进一步推进弥漫性肝病的MRI精准诊断与定量研究

弥漫性肝病是我国面临的重大健康问题.弥漫性肝病随疾病进展会表现为炎症、脂肪变性、肝纤维化及肝硬化等不同病理改变.准确评估弥漫性肝病的病理改变及程度对于治疗决策、预后评估、药物疗效评价等有重要意义.近年,多种定量MRI技术在弥漫性肝病的诊断与评估中展现出较好的应用前景,有待进一步深入研究.     

肝纤维化的DWI研究进展

肝纤维化是慢性肝病的标志,其特征是细胞外基质过度积累。肝组织活检是肝纤维化分期和诊断的金标准,但其为有创检查,且存在取样变异性。因此,临床仍需无创检查技术来评估肝纤维化。DWI及其衍生序列近年来已用于定量评估肝纤维化,通过无创测量受胶原纤维限制水分子的运动来评估肝纤维化的程度,已取得不错的效果。就肝纤维化的DWI技术应用情况进行综述。     

肝纤维化的MRI研究进展

肝纤维化为慢性肝病早期出现的病理改变,早期治疗能明显改善其预后,故早期诊断有重要意义。MRI扫描技术的发展使其能够对肝纤维化的结构、代谢及功能做出评价,就近年来早期诊断肝纤维化的MRI研究进展予以综述。     

肝纤维化的MRI研究进展

肝纤维化为慢性肝病早期出现的病理改变,早期治疗能明显改善其预后,故早期诊断有重要意义.MRI扫描技术的发展使其能够对肝纤维化的结构、代谢及功能做出评价.就近年来早期诊断肝纤维化的MRI研究进展予以综述.     

肝纤维化的MR扩散张量成像定量诊断与分期研究进展

肝纤维化是各种慢性肝病向肝硬化发展的必经过程,该过程是潜隐渐进的,且肝纤维化早期阶段是可逆的。早期定量诊断肝纤维化对其治疗效果、预后评估及促进其逆转具有重要意义。随着功能MRI技术,特别是MR扩散加权成像及扩散张量成像技术的发展,肝纤维化的无创性定量诊断取得一定进展。着重就MR扩散张量成像对肝纤维化的定量诊断与分期研究进展予以综述。     

功能MRI在肌肉损伤中的应用进展

肌肉损伤的早期确诊有助于临床治疗与预后评估。常规MRI作为评估肌肉损伤的最佳影像方法已广泛应用于临床。而近年发展起来的T2 mapping、扩散加权成像（DWI）及扩散张量成像（DTI）等功能MRI技术能够反映肌肉损伤后病理、生理微观变化,可以无创、定量、客观地评估肌肉损伤的严重程度与再生修复情况,甚至可以早期发现肌肉损伤。就功能MRI在肌肉损伤评估方面的应用进展予以综述。     

瞬时弹性成像的研究进展及临床应用

慢性肝纤维化是肝病进展的重要过程,是机体对各种病因所致慢性肝损伤的一种修复反应,是慢性肝病共有的病理变化,也是肝硬化发展的中间环节.肝纤维化在早期乃至后期都可以发生逆转,越早确定肝纤维化的程度,越有利于临床治疗及患者的预后.目前,肝活检仍是诊断肝纤维化的“金标准”,但因其为有创检查,患者不易接受.近年来,肝纤维化无创诊...     

获得性肝性脑部变性的MRI诊断（附7例报告）

获得性肝性脑部变性（acquired hepatocerebral degeneration，AHCD）是慢性肝病引起的一种不可逆的锥体外系综合征，常见于慢性活动性肝炎，酒精性肝硬化及肝移植术后的患者。MR／能有效发现该病的颅内病理改变，本文报道一组经我院临床和MR／诊断为AHCD患者的脑部MRI表现，结合其临床特征，分析AHCD的MRI表现，探讨MRI对该病的诊断价值。     

