磁敏感加权成像在新生儿颅内出血中的应用研究

目的探讨磁敏感加权成像（SWI）在诊断新生儿颅内出血中的应用价值。方法本组研究收集了在新生儿监护室内51例临床表现怀疑有颅内出血的患儿进行头颅MK!常规序列（T1WI、T2WI）和SWI序列的扫面。结果51例新生儿中常规MRI检出颅内出血29例,SWI检出41例。其中经swI序列共检出颅内出血病灶96个,常规序列T1WI序列仅检出病灶65个,T2WI序列仅检出病灶47个。结论在新生儿颅内出血的诊断中,应用SWI序列检出的阳性率、出血灶数目和大小均优于MRI常规序列。     

磁敏感加权成像(SWI)在颅脑疾病中的临床应用

[目的]探讨磁敏感加权成像(SWI)在颅脑疾病中的临床应用价值. [方法]收集有颅脑病变的脑部疾病患者72例,其中脑外伤33例,脑血管畸形11例,脑梗塞17例,脑肿瘤9例,帕金森病2例.行常规T1WI、T2WI、DWI、SWI序列和/或增强T1WI、MRA、PWI、DTI.评价SWI对显示小的出血灶、小的静脉及含铁血黄素、钙化等顺磁性物质的优越性. [结果] SWI在海绵状血管瘤,能鉴别出血与血管,发现更多的小出血灶.在静脉畸形,能够发现更多的细小的静脉向大静脉引流.在脑梗死时,SWI可发现小的出血灶及鉴别皮质层状坏死,在脑肿瘤,SWI显示出小的引流静脉及肿瘤内出血.在脑外伤疾病中,可以发现更多的出血灶及发现CT不能发现的微小出血灶. [结论] SWI是显示低流量血管畸形、小的静脉结构、多发细小的出血以及铁钙沉积十分敏感的新型脉冲序列,可以做为MRI常规序列的重要补充,应用于中枢神经系统疾病的诊断和鉴别诊断.     

梯度回波序列对诊断颅内微出血的应用价值

目的：探讨梯度回波序列（包括常规梯度回波序列GRE及SWI序列）对脑内微出血（CMBs）的诊断价值。方法：以SWI序列检测中存在CMBs的40例脑血管病患者为研究对象,通过多序列对比研究,比较分析CMBs在各序列中的影像学表现、分布及检出敏感性。结果：CMBs在各序列上均表现为圆形或椭圆形低信号缺失。SWI序列检出CMBs共261个,平均每位患者（12.4±9.4）个,其他各序列检出情况依次为：常规GRE序列121（4.6±4.0）个、T1WI序列55（2.6±2.8）个、T2WI序列66（3.1±3.1）个。以SWI为金标准,其他各序列CMBs检出敏感性依次为46.4%、21.1%和25.3%。结论：SWI序列是诊断CMBs的理想方法,常规梯度回波序列对CMBs的诊断具有重要的提示作用。     

磁敏感加权成像技术在脑血管畸形检查和诊断中的价值

目的:探讨磁敏感加权成像技术在脑血管畸形诊断中的价值。方法:经临床及影像检查证实的36例脑血管畸形患者,行头颅MRI横轴面T1WI、T2WI、SWI扫描。比较各序列对脑血管畸形病灶的检出及表现,评价SWI在脑血管畸形检查和诊断中的作用。结果:SWI分别检出海绵状血管瘤、发育性静脉畸形和AVM病灶73个、8个、10个,明显高于T1WI和T2WI检出的病灶数,且病灶边界显示更加清晰,发现更多、更小的病灶。在SWI图像上海绵状血管瘤表现为大小不等的明显低信号,发育性静脉畸形表现为一条边界清晰低信号影,显示更多细小静脉向引流静脉集中呈星芒状,AVM表现为异常粗大的血管迂曲扩张,呈明显的低信号。结论:SWI对脑血管畸形的检出具有极高的敏感性,能够检出更多、更小病灶,且病灶显示更加清晰,可作为脑血管畸形检查的常规。     

