口腔颌面部病发变的MRI应用探讨

目的 探讨口腔颌面部病变的ＭＲＩ表现及应用价值。材料与方法 回顾复习１３例经手术病理及临床确诊的口腔颌面部病变的ＭＲＩ资料，其中包括恶性肿瘤９例，良性肿瘤２例，口腔颌面部感染２例。结果 ＭＲＩ具有优良的软组织分辨率，可清楚显示口腔颌面部正常解剖结构及病理改变。结论 ＭＲＩ对口腔颌面部病变的诊断具有重要价值。     

口腔及口咽部病变的MRI诊断探讨(附19例分析)

目的：探讨MRI对口腔及口咽部病变的征象特点及MRI在口咽口腔病变诊断中的应用价值。方法：分析19例经手术或活检证实的口腔口咽部病变的删征象与手术病理结果对照。结果：MRI对口腔口咽部病变能准确定位，并能助良恶性的鉴别。但对其做组织学定性尚有一定的困难。结论：MRI在口腔口咽部病变的诊断中有重要应用价值。     

CT和MRI对口腔和口咽部病变的诊断价值

目的：探讨CT和MRI对口腔及口咽部病变的诊断价值。方法：回顾性分析63例经病理及细胞学证实的口腔口咽部病变的CT、MRI资料,其中恶性肿瘤40例,良性肿瘤18例,感染性病变5例。结果：40例恶性肿瘤中,CT检查24例,MRI检查16例,除各有一例浅表型溃疡未能显示外,其余病灶及范围均较清晰显示,两者的区别在于MRI显示肿瘤侵犯邻近结构及深部组织方面优于CT;两者在显示良性病变的大小方面与手术结果相同。结论：CT及MRI对口腔口咽部病变的诊断有重要价值,MRI稍优于CT。     

颌面部海绵状血管瘤的MRI诊断价值

目的探讨颌面部海绵状血管瘤的MRI表现和诊断价值。方法回顾性分析我院经手术和病理证实的31例颌面部海绵状血管瘤的MRI表现。结果病变分布在腮腺咬肌区13例,颊部及颧颞部12例,眶部3例,唇部3例。3例为椭圆形或类圆形,2例为梭形,其余26例均表现为团状或片状的不规则形。T1WI上20例表现为长T1信号,7例为等T1信号,4例为稍长T1信号,在T2WI上27例表现为长T2高信号,4例为稍高信号。结论MRI可以明确颌面部海绵状血管瘤的诊断,并能明确病变的形态和范围,为临床诊断及手术方案的制订提供可靠的依据。     

67 Ga显像诊断口腔颌面部良恶性肿块的临床研究

67Ｇａ 枸橼酸 (Ｃｉｔ)对淋巴瘤的诊断价值和疗效评价已有报道[1 3 ] ,但极少用于口腔颌面部肿瘤。笔者对 2 5例口腔颌面部肿块患者进行了6 7Ｇａ Ｃｉｔ显像 ,并与术后病理检查结果进行了比较 ,以探讨其诊断价值 ,现报道如下。资料与方法1 研究对象。口腔颌面部肿块患者 2 5例 ,男 12例 ,女 13例 ,平均年龄5 5 7(2 2～ 83)岁 ,均系我院住院患者 ,其中良性肿块 11例 ,恶性肿块 14例。术后均经病理检查证实。以患者病变对侧正常唾液腺为对照。2 研究方法。①患者静脉注射 111～148ＭＢｑ6 7Ｇａ Ｃｉｔ(上海科兴药业公司提供 )后 2 4、48…     

