磁共振成像在法洛四联症术后随访中的应用价值

目的评价磁共振成像(MRI)在法洛四联症(TOF)术后随访中的应用价值。方法在71例TOF根治术后患者的随访中应用MRI进行检查,扫描序列包括真稳态进动快速成像序列(FIESTA)、相位对比技术(PCMR)和血管增强(CE-MRA)。结果 71例患者中,CE-MRA诊断肺动脉分支狭窄44例(62.0%),其中左肺动脉狭窄29例(40.8%),右肺动脉狭窄4例(5.6%),同时伴有左肺动脉和右肺动脉狭窄11例(15.5%)。FIESTA序列测得右心室舒张末期容积为(115.28±15.18)mL/m2。38例应用PCMR法测量肺动脉血流的患者均存在肺动脉瓣反流,反流分数为(42.12±16.30)%,其中14例(36.8%)肺动脉重度反流(反流分数>40%);在无肺动脉分支狭窄患者中,左肺动脉的反流分数明显高于右肺动脉[(57.70±21.99)%vs(30.32±13.44)%](P<0.01)。33例患者的二尖瓣和三尖瓣血流测量应用PCMR法,结果有18例(54.5%)存在三尖瓣开放延迟于二尖瓣;但三尖瓣开放延迟和无三尖瓣开放延迟患者中,在肺动脉瓣反流分数、右心室舒张末期容积和射血分数上差异均无统计学意义(...     

癫痫脑缺省模式网络改变的功能磁共振成像研究进展

脑缺省模式作为人脑的内在系统,在维持正常内省、认知、片段记忆等起重要作用.各种慢性脑部疾病均能引起脑缺省模式的改变,癫痫发作除可引起脑内异常激活外,对缺省模式网络也会产生影响.文中就静息人脑缺省模式网络的特点、癫痫与负激活、癫痫与脑缺省模式网络的关系进行综述.     

精神分裂症患者手术治疗前后海马磁共振质子波谱成像的研究

目的 探讨精神分裂症患者海马磁共振质子波谱(MRS)的变化特点以及立体定向手术治疗对海马磁共振质子波谱的影响.方法 应用磁共振质子波谱成像技术,对20例正常人和20例精神分裂症患者在手术治疗前、后检测双侧海马NAA/Cr和CHO/Cr的比值并进行统计分析.结果 患者组在手术治疗前的NAA/Cr值低于正常对照组,患者组在手术治疗前的CHO/Cr值高于正常对照组(P<0.01).患者组行手术治疗前与手术治疗后6个月时其双侧海马的NAA/Cr和CHO/Cr比值无显著差异(P>0.05).结论 精神分裂症患者的海马可能存在神经元的损害和细胞膜的代谢异常,立体定向手术对精神分裂症患者的细胞膜代谢无显著影响.     

Changes in Ca2+-ATPase in a guinea pig endolymphatic hydrops model

ObjectiveTo investigate the localization of Ca(2+)-ATPase (Ca(2+) pump) in the cochlear and its change afterendolymphatic hydrops, and to study the relationship between compound action potential (CAP) threshold and the Ca(2+)-ATPase activety.MethodsThe left endolymphatic sac was ablated to induce endolymphatic hydrops in fourteen healthy guinea pigs with normal action potential thresholds measured after asliver ball electrode placed on the round window.Ca(2+)-ATPase activity was studied cytochemically using a lead citrate reaction in control and hydropic ears.The reaction product was lead phosphate particles as an expression of Ca(2+) -ATPase activity, observed with an eletron microscope.ResultsCa(2+)-ATPase activity is mainly found on the endolymphatic surface of Reissner’s membrane, the stereocilia and cuticular plate of inner and outer hair cells, and along the infolded plasma membrane ofstrial marginal cells.CAP thresholds of filtered click are increased and Ca(2+)-ATPase activity significantly decreased after endolymphatic hydrops in the mentioned locations.ConclusionsCAP thresholds are increased and Ca(2+)-ATPase activity are significantly decreased in the cochlea after endolymphatic hydrops.These results suggest that there is a negative correlation between them.      

脑卒中后失语症患者功能磁共振成像研究

目的 通过多模态磁共振分析脑卒中后失语症患者语言功能区的血流量及代谢改变,阐明失语症的机制,为临床失语症的治疗、预后及康复训练提供理论依据.方法 选取2018年10月至2019年10月就诊于牡丹江医学院附属红旗医院神经内科脑梗死后失语患者,按《西方失语症成套测验》判断所有失语患者类型,共纳入35例脑梗死后失语患者,其中...     

