基于深度学习模型实现颈椎MR图像上各结构的自动分割

【摘要】目的：探讨3D U-Net模型自动分割颈椎矢状面T1WI和T2WI图像上颈椎各结构的可行性。方法：回顾性搜集拟诊为颈椎病的92例患者的矢状面T1WI和T2WI图像资料,由两位影像医师在每例患者的2个序列图像上分别人工标注颈椎各结构,包括椎体、椎间盘、硬膜囊、脊髓和椎间孔。将178个序列的图像随机分为训练集（n=138）、调优集（n=20）和测试集（n=20）。采用训练集的数据训练3D U-Net分割模型,在调优数据集中微调参数,在测试集中采用定量指标（Dice相似系数,DSC）和定性指标（主观评分）评价模型的分割效能,并比较各结构的DSC值在3组内及3组间是否存在统计学差异。结果：在测试集中3D U-Net模型分割颈椎椎体、椎间盘、硬膜囊、脊髓和椎间孔的DSC值分别为0.87±0.03、0.85±0.04、0.87±0.04、0.82±0.05和0.57±0.08,分割颈椎各解剖结构的总体DSC值为0.80±0.13。各结构的DSC值在3组内及组间均有统计学差异（P＜0.001）。主观评价显示3D U-Net模型分割颈椎各结构获得的图像均符合临床测量要求。结论：基于矢状面T1WI和T2WI序列的3D U-Net模型对颈椎各结构的分割可达到较高的准确性。     

T2 mapping及IDEAL技术在腰椎间盘退变定量评估中的应用

目的 ：通过3.0 T MRI T₂mapping及非对称回波的最小二乘估算法迭代水脂分离(IDAEL)技术对腰椎间盘退变进行定量评估,为椎间盘退变准确诊断提供依据。方法：前瞻性选取40例下腰痛患者(160个椎间盘)行MRI腰椎间盘矢状位T₁WI、矢状位T₂WI、轴位T₂WI、矢状位T₂mapping成像,以及矢状位IDEAL序列扫描。在矢状位T₂WI图像及IDEAL水相图上对椎间盘行Pfirrmann分级,测量椎间盘髓核及前、后纤维环T₂值、水信号分数(WSF值),分析椎间盘退变与T₂值、WSF值的相关性。结果：160个椎间盘在矢状位T₂WI图像上行Pfirrmann分级,其中Ⅰ级28个,Ⅱ级49个,Ⅲ级45个,Ⅳ级22个,Ⅴ级16个;在IDEAL水相图上行Pfirrmann分级,其中Ⅰ级33个,Ⅱ级49个,Ⅲ级45个,Ⅳ级21个,Ⅴ级12个。矢状位T₂WI图像与ID...     

肺癌靶向治疗后脑膜转移的3D FLAIR增强扫描研究

目的 评价Cube FLAIR T₂WI增强扫描序列对非小细胞肺癌(NSCLC)患者经EGFR-TKIs治疗后出现脑膜转移(LM)的早期识别价值。方法 搜集经病理明确诊断肺癌且经过靶向药治疗后出现LM患者23例,均进行增强T₁WI、矢状面Cube T₁WI与矢状面Cube FLAIR T₂WI增强扫描。所获得扫描图像由2名MRI诊断医师分别盲法阅片分析,评价内容包括脑膜是否强化、LM部位(包括幕上脑浅表区、幕下小脑脑干区及全脑区)、图像质量评价。结果 23例均成功进行增强T₁WI、矢状面Cube T₁WI与矢状面Cube FLAIR T₂WI增强扫描,获得的图像可用于质量评估。增强T₁WI与增强Cube T₁WI相比有2例位于浅表区的病变未检测出(χ²=27.74,P=0.02),增强T₁WI与增强Cube FLAIR T₂W...     