磁敏感加权成像及FLAIR序列在儿童创伤性颅内出血诊断中的价值

目的探讨磁敏感加权成像(SWI)与液体衰减反转恢复(FLAIR)序列检查在儿童创伤性颅内出血的临床诊断的应用价值。方法选取60例创伤性颅内出血患儿,均采用MR进行SWI与FLAIR序列与常规T1WI、T2WI序列扫描检查,对比分析常规T1WI、T2WI扫描与SWI、FLAIR扫描结果的差异,分析儿童创伤性颅内出血的信号特点。结果 SWI序列检查发现脑实质微出血病灶数明显高于常规MR序列与FLAIR序列,差异均具有统计学意义(P<0.05);FLAIR序列检查发现蛛网膜下腔出血病灶数明显多于常规MR与SWI序列检查,差异具有统计学意义(P<0.05);三种检查方法发现的硬膜外出血、脑室内出血病灶数差异均无统计学意义(P>0.05)。结论 SWI序列检查比常规MR扫描可发现患儿微小出血病灶,FLAIR序列检查在蛛网膜下腔出血的检查结果优于常规MR序列,综合利用MR序列扫描检查结果有助于患儿颅内出血的诊断。     

磁敏感加权成像在新生儿缺氧缺血性脑病诊断中的应用

目的分析磁敏感加权成像(SWI)在新生儿缺氧缺血性脑病(HIE)诊断中的应用效果。方法选择2019年1月至2020年10月我院收治的105例HIE患儿,所有患儿均接受MRI常规序列及SWI序列诊断,对比不同序列对颅内出血的检出率及SWI序列中不同病理分级的检出率。结果105例患儿被检出颅内出血37例;SWI序列对颅内出血的检出率高于DW1、T1WI、 T2WI (P <0.05)。SWI对Ⅱ、Ⅲ级颅内出血、静脉血管扩张及颅内出血合并静脉血管扩张的检出率高于Ⅰ级(P <0.05)。结论采用MRI SWI序列诊断HIE可显著提高其病灶检出率,同时对于不同病理分级患者可更精准地诊断出其脑组织损伤程度,对临床治疗方案制定与预后判断有重要意义,具有临床推广应用价值。     

MRI对微出血的诊断价值及序列价值评价

目的 本文旨在分析微出血在磁共振成像不同序列上的影像特点,并评价不同序列的价值.方法 回顾性分析31例（187个病灶）微出血病例影像资料.对比DWI和T2＊WI、SWI和T2＊WI对微出血的诊断价值.结果 扩散加权成像和T2＊WI、SWI和T2＊WI对微出血的检出差别均有统计学意义.结论 磁共振成像对微出血有较高的诊断价值,检查过程中发现怀疑有微出血的病例,需加扫SWI或T2＊WI.     

磁敏感加权成像对急性隐匿性小灶性出血性脑挫伤诊断价值

目的急性隐匿性小灶性出血性脑挫伤(acute occult mini-focal hemorrhagic cerebral contusion,AOMHCC)是脑外伤患者中一种相对少见的颅脑损伤疾病,目前该病早期临床漏诊率高,脑挫伤后遗症频发。本研究探讨磁敏感加权成像(susceptibility weighted imaging,SWI)对AOMHCC的价值,旨在提高该病早期诊断水平,减少漏诊率和脑挫伤后遗症发生率。方法选取2016-01-02-2018-05-30武汉科技大学附属汉阳医院96例脑外伤患者中,对经CT和磁共振成像(magnetic resonance imaging,MRI)联合诊断的49例AOMHCC患者临床和影像资料进行回顾性分析,评价随访CT、MRI常规序列、扩散加权成像(diffusion weighted imaging,DWI)以及SWI 4种检查方式对AOMHCC的敏感性、特异性、准确率、阴性预测值和阳性预测值。结果 96例脑外伤患者CT初诊检查均未发现脑损伤,经CT随访复查和(或)MRI多序列联合诊断共发现49例AOMHCC患者67个病灶。49例AOMHCC患者中,随访CT复查检出11例,MRI常规序列检出26例,DWI检出40例,SWI检出48例。随访CT、MRI常规序列与临床诊断的一致性较差,Kappa值0.4,没有临床使用价值;DWI序列的一致性较高,Kappa=0.688,但远低于SWI,Kappa=0.917,表明SWI序列对检测AOMHCC中的临床价值最大;且其灵敏度和特异度指标均90%,与其他检查方式比较,各指标差异均有统计学意义,均P0.001。结论磁共振SWI序列检查是诊断AOMHCC最有效的影像检查方式,早期应用磁共振SWI序列有助于AOMHCC早发现、早诊断和早治疗,可有效减少该病的漏诊率和脑挫伤后遗症发生率。     

