颞骨薄层横断层解剖与多层螺旋CT图像对照研究

目的:获取成人颞骨亚毫米薄层断面数据,为临床诊断和治疗提供薄层断层解剖学依据。方法:选择成年尸体头部3例(颞骨6侧),先使用多层螺旋CT进行颞骨的各向同性扫描,多向MPR技术重建CT图像;后运用冷冻数控铣削技术制成层厚为0.1 mm的颞骨连续横断面图像,最后对二者进行对照观察。结果:同一标本的多层螺旋CT MPR图像与断面图像均能清晰显示耳颞部微细解剖结构,且二者解剖结构具有良好的一一对应关系。结论:①冷冻数控铣削技术是进行颞骨薄层断层解剖学研究的满意方法。②多层螺旋CT的各向同性扫描技术使断层标本与影像解剖的图像完全匹配成为可能。③本研究提供了一组成人颞骨0.1 mm层厚的薄层断面解剖学资料,将成人颞骨的断层解剖学研究推向了0.1 mm水平。     

肝连续薄层冠状断面数据获取研究

目的 应用数控冷冻铣削技术获取肝的连续薄层冠状断面数据集.方法 经CT、MRI扫描筛选后,选择无明显病变的成年男性尸体1例,截取其上腹部,按直立位置于包埋容器内,经明胶包埋和深低温冷冻后,在低温冷冻室内用数控铣床从前向后连续铣削,获得肝的连续薄层冠状断面,用数码相机逐层拍摄,获取原始数据.结果 该例上腹部标本冷冻铣削后共获得层厚为0.2mm的肝连续冠状断面图像699幅,断面能够清晰显示肝的形态结构、位置及毗邻关系和肝内管道系统及其分支的走行分布.结论 应用数控冷冻铣削技术获取的肝连续薄层冠状断面数据集精度高,质量优,为基于冠状断面数据集的肝及肝内管道系统的三维重建奠定了基础.     

多层螺旋CT颞骨三维成像与解剖学的对照研究

为了验证多层螺旋CT三难成像的测量数据的准确性，选取10％甲醛固定的成人头颅标本12具（24侧），进行颞骨部位的扫描，并应用表面遮盖显示，容积显示技术对颞骨的三维成像，对几处明显的结构进行测量，然后，再解剖测量，对比，结果显示，多层螺旋CT立体图像清晰，各种表面结构清楚，多层螺旋CT成像的测量数据与解剖测量的数据一致，无统计学的差异，研究表明，多层螺旋CT成像测量的数据，可以直接指导临床。     

颞骨内面神经的影像学研究：多层面CT和高场强MR

目的探讨多层面CT和高场强MR对颞骨内面神经及面神经管检查的应用价值.材料和方法选择5例头颅标本行多层面CT和1.5TMR扫描.多层面CT扫描参数如下螺旋方式,管电压120kV,管电流230mA,扫描时间28,视野220mm,扫描层厚5mm,重建厚度1.25mm,螺距13,矩阵512×512.在工作站上行多平面重建.MR检查采用三维稳态射频傅立叶采集(3DRF-FAST)序列(TR50ms,TE13ms,FOV250mm,层厚1.5mm).头颅标本进行大体解剖,结果与CT、MR影像相对照.结果颞骨内面神经管可以通过多平面重建在一个平面内显示,与MR图像相比,多层面CT对于面神经管的显示较好.MR图像可以清晰显示面神经鼓室段、乳突段和膝状神经节.对于5例标本的双侧颞骨内面神经及面神经管分别于MR和多层面CT进行测量,直径分别为1.15±0.25mm,1.26±0.14mm.所测量结果与解剖标本相比无显著性差异(p＞0.05).结论高场强MR和多层面CT是颞骨内面神经和面神经管检查的理想方法,两者结合使用更有利于颞骨内面神经病变的检出.     

螺旋CT薄层重建技术在梗阻性黄疸的诊断价值

目的 探讨螺旋CT薄层重建技术在梗阻性黄疸的诊断价值,以提高对梗阻性黄疸临床诊断准确率.方法 对30例经手术病理证实的梗阻性黄疸患者行螺旋CT螺旋扫描、平扫及增强扫描,层厚和间隔均为5 mm,然后对原始数据进行层厚为1 mm、间隔为1.5mm的薄层轴位重建,并传入工作站进行薄层多平面重组,对胆管梗阻定位和定性诊断作出评价.并与手术病理对照.结果 螺旋CT薄层重建技术对梗阻性黄疸定位和定性的准确率分别为98%和93%.结论 螺旋CT薄层重建技术对梗阻性黄疸定位和定性准确率高,是一种很好的无创性检查方法.     

