胰岛素瘤的MRI诊断

目的：研究磁共振成像对胰岛素瘤的诊断价值。方法：16例手术证实的胰岛素瘤患者于术前行MR检查,扫描序列包括快速自旋回波序列T1W、T2W及脂肪抑制T1W、T2W。结果：16例均能准确检出,10例呈长T1低信号,13例显示不同程度的长T2高信号,T1及T2抑脂图像肿瘤同胰腺的信号对比增强,显示更为清晰。结论：应用MR快速成像技术和脂肪抑制序列,能够对胰岛素瘤进行较精确的定位诊断。     

磁共振胆胰管成像技术应用探讨

目的 评价磁共振胆胰管成像(MRCP)技术在诊断胆管疾病中的应用。方法 56例临床上怀疑胆管疾病患者均经MRCP技术检查。本研究使用GE Signa MR／i1．5T超导性磁共振成像设备和不同的技术序列，诸如二维快速自旋回波T2加权横断面扫描、二维自旋回波T1加权横断面扫描、SSFS序列冠状面扫描、多层薄层T2加权冠状面连续扫描、以及脂肪抑制与预饱和技术序列。结果 按照56例MRCP检查胆管的图像质量，满意者见于43例(76．8％)，欠满意者8例(14．3％)，以及不满意者5例(8．9％)。结论 MRCP在胆胰管疾病诊断中是一种具有较高敏感性、特异性和准确性的非侵袭性影像技术，临床用途广泛，尤其对用ERCP、PTC检查失败或不适合的病人，它堪称理想的替代方法。     

胰腺影像学检查进展

影像学技术的发展极大地促进了胰腺影像诊断水平的提高。本文回顾了螺旋CT和多层面CT、MR成像、ERCP、超声成像和介入放射学技术的进展，及其在胰腺疾病检查中的应用与常见胰腺疾病的影像学表现。多项影像学检查方法和技术的综合应用胰腺影像诊断领域的趋势。     

人体标本踝关节韧带肌腱损伤1．5T和3．0T MR成像比较

目的：比较1．5T和3．0T踝关节MR图像在判定新鲜人体标本韧带肌腱病理表现中的价值。方法：13个新鲜的尸体踝关节标本在1．5T和3．0T机上行MR扫描，选择最优化的踝关节序列包括T1加权、脂肪抑制T2加权、脂肪抑制质子加权和短时反转恢复快速自旋回波序列。采用微创外科技术对5例标本人为地进行踝关节韧带损伤，然后对其行MR扫描。     

MRI脂肪抑制技术的临床应用

目的:探讨脂肪掏技术在MR成像中的临床应用价值。材料与方法:用1.0T超导磁共振装置对22例患者使用化学饱和脂肪抑制序列进行检查,分析其图像质量及临床价值。结果:本组22份病例中12例对比度显示好,尤其后腹膜病灶更好。4例明确病灶为含脂肪成份,4例增强区域显示清晰。结论:MRI脂肪抑制用于人体富于脂肪的脏器,有助于辩认病灶是否含脂类成份;增强后T1加权像加用该技术可消除脂肪的高信号干扰,使图像中的增强部分显示更加清楚。正确使用该技术有利于提高诊断的可靠性,值得推广。     

3.0T磁共振在胰腺病变中的应用探讨

胰腺是人体重要的消化器官,胰腺疾病特别是胰腺癌严重威胁人类健康,因此早期的准确诊断对治疗和愈后起着重要作用,目前CT是胰腺疾病的主要检查手段,近几年高场磁共振的出现,以其敏感的信号变化及多平面成像,脂肪抑制及快速动态增强成像技术在胰腺病变的检查中体现了独特的优势.本文就3.0T磁共振在胰腺病变的应用及新技术做一初步讨论.     

