肾嗜酸性细胞腺瘤的CT诊断与误诊分析

目的探讨肾嗜酸性细胞腺瘤的CT表现及误诊原因,旨在提高本病的诊断准确率。方法回顾分析经病理证实的10例肾嗜酸性细胞腺瘤的临床及CT资料,观察病灶的部位、形态、大小、密度、有无包膜及强化幅度与方式等。结果 10例全部单侧发病,6例位于左肾,4例位于右肾,最大径3.5~12.5cm,平均6.4cm,均呈圆形或类圆形,CT平扫密度均低于肾实质或类似于肾实质,6例密度均匀,4例密度不均;4例病灶内囊变、坏死,边缘及边界均清晰;7例有包膜;10例均未见钙化,肾盂肾盏均呈受压推挤改变。增强皮质期均明显强化,髓质期实质成分均成持续强化,4例囊变区不强化,3例强化病灶内可见"纤维瘢痕征",周围包膜结构显示更加明显。术前CT检查全部误诊,误诊为嫌色细胞癌7例,透明细胞癌3例。结论肾嗜酸性细胞腺瘤CT表现具有一定特征性,肾实质内孤立性肿块,密度稍低于肾实质,且密度常均匀一致,可见假包膜,边缘及边界清晰,增强呈渐进性明显强化,体积较大者病灶内可见囊变、坏死,增强部分病灶内可见"纤维瘢痕征",而对其影像特征及鉴别诊断认识不足是其误诊的主要原因。     

CT在肾嗜酸细胞腺瘤诊断中应用(附6例分析)

目的 探讨CT对肾嗜酸细胞腺瘤术前诊断的可能性.方法 回顾性分析经手术、病理证实的6例肾嗜酸细胞腺瘤的动态增强CT表现,根据病变部位、大小、密度、边缘、强化方式,测量病变平扫及CT动态增强各期的CT值.结果 CT平扫:6例肾嗜酸细胞腺瘤平均CT值35HU,3例密度均匀,1例病灶内见瘢痕样低密度影,2例密度不均匀,其中1例见多发小囊状低密度灶.动态增强CT:6例病灶实质部分CT值在皮质期平均94HU、实质期平均110HU;1例病灶的中心瘢痕呈轻微强化,CT值30HU,1例多发小囊状低密度灶分隔呈持续强化;1例增强扫描呈“节段性强化逆转”,3例包膜轻度延迟强化.结论 CT检查是肾嗜酸细胞腺瘤的首选检查方法,动态增强CT肿瘤实质部分明显持续性强化、肿瘤内星状瘢痕并延迟强化、部分病灶可显示完整并延迟强化的包膜等典型征象有助于肾嗜酸细胞腺瘤的术前诊断并与肾癌相鉴别.     

酷似嗜酸细胞腺瘤的多发肾透明细胞癌CT表现1例

本文报道1例酷似嗜酸细胞腺瘤的多发肾透明细胞癌的CT表现。患者女,50岁,右肾实质内可见4枚大小不等病灶,与肾实质相比,CT平扫示肿瘤外周实质部分呈等密度,中央均可见条状、放射状稍低密度（考虑瘢痕）;增强扫描皮质期肿瘤中央瘢痕未见明显强化,肿瘤外周实质明显不均匀强化,强化程度接近肾实质;实质期及排泄期肿瘤中央瘢痕逐渐延...     

肾嗜酸细胞腺瘤的CT、MRI表现

目的探讨肾嗜酸细胞腺瘤的CT、MRI表现,提高对本病的认识。方法回顾性分析经病理证实的8例肾嗜酸细胞腺瘤的CT或MRI表现,其中5例行CT平扫及多期动态增强扫描,3例行动态MRI增强扫描,包括平扫、肾皮质期、肾实质期及排泄期。结果 8例患者肿瘤均为单发,肿瘤最大横截面的直径为2.0~10.0cm;5例CT扫描肿瘤中3例可见钙化;动态增强中肿瘤强化峰值4例出现于肾皮质期、4例出现于肾实质期,纤维瘢痕呈进行性强化;2例MRI扫描肿瘤可见包膜;排泄期肿瘤密度或信号趋于均匀,与肾实质分界清晰。结论肾嗜酸细胞腺瘤的CT和MRI表现一定的特异性,有助于与肾癌相鉴别。     

肾脏嗜酸细胞腺瘤影像学分析

目的探讨肾脏嗜酸细胞腺瘤的影像学表现,提高对肾脏嗜酸性细胞瘤的影像诊断水平。方法回顾性分析本院经手术病理证实的16例肾脏嗜酸细胞腺瘤的影像学表现,并与手术病理进行对比分析。结果 CT平扫病灶多呈等密度,个别肿瘤边缘可见钙化,CT增强扫描9例为均匀强化,7例为不均匀强化,其中8例在增强扫描皮髓期表现病灶中央星状瘢痕;平扫T1WI病灶呈等低信号,其中8例中央裂隙状疤痕呈更低信号,T2WI病灶呈等或高低混杂信号,中央疤痕呈裂隙状高信号,MR增强扫描9例明显均匀强化,7例不均匀强化,但肿瘤实质部分强化均匀,中央疤痕无强化,或延迟强化。结论肾脏嗜酸细胞腺瘤是一种良性肿瘤,位于肾皮质区,可向肾外突出,边界清楚。平扫肿瘤呈等密度或信号,增强扫描肿瘤实性部分均匀强化,中央出现星状疤痕以及肿瘤内"轮辐状"强化是其特征性影像表现。     

