扩散加权成像对椎体骨折性质的鉴别

目的评价磁共振的扩散加权成像(DWI)在溶骨性转移瘤和良性骨质疏松性所致椎体压缩骨折的鉴别诊断作用。方法对37例X射线诊断为椎体压缩性骨折患者,进行磁共振成像(MRI)检查,分析DWI及表观扩散系数(ADC)值在骨质疏松性和转移瘤性骨折的表现,并与病理诊断相比较。结果椎体溶骨性转移瘤致压缩骨折的DWI呈高信号有24例。溶骨性转移瘤骨折的ADC值为(1.261±0.2)×10~(-3)mm~2/s,显著高于良性骨质疏松性骨折的(0.593±0.457)×10~(-3) mm~2/s(P=0.001)。结论磁共振的DWI能够可靠地区分椎体溶骨性转移瘤骨折与良性骨质疏松性骨折,ADC值亦是一个有较大鉴别作用的指标。     

脊椎转移瘤的MRI诊断研究

目的　探讨脊椎转移瘤的MRI诊断价值并分析其MRI征象。方法　对2 8例脊椎转移瘤患者行T1WI、T2 WI、P(N)I、小翻转角准T2 WI等序列检查并分析。结果　脊椎转移瘤的MRI征象包括:①早期为长T1长T2 均匀信号;②当椎体破坏或压缩时信号混杂;③附件转移为长T1长T2 信号,易形成软组织肿块和压迫脊髓;④邻近椎间盘可有信号改变。结论　MRI是目前对椎体转移瘤最敏感的一种检查手段。     

MRI在骨质疏松性椎体骨折与转移瘤压缩性椎体骨折诊断及鉴别诊断中的应用

目的通过分析骨质疏松性椎体骨折(osteoporotic vertebral fracture,OVF)与转移瘤压缩性椎体骨折(metastaticcompression vertebral fracture,MCVF)的MRI表现特征,探讨MRI在椎体良恶性骨折诊断及鉴别诊断中的价值。方法收集2010年10月—2011年11月具有完整临床资料的OVF患者40例和MCVF患者24例,均给予MRI检查,分析不同类型骨折椎体的形态学异常及信号变化。结果 OVF患者中共有103个椎体发生压缩变形,T1加权像(T1 weight imaging,T1WI)可见椎体终板下或椎体中央部带状低信号,T2WI高信号;MCVF患者中共有60个椎体压缩变形,受累椎体T1WI上均显示弥漫性低信号,T2WI上多呈高信号,信号不均匀。OVF患者中有15个椎弓根信号异常,MCVF患者中有50个椎弓根信号异常,并有膨大改变。OVF患者中病变椎体椎间盘于T2WI上信号减低,并有13例患者椎间盘髓核突入椎体,形成Schmorl结节;MCVF患者中骨折椎体临近椎间盘未见明显异常信号。OVF患者中所有受累椎体周围均未出现异常软组织信号影;MCVF患者中受累椎体周围可见异常软组织信号影占75.0%,软组织肿块突入椎管且压迫硬膜囊占45.8%。结论 MRI平扫和增强扫描对椎体骨折性质判定具有重要价值,值得临床应用。     

老年骨质疏松急性期椎体骨折的MRI分析

[目的]评估MRI在老年骨质疏松急性期椎体骨折的诊断及鉴别诊断价值。[方法]使用0.2T安科OPEN/MARKⅡ扫描机,用SE序列对所有110例60岁以上外伤史隐匿的急性期椎体骨折的老年人,进行胸腰椎冠状、矢状及轴位MR成像进行观察,并与老年人易患的97例脊椎转移Ca和多发骨髓瘤的MRI进行了对照。[结果]老年骨质疏松急性期椎体骨折的MRI有椎体变形和带状长T1长T2信号并存,椎体周径无延长,不累及椎弓和无硬膜外肿块等特点,有别于其他椎体病理骨折的MRI。[结论]MRI是老年骨质疏松急性期椎体骨折的有价值的影像诊断方法。     