磁共振胰胆管成像结合薄层T2WI扩散加权成像对胰胆道梗阻性病变的诊断价值评估

目的评价磁共振成像(MR)水成像技术结合薄层T2WI、扩散加权成像(DWI)在胰胆道梗阻性病变中的临床诊断价值。方法采用重T2加权MR水成像技术及薄层T2WI、DWI对36例患者行磁共振胰胆管成像(MRCP)检查,图像经三维最大信号强度投影及三维表面遮盖显示技术后处理。结果水成像及薄层T2WI、DWI定位诊断率达100%,定性诊断率达88.6%,此技术可清晰显示胰胆管的形态,显示各种胰胆道疾病的异常改变,诊断正确性高。结论对胰胆道梗阻性病变的患者进行MRCP结合薄层T2WI、DWI扫描,诊断胰胆管梗阻的原因更为准确,可以作为常规检查序列推广应用。     

成人椎间盘炎的MRI诊断

目的 评价MRI对成人椎间盘炎的诊断价值。方法 搜集经临床证实的28例椎间盘炎患者的MR影像资料，分析其MRI表现，比较各种成像方法的敏感性与特异性及其在鉴别诊断中的价值。MRI检查使用1．0T超导机，T1、T2加权像及脂肪抑制T2加权像，2例进行了增强检查。结果 75％的病变椎间盘呈不均匀长T2高信号；全组病例均有相邻椎体受累，两个及两个以上受累者达89％。病变椎体均呈显著长T1低信号，25例呈不均匀长T1高信号，脂肪抑制T2加权像上高信号改变更明显。5例可见椎体边缘骨质增生。椎体受累范围大于二分之一者达78．5％。5例椎体边缘骨质破坏、不完整，而82．1％的病变椎体均无明显外形改变。12例椎旁或椎管内可见局限性脓肿影。2例行Gd—DTPA增强后均可见椎间盘及病变椎体内显著异常强化。结论 MRI对成人椎间盘炎具有极高的敏感性与特异性，可准确鉴别本病与椎体结核与肿瘤，是临床上应作为首选的影像检查方法。     

胰腺MRI:技术及诊断研究

目的 :探讨MR不同序列在胰腺病变诊断中的应用价值。方法 :84例胰腺检查包括 5 0例正常胰腺及 3 4例临床怀疑有病变的胰腺 ,其中包括 15例胰腺癌 ,2例胰岛细胞瘤 ,1例粘液性囊腺瘤 ,4例胰周肿瘤 ,12例胰腺炎。MR扫描序列包括常规SET1WI ;FSET2 WI ;增强前、后的脂肪抑制T1WI和GRE。结果 :3 4例异常胰腺中的 2 7例 ,增强前、后T1WI脂肪抑制像提供了最好的诊断信息 ,其次为增强后立即扫描的GRE像。未增强的GRE像极好地显示了急性胰腺炎的特征 ,SET2 WI像对胰岛细胞瘤及胰腺癌的肝转移显示较为敏感。结论 :增强前、后T1WI脂肪抑制序列及动态增强的GER序列 ,应为胰腺MRI的标准序列。     

三维酰胺质子转移加权成像及其联合扩散加权成像鉴别诊断乳腺良性与恶性病变的价值

目的:探讨三维酰胺质子转移加权成像（APTWI）鉴别诊断乳腺良性与恶性病变的价值及APTWI联合扩散加权成像（DWI）的诊断效能。方法:本研究为前瞻性研究。收集2020年7月至12月郑州大学第一附属医院经手术或穿刺病理证实的226例乳腺病变患者。所有患者均接受MR T 1加权成像、T 2加权成像...     