利用深度学习实现CT图像上腰骶椎各结构分割及椎间盘自动定位的可行性研究

目的:探索使用3D U-Net深度学习模型在CT图像上进行腰椎各结构的自动分割及椎间盘自动定位的可行性。方法:回顾性搜集2020年12月1日-2021年3月29日于本院行腰椎平扫CT的患者影像图像,排除腰椎术后、脊柱畸形及骨转移的病例,共纳入了154个图像数据。手工标注腰骶椎各椎体、椎间盘及硬膜囊。按8:1:1比例将数据随机分为训练集(n=125)、调优集(n=14)和测试集(n=15)。利用3D U-Net分割模型进行训练,以医师手动标注结果作为参考标准,根据测试集Dice相似系数(DSC)、体积相似度(VS)和Hausdorff距离(HD)作为评价模型分割效能的指标。应用连通域分割算法进行腰椎各椎间盘定位,以医师判定为金标准,采用混淆矩阵评价模型识别各椎间盘的位置的定位效能。结果:测试集中3D U-Net深度学习模型对腰骶椎各结构分割结果DSC值、VS值均>0.96。模型识别各椎间盘位置的准确率达98.7%,模型预测与医师判定一致性高。结论:3D U-Net深度学习模型和可用于CT图像中腰椎各主要结构的自动分割并通过连通域算法实现椎间盘自动定位。     

脊椎、脊髓疾病的超声图象

作者研究了208例脊椎、脊髓疾病患者术中的超声影象特征及价值。其中颈椎病72例;颈椎椎间盘脱出5例;颈椎后纵韧带骨化42例;外伤(骨折等)7例;脑、腰椎椎间盘脱出12例;腰椎滑脱、狭窄27例;脊髓肿瘤42例。男129例,女79例,年龄14岁～72岁。在椎板切除、椎管减压术后或前入路减压术后能够直视部分硬膜时,使用7.5MHz 探头采用水浸法进行检查。结果见到,颈椎病与术前MRI 显示的脊髓变形、椎间盘脱出、骨棘的状态完全一致,减压术后脊髓形态复原。前方的硬膜常与后纵韧带粘连,为强回声,矢状面与椎体难以区别,横断面见椎体后面有隆起,与脊髓的关系明确。骨折、脱臼采用超声检查能观察脱臼或骨片压     

MRI定量技术对椎间盘退变突出的临床应用研究

目的 应用MRI水脂分离技术(Dixon)联合T₂WI定量测量腰椎间盘水含量,分析椎间盘水含量与年龄、椎间盘高度、椎间盘退变、椎间盘突出及其诊断效能的相关性。方法 搜集77例因下腰痛进行腰椎MRI检查,在T₂-Dixon序列经过后处理测得椎间盘水含量,同时在T₂WI矢状位序列正中层面测量椎间盘高度,对比Pfirrmann(Pm)分级,分析各节段椎间盘水含量与年龄、椎间盘高度、椎间盘退变、椎间盘突出的相关性。结果 椎间盘水含量与Pm分级具有显著相关性,随着分级的增高,椎间盘含水量逐渐下降。将每个节段椎间盘水含量进行两两相比,下位椎间盘水含量低于上位椎间盘,差异有统计学意义(P<0.05)。L_4/5、L₅/S₁椎间盘的高度变化与椎间盘退变程度分级有关;且年龄与椎间盘水含量呈负相关。结论 常规的T₂-Dixon序列测量的椎间盘水含量与椎间盘退变存在显著的相关性,对椎间盘突出具有较敏感的诊断效能,且低位椎间盘变性程度更高。     

腰椎曲度及下腰椎椎间盘高度MSCT负荷前后的比较

目的：对比分析负荷前后MSCT测量的腰椎曲度及下腰椎椎间盘高度变化并与立位X线片对照,检验自制腰椎应力器加压效果。方法：采用自制腰椎应力器对30例腰腿痛患者负荷前后各作一次MSCT扫描,并摄立位X线腰椎侧位平片。在负荷前后Topogram像、负荷前正中矢状面重组图及X线平片上分别测量Th12～S1相邻椎体间夹角、L1与S1夹角、腰椎椎体长度及下腰椎椎间盘高度。在正中矢状面重组图上沿椎间隙夹角平分线重组横轴面图像,测量L3～S1三个椎间隙平面硬膜囊面积并观察椎管内结构变化。结果：负荷前Topogram像与正中矢状面重建像及负荷后Topogram像与X线侧位片上Th12～S1相邻椎体间夹角、L1与S1夹角及腰椎长度、L3～S1椎间盘高度测量结果近乎相等,组间对应测量值比较差异无显著性意义。负荷后L3与L4椎体角显著增大（t=5.36,P〈0.01）,L4与L5、L5与S1椎体角无显著增大（t=2.59,P〉0.05）,其中L4与L5椎体角变化最小。负荷后仅L4-5椎间盘高度显著缩小（t=4.21,P〈0.05）,L3～S1各平面硬膜囊面积均显著缩小,腰椎长度缩短（t=2.37,P〉0.05）,椎间盘膨隆或突出更明显,黄韧带增厚,椎管内结构毗邻关系更密切。结论：自制应力器加压检查能有效模拟人体腰部直立位生理状态情形,对腰椎退变性病变早期诊断及病情的准确评价具有重要意义。     

