参考中文标题：

在肌肉骨骼疾病的诊断带来的好处分子病理学研究：第一部分由两部分组成的审查：软组织肿瘤。

PMID及链接：

19669758 http://www.syyxw.com/Archive/Detail/19669758

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摘  要：

Bone and soft tissue metabolic and neoplastic diseases are increasingly characterized by their molecular signatures. This has resulted from increased knowledge of the human genome, which has contributed to the unraveling of molecular pathways in health and disease. Exploitation of this information has allowed it to be used for practical diagnostic purposes. The aim of the first part of this two-part review is to provide an up-to-date review of molecular genetic investigations that are available and routinely used by specialist musculoskeletal histopathologists in the diagnosis of neoplastic disease. Herein we focus on the benefits of employing well characterized somatic mutations in soft tissue lesions that are commonly employed in diagnostic pathology today. The second part highlights the known somatic and germline mutations implicated in osteoclast-rich lesions of bone, and the genetic changes that disturb phosphate metabolism and result in a variety of musculoskeletal phenotypes. Finally, a brief practical guide of how to use and provide a molecular pathology service is given.

参考中文摘要：

骨与软组织肿瘤和代谢疾病越来越特点是分子信号。这是由于人类基因组，这有助于在健康和疾病的分子途径解开更多的知识。这些信息的开发，使得它必须实际用于诊断。在这个两个目标，第一部分部分审查是提供一个最新的分子遗传学调查日期检讨现有的，通常由专门用于肿瘤疾病的诊断肌肉骨骼histopathologists。在此我们对聘用软组织的诊断，通常在今天就业病变病理特征以及体细胞突变的好处焦点。第二部分强调了已知的体细胞和破骨细胞胚系突变牵连，丰富的骨病变，遗传变化扰乱了不同表型的肌肉骨骼钙磷代谢和结果。最后，简单的如何使用和分子病理学研究提供服务的实用指南给出。

出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :105-15

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肿瘤坏死骨肉瘤：最大的代谢活动从F点列入- 18 FDG PET显像/病理分析中的CT。

PMID及链接：

19760279 http://www.syyxw.com/Archive/Detail/19760279

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OBJECTIVE: To determine if the location of the point of maximum standardized uptake value (SUVmax) being included in or not included in the histopathologic slab section corresponded to tumor necrosis or survival. MATERIALS AND METHODS: Twenty-nine osteosarcoma patients underwent post-chemotherapy [fluorine-18]-fluoro-2-deoxy-D: -glucose (FDG) positron-emission tomography-computed tomography (PET/CT) prior to resection. PET/CT images were correlated with slab-section location as determined by photographs or knowledge of specimen processing. The location of the point of SUVmax was then assigned as being 'in' or 'out' of the slab section. Cox's proportional hazard regression was used to evaluate relationships between the location and value of SUVmax and survival. Logistic regression was employed to evaluate tumor necrosis. RESULTS: No correlation was found between the SUVmax location and survival or tumor necrosis. High SUVmax correlated to poor survival. CONCLUSION: High SUVmax value correlated to poor survival. Minimal viable tumor (> 10%) following chemotherapy is a known indicator of poor survival. No correlation was found between the location of SUVmax and survival or tumor necrosis. Therefore, the SUVmax value either does not correspond to a sufficient number of tumor cells to influence tumor necrosis measurement or it was included in the out-of-slab samples that were directed to viable-appearing areas of the gross specimen. Since high SUVmax has been previously found to correspond to poor tumor necrosis, and tumor necrosis is simply an estimate of the amount of viable tumor, SUVmax likely represents many viable tumor cells. Therefore, when not in the slab section, SUVmax was likely included in the tumor necrosis measurement through directed sampling, validating our current method of osteosarcoma specimen analysis.

