脑胶质瘤病的MRI征象分析

目的：总结和学习脑胶质瘤病的MRI特征。方法：对临床确诊的4例脑胶质瘤病进行回顾性分析，其中包括临床表现及MRI征象等内容。结果：4例患者病情均有进行性加重，表现为头痛、呕吐、智力与精神障碍、癫痫、偏瘫等症状。影像学表现为双侧大脑半球对称性弥散性病灶，并脑白质均受累，占位效应不明显，没有显著强化。结论：脑胶质瘤病的临床表现与MRI征象结合，有助于本病的诊断。     

瘤样脱髓鞘病与脑胶质瘤的MRI影像学特征临床分析

目的探讨并比较瘤样脱髓鞘病与脑胶质瘤的MRI影像学特征与临床特征。方法收集我院经病理证实为瘤样脱髓鞘病患者35例,脑胶质瘤患者30例,通过对比分析两组患者的临床资料和MRI影像学特征差异。结果两组在发病年龄、首次就诊病程及起病形式等方面比较存在显著差异,其中脑胶质瘤患者的发病年龄明显高于瘤样脱髓鞘病患者,脑胶质瘤患者的首次就诊病程较瘤样脱髓鞘病患者为长,且差异具有统计学意义。另外,脑胶质瘤患者的起病形式以慢性起病更为多见,而瘤样脱髓鞘病患者则以亚急性起病更为多见。瘤样脱髓鞘病患者获得随访5个月~5年,失访3例。预后情况:其中痊愈13例,占37.14%(13/35),好转18例,占51.43%(18/35),无效4例,占11.43%(4/35),在无效的4例患者中病情未发生变化2例,病情加重1例,死亡1例。瘤样脱髓鞘病组患者和脑胶质瘤组患者在头痛、偏身肢体无力、视力下降、肢体麻木、言语障碍、认知障碍、头晕、情绪淡漠等首发症状方面比较无明显差异;但是脑胶质瘤组的癫痫发生率明显高于瘤样脱髓鞘病组,且差异具有统计学意义。结论瘤样脱髓鞘病在MRI影像学方面具有一定的特征。     

MRI对脑胶质瘤病的诊断价值

目的：探讨MRI对脑胶质瘤病的诊断价值。方法：分析7例脑胶质瘤病的MRI表现。结果：7例胶质瘤病均侵犯2个脑叶或以上，5例侵及大脑深部结构，病变均呈长T1、长T2信号，占位效应不明显，未见明显强化，DWI示部分病灶呈高信号，ADC图呈低信号，且ADC值低于正常脑实质值，MRS波谱示病变区NAA峰明显降低，2例CHO峰明显升高，未见明显LAC峰，病理证实为脑胶质瘤病。结论：MRI是目前诊断脑胶质瘤病的首选影像学诊断方法。     

磁共振脑灰白质成像在脑灰质异位症中的临床应用

目的：探讨磁共振脑灰白质成像在脑灰质异位症中的诊断价值。方法：回顾性分析5例经临床及MRI检查确诊的脑灰质异位症患者，全部患者均行脑MRI常规T1WI、T2WI序列、FLAIR序列和脑灰白质成像检查。结果：5例脑灰质异位症患者在MRI各扫描序列上病灶信号与脑灰质信号完全相同，特别是在脑灰白质成像上对异位的灰质灶观察更为满意，更有利于判断病变的性质。结论：脑灰白质成像在观察灰质异位方面有独到价值，在分析癫痫病因方面可提供更直接的影像学信息。对于脑灰质异位症患者，脑灰白质成像对于帮助发现病灶并判断其性质甚为必要，是对常规序列的必要补充，具有较高的临床应用价值。     

脑多发胶质瘤影像特点与病理结果的对比分析

目的:探讨脑多发性胶质瘤的影像学特点与病理结果关系,并对其结果进行对比分析,提高对本病的认识和临床诊断.方法:选取我院经手术病理证实的脑多发性胶质瘤患者14例,所有患者均行头部CT和MRI平扫及增强扫描,所有病灶均行手术取材,进行组织病理学切片检查,比较患者影像学特征和病理结果.结果:影像表现为脑内各叶多发肿块样病灶,病变主要在额叶、颞叶呈弥漫性生长,病灶间相互独立.影像MRI增强扫描共显示30个病灶,呈中度至明显强化的病灶13个,都以不均匀强化方式为主,其中有12个经病理证实为星形胶质瘤WHOⅢ-Ⅳ级;17个病灶无明显或轻度强化,其中13个经病理证实为星形胶质瘤WHOⅡ级,3例为少突胶质细胞瘤Ⅱ级.结论:脑多发胶质瘤影像表现特征与其病理学类型及分级相关,可初步诊断该疾病并判断其恶性程度,对临床治疗提供帮助,值得进一步推广应用.     

