青年细支气管肺泡癌X线平片及CT表现分析

目的:研究青年细支气管肺泡癌的胸片与CT表现特征性和病理学发生基础及临床特点,提高对该病诊断认识水平。方法:回顾性对比分析24例。经纤支镜,穿刺活检,手术病理证实的细支气管肺泡癌的胸片及CT表现以及转移灶的特征表现,探讨各型病变的影像学特征。结果:根据大体病理及相对影像上病变形态和分布特点,可将细支气管肺泡癌分为孤立结节型5例占21%,多发结节型11例占46%,弥漫型8例占33%。其中孤立结节型相对特异型征象较多,如分叶征,支气管充气征,胸膜凹陷征;多发结节型;胸片表现为两肺中下叶棉球样征象,但CT显示为两肺弥漫多发结节状,碎路石征象,常伴有胸膜牵拉等征象;弥漫粟粒型:两肺中下叶呈粟粒样改变,部分病例有融合,实变现象,临床上易误诊为粟粒型肺结核,转移瘤或肺炎等疾病。另外,细支气管肺泡癌骨骼转移灶呈浸润性破坏,分布较广,以肋骨和锁骨侵犯为多见。结论:细支气管肺泡癌的影像表现复杂多样,对各型的征象表现进行深入细致地分析,结合临床特点,可提高对本病的诊断符合率。     

细支气管肺泡癌的CT主要征象探讨

目的:探讨细支气管肺泡癌CT表现特点与组织病理的相关性。方法:收集经手术或穿刺活检病理证实的细支气管肺泡癌30例,男14例,女16例,年龄40~75岁,平均62岁。采用螺旋CT增强17例,平扫13例。CT图像上观察病灶的部位、大小、密度分布、内部结构及边缘特征,并评价其征象与组织病理的相关性。结果:单发结节型18例,实变型9例,弥漫小结节型3例。单发结节型主要征象:胸膜牵引征9例(50%),磨玻璃征16例(88.8%),支气管征10例(55.5%),空泡征14例(77.7%)。实变型主要征象:枯树枝征6例(66.6%),蜂房征4例(44.4%),碎路石征3例(33.3%),血管造影征2例(22.2%),弥漫小结节型主要征象:两肺不对称、不均匀弥漫分布大小不等结节,结节融合倾向,伴有母瘤2例(66.6%)。结论:细支气管肺泡癌的影像表现复杂,对各型的征象深入细致地分析,可提高本病的诊断符合率。     

细支气管肺泡癌的CT表现

目的:探讨细支气管肺泡癌的CT表现特点。方法:收集经手术或肺穿刺活检病理证实的细支气管肺泡癌25例,男性15,女性10例,年龄从39～74岁,平均55岁。均行螺旋CT检查,其中HRCT检查7例,增强扫描15例,根据临床、CT表现进行分析。结果:孤立结节型14例,结节中心距胸膜均小于3.1cm,病灶直径为1.4～3.5cm,CT表现有边缘光滑2例,呈分叶征6例,短毛刺征5例,胸膜凹陷征11例,含气支气管征6例,空泡征12例;炎症型或实变型5例,病变呈多个肺段或肺叶的炎症样实变,见支气管气相4例,以及蜂房状含气腔3例;弥漫结节型6例,弥漫分布粟粒状与结节状致密影,大小不等,分布不均。结论:细支气管肺泡癌影像表现复杂,需结合临床及多种影像检查结果,认真细致地综合分析,才能提高本病的诊断符合率。     

细支气管肺泡癌的CT特点与病理基础对照分析

目的 探讨细支气管肺泡癌(BAC)的CT特点与病理学基础.方法 分析44例经病理证实的BAC,根据CT表现分为孤立结节型、肺叶实变型和多发结节型,分别为24例、12例和8例;结合文献对照研究各型肺泡癌的影像特点与病理基础.结果 孤立结节型BAC临床多无症状,CT主要征象:磨玻璃征20例(83.3%)、空泡或支气管充气征18例(75%)、分叶征20例(83.3%)、毛刺征16例(66.7%)、胸膜凹陷征16例(66.7%);肺叶实变型BAC临床相对特异性表现是咳白色泡沫痰,CT主要征象:枯树枝征10例(83.3%)、蜂房征10例(83.3%)、碎路石征6例(50%)、叶间胸膜膨出8例(66.7%)、血管造影征2例(16.7%);多发结节型BAC较少见,临床常见症状为咳嗽,CT表现为两肺野分多发结节,部分结节内见空泡,结节具有融合倾向,伴有母瘤(25%).结论 熟悉BAC各型病理、临床及影像学表现,有助于提高诊断水平.     

