正常月经周期子宫及卵巢高场强磁共振成像

目的：探讨中国生育年龄妇女月经周期子宫及卵巢的高场强磁共振表现。材料与方法：Ｅｉｅｍｅｎｓ公司的１．５Ｔ磁共振仪,对有正常排卵月原２２例妇女进行标准和自旋回波序列Ｔ１、Ｔ２加权成像,测量子宫内膜厚度、卵巢体积及卵泡数目并观察子宫及卵巢信号的变化,结果：Ｔ１另权像上,子宫各层及卵巢均为无显著差别的中等信号;Ｔ２加权像上,子宫由内至外分为４层：高信号内膜层－低信号粘膜下层－中等信号肌氏信号浆膜层;卵巢     

Immature teratoma of the ovary: correlation of MR imaging and pathologic findings

The objectives of this study were to describe MR imaging findings of immature teratoma and to correlate imaging findings with histopathologic findings. The MR findings of ten patients (age range 12–29 years, mean age 19.0 years) with pathologically proven immature teratoma were retrospectively reviewed for tumor size, presence and characteristics of fatty content, presence and characteristics of solid components, and presence of ascites and implants. The MR findings were compared with gross (n=3) and microscopic (n=10) findings. Comparisons between relative amounts of solid components and histologic grades were evaluated by Spearman rank-order correlation. On MR images all lesions appeared to be fat-containing tumors with solid components consisting of numerous cysts of various sizes. Solid tissue exhibited a wide variety of signal intensities on T2-weighted images. Punctate foci of fat were identified in all lesions, whereas fatty fluid was observed only in two. Predominant fluid content exhibited signal intensities similar to simple fluid in nine lesions. Ascites was observed in six lesions, and peritoneal dissemination in three. Pathologic studies confirmed scattered foci of adipose tissue in the solid portions of all cases, and revealed numerous cystic structure formations in these solid components. The correlation coefficient between the amount of solid tissue and the tumor grade was not significant (r_s=0.266). The MR images of immature teratoma tended to show aqueous fluids and the solid components consisting of numerous cysts with punctate foci of adipose tissue, whereas predominant fluid is sebaceous fluid in the vast majority of mature cystic teratomas. Electronic Publication     

MR imaging of clear cell carcinoma of the ovary

Magnetic resonance imaging findings are reported for 12 pathologically proven lesions of clear cell carcinoma (CCC) of the ovary in 11 women (mean age 50 years). T1- and T2-weighted MR images were obtained in all patients, and gadolinium-enhanced MR images were obtained in 9. The mean diameter of the tumors was 13 cm. Seven patients presented with stage-I tumors. All 12 lesions consisted of cystic masses with solid protrusions occurring in 10 and solid masses in 2. The cysts were unilocular in 9 lesions and multilocular in 1. In four lesions, the cysts displayed with high intensity on T1-weighted images. Round solid protrusions were identified in 8 lesions. In 5 lesions, the number of protrusions was only a few. The solid portions of 5 masses had slightly high-intensity regions on T1-weighted images. The number of patients with ascites was three. Magnetic resonance imaging of CCC usually shows a unilocular large cyst with solid protrusions, which are often round and few in number. Such MR imaging findings suggest malignant tumor but are not specific. Received: 26 July 1999 Revised: 11 February 2000 Accepted: 10 August 2000     

