炎症性肠病的MRI进展

炎症性肠病（IBD）是一组病因不明的慢性炎症性肠病,包括克罗恩病（CD）和溃疡性结肠炎（UC）,常导致肠腔狭窄或穿透性肠损伤,其病程发展过程中需要经常评估疾病的活动性和并发症,以便制定正确的治疗方案。MRI软组织分辨力高,可以获得肠壁的动态信息,已应用于对IBD的检出、评估病变活动性、判断病变纤维化程度及鉴别CD与UC等。就MR小肠成像、扩散加权成像、动态增强MRI及磁化传递成像等在IBD中的应用进展予以综述。     

炎症性肠病研究新进展

炎症性肠病（IBD）指溃疡性结肠炎（UC）和克罗恩病（CD）,该二种病均以慢性过程、自动复发、病因未明为其特征.西方国家发病率较高,国内发病有上升趋势,为此,中华医学会消化学会于1978（杭州）、1993（太原）和2000（成都）分别召开了炎症性肠病专项研讨会,对其病因、诊断和治疗的规范进行了讨论.     

脑实质型脑囊虫病的MRI诊断

目的 探讨脑囊虫病的MRI表现及其诊断价值.方法 收集分析21例经临床、病理证实的脑实质型囊虫病患者,常规使用SE和FSE序列并获取轴、矢、冠位及增强扫描图像,分析其各期MRI片征象及病理基础.结果 21例患者中单发8例,多发13例,共计65个病灶.病灶主要分布于皮层及皮层下区.其中活动期5例,蜕变死亡期9例(早期3例,晚期6例),钙化期3例,混杂期4例.活动期MRI表现为囊性空腔和偏心头节,蜕变死亡期表现为"白靶征","多环、分层征",钙化是病灶治疗后转归.结论 MRI对脑虫病的定性、定位及定量具有很高的诊断价值.     

脑囊虫病的MRI诊断

目的：评价脑囊虫病磁共振表现。材料和方法：对9例脑囊虫病MRI回顾性分析。结果：9例中7例可见明显的囊虫结节，1例合并右大脑中动脉闭塞，1例合并蛛网膜下腔囊虫。另2例中，1例表现为白质脱髓鞘改变，1例表现为两顶叶肉芽肿样改变。结论：脑囊虫病分四型、四期。四型包括脑实质型、脑室型、软脑膜型及混合型。四期包括存活期、退变期、坏死期及钙化期。脑实质型MRI较具特征性，可见典型的囊虫结节，即圆形或类圆形、大小约1～10毫米的囊性病灶，其内有偏心或附壁的囊虫头节。存活期囊虫结节MRI表现为囊液T1WI信号与CSF相同，大部分可见偏心或附壁的头节，无囊壁可见，无明显水肿。退变、坏死二期MRI难于区分，此时表现为囊液T1WI信号略高于CSF并随病程延长而信号逐渐增高，囊壁逐渐增厚，一般无头节可见，增强可表现为环状及结节状强化，周围水肿明显。钙化期CT比MR优越。     

细菌与炎症性肠病

炎症性肠病（IBD）是一种病因尚不明确的慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎（UC）和克罗恩病（CD）。此病可能的病因有由基因决定的宿主易患性、肠道细菌的作用、自身免疫、环境因素等。肠道细菌的感染因素作为一种主要病因,虽尚未被证实,但已有许多研究表明,细菌是IBD的促发因素。近年的研究表明,     

细胞因子与炎症性肠病

炎症性肠病目前认为是由多因素相互作用所致,主要包括免疫、环境以及遗传等因素,而由活化的免疫细胞产生的细胞因子,在IBD发病机制中起的作用,越来越引起人们关注。本文对常见的促炎细胞因子、抗炎细胞因子及具有免疫调节活性的细胞因子进行综述。     

