阿尔茨海默病与血管性痴呆的胼胝体MR定量研究

目的　比较MR影像上阿尔茨海默病 (Alzheimer′sdisease ,AD)组、血管性痴呆 (vasculardementia ,VD)组、正常对照 (normalcontrol,NC)组胼胝体面积及胼胝体不同部位的厚度 ,为进一步探讨AD、VD的发病机理提供参考。方法　本研究 70例中AD 2 6例 ,VD 14例 ,年龄匹配的正常对照 3 0例。行磁共振扫描 ,取T1WI正中矢状面测量胼胝体面积及胼胝体前、前中、中、中后、后 5个部位的厚度。结果　AD组与VD组及NC组胼胝体标准化面积分别为 :(3 5 5± 0 5 2 )cm2 ;(3 48± 0 90 )cm2 ;(4 2 3± 0 43 )cm2 。AD组与VD组及NC组胼胝体前、前中、中、中后、后 5个部位标准化厚度分别为 :AD (5 3 4± 1 14)mm ,VD (5 5 3± 1 86)mm ,NC (7 0 6± 1 11)mm ;AD (2 5 3± 0 62 )mm ,VD (2 5 3±0 86)mm ,NC (3 46± 0 66)mm ;AD (2 85± 0 5 4)mm ,VD (2 84± 1 0 4)mm ,NC (3 5 4± 0 61)mm ;AD (2 0 1± 0 5 0 )mm ,VD (1 90± 0 72 )mm ,NC (2 49± 0 65 )mm ;AD (5 46± 0 96)mm ,VD (5 2 2±1 40 )mm ,NC (6 82± 1 0 2 )mm。AD组与VD组胼胝体前、前中、中、中后、后 5个部位的萎缩率分别为 :AD (2 4 3 6± 16 13 ) % ,VD (2 1 70± 2 6 3 5 ) % ;AD (2 6 75± 17 97) % ,VD (2 6 78± 2 4     

100例正常人脑底动脉直径的MR血管成像测量

目的　测量并建立国人正常脑底动脉直径磁共振血管成像 (MRA)正常值。方法　常规MR检查脑实质及脑动脉三维时间飞越法 ( 3DTOF)MRA检查脑底动脉表现无异常者 10 0例 ,其中男5 3例 ,女 47例 ,年龄 4～ 75岁 ,平均 45 8岁 ;≤ 14岁者 12例 ,>14岁者 88例。采用投影仪放大胶片间接测量法测量各脑动脉直径 ,分析其左右侧、年龄和性别上的差异性 ,并统计出各动脉直径的正常参考值。结果　各脑动脉直径测量值为 :眼动脉 (OphA)男为 ( 0 8± 0 2 )mm ,女为 ( 0 9± 0 2 )mm ;颈内动脉 (ICA)C2段男为 ( 3 0± 0 3)mm(≤ 14岁 )和 ( 3 5± 0 6 )mm( >14岁 ) ,女为 ( 2 8± 0 6 )mm(≤14岁 )和 ( 3 1± 0 5 )mm( >14岁 ) ;ICAC4段男为 ( 4 3± 0 6 )mm ,女为 ( 3 9± 0 6 )mm ;大脑前动脉(ACA)A1段男为 ( 2 1± 0 4)mm ,女为 ( 2 1± 0 4)mm ;前交通动脉 (ACoA)男为 ( 1 4± 0 4)mm ,女为( 1 3± 0 4)mm ;大脑中动脉 (MCA)M1段男为 ( 2 7± 0 4)mm ,女为 ( 2 6± 0 4)mm ;基底动脉 (BA)男为 ( 2 9± 0 5 )mm ,女为 ( 2 8± 0 4)mm ;大脑后动脉 (PCA)P1段男左为 ( 2 1± 0 5 )mm、右为 ( 2 0±0 5 )mm ,女左为 ( 2 0± 0 3)mm、右为 ( 1 9± 0 3)mm ;PCAP2段男为 ( 1 8± 0 4)mm     

