桥本甲状腺炎的CT诊断

目的　分析桥本甲状腺炎 (HT)的CT表现 ,探讨其CT特征。资料与方法　回顾分析经病理证实的 2 4例HT的CT表现 ,并与病理作对照。结果　单纯弥漫性改变 16例 ,CT平扫表现为甲状腺弥漫性肿大 ,密度均匀降低 ,接近软组织密度 ,未见钙化 ,均匀强化。弥漫性改变伴结节 8例 ,其中伴多发结节 3例 ,CT表现为弥漫肿大之甲状腺内见多发结节状稍低密度影 ,边界尚清 ,轻度强化 ;伴单发结节 5例 ,其中 4例合并甲状腺癌 ,轻度增大密度减低的甲状腺内见类圆形低密度影 ,均 <3cm ,边界清 ,除 1例中间有裂隙样更低密度影外 ,余均匀强化 ,3例见低密度圈影环绕。另 1例单发结节为单叶术后病例。结论　HT的CT特征大多为弥漫性肿大 ,密度均匀降低 ,无钙化 ,边缘清楚 ,均匀强化 ;有时伴结节 ,特别是单发结节 ,合并癌的可能性较大     

泡状棘球蚴病肝外转移的CT影像特点

目的 探讨肝外泡状棘球蚴病(AE)的CT诊断及鉴别诊断.资科与方法回顾性分析31例经手术或活检病理证实的肝外AE的CT表现. 结果肺AE 24例,CT表现为以肺野外带和肺底分布为主的单发或多发肿块结节,内见钙化灶、小空泡征或空洞;脑AE 17例,平扫呈均质实性肿块或实性肿块伴多发囊泡,增强扫描呈靶样环状强化,6例病灶周围显示小囊泡征;骨AE 4例,CT表现为溶骨性骨质破坏,内见结节样或小圈状钙化灶,病变突破骨皮质后形成软组织肿块;肾上腺AE 14例,CT表现为混杂密度肿块内多发的结节样钙化灶或小囊泡征;肾AE 2例;累及腹膜后和背部软组织AE 4例.结论 CT检查能够明确AE肝外转移部位和侵犯范围,其表现有一定特征,结合流行病史有助于诊断.     

婴幼儿肾脏肿瘤的CT表现

目的：探讨婴幼儿肾脏肿瘤的CT表现及其诊断价值。方法：回顾性分析经病理证实的24例婴幼儿肾脏肿瘤的临床及CT资料,总结分析肿瘤的类型及CT表现。结果：24例中,肾母细胞瘤17例,CT表现为单侧肾脏内混杂密度肿块伴较明显囊变坏死,强化不均匀;2例伴钙化,1例肿块内见脂肪密度;2例伴肾静脉或下腔静脉癌栓,3例伴远处转移（肺、肝脏、骨、胸壁及淋巴结转移）。中胚层肾瘤2例,CT表现为肾脏内软组织密度结节,密度欠均匀,中度强化。透明细胞肉瘤1例,CT表现类似肾母细胞瘤,坏死更显著。乳头状淋巴管内血管内皮瘤1例,CT表现为肾脏内类圆形低密度灶不均质轻度渐进性强化。XP11.2易位性肾癌1例,CT表现为单侧肾脏混杂密度肿块,内有点状钙化,轻度不规则强化,伴腹膜后转移。淋巴瘤2例,其中Burkitt瘤1例,CT表现为双肾多发等密度结节,轻度强化;肝脏内多发低密度灶,轻度强化;急性髓系白血病侵犯肾脏1例,CT表现为单侧肾脏、腹腔、腹膜后、肠系膜及胸壁多发巨大不规则软组织密度肿块。结论：肾母细胞瘤多发于1岁以上的婴幼儿;中胚层肾瘤多发生在1岁内。婴幼儿肾脏肿瘤的诊断参考临床资料结合CT表现,可提高术前诊断准确率。     