多层螺旋CT三维重建成像技术在输尿管病变中的应用价值

目的:探讨多层螺旋CT三维重建成像技术对输尿管病变检查的临床价值。方法:回顾性分析临床怀疑的泌尿系统病变25例,所有病例在行螺旋CT增强扫描前均做了静脉尿路造影或逆行肾盂造影。扫描图像减薄,层厚1.25 mm,层间距1 mm。所有数据传入工作站进行三维重建,并对重建后输尿管图像与CT轴位平扫图像及X线平片对比分析。结果:三维重建泌尿系图像清晰显示输尿管空间结构。结论:多层螺旋CT三维重建技术获得的图像能以最优形式清晰、立体地显示输尿管解剖结构及空间位置关系。     

面神经管螺旋CT多平面和曲面重建成像的临床应用

目的 探讨螺旋CT多平面和曲面重建成像对面神经管显示的临床应用。方法 对1具尸体头颅标本、2个颅骨标本及43例患者进行颞骨螺旋高分辨CT扫描，层厚1．0mm、间距0．2mm、螺距为1。然后进行冠状面、矢状面及斜面的多平面重建(MPR)和面神经管全程的曲面重建成像，对尸体标本解剖面神经管，并与其断面图像对比。结果 CT图像所见与标本解剖一致，40侧正常耳的面神经管迷路段、水平段在轴面扫描图像上显示最优，面神经管垂直段在矢状面及斜面重建图像上显示最优，曲面重建能显示面神经管连续的全程。中耳乳突炎25耳中，面神经管水平段及垂直段有破坏者分别为6耳及5耳；先天性外耳道闭锁的16耳中，面神经管异常达10耳；外伤后面瘫的5耳中，3耳见有面神经管骨折。面神经管在螺旋CT多平面和曲面重建图像上的表现与临床手术所见相符。结论 螺旋CT多平面和曲面重建成像技术有利于面神经管的显示及其病变的诊断。     

多层螺旋CT容积扫描及三维重建在颅骨骨折诊断中的应用

目的探讨多层螺旋CT容积扫描及三维重建技术在脑颅骨骨折诊断中的应用价值。方法对临床确诊的47例颅骨骨折患者术前行多层螺旋CT检查,并根据外伤部位进行容积扫描及三维重建。结果分析层厚为6 mm的横断面图像,发现颅骨骨折43例。容积扫描后行三维重建,47例颅骨骨折均被发现。结论多层螺旋CT容积扫描及三维重建技术用于颅骨骨折诊断确诊率较高。     

多层螺旋CT图像后处理技术在喉癌诊断中的应用

目的:探讨多层螺旋CT图像后处理技术(MPR、CTVE、VRT)在喉癌诊断中的应用价值。方法:27例喉癌患者行螺旋CT增强扫描后,在工作站上进行MPR(multiplanar reconstruction)重建,利用flythrough软件进行CTVE(CTvirtual en-doscopy)成像,利用VRT(volume renderingtechnique)软件进行三维成像。结果:多层螺旋CT进行薄层扫描、MPR重建、CTVE和VRT成像可显示正常解剖结构和病变的大小、部位、范围,图像清晰,CTVE和VRT图像立体直观,CTVE与纤维喉镜所见吻合。结论:MPR是轴位图像很好的补充,CTVE是纤维喉镜重要的补充,螺旋CT MPR、CTVE、VRT重建图像与CT轴位图像结合起来可增加诊断信息量,提高诊断的准确性。     

尸体标本腹腔神经丛:十六层CT图像后处理分析

目的:探讨多层螺旋C T图像后处理在尸体标本腹腔神经节显示中的应用价值.材料和方法:对6具成人尸体标本进行解剖,确定胰腺周围腹腔神经节及神经丛主支的位置和形态,并对其大小进行测量,用碘海醇对其进行涂抹标记,还原尸体各脏器的位置,进行十六层螺旋CT容积扫描,将扫描后的容积数据传至工作站进行图像后处理.在影像上所测结果与尸体解剖比较.结果:6具成人尸体标本腹腔神经节和神经丛主支均位于T12至L1的上缘之间,腹腔神经节多为薄片型,结节型或长条型少见;CT图像与尸体解剖观测一致.腹腔神经节的大小在尸体解剖测量左、右侧上下径分别为16.93±5.16mm和11.98±5.48mm,横径分别为20.02±10.13mm和24.75±10.97mm,厚度分别为2.83±0.45mm和2.08±0.46mm.CT图像后处理MPR影像左、右侧上下径分别为16.42±6.38mm和11.70±2.72mm,横径分别为21.40±7.22mm和23.53±7.21mm,厚度分别为2.75±1.08mm和2.18±0.44mm.VRT影像测量左、右侧上下径分别为17.10±5.42mm和12.25±3.68mm,横径分别为21.92±8.21mm和25.13±6.41mm,厚度分别为2.90±1.12mm和2.28±0.50mm.统计学分析尸体标本与图像后处理影像上的MPR和VRT两组数据测量值间无显著差异(P＞0.05).结论:多层螺旋CT图像后处理技术,能在尸体上准确地、立体地显示腹腔神经节及神经丛主支的位置、形态和大小,为临床腹腔神经丛的扫描奠定了基础.     

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.