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。     

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     

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.     

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。     

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。     

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.     

椎管内皮样囊肿破裂的MRI诊断（附13例报告）

目的 探讨椎管内皮样囊肿破裂（RDIC）的MRI诊断价值。材料与方法 13例RDIC原发灶均经手术和病理证实,皮样囊肿均位于T12以下椎管内,其中9例位于脊髓内,4例位于髓外硬膜下,均行脑和全脊柱MRISE序列T1WI、T2WI,7例有脊柱脂肪抑制序列。5例行脑CT检查,结果 4例髓外硬膜下皮样囊肿破裂MRI与CT均表现在脑池、脑沟或脑室内有脂肪滴,9例脊髓内皮样囊肿破裂者均见脊髓中央管内分布有脂肪滴,其中4例脑室内见脂肪滴,5例脑MRI发现脑底及后颅窝脂肪滴者,CT仅显示2例。脂肪滴MIE SE序列T1WI呈显著高信号,T2WI其信号略有衰减,脂肪抑制序列则呈极低信号;CT上脂肪滴则呈低密度,CT值-20--150HU。结论 MRI是诊断RDIC的最佳影像学方法,其显示RDIC脂肪滴在脑室、蛛网膜下腔和脊髓中央管内分布优于CT。CT与MRI联合应用能有效地鉴别RDIC脂肪滴抑或积气、碘化油滞留和血块。     

肛管直肠原发性恶性黑色素瘤的CT和MRI诊断:2例报告并文献复习

目的探讨早期及晚期肛管直肠原发性恶性黑色素瘤(AMM)的CT和MRI诊断。方法回顾性分析经病理证实的2例AMM患者的临床、CT、MRI和病理资料。结果 CT上早期者未见明显异常,晚期者肿瘤呈蕈伞样充满肠腔而不伴肠梗阻,肠周脂肪间隙模糊,并有淋巴结及远处转移。MRI上早期者肿瘤局限于直肠肛管内,T1WI呈高信号,T2WI呈低信号,晚期者肿瘤突破肠壁全层,侵及直肠系膜,并有淋巴结转移,T1WI呈等信号,T2WI呈高信号。结论AMM的CT和MRI表现具有一定特征性,MRI可用来鉴别肿瘤并评估肿瘤大小、浸润深度及淋巴结受累情况,CT有助于评估远处转移。     

颈深筋膜间隙感染的影像学表现及其临床意义

目的 分析颈深筋膜间隙蜂窝织炎和脓肿的CT和MRI表现，探讨深筋膜间隙感染的诊断标准。方法 回顾分析28例经临床及穿刺证实的颈深筋膜感染的CT和MRI表现。包括咽后间隙11例，咽旁间隙5例，嚼肌间隙4例，多间隙感染8例。结果 颈深部筋膜间隙感染包括蜂窝织炎和脓肿，15例蜂窝织炎，CT可见软组织肿胀，伴有脂肪间隙移位、变小或消失。炎性组织在T1WI呈等、低信号，T2WI呈高信号。13例脓肿，CT可见局部低密度灶，边界清或不清，有强化。脓肿在MRI T2WI上见显著高信号，边界可有强化。结论 CT和MRI对颈深筋膜间隙蜂窝织炎和脓肿的诊断和定位十分准确，能为临床医生提供十分有价值的信息。     

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。     

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 role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

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.     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

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).