99Tcm-MDP全身骨显像诊断骨恶性纤维组织细胞瘤的价值

目的 分析骨恶性纤维组织细胞瘤(BMFH)99Tcm-MDP全身骨显像的影像特点,评价其对BMFH的诊断价值.方法 回顾性分析经手术病理证实的BMFH患者15例[男11例,女4例,年龄23～60(50.4±12.8)岁].所有患者术前均行99Tcm-MDP全身骨显像及X线检查,其中12例行CT检查,7例行MRI检查.以骨骼出现放射性异常浓聚灶或稀疏、缺损区为阳性.总结BMFH全身骨显像特点,并将显像结果与其他影像学结果进行比较.结果 15例BMFH患者全身骨显像结果均阳性,股骨阳性占66.7％(10/15),其中股骨下段占46.7％(7/15),骶骨、胫骨、肱骨、桡骨各占6.7％(1/15),多骨多发病灶占6.7％(1/15);15例患者共发现病灶27处,其中63.0％ (17/27)表现为放射性浓聚伴稀疏、缺损区,37.0％(10/27)仅见放射性浓聚.15例患者X线检查发现病灶20处;12例行CT检查,7例行MRI检查,CT及MRI所示异常部位在全身骨显像中均呈阳性.结论 99Tcm-MDP全身骨显像示:BMFH好发于股骨,以股骨下段多见,病灶呈异常放射性浓聚,其内或伴有放射性分布稀疏、缺损区;该方法可作为BMFH的辅助诊断检查,有助于了解有无多骨病变及有无转移.     

SAPHO综合征25例99Tcm—MDP全身骨显像分析

目的分析滑膜炎、痤疮、脓疱病、骨肥厚、骨炎综合征（即SAPHO综合征）99Tcm．MDP全身骨显像的影像特点,评价骨显像在SAPHO综合征中的应用价值。方法回顾分析25例确诊为SAPHO综合征患者的临床、骨显像及其他影像学资料,将骨骼病变部位分为前胸壁（包括锁骨、胸骨以及胸锁关节、肋胸连接、胸骨柄体连接）、脊柱、下颌骨、骶髂关节以及四肢骨,总结SAPHO综合征骨显像特点,并与其他影像学结果进行比较。结果25例患者中,32％（8／25）合并有皮肤损害;48％（12／25）骨活组织检查证实为慢性非特异性炎性反应。骨显像发现全部患者均有前胸壁受累,胸肋锁骨关节和连接受累率为96％（24／25）,其中胸锁关节、第一肋胸连接以及胸骨柄体连接的受累率分别为60％（15／25）、48％（12／25）和44％（11／25）,但骨显像呈典型“牛头”征表现的患者仅有20％（5／25）;脊柱及四肢骨受累率分别为44％（11／25）和16％（4／25）。骨显像发现68％（17／25）患者有隐匿性病灶,主要分布在第一肋胸连接、胸锁关节、胸骨柄体连接和脊柱。结论胸肋锁骨关节和连接受累为SAPHO综合征的影像特点,结合临床及其他影像学资料,99Tcm--MDP全身骨显像可用于SAPHO综合征患者的诊断与鉴别诊断、发现隐匿病灶以及评价病灶活性。     

99MTc-MDP全身骨显像对骨转移瘤的诊断价值

目的：探讨^99mTc-MDP全身骨显像对骨转移瘤的诊断价值。方法：对300例肿瘤患者静脉注射^99mTc-MDP 15～20mci行SPECT全身骨显像，并对结果进行比较。结果：阳性结果为121例，阳性率为40．3％，其中的75例与X线检查对照，骨显像阳性而X线阴性者12例。结论：SPECT全身骨显像对骨转移瘤早期诊断治疗，预后的观察具有一定的临床价值。     

