乳管镜对乳管内非占位性病变治疗价值研究

目的探讨乳管镜在乳管内非占位性病变中的治疗价值。方法选取中国医科大学附属第四医院乳腺外科2015年1—12月行乳管镜检查的388例乳头溢液患者,对其中的乳管内非占位性病变患者行乳管镜下冲洗治疗,并在治疗后6个月行电话随访。结果本研究388例乳头溢液患者中,301例经乳管镜诊断为乳管内非占位性病变,其中,乳管扩张症17例、乳管炎190例、乳管炎合并乳管扩张症94例。乳管镜下冲洗治疗6个月后进行电话随访,共获得随访281例,随访率为93.4%(281/301)。其中,156例治愈,87例好转,38例无效,治愈率为55.5%(156/281),有效率为86.5%(243/281)。结论乳管镜能够有效诊断乳管内非占位性病变,乳管镜下冲洗治疗取得较好疗效。     

乳管镜下乳头溢液的性状与乳管内病变的相关性

 目的 探讨乳头溢液颜色及溢液量与乳管内相应病变之间的关系。方法 对2014-05至2014-12于武警总医院门诊行乳管镜检查并行相应治疗的174例乳头溢液患者的临床资料进行回顾性分析。结果 174例乳头溢液患者有乳管内占位性病变者共83例(47.7%),其中乳腺癌5例;乳管内无占位性病变者91例(52.3%)。单侧溢液、单孔溢液分别较双侧溢液、多孔溢液在乳管镜下发现乳管内占位的可能性大(P<0.05),血性溢液、淡黄色溢液较其他颜色溢液在乳管镜下发现乳管内占位的可能性大(P<0.05),血性溢液较非血性溢液提示乳腺癌可能性大(P<0.05),单侧溢液中单孔溢液和多孔溢液两者乳管内占位发生率比较无统计学差异。结论 乳头溢液是乳管内病变的早期表现,其中单侧溢液、单孔溢液、血性溢液、淡黄色溢液均提示乳管内占位性病变可能性大,单纯血性溢液是乳腺癌高危因素,单侧溢液无论单孔还是多孔都有临床意义。     

乳管镜在诊断与治疗乳头溢液中的临床应用

目的 探讨纤维乳管镜在诊断与治疗伴有乳头溢液的乳腺疾病中的作用.方法 结合我院自2011年12月～2012年5月收治的24例乳头溢液并行FDS检查及手术的患者临床资料,对比分析手术前临床诊断与术后病理诊断结果.结果 经乳管镜诊断为导管内乳头状瘤10例,乳腺癌5例,乳头状瘤病5例,乳腺增生及乳管扩张症4例.均进行了手术切除活检,经常规病理诊断,确诊为导管内乳头状瘤者10例,乳腺癌者4例,乳头状瘤病6例,乳腺增生及乳管扩张症者4例.结论 乳管镜能够准确、直观地判断乳头溢液性乳腺疾病形成的病因、病变部位和病变范围,是诊断表现为乳头溢液的乳腺导管内疾病的有效手段.     

乳管造影在诊断乳头溢液中的价值

目的：评价乳管造影的临床诊断及应用价值。方法：分析我院从2002年3月-2004年2月因乳头溢液患者的乳管造影结果和病理学检查结果。结果：乳管造影对乳头溢液有较高的诊断价值。结论：乳管造影可对病变做出定位和定性诊断，特别有利于诊断多发病变和乳腺边缘的病变，但不能代替病理检查。     

前列腺癌灌注CT成像的可行性研究

正摘要目的该可行性研究的正摘要目的是通过获得原始数据,以比较常规MRI与CT灌注成像(CTP)用于前列腺癌诊断的效能。方法该前瞻性研究共纳入同时行MRI和CTP检查的     

乳导管内窥镜检查技术与护理

目的:探讨乳导管内窥镜检查的最佳技术方法与相关护理工作问题。方法:对385例乳头溢液患者乳导管内窥镜检查与护理的相关资料进行了回顾性分析。结果:经过正确的操作和恰当的护理,385例患者均配合良好,顺利完成乳导管内窥镜检查,无任何并发症的发生。结论:正确、灵巧的操作技术和细致、周到的术前、术中与术后护理工作,是乳导管内窥镜检查成功实施的重要保障。     

乳头溢液药物灌注治疗效果临床分析

目的通过乳导管造影,观察乳头溢液的导管内特征,探索治疗乳头溢液的方法。方法收集我院2000—2004年乳头溢液98例,其中74例经临床检查、钼钯摄片排除其他疾病,且经乳导管造影确诊为乳导管扩张症48例,囊性乳腺增生病16例,慢性乳导管炎10例。74例乳头溢液均经中西医治疗无效后,才经溢液乳管灌注庆大霉素8万u(单位)2~4ml加地塞米松5mg治疗。结果灌注治疗1个疗程(4~5次),43例溢液停止,乳房疼痛消失,26例乳晕区发痒、刺痛缓解,31例溢液明显减少。经第2个疗程灌注治疗,其中24例溢液停止,5例要反复挤捏患乳才有极少溢液,但疼痛明显消除。结论乳头溢液必须确诊为乳导管扩张症、囊性乳腺增生病、慢性乳导管炎患者方可经溢液乳管药物灌注治疗,效果显著,值得临床应用。     