脑多发胶质瘤影像与病理对照研究

目的 探讨脑多发胶质瘤的影像特点与其病理结果的关系,提高对本病的认识及诊断水平.资料与方法 分析6例经手术病理证实的脑多发胶质瘤的MR及CT影像学资料、病理结果.结果 6例共计13个病灶,MR及CT影像表现为脑内各叶多发肿块样病灶,以额叶最多见,病灶间相互独立.5例影像增强共显示11个病灶,其中7个病灶呈中度至明显强化,病理结果为胶质瘤Ⅲ～Ⅳ级;4个病灶无明显强化,其中2个病灶病理结果为胶质瘤Ⅱ级.结论 脑多发胶质瘤影像表现特征与其病理学类型及分级相关,可初步作出诊断并判断其恶性程度,对临床治疗提供更多帮助.     

替莫唑胺联合光动力显微手术综合治疗功能区脑胶质瘤长期随访研究

正目的:研究化疗联合光动力综合治疗脑胶质瘤以来共45例功能区高级别胶质瘤患者的临床症状改善情况,生存率和影像学变化。方法:功能区恶性脑胶质瘤病例25例,皆有影像学及病理证实,男性13例,女性12例;间变星形细胞瘤6例,间变室管膜瘤3例、间变少枝胶质细胞瘤1例、多形胶质母细胞瘤15例。随机选取同期非光动力治疗的高级别功能区胶质     

酷似胶质瘤的脑疾病影像及临床诊断

目的提高酷似胶质瘤的脑疾病诊断水平。方法搜集经手术、病理及临床追踪证实的9例酷似脑胶质瘤的脑疾病,回顾性分析MR及CT所见以及相关的临床资料。结果9例中包括脑血吸虫肉芽肿2例,病毒性脑炎3例,脑挫裂伤2例,脑脓肿、脑梗死各1例。结论详细分析各种脑病的影像学特点并紧密结合临床资料多能作出鉴别诊断。     

脑胶质瘤病的MRI及MRS研究

目的 :回顾性分析大脑胶质瘤病磁共振成像 (MRI)及磁共振波谱 (MRS)特点 ,以探讨两者对本病诊断的临床价值。方法 :综合 7例患者的临床表现、影像学特点及病理诊断 ,均符合大脑胶质瘤病诊断标准。常规行SE序列平扫及增强。其中 3例行MRS研究 ,二维多体素、点分辨法 (PRESS)、TE 14 4ms。结果 :所有病例均侵犯 2个脑叶或以上。病变区呈长T2 、稍长T1异常信号 ,受累区脑组织肿胀 ,占位效应轻。 3例增强扫描见小结节或片状强化 ,4例无明显强化。 3例MRS表现均有不同程度NAA降低 ,Cho上升 ,Cho/Cr和Cho/NAA的比值上升。结论 :MRI是目前诊断大脑胶质瘤病的首选影像学方法 ,MRS对于鉴别诊断有较大价值。     

AIDS合并进行性多灶性脑白质病的MRI诊断

目的分析AIDS合并进行性多灶性脑白质病的MRI特点,提高诊断的准确性。方法经临床证实的AIDS合并进行性多灶性脑白质病患者37例,均行MRI检查,其中20例患者行增强扫描。结果在有局限性脑功能异常的艾滋病患者中,病变多位于顶叶、枕叶、额叶白质区,以灰白质交界区多见,病变常为多灶性,有融合增大趋势,呈不对称分布,表现为长T_1长T_2信号,无明显占位水肿征象,增强扫描大部分病灶强化不明显,仅少数灰白质交界区病灶轻度强化。结论 AIDS合并进行性多灶性脑白质病具有一定特征性的MRI表现,结合患者临床病史、神经症状及体征、部位、实验室检查等特点,可进一步提高其诊断准确性。     

腺性膀胱炎的影像学表现(附2例报告及文献复习)