腰椎退变性(假性)滑脱的CT诊断与鉴别诊断

目的研究腰椎退变性滑脱的CT特征,使之与腰椎峡部裂引起的真性滑脱鉴别。方法对80例无腰椎外伤史和腰椎椎弓峡部裂史腰椎退变性滑脱的CT资料作回顾性分析。CT扫描范围从滑脱椎体椎弓开始至下位椎体上缘,所扫层面与椎间盘平行。结果 CT扫描有以下特征:①椎间盘退行性改变。②椎骨和椎小关节退行性改变,腰椎椎体边缘骨质增生及腰椎骨质疏松,椎小关节面增生硬化、关节面下囊变、碎裂、关节间隙变窄或不对称和关节囊钙化;滑脱腰椎椎弓完整,椎体及附件整体向前(后)移位,向前滑脱时,滑脱椎体下关节突向前移位,其前缘几乎与下位椎体上椎小关节突前缘相平或超出下位椎体上椎小关节突前缘,关节方向向矢状方向转化。③椎管、椎间孔和侧隐窝狭窄。④终板双重轮廓。结论腰椎退变性滑脱有其CT特征,能与腰椎峡部裂引起的真性滑脱鉴别。     

腰椎滑脱的CT诊断及扫描基线的确立

目的;提高腰椎滑脱CT征象的认识及选择最佳显示的扫描基线。方法：31例分退变滑脱和真性滑脱对退变表现、崩裂滑脱表现和基线显示进行分析。结果：退变性滑脱、真性滑脱有椎间盘病变、硬膜囊受压、侧隐窝变窄、椎间孔变形等;真性滑脱有椎管及硬膜囊矢状径改变,椎间盘“假性滑脱”、“夹心征”、“叠椎征”;椎间孔扫描和峡部扫描需联合使用。结论：CT扫描不仅明确腰椎滑脱,而且可显示许多细小结构,鉴别退变滑脱和真性滑脱;CT扫描基线的灵活使用可获更多图像信息。     

脊柱结核与转移瘤的MRI鉴别诊断

目的:分析脊柱结核与转移瘤的MRI表现并探讨其鉴别诊断价值。材料与方法:选择经临床或手术病理证实的40例结核与36例转移瘤,采用SIEMENS 1.0T超导型磁共振仪,快速自旋回波序列,矢状、冠位、轴位T_1WI和T_2WI检查。结果:脊柱结核和转移瘤均表现有多个椎体骨质破坏,结核累及椎体附件较转移瘤明显少。转移瘤一般不伴有椎间隙的狭窄。结核压迫硬膜囊和脊髓主要是由于楔状变形的椎体后移及寒性脓肿的形成。转移瘤压迫硬膜囊和脊髓主要是由于塌陷椎体前后径的加大以及椎旁硬膜外转移灶从硬膜囊后方压迫所致。结论:脊柱结核和转移瘤均有各自的特征性MRI表现,注意观察受累椎体形态、椎间盘和附件是否受累、有无脓肿和对脊髓及硬膜囊的压迫情况有助于病变的诊断和鉴别诊断。     

Degenerative diseases of the lumbar spine. Comparison of the multiecho data image combination sequence with magnetization transfer saturation pulse versus lumbar myelography/postmyelographic computed tomography

Purpose: To compare a T2* weighted 2D spoiled gradient echo multiecho sequence (MEDIC) with magnetization transfer saturation pulse versus lumbar myelography and postmyelographic computed tomography (pCT). Material and Methods: 84 disk levels in 27 patients were examined. The vertebral bodies, intervertebral disks, neural foramina, cauda equina, ligamentum flavum, and narrowing of the spinal canal were investigated using an evaluation scale. In addition, the pCT and the MEDIC sequence were evaluated for assessing the narrowing of the neural foramina in a phantom study using a cadaver preparation of the lumbar spine. Results: A total of 28 disk herniations, 11 cases of osteophytes narrowing the spinal canal or the neural foramina, and 7 spinal canal stenoses were detected. The pCT was significantly better in visualizing the cauda equina. The MEDIC sequence was significantly superior in visualizing the extension of the ligamentum flavum. No statistical differences between either image modality were found concerning assessment of the narrowing of the neural foramina and the spinal canal, nor regarding evaluation of the vertebral disk and the vertebral body. Measurements of the phantom study showed that the MEDIC sequence did not overestimate narrowing of the neural foramina. Conclusions: The T2* MEDIC sequence has proved to be as accurate as pCT in evaluating osteophytes and narrowing of the neural foramina. In doubtful standard magnetic resonance imaging findings, this means that an additional axial T2* MEDIC sequence may be of value in reaching the same accuracy as pCT.     

