MRI对眼眶横纹肌肉瘤的诊断价值

目的 探讨MRI对眼眶横纹肌肉瘤(rhabdomyosarcoma,RMS)的诊断价值.资料与方法 回顾性分析28例经手术病理证实的眼眶RMS患者的MRI表现.结果 28例中胚胎型21例,未作病理分型7例.均行MRI.病变位于肌锥内间隙23例,肌锥外间隙5例.11例原发,17例术后复发.肿瘤形态多较规则,边界尚清.21例病变较大,挤压视神经及眼球,造成视神经及眼球移位.T1WI上24例较眼外肌呈中等偏低信号,4例呈稍高信号.T2WI上信号强度略高于眼外肌,26例低于眶内脂肪.脂肪抑制序列上呈高信号.结论 眼眶RMS在MRI上有一定的信号特点,而且MRI可以清楚地显示病变范围及其与眶内周围组织的关系,对于眼眶RMS的诊断有重要意义.     

眼眶横纹肌肉瘤30例MRI表现

横纹肌肉瘤（rhabdomyosarcoma）是儿童时期最常见的一种软组织肉瘤,但发生于眼眶者少见[1],影像表现报道则更少[2-5].为了加深影像科、眼科医师对本病的认识及提高术前诊断准确率,笔者将本院2008-05至2013-09收集的眼眶横纹肌肉瘤30例磁共振成像（magnetic resonance imaging, MRI）表现做一总结分析.     

儿童头颈部横纹肌肉瘤的影像表现

目的：探讨儿童头颈部横纹肌肉瘤的影像学表现。方法：回顾性分析15例经病理证实的儿童头颈部横纹肌肉瘤的影像学资料,其中13例行MRI检查,2例行CT检查。结果：15例患儿中,10例肿瘤位于鼻腔及鼻旁窦,1例位于鼻咽及口咽,1例位于右耳,1例位于左侧颞下窝,1例位于右颈部,1例位于左上牙龈。肿瘤形态多不规则,T1wI呈等或稍低信号,T2w1呈稍高信号,信号多不均匀,其中3例见出血,2例见坏死,均无钙化,MRI增强扫描呈不均匀明显强化,5例肿瘤内见多发小环状强化,2例CT增强扫描呈不均匀轻度强化。4例肿瘤侵犯颅内,3例侵犯眼眶,9例侵犯周围骨质结构。结论：儿童头颈部横纹肌肉瘤好发于鼻腔及鼻旁窦内,平扫无明显特异性,MRI增强扫描肿瘤内多发小环状强化具有一定的特征性,结合患者发病年龄及发病部位,可以提示诊断。     

前列腺横纹肌肉瘤的MRI表现(附2例分析)

横纹肌肉瘤是儿童前列腺、膀胱、阴道最常见的恶性肿瘤,占15岁以下儿童恶性肿瘤的4%～8%,其中前列腺横纹肌肉瘤最为多见.前列腺横纹肌肉瘤的MRI表现少见有文献报道.本研究收集2例前列腺横纹肌肉瘤患者的临床及MRI资料,结合文献资料探讨其MRI表现.     

MRI扩散加权成像ADC值在子宫肉瘤诊断中的应用价值

目的 探讨MRI扩散加权成像(DWI)表观扩散系数(ADC)值在子宫肉瘤诊断中的应用价值.方法 回顾性分析24例(包括3例平滑肌肉瘤、5例子宫内膜间质肉瘤、4例腺肉瘤、12例癌肉瘤)经手术病理证实的子宫肉瘤DWI及MRI表现,判断肿瘤的位置、大小、信号特点、强化方式、浸润深度、远处转移及分期情况,测量肿瘤实质部分及相应正常子宫肌层、内膜的ADC值.结果 肿瘤多表现为信号不均伴肌层浸润的软组织肿块,T1WI呈等或稍低信号,T2 WI为中等或高信号,增强多呈明显强化,DWI呈高信号,ADC值减低,本组子宫肉瘤ADC值0.87×10-3mm2/s,显著低于正常子宫肌层(1.59×10-3mm2/s)、内膜(1.73×10-3mm2/s),也显著低于文献报道良性病变的ADC值(1.44～ 1.55×10-3mm2/s).结论 ADC值在子宫肉瘤的诊断与鉴别诊断中具有重要价值,结合MRI平扫及动态增强扫描能进一步提高对该病的诊断及术前分期中的准确性.     

小儿横纹肌肉瘤:影像学表现与评价

本文系统介绍儿童横纹肌肉瘤的病理学分型及特点,以及常见部位横纹肌肉瘤的CT和MRI表现及其鉴别诊断,旨在提高认识和诊断水平.     

