视神经肿瘤的MRI诊断

目的:探讨视神经肿瘤的MRI表现。方法:回顾了18例经MRI检查并经临床病理确诊的视神经肿瘤的病例。结果:视神经脑膜瘤8例,表现为视神经增粗1例,梭形肿块5例,软组织肿块2例。MR T1WI呈等或稍低信号,T2WI呈高信号。视神经胶质瘤6例,表现为视神经梭形增粗2例,椭圆形肿块4例,MR T1WI呈等信号,T2WI呈高信号。视神经转移瘤4例,3例为视网膜母细胞瘤累及视神经,MRI表现为眼球内病变侵犯视神经和视交叉,T1WI呈稍低信号,T2WI呈稍高信号;1例为乳腺癌转移至视神经,MRI表现为视神经椭圆形增粗,T1WI呈等信号,T2WI呈高低混杂信号。结论:MRI是检查和诊断视神经肿瘤的重要检查手段,对大多数病变可做出明确诊断。     

眼球脉络膜血管瘤的影像学表现

目的：探讨眼球脉络膜血管瘤的CT、MRI表现及其诊断、鉴别诊断价值。方法：回顾性分析9例经病理（3例）和临床证实（6例）的脉络膜血管瘤。CT扫描6例，MR检查4例，9例均行B超检查，3例作了眼底荧光血管造影。结果：2例CT平扫示眼球后极球壁轻度或新月形增厚，与球壁呈等密度，5例（1例平扫＋增强）增强示眼球后极部高密度梭形或扁平状隆起均匀肿块，瘤体强化明显。与玻璃体比较3例MR T1WI呈高信号，T2WI呈低信号，与视神经、眼外肌相比呈等信号；1例较小肿瘤辅以增强T1WI脂肪抑制技术被清楚显示。渗出性视网膜脱离在T1WI、T2WI上均呈中、高信号；增强T1WI瘤体显著强化，边界清晰，且信号均匀。B超检查8例为实质不均质肿块占位，1例为均质肿块占位，9例均探及视网膜脱离光带。结论：CT＋MRI＋B超检查对脉络膜血管瘤可得到较为全面的影像学诊断资料，MRI在该病的诊断及鉴别诊断中较CT及B超更具敏感性和特异性。     

眼球脉络膜转移癌的影像学

描述脉络膜转移癌的CT和MRI表现，对两种检查方法进行评估。材料和方法：回顾性分析经手术病理证实的9例脉络膜转移癌病例，其中7例经CT扫描检查，3例作MRI检查。结果：CT扫描显示眼球后部呈扁平状，均质中高密度肿块，有中度增强。MRI检查为扁平或半月状肿块，T1W呈高于玻璃体中等信号，PDW为高信号，T2W呈低信号。瘤体表面渗出性视网膜脱离在T1W和T2W均呈高信号。结论：CT和MRI对脉络膜转移癌等眼球内病变均可作出定位的影像学诊断。MRI对脉络膜转移癌与脉络膜黑色毒瘤的鉴别、瘤体内结构、与渗出性机网膜脱离的区分以及癌肿侵犯巩膜的情况较CT为优。     

副肿瘤性边缘叶脑炎的临床及MRI特征

【摘要】目的：探讨副肿瘤性边缘叶脑炎（PLE）的MRI特征。方法：回顾性分析8例经临床诊断治疗的PLE的临床及MRI资料。所有患者均行常规MRI平扫及DWI检查,其中6例行增强扫描。结果：①8例病变分布均以海马及海马旁回为主,其中3例可见病变同时累及双侧杏仁核、2例累及双侧扣带回、1例累及左侧岛叶、1例累及桥脑。病变双侧对称分布7例,单侧发病1例。②信号特征：6例病变于T1WI上呈较均匀稍低信号,T2WI呈高信号,DWI呈稍高或等信号;2例于T1WI呈等信号,T2WI呈稍高信号,DWI呈等信号;所有病灶在FLAIR图像上均呈高信号。6例行增强扫描,5例病变无强化,1例可见小片状轻度强化。结论：PLE具有较典型的临床及MRI特征,应结合抗体检测及其它全身检查,积极寻找原发肿瘤进行综合治疗。     

虹膜睫状体肿瘤的MRI诊断探讨

目的 分析虹膜睫状体肿瘤的MRI表现,评价虹膜睫状体肿瘤MRI诊断价值.方法 回顾分析8例虹膜睫状体肿瘤MRI表现;8例均行MRI平扫,4例行MRI增强.结果 3例睫状体上皮腺瘤MRI均表现为与晶状体相连的类圆形软组织结节,T1WI和T2WI呈中等信号,MRI增强结节强化.2例睫状体黑色素瘤MRI表现为虹膜睫状体区不规则软组织结节,T1WI呈高信号,T2WI呈低或中等信号.1例虹膜淋巴瘤表现为晶状体、虹膜睫状体和前房内不规则软组织肿块,T1WI和T2WI均呈中等信号.1例虹膜血管平滑肌瘤表现为眼环前部类圆形结节,T1WI和T2WI均呈中等信号,MRI增强结节强化,同时合并视网膜脱离.1例睫状体神经纤维瘤MRI表现为晶状体附近类圆形结节,形状规则、边缘光滑,T1WI和T2WI呈均匀中等信号.结论 MRI可以显示虹膜睫状体肿瘤的大小、部位和种类,可以作为虹膜睫状体肿瘤影像学检查的主要方法.     