骨纤维异常增殖症的全身骨显像及局部SPECT/CT图像特点

目的 :探讨骨纤维异常增殖症(FDB)的~(99)Tc~m-MDP全身骨显像及局部SPECT/CT图像的特点,以提高对其影像学特征的认识。方法:回顾性分析65例经病理或临床随访证实为FDB的患者,均行全身骨显像,共发现126个病灶,并对其中76个行SPECT/CT图像融合,分析全身骨显像及局部SPECT/CT图像特点。结果:65例中,单骨型占78.46%(51/65),以附肢骨受累多见,且下肢骨受累最多见;多骨型占21.54%(14/65),单侧肢体受累11例,双侧肢体受累3例。65例~(99)Tc~m-MDP全身骨显像示病灶处显像剂异常浓聚,在附肢骨及肋骨表现为沿骨干走行的条形浓聚,在颅骨及中轴骨为团块状异常浓聚。SPECT/CT示:囊状型病灶11个,其中无浓聚3个,轻度浓聚5个,高度浓聚3个,所有病灶周缘均异常浓聚;硬化型病灶32个,其中20个均匀异常浓聚,12个不均匀异常浓聚;混合型病灶33个,其中硬化病灶异常浓聚,囊状病灶无明显浓聚。结论:全身骨显像联合局部SPECT/CT显像对FDB的显示有一定特点,不同解剖影像学分型可表现为不同的显像剂浓聚。     

99mTc-枸橼酸盐显像鉴别骨转移癌与良性退行性骨病变

目的 探讨99mTc-枸橼酸盐(99mTc-citrate)显像在骨转移癌与良性退行性骨病鉴别诊断中的价值.方法 对99mTc-亚甲基二膦酸盐(99mTc-MDP)骨显像阳性患者39例(92个病灶)在显像后的2～7 d内行99mTc-citrate显像,并分别进行定性及半定量分析,所有患者的临床诊断均经病理学、影像学、临床随访等证实.结果 定性分析:23例(48个病灶)骨转移癌患者的99mTc-citrate显像示72.92%病灶(35/48)呈异常浓聚;16例良性退行性骨病变者99mTc-citrate显像示88.64%病灶(39/44)无异常浓聚.半定量分析:99mTc-citrate显像示48个骨转移灶的病灶与健侧放射性摄取比(RUR)=1.47±0.42,44个良性退行性骨病灶RUR=1.09±0.38,两者相比差异有显著性(t=2.887,P＜0.01);而99mTc-MDP显像示48个骨转移灶RUR=1.96±0.25,44个良性退行性骨病灶RUR=1.87±0.21,差异无显著性(t=1.178,P＞0.20).结论 对99mTc-MDP骨显像阳性患者,99mTc-citrate显像在鉴别骨转移癌和良性退行性骨病中具有一定价值.     

全身骨显像联合局部SPECT/CT对功能不全性骨折的诊断价值

目的 探讨99Tcm-MDP SPECT全身骨显像联合局部SPECT/CT融合显像对骨质疏松患者功能不全性骨折（IF）的诊断价值。 方法 回顾性分析2012年12月至2017年6月于河南省骨科医院收治的90例符合骨质疏松症诊断标准的患者的99Tcm-MDP SPECT全身骨显像和阳性部位的局部SPECT/CT融合显像结果,分析联合显像对IF的临床诊断效能。90例患者中,男性32例、女性58例,年龄（67.56±7.68）岁,其中22例可疑IF、68例已确诊局部IF。所有患者的最终诊断结果均经过6个月以上临床及影像学随访证实。 结果 99Tcm-MDP SPECT全身骨显像共检出IF病灶234个,均表现为显像剂摄取增高,病变部位及个数为骨盆78个、腰椎49个、胸椎46个、肋骨45个、股骨8个、胫骨4个、跟骨3个及胸骨1个。全身骨显像联合局部SPECT/CT融合显像对IF的诊断灵敏度为100%（234/234）。68.89%（62/90）的患者联合显像检出的IF数目多于显像之前已知的骨折数目。在局部SPECT/CT融合显像检查范围内,CT显示骨折病灶293个,其中SPECT/CT诊断新鲜IF病灶234个、陈旧性IF病灶59个,SPECT/CT对新鲜IF的诊断灵敏度为100%（234/234）。 结论 99Tcm-MDP SPECT全身骨显像联合局部SPECT/CT融合显像对骨质疏松患者IF病灶数目的全身显示及诊断具有较高的临床应用价值。     

