距骨缺血坏死的MRI表现(附12例报告)

目的 评价MRI检查对距骨缺血坏死早期诊断及治疗方法选择的价值.方法 对已确诊的12例距骨缺血坏死的MRI表现进行回顾性分析.结果 本组12例均行MRI检查.4例距骨早期坏死,病灶呈不规则条带状异常信号,T1WI呈低信号,T2WI呈高信号,均伴有周围骨髓水肿;8例典型距骨坏死,即地图样表现,T2WI病灶中间呈高信号,周边环绕低信号的硬化带.结论 MRI对于距骨早期缺血坏死的诊断具有重要价值,并且可以准确评价其坏死程度,为临床治疗方案的选择提供客观依据.     

类风湿性关节炎的MRI表现及其临床价值

目的:探讨类风湿性关节炎的MRI表现及其临床价值。方法:回顾性分析56例经临床诊断的类风湿性关节炎病例的MRI资料,其中5例行增强扫描。结果:56例患者中膝关节受累31例,腕关节受累18例,掌指关节7例。所有受累关节滑膜弥漫性增厚,表现为稍长T1、稍长或长T2信号,T2WI压脂序列呈稍高信号,增强扫描可鉴别关节积液与增厚滑膜。骨髓水肿13例,表现为骨质斑片状稍长T2稍长T1信号,T2WI压脂序列呈稍高信号,界限不清,软骨及骨侵蚀30例,软骨侵蚀表现为T1WI和T2WI压脂序列上信号减低或升高,骨侵蚀在T1WI上为低信号,在T2WI及T2WI压脂序列上为低-高信号,韧带、半月板及肌腱受累50例,表现为增厚滑膜与其界限不清,T1WI及T2WI上信号增高。结论:类风湿性关节炎在MRI各序列上的信号特点具有一定特征性,可作为临床上类风湿性关节炎的重要检查方法。     

膝关节色素沉着绒毛结节性滑膜炎的MRI表现与病理对照研究

目的：探讨膝关节色素沉着绒毛结节性滑膜炎（PVNS）的MRI特征与病理变化的关系。方法通过对11例膝关节PVNS的MRI表现与病理结果进行对照分析,评价膝关节PVNS的MRI影像特点。结果11例中,弥漫型10例,局限型1例;不同程度关节腔积液及关节内脂肪垫受侵7例,半月板及交叉韧带受累4例,软骨或骨受累8例。11例MRI影像均有关节滑膜增厚、滑膜内软组织结节表现,结节于T1WI呈等或低信号,于T2WI呈低信号,1例见滑膜结节内出血,表现为T1WI及T2WI高信号。病理均可见数量不等的增生滑膜绒毛结节,有丰富血管和含铁血黄素沉着。结论PVNS绒毛结节内T1WI呈等或低信号、T2WI呈低信号为其特征性表现,与术中及病理相符,MRI对PVNS的诊断和鉴别诊断具有重要的临床价值。     

手关节MRI在早期类风湿关节炎中的临床应用

目的:探讨早期类风湿关节炎(rheumatoid arthritis,RA)手关节MRI表现及其临床价值。方法:回顾性分析40例经临床诊断早期RA的手关节MRI资料,分析主要MRI征象。结果:40例中,腕关节受累18例,掌指关节10例,近节指间关节12例。所有受累关节有不同程度的滑膜炎和血管翳形成,表现为T1WI稍低信号,T2WI稍高信号,压脂T2WI呈高信号,病变范围显示更清晰。骨髓水肿28例,表现为骨质斑片状T1WI稍低信号,T2WI稍高信号,压脂T2WI呈高信号,界限不清。软骨及骨侵蚀20例,软骨侵蚀表现为毛糙或变薄,T1WI呈稍低信号和压脂T2WI上呈稍低和稍高信号,骨侵蚀表现为关节面边缘不规则小的缺损,T1WI呈低信号,T2WI呈稍高信号,压脂T2WI呈高信号,边界清晰。肌腱受累8例,表现为腱鞘积液和腱鞘滑膜增厚,T1WI呈稍低信号,T2WI呈高信号。5例增强扫描增厚滑膜和血管翳明显强化。10例早期RA治疗后复查,8例滑膜炎、骨髓水肿不同程度缓解,2例骨质侵蚀无明显改善。结论:早期RA手关节MRI各序列上的信号特点具有一定特征性。MRI检查成为RA早期诊断、监测进展及治疗后疗效评估的重要方法。     

不规则骨骨巨细胞瘤的MRI诊断

目的:分析不规则骨骨巨细胞瘤的MRI征象,提高对不规则骨骨巨细胞瘤影像学表现的认识及鉴别诊断水平.方法:结合文献对7例经手术病理证实的不规则骨骨巨细胞瘤的MRI影像表现进行分析.结果:MRI主要影像表现为膨胀性改变、溶骨性破坏及软组织肿块.病变在T1WI呈等或低信号,T2WI为低到高不均匀信号.结论:MRI检查对不规则骨骨巨细胞瘤的诊断和鉴别诊断具有明显的价值,并为临床手术提供可靠的资料.     