儿童膀胱恶性横纹肌肉瘤的CT诊断

儿童膀胱胚胎性横纹肌肉瘤是一种极为少见的恶性肿瘤，我院近５年来收治３例，均发生于尿道内口附近，病理证实为膀胱恶性横纹肌肉瘤，其中２例进行了CT检查，现报告如下。１临床资料本组患儿男１例，女１例，年龄２岁１例，４岁１例。均有血尿，有１例发生尿潴留。查体：尿潴留１例下腹饱满，有压痛，经导尿后未触及腹部肿块；另１例体检无异常。２例CT检查都有膀胱壁局限性的增厚，膀胱前壁有软组织块影突入膀胱内，CT值约３０～８０Hu，增强扫描肿块可见不同程度的增强，膀胱内充盈造影剂后可见突向膀胱腔内的大小不一颗粒状充盈缺损…     

儿童盆腔横纹肌肉瘤CT 表现

目的：探讨儿童盆腔横纹肌肉瘤的CT影像学表现特征。方法回顾性分析9例经病理证实的儿童盆腔横纹肌肉瘤的CT表现,包括肿块的部位、形态、大小、密度、强化方式及强化程度。结果9例中病变主要位于膀胱直肠隐窝8例,后腹膜1例,均表现为巨大不规则软组织肿块,其中8例肿块边界欠清呈分叶状,1例边界清楚有包膜。肿块内可见偏心性带状、团状低密度区,2例肿瘤内混杂出血。肿块易侵犯邻近组织,周围均未见明确肿大淋巴结。CT增强扫描病灶动脉期均表现为轻中度不均匀强化,边缘强化程度较其中心强化明显,静脉期、延迟期呈持续性强化。结论发生于盆腔的儿童RM S在C T影像学表现中有一定的特征性和临床鉴别诊断意义。     

后上纵隔横纹肌肉瘤一例

横纹肌肉瘤在临床上常见，多发生于四肢，纵隔内一般无原发性横纹肌肉瘤，但可有伸入纵隔内的继发性横纹肌肉瘤。我们见１例位于右后上纵隔误诊为神经源性肿瘤者，报告如下。患者男，５１岁。胸背部疼痛１个月，双下肢无力伴感觉障碍且逐步向上发展９天。疼痛为烧灼样，呈...     

前列腺横纹肌肉瘤一例

前列腺横纹肌肉瘤来源于前列腺中胚层。超声及MRI为前列腺肉瘤的常用检查手段,术前误诊率较高。     

Magnetic resonance imaging in pediatric elbow fractures

Purpose: Magnetic resonance imaging (MRI) evaluation of pediatric elbow trauma with or without a visible fracture on radiography.

Material and Methods: MRI was performed in the acute phase in 25 children with an elbow injury. Nine patients with an elbow effusion only on radiographs and 16 with a fracture or luxation seen on radiographs underwent subsequent MRI. No sedation was used.

Results: MRI revealed eight occult fractures (89%) in seven out of nine patients who had only an effusion on radiographs. Based on MRI findings, septic arthritis was suspected in one patient. Two patients out of five with a supracondylar fracture on the radiograph had a cartilage lesion in the humerus. MRI depicted a 3-mm gap on the articular surface in two patients with a lateral condyle fracture, a more accurate fracture location in two patients than the radiographs, and an additional occult fracture in two patients. MRI showed a fracture not seen on radiographs in two of three patients with prior luxation.

Conclusion: MRI is a sensitive and accurate method in the diagnosis of pediatric elbow injuries, especially when only an effusion is present on radiographs. Occult fractures are more common in pediatric patients with elbow injury than reported earlier.     

Magnetic resonance imaging of themusculoskeletal system

The accuracy of magnetic resonance imaging (MRI) in evaluating disorders of the musculoskeletal system is wellestablished. MRI is especially valuable in evaluating pathology of the major joints and soft tissues of the body. Importantly, MRI is a noninvasive technology. As with any new technology in medicine, time is required to establish the place of the technology in the armamentarium of clinicians. This is the unsettled situation MRI finds itself in today.     

Magnetic resonance imaging of the elbow

With the current popularity of racket and throwing sports, the number of individuals seeking medical care for elbow pain and dysfunction has increased. Elbow dysfunction may be related to acute or chronic injury to the soft tissue or osseous components of the elbow. With magnetic resonance imaging (MRI), it is now possible to accurately determine the nature and extent of the pathological changes in ligaments, tendons, muscles, and osseous structures of the elbow joint. This information facilitates the choice of the appropriate therapeutic regimen.     

肿瘤MR分子影像学研究进展

MR分子影像学以分子生物学为基础,借助MRI技术在活体状态下从分子、基因水平对肿瘤进行更早期、更特异性诊断与监测治疗效果。目前关于MR分子影像研究多集中于MR特异性分子探针的制备、肿瘤血管形成显像、报告基因显像、波谱显像等方面,由于MR具有精确的空间定位及功能成像等优势,因此在肿瘤分子影像研究中具有极大的发展潜力,将在21世纪肿瘤的诊断与治疗中发挥重要作用。MR分子影像学以分子生物学为基础,借助MRI技术在活体状态下从分子、基因水平对肿瘤进行更早期、更特异性诊断与监测治疗效果。目前关于MR分子影像研究多集中于MR特异性分子探针的制备、肿瘤血管形成显像、报告基因显像、波谱显像等方面,由于MR具有精确的空间定位及功能成像等优势,因此在肿瘤分子影像研究中具有极大的发展潜力,将在21世纪肿瘤的诊断与治疗中发挥重要作用。     

