CT demonstration of cavernous sinus fat

CT demonstration of cavernous sinus fat deposits has been described as abnormal and potentially a specific sign of Cushing disease. CT scans of 100 patients without biochemical or clinical evidence of Cushing disease and of 10 patients with Cushing disease were studied retrospectively. Twenty-seven percent of the non-Cushing patients demonstrated fat in one or both cavernous sinuses. Forty percent of Cushing disease patients had detectable cavernous sinus fat. While fat deposits were more frequent in the Cushing disease group, this was not statistically significant (p = greater than .6). CT demonstration of cavernous sinus fat ordinarily should be regarded as a normal finding.     

MRI眶内结构定量分析在Graves眼病的应用研究

目的通过MRI测量正常对照组和Graves眼病组的眼外肌、眶内侧脂肪厚度及T2弛豫时间,探讨MRI在Graves眼病诊断、指导临床分期及判断疗效方面的价值。资料与方法正常对照组25名50只眼;Graves眼病组30例,均为双侧突眼,共60只眼,行眼眶MRI扫描。分别测量眼球突出值、眼外肌短径及长径并计算短径与长径的比值（R值）,测量球内侧脂肪厚度,根据SE双回波T2WI测得眼肌及球后脂肪的T2弛豫时间。结果（1）病变组眼球突出值明显大于正常对照组,差异有统计学意义（P〈0.01）。（2）病变组各眼外肌短径均明显大于正常对照组,差异有统计学意义（P〈0.01）;除下直肌外,病变组其余眼外肌的长径与正常对照组差异无统计学意义（P〉0.05）。病变组眼肌的R值均明显大于正常对照组,两组之间差异有统计学意义（P〈0.01）。（3）病变组球内侧脂肪的厚度明显大于正常对照组,两组之间差异有统计学意义（P〈0.01）。（4）病变组与正常对照组之间眼外肌的T2值差异有统计学意义（P〈0.01或0.05）;而球后脂肪T2值差异无统计学意义（P〉0.05）。结论MRI眶内组织的定量测定对Graves眼病的诊断、指导临床分期、判断疗效有一定的帮助。     

原发性结膜下眶脂肪脱垂CT表现

目的 探讨原发性结膜下眶脂肪脱垂的CT表现。资料与方法 回顾分析12例（20眼）老年肥胖患者经临床证实的原发性结膜下眶脂肪脱垂的CT资料。结果 CT示眼球颞上象限结膜下与眶内脂肪相连续的与脂肪密度一致的低密度肿块。8例为双侧,4例为单侧。结论 原发性结膜下眶脂肪脱垂见于老年肥胖患者的颞上象限,CT有助于该病的诊断及鉴别。本病应与表皮样囊肿或皮样囊肿、球结膜下脂肪瘤、眼睑皮肤松弛症鉴别。     

膝关节骨性关节炎髌下脂肪垫在中药治疗前后的CT变化研究

目的:通过对比膝骨性关节炎(knee osteoarthritis,KOA)膝关节髌下脂肪垫治疗前后CT图像的变化,探讨中医药治疗KOA的疗效。方法:将130例KOA患者随机分为2组,治疗组65例给予健步通络熏蒸液熏洗,30min/d,10d为1个疗程,共3个疗程;对照组65例每6d关节内注射玻璃酸钠30mg,共5次;2组皆治疗30d。治疗前后均行膝关节CT扫描,观察治疗前后髌下脂肪垫的变化。结果:治疗组经治疗后髌下脂肪垫的前后径、内外径、上下径均有缩小,密度均有降低,优于对照组;治疗组总有效率(83.08%)优于对照组(76.92%),差异有统计学意义(P0.05)。结论:对比膝关节髌下脂肪垫CT图像的变化是评价中医药治疗KOA疗效的有效方法。     

实验性肥胖大鼠药物减肥研究

 目的 研究胰高血糖素样肽-1受体激动剂(Exendin-4)对营养性肥胖大鼠的减肥作用.方法 建立营养性肥胖动物模型,然后将40只肥胖模型大鼠,随机分成4个组,分别为3个实验组(高、中、低3个剂量组)和1个对照组.连续给药9周,记录体重、摄食量,并检测血清胆固醇、三酰甘油、睾丸脂肪重量和细胞大小.结果 用药后高剂量组大鼠体重增长缓慢,睾丸周围脂肪重量与对照组相比明显降低,差异有统计学意义.而摄食量、血清胆固醇、三酰甘油、脂肪细胞大小不受药物的影响.其他各组与对照组比较差异无统计学意义.结论 Exendin-4长期皮下给药,对肥胖大鼠具有明确的延缓体重增长的效果.     

