眼眶爆裂骨折的CT表现(附64例分析)

目的：通过对眼眶爆裂骨折ＣＴ表现的分析,达到对本病早期诊断的目的。方法：作者回顾性分析了６４例（男５０,女１４）眼眶爆裂骨折的ＣＴ征象、好发部位和发病原因。病人的年龄在５～５７岁之间,平均３１．８ 岁。根据眼眶骨折的ＣＴ表现,将其分为三型：（１）单眶壁爆裂骨折;（２）多眶壁爆裂骨折;（３）混合型骨折（眼眶直接骨折合并有爆裂骨折）。结果：眼眶爆裂骨折的直接ＣＴ征象为眶壁骨质的连续性中断、粉碎、凹陷和曲度失常。其中单眶壁骨折３４ 例,多眶壁骨折７例,混合型骨折２３例。爆裂骨折最好发于眼眶内侧壁和眶底,占９４．８％ ,而混合型骨折眶外侧壁和内壁同时受累多见（占６０．８％ ）。结论：ＣＴ诊断眼眶爆裂骨折具有重要临床价值。     

儿童眼眶骨折的临床与CT分析（附40例报告）

笔者分析４０例儿童眼眶骨折。受伤原因以撞伤、摔伤多见，拳击伤少见。主要表现为视力下降甚至失明、复视及眼球运动障碍。ＣＴ检查常规为水平位及冠状位扫描。主要ＣＴ表现为眶壁骨质连续性中断，占７１．４％眶壁移位眶腔扩大占２８．６％；眶壁直接骨折最多达５０．５％，爆裂骨折占３３．３％，复合骨折占１６．７％；各壁骨折发生率依次为内壁、下壁、外壁及上壁；此外骨折局部可伴有软组织增厚及眼外肌改变。初步认为儿童眼眶     

多层螺旋CT的多平面重建对眼眶爆裂骨折的诊断价值

目的 探讨多层螺旋CT(MSCT)的多平面重建(MPR)对眼眶爆裂骨折的诊断价值.方法 80例眼眶爆裂骨折的患者行MSCT容积扫描得到常规轴位图像后,通过重建得到MPR图像.结果眼眶爆裂骨折的直接MSCT征象表现为:51例眶壁骨质连续性中断、4例可见粉碎骨折及25例眶壁骨质凹陷及曲度失常;间接征象为56例眶内软组织受压移位、8例见上颌窦内结节状或息肉状突起及34例副鼻窦内积液等.眶内壁骨折以横断面显示最佳(34/80),眶下壁骨折以冠状面及矢状面显示最佳(13/80),混合性骨折以冠状面图像显示最佳(4/80). 结论 MSCT容积扫描的多平面重建能全面、准确地诊断眼眶爆裂骨折,为临床治疗和评估预后提供重要的参考价值.     

螺旋CT扫描立体成像对眼眶爆裂骨折的诊断价值

目的 分析眼眶爆裂骨折螺旋CT（SCT）容积扫描的表现,旨在对本病作出早期诊断。资料与方法 回顾性分析80例眼眶爆裂骨折的SCT轴位扫描图像以及多平面重建（MPR）和三维（3D）重建立体图像的CT表现。并根据CT征象将其分为3型：（1）单眶壁爆裂骨折;（2）双眶壁爆裂骨折;（3）混合型骨折（并发其他面部直接骨折的爆裂骨折）。结果 眼眶爆裂骨折的直接SCT征象为眶壁骨质连续性中断、粉碎、凹陷及曲度失常;上颌窦和筛窦内“泪滴征”是诊断眼眶下壁和内侧壁爆裂骨折的特异性间接征象。由于骨折局部往往伴有软组织增厚及眼外肌的改变,所以对早期诊断、选择治疗方法、估计预后及法医学鉴定可提供更多的信息。结论 SCT容积扫描立体成像对诊断眼眶爆裂骨折具有重要价值。     

眼眶爆裂性骨折的螺旋CT诊断

眼眶爆裂骨折（orbital blowout fracture）是指外力作用于眼部使眼眶内压力骤然增高导致眶壁内部发生骨折而眶缘无骨折，一般发生于眶内、下壁。2003年6月～2007年7月，笔者采用螺旋CT扫描准确地对眼眶爆裂骨折特点及眶壁、眶内容物形态定位分析，为临床治疗提供了有效的影像资料，现报告如下。     