MR涎管成像的临床应用进展

磁共振涎管成像可清晰显示涎腺导管系统,且具有无创性、无电离辐射、可三维成像等优点,因而逐步被应用于临床,如对涎石症、涎管异常、舍格伦综合征、口腔干燥症等疾病的诊断,其将有可能取代传统的X线涎腺造影。就MR涎管成像的原理、技术方法及临床应用作一综述。     

MR涎管成像的临床应用进展

磁共振涎管成像可清晰显示涎腺导管系统,且具有无创性、无电离辐射、可三维成像等优点,因而逐步被应用于临床,如对涎石症、涎管异常、舍格伦综合征、口腔干燥症等疾病的诊断,其将有可能取代传统的X线涎腺造影。就MR涎管成像的原理、技术方法及临床应用作一综述。     

弥散法MR膝关节造影可行性研究

目的评价MR对比剂静脉内注射、膝关节腔内弥散关节造影的可行性研究并寻找最佳检查参数. 资料与方法选取膝关节正常者24名,按常规方法进行扫描后再将其分为运动组和未运动组.每组再分为3小组.3个小组分别从静脉注入不同剂量的Gd-DTPA.注射完后未运动组受检者静卧于检查床,进行延迟扫描;运动组步行10 min后再进行扫描,并进行延迟.扫描结束后,对平扫和增强图像中的关节腔周围组织及关节腔内信号进行测量.采集后的数据按组归类,并进行统计处理,观察对比剂注射后关节腔内信号增加程度并选取最佳检查方法. 结果弥散法膝关节造影可使关节腔信号强度明显增加,与周围组织产生明显信号差,以采用注射剂量为0.2 mmol/kg体重,注射后受检者正常步行10 min后造影效果最佳. 结论弥散法MR膝关节造影可起到关节造影的效果,造影效果良好,是一种操作简单、危险性小、并发症少的检查方法.     

Conventional galactography and MR contrast galactography for diagnosing nipple discharge: preliminary results

OBJECTIVE: We wanted to compare the clinical usefulness of conventional galactography and MR contrast galactography for diagnosing patients with nipple discharge. MATERIALS AND METHODS: Both conventional galactography and MR contrast galactography were performed prospectively in 16 patients. Gadopentate dimeglumine (0.1 ml) was mixed with non-ionic contrast medium (0.9 ml) to obtain a resultant volume of 1 ml and this was used for both examinations. Following conventional galactography, MR contrast galactography was performed after direct injection of contrast media into the duct. RESULTS: Conventional galactography and MR contrast galactography were concordant in 13 (81%) of 16 patients; the results were normal in five, ductal dilatation was noted in four and intraductal filling defects were noted in four. The remaining three (19%) patients demonstrated discordant findings on the two examinations. While conventional galactography revealed filling defects, the MR contrast galactography results were normal in two patients. The third patient had kinks-stricture on conventional galactography and MR contrast galactography showed ductal dilatation. This suggested there were false positive results for the three patients' conventional galactography, and all the three patients with discordant results underwent surgery and the histopathologic evaluation showed fibrocystic changes. CONCLUSION: MR contrast galactography may be used as an alternative imaging modality for making the diagnosis of pathologic nipple discharge. However, statistically supported studies with large pools of subjects for comparing the galactography and MR contrast galactography results are needed to confirm our findings.     

Real-time projection MR angiography: feasibility study

Intraarterial injections of small doses of gadopentetate dimeglumine were combined with a fast spoiled-gradient-echo magnetic resonance (MR) sequence to obtain real-time projection angiographic images of the rabbit aorta and canine coronary arteries. Arterial filling and washout, as well as venous and perfusion phases, were clearly displayed, demonstrating that arterial fluoroscopy in which an MR technique is used is feasible.     

MR angiography with superparamagnetic iron oxide: feasibility study.

Magnetic resonance (MR) angiography with blood-pool superparamagnetic iron oxide (SPIO) particles was evaluated in the whole-body vascular system. In 12 adult patients, three-dimensional fast imaging with steady-state precession was performed in successive steps from the lungs to the calves before and after a standard dose for liver imaging (15 mumol of iron per kilogram of body weight) of AMI-25. On SPIO-enhanced MR angiograms, visualization of the pulmonary arterial, whole-body, and lower extremity venous systems was graded as good or sufficient in all patients, and femoral vein thrombosis was clearly demonstrated in one patient.     