Body fat distribution measured with CT: correlations in healthy subjects, patients with anorexia nervosa, and patients with Cushing syndrome

Computed tomography (CT) was used to study fat distribution in three groups of women of comparable age: 39 healthy volunteers, 15 patients with anorexia nervosa, and seven with Cushing syndrome. Patients with anorexia nervosa had a fivefold decrease in subcutaneous fat and only a twofold decrease in intraabdominal fat compared with the values for the volunteers. Patients with Cushing syndrome had less than a twofold increase in subcutaneous fat and greater than a fivefold increase in intraabdominal fat compared with values for the healthy subjects. These findings suggest that fat in different body compartments responds differently to disease processes and that CT can be used to measure these changes.     

螺旋CT眼眶容积测量方法的研究

目的 探讨测量眼眶容积简便、省时又相对准确的CT成像方法 . 资料与方法 以鼻科疾患就诊行16层螺旋CT扫描20例患者,眼眶正常,眼眶区及其周围未见占位性病变.双侧眼眶分别行容积再现(VR)成像,测得容积归入VR组;以层厚/层间距为2 mm/2 mm、2 mm/4 mm、2 mm/5 mm、3 mm/3 mm、3 mm/5 mm横断位重建五组图像,其余各种参数保持一致,并分别命名为A组、B组、C组、D组及E组.对各组测量得到的眼眶容积进行统计学分析. 结果 所得各组数据左右侧差异均无统计学意义.以VR组数据作为参照标准,A组误差率及差别的范围均最小,为2.42%和0.42%～4.40%,E组与其之间的差别最大,为7.35%,D组与其之间差别的范围最大为0.35%～7.75%. 结论 A组层厚及层间距均为2 mm重建图像测量眼眶容积省时、方便、准确,可应用于各类型CT扫描仪.     

Usefulness of the ratio of orbital fat to total orbit area in mild-to-moderate thyroid-associated ophthalmopathy

Objective:

To identify a useful predictor of thyroid-associated ophthalmopathy (TAO) from orbital CT images; to evaluate the orbital fat and extraocular muscle area ratio as a CT-derived measure; and to investigate the correlations between this ratio and the clinical manifestations in mild-to-moderate TAO.

Methods:

Between January 2012 and March 2013, 44 patients with TAO and 23 controls were studied prospectively. All of the patients underwent ophthalmic examinations, including clinical activity score, exophthalmometry, clinical photographs, alternate prism and cover test, duction and version test, Hess screen test, binocular single vision test, thyroid function tests and orbital CT. The cross-sectional areas of the four rectus muscles, superior oblique muscle, optic nerve and total orbit area were calculated in the coronal view 6 mm posterior from the posterior pole of globe.

Results:

The cross-sectional area measured on orbital CT showed increased orbital fat in patients with TAO and an increased orbital fat to total orbit area ratio (fat/orbit) in TAO with retraction and proptosis. There were significant correlations between fat/orbit and margin reflex distance 1 (p = 0.022), margin reflex distance 2 (p = 0.013) and the exophthalmometric value (p = 0.007).

Conclusion:

The orbital fat to total orbit area ratio (fat/orbit) is a useful diagnostic index in mild-to-moderate TAO.

Advances in knowledge:

The orbital CT offers a useful diagnostic index in TAO.     

