脊柱转移瘤的MRI诊断(附34例分析)

目的：探讨MRI对脊柱转移瘤诊断和鉴别诊断的价值。方法：回顾性分析34例脊柱转移瘤的MRI表现，均有明确原发瘤灶。结果：①6例为单椎体病变，28例为多椎体病变；②在T1WI上34例均呈低信号，在T2WI上26例(76．5％)呈高信号，7例(20．6％)呈等信号，1例(2．9％)呈低信号；③椎体骨质破坏分溶骨型、成骨型、混合型三种类型；④椎旁肿块形成者7例(20．6％)；⑤椎管狭窄者13例(38．2％)；⑥跳跃式分布者20例(59．9％)；⑦34例椎间盘的形态及信号均大致正常。结论：脊柱转移瘤具有特征性的MRI表现，综合分析有助于诊断和鉴别诊断。     

MRI STIR技术在诊断脊柱转移瘤中的应用价值

目的: 探讨STIR技术在MRI诊断脊柱转移瘤中的应用价值.材料和方法: 回顾性对照分析42例脊柱转移瘤之常规T1WI、T2WI及STIR序列的表现.结果: 42例共累及196个椎体.71个椎体T1WI呈低信号,T2WI呈高信号,11个椎体T1WI、T2WI均呈低信号,114个椎体T1WI或T2WI呈混杂信号,病灶STIR序列均呈异常高信号.105个椎体形态无明显改变,91个椎体伴有后缘膨隆或压缩性骨折,11例继发椎管狭窄,14例伴椎旁软组织肿块,STIR序列能清晰显示以上所有异常.结论: STIR序列易于发现脊柱转移灶,可较准确地判断肿瘤的侵袭范围及程度,并有助于转移瘤的鉴别诊断.     

STIR序列在脊柱MRI检查中的临床应用

目的探讨短T1反转恢复（Short TI Inversion-Recovery,STIR）成像技术在脊柱MRI检查中的应用价值。方法对73例脊柱病变患者（其中，转移瘤50例，血管瘤10例，脂肪瘤8例，急性外伤5例）进行常规MRI平扫、STIR扫描，分析病变的检出情况、病变形态及信号的显示效果。结果在病变的检出，病变形态及信号的显示方面，STIR扫描明显优于平扫各图像。结论脊柱MRI平扫中STIR成像的应用对病变的检出，病变形态、信号的显示具有明显优势，能提高MRI对疾病诊断准确性。     

MRI在脊柱转移瘤中的诊断价值(附85例分析)

目的 探讨MRI在脊柱转移瘤诊断中的价值.方法 回顾分析85例脊柱转移瘤的MR表现,其中46例曾做平片或/和CT检查.结果 85例共累计388个椎体.所有病椎T1WI均呈低信号,T2WI中354个椎体呈混杂信号,34个椎体为低信号,T2WI/STIR病椎均呈高信号改变.54个椎体不同程度病理性骨折,53个被压缩椎体后缘隆起,54例病变附件破坏,30例伴椎旁软组织肿块及侵犯椎管.46例有平片或/和CT资料,其中18例发现病变,总阳性率39.11%(18/46).结论 MRI较平片及CT更早发现脊柱转移灶,并可较准确地判断肿瘤的范围及程度.     

脊椎转移瘤MRI特点分析

目的评价高场强磁共振成像对脊椎转移瘤的诊断潜能。方法回顾性分析经临床病理证实的30例脊椎转移瘤的MRI改变。结果30例脊椎转移瘤中脊椎转移病灶56个，单发9例，多发21例；T1WI以低信号为主；T2WI以高低混杂信号为主；压脂序列所有病例均表现为高信号。结论高场强磁共振成像是诊断脊椎转移瘤的可靠方法，T1压脂序列可以对其生长方式、转移部位及累及范围进行很好的评估。     

