多层螺旋CT血管造影在主动脉病变诊断中的应用价值

目的:探讨多层螺旋CT血管造影(MSCTA)诊断主动脉病变的能力。方法:对临床可疑主动脉病变75例患者行MSCTA检查,对比剂使用碘海醇90~100ml,流速3~4ml/s,采用Surestar技术跟踪扫描,阈值140~160HU;采用多种图像后处理技术,包括容积重组(VR)、多平面重组(MPR)、曲面重组(CPR)及最大密度投影(MIP)。结果:主动脉瘤20例(发生在开主动脉3例,主动脉弓部7例,腹主动脉10例);主动脉壁内血肿2例,主动脉硬化性溃疡6例,主动脉缩率1例,其中,主动脉瘤及夹层动脉瘤行介入治疗13例,与选择性血管造影结果一致。结论:从SCTA作为一种无创性血管成像技术应用于主动脉病变的诊断,具有安全、可靠、简便、快捷的优势,为临床诊断与治疗提供可靠依据。     

主动脉瘤的CT诊断

目的:探讨螺旋CT血管造影在主动脉瘤中的诊断价值。方法:24例主动脉瘤患者行多层螺旋CT(MSCTA)血管造影并进行二维和三维图像重组,重组方法包括多平面重组(MPR),容积重组(VR),表面遮盖成像(SSD),最大密度投影(MIP)。结果:真性主动脉瘤6例,主动脉夹层动脉瘤17例,1例假性动脉瘤。多种重组图像与轴位图像相结合能清晰地显示动脉瘤的解剖细节及其与周围器官的空间解剖关系。结论:MSCTA对主动脉瘤有较高的临床诊断价值。     

16层螺旋CT血管造影诊断颅内动脉瘤

目的:探讨16层螺旋CT血管造影(MSCTA)诊断颅内动脉瘤的准确性。材料和方法:30例临床怀疑颅内动脉瘤的患者分别进行16层螺旋CT脑血管三维成像(3D-MSCTA)和数字减影血管造影(DSA),所有病例均完成多层面重建(MPR)、三维表面遮盖显示(SSD)、容积显示(VR)和薄层块最大密度投影(MIP),并对照手术或介入栓塞结果评估其诊断价值。结果:MSCTA共发现24例28个动脉瘤,其中22例为单个动脉瘤,2例为两个动脉瘤。动脉瘤直径最小2.7mm,最大35mm。MSCTA能清晰显示动脉瘤的瘤体大小、瘤颈、瘤轴指向、载瘤动脉及其动脉瘤与临近血管分支和骨性组织间的空间关系。23例与手术/DSA结果一致。结论:MSCTA诊断颅内动脉瘤有较高准确性,可部分取代DSA造影检查。     

多层螺旋CT血管造影在主动脉瘤中的临床应用

目的 评价多层螺旋CT血管造影(MSCTA)诊断主动脉瘤的临床价值.方法 对264例全主动脉CTA扫描图像进行回顾性分析,使用方法包括容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR).结果 264例病例中主动脉瘤83例(31%),其中真性动脉瘤74例,位于升主动脉28例,主动脉弓4例,降主动脉1例,腹主动脉33例,全主动脉多发动脉瘤8例;假性动脉瘤及真假混合型动脉瘤9例.结论 MSCTA对主动脉瘤的诊断具有重要价值.     

多层螺旋CT血管成像在体部动脉病变中的应用

目的 评价多层螺旋CT血管成像(MSCTA)在体部动脉性病变诊治中的应用价值.方法 68例经手术病理证实的体部动脉病变患者行MSCTA检查,其中颈部35例,胸腹主动脉及其分支23例,双下肢动脉10例.应用多平面重建(MPR),曲面重建(CPR),最大密度投影(MIP),容积显示技术(VRT)以及血管分析(VA)软件进行图像重建及分析.结果 68例体部动脉病变中,CTA 显示颈动脉钙化斑块伴狭窄25例,颈内动脉闭塞1例,颈总动脉假性动脉瘤1例,颈动脉鞘内神经源性肿瘤伴血管推移2例,椎动脉钙化狭窄5例,椎动脉瘤1例.胸、腹主动脉瘤5例,假性动脉瘤8例,主动脉夹层10例,双下肢动脉硬化性闭塞症9例及下肢血管动静脉瘘1例.结论多层螺旋CT血管成像对体部动脉病变的临床诊治具有重要指导意义.     

