脊椎血管瘤的影像学诊断15例分析

目的 探讨脊椎血管瘤的影像学表现特征,评价其诊断价值.方法 回顾性分析15例经临床及手术病理证实的脊椎血管瘤的X线、CT及MRI表现,并找出其特点.结果 X线片可见椎体呈典型的“栅栏状”改变;CT可见“网眼状”影像中夹杂着低密度脂肪;MRI T1 WI呈混杂高低信号,T2WI为高信号,并随回波时间延长信号逐渐变亮.CT二维重建及MRI冠、矢状位可更好的显示病变椎体断面的“栅栏状”征象.结论 脊椎血管瘤具有影像学特征性表现,MRI在鉴别诊断方面优于X线、CT.     

原发性中枢神经系统淋巴瘤CT与MRI的鉴别诊断

目的探讨原发性中枢神经系统淋巴瘤CT和MRI图像特征及鉴别诊断。方法选取84例脑肿瘤患者,均接受CT和MRI检查,将两种检查方法的检查结果与最终病理结果比较,探讨两种方法的优劣势,研究两种方法对该病的鉴别诊断。结果 CT及MRI检查结果与最终病理确诊结果相比差别无统计学意义(χ2=0.37,P>0.05),两种检查方法最终诊断单发肿瘤10例,多发肿瘤4例;CT检查显示高密度(4例)、等密度(6例)、低密度(4例)。MRI检查显示T1信号略长(4例)、T1信号略长(10例);边缘不清、水肿严重患者有4例;MRI检查选取指标对肿瘤区、水肿区、对照区区分明显。结论运用CT和MRI鉴别诊断原发性中枢神经系统淋巴瘤有较高的临床价值。     

椎管内肿瘤的诊断与治疗

现就近10年来诊治的椎管内肿瘤作回顾性分析,报道如下。1临床资料1.1一般资料本组共37例,男21例,女16例,年龄18～65岁,平均43岁。1.2临床表现病程在半年内者4例,1年内者17例,2年内者13例,2年以上者3例。首发症状:神经根性疼痛17例,感觉异常13例,运动受限3例,局部叩击痛及放射性疼痛4例。全部病例X线摄片检查,有椎间孔扩大、椎弓根变形、椎弓根间距扩大等骨质改变者10例,穿刺脑脊液生化检查及脊髓造影20例,CT25例,CTM10例,MRI20例,脊髓造影阳性率40%(820),CT阳性率60%(1525),CTM阳性率50%(510),MRI100%(2020)1.3治疗方法全部病例均行…     

鞍上区病变的影像诊断与鉴别

目的回顾性分析鞍上病变的CT和MRI影像表现,以提高诊断和鉴别诊断能力。方法收集经CT、MRI检查并经病理或临床证实鞍上区病变32例,均行CT和MRI平扫并大部分增强扫描。结果32例鞍上病变MRI发生率100%,CT发现率93%,定性诊断与病理符合29例。结论应用MRI检查技术是目前诊断鞍上病变最好的方法之一,大部分病例MRI优于CT。MRI以失状、冠状、轴位平扫加增强扫描为基础,必要时辅助特殊序列检查,可以清晰显示病变位置、大小、信号以及周围组织结构关系,提高诊断符合率。     

鞍上区病变的影像诊断与鉴别

目的回顾性分析鞍上病变的CT和MRI影像表现，以提高诊断和鉴别诊断能力。方法收集经CT、MRI检查并经病理或临床证实鞍上区病变32例，均行CT和MRI平扫并大部分增强扫描。结果32例鞍上病变MRI发生率100％，CT发现率93％，定性诊断与病理符合29例。结论应用MRI检查技术是目前诊断鞍上病变最好的方法之一，大部分病例MRI优于CT。MRI以失状、冠状、轴位平扫加增强扫描为基础，必要时辅助特殊序列检查，可以清晰显示病变位置、大小、信号以及周围组织结构关系，提高诊断符合率。     

64层CT后处理技术在关节骨折诊断中的价值

背景：多层螺旋CT结合图像后处理技术对骨折诊断的价值已得到肯定,其中安装有图像后处理软件,可用于各种骨关节外伤的诊断。 目的：评价64层螺旋CT后处理技术在关节骨折中的应用价值。 方法：对36例骨关节损伤患者全部进行X射线平片及多层螺旋CT扫描,并进行多平面重建及容积重建,分析平片、轴位、多平面重建及容积重建对骨折或脱位的显示情况。 结果与结论：所有受试者中,X 射线平片有明确骨折仅20例,容积重建图像可以立体显示骨折线的形态和走行,但容积重建图像对骨皮质轻微分离显示不佳、对关节腔内及椎管内游离骨折片显示困难。多平面重建可以准确显示骨折线以及骨折片的移位。3种方式对关节骨折诊断的阳性率比较有显著性差异。提示,64层螺旋CT后处理技术可以直观、立体、清晰、多角度地显示关节骨折;具有较高的临床应用价值。     

