骨骼肌系统感染的MRI诊断价值

骨骼肌系统感染，于MRI T1 WI上多低信号、T2W1上多高信号。骨髓炎时，T1WI上病灶内低信号，可由纤维化造成。炎性肿块T1WI上高信号可由出血引起，而T2WI上肿块内低信号也可由纤维组织形成产生。STIR成像对显示骨骼肌系统病变有高度敏感性。Gd-DTPA增强后，感染病灶内环状强化是提示脓肿形成或组织坏死液化。骨骼肌系统感染，MRI优于X线平片检查，但类似上述MRI表现也可见于骨骼肌系统的其他良性或恶性病史。因此，必须结合临床资料才能正确诊断。     

脑内海绵状血管瘤的CT和MRI诊断

目的探讨脑实质内海绵状血管瘤（CA）的CT、MRI表现及其诊断价值。方法回顾性分析经手术病理证实的CA12例,8例行CT平扫,4例行CT增强扫描,12例均行MR检查,5例行Gd-DTPA增强扫描。结果12例CA共检出14个病灶。CA可发生于脑内任何部位,单发多见（10/12）。海绵状血管瘤CT平扫表现为类圆形高或稍高密度病灶,多数为不均匀,常伴钙化、出血。MRI平扫大部分表现为T1WI呈等信号或稍高信号,T2WI呈高、低混杂信号,11个病灶周围可见低信号环影,大多数病灶周围无水肿带及占位效应。CT和MRI增强后均呈轻度强化或无明显强化。结论CT和MRI检查对CA具有重要的诊断价值,MRI优于CT,是诊断本疾病最佳的影像学方法。     

大脑胶质瘤病的影像学表现

目的 探讨大脑胶质瘤病的影像学特点．方法 回顾性分析21例大脑胶质瘤病的影像所见。结果 21例均经手术或活检证实，均侵及二个以上脑叶，并侵及颅内深部结构，病变区在CT上表现为弥漫低或稍低密度区，在T1WI呈稍低信号．T2WI呈高或稍高信号，无或有轻度占位效应，增强后病灶大部多无明显强化或轻度强化，小部分区域可强化较明显。结论 影像学检查可清楚显示大脑胶质瘤病，可在术前准确诊断大脑胶质瘤痛。MRI是诊断本病的首选影像学方法，具有重要临床价值。     

羟基磷灰石义眼台纤维血管化的MRI表现

目的探讨造影剂(Gd-DTPA)增强MRI检查评价眼眶内植入羟基磷灰石(hydroxyapatite,HA)义眼台纤维血管化程度的可行性。方法选择2005年12月至2006年11月20例眼眶内植入HA义眼台患者,其中男性11例,女性9例,年龄17～69岁,中位年龄42.41岁。术后1～6个月至少对患者行1次MRI平扫及增强检查,MRI扫描应用1.5 T超导磁共振扫描仪,标准头部线圈。义眼台纤维血管生长程度评价用SE序列T1加权Gd-DTPA增强图像,由一位副高职称MRI诊断医师双盲法按义眼台强化的程度和范围划分为Ⅰ～Ⅳ个等级。结果3例术后1个月,MRI增强表现为义眼台Ⅰ级强化形式;3例术后2个月,表现为Ⅱ级强化;6例术后3个月中5例表现为Ⅲ级强化,1例为Ⅱ级强化;4例术后4个月均为Ⅲ级强化;术后5、6个月各2例表现为Ⅳ级强化。结论MRI可直观地评价义眼台纤维血管化的程度和范围。     

大鼠乳腺癌MRI靶向造影剂的实验研究

目的探讨单克隆抗体造影剂在大鼠乳腺癌模型中的靶向性。方法①利用单克隆抗体LM609与钆双胺（Gd-DTPA）制备抗体造影剂（Gd-DTPA-抗体）;⑦制备15只大鼠乳腺癌模型．分为实验组（A、B组）和对照组（C组）;（3）MRI扫描,分别于注射造影剂前、注射造影剂即刻,10min,6、12、24、36、48h不同时刻测量注射不同浓度Gd-DTPA-抗体（A组质量浓度为0．4690μg／mL,B组质量浓度为0．0469μg／mL）瘤体的信号强度,对照组注射普通造影剂Gd-DTPA（质量浓度0．0469μg／mL）。结果实验A、B2组大鼠注射Gd-DTPA-抗体造影剂6h后．瘤体强化信号值逐渐提高,在约24h后肿瘤的强化值达到了最高。C组内．瘤体则表现为造影剂快进快出的方式。结论单克隆抗体造影剂在大鼠乳腺癌模型中具有靶向性。     

