磁共振脑静脉系血管成像技术及其临床应用

目的探讨磁共振脑静脉系血管成像的技术方法和最佳扫描方案，评价磁共振静脉系血管成像技术(MR venography，MRV)对静脉系疾病的诊断价值及临床意义。方法采用二维时间飞跃法MR血管造影(2D-TOF-MRA)、二维相位对比血管造影(2D-PCA)和三维对比增强MR血管造影(3D-CE-MRA)3种血管成像技术分别对20例健康志愿者和20例临床或MRI疑有静脉系疾病的患者行MRV成像，并采用最大强度投影(MIP)、多平面或曲面重建(MPR)及数字减影MRA(DSMRA)技术对图像进行后处理，观察脑静脉系在MRV中的显示情况及脑静脉系疾病在MRV中表现形式，制定脑静脉系成像的最佳方案。结果本组经3D-CE-MRA静脉系成像诊断为13例颅内静脉窦血栓形成(CVST)及7例颅内肿瘤累及静脉系的阳性显示率为100％，均经临床治疗复诊及手术证实。2D-PCA及2D-TOF-MRA对细小引流静脉显示欠佳，且2D-TOF-MRA对复杂区域内静脉血管亦显示欠佳。结论3D-CE-MRA结合2D-PCA及2D-TOF-MRA静脉成像技术形成全脑静脉系成像，为脑静脉系的最佳成像方案，对临床术前评估和指导治疗有极其重要的意义。     

颅内静脉系统的时间分辨MR血管成像:另外一种MR静脉成像技术

正摘要目的对照对比剂动力学时间分辨影像(TRICKS)MR血管成像(MRA)与二维时间飞跃(TOF)MR静脉成像(MRV)、三维对比增强(CE)MRV正常脑静脉与硬膜静脉窦的影像显示。方法35例连续病人纳入本前瞻性研究。所有病人均接受TOF MRV、TRICKS MRA与CE MRV检查;单一剂量静脉对比剂注射用于后     

脑磁共振静脉成像

目的：磁共振静脉成像(MRV)已被广泛应用于颅内静脉系统检查，特别是用来评价静脉窦血栓形成。本研究的目的是评价脑MRV描述正常颅内静脉系统解剖和变异的作用，评价它在诊断硬脑膜窦血栓形成过程中潜在的误诊因素。材料和方法：对79例常规磁共振表现正常的MRV图像进行分析，观察硬脑膜窦和主要静脉的表现和缺失情况。其中7例志愿者接受了MRV和3DPCMRA两种方法检查。结果：上矢状窦、直窦、Galen静脉和大脑内静脉显示率为100％，枕窦显示率为10％，基底静脉显示率为92％。横窦血流间隙显示率约为34％，均出现在非优势侧横窦，优势侧横窦没有出现流动间隙。结论：MRV是有效的评价颅内静脉系统方法。常规MR表现正常者中有34％可以发现横窦流动间隙，这些流动间隙不应被误诊为静脉窦血栓形成。     

三维增强磁共振静脉成像评价颅内静脉系统

目的:比较三维增强FLASH序列和2D TOF序列MR静脉成像(MRV)对颅内静脉系统的诊断价值.方法:本组11例中健康志愿者6例(正常组),脑静脉窦血栓形成患者5例(病变组),均同时行3D增强FLASH和2D TOF序列MRV扫描,病变组5例患者同时行DSA检查.将脑内主要静脉(14支)的显示情况分为3级:满意显示,一般显示和未显示.比较两种扫描方法对脑内静脉和静脉血栓的显示情况.结果:正常组中三维增强FLASH和2D TOF序列对所观察的14支脑静脉的满意显示率、一般显示率和未显示率分别为88.10%,5.95%,5.95%和30.95%,53.57%,15.48%.三维增强FLASH未显示结构主要为下矢状窦.病变组5例中DSA共发现12处血管病变,三维增强FLASH显示优于2D TOF 10处,两者相仿2处.结论:三维增强FLASH对脑静脉系统的显示优于2D TOF序列,可以提供高质量的脑内静脉结构的图像,对诊断脑静脉内血栓形成有重要临床价值.     

