Objective To investigate the imaging features of dysplasia epiphysealis hemimelica (DEH).Methods Thirteen cases of DEH confirmed by pathology (between 1.5 to 19.0 years old)underwent X-ray scan.Additionally,CT scan was performed in one patient,MR scan was performed in one,and CT and MR scan were both performed in one.Results The lesions all occurred in lower limb.There were 32 lesions,and multiple lesions were detected in 8 cases.Lesions involved holo-epiphyses in 6 cases,Twenty-three lesions were in the medial limbs,3 were in the lateral limb.With Azouz classification,the limited form was identified in 5 cases,while the classic form was identified in 8 cases.Among 13 cases,there were 4 cases with ankle eversion,3 cases with the knock knee,2 cases with the ankle inversion,and 2 cases with the strephexopodia.The metaphysis of 8 cases were widened and deformed,and the provisional zone of calcification of 1case disappeared partly and the epiphysis closed prematurely.Conclusions One or multiple eccentric enlarged ossification center of unilateral or bilateral limb is the imaging feature of DEH.There is sporadic calcification or ossification on the prophase.The calcification or ossification can fuse each other to form agglomerate at the advanced stage.The bone can deform and shift when compressed by the mass,and bone defect can even occur.

Objective To suty the MRI manifestations of juvenile acute articular cartilage injury of the knee joint.Methods MRI findings of cartilage,subcartilage low signal line and subcarilage bone were analysed retrospectively in 53 juvenile patients (ranged in age from 4~27 years) with acute articular cartilage injury confirmed by arthroscopy.Results Sixty-nine cartilage injuries were showed by MRI in 53 patients,including patellas in 25,femoral lateral condyles in 22,femoral medial condyles in 11,trochlea of the femur in 2,and tibial plateau in 9.Acute articular cartilage injury appeared as pure cartilage fracture in 46, including complete split of the cartilage in 22 sites,partly split of the cartilage in 20 sites,and fissur-like fracture in 4 sites.Osteochondral fracture were observed in 23 sites,including avulsion fracture in 13 and osteochondral subsided in 10.Articular cartilage loose bodies and osteochondral loose bodies were found by MRI in 6 and 13,respectively.Conclusion MRI is the best non-invasive method for studying cartilage injury.

Objective To explore scanning technique in 64-slice spiral CT angiography, and to evaluate the clinical value of various of post-processing methods.Methods 45 patients were examined with CT angiography, including 4 cases of thoracic aorta, 15 cases of abdominal aorta,10 cases of pulmonary artery, which delay time was determined by bolus tracking. The delay time of others ,including 4 cases of cerebrovascular, 6 cases of cervicum blood vessel and 6 cases of lower limb artery were determined by artifical. The initial images were processed with MPR, CPR, MIP ,SSD and VRT.Results According to standard valuation of imaging quality ,the good images were 37 cases, the better were 8 cases and none was bad.Conclusion As far as the diagnosis of great vessels is concerned, 64-slice spiral CTA can instead of DSA. MIP and VRT are important methods in post-processing of image.

Objective To analyze the X-ray,CT and MRI appearances of primary synovial osteochondromatosis.Methods CT scanning was performed in 22 cases,of which 16 cases underwent X-ray examination and 2 cases underwent MRI scan.Results Of 22 cases of synovial osteochondromatosis,13 cases were male and 9 cases were female.The monoarticular involvment was found in 20 cases,and double-articular involvment in 2 cases.Variable size and number of the cartilaginous nodules with calcification and ossification within and surround the joints were showed in 20 cases.The soft mass with calcification were showed in 2 cases.Bone destruction were found in 2 cases,which were induced by compression of the cartilaginous nodules,this was confirmed by operations.Conclusion The cartilaginous nodules with calcification or ossification can be shown by X-ray and CT san.The cartilaginous nodules without calcification or ossification can be shown by MR san.

Objective To explore the clinical and MRI features of spontaneous osteonecrosis of the knee(SONK).Methods 15 patients with SONK diagnosed by clinic and imaging were collected.All of cases were examined by MRI,of them 5 cases underwent CT scan and 3 cases underwent radiographic examinations.Results The subchondral lesions were seen in all cases on MRI and the lesions located in the femoral condyle weight-bearing zone in 14 cases.The subchondral "fracture cleft"sign was found in 2 cases;the subchondral long T1 and short T2 linear abnormal signal intensity surrounding with bone marrow edema were shown by MRI in 3 cases of them.The subchondral focal lesions were slight long T1 and long T2 signal intensity in 10 cases.The subchondral lesion were showed clearly only in 2 cases of 5 cases with CT scan,and only 1 case of 3 cases with plain X-ray examinations.Conclusion MRI is more sensitive than CT and radiography in showing the lesions of SONK.The SONK can be diagnosed based on the clinical and MRI features.

Objective To determine the characteristics of paresteal lipomas with hypemstosis (esteochondromas or osseous protuberances)on CT images and to improve the knowledge of diagnosis and differential diagnosis of the disease.Methods CT images and clinical history of 6 patients with pathologically confirmed parosteal lipemas with hyperostosis were retrospectively reviewed.All of the 6 patients underwent plain CT scans.Results CT images clearly show lipomas and osseous projections or osteochondroma in the 6 cases.Parosteal lipomas were found with osteochondronms in 2 cages(1 at the isehium.and the other 1 at the femoral trochanter)and willl osseous protuberances in 4 cases(2 at the diaphysis offemurs.1 at the diaphysis oftibia and the other 1 at the sternum).These osteochondromas and ossous protuberances were surrounded by the adipose component of the neoplasm and had a firm attachment oftlle neoplasm to the underlying bone.The size ofthe osseous projections varied from 0.3 cm x1.2 cm to 6.0 cm x 4.0 cm.The shape of the osgeous projections was various.Osteochondromas found in 2 cases showed cortical continuity with the adjacent bone together with marrow continuity with tlle adjacent bone marrow.In the 4 cages of parosteal lipama with osseous protuberances,2 to 4 osseous protuberances were found in 2 case8 and solitary osseous protuberance were found in the other 2 cases.The lipomatoas companent showed typical features of adipose tissue on all images.The size of the lipomas varied from 3.0 cm ×2.0 cm to 11.0 cm×10.0 cm with clear border.Fibrous septa of different thickness were found within the adipose tissue.There was essification and (or) calcification in 1 case and muscle atrophy in 2 espies.Conclusions CT scan is useful in the presurgical evaluation of parosteal lipomas witll osteochondromas or osseous protuberances became it can demonstrates the morphology,location and extent of the lesions.and it can show their relationship to the surrounding structures. It is important for differential diagnosis and preoperative assessment of the lesion.

Objective To detect the expression and effect of human tumor necrosis facctor related apoptosis-inducing ligand(hTRAIL)in vitro by using a novel double expressing adenoviral vector encoding hTRAIL and firefly lueiferase (luc) gene (Ad-hTRAIL-luc),in which luc wag used, as reporter gene.Methods A549 cells were transduced with the adenoviral vector encoding enhanced green fluorescent protein (EGFP) gene(Ad-EGFP)at variable multiplicity of infection(MOI).Adenoviral transducfion efficiency wag determined 48 h later.A549 cells were transduced with Ad-hTRAIL-luc at variable MOI.and the following tests were performed 48h later,respectively:the expressive ratio of hTRAIL and the apeptotic ratio of A549 cells were meagnred by flow eytometer;counts per minute(cpm)of luminescence were measurde by scintiUation counters. A549 cells were transduced with Ad-luc at variable MOI, and cpm of luminescence was measured by scintillation counters 48 h later. After A549 cells were transduced with AdhTRAIL-luc,the expressive ratio of hTRAIL,the apoptotic ratio of A549 cells and cpm of luminescence were analyzed by one-way ANOVA.The positive ratio of EGFP and cpm of luminescence (Ad-luc) were analyzed bv nonparametric ANOVA.Results After A549 cells were transfected with Ad-hTRAIL-luc,the expressive ratio of hTRAIL on the cell membrane of the groups were(2.37±0.04)/,(3.16±0.03)/,(3.64±0.03)/,(3.96±0.02)/,(4.24±0.02)/,(4.34±0.02)/ respectively,which showed significant difference between each other (P＜0.01);and the apoptotic ratio of A549 cells were (1.52±0.04)/,(2.93±0.02)/,(3.39±0.02)/,(3.64±0.02)/,(3.86±0.02)/,(4.08±0.02)/,(4.20±0.02)/,respectirely,and it showed significant difference between each other (P＜0.01);cpm of luminescence were 465 561±26 801,1 038 576±29 417,937 655±23 197,786 432±20 028,524 288±16 338,401 566±15 961,respectively,and it also showed significant difference between each other(P＜0.01).There was a positive relationship between the expressive ratio of hTRAIL and cell apoptotic ratio of A549 cells (r=0.984,P＜0.01).Conclusion The double expressing adenoviral vector Ad-hTRAIL-luc can transfer luc and hTRAIL gene to A549 cells efficiently,and the activity of luc may reflect the effect of hTRAIL as well as the expression of hTRAIL.

Objective To explore the imaing features of hemangioma in the long bone and improve the diagnostic level of this disease. Methods The X-ray(14 cases), CT(9 cases) and MRI(6 cases)findings of 18 patientswith histologically proven hemangioma in the long bone after surgery were retrospectively reviewed. Results Ten tumors occurred in medullary cavity or bone end(medullary type),6 on the surface of bone (periosteal type) and 3 in cortex (intracortical type). X-ray findings: among 8 cases of medullary type, 3 showed honeycomb appearance, 3 lytic areas with sclerotic borders, one purely osteolyticchanges, and 1 frosted glass; 3 cases of periosteal type showed sclerosis and thickening of the underlying cortex; 3 cases of intracortical type showed well-defined osteolytic foci. CT findings: among 6 cases of medullary type, 5 appeared as expansile lytic lesion with uneven selerotic rim (3 cases)orhoneycomb appearance (2 cases), 1 cribriform appearance in the cortical bone, 2 periostealnew bone formation in vertical radiation pattern; 1 ground-glass appearance; among 2 cases of periosteal typeone showed regular cortical thickening, and the other irregular periosteal proliferation with marrowing of medullarycavity; 1 case of intracorticaltype showed density similar to that of soft tissue, with cortical thickening and expansion . MRI findings: 2 apeared as well-defined lesions with low signal intensity on T1WI and high signal intensity on T2WI; 1 appeared as ill-defined lesion with low to intermediate signal intensity on T1 WI and T2 WI. One showed breakthrogh of cortex and formation of soft tissue mass with low signal intensity on T1 WI and high signal on T2WI. Two showed thickening of periosteumwith intermediate signal intensity in one of them and very low signal intensity in the other. Two showed abnormal signal intensity in surrounding muscles, which was high on T2 WI and intermediate on T1 WI. Conclusions The soap-bubble or honeycomb appearance is the typical radiographic finding of hemangioma in long bone. CT and MRI can provide useful information for the diagnosis of hemangioma in long bone.

Objective To investigate the clinical efficiency of branch artery of the sural medial gastrocnemius muscle flap combine with sural nerve nutritional vessel axial.Methods From February 2006to March 2010,according to the position and size of the soft tissue defects,the muscle flap combined with branch artery of the sural medial gastrocnemius and sural nerve nutritional vessel axial were desingned and obtained to repair 7 cases of sofi tissue defects of the upper-region of the tibial.The flap size ranged from 8.0 cm × 8.0 cm to 12.0 cm × 10.0 cm.The vessel pedicle of branches ranged from 1.8-3.0 cm.The distribution of the vessel pedicle of branches ranged from 10.0-17.0 cm on the distant popliteal fossa,and ranged from 2.0-5.0 cm on the back of medial line.Results The outline and function were satisfactory during 6-15 months follow-up.Conclusion The blood supply of this flap is reliable without sacrifice of major arteries.Flap elevation is easy.It can transfer to a long distance and can repair large skin defects.It is very useful in repairing upper-region of the tibial large soft tissue defect.

Objective To explore the image quality of 3.0 T Magnetic Resonance foot and ankle array coil on Achilles tendon ab-normalities for the clinical application.Methods 26 patients (with Achilles tendon symptoms)and 5 volunteers underwent MR exam-ination.The scanning sequences were used:T1 WI、PDWI、T2 WI-FS and STIR.Image diagnoses and clinical data of all patients were obtained and analyzed.Subjective scores on image quality were used.Degrees of comfort in coil were evaluated.Results 10 patients had Achilles tendon inj ury,6 patients with Achilles tendonitis,3 patients with part Achilles tendon rupture,1 patient with tendon xanthoma,and 6 patients were normal.Image scores in patients with T1 WI、PDWI and T2 WI-FS sequences were higher,the anatom-ic structures,lesions of whole Achilles tendon were clear.On the contrary,the lower scores were in STIR sequences.In the heel, images were distorted,the level of organization was disappeared and signal intensity was increased.The volunteers felt a slight dis-comfort at the coil entrance and support point of the heel.Conclusion Patients using 3.0T foot and ankle array coil for the Achilles tendon scanning could get high image quality and degrees of comfort.