鼻咽癌放疗后放射性脑病的CT及MRI表现

目的：观察鼻咽癌放疗后放射性脑病(REP)的CT及MRI表现，并探讨其诊断价值。方法：对48例鼻咽癌放疗后REP的CT及MRI资料进行回顾性分析。结果：REP的发生以颞叶最常见，可累及额、顶叶。其CT主要表现为指套状低密度水肿带．增强后无明显强化。而MRI则表现为指套状水肿、脑坏死、囊变，T1WI呈低信号，T2WI呈高信号．增强后呈脑回状或不规则强化．囊变区则呈环状强化。结论：鼻咽癌放疗后REP的CT及MRI具有一定的特征性．诊断价值较大。     

鼻咽癌放射治疗后放射性脑损伤的影像学表现

目的 探讨鼻咽癌放射治疗(简称放疗)后放射性脑损伤的CT、MRI、正电子发射计算机体层摄影术(PET)的影像学以及组织病理学特征。方法 回顾分析鼻咽癌(NPC)放疗后放射性脑损伤71例患者的临床、CT、MRI、PET以及手术病理学资料。结果 病变位于颞叶、脑干或小脑，其CT表现为均匀或不均匀的低密度，位于颞叶者，呈“指状”低密度。23例患者(29个病灶)行CT增强扫描，86．2％(25／29)的病灶无强化。MRI示损伤脑组织的T1、T2弛豫时间延长，可呈不均匀信号改变。20例患者(29个病灶)行MR增强扫描，65．5％(19／29)的病灶呈“花环状”强化。2例病人行PET扫描，1例与CT及MRI所示病变相符合。3例患者颞叶手术切除术及组织病理学检查均为放射性脑坏死。结论 (1)MR平扫或增强扫描发现病变的敏感度均高于CT和PET。(2)T1WI和T2WI显示的不均匀信号提示为坏死，且均位于照射野内。(3)增强MRI所示的“花环状”强化，是放射性脑坏死的特征。(4)PET在放射性脑损伤诊断中可作为CT或MRI的补充。     

鼻咽癌放疗后放射性脑病的MRI特征

目的：探讨鼻咽癌放疗后放射性脑病（REP）的磁共振（MRI）形态学表现特征，并探讨其诊断价值。方法：对66例放射性脑病的MRI资料进行回顾性分析。结果-REP的发生以颗叶多见，66例REP中累及单侧颞叶12例，双侧颞叶54例。其特征性表现为：（1）指状水肿并局限性坏死：T1WI为指状低信号，12WI为高信号，T1WI＋Gd-FYFPA增强呈脑回状或环形强化。（2）囊性变：T1WI为类圆形水样低信号，T2WI为高信号，T1WI＋Gd-DTPA增强囊壁略强化。（3）占位效应明显。结论：鼻咽癌放疗后REP的MRI表现具有特征性，可作为REP诊断的主要方法。     

鼻咽癌放射治疗后颞叶放射性脑病低场MR诊断

目的分析鼻咽癌(NPC)放疗后颞叶放射性脑病(REP)的低场强MRI表现,探讨其影像学特征性改变。方法分析25例鼻咽癌放疗后诊断为颞叶放射性脑病(REP)患者MRI表现和临床资料及随诊观察。结果 25例REP中累及单侧颞叶9例,累及双侧颞叶16例。表现为局限性脑水肿并局灶性坏死:病灶为斑片状或不规则形,T1WI呈低信号或等信号;T2WI呈高信号或等高混杂信号。T1WI+Gd-DTPA增强扫描可见脑回状或不规则环形强化。12例经治疗后行MRI复查,2例症状改善,MRI异常信号明显减少,9例病灶无变化,其中3例症状有改善,6例症状体征无变化,1例病灶增大。结论鼻咽癌放射治疗后REP的MRI表现有一定的特征性,可作为REP诊断的主要方法。     

CT、MRI与DSA在脑内型海绵状血管瘤诊断中的价值

目的探讨CT、MRI与DSA检查在脑内型海绵状血管瘤诊断中的价值。资料与方法回顾性分析经手术病理证实的22例脑内型海绵状血管瘤患者资料,CT平扫22例,其中增强扫描17例。MRI检查22例,其中增强扫描13例。DSA检查5例。结果CT表现为高密度,略高密度,等密度。MRI表现为T1WI呈等或略低信号、T2WI呈高信号;T1WI与T2WI均呈高信号,病灶周围可见低信号环;T1WI与T2WI均呈低信号。病灶无占位效应或占位效应轻微,病灶多为不强化及轻微强化。DSA检查无肿瘤染色。结论脑内型海绵状血管瘤MRI表现典型,比CT表现更具特异性,与CT检查结合是诊断脑内型海绵状血管瘤的有效方法,参考DSA表现有利于脑内型海绵状血管瘤的诊断。     