Castleman病多系统病变的CT表现

目的 分析Castleman病（CD）多系统病变的CT表现特征,提高对本病各系统受累的影像学认识。方法 选取31例经病理确诊为Castleman病的CT图像资料,其中单中心型（UCD）17例,均为透明血管型（HV）;多中心型（MCD）14例,均为浆细胞型（PC）。结果 17例UCD位于颈部3例,胸部9例,腹部5例,CT表现为单发均质或主体均质等密度类圆形肿物,14例增强后肿物呈均质或主体均质明显强化。4例出现结外器官肺异常,3例表现为肺内小结节影,1例呼吸气相HRCT两肺表现为闭塞性细支气管炎。14例MCD均可见全身多发淋巴结肿大,11例增强扫描显示肿大淋巴结均质强化;其中淋巴结轻度强化7例,中度和明显强化各2例。14例MCD中,12例出现结外器官组织异常,其中8例出现肺部异常,7例肝脾肿大,4例出现浆膜腔积液;肺部异常表现为两肺小叶中心分布小结节影8例,1～2 cm大结节影2例;其他征象包括：磨玻璃密度影、小叶间隔增厚和索条影各4例,斑片状实变3例,囊腔2例,血管支气管束增粗1例。结论 CD除了淋巴结外,还累及结外器官,具体CT表现与CD的病理分型有关。     

儿童颅面骨转移性神经母细胞瘤的CT和MRI诊断

目的 探讨儿童颅面骨转移性神经母细胞瘤的CT和MRI特征.方法 分析7例经病理证实的颅面骨转移性神经母细胞瘤患儿的CT和MRI资料,7例患儿均行眼眶CT平扫、MRI平扫和增强扫描,其中5例行上腹部平扫,3例行腹部增强扫描.结果 7例患儿中6例多发,1例单发;多发病灶以颅眶骨交界为著.CT均表现为受累骨质呈虫蚀状破坏,骨皮质毛糙不整,骨膜下可见垂直针状高密度影,受累骨质周围见梭形稍高密度肿块,内见斑点、斑片、不规则高密度影;7例MRI平扫表现为正常骨髓信号被软组织肿块替代,肿块呈等T1、不均匀等、稍长T2信号;MRI增强扫描显示病变不均匀强化,其中4例伴相邻脑膜增厚、异常强化、破坏中断.5例上腹部CT平扫表现为单侧肾上腺区或腹膜后软组织肿块伴腹膜后多发淋巴结肿大,肿瘤密度不均;3例上腹部CT增强扫描显示病变不均匀强化.结论 儿童颅面骨转移性神经母细胞瘤的CT和MRI表现具特征性,CT对针状骨膜反应和肿块内钙化斑的显示较MRI更具鉴别诊断价值,而MRI对病变范围及脑膜转移的显示优于CT.     

儿童Castleman病CT影像表现

目的：Castleman病又称巨大淋巴结增生症,是一种介于炎症和肿瘤之间的少见的不典型淋巴组织增生性疾病,儿童病例更是罕见。总结分析儿童CD的病理及CT影像学表现,以期提高对儿童CD的cT表现的认识及诊断。方法：回顾性分析2009年-2012年临床及CT影像资料完整经手术病理证实的6例儿童CD患者。结果：6例中男4例,女2例,年龄10～12岁的5例,4岁1例,平均年龄9．7岁。局限型CD5例（83％）,病理类型均为透明血管型,多中心型1例（17％）,病理类型为浆细胞型。5例透明血管型中的4例CT平扫均表现为团块状均匀的软组织密度影,增强后明显均匀强化,呈类似血管样强化,可见丰富的滋养血管,未见明显钙化、坏死及囊变征象。1例发生于腹膜后的透明血管型CD表现为巨大不规则混杂密度影,伴有典型中央分支状钙化,并可见明显坏死、囊变,增强后明显不均匀强化,亦可见较多滋养血管。1例浆细胞型CD表现为多发淋巴结肿大,CT平扫密度均匀,边界清楚,增强后轻到中度强化,未见明显滋养血管及钙化、囊变等。结论：儿童CD的,临床表现多样,诊断较为复杂,CD病变均发生在淋巴组织丰富的部位。年长学龄儿童多见,CT表现与病理分型密切相关,透明血管型CD在CT增强后的类似血管样强化有一定的特征,能提供较大的诊断价值。     

