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1
参考中文标题：
成像在肩关节疾病。
PMID及链接：
17624527 http://www.syyxw.com/Archive/Detail/17624527
摘 要：
Clinical assessment of the patient with shoulder symptoms can usually localize the cause to one of a few syndromes, each associated with specific imaging questions. MRI is used as the primary form of investigation for recurrent dislocation, SLAP lesions and PSI, as well as articular cartilage, synovial disease, tumours and infection. Ultrasound plays the leading role in impingement, acromioclavicular disease, dynamic assessment and guided therapy. Both techniques are reported to play a role in adhesive capsulitis. In our hospital, approximately four times as many shoulder ultrasound examinations as shoulder MRI are carried out, but elsewhere these proportions will vary according to the prevalence of clinical syndromes in the population being treated.
参考中文摘要：
临床评估患者肩部症状通常可以本地化的原因之一，一些症状，每个与特定的成像问题。 MRI是作为主要形式的调查，经常脱位，巴掌病变及防扩散，以及关节软骨，滑膜疾病，肿瘤和感染。超声起着主导作用，撞击，肩病，动态评估和指导治疗。这两种技术的报告中发挥作用，胶粘剂capsulitis 。在我们的医院，约4倍，许多肩膀超声波检查的肩膀进行MRI检查，但其他地方的这些比例将因普遍存在的临床症状的人口正在接受治疗。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1013-6
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2
参考中文标题：
磁共振成像骨髓肿瘤，第2部分。 [审查] [ 61参]
PMID及链接：
17492444 http://www.syyxw.com/Archive/Detail/17492444
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摘 要：
Magnetic resonance imaging plays an integral role in the detection and characterization of marrow lesions, planning for biopsy or surgery, and post-treatment follow-up. To evaluate findings in bone marrow on MR imaging, it is essential to understand the normal composition and distribution of bone marrow and the changes in marrow that occur with age, as well as the basis for the MR signals from marrow and the factors that affect those signals; these points have been reviewed and illustrated in part 1 of this two-part article. Part 2 will emphasize the practical application of MR imaging to facilitate differentiation of normal marrow, tumor, and treatment-related marrow changes in oncology patients, and will review complementary MR techniques under development. [References: 61]
参考中文摘要：
磁共振成像起着不可或缺的作用进行探测和定性骨髓病变，规划活检或手术，治疗后的后续行动。评价结果在骨髓的磁共振成像，至关重要的是理解的正常组成和分布骨髓和骨髓的变化，随着年龄的发生，以及以此为基础的MR信号骨髓和这些因素的影响信号;这些问题进行了审查，并说明在第1部分的两个部分的文章。第2部分将侧重于实际应用磁共振成像，以促进分化的正常骨髓，肿瘤，治疗相关的骨髓肿瘤患者的变化，并将审查补充磁共振技术正在开发中。 [参考文献： 61 ]
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1017-27
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3
参考中文标题：
评价径向序列成像检测髋臼labral眼泪议员在髋关节。
PMID及链接：
17712555 http://www.syyxw.com/Archive/Detail/17712555
摘 要：
OBJECTIVE: In recent years, radial imaging has been advocated for improved visualization of the acetabular labrum in magnetic resonance arthrography of the hip. The purpose of this study was to investigate whether radial imaging demonstrates labral tears not visible on standard imaging planes. METHODS: Fifty-four consecutive magnetic resonance (MR) arthrograms of the hip that included radial imaging over 2 years were retrospectively analyzed by two radiologists. Standard imaging planes and radial imaging were reviewed for identification of labral tears in four specific areas of the labrum: anterosuperior, posterosuperior, anteroinferior, and posteroinferior. The standard imaging sequences include fat-saturated spin-echo T1-weighted images in the coronal and oblique axial planes, non-fat-saturated T1-weighted images in the coronal and sagittal planes, and T2-weighted sequence in the axial plane. Radial imaging was performed as previously described using fat-saturated T1-weighted sequences. RESULTS: Using standard imaging planes, 50 anterosuperior, 31 posterosuperior, 10 anteroinferior, and 9 posteroinferior labral tears were detected in 54 MR arthrograms of the hip. Using radial sequences alone, 44 anterosuperior, 25 posterosuperior, 9 anteroinferior, and 5 posteroinferior labral tears were detected. In all four areas of the labrum, the radial imaging did not show any labral tear not seen on standard imaging planes. DISCUSSION: In MR arthrography of the hip, radial imaging did not reveal any additional labral tears. Standard imaging planes sufficiently demonstrate all acetabular labral tears.
