四肢关节隐性骨损伤的影像学评价

目的 :探讨四肢关节隐性骨损伤的影像学表现并评价X线平片及MRI检查的价值。方法 :搜集 3 4例有外伤史且临床检查提示有四肢关节骨损伤的病例。所有患者外伤后 1天内行X线摄片检查。随后行MRI检查 ,2周内行MRI检查 5例 ,2周后行MRI检查 2 9例。采用矢状位T1WI (TR 45 0msTE 12ms)、矢状位T2 WI加FS (TR 3 0 0 0msTE 96ms)及冠状位ME 2D (TR 775msTE 2 7ms)等序列成像 ,层厚为 4mm ,层间距为 0 .1mm。结果 :所有 3 4例患者 ,常规X线检查结果均为阴性。MRI检查 3 4例患者共发现 44个骨挫伤病灶 ,其中T1WI上 3 1个病灶 ( 70 .5 % )为较低信号 ,T2 WI加FS上 44个病灶 ( 10 0 % )全部表现为高信号 ,ME序列上 44个病灶 ( 10 0 % )全部表现为稍高或高信号。结论 :在隐性骨损伤的诊断中 ,MRI是目前最佳的检查方法。对于外伤后X线平片表现为阴性 ,而临床上仍疑诊为骨损伤者 ,有必要进行MRI检查 ,以T2 WI加FS和ME序列对隐性骨损伤的诊断最具价值。     

常规MR诊断Wallerian变性的临床价值

目的探讨常规MRI在诊断脑损害后锥体束Wallerian变性中的价值。方法对69例脑损害后锥体束Wallerian变性患者行MRI检查。常规行快自旋回波序列(FSE常规横断位、矢状位及冠状位扫描):1.5T:T1WI FSE(TR550ms TE 15ms)T2WI FSE(TR 2 800ms TE 131ms)0.5T:T1WI SE(TR 500ms,TE 15ms);T2WI FSE(TR 3 000ms,TE130ms),层厚5mm,层间距1.0mm。结果 69例Wallerian患者中,Wallerian患者脑损害发生时间与检查时间为5周~3年,其中4~5周2例,5周~12月60例,大于12月7例,异常信号经放射冠、穿过内囊膝部及(或)后肢的前半部、大脑脚外侧及脑桥基底部达延髓锥体,且连续多于3个层面(3个层面以上)可观察到;常规MRI条状异常信号为稍长T_1信号,长T_2信号2例,T2Flair序列呈斑片状稍高信号;67例条状异常信号为长T_1长T_2信号,有12例观察到病侧脑干萎缩,以中脑患侧大脑脚萎缩较显著。结论 MRI可明确显示脑损害后锥体束Wallerian变性,有助于临床医师对患者预后正确评估及制定运动功能康复的治疗计划。     

剖宫产切口瘢痕早期妊娠1例

患者女,33岁。停经42天伴轻微腹痛就诊。查血β-HCG增高。既往剖宫产1次,剖宫产方式为子宫下段横切口;腹部超声提示宫颈妊娠。磁共振检查使用Siemens公司NOVUS 1.5T扫描仪,相控阵体线圈,平扫常规行横断位二维FLASH序列T1WI、TSE序列矢状位T2WI脂肪抑制成像及冠状位trufi序列,T1WI:TR 133ms,TE 2.85ms;T2WI:TR 3 500ms,TE 80ms;trufi:TR 4.8ms,TE 2.4ms。横断位     

特发性滑膜骨软骨瘤病(ISO)的MR表现

作者回顾性分析了21例ISO术前MRI,男14例,女7例,年龄7～68岁。累及膝关节7例,髋关节5例,肩关节与肘关节各3例及腕关节与踝关节各2例,其中踝关节受累为双侧。各例均有平片,5例有CT片。 MR检查用1或1.5T扫描仪。T_1WI SE序列参数TR450～700/TE15～26ms及T_2WI SE序列参数TR1800～2500ms/TE15～20及70～100ms。     

脉络膜裂囊肿的影像学诊断

本文分析CT、MR诊断的21例脉络膜裂囊肿,以提高对本病的认识。1材料与方法1.1一般资料MR诊断为脉络膜裂囊肿21例,男15例,女6例,年龄5~60岁,平均35.2岁。其中外伤5例,健康查体5例。1.2扫描方法采用日立MRP-7000AD 0.3T磁共振机,行自旋回波序列(SE)T1WI(TR/TE=500ms/20ms),快速自旋回波序列(FSE)T2WI(TR/TE=4000ms/117ms)及FLAIR序列(TR/TE/TI=6000ms/117ms/1500ms)分别采集轴位图像及冠状位SE-T1WI、矢状位FSE-T2WI图像,层厚5~8mm,间隔1~2mm。3例患者按照0.1mmol/kg静脉注射欧乃影后行轴位、冠状位及矢状位T1WI增强扫…     