磁共振成像在牙根尖周病变中的临床应用价值

目的探讨磁共振成像（MRI）在诊断牙根尖周炎性病变中的临床应用价值。方法选取8名有牙髓及牙周病变的病例,对口腔上下颌牙进行MRI检查,分析牙根尖周病变的MRI表现,并与X线牙片进行对照。结果 8例均有牙根尖周炎症水肿表现,T1WI上信号减低,T2WI信号稍增高,脂肪抑制像上呈明显高信号,其中3例病变范围显示较普通X线牙片大,2例普通X线牙片显示正常而MRI显示有炎性病变,2例显示牙根尖与上颌窦囊肿的关系。结论 MRI可敏感地显示牙根尖周的炎性病理改变,MRI在显示病变的大小、范围及其与周围结构关系方面比X线片优越,并能显示普通X线牙片所不能显示的病理改变,MRI在牙根尖周炎性病变诊断中具有重要的临床应用价值。     

口腔颌面部动静脉畸形栓塞术前病灶体积测量的临床应用

目的评价口腔颌面部动静脉畸形(AVM)介入术前应用兴趣区(ROI)体积测量法的临床意义。方法在MRI和多层螺旋CT(MSCT)图像基础上运用GEAW4.1软件ROI体积测量法,测定3例口腔颌面部AVM病灶体积,根据术前所得体积测定值指导栓塞剂用量,并观察其疗效。结果3例测得MRI和MSCT数据,运用ROI体积测量法测得的体积值分别为7.515cm3、1.195cm3及10.714cm3。然后,根据所测得体积值应用相应的栓塞剂量栓塞治疗,均取得较为满意的疗效。另1例因双侧供血动脉被结扎,且病变弥漫,无法进行准确的体积测量。结论MRI对显示软组织AVM有优势,MSCT则适用于颌骨内AVM检查。口腔颌面部AVM栓塞术前,在MRI和MSCT图像基础上采用GEAW4.1软件ROI体积测量法能得较准确的体积值,对口腔颌面部AVM介入栓塞术前栓塞剂用量的估算(特别是液态栓塞剂量)有一定的指导意义。     

梯度回波反相位T1WI对口腔颌面部疾病的诊断价值

目的探讨梯度回波反相位T1WI(GRE-OP-T1WI)对口腔颌面部疾病的诊断价值. 资料与方法对10名健康志愿者(对照组)绘制GRE-T1WI的回波时间-信号强度(TE-SI)曲线以确定0.5T场强中GRE-OP-T1WI的最小TE值,然后对23例口腔颌面部疾病患者(研究组)进行GRE-OP-T1WI与常规MRI序列对病灶显示程度的比较研究. 结果 0.5T MR仪实际最小TEOP值为21ms; 平扫和增强GRE-OP-T1WI与T2WI、平扫和增强T1WI相比能显著提高病灶显示程度. 结论 GRE-OP-T1WI可以抑制少量脂肪,对口腔颌面部疾病的诊断是常规MRI序列的有效补充,尤其对中、低场MR设备具有极大的应用价值.     

女性盆腔良性占位性病变的MRI诊断与鉴别诊断

目的 评价MRI对女性盆腔良性占位病变的诊断价值.方法 回顾性分析33例经手术病理证实的盆腔良性占位病变患者的MRI征象.结果 33例手术病理检出64个病灶,MRI检出59个(59/64,92.2%),3个子宫肌瘤及2个成熟畸胎瘤MRI未检出而漏诊(5/64,7.8%).MRI检出的59个病灶中57个病灶部位与手术病理一致,准确性为96.6%(57/59),56个病灶MRI诊断结果与手术病理相符,符合率94.9%(56/59).子宫病变主要表现为实质性肿块或子宫内膜增厚;卵巢病变主要表现为囊性、囊实性肿块影.结论 MRI对盆腔良性肿块的定位具有很高的准确性,对良性肿块的鉴别诊断亦具有较高的准确性.     