肝纤维化分子显像的研究进展

肝纤维化是一种伴随慢性肝病的病理过程,具有较高的发病率和病死率。目前诊断肝纤维化的金标准是肝活检术,但肝活检术有其局限性,且目前尚无有效的无创诊断肝纤维化的手段。在肝纤维化的早期阶段,其可通过治疗“逆转”,因此,肝纤维化的诊断和精确分期在控制该疾病中非常重要。由于分子影像学技术具有无创、特异度高等优点,因此其发展具有巨大潜力。笔者对磁共振分子影像学技术和核医学分子影像学技术在肝纤维化诊断和分期方面的最新进展进行概述。     

肝纤维化诊断中磁共振成像的应用

肝纤维化普遍存在于患有各种慢性肝病的患者中,是肝脏的一种病理反应。早期的肝纤维化可以通过治疗恢复,因此及时的诊断出早期肝纤维化并给予患者相应的治疗,能够推迟乃至是避免肝纤维化转变成目前还无法治愈的肝硬化。目前,临床上对于患者肝纤维化的诊断以及对其分期判断的"金标准"是肝穿刺活检,但是该方法会对患者的身体造成一定程度的损伤。随着磁共振成像(MRI)技术的不断发展,其作为一种不会造成创伤的诊断方式,并且无辐射、高准确度等优点。本文对磁共振成像在诊断肝纤维化方面的研究进展进行综述。     

肝纤维化的磁共振定量诊断与分期研究进展

肝纤维化是各种慢性肝脏疾病的共同特征,早期定量诊断肝纤维化对其治疗方法选择及促进其逆转具有重要意义.肝脏活检是肝纤维化诊断的金标准,但因其为有创性检查,在临床应用受到限制.磁共振定量技术是一种无创性检查技术,近年来在评价肝纤维化方面取得较大进展.就肝纤维化的磁共振定量诊断与分期的研究进展予以综述.     

Quantification of liver iron with MRI: State of the art and remaining challenges

Liver iron overload is the histological hallmark of hereditary hemochromatosis and transfusional hemosiderosis, and can also occur in chronic hepatopathies. Iron overload can result in liver damage, with the eventual development of cirrhosis, liver failure, and hepatocellular carcinoma. Assessment of liver iron levels is necessary for detection and quantitative staging of iron overload and monitoring of iron‐reducing treatments. This article discusses the need for noninvasive assessment of liver iron and reviews qualitative and quantitative methods with a particular emphasis on magnetic resonance imaging (MRI). Specific MRI methods for liver iron quantification include signal intensity ratio as well as R2 and R2* relaxometry techniques. Methods that are in clinical use, as well as their limitations, are described. Remaining challenges, unsolved problems, and emerging techniques to provide improved characterization of liver iron deposition are discussed. J. Magn. Reson. Imaging 2014;40:1003–1021 . © 2014 Wiley Periodicals, Inc .     

MR in the diagnosis and monitoring of multiple sclerosis: an overview

Multiple sclerosis is a chronic, persistent inflammatory-demyelinating disease of the central nervous system that typically presents as an acute clinically isolated syndrome attributable to a monofocal or multifocal demyelinating lesion, which usually affects the optic nerve, spinal cord, or brainstem and cerebellum. Although the diagnosis of multiple sclerosis is still based on clinical findings, magnetic resonance imaging is now integrated in the overall diagnostic scheme of the disease because of its unique sensitivity to demonstrate the spatial and temporal dissemination of demyelinating plaques in the brain and spinal cord. Conventional magnetic resonance imaging techniques, such as T2-weighted and gadolinium-enhanced T1-weighted sequences are highly sensitive in detecting multiple sclerosis plaques and provide a quantitative assessment of inflammatory activity and lesion load. However, there is a persisting mismatch between clinical and magnetic resonance imaging efficacy of approved treatments, which underlies the fact that this technique does not suffice to explain the entire spectrum of the disease process. In recent years, great effort has been dedicated to overcoming these limitations by using non-conventional magnetic resonance-derived metrics that can selectively measure the more destructive aspects of multiple sclerosis pathology and monitor the reparative mechanisms. These metrics, which include unenhanced T1-weighted imaging, measures of central nervous system atrophy, magnetization transfer imaging, proton magnetic resonance spectroscopy, diffusion-weighted imaging, and functional magnetic resonance imaging, provide a better approximation of the pathological substrate of the multiple sclerosis plaques, have increased our understanding of the pathogenesis of the disease, and have proven useful for studying the natural history of multiple sclerosis and monitoring the effects of new treatments. Therefore, magnetic resonance imaging not only plays an essential role in the diagnosis of multiple sclerosis, but can also serve as a true biological marker of the severity of this disease.     