低剂量螺旋CT肺部扫描对肺密度的评价

目的　探讨螺旋CT扫描剂量、层厚是否对肺密度有影响 ,以决定常规剂量螺旋CT扫描测得的肺密度值能否适用于低剂量螺旋CT。资料与方法　对 2 0名志愿者进行胸部螺旋CT扫描 ,采用 5种不同参数重复扫描 :低剂量 (5 0mA) ,层厚 8mm、5mm、3mm ;常规剂量 (2 0 0mA) ,层厚 5mm、3mm。分别在主动脉弓、气管隆突、下肺静脉干平面测量肺密度 (HU) ,计算不同剂量、层厚平均肺密度并进行统计学分析。结果　低剂量CT扫描 3种层厚中 8mm的肺密度值为 - 793± 4 5HU ,5mm为 - 80 0± 4 6HU ,3mm为 - 80 2± 5 1HU ,三者无统计学差异 (P >0 .0 5 ) ;层厚 5mm的肺密度值 ,低剂量为 - 80 0± 4 6HU ,常规剂量为 - 80 1± 37HU ,两者无统计学差异 (P >0 .0 5 ) ;层厚 3mm的肺密度值 ,低剂量为 - 80 2± 5 1HU ,常规剂量为 - 80 5± 4 9HU ,两者无统计学差异 (P >0 .0 5 )。结论　扫描剂量和层厚对肺密度没有显著影响 ,低剂量螺旋CT值可以参考常规剂量扫描测得的肺密度值来判断有无肺气肿等异常。     

颈髓CT横断面测量对脊髓型颈椎病的诊断价值初探

目的 :评价颈髓CT横断面测量对于诊断脊髓型颈椎病的应用价值。方法 :异常组选取 76例临床明确的脊髓型颈椎病的病人 ,正常 (对照 )组选取 6 8例临床排除脊髓型颈椎病及CT证实无椎管狭窄的正常人。全部进行C4～ 5　和C5～ 6　椎间盘螺旋CT扫描 ,并测量相关层面颈髓的矢状径和颈髓的横断面积。结果 :异常组的C4～ 5　椎间盘水平颈髓矢状径均值为 5 .90± 0 .78mm ,颈髓的横断面积均值为 76 .91± 11.5mm2 ,C5～ 6椎间盘水平颈髓矢状径均值为 5 .83± 0 .73mm ,颈髓的横断面积均值为 6 9.5 1± 10 .9mm2 ;正常组相对应的数据为 7.87± 0 .89mm ,95 .2 9± 12 .4mm2 ,7.75± 0 .82mm和 86 .35± 12 .0mm2 。上述两组数据两两比较有显著差异 (P <0 .0 0 1)。结论 :CT测量颈髓的矢状径和横断面积对于脊髓型颈椎病的诊断具有重要价值     

正常人内耳前庭、半规管及耳蜗的MRI测量

目的　利用高级快速自旋回波 (FASE)重T2 WI三维重建技术重建正常内耳膜迷路 ,建立内耳系统各主要结构的MRI测量正常值。方法　将 5 3例健康志愿者按年龄分为婴幼儿组、少年组、青年组、中年组和老年组 ,共 10 6只内耳分别行三维 ( 3D)FASE重T2 WI横断扫描。原始图像行最大强度投影 (MIP)重建 ,多角度旋转并测量内耳各主要结构的径线 ( 3个半规管高度和管径 ,耳蜗蜗高、底周直径和管径 ,前庭垂直径 ) ;行透视容积成像 (PVR)重建测量内耳液体容积。各观察指标就侧别、性别和年龄组间进行比较。结果　 ( 1) 3DFASE重T2 WI可清晰显示正常膜迷路结构和内听道内的神经 ;( 2 )内耳液体容积无年龄组间、侧别间差异 ,但男性 ( 0 2 42± 0 0 2 3 6)mm3与女性 ( 0 2 2 6±0 0 2 1)mm3间差异有非常显著性意义 (P <0 0 0 1)。 3个半规管高度、前庭垂直径无年龄组间、侧别间差异 ,但上半规管高度男性 ( 5 5 11± 0 62 6)mm与女性 ( 5 167± 0 3 5 7)mm间差异有非常显著性意义(P <0 0 0 1) ;水平半规管高度男性 ( 3 763± 0 495 )mm与女性 ( 3 44 6± 0 40 5 )mm间差异有非常显著性意义 (P <0 0 0 1) ;后半规管高度男性 ( 5 2 2 7± 0 5 47)mm与女性 ( 4 786± 0 5 0 0 )mm间差异有非常显著性意义 (     

