螺旋CT多期扫描技术对胰腺癌的诊断价值

目的：探讨螺旋CT多期扫描对胰腺癌的诊断价值。方法：搜集行SCT动脉期、胰腺期、肝脏期三期扫描的胰腺肿块75例，均经手术病理证实，其中胰腺癌53例，局限性胰腺炎22例，比较肿瘤与炎症在SCT增强扫描各期中的表现。结果：本组胰腺癌53例，其中胰头癌33例，胰颈癌4例、胰体癌14例，胰尾癌2例。局限性胰腺炎22例，头、颈、体、尾分别为17例、2例、2例、1例。增强扫描，动脉期胰腺癌低密度43例，等密度10例，胰腺炎低密度2例，等密度20例；胰腺期胰腺癌低密度51例，等密度2例，胰腺炎低密度1例，等密度21例；肝脏期胰腺癌低密度42例，等密度11例；胰腺炎22例均为等密度。结论：胰腺螺旋CT动脉期、胰腺期、肝脏期三期增强扫描在胰腺癌诊断中具有非常重要的临床价值。     

多排螺旋CT曲面重建在胰腺和胰周病变中的应用

目的　探讨多排螺旋CT曲面重建在胰腺及胰周病变中的应用价值。方法　对胰腺和胰周病变的患者共 17例采用多排螺旋CT扫描上腹部 (5例单纯平扫 ,11例平扫 增强 ,1例行静脉CT胆道造影 ) ,其中胰腺癌 4例 ,胆总管结石 3例 ,慢性胰腺炎伴假性囊肿 3例 ,真性囊肿合并慢性胰腺炎及胆道梗阻 1例 ,囊腺瘤 1例 ,胰岛细胞瘤 1例 ,胰周淋巴结肿大 3例和 1例脾动脉瘤。由操作者经特定的解剖结构和病变画线做曲面重建。结果　多排螺旋CT可获得高质量的曲面重建图像 ,跟踪显示胰胆管或胰周血管 ,和清晰显示病灶与胰腺、胰胆管和胰周血管的关系。结论　多排螺旋CT薄层扫描能获得胰腺高质量曲面图像 ,提供独特的解剖信息和相关病理征象 ,有助于胰腺和胰周病变的诊断及局部侵犯的评价 ,指导临床治疗方案的选择与实施。     

螺旋CT双期增强扫描对可疑胰头癌的鉴别诊断

目的：探讨螺旋CT双期增强扫描对可疑胰头癌的鉴别诊断价值。方法：对49例经超声和临床拟诊的胰头癌行胰腺的螺旋CT双期增强扫描,动脉期和门静脉期延迟扫描时间分别为25秒和60秒,所有病例经病理或临床追踪诊断。结果：49例中,胰头变异例,胰头周围淋巴结病6例,慢性胰腺炎7例,胰头癌31例。其中46例（94%）诊断正确,1例胰头周围淋巴结结核和 2例慢性胰朱炎误诊为胰头癌。结论：螺旋CT双期增强扫描对可疑胰头癌的鉴别诊断有很高的价值。     

胰腺癌螺旋CT动态增强扫描征象的探讨

目的 :对胰腺癌螺旋CT动态增强扫描征象进行探讨。方法 :病理证实胰腺癌 37例 ,胰头癌 2 8例 ,胰体癌 5例 ,胰尾癌 4例。其中男 30例 ,女 7例。给予高分辨率螺旋CT动态增强扫描。结果 :胰腺癌主要征象 :胰腺肿块 ,在动脉期 (胰腺期 )表现为明显的低密度灶 ,胰腺肿块低密度灶与正常胰腺组织密度差有显著差异。其他征象 :胰管和胆管扩张 ;胰周脂肪间隙模糊 ;胰周血管变形和周围淋巴结肿大等。结论 :螺旋CT动态增强扫描对检出胰腺癌是非常有效的方法。     

小胰腺癌的多层螺旋CT诊断价值

目的探讨小胰腺癌的多层螺旋CT诊断价值。方法回顾性分析18例经手术病理证实的小胰腺癌的MSCT征象。结果本组18例小胰腺癌中,肿瘤位于胰头钩突部16例,胰颈部2例;肿瘤4例形态不规则,12例呈圆形或椭圆形;肿瘤最大径为12～30mm不等;CT平扫等密度10例,稍低密度8例;增强扫描16例肿瘤动脉期边缘轻度不均匀强化,呈明显低密度,门脉期及延迟期呈相对低密度;2例肿瘤三期均呈等密度;9例伴有不同程度的肝内外胆管扩张,17例伴胰管扩张。术前MSCT诊断正确16例,漏诊2例,诊断正确率为88．9％。结论多层螺旋CT三期扫描是诊断小胰腺癌有效、准确的检查方法。     

胰腺囊腺瘤和囊腺癌螺旋CT表现

目的 探讨胰腺囊腺瘤和囊腺癌螺旋CT表现及特征.方法 回顾分析经病理证实的10例胰腺囊腺瘤和囊腺癌CT影像学特点,10例均行CT平扫及双期增强扫描.结果 CT拟诊胰腺浆液性囊腺瘤2例,黏液性囊腺瘤4例,黏液性囊腺癌2例,胰腺假性囊肿1例,胰腺癌1例,其中CT误诊4例.本组病例提示病灶囊壁厚度,有无壁乳头及钙化的存在等影像学特征,对肿瘤良恶性鉴别诊断有重要意义.结论 通过螺旋CT扫描能够对胰腺浆液性囊腺瘤、黏液性囊腺瘤或囊腺癌作出较为准确的判断.     

