磁共振脊髓成像诊断椎管病变的价值

探讨ＭＲＭ诊断椎管病变的价值及ＭＲＭ技术方法。材料与方法：对７１例椎管病变的常规ＭＲＩ检查及ＭＲＭ表现进行了分析,其中髓内肿瘤８例,髓外硬膜内肿瘤１４例,硬膜外肿瘤９例,结核３例,脊椎外伤７例,脊柱闭合不全６例,椎间盘突出及骨性椎管狭窄２４例。     

周围神经病变的MRI研究进展

近年来 ,ＭＲＩ新技术不断涌现 ,相控表面线圈的应用 ,使ＭＲ图像分辨率、信噪比和对比噪声比明显提高 ,周围神经及其病变的ＭＲＩ研究也渐受重视并在临床诊疗中发挥着越来越重要的作用。周围神经病变繁杂 ,目前ＭＲＩ研究较多、进展较快的主要是发病率较高的视神经、三叉神经、听神经和面神经等颅神经病变 ,臂丛、腰骶丛及其分支病变。因此 ,笔者结合重点阐述以上周围神经病变的ＭＲＩ表现及其临床价值。一、颅神经病变的ＭＲＩ研究进展(一 )视神经病变的ＭＲＩ表现ＭＲＩ是目前诊断视神经病变最准确的影像学检查方法 ,能比较准确地提供视…     

MRI新技术在肺及气道病变中的应用研究进展

目前先天性心脏病(CHD)合并肺及气道病变的诊断主要依靠CT,但MRI因其无电离辐射、软组织分辨力高而极具优势。近年来不断出现的MRI新技术新序列逐渐克服传统MRI序列在显示肺及气道病变方面的局限性,其中三维快速场回波(3D-TFE)序列、三维平衡快速场回波(3D-B-TFE)序列可以清晰显示气道,超短回波时间(UTE)序列主要用于肺成像。这3种MRI新序列独特的成像优势使得MRI在CHD合并气道和肺病变的应用成为可能,也进一步实现了安全、无创、高效的疾病诊断。     

骨髓病变的MRI研究进展

【摘要】骨髓的病变主要指正常的骨髓组织被病理组织完全或部分替代、浸润。MRI是研究骨髓病变的首选影像学方法,近年来扩散加权成像（DWI）、磁共振波谱成像（MRS）、动态增强磁共振成像（DCE-MRI）、正电子断层扫描-磁共振成像（PET-MRI）等MRI新技术逐步应用于骨髓病变的临床及科研,为骨髓病变的深入研究提供新的思路和方法。     

脊髓损伤的MRI诊断

本文收收集了１２４例脊髓损伤行ＭＲＩ检查者，据其ＭＲＩ所见将脊髓损伤分为五型，并对各型脊髓损伤与相应临床表现的关系，与原发脊柱损伤的关系，ＭＲＩ诊断要点以及脊柱术后改变等进行了分析，还探讨了脊髓外伤后软化、囊性变等问题。     

脊髓病变病人的脑脊液流动MRI研究

目的：利用相位对比动力学MRI研究脊髓病变病人的脑脊液动力学。材料和方法：对脊椎侧凸病人20例，脊髓空洞症病人20例，Chiari畸形病人20例，脊髓肿瘤20例和无脊椎脊髓病变50例，采用Philips 1．5T超导型磁共振常规MRI检查后，行磁共振Qflow序列检查。测量部位选择C2—3椎间盘横断面，将检测数据传到Easyvison后处理工作站计算出流速和流量，并通过软件模拟出脑脊液流动的波形。结果：以50例无脊椎脊髓病变的脑脊液动力学为等动力学参照，发现脊椎侧凸病人和脊髓肿瘤的脑脊液动力学为高动力学，脊髓空洞症病人和Chiari畸形病人的脑脊液动力学为低动力学。结论：①无创伤性相位对比动力学MRI为研究脊髓病变病人的脑脊液流动提供可靠、稳定的技术方法；②脊髓空洞症脑脊液低动力学为临床脊髓空洞症做出定量的诊断，有进一步研究和推广应用的价值。     

脊髓纵裂畸形的MRI诊断

目的:探讨脊髓纵裂畸形的MRI诊断价值。方法:共搜集8例脊髓纵裂畸形的临床及MRI资料,其中,男1例,女7例,年龄1~29岁,平均11岁。均行横轴面、冠状面T1WI,矢状面T1WI、T2WI。结果:本组Ⅰ型6例,2个半脊髓分别位于各自独立的硬膜囊,中间为骨或软骨间隔分开;Ⅱ型2例,2个半脊髓位于同一硬膜囊内,中间可有纤维性间隔。结论:MRI是诊断脊髓纵裂畸形及其椎管内伴发病变最有效的非创伤性检查方法;横断面T1WI是诊断脊髓纵裂的最佳断面;冠状面T1WI也能较好显示地病变。     