99Tcm-MDP骨显像肝脏异常显影原因分析

目的 分析99Tcm-MDP全身骨显像肝脏异常显影的可能原因。方法 回顾性分析2013年1月至2015年7月于我院核医学科行99Tcm-MDP全身骨显像患者中肝脏异常显影20例,显像结果与其他影像学检查和（或）病理结果、实验室检查进行对比分析。结果 20例肝脏异常显影的患者中,原发性肝损伤3例、继发性肝损伤17例[其中包括多发性骨髓瘤引发肝功能异常1例,恶性肿瘤化疗后肝功能异常8例,肿瘤肝转移7例（结肠癌肝转移5例、肝癌肝内转移1例、肺癌肝转移1例）、慢性肾衰竭铁剂治疗后肝脏摄取1例]。结论 99Tcm-MDP全身骨显像肝脏异常显影的原因较多,除显像技术原因外,应警惕各种原因导致的肝脏损伤,为患者提前进行临床干预提供一定参考。     

肾性骨病核素骨显像结果分析

目的 探讨99Tcm-亚甲基二磷酸盐(99Tcm-MDP)骨显像在肾性骨病中的应用价值.方法 选择我院2008～2011年经过确认的肾性骨病36例,行核素SPECT显像,分析其影像学表现.结果 10例双侧胫腓骨摄取增加;8例双下肢骨、6例全身长骨骨摄取不均匀;5例全身关节膨大,双侧肱骨、股骨弯曲畸形;6例全身关节膨大伴周围软组织钙化;1例全身关节膨大伴全身多处软组织包块.结论 结合临床资料,99Tcm-MDP骨显像能准确判断病变性质,可为肾性骨病的诊治提供有力依据.     

99Tcm-MDP骨显像对SAPHO综合征的诊断价值

目的 探讨骨显像在滑膜炎、痤疮、脓疱病、骨肥厚、骨炎(SAPHO)综合征诊断中的临床价值.方法 回顾性分析8例SAPHO综合征的临床表现及99Tcm-MDP骨显像结果.结果 8例SAPHO综合征患者骨显像均阳性,前上胸壁异常放射性浓聚灶7例,单侧骶髂关节受累3例,颈、胸、腰椎体受累2例,肱骨及手足小关节受累1例,且发现了4处无症状的病灶.结论 骨显像的部分特征性表现有助于早期诊断及发现全身没有症状的病灶.     

骨显像在儿童常见恶性实体瘤骨转移中的应用

目的 探讨骨显像在诊断儿童常见恶性实体瘤骨转移中的价值。方法 202例恶性实体瘤（淋巴瘤91例、神经母细胞瘤81例、横纹肌肉瘤20例、肾母细胞瘤10例）患儿行^99Tc^m-MDP全身骨显像，观察各自骨转移发生率、表现特征及好发部位。结果 202例患儿骨显像阳性者92例，占45．5％，其中单发病灶20例，多发病灶72例。好发部位为下肢骨骼和椎体。91例淋巴瘤骨显像阳性者38例，占41．8％，单发与多发性转移灶分别占28．9％与71．1％。肾脏受累15例，占16．5％；81例神经母细胞瘤阳性46例，占56．8％，单发与多发性转移灶分别占21，7％与78．3％。原发灶显影30例，占37．0％；20例横纹肌肉瘤阳性8例，占40，0％；10例肾母细胞瘤均未见骨骼转移。结论 骨显像对诊断儿童恶性实体瘤的骨转移有一定的价值，神经母细胞瘤的骨转移最常见，肾母细胞瘤极少发生骨骼浸润。^99Tc^m-MDP骨显像可显示恶性淋巴瘤的肾脏受累情况。     

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.