脊柱转移瘤的MRI诊断

目的探讨MRI对脊柱转移瘤的诊断价值。方法对62例经手术证实的脊柱转移瘤均行平扫和增强扫描，分别采用SE序列T1WI，T2WI及STIR序列。结果62例中，单椎体受累12例，多椎体受累50例。单纯附件受累1例，并椎旁软组织肿块9例，椎管受累11例，合并椎体压缩性骨折7例。结论MRI是脊柱转移瘤的高敏感性检查方法，有助于临床确定治疗方案和评价预后。     

脊柱转移瘤的MRI诊断与评价

目的探讨脊柱转移瘤的MRI诊断。方法回顾性分析128例临床资料完整的脊柱转移瘤的MRI表现。结果（1）信号异常87.5%表现为T1W低信号,12.5%表现为T     

脊柱转移瘤的MRI诊断(附20例报告)

本文对20例经手术病理证实的脊柱转移肿瘤的原发肿瘤及转移部位进行了分析。脊柱转移瘤的MRI特征性表现：（1）受累椎体呈长T1低信号，长T2高信号表现。（2）多发转移瘤的“跳跃征”。（3）椎间盘一般不受侵犯。复习文献对脊柱转移瘤的诊断和鉴别诊断进行了讨论。     

CT、MRI对脊柱转移瘤的诊断价值

目的探讨CT、MRI诊断脊柱转移瘤的价值。方法回顾性分析55例经病理、临床证实脊柱转移瘤患者的CT和MRI表现。结果 CT、MRI检出55例脊柱转移瘤123个椎体受累,累及附件89个,累及椎管53处,椎旁软组织肿块65处,病理性骨折12处。CT表现为溶骨型、成骨型、混合型三种骨质改变。MRI表现为多数椎体形态无改变,少数椎体楔形变,双凹变形或伴前后径增大。椎体信号呈三种类型改变:均匀或略不均匀长T1、长T2信号;长T1短T2信号;T1WI不均匀低信号,T2WI混杂信号。MRI增强后病灶呈不同程度强化。结论 CT、MRI诊断脊柱转移瘤各有优势。CT显示脊柱转移瘤的骨质破坏改变优于MRI。MRI在鉴别诊断脊柱转移瘤病理性压缩骨折和诊断早期脊柱转移瘤中明显优于CT。     

低场MRI对诊断乳腺肿块的临床应用研究

目的：探讨低场强MRI对诊断乳腺肿块的临床应用价值。方法：对25例共26例临床可扪及的乳腺肿块患者行T1WI和STIR横断面及矢状面扫描，逐个记录肿块的MRI形态和信号特征，依据肿块的形态、边缘、纵横比、内部信号、周围腺体及皮肤改变、腋窝淋巴结肿大等表现对肿块性质进行前瞻性分析判断，和手术及病理结果对照，计算MRI对诊断乳腺肿块的准确性。结果：乳腺囊肿于T1WI信号有特异性，乳腺实性肿块于T1WI信号无特征性，但可以显示肿块形态及与腺体下脂肪垫的关系。STIR可清晰显示乳腺肿块的形态和信号特征，并可同时显示肿块同腺体、皮肤及腋窝淋巴结肿大的关系。良恶性肿块间在形态、边缘、纵横比及内部信号特征方面具有显著性差异。结合STIR所显示的乳腺肿块的形态和信号特点，MRI诊断乳腺肿块的敏感性为93％，准确率为81％。结论：低场强MRI是诊断乳腺肿块的理想手段，尤其在诊断乳腺囊肿、乳腺炎和典型的浸润性导管癌及乳腺纤维腺瘤方面效果明显。     

高场MR与超低场MR诊断脊柱转移瘤

目的：探讨两种不同场强MR机对脊柱转称瘤的诊断价值,各自的信号变化以及不同的扫描技术特点,为两种场强MR诊断该疾病提供客观的依据。方法：回顾性总结高场MR（1．5T）与超低场MR（0．04T）诊断脊柱转移瘤各20例,分析其各自的特点。结果：两种场强发现病灶的敏感率均达到100％,敏感序列完全不同,高场是T1W,超低场是T2W,高场机的图像空间分辨率,序列选择,扫描时间等均明显优于超低场。结论：两种场强的MR机诊断脊柱转移瘤敏感,可靠,高场MR能提供更多的病理信息。     