磁共振弥散张量成像在脑胶质瘤手术前后的价值

目的探讨磁共振弥散张量成像在脑胶质瘤手术前后的价值。方法回顾性分析2010年5月~2013年10月我院收治的20例脑胶质瘤患者及20例来我院进行健康体检的健康人并进行MRI及DTI检查。分析低级别胶质瘤及高级别胶质瘤与相邻脑白质纤维束的解剖关系及临床症状的评价,比较高级别胶质瘤患者胶质瘤病灶区、灶周水肿区及正常白质区的MD值、FA值。结果低级别胶质瘤(Ⅰ~Ⅱ级共13例)推移相邻脑白质纤维束,手术效果较好,切除充分,患者的临床症状在术后较术前均明显改善。高级别胶质瘤(Ⅲ~Ⅳ级共7例)浸润、破坏相邻脑白质纤维束,患者的临床症状在术后较术前改善不明显。三个区域的MD值由高到低依次为:胶质瘤病灶区、灶周水肿区、正常白质区,差异有统计学意义(P<0.05),胶质瘤病灶区MD值高于灶周水肿区,但无统计学意义(P>0.05)。FA值由高到低依次为正常白质区、灶周水肿区、胶质瘤病灶区,有统计学意义(P<0.05)。结论 DTI技术对手术方案的制定、手术切除范围的判断均有积极的作用,并且对手术风险的评估及患者疾病预后的预测也有重要的作用。     

功能磁共振对脑梗死后出血性转化的预测

目的探讨功能磁共振在脑梗死患者出血性转化中的预测价值。方法对44例脑梗死患者进行队列研究。所有患者均进行弥散加权成像（diffusion-weighted imaging,DWI）及灌注加权成像（perfusion-weighted imaging,PWI）检查。患者根据有无溶栓分为溶栓组20例,非溶栓组24例;根据有无出血性转化（hemorrhagic transformation,HT）分为HT组13例,非HT组31例。比较各自临床及功能磁共振上的特点。结果 44例患者中,发生HT的患者共13例,占29.5%。其中溶栓组发生HT 8例,占40%。保守治疗组发生HT 5例,占20.8%。溶栓组PWI上相对局部脑血容量值（relative regional cerebral blood volume,rrCBV）较非溶栓组降低,差异有统计学意义（P=0.037）。HT组入院时血糖、DWI上病灶体积、最低ADC值异与非HT组差异有统计学意义。结论脑梗死后HT是一个常见的并发症,溶栓治疗后发生率增加,功能磁共振可以预测溶栓后HT。     

社区人群说谎的功能磁共振研究

目的 探讨社区人群与说谎有关的认知模式及神经联系.方法 对社区志愿者进行说真话及说谎条件下的功能磁共振扫描.使用SPM2软件分析受试在两条件下脑区激活的差异.结果 说谎任务对比说真话任务,受试双侧背外侧前额叶、额内侧回、顶下小叶、右颞下回及小脑激活显著增加.结论 大脑的特定区域参与说谎或说真话,并能被功能磁共振成像(fMRI)检测到.     

早期类风湿关节炎的磁共振改变及其在诊断中的价值

目的探讨核磁共振检查在早期类风湿关节炎诊断中的意义.方法对42例疑似早期类风湿关节炎患者同时行MRI、X-ray及常规血清检查.结果 95.3%患者出现MRI改变,关节积液18例(其中2例合并骨髓水肿),关节软骨水肿、变性、破坏8例,骨侵蚀、关节间隙狭窄5例,骨髓水肿4例,韧带及副韧带增厚3例,腱鞘膨大积液6例.结论 MRI有助于早期类风湿关节炎的诊断,是一种比X线更敏感的检测方法.     

Cardiac magnetic resonance imaging

Recent advances in technology have allowed magnetic resonance imaging to be exploited in cardiology. It is capable of giving high definition structural and functional information. The current applications of this technique and how it may develop in the future are reviewed.     

Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele

CONTEXT: Hindbrain herniation occurs in a large percentage of children with myelomeningocele and is the leading cause of death in this population. The effect of early fetal closure of myelomeningocele on hindbrain herniation is unknown. OBJECTIVE: To determine whether early fetal closure of myelomeningocele affects hindbrain herniation. DESIGN: Case series of patients undergoing fetal myelomeningocele closure with serial measurements of hindbrain herniation and a mean follow-up of 182 days. SETTING: Tertiary care medical center. PARTICIPANTS: Ten patients undergoing fetal myelomeningocele closure at 22 to 25 weeks' gestation between March 1998 and February 1999. MAIN OUTCOME MEASURES: Need for shunt placement; degree of hindbrain herniation (grades 0-3) found on magnetic resonance imaging (MRI) performed prior to surgery and 3 and 6 weeks after fetal surgery, as well as shortly after birth; gestational age at delivery. RESULTS: All initial fetal MRI scans performed at 19 to 24 weeks' gestation showed significant (grade 3) cerebellar herniation and absence of spinal fluid spaces around the cerebellum. Six fetuses were delivered electively at 36 weeks' gestation after lung maturity was established. The other 4 were delivered prematurely, at 25, 30, 30, and 31 weeks of gestation, and the 25-week gestation neonate died. All 9 surviving neonates showed improvement in the hindbrain hernia at the 3-week postoperative fetal scan (grade 2, n = 4; grade 1, n = 5). On the postnatal scan, all patients showed grade 1 hindbrain herniation. Only 1 patient required placement of a ventriculoperitoneal shunt. CONCLUSION: In this series of patients, fetal myelomeningocele closure resulted in improvement in hindbrain herniation as demonstrated by serial MRI scans.     

磁共振多序列成像在三阴性乳腺癌新辅助化疗后保乳手术中的应用

目的 比较磁共振多序列成像与超声体表定位在三阴性乳腺癌(TNBC)患者接受新辅助化疗后保乳手术中的应用效果.方法 选取2018年10月至2020年10月该院确诊的TNBC患者124例,均接受新辅助化疗(多西他赛联合卡铂),采用随机数字法分为对照组和观察组,每组62例.对照组采用超声体表定位法,观察组采用磁共振多序列成像(T1 WI、T2 WI、DWI、T2 WI/SPAIR、DCE等)确定保乳手术切除范围.比较两组患者术前评估肿瘤最大径、肿瘤/乳房体积比,以及与实际手术切除肿瘤体积吻合率、切缘阴性率、手术时间、并发症发生率等.结果 与对照组比较,观察组患者术前评估肿瘤最大直径、肿瘤/乳房体积比均缩小,实际手术切除肿瘤体积吻合率、切缘阴性率均提高,差异均有统计学意义(P<0.05);两组患者手术时间、并发症发生率比较,差异均无统计学意义(P>0.05).结论 MRI多序列成像可为TNBC新辅助化疗后保乳手术提供更准确的切除范围.     

Nuclear magnetic resonance imaging in medicine

Using the technique of nuclear magnetic resonance (NMR, MR, MRI), the first images displaying pathology in humans were published in 1980.¹ Since then, there has been a rapid extension in the use of the technique, with an estimated 225 machines in use in the USA at the end of 1985.² Considerable enthusiasm has been expressed for this new imaging technique,³ although awareness of its high cost in the present economic climate has led to reservations being expressed in other quarters.² The aim of this article is to give an outline of the present state of NMR, and indicate some possible future developments.     

磁共振扩散谱成像

磁共振成像技术(magnetic resonance imaging,MRI)通过探测水分子的扩散特征能获取生物组织的物理特征和微观结构,进而提供生物学和临床医学信息,具有无创、无须使用外源性对比剂等优点~[1].     

夹型硅胶在内淋巴囊引流术中的应用

目的：探讨应用夹型硅胶内淋巴囊引流术治疗梅尼埃病的方法和疗效。方法：对12例梅尼埃病患者于显微镜下行内淋巴囊引流术，置入夹型硅胶，术后随访1年6个月至4年8个月。结果：按疗效评定标准，A级3例，B级5例，C级3例，D级1例。有效率91．67％。结论：夹型硅胶内淋巴囊引流术治疗梅尼埃病能保证引流通畅，保留听力。     

重型颅脑损伤后脑干病变的早期核磁共振表现

目的：本探讨重型颅脑损伤后脑干病变的早期核校对共振（MRI）表现。评价颅脑损伤后早期行MRI扫描的价值。方法：对61例重型颅脑损伤后7天内的患进行了MRI检查，同时还做了早期电子计算机体层扫描（CT）采用MRI批描来判定病变的形态学特征；而采用体感诱发电位（SEPs)和听觉诱发电位（BAEOs)来判定脑干功能。结果：39例患（占64%）发现有脑干病变，双侧桥脑病变（100%）死亡，非脑干病变死亡率为9%。在个别情况下，原发性和继发性脑干病变之间有着典型的临床区别。在MRI影像学上，伤后2天以上的所有病变都会出现高信号和1或低信号改变；伤后2天内，原发性病变在MRI影像学上呈低信号改变，而1例继发性脑干病变在MRI影像学上则无出血表现。结论：早期MRI扫描对判断脑干病变具有很大的价值。