脑实质型脑囊虫病的MRI诊断

目的：探讨脑实质型脑囊虫病各期的ＭＲＩ表现。材料和方法：５４例经临床和ＭＲＩ诊断的脑实质型脑囊虫病患者。其中３０例做了增强扫描。分析其在各个病理阶段的ＭＲＩ表现。结果：活虫期４０例，变性水肿期４５例，肉芽肿期５例，钙化期４例。活虫期ＭＲＩ发现圆囊腔内带有偏心的头节，是ＭＲＩ诊断脑囊虫病的确切依据。结论：ＭＲＩ能清楚显示脑囊虫病在脑内病变的大小、范围、数目和部位。ＭＲＩ的准确分期为临床治疗提供有力的帮助。     

炎症性肠病临床、病理及影像学诊断研究进展

随着生活节奏加快、环境因素影响和饮食结构的变化,我国炎症性肠病的发病率近年呈持续上升趋势.临床医生对该病的诊断主要依靠内镜病理,但其敏感性、特异性和病人顺应性不高.随着影像技术的快速发展,多种无创伤性的影像诊断方法 正在成为炎症性肠病筛查和诊断的重要手段,对内镜和病理诊断起到了协同、补充的作用.     

线粒体脑肌病的MRI诊断价值

目的 探讨线粒体脑肌病的脑部MRI表现及其诊断价值。资料与方法 对13例线粒体脑肌病患者的临床、实验室及MRI表现进行回顾性分析。结果 13例头部MRI检查均显示异常,对病变的检出率为100％,主要MRI表现为3类：（1）大脑半球多发单侧或双侧病变（7例）,4例呈对称性,病变呈片状等长T1、长T2信号,以一侧或两侧颞顶枕时皮层和皮层下白质最常受累。（2）大脑半球皮层和深部灰质核团同时出现片状等长T1、长T2信号2例。上述两类脑内病变有5例合并脑萎缩。（3）脑实质信号正常,但有脑萎缩4例,其中桥脑、延髓及小脑萎缩3例,大脑半球、脑干、小脑萎缩1例。结论 MRI对线粒体脑肌病的脑内病变显示敏感且准确,对其早期诊断、指导治疗、判断疗效和提示预后具有重要价值。     

MRI in patients with inflammatory bowel disease

Inflammatory bowel disease (IBD) affects ≈1.4 million people in North America and, because of its typical early age of onset and episodic disease course, IBD patients often undergo numerous imaging studies over the course of their lifetimes. Computed tomography (CT) has become the standard imaging modality for assessment of IBD patients because of its widespread availability, rapid image acquisition, and ability to evaluate intraluminal and extraluminal disease. However, repetitive CT imaging has been associated with a significant ionizing radiation risk to patients, making MRI an appealing alternative IBD imaging modality. Pelvic MRI is currently the imaging gold standard for detecting perianal disease, while recent studies indicate that MRI bowel-directed techniques (enteroclysis, enterography, colonography) can accurately evaluate bowel inflammation in IBD. With recent technical innovations leading to faster and higher resolution body MRI, the role of MRI in IBD evaluation is likely to continue to expand. Future applications include surveillance imaging, detection of mural fibrosis, and early assessment of therapy response.     

炎症性肠病的MRI进展

炎症性肠病(inflammatory bowel disease,IBD)主要包括2种慢性肠道疾病,即溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD)[1].MRI可采用多平面、多参数、多序列成像方式,除可显示解剖学信息以外还能提供功能学参数,从而能更全面地诊断和评价IBD[1-2].另外,由于其检查无创、无电离辐射,十分适合作为IBD患者长期随访手段.本文就IBD的MRI研究进展进行综述.     

