉分支。CTP能直观地评价门静脉和肝静脉的位置、管径、有无门静脉受侵或癌栓形成 ,了解门解脉高压侧支循环的分布范围和程度。CTP有助于经颈静脉肝内门腔静脉分流术 (TIPS)术前定位、Budd Chiari综合症的诊断和术后随访。SSDCTP立体感强 ,但不利于细微结构和癌栓的显示。结论 :CTP是门静脉和肝静脉无创性检查的可靠方法 ,有较高的临床应用价值。     

单次屏气三维对比增强磁共振门静脉造影

目的探讨中次收气三维对比增强门静脉造影（3DCEMRP）方法并初步评价其临床应用价值。方法39例病人接受3DCEMBP检查及三维时间飞越法（2DTOF）门静脉成像，其中无肝脏疾患者8例，肝硬化18例，肝癌12例，脾静脉血栓形成1例，Gd-DTPA用量为每公斤体重0.1～0.2mmol，用团注实验剂量确定门静脉峰值通过时间及扫描延迟时间，所有图像分别经最大信号强度投影（MIP）重建，评价门静脉成像质量、开放程度、侧支血管及从静脉曲张的情况。结果门静脉内造影剂峰值通过时间为17～45秒，所有病例3DCE哑MRP成像质量明显优于2DTOF门静脉成像。8例无肝脏疾病者，CEMRP均完整显示门静脉主干及肝内4级以上的分支；18例肝硬化中有17例显示门、脾静脉扩张迂曲，其中10例显示食管胃底静脉曲张，1例门静脉主干近段闭塞，12例肝癌中，5例门静脉主干和（或）其主分支闭塞，6例显示肝内门静脉分支受压、移位；1例脾静脉血栓形成，见脾静脉闭塞及广泛的侧支血管。结论3DCEMRP为一快速、有效评价门静脉系统的检查方法。     

16层螺旋CT肝脏多期扫描的方法与实用价值

目的:探讨16层螺旋CT肝脏多期扫描的方法及应用价值。方法:150例疑有肝脏病变的患者行16层螺旋CT多期扫描。层厚7.5mm,螺距1.375,扫描时间0.8s/r,静脉团注对比剂80～120ml,分别延时23～28s、45～50s58～65s行肝动脉期(动脉早期)、门静脉流注期(动脉晚期)和肝静脉期(实质期)扫描,并对图像作回顾性分析,比较增强前后腹主动脉、门静脉、肝静脉的CT值变化和后处理图像显示肝动脉、门静脉、肝静脉的能力。结果:16层螺旋CT肝脏多期扫描,肝脏血管增强后与增强前的密度差在91.9HU以上,VR、MIP、MPR图像上100%显示肝动脉(150/150),门静脉显示率为96.7%(145/150),肝静脉显示率为95.3%(143/150)。5例门静脉显示不清的病例中,3例为肝癌合并肝门区淋巴结转移,1例肝癌合并门静脉癌栓形成,1例为严重肝硬化合并腹水、脾肿大;7例肝静脉显示不清中有5例与门静脉显示不清的5例为相同病例,其余2例为严重肝硬化合并腹水。结论:16层螺旋CT肝脏多期扫描对评估肝脏病变、肝脏血管的正常、变异以及病变对血管的影响有很大帮助,但是对于严重肝硬化门静脉高压、门静脉狭窄、门静脉血栓(包括癌栓)形成的病例,显示门静脉和肝静脉不理想。     

门静脉高压患者多层螺旋CT在体测量研究

目的 通过多层螺旋CT门静脉血管成像,探讨门静脉高压患者门静脉系统管径、肝脾体积、肝实质强化与病因及肝功能之间的关系.资料与方法 采用16排多层螺旋CT对126例临床和实验室指标提示门静脉高压患者和47例非门静脉高压者进行门静脉CTA,并进行胃左静脉、门静脉、脾静脉、肠系膜上静脉内径测量,肝脏、脾体积测量及门静脉期肝实质和门静脉主干CT值的测量,并用SPSS 11.0统计软件包对获得数据进行分析.结果 门静脉高压患者与正常对照组相比,门静脉内径分别为(13.73±3.36) mm和(13.61±1.90) mm,脾静脉内径分别为(10.30±3.28) mm和(9.23±1.39) mm,肠系膜上静脉内径分别为(10.83±2.03) mm和(10.46±1.32) mm,胃左静脉宽度分别为(5.10±3.49) mm和(1.48±1.59) mm,肝脏体积分别为(1189.46±305.36) cm3和(1322.40±283.81) cm3,脾体积分别为(809.37±471.14) cm3和(255.53±110.35) cm3.两组间对比有统计学意义(P＜0.05).结论 多层螺旋CT门静脉血管成像在显示门静脉高压患者相关血管形态、肝脾体积及肝实质强化等多方面能提供有价值的信息,可为临床治疗方案的选择和疗效的观察评估提供影像学依据.     

64层螺旋CT静脉成像在肝硬化门脉高压症早期诊断中的价值

目的 探讨64层螺旋CT在肝硬化门脉高压的早期诊断.方法 研究经病理和/或临床诊断的42例肝硬化早期、中晚期病人64层螺旋CT门静脉及肝静脉血管成像表现,测量42例患者及15例健康者门静脉和肝右静脉管径并分析64层螺旋CT门脉血管成像法在肝硬化门脉高压症的早期诊断价值.结果 所有病人的观察血管在显示较佳的基础上,测得门静脉宽度(PV)在正常对照组(＜12 mm)与其他2组比较有显著性差异,肝硬化代偿组与失代偿组之间差异无明显统计学意义;肝右静脉宽度(RHV)在代偿期内径明显增宽,＞10 mm,而失代偿期肝静脉明显变窄,血管强化密度减低;PV/RHV比值在失代偿期约1.77±0.06,正常对照组及肝硬化代偿组PV/RHV均＜1.5.利用后处理软件最大密度投影(MIP)观察门静脉及肝右静脉血管,代偿组可显示3级以上的门静脉及肝右静脉,失代偿组肝右静脉显示欠佳,最多显示1级,门静脉属支走行扭曲且最多显示3级.结论 64层螺旋CT肝、门静脉血管成像对临床肝硬化门脉高压的早期诊断有重要临床意义.     

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.