多层螺旋CT尿路成像的临床应用价值

目的 探讨多层螺旋CT尿路成像(CTU)在泌尿系统疾病中的临床应用价值.方法 对我院2011年6月至2012年4月86例患有泌尿系统疾病的患者进行CTU检查,并收集临床资料.结果 86例患者中CTU诊断结石、肿瘤、畸形的准确率为100％.结论 CTU是诊断泌尿系统疾病的理想方法,值得应用及推广.     

CT尿路造影在泌尿系统疾病的诊断价值

目的：探讨IVU后CT尿路造影（CTU）在诊断泌尿系统疾病及评估IVU不显影肾的肾功能应用价值。方法：对IVU 120min单侧肾不显影或IVU显示泌尿系统形态结构异常，但不能确诊的60例作IVU后CT扫描。结果：CTU对IVU不显影或不能确诊的疾病做出明确诊断；对IVU不显影的梗阻肾的肾功能做出进一步评估。结论：IVU后CT尿路造影把IVU与CT结合为一体，可作为IVU的一种重要补充检查方法，具有重要的临床应用价值。     

64排VCT泌尿系成像中采用分离团注技术降低患者辐射剂量的应用

目的 研究分离团注技术的64排VCT泌尿系成像(CTU)中降低病人辐射剂量的可行性及临床应用价值.方法 对120例患有泌尿系疾病的患者进行分组.其中有60例(A组)行分离团注技术CTU扫描.另外60例(B组)用单次团注方法行CTU扫描.然后,对2组成像质量及辐射剂量进行对比分析.结果 A组60例患者中的54例(90%)输尿管中、下段显示良好和60例(100%)上段输尿管、肾盂肾盏显示优秀,与B组相比,图像质量接近或略提高,但可减少辐射剂量17%～26%.结论 应用分离团注技术做CTU扫描,可降低病人辐射剂量.同时,又可获得优质的能用于诊断的泌尿系图像.     

CT尿路造影时患者的辐射剂量与风险评估

CT尿路造影(computed tomography urography,CTU)较泌尿系统其他影像检查方法具有更高的组织结构分辨能力和更清晰的三维影像效果,而且检查过程还具有无痛、快捷的特点,因此,被广泛用于临床泌尿系统及相关腹部疾病的影像学诊断,成为泌尿系统疾病首选的"一站式"影像学检查方法和评估诊断的金标准[1].CT尿路造影是采用大范围、重复多次并涉及照射人体辐射敏感部位(生殖腺)的高剂量薄层扫描方式,患者接受的辐射剂量居泌尿系统X线检查方法的首位,因此,在考虑到优越的影像诊断收益的同时,患者在检查中所接受的辐射剂量及所产生的伤害亦不容忽视.为此,笔者针对CTU检查时患者接受的辐射剂量与危险进行了测量与评估.     

低辐射剂量脑CTA的应用价值

目的：对比分析低辐射剂量和常规剂量脑CTA对脑动脉血管的显示效果并进一步探讨低辐射剂量脑CTA的临床应用价值.材料和方法：将80例患者随机分成两组,分别行低剂量与常规剂量脑CTA检查,对横轴图像、容积显示（VR）和最大密度投影（MIP）图像进行观察和对比分析,主要评价CTA图像中脑动脉血管的显影强度、图像噪声以及脑动脉血管结构的显示效果.结果：低剂量组CTA平均辐射剂量（18.58mGy）比常规剂量组（37.17mGy）降低50%,低剂量组CTA脑动脉血管的显影强度与常规剂量组相比无显著性差异（P=0.296）,其噪声略大于常规剂量组,但无显著性差异（P=0.235）.两组间VR和MIP图像中的脑动脉结构的显示效果无显著性差异（P=0.128）.结论：同常规剂量CTA相比,低剂量CTA的显影强度、脑动脉结构的显示效果与常规剂量组无明显差异,较大地降低了辐射剂量,具有较好的应用前景.     

