腰骶丛DTI对慢性炎性脱髓鞘性多发性神经根神经病的诊断价值

【摘要】目的：探讨腰骶丛神经DTI对慢性炎性脱髓鞘性多发性神经根神经病（CIDP）的诊断价值。方法：采用3.0T MR仪对11名健康志愿者及16名CIDP患者进行腰骶丛常规MRI扫描和腰骶丛神经DTI扫描。其中DTI扫描范围包括L3～S1神经根,在DTI参数图上行FA、λ1、λ2、λ3的参数值测量,通过所得测量值计算出FA、AD、RD、MD参数值。健康志愿者组及CIDP组对应的FA、AD、RD、MD参数值行两独立样本t检验。结果：健康对照组FA、AD、RD、MD值分别为0.263±0.091、（4.993±0.647）×10-3mm2/s、（4.435±0.745）×10-3mm2/s、（4.672±0.642）×10-3mm2/s;CIDP组FA、AD、RD、MD值分别为0.225±0.053、（5.261±0.365）×10-3mm2/s、（5.657±0.292）×10-3mm2/s、（4.872±0.312）×10-3mm2/s。CIDP组与健康对照组相比FA及ADC值明显下降,AD、RD、MD值明显升高（P＜0.05）。结论：CIDP患者的腰骶丛神经DTI参数的变化对CIDP早期诊断和分期具有重要价值。     

慢性炎性脱髓鞘性多发性神经病的评价:inkedrest-tissue?快速采集弛豫增强成像(3DSHINKEI)显示3D神经鞘信号增强

正摘要目的评价inkedrest-tissue快速采集弛豫增强成像(SHINKEI)对慢性炎性脱髓鞘性多发性神经病(CIDP)病人的3D神经鞘信号的增强作用。方法该回顾性研究经机构     

炎性脱髓鞘性多发性神经根神经病分型与预后的相关因素研究

目的 探究炎性脱髓鞘性多发性神经根神经病的临床表现及检查特征,分析各分型的特征及其预后的相关因素.方法 选取接受治疗的90例诊断为炎性脱髓鞘性多发性神经根神经病的患者,对其进行分型并分析其预后的相关因素.结果 依据病情的峰值时间不同分为AIDP(急性炎性脱髓鞘性多发性神经根神经病)组和CIDP(慢性炎性脱髓鞘性多发性神经根神经病)组,两组患者的脑脊液蛋白含量、有无前驱感染、前有无肌肉萎缩、无颅神经症状比较差异显著(P＜0.05);依据预后情况不同分为预后良好组和预后较差组,两组患者的病情达峰值时肌力评价差异显著(P＜0.05),具有统计学意义.结论 临床区别AIDP和CIDP可以通过观察患者的脑脊液蛋白含量、有无前驱感染、前有无肌肉萎缩、无颅神经症状的情况.病情达到峰值时肌力评分较高者病情较轻,同时病情达到峰值时肌力评分还能够预测患者的预后情况.     

MRI对上皮性卵巢癌组织学分型的诊断应用

常规MRI可从形态学角度评估上皮性卵巢癌（EOC）组织学分型,扩散加权成像（DWI）、体素内不相干运动成像（IVIM）及动态增强MRI（DCE-MRI）等功能成像技术可进行定量后处理分析。基于MRI的影像组学通过全面分析Ⅰ型和Ⅱ型EOC的影像特征,在术前可以预测EOC分型,有助于制定个体化治疗方案及评估预后。就DWI、IVIM、DCE-MRI及影像组学在鉴别EOC分型中的应用进行综述。     

高压氧综合治疗慢性格林巴利22例

慢性格林巴利又称慢性炎症性脱髓鞘性多发性神经病(CIDP)，病程缓慢易复发，本文选择我院1996年以来收治的CIDP22例应用高压氧(HBO)综合治疗，取得较满意疗效，结果报道如下。     

肺部孤立性实性病变的磁共振DWI技术优选

【摘要】目的：比较快速自旋回波扩散加权成像(TSE-DWI)与平面回波（EPI）DWI对肺部孤立性实性病灶的成像质量，探讨TSE-DWI在肺部孤立性病灶中的临床应用价值。方法：对40例肺孤立性实性病变患者分别行TSE-DWI及EPI-DWI扫描（b=600s/mm2），测量并比较两个序列图像上病灶的信噪比、病灶及脊髓的ADC值、变形率、成像效率及图像质量的主观评分。结果：TSE-DWI序列的病灶成像效率为100%（40/40）；EPI-DWI的成像效率为90%（36/40），4例病灶的图像变形严重，无法测量其ADC值。TSE-DWI序列上脊髓的ADC值高于EPI-DWI序列（P<0.01）。病灶在TSE-DWI上的ADC值高于EPI-DWI序列（P=0.007）。病灶在TSE-DWI上的变形率明显低于EPI-DWI序列（P<0.01）。图像质量的主观评分，TSE-DWI序列中39例为3分、1例为2分，EPI序列中主观评分19例为3分、17例为2分、4例为1分（图像变形无法测量），两组间图像质量主观评分的差异具有统计学意义（P＜0.001）。结论：TSE-DWI的病灶变形率、成像效率及主观评分均较EPI-DWI序列高，可作为胸部孤立性病变的常规扫描序列。     