参考中文摘要：
目的：近年来，放射成像一直主张改善可视化的髋臼唇在磁共振造影的髋关节。本研究的目的是调查是否径向成像表明labral眼泪不可见的标准成像飞机。方法： 54个连续磁共振（先生） arthrograms髋关节，其中包括径向成像超过2年进行回顾性分析由两名放射。标准成像和放射成像飞机进行了审查鉴定labral眼泪在四个具体领域的唇： anterosuperior ，后上方， anteroinferior ，和posteroinferior 。标准成像序列包括脂肪饱和自旋回波T1加权图像在日冕和斜轴架，非脂肪饱和T1加权图像在冠状和矢状面，和T2加权序列中的轴面。径向成像进行如前所述使用脂肪饱和T1加权序列。结果：使用标准成像飞机， 50 anterosuperior ， 31后上方， 10 anteroinferior ， 9 posteroinferior labral眼泪发现了54个议员arthrograms髋。用径向序列，仅44 anterosuperior ， 25后上方， 9 anteroinferior ， 5 posteroinferior labral眼泪被发现。在所有四个领域的唇，径向成像没有任何labral泪没有看到标准成像飞机。讨论：在MR的髋关节，桡成像没有透露任何其他labral眼泪。标准成像飞机充分证明所有髋臼labral眼泪。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1029-33
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4
参考中文标题：
B值优化中弥散加权MRI对鉴别良，恶性椎体骨折。
PMID及链接：
17786434 http://www.syyxw.com/Archive/Detail/17786434
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摘 要：
OBJECTIVE: The objective was to explore the optimal b value in diffusion-weighted imaging (DWI) of MRI for differential diagnosis of benign and malignant vertebral fractures. MATERIALS AND METHODS: Thirty-four consecutive patients with vertebral compression fractures underwent sagittal diffusion-weighted imaging (DWI) with different b values. The group included 14 patients with 18 benign vertebral fractures due to osteoporosis and/or trauma and 20 patients with 27 malignant vertebral fractures due to malignancy. The quality of the images was analyzed qualitatively on a three-point scale and quantitatively by measurement of the signal-to-noise ratio (SNR). Apparent diffusion coefficient (ADC) values were also calculated. RESULTS: Smaller b values correlated with better DW image quality. We found significant differences in the qualitative points values among the DW images with different b values (F=302.18, p<0.001). The mean SNR of the images ranged from 21.75+/-3.64 at a b value of 0 s/mm2 to 5.31+/-3.17 at a b value of 800 s/mm2. The SNR of DWI with a b value of 300 s/mm2 (18.62+/-2.47) was significantly different from that with other b values (p<0.01). The mean combined ADC values of malignant fractures were significantly lower than those of benign ones on DWI with a b value of 300 s/mm2 (t=9.097, p<0.01). Four cases of benign vertebral fractures were misdiagnosed as being malignant when b values of 0 s/mm2 and 100 s/mm2 were used. CONCLUSIONS: When DWI with multiple b values is used to differentiate benign from malignant vertebral compression fractures, b values within the range of around 300 s/mm2 are recommended, taking into account both SNR and diffusion weighting of water molecules.
