颈深筋膜间隙感染的影像学诊断

目的 探讨影像学在颈深筋膜间隙感染的诊断价值.方法 回顾性分析47例颈深筋膜间隙感染的影像学表现.结果 单间隙受累24例,多间隙受累23例.蜂窝织炎17例,脓肿30例.蜂窝织炎CT表现为软组织肿胀,边界不清,增强扫描呈弥漫性强化;MRI蜂窝织炎呈弥漫性长T1长T2信号.脓肿CT表现为局限的低密度病灶,可有气体密度影,增强扫描脓肿壁呈环形强化,脓液不强化,MRI中脓肿呈明显长T2信号影,脓肿壁在T1WI及T2WI呈中等或者低信号;并发症9例,与无并发症组比较,脓肿、多间隙感染、多间隙脓肿发生例数增高;颈动脉间隙、椎周间隙、脏器间隙感染更容易出现并发症.结论 影像学检查在颈深筋膜间隙感染诊断及治疗中有重要价值.     

眼眶蜂窝织炎的CT、MR表现

目的 分析眼眶蜂窝织炎的CT、MR表现及探讨其临床价值.资料与方法回顾总结20例眼眶蜂窝织炎患者的CT、MR征象.男11例,女9例.仅行眼眶CT检查18例,眼眶CT、MRI同时检查2例.结果鼻窦源性13例,外伤源性6例,颌面部感染1例.骨膜下脓肿形成5例,肌锥内间隙脓肿1例,肌锥外间隙炎症4例,眶隔前炎症3例,弥漫性炎症7例.影像特征为眶内正常结构界面消失和球后脂肪局限或弥漫性浸润.结论 CT、MRI检查对诊断眼眶蜂窝织炎有重要价值.     

儿童眼眶转移性神经母细胞瘤和绿色瘤的特征性MR表现

目的 分析儿童眼眶转移性神经母细胞瘤和绿色瘤的特征性MR表现。资料与方法 回顾性分析经手术病理证实的9例儿童眼眶转移性神经母细胞瘤和5例绿色瘤的CT和MRI表现。所有病例均行CT平扫以及MRI平扫和增强扫描。结果 14例CT表现均为眼眶不规则肿块和邻近的眶壁溶骨性骨质破坏,7例骨质破坏区邻近的颅内可见扁平不规则肿块。2例转移性神经母细胞瘤表现为眼眶肌锥外间隙肿块内有与眶外壁垂直的针状高密度影。14例MRI表现为眼眶肌锥外间隙略长T1、略长T2信号不规则软组织影,7例骨质破坏区邻近的颅内硬膜外间隙可见略长T1、略长T2信号扁平不规则肿块,增强后明显强化。14例双侧眶骨及蝶骨大翼,9例斜坡和双侧岩尖及2例双侧颞骨鳞部骨髓腔脂肪高信号影被略长T1、略长T2信号影取代,采用脂肪抑制的增强T1WI显示均有强化,强化程度与眼眶内肿块相似。结论 儿童眼眶转移性神经母细胞瘤和绿色瘤的眶壁和颅面骨MR表现具有特征,有助于诊断和鉴别诊断。     

颈深筋膜间隙感染的影像学表现及其临床意义

目的 分析颈深筋膜间隙蜂窝织炎和脓肿的CT和MRI表现，探讨深筋膜间隙感染的诊断标准。方法 回顾分析28例经临床及穿刺证实的颈深筋膜感染的CT和MRI表现。包括咽后间隙11例，咽旁间隙5例，嚼肌间隙4例，多间隙感染8例。结果 颈深部筋膜间隙感染包括蜂窝织炎和脓肿，15例蜂窝织炎，CT可见软组织肿胀，伴有脂肪间隙移位、变小或消失。炎性组织在T1WI呈等、低信号，T2WI呈高信号。13例脓肿，CT可见局部低密度灶，边界清或不清，有强化。脓肿在MRI T2WI上见显著高信号，边界可有强化。结论 CT和MRI对颈深筋膜间隙蜂窝织炎和脓肿的诊断和定位十分准确，能为临床医生提供十分有价值的信息。     