眼球脉络膜黑色素瘤的CT和MRI表现

目的:分析眼球脉络膜黑色素瘤的CT和MRI表现,并探讨其在诊断和鉴别诊断中的价值.材料和方法:回顾性分析经手术和病理证实的25例眼球脉络膜黑色素瘤,其中CT扫描13例,MRI检查7例,CT加MRI检查5例.结果:本组仅1例肿瘤侵及球外,其余均局限于眼球内.3例为梭形,21例为蘑菇形.CT平扫密度较均匀,接近眼环密度;增强后12例呈明显均匀强化,3例不均匀强化.1例伴有斑片状钙化.14例显示肿瘤的一侧或两侧周边区半月形视网膜剥离.与玻璃体比较T1WI呈高信号,T2WI呈低信号.10例显示视网膜剥离,渗液在T1WI、T2WI上均呈中高信号.增强后T1WI示瘤体中等至明显强化,周边积液未见强化,仅1例周边积液显示中等强化.结论:CT与MRI均能显示眼球内的病灶,MRI对该病的诊断及鉴别诊断优于CT且具有特征性.     

椎管内髓外硬膜下肿瘤的MRI诊断

目的：探讨MRI对椎管内髓外硬膜下肿瘤的诊断价值以及与髓硬膜外肿瘤的鉴别。资料与方法：分析经手术病理证实的10例髓硬膜下肿瘤的MRI表现。结果：MRI定位正确率100％。5例神经鞘瘤T1WI呈略高于脊髓信号，增强扫描后肿瘤信号呈中高程度强化，3例见有神经孔扩大，其中1例位于腰骶部椎管内，呈串珠状，2例神经纤维瘤与神经鞘瘤信号相仿，2例脊膜瘤T1WI呈低或等信号，T2WI呈高或等信号，增强扫描呈明显的异常强化，1例脂肪瘤T1WI及T2WI均呈略高信号，增强扫描后无明显强化。结论：根据椎管内髓外硬膜下原发肿瘤的MR表现，可准确定位并可推测其病理类型。     

木村病MRI征象分析

【摘要】目的：探讨不同部位木村病（KD）的临床和MRI特征。方法：回顾性分析本院14例经病理证实的木村病患者的临床及MRI资料。结果：14例患者外周血嗜酸性粒细胞数均增高，1例骨髓细胞学嗜酸性粒细胞增高，8例伴有皮肤瘙痒症状，1例伴有全身粟粒样红色丘疹。病变单双侧发病各7例，累及头颈部12例（其中累及腮腺区7例，耳后区1例，颌面部2例，眼眶2例）、腹股沟区1例、肘关节1例。病变的MRI表现可分为多发结节型（3例）或弥漫肿大型（11例）。多发结节型：边界清楚，T1WI上呈低或等信号，T2WI上呈稍高或高信号，DWI上呈高信号，增强扫描病变呈明显均匀强化；弥漫肿大型：T1WI上呈稍低或等信号，T2WI上呈混杂稍高信号，DWI上呈不均匀稍高信号，增强扫描病变呈不均匀中度强化。反应性增生的淋巴结均呈明显强化且DWI上呈高信号。结论：DWI和增强扫描在木村病的诊断中可对常规MRI提供重要的补充信息，结合患者的血常规检查和临床症状，可进一步提高诊断准确性。     

骶前间隙肿瘤的MRI诊断

目的：了解骶前间隙肿瘤的MRI表现特征。方法：分析73例骶前间隙肿瘤的MRI表现，包括纤维脂肪血管瘤、未分化癌和淋巴瘤各1例，畸胎瘤和骨巨细胞瘤各3例，神经源性肿瘤18例，骶尾部脊索瘤22例，转移瘤24例。结果：畸胎瘤含脂肪、纤维和液体等成分；纤维脂肪血管瘤含有粗大血管；骨巨细胞瘤呈溶骨性破坏，1例在T2WI有液－液平面；神经源性肿瘤通过骶孔与骶管内病变相连，神经节母细胞瘤和神经外胚层瘤破坏孔；9例脊索瘤在T2WI有条状低信号纤维结构和高信号粘液基质；未分化癌和淋巴瘤T1WI呈略低信号，T2WI呈略高和较高信号；19例转移瘤有多处骨骼破坏，5例只有骶椎侵犯。结论：MRI可清楚地显示骶前间 隙肿瘤的部位和范围，其中多数肿瘤可以定性。     

手部常见软组织肿瘤的MRI表现

目的 :探讨手部常见软组织肿瘤的MRI特点。方法 :对53例经病理确诊的手部常见软组织肿瘤的临床资料及MRI特点进行回顾性分析,53例均行MRI平扫,其中38例行MRI增强扫描。结果:53例中腱鞘巨细胞瘤17例,血管瘤12例,血管球瘤11例,腱鞘囊肿8例,脂肪瘤5例。MRI表现:腱鞘巨细胞瘤T1WI多呈等低信号,T2WI呈高低混杂信号,边缘多可见低信号包膜影,增强扫描多明显强化;血管瘤T1WI多呈以稍高信号为主的混杂信号,PDWI多呈不均匀高信号,瘤内多可见出血,增强扫描不均匀明显强化;血管球瘤T1WI呈等低信号,PDWI呈高信号,增强扫描明显均匀强化;腱鞘囊肿T1WI呈稍低信号,PDWI呈高信号,部分瘤内可见线状低信号分隔影,增强扫描包膜强化;脂肪瘤T1WI呈高信号,PDWI及STIR呈低信号。结论 :手部常见软组织肿瘤多具有典型的MRI表现,MRI可作为诊断手部软组织肿瘤的首选方法。     

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.