心肌梗死模型家猪存活心肌的磁共振延迟成像评价

背景：心脏磁共振延迟成像被认为是极有前景的无创性判断心肌存活状态的影像检查手段。目前常用的对比剂Gd-DTPA存在过高或过低评价存活心肌和不可逆性梗死心肌,而坏死亲和性对比剂ECIII-600可以准确地反映坏死心肌的面积。 目的：对比冠脉内注射坏死亲和性对比剂在猪再灌注急性心肌梗死存活心肌诊断中的应用价值。 方法：三四个月龄普通家猪12头,建立急性再灌注心肌梗死动物模型,分别冠脉内注射0.1 mmol/kg Gd-DTPA或         0.005 mmol/kg ECIII-600。胸导R波触发心电门控,T1加权FAST序列,短轴面延迟强化扫描成像。扫描结束后沿短轴面将心脏切成6 mm断面行氯化三苯基四氮唑染色和光镜检查。比较相应层面的MRI延迟强化区和氯化三苯基四氮唑染色所示梗死区的关系。 结果与结论：注射Gd-DTPA的延迟成像10 min时强化区面积与氯化三苯基四氮唑染色相比过高估计梗死心肌面积约21%,30 min时强化区面积与氯化三苯基四氮唑染色结果一致,之后则过低估计坏死心肌的面积;注射ECIII-600的延迟磁共振成像在坏死区显示强烈而持续的对比增强,强化区面积与氯化三苯基四氮唑染色所示心肌梗死面积一致。说明ECIII-600增强磁共振延迟成像可以准确反映急性心肌梗死面积。Gd-DTPA评价心肌梗死面积不稳定,观察时间窗短,心脏磁共振成像应在对比剂注射后1 h以内完成。     

MRI检查对宫颈癌的诊断价值研究

目的 探讨宫颈癌的MRI表现,评价MRI成像对宫颈癌诊断及判断周围侵犯的价值.方法 对经病理证实的20例宫颈癌患者(术前)行常规MRI及增强检查;行盆腔的轴面SET1WI,轴面及矢状面脂肪抑制(SPIR)T2WI,轴面弥散加权成像(DWI)及欧乃影(Gd-DTPA)增强后轴面、矢状面SET1WI扫描.在MRI图像上观察原发肿瘤的位置、信号特征及侵犯范围.结果 MRI常规序列及增强检查检出全部病例,准确率100％.宫颈癌的MRI表现颇具特征性,T2WI呈较高信号,T1WI呈等或低信号,DWI普通呈高信号,Gd-DTPA增强后T1WI可轻度强化.结论 MRI能多方位清晰显示宫颈癌瘤灶及侵犯范围与途径,明显优于其他影像学检查方法.     

强直性脊椎炎与细菌感染的关系初步研究

本文同时检测了正常人和强直性脊椎炎患者血清中抗３种细菌的抗体水平。结果显示：ＡＳ病人血清中抗肺炎克雷白菌和福氏志贺菌的抗体水平显著高于正常对照组，且这两种抗体的升高之间无相关性；抗鼠伤寒沙门菌的抗体水平则与正常人无显著差异。提示肺炎克雷白菌和福氏志贺菌可能在强直性脊椎炎的发病中起作用。     