CT in the diagnosis of isolated cysticercal infestation of extraocular muscle

AIM: To evaluate the use of computed tomography (CT) and ultrasound (US) to diagnose orbital cysticercosis, and present the diagnostic features. METHOD: US and CT were used to evaluate patients with proptosis. Four patients were diagnosed as having orbital myocysticercosis and treated with oral albendazole and corticosteroid. Follow-up was undertaken with US and CT. RESULT: US features were confirmatory of myocysticercosis in two eyes where as CT was effective in diagnosing the condition in all four eyes. In two patients the medial rectus was involved, in one the superior rectus and, in the other, the inferior rectus muscles. Serial US and CT revealed complete resolution of the lesions in 3 months. CONCLUSION: CT is useful method in diagnosing isolated orbital myocysticercosis. Our report demonstrated that ophthalmic signs and symptoms in the presence of proptosis, especially in an endemic region, should alert the clinician to the possibility of myocysticercosis. Though CT is superior, US can be used as a economical follow-up investigation.     

CT and MR imaging of the pediatric orbit.

Orbital abnormalities encountered in the pediatric population differ substantially from those found in adult patients. Retinoblastoma, the most serious intraocular tumor, is often difficult to diagnose, but use of computed tomography (CT) (which reveals the characteristic focal calcification) and magnetic resonance (MR) imaging allows this tumor to be differentiated from pseudogliomas, such as Coats disease, and retrolental fibroplasia. CT and MR imaging help in the differentiation of orbital cellulitis from preseptal, lacrimal, and eyelid infectious processes and of orbital pseudotumor from Graves disease. In cases of orbital trauma, CT is excellent for detecting orbital fractures and metallic foreign bodies; MR imaging is better for depicting ocular and optic nerve injuries. Both modalities allow the differentiation of rhabdomyosarcoma from dermoid, cavernous hemangioma, and lymphangioma and provide helpful information for the diagnosis of many other tumors. Since CT and MR imaging have widely expanded the capabilities of orbital imaging, it is more important than ever before for radiologists to understand pediatric orbital disease.     

眼眶横纹肌肉瘤的临床特点及影像学评价

目的 探讨眼眶横纹肌肉瘤的临床特点及影像学表现。材料与方法 结合16例经病理证实的眼眶横纹肌肉瘤的临床特点,回顾性分析其B超、CT和MRI特征。结果 眼眶横纹肌肉瘤主要临床特点为发展迅速的进行性眼球突出,眼眶内上象限为其好发部位。B超检查显示肿瘤为低或无回声区。16例CT平扫,14例与眼外肌呈均匀的等密度,边缘清楚。10例行增强扫描,明显强化4例,中等强化5例。骨质破坏5例。9例行MRI检查,T1WI肿瘤与眼外肌呈等信号或略低信号,T2WI呈高信号;6例行增强扫描,4例中等度强化,2例明显强化。在脂肪抑制和增强T2WI上呈高信号。结论 超声、CT和MRI,尤其CT和MRI能较准确的显示横纹肌肉瘤的部位、形态和内部结构,结构临床特征,能较准确作出定性诊断,对临床选择治疗方案有重要价值。     

Arthrofibrosis associated with total knee arthroplasty: gray-scale and power Doppler sonographic findings

OBJECTIVE: The objective of this study was to determine gray-scale and power Doppler sonographic findings in patients with arthrofibrosis associated with total knee arthroplasty. SUBJECTS AND METHODS. From a consecutive cohort of more than 3000 mobilebearing total knee arthroplasties, 44 cases (1.5%) with arthrofibrosis were identified, of which 38 were recruited for a clinical and sonographic investigation. A control group of 38 patients with a well-functioning total knee arthroplasty was matched. Synovial hypertrophy, presence of neovascularity, patellar tendon thickness, and extent of effusion were assessed. RESULTS: Synovial membrane thickness was significantly (p < 0.001) increased in the arthrofibrosis group (medial, 3.4 mm; lateral, 3.0 mm; suprapatellar, 3.1 mm) when compared with the control group (medial, 2.0 mm; lateral, 2.0 mm; suprapatellar, 1.9 mm). When a cutoff of 3.0 mm was used, sonography had a sensitivity of 84% and a specificity of 82% for detecting arthrofibrosis. Neovascularity (rated as grades 0-3) of the synovial membrane and Hoffa's fat pad was significantly (p 相似文献   

