CT检查502例外伤性颅底骨折

目的:评价CT对外伤性颅底骨折诊断的价值.材料和方法:经CT轴位颅底薄层扫描确诊为颅底骨折的病人502例,分析骨折情况;其中65例病人加作3mm薄层螺旋扫描再作1mm薄层骨算法重建,并与自身常规薄层扫描进行比较.结果:颅前窝骨折者272例、颅中窝骨折者122例,颅后窝骨折者135例;两个颅窝同时骨折者73例,三个颅窝同时骨折者7例;在经两种不同扫描方法检查的65例中比较骨折显示率,常规薄层扫描为80.26%;3mm薄层螺旋扫描再作1mm薄层骨算法重建为100%,经统计学分析差异有显著性(0.05≥P＞0.01).结论:常规CT轴位薄层扫描能直接显示颅底骨折的直接征象和间接征象,对外伤性颅底骨折的诊断有重要价值;螺旋CT轴位3mm薄层螺旋扫描、1mm薄层骨算法重建能明显提高颅底骨折的显示率.     

16层螺旋CT鼻窦区冠状位重组图像与扫描图像的对比研究

目的对比分析16层螺旋CT不同扫描方法以及不同重建算法对鼻窦区解剖结构的显示。方法将56例鼻窦扫描患者分为正常组（34例）与炎症组（22例）。每组患者根据扫描方法不同分为轴位扫描冠状位重组组和直接冠状位扫描组,均用软组织算法重建。选取其中正常组18例、炎症组16例同时行高分辨率算法重建。评价不同扫描方法、不同重建算法时的图像质量。结果两组中冠状位重组图像与直接冠状位扫描图像的图像质量差异均无统计学意义。正常组中,高分辨率重建算法的图像质量均高于软组织重建算法,差异有统计学意义;炎症组中,高分辨率重建算法与软组织重建算法的图像质量的差异无统计学意义。结论利用16层螺旋CT轴位扫描图像并进行冠状位重组,所得信息明显优于只对患者进行一次冠状位扫描,且高分辨算法对正常组细小结构的显示优于软组织算法。     

螺旋CT多平面重组在副鼻窦检查中的应用

目的 :利用螺旋CT多平面重组技术探讨副鼻窦轴位扫描能否代替直接冠状位扫描。方法 :对 15例能合作的患者 ,均行副鼻窦轴位及冠状位扫描。使用美国GEProspeedFII双排螺旋CT机 ,层厚 5mm ,螺距 0 .75 ,连续横轴位扫描 ,利用多平面重组 (MPR)技术得到冠状位、矢状位重组图像 ;直接冠状位扫描获取冠状位图像 ;将同一患者的两组不同冠状位图像比较 ,主要观察各鼻窦窦壁及窦口。结果 :轴位扫描后重组所获图像亦能从多方位多角度观察 ,清楚显示各鼻窦及窦口。结论 :重组冠状位图像与直接冠状位扫描图像效果相同 ,可以取代直接冠状位扫描。避免后者检查时头部后仰造成的不适 ,患者容易接受 ,值得推广。     

筛骨骨折16层螺旋CT薄层扫描研究

目的:探讨16层螺旋CT对外伤性筛骨骨折的诊断价值.方法:收集经常规轴位颅底5mm螺旋扫描2.5mm高分辨率骨算法重建(常规组),复查时接受2.5mm薄层螺旋扫描1.25mm高分辨率骨算法重建(薄层组),共108例,比较这两种扫描方法的骨折诊断情况.结果:108例筛骨骨折患者中,骨折线仪累及筛骨右侧40例,仅累及左侧47例,累及双侧21例;线性骨折37侧,凹陷性骨折71侧;筛骨骨折伴内直肌肿胀、迂曲46侧,筛窦眶内容物疝57侧,内直肌与纸样板间脂肪间隙变窄或消失85侧.脂肪间隙增宽9侧,脂肪间隙混浊98侧;眶内积气29侧,眼球内陷12侧,眼球突出18侧,伴视神经肿胀23侧,筛窦外伤性积液、积血59侧.比较两组骨折显示率:常规组为78.20%;薄层组为100%,经统计学(U检验)分析差异有高度显著性(P<0.01).结论:常规组扫描法能显示筛骨骨折的直接征象和间接征象,能很好地分型,有诊断价值;缺点是漏诊率较高.薄层组扫描法对筛骨骨折的正确分型以及显示骨折的直接和间接征象的能力都明显地优于常规组,能克服常规组的不足.能充分发挥16层螺旋CT的优势,对法医伤情鉴定及临床治疗具有重要意义,值得推广.     

