LAC-HSA-SPIO增强磁共振成像检测大鼠肝癌的实验研究

目的 :探讨利用肝细胞去唾液酸糖蛋白受体 (ASG受体 )介导的LAC HSA SPIO对比剂检测肝癌的可能性。方法 :建立二乙基亚硝胺诱导的大鼠肝癌模型 ( 8例 ) ,获平扫及注射LAC HSA SPIO ( 1.2mgFe/10 0g体重 )后大鼠肝脏双回波SE像 ( 2 0 0 0 /30～ 80 ) ,测定肝实质强化率 (PCE)和肝癌灶信号对比度 /噪声比 (CNR)。结果 :①注药后在T2 WI肝实质PCE为 71.8%± 16.3% ,癌结节为 10 .2 %± 4.8% (P <0 .0 1) ;②增强后PD WI上瘤结节CNR由平扫时 1.6± 0 .3上升至 8.2± 4.6(P <0 .0 1) ,T2 WI癌结节CNR由 4.7± 3.1上升至 8.9± 4.0 ( 0 .0 1

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SPIO与Gd-DTPA联合增强检测大鼠肝癌病灶的实验研究

目的 :观察联合使用SPIO和Gd DTPA对大鼠肝癌模型的增强特点。材料和方法 :制作 3 0只大鼠肝癌模型 ,增强前后行MR扫描 ,平扫序列包括SE、TSE、GRE的T1、T2WI序列。增强扫描分为 4组 ,其中Gd +SPIO联合增强组 10只 ,先注射Gd DTPA ,行SE、GRET1WI扫描 ,随后给予SPIO造影剂 ,扫描序列同平扫 ;SPIO +Gd联合增强组 10只 ,先注射SPIO ,行SE、GRET1WI扫描 ,12min后再给予Gd DTPA ,扫描序列同平扫 ;Gd、SPIO增强组各为 5只 ,增强扫描序列同平扫。分析各增强扫描组中病灶的增强特点。结果 :两种联合增强方法中 ,肝脏信号强度在所有扫描序列中均较平扫时下降 ,但与SPIO增强组无差异 ;病灶的SNR、CNR在SE、GRET1WI中明显高于平扫和SPIO、Gd DTPA增强法 ;在T2WI中病灶的SNR、CNR和单独使用SPIO无显著性差异。两种联合增强方法之间的SNR和CNR在每种扫描序列中没有显著性差异。结论 :SPIO和Gd DTPA联合增强方法利用了两种造影剂的优势 ,增加了肿瘤病变的对比 ,可提高发现病变的几率。     

超顺磁性氧化铁在大鼠诱癌模型磁共振诊断与鉴别诊断中的作用

目的研究超顺磁性氧化铁(SPIO)在大鼠诱癌模型的磁共振成像中对增生性结节与肝癌的鉴别作用，以及SPIO增强前后对各型肝癌的检出率。材料与方法42只诱发型肝癌模型鼠在肝硬化多发增生性结节基础上，共计生成379个肝癌，行平扫及SPIO增强扫描，分析增生性结节与肝癌的不同强化方式，并与病理对照统计平扫与增强扫描各型肝癌的检出率。结果增生性结节在SPIO增强扫描T2WI上信号明显降低，而肝癌的信号无明显改变；肝癌SPIO增强扫描T2WI检出率与病理接近，而平扫T2WI检出率与病理相差显著，其中平扫微癌与小癌的漏检率分别达32．9％与12．9％。结论SPIO是一种有效的检测肝癌的磁共振对比剂，不仅能提高小肝癌的检出率而且对增生性结节与肝癌的鉴别提供帮助。     

