翼腭窝解剖及病变的CT与MRI对照研究

目的:研究翼腭窝(PPF)及其交通的解剖和病变影像特征。方法:4具尸体头颅冰冻切片与同层CT及MRI对照,1例行大体解剖;50例志愿者和79例患者分别行正常PPF和病变PPF影像检查。结果:PPF内充填脂肪,窝内神经、血管表现为低密度脂肪内点条状软组织密度影或高信号脂肪内稍低或流空信号。本组8例CT与5例MRI仅显示呈短条或斑点状的翼腭神经节的可疑影像。有3例4侧圆孔及9例16侧翼管走行于蝶窦内,1例1侧圆孔出颅后未汇入PPF而进入同侧翼板。翼腭管长度为(12.88±1.82)mm;79例病变中肿瘤71例(继发肿瘤69例),其中继发恶性肿瘤62例,浸润性破坏骨壁,直接或间接侵犯PPF,边界不清。12例继发恶性肿瘤致PPF扩大,其中鼻咽癌10例,PPF扩大程度较小且常伴骨壁的溶骨性破坏。原发性和继发性纤维血管瘤增强CT及T2WMRI显示边界清楚,PPF明显扩大,骨破坏呈压迫性。病变PPF内脂肪变模糊,部分或全部消失。1例鼻腔囊腺癌呈结节状神经周跳跃转移海绵窦及Meckel腔区。结论:PPF内充填脂肪,PPG影像难以清楚显示,翼腭管长度能在CT上测量,圆孔及翼管位置可变异;PPF病变以继发恶性肿瘤为主,窝内脂肪变模糊、消失常提示受侵。恶性肿瘤可使PPF稍扩大,也可沿交通内神经周转移。     

颞下窝病变CT MRI诊断

本文报告了87例经病理证实颞下窝病变CT或MRI表现,发现该窝病变以继发肿瘤为主（79/87）,也可见于炎症（4/87）,原发肿瘤少见（4/87）。继发侵犯可来自窝壁各方向,但以鼻咽癌内侧壁、上颌窦癌前壁侵入为主。文内讨论了颞下窝解剖定位及继发侵犯的改变特点,指出横切CT和MRI对观察颞下窝病变具有基本等同诊断作用,并应为首选扫描方位。     

鼻腔和鼻旁窦腺样囊性癌的影像学表现

目的：分析鼻腔鼻旁窦腺样囊性癌的影像学表现，评价其临床价值。资料与方法：回顾分析临床病理证实的鼻腔鼻旁窦腺样囊性癌25例，CT检查23例，其中CT平扫5例，增强扫描3例，平扫加增强扫描15例；MR扫描3例，均为平扫加增强扫描。结果；肿瘤原发于鼻腔5例，上颌4例，筛窦2例，蝶窦1例，其余3例为鼻腔筛窦和鼻腔上颌窦肿块。肿瘤侵及范围包括鼻腔，上颌窦，筛窦，蝶窦，翼腭窝，颞下窝，眼眶，硬腭，眶下裂，圆孔，海绵窦等。窦腔呈膨胀性扩大和骨壁侵蚀性吸收破坏，并沿三叉神经分支润蔓延（表现为软组织侵及翼腭窝，眶下裂，圆孔，海棉窦等）。CT检查23例，其中20例表现为肿块内有低密度囊变区，占86％；2例肿块内有钙化，占8％；1例肿块密度较均匀。结论：鼻腔鼻旁窦腺样囊性癌多表现为圆形或类圆形肿块，肿块内有大小不等低密度囊性区，窦腔呈膨胀性扩大和骨壁呈侵蚀性吸收破坏，并有沿三叉神经浸润蔓延的特性。     

鼻咽和咽旁邻近或远处肿瘤累及该区的CT分析

目的提高鼻咽和咽旁邻近或远处肿瘤累及该区的认识水平.方法搜集31例,除1例经病史和同位素扫描诊断外,其余经手术或活检病理确诊.常规采用轴位CT平扫,18例加作增强,5例加作冠状位扫描.详细分析了它们的CT表现.结果31例中,来自鼻腔者9例,其中3例内翻乳头状瘤和1例嗅神经母细胞瘤边界清楚,其余恶性肿瘤境界不清,有2个以上部位骨破坏;上颌窦齿槽恶性肿瘤13例,膨胀性生长,均破坏上颌窦外后壁侵及颞下窝,有11例上颌窦顶部破坏,其中8例累及翼腭窝;口咽扁桃体癌3例,沿咽侧壁向上蔓延,1例侵犯颞下窝;下颌骨透明细胞癌、转移瘤和造釉细胞瘤各1例,肿块占据颞下窝;颈部血管肉瘤1例,向上经茎突后内侧累及咽旁区;外耳道癌1例,破坏周围骨质,蔓延至咽旁区和鼻咽;蝶骨大翼转移瘤1例,膨胀性生长,直接向颅内和咽旁扩展.结论根据CT表现,多数肿瘤可明确原发部位,作出诊断.     