酰胺质子转移成像在前列腺癌中的应用进展

酰胺质子转移（APT）成像是检测酰胺质子对自由水中氢质子交换饱和的成像技术,通过检测细胞中蛋白质、多肽水平反映肿瘤的恶性程度和侵袭性。就APT成像及其联合T2mapping、扩散加权成像（DWI）、体素内不相干运动（IVIM）成像、mDIXON-Quant序列和前列腺特异性抗原（PSA）等在前列腺癌诊断、危险度分层及骨转移预测等方面的研究进展进行综述。     

肝性脑病楔前叶的影像学研究进展

肝性脑病(HE)是一种可逆性神经精神异常综合征,发病率较高。目前关于HE诊断的相关研究主要致力于寻找神经系统异常的生物标志物。采用多种功能成像技术可以观察到HE病人楔前叶（PC）存在结构、功能等异常,且PC的异常程度与HE病人临床表现、认知功能测试结果及生化指标密切相关。就静息态功能MRI（rs-fMRI)、扩散张量成像（DTI）、MR波谱成像（MRS）等成像技术对HE病人PC的改变及其特点的研究进行综述。     

磁共振定量功能成像在评价乳腺癌新辅助化疗中的应用进展

【摘要】新辅助化疗（NACT）已成为局部进展期乳腺癌的标准治疗方案，评估化疗效果对于调整和制定个性化治疗方案至关重要，磁共振功能成像在评估治疗反应方面要优于单纯形态学评价，定量功能成像会提供更多量化的信息。本文总结了目前应用较多的动态对比增强磁共振成像（DCE-MRI）、灌注加权成像（PWI）、扩散加权成像（DWI）及磁共振波谱（MRS）技术的主要进展及优缺点，并探讨了结合纹理分析及人工智能技术的发展方向。     

功能MRI在评价对比剂诱导急性肾损伤中的研究进展

对比剂诱导急性肾损伤（CI-AKI）是注射碘对比剂后严重的并发症之一,早期诊断和治疗可以改善或延缓肾损伤。目前多种功能MRI（fMRI）技术可用于肾损伤后肾脏微循环和病理生理学的评估,包括扩散加权成像（DWI）、体素内不相干运动（IVIM）成像、扩散张量成像（DTI）、扩散峰度成像（DKI）、血氧水平依赖（BOLD）成像、动脉自旋标记（ASL）成像等。这些技术不但可以对肾功能损害进行定量分析,还可以在肾损伤的早期诊断和监测方面提供更多信息。就CI-AKI的发病机制及fMRI评价CI-AKI的研究现状做一综述。     

Invited. Ultrafast MR imaging of the abdomen: Echo planar imaging and diffusion-weighted imaging

Ultrafast MRI technique has become available with the introduction of new generation MR scanners for abdominal imaging. However, there is no consensus about the optimal imaging acquisition at the present time. Because single shot echo planar imaging (EPI) technique is based on high technology and had just applied in clinical imaging, further clinical investigation will be needed. Currently, the hypersensitivity to magnetic inhomogeneity and local magnetic susceptibility and the low spatial resolution may limit the widespread application of EPI technique. In addition to providing information for morphologic diagnosis, EPI will be more widely used for functional and qualitative diagnosis. Diffusion-weighted imaging can be used for differentiation of solid tumors according to their different cellular construction, evaluation of cystic lesions based on the different viscosity of their contents, and assessment of diffused pathologic changes in the parenchyma of solid organs. In addition to the previous parameters such as proton density and T1 and T2 values, diffusion factors may provide important information for the qualitative and dynamic evaluation of abdominal pathologic changes. Even though there are many difficulties that must be solved for diffusion-weighted imaging, a more wide application of this technique is expected through technologic improvement.     