软骨母细胞瘤的影像学表现

目的 :探讨软骨母细胞瘤的影像学特征及诊断价值。方法 :分析9例经病理证实的软骨母细胞瘤的影像学表现。结果:病灶位于肱骨3例、股骨3例、胫骨2例、距骨1例;病灶呈类圆形、分叶状骨质破坏区,膨胀性生长6例,偏心性生长7例。病灶内常见钙化灶,病灶周缘见硬化边,少数有软组织肿胀、骨膜反应。T1WI呈稍低信号,T2WI呈高低混杂信号,病灶周围骨髓腔见长T1、长T2水肿信号,骨膜反应呈条状长T1、短T2信号。结论:软骨母细胞瘤好发于青少年四肢长管骨骨骺区,具有一定的影像学特征,结合X线、CT和MRI一般能作出正确诊断,但应注意与其他骨病鉴别。     

中耳炎侵犯迷路的影像表现

目的:探讨中耳炎侵犯迷路的HRCT和MRI表现及其诊断价值与局限。方法:回顾性分析24例(24耳),经临床综合诊断为中耳炎侵犯迷路患者的HRCT和MRI表现。结果:骨迷路破坏8耳,HRCT诊断7耳,表现为骨迷路破坏,中耳内病变与迷路腔相通。迷路腔淋巴液受侵14耳,HRCT显示骨迷路破坏9耳,骨迷路完好5耳。MRI示8耳迷路腔淋巴液于T1WI上信号升高,T2WI信号无变化,其中7耳增强扫描有明显强化,1耳轻度强化;5耳迷路腔淋巴液于T1WI信号升高,T2WI信号减低,其中4耳明显强化,1耳轻度强化;1耳迷路腔淋巴液于T1WI和T2WI信号无变化,增强后明显强化。迷路增生、硬化1耳,HRCT显示耳蜗骨迷路骨质增厚、硬化,迷路腔变窄;MRI上表现为蜗腔变细。骨迷路广泛破坏1耳,位于耳蜗后部骨迷路内,HRCT显示骨迷路内大片软组织密度影,周围骨质破坏,内部可见形态不规则死骨;MRIT1WI和T2WI显示骨迷路内均呈混杂信号,增强后有不均匀强化。结论:HRCT和MRI可显示中耳炎侵犯迷路的程度,能为临床制定治疗方案提供重要信息。     

MRI对肺癌诊断的临床价值(附30例报告)

目的:分析肺癌的MRI信号特点,以探讨MRI在肺癌诊断中的价值。方法:回顾性分析30例肺癌MRI表现,以同层椎体为背景,按高、中、低三种等级将30例肺癌统计T2WI、T1WI信号强度变化。结果:中央型19例,在T2WI上呈高信号8例,等信号11例,信号均匀11例,信号不均匀8例;在T1WI上呈略高信号7例,等信号11例,低信号1例,信号均匀15例,不均匀4例。周围型11例,在T2WI上呈略高信号6例,等信号5例,信号均匀6例,信号不均匀5例;在T1WI上略高信号3例,等信号8例,信号均匀7例,信号不均匀4例。增强7例均显示明显强化,肿块与纵隔淋巴结呈一致性强化,肿块呈慢强化,阻塞性肺炎呈快速强化,坏死和纤维组织强化不明显。结论:肺癌的MRI平扫信号在T2WI上以稍高信号至等信号为主,在T1WI上以等信号至稍低信号为主,T2WI能区别实质性肿块与坏死、纤维组织和阻塞性病变,MRI扫描对肺癌制定治疗方案具有重要价值。     

新生儿胆红素脑病脑损伤的MRI诊断价值

目的 :探讨新生儿胆红素脑病(NBE)脑损伤的MRI诊断及应用价值。方法 :回顾性分析45例NBE患儿头部MRI表现及临床资料。结果:45例中33例颅脑MRI表现为双侧苍白球区对称性T1WI高信号,17例T1WI高信号同时累及底丘脑或丘脑腹外侧;T2WI均呈等信号,T2FLAIR呈等或稍高信号;DWI均未见明显异常信号改变。12例1~3个月随访复查颅脑MRI,4例T2WI呈对称性稍高信号,临床上有脑损伤后遗症改变;8例颅脑MRI检查未见明显异常,临床上也未见明显神经异常症状。结论:新生儿NBE颅脑MRI苍白球区有特征性表现,即急性期为苍白球对称性T1WI高信号,慢性期为对称性T2WI稍高信号,可为临床早期诊断及预后判断提供帮助。     

胎儿子宫阴道积液的产前MRI诊断

回顾性分析2014年1月至2021年8月湖北省妇幼保健院12例子宫阴道积液胎儿的临床及MRI资料。5例产前诊断为泄殖腔畸形胎儿均在引产后得到证实, 其中3例为双子宫双阴道, 5例均表现为子宫阴道扩张积液, T2WI上积液信号与膀胱信号相似, T1WI上直肠高信号未见, 结肠扩张, 腹腔积液, 肾积水。7例产前诊断为单纯梗阻性子宫阴道积液的胎儿表现为子宫阴道扩张积液, T1WI上直肠高信号存在, 2例引产及1例生后随访证实为阴道斜隔, 2例生后手术证实为单纯处女膜闭锁, 2例引产证实为阴道闭锁。产前MRI可以排除泄殖腔畸形引起的胎儿子宫阴道积液, 但对单纯梗阻性胎儿子宫阴道积液鉴别诊断困难。     

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.     

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.     

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）