T2-tirm与3D-medic MRI序列在显示脊神经损伤中的效能比较

目的比较T2-tirm序列和3D-medic序列显示脊神经解剖形态及病变的能力。方法 20例患者均经T2-tirm及3D-medic两种序列的脊神经成像,将获得的图像进行最大强度投影(MIP),多平面重组(MPR)及曲面重建(CPR)以充分显示脊神经损伤。以脊神经节后神经部分同层显示情况比较两种序列对脊神经解剖结构及病变的显示能力。结果 T2-tirm和3D-medic两种序列都能显示脊神经影像,但显示程度不同,3D-medic序列在显示脊神经解剖结构细节及病变方面优于T2-tirm序列。结论 3D-medic MRI神经成像术操作简单,能直观清晰地显示脊神经的走行,并提供较为可靠的脊神经局部解剖信息,值得在临床上推广使用。     

内耳迷路造影：磁共振3D快速成像技术及图像分析

随着磁共振技术在临床上的普及应用和内耳疾病在临床治疗上的进步，有关迷路解剖形态及病变的研究，越来越引起人们的注意。磁共振成像具有无辐射、多层面、多序列成像的优点，特别是MR水成像技术，因能直接显示迷路的立体解剖形态。而得到临床医师的青睐。内耳迷路的MRI及3D水成像图像，不仅可用以观察内耳解剖结构及评价内耳发育情况，对各种耳部病变亦有诊断价值。还可用来做电子耳蜗植入前的术前筛查和其它相关的术前评价。     

胰胆管成像影像学进展

详尽了解胰胆管系统的解剖结构及其形态学改变不仅有助于胰胆管系统疾病的诊断与鉴别诊断,而且对指导临床治疗有着十分重要的意义。特别是近年来,随着腹腔镜胆道手术的开展和普及,对影像检查技术的要求越来越高,因为术前了解胰胆管系统解剖及其变异和病变能降低术中胆道损伤的危险性。因此,无创、安全、简便、快速、准确的胰胆管成像方法一直是影像学和临床医师长久的期望。传统     

肩关节损伤的MRI评价

肩关节损伤往往带有关节囊内外非骨性结构的损伤，由于MRI对软组织结构比X线平片及CT能更好成像显示，MRI成为肩关节损伤检查的重要方法。本文复习了肩关节加MRI成像方法及正常解剖结构，综合评述肩关节损伤常见病变特征及MRI表现。     

关节损伤影像诊断的特点和进展

关节损伤是骨肌系统的常见病变,多为暴力导致关节结构的撕裂,可致关节疼痛及功能障碍。稳固关节的结构不完整时可以导致关节不稳,甚至脱位。因此,对关节损伤的早期诊断和治疗至关重要。X线平片、X线关节造影、CT和MRI可用于该病的诊断,特别是CT关节成像、MR T_2mapping、超短回波时间序列成像和MR关节成像等影像新技术可以对损伤程度进行定量分析,并能够评估关节微结构损伤。就韧带、肌腱、关节盘与关节盂唇的正常解剖、损伤机制以及上述结构损伤和关节不稳或脱位的影像特点、研究进展及治疗方法等予以阐述。     

螺旋CT三维重建成像在骨外伤中的临床应用探讨

螺旋CT三维重建（three—dlmonsional reconstruction，简称3D）成像在骨外伤的临床诊疗中正逐步得到广泛应用。其能直观、精确地显示病变的立体形态，详细了解各解剖结构的空间关系，被称为“非损伤性立体解剖”。本人搜集了行螺旋CT薄层扫描三维重建成像的28例骨外伤资料，就其临床应用价值进行探讨。     

胸主动脉MR仿真内镜检查的临床应用及其缺陷

目的：研究MR仿真内镜（MRVE）对胸主动脉解剖及病变的临床应用价值。探讨其成像方法及存在缺陷。方法：对20例健康检查者及33例临床考虑胸主动脉病变的患者行MR三维动态增强扫描血管成像（3D-DCE-MRA）检查，将其原始数据进行仿真内镜重建处理，观察其对血管内表面解剖及病变的显示能力。结果：MRVE直观地显示胸主动脉解剖及病变情况，21例夹层动脉瘤，MRVE清楚地显示夹层动脉瘤入口，内膜移位及瘤腔情况；对主动脉瘤及大动脉炎可显示其扩张或缩窗的内腔结构；对法乐氏四联征，清楚地显示主动脉骑跨及骑跨程度；半环状伪影为MRVE主要存在的伪影。结论：MRVE能直观地显示胸主动脉内壁的解剖及病变情况，可作为临床怀疑胸主动脉病变患者的常规检查手段。     