子宫良性肿瘤的MRI检查和诊断

目的：分析各种子宫良性肿瘤ＭＲＩ 图像,探讨ＭＲＩ 在子宫良性肿瘤中的诊断价值。材料和方法：共收集本院１９９４ － １９９９ 年临床疑子宫良性肿瘤病人３９ 例。ＭＲＩ 检查在ＧＥ Ｖｅｃｔｒａ０ ．５Ｔ 和ＧＥｓｉｇｎａ Ｈｏｒｉｚｏｎ１ ．５Ｔ 超导成像仪上进行,采集矢状面ＦＳＥ Ｔ２ ＷＩ 像,横断面ＳＥ Ｔ１ ＷＩ 像和ＦＳＥ Ｔ２ ＷＩ 像,并对各种病变所致子宫和宫颈的位置、大小、外形与其各层结构变化进行仔细观察和分析,与手术病理对照,以确定ＭＲＩ 的诊断价值。结果：３９例ＦＳＥ Ｔ２ ＷＩ 图像均清晰显示子宫及宫颈诸层结构;矢状面更可清楚显示子宫位置和大小。３９ 例病变均经病理证实,２３ 例为子宫肌瘤,子宫形态均增大,连结层和内膜层可受压,其中１７ 例Ｔ１ ＷＩ 和Ｔ２ ＷＩ 上表现为低信号影,６ 例为低到高不均匀信号影。１２ 例为子宫腺肌瘤,Ｔ２ ＷＩ 上连结层结构不清及较低信号,且增厚。１ 例为纳氏囊肿,Ｔ１ ＷＩ 上为子宫颈后壁内低信号囊状影,边缘光滑,Ｔ２ ＷＩ 上为均匀高信号影。本组有１ 例多发性肌瘤出血ＭＲＩ 上被误诊为子宫腺肌瘤;有２ 例子宫浆膜下肌瘤似游离于盆腔内,而漏诊。结论：ＭＲＩ 横断面及矢状面ＦＳＥ Ｔ２ ＷＩ 能清晰显示     

卵巢良性肿瘤的MRI诊断与鉴别诊断

目的：探讨卵巢良性肿瘤典型与不典型的MRI征象,提高卵巢良性肿瘤诊断及鉴别诊断的水平。方法：搜集经手术和病理证实22例盆腔肿块,所有病例均行MRI平扫及增强检查,回顾性分析其MRI征象。结果：22例中,浆液性囊腺瘤10例,粘液性囊腺瘤8例,囊性畸胎瘤3例,卵巢纤维瘤1例。浆液性囊腺瘤表现为：囊壁薄且规则,无分隔或分隔薄且均匀。粘液性囊腺瘤表现为瘤壁和间隔厚薄不均匀;囊内信号不均匀。囊性畸胎瘤主要表现为瘤体内均见脂肪成分。结论：卵巢良性肿瘤由于组织成分不同,MRI表现具有一定的特征。     

前列腺增生和前列腺癌的MRI和MRS表现

目的　分析良性前列腺增生 (BPH)和前列腺癌 (PC)的MR和MRS的表现 ,探讨MRS在前列腺病变诊断中的价值。资料与方法　回顾分析经病理证实的 2 7例 (BPH 1 7例 ,PC 1 0例 )患者的临床资料及MRI和MRS所见。MRI分析指标为前列腺大小和形态、病变位置、信号特点和肿瘤侵犯程度。MRS观察枸橼酸盐 (Citr)和胆碱复合物(Cho)化学位移及其比值。结果　 1 2例 ( 1 2 / 1 7,70 .6 %)BPHT1 WI上前列腺不规则增大 ,呈均匀的低信号 ,5例( 5 / 1 7,2 9.4 %)前列腺大小、形态正常 ;T2 WI上前列腺中央腺体显著增大 ,与外周带高信号分界清楚 ,1 4例 ( 82 .4 %)增生腺体表现为多个大小不等的圆形低信号和高信号结节灶 ,3例 ( 1 7.6 %)表现为弥漫性低信号 ;MRS上Citr波峰升高 ,Citr/Cho比值增大。 1 0例PCT2 WI上高信号外周带内见局灶性低信号区 ;4例位于前列腺包膜内 ,6例前列腺包膜受累 ,3例侵犯精囊 ,2例侵犯血管神经束 ,1例侵犯膀胱 ,1例盆腔内见多个肿大淋巴结 ,部分相互融合成块。MRS上Citr峰明显下降 ,Cho峰升高 ,Citr/Cho比值明显下降 ,与BPH比较有显著性差异 (P <0 .0 5 )。结论　MRI能很好地反映BPH特点和判断PC包膜内、外受累 ;MRS能提供前列腺组织的代谢信息有助于鉴别PC和BPH。     

Imaging features of benign adrenal cysts

Benign adrenal gland cysts (BACs) are rare lesions with a variable histological spectrum and may mimic not only each other but also malignant ones. We aimed to review imaging features of BACs which can be helpful in distinguishing each entity and determining the subsequent appropriate management.     