MRI及动态增强扫描在子宫内膜息肉样病变中的诊断及病理分析

目的探讨子宫息肉样病变中MRI及动态增强扫描的诊断价值及相应的病理基础。方法回顾性分析经术后病理证实的子宫内膜息肉样病变52例,将病灶MRI平扫及增强扫描图像与术后病理结果进行对照。采用Fisher精确概率法对囊变区、纤维核及完整结合带在子宫内膜息肉样病变中的出现频率进行分析比较。结果 29例子宫内膜恶性息肉病变在MRI子宫结合带中断或模糊征象出现的概率均较子宫内膜息肉及子宫黏膜肌瘤高,差异具有统计学意义(P值均0.05)。肿块内囊变影及不定形纤维核影见于子宫内膜息肉,2种征象在子宫内膜息肉中的出现概率均较子宫内膜恶性息肉样病变及子宫黏膜肌瘤高,差异具有统计学意义(P值均0.05);MRI对所有52例子宫内膜息肉样病变定性诊断的敏感度为82.7%,特异度为100%,准确度90.4%;对子宫内膜恶性肿瘤分期诊断的准确度为95.0%。结论MRI平扫及增强扫描能较好的反映子宫内膜息肉样病变的良恶性病变特征,具有很好的临床应用价值。     

鼻腔及鼻旁窦神经鞘瘤的影像学表现

目的 分析鼻腔和鼻旁窦神经鞘瘤的CT与MRI表现,提高诊断及鉴别水平.资料与方法 经病理证实的鼻腔、鼻旁窦神经鞘瘤8例,均行CT平扫,其中4例行增强扫描;MRI检查2例,同时行平扫和增强扫描.结果 良性4例,恶性4例.肿瘤原发于鼻腔4例,上颌窦3例,筛窦1例,无一例发生颈淋巴结转移.肿块在CT上多呈较均匀中等密度,3例密度不均;MRI T1WI呈中等信号,T2WI示中等或不均匀稍高信号,增强扫描肿瘤呈轻至中度强化或边缘强化.结论 鼻腔、鼻旁窦神经鞘瘤的CT与MRI表现无显著特异性,均能很好地显示肿瘤侵犯范围及骨质破坏情况.     

颅骨动脉瘤样骨囊肿的影像学表现

目的：探讨颅骨动脉瘤样骨囊肿的影像学表现，提高对颅骨动脉瘤样骨囊肿的认识。资料与方法：搜集经手术病理证实的4例颅骨动脉瘤样骨囊肿，全部病例均作了CT平扫与MRI检查，其中1例摄有颅骨平片，1例MR／增强扫描，1例DSA检查。结果：4例颅骨动脉瘤样骨囊肿中，1例位于左蝶骨嵴和左眶骨处，2例位于左颞骨。1例位于右额骨。CT上均表现为不同程度的膨胀性吹气球样溶骨破坏区，密度不均匀；MRI示有出血、囊变及液面，T1WI和R2WI上呈混杂信号，1例增强后示肿瘤实质和邻近脑膜强化；血管造影示血管有推移改变。结论：颅骨动脉瘤样骨囊肿的影像学表现有一定的特征性，CT与MRI相结合能提示诊断，并有助于评价周围结构。     

儿童颅内肿瘤的MRI表现和诊断

目的 分析131例儿童颅内肿瘤的MRI表现，总结MR诊断方法和步骤。资料与方法 就本院131例儿童颅内肿瘤的MRI表现作一回顾性分析，涉及肿瘤15种，其中胶质瘤39例，颅咽管瘤15例．髓母细胞瘤13例．室管膜瘤12例，垂体瘤9例，脑膜瘤8例，生殖细胞瘤7例，白血病和淋巴瘤6例，脂肪瘤5例，海绵状血管瘤4例，组织细胞瘤4例，胆脂瘤3例，脉络膜乳头状瘤2例，听神经瘤2例．血管母细胞瘤2例。结果 93例获得病理证实，MRI诊断与病理符合82例，正确率88．2％。结沦 只要掌握好儿童颅内肿瘤的特点和正确的MRI诊断方法、步骤，就可能对儿童颅内肿瘤作出准确的定位、定性诊断。     