Diffusion-weighted MR neurography of the brachial plexus: feasibility study

The University Medical Center Utrecht institutional review board approved this study, and informed consent was obtained from all subjects. The purpose of this study was to introduce and assess diffusion-weighted (DW) magnetic resonance (MR) neurography for imaging of the brachial plexus. DW MR neurographic images were displayed with a maximum intensity projection technique. DW MR neurography was evaluated in five healthy volunteers and five patients. DW MR neurography showed a long trajectory of the brachial plexus in all healthy volunteers. In all patients, DW MR neurography clearly showed the location of the disease. The proposed DW MR neurography technique can be used to obtain an overview image of the brachial plexus, with excellent conspicuity of the nerves and surrounding structures.     

Development of contrast-enhanced virtual MR cholangioscopy: a feasibility study

The purpose of this study was to examine the feasibility of contrast-enhanced virtual MR cholangioscopy (CE VMRC). Intraluminal views of the extrahepatic biliary tree were generated in ten patients undergoing abdominal MRI post mangafodipir trisodium administration employing coronal 2.5-mm 3D fast low-angle shot (FLASH) images (TR 6.8 ms, TE 2.3 ms, matrix 195 x 512) with fat saturation and a commercially available software. Contrast-enhanced VMRC was compared with single-shot turbo spin-echo T2-weighted MR cholangiography (T2 MRC) in terms of ductal visualization and artifact presence, utilizing a five-point grading scale. Four anatomic segments were evaluated: the intra- and extra-pancreatic segment of the common bile duct (CBD), and the cystic duct and the area of hepatic duct bifurcation. Both CE VMRC and T2 MRC depicted 38 of 40 segments. There were no significant differences between CE VMRC and T2 MRC in ranking ductal segments visualization ( p=0.27). The high contrast between intraluminal fluid and extraluminal tissues facilitated the generation of endoscopic views. Contrast-enhanced virtual MR cholangioscopy is a feasible technique providing endoscopic views of the CBD. Initial results show correlation of CE VMRC with projectional MR cholangiography.     

MR fluoroscopy: Technical feasibility

A method of magnetic resonance image acquisition and reconstruction is described in which high imaging rates and fast reconstruction times are allowed. The acquisition is a modification of the basic FLASH sequence but with a restricted number N of phase encodings. The encodings are applied sequentially, periodically, and continuously. Images are formed by sliding a window of width N encodings along the acquired data and reconstructing an image for each position of the window. In general the acquisition time per image exceeds the time between successive images, and the method thus has a temporal lag. Experimental studies were performed with a dynamic phantom using 48 phase encodings and a TR of 20 ms, for an image acquisition time of about 1 s. The image display rate in the reconstructed sequence was 12.5 images/s, and the image sequence portrayed the motion of the phantom. Additional studies were done with 24 encodings. It is shown how the sliding window technique lends itself to high-speed reconstruction, with each newly acquired echo used to quickly update the image on display. The combination of the acquisition technique described and a hardware implementation of the reconstruction algorithm can result in realtime MR image acquisition and reconstruction. © 1988 Academic Press, Inc.     

MR imaging with remote control: feasibility study in cardiovascular disease

The institutional review board approved this HIPAA-compliant study and waived informed consent. The purpose was to retrospectively evaluate remote control magnetic resonance (MR) imaging in complex cardiovascular procedures, whereby operational expertise was made available locally from a remote location. Thirty patients underwent cardiac (12 patients) and/or vascular (30 patients) 1.5-T MR imaging with a remote operator by using a personal computer. All patient studies were compared with 30 control studies obtained with conventional local imaging. Cardiac cine, myocardial delayed enhancement, and MR angiograms were assessed for overall image quality and motion artifact. MR angiograms were evaluated for vascular definition. Image quality was excellent in 90% (38 of 42) of remote images versus 60% (25 of 42) of control group images (P < .01). Scores for motion artifact were not significantly different (P = .11). Interactive MR imaging was successfully implemented with remote control in complex cardiovascular cases; diagnostic quality of images was superior to that of images obtained locally.     

Line-scan diffusion tensor MR imaging at 0.2 T: feasibility study

PURPOSE: To investigate and measure apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values using data obtained with line-scan diffusion-weighted imaging (DWI) of human brains on a 0.2 Tesla MR imager. MATERIALS AND METHODS: Diffusion-tensor imaging (DTI) was performed on eight healthy volunteers. The signal-to-noise ratios (SNRs) of white matter and cerebrospinal fluid were measured. ADC and FA were also measured from the data obtained from all subjects. Three-dimensional corticospinal fiber tracts were reconstructed from the DT images and a qualitative evaluation was done. RESULTS: The total scan time was 52 minutes 30 seconds for 18 slices with full-tensor images covering the whole brain. The ADCs and FAs show the appropriate values, in comparison with values obtained at high field strength in previous studies. Corticospinal fibers were demonstrated more clearly on images obtained at 0.2 T than at 1.5T. CONCLUSION: DTI at low field strength may be feasible for clinical use to estimate the white matter of brain with limited coverage, which often may be sufficient.