参考中文摘要：
目标：目标是探讨B值的最佳弥散加权成像（ DWI ）的MRI鉴别诊断良，恶性椎体骨折。材料与方法： 34名患者连续脊椎压缩性骨折进行矢状弥散加权成像（ DWI ）不同的b值。该小组包括14例18良性椎体骨折由于骨质疏松症和/或心理创伤和20例恶性椎体骨折27日因恶性肿瘤。图像质量是定性分析的三点规模和定量测量信号信噪比（ SNR ） 。表观弥散系数（ ADC ）值计算。结果：小b值与图像质量更好的数据仓库。我们发现显着性差异点的质量数据仓库之间的价值观念不同的图像b值性（ F = 302.18 ，磷“ 0.001 ） 。平均信噪比的图像从21.75 + / -3.64在抗体值为0 s/mm2至5.31 + / -3.17在公司价值800 s/mm2 。信噪比成像与公司价值300 s/mm2 （ 18.62 + / -2.47 ）明显不同，与其他b值（ p “ 0.01 ） 。平均ADC值合并恶性骨折明显低于良性的在DWI与公司价值300 s/mm2性（ t = 9.097 ，磷“ 0.01 ） 。四例良性椎体骨折被误诊为恶性时， b值为0 s/mm2和100 s/mm2使用。结论：当成像多b值是用来区分良，恶性椎体压缩骨折， b值范围内，大约300名s/mm2建议，同时考虑到与扩散加权信噪比的水分子。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1035-41
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5
参考中文标题：
偶hallucal籽骨：与外翻和跖骨指数。
PMID及链接：
17768619 http://www.syyxw.com/Archive/Detail/17768619
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摘 要：
OBJECTIVE: The objective was to relate the incidence of the partition of the hallucal sesamoid bones to the size of the first metatarsal and the hallux valgus deformity. MATERIALS AND METHODS: In a sample of 474 radiographs, the frequency of appearance of bipartite sesamoids was studied. The length and relative protrusion of the first metatarsal, and the hallux abductus angle, were measured and compared between the feet with and without sesamoid partition. RESULTS: The results showed that 14.6% of the feet studied had at least one partite sesamoid, that the sesamoid most frequently divided was the medial, and that unilateral partition was the most common. No difference was found in the incidence of partite sesamoids between men and women, or between left and right feet. CONCLUSION: Protrusion and length of the first metatarsal are greater in feet with partite sesamoids than in feet without this condition. A significantly higher incidence of bipartite medial sesamoid was obtained in feet with hallux valgus compared with normal feet.
参考中文摘要：
目标：目标是要涉及的发病率的分割hallucal籽骨的大小第一跖骨和外翻畸形。材料与方法：样本， 474片的频率出现偶籽骨进行了研究。长度和相对突出的第一跖骨和外翻abductus角度，进行测量和比较英尺和无籽分区。结果：结果表明， 14.6 ％的脚下研究至少有一个部籽，籽认为是最常见的划分内侧，并单方面分割是最常见的。无差异中发现的发病率部籽骨之间的男性和女性之间，或左，右英尺。结论：椎间盘突出和长度第一跖骨有更大的脚部籽骨比英尺没有这个条件。阿的发病率明显高于双边内侧籽获得了脚外翻与正常英尺。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1043-50
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6
参考中文标题：
放射性表现在成人肌内haemangiomas ：磁共振成像，计算机断层显像和超声表现。
PMID及链接：
17849114 http://www.syyxw.com/Archive/Detail/17849114
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摘 要：
OBJECTIVE: Intramuscular haemangiomas in adults may appear similar to soft tissue sarcomas on imaging. This study evaluates the imaging characteristics of intramuscular haemangiomas on magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound. SUBJECTS AND METHODS: Retrospective review of medical records, imaging and pathology details of 34 patients presenting with intramuscular haemangiomas was performed. Age of patient, size, site of lesion and type of imaging was recorded. Lesions were evaluated for calcification, presence of fat, outline, texture, vascularity, enhancement and involvement of local structures. RESULTS: There were 12 male and 22 female patients aged between 9 years and 90 years (mean 39 years). Twenty-two lesions involved muscles of the extremities and 12 involved muscles of the trunk. Mean duration of the lesions was long: 59.3 months (range 3-240 months), with an average size of 7.5 cm (1.5-15 cm). Imaging comprised 27 MR studies, seven CT scans, 19 ultrasounds, and eight plain films. All lesions were well defined, lobulated and heterogeneous. None showed local invasion. On MRI and CT, 93-100% showed the presence of fat and 100% showed vascular channels and enhancement on MRI, CT and ultrasound. Phleboliths were seen on four plain films (50%) and on the corresponding MR images. On MRI, 70% of lesions had mildly hyperintense signal on T1-weighted sequences and 96% had hyperintense signal on T2-weighted sequences (relative to skeletal muscle). Histopathology confirmed diagnosis in all cases, showing the presence of fat, medium/large vessels and skeletal muscle. CONCLUSION: Intramuscular haemangiomas have characteristic appearances on MRI, CT and ultrasound. Long history, presence of fat, calcification and internal vessels should alert the radiologist to this diagnosis prior to biopsy.