颞骨平行枕眶线多层螺旋CT扫描法及其价值

目的:探讨以平行枕眶线扫描图像为基础的常规轴位和冠状位MPR图像是否能够取代直接轴位和冠状位图像。方法:三位医师分别观察50例颞骨CT扫描图像,分析直接常规轴位(25例)、冠状位(25例)CT扫描图像和其相应的常规轴位、冠状位MPR图像显示颞骨结构的差异。结果:所有观察者均认为直接常规轴位、冠状位CT扫描图像略优于相应的轴位、冠状位MPR图像。直接轴位、冠状位CT扫描图像和相应的轴位、冠状位MPR图像的质量差异较小。结论:以平行枕眶线扫描图像为基础的常规轴位和冠状位MPR图像可取代直接轴位和冠状位扫描图像。     

多层螺旋CT在肋骨骨折中的应用

目的 :探讨多层螺旋CT扫描检查对肋骨骨折的诊断价值。方法 :65例肋骨骨折患者行X线及多层螺旋CT扫描检查 ,观察和分析骨折的位置、数量及周边的其他病变。结果 :65例中 ,CT检查共发现肋骨骨折 12 1处 ,肋软骨骨折 5处。冠状位及矢状位重组图像清晰地显示出骨折线的数目及断端移位情况。结合 4D重组图像 ,肋骨骨折线的显示更直观、明了。X线检查共发现肋骨骨折 117处 ,肋软骨骨折 0处。结论 :多层螺旋CT轴位图像、MPR及 4D重组图像的联合应用 ,对判断肋骨骨折有很高的诊断价值 ,优于常规X线检查。     

CT冠状面与轴位扫描对颅底骨折诊断的比较研究

目的探讨ＣＴ冠状面扫描在颅脑外伤合并颅底骨折诊断中的应用价值。方法采用ＣＴ冠状面和轴位扫描,对２６例颅脑外伤并颅底骨折患者进行分析对比。结果２６例颅底骨折中ＣＴ冠状面扫描显示骨折线２２例,占８４．６％,ＣＴ轴位扫描显示骨折线７例,占２６．９％,两组比较有显著性差异（Ｐ＜０．００１）。结论在颅脑外伤并颅底骨折时,应用ＣＴ轴位扫描加冠状面扫描能进一步明确颅底骨折的部位、范围和程度,具有重要的临床应用价值     

64排CT不同重建方法对桡骨下端隐匿性骨折的诊断价值比较

目的比较多排螺旋CT不同重建方法对桡骨下端隐匿性骨折的诊断价值。方法回顾性分析42例桡骨下端隐匿性骨折患者的螺旋CT资料,均对桡骨下端进行轴位MPR、矢状位MPR、冠状位MPR、容积重建(VR)成像,比较不同重建方法所得图像对桡骨下端隐匿性骨折的显示情况。结果42例桡骨下端隐匿性骨折中,轴位MPR、矢状位MPR、冠状位MPR、VR图像对骨折的显示率分别为64.3%、90.5%、83.3%、52.4%。对桡骨下端隐匿性骨折,矢状位MPR及冠状位MPR优于轴位MPR及VR图像(P0.05)。矢状位MPR与冠状位MPR对桡骨下端隐匿性骨折的显示率差异无统计学意义(P=0.508),轴位MPR与VR图像对桡骨下端隐匿性骨折的显示率差异无统计学意义(P=0.267)。结论螺旋CT的MPR图像可准确地检出桡骨下端隐匿性骨折。矢状位MPR及冠状位图像显示骨折线更清楚,需重点观察,轴位MPR图像对骨折显示率低,VR图像对桡骨下端隐匿性骨折有时难于判断。     

颅底骨折的CT薄层扫描高分辨重建技术与常规扫描的对比研究

目的　通过 2种扫描方法的对比 ,探讨CT薄层扫描 ,高分辨重建技术的特点 ,各类参数的使用 ,以及该技术在颅底骨折检查中的优越性。方法　对经筛选的 2 8例脑外伤病人除进行常规CT检查外 ,又对其颅底进行薄层扫描 ,并进行高分辨重建。结果　 2 8例脑外伤病人在常规CT检查时 ,只有 2 0例怀疑有颅底骨折 ( 71.4%) ,但不能确诊 ,在进行薄层扫描 ,并进行高分辨重建后 ,2 8例均可确诊为颅底骨折 ( 10 0 %)。高分辨薄层图像 ,清晰显示骨折线 ,并且每个病例有多幅图像支持诊断。结论　对疑有颅底骨折的病人 ,正确而熟练地运用CT薄层扫描 ,并进行高分辨重建 ,能明确诊断 ,减少误诊     

256层螺旋CT轴位与冠状位重建对窦口-鼻道复合体正常解剖及变异的对比观察

目的：探讨多层螺旋CT（MSCT）轴位和冠状位重建对窦口-鼻道复合体（OMC）区域的正常解剖结构和变异显示能力及差异。方法：利用32例健康体检者和23例因非鼻及副鼻窦疾病而行头颈部CT扫描者,常规扫描后进行轴位和冠状位标准重建,分别对比观察OMC区域的正常解剖结构和变异及显示能力。结果：轴位和冠状位重建图像对双侧额窦开口、中鼻甲和中鼻道的显示能力无明显差异。但轴位图像在显示筛漏斗、前中组筛窦、上颌窦开口及钩突等的显示能力明显较冠状位差。结论：对OMC区域的正常结构和变异的显示冠状位明显优于轴位,冠状位重建可以代替冠状位扫描,以消除冠状位扫描给患者带来的不便。     

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.