子宫平滑肌瘤的磁共振研究

目的：探讨子宫平滑肌瘤的MRI类型，总结其MRI特征及磁共振诊断的准确性和敏感性。方法：回顾性分析30例经手术病理证实的子宫平滑肌瘤患者的MRI资料。结果：30例子宫平滑肌瘤患者中，共有肌瘤54个。MRI表现为：①子宫不同程度增大和轮廓改变；⑦T2WI病灶边界清晰，周围常有高信号环；③T2WI信号强度普通型为均匀极低信号、细胞型为均匀高信号、退变型为不均匀信号；④TlWI信号强度均为等信号，不易识别；⑤细胞型者均匀增强、迟变型者强化表现各异。结论：MRI能清晰、准确地显示子宫平滑肌瘤，为临床诊断提供可靠依据。     

子宫肌瘤的MR成像研究以--DSA为参照

目的 以DSA为参照评价子宫肌瘤的MRI表现。资料与方法 对DSA上有明显血供的子宫肌瘤行MRI检查,所有病例采用SE T1、turbo—SE T2WI和SET1WI增强扫描,对比剂为Gd—DTPA,剂量0．1mmol／kg体重,对不同成像序列的MRI信号特点和相关征象进行分析。结果 37个肌瘤T1WI均表现为等、低信号T2WI多为等、高信号(28个肌瘤),增强扫描肌瘤均出现明显强化,信号多数高于或等于子宫肌层(35个肌瘤)。多数肌瘤内部为均匀结节状或团块状改变,其间可见分隔结构,肌瘤包膜在T1WI、T1WI和增强扫描时能明确显示。结论 DSA表现明显血供的子宫肌瘤MRI有一定的特征性表现,增强扫描能够较为准确地反映肌瘤血供。     

脑膜瘤的MRI表现与组织病理对照研究

目的　研究脑膜瘤的磁共振表现与其病理分类之间的关系。方法　回顾分析 12 8例经手术病理证实为脑膜瘤患者的MRI表现。结果　T1WI图像 ,上皮型脑膜瘤 2 9例 ( 4 9% )呈低信号 ,11例 ( 19% )呈稍低信号 ,17例 ( 2 9% )呈等信号。而纤维型脑膜瘤T1WI信号类型分别为 2 3例 ( 5 9% ) ,5例 ( 13 % )和 9例 ( 2 3 % )。在T2 WI图像上 ,3 4例 ( 5 8% )上皮型脑膜瘤呈高信号 ,15例 ( 2 5 % )呈稍高信号 ,10例 ( 17% )呈等信号 ,而纤维型分别为 2例 ( 5 % ) ,8例 ( 2 0 .5 % )和 11例 ( 2 8% )。上皮型、纤维型、移行型在T1WI上均呈现等、低信号 ,而在T2 WI图像上 ,上皮型、血管瘤型及移行型呈现为高信号或稍高信号 ;纤维型脑膜瘤T1WI以低或稍低信号为主。结论　在MRIT1WI图像上 ,各组织学类型之间信号强度的分布无显著性差别 ,而在T2 WI上 ,信号强度与病理类型具有统计学的相关性     

子宫平滑肌瘤的MRI诊断

目的　探讨子宫平滑肌瘤的MRI表现及其诊断价值。方法　全部病例均行MRI及超声检查。结合手术病理结果回顾性分析 32例 ( 71个病灶 )子宫平滑肌瘤的MRI表现 ,并与超声检查相对比。结果　所有病灶MRI均表现为T1WI中等或略低信号 ;T2 WI低信号 ,退变型肌瘤夹杂有斑片状高信号 ,肿瘤边界清楚 ,瘤周大多可见包膜 ( 5 5 / 71)。对发现 <2cm的肿瘤、判断肿瘤变性及肿瘤的定位MRI均优于超声检查。结论　子宫平滑肌瘤MRI表现颇具特征性 ,较B超检出率更高 ,可获得更精确的资料 ,对制定治疗方案及随访观察肿瘤的变化具有较大的临床意义     