组胺在豚鼠颈上神经节中的分布

目的 检测组胺在外周交感神经元中的分布。方法 应用原位杂交组织化学技术检测组氨酸脱羧酶(HDC)mRNA的表达，用荧光双标免疫组织化学技术观察组胺和酪氨酸羟化酶(TH)在神经细胞中的共存。结果豚鼠颈上神经节中有较多的神经元呈．HDC阳性，HDC mRNA阳性信号在大、小细胞的细胞浆内均有分布，在细胞核内未检测到阳性信号；组胺的阳性细胞和TH的阳性细胞在豚鼠颈上神经节中均有大量分布，在大型和小型神经元内均发现有双标阳性信号；6．羟多巴胺(6-OHDA)化学损毁颈上神经节的交感神经细胞后阳性细胞大量减少。结论 提示在颈上神经节细胞的胞浆内有组胺的合成，组胺与单胺类神经递质在外周交感神经元中共存。     

原发椎管内外周型原始神经外胚层肿瘤2例

目的探讨椎管内原发外周型原始神经外胚层肿瘤的临床特点、诊断、病理表现和治疗进展。方法分析2例经影像学、手术和病理检测证实的椎管内原始神经外胚层肿瘤,回顾相关文献,总结其临床特点。结果 2例病变术前行MRI检查呈等T1WI和等T2WI信号,增强后明显强化;镜下部分切除病变,术后病理检查提示均为外周型原始神经外胚层肿瘤,术后行放疗和化疗,分别随访13和10个月。结论椎管内原始神经外胚层肿瘤发病率低,好发于青少年,影像学无明显特异性,病理检查是可靠的诊断依据,预后较差。     

A comparison of rat femoral, sternebral and lumbar vertebral bone marrow fat content by subjective assessment and image analysis of histological sections

A subjective assessment of the amount of fat within the available marrow space was made from histological sections of the femur, sternebrae and lumbar vertebrae in rats. The sternebrae and vertebrae showed considerably less variability than the femur. Comparison between subjective assessment and image analysis of femoral bone marrow fat showed that there is no great advantage to be gained from using the latter technique. It was concluded that evaluation of sternebral and vertebral bone marrow results in a more accurate assessment of fat content.     

磁共振在儿童椎体骨髓转化及病变中信号类型的初步研究

目的通过分析椎体骨髓磁共振信号类型分布与年龄、性别的关系,探讨正常儿童椎体骨髓转换中磁共振信号的变化规律及其在椎体病变中的应用。方法选择分析105例正常儿童的脊柱椎体磁共振T1加权序列图像,其中男性63例,女性42例,年龄3个月～17岁(平均年龄6.56岁);同时选择血液系统疾病患儿共32例作为病变组对照研究,其中男性18例,女性14例,年龄3～14岁(平均年龄8.09岁)。病种包括各种原因所致贫血(19例)和白血病(13例)。采用GE 0.2 TProfile Gold永磁型开放式磁共振扫描仪进行脊柱矢状位SE T1WI扫描。采用四级六分法对椎体T1WI表现进行分型观察,并对所获得的数据与年龄、性别的关系进行统计学处理。结果不同年龄组间脊柱椎体信号类型分布差异具有显著统计学意义(P<0.01);0～5岁儿童脊柱椎体信号类型主要为Ⅱa、Ⅲ和Ⅳa型,6～17岁儿童脊柱椎体信号类型主要为Ⅳa和Ⅳb型;脊柱椎体信号类型在不同性别间分布差异均具有显著统计学意义(P<0.01);病变组脊柱椎体表现为Ⅰ型弥漫性T1低信号者最常见(75.6%),其他常见类型还包括Ⅱa型和Ⅳa型。结论椎体磁共振T1信号表现类型的分布与年龄及性别密切相关,不同年龄、不同性别间椎体磁共振成像表现具有显著差异。同时,病变组不同年龄段患儿椎体均主要表现为弥漫性T1信号减低。因此,椎体磁共振表现分型研究有助于直观显示骨髓正常发育过程及弥漫性骨髓病变或翻转的发生。     

Assessment of cortical and trabecular bone distribution in the beagle skeleton by neutron activation analysis

