原发性肺黏液腺癌的CT和MRI表现

目的 结合病理探讨原发性肺黏液腺癌（PPMA）的CT和MRI表现。资料与方法 回顾性分析南京市胸科医院2018年1月—2020年12月经手术病理或穿刺活检证实的30例PPMA的临床及影像资料,结合病理分析其CT和MRI表现。结果 30例患者中,26例表现为结节/肿块型,4例表现为实变型。26例结节/肿块型CT表现为直径0.7～5.8 cm,分叶征14例,毛刺征9例,胸膜凹陷9例,空泡/假空洞征8例,支气管充气征11例。病灶周围见磨玻璃影11例。结节/肿块实性区平扫平均CT值（35.3±4.1）Hu,10例CT增强扫描中4例可见强化血管影穿行。4例实变型CT表现为病灶密度偏低4例,边缘模糊3例,支气管充气征3例,实变周围多发磨玻璃影4例,2例行增强扫描均可见血管造影征。病灶直径>2 cm的15例患者行MRI扫描,11例结节/肿块型病灶T1WI均呈等信号,4例T2WI呈均匀高信号,4例呈稍高信号,3例呈等高混杂信号。4例实变型病灶T1WI呈等信号,T2WI呈大片高信号,T2WI-spc呈高信号,呈“白肺征”。结论 原发性肺黏液腺癌CT表现为密度偏低的结节肿块或大片实变,毛刺细软及胸膜...     

颅内软骨肉瘤的CT及MRI表现

目的　探讨颅内软骨肉瘤的CT、MRI特征。方法　对经手术病理证实的 3例颅内软骨肉瘤的临床资料进行了回顾性分析。结果　 3例CT平扫显示不规则分叶状肿块 ,瘤周水肿不明显 ,2例伴有瘤内钙化及局部颅骨侵蚀。MRI显示肿瘤在T1WI为低、等信号 ,T2 WI为高信号 ;MRI增强时T2 WI中央低信号部分不强化 ,周边强化明显。结论　颅内软骨肉瘤好发于颅底软骨联合处 ,常伴瘤内钙化和局部颅骨侵蚀 ,但须依靠病理及免疫组化染色确诊与鉴别诊断     

Madelung综合征的影像表现(附4例报告)

目的探讨Madelung综合征的CT与MRI表现特征。方法搜集4例Madelung综合征患者。2例患者行CT增强扫描,2例行MRI平扫。分析其临床特点及影像表现。结果 4例Madelung综合征患者均有长期大量饮酒史,表现为颈及肩背部浅层皮下脂肪及深层脂肪增多。CT显示病变部位增厚的脂肪组织,CT值为-100HU;MR T1WI、T2WI及T2WI脂肪抑制序列均能显示病变部位脂肪增多,呈短T1、长T2信号,在脂肪抑制序列上呈低信号,脂肪组织间有纤维组织分隔。CT与MRI均能显示喉内及其周围结构脂肪组织浸润,双侧背阔肌、胸锁乳突肌缩小变薄,肌间隙稍增宽。结论 CT与MR检查对Madelung综合征可明确诊断,为临床治疗提供有价值的信息。     

胸部节细胞神经瘤的CT和MRI表现

目的 探讨胸部节细胞神经瘤的CT及MRI表现,提高对该病的诊断和鉴别诊断能力.方法 回顾性分析20例经手术病理证实的胸部节细胞神经瘤的临床、CT(14例)、MR(6例)平扫和增强扫描及所有病理学资料.结果 20例胸部节细胞神经瘤中,发生于后纵隔17例、侧胸膜2例、右侧整个胸腔1例.14例肿瘤平扫CT值20～40 HU,平均30.5 HU,4例伴有小结节状钙化,1例伴有斑片状脂肪密度影;动脉期增强CT值0～12 HU,平均6.2 HU,延迟期增强10～20 HU,平均14.3 HU.MRI检查5例在T1 WI上为均匀低信号,1例在T1WI上低信号内夹杂斑片状高信号脂肪影;T2WI上6例为不均匀高信号,其中1例呈旋涡状征象;增强后动脉期呈轻度不均匀强化,延迟期逐渐进行性轻度强化.结论 增强后CT及MRI显示肿瘤在动脉期不强化或轻微强化、延迟后逐渐轻度强化是胸部节细胞神经瘤的特征性表现.     

