骨样骨瘤与骨母细胞瘤的影像学分析

骨松质型骨样骨瘤与骨皮质型骨母细胞瘤的影像学诊断与鉴别诊断在临床上尚有一定难度。发生于长骨骨端、椎体及附件的骨样骨瘤,应注意与骨母细胞瘤相鉴别,而发生于骨干骨皮质的骨母细胞瘤应注意与骨样骨瘤鉴别。     

带凹槽骨穿针穿刺对骨病变的诊断

带凹槽骨穿针穿刺对骨病变的诊断司建国，刘志雄骨科主题词骨疾病对于骨病变术前明确诊断，对正确治疗起着十分重要的作用。近年来，随着ＣＴ、ＭＲ在临床上的广泛应用，对骨病变的诊断水平已有明显提高。但以骨破坏为主的疾病，包括骨肿瘤、骨结核、非特异性感染等术前定...     

不规则骨骨巨细胞瘤的MRI诊断

目的:分析不规则骨骨巨细胞瘤的MRI征象,提高对不规则骨骨巨细胞瘤影像学表现的认识及鉴别诊断水平.方法:结合文献对7例经手术病理证实的不规则骨骨巨细胞瘤的MRI影像表现进行分析.结果:MRI主要影像表现为膨胀性改变、溶骨性破坏及软组织肿块.病变在T1WI呈等或低信号,T2WI为低到高不均匀信号.结论:MRI检查对不规则骨骨巨细胞瘤的诊断和鉴别诊断具有明显的价值,并为临床手术提供可靠的资料.     

距骨骨母细胞瘤一例

患者,男,25岁,于外伤后1个月,因右踝关节持续肿痛来院就诊。查体:右踝关节局部肿胀,压痛,皮肤稍热,余未见异常。X线平片;右踝关节骨质未见骨折征象。右距骨见一偏心性膨胀性骨质破坏区,直径约2.5cm,呈多囊状改变,边缘硬化,厚薄不一,骨皮质变薄。X线诊断:右距骨动脉瘤样骨囊肿。病理诊断:右距骨骨母细胞瘤并动脉瘤样骨囊肿。讨论:骨母细胞瘤又称成骨细胞瘤,发生于距骨者较为少见,起病隐缓,大多仅感局部钝痛,服用水杨酸类药物疼痛并不缓解。此病主要与骨样骨瘤及其它囊状膨胀性病变如骨巨细胞瘤、动脉瘤样骨囊肿、骨囊肿等鉴别。(2003-01-07…     

腕豆状骨的投照体位

由于腕豆状骨位于腕关节尺侧的前下方，人体滑倒用手触地时，容易首先触及易使豆状骨骨折或脱位。常规腕关正侧位摄影，豆状骨被三角骨或其它骨头重叠，不易观察其祥细情况。经多次投照证实，通过下述方法投照能更好地显示豆状骨及其与周围的结构关系，诊断时结合腕关节正位，对豆状骨的诊断帮助很大。为了使两腕豆状骨对照和摄影体位的标准，摄影时同时摄双腕豆状骨。     

骨血管瘤的X线诊断

目的：探讨骨血管瘤的X线表坎特点及诊断和鉴别诊断。材料和方法：对发生于脊柱、颅骨、长管状骨、肋骨、肩胛骨共15例进行X光摄片、结果：骨血管瘤的基本X线表现是：椎体为栅栏状或网眼状、颅骨为放射状、长管状骨为泡沫状等改变。结论：骨血管瘤发生在不同部位有不同的特点，这些特点具有较高的诊断和鉴别诊断价值。     

骨短距蛋白与骨再建

骨再建是一种骨自身调节过程,包括骨形成和骨吸收两部分。随着基础医学和分子生物学研究的进展,骨再建的研究方法在日趋复杂化的同时也更趋于完善。当前骨再建的研究已达到细胞学和分子生物学水平,重点之一是研究由骨组织自身产生的,在骨微小环境中对骨再建起调节作用的生物活性物质。因为这些由骨组织产生的生物活性物质仅在骨组织内发挥作用,故     

距骨骨软骨瘤1例

患者男,20岁。五年前因踢足球挫伤右足,疼痛未治疗。近两年来,患处长一结节,逐渐长大,胀痛不适。查体:右足背近踝关节处扪及约3cm×3cm×3cm结节,质硬,固定。踝关节活动自如。X线右足侧位片示距骨前缘有2.0cm×2·5cm的偏心性膨胀性骨膨起,骨皮质呈弹壳状,内有不规则钙化及骨化,较透亮,周围无骨膜反应,软组织相应外膨(图1)。X线诊断:右距骨良性骨肿瘤(骨软骨瘤可能性大)。图1X线右足侧位片示距骨前缘2.0cm×2.5cm的偏心性膨胀性骨膨起图2病理切片示骨软骨瘤手术切除见病灶切面呈紫红色,为颗粒状,质脆易碎,病理诊断骨软骨瘤(图2)。讨论:单…     

