前列腺动脉的解剖及临床意义

前列腺动脉的起源和走行具有较高的变异性;传统解剖学中的前列腺动脉描述与活体影像解剖的表现有部分差异;正确辨认前列腺动脉及其与周围血管的吻合是血管内介入诊疗前列腺疾病的首要和关键.     

Primary synovial sarcoma of the kidney: use of PET/CT in diagnosis and follow-up

Primary renal synovial sarcoma is a rarely seen renal neoplasm. An experienced uropathologist is needed to make the pathological diagnosis. A patient, operated on with a prediagnosis of renal cell carcinoma, the pathology of which was reported as synovial sarcoma, is presented in this article. 18F-fluoro-deoxyglucose positron emission tomography and computed tomography were performed preoperatively and in the postoperative follow-up to detect the primary tumor and lymph node metastases.     

腕管综合征的MRI诊断

研究腕管综合征（CTS）的MRI特征及应用价值。材料和方法：经临床及手术证实的CTS12例，行MRI检查，以横断面为主。结果：12例CTS的MRI表现为：正中神经进入腕管时肿胀增粗12例，正中神经肿胀率（MNSR）为2．25：1。正中神经腕管内受压变扁12冽，正中神经扁平率（MNFR）为3．4。腕横韧带向掌侧膨隆10例，腕横韧带膨隆率（BR）为15．8％。T2WI像正中神经信号增高12例。结论：MRI对CTS的诊断、治疗方式的选择及疗效观察有重要的价值。     

寰椎后桥的X线诊断和临床意义

目的探讨寰椎后桥的临床意义,以提高对寰椎后桥的认识。方法回顾2009年1月至2012年10月期间24例寰椎后桥患者,并分析其成因及临床症状。结果在24例患者中,单纯性寰椎后桥10例．伴骨质增生或椎间盘病变14例;仅有头颈部不适者4例,外伤检查发现1例,发作性眩晕或上肢无力麻木者19例。结论寰椎后桥可以作为颈性眩晕的病因之一,应引起影像科医生及临床医生的重视。     

药物洗脱支架在后循环动脉狭窄治疗中的应用

目的 研究在后循环动脉狭窄治疗中应用药物洗脱支架的安全性和疗效性.方法 经常规造影证实椎动脉狭窄者30例,接受支架置入治疗者19例.局麻或全麻下经右股动脉以Seldinger技术置入6 F导管鞘,在相应导丝辅助下使导引导管进入锁骨下动脉或椎动脉,血管造影后沿导引导管插入0.014英寸、300 cm或205 cm导丝至狭窄远端,经此微导丝交换置入相应规格球囊扩张式CypherTM支架(10例)或TAXUSTM支架(9例).结果 19例患者手术均成功,无死亡和并发症,置入支架贴壁良好,血流明显改善,狭窄远端分支血管(小脑后下动脉等)充盈明显改善,狭窄率由原来的平均87.5%降至平均5.2%.15例表现为眩晕症状的患者术后症状消失12例(80%),改善3例.表现为共济失调的6例患者术后共济运动基本正常4例,明显改善2例,表现为小脑性语言障碍的1例患者术后明显改善.完成至少1次造影随访的患者15例,经DSA证实无再狭窄发生.所有患者门诊随访,最长18个月.结论 药物洗脱支架在后循环动脉狭窄的治疗中安全、有效,在短期内能防止术后再狭窄,长期疗效需进一步观察,需要大样本的随机对照研究进一步证实.     