眼眶静脉性血管瘤的MRI和CT表现

目的 分析眼眶静脉性血管瘤的MRI、CT表现,提高对眼眶静脉性血管瘤的影像学认识.资料与方法 对49例经手术病理证实的眼眶静脉性血管瘤患者的MRI、CT资料进行回顾性分析.结果 49例中,位于眼眶前部1例,肌锥内间隙18例,肌锥外间隙3例,肌锥内外间隙同时受累27例.MRI扫描41例显示为边界清楚但不光滑,形状不规则的不均质肿块.6例肿物边界不清.与眼外肌相比,T1WI呈低或等信号,T2WI呈高信号,肿瘤内部或周边可见血管流空信号.T2WI脂肪抑制序列高信号不被抑制.46例眼球明显向前突出,7例显示眼球受压变形.29例显示病变沿眼球壁生长呈铸形.15例显示眶尖脂肪间隙消失.7例可见肿物向颅内蔓延.14例具有急性突眼病史者显示出血信号,7例可见液.液平面.CT扫描显示为不均匀的较高密度.5例显示单个或多个的静脉石.26例眶骨受压,眼眶扩大.10例显示眶上裂扩大.结论 眼眶静脉性血管瘤在MRI、CT上分别具有其特征性征象.CT对展示骨性结构及钙化有优势,而MRI对肿瘤的内部形态及其与周围组织结构关系的进一步判断更具意义.MRI在定位和定性诊断上优于CT.     

眼眶淋巴瘤的MRI征象

目的探讨眼眶淋巴瘤的MRI特点,提高对本病的认识和术前诊断准确率。资料与方法回顾性分析8例经手术病理证实的眼眶淋巴瘤的MRI表现,包括病变部位、数量、形态、大小、MRI信号及对邻近结构的侵犯。结果 8例患者中,6例为单侧,2例为双侧。4例位于眼眶前部,包括眼睑、泪腺及眼球周围,1例位于肌锥外间隙,4例呈弥漫性,位于眼眶前部及肌锥内外间隙,并不同程度地包绕眼球;1例可见眼眶骨质破坏,并突破眶骨向颅内外蔓延;8例均未见囊变、坏死。6例平扫T1WI呈等信号,2例呈稍低信号;6例T2WI呈均匀稍高信号,2例呈等信号;增强扫描后6例呈与眼外肌信号一致的中度均匀强化,2例为轻度均匀强化。结论眼眶淋巴瘤的MRI表现有一定的特征性,好发于眶隔前部,并向眶内侵犯;单侧多见,也可以双侧多发;呈多形性、塑形性、浸润性生长,信号多均匀,增强扫描多呈轻中度强化,少见骨质破坏,掌握其MRI表现有助于术前定性诊断。     

眶部肌锥外间隙非霍奇金淋巴瘤的高分辨率MRI表现

目的探讨眶部肌锥外间隙非霍奇金淋巴瘤(NHL)的高分辨率MR(HRMR)成像特征。方法回顾性分析16例经病理诊断明确的眶部肌锥外间隙NHL病灶的位置、数目、形态、大小、MRI信号及其对邻近结构侵犯等。MR扫描采用15TMR扫描机,眼眶部表面线圈,SE及快速SE(FSE)序列常规横轴面或冠状面及斜矢状面扫描,全部病例行脂肪抑制技术。全部病例均行增强扫描及HRMRI检查。结果16例中的13例病灶位于肌锥外间隙的前上份,紧靠眶隔的后方,呈不规则的长条状铸型改变;其余3例为弥漫性病变,累及眶部肌锥外间隙,呈不规则形。11个病灶的体积>3cm3,4个病灶的体积为中等大小(1~3cm3),只有1例病灶<1cm3。13例病灶边缘不清晰并浸润眼外肌但不推移眼外肌;7例浸润眼球壁,仅3例眼球突出,2例弥漫性病变者伴有骨质破坏。与肌肉比较,所有16例病灶T1WI均为等信号,T2WI表现为高信号13例,等信号3例;所有16例病灶均有强化,15例为均匀强化,10例为明显强化。结论眶部肌锥外间隙NHL的HRMRI表现具有一定的特征性,表现为铸型生长、位于肌锥外间隙的前份,紧靠眶隔的后方、病灶边缘欠清晰并浸润,但不推移眼外肌,T1WI信号等于肌肉、T2WI信号高于肌肉、增强扫描病灶呈明显强化。眶部肌锥外间隙NHL的HRMR影像学特征有助于临床与其他眶部占位相鉴别。     