颈椎生理曲度改变的X线表现及其临床意义

目的 分析颈椎生理曲度改变的X线表现及其临床意义.方法 125例临床怀疑颈椎生理曲度异常的病例均摄颈椎正侧位、双斜位片,摄片时患者头颈部体位为立位听鼻线平行于水平面.在颈椎侧位片上测量椎体前缘序列弧线的弧弦距.结果 在125例中,颈椎生理曲度轻度变直见于76例（60.8%）,颈椎生理曲度明显变直或消失32例（25.6%）,颈椎生理曲度呈节段性向后凸出13例（10.4%）,以及颈椎椎体间发生局限性偏移或错位4例（3.2%）.结论 颈椎生理曲度改变的X线表现,在排除外伤等其他因素后,可提示颈椎病的诊断.     

良恶性胸腔积液的CT特征

目的 分析良恶性胸腔积液及胸膜增厚的cT表现，探讨两者间的不同特点。方法 分析145例经临床及病理证实的良恶性胸腔积液（良性68例，恶性77例）的CT征象。结果 145例胸腔积液中有115例伴有不同程度的胸膜增厚，根据其形态的不同可分为6种类型（恶性4型，良性2型）。结论 仅凭胸腔积液的密度不能区别其良恶性，胸膜的增厚有鉴别诊断意义，恶性胸腔积液的特点为胸膜明显增厚，一般大于10mm，且厚薄不均匀。良性胸膜增厚较轻，多小于10mm，且均匀一致。     

MR features of fluid-fluid levels in ovarian masses

To evaluate retrospectively the frequency and imaging features of fluid-fluid levels (FFLs) in pathologically proven ovarian masses on magnetic resonance (MR) images. The authors reviewed the preoperative MR findings of 556 ovarian masses in 428 patients. Presence, numbers, and signal intensities (SI) of FFLs were analyzed. In non-teratomas, we assessed whether SI of the FFLs of benign masses and malignant neoplasms differed using the χ² test. FFLs were observed in 66 of 556 ovarian masses (11.9%) on MR images, fat-fluid levels were observed in 11 of 80 teratomas, and FFLs attributed to hemorrhage in 54 of 476 non-teratomas and one twisted teratoma. Non-neoplastic cystic lesions were most common non-teratomas to contain FFLs (27/197, 13.7%), followed by malignant neoplasms (23/177, 13.0%). Benign neoplasms rarely contained FFLs (4/102, 3.9%); those that did were commonly associated with complications such as torsion or inflammation. A hypointense supernatant layer together with a hyperintense dependent layer on T1-weighted images (T1WIs) was significantly more common in malignant neoplasms than in benign masses (P < 0.0001). FFLs occurred in various ovarian masses ranging from benign to malignant neoplasms on MR images. In non-teratomas, a hypointense supernatant layer and a hyperintense dependent layer on T1WIs may favor a diagnosis of malignancy.     

骨良性纤维组织细胞瘤的影像表现

目的:探讨骨良性纤维组织细胞瘤的影像学特征,提高对该病的诊断能力.方法:回顾性分析10例骨良性纤维组织细胞瘤患者的临床资料,其中8例行X线检查,6例行CT检查,4例行MRI检查.结果:本组骨良性纤维组织细胞瘤病灶,在X线片上表现为地图样溶骨性边缘整齐的骨质破坏,大部分有硬化缘.CT图像上密度类似于肌肉或比肌肉稍低;MR...     