参考中文摘要：
目的：肌内haemangiomas成人可能会出现类似的软组织肉瘤的影像。本研究评估影像学特征肌肉注射haemangiomas的磁共振成像（ MRI ） ，计算机断层扫描（ CT ）和超声波。主题和方法：回顾性审查的医疗记录，影像和病理资料34例提出与肌肉注射haemangiomas进行。病人的年龄，大小，病灶部位和类型的影像记录。病灶钙化的评价，存在的脂肪，大纲，纹理，血管，加强和地方机构的参与。结果：有12个男性和22例女性，年龄介乎9岁和90岁（平均39岁） 。 22个病灶参与肌肉四肢肌肉和12个参与的躯干。平均持续时间是漫长的病变：五十九点三个月（范围3-240个月） ，平均尺寸不超过7.5厘米（ 1.5-15公分） 。 27磁共振成像研究组成， 7 CT扫描， 19超声波检查， 8平片。所有病灶明确界定，分叶状异构。无显示，当地入侵。在MRI和CT ，显示93-100 ％存在脂肪和100 ％的显示血管的渠道和增强的MRI ， CT和B超。 Phleboliths被视为四个平片（ 50 ％ ）和相应的MR图像。 MRI上， 70 ％的病灶轻度高信号， T1加权序列和96 ％的高信号， T2加权序列（相对于骨骼肌） 。组织病理学确诊在所有情况下，显示存在脂肪，中型/大型船只和骨骼肌。结论：肌肉注射haemangiomas有特点的MRI表现， CT和B超。悠久的历史，存在的脂肪，血管钙化和内部应该提醒放射此之前活检诊断。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1051-9
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7
参考中文标题：
敏感性和特异性，影像学特征的平原周围enthesopathy在主要网站中银屑病性关节炎。
PMID及链接：
17849113 http://www.syyxw.com/Archive/Detail/17849113
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摘 要：
BACKGROUND: It has been proposed that the defining difference between rheumatoid arthritis and spondyloarthropathy (including psoriatic arthritis) is the initial pathological lesion where the emphasis in psoriatic arthritis is on the enthesis and in rheumatoid arthritis on the synovium. Classical radiological descriptions of seronegative spondyloarthropathy include enthesopathy at major entheseal insertions characterised by erosions and exuberant new bone formation. In this study, the plain radiographic features of spondyloarthropathy are compared between psoriatic arthritis, other spondyloarthropathies and rheumatoid arthritis. METHODS: The CASPAR study collected clinical, radiological and laboratory data on 588 patients with physician diagnosed psoriatic arthritis and 525 controls with other inflammatory arthritis, 70% of which had rheumatoid arthritis. Plain radiographs of the pelvis and heels were part of the study protocol, although radiographs of other potential entheseal sites such as the knee, elbow and shoulder, were interpreted if available. All radiographs were read blind by two observers working in tandem. RESULTS: Significant differences in entheseal erosion and entheseal new bone formation were found between psoriatic arthritis, ankylosing spondylitis, undifferentiated spondyloarthropathy, rheumatoid arthritis and other diagnoses (entheseal erosion, chi-squared 20.8, p=0.008; entheseal new bone formation, chi-squared 24.5, p=0.001). These differences were mainly due to a higher proportion of these features in ankylosing spondylitis. No differences in the plain radiographic features of enthesopathy were found between psoriatic arthritis and rheumatoid arthritis except in the case of entheseal new bone formation at sites of attachment of inguinal ligament, sartorius and rectus femoris muscles to the ilium (OR 3.01, 95% CI 1.13-8.02). Very few subjects with symptomatic heel involvement had radiographic changes and minimal differences were found between those with and without symptoms in terms of new bone formation and erosion at either calcaneal site. CONCLUSIONS: New bone formation and erosion at major entheseal sites is most commonly seen in ankylosing spondylitis. Plain radiographic features of major enthesopathy are poor discriminators between psoriatic arthritis and rheumatoid arthritis.