参考中文摘要：

目的：确定的最高标准摄取值（SUVmax）点的位置正在或不包括在病理平板节中包含对应的肿瘤坏死或生存。材料与方法：29位后的骨肉瘤患者接受化疗[氟- 18]氟- 2 -脱氧- D：-葡萄糖（葡萄糖）正电子发射断层扫描型计算机断层扫描（PET / CT）的前切除。 PET / CT的图像相关的平板节由照片或样品加工知识确定位置。该点的位置的SUVmax当时在被指定为''或'走出板区段。考克斯的比例风险回归分析评价之间的位置和SUVmax和生存价值的关系。 Logistic回归是用来评估肿瘤坏死。结果：无相关关系的SUVmax位置和生存或肿瘤坏死找到。高SUVmax相关，穷人的生存。结论：高SUVmax价值相关，穷人的生存。最低可存活肿瘤（“10％），化疗后，穷困的生存已知的指标。无明显相关性之间SUVmax和生存或肿瘤坏死的位置。因此，SUVmax价值或者不符合肿瘤细胞的足够数量影响肿瘤坏死测量或它的失去了板式样品都是针对出现的可行的大体标本领域包括在内。由于高SUVmax以前已发现符合贫困肿瘤坏死，肿瘤坏死只是一个可行的肿瘤数量的估计，SUVmax可能代表了许多可行的肿瘤细胞。因此，没有在平板节，SUVmax很可能包括在通过针对肿瘤坏死抽样测量，证明我们的骨肉瘤标本分析，目前的方法。

出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :131-40

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单光子发射计算机断层扫描/螺旋CT对骨转移的癌症患者与已知的融合显像诊断。

PMID及链接：

19669135 http://www.syyxw.com/Archive/Detail/19669135

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PURPOSE: To evaluate single photon emission computed tomography (SPECT)/spiral computed tomography (CT) fusion imaging for the diagnosis of bone metastasis in patients with known cancer and to compare the diagnostic efficacy of SPECT/CT fusion imaging with that of SPECT alone and with SPECT + CT. MATERIALS AND METHODS: One hundred forty-one bone lesions of 125 cancer patients (with nonspecific bone findings on bone scintigraphy) were investigated in the study. SPECT, CT, and SPECT/CT fusion images were acquired simultaneously. All images were interpreted independently by two experienced nuclear medicine physicians. In cases of discrepancy, consensus was obtained by a joint reading. The final diagnosis was based on biopsy proof and radiologic follow-up over at least 1 year. RESULTS: The final diagnosis revealed 63 malignant bone lesions and 78 benign lesions. The diagnostic sensitivity of SPECT, SPECT + CT, and SPECT/CT fusion imaging for malignant lesions was 82.5%, 93.7%, and 98.4%, respectively. Specificity was 66.7%, 80.8%, and 93.6%, respectively. Accuracy was 73.8%, 86.5%, and 95.7%, respectively. The specificity and accuracy of SPECT/CT fusion imaging for the diagnosis malignant bone lesions were significantly higher than those of SPECT alone and of SPECT + CT (P < 0.05). Among 37 equivocal lesions revealed with SPECT, the diagnostic accuracy of bone lesions was 45.9% for SPECT + CT and 81.1% for SPECT/CT fusion imaging (chi(2) = 9.855, P = 0.002). The numbers of equivocal lesions were 37, 18, and 5 for SPECT, SPECT + CT, and SPECT/CT fusion imaging, respectively, and 29.7% (11/37), 27.8% (5/18), and 20.0% (1/5) of lesions were confirmed to be malignant by radiologic follow-up over at least 1 year. CONCLUSIONS: SPECT/spiral CT is particularly valuable for the diagnosis of bone metastasis in patients with known cancer by providing precise anatomic localization and detailed morphologic characteristics.

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出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :147-53

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选择性动脉栓塞的36与N骨架动脉瘤样骨囊肿- 2 -氰基丙烯酸正丁酯。