The distribution of bone calcium between morphologically identifiable cortical and trabecular bone obtained by dissection and quantitated by neutron activation analysis (NAA) is described. The skeleton of a female beagle dog was dissected into approximately 400 pieces and assayed for ⁴⁹Ca produced in the University of California, Irvine TRIGA reactor. For each of the skeletal sections, we give the initial weight of the alcohol-fixed tissue, which includes cortical bone, trabecular bone, marrow, and cartilage, and a final tissue weight after the marrow and trabecular bone have been dissected away; total section and cortical section calcium weights are reported. The level of detail is represented, for example, by the vertebrae, which were divided into three parts (body, spine, and transverse processes) and by the long bones, which were divided into 10–12 parts such that characterization of the epiphysis, metaphysis, and diaphysis was accomplished. The nedian percentage cortical calcium values for cervical, thoracic, and lumbar vertebrae were 82%, 56%, and 66%, respectively; however, variation within these groups and among individual vertebral sections was about a factor of 2. For long bones, the median percentage cortical calcium varied from 90–100% in the midshaft to below 50% in the proximal and distal sections. The final calculated cortical tissue-to-calcium mass ratio (TCR) varied from about 4.5 for midshafts of the long bones to about 9 for thoracic vertebral bodies and indicated that the mineral fraction of cortical bone is not constant throughout the skeleton. The ratio of cortical to trabecular calcium in the skeleton was 79.6:20.4.     

Vertebral column regionalisation in Chinook salmon,Oncorhynchus tshawytscha

Teleost vertebral centra are often similar in size and shape, but vertebral‐associated elements, i.e. neural arches, haemal arches and ribs, show regional differences. Here we examine how the presence, absence and specific anatomical and histological characters of vertebral centra‐associated elements can be used to define vertebral column regions in juvenile Chinook salmon (Oncorhynchus tshawytscha). To investigate if the presence of regions within the vertebral column is independent of temperature, animals raised at 8 and 12 °C were studied at 1400 and 1530 degreedays, in the freshwater phase of the life cycle. Anatomy and composition of the skeletal tissues of the vertebral column were analysed using Alizarin red S whole‐mount staining and histological sections. Six regions, termed I–VI, are recognised in the vertebral column of specimens of both temperature groups. Postcranial vertebrae (region I) carry neural arches and parapophyses but lack ribs. Abdominal vertebrae (region II) carry neural arches and ribs that articulate with parapophyses. Elastic‐ and fibrohyaline cartilage and Sharpey's fibres connect the bone of the parapophyses to the bone of the ribs. In the transitional region (III) vertebrae carry neural arches and parapophyses change stepwise into haemal arches. Ribs decrease in size, anterior to posterior. Vestigial ribs remain attached to the haemal arches with Sharpey's fibres. Caudal vertebrae (region IV) carry neural and haemal arches and spines. Basidorsals and basiventrals are small and surrounded by cancellous bone. Preural vertebrae (region V) carry neural and haemal arches with modified neural and haemal spines to support the caudal fin. Ural vertebrae (region VI) carry hypurals and epurals that represent modified haemal and neural arches and spines, respectively. The postcranial and transitional vertebrae and their respective characters are usually recognised, but should be considered as regions within the vertebral column of teleosts because of their distinctive morphological characters. While the number of vertebrae within each region can vary, each of the six regions is recognised in specimens of both temperature groups. This refined identification of regionalisation in the vertebral column of Chinook salmon can help to address evolutionary developmental and functional questions, and to support applied research into this farmed species.     

强直性脊椎炎骶髂关节早期改变的MRI诊断

目的:探讨强直性脊柱炎(AS)骶髂关节(SIJ)早期改变的MRI表现及诊断。方法:回顾性分析经病理证实的50个AS骶髂关节早期改变的MRI表现。结果:MRI显示47个SIJ滑膜软骨异常,在这些关节中骨髓水肿、骨髓内脂肪沉积分别有45、28个,骨质侵蚀及骨质硬化各有15、6个。MRI动态增强发现在这47个滑膜软骨异常的关节中,30个轻度强化,17个明显强化。3个关节MRI未见异常,动态增强示这3个关节无异常强化。结论:关节滑膜软骨异常、骨髓水肿、脂肪沉积等是AS骶髂关节早期改变的MRI重要征象,可作为MRI诊断早期AS的依据。     

Developmental Failure of Segmentation in a Caudal Vertebra of Apatosaurus (Sauropoda)