目的：探讨腺性膀胱炎的影像学表现。材料与方法：搜集２例经手术病理证实腺性膀胱炎的临床、Ｂ超、ＣＴ及ＭＲＩ表现,结合复习国内外有关文献。结果：腺性膀胱炎的病理表现有特征性,但影像学表现无特异性。结论：影像学对腺性膀胱炎诊断有很帮助,但确诊要靠膀胱镜病理活检。     

腺性膀胱炎的临床与MRI分析

目的:探讨腺性膀胱炎的临床和MRI诊断特点.方法:对5例经膀胱镜及病理确诊为腺性膀胱炎患者的临床、膀胱镜和MRI表现进行回顾性分析,并复习相关文献.结果:5例患者的主要临床表现为血尿、尿路刺激症状及排尿困难等.病变好发于膀胱颈部和底部,于平扫T1WI均为等或低信号,T2WI为高信号,2例病变信号均匀,3例病变中可见囊变;增强扫描示病变轻度强化.结论:腺性膀胱炎易与膀胱癌混淆,MRI能清楚显示腺性膀胱炎的病变部位、范围、轮廓以及与邻近组织的关系,但无特异性,最后确诊需临床、影像和病理三者结合,病理检查是确诊的主要手段.     

Juvenile ossifying fibroma of the facial skull. Computerized tomography and nuclear magnetic resonance tomography

The clinical and radiological features in a case of a juvenile ossifying fibroma of the skull were studied with CT and MRI. The combination of both imaging modalities allows a precise prediction of tumor components and extension.     

Moyamoya disease--imaging with magnetic resonance

We report a case of moyamoya disease in a young adult female, in whom the initial clinical and radiological features were considered to be compatible with multiple sclerosis. The subsequent development of cerebral infarction led to the typical moyamoya features being found on carotid angiography. Magnetic resonance imaging (MRI) features of dilated collateral arteries were then recognized, and the initial MRI findings considered to represent demyelination were reinterpreted as areas of infarction. Although rare, moyamoya disease should be considered in the differential diagnosis in young patients presenting with symptoms and signs suggestive of multiple sclerosis. The diagnosis may be suggested by typical MRI findings.     

Central gland and peripheral zone prostate tumors have significantly different quantitative imaging signatures on 3 Tesla endorectal, in vivo T2-weighted MR imagery

Purpose:

To identify and evaluate textural quantitative imaging signatures (QISes) for tumors occurring within the central gland (CG) and peripheral zone (PZ) of the prostate, respectively, as seen on in vivo 3 Tesla (T) endorectal T2‐weighted (T2w) MRI.

Materials and Methods:

This study used 22 preoperative prostate MRI data sets (16 PZ, 6 CG) acquired from men with confirmed prostate cancer (CaP) and scheduled for radical prostatectomy (RP). The prostate region‐of‐interest (ROI) was automatically delineated on T2w MRI, following which it was corrected for intensity‐based acquisition artifacts. An expert pathologist manually delineated the dominant tumor regions on ex vivo sectioned and stained RP specimens as well as identified each of the studies as either a CG or PZ CaP. A nonlinear registration scheme was used to spatially align and then map CaP extent from the ex vivo RP sections onto the corresponding MRI slices. A total of 110 texture features were then extracted on a per‐voxel basis from all T2w MRI data sets. An information theoretic feature selection procedure was then applied to identify QISes comprising T2w MRI textural features specific to CG and PZ CaP, respectively. The QISes for CG and PZ CaP were evaluated by means of Quadratic Discriminant Analysis (QDA) on a per‐voxel basis against the ground truth for CaP on T2w MRI, mapped from corresponding histology.

Results:

The QDA classifier yielded an area under the Receiver Operating characteristic curve of 0.86 for the CG CaP studies, and 0.73 for the PZ CaP studies over 25 runs of randomized three‐fold cross‐validation. By comparison, the accuracy of the QDA classifier was significantly lower when (a) using all 110 texture features (with no feature selection applied), as well as (b) a randomly selected combination of texture features.

Conclusion:

CG and PZ prostate cancers have significantly differing textural quantitative imaging signatures on T2w endorectal in vivo MRI. J. Magn. Reson. Imaging 2012;36:213–224. © 2012 Wiley Periodicals, Inc.     

