颅内孤立性纤维瘤的影像学和病理学特征

目的探讨颅内孤立性纤维瘤的影像学和病理学特征。方法回顾性分析4例经手术病理证实颅内孤立性纤维瘤的MRI表现以及病理学资料,并结合文献复习。结果肿瘤发生在幕上3例,跨越幕上和幕下1例。肿瘤主体T_1WI呈等信号,T_2WI呈等/低或稍高信号,1例病灶内伴有囊变、坏死,2例病灶内有流空信号,瘤周无水肿或轻度水肿。增强后均明显强化,2例见脑膜尾征。免疫组织化学检查CD34、CD99以及Vim均为阳性,S-100为阴性。结论颅内孤立性纤维瘤MR表现有一定特征性,瘤内出现粗大的流空信号、T_2WI低信号区明显强化是具有诊断价值的征象,最终确诊需依靠免疫组织化学检查。     

颅内孤立性纤维瘤的CT和MRI表现

目的分析颅内孤立性纤维瘤的CT和MRI表现,提高对其认识。资料与方法回顾性分析5例经手术病理证实的颅内孤立性纤维瘤的CT和MRI表现。1例行CT增强扫描,3例行MRI平扫和增强扫描,1例同时行CT和MRI扫描。结果 5例颅内孤立性纤维瘤均为单发,肿块形态不规则,边界清楚,直径1.2～6.5 cm。发生于颞叶1例,鞍内1例,桥小脑角区1例,中后颅窝三叉神经走行区1例,顶叶1例。CT平扫病灶均为高密度,增强扫描均匀强化。MR T1WI上3例病灶为等信号;1例为多发分隔囊状低信号。T2WI上3例病灶表现为等、低混杂信号,病灶内见少量斑片状高信号;1例为多发分隔囊状高信号。MRI增强所有病灶实质部分显著强化,T2WI低信号区明显强化,坏死囊变区未见强化。结论颅内孤立性纤维瘤MRI表现有一定的特点,MR T2WI上低信号、增强扫描呈显著强化较具特征。     

中枢神经系统孤立性纤维瘤的MRI特点

目的 探讨中枢神经系统孤立性纤维瘤的影像学特征.方法 10例经手术病理证实的孤立性纤维瘤行T1WI、T2WI及增强扫描,且颅内者行DWI检查,椎管内者行STIR检查,分析其部位、形态、瘤周水肿、信号特点、强化程度、邻近颅骨改变等.结果 颅内病变多位于幕下,椎管内病变多位于胸段.肿瘤多呈等或稍长T1、等或稍长或短T2信号,肿瘤呈“黑白相间征”及“黑白反转征”是其特点,DWI多呈等低信号,多无明显水肿,增强扫描明显强化.“脑膜尾征”或“脊膜尾征”少见,邻近骨质受累少见,3例受压变薄.结论MRI对颅内孤立性纤维瘤的诊断及鉴别诊断有重要价值.     

颅内孤立性纤维瘤的MRI表现

目的:探讨颅内孤立性纤维瘤(I-SFT)的MRI表现。方法:回顾性分析8例经手术病理证实的I-SFT的MRI及病理学资料。结果:肿瘤发生在幕下2例,幕上3例(其中侧脑室内1例),跨越幕上及幕下2例,鞍区1例。1例鞍区肿瘤在T1WI、T2WI上呈均匀等信号,其余7例信号不均,T1WI、T2WI上以等、稍高信号为主,其中5例T2WI见小斑片状低信号区,3例见囊变灶,5例病灶内可见粗大流空血管影。MRI增强扫描示8例均明显强化;鞍区肿瘤强化均匀,其余7例强化不均;5例T2WI低信号区明显强化,3例囊变区未见强化,2例可见脑膜尾征。除侧脑室内1例周围脑实质水肿明显外,其余7例无或轻度水肿。病理显示8例均见丰富的小梭形细胞;免疫组化显示CD34(~),CD99(+),Bcl(+),Vimentin(+),EMA(-)。结论:I-SFT的MRI表现有一定的特点,当脑膜肿瘤呈等、较高信号,增强呈明显强化,其内出现粗大流空血管、T2WI低信号区时,可考虑该病诊断,但其确诊仍需依靠组织病理学。     

颅内孤立性纤维瘤的影像表现

目的 探讨颅内孤立性纤维瘤(ISFT)的影像特征.方法 回顾性分析经病理及免疫组织化学证实的10例ISFT患者的CT及MRI表现.所有患者均行MR平扫及增强扫描,其中4例行CT平扫.结果 所有病例术前均误诊为脑膜瘤,5例位于幕上、4例位于幕下、1例同时生长于幕上及幕下.所有病变均起源于颅内硬脑膜,8例肿瘤边缘可见明显分叶或浅分叶.4例CT检查均呈稍高密度,1例压迫颅底骨质致骨质吸收.仅1例可见包膜点样钙化,所有病灶实质内均未见钙化.T1WI以等、稍高信号为主,4例病灶信号均匀、6例信号不均.T2WI 2例病灶呈均匀等信号及低信号,4例表现为等、稍高或低信号相间,2例合并囊变,2例可见稍高T2信号及低T2信号两部分,呈所谓“阴阳征”.增强扫描所有病灶均明显强化,8例强化不均匀,低T2信号区域可见明显强化,4例出现“脑膜尾征”.结论 ISFT影像表现具有一定特点,当脑外肿瘤明显分叶,T2WI信号不均,存在低T2信号区域并明显强化,“脑膜尾征”较少或轻,无颅骨增厚等征象时有助诊断,典型“阴阳征”提示孤立性纤维瘤可能性大.     