不同MR扫描序列在SPIO增强大鼠肝癌模型的对比研究

目的：比较多种扫描序列超顺磁氧化铁（SPIO）增强扫描对显示大鼠肝癌病灶的能力，找出最佳扫描方案。TSE T2WI、SE双回波的T2WI＋PDWI、GRE T1WI、T2^＊WI，分析增强前后大鼠肝癌病灶的强化特征，并进行病理学检查对照分析。结果：注射SPIO对比剂后，所有扫描序列均显示肝脏的信号强度较增强前有不同程度的下降，肝癌病灶CNR均分别高于平扫。增强后GRE T2^＊WI中病灶的CNR明显高于其它序列，但增强后TSE T2WI和常规SE T2WI在显示病变的SNR、CNR方面没有显著性差异。结论：SPIO增强后检测肝癌病灶的各种序列中，以GRE T2^*WI最为敏感，其次是双回波的T2WI＋PDWI序列。     

钆喷酸葡甲胺脂质体的制备及对大鼠肝癌灶的诊断作用

目的 :探讨Gd DTPA脂质体造影剂对大鼠肝癌灶的诊断价值。方法 :采用冻融超声法制备出粒径 0 .61±0 .3 4 μm的装载Gd DTPA的脂质体 ,二乙基亚硝胺法建立大鼠肝癌灶模型 ( 5例 ) ;观察静注 0 .1mmol/10 0 g体重Gd DT PA脂质体后大鼠肝癌灶显示情况 ,并与尸检对照。结果 :脂质体造影剂包裹率为 2 0 .1% ,能有效、持续地造成肝脏选择性靶向强化 ,从而衬托出肝癌病灶 ,使癌灶检出率由平扫 17.6%上升至增强后的 76.5 % ( 0 .0 1

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肝动脉和经动脉门脉造影螺旋CT联合应用对肝癌的诊断价值

目的　探讨螺旋CT扫描在肝动脉造影CT(CTHA)和经动脉门脉造影CT(CTAP)对肝癌的诊断价值。方法　分析 2 1例肝癌病人CTAP和CTHA图像 ,并与螺旋CT三期增强扫描进行对照。结果　三期增强扫描病灶检出率为 72 .4% (5 5 /76) ;CTAP病灶检出率为 96.1% (73 /76) ;CTHA病灶检出率为 88.2 % (67/76) ;CTAP和CTHA联合应用病灶检出率为 98.7% (75 /76) ,可检出 0 .5cm的微小癌灶。CTAP和CTHA均可出现非病理性表现 ,CTAP灌注异常出现率为 2 2 .3 % ,CTHA非病理性强化灶出现率为 3 0 .2 %。结论　螺旋CT动脉造影能显著减少造影剂用量 ,提高图像质量 ,CTAP和CTHA联合应用肝癌病灶检出率明显高于CT三期增强扫描。CTAP和CTHA结合分析可减少假阳性率。     

诱发性大鼠肝硬化性肝癌超顺磁性氧化铁增强MRI与电镜表现

目的 研究诱发性大鼠肝硬化性肝癌超顺磁性氧化铁(SPIO)增强MRI与电镜表现. 材料与方法 16只由二乙基亚硝胺(DENA)诱导的肝硬化性肝癌大鼠行肝脏SPIO增强前后MR扫描,再行肝脏病理学及电镜检查. 结果 肝癌在T1WI上为低或等低信号,T2WI为较高信号.SPIO增强T2WI上,正常肝实质、肝硬化组织信号强度(SI)较增强前明显下降,肝癌SI较增强前无明显下降,其对比噪声比(CNR)升高,病变显示清晰.SPIO增强T1WI上正常肝实质及硬化肝组织SI无明显下降,肝癌SI较增强前升高,其CNR较增强前降低,病变显示不清楚.电镜下正常肝组织枯否细胞(KC)内溶酶体丰富,可见较多黑色颗粒状SPIO粒子,胞浆内可见大的SPIO簇.肝硬化组织细胞间隔增宽,胶原纤维明显增多,KC数量无明显减少,其内溶酶体有所减少,可见散在SPIO粒子,胞浆内可见较大的SPIO簇.肝癌组织KC数量减少或消失,癌细胞内细胞器基本消失,核异型. 结论 诱导性大鼠肝硬化性肝癌MR信号表现与人类肝癌相似.SPIO增强肝脏信号改变和KC数量及吞噬功能有一定关系.SPIO增强T2WI不仅能提高肝癌的对比,且能间接反映KC数量,可以预测肝癌组织学分级.     