脊柱转移瘤的MRI表现及早期诊断

[目的]探讨脊柱转秽瘤的MRI表现及早期特征.[方法]对38例脊柱转移瘤患者MRI表现进行分析.[结果][1]病变椎体及附件呈不均匀长T1长T2信号,多椎体受累者呈跳跃状分布,椎间盘不受累.[2]多椎体受累合并附件破坏及椎旁软组织肿块属于晚期表现.[3]椎体后部及椎弓局灶性骨破坏是诊断早期脊柱转移瘤的重要根据.[结论]脊柱转移瘤具有特征的MRI表现,对早期诊断有确切价值.     

原发性肝淋巴瘤的MRI表现及鉴别诊断

目的：探完原发性肝淋巴瘤的MRI表现及鉴别诊断过程中的意义;方法：回顾性分析经过病倒证实的5例原爱性肝淋巴瘤MRI表现,并对原发性肝淋巴瘤的MRI表现及鉴别诊断进行结果分析;结果：肝淋巴瘤MRI主要表现为：DW1为稍高信号,T1W1为低、等信号,T2W1信号种类较为复杂,存在等信号、等低信号以及中等信号等,偶尔存在低信号包膜。病灶动态增强表现为进行性轻度、中度延迟性强化,经增强后主要表现为动脉期轻度强化或无明显强化,门脉期表现为轻度以及中度均匀强化,部分患者呈边缘强化;结论：通过原发性肝淋巴瘤的MRI表现及临床特征,可区别于肝脓肿、肝癌、肝转移瘤等疾病。     

胸腰椎衰竭性骨折影像诊断

目的 总结分析胸腰椎衰竭性骨折及影像学表现.方法 30例中老年腰腿痛患者进行胸椎腰椎正侧位片,CT检查及MRI检查.结果 30例患者都有明显骨质疏松,胸椎、腰椎多个椎体楔形或双凹镜状的‘鱼椎’样改变,椎旁软组织肿胀.结论 影像学检查能明确诊断胸椎、腰椎衰竭性骨折,并能转移瘤鉴别.     

短时反转回复序列低场强MRI在诊断脊柱转移瘤中的价值

目的：探讨短时反转回复序列（STIR）低场强MRI在诊断脊柱转移瘤中的临床价值。方法：总结23例使用短时反转回复序列低场强MRI在诊断脊柱转移瘤患者的临床经验。结果：本组23例确诊患者,共累及椎体79个,T1加权像有4例略低信号,19例低信号,可以或容易辨认病灶。T2加权像15例高信号,5例为略高或等混杂信号,3例为低信号;其中有3例T1、T2加权像上均呈低信号,STIR序列上3例为低信号,20例均为高信号。6例存在显著的椎体附件骨质破坏。结论：STIR可以作为常规脊柱病变扫描的有效补充,尤其是针对恶性肿瘤可疑的脊柱转移患者,具有早期诊断和鉴别诊断的意义。     

脊柱转移瘤MR不同序列诊断价值比较

进行了脊柱转移瘤的磁共振SE T1WI、SE T2WI、STIR序列图像的对比研究。结果表明:MRI对脊柱转移瘤有肯定诊断价值,T1WI、STIR序列是脊柱转移瘤MR检查中重要且简捷的扫描序列。     

核磁共振成像在诊断睾丸附睾肿块临床价值

目的探讨核磁共振成像(MRI)用于睾丸附睾肿块诊断的临床价值。方法回顾性分析经广东省农垦中心医院手术及病理学检查确诊的1 6例睾丸附睾肿块患者的影像学资料,分析其MRI表现。结果 1 6例睾丸附睾肿块病灶MRI影像显示不同程度的肿大,边界清或不清。其中精原细胞瘤5例,以实质性改变为主,病灶内见均匀等T1、T2信号及大小不等片状长T1、T2信号,病灶轻度强化;混合型生殖细胞瘤2例,MRI表现T1 WⅠ、T2 WⅠ呈高混杂低信号;畸胎瘤3例,良性畸胎瘤呈椭圆形,T1 WⅠ、T2 WⅠ呈高混杂低信号及轻度强化,恶性畸胎瘤增强后呈不均匀明显强化;内胚窦瘤(卵黄囊瘤)1例,边缘欠规整,T 2 WⅠ高信号及不均匀强化;附睾囊肿及附睾结核各发生1例;非特异性肿块3例。结论M R I的多方位、多序列扫描能清楚显示睾丸附睾病变,对早期诊断及治疗有较高的价值。     