腰部浅筋膜炎48例CT、MRI诊断结果分析

 目的 探讨CT及MRI在腰部浅筋膜炎诊断上的应用,进一步提高对腰部浅筋膜炎影像学表现的认识。方法 收集2018年1-12月经临床及影像学确诊的48例腰部浅筋膜炎患者的CT及MRI扫描结果,进行两种影像学检查的回顾性对比分析。其中男23例,女25例,年龄21～64岁,平均44岁。均行腰椎CT及腰椎MRI检查。CT检查常规行1 mm重建,并做矢状位MPR。MRI检查采用1.5T超导磁共振成像系统,扫描节段同CT,采集矢状位T₁WI序列、矢状位T₂WI序列、横轴位T₂WI序列及矢状位T₂_TIRM序列图像。结果 CT观察到异常37例,对腰部浅筋膜炎的检出率为77.1%,可见到腰部浅筋膜明显增粗呈网状、絮状,边界模糊不清;MR观察到异常48例,对腰部浅筋膜炎检出率为100%。MR上观察到片状型浅筋膜炎8例,条状型浅筋膜炎26例;积液型浅筋膜7例;混合型浅筋膜炎7例。结论 CT及MRI对腰部浅筋膜炎的诊断均有重要意义,其中MR可列为首选检查。     

脊髓马尾区神经鞘瘤的MRI诊断分析

目的:探讨马尾神经鞘瘤的MRI诊断价值。方法:回顾性分析18例经手术病理证实的马尾神经鞘瘤的MRI平扫和增强后的形态及信号特点,以及受累马尾神经的形态及信号特点。结果:18例马尾神经鞘瘤中16例为单发,2例为多发(共5个病灶),肿瘤长径平均30mm。14例位于硬膜内,肿瘤为圆形、卵圆形,相邻脊髓圆锥受压或马尾神经推压移位;3例跨硬膜内外生长,肿瘤为哑铃形,沿椎间孔向外生长,椎间孔扩大,椎体后缘压迫性骨吸收。1例位于硬膜外,肿瘤呈哑铃状,自椎管沿椎间孔向外延伸,相邻蛛网膜下腔受压变窄。病灶T1WI等或(和)低信号,T2WI等或(和)高信号,2例T2WI混杂斑点状低信号,13例内部见囊变区,增强扫描肿瘤呈明显均匀或不均匀强化,13例可见肿瘤上、下方或侧方有增粗强化的马尾神经。结论:MRI能清楚显示马尾神经鞘瘤的大小、形态、内部情况及与邻近马尾神经、硬膜囊的关系,对于临床诊断及制定手术方案具有非常重要的意义。     

腰椎峡部裂并脊椎滑脱的MRI表现及影像学比较

目的 :探讨MRI在腰椎峡部裂并脊椎滑脱症中的诊断价值。方法 :分析总结 5 3例腰椎峡部裂并脊椎滑脱症的传统X线片、CT、MR扫描表现并进行比较。结果 :传统X线平片表现为腰椎滑脱、峡部裂、局部骨质增生硬化 ;CT表现为峡部裂、局部骨质增生硬化、韧带肥厚、椎管狭窄及矢状径增大 (双管征 )、椎间盘变形 ;MRI表现为峡部骨髓信号连续性中断、局部骨质呈T1、T2 低信号、韧带肥厚、腰椎滑脱、椎间孔变形 (双叶征 )、神经根卡压、节段性椎管扩张和狭窄。结论 :MR扫描对腰椎峡部裂并脊椎滑脱症的诊断具有重要的临床应用价值     

Degenerative disc disease of the lumbar spine: a prospective comparison of fast T1-weighted fluid-attenuated inversion recovery and T1-weighted turbo spin echo MR imaging