Comparison of whole-body MR imaging and bone scintigraphy in the detection of bone metastases from breast cancer

The aim of this study was to investigate the usefulness of whole body MR imaging (WB-MRI) in the detection of bone metastases from breast cancer and to compare the results with those from bone scintigraphy. In 21 patients with suspected bone metastasis from breast cancer, both bone scintigraphy and WB-MRI were performed. With WB-MRI, coronal images were obtained using a body coil in an FOV of 48 cm, and sequences of fast short TI inversion recovery (STIR) and gadolinium-enhanced fast spoiled GRASS (SPGR) were used in three parts: from the head to the thorax, the abdomen to the pelvis, and the lower extremities. Of the total 105 metastatic bone lesions, 65 (61.9%) were detected by bone scintigraphy, 98 (93.3%) by fast STIR, and 74 (70.5%) by fast SPGR. Thus, the detection of bone metastases by WB-MRI was excellent. However, detectability in the ribs was lower for WB-MRI than for bone scintigraphy. Contrast-enhanced MRI was useful in the differentiation of osteosclerotic lesions, in which high signal intensity is rare, pleural effusion, which has high signal intensity on STIR, and bone metastatic lesions. In conclusion, WB-MRI showed high reliability in the detection of bone metastatic lesions from breast cancer.     

Magnetic resonance imaging of the solitary hepatic mass: Direct correlation with pathology and computed tomography

Magnetic resonance images (MRI) of the liver were obtained using a combination of short time inversion recovery (STIR) and spin echo (SE) sequences. These were correlated with comparable tissue slices generated from resected specimens obtained at partial hepatectomy. All 10 cases appeared to have solitary masses on contrast enhanced computed tomography (CT). Histological examination revealed five primary tumours (two hepatocellular carcinomas, two haemangiomas and one cholangiocarcinoma) and five metastatic tumours. The STIR images demonstrated a high signal intensity in all areas of viable tumour involvement and reduced signal intensity in regions of confluent necrosis with superimposed haemorrhage or calcification. This sequence also demonstrated additional areas of high signal intensity adjacent to several lesions which were not visible on CT. Microscopy of these regions in the specimens demonstrated no tumour involvement or steatosis and their precise cause remains obscure. All the lesions demonstrated on the CT images were visible on MRI and no additional lesions were discovered on detailed microscopical examination of the specimens. Delineation of the extent of the cholangiocarcinoma was a problem with both techniques. MRI showed no major advantage over CT except for a higher contrast of the lesion compared with normal liver and also a better delineation of the tumour mass.     

Visceral metastases from melanoma: findings on MR imaging.

Typical ocular and CNS melanomas are hyperintense on T1-weighted MR images and hypointense on T2-weighted MR images. We performed MR imaging in 48 patients with melanoma metastatic to visceral organs. Images were reviewed retrospectively in order to determine whether there were predominant MR features specific for visceral melanoma and to see if visceral metastases have MR characteristics similar to metastases in the CNS. Eleven patients also were examined after injection of gadopentetate dimeglumine to evaluate the enhancement characteristics of these tumors. Two hundred sixty-one lesions were found. Lesions were classified according to their signal intensities relative to uninvolved liver on T1-weighted, T2-weighted, and short TI inversion recovery (STIR) pulse sequences. Most commonly, lesions were either hypointense or isointense on T1-weighted sequences and hyperintense on T2-weighted and STIR sequences (185 lesions). Less frequently, lesions were hyperintense on T1-weighted sequences and hypointense or isointense on T2-weighted and STIR sequences (59 lesions). A mixed pattern was seen on T1- and T2-weighted sequences in 17 lesions. The patterns did not correlate with lesion size. Of the three sequences studied by subjective comparison, the STIR sequence in our series had the highest sensitivity for lesion detection and yielded the highest lesion conspicuity. Injection of gadopentetate dimeglumine in 11 patients did not increase either the number or the conspicuity of lesions seen. Our results show that visceral metastases from melanoma have a wide variety of appearances on MR images. The STIR sequence appears to be optimal, and the metastases do not enhance with gadopentetate dimeglumine.     

