MSCT灌注成像在乳腺肿瘤诊断中的临床应用

目的 评价MSCT灌注成像对乳腺良恶性肿瘤的诊断价值.资料与方法 对20例乳腺肿瘤(包括15例乳腺癌和5例纤维腺瘤)的MSCT灌注成像进行回顾性分析.结果 乳腺癌组与对侧正常乳腺组间血流量(BF)、血容量(BV)和表面通透性(PS)差异有统计学意义(P<0.05),但MTT均值差异无统计学意义(P>0.05).纤维腺瘤组与乳腺癌组之间的BF、BV和PS差异有统计学意义(P<0.05),MTT均值差异无统计学意义(P>0.05).大于2 cm的乳腺癌的中心与边缘之间的BF、BV和 PS差异有统计学意义(P<0.05), MTT均值差异无统计学意义(P>0.05).小于2 cm的乳腺癌的中心与边缘之间的BF、BV、MTT和PS差异无统计学意义(P>0.05).结论 MSCT灌注能反映乳腺病变的血液灌注特点,有助于乳腺良、恶性病变的鉴别诊断.     

CT灌注成像在乳腺癌及部分乳腺良性疾病诊断中的应用研究

目的 探讨CT灌注检查在乳腺疾病诊断中的应用价值. 资料与方法 将22例分为乳腺癌组和乳腺炎症组行CT灌注检查,采用GE AW4.1工作站perfusion 3体部肿瘤灌注软件行图像后处理,得出各组灌注参数值并与正常乳腺组织进行对照分析. 结果 乳腺癌组、乳腺炎症组表面通透性(PS)、血容量(BV)、血流量(BF)平均值均高于正常乳腺组织,其差异具有统计学意义(P＜0.05).乳腺炎症组PS、BV平均值高于乳腺癌组,两者差异具有统计学意义(P＜0.05).平均通过时间(MTT)值差异均无明显统计学意义(P＞0.05).术后瘢痕区PS、BV、BF平均值低于正常乳腺组织. 结论 CT灌注检查可以反映乳腺病变的血流灌注及功能学改变,是诊断乳腺病变可行的辅助检查方法.     

MSCT灌注成像对肺内肿块的定性及定量研究

目的:探讨多层CT灌注成像对肺部肿块的诊断价值并与肿瘤血管生成进行相关性分析。方法:对53例确诊的肺部结节或肿块性病变进行CT灌注成像。分析并记录血流量(BF)、血容量(BV)、平均通过时间(MTT)和毛细血管表面通透性(PS)。27例手术切除标本进行免疫组化染色,测定MVD和VEGF表达值,并与CT灌注参数进行相关性分析。结果:3组结节间BF、BV、PS值均表现为恶性>炎性>良性;恶性结节的BF、BV和PS值均显著高于良性结节,差异有极显著性意义(P<0.01);恶性与炎性结节间、炎性与良性结节间PS值差异有显著性意义(P<0.05),BF和BV值差异无显著性意义(P>0.05)。3组结节间MTT值差异无显著性意义(P>0.05)。MVD及VEGF与BF、BV及PS值之间均具有正相关性,与MTT值无明显相关性。结论:CT灌注成像能较全面地反映肺部病变的血流信息,可为肺部病变的鉴别诊断及评价肺癌血管生成提供依据。     

食管癌螺旋CT灌注成像与肿瘤血管生成的相关性研究

目的探讨食管癌螺旋CT灌注成像与肿瘤血管生成的相关性。资料与方法对50例食管癌患者行多排螺旋CT灌注扫描,分析食管癌CT灌注成像参数血容量(BV)、血流量(BF)、平均通过时间(MTT)、表面通透性(PS)与微血管密度(MVD)及血管内皮生长因子(VEGF)表达之间的关系。结果 50例食管癌中,VEGF阳性表达率为62%(31/50),阴性表达率为38%(19/50),MVD值在两组间的差异具有统计学意义(P<0.05);BF值与MVD呈正相关(P<0.05),BV及PS值与MVD呈显著性正相关(P<0.01),MTT值与MVD无相关性(P>0.05);PS值与VEGF表达呈正相关(P<0.05),BF、BV及MTT与VEGF表达无相关性(P>0.05)。结论食管癌CT灌注成像能够在一定程度上反映活体的肿瘤血管生成状况。     

64层CT灌注成像评价周围动脉闭塞性疾病的临床应用研究

目的:探讨CT灌注成像在评价周围动脉闭塞性疾病方面的应用价值.材料和方法:采用64排螺旋CT对24例周围动脉闭塞性疾病患者和14例正常志愿者进行下肢CT灌注扫描,计算血容量(blood volume,BV)、血流量(blood flow,BF)、平均通过时间(mean transit time,MTT)和灌注达峰时间(time to peak,TTP)灌注参数,分析缺血组与对照组各灌注参数之间的差异.将周围动脉闭塞性疾病患者根据病情严重程度的Fontaine分级分成4组,分别对比4个组之间各灌注参数的差异.结果:缺血组BV、BF参数患病下肢均低于对照组(P<0.05).缺血组临床分级各组之间BV值均存在显著差异(P<0.05),BF在Ⅰ级和Ⅲ级间差异有统计学意义(P<0.05).MTT和TTP在各级别组间差异均无统计学意义(P>0.05).结论:BV、BF值可作为CT灌注成像评价周围动脉闭塞性疾病病情轻重的参考指标.     

CT灌注成像在乳腺良、恶性病变诊断中的应用

目的对乳腺病变CT灌注进行初步评价。方法22例乳腺疾病女性行乳腺CT灌注。其中纤维腺瘤1例(合并乳腺囊肿);其他良性病变5例;乳腺癌16例。采用电影模式(0.5s/r),120kV,60mA,5mm×4;注射流率4.0ml/s,延迟5s,扫描时间50s。利用GE公司Perfusion3体部灌注软件,分别测量血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS),并进行统计学分析。结果乳腺癌组BF、BV、MTT、PS均值分别为(33.55±28.40)ml.min-1.100g-1、(5.60±3.08)ml/100g、(15.37±6.41)s和(18.71±10.42)ml.min-1.100g-1,对侧正常乳腺组BF、BV、MTT、PS均值分别为(10.36±9.44)ml.min-1.100g-1、(0.70±0.22)ml/100g、(13.55±7.27)s和(1.54±1.74)ml.min-1.100g-1,2组间BF、BV、PS均值差异有统计学意义(P<0.05),MTT均值差异无统计学意义(P>0.05)。纤维腺瘤BF、BV、MTT、PS均值分别为(62.57±19.62)ml.min-1.100g-1、(7.37±1.30)ml/100g、(11.24±3.34)s和(27.63±3.87)ml.min-1.100g-1,与乳腺癌组之间PS均值差异有统计学意义(P<0.05),BF、BV、MTT均值差异无统计学意义(P>0.05)。其他良性病变BF、BV、MTT、PS均值分别为(7.65±10.24)ml.min-1.100g-1、(1.23±0.97)ml/100g、(14.94±10.68)s和(1.81±1.72)ml.min-1.100g-1,与乳腺癌组之间BF、BV、PS均值差异有统计学意义(P<0.05),MTT均值差异无统计学意义(P>0.05)。结论CT灌注成像能反映乳腺病变的血液灌注特点,提供有价值的血流动力学信息,有助于乳腺良、恶性病变的鉴别诊断。     

活体肝移植术后肝静脉淤血的MSCT灌注研究

目的 利用MSCT灌注成像评价活体肝移植(LDLT)术后肝静脉淤血区及非淤血区的血流动力学改变.方法 22例在本院移植外科施行活体右半肝移植的供、受者纳入本研究,所有受试者均于术后早期(1月以内)进行MSCT平扫、增强及灌注检查,同期纳入10例健康志愿者作为对照组.记录并比较对照组及LDLT术后肝静脉淤血区和非淤血区肝实质的肝血容量(BV)、血流量(BF)、平均通过时间(MTT)、表面通透性(PS)和肝动脉指数(HAF).结果 8例供、受者(36.36%)LDLT术后早期出现肝静脉淤血.与对照组相比,淤血区肝实质BV、BF和HAF升高,具有统计学意义(P<0.05),MTT和PS差异没有统计学意义(P>0.05).非淤血区与对照组肝实质之间各项灌注参数差异均无统计学意义(P>0.05).淤血组与无淤血组非淤血区肝实质之间BV、BF、MTT、PS和HAF差异均无统计学意义(P>0.05).结论 MSCT灌注成像可对肝移植术后肝血流动力学进行检测.     

多层螺旋CT灌注成像在食管癌诊断中的应用价值

目的:探讨多层螺旋CT(MSCT)灌注成像技术诊断食管癌的价值。方法:利用4层MSCT灌注成像技术前瞻性研究分析87例食管癌及40例非食管病变患者食管的各项灌注参数,包括血液流速(BF)、血流量(BV)、平均通过时间(MTT)及表面通透性(PS)。结果:食管癌各项灌注参数值均高于正常食管的灌注参数值,其中MTT及BV在两者之间差异有显著性意义(P<0.05),PS值有极显著性意义(P<0.01)。结论:MSCT灌注成像技术在食管癌诊断中有积极的临床应用价值。     

肾脏肿瘤CT灌注成像的应用分析

目的 探讨多层螺旋CT灌注成像技术在肾脏肿瘤诊断以及预后评估的价值.方法 本实验包括28例肾脏肿瘤病例(21例肾细胞癌、7例良性肿瘤),所有病例均有完整的临床、病理资料.先行肾脏常规平扫,选定肿瘤最大层面进行灌注扫描.将所得数据传入ADW4.2工作站,应用Perfusion 3.0软件以同层面腹主动脉作为流入动脉分别测量BF、BV、MTT、PS,并进行统计学分析.结果 肾细胞癌、肾脏良性肿瘤及对侧正常肾脏CT灌注值BF、BV、PS均值组间差异有统计学意义(P<0.001),MTT均值差异无统计学意义(P>0.05).结论 不同性质肾脏肿瘤CT灌注值有明显差异.CT灌注成像有助于术前判断肾脏肿瘤性质、分期及预后.     

胃肿瘤64层螺旋CT灌注成像的初步研究

目的 探讨64层螺旋CT胃灌注成像在胃癌及胃间质瘤诊断及鉴别诊断中的临床应用价值.方法 对经手术病理证实的73例胃癌及43例胃间质瘤患者行64层螺旋CT灌注成像扫描,经ADW4.3工作站处理,得出相关灌注参数及灌注图像,并进一步分析不同分化程度胃癌及胃间质瘤与其灌注参数之间的关系.结果 胃癌灌注参数:血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)值分别为(121.6±61.06) ml·100 g-1·min-1,(10.45±7.09) ml/100 g,(6.89±3.59) s,(26.31±14.99) ml·100 g-1·min-1;良性胃间质瘤灌注参数BF、BV、MTT、PS值分别为(77.28±25.57) ml·100 g-1·min-1,(7.91±2.84) ml/100 g,(7.37±2.38) s,(13.99±4.06) ml·100 g-1·min-1;恶性胃间质瘤灌注参数BF、BV、MTT、PS 值分别为 (95.13±29.75) ml·100 g-1·min-1,(8.21±2.65) ml/100 g,(7.33±1.83)s,(14.15±4.04) ml·100 g-1·min-1.不同分化程度胃癌(分化组与未分化组)灌注参数值PS差异有统计学意义(P<0.01);不同分化程度胃间质瘤(良性与恶性)灌注参数BF、BV、MTT、PS值差异均无统计学意义(P＞0.05);胃癌与恶性胃间质瘤灌注参数BF、MTT、PS值差异有统计学意义(P<0.05).结论 64层螺旋CT灌注成像对于进一步明确胃癌及胃间质瘤的诊断及鉴别诊断具有较大的临床应用价值,并对其治疗及预后方面有一定指导意义.     

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.