椎管内肿瘤的动态增强磁共振成像

对３７例椎管内肿瘤进行动态增强磁共振成像。结果表明：强化峰值在９０ｓ内仅见于血管母细胞瘤，１８０ｓ内多见于星形细胞瘤、脊膜瘤及转移瘤，神经鞘瘤的最大对比增强率高于脊膜瘤（Ｐ〈０．０５）。肿瘤的对比增强率－时间曲线、增强程度和增强形态对组织学定性和富血管度预测具有重要价值。     

椎管内肿瘤磁共振成像诊断的意义

目的:研究椎管内肿瘤磁共振成像诊断的意义。方法:选取接受检查的22例椎管内肿瘤患者资料,所有患者均经过手术病理学检查确诊为椎管内肿瘤。为所有患者实施磁共振成像检查,分析椎管内肿瘤磁共振成像诊断的意义。结果:22例患者磁共振检查中肿瘤多处于椎管内各个位置,胸腰段位置的患者数量相对较多。同时,瘤体长度在1~5 cm之间,呈现出椭圆形、哑铃形或者不规则形态。椎管内肿瘤磁共振成像诊断中,T1W像上呈现出低信号或者等信号状态,T2W像上呈现出高信号或者混杂信号状态。常规MRI扫描后实施Gd-DTPA增强扫描,呈现出病灶不规则增强的特点,病灶能够看到囊性变区。磁共振成像诊断髓外硬脊膜内肿瘤14例,硬脊膜外肿瘤5例,髓内肿瘤3例。病理学诊断髓外硬脊膜内肿瘤13例,硬脊膜外肿瘤5例,髓内肿瘤4例。磁共振成像诊断符合率为90.91%,与病理学诊断结果比较,差异无统计学意义(P>0.05)。结论:椎管内肿瘤磁共振成像诊断的价值突出,临床诊断符合率较高,能够清晰患者发病的位置、病灶发展的具体情况等,为椎管内肿瘤患者的临床治疗方案设计能够奠定良好的基础。     

椎管内肿瘤的磁共振诊断

目的：探讨磁共振成像对椎管内肿瘤的诊断价值。方法：对42例经磁共振成像诊断或手术病理证实的椎管内肿瘤患者的磁共振图像进行分析研究。结果：42例椎管内肿瘤患者中，脊髓 内肿瘤6例，髓外硬膜下肿瘤29例，硬膜外肿瘤7例，磁共振成像对病变的显示直观清晰，定位定性准确。结论：磁共振成像对椎管内肿瘤有很高的诊断价值，应为影像学首选检查方法。     

磁共振成像对椎管内肿瘤的诊断价值

磁共振成像对椎管内肿瘤的诊断价值徐方元刘晓红椎管内肿瘤传统的椎管脊髓造影检查，有时可引起脊髓蛛网膜炎、神经根炎等〔１〕；而磁共振成像（ｍａｇｎｅｔｉｃｒｅｓｏｎａｎｃｅｉｍａｇｉｎｇ，ＭＲＩ）对椎管内肿瘤的诊断，具有明显的优越性。１９９３年２月～１９...     

椎管内肿瘤的动态增强磁共振成像

对３７例椎管内肿瘤进行动态增强磁共振成像。结果表明：强化峰值在９０ｓ内仅见于血管母细胞瘤，１８０ｓ内多见于星形细胞瘤、脊膜瘤及转移瘤，神经鞘瘤的最大对比增强率高于脊膜瘤（Ｐ＜０．０５）。肿瘤的对比增强率——时间曲线、增强程度和增强形态对组织学定性和富血管度预测具有重要价值     

椎管内肿瘤MRI扫描及临床分析

目的 探讨MRI扫描对椎管内肿瘤的诊断价值。方法 对59例椎管内肿瘤进行MRI扫描，并结合病理检查及临床进行分析。结果 MRI扫描对管内肿瘤术前定位准确率为96．6％，术前定性准确率为76％，特别是对椎管内硬脊膜下或脊髓内大部分肿瘤能作出定性诊断。结论 MRI扫描对椎管内肿瘤的诊断和鉴别诊断明显优于其他影像学检查，应用为首选方法。     