《脊柱脊髓影像学》——一部完整的脊柱脊髓影像学教材

近一个世纪以来，脊柱的X线成像局限于骨性结构。虽然椎管造影、髓核造影、脊椎动脉造影等相继为椎管内病变、椎间盘病变、脊髓血管性病变的直接或间接诊断提供了可能性，然而由于都是损伤性检查，成像质量也不满意，临床应用受到一定的限制。直到CT、MRI的问世，使脊柱骨性结构的精确解剖定位和椎管内脊髓的直接成像成为现实，尤其是MRI，可任意平面成像以及对病变组织的高度敏感度，     

儿童长骨生长板损伤组织学和影像诊断

目的：认识儿童生长板损伤不同类型的预后及易发生畸形的类型。方法：30例1～9岁儿童肘关节肱骨远端骺软骨骨折X线资料,3例肱骨远端生长板损伤MR成像,4例膝和踝关节生长板骨折MR成像,另有11只实验兔骨骺牵拉延长术后平片、微血管摄影和病理切片。生长板损伤采用Salter-Harris分类法分为5型。结果：第3型,骨折线垂直经过骨骺然后水平向生长板裂开;第4型,骨折经过骨骺穿过生长板至干骺端骨折;第5型,损伤生长板的问叶细胞。上述三种类型都可发生骨骺早闭。而第1型（骨骺牵拉分离）和第2型（骨折线经生长板进入干骺端）一般预后好,不发生畸形。结论：儿童肘关节创伤X线平片和MRI可显示骨折解剖,准确的分型和判断预后是非常重要的。     

磁共振扩散成像及磁敏感加权成像在脊髓损伤中的应用

目前,脊髓MR成像常规检查是诊断脊髓损伤的最佳手段,能清楚地显示受损伤脊髓形态及信号改变,以此明确疾病,但是当MRI常规检查出现信号改变时往往提示脊髓损伤严重,并非病变的早期,使得病人错过最佳治疗时期。而MR扩散加权成像(DWI)和磁敏感加权成像(SWI)对脊髓损伤的早期诊断、治疗和预后均具有重要价值。对DWI及SWI在急慢性脊髓损伤中的应用情况及研究进展进行综述。     

Magnetic resonance imaging of the elbow in athletes

Acute and chronic elbow pain is common, particularly in athletes. Although plain radiographs, ultrasound, and computed tomography all have a role to play in the investigation of elbow pain, magnetic resonance imaging (MRI) has emerged as the imaging modality of choice for diagnosis of soft tissue disease and osteochondral injury around the elbow. The high spatial resolution, excellent soft-tissue contrast, and multiplanar imaging capabilities of MRI make it ideal for evaluating the complex joint anatomy of the elbow. This article reviews imaging of common disease conditions occurring around the elbow in athletes, with an emphasis on MRI.     

Magnetic resonance imaging of the elbow

Elbow pain is frequently encountered in clinical practice and can result in significant morbidity, particularly in athletes. Magnetic resonance imaging (MRI) is an excellent diagnostic imaging tool for the evaluation of soft tissue and osteochondral pathology around the elbow. Recent advances in magnetic field strength and coil design have lead to improved spatial resolution and superior soft tissue contrast, making it ideal for visualization of complex joint anatomy. This article describes the normal imaging appearances of anatomy around the elbow and reviews commonly occurring ligamentous, myotendinous, neural, and bursal pathology around the elbow. J. Magn. Reson. Imaging 2010;31:1036–1053. © 2010 Wiley‐Liss, Inc.     

Clinical impact of elbow magnetic resonance imaging

The elbow and its articulations are subject to tremendous forces during overhead sports. The elbow joint is vulnerable to a variety of injuries as a result of either acute traumatic events or chronic repetitive overuse. Elbow pathology in throwing athletes has been classified according to the mechanism of injury: medial tension overload, lateral compression, extension overload, and posterolateral rotatory instability. Given the complexity of these injuries, complete diagnosis and treatment requires a thorough evaluation of the elbow. This evaluation begins with a history and physical examination, an understanding of pathomechanics, and an assessment of normal and pathological anatomy. Imaging studies may be of assistance in defining this anatomy. The correlation of these imaging studies with clinical information is essential in the proper diagnosis and management of these complex injuries. This article presents the impact of elbow magnetic resonance imaging (MRI) for the clinical diagnosis of the three most common elbow disorders for which MRI has diagnostic efficacy in the athlete.     