Orbital Fat Volumetry and Water Fraction Measurements Using T2-Weighted FSE-IDEAL Imaging in Patients with Thyroid-Associated Orbitopathy

BACKGROUND AND PURPOSE:The quantitative evaluation of orbital fat proliferation and edema and the assessment of extraocular muscles are useful for diagnosing and monitoring thyroid-associated orbitopathy. To evaluate therapy-induced quantitative changes in the orbital fat of patients with thyroid-associated orbitopathy, we performed volumetric and water fraction measurements by using T2-weighted FSE iterative decomposition of water and fat with echo asymmetry and least-squares estimation (FSE-IDEAL) imaging.MATERIALS AND METHODS:Orbital FSE-IDEAL images of 30 volunteers were acquired twice within 1 week. Nine patients with thyroid-associated orbitopathy underwent FSE-IDEAL imaging before and after methylprednisolone pulse therapy, and the treatment results were assessed by using their pre- and post-methylprednisolone pulse therapy clinical activity scores. We performed volumetric and water fraction measurements of orbital fat by using FSE-IDEAL imaging and evaluated interscan differences in the volunteers. In patients with thyroid-associated orbitopathy, we compared pre- and posttherapy orbital fat measurements and assessed the correlation between the pretherapy values and clinical activity score improvement.RESULTS:The reproducibility of results obtained by the quantitative evaluation of orbital fat in volunteers was acceptable. After methylprednisolone pulse therapy, the water fraction in the orbital fat of patients with thyroid-associated orbitopathy was significantly decreased (P < .001). There was a significant positive correlation between the pretherapy water fraction and clinical activity score improvement (right, r = 0.82; left, r = 0.79) and a significant negative correlation between the pretherapy volume and clinical activity score improvement (bilateral, r = −0.84).CONCLUSIONS:Volumetric and water fraction measurements of orbital fat by using FSE-IDEAL imaging are feasible and useful for monitoring the effects of therapy and for predicting the response of patients with thyroid-associated orbitopathy to methylprednisolone pulse therapy.

Thyroid-associated orbitopathy (TAO) is the most common extrathyroid manifestation of Graves disease. The enlargement of orbital fat and extraocular muscles in the relatively fixed volume space imposed by the bony orbit may produce proptosis, ocular motility loss, and decreased visual acuity.¹ Histologic studies showed lymphocytic infiltration and edema due to the accumulation of hydrophilic, interstitial glycosaminoglycans in the orbital fat and extraocular muscles,^2,3 attributable to antigenic cross-reactivity between thyroid proteins and orbital fibroblasts.⁴The course of TAO can be divided into the active, regressing, and a burnt-out phase.⁵ Early active disease is treated with combined immunosuppression.^6,7 The identification of patients who stand to benefit from this therapy is important but clinically difficult, despite the availability of activity scoring systems. Consequently, objective methods are needed.CT has been used to quantify the volume of extraocular muscles and orbital fat in TAO.^8–11 However, ocular radiation exposure limits its clinical use. Because MR imaging without ionizing radiation yields orbital images with excellent soft-tissue contrast in any plane, it has been used for evaluating TAO.^12–15The quantitative evaluation of the orbital fat volume on T1-weighted images was reported useful for assessing the severity of TAO and for monitoring the treatment response.^12,16 Recently, Higashiyama et al¹⁷ demonstrated that after methylprednisolone pulse therapy (MPPT), the orbital fat volume was unchanged, while the total volume of extraocular muscles was decreased on T2-weighted images. However, in our search of the literature, we found no reports on quantitative changes in orbital fat edema after MPPT or orbital irradiation. Consequently, the correlation between the volume and edema of orbital fat and the treatment response of patients with TAO remains to be elucidated.FSE iterative decomposition of water and fat with echo asymmetry and least-squares estimation (FSE-IDEAL), a novel 3-point Dixon method, is useful for separating the fat signal from the water signal^18,19 but has not been used to quantify the orbital structures in TAO. To evaluate the feasibility of FSE-IDEAL imaging for the precise quantitative evaluation of orbital fat, we subjected healthy volunteers to 2 FSE-IDEAL imaging studies performed during 1 week. We measured the volume and the water fraction of their orbital fat and ascertained the reproducibility of the measurement results. We also acquired FSE-IDEAL images in patients with TAO to assess MPPT-induced changes in the volume and water fraction of their orbital fat and evaluated the correlation between the quantitative values of orbital fat and the improvement in their symptoms.     

