DWI对二氯乙烷中毒性脑病的诊断价值(附7例报告)

目的:探讨二氯乙垸中毒性脑病的DWI表现.方法:对7例二氯乙烷中毒性脑病患者行头颅常规MRI 及DWI检查,并测量病灶的ADC值.结果:7例均可见双侧额颞枕顶叶皮质下及白质、小脑齿状核、豆状核、丘脑、外囊和内囊等区域异常信号,常规MRI上呈长T1、长T2信号,DWI上呈高信号.轻症患者(5例)ADC图上病灶呈高信号,重...     

有机磷中毒性脑病恢复期MRI表现(附4例报告)

目的:探讨有机磷中毒性脑病恢复期的MRI特征.方法:回顾性分析4例重度有机磷中毒慢性期脑结构变化.结果:双侧巴宾斯基征阳性4例,脑电图轻度异常4例.1例右侧小脑半球和中脑长T1长T2信号.1例双侧尾状核和壳核对称性长T2信号,T1WI高信号.1例双侧尾状核、壳核和苍白球对称性长T1长T2信号,侧脑室扩大,小脑萎缩.1例双侧尾状核、壳核和苍白球对称性异常信号,T1WI部分萎缩的小脑回呈高信号;脑室扩大,双侧枕叶内侧回、脑干和小脑萎缩.结论:有机磷中毒性脑病恢复期MRI表现主要累及尾状核、苍白球、丘脑、中脑和小脑;严重者皮质出现软化灶,伴有脑萎缩.     

桥脑出血或梗死继发双侧小脑中脚Wallerian变性及肥大性下橄榄核变性的MR浅析(附5例报告)

目的探讨继发于桥脑出血或梗死并同时继发双侧小脑中脚Wallerian变性(WD)及肥大性下橄榄核变性(HOD)的发病机制、MRI特征及其与原发病灶关系,以期提高对该病的认识。方法回顾性分析5例继发于桥脑出血或梗死同时继发双侧小脑中脚WD及HOD的MRI表现,同时根据MRI表现和解剖结合文献对其进行分析。5例均行MRI常规序列和DWI、SWI或T2*WI序列扫描。结果 5例中3例桥脑基底部背侧出血,均继发双侧HOD及双侧小脑中脚WD。1例桥脑右背侧出血继发右侧HOD及双侧小脑中脚WD,1例桥脑左背侧梗死继发左侧HOD及双侧小脑中脚WD。HOD表现为单侧或双侧下橄榄核体积增大,T1WI呈等或稍低信号,T2WI呈稍高或高信号,FLAIR呈等或稍高信号,DWI呈等或稍高信号,ADC图呈等或稍高信号,SWI或T2*WI呈等或稍高信号,其对原发出血病灶显示最好。双侧小脑中脚WD早期表现为对称性DWI图高信号,ADC图低信号,T2WI稍高信号,T1等信号;中后期表现为DWI图等或稍低信号,ADC图稍高信号,T1WI稍低信号,T2WI稍高信号。结论肥大性下橄榄核变性多继发于桥脑背盖部病变,并且有特定的发病部位和较为特征的MRI表现;双侧小脑中脚对称性异常信号不难发现,但当同时存在桥脑出血或梗死、HOD及双侧小脑中脚对称性异常信号时要考虑到是桥脑出血或梗死同时继发HOD及双侧小脑中脚的WD,而不要盲目的把它们误认定为是三个原发孤立病变。     

可逆性后部脑白质病综合征MRI诊断分析

目的探讨可逆性后部脑白质病综合征(PRES)MRI及临床特点。方法回顾性分析9例PRES患者的MRI表现及临床资料,所有患者均接受MRI平扫,包括常规T2WI、T1WI、FLAIR序列扫描、DWI,5例行MRV检查,3例行MR增强扫描,5例经治疗后复查MRI。结果 9例患者均有突发性血压升高病史,其中6例为先兆子痫或子痫,高血压病2例,肾功能不全1例。病变主要累及顶枕叶白质区,其次为额叶、基底节区,MRI呈对称性长T1长T2信号,FLAIR为高信号,DWI为等信号,ADC图呈高信号7例,2例为等信号。5例复查MRI脑白质病灶完全恢复。结论 MRI对PRES可作出明确诊断,其典型征象为双侧顶枕叶白质区多发对称性血管源性水肿,FLAIR、T2W序列显示病灶最佳,DWI、MRV在鉴别诊断中具有重要意义。     

急性甲苯中毒性脑病的MRI表现

目的探讨急性甲苯中毒性脑病的MRI表现。方法回顾性分析本院临床确诊的6例急性甲苯中毒患者的临床资料和MRI表现。结果 6例患者首次头颅MRI均表现为两侧大脑半球白质广泛受累,同时累及两侧外囊、小脑齿状核、豆状核6例,累及丘脑1例。病灶T1WI呈低信号,T2WI呈较明显高信号;FLAIR上呈高信号,DWI呈高信号,ADC图呈高信号;1例行增强扫描未见强化。6例均见脑回肿胀,脑沟、脑池变浅,脑沟模糊不清,脑室系统变窄。4例随访显示原有病灶范围稍缩小,同时有脑萎缩表现。结论临床上有明确的甲苯接触史及相应的临床表现,程度较重者可致脑水肿,结合头颅MRI表现可对急性甲苯中毒性脑病的严重程度作出评估。     