脊髓梗死MRI表现2例

脊髓梗死是脊髓动脉血栓形成或栓塞,造成供血区域缺血缺氧而发生组织坏死软化,并出现相应神经系统症状。发生于脊髓前动脉的梗死,称脊髓前动脉综合征;发生于脊髓后动脉的梗死,又称脊髓后动脉综合征[1]。脊髓梗死与脑梗死比较相对少见[2],本文报告2例经临床证实的脊髓梗死病例。     

MRI对急性脊髓损伤的评价

目的 探讨MRI在评价急性脊髓损伤中的临床应用价值.方法 收集急性脊髓损伤患者50例,行同期X线片、CT和MRI检查,MRI检查应用1.5T超导型磁共振成像仪,采用自旋回波序列和快速自旋回波序列,常规矢状位及横轴位扫描,17例加扫冠状位.结果 脊髓水肿:MRI检出16例,CT检出4例;脊髓挫伤出血:MRI检出21例,CT检出11例;脊髓受压变形:MRI检出34例,CT检出15例;脊髓断裂:MRI检出10例,CT检出3例.X线片未检出上述脊髓损伤.结论 MRI对评估脊髓损伤明显优于X线片和CT扫描,是急性脊髓损伤的最佳检查与诊断方法.     

MRI in chronic spinal cord trauma

Summary Eighty-seven patients aged 16–68 years have been examined by magnetic resonance imaging (MRI) following spinal injury. The MRI findings have been correlated with length of history between trauma and investigation, extent of residual function and site of injury. They include changes at the site of injury consistent with myelomalacia in 37%, a syrinx in 40%, persistent cord compression in 32% and atrophy in 18%. An extensive syrinx can develop within 2 months of injury and it is nearly twice as common in patients with complete paralysis as in those whose paralysis was incomplete. It is suggested that investigation and management of spinal trauma should include early and repeated MRI examinations to detect sequelae at an early stage.     

MRI对急性脊髓损伤的评价

目的：探讨急性脊髓损伤的ＭＲＩ表现及其与预后的关系。材料与方法：２３例脊髓损伤患者于伤后７天内行１．０Ｔ超导ＭＲ机检查，并采用ＡＳＩＡ损伤分级评价其神经功能。结果：２３例在ＭＲＩ上均显示脊髓异常信号，其中１９例有脊柱骨和（或）韧带损伤。脊髓损伤有两种信号类型，１０例见急性脊髓出血，在Ｔ２ＷＩ上表现为中心低信号、周围高信号；１３例为脊髓挫伤或水肿，Ｔ２ＷＩ表现为脊髓均匀或不均匀的高信号区。１１例能评价预后，两种信号类型脊髓损伤的神经功能恢复没有明显差异。１３例完全性脊髓损伤和１０例不完全性脊髓损伤，在Ｔ２ＷＩ上异常信号的平均面积分别为４．４４±１．８０ｃｍ２及１．７６±０．８０ｃｍ２。１１例治疗后，神经功能改善６例，没有明显改善５例，异常信号区的平均面积分别为２．４１±１．０５ｃｍ２及４．８２±１．８６ｃｍ２。脊髓异常信号区面积的大小与脊髓损伤严重性及其预后的改善有关。结论：ＭＲＩ能清楚地显示急性脊髓损伤的各种病理改变，Ｔ２ＷＩ上异常信号区的大小是评价急性脊髓损伤严重性及预后的重要指标。     

Comparison of MRI pulse sequences for investigation of lesions of the cervical spinal cord

Small spinal cord lesions, even if clinically significant, can be due to the low sensitivity of some pulse sequences. We compared T2-weighted fast (FSE), and conventional (CSE) spin-echo and short-tau inversion-recovery (STIR)-FSE overlooked on MRI sequences to evaluate their sensitivity to and specificity for lesions of different types. We compared the three sequences in MRI of 57 patients with cervical spinal symptoms. The image sets were assessed by two of us individually for final diagnosis, lesion detectability and image quality. Both readers arrived at the same final diagnoses with all sequences, differentiating four groups of patients. Group 1 (30 patients, 53 %), with a final diagnosis of multiple sclerosis (MS). Demyelinating lesions were better seen on STIR-FSE images, on which the number of lesions was significantly higher than on FSE, while the FSE and CSE images showed approximately equal numbers of lesions; additional lesions were found in 9 patients. The contrast-to-noise ratio (CNR) of 17 demyelinating lesions was significantly higher on STIR-FSE images than with the other sequences. Group 2, 19 patients (33 %) with cervical pain, 15 of whom had disc protrusion or herniation: herniated discs were equally well delineated with all sequences, with better myelographic effect on FSE. In five patients with intrinsic spinal cord abnormalities, the conspicuity and demarcation of the lesions were similar with STIR-FSE and FSE. Group 3, 4 patients (7 %) with acute myelopathy of unknown aetiology. In two patients, STIR-FSE gave better demarcation of lesions and in one a questionable additional lesions. Group 4, 4 patients (7 %) with miscellaneous final diagnoses. STIR-FSE had high sensitivity to demyelinating lesions, can be considered quite specific and should be included in spinal MRI for assessment of suspected demyelinating disease. Received: 21 September 1999/Accepted: 10 December 1999     

MRI of radiation induced spinal cord glioma

Summary Radiation induced neoplasms of the spinal cord are rare lesions. This report details the MR evaluation of a patient with radiation induced astrocytoma of the cervical cord. The diagnosis of second primary neoplasm should be considered in patients with prior radiation therapy when MRI demonstrates an intramedullary lesion.     