OBJECTIVE: To compare fast T1-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted turbo spin-echo (TSE) imaging of the degenerative disc disease of the lumbar spine. MATERIALS AND METHODS: Thirty-five consecutive patients (19 females, 16 males; mean age 41 years, range 31-67 years) with suspected degenerative disc disease of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted TSE and fast T1-weighted FLAIR sequences. Two radiologists compared these sequences both qualitatively and quantitatively. RESULTS: On qualitative evaluation, CSF nulling, contrast at the disc-CSF interface, the disc-spinal cord (cauda equina) interface, and the spinal cord (cauda equina)-CSF interface of fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P<0.001). On quantitative evaluation of the first 15 patients, signal-to-noise ratios of cerebrospinal fluid of fast T1-weighted FLAIR imaging were significantly lower than those for T1-weighted TSE images (P<0.05). Contrast-to-noise ratios of spinal cord/CSF and normal bone marrow/disc for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P<0.05). CONCLUSION: Results in our study have shown that fast T1-weighted FLAIR imaging may be a valuable imaging modality in the armamentarium of lumbar spinal T1-weighted MR imaging, because the former technique has definite superior advantages such as CSF nulling, conspicuousness of the normal anatomic structures and changes in the lumbar spinal discogenic disease and image contrast and also almost equally acquisition times.     

基于MRI影像组学模型对食管癌淋巴结转移的预测价值

目的 探讨基于T₂WI及增强T₁WI序列MRI影像组学特征构建模型预测食管癌淋巴结转移的价值。 方法 回顾性收集经病理证实并行多模态MRI检查的食管癌病人120例，男89例，女31例，平均年龄（63.4±8.2）岁。将病人按7:3比例随机分为训练集84例和验证集36例。以手术病理为金标准将病人分为淋巴结转移阴性组（56例）和阳性组（64例）。采用A.K.软件基于T₂WI和增强T₁WI获取肿瘤兴趣区体积（VOI），提取影像组学特征并进行降维筛选，并采用Logistic回归分析法构建基于T₂WI、增强T₁WI、联合T₂WI+增强T₁WI序列的影像组学模型。2组间一般临床资料比较采用独立样本t检验和χ²检验。采用组内相关系数（ICC）分析2名医师获取VOI的一致性。采用受试者操作特征（ROC）曲线评估预测模型的诊断效能，计算其曲线下面积（AUC），并采用DeLong法比较不同模型的AUC值。 结果 淋巴结转移阴性和阳性组间病人的性别、年龄，肿瘤位置、病理类型及肿瘤长度的差异均无统计学意义（均P>0.05）。2名医师在T₂WI和增强T₁WI影像上获取VOI的一致性均较好（均P>0.8）。经筛选后，基于T₂WI、增强T₁WI、T₂WI+增强T₁WI联合序列获得的影像组学特征分别有5、6、9个。在训练集及验证集中联合模型的AUC高于增强T₁WI和T₂WI模型，且增强T₁WI模型的AUC高于T₂WI模型（均P<0.05）。 结论 基于MRI影像组学特征构建的模型对食管癌病人术前淋巴结转移具有良好的预测效能，且T₂WI+增强T₁WI联合模型较单序列模型的预测价值更高。     

Magnetic resonance imaging in the management of suspected spinal canal disease in patients with known malignancy

AIM: The aim of this study was to examine the spectrum of spinal canal disease in patients with known malignancy using magnetic resonance imaging (MRI). MATERIALS AND METHODS: One hundred and fifty-five patients underwent a total of 159 spinal MRI examinations over a three-year period. Patients were examined using a 1.0T magnet and a phased array surface spine coil. Sagittal T1 weighted spin echo and STIR sequences were routinely employed. Axial T1 and T2 weighted spin echo images were obtained at sites of identified pathology. Contrast enhanced sagittal and axial T1 weighted spin echo images were acquired when the unenhanced appearances did not correlate with the clinical findings or when the images suggested intradural or intramedullary disease. RESULTS: Malignant disease affecting the spinal cord or cauda equina was noted in 104/159 (65%) patients (extradural n= 78, intradural n= 20, intramedullary n= 7); one patient had evidence of both intradural and intramedullary deposits. Multiple levels of extradural cord/cauda equina compression were present in 18/78 patients (23%). The thoracic spine was the most frequently affected (74%). Bone elements were the major component of extradural compression in 11/78 patients (14%). Intradural metastases were multiple in 15/20 patients (75%). Four of the six solitary intramedullary metastases were situated in the conus medullaris. CONCLUSION: Magnetic resonance imaging of the entire spine is the investigation of choice in patients with known malignancy and suspected spinal canal disease. Contrast-enhanced images should be acquired when the unenhanced appearances do not correlate with the clinical findings or when they suggest intradural or intramedullary disease.Loughrey, G. J. (2000). Clinical Radiology55, 849-855.     