细支气管肺泡癌的CT表现

细支气管肺泡癌(bronchioloalveolar cell carcinoma):临床上较少见,常根据CT表现将细支气管肺泡癌分为以下3型,孤立结节型、浸润实变型、弥漫型,其中孤立结节型相对常见,影像学有一定的特征,但易与良性病变混淆。本文介绍作者遇到的孤立结节型4例,均经手术病理证实,探讨其影像     

弥漫型肺泡癌的高分辨CT特征分析

目的 :回顾性分析弥漫型肺泡癌的高分辨CT(HRCT)表现特征。方法 :总结 12例经临床和病理证实的弥漫型肺泡癌HRCT表现。结果 :12例弥漫型肺泡癌可见磨玻璃影者 11例 ,实变 9例 ,多发结节 7例 ,“碎石路样”表现者 2例 ,其中 11例为混合表现。 6例有支气管气像 ,9例病变呈均匀或不均匀低密度 ,2例出现“血管造影征” ,2例伴少量胸腔积液 ,1例纵隔淋巴结肿大。结论 :弥漫型肺泡癌的HRCT表现多种多样 ,最常见的表现是多发结节、实变和磨玻璃影的混合影。HRCT片上出现实变和结节共存、伴磨玻璃影的小叶中心结节和远离实变的磨玻璃影时 ,则强烈提示弥漫型肺泡癌。     

孤立型细支气管肺泡癌的 HRCT表现与病理分析

目的分析孤立型细支气管肺泡癌的HRCT表现.方法回顾分析了20例经手术病理证实的孤立型细支气管肺泡癌的HRCT表现.结果病灶大多位于肺野外围胸膜下,形态不规则,可以为结节肿块,小斑片与星状;具有磨玻璃征,含多个空泡或呈蜂窝征的病灶,在肺泡癌中出现率较高.结论磨玻璃征和蜂窝征往往提示肺泡癌的诊断.     

^18F-FDG PET-CT结合HRCT诊断细支气管肺泡癌的价值

目的探讨^18F-FDG PET-CT结合HRCT诊断细支气管肺泡癌的价值。方法回顾分析经病理证实的24例细支气管肺泡癌患者的PET-CT及其HRCT图像资料。分别记录其形态学表现及放射性分布，同时测量其最大SUV值（SUVmax）。结果根据形态学表现分为3型：（1）孤立结节型（12例）：表现为密度略不均匀或并有磨玻璃样密度的单发结节，主要征象为分叶、短毛刺、支气管充气征、胸膜凹陷征、空泡征、晕征、血管集束征。SUVmax均值为3．78±1．54；（2）多发结节型（5例）：表现为两肺散在多发的结节，以中下肺叶为主，结节大小不一，小结节无放射性聚积，对于直径〉5mm的结节，SUVmax均值为3．46±1．32。（3）肺炎型（7例）：为一个或多个肺叶的实变。其内见充气支气管征或蜂窝征，放射性分布不均匀，部分病灶FDG摄取为阴性。结论^18F-FDG PET-CT结合HRCT在细支气管肺泡癌的诊断中具有重要的应用价值。诊断时要密切结合PET与HRCT图像，以最大限度地减少误诊。     

多层螺旋CT后处理技术对孤立型细支气管肺泡癌的诊断价值

目的 探讨多层螺旋CT三维重组对孤立型细支气管肺泡癌(bmnchioloalveolar carcinoma,BAC)的诊断价值.资料与方法 经病理证实的孤立型BAC 35例,分析高分辨率CT(HRCT)扫描、多平面重组(MPR)和容积再现(VR)技术对孤立型BAC基本征象的显示价值,并与常规横断位图像对比分析.结果 35 例孤立型BAC根据CT图像上病灶密度表现将病灶分为3种类型:(1)单纯磨玻璃密度结节(8例);(2)混杂密度结节(20例);(3)单纯实性密度结节(7例).HRCT、MPR及VR在湿示孤立型BAC的空泡征、纯磨玻璃征、环晕征、分叶征、毛刺征、胸膜凹陷征及支气管血管集束征方面优于常规横断位.结论 HRCT及三维重组,较常规横断位扫描能更准确地显示孤立型BAC的内部细微结构及周围形态改变,对孤立型BAG诊断具有重要价值.     

实变型细支气管肺泡癌的CT表现及病理基础

目的:探讨实变型细支气管肺泡癌(BAC)的CT表现特点。方法:对13例经病理证实的实变型BAC的CT征像及其病理特征进行回顾性分析。结果:13例中,单发肺叶实变8例,多发肺叶或肺段实变3例,单发肺段实变2例;实变肺密度低于心肌8例,伴见血管造影征或血管高密度征7例、支气管气像征9例伴枯树枝征6例;实变肺周见蜂窝肺征9例,磨玻璃征7例,多发小结节2例;少量胸水1例,肺门淋巴结肿大及肺气囊腔各1例。13例中9例CT首诊误诊为肺炎,4例正确诊断。结论:实变肺密度低、蜂窝肺征、血管造影征尤其是血管高密度征、枯树枝征及多发腺泡结节是实变型BAC的主要CT表现特点;磨玻璃影是早期表现,但特异性不大;CT引导肺穿刺活检是较理想的确诊手段。     

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.     

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).     

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.     

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）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme