Value of MRI in the evaluation of lipid storage myopathy

AIM:To investigate the magnetic resonance imaging(MRI)findings of lipid storage myopahty(LSM)，evaluate the clinical value of MRI for LSM.and thigh,spin echo sequence,fast spin echo sequence and short tau inversion recovery(STIR)were utilized .RESULTS:The signal intensity of diseased muscle of 8 cases with LSM was hyperintense on T2-weighted images (T2WI) and T1-weighed images (T1WI),and hyperintense signal intensity on T2WI and iso-intense on T1WI was seen on 2 patients as well.CONCLUSION:MRI can provide objective data for clinical diagnosis,therapeutic evaluation and folow-up.It can also help th decide the accurate localiztions for biopsies.     

磁共振全域直方图分析鉴别子宫富于细胞平滑肌瘤和肌瘤变性的价值

目的评估肿瘤磁共振全域直方图分析鉴别子宫富于细胞平滑肌瘤(uterine cellular leiomyoma,UCL)和子宫肌瘤变性(degeneration of uterine leiomyoma,UL-D)的价值.材料与方法回顾性研究2016年3月至2021年4月经病理证实的48例子宫富于细胞平滑肌瘤和44例UL-D患者的影像和临床资料,术前均行1.5 T磁共振常规扫描和扩散加权成像(diffusion weighted imaging,DWI)扫描,2名医师利用MaZda软件在T2WI(T2 weighted imaging)及ADC图上独立勾画肿瘤感兴趣区(volume of interest,VOI),进行灰度图直方图分析,提取T2WI及ADC图灰度直方图参数,包括均值(mean)、方差(variance)、偏度(skewness)、峰度(kurtosis)、第1、10、50、90、99百分位数(Perc 1％、Perc 10％、Perc 50％、Perc 90％、Perc 99％).采用组内相关系数(intra-class correlation coefficients,ICC)评价不同观察者判断的一致性,利用二元Logistic回归方法筛选参数以构建预测模型,利用ROC曲线分析评估单一参数及Logistic回归模型诊断效能.结果组内ICC为0.844,两组间ADC直方图参数mean、variance、skewness、Perc 1％、Perc 10％、Perc 50％、Perc 90％、Perc 99％及T2WI直方图参数variance、kurtosis、Perc 1％有统计学意义(P<0.05),绘制其受试者工作特征(ROC)曲线,曲线下面积(AUC)分别为0.833、0.677、0.674、0.736、0.777、0.824、0.848、0.822及0.705、0.660、0.640.二元Logistic回归分析及ROC分析,T2WI、ADC、T2WI+ADC模型AUC分别为0.790、0.848、0.881,相对应约登指数分别为0.4830、0.6250、0.6288.ROC曲线两两比较,T2WI与ADC、(T2WI+ADC)与T2WI、(T2WI+ADC)与ADC的P值分别为0.3425、0.0394、0.2348.结论肿瘤全域(T2WI、ADC)直方图定量参数值有助于子宫富于细胞平滑肌瘤与UL-D的鉴别诊断,联合T2WI+ADC模型具有最高的曲线下面积,但诊断效能不优于ADC参数.     

FLAIR序列在颅脑MRI检查中的应用

MRI现已被广泛应用于临床,特别是对神经系统疾病的诊断被公认为具有无可比拟的优势.目前,快速自旋回波序列(turbo spin echo,TSE)序列T1加权像(T1-weighted imaging,T1WI)和T2加权像(T2-weighted imaging,T2WI)在神经系统检查中被常规采用,但脑脊液在T2WI为明显高信号,由于其部分容积效应的影响,对位于脑表面、脑室内或邻近脑室部位微小病灶的显示有一定的限度,易导致漏诊.液体衰减反转恢复(fluid attenuated inversion recovery,FLAIR)能够抑制自由水信号,从而能够减少T2WI脑脊液高信号对邻近病变的影响.本次研究着重探讨FLAIR序列在神经系统成像中的应用价值.现报道如下.     

Differential diagnosis of a vanishing brain space occupying lesion in a child

We describe clinical, diagnostic features and follow up of a patient with a vanishing brain lesion. A 14-yearold child admitted to the department of Neurology at September 2009 with a history of subacute onset of fever, anorexia, vomiting, blurring of vision and right hemiparesis since one month. Magnetic resonance imaging(MRI) of the brain revealed presence of intraaxial large mass(25 mm × 19 mm) in the left temporal lobe and the brainstem which showed hypointense signal in T1 W and hyperintense signals in T2 W and fluid attenuated inversion recovery(FLAIR) images and homogenously enhanced with gadolinium(Gd). It was surrounded by vasogenic edema with mass effect. Intravenous antibiotics, mannitol(2 g/12 h per 2 d) and dexamethasone(8 mg/12 h) were given to relief manifestations of increased intracranial pressure. Whole craniospinal radiotherapy(brain = 4000 CGy/20 settings per 4 wk; Spinal = 2600/13 settings per 3 wk) was given based on the high suspicion of neoplastic lesion(lymphoma or glioma). Marked clinical improvement(up to complete recovery) occurred within 15 d. Tapering of the steroid dose was done over the next 4 mo. Follow up with MRI after 3 mo showed small lesion in the left antero-medial temporal region with hypointense signal in T1 W and hyperintense signals in T2 W and FLAIR images but did not enhance with Gd. At August 2012, the patient developed recurrent generalized epilepsy. His electroencephalography showed the presence of left temporal focus of epileptic activity. MRI showed the same lesion as described in the follow up. The diffusion weighted images were normal. The seizures frequency was decreased with carbamazepine therapy(300 mg/12 h). At October 2014, single voxel proton(1H) MR spectroscopy(MRS) showedreduced N-acetyl-aspartate(NAA)/creatine(Cr), choline(Cho)/Cr, NAA/Cho ratios consistent with absence of a neoplasm and highly suggested presence of gliosis. A solitary brain mass in a child poses a considerable diagnostic difficulty. MRS provided valuable diagnostic differentiation between tumor and pseudotumor lesions.     

基于前列腺影像报告和数据系统评估T2WI联合分段读出弥散加权成像诊断早期前列腺癌的价值

目的比较分段读出平面回波成像(readout-segmented echo-planar imaging,RS-EPI)与单次激发平面回波成像(single-shot echo-planar imaging,SSEPI)在早期前列腺癌诊断中的价值。材料与方法回顾性纳入20例行3.0T MRI SS-EPI和RS-EPI检查的早期前列腺癌患者。两位影像科医生在不提供任何临床资料的情况下参照PI-RADS标准分析T2WI、RS-EPI和SS-EPI图像,按六分区法对前列腺各个分区出现癌的可能性进行评分。共组成5种方案:方案1:T2WI;方案2:SS-EPI;方案3:RS-EPI;方案4:T2WI+SS-EPI;方案5:T2WI+RSEPI。采用受试者工作特征(receiver operating characteristic,ROC)曲线比较5种方案的诊断效能。结果方案1~5的曲线下面积分别为0.789、0.790、0.874、0.838、0.881,由高到低的顺序为T2WI+RS-EPIRS-EPIT2WI+SS-EPISSEPIT2WI。方案1与方案3、方案4、方案5,方案2与方案3、方案4,方案4与方案5之间ROC曲线下面积差异有统计学意义(P0.05)。方案1与方案2,方案3与方案4、方案5之间ROC曲线下面积差异无统计学意义(P0.05)。结论 T2WI联合应用DWI可提高早期前列腺癌的诊断效能,T2WI联合RS-EPI的诊断效能高于T2WI联合SS-EPI,更利于临床早期前列腺癌的诊断。     

腰骶神经根疾病核磁共振脊髓造影的影像学分析

AIM: To illustrate the magnetic resonance(MR) myelography features in the disease of lumbosacral nerve roots. METHODS: MR myelography using heavily T2 weighted spin-echo imaging with fat suppression was performed in 75 cases with chronic pain of waist on a Siemens Magneton Impect 1.0 T MR unit Maximum intensity projection (MIP) was used for image reconstruction. RESULTS: The thecal maugins, nerve roots and nerve root sheaths were well demonstrated on MR myelography image. In 75 patients with chronic of waist, nerve root disease was found in 11 cases. 6 nerve root abnormality (8% ), 2 perineural cyst (3% ), 3 neurofibroma (4% ) had their own MR myelography features. CONCLUSION: MR myelography can show the morphologic and structural change of lumbosacral nerve roots. In MR myelography image, disease of lumbosacral nerve roots has a characteristic finding. MR myelography is very useful in diagnosis of nerve-root disease.     

不同磁共振成像序列在颈髓损伤中的应用比较

目的 比较常规MRI序列、梯度回波T2*加权成像(T2*WI)及磁敏感加权成像(susceptibility weighted imaging,SWI)在急性颈髓损伤(SCI)中的应用价值.方法 对16例有急性颈椎外伤病史的患者,均采用3T MRI (TrioTim,Siemens Medical Solution)行...     

Diffusion—tensor magnetic resonance imaging in brain white matter diseases

Objective To evaluate the usefulness of diffusion-tensor MR imaging in brain white matter diseases.Methods A combined conventional and diffusion tensor MRI were obtained from 10 multiple selerosis,10 multiple lacunar infarction,3 cysticercosis,1 angiitis, 1morphinist and 10 healthy control volunteers.After oblaining mean diffusivity (D) and fractional anisotropy images and image coregistration,the corelations of the lesions and the white matter pathways were investigated.D and A values were measured form four big lesions which can be seen in T2WI and compared to contralateral white matter.Also D and AI value of four different anatomic locations of normal-appearing white matter regions were measured in all patients and controls.Results Whereas the lesions of infarction,cysticercosis and angiitis were in and outside the white matter pathways,all plaques of multiple sclerosis were inside the whit matter pathways.The brain white matter lesions by 1 morphinist were beside the lateral ventricle with big pachy appearance,which was partly inside white matter.For MS,D value was higher in lesion than contorl white matter. But for other diseases,D value could be seen higher or lower compared to healthy side.Ai values were lower in all lesions,D valuewas higher and AI was lower in normal appearing brain white matter when comparing MS to other cases or healthy control volunteers.Conclusion Diffusion tensor MR images can determine the correlations of the lesions and brain white matter pathways.The changes of D and AI values can improve specificity in differential diagnoses though quanti6tatively analyzing the tissue damage in lesions and normal-appearing brain white matter.     

The imaging analysis of magnetic resonance myelography in disease of the lumbosacral nerve roots

AIM：To illustrate the magnetic resonce(MR) myelography features in the disease of lumbosacral nerve roots.METHODS:MR myelography using heavily T2 weighted spin-echo imaging with fat supression was performed in 75 cases with chronic pain of waist on a Siemens Magneton Impect 1.0 TMR unit.Maximum intensity projection(MIP) was used for image reconstruction.RESULTS:The thecal maugins,nerve roots and nerve root sheaths were well demonstrated on MR myelography image.In 75 patients with chronic of waist,nerve root disease was found in 11 cases.6nerve root abnormality (8%),2perineural cyst(3%),3 neurofibroma(4%) had their own MR myelography features.CONCLUSION:MR myelography can show the morphologic and structural change of lumbosacral nerve roots.In MR myelography image,disease of lumbosacral nerve roots has a characteristic finding.MR myelography in very useful in diagnosis of nerve-root disease.     

基线磁共振T2WI纹理预测晚期直肠癌转化治疗原发灶疗效的应用研究

目的 探讨基线磁共振成像(magnetic resonance imaging,MRI)T2WI图像纹理分析在晚期直肠癌转化治疗原发灶疗效的预测价值.材料与方法 回顾性分析临床及病理证实为晚期直肠癌的患者66例,基线行盆腔MRI平扫、增强及扩散加权成像(diffusion weighted imaging,DWI)检查...     

多参数MRI放射组学预测上皮性卵巢癌患者术前腹膜转移

目的评价基于多参数磁共振成像(multiparameter magnetic resonance imaging,MP-MRI)的放射组学特征对上皮性卵巢癌腹膜转移的预测价值.材料与方法回顾性收集86例上皮性卵巢癌患者纳入研究,所有患者均行轴位脂肪抑制T2加权成像(fat suppression-T2 weighted imaging,FS-T2WI)、扩散加权成像(diffusion-weighted imaging,DWI)和动态增强(dynamic contrast enhanced,DCE)-T1WI扫描,从每个患者术前FS-T2WI、DWI和DCE-T1WI图像中提取定量成像特征,建立放射组学模型、临床模型;结合放射组学特征及临床病理危险因素,构建放射组学诺模图,通过受试者工作特性曲线、AUC、校准曲线和临床实用性来评估该放射组学诺模图的预测性能.结果来自MP-MRI组合序列的放射组学模型比单独来自FS-T2WI、DWI和DCE-T1WI的模型具有更高的AUC(0.865 vs.0.749、0.765、0.736).诺模图(0.953)显示出比临床模型(0.819)和组学模型(0.865)更好的诊断效果.结论基于MP-MRI组合序列的放射组学诺模图对腹膜转移显示出良好的预测准确性,可用于术前识别上皮性卵巢癌患者的腹膜转移.     

磁共振T2 mapping技术在体部恶性肿瘤中的研究进展

随着磁共振影像技术及大数据的快速发展,肿瘤的影像诊断不仅仅是局限于影像表现,如何将肿瘤病灶的特性进行定量成像评价逐渐成为研究的热点。目前,T1加权成像(T1 weighted imaging,T1WI)、T2加权成像(T2 weighted imaging,T2WI)、弥散加权成像(diffusion weighted imaging,DWI)及动态增强(dynamic contrast enhancement,DCE)技术已经成为磁共振检查的常规序列,各加权序列图上信号强度的大小仅能间接反映组织的特性。T2 mapping成像技术是定量成像技术中的一种,具有客观性、较好的可重复性及稳定性,在骨关节炎和心肌水肿中的运用和研究较多。随着技术的发展及体部肿瘤发病率的逐年升高,近年来也逐渐开始被应用到体部肿瘤方面的研究,作者就T2 mapping在体部恶性肿瘤中的定量研究进展予以综述。     

Comprehensive rehabilitation of closed injury of brain

Objective:To observe the effect of physical factors and promotion canalization on closed injury of brain,Method:68 cases of closed injury of brain were given the comprehensive rehabilitation therapy with many physical factors and promoting canalization technique,Result:The patients‘ consciousnesses were significantly improved after treatment.The motorial function of hemiplegic limbs was distinctly improved(P&;lt;0.05).The balance functions were distinctly improved (P&;lt;0.001).The activities of daily living abilities were significantly improved (P&;lt;0.05).Conclusion:The physical factors and promoting canalization treatment on the closed injury of brain are functionally effective.     

滑膜肉瘤的MRI表现分析

目的:分析滑膜肉瘤(synovial sarcoma,SS)的磁共振成像(magnetic resonance imaging,MRI)表现,以增加对该肿瘤的认识及提高诊断准确度。方法:回顾并分析26例SS患者的MRI表现,比较不同病理学类型及不同部位的SS MRI表现差异。结果:26例患者,20例发生关节周围,6例位于非关节周围。T1加权成像(T1-weighted imaging,T1WI)呈不均匀等或略高信号,T2加权成像(T2-weighted imaging,T2WI)呈不均匀高信号,增强后呈明显不均匀强化。22例伴分隔;19例伴坏死囊变;5例伴"液-液平";19例伴"结节堆积征";19例伴"三联征"。梭形细胞与双相型、关节与非关节周围SS的MRI征象无明显差异。"结节堆积征"、T2WI"三联征"的发生与肿瘤的大小存在中度正相关(r=0.73,P=0.002 9)。结论:SS的MRI表现有典型特征,多数可以做出定性诊断;MRI征象与肿瘤的大小之间存在中度正相关。不同病理学类型及不同部位的SS MRI表现无明显差异。     

非致伤因素对轻中型颅脑损伤恢复期的影响

Background: It is well know that prognosis of traumatic brain injury (TBI) has direct effected by injury degree. Although obvious injury is not detected by CT or MRI, some patients have bad prognosis. Objective: To discuss no efficient cause on rehabilitation in mild and moderate traumatic brain injury patients. Design: The research and follow-up survey are given to patients who have mild and moderate traumatic brain injury in our hospital (1996.6～ 2001.6). Unit: 251 Hospital of PLA.     

The effect of rehabilitation training on the treatment of infected artifidal joint

BACKGROUND: The key of curing infected-artificial joint is how to improve bone union and close surface of wound.OBJECTIVE:To explore the effect of rehabilitative training on the treatment of infected artificial joint of tibia.UNIT: Department of Orthopaedics, the 309th Hospital of PLASUBJECTS: 16 patients with infected artificial joint were recruited from May 1994 to July 2001, 12 males and 4 females, average 34 years. All the cases met the following criteria: (1 )The part of fracture was in middle or lower position of tibia; (2) Soft tissue defect of anterolateral surface of libra and exposure of libra and screw of steel plate, average area 14. 5 cm2; (3) Secondary infection after operation and fracture did not unite; (4) Duration of disease was more     

急性脑梗塞的MRI序列选择研究(附116例临床观察)

目的:研究急性梗塞MRI检查序列选择.材料与方法:选取2006年3月～2007年2月临床怀疑脑梗塞、发病时间在＜14d的MR检查者116例,MR序列选择,T1WI、T2WI、T2W-FLAIR、DWI,重点观察FLAIR及DWI诊断价值.结果:116例中,111例(111/116)诊断为脑梗塞,5例(5/116)经临床证实为TIA.DWI共检出新病灶73例84个病灶(73/111),其中36(36/84)个病灶在T1WI、T2WI、T2W-FLAIR未见显示.FLAIR共检出腔梗灶或软化灶75例(75/111),其对皮层下梗塞灶显示优于T2WI.结论:对临床怀疑急性脑梗塞者应行有T2W-FLAIR、DWI序列的头颅MRI检查.     