参考中文摘要：
背景：有人建议，确定区别类风湿关节炎和脊柱（包括银屑病性关节炎）是最初的病理病变的重点是在银屑病性关节炎的enthesis和类风湿关节炎的滑膜。古典放射性说明血清阴性脊柱包括enthesopathy主要特点是entheseal插入糜烂和旺盛的新骨形成。在这项研究中，普通X线特点脊柱是比较银屑病性关节炎，其他病和风湿性关节炎。方法：收集临床卡斯帕研究，放射性和实验室数据的588例医生诊断银屑病性关节炎和525的控制与其他炎症性关节炎， 70 ％的有类风湿关节炎。 X线骨盆和高跟鞋的一部分，研究协议，但X光片的其他潜在entheseal网站，如膝，肘和肩，如果有解释。所有X光宣读了盲人的两名观察员工作相协调。结果：显着性差异entheseal侵蚀和entheseal新骨形成之间发现银屑病性关节炎，强直性脊柱炎，未分化脊柱关节病，类风湿关节炎和其他诊断（ entheseal侵蚀，卡方8月20日， p值= 0.008 ; entheseal新骨形成，卡方5月24日， p值= 0.001 ） 。这些差异主要是由于较高比例的这些功能，强直性脊柱炎。没有分歧平原影像学表现enthesopathy被发现之间的银屑病性关节炎和类风湿关节炎的情况除外entheseal新骨形成的场址的附着腹股沟韧带，缝匠肌和股直肌的髂骨（或3.01 ， 95 ％ CI为1.13 -8.02 ） 。极少数科目有症状足跟参与了X光的变化和差异，最小的人之间，并没有出现在新骨形成，并侵蚀或者跟骨网站。结论：新骨形成，并侵蚀主要entheseal网站是最常见的强直性脊柱炎。平原影像学表现主要enthesopathy是穷人discriminators之间银屑病性关节炎和类风湿关节炎。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1061-6
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8
参考中文标题：
慢性运动室综合征下肢：提高甄别使用一种新型的双鸟笼线圈和扫描仪行使议定书。
PMID及链接：
17701169 http://www.syyxw.com/Archive/Detail/17701169
摘 要：
OBJECTIVE: The purpose of this study was to design and evaluate an MRI screening protocol for chronic exertional compartment syndrome (CECS) of the lower legs using an in-scanner exercise protocol and novel dual birdcage coil design for improved imaging. MATERIALS AND METHODS: Coil and phantom studies: a custom-made dual birdcage coil designed for this protocol was evaluated for uniformity and signal-to-noise ratio (SNR) compared with a conventional phased-array receive-only torso coil and the body coil. Phantom and normal subject studies were performed to confirm coil performance. In-vivo studies: eight unaffected subjects and 42 patients with lower extremity symptoms suggestive of CECS were imaged with the dual birdcage coil and an in-scanner exercise protocol which included imaging at rest, during isometric resisted dorsi flexion, at rest (recovery), during isometric resisted plantar flexion and, again, at rest. Of 42 patients, 14 had confirmed CECS and 28 had lower extremity anomalies attributable to other causes. Ratios of relative T2-weighted signal intensities were calculated for exercise and recovery images compared to baseline after processing of images, including re-registration for motion, smoothing and segmentation to remove bone and pulsation artifacts from blood vessels. RESULTS: Receiver operating characteristic (ROC) analysis showed a threshold for the ratio of relative T2-weighted signal intensity of 1.54 to have a sensitivity of 96%, specificity of 90% and accuracy of 96% for CECS. Patients with CECS had their peak ratio of signal intensity compared with baseline during the first recovery period after isometric dorsi flexion, whereas unaffected subjects and patients with other causes of exercise-induced lower extremity pain reached their peak values during exercise (P<0.001). CONCLUSION: We have developed the first in-scanner MRI exercise protocol for the assessment of patients with suspected CECS. The technique shows high accuracy, sensitivity and specificity for diagnosis in this small cohort of patients with CECS. Further study may allow this non-invasive test to be used as a triage tool for invasive intracompartmental pressure measurements in patients with suspected CECS.