胰腺癌:MRI检查技术和诊断

胰腺癌的患病率呈上升趋势。更重要的是胰腺癌早期没有症状，恶性程度高，发展快，侵及范围广，病死率高。外科手术切除是胰腺癌治疗的有效手段，胰腺癌的检测和分期是MRI的重要课题。近年来，MRI技术的发展可以较全面地评价胰腺及胰腺病变，这些技术包括屏气T1加权成像及其脂肪抑制，T2加以成像及其抑制、Gd-DTPA,动态增强、MRCP和MRA，这些脉冲序列各自有其不同的组织对比机制，而且是相互补充的。其中Gd-DTPA动态增强MRI是检测胰腺癌最可靠，应用最广的技术，它们的联合应用，在检测胰腺癌，特别是局限于胰腺内的小部肿，优于螺旋CT；在胰腺癌的分期中，动态增强MRI在确定肿瘤的局部侵犯和肝转移上优于螺旋CT，对血管的侵犯的判断两者相似。     

MR imaging in the diagnosis of pancreatic disease

MR imaging examinations of 20 patients with normal pancreas and of 38 patients with suspected pancreatic disease were analyzed retrospectively to evaluate the ability of MR imaging to depict the normal and abnormal pancreas, establish MR criteria for various pancreatic diseases, determine if MR imaging can distinguish among various pancreatic diseases, and compare the usefulness of MR imaging with CT. In all 20 patients with normal pancreas and in 34 of the 38 patients with suspected pancreatic disease excellent or good evaluation of the pancreas was achieved. A 0.35-T magnet (Diasonics MT/S) was used, and both T1- and T2-weighted images were needed. T1 and T2 relaxation times and MR signal intensities showed no specific pattern to allow consistent differentiation between normal and diseased pancreatic tissue or to distinguish between tumor and inflammation. In the 29 patients in whom MR and CT images could be compared, MR imaging and CT provided equivalent information in 20 (69%). In 4 patients (14%), MR imaging added information, and in 5 patients (17%) of cases, MR imaging yielded less information than CT. MR imaging of the pancreas was found to be superior to CT in selected instances, such as in the staging of pancreatic neoplasms (n = 4) and in the evaluation of pancreatic disease after surgery (n = 3). We conclude that, at present, MR imaging should not be used as the screening method for pancreatic disease but should be reserved as an adjunct when the information provided by CT is insufficient.     

3.0T磁共振弥散加权成像在胰腺癌中的应用价值

目的:分析评价在3.0T磁共振非脂肪抑制憋气DWl序列在胰腺癌中的应用价值.方法-30例正常志愿者与30例经手术病理证实的胰腺癌患者,在3.0T磁共振上,术前行基于SE-EPI的非脂肪抑制憋气DWI序列,b值为0和600s/mm2,统计学比较分析正常胰腺、胰腺癌及远端炎症区的ADC值.结果:不同组织的ADC值从低到高依次为胰腺癌、正常胰腺、远端炎症,单因素方差分析显示不同组织的ADC值有明显统计学差异,F值为18.716,P值为0.0004,两两比较分析显示胰腺癌分别与正常胰腺及远端炎症的ADC值统计学有明显差异,P值分别为0.00483及0.00191.结论:在3.0T磁共振上,非脂肪抑制憋气DWI序列有助于病灶筛查,其ADC值能够较好的反映胰腺癌、正常胰腺及远端炎症的组织病理状态.     

MR imaging of pancreatic lesions. Comparison of manganese-DPDP and gadolinium chelate.

RATIONALE AND OBJECTIVES: To compare manganese-DPDP-enhanced and gadolinium-DTPA-enhanced MR imaging in patients suspected of having pancreatic cancer. METHODS: Fifteen patients who underwent MR imaging for suspected pancreatic cancer and received gadolinium-DTPA took part in a clinical phase III trial in which the efficacy of manganese-DPDP for detection of pancreatic cancer was evaluated. T1-weighted gradient-echo (GRE) images with and without fat suppression were used. Signal-to-noise ratio and contrast-to-noise ratio were calculated before and after the administration of each contrast agent. Image quality was assessed using a four-step score; delineation of the normal pancreas was assessed by two readers in consensus. RESULTS: In terms of pancreatic signal-to-noise ratio, only gadolinium-DTPA-enhanced fat-suppressed and non-fat-suppressed GRE imaging showed a significant (P < 0.001) increase (72% and 61%, respectively). In the patients with a focal pancreatic lesion (n = 14), a significant increase in contrast-to-noise ratio was found only in manganese-DPDP-enhanced GRE imaging without (106%) and with (82%) fat saturation. Qualitative image analysis demonstrated a significant improvement of manganese-DPDP-enhanced fat-suppressed MR images in delineating the pancreatic parenchyma (P < 0.01) as well as pancreatic tumors (P < 0.01). CONCLUSIONS: T1-weighted manganese-DPDP-enhanced GRE imaging with fat saturation should be regarded as the most suitable combination for detecting a pancreatic lesion.     