基于光梭成像的新型加速技术在颅脑MRI中的应用价值研究

目的:评估基于光梭成像(constellation shuttling imaging,uCS)技术加速的颅脑MRI图像质量及扫描时间,为其在临床常规化应用提供依据。方法:20名志愿者每人接受2次颅脑MRI扫描,包括快速自旋回波轴位T1加权成像(T1-weighted imaging, T1WI)、T2-液体抑制反转恢复序列(fluid attenuated inversion recovery sequence, FLAIR)、矢状位T1WI及梯度回波矢状位3D-T1WI序列扫描,分别采用并行采集技术(即常规扫描)和uCS加速技术,记录并比较扫描时间。采用主观(Likert 5级评分法,内容包括图像伪影及整体质量)与客观(定量测定图像信噪比)相结合的方法,对各序列采集的图像质量进行综合评价。结果:基于uCS技术加速后的颅脑MRI扫描时间均比常规扫描时间缩短约26.3%(542 s比735 s),其中3D序列时间缩短尤为明显,达39.0%。在图像整体质量及伪影评估方面,各项uCS加速序列与常规扫描序列之间差异均无统计学意义(P0.05)。在信噪比方面,uCS轴位及矢状位T1WI序列的信噪比显著高于常规扫描轴位及矢状位T1WI序列(P0.05)。uCS加速的FLAIR及3D-T1WI与常规扫描序列相比,信噪比差异没有统计学意义(P0.05)。结论:与常规MRI序列扫描相比,uCS技术可以显著缩短脑部MRI的图像采集时长,同时能保证图像质量。     

Microskin graft on contracture deformity of scar after extensive deep burn

Background:Contracture deformity of scar in late stage of extensive deep burn often neded repeated surgical platics and no fitful auto-skin of lacking were the common problems in clinic.Objective:To explore the effects of microskin graft on contracture deformity of scar after extensive deep burn.Unit:150th Hospital of PLA.Subjects:7 cases,23 locations of contracutre of scar were investigated including 3 males and 4 females,aged 14-46(mean:30)years old.Burn area was 76%-96% TBSA,with deep second degress over 65% and third degree over 90%. Operation regions:neck region,3 locatons,auxillary region,6 locations,elbow region,5 locations.wrist region,2 locations,popliteal fossa region,7 locations.Surgical opportunity:5 months-3 years after healing of wound surface.Source of heterogenous skin:Preserved with liquid nitrogen ,1 case:Fresh heterogenous skin,2 cases;From directly-related families,4 cases.Intervention:Adhesion was relaxed completely from contracture region to deep fascia at articular regions of limbs to achieve maximal degree of flexing and extending with no tension at edges of incision.If contracture of muscle and tendon affecting extending of joints was observed,muscle tendon might be pro longed.Exposing muscle tendon,nerve,vessels might be covered with peripheral tissues.Scars at neck,auxillary region must be removed or relaxed completely to restore function to normal or near to normal.Hemostasis must be complete.According to the ration of areas of providing and accepted skin,1 tp 6-8,intermediate thickness auto-skin was incised with rolling dermatome and clipped into 1 mm^2 of microskin that was sprinkled evenly on fitfully clipped heteropenous dermis.Heterogenous skin with mincroskin was grafted on wound surface,sutured,fixed and bandaged compressively with thick dressing.Neck,madnible,and auxillary region were bandaged with packaged and compressively and fixed with plaster support.After healing of graft wound surface,locak region must be compressed with elastic cover for 6-8 months and function exercises were taken to prevent hypertrophy of scar and second contracture.Resulty:Dressings were changed 7-8 days after operation,auto-skin was observed good,black blotch appeared in part of au toskin at about 3 weeks,fused into flat and sepaated.Auto-skin existed for a longer time and separated successively until wound surface was covereb by microskin in 16 locations,residual wound surface after heterogenous skin seperated in 7 locations healed after dressing was changed.After 1-3 years of follow-up,grafted skin was neat with mild scar,smooth surface and articular moving function and apperance were satisfying thwat was familiar to the effects of free lafge skin graft.Conclusiong:Microskin graft on deformity of joint and functional part was an effective method.     

短暂性脑缺血发作导致的脑梗死与脑血栓形成神经功能恢复比较

Background: Ischemia of brain has the highest incidence rates in cerebral apoplexy. Most of transient ischemia attacks( TIA) break out repeatedly, and end in cerebral infarction. Now reports on comparison of neural function defects and rehabilitation degree caused by them are rare.