自内向外顺序染色征象在血管造影和CT诊断小肝癌中的作用

目的:描写自内向外顺序染色征象以有助于血管造影和CT对小肝癌的诊断.材料和方法:14例直径3cm以下的小肝癌(手术病理证实10例,符合全国诊断标准4例).均行CT检查,行血管造影和CTA检查者分别是9例和3例.结果:9例血管造影者中8例富血管性者均呈自内向外顺序染色;3例CTA者亦呈上述征象;呈此征象的首例因对其认识不足而误诊,认识此征后其余7例诊断均正确.结论:自内向外顺序染色征象在血管造影和CT对小肝癌的诊断中有很大价值.     

小肝癌CT和血管造影诊断——自内向外顺序染色征象的意义

作者报告14例直径在3.0cm 以下小肝癌的 CT、血管造影和 CT 血管造影检查征象和结果,其中10例经手术和病理证实。提出自内向外顺序染色征象,及其对小肝癌的检测和诊断价值进行了讨论,强调 CT 和血管造影显示此征象对诊断小肝癌具有重要意义。     

CT引导下经皮肝穿刺微波治疗原发性肝癌后肝动脉造影表现

目的:探讨原发性肝癌微波治疗后的DSA表现及临床意义。方法:本组共12例原发性肝癌,均为单发病灶,肿瘤直径3.0～6.5cm(平均4.4cm),经皮肝穿刺微波治疗术后1～3个月内行肝总动脉及可疑区域供血动脉超选择性血管造影,同时对残留及复发灶进行栓塞治疗。结果:术后造影表现为微波治疗的肿瘤区多为无血管区,呈圆形或类圆形无染色或低密度染色区;治疗边缘区可见以下几种征象:肉芽形成(7例)、出血(3例)、边缘残留或复发(7例)和无异常造影征象(2例)。肝内异位复发灶(7例)造影表现同其原发肿瘤常见造影表现。本组12例造影发现原位边缘复发和/或肝内异位复发灶8例并全部完成栓塞治疗。结论:微波治疗区域的边缘征象的发现和鉴别是判断局部残留及复发的关键,DSA在疗效的观察及进一步综合治疗中有较高的临床价值。     

肝癌射频治疗后的血管造影表现

目的　了解肝癌射频治疗后的DSA征象 ,为评价肝癌射频治疗的疗效和选择理想的术后影像学随访手段提供参考。资料与方法　本组共 8例 ,原发性肝癌 7例 ,转移性肝癌 1例 ;6例为单发病灶 ,2例各为 2个病灶 (1例为原发 ,1例为转移 ) ;肿瘤直径 3～ 7.5cm(平均 4 .3cm)。肝总动脉及可疑区域供血动脉超选择性造影。结果　DSA表现 :射频治疗的肿瘤区多为圆形或类圆形无染色的低密度区 ;边缘区可见以下几种征象 :(1)局部染色 ;(2 )肝动脉门静脉瘘 ;(3)边缘区出血 ;(4 )边缘复发 ;(5 )无异常造影征象。肝内异位复发灶造影表现同其原发肿瘤常见造影表现。本组 7例造影发现原位边缘复发和 /或肝内异位复发灶。结论　发现和鉴别射频治疗区域的边缘征象是判断局部复发的关键。 (1)肉芽组织染色为治疗区边缘常见征象 ,多见于治疗后 1个月内。 (2 )局部肝动脉门静脉瘘是射频治疗的并发症 ,常因局部肝动脉灌注不足和门静脉异常灌注 ,掩盖局部复发征象。 (3)边缘出血与局部复发的鉴别要点在于 :前者为片状染色 ,时相更早 ,门静脉显影后仍有对比剂存留 ;边缘复发多为结节状 ,分布不均 ,突出于治疗轮廓以外。 (4 )射频治疗 3个月后 ,原肿瘤病灶边缘应无异常血管征象 ,若有染色应考虑复发。DSA在检出 <1cm的边缘结节复发和肝     

10例肝细胞癌脂肪变的X线特征

肝癌内含脂肪成份少见。作者报告了10例肝细胞癌(HCC)脂肪变病例的CT、血管造影、CT-血管造影及B超表现。10例中有3例肿瘤直径<3.5cm者脂肪变呈弥漫性,分布整个瘤体,余7例肿瘤直径>3.5cm者脂肪变呈单发或多发局限性病灶。B超上HCC脂肪变呈高回声区,缺乏特异性;CT上表现为低密度灶,CT值<-10HU;血管造影显示为少血管病灶。有2例血管造影未能显示肿瘤染色,而在CT-血管造影上则显示有明显环状肿瘤包膜染色及浅淡的瘤体内分隔染色。作者认为,肝囊肿CT密度约为0-10HU,正常肝实质及肝脏恶性肿瘤密度则相对较高,脂肪变的CT密     