中枢神经系统多原发性及多源性肿瘤的MRI分析

目的 探讨中枢神经系统多原发性及多源性肿瘤的MRI诊断价值。资料与方法回顾性分析3l例经病理证实的中枢神经系统多原发性及多源性肿瘤的MRI资料。结果多原发性肿瘤17例，其中，颅内多发性胶质瘤8例，多发性脑膜瘤2例，椎管内多发性神经纤维瘤4例，神经鞘瘤3例；多源性肿瘤14例，其中10例为神经纤维瘤病合并颅内或椎管内肿瘤，有1例肿瘤细胞类型达到3种。结论MRI对多原发性肿瘤和多源性肿瘤具有重要的诊断价值。     

Imaging findings of extrapulmonary metastases of osteosarcoma

PURPOSE: To review imaging findings of extrapulmonary metastasis from osteosarcoma and to evaluate them for any consistent pattern and correlation between imaging findings. MATERIALS AND METHODS: This study was retrospectively conducted in 13 patients with extrapulmonary metastasis of pathologically confirmed osteosarcoma. We evaluated the radioisotope (RI) scans (n=16), ultrasonography (USG) (n=4), computed tomography (CT) scans (n=10), MRIs (n=6), clinical records, and pathological reports for assessment of imaging findings and correlation between radiologic findings and RI uptake of the lesions. Points evaluated were the following: uptake on RI scans, presence of mineralization on CT, and MRI, size, enhancement pattern, attenuation on CT, signal intensity (SI) on MRI, and echogenicity on USG. RESULTS: Extrapulmonary metastatic sites were diverse, including another bone other than the primary site (n=6), lymph node (n=4), pleura (n=2), liver (n=2), pancreas (n=1), kidney (n=1), peritoneum (n=1), muscle (n=1), and subcutaneous fat layer (n=1). One patient had tumor growth within the pulmonary artery and jejunum. Among 21 metastatic sites in 13 patients, bone scan was performed in 16 cases and RI uptake was detected in 10 lesions. Calcification was detected in eight lesions on radiologic imaging, including plain radiography, USG, CT, and MRI. Two lesions showed RI uptake without definite calcification or ossification on MRI and plain radiography, respectively. We analyzed the enhancement pattern and mass size in 18 metastatic sites and these factors had poor correlation with uptake on RI scans. CONCLUSION: The sites and imaging findings of extrapulmonary metastasis of osteosarcoma were variable. All the lesions with mineralization were detectable on RI scans prior to radiologic imaging. RI scan has a limited role in the evaluation of metastatic lesions without mineralization.     

Integrated imaging using MRI and 123I metaiodobenzylguanidine scintigraphy to improve sensitivity and specificity in the diagnosis of pediatric neuroblastoma

OBJECTIVE: The objectives of this study were to compare MRI and iodine-123 ((123)I) metaiodobenzylguanidine (MIBG) scintigraphy in the detection of neuroblastoma lesions in pediatric patients and to assess the additional value of combined imaging. MATERIALS AND METHODS: Fifty MRI and 50 (123)I MIBG examinations (mean interval, 6.4 days) were analyzed retrospectively with regard to suspected or proven neuroblastoma lesions (n = 193) in 28 patients. MRI and MIBG scans were reviewed by two independent observers each. Separate and combined analyses of MRI and MIBG scintigraphy were compared with clinical and histologic findings. RESULTS: With regard to the diagnosis of neuroblastoma lesion, MIBG scintigraphy, MRI, and combined analysis showed a sensitivity of 69%, 86%, and 99% and a specificity of 85%, 77%, and 95%, respectively. On MRI, 15 false-positive findings were recorded: posttherapeutic reactive changes (n = 10), benign adrenal tumors (n = 3), and enlarged lymph nodes (n = 2). On MIBG scintigraphy, 10 false-positive findings occurred: ganglioneuromas (n = 2), benign liver tumors (n = 2), and physiologic uptake (n = 6). Thirteen neuroblastoma metastases and two residual masses under treatment with chemotherapy were judged to be false-negative findings on MRI. Two primary or residual neuroblastomas and one orbital metastasis were misinterpreted as Wilms' tumor, reactive changes after surgery, and rhabdomyosarcoma on MRI. Thirty-two bone metastases, six other neuroblastoma metastases, and one adrenal neuroblastoma showed no MIBG uptake. On combined imaging, one false-negative (bone metastasis) and three false-positive (two ganglioneuromas and one pheochromocytoma) findings remained. CONCLUSION: In the assessment of neuroblastoma lesions in pediatric patients, MRI showed a higher sensitivity and MIBG scintigraphy a higher specificity. However, integrated imaging showed an increase in both sensitivity and specificity.     