侵蚀性纤维瘤病的MRI诊断

目的分析侵蚀性纤维瘤病的MRI表现,探讨MRI对该病的诊断价值.资料与方法回顾性分析11例经手术及病理证实的侵蚀性纤维瘤病的MRI表现.结果全部病例肿块均沿肌纤维浸润性生长,累及多块肌肉.8例无包膜,1例包膜不完整,2例可见假包膜;8例可见斑片状T1WI、T2WI低信号;4例可见T1WI、T2WI与肌肉等信号区域;增强扫描肿块不同程度强化;而T1WI、T2WI低信号以及与肌肉等信号区域不强化.全部病例瘤周未见水肿,瘤内未见坏死囊变区. 结论侵蚀性纤维瘤病的MRI表现有一定的特征性,MRI检查对该病的定性诊断与鉴别诊断有重要的价值.     

颅内血管外皮细胞瘤的MRI诊断

目的:探讨不同级别颅内血管外皮细胞瘤(HPC)的MRI特征,提高对该病的认识及术前诊断的准确性。方法:回顾性分析9例经手术和病理证实的不同级别颅内HPC的MRI征象。结果:9例患者中,8例位于颅内脑外,1例位于侧脑室内。WHOⅡ级HPC 5例,呈类圆形,边界清,瘤周水肿不明显,无相邻骨质破坏,2例与硬脑膜以窄基底相连,2例见"脑膜尾征";WHOⅢ级间变型HPC 4例,呈分叶状及不规则形,边界不清,瘤周水肿明显,有囊变、坏死,以窄基底与硬脑膜相连,2例相邻骨质破坏。肿瘤实性部分T1WI呈等或略低信号,T2WI为等或略高信号,DWI图像呈略高信号,内部囊变坏死呈长T1长T2信号,DWI图像呈低信号,增强扫描不均匀强化。7例瘤周或瘤内见流空血管影。结论:术前磁共振检查可为颅内HPC的临床诊断、治疗及判断预后提供帮助。     

卵巢卵泡膜瘤-纤维瘤的MRI诊断

目的:探讨卵巢卵泡膜瘤-纤维瘤的MRI特点及其诊断价值。方法:回顾性分析经手术病理证实的12例卵泡膜瘤-纤维瘤的MRI表现。结果:12例卵泡膜瘤-纤维瘤中,卵泡膜细胞瘤4例,卵泡膜纤维瘤6例,纤维瘤2例。肿瘤最大径2.0～13.6cm,平均5.2cm。肿瘤呈圆形8例,卵圆形4例。全部肿瘤边界清楚,8例可见包膜显示。肿瘤信号均匀8例,小囊变3例,大囊变1例。所有肿瘤T1WI呈低或稍低信号(与子宫对比);卵泡膜细胞瘤T2WI呈高或稍高信号,卵泡膜纤维瘤T2WI呈低信号5例,稍高信号1例;纤维瘤T2WI呈低信号;所有肿瘤增强后均轻度强化。结论:卵泡膜瘤-纤维瘤的主要MRI表现为良性实性肿瘤的形态学特征及少血供的强化特点,肿瘤T2WI呈低信号结合少血供的强化特点对卵泡膜纤维瘤及纤维瘤的诊断具有重要定性诊断价值。     

韧带样纤维瘤病MRI特征表现及其病理基础

目的：探讨韧带样纤维瘤病（DF）的MRI特点,重点分析MRI特征影像及其病理基础,评价MRI在DF诊断中的价值。方法回顾性分析经手术病理证实14例韧带样纤维瘤病的MRI表现（14个病灶均行M RI增强及延迟扫描）,与术后病理结果进行比较,并探讨M RI特征影像的病理基础。结果14例均为单发病灶（腹外型7例、腹壁型4例、腹内型3例）,其中有2例为术后复发,肿瘤沿着肌肉长轴生长。T1 WI呈等或稍低于肌肉的信号,T2 WI呈高于肌肉信号,增强扫描病灶均呈不均匀强化,以延迟强化为明显,病灶内可见条状或带状 T1 WI及 T2 WI低信号,增强后未见强化。14例病灶内均未见坏死、囊变及瘤周水肿。病理组织学上肿瘤由不同比例的成纤维细胞、纤维组织和胶原纤维束组成,纤维细胞及成纤维细胞密集区域T2 WI信号增高,而肿瘤内胶原纤维区域在 T1 WI、T2 WI均为低信号。肿瘤内见较多血管壁完整的毛细血管,这是病灶延迟强化的病理基础。结论病灶内可见T1 WI、T2 WI均呈带状低信号且增强扫描不强化以及病灶延迟强化是DF的特征性MRI表现。MRI可以很好评估肿瘤侵犯范围及其与周围结构的关系,有助于DF的诊断和鉴别诊断。     

脑内节细胞胶质瘤的MRI征象

目的：探讨颅内节细胞胶质瘤的MRI征象.方法：回顾性分析16例经手术和病理证实的脑内节细胞胶质瘤的MRI征象.结果：肿瘤位于大脑半球13例,其中位于颞叶6例,额叶4例,顶叶2例,枕叶1例;位于丘脑1例;位于鞍上区1例;位于四脑室1例.囊性病变2例,囊实性病变8例,实性病变6例.T1WI病变囊性部分呈低信号,实性部分呈低信号（n=9）或等信号（n=5）;T2WI囊性部分呈高信号,实性部分呈等信号或高信号;增强扫描示病变实性部分及壁结节明显或轻度强化,囊壁强化（n=4）或不强化（n=6）.结论：MRI检查可较好地显示肿瘤的部位、形态及其与邻近组织的关系,有助于对脑内节细胞胶质瘤的诊断及鉴别诊断.     

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.     

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）     

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.