MRI对血精性精囊炎的诊断价值

目的分析血精性精囊炎的MRI表现，探讨MRI在血精性精囊炎诊断中的价值。方法回顾性分析了25例血精性精囊炎的MRI表现，观察其形态、大小及内部异常信号改变，分别采用SE T1WI(TR/TE558／14ms)，Flash 2D水激励T1WI(TR/TE18．5／5．2ms)，TSE T2WI(TR/TE 4000／99ms)加脂肪抑制序列扫描。结果本组25例血精性精囊炎均表现为两侧精囊体积增大；精囊内“出血”于SE T1WI呈斑片状／斑点状高信号，此高信号影于Flash 2D水激励T1WI序列显示更清晰，低信号精囊管道壁因高信号出血衬托而得以显示；精囊内“出血”于TSE T2WI呈相对较低信号，低信号精囊管道壁被较低信号出血影掩盖而显示不清。结论MRI能对血精性精囊炎做出明确诊断，是血精性精囊炎最可靠的影像学检查方法。     

Lumbar vertebral hemangioma with extradural extension, causing neurogenic claudication: a case report

The authors present a rare case of lumbar vertebral hemangioma extending to the epidural space with a bisected appearance and impinging on thecal sac. This 52-year-old lady presented with one year history of low back pain and bilateral leg radiation. Plain radiography showed vertical linear streaks at L2 vertebral body and axial computed tomography (CT) scan revealed small "polka dot" appearance within the vertebral body. Magnetic resonance imaging (MRI) showed low signal intensity on T1-weighted images in L2 vertebral body which was not characteristic for hemangioma. The patient underwent an L2 laminectomy, spinal canal decompression and posterior spinal instrumentation. This study indicates that lumbar vertebral hemangioma can extend to the epidural space and cause neurologic symptoms. Magnetic resonance imaging may not show diagnostic features, especially in active lesions and plain radiography and CT scan may be helpful.     

MRI of an intrathoracic malignant tumor invading the chest wall

22 patients with intrathoracic malignant tumors suspected of invading the chest wall were examined with CT and MRI. Chest wall invasion was operatively confirmed in 19 cases and excluded in the other 3 cases. CT showed tumor infiltration of the chest wall in 14/19 cases, no morphological changes in 5/19 cases. Thoracic wall invasion was demonstrated by MR in all 19 cases. Typical MR finding of malignant invasion was local lesion within the chest wall showing high signal intensity in post-Gd T1-weighted images and in T2-weighted images. Reactive inflammatory changes as well as malignant infiltration of the pleura showed high signal intensity on enhanced T1-weighted images and on T2-weighted images.     

磁共振成像（MRI）评价肛瘘与手术的相关性

目的：探讨磁共振成像（MRI）评价肛瘘与手术的相关性,为临床诊断提供参考。方法：选取2012年2月-2014年5月本院疑似肛瘘的58例患者为研究对象,平均年龄（43.35±12.21）岁。所有患者均采用PHILIPS Achieva 1.5 T超导型磁共振扫描仪扫描进行MRI检查,相控阵列线圈,层厚4 mm,无间隔,分别作横轴位、横截面及矢状面扫描,记录扫描所得数据。结果：MRI能够正确识别内口56例,脓腔54例,主管55例,支管51例。T2-weighted快速自旋回波脂肪饱和图像和增强后的T1-weighted快速自旋回波脂肪饱和图像进行对比检测支管和内口情况,除3例患者的支管出现在T1-weighted image TSE TRA FS却在T2-weighted image TSE TRA FS上消失,这两个序列检查支管的准确方面比较差异无统计学意义（X^2=1.037,P=0.387）。除7例患者的内口出现在T2-weighted image TSE TRA FS却在T1-weighted image TSE TRA FS上消失,这两个序列检查内口的准确方面比较差异有统计学意义（X^2=5.02,P=0.04）。结论：T2-weighted image TSE TRA FS在检查内口方面效果更佳,MRI检查可以为临床提供准确的术前信息,是一种无创、准确、可靠的肛瘘检查方法,具有重要的临床实用和推广价值。     