多发性骨软骨瘤病的99Tcm-MDP全身骨显像分析

目的 分析多发性骨软骨瘤病的99mTc-MDP全身骨显像的影像特点,评价骨显像在多发性骨软骨瘤病中的应用价值.方法 回顾分析62例确诊为多发性骨软骨瘤病患者的临床、骨显像及其他影像学资料,总结多发性骨软骨瘤病的骨显像特点,并与其他影像学结果进行比较.结果 62例患者中,100％在身体不同地方发现无痛性骨性包块,其中17.7％伴有关节功能障碍,53.2％有家族史.骨显像发现全身骨骼受累最多的部位前三位分别为胫骨近端17.4％、股骨远端17.0％、股骨近端16.4％.受累最少的部位为颅骨0％.在所有病灶中,1级摄取病灶占全部病灶的7.9％(24/305)、2级摄取病灶占全部病灶的34.1(104 /305)、3级摄取病灶占全部病灶的40.0％(122/305)、4级摄取病灶占全部病灶的18％(55/305).结论 多发性骨软骨瘤病的全身骨显像表现为长骨末端异常的、不规则的、多处的放射性浓聚,结合临床及其他影像学资料,99mTc-MDP全身骨显像可用于多发性骨软骨瘤病患者的诊断与鉴别诊断、随访以及肿瘤恶变的评价.     

骨样骨瘤的CT表现及诊断价值探讨

目的探讨CT扫描在骨样骨瘤中的诊断价值。方法对经CT诊断、临床证实的25例骨样骨瘤临床资料进行系统性分析，并与X线检查方法作比较。结果骨样骨瘤的CT表现为瘤巢及其周围形成的程度不同的反应性骨硬化。结论与X线平片相比，CT扫描易于发现骨样骨瘤的瘤巢，从而确诊本病。CT扫描在骨样骨瘤诊断中具有重要的价值。     

Effective presentation of medical images on an electronic display station

In summary, the following should be parts of a useful system for electronic medical image display. 1. All display scales should be linearized. 2. Contrast Limited Adaptive Histogram Equalization should be applied to all slices as they arrive at display. 3. A screen or portion thereof should be dedicated to a low-sampled index of all slices, and navigation among the slices should be accomplished by reference to this index. 4. One second access to any slice or group of slices from the index should be provided.     

Photon activation therapy

It is suggested here that significant advantages should accrue from the use of 40 keV photons from implanted sources of 145Sm. These energies should stimulate Auger electron cascades from IdUrd, as well as produce non-repairable damage from radiosensitization. The use of low dose rates (approximately 10 rd/hr) should allow repair in normal tissues exposed to the activating photons. Utilization of this technique with brain tumors should minimize problems associated with radiosensitization of normal tissues, as CNS tissues do not synthesize DNA. The deposition of high LET radiations selectively in tumor cells provides unique advantages not available to either conventional therapy or other forms of particle therapy (fast neutrons, protons, pions, heavy ions).     

Clinical prediction rules in trauma imaging: who, how, and why?

Clinical prediction rules are multifactorial tools used to aid in clinical decision making. In radiology, clinical prediction rules are an important method for determining who should undergo imaging and, in combination with cost-effectiveness analysis, how imaging should be performed. To be useful, clinical prediction rules should be clinically important, have face validity, be reproducible and easy to use, be clinically relevant, and suggest a course of action. To insure generalizability, clinical prediction rules should also be validated in subjects distinct from those used to develop the rule. In this review, several examples from trauma imaging are used to demonstrate the development, validation, and use of clinical prediction rules.     

Lessons learned from Shuttle/Mir: psychosocial countermeasures

BACKGROUND: During future long-duration space missions, countermeasures need to be developed to deal with psychosocial issues that might impact negatively on crewmember performance and well-being. METHODS: In our recently completed NASA-funded study of 5 U.S. astronauts, 8 Russian cosmonauts, and 42 U.S. and 16 Russian mission control personnel who participated in the Shuttle/Mir program, we evaluated a number of important psychosocial issues such as group tension, cohesion, leadership role, and the displacement of negative emotions from crewmembers to people in mission control and from mission control personnel to management. RESULTS: Based on our findings, which are reviewed, a number of psychosocial countermeasures are suggested to help ameliorate the negative impact of potential psychosocial problems during future manned space missions. CONCLUSIONS: Crewmembers should be selected not only to rule out psychopathology but also to select-in for group compatibility and facility in a common language. Training should include briefings and team building related to a number of psychosocial issues and should involve both crewmembers and mission control personnel. During the mission, both experts on the ground and the crewmembers themselves should be alert to potential interpersonal problems, including the displacement of negative emotions from the crew to the ground. Supportive activities should consist of both individual and interpersonal strategies, including an awareness of changing leisure time needs. Finally, attention should be given to postmission readjustment and to supporting the families on Earth.     

Persistent hyperextension of the neck in breech ("star-gazing fetus") and in transverse lie ("flying-fetus"): indication for cesarean section.

All pregnancies with a breech or transverse lie should be examined roentgenologically, at least after the onset of labor, and those in whom hyperextension of the neck persists should be sectioned to avoid the real danger of injury to the cervical cord incurred in vaginal delivery. The radiologist should not assume a seriously deformed fetus just from the hyperextension; most of these fetuses are otherwise normal.     

某航校1991年-1999年乙型病毒性肝炎流行病学调查分析

目的;以某航运学校1991－1999年入校新生为对象,试图为以农村学生为主要生源的学校,提供乙型病毒性肝炎预防和控制的一些依据。方法：采用ELISA法进行HBs Ag检测。结果：航校HBsAg阳性率明显高于全国乙肝现象患病率,乙肝的发病率逐年下降,尤其是1999年乙肝的发病率下降比较显著。结论：本调查认为;应严格体检制度,发现具有HBV感染者,及时予以隔离,对于易感人群应进行乙肝疫苗的预防接种。     

Profiling children for sports participation

A profile of a child prior to participation in sports should be directed toward the specific demands of the sport. Medical, orthopedic, and fitness factors should be carefully evaluated so that intervention can be developed that will reduce the possible adverse effects of participation and, secondarily, improve performance. A child should not be excluded from sports unless specific risk-to-benefit ratios are firmly established.     

Screening mammography: proven benefit,continued controversy

Screening mammography, despite its limitations, remains the best means for diagnosing breast cancer in asymptomatic women. Regarding the continuing controversies concerning the age at which screening should start, evidence supports beginning regular screening at age 40 in women at average risk . Similarly, evidence suggests that the screening interval should be yearly, especially in younger women. Rather than an arbitrary age at which screening should stop, the decision on screening elderly women should be made on an individual basis, taking into account level of health and life expectancy. More work needs to be done on determining the optimum screening strategies for high-risk women. As to the interpretation of screening mammography, a certain level of observer variability and of false-negative and false-positive readings are inherent in the process. These should be kept to a minimum through efforts by the interpreting radiologist to improve performance through auditing of individual results and continuing education. The impact of double reading and computer-aided detection in the interpretation of screening mammograms warrants further evaluation in terms of efficacy and cost-effectiveness. Despite these continuing controversies, mortality from breast cancer in the United States has been decreasing steadily for the past 25 years. The magnitude of the decrease has been reported to range from 8% to 25%. Although some of this decrease may be attributable to improvements in the treatment of breast cancer, early detection through screening mammography has undoubtedly played a role in this mortality reduction. The controversies that surround the issue of screening should not detract from the fact that screening mammography has proved to save lives.     

Responsible conduct of radiology research. Part III. Exemptions from regulatory requirements for human research

The purpose of this series of articles is to explain the ethical and legal basis for responsible conduct of radiology research and the rules that an investigator needs to follow. In this article (part three of the series), the situations in which human research in radiology is exempt from regulatory requirements are explained. There are several situations in which an activity falls under the regulatory definition of research but is exempt from the research regulations. Investigators who conduct exempt research should know the regulatory criteria for the exemptions. In the case of research that is potentially exempt from the Department of Health and Human Services regulations, the institutional review board or an authority other than the investigator should make the determination of whether a proposed research activity is exempt from the regulations. For research exempt from Food and Drug Administration regulations, investigators should follow institutional guidance and seek input from the institutional review board or Food and Drug Administration for questionable cases.     

Revision anterior cruciate ligamentsurgery: Preoperative evaluation and considerations

An orthopedic surgeon must carefully evaluate each patient before proceeding with revision anterior cruciateligament (ACL) surgery. A concerted effort directed at delineating the reason(s) for failure of the primary reconstruction should be undertaken to prepare an orthopedic surgeon for revision ACL surgery. The evaluation should include a detailed history from the preoperative period of the primary ACL until the present. Physical examination should evaluate the knee for previous scars as well as associated laxity. Diagnostic studies should at a minimum include plain radiographs and magnetic resonance imaging. In addition, the operative surgeon should be experienced in ACL surgical techniques, have the appropriate tools and fixation devices, and have several graft choices. Finally, if there is any question about the ability to place the tunnels appropriately or obtain solid fixation, strong consideration should be given to staging the revision reconstruction.