PMID及链接：

19669138 http://www.syyxw.com/Archive/Detail/19669138

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BACKGROUND: Aneurysmal bone cyst (ABC) is a lytic benign bone lesion representing about 1% of all primary bone tumors. The lesion causes pain and swelling, which are generally present for less than 3 months. METHODS: From April 2003 to April 2008 36 patients affected by aneurysmal bone cysts were treated by selective arterial embolization with N-2-butyl cyanoacrylate. The study population comprised 20 male and 16 female patients with an age range of 3.3-60.8 years. Nine lesions were localized in the appendicular skeleton (1 in the upper and 8 in the lower limb), 4 in the thoracic cage (1 rib lesion and 3 scapular lesions), 17 in the pelvis and 6 in the spine (1 thoracic and 5 sacral localizations). RESULTS: A total of 55 embolizations were performed: in 22 cases (61%) only one embolization was needed, whilst two embolizations were necessary in 9 cases (25%) and 3 in the remaining 5 patients (14%). The treatment was effective in 32 patients (94% ): follow-up was 0.9-5 years. In one patient, previously surgically treated, only the cyanoacrylate embolization turned out to be useful for healing the lesion. Another 7 patients underwent surgery during the study period. In the 55 procedures we performed we had 3 complications (5%): 2 cases of skin necrosis and 1 of transient paresis. CONCLUSIONS: Arterial embolization with cyanoacrylate may be the treatment of choice for aneurysmal bone cysts. Embolization is a less invasive, lower cost, simpler procedure than surgery and is easily repeatable.

参考中文摘要：

背景：动脉瘤样骨囊肿（ABC）的是裂解良性骨病变约占所有小学的1％，骨肿瘤。病变引起的疼痛和肿胀，一般都低于目前的3个月。方法：从2003年4月至4月的动脉瘤样骨囊肿的影响2008年36例治疗选择性动脉栓塞与N - 2 -氰基丙烯酸正丁酯。被研究的人口组成与3.3-60.8岁的年龄范围20男性和16个女性。 9个病灶定位于附肢骨骼（1上游和下肢8），4时在胸廓（1罗纹病变和3肩胛病灶），17日在骨盆和脊柱6（1胸5 ）骶本地化。结果：55共进行栓塞：在22例（61％）只有一个栓塞是必要的，而在两个栓塞9例（25％）和3需要在剩余的5例（14％）。有效的治疗32例（94％）：随访0.9-5年。在一名病人，以往手术治疗，只有丙烯酸酯栓塞原来是治病用的病变。另7例手术在研究期间手术。在我们的55个程序进行，我们有3个并发症（5％）：2皮肤坏死和瞬态麻痹1例。结论：动脉栓塞与丙烯酸酯可能是所选择的动脉瘤样骨囊肿的治疗。栓塞术是一种创伤小，成本低，简单不过的手术程序，是很容易重复。

出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :161-7

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早期经验加腹腔纤维瘤病经皮冷消融。

PMID及链接：

19768644 http://www.syyxw.com/Archive/Detail/19768644

摘  要：

OBJECTIVE: Surgical resection, radiation therapy and chemotherapy are all accepted as standard treatments for extra-abdominal desmoid (EAD) tumors, but their effectiveness has been limited by frequent local recurrence. The purpose of this article is to describe our early experiences with using percutaneous cryoablation for local control of extra-abdominal desmoid tumors in five patients whose tumors had failed to respond to standard therapy. MATERIAL AND METHODS: In a retrospective search of our institution's radiology database for patients who had undergone percutaneous cryoablation for treatment of EAD tumors between June 2004 and July 2007, we identified five patients (three female and two male). No patients were excluded from this review. Three of these patients had been referred for cryoablation for local tumor control, and two had been referred for palliation of inoperable tumors. The age range of the patients at the time of cryoablation was 9-41 years. The treated EAD tumors were located in the neck, shoulders and trunk and ranged in size from 3.0 cm to 10.0 cm. Medical records were reviewed for short-term and long-term follow-up, and patients were contacted for additional follow-up. Patients were asked to rate their pain as absent, mild, moderate or severe, and to compare it with their levels before cryoablation, describing it as improved, unchanged or worsened. Radiology records were reviewed to follow the size of the EAD tumors before and after cryotherapy. RESULTS: For the three patients referred for local control of EAD tumors, complete tumor coverage with the ablation zones was achieved. Two of these patients, with masses 3.0 cm and 4.9 cm in diameter, reported complete absence of pain at both short-term and long-term follow-up at 13 months and 49 months. Their tumors had completely resolved on long-term imaging follow-up at 19 months and 43 months. The third patient, with a 6.1 cm mass, reported improved mild pain at 6 months, and imaging showed a moderate decrease of tumor size. For the two patients referred for palliative therapy, initial partial pain relief was felt 2 weeks after the procedure, At long-term (58 months) follow-up of one patient with a 9.1 cm mass, the tumor was still present although reduced in size, and local pain had returned to its former moderate level. In the other patient who underwent only partial treatment of a 10.0 cm mass, at long-term follow-up (36 months) the mass had enlarged and pain had returned to the pretreatment, moderate level. CONCLUSION: Cryoablation appears to be an effective alternative treatment for the achievement of local control of small and moderately sized EAD tumors, but it is likely of limited use in patients with larger tumors that have untreatable regions due to involvement of vital structures. Continued research evaluating cryoablation for the treatment of EAD tumors is needed.

