CT造影与MRI造影诊断肩关节SLAP损伤的比较

目的 探讨肩关节腔CT造影与MRI造影在临床诊断肩关节上盂唇由前向后损伤(Superior labral anteroposterior,SLAP)中的应用价值.方法 纳入自2017-01-2020-06疑似肩关节SLAP损伤68例,患者分别进行肩关节CT和MRI造影,以关节镜检查结果为标准,比较CT造影和MRI造影诊...     

肩袖损伤诊断中肩关节造影和MRI的敏感性和特异性比较

目的 通过随访分析,比较肩关节造影和ＭＲＩ诊断户袖部分和完全撕裂的敏感性和特异性。方法 对５３例怀疑有肩袖损伤（包括部分撕裂和完全撕裂）患者的术前关节造影和ＭＲＩ检查结果与术中发现进行比较分析。结果 肩关节造影、ＭＲＩ诊断肩袖部分撕裂的敏感性分别为７０％和８０％,特异性均为７５％。诊断肩袖完全撕裂的敏感性分别为８７％和９０％,特异性分别为１００％和７５％。结论 关节造影与ＭＲＩ诊断肩袖损伤敏感性无     

外展外旋位肩关节MR造影对Perthes病变的价值

目的比较肩关节MR造影处于外展外旋位（ABER位）与中立位对Perthes病变的诊断价值。方法由两名影像诊断医师独立回顾分析206例肩关节MR造影图像,每例患者均行中立位与ABER位检查,分析结果与肩关节镜手术相比较。计算肩关节MR造影中立位与ABER位评价Perthes病变的诊断敏感性和特异性,并采用McNemar检验进行统计分析。采用Kappa统计计算两名影像诊断医师评价的一致性。结果 206例患者中,35例证实为Perthes病变,60例前下盂肱韧带复合体正常。对于这95例,肩关节MR造影中立位评估Perthes病变的敏感性和特异性分别为65.71%～68.57%和95%～96.67%,ABER位则为88.57%～91.43%和91.67%～93.33%。肩关节MR造影ABER位的敏感性显著高于中立位检查（P〈0.05）。2名影像诊断医师的评价一致性极好（Kappa〉0.75）。结论肩关节MR造影ABER位可以明显提高Perthes病变的诊断敏感性。     

肩关节前方盂唇损伤的MRI和MR关节造影诊断

目的:探讨MRI和MR关节造影在肩关节前方盂唇损伤中的诊断价值,评估MR关节造影在鉴别肩关节前方盂唇不同类型损伤中的作用。方法:自2007年1月至2010年12月,对经肩关节MRI、MR关节造影诊断后进行关节镜手术治疗的153例肩部损伤患者的临床资料进行了回顾性分析。由1位骨骼肌肉系统影像学医生和1位运动医学医生共同阅片,得出一致的MRI和MR关节造影诊断,并与关节镜下结果进行比较。计算MRI和MR关节造影诊断肩关节前方盂唇损伤的敏感性、特异性和准确性。在MR关节造影下存在前方盂唇损伤的患者中,对其不同类型损伤进行分型,与关节镜下分型进行对比研究。结果:153例中,肩关节前方盂唇损伤78例,肩袖损伤67例,上盂唇从前到后(superior labrum anterior to posterior,SLAP)损伤8例,MRI和MR关节造影诊断肩关节前方盂唇损伤的灵敏度分别为80.8%和92.3%,特异度分别为89.3%和97.3%,准确度分别为85.0%和94.8%。78例关节镜下存在肩关节前方盂唇损伤的患者中,Bankart损伤39例,前方盂唇骨膜袖套样撕脱(ALPSA)损伤32例,Perthes损伤7例,MR关节造影正确诊断Bankart、ALPSA和Perthes损伤的灵敏度分别为84.6%、84.4%和57.1%。结论:MR关节造影较MRI诊断肩关节前方盂唇损伤的灵敏度、特异度和准确度更高,MR关节造影能在术前进一步明确盂唇损伤的类型,为确定术前计划提供依据。     

磁共振泌尿系造影技术在肾移植中的临床应用

目的 评价磁共振泌尿系造影技术对揭示肾移植术后尿路梗阻部位及原因的价值。方法 用重Ｔ２加权快速自旋回波（ＦＳＥ）序列和脂肪抑制技术作ＭＲ泌尿系成像２８例,原发病均为慢性肾炎尿毒症,均为首次移植。临床诊断急性排斥３例,移植肾肾功能延迟恢复１例,Ｂ超显示移植肾轻度积水２例,移植肾、输尿管中度积水３例,所有图像均作最大信号强度投影（ＭＩＰ）处理。结果 ２７例肾移植术后均清楚显示肾实质和泌尿系集合系统高质     

