肠系膜静脉血栓形成的MDCT诊断价值

目的探讨肠系膜静脉栓塞的临床特点和MDCT表现。方法对15例肠系膜静脉栓塞患者行CT增强检查,分析MDCT表现及临床特征。结果 15例增强扫描均可见肠系膜静脉内充盈缺损,3例可见肠系膜上静脉增宽,6例可见肠壁增厚呈"靶环状",1例可见肠壁积气,11例可见腹水形成,3例可见肠系膜周围脂肪水肿。结论 MDCT检查早期诊断肠系膜静脉血栓形成,是有效可靠的影像学方法。     

急性门静脉和肠系膜上静脉血栓形成的CT诊断

目的:分析急性门静脉及肠系膜上静脉血栓形成的临床及CT表现。方法:回顾性分析9例经手术及临床综合诊断证实的急性门静脉及肠系膜上静脉血栓形成病例的CT表现,9例均行CT平扫,3例行增强扫描。结果:9例CT平扫均显示门静脉或肠系膜上静脉增粗,7例见腔内高密度影,8例见腹腔积液,5例见小肠管壁增厚、水肿;3例强化扫描示静脉内低密度充盈缺损。结论:CT对诊断急性门静脉及肠系膜上静脉血栓形成具有重要意义;临床上对急性腹痛,不明原因腹水及可疑肠梗阻的病例,应注意观察其门脉系统情况。     

肠系膜上静脉血栓形成的CT诊断

目的探讨螺旋CT对肠系膜上静脉血栓形成的诊断价值。方法回顾性分析临床证实的13例肠系膜上静脉血栓形成的CT表现特点。13例均行CT平扫及多期增强扫描,其中4例行口服对比剂后延迟扫描。部分图像数据行多平面最大密度投影等后处理。结果所有病例均表现有肠系膜充血水肿,8例于增强扫描后显示有肠系膜上静脉内圆形充盈缺损。其余5例发生于末梢血管的病变。CT未能直接显示血栓,扫描显示了肠管扩张、肠壁增厚、靶征、肠壁强化程度减低、缺失或肠间小气泡影等反映继发肠缺血表现的CT征象。后两者对肠缺血坏死的判断,有较高的特异性。而肠坏死的发生与血栓是否位于主干并无直接关系。结论螺旋CT是诊断肠系膜上静脉血栓形成的重要的检查方法。     

急性肠系膜上动脉血栓形成的螺旋CT诊断

目的:分析急性肠系膜上动脉血栓形成的临床特点及螺旋CT表现,提高认识水平.方法:回顾性分析7例经手术证实为肠系膜上动脉血栓形成的螺旋CT表现.7例均行平扫加增强扫描,及最大密度投影图像后处理重建.结果:7例增强均显示肠系膜上动脉血栓形成的直接征象为肠系膜上动脉管腔充盈缺损.螺旋CT平扫5例出现肠系膜上动脉密度增高,4例肠系膜上静脉与肠系膜上动脉管径比例<1,4例肠系膜上动脉壁斑片状钙化,2例肠腔淤积扩张,2例薄纸样肠壁及腹腔积液等征象.7例最大密度投影重建显示肠系膜上动脉血管内不同程度充盈缺损、管腔狭窄.结论:螺旋CT检查对于早期诊断肠系膜上动脉血栓形成是一种有价值的方法.对于不明原因所致腹痛及临床怀疑肠系膜缺血的患者均应及时行螺旋CT检查.     

64层螺旋CT对急性肠系膜血管栓塞的诊断价值分析

目的 探讨64层螺旋CT血管造影对急性肠系膜血管栓塞(AMI)的诊断价值.方法 回顾性分析经64层螺旋CT全腹平扫加多期动态增强扫描诊断的15例AMI.其中,肠系膜上动脉栓塞3例(完全栓塞1例,不完全栓塞2例),肠系膜上静脉栓塞12例.结果 15例AMI直接征象:动脉期显示肠系膜上动脉完全或部分充盈缺损,可诊断为肠系膜上动脉完全或部分栓塞(3例).静脉期显示肠系膜上静脉完全或部分充盈缺损,可诊断为肠系膜上静脉完全或部分栓塞(12例);间接征象“缆绳征”12例,肠系膜水肿10例,肠管壁增厚12例,肠管扩张、积液8例,肠壁强化减弱7例,其中2例可见节段性未强化区,腹水6例,肾前筋膜增厚4例,肠壁积气2例.平扫肠系膜上动脉或上静脉高密度征7例(静脉栓塞6例,动脉栓塞1例),肠系膜上静脉栓塞累及门静脉、脾静脉6例,其中4例在增强扫描时,可见肝脏异常低灌注区.结论 64层螺旋CT平扫加多期动态增强扫描对急性肠系膜血管栓塞的诊断及时准确,应作为临床怀疑肠系膜血管疾病首选检查方法,值得推广应用.     

