16层CT血管造影在肺动脉栓塞诊断中的应用价值

目的 探讨16层CT肺动脉造影对肺动脉栓塞(PE)的诊断价值.方法 对24例PE患者行16层CT血管造影检查,采用多平面重建(MPR)、最大密度投影(MIP)、容积再现(VR)多种图像后处理技术,并结合轴位图像进行综合分析.结果 24例均能显示肺动脉栓塞的部位、范围、局部管腔狭窄程度,19例急性肺动脉栓塞的直接征象为“截断征”、“双轨征”;5例慢性肺动脉栓塞主要表现为肺动脉管腔内偏心性、附壁性的充盈缺损.结论 16层CT血管造影是诊断肺动脉栓塞及其溶栓疗效评价和随访最有效的无创性检查方法之一.     

螺旋CT血管造影诊断肺动脉栓塞

目的:评价螺旋CT血管造影(SCTA)在诊断肺动脉栓塞(PE)中的作用.材料和方法:对临床怀疑PE经SCTA明确诊断的21例患者进行回顾性分析.结果:21例患者累及97处肺动脉及其分支.直接征象:部分性充盈缺损;附壁性充盈缺损;中心性充盈缺损即轨道征;完全阻塞.间接征象:局限性肺纹理稀疏,肺动脉高压,右心扩大,胸腔积液,肺梗死灶.结论:螺旋CT血管造影对肺栓塞能明确诊断,是安全、无创、快捷的诊断方法,易于广泛应用.     

多层螺旋CT对肺动脉栓塞的诊断价值

目的探讨肺动脉栓塞(pu lmonary embolism,PE)的多层螺旋CT(MSCT)表现特征,评价MSCT对PE的诊断价值。方法回顾分析43例临床诊断PE患者的16层螺旋CT肺动脉造影资料的影像学表现,并与其肺动脉造影(DSPA)或随访结果相对照。结果本组43例均与临床诊断相符,中心型16例,周围型23例,混合型4例。多层螺旋CT肺动脉造影(MSCTPA)对叶及叶以上肺动脉的显示率达100%,检出PE阳性20支,段肺动脉清楚显示726支(显示率达84.4%),检出PE阳性109支,亚段肺动脉清楚显示1185支(显示率达68.9%),检出PE阳性61支。PE的直接征象包括血管腔完全闭塞、部分充盈缺损、轨道征和附壁血栓;间接征象有肺梗死灶、“马赛克”征、右室增大和/或肺动脉扩张、胸腔积液、心包积液等。结论MSCTPA诊断PE简便、安全、无创,对亚段肺动脉栓塞的诊断准确、可靠,是诊断早期肺动脉栓塞的首选方法。     

肺血栓栓塞症在螺旋CT血管造影中的临床应用

目的：探讨螺旋CT在肺血栓栓塞症(简称VIE)血管造影中的扫描技术及其对肺血栓栓塞症的诊断价值。材料与方法：对26例临床疑诊为肺血栓栓寒症的患者进行螺旋CT血管造影，其中有4例在溶栓治疗后进行血管造影复查，患者常规先进行螺旋CT平扫，然后经肘正中静脉由高压注射器注入对比剂120ml，扫描延迟时间为20-25秒，注射速度为3ml/s，由膈顶上扫描至主动脉弓下，扫描范围约12—16cm，层厚为2—4mm，果：26例患者中6例血管造影显示肺动脉正常，16例均显示有肺血栓典型症状，呈条状或不规则的充盈缺损影像表现，4例经溶栓治疗后，肺血栓有不同程度的吸收。结论：一应用螺旋CT血管造影成像技术，能够对肺动脉血栓栓塞症进行较精确的定位诊断。     

多层螺旋CT血管成像诊断肺动脉栓塞的价值

目的探讨多层螺旋CT(multi-slice spiral CT,MSCT)血管成像诊断肺动脉栓塞的价值.材料和方法回顾性分析17例急性肺动脉栓塞的MSCT肺血管造影表现.结果确诊为肺动脉栓塞17例,209处肺动脉及分支受累.其中第2级肺动脉受累9例11支,第3级肺叶动脉受累13例31支,第4级肺段动脉受累116支和亚段肺动脉受累51支.MSCTA显示肺动脉栓塞的直接征象为肺动脉内的不规则充盈缺损及完全阻塞,其中栓塞表现为中央型充盈缺损4例、偏心性充盈缺损12例、附壁血栓4例及完全阻塞5例;间接征象有肺门动脉增宽、肺梗死、局限性肺纹理稀疏、胸腔积液、右心室肥大等.结论MSCT肺血管造影诊断肺动脉栓塞,无创、快捷、有效、敏感性高,可作为肺栓塞的首选检查方法.     