Bildgebung des Ellenbogengelenks mit Fokus MRT

This review article discusses the magnetic resonance imaging (MRI) features and pathological changes of muscles, nerves and the synovial lining of the elbow joint. Typical imaging findings are illustrated and discussed. In addition, the cross-sectional anatomy and anatomical variants, such as accessory muscles and plicae are discussed. Injuries of the muscles surrounding the elbow joint, as well as chronic irritation are particularly common in athletes. Morphological changes in MRI, for example tennis or golfer’s elbow are typical and often groundbreaking. By adapting the examination sequences, imaging planes and slices, complete and incomplete tendon ruptures can be reliably diagnosed. Although the clinical and electrophysiological examinations form the basis for the diagnosis of peripheral neuropathies, MRI provides useful additional information about the precise localization due to its high resolution and good soft tissue contrast and helps to rule out differential diagnoses. Synovial diseases, such as inflammatory arthritis, proliferative diseases and also impinging plicae must be considered in the MRI diagnostics of the elbow joint.     

Collateral Ligaments

The collateral ligaments of the elbow are responsible for stability in response to varus and valgus stress. Injury to the collateral ligaments can be acute, but it is usually due to repetitive microtrauma. In the general population, collateral ligament injury is rare, but in the appropriate individual with the proper forces applied to the elbow, this type of abnormality is not uncommon. The elbow is the second most commonly injured joint because of overuse. Magnetic resonance imaging (MRI) is the best technique available for visualization of the ligaments. Contrast injection further enhances identification of these structures and helps to define pathological conditions affecting them. This article demonstrates some normal anatomy and shows examples of collateral ligament pathology in unenhanced and enhanced MR images.     

Magnetic resonance imaging of the elbow

With the current popularity of racket and throwing sports, the number of individuals seeking medical care for elbow pain and dysfunction has increased. Elbow dysfunction may be related to acute or chronic injury to the soft tissue or osseous components of the elbow. With magnetic resonance imaging (MRI), it is now possible to accurately determine the nature and extent of the pathological changes in ligaments, tendons, muscles, and osseous structures of the elbow joint. This information facilitates the choice of the appropriate therapeutic regimen.     

Bildgebung des Ellenbogengelenks mit Fokus MRT

Imaging of the elbow joint places high demands on the quality of imaging due to the challenging anatomy and the sometimes subtle findings. For the diagnosis of periarticular soft tissues, ligamentous structures and in individual cases for fracture and tumor diagnosis, magnetic resonance imaging (MRI) is mostly groundbreaking and allows a reliable diagnosis in most cases. This review article discusses the complex imaging anatomy and anatomical variants of this joint and the most common osseous and ligamentous injuries of the elbow joint are presented. The typical MRI findings and indications are illustrated and discussed and possible pitfalls are pointed out. The various examination techniques and MRI sequences are also addressed.     

Band- und Sehnenverletzungen des Ellenbogens in der Magnetresonanztomographie

An overview about the normal anatomy and frequent pathologies of tendons and ligaments of the elbow using MRI will be provided. The unique joint configuration and articulation, as well as passive ligamentous and active muscle structures as well as the unique configuration of the articulating components of the elbow contribute to joint stabilization. MRI is an essential imaging modality in patients with ligamentous injuries including the sequelae of joint dislocation as well as chronic pathologies such as long-standing and refractory tendinopathies. Ideally, when reporting MRI of the elbow, the joint is separated into its four compartments, anterior, posterior, medial and lateral, allowing precise, comprehensive and structured reporting.     

MR Imaging of Pediatric Elbow Trauma

Magnetic resonance imaging (MRI) of the pediatric elbow is important because it allows delineation of fracture type in a joint with complex anatomy, made more complex by the variable appearance of ossification centers of the distal humerus.1-4 Acute and chronic injuries can be evaluated with MRI using several classification systems. Accurate diagnosis of pediatric elbow trauma with MRI has management implications. For example, a Salter-Harris II fracture can be differentiated from a Salter-Harris IV physeal fracture by delineating intra-articular fracture extension and displacement, which requires open reduction internal fixation. The former is treated with closed reduction if nondisplaced, and the latter, with open reduction and internal fixation. The rate of complications in this age group is high and the treatment for these deformities thereafter can be difficult. There is also a useful role for MRI when the clinical history is unobtainable or absent as in a case of child abuse, for example. The multiplanar capability of MR allows for good preoperative planning to delineate fragment displacement. The main fracture classifications are presented.     

Physical examination of the athlete's elbow

Elbow injury is encountered less frequently than are other joint conditions. The bony architecture, muscle, ligament, and nerve anatomy are complex, and the forces leading to injury in the athlete's elbow are unique. Appreciating the pathomechanics leading to injury and a detailed knowledge of elbow anatomy are the foundation for conducting a directed history and physical examination that achieves an accurate diagnosis. Recent advances in physical examination have improved our ability to accurately diagnose and treat athletic elbow disorders. This article reviews general and focused physical examination maneuvers of the elbow in a systematic anatomic fashion.