中毒性脑病的影像学表现

目的 :探讨不同病因引起的中毒性脑病的MSCT和MRI表现,以提高对该病的影像学认识。方法 :回顾性分析经临床确诊的20例病因明确的中毒性脑病患者,均行MRI检查,其中6例同时行MSCT检查,分析其MSCT和MRI表现。结果:20例MRI检查均有阳性发现,病变主要累及两侧大脑半球白质纤维及部分核团(放射冠17例,两侧基底节8例,丘脑5例,脑干3例,小脑齿状核3例,视辐射3例,胼胝体2例),两侧较对称分布,T1WI呈低或略低信号,T2WI、DWI、FLAIR呈高或略高信号。6例CT检查中,3例无异常,2例累及范围较MRI小,1例与MRI表现一致。结论:中毒性脑病主要累及两侧大脑半球白质纤维及部分核团,呈对称性分布,DWI及FLAIR序列具有较高的敏感性和准确性,对临床正确诊断和及时诊治具有重要价值。     

新生儿色素失禁症中枢神经系统受累的MRI表现

目的 探讨新生儿色素失禁症(IP)中枢神经系统受累的MRI表现.方法 17例经临床、皮肤活检或NEMO基因检测证实的新生儿IP的MRI及临床资料进行回顾性分析.结果 新生儿IP 17例,12例头颅MRI检查发现病灶,其中3例MRI平扫发现病灶,T2WI呈稍高信号、T1WI呈稍低信号,其余9例MRI平扫未发现病灶.12例扩散加权成像(DWI)扫描均发现病灶,DWI图表现为双侧大脑皮层及皮层下、基底节、半卵圆中心、侧脑室旁多发的非对称性点片状高信号,相应部位表观扩散系数(ADC)图呈低信号,其中累及基底节4例、胼胝体5例,丘脑2例.结论 新生儿IP中枢神经系统受累的MRI表现有一定特征性,DWI对病变的早期发现及预后评估有重要价值.     

副肿瘤性边缘叶脑炎的临床及MRI特征

【摘要】目的：探讨副肿瘤性边缘叶脑炎（PLE）的MRI特征。方法：回顾性分析8例经临床诊断治疗的PLE的临床及MRI资料。所有患者均行常规MRI平扫及DWI检查,其中6例行增强扫描。结果：①8例病变分布均以海马及海马旁回为主,其中3例可见病变同时累及双侧杏仁核、2例累及双侧扣带回、1例累及左侧岛叶、1例累及桥脑。病变双侧对称分布7例,单侧发病1例。②信号特征：6例病变于T1WI上呈较均匀稍低信号,T2WI呈高信号,DWI呈稍高或等信号;2例于T1WI呈等信号,T2WI呈稍高信号,DWI呈等信号;所有病灶在FLAIR图像上均呈高信号。6例行增强扫描,5例病变无强化,1例可见小片状轻度强化。结论：PLE具有较典型的临床及MRI特征,应结合抗体检测及其它全身检查,积极寻找原发肿瘤进行综合治疗。     

联合MRI常规与弥散成像判断多发性硬化斑块的病理基础

目的：研究MRI常规与弥散成像（DWI，DTI）联合应用，在判定多发性硬化斑块病理基础中的价值。材料和方法：对14例脑部多发性硬化病例进行联合MRI常规及弥散加权（DWI）、弥散张量成像（DTI）。其中1例为继发进展型（SP型），13例为好转－复发型（RR型）。首次发作期（急性斑块）成像者5例，缓解期（慢性斑块）成像者9例。分析常规MRI T1WI、T2WI及DWI、DTI成像后所获得的ADC图、FA图上的信号改变，量化分析DTI成像中的平均D值及各向异性指数AI值。结果：急性与慢性MS斑块MRI表现明显不同。急性MS斑块较大，斑块内信号不均匀，大致可以分为两部分：中心为数毫米至2cm不等的圆形或卵圆形异常信号影，呈T1WI低、T2WI高信号，推测病理为脱髓鞘或轴索丢失。周围为片状不规则形T1WI略低、T2WI略高信号影，考虑为水肿。发作MS斑块DWI可呈现高信号，e指数ADC图亦可呈现高信号，但范围后者明显小于前者。斑块中心平均D值升高、AI值明显下降，周围ADC值亦升高，但不如前者明显，AI值无明显改变，支持常规MRI关于斑块病理的推测。慢性MS斑块较小，多呈小片状或宽条状分布于侧脑室旁，T1WI呈略低信号、T2WI高信号。DWI呈近等信号、e指数ADC图呈等或略低信号。斑块平均D值不同程度升高，AI值下降，提示为脱髓鞘或轴索丢失，而无水肿存在。结论：联合MRI常规与弥散成像可以判断多发性硬化斑块的病理，从而进一步加深了对MS斑块病理的认识。     

苯中毒性脑病的CT与MRI表现

目的探讨苯中毒性脑病的CT、MR表现。方法回顾性分析8例苯中毒性脑病患者的CT和MR表现。结果行CT检查7例,病灶均表现为两侧对称性大脑皮层下白质区低密度影,并有不同程度的脑肿胀。行MR检查8例,病灶均累及两侧额颞顶枕叶脑白质、外囊及两侧齿状核,其中6例病灶累及苍白球;2例病灶累及丘脑。病灶于T2加权呈高信号,T1加权呈低信号,其中5例DWI高信号,ADC图低信号;3例DWI高信号,ADC图高信号。2例MR增强检查均未见明显异常强化。结论苯中毒性脑病有较为典型的影像学表现,CT、MRI检查对苯中毒性脑病有重要的诊断价值。     

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.