Magnetic resonance imaging findings of endometrioid adenocarcinoma of the ovary

PURPOSE: We assessed magnetic resonance imaging (MRI) features and clinical characteristics of ovarian endometrioid adenocarcinoma. MATERIALS AND METHODS: A total of 31 patients with 39 surgically proven ovarian endometrioid adenocarcinomas were analyzed retrospectively. Histologically, 13 lesions in 12 patients arose from proven endometriomas (group A), and 26 lesions in 19 patients did not coexist with endometrioma (group B). The morphological pattern of the lesion on MRI was classified as a solid or a cystic type: A solid type was defined as a solid component occupying more than half of the lesion; and a cystic type was a cystic lesion with one or more mural nodules. RESULTS: Altogether, 11 lesions in group A were the cystic type on MRI, whereas 24 lesions in group B were the solid type (P < 0.0001). Among the 11 cystic-type lesions in group A, the cysts of 5 lesions were hypointense on T1-weighted images, and the cysts of 6 lesions were hyperintense on T1- and T2-weighted images without "shading." The nuclear grade was higher (P = 0.0028) and the clinical stage more advanced (P = 0.0018) in group B compared to group A. CONCLUSION: MRI of ovarian endometrioid adenocarcinomas revealed two types: a solid type and a cystic type. The lesions arising from endometriomas tended to be the cystic type on MRI and have a good prognosis. Preexisting endometrioma in this entity rarely showed "shading" on T2-weighted images.     

脑裂畸形的MR影像征象分析(附32例报告)

目的：探讨脑裂畸形的MR影像特征。方法：回顾性分析32例脑裂畸形的MR表现。结果：本组32例，共42例裂隙，融合型29侧，分离型13例，其MR影像表现为横贯一侧或双侧大脑半球并衬有灰质的裂隙，裂隙外侧端脑表面常见楔形缺损（36／42），其位置大多数在大脑半球凸面中部三分之一（29／42），裂隙内侧端脑室缘呈幕状突起（19／42）或突向脑室腔的灰质块（15／42），裂隙常与侧裂池相连（26／42），二者位置关系呈直线裂，直角型及锐角型三种类型，直角型最常见。绝大多数病例侧脑室扩大（29／32），其中17例对称性扩大。12例美丽 灶侧脑室扩大更明显，合并透明隔缺如28例，灰质异位11例，多微小脑回7例，结论：脑裂畸形的MR影像征象具有特征性，目前是诊断脑裂畸形的金标准。     

Differentiation between benign phyllodes tumors and fibroadenomas of the breast on MR imaging

Purpose

The purpose of this study was to determine the factors that contribute to the differentiation between phyllodes tumors (PTs) and fibroadenomas (FAs) on MR imaging.

Materials and methods

This retrospective study included 19 PTs and 18 FAs with ≥2 cm diameter. The presence or absence of a capsule and internal septum, the extent of lobulation, and the apparent diffusion coefficient (ADC) values were determined. The presence or absence of a cystic component, the time–intensity curve, and the signal intensity on delayed-phase contrast-enhanced T1WI were also evaluated in 31 patients (16 PTs and 17 FAs) who underwent a contrast-enhanced study.

Results

Cystic components were seen in 10 of the 16 PTs (63%) and in 4 of the 17 FAs (24%; P = 0.03). The PTs showed strong lobulation more frequently compared to the FAs (14/19 [74%] vs. 7/18 [39%], respectively; P = 0.04). Though there was no significant difference, PT tended to be heterogeneous more frequently on the delayed phase of the contrast-enhanced T1WI compared to the FA (11/16 [69%] vs. 7/17 [41%], respectively). No significant difference was found in the other findings.

Conclusions

Although PTs and FAs show similar MR findings, the presence of a cystic component, strong lobulation, and heterogeneity on delayed-phase contrast-enhanced T1WI suggests a PT.     