多层螺旋CT肺动脉栓塞直接征象与溶栓效果的对照

目的　探讨多层螺旋CT肺血管造影 (MDCTPA)中肺动脉栓塞 (PE)直接征象与内科溶栓治疗效果的联系。方法　对比分析 2 8例PE患者于溶栓前后MDCTPA的影像表现 ,依据MDCTPA表现具体分型为 :Ⅰ型 :管腔中心充盈缺损。Ⅱ型 :附壁充盈缺损并凸向腔内。Ⅲ型 :附壁充盈缺损并凹向腔内。Ⅳ型 :血管分支没有增强。结果　 2 8例PE影像资料中 ,受累肺动脉共计 93支 ,可分析的受累肺动脉分支 (2～ 4级 )共 74支。统计提示Ⅲ型栓塞表现的内科溶栓抗凝治疗效果 (2 3% ,5 / 2 2支 )显著差于Ⅰ型 (95 % ,19/ 2 0支 )与Ⅱ型 (77% ,2 0 / 2 6支 ) ,差异有显著性意义 (χ2 值分别为 2 2 344和14 0 2 5 ,P值均P <0 0 1)。结论　MDCTPA对肺动脉栓塞影像表现的精细显示 ,能够对内科溶栓抗凝治疗效果进行预测 ,有助于制定临床治疗方案     

螺旋CT肺动脉造影对肺栓塞的诊断

目的：评价螺旋CT及其肺动脉造影诊断肺动脉栓塞（PE）的价值。方法：回顾性分析12例PE患,均行螺旋CT容积扫描,并在工作站进行图像后处理,获得肺动脉多平面重建图像及三维立体图像。结果：对12例196支肺动脉分支进行分析,受累率为46.4%;栓子发生在主肺动脉、左右肺动脉干及叶段肺动脉。多平面重建图像上表现为充盈对比剂血管内有充盈缺损区,或其远侧方无对比剂充填区。肺动脉成像示,主干血管内可见充盈缺损影,或呈截断状影;叶栓塞或段栓塞亦呈突然“截断状”,其远侧方肺动脉分支不显影或呈纤维状。结论：螺旋CT肺动脉造影不仅可以获得轴位图像,而且可以获得立体图像,可多轴向旋转观察PE部位,是诊断叶或段以上PE可靠而直观的检查方法。     

256层螺旋CT血管造影对肺栓塞的临床诊断价值

目的评价256层螺旋CT对肺栓塞(PE)的临床诊断价值,着重探讨肺栓塞的好发部位及分布规律。方法采用Philips 256层brilliance i CT对我院70例疑似PE的患者行肺动脉CT血管造影,并运用多种后处理软件对影像特征进行分析。结果 CT肺血管造影(CTPA)确诊肺栓塞24例,共发现栓子125个。栓塞部位主要位于两下肺动脉(占72.00%),以肺段动脉栓塞最多见(占56.00%),栓塞类型以偏心型肺栓塞(占52.00%)为主。间接征象中,胸腔或心包积液5例,肺梗死7例,肺动脉高压9例,马赛克征或肺少血征11例,心功能不全3例等。双侧肺栓塞21例,仅右肺栓塞3例,7例PE患者溶栓治疗后复查CT,血栓均有减少或消失。结论 256层螺旋CT具有超高空间分辨率及密度分辨率,同时配合强大的后处理软件,能准确、快速的诊断肺动脉栓塞,成为临床首选方法。     

增强螺旋CT和肺动脉造影在肺动脉栓塞诊断和治疗中的应用

目的 评价螺旋CT和肺动脉造影在肺动脉栓塞诊断和治疗中的作用。方法 回顾性分析经螺旋CT增强和肺动脉造影明确诊断的18例患者的影像资料。其中12例经肺动脉造影后，行导管抽吸和局部溶栓治疗。结果 18例患者累及107处肺动脉及其分支，双肺下叶主支受累最多，达28．97％，累及左、右肺动脉主干者占22．43％，累及肺叶以下分支达40．18％，累及主肺动脉者占8．41％。肺动脉栓塞的影像学直接征象包括部分性充盈缺损、附壁性充盈缺损、中心性充盈缺损（即“轨道征”）、完全阻塞，间接征象包括主肺动脉增宽、局限性肺纹理稀疏、肺梗死和胸腔积液。12例术后临床症状改善，动脉血氧分压增高。结论 螺旋CT增强扫描是一种有效的诊断肺动脉栓塞的无创性检查手段，且诊断率较高。     

肺动脉栓塞的螺旋CT血管造影的诊断研究(附七例报告)

目的评价螺旋ＣＴ血管造影（ＳＣＴＡ）诊断肺动脉栓塞（ＰＥ）的可信性。方法对７例临床怀疑ＰＥ的患者行螺旋ＣＴ血管造影,其中６例在溶栓治疗２０天后进行了复查。结果７例患者累及２０处肺动脉及其分支。栓子表现为肺动脉腔内柱状、丘状及不规则形充盈缺损。７例均有肺动脉高压,其中６例中心肺动脉扩张呈“残根征”改变。６例经溶栓治疗后,４例栓子完全消失,１例明显缩小,１例略有缩小。结论螺旋ＣＴ血管造影是诊断中心性肺动脉栓塞可靠而直观的检查方法,并可较准确地判断溶栓疗效。     

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.