小腿骨筋膜间隔综合征MRI表现及其诊断价值

目的　总结小腿骨筋膜间隔综合征 (ostealcompartmentsyndrome ,OCS)的MRI表现特点及其诊断价值。　方法　回顾分析 15例经临床证实的小腿OCS患者的临床及MRI资料。结果　 15例中表现为多个筋膜间室受累 14例 ;单室受累 1例。急性期MRI表现为受累肌肉高度水肿 ,T1WI为低信号、T2 WI为高信号 ,肌间隔结构模糊 ;亚急性期信号混杂。与肌肉水肿相比 ,肌肉坏死区在T1WI呈更低信号 ,T2 WI呈更高信号 ,而肌肉内出血在T1WI、T2 WI上均呈高信号 ;慢性期主要表现为受累肌肉萎缩、肌间隔脂肪增多和深筋膜增厚。　结论　小腿OCS的MRI表现具有一定特征性。MRI可帮助临床诊断可疑病例 ,明确病变部位、范围和程度 ,并帮助临床制定治疗计划     

应激性心肌病的磁共振成像特点

目的 分析总结应激性心肌病的磁共振成像特点.方法 对确诊的6例应激性心肌病患者行心脏磁共振成像检查,对其磁共振成像特点进行分析总结.结果 所有患者左室射血分数降低（23％ ～45％,平均35％）,心室发生气球样变形（4例位于心尖,2例位于心室中部）;但受累节段无明显的坏死和纤维化,这与急性心肌梗死的磁共振成像特点不同.结论 应激性心肌病患者有典型的磁共振成像特点,有助于与急性心肌梗死的鉴别.     

Magnetic resonance imaging using hyperpolarized He-gas

Rationale and Objectives. Current imaging procedures of the lung concentrate on visualization of morphology. Computed tomography is the imaging method of choice for the majority of pulmonary diseases. Functional data are commonly obtained from arterial blood gas analysis, spirometry, and body plethysmography, which all suffer from lack of regional information.Materials and Methods. Magnetic resonance imaging (MRI) of the lung has been advanced recently by the use of hyperpolarized ³He as a new contrast mechanism. Four different image acquisition modes are performed during a typical patient study.Results. ³He-MRI yields functional information about the lung with a high spatial and temporal resolution, avoiding the risks of ionizing radiation. The method is currently limited by high costs and restricted availability of the gas.Conclusion. In this article, the experience obtained at the University of Mainz, being Europe’s most experienced center performing ³He-MRI in humans, is reviewed against the international background.     

颈部病变淋巴结实质区和坏死区表观扩散系数值的鉴别诊断价值

目的 探讨淋巴结实质区和坏死区的表观扩散系数(ADC)值对颈部淋巴结病变的鉴别诊断价值.方法 对36例颈部淋巴结转移癌、19例淋巴瘤和23例淋巴结结核患者进行扩散加权成像(DWI),测量并比较不同病变巾淋巴结实质区和坏死区的ADC值,评价两者对3种淋巴结病变的鉴别诊断能力.共对病理(114枚)和临床随访(63枚)证实的177枚淋巴结进行ADC值的测量和分析,其中转移癌性淋巴结84枚,淋巴瘤性淋巴结40枚,结核性淋巴结53枚.2组均数的比较采用独立样本t检验,2组以卜均数的比较采用单向方差分析(one-way ANOVA).结果 转移癌、淋巴瘤和结核的淋巴结实质区的ADC值分别为(0.93±0.16)、(0.64±0.13)和(1.01±0.11)×10-3mm2/s(F=82.928,P<0.01),淋巴结转移癌和结核中淋巴结坏死区的ADC值分别为(2.02±0.36)、(1.25±0.15)×10-3mm2/s(t=12.045,P<0.01).当淋巴结实质区的ADC值≤0.77×10-3mm2/s时,诊断为淋巴瘤的敏感度、特异度分别为83%和89%.当淋巴结坏死区的ADC值≥1.60×10-3mm2/s时,诊断为淋巴结转移癌的敏感度、特异度分别为88%、100%.结论 测量淋巴结的ADC值,尤其是坏死区的ADC值有助于淋巴结病变的鉴别诊断.     

Magnetic resonance imaging of arachnoid cysts

A retrospective review of magnetic resonance imaging (MRI)—computed tomography (CT) correlation was performed in 29 patients with arachnoid cysts. Short TR, short TE spin echo (SE) pulse sequences provided the best anatomic definition whereas multiple echo long TR, TE sequences allowed comparison of the signal intensity of the cyst with that of cerebrospinal fluid (CSF). Simple arachnoid cysts were isointense while neoplastic, hemorrhagic or inflammatory cysts were hyperintense relative to CSF. The CT differential diagnosis of an arachnoid cyst (depending upon its location) may include other cystic collections such as craniopharyngioma, epidermoid, astrocytoma, and chronic subdural hematoma. However, on MRI the combination of extraaxial location, morphological features, and signal intensity matching that of CSF allows one to make the diagnosis of an uncomplicated arachnoid cyst with confidence.