磁共振成像在肩袖损伤诊断中的应用——附100例临床结论分析

目的 通过对100例肩关节检查结果分析,讨论磁共振成像(MRI)对肩袖损伤诊断的作用.方法 回顾性研究2006年12月至2007年4月100例疑似肩袖损伤病人理学检查结果和MRI检查结论,并结合20例小切口开放肩袖修补术所见,比较两者对肩袖损伤诊断的作用.结果 对100例疑似肩袖损伤、Constant评分＜70分的病人行常规MRI检查,77例提示肩袖损伤(肌腱炎或肌腱断裂),7例肱二头肌长头腱损伤,8例肩锁关节炎,8例无明显影像学异常,临床诊断为"凝肩" .对20例肩袖损伤进行手术治疗,以术中所见分析术前不同理学检查和MRI检查对诊断肩袖损伤的作用.所有体检方式诊断肩袖断裂与否的特异性差,P＞0.05;MRI诊断肩袖断裂的特异性好,P＜0.05.结论 常规MRI检查对肩袖损伤的诊断具有重要作用,理学检查诊断肩袖损伤的灵敏度高,特异性差.理学检查结合MRI检查可提高肩袖损伤诊断的准确性,为临床制定治疗方案提供参考.     

磁共振胰胆管造影在阻塞性黄疸诊断中的应用

目的　评价磁共振胰胆管造影 (MRCP)技术在阻塞性黄疸诊断中的临床应用价值。方法　采用GE超导0 .5T ,Vectra 2磁共振成像仪 ,快速自旋回波 (FSE)重T2 加权扫描及最大强度投影 (MIP)重建图像 ,对 48例阻塞性黄疸患者作MRCP检查 ,所有患者均经手术证实。结果　各种病变的MRCP图像均有其特征性表达 ,MRCP对阻塞性黄疸的定位准确率为 10 0 % ,定性准确率为 93 .8%。结论　MRCP对阻塞性黄疸的诊断是一种有效、安全、可靠的方法。     

磁共振水成像尿路造影诊断输尿管疾病

1 临床资料 1997-06/2001-07采用磁共振水成像尿路造影(MRU)对45例有输尿管疾病患者进行诊断,男33例,女12例。年龄18～75(平均47)岁。血尿36例,腰部胀痛20例,有阵发性发作肾绞痛19例,有膀胱刺激症13例。45例病例中因不能耐受腹部加压,拒绝行IVP检查或逆行插管9     

肩关节造影在基层医院中的应用

肩关节软组织疾病，是引起肩痛、肩关节功能障碍的主要原因之一。在基层医院由于缺乏CT、MRI及关节镜等昂贵的仪器设备，对肩关节软组织疾病诊治的诊断相对困难。本院对６例肩关节疾病进行肩关节造影检查，这一方法简单、有效，适应基层医院推广应用。现报道如下。临床资料１．一般资料：本组患者６例，均为男性；年龄３９～６５岁，平均５３岁；病程１～５个月，平均３月。有外伤史４例，其中临床诊断为肩袖间隙分裂１例，肩峰下撞击症１例，冻结肩１例；肩外展３０～８５度，平均５２．５度；肩坠落试验阳性３例，疼痛弧征阳性１例，撞…     

磁共振成像及其尿路造影对输尿管疾病的诊断价值

目的探讨磁共振成像（MRI）及磁共振尿路造影（MRU）对输尿管病变的诊断价值。方法对114例临床怀疑输尿管疾病的患者行磁共振成像（MRI）及磁共振尿路造影（MRU）检查,所有病例均经手术、病理或输尿管镜检证实。结果 114例输尿管疾病包括：先天性异常15例,良性狭窄21例,输尿管结石36例,输尿管癌18例,外在性病变24例。MRU对输尿管病变的定性诊断准确率为81.6%（93/114）;与常规MRI结合,定性诊断准确率提高到92.1%（105/114）。结论 MRU对输尿管病变的诊断具有良好的效果,特别适用于IVP禁忌证和肾功能丧失者;与常规MRI结合,可提高输尿管病变的定性诊断准确率。     

Accuracy of shoulder joint injections with ultrasound guidance: Confirmed by magnetic resonance arthrography