髌骨软化的MRI诊断

为了探讨MR对髌骨软化的诊断价值,作者对52例患者结合关节镜作了MRI研究。男40例,女12例,年龄14～72岁。采用GE1.5T MRI系统,肢体表面线圈,横断双回波SE序列,PWI:TR/TE1500/20ms,T_2WI:TR/TE 1500/80ms,层厚5 mm,层间隔2.5mm,视野16cm,矩阵192×256;矢状面T_1WI用SE序列,TR/TE800/20ms,3mm层厚连续扫描。作者把髌软骨在PWI和T_2-WI上信号分为7类:①不均匀低信号;②各关节面信号增强;③一个面信号可能增强;④局限性信号明显增强;⑤平行于关节面的线样高信号;⑥垂     

双侧丘脑对称生长星形细胞瘤一例

患者,男,23岁。头晕,头痛5个月。MR扫描：SE T1WI：TR415MS,TE 15MS;TSE T2WI：TR3000ms,TE 96ms。矢状位及轴位像见双侧丘脑对称性增大,T1WI病变吴低信号,T2WI呈高信号,边界清楚（图1,2）。增强扫描病变未见强化（图3）。MRI诊断：双侧丘脑病变,考虑为胶质瘤可能性大。     

平片阴性的踝关节周围疲劳骨折的MRI表现

目的　探讨足部踝关节周围疲劳性骨折MRI表现。方法　无明确外伤史的 15例患者 ,男 11例 ,女 4例 ,年龄 15～ 45岁 ,平均 2 2岁。X线均表现为阴性 ,临床有局部疼痛症状。MRI使用Siemensvision -plus 1.5T超导高场系统成像。常规SE序列T1 WI成像(TR TE =70 0ms 2 0ms)、FSE序列T1 WI(TR TE =470 0ms 10 0ms)和T2 WI脂肪抑制 (FS)序列。结果　 15例MRI均表现有踝关节周围骨内异常信号 ,其中有 6例在距骨、7例在跟骨、1例在舟状骨、1例同时累及跟骨和距骨。 15例共 16处均表现为受累骨内骨髓片状异常信号 ,10处为T1 低信号T2 高信号 ,6处为T1 低信号T2 混杂信号 ,脂肪抑制序列表现为明显高或混杂信号。结论　平片阴性的踝关节周围疲劳骨折的MRI表现为受累骨松质内骨小梁骨折以及骨松质内不规则水肿     

早期成人股骨头缺血性坏死的MRI诊断(附35例报告)

股骨头坏死早期诊断、早期治疗可改善预后,MRI是股骨头坏死早期诊断的有效方法,本文介绍我院35例的经验如下。1材料与方法我院1998年~2005年间35例中,男27岁,女8岁,年龄23~68岁,平均年龄44·5岁。采用1980年Ficat等[1]对FHN4期分法的Ⅰ~Ⅱ期定为早期,35例55髋早期FHN的MRI资料及其中25例X线平片资料进行分析。其中2例经活检病理证实,全部病例MRI检查均采用GE Vectra0·5T超导型扫描仪,体线圈,取仰卧位,常规行横轴位SE T1WI和SET2WI及冠状位SE T1WI,部分病例行冠状位SE T2WI,层厚5mm,间距1mm。25例X线平片采用GE 500mA投照…     

髓核化学溶解术后椎间隙的MRI表现:对术后椎间盘变性的推测

作者对26例腰椎间盘脱出髓核化学溶解术后的椎间隙进行了研究。男22例,女4例,年龄17～58岁。发生于L_(4～5)椎间盘21例,L_5～S_1椎间盘5例。使用0.5T超导型MR机和体线圈,获取层厚1.0cm的矢状面T1(SE TR500ms/TE40ms)和T_2(SE TR1500ms/TE80ms)加权象,并摄同期腰椎侧位和过伸过屈侧位X线片。利用Brandner′s方法计算椎间盘前份和后份的高度指数,用Wiltse′s法测量脊柱前凸角。髓核溶解术后3个月,脱出椎间盘后份的平均高度指数在MRI和腰椎侧位片上分别降至治疗前的57%和63%,2年后未见增加;其前份平均高度指数分别降至治疗前的41%和59%,2年后又分别升至67%和71%。治疗后3个月,治疗部位的平均脊柱前凸角在MRI和腰椎     

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 role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

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.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.