MSCT主动脉血流动力学分析及MSCTA的临床应用价值探讨

目的：探讨多层螺旋CT主动脉的血流动力学及MSCTA的临床应用价值。方法：采用多层螺旋CT对20例主动脉进行全程血管造影，测量主动脉5处CT值，即主动脉根部、主动脉弓部、平膈顶处、肾动脉起始处、髂总动脉分叉处。并对全程主动脉造影的MSCTA进行多平面重建(multi-planar reconstruction，MPR)、最大密度投影法(maximum intensity projection，MIP)、仿真内窥镜(virtual endoscopy，VE)、容积重建(volume rendering，VR)、表面阴影显示法(surface shadow display，SSD)重建。结果：20例主动脉全程MSCTA进行多种处理后显示主动脉夹层6例、腹主动脉瘤8例、主动脉粥样硬化症1例、右侧髂总动脉瘤1例及正常主动脉4例。主动脉各测量点平均CT值分别为主动脉根部208．05HU、主动脉弓部233．45HU、平膈顶处236．65HU、肾动脉起始处237．65HU、髂总动脉分叉处222．6HU。结论：利用MSCT可以对主动脉的血流动力学进行评价。主动脉全程的MSCTA有很大的临床应用价值。     

MSCT胸腹联合造影对急性大血管病变的诊断价值探讨

目的:探讨多层螺旋CT血管成像(MSCTA)对胸腹部急性大血管病变的临床应用价值。方法:对46例临床可疑急性大血管病变患者行MSCT胸腹联合增强扫描,造影剂使用浓度为300mg/100ml的碘海醇,速率3ml/s;图像后处理技术采用SVR、MIP、MPR及CPR。结果:46例中,主动脉夹层动脉瘤12例,肺动脉栓塞4例,动脉瘤3例,肠系膜上动脉栓塞2例,主动脉缩窄1例,MSCTA均能准确、清晰显示。结论:MSCTA诊断急性大血管病变准确、简便、快捷,三维重组图像更加清晰、直观显示病变的部位及形态特征,立体感强,体现出MSCTA对急性大血管病变诊断中的优势。     

16层螺旋CT外周动脉血管造影术的临床应用

目的:探讨16层螺旋CT在外周血管疾病中成像技术及临床应用价值.材料和方法:对21例临床怀疑周围血管疾病的患者,行多层螺旋CT血管造影(MSCTA).扫描范围 1100～1200mm,层厚2mm,重叠50%,螺距0.75,准直16×1.5,球管旋转时间0.75s,智能跟踪自动触发扫描,扫描时间 20～35s.造影剂量100ml,注射速度3ml/s.对全部图像行最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)、容积再现(VR),并对图像进行评价.21例中3例行DSA检查,4例行手术治疗.结果:MSCT动脉成像可以清晰地显示上肢动脉和腹主动脉及髂总动脉、髂内外动脉、股动脉、胫动脉、腓动脉的主干及分支.21例中,8例表现为不同部位、不同程度的动脉粥样硬化,急性动脉血栓2例,双侧髂总动脉瘤1例,外伤性假性动脉瘤1例,股动脉外伤性动脉损伤2例,医源性损伤1例,正常表现6例.结论:MSCT血管成像是一项高度准确的成像技术和侵袭性小的检查方法,已成为临床诊断外周血管疾病的首选方法.     

多层螺旋CT肝动脉成像的临床应用

目的:评价多层螺旋CT肝动脉血管成像(MSCTA)和三维重建(3D)的临床应用价值。方法:对95例患者的肝动脉进行了MSCTA成像,其中肝细胞癌22例,肝血管瘤12例,肝转移瘤12例,肝脏AVM1例,局灶结节样增生1例,肝内胆管腺瘤1例,同期15例肝癌患者行常规肝脏血管造影(DSA)与其对照。结果:MSCTA三维重建能清晰显示肝动脉的正常解剖及其变异,与常规血管造影无明显差别,同时还能很好地显示肝脏病变的供血动脉及肿瘤血管。结论:MSCTA可以较好地显示腹主动脉和肝动脉较大分支处的复杂的解剖关系及变异,与常规血管造影相吻合,同时由于其操作方法简单,安全,故具有较高的临床价值。     

多层螺旋CT血管造影在主动脉夹层及主动脉瘤诊断中的价值

目的：探讨多层螺旋CT血管造影在主动脉夹层及主动脉瘤中的临床应用价值。方法：对34例临床怀疑主动脉疾病者进行CT血管造影，层厚3．2mm，重建间隔1．6mm，pitchl 25，对比剂用量100ml，注射速度3ml/s，延迟时间23～28s；对所有病人进行最大密度投影、多平面重组、表面遮盖显示、仿真内窥镜、容积再现重组。结果：34例中，正常者7例，主动脉夹层16例，主动脉瘤7例，左锁骨下动脉瘤1例，马凡综合征1例，主动脉弓血管置换术后1例，腹主动脉瘤血管内支架术后1例。结论：MSCTA在主动脉夹层及主动脉瘤中有积极的临床应用价值，横断面CTA为诊断主动脉疾病的基础，图像后处理技术作为补充。     

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.