参考中文摘要：
目的：本研究主要是设计和评估的MRI检查议定书慢性运动室综合征（ CECS ）的下肢使用的扫描仪行使议定书和新的双鸟笼线圈设计改进成像。材料与方法：线圈和幻像研究：一个特制的双鸟笼线圈设计被评为本议定书的统一性和信号信噪比（ SNR ）与传统的相控阵接收只有躯干线圈和体线圈。幻影和正常人进行了研究，以确认线圈性能。体内研究： 8不受学科和42例下肢症状暗示CECS被拍摄的双重鸟笼线圈和一个扫描器行使议定书，其中包括成像在休息期间，等距抵制背阔肌前屈，在休息（恢复） ，在等距抵制跖屈，并再次，在休息。 42例， 14日已经证实了CECS和28下肢异常由于其他原因。比率相对T2加权信号强度，计算运动和恢复图像的基准相比，处理后的图像，其中包括重新登记的议案，平滑和分割，消除骨和脉动文物从血管。结果：受试者工作特征（ 02 ）分析表明，阈值的比率，相对T2加权信号强度1.54有96 ％的敏感性，特异性为90 ％和96 ％ ，准确性为CECS 。 CECS患者有其峰比值的信号强度与基准相比，在第一回收期长背阔肌后屈曲，而不受主体和其他原因造成的患者运动诱发下肢疼痛达到峰值运动（ P “ 0.001 ） 。结论：我们已经开发出了第一次行使议定书磁共振扫描仪的评估病人的怀疑CECS 。该技术显示精度高，灵敏度和特异性诊断队列在这个小患者CECS 。进一步的研究可能会允许这种非侵入性测试，被用来作为分流工具侵入intracompartmental压力测量患者涉嫌CECS 。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1067-75
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9
参考中文标题：
纤维化不全ossium ：磁共振成像的轴向和四肢骨骼和相关了一个独特的影像外观。
PMID及链接：
17618434 http://www.syyxw.com/Archive/Detail/17618434
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摘 要：
We describe a distinctly unusual MR appearance of the cancellous bone never before described in a patient with biopsy-proven fibrogenesis imperfecta ossium.
参考中文摘要：
我们描述一个明显的不同寻常的MR表现比以往任何时候都松质骨中描述患者活检证实纤维化不全ossium 。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1077-84
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10
参考中文标题：
外观Mazabraud综合征的氟- 18 - FDG PET / CT显像。
PMID及链接：
17589842 http://www.syyxw.com/Archive/Detail/17589842
摘 要：
Mazabraud's syndrome is a rare disorder, the main characteristics of which are fibrous dysplasia of bone associated with intramuscular myxomas. The metabolic characteristics of intramuscular myxomas, associated with fibrous dysplasia, have not previously been described with 18F-FDG-PET. Our case demonstrates that there is low, but not insignificant uptake associated with these intramuscular myxomas, with a standardized uptake value (SUV) range between 1.3 and 2.6. As such, this entity merits consideration when evaluating hypoattenuating intramuscular masses, particularly in the context of fibrous dysplasia.
参考中文摘要：
Mazabraud氏综合征是一种罕见的疾病，其主要特点是骨纤维异常增殖症与肌内粘液瘤。代谢特点肌内粘液瘤，骨纤维异常增殖症有关，而以前并未描述，氟- 18 - FDG显像。我们的情况表明，有低，但并非没有意义的吸收与这些肌内粘液瘤，以标准化摄取值（ SUV ）介于1.3和2.6 。因此，值得考虑这一实体在评价hypoattenuating肌肉注射群众，特别是在骨纤维异常增殖症。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1085-9
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11
参考中文标题：
骨肉瘤腰骶部脊柱入侵中央静脉通路，右侧心脏商会和肺动脉。
PMID及链接：
17618433 http://www.syyxw.com/Archive/Detail/17618433
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摘 要：
We report an unusual case of lumbosacral osteogenic sarcoma with cauda equina syndrome and invasion into the central venous and cardiac system. A 41-year-old Hispanic man presented to the emergency department complaining of severe low back pain, cauda equina syndrome, bilateral lower extremity edema, and an extra heart sound on physical examination. CT of the lumbosacral spine done in the emergency department demonstrated a sclerotic lesion in the sacrum with cortical destruction, extension into the spinal canal and a bulky soft tissue mass containing calcifications. Supplemental MRI demonstrated marrow replacement of L4, L5, and the sacrum, soft tissue extension of the tumor, and invasion iliac veins extending into the IVC; however, the full extent of the intravascular tumor was not seen on this examination. Surgical laminectomy and biopsy of the spinal tumor provided the diagnosis of osteogenic sarcoma. A transthoracic echocardiogram was performed while the patient was recovering due to nonsustained ventricular tachycardia, which showed an echogenic mass within the right atrium and ventricle. CT pulmonary angiogram confirmed the echocardiogram showing a tumor extending through the pulmonary valve into the main pulmonary artery. The patient underwent en bloc resection of the tumor from the venous and cardiac systems. Histologic examination of the tumor confirmed osteogenic sarcoma. While vertebral osteogenic sarcoma is uncommon, invasion of the spinal canal is common in these tumors. However, tumor extending into the central venous and cardiac system is rare. The previously reported cases of central venous and cardiac involvement have been related to distant metastases or primary cardiac osteosarcomas. There is only one other reported case of direct extension into the venous system by an iliac bone osteosarcoma in an adolescent; however, the tumor did not extend into the pulmonary circulation.