磁敏感加权对弥漫性轴索损伤的诊断价值

目的 探讨磁敏感加权成像（SW）对弥漫性轴索损伤（DAI）的诊断价值。方法 对43例临床可疑DAI病例行常规MR（TSE、FLAIR、DWI）及SWI检查,分别检测各方法所示患者脑内出血灶数量。结果 SWI共显示1132个出血灶,较CT、常规MR序列显示更多。结论 SWI能非常敏感地检出外伤后弥漫性轴索损伤患者脑内的小出血灶,可以进一步提高对弥漫性轴索损伤的诊断正确率,帮助临床医生早期诊断、治疗。     

MR磁敏感加权成像在重型创伤性颅脑损伤诊断中的应用价值

目的 探讨MR磁敏感加权成像(SWI)在重型创伤性颅脑损伤(sTBI)诊断中的价值.方法 选择60例sTBI患者作为研究对象,对所有患者CT、MR常规序列和SWI扫描,比较各种方法检出出血灶的数目,分析SWI检出出血灶数目和体积与格拉斯哥昏迷评分(GCS)的相关性,并分析出血灶数目与格拉斯哥预后评分(GOS)的相关性.结果 60例sTBI患者磁共振SWI成像共检出出血灶1714个,MR常规序列和CT共检出病灶515个和165个,SWI出血灶检出数量分别是MR常规序列和CT扫描的3.33倍和10.39倍.随着GCS评分的减少,sTBI患者的出血灶数量和体积均呈增加趋势(P<0.05,P<0.01),SWI检查的病灶数量和体积与GCS评分呈负相关(r=—0.418,—0.526,P<0.05),出血灶数量与sTBI患者GOS评分呈负相关(r=—0.533,P<0.05),差异均有统计学意义.结论 MR SWI成像检出出血灶的数目远多于CT和MR常规序列,可对sTBI患者的诊断和病情评估提供更为全面的影像学依据,在sTBI患者的诊断中具有重要价值.     

烟雾病间接血管重建术后脑内钙化分析

目的：分析烟雾病术后患者脑内钙化的特点及形成机制。方法：选取我院2004年11月至2005年11月手术后复查CT扫描的烟雾病患者28例,年龄4～46岁,中位年龄17岁。男女比例为1：1。手术至CT检查最短间隔为1～90d,中位时间7d。结果：本组烟雾病间接血管重建术患者中4例出现脑内钙化,发生率为14．3％（4／28）,其中3例钙化发生在脑出血患者中,占5例脑内出血患者的60％（3／5）,且钙化与出血部位一致。结论：烟雾病间接血管吻合术后患者脑内出血与钙化灶形成关系密切,可能是钙化形成诱导因素所致。     

Taenia solium cysticercosis in Bali, Indonesia: serology and mtDNA analysis

An active Taenia solium cysticercosis case in Bali, Indonesia, was followed-up by serology and computed tomography. Serology using semi-purified glycoprotein and recombinant antigens showed a drastic drop in titers after calcification of the cysts. Three paraffin-embedded cysts, prepared for histopathological examination, from three other patients were used for mtDNA analysis. The sequences of cox1 gene from T. solium cysticerci from Bali differed from those in Papua and other Asian countries.     

Iron absorption by humans from hemosiderin and ferritin, further studies.