体素内不相干运动扩散加权成像在肝纤维化定量诊断与分期中的研究进展

肝纤维化是指在各种致病因素作用下肝内结缔组织异常增生。肝脏的任何损伤在修复过程中都有肝纤维化过程,但是如果损伤因素长期存在,纤维化将持续进展,并发展成肝硬化。早期肝纤维化通过干预可逆转。因此,早期定量诊断肝纤维化对其临床治疗方案的选择及促进其逆转具有重要意义。随着MRI技术的发展,肝纤维化无创定量诊断及分期取得了较大进展。着重就MRI体素内不相干运动扩散加权成像在肝纤维化的定量诊断与分期中的研究进展予以综述。     

Cerebral manifestations in liver disease and transplantation

Patients with liver disease frequently develop cerebral complications. The brain may be affected directly by the pathological process or agent responsible for the liver disease, as a consequence of the metabolic and haemodynamic derangement caused by hepatic dysfunction, or as a complication of the treatment of liver disease. Computed tomography (CT) and magnetic resonance imaging (MRI) can be helpful in the diagnosis and management of these complications, and advanced techniques such as diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) are providing new insights into the underlying pathophysiological processes. We present a radiological overview of the cerebral manifestations of liver disease, categorized as acute presentations, chronic presentations, and conditions occurring in the context of liver transplantation.     

神经黑色素敏感的MRI在帕金森病中的应用进展

帕金森病（PD）以含神经黑色素的儿茶酚胺类神经元进行性坏死为病理特征。神经黑色素敏感磁共振成像（NM-MRI）可以检测颅内神经黑色素的含量,从而对PD进行诊断、鉴别诊断、亚型评估及病情监测。目前PD NM-MRI的临床应用基于不同的成像技术及数据分析方法,包括不同的成像序列、成像维度、磁场强度及评估对象、评估指标、数据分析方法等。就NM-MRI的成像技术、PD的临床应用及其不同的数据分析方法予以综述。     

Measuring cartilage morphology with quantitative magnetic resonance imaging

Magnetic resonance imaging (MRI) is a three-dimensional imaging technique with unparalleled ability to delineate articular cartilage morphology in health and disease. In this article we will review work on the assessment of cartilage morphology with quantitative magnetic resonance imaging and its relevance to the study of cartilage anatomy, physiology, deformation, disease status, disease progression, and response to treatment. The review outlines available pulse sequences and techniques for segmentation and morphological analysis of cartilage morphology. It addresses the accuracy (validity) and precision (reproducibility) of these techniques and summarizes studies on cartilage deformation in intact joints. This article will also review work on determinants and functional adaptation of cartilage morphology and describe changes seen in osteoarthritis. We conclude that fat-suppressed or water excitation gradient-echo magnetic resonance sequences and state-of-the-art digital image analysis techniques display high accuracy and adequate precision for quantitative assessment of cartilage morphology. This renders these techniques powerful and promising tools for cartilage and osteoarthritis research.     

Magnetic resonance imaging of facial muscles

Facial and tongue muscles are commonly involved in patients with neuromuscular disorders. However, these muscles are not as easily accessible for biopsy and pathological examination as limb muscles. We have previously investigated myasthenia gravis patients with MuSK antibodies for facial and tongue muscle atrophy using different magnetic resonance imaging sequences, including ultrashort echo time techniques and image analysis tools that allowed us to obtain quantitative assessments of facial muscles. This imaging study had shown that facial muscle measurement is possible and that useful information can be obtained using a quantitative approach. In this paper we aim to review in detail the methods that we applied to our study, to enable clinicians to study these muscles within the domain of neuromuscular disease, oncological or head and neck specialties. Quantitative assessment of the facial musculature may be of value in improving the understanding of pathological processes occurring within facial muscles in certain neuromuscular disorders.