小儿淋巴管瘤的CT诊断

目的：分析小儿淋巴管瘤的CT表现和病理基础。方法：对6例经手术或临床治疗有效证实的小儿淋巴管瘤的CT表现进行研究。结果：6例CT平扫均为多房状、薄壁、水样密度肿块，沿疏松间隙弥漫性生长，其中3例密度均匀，3例伴较高密度区，其中1例有分层波面；增强后囊壁均有不同程度强化，2例于部分囊壁之间见斑点状强化影。3例位于颈部，其中1例累及上纵隔；1例位于腋窝；2例前胸壁及前上纵隔同时受累，其中1例病灶大部位于纵隔内。结论：CT检查能较准确地显示出淋巴管瘤的部位、范围、内部特征等，因而对其定位和定性有较大价值。     

胃神经鞘瘤的CT诊断

目的探讨胃神经鞘瘤(GS)的CT影像特点,提高对GS的认识及诊断准确率。方法回顾性分析经过手术病理证实的11例GS的CT表现,总结其影像学特点。结果 11例均为单发病灶,10例位于胃体,1例位于胃窦。10例呈圆形或卵圆形,1例呈浅分叶状。8例向腔外生长,2例向腔内、外生长,1例向腔内生长。9例平扫密度均匀;2例密度不均匀,其中1例囊变及溃疡,1例边缘点状钙化。增强扫描10例动脉期轻度强化,门静脉期中等度强化,平衡期呈明显强化。5例患者伴周围淋巴结肿大。结论 GS有一定的CT影像学特点,多位于胃体,平扫密度均匀,坏死与钙化少见,增强扫描具有渐进性强化的特征,CT可以对GS做出较准确的诊断。     

喉部非上皮性良性肿瘤的CT诊断

目的研究分析喉部非上皮性良性肿瘤的CT表现，并探讨其在临床诊断和治疗中的价值。方法对39例经手术、病理或临床综合诊断证实（主要为喉镜）的喉部非上皮性良性肿瘤均行CT检查。平扫10例、增强扫描31例，其中平扫＋增强2例。结果血管瘤22例，伴有静脉石9例，与周围肌肉密度相比，8例平扫呈等密度，14例增强扫描显示中度至明显强化9例，无明显强化5例。神经源性肿瘤6例，其中神经鞘瘤5例，平扫时呈低或中等密度，增强后均匀或不均匀强化，另1例神经纤维瘤平扫显示均匀低密度。软骨瘤3例，增强扫描显示不均匀强化。多形性腺瘤3例，中度至明显强化，其中1例明显囊性变。脂肪瘤2例，均为不强化的低密度。淋巴管瘤、平滑肌瘤和纤维瘤各1例，其中淋巴管瘤增强后无强化；平滑肌瘤增强扫描后中等至明显强化，密度均匀；纤维瘤不均匀强化伴有囊性变。结论CT可清楚显示喉部非上皮性良性肿瘤的形态、范围大小和密度特征，为诊断定性和临床治疗提供重要依据。     

软组织转移瘤影像学诊断

目的探讨软组织转移瘤的影像学表现特点。方法选择经病理证实的软组织转移瘤35例,分析其CT和MRI表现特点。结果 CT检查31例,其中平扫13例,增强扫描15例,平扫并增强扫描3例。MRI平扫3例。19个肌肉内转移瘤CT平扫表现为等密度或略低密度肿块,边界不清,密度均匀或不均匀,最大径1.2~25.3cm;4例(21.52%)表现为弥漫性肌肉肿胀,密度均匀,与炎症相似;3例肿块内可见成簇的颗粒状或无定形钙化。9个皮下组织转移瘤CT平扫表现为多发或单发结节状或团块状等或略低密度灶,最大径0.5~5.2cm,边界清;2个表现为皮下组织内饼状软组织密度灶,边界不规则。CT增强扫描,病灶呈均匀或不均匀轻中度强化;其中7例(33.33%)呈环形强化,病灶中心不强化。3例MRI平扫表现为等长T1,不均匀长T2异常信号;2例边界清楚,1例边界不清。结论软组织转移瘤不罕见,在软组织肿瘤诊断中应注意鉴别。     

小儿淋巴管瘤的CT和MRI诊断

目的 探讨儿童淋巴管瘤的CT和MRI表现及其诊断价值.方法 回顾性分析经手术病理证实的43例淋巴管瘤的CT和MRI影像资料,CT检查37例,MRI检查6例.结果 病变发生于颈部21例,其中同时累及纵隔和/或腋窝6例;肠系膜7例;腹膜后7例;大网膜3例;胸腹壁3例;四肢2例.主要表现为:(1) 边缘清楚或不清楚的单房性(n=5)或多房囊性(n=38)薄壁肿块;(2) 沿疏松组织间隙生长(n=22);(3) 5例出血者瘤内密度增高,其中2例可见液-液平面;(4) 2例合并感染者,囊壁增厚;(5)增强扫描囊壁及分隔轻度强化,囊内不强化;(6) T2WI均呈高信号影,T1WI呈低信号或等信号影,合并出血者T1WI呈高信号影.结论 淋巴管瘤的CT、MRI表现具有特征性,对临床治疗有重要价值.     