乳腺非肿瘤性病变的MRI表现

目的:探讨乳腺非肿瘤性病变的MRI表现。方法:分析38例乳腺内非肿瘤性病变的常规MRT1WI、T2WI、脂肪抑制序列T2WI、动态增强序列扫描的特点。结果:乳腺囊性增生症12例:T1WI和T2WI均呈均匀等信号,压脂后清晰显示乳腺导管系统自乳头向后方呈树枝状分布,其中增强后呈弥漫性斑点状强化8例,均匀片状强化2例,局限性小片状强化2例;囊肿6例:呈液体信号,囊液不强化,囊壁边缘轻度强化;术后瘢痕6例:局限性腺体聚拢4例,星芒样改变2例,但无病变实体,T1WI均呈等信号,T2WI呈等信号及低信号各3例,斑痕与周围腺体均无强化或轻度强化;自体脂肪隆胸后脂肪坏死3例:多发圆形及椭圆性脂肪信号肿块,动态增强各序列均无强化;注射聚丙烯酰胺水凝胶(postoperative augmentation mammoplasty with HPAG)假体泄漏7例:均显示假体轮廓不整,T1WI呈低信号,T2WI呈均匀高信号,腺体周围清晰见泄漏的假体信号;慢性炎症4例:3例T1WI呈等低混杂信号,T2WI呈高信号,增强后呈明显均匀强化,1例TWI伴有灶性多发低信号。结论:正确认识乳腺非肿瘤性病变的MRI表现,可避免不必要的活检和手术。     

周围神经鞘瘤的CT和MRI表现

目的：探讨周围神经鞘瘤的CT和MRI表现。方法：回顾性分析13例经病理证实的周围神经鞘瘤的CT和MRI表现,其中发生在颈椎和胸椎椎间孔内的2例、颈部1例、枕部1例、纵隔1例、胸壁1例及下肢7例。结果：肿瘤均呈椭圆形,边界清楚光滑,沿神经走行方向生长,2例有邻近椎间孔扩大。CT显示肿瘤包膜密度高,包膜内肿瘤组织密度低于肌肉组织。MRI T1WI显示肿瘤呈中～低信号,T2WI呈不均匀高信号,增强后有不均匀强化。其中显示靶征4例,神经出入征3例,脂肪包绕征8例,脂肪尾征7例及脑脊液尾征1例。结论：周围神经鞘瘤的影像学表现有一定特征性,CT和MRI对诊断有重要价值。     

特殊病理类型肾脏血管平滑肌脂肪瘤的CT和MRI表现

目的:探讨肾脏少见病理类型的血管平滑肌脂肪瘤的CT、MRI影像表现,提高对该病变的影像表现认识。方法:回顾性分析6例经手术病理证实的肾脏不典型血管平滑肌脂肪瘤的CT、MRI影像资料,分析其病灶大小、部位、边界、CT平扫及增强表现和MRI信号特征以及肝、肾的伴发病灶等。结果:肿块来源肾实质,可突出肾轮廓或贯穿肾实质,边界光整;CT、MRI平扫肿块呈混杂密度或信号,MRT2WI病灶内可见与肌肉相似的稍低信号,肿块内常伴囊变、出血,可见假包膜、钙化,但均无明显脂肪密度或信号;增强扫描皮质期呈轻中度强化。结论:肾脏不典型血管平滑肌脂肪瘤CT、MRI表现多样,灶内无明显脂肪是其共性,病灶边界光整,MRT2WI病灶内见与肌肉相似的稍低信号影可提示诊断,但最后确诊仍需依赖病理。     