磁共振成像诊断椎管内神经源性肿瘤的临床应用价值

目的研究应用磁共振成像诊断椎管内神经源性肿瘤的临床价值。方法选取该院收治的经手术和病理证实为椎管内神经源性肿瘤患者53例,对其磁共振影像特征进行回顾性分析。结果 53例患者通过磁共振成像(MRI)共检查出51例椎管内神经源性肿瘤,均为椎管内生长,其中,椎间孔未扩大但神经根有加粗6例、椎间孔有扩大31例和椎间孔及神经根均没有变化14例;肿瘤边缘光滑规整28例、边缘不光滑规整17例和病灶内信号均匀6例。42例病灶处T1加权图像为等长信号,9例为短信号;9例T2加权图像为等长信号,42例为短信号。病灶处出现囊变13例、出现斑片状坏死9例、出现斑点状坏死10例和没有出现囊变及坏死19例。通过增强扫描的病例有37例,其中,信号明显为不均匀强化20例、均匀强化17例。MRI神经纤维瘤的诊断准确率为90.91%(10/11),MRI神经鞘瘤的诊断准确率为87.50%(7/8),MRI节细胞神经瘤、畸胎瘤、成神经细胞瘤和表皮样囊肿的诊断准确率分别为100.00%(2/2)、100.00%(1/1)、100.00%(2/2)和100.00%(3/3);MRI椎管内神经源性肿瘤的准确率为92.59%(25/27),略低于病理诊断的100.00%(27/27),比较差异无统计学意义(P0.05)。结论 MRI对于椎管内神经源性肿瘤诊断具有较高的准确率,能够为临床制定肿瘤切除手术方案提供正确的诊断信息。     

脊椎转移瘤的MRI探讨

目的 观察ＭＲＩ各序列对脊椎转移瘤的诊断价值并分析其ＭＲＩ征象。方法 对２２例脊椎转移瘤病人行Ｔ１ＷＩ，Ｔ２ＷＩ，Ｐ（Ｎ）Ｉ，小翻转角准Ｔ２Ｗ等序列检查并对病变信号的清晰度分级。     

增强磁共振成象动态扫描显示心绞痛病灶的初步研究

通过总结22例心绞痛患者经钆－二乙烯三胺五乙酸（Gd－DTPA）增强磁共振成象（MRI）动态扫描的研究结果，提出Gd－DTPA增强MRI动态扫描可以显示心绞痛病灶。22例心绞涌患者均为临床证实。增强检查方法为ECG门控，同一检查区域连续扫描4次，时间间隔为5、10、20和30min。信号测量由MRI机内在测量功能完成。结果：22例中有18例表现为增强后心肌局灶性高信号区。通过分析病灶区动态信号变化曲线并与正常心肌对比，发现其特点为病灶区增强后10min最高，信号增强率和信号对比率的最高峰也都在10min左右。而正常心肌的最高峰出现在5min时。这个结果与急、慢性心肌梗死MRI动态曲线的变化情况也不相同。表示心绞痛病灶区增强的原理和心肌梗死的增强原理并不完全相同。结论：Gd－DTPA增强MRI动态扫描完全可以定位和定量地显示心绞痛的病灶，但对它的增强原理目前尚不完全了解。     

椎管内神经源性肿瘤的MRI诊断

目的评价MRI在椎管内神经源性肿瘤诊断中的应用价值。方法回顾性分析68例经手术及病理证实的椎管内神经源性肿瘤的MRI表现。结果神经鞘瘤21例,均为单发,其信号特点为长T1、长T212例,等T1、长T26例,长T1、混合T23例;其中4例伴囊变;在17例强化病灶中,呈环状强化15例,不均匀强化2例。神经纤维瘤47例,单发41例,多发6例,其信号特点与神经鞘瘤相似,以长T1、长T2改变为多见;有囊变11例;增强扫描32例,呈均匀强化或环状强化;5例可见椎弓根骨质局限性吸收、破坏。结论MRI平扫结合增强扫描对椎管内神经源性肿瘤的定位及定性诊断具有重要价值。     