节细胞神经瘤的CT表现及病理分析

目的探讨节细胞神经瘤的CT平扫与动态增强扫描的特征性表现。方法回顾性分析10例经手术与病理证实节细胞神经瘤的CT表现,所有病例均行CT平扫,动脉期、静脉期及延迟期动态增强扫描。结果肿块位于纵隔7例,肾上腺2例,腹膜后1例。肿块边界清晰,呈椭圆形2例,不规则形8例,肿块大小为1.2cm×2.2cm×3.0cm～6.5cm×6.5cm×7.5cm,4例肿块有嵌入性生长特点。CT平扫肿块密度低于肌肉,密度均匀者9例,密度不均匀者1例,其中3例伴有颗粒状、条状钙化。增强扫描后,肿块表现为不同的强化型式,其中,1例肿块无强化;7例肿块动脉期无明显强化,静脉期及延迟期逐渐轻度强化;2例肿块动脉期轻度强化,静脉期及延迟期逐渐明显强化。结论节细胞神经瘤有一些特征性影像表现及强化型式,CT动态增强扫描有助于其诊断及鉴别诊断,可清晰显示病变同周围血管及器官之间的关系,并为手术治疗提供更多参考信息。     

淋巴管瘤的影像学表现

目的:探讨淋巴管瘤的影像学表现及其与病理的相关性.方法:经手术病理证实的淋巴管瘤26例,男15例,女11例,年龄1个月～68岁,平均19.4岁.7例行CT检查纳入研究,其中6例有平扫加增强扫描;1例行MRI检查;24例行超声检查.结果:CT上病灶均为囊性病变,密度均匀,边界较清楚,壁薄.2例病灶呈单房,5例病灶内可见分隔并形成多房,增强扫描囊壁及部分分隔强化,囊内未见强化.MRI上病变在T1WI上为低信号,T2WI上呈高信号,病变信号不均匀,边界欠清楚,其内见分隔.超声声像图上病灶均为囊实性低回声或无回声肿块影,其中10例病变回声不均质,14例探及条形分隔反射,其中3例分隔为蜂窝状、网状,3例边界不清;彩色多普勒血流成像探及囊内及分隔内血流7例.手术病理显示病变全部为囊性,可看到扩张的淋巴管,有些病灶内可见血管,并见一些纤维组织及脂肪组织成分.结论:淋巴管瘤有较为典型的影像学表现:囊性,薄壁肿块,密度较均匀,边界较清楚;病理与影像一致性好.     

小儿睾丸内胚窦瘤的CT评价

目的评价CT扫描对诊断小儿睾丸内胚窦瘤的临床意义。方法 11例经手术病理证实的小儿睾丸内胚窦瘤患者均经CT平扫与增强扫描,随后,对全部患者的CT表现进行了回顾性分析。结果小儿睾丸内胚窦瘤CT平扫表现为睾丸内软组织肿块,边界不清,7例的肿瘤病灶表现为不均匀,其中2例瘤内可见小片状钙化,2例瘤内可见小片状低密度影;另4例的肿瘤病灶表现为密度均匀。增强扫描显示全部患者的肿瘤病灶呈明显片状、团块状强化,2例小片状低密度影处增强后无强化。结论 CT平扫与增强扫描在小儿睾丸内胚窦瘤的诊断中起重要作用,尤其结合血清甲胎蛋白测定可准确地将其与睾丸的其他肿瘤相鉴别。     

小儿胸膜肺胚细胞瘤的CT表现

目的　总结小儿胸膜肺胚细胞瘤(pleuropulmonaryblastoma,PPB)的CT表现特点,以提高早期诊断率。方法　10例小儿PPB均经手术及病理证实,全部行CT平扫,其中7例同时行增强扫描。结果　10例中发生于左肺9例,右肺1例。按Dehner分型:Ⅱ型2例,Ⅲ型8例。病变直径5~16cm,其中>8cm者7例。CT平扫表现: 2例为囊实性混杂密度占位,囊内均含多少不等气体。8例为类圆形或形态不规则软组织密度占位,其内见不规则略低密度区;增强扫描实性部分有不同程度的增强,低密度区不强化。合并胸腔积液、肺不张各4例,肋骨破坏及胸壁软组织肿物2例。结论小儿PPB是儿童期少见的胚胎性恶性肿瘤,CT扫描为早期诊断及观察病变变化的首选方法。     

小儿腹部内胚窦瘤的CT诊断

目的 提高对小儿腹部内胚窦瘤CT表现的认识。方法 回顾性分析23例经手术病理证实的小儿腹部内胚窦瘤的临床和CT资料。结果 23例CT平扫均表现为实性肿块，18例肿块表现为不均质密度，5例表现为均质密度。19例增强CT扫描表现为中～高度不均匀强化，其中9例表现为周边部的不规则条状及网状强化。结论 CT对小儿腹部内胚窦瘤具有一定的诊断价值，结合血清甲胎蛋白测定有助于与其他肿瘤进行鉴别。     

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.