BACKGROUNDIntra-articular glenohumeral joint injections are essential procedures for treating various shoulder disorders. Fluoroscopy-guided injections have been extensively used; however, they pose a risk of radiation exposure and are expensive and time-consuming. Recently, it has been suggested that ultrasound-guided injections are accurate and cost effective procedures.AIMTo evaluate the accuracy of ultrasound-guided glenohumeral injections using a posterior approach that is confirmed using magnetic resonance arthrography (MRA).METHODSThe study included 179 shoulders of patients with recurrent anterior instability (150 patients; 103 and 76 right and left shoulders, respectively; 160 males and 19 females; average age = 20.5 years; age range: 14-63 years) who underwent MRA for preoperative diagnosis. They were injected with 12 mL lidocaine (1%) using the ultrasound-guided posterior approach and then underwent magnetic resonance imaging. Two shoulder surgeons, except for the injector, evaluated the transverse relaxation (T2)-weighted images of axial planes and classified the intra-articular condition of injected contrast into three groups based on one of the three following scenarios: no leakage, injection into the glenohumeral joint without leakage; minor leakage, practical intra-articular injection with some leakage outside the posterior rotator cuffs; and major leakage, inaccurate injection with mass leakage without any contrast into the joint. The inter-rater reliability between two assessors was also evaluated by calculating Cohen’s kappa coefficient. The learning curve was assessed regarding the inaccurate injection rate by analyzing Spearman’s rank correlation coefficient.RESULTSOf the 179 injections, 163 shoulders (91.0%) had no leakage, 10 shoulders (5.6%) had minor leakage, and six shoulders (3.4%) had major leakage. In total, 173 shoulders (96.6%) were intra-articularly injected; thus, we could detect anterior labrum and capsular pathologies. Regarding the inter-rater reliability, the kappa coefficient was 0.925, indicating consistency in the evaluations by both examiners. Regression analysis of the inaccurate injection rate for assessingtechnical learning showed a logarithmic curve with a downward trend (R² = 0.887, P < 0.001). Three (50%) of the six inaccurate injections classified into “major leakage” were observed in the first 30 injections, indicating that the accurate injection showed a leaning effect.CONCLUSIONUltrasound-guided intra-articular glenohumeral injections using a posterior approach had high accuracy; however, injection accuracy depends on clinical experience.     

外伤性肩袖破裂的诊治方法

探讨外伤性肩袖破裂的诊治方法和效果。方法采用肩关节造影和核磁共振成像诊断２４例外伤后肩痛病例。非手术治疗４例,手术治疗２０例,行原肌腱附着区域肌腱－骨缝合固定。结果肩关节腔造影诊断１５例肩袖完全破裂。核磁共振成像诊断１６例岗上肌腱完全破裂,２例岗上－岗下肌腱完全破裂,６例岗上肌腱部分破裂。     

15例膝关节病变的MRI诊断

目的：探讨膝关节病变的MRI诊断及其临床应用价值。方法：对15例利用MRI诊断膝关节病变患者进行回顾性分析。结果：7例出现半月板异常信号，其中2例半月板水平状撕裂并囊肿；关节腔积液8例，有1例积血；韧带损伤1例；滑膜病变2例；神经鞘瘤囊变1例；骨髓水肿4例。结论：膝关节病变的MRI对显示膝关节软骨、韧带、关节囊等软组织有明显优越性，可作为膝关节病变术前诊断的首选方法。     

急性滑脱性髌股关节撞击症的认识与MRI诊断

目的 认识并定义急性滑脱性髌股关节撞击症，探讨其发病机制及MRI诊断。方法 回顾性分析自2001年5月～2002年7月，34例经MRI诊断的急性滑脱性髌股关节撞击症的MRI表现，并结合临床资料、X线片、CT及关节镜所见进行分析。从矢状、冠状及横断三个平面行MR扫描，扫描方法采用：(1)三维快速梯度回波序列(FE3D)T1及T2加权像．该序列可较好地显示关节软骨及软骨下骨的损伤程度；(2）脂肪抑制梯度回波反转恢复序列(STIR)PD加权像，该序列对骨及软骨损伤有非常高的敏感性；(3)脂肪抑制快速自旋回波反转恢复序列(TSHIRT)T2加权像，该序列可显示韧带损伤情况。结果34例外伤后膝关节MRI均显示髌骨内下部及股骨外髁前外侧部对应的软骨下骨质异常信号改变。表明为骨损伤．与关节镜相比，34例中MRI可见20例髌骨内下部软骨骨折．其中15例为骨软骨骨折；8例股骨外髁前外侧部软骨骨折，其中6例为骨软骨骨折；11例关节囊内可见游离软骨或骨软骨碎片影。27例MRI显示不同程度髌内侧支持带损伤，其中Ⅰ度8例，Ⅱ度12例，Ⅲ度7例。所有患者均可见关节积液，其中单纯积液6例，血性积液18例．脂肪血性积液10例。23例可见髌骨外侧半脱位，结论 急性滑脱性髌股关节撞击症拟定义为当膝盖节急性屈曲外翻时．髌骨在向外侧滑脱或脱位后再自行复位的过程中．髌骨内侧面与股骨外髁相互撞击或挤压．并随之产生的一系列膝关节各解剖结构的损伤，主要包括髌骨内侧面骨软骨损伤、股骨外髁前外侧部骨软骨损伤、髌骨脱位或半脱位、髌内侧支持带损伤，关节囊积液。MRI提高对该症的检出率，并可全面而准确地表现各解剖结构的损伤程度。     