副鼻窦原发恶性肿瘤的CT诊断（附29例报告）

副鼻窦的原发恶性肿瘤在临床上并不少见,多数病变起源于上颌窦,筛窦和蝶窦的恶性肿瘤相对少见,常规X线平片和断层仅能显示窦腔的均匀高密度影和较明显的骨壁破坏。CT不仅能显示副鼻窦内的软组织肿块,各窦壁的骨质破坏程度及病变向颞下窝、翼腭窝、     

上颌窦区肿瘤的影像鉴别诊断

目的结合上颌窦区3种肿瘤的影像特征,提高上颌窦区肿瘤的鉴别诊断能力。方法通过观察对比上颌窦区腺样囊性癌、神经纤维瘤和骨化性纤维瘤(各1例)的临床特点及CT、MRI表现,分析上颌窦区肿瘤的影像表现异同点。结果上颌窦腺样囊性癌表现为边界不清,受累窦壁骨质呈溶骨性骨质破坏,MRI呈混杂T_1、T_2信号,不均匀强化。翼腭窝神经纤维瘤表现为边界清,邻近骨质呈压迫性骨质吸收,MRI呈混杂等长T_2信号,增强扫描呈不均匀强化。骨化性纤维瘤表现为边界清,窦壁骨质呈膨胀性改变,有骨性包壳,MRI呈混杂T_1、T_2信号,不均匀强化。结论骨质改变是上颌窦区肿瘤鉴别诊断的关键点,最终诊断需要结合临床、CT和MRI表现。     

颌骨囊肿和肿瘤CT、MRI比较研究

目的:探讨颌骨囊肿、肿瘤CT和MRI的影像表现,比较两种方法的诊断价值及其在临床应用中的意义.方法:回顾分析46例、共49个经病理证实的颌骨囊肿和肿瘤的影像资料.所有病例均行CT和MRI检查,其中增强7例.将病变两种检查方法的表现特征进行分类对比,比较各自显示病变的优劣和诊断价值.结果:CT在评价病变与周围牙齿关系方面优于MRI(P＜0.001).对下颌神经管受侵(P＜0.01)、病变范围和髓腔侵犯的评价MRI优于CT.CT和MRI在评价病变边界、病变与周围骨皮质关系、病变与上颌窦关系及周围软组织侵犯方面价值相近(P＞0.05).结论:CT和MRI可准确显示颌骨病变的部位、范围和病变特征,二者相结合,可提高对颌骨病变诊断和评估的准确性.CT仍是显示颌骨病变的基础手段;对于恶性肿瘤和肿瘤复发,MRI检查非常必要.     

上颌窦炎性假瘤的CT和MRI表现(附3例报告)

目的 探讨上颌寞炎性假瘤的CT和MRI表现特征.资料与方法 回顾性分析3例经病理证实的上颌窦炎性假瘤的影像资料,3例均同时行CT及MRI平扫及增强扫描.结果 发生于左、右侧上颌窦各1例,发生于双侧上颌窦1例.CT表现为窦腔充满等密度软组织肿块;窦壁骨质弥漫硬化、增厚,伴发"虫蚀"样骨质吸收、破坏,1例眼眶受侵,1例翼腭窝、颞下窝受侵.MRI表现为与脑实质比较,窦腔肿块T1WI呈等信号,T2WI呈不均匀低信号,增强扫描1例病灶呈轻度不均匀强化,2例病灶呈中等度不均匀强化.结论 窦壁增厚、硬化,伴"虫蚀"样骨质吸收、破坏,T2WI上病变呈不均匀低信号为上颌窦炎性假瘤的特征性表现.CT和MRI联合应用能够对其诊断和治疗提供更全面的信息.     

恶性副鼻窦病变的CT诊断及鉴别诊断

作者在20000例CT检查中发现副鼻窦恶性肿瘤15例。多数为上颌窦肿瘤(87％),其中癌10例,非何杰金氏淋巴瘤4例,黑色素瘤1例。CT所见副鼻窦中癌的形态为边缘不规则,窦腔阻塞,多数为均匀软组织密度,及特有的隆起,几乎均破坏骨壁,偶然肿瘤内可证实有骨块,一般广泛浸润邻近部位。多侵犯筛窦及眼眶,额窦及蝶窦较少,最后侵达颅底及颅内。造影后颅内肿瘤影象加重,特别有利于肿瘤的显示。颞下窝及/或蝶颚窝受累知肿瘤主要侵犯背内侧,向腹下侧侵犯时,硬颚、齿槽     

上颌窦癌骨破坏的X线分析

作者分析了10例上颌窦扁平上皮癌病人的X线片。年龄34～80岁,男9例,女1例。10例中有7例鼻出血、颊部肿胀等,考虑为上颌窦癌征象,单纯X线平片不能明确骨破坏,经CT检查有5例可见骨形破坏。此组病例行X线摄影(Caldwell位及Waters位)、断层摄影(鼻额位,矢状位)及CT检查,并以上颌窦为中心部位分析比较肿瘤影和骨壁状态。各种X线摄影在1～2周内完成,可以不考虑肿瘤的大小变化。X线平片可观察上颌窦外侧壁状态、上颌窦面积、内侧壁及眶窝下缘;断层摄影可分析上颌窦外侧壁、内侧壁、眶底及前壁状态;CT扫描同样亦观察外侧壁、内侧壁、眼眶底、前壁四面的状态。并可通过X线平片的骨壁影象比较两侧上颌窦面积。结果表明:X线摄影能够检查出完全性骨破坏,而不完全性骨破坏则有可能漏诊。这     

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）