64层螺旋CT对急性门静脉和肠系膜上静脉血栓的诊断价值

目的 探讨64层螺旋CT对急性门静脉和肠系膜上静脉血栓的诊断价值.资料与方法回顾性分析经手术及临床确诊的19例急性门静脉和肠系膜上静脉血栓形成患者的64层螺旋CT表现.19例均行平扫,14例加行增强扫描,并应用多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)和容积再现(VR)行多层螺旋CT血管成像(MSCTA).结果 19例平扫均显示门静脉和肠系膜上静脉增粗,12例肠系膜周围脂肪密度增高,13例管腔内高密度,10例有不同程度腹腔积液,14例肠管扩张、积气积液,10例肠壁增厚水肿;14例增强扫描均显示静脉内低密度充盈缺损,门静脉和肠系膜上静脉管壁环形强化,肠管管壁强化呈"靶征",3例肠管未强化,5例显示肝脏一过性供血不足,门静脉期供血减少.结论 64层螺旋CT平扫及增强扫描,以及三维重组技术相结合能够早期发现急性门静脉和肠系膜上静脉血栓形成.     

多层螺旋CT在肠系膜静脉血栓诊断中的应用

目的探讨多层螺旋CT(MSCT)对肠系膜静脉血栓形成诊断的价值。方法回顾性分析8例诊断为肠系膜静脉血栓形成的平扫及增强MSCT表现,其中1例手术证实。结果8例患者MSCT检查均显示不同程度的腹腔积液,肠系膜周边脂肪密度增高,肠系膜上静脉增宽。7例平扫密度增高,其中2例血栓累及门静脉,5例出现肠管扩张、积气积液,5例出现肠管管壁增厚。增强后,肠系膜静脉管壁环形强化,肠管管壁强化呈“靶征”,1例肠管未见强化。抗凝治疗后,1例血栓基本消失,3例肠系膜静脉建立侧枝循环。结论MSCT增强扫描与三维重建技术相结合能早期发现肠系膜静脉血栓形成,它是一种有效、无创的影像学检查手段。     

胰岛细胞瘤的CT表现与鉴别诊断

目的：探讨CT在胰岛细胞瘤诊断和鉴别诊断中的价值。资料与方法：回顾性分析10例经病理证实的胰岛细胞瘤CT表现并对CT检查方法进行比较。其中常规CT扫描并增强6例，螺旋CT扫描并双期增强扫描4例。结果：胰岛素瘤5例，大小为0．9－2．0cm。3例常规CT平扫并增强扫描未发现肿瘤，2例螺旋CT平扫为等密度，增强扫描在动脉期为高密度，门脉期为等密度。无功能性胰岛细胞瘤5例，大小为2．0－6．0cm，其中3例常规CT平扫，1例未发现肿瘤，2例呈不均匀密度，均匀稍高密度；增强扫描呈周边明显强化，中心稍强化、均匀强化；2例螺旋CT平扫呈不均匀密度，双期增强呈周边强化，不均匀强化。结论：CT检查对于＞2cm的胰岛细胞瘤有较大的诊断价值，而对于＜2cm的肿瘤检查方法直接影响病变的检出。     

急性肠系膜血管梗塞的CT表现

目的评价CT对急性肠系膜血管梗塞（AMI）的诊断价值。方法搜集AMI病例10例，男6例，女4例，平均年龄67．2岁。除1例在诊断次日死亡外，其余均经手术病理证实。其中肠系膜上动脉（SMA）梗塞4例，肠系膜上静脉梗塞（SMV）5例，肠系膜下静脉（IMV）梗塞1例。除1例行CT平扫外，其余9例均行CT平扫及增强扫描，详细分析其影像学表现。结果直接征象为血管内充盈缺损（8例）。间接征象包括肠腔扩张积液（4例）、肠壁增厚（6例）、薄纸样肠壁（4例）、缆绳征（5例）、肠系膜积液（3例）、肠壁积气（2例）、门静脉积气（1例）及腹腔积液（3例）。结论CT是诊断急性肠系膜血管梗塞的一种快速、敏感、可靠及无创伤的影像学方法。     

小肠缺血性肠病的多层螺旋CT诊断

目的：分析小肠缺血性肠病的多层螺旋CT表现，以提高其CT诊断水平。材料和方法：收集本院19例最终诊断为小肠缺血性肠病并行CT检查的患者，分析其CT表现及病因。除4例急诊检查外，其余15例检查前均口服2．5％等渗甘露醇1000—1500ml作为肠道对比剂，每一例均行平扫、动脉期和静脉期增强扫描，15例行冠状面最大密度投影（MIP）和多平面重组（MPR）后处理。结果：CT表现为肠壁增厚16例（84％），分层强化呈靶征14例（占增厚肠壁87．5％），肠壁菲薄、无强化2例，肠腔扩张、积气、积液14例（73．7％），肠系膜浑浊15例（78．9％），腹水13例，肠壁积气3例，门静脉积气、肠系膜上动脉（SMA）充盈缺损、僵硬狭窄及肠系膜上静脉（SMV）闭塞各1例，肠系膜小血管充血（增粗、密集呈“梳征”）16例，缺血（变细、稀疏、强化减弱）3例。病因为系统性红斑狼疮（SLE）引起的血管炎7例，肠梗阻4例，SMA栓塞（均为房颤患者）、肠系膜扭转和外伤分别为2例，动脉粥样硬化、SMV血栓形成各1例。7例SLE均广泛累及十二指肠、空肠及回肠，其中5例同时累及结肠。结论：小肠缺血性肠病的多层螺旋CT表现为：①肠壁和肠系膜缺血：肠壁水肿、增厚、分层强化呈靶征，肠系膜浑浊，血管炎所致缺血性肠病常累及整个小肠及结肠；②肠系膜血管异常：SMA及SMV狭窄或闭塞，肠系膜小血管充血或缺血。     

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.