CT features of torsion of benign cystic teratoma of the ovary

PURPOSE: The purpose of this work was to evaluate the usefulness of CT scans for distinguishing torsed from uncomplicated benign cystic teratoma (BCT). METHOD: Retrospective analysis was performed in 14 torsed BCTs (14 patients) and in 23 uncomplicated BCTs (20 patients) for comparison. The features on CT scans were compared to the pathologic findings. RESULTS: CT findings indicating torsed BCT were the presence of eccentric wall thickening of >1 cm, peritumoral infiltration, and presence of enlarged solid tubal mass adjacent to the uterus (p < 0.05). CONCLUSION: The present study suggests that CT is useful in differentiating torsed from uncomplicated BCT. Although CT findings are not specific for some patients, detection of certain CT findings could increase the diagnostic accuracy.     

Massive edema of the ovary: High resolution MR findings using a phased-array pelvic coil

We report a rare premenarchal case of massive ovarian edema in which high resolution MRI findings more accurately reflected characteristic pathologic changes of this condition compared with CT and ultrasound. A potential role of MR in preoperative diagnosis of massive ovarian edema is suggested.     

The MRI appearance of the optic nerve sheath following fenestration for benign intracranial hypertension

Optic nerve fenestration is carried out in cases of severe benign intracranial hypertension. This study aimed to monitor the optic nerve sheath appearances and orbital changes that occur following this procedure. The eight patients were all female with an average age of 37.3 years and a range of 20–58 years. The duration of symptoms was 2–6 years. Symptoms included headaches, diplopia and visual obscurations. Examination revealed severe papilledema. All investigations, including MRI, biochemical and immunological tests, were negative. Patients had fenestration of a 2 mm × 3 mm segment of the medial aspect of the optic nerve sheath. Imaging was obtained with a 1 T MRI machine using a head coil. Coronal, axial and sagittal 3 mm contiguous sections using STIR sequences with TR 4900 ms, IT 150 ms and TE 60 ms were obtained. Five patients showed clinical improvement. The post-operative MRI findings in four of these included a decreased volume of cerebrospinal fluid (CSF) around the optic nerve sheaths and a localized collection of fluid within the orbit. There were no MRI changes in the three patients with no clinical improvement. Decreased CSF volume around the optic nerve and a fluid collection within the orbit may indicate a favorable outcome in optic nerve fenestration. Received 23 June 1997; Revision received 16 January 1998; Accepted 18 March 1998     

Adnexal torsion: MR imaging findings of viable ovary

We report a case of torsed ovarian cystic tumor, in which contrast-enhanced high-resolution MR images accurately contributed to the diagnosis of torsion despite the lack of symptoms and to the preoperative evaluation of viability of the edematous ovary. Accurate preoperative assessment by MR images and prompt conservative surgical approach succeeded in salvaging the involved ovary. Received: 18 February 2000; Accepted: 27 March 2000     

Arrhythmogenic right ventricular dysplasia: MR features

Arrhythmogenic right ventricular dysplasia (ARVD) is a heart disease characterized by a total or partial fat replacement of the myocardium. A total of 30 patients were studied with a suspected diagnosis of ARVD. Clinical criteria used for evaluation of ARVD were: (a) ventricular origin arrhythmias with a left bundle branch block configuration, (b) T-wave inversion in the anterior precordial leads, (c) ventricular kinetic alterations observed using echocardiography and angiography and (d) cardiac failure when there are no pathologies attributable to other heart diseases. All patients had serial EKG and echocardiography tests. One third of patients underwent angiocardiography; 7 of 30 had Holter; 7 of 30 had exercise test just to evaluate the effectiveness of the anti-arrhythmic therapy. All patients underwent MRI examination. The following MRI criteria were used: (a) high-intensity areas indicating the fatty substitution of the myocardium, (b) ectasia of the right ventricular outflow tract, (c) dyskinetic bulges, (d) dilation of the right ventricle and (e) enlargement of the right atrium. The diagnosis of ARVD was classified as highly probable for patients manifesting at least three positive criteria, probable with two positive criteria, dubious with one and negative in the absence of all criteria. Highly probable diagnosis of ARVD was made in 8 patients, probable in 4, dubious in 7 and negative in 11. The MRI technique is very effective in the assessment of ARVD. The MRI criteria may be helpful in the diagnosis of this condition. Received 9 August 1995; Revision received 27 December 1995; Accepted 16 July 1996