RETROSPECTIVE ANALYSIS OF MAGNETIC RESONANCE MYOCARDIAL DELAYED ENHANCEMENT

Objective To explore the imaging and related clinical characteristics of magnetic resonance （MR） delayed enhancement in patients with ischemic or nonischemic heart disease. Methods Thirty-two cases who underwent MR myocardial cine and delayed enhancement imaging from January 2004 to October 2006 were retrospectively analyzed. The cine sequence imaging included the four-chamber view and the left ventricular short axis view. The delayed enhancement imaging was taken 10 minutes after the infusion of gadolinium from the antecubital vein with a segmented inversion-recovery-prepared Tl-weighted fast gradient echo sequence. Patients underwent coronary computed tomography angiography （CTA） two weeks before or after the MR imaging examination. Combined with clinical history, the clinical and MR imaging characteristics of the patients who had delayed enhancement were analyzed. Results MR delayed enhancement could be found in 16 cases. Among them, 12 cases had ischemic heart disease. Their coronary CTA showed one to three vessel diseases. The delayed enhancement was transmural or subendocardium, and the area of delayed enhancement corresponded well with one or more coronary arteries which had severe stenosis or occlusion. Four cases had nonischemic heart diseases One case was dilated cardiomyopathy, with diffuse small midwall spots in delayed enhancemen and only 30% stenosis of the anterior descending coronary artery in coronary CTA. One case was hypertrophic cardiomyopathy, with delayed enhancement of strip- and patch-shaped at midwall of the hypertrophic myocardiurn. One case was restrictive cardiomyopathy, and the delayed enhancement was located in the area of subendocardium of both the right and left ventricles. Coronary CTA of these two cases were normal The other case was a mass of the lateral wall of the left ventricle, and the delayed enhancement with a clumpy shape was located in the lateral wall of the left ventricle. Conclusions MR myocardial delayed enhancement is not a specific sign of myocardial infarction of ischemic heart disease. Nonischemic heart diseases including all kinds of primary cardiomyopathy and some other diseases affecting myocardium can also cause delayed enhancement, but their characteristics are different. The differentiation of the etiology of the nonischemic heart disease with delayed enhancement relies upon the intimate connection with clinical history and the cine sequence MR images.     

磁共振动态增强检查技术在乳腺疾病诊断中的价值分析

目的：探讨3.0T磁共振动态增强检查VIBRANT（ Volume Imaging for Breast Assessment,乳腺容积成像序列）技术在乳腺疾病诊断中的价值。方法：回顾性分析经手术病理证实的32例乳腺疾病病人的MRI资料,分析病变信号、形态、时间-信号强度曲线,计算VIBRANT动态增强扫描技术用于诊断良恶性病变的灵敏度、特异度、准确度。结果：采用VIBRANT乳腺动态增强扫描技术后,在保证图像信噪比的条件下,克服了传统动态增强检查的缺点,并且结合病变动态增强后的征象和时间-信号曲线图,明显提高了对乳腺良、恶性病变的诊断,其诊断的敏感性为100%,特异性为81.25%,准确性为93%。乳腺肿瘤动态增强曲线流入型与流出型（ P=0.000）、平台型与流出型（P=0.001）,差异有统计学意义;流入型与平台型（P=0.209）,差异无统计学意义。结论：VIBRANT动态增强扫描技术为乳腺磁共振动态增强检查提供了更新、更好的方法,对提高乳腺疾病诊断的正确性无疑是一种更先进的技术。     

动态增强MRI技术对肝血管瘤的诊断价值

目的：研究动态增强及延迟增强扫描MRI对肝血管瘤的诊断价值。方法：34例肝血管瘤病人行常规MRI、T1WI和T2WI横断面扫描。经肘静脉团注Gd-DTPA以2～3mL/s速度注入,并以同样速度推入20mL生理盐水冲洗（推入时间5～10s）,再行T1WI动态增强扫描及延迟增强扫描,分析病灶及邻近肝实质增强。结果：共发现肝血管瘤病灶67个,T1WI上呈低信号,T2WI上呈高信号;动态增强显示46个病灶呈边缘不连续的结节样强化,21个病灶呈周边不规则强化或迅速强化充填;5个病灶动态增强早期见引流静脉较早强化,14个病灶瘤周肝实质强化。结论：磁共振成像检查中,动态增强扫描及延迟扫描能够显示肝血管瘤及邻近实质强化方式,与其他成像序列结合更有利于肝血管瘤的诊断。     