The effect of pharyngeal soft tissue components on snoring

OBJECTIVE: To determine the effect of oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thickness, and parapharyngeal wall thickness on snoring. MATERIALS AND METHODS: Fifty-six individuals (35 men, 21 women) complaining of snoring in a questionnaire administered to patients attending the MR unit for cervical MR imaging were enrolled as the study group, and 39 (23 men, 16 women) individuals with no complaint of snoring were enrolled as the control group. Firstly, patients' body mass index (BMI) was determined. Then turbo spin echo T2-weighted MR imaging in the axial plane was performed, from the nasopharynx to the hyoid bone level, in both groups. From the MR images, oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thickness and parapharyngeal wall thickness measurements were made. Finally, the results were statistically analysed using SPSS (Statistical Package for Social Sciences) for Windows 10.0. Student's t-test was used as a complementary method in the analysis of the study data. The correlations between BMI and parapharyngeal wall thickness, and BMI and oropharyngeal air column area were determined by Pearson's correlation analysis. RESULTS: No statistically significant difference was found between study and control groups in terms of mean age, pterygoid muscle thickness, or pharyngeal fat pad thickness (P>.05). Snorers' BMI levels (P<.01) and average parapharyngeal wall thicknesses (P<.05) were statistically significantly higher than those of the control subjects. Snorers' oropharyngeal air column area was significantly narrower than that of the control subjects, statistically (P<.01). CONCLUSION: As a result of the study, it was concluded that only oropharyngeal air column area and parapharyngeal muscle thickness had an effect on snoring.     

Applicability of contrast‐enhanced ultrasound in the diagnosis of plantar fasciitis

Contrast‐enhanced ultrasound (CEUS) is used to visualize the microvascularization in various tissues. The purpose of this study was to investigate whether CEUS could be used to visualize the microvascular volume (MV) in the plantar fascia, and to compare the method to clinical symptoms and B‐mode ultrasound (US) in patients with plantar fasciitis (PF). Twenty patients with unilateral PF were included and were divided by US in insertional thickening (10), midsubstance thickening (5), and no US changes (5). The MV was measured simultaneously in both heels. Four areas in the plantar fascia and plantar fat pad were measured independently by two observers. Inter‐ and intra‐observer correlation analyses were performed. The asymptomatic heels showed a constantly low MV, and for the whole group of patients, a significantly higher MV was found in the symptomatic plantar fascia and plantar fat pad. Inter‐observer correlation as well as intra‐observer agreement was excellent. The MV in the plantar fascia and plantar fat pad can be measured reliably using CEUS, suggesting that it is a reproducible method to examine patients with plantar fasciitis.     

4周有氧运动对不同肥胖程度、肥胖类型儿童少年血清胰岛素水平的影响

目的:探讨4周有氧运动对不同肥胖程度、肥胖类型儿童少年血清胰岛素水平的影响。方法:以参加2011年上海巅峰运动减肥夏令营的82名肥胖儿童少年为研究对象,进行4周有氧运动为主结合适当饮食控制的减肥运动训练,实验前后测定身高、体重、体脂率、腰围等身体形态指标及空腹血清胰岛素水平。分别依据体脂率、腰围身高比,对受试对象进行肥胖程度及肥胖类型分组。结果:实验前,肥胖儿童少年血清胰岛素水平由高到低依次为:极重度肥胖组>重度肥胖组>中度肥胖组>轻度肥胖组>超重组,腹型肥胖组胰岛素水平显著高于周围型肥胖组(P<0.01)。实验后,受试对象腰围身高比、体脂率、胰岛素均显著下降(P<0.01),胰岛素下降幅度由高到底依次为:极重度肥胖组>重度肥胖组>中度肥胖组>轻度肥胖组>超重组。腹型肥胖组各指标下降幅度均大于周围型肥胖组(P<0.01)。结论:儿童少年血清胰岛素水平随肥胖程度加重而升高,腹型肥胖者胰岛素水平较周围型显著升高,有氧运动减肥是降低肥胖儿童少年尤其腹型肥胖者肥胖程度和血清胰岛素水平的有效途径。     