泌乳素分泌型垂体微腺瘤多模态MRI:3D VISTA T2WI与常规序列的比较

目的:探讨多模态MRI对激素分泌型垂体微腺瘤的诊断价值。方法:将147例临床确诊的高泌乳素血症患者纳入研究,所有患者行垂体常规序列平扫和增强扫描(冠状面T₁WI、T₂WI和增强前后矢状面T₁WI)、冠状面动态增强扫描及增强后3D容积采集快速自旋回波(VISTA)序列T₂WI。将每例患者的MRI图像按照序列进行组合,得到3组图像集,A组包括常规序列平扫+增强扫描(动态增强扫描和常规增强扫描),B组仅包括增强后3D-VISTA T₂WI,C组包括所有序列的图像(A+B)。由3位放射科医师分别对3组图像进行阅片分析,采用McNemar检验比较3组中对泌乳素分泌型垂体微腺瘤的检出效能。结果:单独3D-VISTA T₂WI序列对垂体微腺瘤的检出结果与金标准(临床诊断结果)间的差异有统计学意义(P=0.000),平扫+增强MRI(A组)及其联合增强后3D-VISTA T₂WI(C组)对垂体微腺瘤的诊断结果与金标准(临床诊断结果)间的差异无统计学意义(P=0.245;P=0.109)。A组对垂体微腺瘤的诊断敏感度和特异度分别为49%(34/69)和68%(53/78),B组分别为46%(32/69)和97%(76/78),C组分别为88%(61/69)和97%(76/78);平扫+增强序列结合增强后3D-VISTA T₂WI的综合影像组(C组)显示出更高的敏感度和特异度。结论:对于高泌乳素血症患者,增强后3D-VISTA序列T₂WI作为常规MRI序列的重要补充,可明显提高诊断的敏感性及阴性预测值,该序列联合平扫+增强序列在诊断泌乳素型垂体微腺瘤方面具有重要价值。     

Bestrahlungsplanung rückenmarksnaher Tumoren unter Zuhilfenahme der CT-Myelographie

BACKGROUND AND AIM: Artifacts due to metal implants are an important problem in diagnostic radiology and radiotherapy planning in tumors such as chordoma of the spine. A strict differentiation between target and radiosensitive structures e.g. spinal cord is absolutely essential for high-dose radiotherapy. Up to now CT and MRI techniques have provided only limited image quality in such situations. We introduce an approach to facilitate segmentation by using the technique of CT-myelography for radiation treatment. PATIENT AND METHOD: A 48-year-old woman with multiple inoperable relapses of a chordoma in the lumbar spine and extensive metal instrumentation in this area was given to radiotherapy using IMRT-technique (intensity modulated). MRI- and CT-planning images did not allow differentiation between myelon, cauda equina, dural sac and tumor. In this situation we performed a CT-myelography with the patient in treatment position. RESULT: CT-myelographic images enabled precise differentiation between myelon, cauda equina and intraspinal tumor. A substantial improvement of the segmentation of the spinal cord was obtained. There was no compression of the dural sac along the spine. This information provided the basis for a precise radiotherapy planning in IMRT-technique. CONCLUSION: In situations where CT- and MRI-techniques are not able to generate precise images which allow differentiation between tumor, myelon and cauda equina because of metal artifacts, CT-myelography is a promising technique which may help the diagnostic radiologist and radiation oncologist in planning radiotherapy.     

骨质疏松与恶性骨质破坏致椎体压缩性骨折的CT磁共振成像影像特点及鉴别诊断

目的 探究采用CT、磁共振成像(MRI)鉴别诊断骨质疏松与恶性骨破坏导致的椎体压缩性骨折的临床疗效.方法 选择2019年12月至2020年12月经临床诊疗证实为骨质疏松及恶性骨质破坏致脊椎骨折的患者76例,分为2组:A组(骨质疏松改变并伴有压缩性骨折,36例),B组(恶性骨破坏致压缩性骨折,40例).对比2组患者椎体、...