低剂量CT尿路成像的临床应用价值

目的 探讨低剂量CT尿路成像(CTU)的临床应用价值.方法 79例有泌尿系临床症状拟行CTU检查的患者随机分为2组:常规剂量组37例,扫描参数为管电压120 kV,管电流350 mA;低剂量组42例,扫描参数为管电压120 kV,根据患者的体型将管电流设为100～120mA.2名医师采用双盲法对平扫、皮质期、实质期、排泄期横断面及排泄期重组图像进行影像质量评分(IQS),测量感兴趣区(ROI)图像噪声即CT值的标准差(SD),记录有效剂量(ED)及临床诊断符合率.结果 2组间SD、ED值及平扫IQS差异有统计学意义(P＜0.01),而增强扫描各期横断面及排泄期重组图像IQS、临床诊断符合率差异无统计学意义(P＞0.05),所有图像质量均满足诊断要求.结论 低剂量CTU在显著降低辐射剂量的同时可获得满足诊断要求的影像,具有良好的临床应用价值.     

多层螺旋CT尿路造影在尿路梗阻性疾病中的临床应用

目的探讨多层螺旋CT尿路造影在泌尿系梗阻性疾病诊断中的应用价值。方法对48例泌尿系统梗阻性疾病者,分别进行多层螺旋CT平扫及多时相期CT增强扫描。对增强后各期图像进行相关处理,以不同的三维重建方式获得CTA、CTU影像。所有病例均经临床及手术证实。结果48例中肾脏及输尿管先天畸形者15例;输尿管阴性结石致肾盂输尿管积水者4例;泌尿系炎症者5例;肾及输尿管、膀胱结核6例;外源性压迫导致肾盂及输尿管积水者8例;泌尿系肿瘤者10例。结论多层螺旋CT泌尿系造影对尿路梗阻性疾病的诊断具有很高的应用价值。     

CTU在泌尿系统疾病诊断中的应用

目的:探讨CTU对泌尿系统疾病的诊断价值。方法:回顾性分析有临床症状且行CTU检查的患者106例。均先行常规平扫,后行皮质期、髓质期、排泄期扫描,获得容积数据后在Toshiba Vitrea 2.0工作站行MPR、CPR、VR、MIP等后处理,获得肾盂、肾盏、输尿管、膀胱的完整全尿路三维影像。结果:106例中,泌尿系阴性结石32例,肾脏输尿管膀胱肿瘤23例(均经手术病理证实),肾盂旁囊肿25例,双侧巨输尿管6例,与临床、病理、术后诊断相符率为94%。结论:CTU及其三维重建后处理,可清晰显示泌尿系统疾病的部位及尿路梗阻情况,且无创、高效、安全、准确,可大大提高病灶的检出率。     

“双低”CT尿路造影检查方法在小儿泌尿系统畸形中的应用

目的：探讨“双低”CT 尿路造影(CTU)检查方法在小儿泌尿系统疾病诊断中的应用。方法入选病例经超声(US)筛查,排除肾结石、肿瘤或肿瘤样病变,拟诊为泌尿系统发育畸形,扫描方法：双期注射对比剂,一期扫描,取皮质-分泌期图像,使用碘克沙醇270 mg I/mL 对比剂,记录每个病例的剂量长度乘积(DLP),并根据公式换算有效剂量(ED),由2名阅片者对图像进行独立阅片,并对图像进行主观评价,诊断结果与临床对照。结果2组病例的诊断符合率均为100%,图像质量良好。结论CTU 是小儿泌尿系统发育畸形的重要诊断手段,使用“双低”方法,在保证诊断的前提下,减少了 CT 辐射剂量,降低了对比剂用量。     

螺旋CT动脉三期扫描联合CTA技术在小肝癌诊断的应用研究

目的探讨螺旋CT动脉三期扫描联合血管造影(CTA)技术对小肝癌诊断的临床应用价值。方法回顾性分析27例经手术病理或穿刺病理确诊的小肝癌患者的CT资料,术前均行螺旋CT动脉三期扫描及血管造影CTA重建。结果肿瘤在动脉早期无强化13例,强化14例,其中血管样强化9例,肿瘤实质样强化5例,轻度强化8例,中度强化4例,重度强化2例;动脉中期无强化3例,强化24例,其中血管样强化16例,肿瘤实质样强化8例,轻度强化11例,中度强化4例,重度强化9例;动脉晚期均有不同程度强化,其中血管样强化4例,肿瘤实质样强化23例,轻度强化2例,中度强化5例,重度强化20例。能够充分显示小肝癌的供血血管数量及形态,动脉早期1例,动脉中期9例,动脉晚期5例。结论螺旋CT动脉三期扫描联合血管造影(CTA)技术对小肝癌的诊断具有重要的临床价值。     

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.     

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.     

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）