Iron absorption from hemosiderin and ferritin biosynthetically labeled with radioactive iron has been studied in 61 subjects. The geometrical mean iron absorption from hemosiderin in both normal and iron deficient subjects was 3.4%. Its mean absorption ranged from 1.9% in normal subjects to 4.7% in subjects with moderate iron deficiency and 7.3% in subjects with marked iron deficiency. The iron absorption from hemosiderin was markedly increased when it was administered with ascorbic acid or liver. The absorption of iron from hemosiderin when hemosiderin and wheat were consumed in a meal, was lower than the absorption from wheat. Iron from liver ferritin and liver hemosiderin were less absorbed in this study than that previously reported for liver hemoglobin. The studies presented here support the possibility that ferritin and hemosiderin form an iron pool different from the non-heme pool formed by vegetal iron, egg iron and ferric and ferrous salts.     

食管静脉套扎术联合脾动脉栓塞术用于肝硬化出血的二级预防

目的 评价食管静脉曲张套扎术联合部分脾动脉栓塞术用于肝硬化食管静脉曲张出血的二级预防的临床效果.方法 105例肝硬化合并脾亢患者被分为食管静脉曲张套扎组(EVL) 53例,和食管静脉曲张套扎联合脾动脉栓塞治疗组(EVL+PSE) 52例.分别行EVL和EVL+PSE治疗.术后比较2组患者外周血细胞,门静脉和脾静脉内径,术后比较食管静脉曲张、门脉高压性胃病,胃底静脉曲张.随访1年,比较再出血情况.结果 治疗1周后EVL+PSE组较EVL组外周血白细胞,血小板明显增加(P＜0.05),治疗后1月EVL+PSE组较EVL组门静脉、脾静脉管径明显缩小.1年后复查胃镜,EVL食管静脉曲张消失为17例,根除率为32％.EVL+PSE食管静脉曲张消失为33例,根除率为63.4％(33/52).而门脉高压性胃病、胃底静脉曲张发生率,EVL组明显高于EVL+PSE组,P＜0.05.EVL组53例患者1年内再出血为22.6％ (12/53),EVL+PSE组52例患者中再发出血率为9.6％ (5/52).结论 EVL+PSE用于肝硬化脾亢食管静脉曲张出血二级预防临床疗效优于单纯EVL.     

胰腺实性假乳头状瘤超声诊断探讨

目的:探讨胰腺实性假乳头状瘤的超声诊断特征。方法:选择2015年1月~2019年5月在本院行胰腺肿块切除术治疗的20例病理诊断胰腺实性假乳头状肿瘤患者作为研究对象。术后收集患者病理诊断结果和术前超声诊断结果,对比两组结果符合情况,并分析超声检查的肿瘤特征。结果:彩色超声诊断结果与术后病理诊断比较显示,误诊率为35.00%,漏诊率为0,与病理诊断符合率65.00%。所有肿瘤均为单发,边界清晰,肿瘤最大直径为35~78mm,平均(56.03±21.03)mm。肿瘤生长部位以胰头部和胰尾部为主,肿瘤形态以类圆形和椭圆形为主,胰腺肿块多存在包膜回声,后方无回声衰减。肿瘤内部回声以实性回声为主,囊性回声和囊/实兼备者较少。主胰管扩张情况观察可见,无扩张者占比最高,明显扩张和轻度扩张者较少。血流信号探查显示,多数肿块内存在少许血流信号。肿瘤多无钙化,仅少量伴钙化。肿瘤未侵犯肠系膜血管、脾动静脉及其他腹腔静脉。结论:超声检查对胰腺实性假乳头状瘤的诊断有一定价值,可联合肿瘤特征分析,进一步提高超声诊断准确性。     

浅谈不同年龄结节性甲状腺肿合并甲状腺癌患者甲状腺超声特征的临床比较

目的:给予不同年龄结节性甲状腺肿合并甲状腺癌患者实施甲状腺超声检查,对相应的超声检查特征展开分析.方法:选择2018年6月～2019年6月的114例患者为对象,所有患者均被确诊为结节性甲状腺肿合并甲状腺癌,并且利用甲状腺二维超声及多普勒超声对患者进行检查,依据患者年龄阶段均分为两组,每组中各纳入57例患者,年龄超过60...     