直接三维增强MRV技术在下肢静脉血管造影中的应用

目的探讨直接三维增强MRV技术在下肢静脉血管造影中的应用。方法使用GE公司S igna 1.0T磁共振成像系统,对15例经手术、DSA或超声多普勒证实的下肢静脉疾病患者行MRV检查,观察直接三维增强MRV对下肢静脉病变的显示。结果15例患者均获得轮廓清晰、伪影少、信号强,且直观完整三维立体下腹、盆腔和下肢的深、浅静脉图像。结论直接三维增强MRV技术为一种良好的下肢静脉造影方法。     

CT和MR血管造影在颅内静脉畸形诊断中的应用

目的：评价CT、MR血管造影在诊断颅内静脉畸形中的价值与限度。材料和方法：5例经DSA证实的颅内静脉畸形病例,男2例,女3例,平均年龄37岁（10-66岁）,幕上1例,幕下4例。分别在动脉期（CTA）和静脉期（CTV）扫描采样,运用SSD和MIP进行重建,全部病例行MRA、MRV检查,4例做了增强前后MRV检查。结果：CTA显示所有病灶,但没有显示颅内静脉畸形的“海蛇头“,即引流静脉影像特征,而CTV不仅显示病灶,而且还显示了引流静脉“海蛇头“影像特征;MRV显示5例病灶和其特征性的“海蛇头“影像特征,MRA没有一例显示病灶的“海蛇头“表现,4例增强前后MRV没有明显差异。结论：MRV和静脉期的CT血管造影（CTV）是诊断和随访颅内静脉畸形的有效方法,优于动脉期的CT血管造影（CTA）,MRA可作筛选之用,排除其他血管性病变。     

磁敏感加权成像和三维对比增强MR静脉成像对上矢状窦旁桥静脉的显示及比较

目的 比较磁敏感加权成像( SWI)和三维对比增强MR静脉成像(3D-CE MRV)技术 对上矢状窦旁桥静脉的显示能力,为神经外科手术的术前影像学检查提供依据.方法 20例(40侧)健康成人受检者分别行矢状面3D-CE MRV和横轴面SWI检查.3D-CE MRV的原始图像行MIP,SWI原始图像行MinIP及MPR处...     

静脉性脑梗死MR影像特点

目的回顾总结静脉性脑梗死MRI及MRV影像表现,旨在提高影像诊断水平。方法对15例静脉性脑梗死的MR表现进行了回顾性分析,其中9例临床治疗后复查MR表现明显好转,临床症状明显改善。15例均行常规MRI平扫,其中9例同时进行MR增强及3DCE-MRV,6例行2DTOF MRV。结果 15例脑内多发病灶9例,单发病灶6例,其中2例脑梗死伴出血改变。15例中发生于额叶4例,顶叶6例,颞叶3例,枕叶1例,小脑1例。静脉栓塞部位11例为上矢状窦,1例直窦及左横窦,1例右侧横窦及乙状窦,2例皮层大脑浅静脉。9例行增强扫描,5例病灶内不规则强化,2例脑膜强化,3例无强化.7例MRV均显示栓塞的静脉血流信号丢失或缺损,3例出现异常静脉侧支或引流静脉异常扩张。结论静脉性脑梗死MR影像表现具有特征性,MRI结合MRV可以作为首选的无创检查方法,对静脉栓塞早期诊断和治疗有重要作用。     

SWI在脑静脉血管畸形诊断中的价值

目的 探讨磁敏感加权成像(SWI)在诊断脑静脉血管畸形(CVM)中的特点,以提高诊断准确率.方法 回顾分析70例CVM患者的影像资料,将SWI与常规MR对比,评价SWI对CVM检出的优越性.结果 70例患者SWI均得到明确显示,T1WI发现病灶55例,T2WI发现病灶59例,常规MR呈管状或条形流空信号,且只显示明显扩张的髓静脉及增粗的引流静脉,而SWI较常规MR更敏感更清晰地显示所有扩张的髓静脉呈放射状汇入增粗的引流静脉,呈现特征性的“水母头”状表现.结论 SWI比常规MR对CVM的检出更为敏感,结合常规MR能够做出CVM的定性诊断,有利于临床治疗及预后.     

脑发育性静脉异常的MRI诊断评价

目的分析脑发育性静脉异常（DVA）的MRI表现及诊断价值。方法对16例MR诊断为DVA的临床资料进行回顾性分析。结果16例平扫显示引流静脉,12例增强扫描均显示引流静脉及髓静脉,并呈特征性表现,5例磁共振血管造影（MRA）发现3例粗大引流静脉。结论MR平扫能显示引流静脉;MR增强扫描可以显示细小髓静脉,是诊断DVA准确、可靠的方法。     

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.