增强-选择激发脂肪抑制T1加权成像在磁共振检查中的应用

对３２例病人同时作增强－ＦＳ－Ｔ１加权图像和增强自旋回波（ＳＥ）Ｔ１加权图像。用病变显示程度和病灶信号强度两项指标进行对比分析。病灶显示程度“优”者在增强－ＦＳ－Ｔ１加权图像上远远多于增强－ＳＥ－Ｔ１加权图像。信号强度“高”者亦前者较后者为多。分析结果表明增强－ＦＳ－Ｔ１加权图像对正确评价强化病变的轮廓、大小及某些鉴别诊断明显优于增强－ＳＥ－Ｔ１加权图像，特别是对含脂肪、骨髓较多的部位。     

腰椎管的MRI定量测量研究进展

综述了腰椎管测量的X线、CT及MRI等影像学检查的进展，尤其述及的是MRI在测量腰椎管方面尚无定论。有关MRI的各种研究方法及测量方法为临床进一步研究腰椎管狭窄提供了广阔地应用前景。     

DIFFERENTIATION BETWEEN MALIGNANT AND BENIGN OVARIAN TUMORS BY MAGNETIC RESONANCE IMAGING

Objective To determine the magnetic resonance （MR） imaging findings of an ovarian mass which are most predictive of malignancy and assess the value of intravenous gadolinium administration in the characterization of an ovarian mass. Methods Totally 74 consecutive patients with a clinically or sonographicaUy indeterminate adnexal mass underwent MR imaging, of whom 59 had subsequent surgical resection of 70 adnexal masses. These 59 patients formed the study population. MR imaging studies were prospectively and independently reviewed by a senior and a junior radiologist. The senior radiologist also reevaluated the studies in a blind fashion after a minimum 6 months interval. The sensitivity, specificity, positive predictive value, and negative predictive value of contrast-enhanced and unenhanced MR im- aging were evaluated Results The most predictive MR imaging findings for malignancy were presence of vegetations in a cystic lesinn and presence of necrosis in a solid lesion. The odds ratio was even higher when the ancillary finding of peritoneal metastasis or ascites was present. Contrast media contributed significantly to lesinn characterization. Total 70 ovarian masses were detected by contrast-enhanced MR imaging including 37 malignant ovarian masses and 33 benign ovarian masses with 87% （61/70）accuracy, 86% （32/37）sensitivity, 88% （29/33）specificity, 89% （32/36）positive predictive value, and 85% （29/34） negative predictive value, whereas 70 ovarian masses were detected by unenhanced MR imaging with 74% （52/70） accuracy, 73 % （27/37） sensitivity, 76 % （ 25/33 ） specificity, 77% （27/35） positive predictive value, and 71% （ 25/35 ） negative predictive value. There were significant differences in accuracy （ P 〈 0. 01 ）, sensitivity （ P 〈0. 01 ）, specificity （ P 〈0. 01 ） between contrast-enhanced and unenhanced MR imaging. Conclusion Contrast-enhanced MR imaging is highly accurate in detection and characterization of complex adnexal masses.     

自制维影钆胺(Gd—DTPA)在磁共振成像中应用的初步报告

报告自制的磁共振成像造影剂维影钆胺首次临床应用情况。观察了iv维影钆胺前后磁共振成像T_1加权扫描的效果,从正常组织和病变组织的MR信号增强效果进行了评价。静脉注射维影钆胺后,正常组织MR信号明显增强的有脑下垂体,鼻粘膜和肾脏,轻度增强的有肝脏。无明显增强的有脑白质。5例中枢神经轴外肿瘤病灶可见明显强化,检出了2个CT扫描和非增强磁共振扫描阴性的微小神经瘤,排除了1例脊髓肿瘤性空洞,确诊了1例海绵状血管瘤 可见自制维影钆胺是一种有效的磁共振成像造影剂。