A vertebral element assigned to an Apatosaurus cf. ajax from the Late Jurassic Morrison Formation is described. The specimen exhibits an unusual morphology where two vertebrae are nearly seamlessly fused together, including the haemal arch that spans them. This morphology is thought be the result of a developmental abnormality. CT scans of the specimen reveal a thin zone of dorsoventral thickening between the two neural arches consistent with cortical bone. Contrast in internal morphology differentiates the anterior and posterior vertebral bodies with the anterior expressing greater porosity, which increased accommodation for barite‐rich calcite precipitation. No vacuities are observed to suggest the former presence of an intervertebral disk or intervertebral joints: the absence of an intervertebral disc or intervertebral joints is indicative of a condition known as block vertebra. Block vertebrae occur with the loss, or inhibition, of somitocoele mesenchyme early in embyogenesis (i.e., during resegmentation of the somites responsible for the formation of the affected vertebra). The derivatives of somitocoele mesenchyme include the intervertebral disc and joints. Although vertebral paleopathologies are not uncommon in the fossil record, this specimen is the first recognized congenital malformation within Sauropoda. Anat Rec, 297:1262–1269, 2014. © 2014 Wiley Periodicals, Inc.     

Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region

The vertebral artery, cervical spinal nerves, spinal nerve roots, and the bony and ligamentous tissue related to the cervical vertebrae are structures whose anatomy determines the path of a surgical approach. Defining the anatomy and, in particular, determining the precise location of vulnerable structures at the intervertebral foramen and the uncovertebral foraminal region (UVFR), a region defined by the uncinate process anteriorly, the facet joint posteriorly and the foramen transversarium laterally, has critical significance when selecting the safest surgical approach. We studied the anatomy of the vertebral artery, cervical spinal nerves, and spinal nerve roots within the UVFR in six cadaver specimens. We also obtained measurements of bony structures in 35 dry cervical vertebral columns, from C3-C7. The uncinate process (UP) projects superiorly from the posterolateral aspect of each cervical vertebral body, except for the first and second vertebrae. Because the posterior part of the UP lies adjacent to the vertebral artery, spinal nerve, and spinal nerve roots, its resection creates sufficient space to decompress these structures directly. The posterolateral surface of the UP is covered by ligamentous tissue that originates from the posterior longitudinal ligament and protects the neural and vascular structures during their decompression in the UVFR.     

Lymphatico-venous anastomosis after obstruction of abdominal lymphatics and lymphatic drainage of the prostate in canines

The communication between abdominal lymphatics and the vertebral venous system in canines was observed under conditions of lymphatic obstruction. After obstructing lymphatics of the lumbar trunks, lipiodol was injected into the pedal lymphatics and visualized to enter the inferior vena cava 10 days later, and the vertebral venous system 12 days later by fluoroscopy. Radiographs of the transverse sectioned vertebrae showed that the contrast medium flowed from the para-aortic lymph nodes into the vertebral venous system and entered the vessels around the vertebrae and in the spinal canal, and the vertebral body at the ventral surface of lumbar vertebra. Histologically, the contrast medium was identified in the Haversian canal and peripheral region of the bone marrow. These results suggest that prostate cancer may metastasize the vertebral bone through the lymphatico-venous anastomosis and vertebral venous system. © 1993 Wiley-Liss, Inc.     

下颈椎血供的解剖研究及其临床意义

目的为颈椎前路减压手术中减少出血量,改善显露和减少手术并发症的发生提供解剖学基础。方法在15具成人尸体标本上,解剖观测C3～7椎体前后部血供的起源、走行、分支及吻合。结果椎体前部血供来自颈升动脉脊支、甲状腺下动脉和颈深动脉脊支,C4～7椎前动脉在椎体上的分支相互吻合,在颈长肌的内侧缘处常吻合成一纵行动脉链;椎体后部血供来自椎间动脉发出的椎后动脉,其分支在颈椎体后部吻合形成节段性弧形动脉吻合链。结论阻断术椎的椎前动脉及其与相邻椎前动脉的纵行动脉吻合,并在颈椎后部减压时注意对硬膜囊外侧缘及椎体中部处的椎后动脉及其分支的处理,可减少颈椎前路减压手术的术野出血,改善手术显露。     