(足母)外翻及正常足部的X线测量分析

目的 :通过外翻 (HV)和正常足部的X线测量分析 ,探讨外翻的发病机制及临床意义。方法 :对 118例正常人中 12 1足和 5 1例HV病人中 5 6足的外翻角 (HVA)、1～ 2跖骨间角、1～ 5跖骨间角和第 1跖骨长度与趾长度之比率进行测量 ,将测量数据进行统计学处理。结果 :正常足和HV病人测量结果分别为 :HVA 11.32°± 7.11°和 2 7.31°±6 0 3°,1～ 2跖骨间角 7.5 0°± 3.2 1°和 10 .2 1°± 3.5 6° ,1～ 5跖骨间角 2 1.80°± 7.6 0°和 2 7.92°± 9.80°,第 1跖骨长度与趾长度比值 1.13± 0 .0 9和 1.16± 0 .13。正常足男、女之间各种角度无统计学差异 (P >0 .0 5 ) ,正常足与HV病人的HVA、1～ 2和 1～ 5跖骨间角均有显著性差异 (P <0 .0 0 0 5 ) ,第 1跖骨长度与趾长度比值无差异 (P >0 .0 5 )。结论 :HV病人的首要X线表现为HVA增大 ,1～ 5跖骨间角增大是发生HV的主要基础 ,1～ 2跖骨间角增大是继发改变。HVA >2 0°,1～ 2跖骨间角 >10°是诊断和治疗HV的重要客观指标。     

胰腺多层螺旋CT灌注研究

目的　使用多层螺旋CT的肿瘤灌注软件 ,测量和评价正常胰腺和胰腺癌的CT灌注情况。方法　采用GELightspeedUltra多层螺旋CT的电影模式 ( 1s/周 ) ,5mm层厚 ,4层 ,12 0kV ,60mA ;采用高压注射器注射非离子型对比剂 50ml( 3 0 0mgI/ml) ,流率 3 5ml/s ,延迟 5s ,数据采集 45s。在SunUltraAW 4 0工作站使用Perfusion 2 (GE公司 )软件包 (去卷积算法 ) ,分别测量 3 7例正常胰腺和 3 7例胰腺癌及 3例无功能胰岛细胞瘤的血流量 (BF)、血容量 (BV)、平均通过时间 (MTT)和表面通透性(PS)的平均值 ,并进行统计学分析。结果　正常胰腺组的BF、BV、MTT和PS的平均值分别为 ( 3 3 86 2± 1596 1)ml·min- 1·kg- 1、( 2 67 3± 13 0 2 )ml·kg- 1、( 6 59± 2 59)s、( 2 88 2± 2 0 3 9)ml·min- 1·kg- 1。胰腺癌组的BF、BV、MTT和PS的平均值分别为 ( 2 3 2 3 1± 1841 2 )ml·min- 1·kg- 1、( 189 7± 160 6)ml·kg- 1、( 7 93± 3 92 )s、( 4 57 2± 2 61 6)ml·min- 1·kg- 1。胰腺癌组和正常胰腺组的BF、BV和PS的平均值差异具有显著性意义 (P值分别为 0 0 1、0 0 2 5和 0 0 0 3 )。胰腺癌和正常组织的MTT的平均值差异无显著性意义 (P =0 0 87)。结论　多层螺旋CT的胰腺灌注图像和数值比较容易获得。     

成人眼球结构的螺旋CT测量

目的　利用螺旋CT图像测量建立本地成人眼球结构CT测量正常参考值。资料与方法　对 2 6 0例CT扫描原始或重建图像进行眼球测量分析 ,测量指标包括眼球前后径、横径、前房轴深、晶体厚度、玻璃体腔径。用SPSS 11.0统计软件进行各测量指标在不同性别、年龄间的比较及眼球前后径与前房轴深、晶体厚度、玻璃体腔径相关性分析。结果　 (1)CT扫描图像能清晰显示眼球结构 ,边缘清晰。 (2 )除晶体厚度外 ,眼球各结构的CT测量值在不同年龄组中无显著性差异 ,男性眼球前后径、横径、前房轴深、玻璃体腔径值分别为 (2 5 .12± 0 .83)mm ,(2 5 .2 5± 0 .15 )mm ,(2 .71± 0 .5 1)mm ,(15 .77± 0 .81)mm ;女性为 (2 4 .4 8± 0 .79)mm ,(2 4 .5 4± 0 .84 )mm ,(2 .5 4±0 .4 5 )mm ,(15 .0 9± 0 .93)mm。晶体厚度男女间差异无显著意义 ,但各年龄组间有差异。 70岁前晶体厚度随年龄增长而增厚。玻璃体腔径与眼轴长显著正相关。结论　首次制定了本地成人不同性别眼球各结构的CT测量正常参考值 ,并发现除晶体厚度外 ,眼球各径线测量值男性均大于女性。 70岁前晶体厚度随年龄增长而增厚     