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出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :175-82

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阿病理学评价凹面形低强度带T1加权磁共振成像在软骨不全骨折的股骨头。

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19588136 http://www.syyxw.com/Archive/Detail/19588136

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A 73-year-old female suffered from right hip pain without any history of antecedent trauma. The initial radiograph showed a slight narrowing of the joint space in the right hip. The patient was treated by non-weight bearing for 5 weeks. Radiographs obtained 3 months after the onset of pain showed the progression of both the joint-space narrowing and subchondral collapse at the superior portion. T1-weighted MR (magnetic resonance) images obtained 3 months after the onset revealed an irregular-shaped low-intensity area just beneath the articular cartilage as well as a low-intensity band, which was concave to the articular surface. A total hip replacement was performed. A histopathological examination revealed fracture callus and granulation tissue in the subchondral area. This subchondral fractured area was surrounded by vascular rich granulation tissue and fibrous tissue, which corresponded to the concave-shaped low-intensity band observed on the T1-weighted image.

参考中文摘要：

一位73岁的女性因右髋疼痛没有任何历史先例创伤。最初的X光略有缩小的共同空间，右髋。病人是治疗非承重为5周。 X光片后3个月内获得的发生疼痛的进展表明双方联合空间缩小和软骨崩溃在上级部分。 T1加权磁共振（核磁共振）图像获得3个月后开始显示不规则形低烈度地区公正下方的关节软骨，以及低烈度带，这是凹的关节面。阿全髋关节置换手术。阿病理学检查发现骨折骨痂和肉芽组织中的软骨区。这软骨断裂地区被包围的血管丰富的肉芽组织和纤维组织，相对应的凹面形低强度波段观察的T1加权图像。

出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :185-8

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获得卡沃-内翻畸形的从犯跟骨造成：1例报告及文献复习。

PMID及链接：

19789868 http://www.syyxw.com/Archive/Detail/19789868

摘  要：

We describe an unusual cause of an acquired cavo-varus foot deformity produced by progressive enlargement of an accessory calcaneal ossicle. A 13-year-old boy with constitutional plano-valgus flat feet noted a gradual change in foot shape associated with lateral ankle pain on ambulation following an inversion injury 2 years earlier. CT and MRI scans confirmed a large accessory calcaneal ossicle lying within the sinus tarsi, with associated marrow oedema. Following surgical excision of the ossicle, the foot returned to its original shape and the symptoms were alleviated. This is the fifth reported case of an accessory calcaneal ossicle, but the only case that has occurred in a flatfooted individual. We also present the first reported MRI images of the lesion confirming pathological marrow oedema as a response to mechanical stress.

参考中文摘要：

我们形容一个被收购卡沃不寻常的事业，足内翻畸形的一个配件跟骨听小骨逐步扩大生产。一名13岁的宪法龙门，外翻扁平足注意到，在行走与踝关节外侧疼痛相关的脚型逐步改变反转之后2年前受伤岁男童。 CT和核磁共振扫描证实了大型配件跟骨听小骨跗骨窦内说谎，相关的骨髓水肿。继手术切除的小骨，脚恢复到原来的形状和症状得到缓解。这是第五次报告的一个附件跟骨听小例子，但只有一宗案件已经在措手不及个别发生。目前我们还首次报告的确认作为对机械压力的反应骨髓水肿病理病变的MRI图像。

出  处：

Skeletal radiology. 2010 Feb  ,39 (2) :193-7

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