抑制核因子-κB活性对糖尿病大鼠肾组织一氧化氮水平的影响

目的:研究抑制核因子κB(NFκB)活性对实验性糖尿病大鼠肾组织一氧化氮(NO)水平的影响。方法:雄性Wistar大鼠分为3组,A组(11只)为正常对照组,B组(11只)为糖尿病未干预组,C组(9只)为糖尿病大鼠吡咯烷二硫基甲酸酯(PDTC,NFκB活性抑制剂)干预组。以链脲佐菌素(STZ)制备糖尿病大鼠模型。大鼠饲养18周后取出肾脏以电泳迁移率变动分析技术检测NFκB活性,RT PCR技术检测诱导型NO合成酶(iNOS)mRNA表达并检测肾组织NO水平,同时电镜检测大鼠肾小球基底膜厚度及系膜基质密度(系膜基质面积/系膜面积)。采用大鼠白蛋白特异的酶免疫分析试剂盒检测24h尿白蛋白排泄(UAE)。结果:肾组织iNOSmRNA表达在B组大鼠(0.30±0.12)显著高于A组(0.12±0.04,P<0.01)和C组(0.16±0.08,P<0.01)。肾组织NO水平在B组大鼠(0.56±0.20μmol/mg肾组织)显著低于A组(1.05±0.25μmol/mg肾组织,P<0.01)和C组(1.45±0.61μmol/mg肾组织,P<0.01)。基底膜厚度在B组大鼠(531.6±107.6nm)显著高于A组(312.4±25.4nm,P<0.05)和C组(315.8±21.4nm,P<0.05)。系膜基质密度在B组大鼠(56.41±6.78)显著高于A组(33.95±5.22,P<0.05)和C组(37.97±7.37,P<0.05)。结论:在实验糖尿病大鼠,肾组织iNOSmRNA表达明显增加,但NO水平明显降低;抑制NFκB活性不但能延     

MR imaging of the alar ligament: morphologic changes during axial rotation of the head in asymptomatic young adults

OBJECTIVE:. The alar ligament plays a critical role in limiting the axial rotation of the head, the left alar ligament being stretched on rotation to the right and vice versa. The purposes of this study were to assess the usefulness of MR imaging in demonstrating the alar ligament and also to identify its morphologic changes during axial rotation of the head in asymptomatic young volunteers. DESIGN AND PATIENTS:. Twenty-two healthy volunteers participated in this study. All subjects underwent four series of contiguous fast spin echo density-weighted MR images with a 2 mm slice thickness including axial and coronal images with the head in neutral position, and coronal images with alternate head rotation to the right and left. The alar ligaments seen on each series of MR images were visually graded 0-2, and grade comparisons were performed between the four series of MR images. We also assessed the morphologic changes of the alar ligament on coronal images during axial rotation of the head. RESULTS:. Grade comparisons for the demonstration of the alar ligament revealed that each of three series of coronal images was statistically significantly better in grade than axial images. During axial rotation of the head, MR images showed rather constant morphologic changes of the alar ligament: elevation and wrapping of the contralateral alar ligament around the dens, associated with slightly upward movement of C1-C2 on that side. This wrap-around effect of the contralateral alar ligament in relation to the dens sometimes caused the apparent shortening of the alar ligament on that side. CONCLUSION:. Reliable assessment of the anatomy and function of the alar ligament can be achieved with MR imaging, preferably in coronal planes. MR imaging with the aid of a functional study may be a valuable imaging modality in the evaluation of alar ligament failure.     

磁共振成像对硬脊膜动静脉瘘的诊断及随访价值

目的：讨论MRI对硬脊膜动静脉瘘（SDAVF）的初步诊断及随访价值。方法：回顾性分析资料完整的13例SDAVF患者的手术前后或栓塞前后MRI资料。结果：13例患者中手术前或栓塞前诊断为椎间盘突出7例,脊髓炎3例,神经根炎1例,正确诊断2例,误诊率高。分析MRI片提示病灶区脊髓呈现平均连续5个椎体节段长T2信号,T1、T2加权像髓外硬膜下可见密集的血管流空影。10例患者在T1增强中见到迂曲扩张的冠状静脉丛,术后或栓塞后3－6个月复查MRI,长T2信号及血管流空影消失。结论：MRI对硬脊膜动静脉瘘（SDAVF）的诊断治疗具有较可靠的初诊及随访意义,脊髓长T2信号及血管流空影对诊断有意义。