Prebiopsy magnetic resonance spectroscopy and imaging in the diagnosis of prostate cancer

Introduction: Existing screening investigations for the diagnosis of early prostate cancer lack specificity, resulting in a high negative biopsy rate. There is increasing interest in the use of various magnetic resonance methods for improving the yield of transrectal ultrasound‐guided biopsies of the prostate in men suspected to have prostate cancer. We review the existing status of such investigations. Methods: A literature search was carried out using the Pubmed database to identify articles related to magnetic resonance methods for diagnosing prostate cancer. References from these articles were also extracted and reviewed. Results: Recent studies have focused on prebiopsy magnetic resonance investigations using conventional magnetic resonance imaging, dynamic contrast enhanced magnetic resonance imaging, diffusion weighted magnetic resonance imaging, magnetization transfer imaging and magnetic resonance spectroscopy of the prostate. This marks a shift from the earlier strategy of carrying out postbiopsy magnetic resonance investigations. Prebiopsy magnetic resonance investigations has been useful in identifying patients who are more likely to have a biopsy positive for malignancy. Conclusions: Prebiopsy magnetic resonance investigations has a potential role in increasing specificity of screening for early prostate cancer. It has a role in the targeting of biopsy sites, avoiding unnecessary biopsies and predicting the outcome of biopsies.     

MRI引导下肩关节穿刺造影

目的：探讨MRI引导下肩关节直接穿刺造影的方法及临床应用。方法：选取2008年4—10月间临床怀疑有肩袖损伤的患者40例（其中男29例,女11例;年龄22-70岁,平均35岁）,进行MRI引导下肩关节直接穿刺造影检查,对于肩袖结构及肌腱附着处、盂唇进行显示及诊断,所得结果与关节镜探查结果进行比较。结果：40例可疑肩袖损伤的患者中,28例经关节镜证实肩袖不同结构撕裂。MRI引导下肩关节造影清晰显示病变36例,造影剂外渗进入周围滑囊1例,关节腔内进入气体1例,无肩袖损伤2例。MRI平扫和造影检查共同诊断肩关节损伤26例,与关节镜结果一致。结论：MRI引导下前部直接穿刺肩关节造影是一种微创的显示肩袖损伤的检查方法,具有较高的准确率,可作为临床诊断肩袖损伤常规的检查方法。     

Giant bladder diverticulum due to previous bullet injury: Findings of gadolinium-enhanced magnetic resonance imaging

Non-obstructive acquired giant bladder diverticulum is rare. An 84-year-old man presented with difficulty in urination. Radiological examinations including pelvic magnetic resonance imaging, urethrocystography and urethrocystoscopy demonstrated a giant bladder diverticulum with normal infravesical urinary tract. The patient had a past history of gunshot bladder injury and underwent surgical removal of the bullet. The giant bladder diverticulum was thought to be associated with the injury or the operation.     

Patterns of cerebral injury in a series of infants with congenital diaphragmatic hernia utilizing magnetic resonance imaging

Background

Congenital diaphragmatic hernia (CDH) is a condition with significant mortality and respiratory morbidity. Long-term neurodevelopmental outcome is not yet well documented.

Methods

The authors examined all cases of CDH at their institution over a 12-month period and performed magnetic resonance imaging (MRI) of the brain postoperatively.

Results

Eight of 10 patients survived to have an MR brain scan. All 8 patients had cerebral injury detected on MRI, with a predominance of white matter and deep nuclear gray matter injury.

Conclusions

Cerebral injury detected with MRI is common in infants with congenital diaphragmatic hernia. The long-term significance of these MRI abnormalities is unknown, although the need for good long-term neurodevelopmental follow-up of infants with CDH is highlighted.