颅内非肿瘤性疾病的磁共振成像

本文复习了颅内非肿瘤性疾病的磁共振成像(简你MRI)近况,MRI受组织参数(T_1,T_2,ρ和流动效应)和仪器参数(TR,TE)等影响,使图象解释比X线CT复杂,但对某些病理过程的解释比X线CT更为正确.文中重点复习了中枢神经系统绝大多数非肿瘤性疾病的MRI表现,总的看来在非肿瘤性疾病的诊断中MRI优于X线CT.     

CT和MRI诊断外周型原始神经外胚层肿瘤的临床价值

目的探讨CT与MRI检查对外周型原始神经外胚层肿瘤(pPNETs)的诊断价值。方法回顾分析27例pPNETs患者的CT与MRI检查资料,比较CT、MRI表现与手术病理结果。结果 pPNETs位于肌肉18例,盆腔6例,胸腔3例;术前CT、MRI诊断与术后病理诊断符合率为55.56%,误诊率为44.44%。CT平扫显示肿瘤密度类似于相邻肌肉组织,经增强扫描可见中等以上强化,经双期增强扫描可见进行性不均匀强化。MRI检查在T1WI上为不均匀略低或等信号,在T2WI上为不均匀略高或高信号,经增强扫描可见显著不均匀强化。结论 pPNETs具有特征性CT和MRI征象,CT和MRI检查对于临床诊断鉴别、治疗决策以及预后评估具有重要指导意义。     

SPECT在脑部疾病中的应用

本文报告259例脑部疾病病人SPECT脑显像结果，并与CT，MRI，EEG及TCD等检查作比较。结果表明：SPECT对脑梗塞的早期确诊，TIA的辅助诊断和癫痫的定位诊断有较大价值。脑血流断层显像诊断意义大，但其他核素显像方法在某些疾病中仍有很大诊断价值。     

MRI在疑难脊柱疾患诊断中的临床应用价值

MRI可三维立体地显示脊柱诸解剖结构和脊髓,现已成为脊柱疾患的一种重要影像学诊断方法。作者于1939年间,应用MRI诊断疑难脊柱疾患57例,现就其临床应用价值讨论如下。临床资料本组57例,男34例,女23例。年龄最小者29岁,最大者60岁,平均46.8岁。临床诊断、X线检查、脊髓造影及CT扫描结果见附表。附表 57例脊柱疾患四种检查结果和临     

烟雾病的诊断与鉴别诊断

目的 评价烟雾病的诊断方法，讨论其鉴别诊断。方法 回顾性分析11例烟雾病的CT、MRI及MRA资料，分析脑实质及脑血管的形态学改变。结果 CT及MRI表现为脑实质改变。脑出血3例，脑梗化6例，脑萎缩2例；MRA均见有不同程度的颈内动脉分叉以上狭窄或闭塞，其中双侧颈内动脉狭窄6例，单侧颈内动脉狭窄5例；大脑中动脉狭窄20支，大脑前动脉狭窄18支，大脑后动脉狭窄14支；9例同时显示异常血管网。结论 烟雾病主要靠放射学诊断，MRA可很好地显示烟雾病异常血管，可作为筛台烟雾病首选方法。诊断时，要排除脑中风、动脉瘤和动静脉畸形出血。     

超低场磁共振成象诊断老年人缺血性脑梗塞(273例分析)

回顾分析60岁以上缺血性脑梗塞273例(含792个病灶),剖析病灶的超低场(ULF)磁共振成象(MRI)表现。在T_2权重图象上显示的病灶在T_1权重图象上有36.24％未能显示,强调检查应从T_2权重图象开始。MRI发现病变较CT早,对脑中线及后颅窝病变的显示较CT敏感和清晰。     

Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

OBJECTIVE: To identify global research trends in neuroimaging diagnosis for cerebral infarction using a bibliometric analysis of the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of data retrieval for neuroimaging diagnosis for cerebral infarction containing the key words "CT, magnetic resonance imaging, MRI, transcranial Doppler, transvaginal color Doppler, digital subtraction angiography, and cerebral infarction" using the Web of Science. SELECTION CRITERIA: Inclusion criteria were: (a) peer-reviewed articles on neuroimaging diagnosis for cerebral infarction which were published and indexed in the Web of Science; (b) original research articles and reviews; and (c) publication between 2004-2011. Exclusion criteria were: (a) articles that required manual searching or telephone access; and (b) corrected papers or book chapters. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to country; (3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on neuroimaging diagnosis for cerebral infarction. RESULTS: Imaging has become the predominant method used in diagnosing cerebral infarction. The most frequently used clinical imaging methods were digital subtraction angiography, CT, MRI, and transcranial color Doppler examination. Digital subtraction angiography is used as the gold standard. However, it is a costly and time-consuming invasive diagnosis that requires some radiation exposure, and is poorly accepted by patients. As such, it is mostly adopted in interventional therapy in the clinic. CT is now accepted as a rapid, simple, and reliable non-invasive method for use in diagnosis of cerebrovascular disease and preoperative appraisal. Ultrasonic Doppler can be used to reflect the hardness of the vascular wall and the nature of the plaque more clearly than CT and MRI. CONCLUSION: At present, there is no unified standard of classification of cerebral infarction imaging. Detection of clinical super-acute cerebral infarction remains controversial due to its changes on imaging, lack of specificity, and its similarity to a space-occupying lesion. Neuroimaging diagno- sis for cerebral infarction remains a highly active area of research and development.     

小儿外伤性脑梗塞的早期诊断与治疗(附36例临床观察)

目的探讨小儿外伤性脑梗塞的诊断与治疗。方法对36例小儿外伤性脑梗塞进行临床观察及脑CT、MRI扫描。结果确切的头颈部外伤史，伤后抽搐、无严重意识障碍．1～6d后出现偏瘫、失语等临床表现，头颅CT、MRI检查可提高小儿外伤性脑梗塞早期诊断的准确性。结论小儿外伤性脑梗塞以基底节区多见。给予脱水，扩血管及神经保护剂、钙离子通道拮抗剂、激素等药物应用治疗预后良好。     

Magnetic resonance imaging of the brain and spine

Summary The efficacy of magnetic resonance imaging (MRI) in the diagnosis of diseases of the central nervous system is reviewed. MRI, computed tomography (CT) and certain radionuclide studies are compared in the evaluation of intracranial tumours, cerebral vascular disease, multiple sclerosis and other white matter diseases, dementia, head injury, infection, epilepsy, spinal lesions and in paediatric central nervous system disorders. The measurement of cerebrospinal fluid volumes and dynamics by MRI is discussed. MRI most clearly has advantages where CT is degraded by bone hardening and streak artefacts (spine, skull base, posterior and temporal fossa, sella and parasellar regions) and in diseases in which the X-ray attenuation of the suspected lesion differs little from normal parenchyma (paediatric brain disorders, demyelination and dysmyelination, early oedema associated with infarction, infection or low-grade infiltrating neoplasm, subacute and chronic haemorrhage and lesions in the spinal subarachnoid space and cord). Elsewhere MRI and CT should be seen as complementary rather than competitive methods of imaging. In spite of an absence of information about the contribution of MRI to management decisions and a lack of rigorous, prospective controlled trials, MRI will play an increasing role in the diagnosis of diseases of the central nervous system.     

CTA在外伤性脑梗死的早期诊断及预后判定中的作用

目的探讨CT血管造影（CTA）对外伤性脑梗死（PTCI）早期诊断及患者预后判定的作用。方法回顾性分析30例重型、特重型颅脑损伤并发PTCI患者的临床资料,均行常规头部CT及CTA动态检查。结果伤后CT诊断PTCI 10例,查出时间为伤后（49.5±9.2）h;CTA诊断PTCI 20例,检出时间为（27.7±5.3）h;两者检出时间差异显著（P〈0.05）。按GOS评分评估患者预后,CTA示动脉闭塞14例中,中残3例,重残3例,植物生存2例,死亡6例;CTA示颅内动脉穿支减少8例中,中残2例,重残2例,植物生存1例,死亡3例;CTA示静脉闭塞8例中,中残1例,重残2例,死亡5。结论 CTA可用于重型、特重型颅脑损伤并发PTCI的的早期诊断及预后判定。     