Decontamination of Winter Flounder (Pleuronectes americanus) Following Chronic Exposure to Effluent from a Pulp and Paper Mill

A study was conducted to determine the influence of decontamination on winter flounder living downstream from a pulp and paper mill. The fish and controls were held 8–26 weeks under contaminant-free conditions in aquaria supplied with ambient sea water. Groups of flounder, for comparison, were also sampled near the paper mill at the time of or following autopsy. No differences were apparent in length/organ-weight relationships between depurated and control groups after 26 weeks at 0–6°C, but condition factor, gonadal and hepatosomatic indices, coincident with elevated levels of detoxifying enzymes, differed from field-derived samples. Pathological changes, including hemosiderin deposits in the liver and spleen, decreased, whereas pericholangitis and clear cell foci were apparent in the depurated fish and in the field samples. In two additional groups decontaminated for 8–16 weeks at 6–16°C, there was no evidence of pericholangitis, but hemosiderin deposits persisted and an increase of fibrosis and clear cell foci occurred in contrast to the field group. These results suggest that some tissue repair in the liver transpired primarily during summer while other lesions, such as preneoplastic clear cell foci, which were probably induced prior to depuration, increased, but hemosiderin concentration remained unchanged. The latter observation is consistent with previous studies that suggest that hemosiderin concentration is not seasonally but age influenced. Received: 4 June 1999/Accepted: 5 August 1999     

Prothrombin time ratio and other factors associated with bleeding in patients treated with warfarin

We previously showed that the risk of major hemorrhage in patients with venous thromboembolism treated with warfarin was strongly related to duration of anticoagulant therapy. We here report the results of a more detailed analysis of factors other than duration of warfarin therapy associated with the risk of hemorrhage in these patients. Almost 7% of patients had a major hemorrhage on warfarin and an additional 23.7% had at least one minor bleeding episode. Age, female sex, and congestive heart failure were associated with small increases in the risk of major hemorrhage but not with the risk of minor bleeding. A prothrombin time ratio greater than 2.5 was associated with a fourteen-fold increase in the risk of a major hemorrhage (95% CI 5.1, 42.7), but major hemorrhages occurred in patients on warfarin at all measured values of the prothrombin time ratio. Taken together with the findings from our previous analysis, the study suggests that prevention of bleeding in patients on warfarin would best be accomplished by minimizing the duration of warfarin therapy, by scrupulous monitoring of the prothrombin time ratio, and by considering the "therapeutic range" for the prothrombin time ratio to be somewhat less than 2.0-2.5.     

Etiology of Pleural Calcification: A Study of Quebec Chrysotile Asbestos Miners and Millers

A review of 15,689 chest radiographs of Quebec chrysotile miners and millers, representing the latest film prior to November 1, 1966, for all such persons ever x-rayed, identified 206 men with pleural calcification. Of these, 198 had worked in the Thetford Mines area, 6 at Asbestos, and 2 at St. Remi de Tingwick; 2.5%, 0.08%, and 1% of the films from these areas, respectively. A series of case-control studies revealed that pleural calcification was concentrated in men employed at a small group of mines in Thetford Mines and occurred more often among miners and maintenance personnel than among millers. Calcification was not related to past history of illness or injury, place of residence, or employment in other industries. The distribution of pleural calcification in this Quebec industry suggests that it is related to some characteristic of airborne dust or mineral closely associated with the chrysotile that is encountered during mining in Thetford Mines but not in other mining areas. Possible minerals include mica, talc, and breunnerite.     

Pleural calcification in northwest Greece

Mass miniature radiography in 1969 detected a high prevalence of pleural calcification in three villages in northwest Greece. In 1980 a survey of a 15% sample of the population over the age of 10 was carried out with a 80% response rate. Full-size radiographs, ventilatory capacity measurements, and a detailed questionnaire on respiratory symptoms, type of work, and residence were used. Independent classification of the 408 films by two readers using the ILO/UC scheme showed very few small opacities but a very high prevalence of pleural calcification first evident in young adults and rising to 70% in the elderly. The overall prevalence was 34.7% in men and 21.5% in women. A comparison with the 1969 survey showed a progression rate of 5% per annum. In neither sex was there a significant relation of pleural calcification to smoking, ventilatory capacity, nor type of work, though those classified as field croppers had a slightly higher prevalence. There was no obvious evidence of increased lung cancer or mesothelioma in the villages. The agent responsible for this apparently benign condition was not identified.