子宫肌瘤子宫动脉栓塞术前后的MRI表现

目的　探讨子宫肌瘤子宫动脉栓塞术 (UAE)前后的MRI表现。方法　对 34例子宫肌瘤患者 (共 6 2个肌瘤 )在UAE前和术后 4个月行MR平扫和增强检查 ,肌瘤信号强弱与骨骼肌相比较 ,肌瘤体积测量按椭球计算公式。结果　 6 2个肌瘤术前平均体积为 85 6cm3 (范围 0 3～2 4 8 4cm3 ) ;UAE后 4个月肌瘤平均体积为 32 6cm3 (范围 0 3～ 6 5 4cm3 ) ,体积总缩小率为 5 8 32 % (t=3 18,P <0 0 1) ,术前体积大于 35cm3 的 4 0个肌瘤缩小率为 6 2 4 8% (t=4 4 5 ,P <0 0 1) ;而术前体积小于 35cm3 的 2 2个肌瘤体积缩小率为 38 6 9% (t=1 13,P >0 0 5 )。UAE后T1WI上肌瘤信号 38个为均匀等、低信号 ,2 0个呈等信号 ,4个为稍高信号 ;T2 WI上肌瘤信号 5 5个为极低信号 ,7个为稍低信号。UAE后 4 0个较大肌瘤中 38个无强化 ,而 2 2个术前体积小于 35cm3 的肌瘤仅 5个无强化 ,17个仍有不同程度强化 ,正常子宫肌层强化明显。结论　MRI有助于评价子宫肌瘤UAE前后的体积和血供改变。     

MRI对子宫肌瘤高强度聚焦超声治疗前后的诊断价值

目的 探讨子宫肌瘤的MR表现及MRI对高强度聚焦超声(HIFU)治疗后的评价价值.方法 回顾性分析我院36例 共54个肌瘤在HIFU治疗前及治疗后1、3、6月行MRI平扫、增强资料,对比治疗前后肌瘤的MRI信号、体积及强化程度变化.结果 HIFU术后1月,38个肌瘤为稍短TIWI短T2WI信号,7个为等T1WI稍长/短混杂T2WI信号,9个为稍短/长T1WI短T2WI信号.术后3个月及6个月,7个肌瘤T2WI信号进一步降低且坏死范围有所扩大,余47个肌瘤信号与1月相比无明显变化.增强扫描47个肌瘤尤明显强化,7个术后以稍长T2WI为主混杂信号的肌瘤轻度不均匀强化,正常子宫肌层强化与术前相比无明显变化.54个肌瘤HIFU术前平均体积为57.2 cm3,术后6个月平均体积为50.9 cm3,体积总缩小率为11%(t=2.56,P＞0.05),差异无显著意义.结论 MRI能有效观察子宫肌瘤HIFU治疗前后信号、血供和大小改变,是HIFU术后随访及疗效评价的有效手段.     

软骨肉瘤的影像诊断与鉴别诊断

目的:探讨软骨肉瘤的影像学表现,提高对本病诊断的准确性。方法:回顾性分析25例经手术病理证实的软骨肉瘤的X线、CT和MRI资料。结果:25例软骨肉瘤中原发23例,其中普通型20例,去分化型、黏液型及透明细胞型各1例;继发2例。X线及CT表现:原发的23例中溶骨性骨破坏5例,混合性骨破坏18例,形成软组织肿块20例,其中表现为低密度19例,等密度1例。20例普通型及1例黏液型见散在钙化。MRI表现:普通型软骨肉瘤T1WI呈等或稍低信号,T2WI呈等或稍高信号;黏液型T1WI呈等、低混杂信号,T2WI呈稍高、低的混杂信号,钙化T2WI呈低信号;透明细胞型病例T1WI及T2WI呈近乎等信号;去分化型T1WI呈等低混杂信号,T2WI呈不均匀高信号。6例普通型及1例继发型出现环形、间隔样中等-明显强化,黏液型及去分化型呈不均匀中等-明显强化。结论:普通X线及CT是软骨肉瘤影像诊断及鉴别诊断的主要手段,MRI显示软骨信号为重要提示。MRI显示病变范围更为清楚、准确,为临床治疗提供可靠依据。     