变应性真菌性鼻窦炎累及眼部的CT诊断

目的 探讨变应性真菌性鼻窦炎累及眼部的CT表现。资料与方法回顾性分析6例经病理组织学证实的变应性真菌性鼻窦炎，均出现眼部症状，包括突眼5例，眼球移位4例，视力减退3例；鼻部主要症状为奶酪状黏涕、鼻塞。结果6例变应性真菌性鼻窦炎均累及双侧多个鼻窦。CT平扫示受累鼻窦窦腔充满软组织影，伴有多发条状、葡行性或斑片状高密度影(软组织窗)，边界清楚，也可伴有磨玻璃状高密度影(骨窗)，边界较模糊；鼻窦膨胀．窦壁骨质变形、变薄、连续中断。病变累及眼眶，4例侵犯眶内壁，1例侵犯眶上壁，1例同时侵犯眶内、上壁．与邻近眼外肌分界不清；眶尖容积变小2例，6例眼球均不同程度突出。结论双侧鼻窦充满软组织影，伴有条状或葡行高密度影是诊断本病的特征性CT征象，根据此征象可提出本病的诊断；本病进展期常侵犯眼眶，有时患者可能以眼部症状首先就诊，应引起临床及影像科医师的重视。     

Computer analysis of orbital fat and muscle volumes in Graves ophthalmopathy

A technique using special computer programs and data from high-resolution computed tomographic scans has been developed that provides accurate and reproducible volume measurements for muscle and fat in the orbit. Normal values for retrobulbar fat and muscle were established in 19 adults. Nineteen patients with Graves exophthalmopathy were then studied, and a spectrum of change was found that included varying degrees of increased muscle volume or increased volume of both muscle and fat. Further categorization of these changes related to clinical characteristics should lead to a better understanding of the mechanism for ophthalmopathy in Graves disease.     

Kissing intrasellar carotid arteries in acromegaly: CT demonstration

Acromegaly is a disease with protean manifestations that are well described in the literature. One finding infrequently encountered is aneurysmal dilatation of the internal carotid arteries and their branches. A case is presented, with CT documentation, in which the enlarged cavernous portions of the internal carotid arteries prolapsed into the sella turcica and enlarged it. Frontal bossing, frontal sinus enlargement, a dense cortical calvarium, prominent inion, and proptosis secondary to extraocular muscular enlargement were findings also present in this patient. The sella CT appearance has brought the term "kissing intrasellar arteries" to mind to suggest the diagnosis.     

Dimensions and volumes of the orbit and orbital fat in posttraumatic enophthalmos

OBJECTIVES: To estimate from 2D and 3D-CT the anatomical defects that are most likely to be responsible for posttraumatic enophthalmos. MATERIALS AND METHODS: The morphology and dimensions of the orbit and of fat content were investigated in 25 patients 6-12 months after treatment for complex orbital fractures by image analysis and volumetric estimation from 2D and 3D-CT. RESULTS: The shape of orbit was very often changed from conical to more rounded due to enlargement of the posterior segment. The retrobulbar fat appeared fragmented and dislocated posteriorly. No changes were observed in the structural appearance or radiodensity of either the orbital fat or muscles. There was reduced sagittal eye projection, increased width of the orbital rim, downward dislocation of the posteromedial orbital floor, and increased volume in the posttraumatic orbits which was significantly different (P < 0.05). Enophthalmos was correlated with orbital volume and height of the retrobulbar portion of the orbit. The volume of fat did not correlate with enophthalmos. CONCLUSIONS: Posttraumatic enophthalmos appears to be more commonly related to failure in correcting the orbital volume and in reducing the outward dislocation of the posterior orbital floor and not to changes in the fat content.