Various diffusion magnetic resonance imaging techniques for pancreatic cancer

Pancreatic cancer is one of the most common malignant tumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods are conducive to detecting small lesions. Compared to the other techniques, magnetic resonance imaging (MRI) has irreplaceable advantages and can provide valuable information unattainable with other noninvasive or minimally invasive imaging techniques. Advances in MR hardware and pulse sequence design have particularly improved the quality and robustness of MRI of the pancreas. Diffusion MR imaging serves as one of the common functional MRI techniques and is the only technique that can be used to reflect the diffusion movement of water molecules in vivo. It is generally known that diffusion properties depend on the characterization of intrinsic features of tissue microdynamics and microstructure. With the improvement of the diffusion models, diffusion MR imaging techniques are increasingly varied, from the simplest and most commonly used technique to the more complex. In this review, the various diffusion MRI techniques for pancreatic cancer are discussed, including conventional diffusion weighted imaging (DWI), multi-b DWI based on intra-voxel incoherent motion theory, diffusion tensor imaging and diffusion kurtosis imaging. The principles, main parameters, advantages and limitations of these techniques, as well as future directions for pancreatic diffusion imaging are also discussed.     

Chronic inflammatory demyelinating polyneuropathy: A unique case of chronic disease with atypical features

We present a unique case of diffusely extensive Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). Typically affecting the peripheral nervous system and manifesting with muscle weakness, breakdown or paresthesia, we present a case that additionally demonstrates; cranial nerve involvement, central nervous system parenchymal lesions, and chronic osseous remodeling of the nerve tracts. Cranial nerve involvement to this extent has only been described in one other case report to our knowledge. Central nervous system parenchymal lesions are extremely rare in CIDP and no discrete discussion about osseous remodeling has been presented, thus far, in the literature. The findings illustrated in this case may spur further understanding of imaging characteristics most associated with chronic CIDP disease and care measures that could help stratify patients most at risk for severe symptomologies.     

乳腺磁共振扩散加权成像的应用

目的：探讨乳腺磁共振扩散加权成像（DWI）检查的可行性,并重点探讨影响DWI图像质量的技术参数。方法：使用GE1．5T磁共振扫描仪及阵列线圈对32例乳腺疾病患者行常规SE序列扫描,其中19例为良性肿瘤,5例炎性病变,6例恶性肿瘤．均经手术及病理证实;另硅胶置入2例。使用体线圈行DWI序列扫描,采用全方位扩散梯度及5个b值扫描。DWI总的扫描时间40s。结果：在DWI序列扫描中,良性和恶性肿瘤均为高信号,计算ADC值可鉴别良性和恶性肿瘤．通过各种扫描参数的合理匹配,可使图像质量的信噪比达到最佳,并减少图像的几何变形。结论：DWI对于检查乳腺病变是一种快速可行并行之有效的技术。     

急性骨髓炎的影像学诊断研究进展

急性骨髓炎的影像学诊断技术包括X线平片、超声、CT、MRI及放射性核素显像.早期X线平片的诊断灵敏度低.超声能早期发现深部软组织及骨膜下脓肿,但图像质量取决于操作者的熟练程度.CT能早期观察到微小的骨质改变,但灵敏度较低.MRI可优于其他检查显示髓腔内的病变,但对于死骨、钙化的诊断不如CT灵敏.放射性核素显像剂的种类繁...     

表观扩散系数在乳腺病变诊断中的应用价值

目的:对比乳腺良、恶性病变的表观扩散系数(apparent diffusion coefficient,ADC),探讨DWI在乳腺病变中的诊断价值.材料和方法:搜集术前行MR检查并经病理证实的236例乳腺病变,采用平面回波-扩散加权成像序列(EPH)WI);测量病变区和对侧正常乳腺腺体的ADC值,应用t检验比较良、恶性病变及正常腺体ADC值的差异,采用接收者工作特征曲线(receiver operating characteristic curve,ROC)确定良、恶性病变的ADC界值;根据BI-RADS MRI将乳腺病变分为肿块性病变和非肿块性病变,比较ADC值在两组病变中定性诊断效能.结果:236例乳腺病变中,恶性病变ADC值[(1.08±0.32)X 10-3mm2/s]显著低于良性病变[(1.48±0.35)×102mm2/s],差异有统计学意义(P=0.01);根据ROC曲线确定ADC界值为1.25×10-2mm2/s,诊断敏感性和特异性分别为78.2%和77.5%.肿块性病变良、恶性ADC界值为1.15×10-3mm2/s(敏感性和特异性分别为79.8%和81.8%),非肿块性病变良、恶性ADC界值为1.35×10-3mm2/s(敏感性和特异性分别为78%和72%).绪论:根据ADC界值可以鉴别乳腺良、恶性病变;对肿块性病变和非肿块性病变应采用不同的ADC界值;DWI对肿块性病变的诊断效能优于非肿块性病变.     

