骶骨肿瘤的CT、MR表现及鉴别

目的：通过对骶骨肿瘤CT及MR表现的分析,提高对其影像诊断的认识。材料和方法：28例骶骨肿瘤,其中脊索瘤10例;神经源性肿瘤8例;转移瘤4例;巨细胞瘤5例;淋巴瘤1例。全部病例均行CT检查,22例行MR检查,并对其中CT、MR表现进行分析。结果：各种骶骨源性肿瘤及肿瘤样病变的征象包括：软组织肿块、骶孔扩大变形,病灶内钙化及骨嵴形成,髓腔浸润,病变不同的中心位置及范围。脊索瘤、巨细胞瘤、神经源性肿瘤的MR信号有一定特点。结论：CT特别是MR可作为骶骨肿瘤的有效诊断方法。     

骶骨肿瘤CT与MRI诊断

目的　了解骶骨肿瘤的CT和MRI表现特征。方法　分析 69例骶骨肿瘤的CT和MRI表现 ,包括动脉瘤样骨囊肿(ABC)、骨母细胞瘤、骨肉瘤各 1例 ,骨髓瘤 2例 ,淋巴瘤 3例 ,骨巨细胞瘤 5例 ,脊索瘤 2 3例 ,转移瘤 33例。结果　骨巨细胞瘤位于椎体和前部附件 ,呈溶骨性破坏 ;ABC位于后部附件 ,MRI有液 -液平面 ;骨母细胞瘤和骨肉瘤CT呈骨性密度 ,MRI信号较低 ,后者伴软组织肿块 ;2 2例脊索瘤伴骶前包块 ,1 1 / 1 6例CT上出现钙化 ,9例在T2 WI有条状低信号纤维结构和高信号粘液基质。骨髓瘤 (1例 )、淋巴瘤和转移瘤在T1 WI和T2 WI分别呈略低信号和较高信号 ,1例骨髓瘤在T2 WI呈较高信号。结论　CT和MRI可清楚地显示肿瘤的部位和范围 ,两者结合 ,多数肿瘤可以定性     

骶骨原发性肿瘤的X线与CT分析

目的　分析骶骨原发性肿瘤的X线和CT表现。方法　回顾性分析经临床手术病理证实的 10例骶骨原发性肿瘤 ,其中脊索瘤 5例 ,骨巨细胞瘤 2例 ,软骨肉瘤 2例 ,神经鞘瘤 1例。结果　 (1)脊索瘤常累及S3～ 5,有中央性肿块 ,平片与CT为溶骨性骨质破坏 ,瘤内有残余骨嵴和钙化 ;(2 )骨巨细胞瘤常累及S1～ 3,呈膨胀性骨质破坏 ,好发于青年人 ;(3 )软骨肉瘤 ,神经鞘瘤X线和CT上各有特点。本组 1例软骨肉瘤从S1～ 3骨质破坏 ,并向盆腔内长出一巨大肿块。结论　X线平片与CT结合 ,有助于骶骨原发性肿瘤的诊断与鉴别诊断     

原发性骶骨肿瘤病理及影像学表现

目的:分析原发性骶骨肿瘤的病理学分型及影像学表现特点。方法:48例原发性骶骨肿瘤均经手术病理证实,术前均行常规X线平片、CT和/或MR检查,结合病理回顾分析了其影像学表现。结果:原发性骶骨肿瘤以脊索瘤(21例)最多见,其次是巨细胞瘤(7例)、神经源性肿瘤(6例)、软骨肉瘤(4例)、滑膜肉瘤(3例),囊肿(3例),其它相对少见,包括纤维组织细胞癌1例,尤文氏肉瘤1例,梭形细胞癌1例,节细胞神经瘤1例。影像表现包括软组织肿块、骶孔扩大、瘤灶内钙化、骨嵴形成等不同特点。常见原发骶骨肿瘤常有其特征性影像学表现。结论:原发骶骨肿瘤病理分型相对复杂,影像表现多样化,诊断常需综合不同影像检查手段。     

骶椎肿瘤的CT表现及其临床意义

目的探讨骶椎肿瘤的CT表现及其临床意义.方法回顾性分析行CT检查并经临床病理证实的14例(男9例,女5例)骶骨肿瘤,就骨质破坏,钙化,软组织肿块和病变与邻近组织的关系等方面进行分析.结果转移瘤CT表现为椎体和附件骨质破坏,无钙化.脊索瘤亦表现为溶骨性骨质破坏,伴有软组织肿块,常有钙化.巨细胞瘤呈膨胀性生长,压迫周围组织或器官.神经纤维瘤、骨软骨瘤及软骨肉瘤的CT表现典型.结论CT扫描在骶椎肿瘤的发现和估价病变方面具有较高的敏感性,对治疗计划的制订有重要的参考作用.     