眼眶爆裂骨折的螺旋CT诊断及临床价值

目的　探讨眼眶爆裂骨折的螺旋CT(SCT)表现 ,评价临床指导价值。方法　 12 0例眼眶爆裂骨折行SCT容积扫描得到常规轴位像后 ,通过重建得到多平面 (MPR)图像 ,根据图像分析并结合临床征象 ,其中 10 8例保守治疗 ,12例手术治疗。结果　眼眶爆裂骨折的直接CT征象为眶壁骨质连续性中断、粉碎、凹陷及曲度失常 ,上颌窦腔出现“泪滴征”是诊断眼眶下壁骨折的特异性间接征象 ,眼外肌明显嵌顿及眼球内陷和牵位试验阳性是手术治疗的指征。结论　SCT容积扫描多平面像能全面、准确地诊断眼眶爆裂骨折 ,对临床治疗方法的选择有重要价值     

儿童眶下壁骨折的CT影像学特点

目的 探讨儿童眶下壁骨折的CT特点,提高对其影像学特点的认识.方法 回顾性分析25例眶下壁骨折患儿的临床及CT表现.结果 25例患儿共计26眼眶下壁骨折,其中右侧15例,左侧11例.其中18眼(69.2％)单纯下壁骨折.眼眶爆裂骨折20眼(76.9％),直接骨折6眼(23.1％),18眼(69.2％)眶下管或(及)眶下沟受累,18眼(69.2％)眼眶内脂肪疝入上颌窦,12眼(46.2％)累及下直肌,其中8眼(66.7％)伴有下直肌疝,7眼(58.3％)伴有下直肌嵌顿.结论 儿童眶下壁骨折多为爆裂骨折,易累及眶下管,易出现脂肪疝及下直肌疝,甚至嵌顿.外伤后应及时进行CT检查,有利于对眼外伤后眶壁骨折做出早期诊断,为临床治疗提供可靠依据.     

MPR在眼眶爆裂骨折诊断中的应用

目的:探讨16层CT MPR对眼眶爆裂骨折的诊断价值。方法:回顾性分析46例眼眶爆裂骨折的16层CT的横断位、MPR及3D图像。结果:MPR能准确显示骨折,直接显示出骨折线11例,内直肌增粗32例,眼肌及眶内脂肪疝入副鼻窦者26例,内直肌及眶内侧壁之间脂肪间隙变窄或消失者25例,眶内及眼睑皮下积气20例,副鼻窦积液或塌陷者35例。46例均见眼眶周围软组织肿胀。眶内侧壁骨折以横断面显示最佳,眶下壁骨折以冠状面及矢状面显示最佳,混合性骨折以冠状面显示最佳。结论:16层CT容积扫描的MPR能全面而准确地诊断眼眶爆裂骨折,对临床治疗及预后评估有重要价值。     

眼眶爆裂骨折的CT表现

目的:探讨眼眶陈旧性与非陈旧性爆裂骨折的CT表现及其诊断价值。方法:回顾性分析1 445例眼眶爆裂骨折的CT图像,分析骨折的部位、程度、形态及其特点。结果:单纯内侧壁骨折873例,单纯下壁骨折328例,内侧壁及下壁同时骨折244例。眼眶非陈旧性爆裂骨折CT表现为骨质明显中断,骨折线清晰,邻近副鼻窦腔积液、积血,近期复查窦腔内积液明显吸收,有皮下及眶内气肿,无眼球内陷;陈旧性爆裂骨折CT表现为骨质变形,骨折线光滑连续,复查窦腔内无明显变化,无皮下及眶内气肿,眼球不同程度内陷。结论:CT扫描能够准确显示眼眶爆裂骨折的直接及间接征象,明确骨折部位、程度,客观评价非陈旧性或陈旧性骨折,对于临床诊断、治疗、法医鉴定具有重要价值,但不能明确判断眼眶部位的具体受伤时间。     

眼眶内侧壁凹陷骨折的CT诊断与鉴别诊断

目的:了解眼眶内侧壁凹陷骨折及正常凹陷的不同CT表现特点。方法:对眼眶内侧壁骨折凹陷与正常凹陷的多排螺旋CT直接及间接征象进行回顾性分析,观察其异同之处。结果:20例眼眶内侧壁凹陷骨折直接征象为眶壁骨质的连续性中断、骨质塌陷、断端分离、表面毛糙,多合并内直肌增粗、眶内积气、筛窦积液、积血等间接征象;而20例眼眶内侧壁正常凹陷表现为眼眶内侧壁虽有不同程度的凹陷,但表面光滑,未见内直肌增粗等间接征象。结论:对眼眶内侧壁凹陷骨折的直接征象及间接征象的细心观察有助于判断骨折与否。     

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.