基于CT多平面重建及MRI分析新鲜骨质疏松性椎体压缩骨折椎体内骨折区域形态类型及分布规律

文题释义： 骨质疏松症：是一种以骨量低下、骨微结构破坏导致骨脆性增加，易发生骨折为特征的全身性骨病。骨质疏松症分为原发性和继发性2大类，原发性骨质疏松症又分为绝经后骨质疏松症、老年性骨质疏松症和特发性骨质疏松症3种。继发性骨质疏松症通常由后天多种因素(物理、力学、化学)或疾病所致。双能X射线骨密度T值≤-2.5SD即可诊断为骨质疏。 胸、腰椎体压缩性骨折的诊断：胸、腰椎体压缩性骨折是骨质疏松常见并发症之一，X射线是诊断胸、腰压缩性骨折的首选检查方式，其有利于观察脊柱序列的连续性，可同时观察整个胸腰段以及更多椎体受伤情况，例如椎体的高度、宽度、楔形改变以判断骨折压缩的程度，但难以显示骨细微结构变化。CT检查可从冠状面、矢状面、横断面显示椎体三柱情况，但对椎管内外软组织显示不如MRI。MRI可有效鉴别陈旧及新鲜椎体压缩性骨折，同时可鉴别椎体良性及恶性病变；此外，MRI对于脊髓、神经损伤、椎管内病变等准确性高于CT，但显示骨折线、小关节骨折或脱位等不及CT。 背景：既往有学者根据X射线、MRI等对骨质疏松性椎体压缩骨折进行分类，然而目前国内外关于骨质疏松性椎体压缩骨折中椎体内骨折区域的形态类型及分布规律的研究鲜有报道。 目的：应用CT多平面重建及MRI观察并总结新鲜骨质疏松性压缩骨折椎体内的骨折区域形态类型及分布规律。 方法：回顾性分析2011年9月至2017年6月广州中医药大学第一附属医院收治的352例骨质疏松性椎体压缩骨折患者的临床资料，其中男69例，女283例，平均年龄73.07岁。入院后所有患者完善X射线、CT多平面重建、MRI及骨密度等检查，根据患者临床症状及影像学检查确诊477个椎体为新鲜骨质疏松性压缩骨折。将多平面重建CT中致密影或透亮线及MRI中骨髓水肿带定义为骨折区域，由2名脊柱外科医师及1名影像科医师通过多平面重建CT及MRI观察并总结骨折区域的形态类型及分布规律。研究已获得广州中医药大学第一附属医院伦理委员会批准，批准号：ZYYECKYJ【2017】057。 结果与结论：①MRI可清晰显示472个椎体内骨折区域，不能清晰显示5个椎体内骨折区域；多平面重建CT可清晰显示469个椎体内骨折区域，不能清晰显示8个椎体内骨折区域，其中包括MRI中无法分析骨折区域的5个椎体；两种检查方法观察骨折椎体内骨折区域无明显差异(P=0.402)，最终发现8个椎体不能通过CT或MRI判断其骨折区域形态；②以矢状面CT、MRI图像为主观察469个椎体，骨折区域形态类型分为嵌插型(n=311，66.31%)和裂隙型(n=158，33.69%)，在裂隙型椎体中，26个椎体裂隙内含有气体，28个椎体裂隙内含有液体，7个椎体裂隙内同时存在气体和液体；③以矢状面CT、MRI图像为主观察469个椎体，骨折区域在椎体内的分布位置分为上方型(n=238，50.75%)、下方型(n=80，17.06%)、前方型(n=21，4.48%)、中央型(n=110，23.45%)、混合型(n=20，4.26%)；④结果表明，结合多平面重建CT及MRI能有效辨别椎体内骨折区域形态类型及明确骨折区域在椎体内分布情况，这对于分析新鲜骨质疏松性椎体压缩骨折受伤机制及制定治疗方案有一定的指导意义。 ORCID: 0000-0002-2990-7592(莫凌) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程