颊间隙病变的CT和MRI表现

目的：分析颊间隙病变的CT、MRI表现,旨在提高该间隙病变的诊断。方法：回顾性分析2002年1月～2008年3月CT或／和MRI检查发现颊间隙病变及其累及颊间隙病变23例,包括感染性病变3倒,肿瘤性和肿瘤样病变20例。除5例经临床治疗后证实外,其余均经手术和穿刺活检病理确诊。结果I3例感染性病变表现为颊脂体及其周围脂肪密度增高;原发和累及颊间隙的肿瘤和肿瘤样病变CT、MRI表现多样,除血管瘤Tz加权表现较具特征性外,其余肿瘤信号缺乏特征;多数恶性肿瘤边界不清;肿块相对较大;累及颊间隙的恶性肿瘤多表现为多间隙侵犯;MRI和CT均能清晰显示病变侵犯的范围。结论：CT和MRI是诊断颊间隙病变的重要检查手段,对病变的来源及范围可做出较为准确的评价,对定性具有一定的诊断价值,可为临床制定治疗方案和预后提供依据。     

脑脊膜转移的MRI表现

目的：总结脑脊膜转移的ＭＲＩ表现及其与原发肿瘤的关系。材料与方法：复习２０例符合下述３项标准的病例的临床及ＭＲＩ资料：（１）有病理证实的原发恶性肿瘤史;（２）新近发生神经系统症状和体征;（３）静脉注射Ｇｄ－ＤＴＰＡ后ＭＲＩ示脑脊膜异常强化。结果：原发肿瘤：癌１２例,非何杰金淋巴瘤８例。ＭＲＩ表现有：（１）脑脊膜异常强化２０例;（２）神经根异常强化１３例,其中马尾终丝病变１０例;（３）脑积水２例。脑     

Detection of recurrent ovarian cancer at MRI: comparison with integrated PET/CT

OBJECTIVE: To compare the diagnostic performances of magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for the detection of recurrent ovarian tumor. METHODS: Thirty-six patients who underwent primary cytoreductive surgery for ovarian carcinoma received both MRI and PET/CT for the evaluation of ovarian tumor recurrence. Recurrent ovarian tumors in abdomen and pelvis were classified based on site as follows: (1) local pelvic recurrence, (2) peritoneal lesion, (3) lymph nodal metastasis, and (4) distant metastasis. Patient-based and lesion-based analyses were retrospectively performed with the aim of detecting tumor recurrence. For the detection of recurrent ovarian tumors, we compared patient-based and lesion-based diagnostic accuracies of these 2 modalities using the McNemar test. RESULTS: Histopathologic, clinical, and radiological follow-up findings revealed recurrent ovarian tumors in 35 sites of 22 patients. These 35 sites consisted of local pelvic recurrence (n = 15), peritoneal lesions (n = 14), lymph nodal metastasis (n = 4), and abdominal wall metastasis (n = 2). In detecting recurrent ovarian tumor, patient-based sensitivity and the accuracy of PET/CT and MRI were 73% and 91% (P < 0.05), and 81% and 89% (P > 0.05), respectively. In addition, overall lesion-based sensitivity of PET/CT and MRI were 66% and 86%, respectively (P < 0.05). In detecting peritoneal lesions, overall lesion-based sensitivity and accuracy of PET/CT and MRI for peritoneal lesions were 43% and 86%, and 75% and 94%, respectively (P < 0.05). CONCLUSIONS: Magnetic resonance imaging is more sensitive than PET/CT for detecting local pelvic recurrence and peritoneal lesions of recurrent ovarian tumors.