肾嗜酸细胞腺瘤的CT表现与病理对照分析

目的探讨肾嗜酸细胞腺瘤的CT表现与病理对照分析,以提高对本病的认识。方法回顾性分析经病理证实的8例肾嗜酸细胞腺瘤患者的影像与病理资料。8例均行CT平扫及多期增强扫描,包括肾皮质期、髓质期和排泄期。结果 CT平扫示8例患者均为单发,7例位于右肾,1例位于左肾,最大径3.9～13.0cm,平均5.9cm,均大于3cm,1例可见钙化。增强扫描:皮质期8例病灶均明显强化。髓质期7例病灶持续强化,8例病灶内可见"星芒状"瘢痕,6例有相对完整假包膜。结论肾嗜酸细胞腺瘤的CT表现与病理表现有相关性,CT表现典型者可作出正确诊断。     

肾嗜酸细胞腺瘤的影像学表现及鉴别诊断

目的：探讨肾嗜酸性细胞腺瘤的CT和MRI表现,以提高对本病的认识。方法：回顾性分析经病理证实的9例肾嗜酸细胞腺瘤患者的影像资料。9例均行CT平扫及多期增强扫描,包括肾皮质期、髓质期和排泄期;其中1例同时行MRI检查,1例行IVP检查。结果：CT平扫示9例病灶均为单发;7例位于左肾,2例位于右肾,最大径2．0—10．0cm,平均5．1cm,〈3．0cm者2例,2例可见钙化。增强扫描：肾皮质期示9例病灶明显强化,肾髓质期示6例病灶持续强化,6例病灶内可见“星芒”状瘢痕,5例有相对完整假包膜。1例病灶于MRI T1WI上呈等、低信号,T2WI呈混杂高信号,可见清晰包膜。结论：肾嗜酸细胞腺瘤的影像学表现有一定特征性,有助于同肾癌和肾血管平滑肌脂肪瘤鉴别。     

肾嗜酸细胞腺瘤的MSCT表现及病理基础

目的:分析8例肾嗜酸细胞腺瘤(renal oncocytoma,RO)的SCT表现和病理特点,以提高CT对该病诊断的准确性。方法:8例均经手术病理证实,CT全肾平扫后行皮质期、实质期动态增强扫描。结果:CT平扫7个病灶为等密度,1个为略高密度,内见低密度影。皮质期所有病灶均强化,2个病灶出现"车辐征",5个出现中心瘢痕。实质期所有病灶密度明显低于肾实质,6个病灶强化明显减低。结论:SCT能显示RO的某些特征,有助于术前诊断。     

肾脏嗜酸细胞腺瘤的CT诊断

目的 探讨肾嗜酸细胞腺瘤(RO)的CT表现,以提高对其诊断的准确性. 资料与方法 回顾性分析经病理证实的14例RO的CT资料,全部经MSCT多期检查,包括平扫、增强皮质期和髓质期,其中5例另行排泄期扫描. 结果 病灶全部单发,9例位于左肾,5例位于右肾,最大径2.0～11.6 cm,平均6.2 cm,<3.0 cm者3例.皮质期,12例病灶明显强化,其中9例强化低于肾皮质,3例强化接近于肾皮质.髓质期,9例强化程度下降并低于肾脏髓质, 3例持续强化但在排泄期见密度开始下降.2例在皮质期至排泄期表现为持续的强化.8例见星芒样瘢痕,8例见完整包膜,4例见中央钙化. 结论 大部分RO为富血供,增强后实质部分均匀强化,囊变或坏死罕见,有助于与肾透明细胞癌及肾嫌色细胞癌等相鉴别.     

肾嫌色细胞癌的多层螺旋CT表现

目的:挖掘肾嫌色细胞癌(ChRCC)的多层螺旋CT表现特点,提高其术前影像诊断准确性。方法:收集经手术病理诊断的ChRCC患者7例,男例3例,女4例,年龄48～70岁,平均55.1岁。术前均行4层或16层螺旋CT平扫、增强皮质期和实质期动态扫描。回顾性分析肿瘤大小、形态、密度、强化程度等CT征象,其中以肿瘤的相对强化程度评价肿瘤强化表现。结果:肿瘤轴位长径14.8～89.9mm,平均50.0mm,边界均清楚、光整。平扫等密度或略高密度,密度均匀5例,不均匀2例。不均匀2例中,1例为体积最大者,边缘少许小钙化,内见坏死囊变区及条片状瘢痕,另1例内见星状瘢痕。增强扫描皮质期及实质期病灶轻度强化6例,明显强化1例,均匀强化5例,不均匀2例。增强皮质期病灶/肾皮质密度比值平均为0.544,增强实质期病灶/肾皮质密度比值平均为0.494。结论:ChRCC瘤体密度较均匀,轻度强化,瘤内钙化、出血及坏死囊变者少,CT对其诊断可提供重要线索。     

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.