MRI diagnosis and follow-up of subcutaneous fat necrosis

The purpose of this report is to present the MRI features of subcutaneous fat necrosis (SFN) and the natural history of this process. We have seen 12 patients with SFN, one case of which was confirmed histopathologically. In six patients, a follow-up MRI study was performed. MRI findings were very similar in all of the cases: small, linear, and spiculated lesions with one or two components: a globular area yielding high signal intensity on T1-weighted images, intermediate to high signal intensity on fast SE T2-weighted images and focal signal void on short-inversion -time inversion recovery (STIR) sequence, corresponding to an area of fat necrosis; and a laminar starred component, with low signal intensity on T1 and fast SE T2-weighted images and high signal intensity on the STIR sequence, corresponding to reactive fibrous tissue. The follow-up MRI study of six patients showed either disappearance (n = 2) or decrease in size (n = 3) of the globular component; in one patient, no change was observed. A less prominent decrease of the laminar component also was seen in five patients. One patient did not present any change in this laminar component. The most characteristic MRI findings of this lesion are the high signal intensity areas on T1-weighted images, their small size (<3 cm), their linear spiculated shape with both laminar and globular components, and no contrast enhancement after injection of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) injection. We believe that the location, size, morphology, and MRI signal intensity of SFN may allow its differentiation from other types of soft tissue lesions.     

Metastatic melanoma: Correlation of MRI characteristics and histopathology

To correlate the findings on MRI with histopathology of metastatic melanoma, MRI was performed on 29 patients with 36 lesions, using spin-echo and inversion recovery sequences. Histopathologic examination of lesions was performed within 4 weeks of imaging. Lesions were categorized according to cell type and were also evaluated for the presence and extent of melanin, iron, and necrosis. These data were then correlated with the signal intensities of the lesions. Enhancement of lesions after injection of intravenous gadolinium was calculated and correlated to vascularity of the tumor. Melanin was present more frequently in lesions appearing hyperintense or with mixed signal intensity (12/15) than in those appearing hypo- or isointense (6/21) on the T1-weighted sequence. This trend was significant (P=.013). Also, more lesions appearing mixed, ie, having both hypo- and hyperintense components, contained melanin (15/23), as opposed to lesions that appeared to be only hyperintense (3/13) on the STIR sequence. There was no clear association between signal intensity and melanin content on the T2-weighted sequence. There was no significant association between the signal intensities on the MR images and the iron content, tumor size, or tumor cell type of these lesions. There was no clear association between enhancement after gadolinium injection and vascularity, as assessed by histology. The authors concluded in this study that T1 shortening and hypointensity on the STIR sequence seen in patients with metastatic melanoma are most closely related to the melanin content of the tumor.     

MR不同序列诊断早期脊柱转移瘤的价值

目的:探讨MR不同序列在诊断早期脊椎转移瘤中的价值.方法:25例临床怀疑脊柱转移瘤患者行脊柱磁共振检查,磁共振扫描序列包括自旋回波(SE)T1WI、快速自旋回波(TSE)序列T2WI、快速翻转恢复序列(STIR)、梯度回波(GRE)序列二维多回波聚合(Me-2D).结果:25例均发现脊柱转移瘤病灶,共73个椎体和45个附件受累.椎体的异常在各序列图像显示情况不同,T1WI显示73个异常椎体,T2WI显示55个,STIR显示69个,Me-2D显示73个.在T1WI序列图像有24个椎体表现为弥漫性异常信号,49个椎体局部信号异常.Me-2D序列显示椎体局部受累病灶边缘及骨小梁结构清晰.结论:SE T1WI,TSE T2WI及GRE Me-2D序列结合能够更敏感地发现椎体受累早期改变.