MRI of bronchogenic carcinoma

47 patients with histologic/cytologic confirmed bronchogenic carcinoma were examined with CT and MRI. Negative and contrast enhanced CT examinations were performed, MR images were obtained with ECG gated T1- and T2-weighted SE sequences in axial and coronal planes. Both methods were evaluated with respect to tumor imaging and delineating of tumor extensions. CT and MRI were generally in agreement for primary tumor and lymph node staging. 7 out of 10 patients with malignant pericardial involvement and 3 out of 27 patients with mediastinal subcarinal lymph node metastases were identified only in MR images. MRI was superior to CT in demonstration of aortic involvement, poststenotic syndrome and extension of chest wall invasion. Additionally MRI gave functional informations about blood flow in case of superior vena cava obstruction.     

Magnetic resonance appearance of asbestos-related benign and malignant pleural diseases

OBJECTIVES: This study describes the magnetic resonance findings of benign and malignant pleural diseases in asbestos-exposed subjects. METHODS: Thirty patients with a history of asbestos exposure and pleural lesions in chest X-rays and computed tomography scans were examined with a 0.5- and a 1.5-T magnetic resonance unit. The examination protocol included cardiac-gated proton density and T2-weighted images, unenhanced and enhanced (Gd-DTPA; 0.1 mmol/ kg) T1-weighted images in the axial plane and sometimes in another orthogonal plane (sagittal or coronal or both). All the magnetic resonance images were reviewed by 3 experienced observers, who visually evaluated morphologic features, signal intensity, and contrast enhancement of pleural lesions. The diagnosis was established by means of percutaneous biopsy, thoracotomy, and combined clinical and radiological follow-up for at least 3 years. RESULTS: Eighteen patients affected with multiple pleural plaques showed low signal intensity on both unenhanced and enhanced T1-weighted and proton density and T2-weighted images. In 2 of these patients an acute pleural effusion was observed. All the malignant lesions (11 mesotheliomas) and a solitary benign pleural plaque revealed high signal intensity on the proton density and T2-weighted images and inhomogeneous contrast enhancement in the postcontrast T1-weighted images. The sensitivity, specificity, and diagnostic accuracy of the magnetic resonance imaging in classifying a lesion as suggestive of malignancy were 100%, 95% and 97%, respectively. CONCLUSIONS: The results point out 2 magnetic resonance signal intensity patterns for asbestos-related pleural lesions: (i) low-signal intensity on unenhanced and enhanced T1-weighted and proton density and T2-weighted images for benign plaques and (ii) nonhomogeneous hyperintensity in T2-weighted and enhanced T1-weighted images for malignant mesotheliomas.     

On-off study of manganese administration to adult patients undergoing home parenteral nutrition: new indices of in vivo manganese level