经脾门静脉造影磁共振成像(MRSP)对肝脏占位病变的检出及其表现

目的将磁共振介入方法———经脾门静脉造影磁共振成像(MRSP)用于肝脏占位性病变的检出,并观察分析病灶的表现。资料与方法肝脏占位性病变15例,其中原发性肝癌4例,肝脏转移瘤6例,炎性假瘤3例,局灶性结节增生2例。应用TurboFLASH序列进行肝脏的平扫、门静脉期、实质期、延迟期扫描,测量各期肝脏实质、病灶实质及背景噪声的信号强度,比较各期肝实质病灶对比噪声比(CNR),分别描述各病变的MRSP表现。结果门静脉期CNR最大(均值为18.04±5.65);平扫期最小(7.26±3.20);门静脉期与其他各期均有统计学意义(P<0.05)。原发性肝细胞癌、转移性肝癌、局灶性结节增生、炎性假瘤在MRSP各期中表现不同。结论肝脏占位性病变在MRSP门静脉期能突出显示而检出;并在三期动态扫描中有不同的表现,对鉴别诊断有一定的帮助。     

肝细胞癌综合治疗后复发的小肝癌患者MRI平扫和动态增强各序列图像表现分析

目的分析肝细胞癌(HCC)综合治疗后复发的小肝癌(s HCC)患者磁共振(MRI)图像表现,提高对复发s HCC的认识。方法回顾分析本院36例HCC综合治疗后复发的s HCC患者,共44个病灶,均行MRI平扫和动态增强扫描,其中16例患者在3～6月后复查MRI,分析病灶图像特征。测量典型"快进快出"强化方式癌灶(A组)与非典型强化方式癌灶(B组)的长径和表观弥散系数(ADC)值,并比较两组差异。结果 MRI平扫T2压脂序列显示高信号癌灶39个(88. 64%),T1压脂序列显示低信号癌灶37个(84. 09%),弥散加权成像显示高信号癌灶41个(93. 18%),双回波序列显示含脂质成分癌灶4个(9. 09%)。MRI动态增强序列显示典型"快进快出"强化方式癌灶30个(68. 18%),非典型强化方式癌灶14个(31. 82%),延迟期出现"假包膜"征象癌灶12个(27. 27%)。A组癌灶长径大于B组,ADC值低于B组(P均0. 05)。结论结合MRI平扫和动态增强各序列,有利于s HCC癌灶的检出,是诊断HCC综合治疗后复发的s HCC的重要方法。     

乙型肝炎肝硬化背景下小肝癌的CT平扫、增强扫描与MRI平扫、DWI表现分析

目的 :分析乙型肝炎肝硬化背景下小肝癌的CT平扫、增强扫描与MRI平扫、DWI的表现。方法 :选取经组织病理学确诊的乙肝肝硬化背景下的小肝癌65例共74个肿瘤病灶,比较CT平扫、CT增强扫描、MRI平扫、DWI对小肝癌总的检出率、不同直径小肝癌的检出率及包膜显示率。结果:CT平扫对病灶检出率为64.86%;CT增强扫描动脉期、门静脉期、延迟期对病灶检出率分别为85.14%、68.92%、72.97%;MRI平扫对病灶检出率为86.49%;DWI为93.24%。各种方法对小肝癌病灶检出率的差异有统计学意义(P0.001)。CT平扫、CT增强扫描、MRI平扫、DWI对包膜的显示率分别为40.54%、59.46%、71.62%、97.30%,差异有统计学意义(P0.001)。CT增强扫描动脉期、门静脉期、延迟期对直径≤1 cm的小肝癌检出率均低于对直径1~3 cm小肝癌的检出率(均P0.05)。结论:DWI对小肝癌的检出率和包膜显示率最高,且CT增强扫描更易检出直径1~3 cm的病灶。     

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.     

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     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

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).