胰腺癌可切除性螺旋CT双期扫描征象与手术结果对比研究

目的：探讨螺旋CT双期扫描对胰腺癌可切除性评估的价值。方法：对41例CT诊断胰腺癌患者与手术及病理结果对照。并回顾性分析胰腺肿瘤导致胰周器官侵犯时手术切除的可能性。结果：手术及病理证实37例为胰腺癌，手术切除14例，其中胰头癌7例(包括1例胆管远端癌)，体尾癌7例。所切除的14例中有Ⅰ期8例，Ⅱ期3例，Ⅲ期2例，Ⅳ期1例。即7例中存在不同程度的周围器官侵犯和转移。结论：①对手术切除性评估不能局限于肿块大小和周围器官是否侵犯，而应根据肿瘤生长部位，形态具体分析；②螺旋CT双期扫描对胰腺癌诊断准确性高，但胰头癌与壶腹部癌及胰头慢性炎症的鉴别有时仍存在一定困难。     

18F-FDG PET显像对胰腺良恶性病变鉴别诊断的作用

目的探讨18F-脱氧葡萄糖(FDG) PET显像对胰腺良恶性病变鉴别诊断的价值.方法临床疑胰腺病变患者30例,其中胰腺恶性肿瘤20例胰腺癌15例,胰腺癌切除术后复发3例,低恶性胰岛细胞瘤、癌肉瘤各1例;胰腺良性病变10例,均为慢性胰腺炎,其中3例并假性囊肿形成.除8例慢性胰腺炎为临床、放射学随访3～12个月外,余均由组织病理学检查证实.静脉注射18F-FDG 222～296 MBq 1 h后行PET显像.测定肿瘤体积和标准摄取值(SUV),并与PET检查前2周内CT(25例)、MRI(8例)结果对照.结果 20例胰腺恶性肿瘤中19例肿瘤明显摄取18F-FDG,平均SUV 4.91±3.65.10例慢性胰腺炎中9例病灶轻度或无摄取18F-FDG,平均SUV 1.70±1.12(t=2.69,P=0.012).4例肿瘤病灶直径≤3 cm,SUV 2.75±0.63;6例3.1～5 cm,SUV 4.59±3.06;10例>5 cm,SUV 5.46±2.29(χ2=9.02,P=0.011).1例PET假阳性为慢性胰腺炎并假性囊肿,SUV 4.82;1例PET假阴性为胰头癌术后复发,病灶SUV 2.1.以SUV 2.5为胰腺良恶性病变的判断阈值,18F-FDG PET显像诊断胰腺癌灵敏度、特异性和准确性分别为95.0%、90.0%、93.3%,明显高于CT(75.0%、55.6%、68.0%,χ2=5.89,P=0.015).结论 18F-FDG PET显像诊断胰腺癌灵敏度、特异性较高,尤其适于胰腺癌术前分期和术后复发、转移的探查.     

胰腺疾病的MR胰胆管成像征象的定量分析

目的　研究不同胰腺疾病的MR胰胆管成像 (MRCP)特征 ,探讨特征性表现及MRCP对胰腺疾病的诊断价值。方法　对 111例临床怀疑胰腺疾病的患者进行MRCP检查。MRCP扫描序列包括 :厚层快速自旋回波 (TSE)序列和薄层半傅立叶采集单次激发快速自旋回波 (HASTE)序列 ,其中胰腺癌 4 6例 ,慢性胰腺炎 39例 ,壶腹周围癌 2 3例 ,胆总管结石 3例。结果　 (1) 37例胰腺癌、2 4例慢性胰腺炎和 12壶腹周围癌出现胰管改变 ,其中 33例胰腺癌、0例慢性胰腺炎和 12例壶腹周围癌出现胰管平滑扩张并中断 ,经统计学分析 χ2 =5 7 911,P <0 0 1;2例胰腺癌、2 3例慢性胰腺炎和 0例壶腹周围癌出现胰管不规则扩张且贯通病变区 ,经统计学分析 χ2 =6 0 343,P <0 0 1。 (2 ) 2 9例胰腺癌、10例慢性胰腺炎和 2 3例壶腹周围癌出现胆总管扩张 ,其中 2 9例胰腺癌、1例慢性胰腺炎和 2 3例壶腹周围癌出现胆总管扩张后截断 ,经统计学分析 ,χ2 =6 1 2 17,P <0 0 1。 (3) 2 9例胰腺癌、1例慢性胰腺炎和 12例壶腹周围癌出现双管征 ,经统计学分析 ,χ2 =34 6 5 4 ,P <0 0 1。 (4 ) 2 4例慢性胰腺炎、0例胰腺癌和 0例壶腹周围癌出现假性囊肿 ,经统计学分析 ,χ2 =5 4 5 93,P <0 0 1。结论　不同胰腺疾病有其相对应的特征性表现 ,MRCP能够显     

胰腺炎并发假性囊肿或积液的CT分型与命名

目的：探讨胰腺炎并发假性囊肿或积液的CT分型与命名，为其诊断及鉴别诊断提供依据。方法：分析我院收治的胰腺炎合并假性囊肿或积液40例的CT影像学特征、发病机制及病理特点，并根据以上特征进行临床分型与命名。结果：以胰腺为主体，由近至远对胰腺炎并发假性囊肿或积液进行分型和命名，可分为胰内型、胰周型、胰内伴胰周型、异位型、胰内伴异位型、胰周伴异位型和胰内胰周伴异位型等7种类型。结论：分型与命名既能反映病源性质，又能确切地反映病变受累范围及CT扫描的特征，有利于诊断及制定有效治疗措施和选择手术时机及方式。     

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.