肾上腺少见肿瘤的CT表现及其病理基础

目的探讨肾上腺少见肿瘤的CT表现特征与病理的相关性,以提高诊断水平。资料与方法对18例经手术病理证实的少见肾上腺肿瘤进行回顾性分析,包括肾上腺节细胞神经瘤5例,髓性脂肪瘤4例,淋巴瘤3例,囊肿、神经鞘瘤各2例以及神经节母细胞瘤、畸胎瘤各1例。在CT图像上,观察病变的位置、大小、形态、密度、内部结构及其与周围结构的关系。结果肾上腺节细胞神经瘤CT表现为均匀软组织密度肿块,1例有点状钙化。髓性脂肪瘤为以脂肪密度为主的肿块。淋巴瘤为软组织密度肿块。良性神经鞘瘤为软组织肿块,有囊变及钙化;恶性神经鞘瘤也为软组织肿块,内见坏死区,伴淋巴结转移。囊肿呈水样密度,壁薄光整,1例有囊壁钙化。神经节母细胞瘤为密度不均匀软组织肿块,内见坏死灶,伴周围淋巴结肿大。畸胎瘤为含钙化、脂肪及软组织成分的肿块。结论CT可揭示肾上腺少见肿瘤的病理基础,它们存在一定的影像表现特点,CT是临床上最常用的影像学检查方法。     

纵隔局限型透明血管型Castleman病的CT诊断和鉴别诊断

目的:分析纵隔局限型透明血管型Castleman病的CT表现特征,探讨与纵隔其他病变的CT鉴别诊断要点,以提高其影像诊断准确率,减少误诊。方法:回顾性分析7例经临床诊断及病理证实的纵隔局限型透明血管型Castleman病的CT表现,观察病变生长部位、形态、边缘、密度及其强化特点。结果:本组7例,肿块均位于纵隔内或大部分位于纵隔内,其中4例均位于前上纵隔血管前间隙、中线旁偏一侧生长,1例位于右心缘旁,2例位于主肺动脉窗;7例病变均呈类圆形或椭圆形,其中5例病变边缘清晰光整,2例边缘略呈浅分叶状改变;5例病变部分与邻近肺野相邻、瘤肺界面光整;7例病变均呈软组织密度肿块影,4例病变中央可见裂隙状低密度影,1例可见点状钙化影;7例增强扫描均呈明显不均匀强化、CT值平均增加(70±13)HU,4例中央裂隙状低密度影强化不明显,2例病变边缘可见粗大迂曲血管影,2例可见强化包膜影。影像学表现为类似胸腺肿瘤4例,类似淋巴瘤或淋巴结转移2例,其他1例。结论:纵隔局限型透明血管型Castleman病主要CT表现为软组织密度肿块伴显著持续强化,病变内少见钙化及无强化的裂隙状低密度影,具有一定特征性,可提高其影像诊断的准确率、减少误诊。     

Castleman病的CT表现及病理分析

目的：探讨Castleman病（CD）的CT表现特征,以提高该病的诊断准确率。方法：收集经病理证实的10例CD,结合病理分析其CT表现特征。结果：10例中局限型CD 8例,病理均为透明血管型,均为单发,其中颈部2例,腹膜后肾脏前上方1例,前上纵隔2例,后纵隔1例,右肺门旁1例,右侧盆腔入口腰大肌旁1例,最大径3.3～8.5 cm（平均6.1 cm）;均呈圆形、类圆形或椭圆形肿块,7例密度均匀,1例密度不均,2例伴斑点状、条状钙化,6例边界清晰,2例部分边界与邻近结构欠清;增强扫描6例中,5例明显强化,1例中度强化,4例均匀强化,2例不均匀强化,4例病灶周围见强化血管影。多中心型CD 2例,1例双侧腋窝、腹膜后及双侧腹股沟多发增大淋巴结,增强扫描淋巴结呈均匀轻中度强化,病理为透明血管型;1例双侧肺门及纵隔多发增大淋巴结,病理为浆细胞型。结论：典型的CD常为局限型,病理上多为透明血管型,其CT表现具有显著特征性,有较高的诊断价值;不典型的CD仍需病理确诊。     

腮腺淋巴瘤的CT表现

目的 探讨腮腺淋巴瘤的CT表现特点.方法 搜集经针刺活检或手术病理证实的腮腺淋巴瘤6例,结合文献,详细分析其CT表现特点.结果 6例中发生于右侧3例,左侧2例,双侧1例.2例表现为腮腺内单发巨大软组织肿块影;4例呈多发结节及肿块影,伴有颈部淋巴结肿大并且融合呈团块影.6例病灶密度均匀,肿块大而无坏死或仅有少量坏死,边缘清楚,增强扫描病灶明显强化.结论 根据CT表现特点,可提示腮腺淋巴瘤的诊断.     

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.