兔VX2移植性肝癌血管造影

目的研究兔VX2肝癌血管造影表现.方法34只新西兰大白兔开腹直视下肝左中叶瘤组织块接种VX2肿瘤,接种后第3周直视下穿刺右侧股动脉进路行腹腔动脉-肝动脉造影.结果6只兔数字电影方式(DC)腹腔动脉造影不能清晰显示肿瘤血管与肿瘤染色征象;28只兔数字减影方式(DSA)腹腔动脉造影,都能清晰显示肿瘤血管与肿瘤染色征象.兔肝VX2肿瘤典型血管造影征象表现为肿瘤呈膨胀性生长,供血动脉环绕肿瘤呈握拳状、抱球状、环圈状,从环绕的肿瘤主干血管上发出或长或短的细小芽状、根状、丝状的增生血管从周边向中心推进,显影的周边血管密度明显大于肿瘤中心,形成薄壁、厚壁、玉佩状等形状的圆形或椭圆形周边深染中心相对淡染的肿瘤染色结节;≥1cm的肿瘤结节染色完整、边缘清晰,当肿瘤较小时结节呈团片状染色,边缘欠清晰.结论兔肝VX2肿瘤为富血供性肿瘤,肿瘤周边部血供比中心部丰富,腹腔动脉造影足以显示清晰典型征象.     

原发性肝癌肿瘤新生血管形态特征与其DSA血供分型关系的研究

目的　探讨原发性肝癌肿瘤新生血管形态特征与其DSA血供分型的关系。方法　收集1988年 1月～ 2 0 0 2年 2月间 ,我们两所医院手术切除前曾行血管造影且未做栓塞治疗的原发性肝癌标本 32例。血管造影至手术切除时间为 13～ 70d ,平均 (31.9± 19.1)d。肿瘤直径为 2～ 2 3cm ,平均 (8.0 5± 6 .17)cm。对其DSA血供分型、肿瘤新生血管密度 (MVD)计数、肿瘤新生血管分型、肿瘤新生血管直径测量、梁索直径测量 ,并对观察指标做相关统计学分析。结果　①肝癌DSA血供与肿瘤新生血管分型呈正相关趋势 ;②MVD在乏血供组低于中等血供、富血供组 ;③新生血管直径、新生血管梁索直径比呈随HCC造影血供增加而增大的趋势。结论　①肝癌肿瘤MVD、形态及分布不均匀 ;②肝癌在生长的不同阶段 ,其肿瘤新生血管特征是不同的 ,并有一定的发展规律 ;③肝癌DSA不同血供类型之间有明显的肿瘤新生血管特征差异     

肝血管瘤选择性动脉造影加栓塞治疗

目的　探讨肝血管瘤的动脉造影表现 ,寻找理想的栓塞方法 ,提高介入治疗效果。方法　经股动脉插管、选择性肝动脉造影后 ,采用超液化碘油加平阳霉素栓塞治疗肝血管瘤 40例 ,随访 6～ 48个月。结果　肝血管瘤典型的瘤体显影形态 ,染色时间(早出晚归 )征象可与肝癌鉴别 ;40例栓塞治疗后 ,3 0例缩小 5 0 %以上 ;4例大小无变化 ,复查彩超瘤体内信号均减弱 ,有效率 85 %(3 4 40 ) ,所有患者术后反应轻、并发症少。结论　选择性肝动脉造影及栓塞是一种较理想的肝血管瘤诊断和治疗方法。     

肝脏不同肿瘤性病变中央瘢痕的CT及MRI表现与研究价值

目的通过分析肝脏不同肿瘤性病变中央瘢痕的CT及MRI表现,探讨中央瘢痕对肝脏肿瘤性病变的诊断与鉴别诊断意义。方法回顾性分析我院近两年来经CT和(或)MRI检查的173例肝脏肿瘤,其中具有中央瘢痕者59例:肝血管瘤14例、局灶性结节增生(FNH)32例、纤维板层型肝癌(FLHCC)11例、肝细胞肝癌(HCC)和肝转移癌各1例。结果含中央瘢痕的血管瘤和FLHCC通常直径5cm,FNH直径多数5cm。FNH中央瘢痕较小、典型表现呈"星芒状",平扫:CT表现为低密度、MRI呈长T_1长T_2信号,增强扫描延迟强化;FLHCC中央瘢痕大而宽、可达病灶边缘,平扫:CT表现为低密度、MRI各序列均呈低信号,增强扫描无强化或轻度延迟强化;巨大血管瘤中央瘢痕形态多样,平扫:CT表现为更低密度,MRI呈长T_1长T_2信号,增强扫描无强化;HCC中央瘢痕延迟扫描无强化;转移癌的中央瘢痕类似液化、坏死,增强后无明显强化。结论中央瘢痕的不同形态及特征性强化方式结合瘤体主体的强化特征对肝脏肿瘤的定性和鉴别具有非常重要的参考价值。     

标记RBC-SPECT显像对鉴别肝血管瘤与肝细胞肝癌的价值

肝血管瘤是最常见的肝脏良性肿瘤,它与其它恶性肿瘤尤其是肝细胞肝癌(HCC)相鉴别极为重要.虽然~(99m)Tc-RBC常规显像对肝血管瘤具有高的特异性,但对直径<3cm或深部的灵敏性则低.本文为了证实小病变的灵敏性,特选择性地观察了直径小于5cm的小肝血管瘤和小HCC.方法:自1981年7月至1988年4月,对超声显像和CT检出的可疑肝血管瘤、HCC者行~(99m)Tc-RBC     

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.     

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.     

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).     

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.