BACKGROUND: Recently, there have been reports that magnetic resonance imaging (MRI) reveals high-intensity T1-weighted images (HI) in the basal ganglia (especially in the globus pallidus) of patients receiving total parenteral nutrition (TPN). This finding is presumably due to excess administration of manganese. We investigated the reversibility and reproducibility of these changes by means of an on-off manganese administration study. We also investigated the temporal relationships between the intensity of T1-weighted images (MRI intensity) and the whole-blood and plasma manganese concentrations to evaluate the potential for the MRI intensity to serve as an index of the in vivo manganese level. METHODS: Eleven adult patients undergoing home parenteral nutrition received TPN solutions containing manganese (0 or 20 micromol/d) according to an on-off design. The whole-blood and plasma manganese concentrations were determined at the same time the brain MRI was performed. RESULTS: Both the whole-blood manganese concentration and the MRI intensity in the globus pallidus changed in response to the administration and withdrawal of manganese. It took at least 5 months for HI to disappear when manganese was withdrawn, and this change was reversible and reproducible. The whole-blood manganese concentration showed strong correlations with both the MRI intensity and the T1 value (r = 0.7693, -0.7011). The MRI intensity and the T1 value showed a strong correlation (r = -0.9051). CONCLUSIONS: The whole-blood manganese concentration, the MRI intensity in the globus pallidus and the T1 value, an objective index of the MRI intensity, may be useful indices of the manganese level in the body.     

MR imaging of idiopathic transient osteoporosis of the hip

Four patients with idiopathic transient osteoporosis of the hip were examined by magnetic resonance imaging (MRI). MRI clearly showed low signal intensity in the affected femoral head on T1-weighted images and high signal intensity on T2-weighted images. After regression of hip pain, MR images became normal. MRI was a useful method for diagnosis and follow-up study of idiopathic transient osteoporosis of the hip.     

小儿流行性乙型脑炎的临床及MRI特征分析

目的探讨小儿流行性乙型脑炎（乙脑）的临床特点与颅脑MRI影像特征及其与预后的关系,为临床早期诊治提供依据。方法回顾性分析本院收治的145例流行性乙型脑炎患儿的临床及MRI资料。98例行0．35TMRI检查获得常规T1WI、T2WI及FLAIR序列,47例行1．5TMRI检查除采集常规序列外,还采集了DWI序列。分析脑部MRI表现：病灶累及的部位、范围和MRI信号特征。结果MRI平扫中106例（73．1％）发现脑实质异常信号影,其病灶不同程度的累及丘脑,87例同时累及中脑大脑脚,同时累及基底节、脑皮质及小脑受累分别为32例、43例和2例;15例累及脑白质。病灶表现为不同范围的T2WI高信号病变,T1WI多呈低信号,少数呈等信号。FLAIR上全部可见高信号灶,少数高信号灶中心可见低信号影。38例FLAIR显示脑实质异常信号灶较T2WI更多。DWI上28例可见脑实质高信号病灶,12例可见低信号病灶,7例在DWI及ADC图均呈等信号改变。1．5TMRI阳性率（87．2％）明显高于0．35TMRI（66．3％,X^2=7．06,P〈0．01）。结论MRI能显示乙脑患儿颅脑病变的部位及范围,累及丘脑及中脑大脑脚为其特征性表现。FLAIR及DWI对乙脑的早期诊断具有很高的价值。     

急性自发性硬脊膜外血肿的诊断和治疗

目的 分析和探讨急性自发性硬脊膜外血肿(ASSEH)的临床特征、诊断和治疗.方法 对5例经手术证实的ASSEH病例的诊断和显微手术治疗进行回顾性分析.5例患者主要临床症状为突发颈肩部/腰背部剧痛,并迅速出现迟缓性瘫痪和植物神经功能障碍.MRI检查均表现为椎管内硬膜外条状或梭形病灶,边界清楚,未见强化.急诊在显微镜下行后路椎管探查椎板切除血肿清除术.结果 所有患者手术经过顺利,术中见血肿位置与MRI提示的一致,清除褐色胶冻样血肿5～15 ml,显微镜下未见蛛网膜下隙和脊髓异常.按照国际脊髓损伤神经分类标准评分,术后11～30 d神经功能从术前的B、C级均恢复到E级,未有并发症发生.随访1～6个月均未见异常.结论 结合临床症状和MRI可提高ASSEH正确诊断率,而术前行数字减影血管造影(DSA)并非必要.急诊显微神经外科手术是治疗症状性ASSEH的有效手段,术后DSA有助于排除脊髓血管畸形.