多层CT仿真支气管镜成像参数的优化

目的　探讨合理的多层螺旋CT仿真支气管镜成像扫描和重建参数。方法　 1 2 0例健康志愿者均分为 6组 ,分别接受不同参数组合的扫描 (MarconiMX 80 0 0机型 ) ,包括层厚 6 5、3 2mm(准直分别为 5 0、2 5mm) ,螺距 1 2 5、1 75 ,曝光量 1 95、1 0 0、50mAs,标准分辨率和高分辨率扫描 ,所有病例均 50 %重叠重建 ,其中第 1、2组根据不同重建间隔及不同滤过算法组合共 5种方法重建。分别对第 1段支气管 (S1 )作CT仿真支气管镜 (VB)观察 ,测定VB下最末端支气管内径。结果(1 )扫描层厚和曝光量影响VB效果 ,层厚 3 2mm时可观察S1最小支气管内径为 2 1 8～ 2 63mm ,明显优于层厚 6 5mm时的 3 2 5mm(t=3 61 9,P <0 0 1 ) ,曝光量则以 1 95mAs为佳 (F =8 35 ,P <0 0 1 )。而螺距和扫描分辨率则无明显影响 (P >0 0 5)。 (2 )重建间隔显著影响VB效果 ,第 2组中VB效果以重建间隔 0 5mm时为优 (F =3 53 ,P <0 0 5) ,但 1 6与 1 0间及 0 5与 1 0间差异无显著性意义。 0 5mm时可观察S1最小支气管内径为 (1 68± 0 2 1 )mm ,1 6mm时可观察S1最小支气管内径为 (2 1 0± 0 36)mm。第 1组中VB效果以重建间隔 3 2mm时最差 (F =3 2 0 ,P <0 0 5) ,2 0与 1 0mm时差异无显著性意义。 2 0mm时可观察S1最小     

MR扩散张量成像在阿尔茨海默病评估中的作用

目的　应用MR扩散张量成像技术 (DTI)评价阿尔茨海默病 (AD)患者脑白质有无损伤及其损伤的部位。方法　对 2 4例AD患者和 2 1例年龄匹配的健康老年人的脑部进行MR常规和DTI扫描 ,对双侧颞、顶、额叶及扣带的平均扩散系数 (ADC)和各向异性分数 (FA)的平均值进行测量并统计。结果　AD患者额叶、顶叶、颞叶、扣带的FA值分别为 0 37± 0 0 6 ,0 32± 0 0 5 ,0 2 6± 0 0 3,0 4 7±0 0 9,ADC值分别为 9 5 0e 1 0± 2 0 2e 1 0 ,1 0 5 5e 1 0± 1 4 3e 1 0 ,1 1 4 5e 1 0± 0 76e 1 0 ,1 0 1 0e 1 0±2 1 8e 1 0 ;健康老年人相应部位的FA值分别为 0 4 4± 0 0 6 ,0 38± 0 0 5 ,0 32± 0 0 5 ,0 5 6± 0 0 6 ,ADC值分别为 8 75e 1 0± 1 6 3e 1 0 ,9 83e 1 0± 0 99e 1 0 ,1 1 1 3e 1 0± 0 78e 1 0 ,8 2 8e 1 0± 1 6 5e 1 0。AD患者的额叶、顶叶、颞叶及扣带部位的FA值较健康老年人降低 (P≤ 0 0 0 6 ) ,扣带部位的ADC值较健康老年人升高 (P≤ 0 0 0 6 ) ,而额叶、顶叶、颞叶的ADC值在两组之间差异无统计学意义 (P >0 0 0 6 )。结论　DTI检测出AD额叶、颞叶、顶叶及扣带部位脑白质有损伤 ,提示AD患者不仅有灰质病变 ,并且脑白质亦存在异常。     

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.