Antemortem diagnosis of Marchiafava-Bignami disease

Marchiafava-Bignami disease (M-B disease) is a peculiar disease, observed in hardened drinkers and resulting in demyelinization and necrosis of the corpus callosum. The clinical symptoms are diverse, and it is difficult to diagnose accurately while the patient is alive. Almost all reports in the past have been based on necropsy. Only three cases of M-B disease have been reported in Japan so far, none of which was based on a diagnosis while the patient was alive. We have been able to perform diagnosis of M-B disease while the patients were still alive by means of X-ray computed tomography (CT) and magnetic resonance imaging (MRI), and to study the clinical symptoms from the acute stage. In addition to the study on our own patients, we also conducted a neurosymptomatic study on the clinical symptoms of 6 cases, for which details of the symptomatology have been described-out of about 150 cases reported in the past. In the acute stage of M-B disease, we observed psychic symptoms, such as clouding of consciousness, mnemonic disorders and disorders and disorientation, or various frontal lobe symptoms, such as change in personality, raptus nervorum, dysphemia, pyramidal signs and astasia-abasia. These are non-specific symptoms and it is necessary to differentiate from encephalitis and other encephalopathy. In the chronic stage, dysphemia becomes sustained and, in addition, symptoms of transection of the corpus callosum are noted among the disorders of higher cerebral functions. If M-B disease is suggested from clinical symptoms, it is advisable to confirm the lesions in the corpus callosum by X-ray CT and MRI.(ABSTRACT TRUNCATED AT 250 WORDS)     

磁共振波谱在脑内肿瘤鉴别诊断中的价值研究

目的探讨磁共振波谱（MRS）在脑内肿瘤鉴别诊断中的应用价值。方法收集75例颅内占位性病变患者术前行磁共振波谱检查的临床资料,对其经临床手术、病理诊断证实的最终结果进行分析。结果MRS提示肿瘤72例,病理证实70例;脑脓肿1例,病理证实1例;MRS提示囊性占位2例。胶质瘤的MRS表现为NAA明显降低或降低,Cho升高,肿瘤周围脑组织呈类似改变;脑膜瘤的MRS表现为NAA消失或降低,Cho升高或明显升高,Cr信号降低,可见到Ala峰,肿瘤周围脑组织相对正常;转移瘤的MRS表现为Cho明显升高,NAA明显降低,而瘤旁脑组织MRS波形基本正常;淋巴瘤的MRS表现为肿瘤区域NAA降低,Cho升高或明显升高,并可见到Lip峰。结论MRS作为无创性的检测手段,对脑内肿瘤的鉴别诊断有较大的参考价值。     

Magnetic resonance imaging in pediatric neurologic disorders

We present our initial experience with magnetic resonance imaging (MRI) in 301 pediatric patients with a variety of neurologic disorders. MRI does not require ionizing radiation and can be done easily and safely in children. It is equal or superior to computed cranial tomographic (CT) scans in demonstrating most types of pediatric neurologic disorders. MRI is often superior to CT scans in demonstrating intracranial tumors, although both studies are usually abnormal in highly malignant tumors. No clear advantage was shown with either MRI or CT scans for fluid-filled intracranial lesions. Lesions of the brain stem and upper cervical region, such as Chiari malformation, are well delineated by MRI. Increased signal from the paranasal sinuses was frequently evident by MRI, but, in most instances, there was no clinical indication of sinus disease. Large arteries can be visualized as an area of diminished signal, and intracranial hemorrhage, dural sinus thrombosis, and cerebral infarction were demonstrated. The increased anatomic detail pictured by MRI allows the diagnosis of congenital defects, such as agenesis of the corpus callosum or septum pellucidum, that are not always apparent with CT scans. Although our experience with spinal cord lesions was not extensive, fluid-filled lesions within the cord can be reliably demonstrated.     

Moyamoya病的临床表现与影像学特点

目的 回顾分析12例Moyamoya病的临床和影像学特征，探讨Moyamoya病的影像学诊断价值。方法 分析12例Moyamoya病患的临床资料及数字减影血管造影(DSA)、磁共振血管造影(MRA)、磁共振成像(MRI)和CT结果。结果 所有病例均表现有颈内动脉或其分支不同程度的狭窄或闭塞和颅底异常血管网(MMD血管)；其中病变呈双侧8例．单侧4例。12例中头颅CT表现有梗塞灶4例，脑出血5例，其余3例表现正常。结论 除DsA外．MRI和MRA是两种可以很好评价Moyamoya病的影像学方法。若儿童或青壮年发生脑血管病，反复出现脑梗死或出现脑室出血、脑叶出血或蛛网膜下腔出血(SAH)则要考虑Moyamoya病的可能。