咀嚼肌间隙原发病变的CT、MRI诊断

目的探讨咀嚼肌间隙原发病变的CT、MRI表现,以提高诊断的准确性. 资料与方法回顾分析21例经手术病理证实的咀嚼肌间隙原发病变的CT、MRI资料. 结果 21例中,血管瘤4例,淋巴管瘤1例,脓肿3例,下颌骨边缘性骨髓炎4例,脂肪瘤2例,下颌骨黏液样瘤2例,下颌骨巨细胞肉芽肿及尤文肉瘤各1例,横纹肌肉瘤3例.所有病例均有间隙内脂肪密度不同程度的消失,肿瘤及感染病例可见咀嚼肌间隙变形,且咀嚼肌有不同程度的肿胀.血管瘤可见不均匀的强化;淋巴管瘤无强化,表现为多个小结节影;下颌骨巨细胞肉芽肿及下颌骨黏液样瘤可见下颌骨破坏;尤文肉瘤在CT上未见骨质破坏,在MR T1WI上可见下颌骨内的高信号脂肪影消失. 结论 CT和MRI可以清楚显示咀嚼肌间隙内的病变及其范围,可为临床手术提供依据.     

眼眶静脉性血管瘤的MRI和CT表现

目的 分析眼眶静脉性血管瘤的MRI、CT表现,提高对眼眶静脉性血管瘤的影像学认识.资料与方法 对49例经手术病理证实的眼眶静脉性血管瘤患者的MRI、CT资料进行回顾性分析.结果 49例中,位于眼眶前部1例,肌锥内间隙18例,肌锥外间隙3例,肌锥内外间隙同时受累27例.MRI扫描41例显示为边界清楚但不光滑,形状不规则的不均质肿块.6例肿物边界不清.与眼外肌相比,T1WI呈低或等信号,T2WI呈高信号,肿瘤内部或周边可见血管流空信号.T2WI脂肪抑制序列高信号不被抑制.46例眼球明显向前突出,7例显示眼球受压变形.29例显示病变沿眼球壁生长呈铸形.15例显示眶尖脂肪间隙消失.7例可见肿物向颅内蔓延.14例具有急性突眼病史者显示出血信号,7例可见液.液平面.CT扫描显示为不均匀的较高密度.5例显示单个或多个的静脉石.26例眶骨受压,眼眶扩大.10例显示眶上裂扩大.结论 眼眶静脉性血管瘤在MRI、CT上分别具有其特征性征象.CT对展示骨性结构及钙化有优势,而MRI对肿瘤的内部形态及其与周围组织结构关系的进一步判断更具意义.MRI在定位和定性诊断上优于CT.     

肾上腺髓质脂肪瘤CT和MRI表现与其病理特点分析

目的分析肾上腺髓质脂肪瘤的CT及MRI特征,提高诊断的准确率,为患者治疗方案的选择及为手术风险的预判提供影像依据。方法回顾性分析了17例经手术病理证实的AML患者的CT(含CTA)或MRI资料,其中男性8例(47.0%),女性9例(53.0%),观察病灶的影像学特征、平扫和增强特点及血供情况。结果病灶多呈椭圆形或类圆形,边界清楚,CT平扫密度欠均匀,可见脂肪成分及增生的肾上腺成分,增强扫描肾上腺成分强化,脂肪成分无强化,可见钙化。CTA显示病灶血供来自肾动脉或腹主动脉分支。MRI病灶T1WI、T2WI均以混杂高信号为主,病灶高信号部分在T2WI脂肪抑制序列呈低信号,DWI呈稍高信号,同/反相位序列同相位呈高信号,反相位呈低信号,说明病灶以脂肪成分为主,肾上腺成分T1WI、T2WI、T2WI脂肪抑制、DWI均呈等信号,增强扫描肾上腺成分强化,脂肪成分未见明显强化。光镜下病灶均由大片成熟脂肪组织、造血细胞岛及边缘增生的肾上腺组织三种成分构成。结论肾上腺髓质脂肪瘤具有一定的CT及MRI特征,只有将CT(含CTA)、MRI技术结合起来,才能在最大程度上降低其误诊率,提高诊断准确性。     

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.