脊髓多发性硬化的MRI诊断

目的：提高对脊我发性硬化ＭＲＩ特征的认识。材料与方法：地１４例脊髓多发性硬化患者进行颈部ＭＲＩ检查。对病变的长度，横断面上病变大小、位置及病变的强化进行评价结果：１４例患者共发现病变３１个。脊髓多发性硬化ＭＲＩ特征性表现为；大多数为矢状位长度小于２个椎体（８７．１％），病变长度大于宽度，病变局部脊髓政党或轻度肿胀。结论：ＭＲＩ不仅可以发现脊髓多发化病变，并且能显示其特征性表现，有助于与其他脊人病变     

脊髓血管母细胞瘤的MRI诊断与鉴别诊断

目的探讨脊髓血管母细胞瘤的MRI表现特征。方法回顾性分析8例经手术和病理证实的脊髓血管母细胞瘤的临床及MRI检查资料。结果6例单发,2例多发,所有病灶均位于脊髓内,颈髓及胸髓各5个,肿瘤多呈点状或结节状、香肠状、葫芦形或不规则形,壁结节MRT1WI呈等信号,T2WI呈稍高信号,增强后肿瘤呈显著强化,肿瘤常继发囊肿或大范围脊髓空洞以及水肿,大于lcm的肿瘤内部及周围常见流空血管影。结论脊髓血管母细胞瘤的MRI影像表现具有特征性,掌握这些MRI表现有利于提高脊髓血管母细胞瘤的诊断正确性。     

无骨折脱位颈段脊髓损伤的MRI表现

目的：探讨无骨折脱闰颈段脊髓损伤的机制及ＭＲＩ表现。方法：收集１５例经Ｘ线,ＣＴ或ＭＲＩ检查未见骨折脱位的颈段脊髓损伤的病例。所有病例均行矢状位,轴位扫描,均行ＳＥ序列Ｔ１ＷＩ及ＦＳＥ序列Ｔ２ＷＩ。结果：７例有颈椎间盘突出,其中４０岁以上的有６例,前纵韧带撕裂５例,４例为４０岁以上,脊髓受压７例,为突出间盘及肥厚黄韧带压迫所致。所有病例在Ｔ２ＷＩ均呈现出明显的异常信号。脊髓挫伤,水肿１１例,出血１     

脊髓血管母细胞瘤的MRI特点

目的:探讨脊髓血管母细胞瘤的MRI表现,提高对该病的影像诊断水平.方法:回顾性分析经临床诊断及术后病理证实的24例脊髓血管母细胞瘤患者的MRI表现.结果:24例肿瘤主要表现为颈胸段脊髓内类圆形病灶,大囊结节型19例,实性结节型5例;单发20例,多发4例;3例肿瘤的最大径≥5 cm,其余病灶均＜5 cm;病灶在T1 WI上呈低信号或等信号,T2 WI上呈高信号;注射对比剂后囊性结节型肿瘤表现为壁结节明显强化而边缘不强化,实性结节型肿瘤表现为显著均匀强化.病理检查显示手术切除组织呈典型的血管母细胞瘤表现,CD31、CD34血管免疫标记阳性,Vim和S-100阳性.结论:MRI平扫及增强扫描在脊髓血管母细胞瘤的影像诊断中具有良好的诊断及鉴别诊断价值.     

MRI of spinal cord involvement in Behçet's disease: case report

MRI demonstrated well-defined areas of signal change and moderate contrast enhancement in the thoracic spinal cord of a patient with Behçet's disease presenting with subacute myelopathy. The patient improved after intravenous steroids, and MRI 5 months later showed a normal spinal cord.     

MRI of spinal cord and brain lesions in subacute combined degeneration

Subacute combined degeneration is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and even more rarely of the pyramidal and spinocerebellar tracts and cerebellum. We present the initial and follow-up MRI appearances in a patient with subacute combined degeneration of the spinal cord, brain stem and cerebellum, due to vitamin B₁₂ deficiency. The lesions in these structures were demonstrated clearly as pathologically high-signal areas on T2-weighted images. These lesions, except those of the brain stem and cerebellum, disappeared 4 months after therapy. MRI 14 months after the patient's discharge on vitamin B₁₂ therapy showed the same picture. Received: 24 July 1997 Accepted: 20 November 1997