Various diffusion magnetic resonance imaging techniques for pancreatic cancer

Pancreatic cancer is one of the most common malignant tumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods are conducive to detecting small lesions. Compared to the other techniques, magnetic resonance imaging (MRI) has irreplaceable advantages and can provide valuable information unattainable with other noninvasive or minimally invasive imaging techniques. Advances in MR hardware and pulse sequence design have particularly improved the quality and robustness of MRI of the pancreas. Diffusion MR imaging serves as one of the common functional MRI techniques and is the only technique that can be used to reflect the diffusion movement of water molecules in vivo. It is generally known that diffusion properties depend on the characterization of intrinsic features of tissue microdynamics and microstructure. With the improvement of the diffusion models, diffusion MR imaging techniques are increasingly varied, from the simplest and most commonly used technique to the more complex. In this review, the various diffusion MRI techniques for pancreatic cancer are discussed, including conventional diffusion weighted imaging (DWI), multi-b DWI based on intra-voxel incoherent motion theory, diffusion tensor imaging and diffusion kurtosis imaging. The principles, main parameters, advantages and limitations of these techniques, as well as future directions for pancreatic diffusion imaging are also discussed.     

脂肪抑制技术在肝脏MRI中的应用价值

目的：探讨脂肪抑制技术在肝脏MRI中的应用价值。方法：对经手术病理证实或临床诊断的66例（其中正常17例，病变49例）作了脂肪抑制的肝脏MRI图像进行评分，并对其中44例计算肝脏及其病灶的信噪比（SNR）、对比噪声率（CNR）。结果：在显示肝脏及其病灶时，脂肪抑制与非脂肪抑制序列间并无显著性差异（P＞0．05）。结论：在肝脏MRI时，常规非脂肪抑制序列仍是基本的成像序列，必要时可加用FS脂肪抑制序列。     

影像技术在胰腺脂肪浸润与2型糖尿病相关性研究中的应用进展

胰腺脂肪浸润与2型糖尿病（T2DM）的发病有相关性,通过测量胰腺的脂肪含量可以评估胰腺的脂肪浸润情况,对T2DM的预防、早期诊断有非常重要的临床意义。相对于组织病理学活检技术,通过影像学方法测量胰腺脂肪含量具有安全、简单、可重复性高等优点。就基于超声、CT及多种MRI脂肪定量技术在胰腺脂肪浸润与T2DM相关性分析中的研究进展予以综述。     

MR imaging of the pancreas: a practical approach

This article reviews the current practical MRI techniques in assessment of the pancreas. With the comprehensive "one-stop-shopping" approach, the great majority of pancreatic diseases can be detected and characterized by the use of a combination of T1, T2-weighted, MRCP, and fat-suppressed T1-weighted dynamic post-gadolinium SGE sequences. This approach may provide the clinician with information regarding the site, nature, and staging of pancreatic tumor in a single setting. In many institutions worldwide, however, including our own, CT remains the main imaging method for the assessment of acute pancreatic diseases, due largely to its wide availability. MR imaging is reserved for the indications listed above, most importantly, the detection of small and non-organ-deforming pancreatic ductal adenocarcinoma, islet cell tumors, choledocholithiasis and pancreatic duct calculi, cholangiocarcinomas, and in cases of pancreatic head enlargement with no mass discernable on CT.