MRI对前列腺中央腺体T2WI低信号结节的良恶性分析

目的:探讨前列腺中央腺体T2WI低信号良、恶性结节的MRI表现,以提高鉴剐诊断的能力.方法:符合纳入标准的19例前列腺癌结节和61例前列腺增生患者经多序列MRI检查并经组织病理学证实.对两者在T2WI上的信号和边缘.DWI信号强度和ADC值、及多期DCE的最大信号强度和时间信号强度曲线的类型进行比较分析.结果:19例前列腺癌结节T2WI上边界不清、部分不清16例,边缘清楚3例,呈均质低信号;61例前列腺增生结节边缘不清及部分边界不清共34例,边缘清楚27例,信号均匀30例,信号不均匀31例.两者具有显著性的差异(P=0.007).于DWI,前列腺癌结节信号强度(b值为800 s/mm2)为60.6±10.7明显高于增生结节(49.7±8.5)(t值为 5.793,P=0.00).前列腺癌结节ADC值为(0.83±0.18)×10-3mm2/s,明显高于增生结节(1.17±0.24mm2/s)(t值为0.4 60,P=0.00).多期DCE,前列腺癌的最大信号强度为385.60±108.27,增生结节的最大信号强度为393.21±111.28(t值为-0.270,P=0.788),两者比较没有显著性差异.前列腺癌时间信号强度曲线以速升速降为主,而增生结节以渐进型和速升平台型为主,两者具有显著性差异(P=0.00);其中速升速降型和渐进型曲线于组间具有显著性差异).结论:前列腺中央叶T2WI低信号结节中,前列腺癌与前列腺增生于T2 WI边缘和信号均匀性、DWI的信号强度和ADC值、曲线类型均有差异.故MRI多序列成像分析助于对中央腺体T2WI低信号结节良恶性的鉴别诊断.     

子宫肌瘤的低场MRI表现及诊断价值(附24例分析)

目的探讨子宫肌瘤的低场MRI表现及其诊断价值。方法对24例子宫肌瘤患者行MRI检查,SE序列,常规T1WI、T2WI及多方位成像,对其MRI表现进行回顾性分析。结果18例多发肌瘤,5例单发肌瘤,MRI共检出41个病灶,所有病灶在T1WI上表现为等或低信号,在T2WI上表现为低或混杂信号。其中23例经手术治疗,1例行介入栓塞治疗。结论低场MRI对子宫肌瘤在观察大小、形态、位置与子宫腔的关系和肌瘤在定性方面上有较高的诊断价值,可作为B超检查的重要补充手段。     

MRI对肺癌诊断的临床价值(附30例报告)

目的:分析肺癌的MRI信号特点,以探讨MRI在肺癌诊断中的价值。方法:回顾性分析30例肺癌MRI表现,以同层椎体为背景,按高、中、低三种等级将30例肺癌统计T2WI、T1WI信号强度变化。结果:中央型19例,在T2WI上呈高信号8例,等信号11例,信号均匀11例,信号不均匀8例;在T1WI上呈略高信号7例,等信号11例,低信号1例,信号均匀15例,不均匀4例。周围型11例,在T2WI上呈略高信号6例,等信号5例,信号均匀6例,信号不均匀5例;在T1WI上略高信号3例,等信号8例,信号均匀7例,信号不均匀4例。增强7例均显示明显强化,肿块与纵隔淋巴结呈一致性强化,肿块呈慢强化,阻塞性肺炎呈快速强化,坏死和纤维组织强化不明显。结论:肺癌的MRI平扫信号在T2WI上以稍高信号至等信号为主,在T1WI上以等信号至稍低信号为主,T2WI能区别实质性肿块与坏死、纤维组织和阻塞性病变,MRI扫描对肺癌制定治疗方案具有重要价值。     

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.     

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.