骶骨神经源性肿瘤的X线平片及CT分析（附6例报告）

目的：通过分析骶骨神经源性神经肿瘤的Ｘ线和ＣＴ表现，提高其诊断水平，材料与方法，６例骶骨神经源性肿瘤，其中神经鞘瘤４例，恶性肿瘤鞘瘤１例，神经纤维瘤１列，对其平片及ＣＴ表现进行分析，结果：平片表现，骶骨神经源性肿瘤多位于上部骶椎，偏侧性生长，骶孔或骶骨内奢望生扩大破坏或变形及多囊状膨胀溶骨性骨质破坏，边缘骨质硬化，ＣＴ表现，膨胀的溶骨破坏区被软组织肿块充填，骨壁变薄，肿块无钙化，肿瘤破坏骨壁或骶孔     

骶前间隙肿瘤的MRI诊断

目的：了解骶前间隙肿瘤的MRI表现特征。方法：分析73例骶前间隙肿瘤的MRI表现，包括纤维脂肪血管瘤、未分化癌和淋巴瘤各1例，畸胎瘤和骨巨细胞瘤各3例，神经源性肿瘤18例，骶尾部脊索瘤22例，转移瘤24例。结果：畸胎瘤含脂肪、纤维和液体等成分；纤维脂肪血管瘤含有粗大血管；骨巨细胞瘤呈溶骨性破坏，1例在T2WI有液－液平面；神经源性肿瘤通过骶孔与骶管内病变相连，神经节母细胞瘤和神经外胚层瘤破坏孔；9例脊索瘤在T2WI有条状低信号纤维结构和高信号粘液基质；未分化癌和淋巴瘤T1WI呈略低信号，T2WI呈略高和较高信号；19例转移瘤有多处骨骼破坏，5例只有骶椎侵犯。结论：MRI可清楚地显示骶前间 隙肿瘤的部位和范围，其中多数肿瘤可以定性。     

斜坡脊索瘤螺旋CT表现及鉴别诊断

目的探讨螺旋CT在斜坡脊索瘤诊断及鉴别诊断中的价值。方法分析11例经手术病理证实斜坡脊索瘤的螺旋CT资料。结果 11例中,肿瘤位于上斜坡区3例,同时累及上、中斜坡区7例,累及中、下斜坡区仅1例。肿瘤形态以不规则、分叶状为主,大小不一。肿瘤骨质破坏区,边缘较清晰,但不锐利,骨质破坏旁软组织肿块侵及、压迫颅内组织时,与颅内正常组织交界不清。肿瘤密度混杂,11例均见斜坡不同程度的骨质破坏,邻近可见软组织肿块形成,7例肿瘤内见钙化或残存骨,对周围正常结构均产生不同程度的侵及、压迫、包绕表现。结论螺旋CT对斜坡脊索瘤的诊断及鉴别诊断有着重要的价值。     

骶骨嗜酸性细胞肉芽肿一例

患者　女 ,2 4岁。右骶部隐痛 2 0个月 ,加重 1个月。患者于 2 0个月前不慎扭伤腰骶部 ,伤后骶部一直隐痛 ,1个月前骶部疼痛加剧伴右下肢跛行。体检 :右骶部压痛及叩击痛 ,骨盆挤压分离试验阳性。骶尾骨正位X线平片 :骶骨右侧偏上见一椭圆形骨质缺损区 ,约 4 .5cm× 8.0cm大小 ,边缘清晰 ,有硬化现象 ,其内未见钙化及残存骨影 ,右侧S1～ 3 骶孔破坏消失。X线诊断 :骶骨良性肿瘤 ,以神经源性肿瘤可能性大 ,不除外骨巨细胞瘤 (图 1)。CT平扫 :骶骨右侧呈明显膨胀性骨质破坏 ,破坏区内示较均匀之软组织影 ,部分突出于盆腔内 ,右侧髂骨下部前…     

脊柱原发性骨肿瘤CT和MRI观察

目的：了解脊柱肿瘤的CT和MRI表现特征。资料与方法：分析49例脊柱肿瘤的CT和MRI表现，包括成骨细胞瘤、骨髓瘤和骨肉瘤各2例，动脉瘤样骨囊肿（ABC）3例，血管瘤和淋巴瘤各5例，骨巨细胞瘤多位于椎体，呈溶骨性破坏；成骨细胞瘤和骨肉瘤CT呈骨性密度，MRI信号较低，后者伴软组织肿块；22例脊索瘤伴骶前包块，11／16例CT上出现钙化，9例在T2WI有条状低信号纤维结构和高信号粘液基质。骨髓瘤（1例）、淋巴瘤在T1WI和T2WI分别呈略低信号和较高信号，1例骨髓瘤在T2WI呈高信号。结论；CT和MRI可清楚地显示肿瘤的部位和范围，两者结合，多数肿瘤可以定性。     

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.