炎性肠病相关骨质疏松的影像学研究进展

骨质疏松症（OP）是炎性肠病（IBD）病人最常见的肠道外表现之一。双能X线吸收测量仪、CT、MRI以及定量超声等影像方法可以评估IBD病人的骨量、骨结构、骨髓脂肪以及骨强度变化,对IBD的诊断治疗及预后评估具有重要意义。就IBD相关OP的发病机制、影像学研究进展及其临床应用予以综述。     

Small bowel imaging of inflammatory bowel disease

The study of the small bowel (SB) has always been challenging both for clinicians and radiologist. It is a long and tortuous tube that can be affected by various pathologies whose signs and symptoms are usually non specific and can mimic other acute abdominal disorders. For these reasons, imaging plays a central role in the diagnosis of the different pathological conditions that can occur. They are important also in the management and follow up of chronic diseases. We expose and evaluate all the radiological methods that are now available for the study of the SB with particular emphasis on the technological improvement of cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI). These techniques have, infact, highly improved in terms of execution times (fast acquisitions images), patients discomfort and radiation dose, for CT, with consequent reduced biological risks. Moreover, the new post-processing options with multiplanar reconstruction and isotropic images have made significant changes in the evaluation of the exams. Especially MRI scans have been improved by the advent of new sequences, such as diffusion weighted imaging and cine-MRI, parallel imaging and breath-hold sequences and can provide excellent soft-tissue contrast without the use of ionizing radiations.     

CT of inflammatory bowel disease

Computed tomography (CT) provides an important perspective in patients with inflammatory bowel disease that often has a profound influence on the therapeutic decision-making process. By virtue of its ability to image the bowel wall, serosa, and mesentery directly and noninvasively, CT can diagnose infectious and inflammatory complications that often can only be inferred indirectly by barium studies and endoscopy.     

Radiological interventions in inflammatory bowel disease

INTRODUCTION: Abscesses, fistulas,hemorrhages and stenoses are common complications of inflammatory bowel diseases. This study provides an overview on various methods of radiological intervention and the clinical usefulness of these methods is analyzed. METHODS: The success rate of percutaneous abscess drainage (PAD), embolisation of hemorrhages and dilatation of bowel stenoses is reviewed and current literature is addressed. Success rate is defined in terms of cure rate and need for subsequent surgery. RESULTS: After PAD, surgery can be avoided during the observation period in about 50% of patients with abscesses due to Crohn's disease and diverticulitis. Preoperative PAD reduces the degree of invasiveness and thus the risk of surgery. Abscess recurrence is found with the same frequency following surgery or PAD. Bowel dilatation can be performed both with radiological and with endoscopic guidance.Embolisation of GI-hemorrhage is technically feasible, but the indication should be limited to strictly selected cases. CONCLUSIONS: In treating abscesses and fistulas associated with Crohn's disease and diverticulitis, PAD is a valuable treatment option. Embolisation or dilatation are restricted to rare cares.     

Malignancy complicating inflammatory bowel disease

There is now general agreement that both ulcerative colitis and Crohn's disease predispose patients to the development of malignancy. Many controversies still remain concerning the incidence of this complication as well as the diagnostic approach to be taken with these patients. This article reviews the topic and examines the contribution the radiologist can make in evaluating the patient with chronic inflammatory bowel disease.     

Thoracic manifestations of inflammatory bowel disease

OBJECTIVE: The purpose of this article is to present the spectrum of inflammatory bowel disease manifestations in the chest, including the airways, lung parenchyma, pulmonary vasculature, and serosal surfaces. CONCLUSION: The spectrum of inflammatory bowel disease manifestations in the chest is broad, and the manifestations may mimic other diseases. Knowledge of these manifestations in conjunction with pertinent clinical data is essential for establishing the correct diagnosis and treatment.     

Hepatobiliary complications of inflammatory bowel disease

A variety of biliary and hepatocellular diseases occur with increased incidence in patients with inflammatory bowel disease. These include fatty infiltration of the liver, cholelithiasis, pericholangitis-primary sclerosing cholangitis, cirrhosis, chronic active hepatitis, liver abscess, amyloidosis, granulomatous hepatitis, and bile duct carcinoma. Radiography is essential in accurate diagnosis.