眼眶淋巴瘤CT和MRI诊断分析

目的分析眼眶恶性淋巴瘤的CT和MBI表现特点,以提高对本病的诊断和鉴别诊断水平。资料与方法回顾性分析70例病理证实的眼眶恶性淋巴瘤的临床和影像资料,70例均做CT检查,9例加做MBI检查,分析肿瘤部位、密度、信号、形态和骨质等表现。结果男女之比4：1,中位年龄57岁,68例（97％）为B细胞型淋巴瘤,5例（7％）伴有身体其他部位淋巴瘤。双侧眼眶发病19例（27％）,共计70例／89眶。影像学表现：（1）侵犯部位：肿瘤弥漫侵犯眼球前后和肌锥内外间隙18例／24眶,球后20例／24眶（肌锥内间隙为主14例／16眶,肌锥外间隙为主6例／8眶）;局限于眼睑7例／9眶,结膜4例／5眶,泪腺区11例／14眶,泪囊区5例／5眶,眼外肌3例／6眶,眼眶鼻侧和筛窦2例／2眶。（2）密度和信号：多数肿瘤CT平扫和增强扫描密度均匀（分别为87％和81％）,48例（90％）呈中度或明显强化。多数肿瘤（8／9）在T1WI和T2阳上呈中等、均匀信号,与脑灰质相仿,T2信号略高于T1,强化均匀。（3）形态边缘：肿瘤形态多不规则,边缘呈浸润状,沿眼球壁、泪腺、视神经、眼外肌、眶隔或眶壁蔓延生长。（4）眶骨：66例（94％）无骨质改变。结论眼眶恶性淋巴瘤的CT和MRI表现具有一些特征,影像学检查对本病的诊断具有重要价值,但部分病例与炎性假瘤和良性淋巴组织增生性病变鉴别较困难。     

急性眼眶炎性病变CT、MRI表现

目的分析急性眼眶炎性病变的CT、MRI表现并探讨其临床价值。方法回顾总结40例眼眶炎性病变患者的CT、MRI征象。眼眶CT、MRI检查12例,仅行眼眶CT检查28例。结果按病因分类:鼻窦源性22例,外伤源性12例,肝克雷伯杆菌感染2例,糖尿病4例。按累及结构分类:骨膜下脓肿形成5例,肌锥内间隙脓肿1例,肌锥外间隙炎症4例,眶隔前炎症3例,海绵窦炎3例,弥漫性炎症7例,内源性眼内炎3例,眼球筋膜炎5例,泪囊炎2例,泪腺炎7例。眼眶炎症影像特点取决于受累结构及范围,表现为眶内正常结构界面消失和一个或多个解剖间隙局限或弥漫浸润。结论 CT、MRI对客观显示眼眶炎症的致病原因和累及范围具有重要价值。     

眼眶淋巴瘤多模态影像分析

【摘要】目的：探讨眼眶淋巴瘤多模态影像学特征。方法：回顾性分析27例经病理证实为眼眶淋巴瘤患者的治疗前MRI、CT增强扫描及18F-FDG PET/CT影像。评估内容包括病灶的MRI特征、CT增强扫描特征及最大标准摄取值（SUVmax）。结果：总共收集27例（34眶）患者,其中25例（31眶）行眼眶MR扫描,10例（13眶）行CT增强扫描及18F-FDG PET/CT扫描。病变多位于眶隔前区（15.38%）、泪腺区（23.08%）及肌锥区（21.54%）。病灶在压脂T2WI上,11例呈均匀稍高信号,13例呈等信号,1例呈混杂高信号;压脂T1WI上,24例呈等信号,1例呈稍低信号;压脂T1WI增强扫描上,15例呈中度均匀强化,8例为轻度均匀强化,2例为不均匀强化;7例可见骨质破坏。10例行CT增强扫描及18F-FDG PET/CT扫描患者中,病理组织类型为黏膜相关淋巴组织边缘区B细胞（MALT）淋巴瘤5例,弥漫大B细胞淋巴瘤（DLBCL）5例,其中1例DLBCL患者在CT上表现为不均匀密度,其余9例表现为均匀密度。两种病理类型病灶的△CT值差异无统计学意义（统计值0.60,P>0.05）。DLBCL与MALT淋巴瘤病灶的SUVmax差异具有统计学意义［6.40（5.40～7.10） vs. 11.40（9.63～25.60）,P=0.009］。结论：眼眶淋巴瘤病变多位于眶隔前区、泪腺区及肌锥区。MRI上病灶压脂T1WI多呈等信号,压脂T2WI呈等或稍高信号,增强扫描呈轻到中度强化;在CT上表现为均匀密度,增强扫描呈轻到中度强化,病灶的强化程度对鉴别DLBCL和MALT淋巴瘤无帮助。在18F-FDG PET/CT中,DLBCL的SUVmax较高,病灶的SUVmax 有助于鉴别DLBCL和MALT淋巴瘤。     

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.