Symptomatic resolution of spinal osteoid osteoma with conservative management: imaging correlation

A 10-year-old girl presented with a history of painful scoliosis. Imaging performed, including computed tomography (CT) and magnetic resonance imaging (MRI), demonstrated a lesion with radiological features consistent with an osteoid osteoma (OO) of the 6th thoracic vertebra. The patient was treated conservatively with non-steroidal anti-inflammatory drugs (NSAIDs). Over eight months of clinical and radiological surveillance, she became entirely asymptomatic and demonstrated complete resolution of the scoliotic curve. The CT and MRI features of the osteoid osteoma during the period of surveillance are presented and are correlated with the corresponding clinical features.     

Dandy-Walker综合征的MRI诊断(附6例报告)

目的:探讨Dandy-Walker综合征(DWS)的临床及MRI表现特征。方法:对6例经MRI诊断为DWS进行回顾性分析。结果:MRI主要表现为小脑蚓部缺如,小脑半球部分发育不全伴分离、移位;第四脑室囊状扩大与后颅窝囊腔相通;后颅窝扩张伴有横窦、窦汇和小脑幕上移;常伴有幕上不同程度梗阻性脑积水及其他颅内畸形。结论:DWS的MRI表现具有特征性,MRI是诊断DWS的最理想的影像学方法。     

M.R.I. spectrum of intrinsic spinal cord lesions.

We report our experience of 42 patients undergoing magnetic resonance imaging (MRI) studies demonstrating intrinsic lesions of the spinal cord, excluding those secondary to spondylosis, trauma or congenital malformations. Histological confirmation of the radiological diagnosis was obtained in 15 (36%). MRI is more sensitive than either myelography or CT. MRI identified a previously non-visualised lesion in 17 of 30 cases. In a further 13 cases, MRI contributed by identifying associated features such as cysts and haemorrhage which have aided in the diagnosis and management of the patients. The last 12 cases, which were patients with multiple sclerosis, had MRI as the only neuroradiological examination. These illustrate a range of appearances. The overlap of imaging appearances of the various pathologies implies that a useful diagnosis and differential can only be offered by considering the MRI appearances of a lesion, with its associated features, with the clinical presentation, and with other imaging modalities where appropriate.     

颅内室管膜下瘤的CT及MRI影像学表现分析

目的探讨颅内室管膜下瘤的CT及MRI影像学特征。资料与方法回顾性分析5例经手术病理证实的室管膜下瘤患者的临床和影像学资料。结果室管膜下瘤属良性肿瘤,中年男性多见,具特征性表现:(1)幕上肿瘤多位于侧脑室内室间孔或透明隔附近,幕下则以第四脑室多见;(2)肿瘤多呈类圆形、椭圆形或轻度分叶,边界清楚,以实性成分为主,病灶内可伴小囊变及出血,幕上肿瘤钙化较少见,幕下者部分可见钙化;(3)CT平扫示肿瘤实性部分呈等或低密度,MR平扫T1WI呈低、稍低或等信号,T2WI以高信号为主;瘤内小囊变区呈更低密度及长T1、长T2信号;(4)CT、MR增强扫描,病灶无明显强化或轻度强化。结论充分认识颅内室管膜下瘤的CT及MRI影像学特征对肿瘤的术前诊断和术后评价具有重要意义。     

A brainstem variant of reversible posterior leukoencephalopathy syndrome

Reversible posterior leukoencephalopathy syndrome (RPLS) is caused by various heterogeneous factors, the commonest being hypertension, followed by nonhypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. Patients with RPLS exhibit bilateral white and gray matter abnormalities in the posterior aspects of the cerebral hemispheres. However, this syndrome may affect the brainstem predominantly, and these cases are designated as hypertensive brainstem encephalopathy. We present here two patients with reversible brainstem encephalopathy: one with hypertension and the other without hypertension. These patients presented with swelling and diffuse hyperintensities of the brainstem in fluid-attenuated inversion-recovery (FLAIR) and T2-weighted MRI, but with relatively mild clinical symptoms. They recovered without major neurological deficits, but had residual lacunar lesions in the pons. Reversible brainstem encephalopathy with characteristic MRI features was found in both hypertensive and nonhypertensive patients. These patients were diagnosed with a brainstem variant of RPLS, which is potentially fully reversible after an adequate treatment, and therefore should be carefully differentiated from other brainstem disease conditions.