背景抑制磁共振弥散成像(D WIBS)技术在肝脏局灶性占位性病变中的初步应用

目的:探讨背景抑制磁共振弥散成像(DWIBS)技术在肝脏局灶性占位性病变中的应用价值。方法:回顾性分析肝脏局灶性占位性病灶25例49个。其中肝细胞癌9例12灶,肝转移瘤6例18灶,肝囊肿7例16灶,肝血管瘤3例3灶的背景抑制磁共振弥散成像(b=600s/mm2),测量各病灶的表观弥散系数(ADC)值并进行比较,利用3D-MIP重建及黑白翻转技术,观察病变显示效果。结果:在b=600s/mm2的图像中,肝脏恶性肿瘤多表现为高信号;肝脏良、恶性肿瘤间差异具有统计学意义(P<0.05);肝细胞癌与肝转移瘤组间、肝囊肿与肝血管瘤组间无统计学差异(P>0.05)。背景抑制的DWI经MIP重建及黑白翻转技术,病变周围组织信号被抑制,得到类PET图像,25例49个病灶,均清晰显示。结论:背景抑制磁共振弥散加权成像在显示病灶方面有一定优势;应用DWI结合ADC值对于肝脏良、恶性占位病变有一定鉴别价值。     

Demonstration of spinal cord and nerve root abnormalities by diffusion neurography

OBJECTIVE: Diffusion-weighted magnetic resonance imaging postprocessed by maximum-intensity projection reportedly demonstrates the nerve roots. We modified this technique using a fluid-attenuated inversion-recovery-based diffusion-tensor scan using parallel imaging and evaluated its feasibility in demonstrating spinal cord and nerve root abnormalities. METHODS: We applied this technique to 18 patients with miscellaneous pathological conditions that included multiple sclerosis, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), neurofibromatosis (NF), schwannoma, cord injury, and tethered cord. The neurographic images were visually assessed regarding the lesion depiction. RESULTS: In each subject, not only the cord but also the nerve roots were visualized. This technique demonstrated cord plaques of multiple sclerosis (5/6 cases), enlarged nerve roots in CIDP (3/3 cases), multiple neurogenic tumors in NF (3/3 cases), and schwannoma (1/1 case). It better demonstrated nerve root abnormalities of CIDP (3/3 cases) and NF (2/3 cases) than conventional magnetic resonance images. CONCLUSION: This technique can effectively demonstrate most of the cord and nerve root pathology.     

磁共振扩散加权成像在乳腺病变诊断中的应用

目的：探讨单纯磁共振扩散加权成像对诊断乳腺病变的临床应用价值。方法：对临床拟诊为乳腺肿块的37例患者行磁共振扩散加权成像检查,并获得病理证实,其中良性病灶18个,恶性病灶19个。描记扩散图像上病变的兴趣区,由软件计算获得表观扩散系数（ADC）值。对获取数据进行统计分析,采用t检验对良性和恶性病变的ADC值进行比较。结果：12例良性病变在DWI上呈等信号或高信号,但ADC值升高或下降不明显,6例良性病变DWI上呈高信号,ADC值明显下降;19例恶性肿瘤DWI上呈高信号,ADC值明显下降。良性病变组ADC值为（1.474±0.441）×10^-3mm^2/s,恶性病变组ADC值为（1.082±0.160）×10^-3mm^2/s,两者间差异有显著性意义（P=0.002）。结论：MR扩散加权成像ADC值测量在乳腺病变定性诊断中有一定的辅助诊断价值。     

Morphological and functional MRI, MRS, perfusion and diffusion changes after radiosurgery of brain metastasis

Radiosurgery is a noninvasive procedure where spatially accurate and highly conformal doses of radiation are targeted at brain lesions with an ablative intent. Recently, radiosurgery has been established as an effective technique for local treatment of brain metastasis. After radiosurgery, magnetic resonance (MR) imaging plays an important role in the assessment of the therapeutic response and of any complications. The therapeutic approach depends on the imaging findings obtained after radiosurgery, which have a role in the decision making to perform additional invasive modalities (repeat resection, biopsy) to obtain a definite diagnosis and to improve the survival of patients. Conventional MR imaging findings are mainly based on morphological alterations of tumors. However, there are variable imaging findings of radiation-induced changes including radiation necrosis in the brain. Radiologists are sometimes confused by radiation-induced injuries, including radiation necrosis, that are seen on conventional MR imaging. The pattern of abnormal enhancement on follow-up conventional MR imaging closely mimics that of a recurrent brain metastasis. So, classifying newly developed abnormal enhancing lesions in follow-up of treated brain metastasis with correct diagnosis is one of the key goals in neuro-oncologic imaging. To overcome limitations of the use of morphology-based conventional MR imaging, several physiological-based functional MR imaging methods have been used, namely diffusion-weighted imaging, perfusion MR imaging, and proton MR spectroscopy, for the detection of hemodynamic, metabolic, and cellular alterations. These imaging modalities provide additional information to allow clinicians to make proper decisions regarding patient treatment.