子痫性脑病的影像学诊断

目的:探讨子痫性脑病的影像学表现。方法:回顾性分析9例子痫性脑病患者的临床和影像学表现。9例行MRI检查,6例行CT,且都行CT或MRI复查。结果:3例CT显示双侧额叶、顶叶及枕叶皮层及白质内对称性斑片状低密度影,3例未见异常。9例MRI显示病灶呈双侧对称性分布,多数病灶位于旁正中矢状位、顶枕叶脑实质内;病灶T1WI呈等或低信号,T2WI呈高信号;早期多无明显占位效应,严重者表现为脑室、脑池受压、变小或闭塞;增强扫描多数病灶无明显异常强化;经对症处理后复查示所有病变几乎完全吸收消失,临床症状也在2周~3月内部分改善或痊愈。结论:子痫性脑病有特征性影像学表现。正确认识子痫性脑病对早期诊断和治疗具有非常重要的意义。     

上皮样肉瘤CT和MRI表现及其病理基础

目的 探讨上皮样肉瘤(ES)的CT、MRI表现及其病理基础.方法 回顾性分析5例经手术病理证实的ES的CT、MRI和病理学表现.结果 5例ES中,发生于左前臂、左足、右眼眶、左外耳道、左侧阴茎根部各1例.3例行CT扫描,2例呈类圆形,1例呈铸状.1例边界清楚,1例部分边界不清,侵犯周围组织.CT平扫密度均不均匀,伴有斑片状低密度区,其中1例为囊实性肿块;增强扫描肿块不均匀强化,1例边缘及分隔轻度强化,1例中度渐进性强化;1例体积较小,密度均匀.其中2例行MRI扫描,T1WI:2例病灶以等信号为主,1例病灶内见稍高信号区;T2WI:2例病灶呈高信号为主混杂信号,1例病灶内见少量斑片状等或低信号,MRI增强扫描病灶呈不规则环状强化,内有斑片状坏死区无强化.免疫组织化学:Vimentin阳性率100％(5/5),CK阳性率80％(4/5),EMA阳性率100％(3/3),CD34阳性率50.0％ (2/4),HMG45阴性率100％(5/5),S-100阴性率75.0％ (3/4),SMA阴性率66.7％(2/3),CD31阴性率50.0％(1/2).结论 ES的CT和MRI表现均有一定的特点,单发或多发,边界不清,CT平扫密度不均匀,增强扫描不均匀轻到中度强化,边缘条状或片状强化;MR T1WI呈均匀等信号,T2WI呈混杂高信号,增强扫描呈不均匀显著强化.     

恶性血液系统疾病并发肝脏真菌感染的CT和MRI诊断

目的 探讨恶性血液系统疾病并发肝脏真菌感染的CT和MRI表现.方法 回顾性分析11例经临床和活检病理证实的肝脏真菌感染的临床和影像资料,着重分析其CT和MRI影像表现.结果 肝内病灶一般呈多发,圆形或类圆形,直径＜2 cm.CT平扫病灶呈低密度;7例增强后动脉期呈外周环形强化或病灶周围异常高灌注,1例病灶中心强化呈"靶样"改变,2例无明显强化;门脉和延时期病灶多逐渐呈相对等密度;MRI上病灶T1WI呈低信号,T2WI呈等或高信号,2例T1WI上可见病灶外周低信号环.结论 肝脏真菌感染的CT和MRI表现有一定特异性,动态CT增强和MRI检查有助于该病的鉴别诊断.     

脊髓海绵状血管瘤的MRI表现及其病理基础

目的：探讨脊髓海绵状血管瘤的MRI表现特征及其病理基础。方法：对比分析13例脊髓海绵状血管瘤患者术前的MRI表现及其术后病理标本。结果：13例脊髓海绵状血管瘤中，11例位于胸段，2例位于下颈段脊髓内，均为单发，病灶处脊髓增粗9例，萎缩2例，正常2例。病灶呈爆米花状或桑椹状，瘤巢较小，一般不超过脊髓横径。T1WI、T2WI均为混杂信号，且T2WI病灶周围呈低信号环10例，占76．92％；T1WI等信号、T2WI低信号2例，T1WI、T2WI均为高信号1例；增强扫描后，7例病灶中心有中等强化。MRI信号改变与瘤巢反复出血不同时期出血成分沉积及血栓形成、胶质增生密切相关。结论：MRI能反映脊髓海绵状血管瘤的病理变化，对术前确诊具有重要价值。     

颅内血管平滑肌瘤的影像表现(附2例讨论)

目的探讨颅内血管平滑肌瘤的CT及MRI表现。资料与方法结合文献回顾性分析2例经手术病理证实的位于颅内鞍旁的血管平滑肌瘤的CT及MRI表现。2例均行MRI平扫及增强,1例行MRI动态增强,1例行CT平扫。结果 2例均位于右侧鞍旁。例1行CT平扫示中颅窝鞍旁类圆形稍高密度肿块,密度均匀,周围未见水肿,MRI平扫T1WI呈低信号,扩散加权成像(DWI)呈低信号,T2WI呈不均高信号,内可见条状低信号。病灶周围见薄层环状水肿带,增强扫描肿块明显均匀强化,局部可见脑膜尾征;例2 MRI平扫示鞍旁卵圆形肿块,T1WI呈等信号,T2WI呈高信号,右三叉神经受压,增强扫描早期示病灶中心斑片状强化,增强晚期示病灶逐渐从中心向周边强化。结论动态增强扫描呈中心性渐进性强化可能为颅内血管平滑肌瘤特征性表现,有助于其诊断与鉴别诊断。     

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.