参考中文摘要：
我们报告一个不寻常的案件腰骶部骨肉瘤与马尾神经综合征和入侵到中央静脉和心脏系统。 41岁的西班牙裔男子向急诊抱怨严重腰痛，马尾神经综合征，双边下肢水肿，和额外心音体检。电脑断层的腰骶部脊柱所做的那样表现出急诊硬化病变的骶骨皮质破坏，延长到椎管和一个庞大的软组织肿块含有钙化。 MRI检查显示骨髓补充更换腰椎，腰5和骶骨，延长软组织肿瘤，并入侵髂静脉延伸到下腔静脉，但最大限度的血管瘤没有看到关于这个考试。手术切除和切片脊髓肿瘤的诊断提供了骨肉瘤。阿经超声心动图进行，而恢复的病人，由于nonsustained室性心动过速，这表明了回声大规模的右心房和心室。 CT肺血管造影证实的超声心动图显示肿瘤扩大通过肺动脉瓣到主肺动脉。病人接受整块切除肿瘤的静脉和心脏系统。病理检查证实的骨肉瘤肿瘤。虽然腰椎骨肉瘤是罕见，入侵椎管是常见的肿瘤。然而，肿瘤扩展到中央静脉和心脏系统是罕见的。由先前公布的情况下中心静脉和心脏介入已与远处转移或原发性心脏骨肉瘤。只有一个报告的其他情况下直接扩展到静脉系统的髂骨骨肉瘤的青少年;然而，肿瘤并没有延伸到肺循环。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1091-6
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12
参考中文标题：
腕，跗骨溶解与肘部参与。
PMID及链接：
17618432 http://www.syyxw.com/Archive/Detail/17618432
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摘 要：
Carpal-tarsal osteolysis is a rare condition that manifests as the progressive resorption of carpal and tarsal bones in young children. The diagnosis of this condition is often difficult and delayed as the initial clinical presentation is non-specific. Radiographic changes occur gradually, are often not seen at presentation and depend on recognising loss of bone in the ossification centres of the carpus and tarsus. MRI demonstrates morphological abnormalities in the cartilaginous, as well as the osseous components, of the developing carpal and tarsal bones and therefore may be helpful in predating the radiographic changes. Ultrasound appears to contribute little to the diagnosis and may be misleading. Exclusion of other conditions, particularly juvenile idiopathic arthritis, is important in making the diagnosis. MRI can be useful in excluding an inflammatory arthropathy, and suggesting the diagnosis of carpal-tarsal osteolysis.
参考中文摘要：
腕，跗骨溶解是一种罕见的情况下，表现为逐渐吸收腕和跗骨在年幼的孩子。对这种状况往往是困难和延迟的初步临床表现是不具体的。射线逐渐发生变化，往往没有看到介绍，取决于承认损失骨骨化中心的腕骨和跗节。磁共振成像显示形态异常软骨以及骨组成部分，在发展中腕和跗骨，因此可能会有所帮助早射线变化。超声似乎贡献不大的诊断，并可能会产生误导。排除其他条件，特别是幼年特发性关节炎，是很重要的决策诊断。 MRI检查可有助于排除炎性关节病，并提出诊断腕跗骨溶解。
出 处：
Skeletal radiology. 2007 Nov ,36 (11) :1097-101
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