磁共振血管成像Willis环的变异及其意义

目的：调查在MRA下Willis环的变异情况，并探讨MRA评价Willis环的临床意义。方法：回顾性分析204例MRI检查脑内无明显异常的3D－TOF MR血管成像图像，统计各个动脉的变异情况。MRA未被显示的动脉被判断为缺如，对称性动脉一侧直径为对侧直径1／2以下者被认为发育不全。结果：A1段的缺如上8．3％，发育不全占10．8％，A1段的发育不良或缺如与同侧PCoA增粗呈正相关；ACoA显示率41．7％，且男性大于女 性；PCoA的显示率41．2％，女性大于男性，胚胎型PCoA发生率29．9％，永存三叉动脉发生率0．5％。结论：MRA评价Willis环变异有重要的临床意义。     

旋转DSA诊断颅内动脉瘤更具优势——旋转DSA与MRA的对比研究

目的比较旋转数字减影血管造影（digitalsubtraction angiography，DSA）与磁共振血管成像（magnetic resonance angiography，MRA）在颅内动脉瘤诊断中的价值。方法40例疑为颅内动脉瘤的患者同时行旋转DSA和MRA检查。评估旋转DSA显示动脉瘤的个数、部位、大小、形态、动脉瘤颈及与载瘤动脉的关系，并与MRA进行比较分析。结果40例患者共40个动脉瘤，旋转DSA检查发现39个，敏感性为97．5％，直径大小为2～30mm。MRA检查发现36个，敏感性为90％，直径大小为4-30mm。旋转DSA检查对动脉瘤的全貌、瘤颈的位置和结构及与周围血管分支的解剖关系均能清晰显示。旋转DSA显示动脉瘤的部位、大小和形态同MRA基本一致。结论旋转DSA技术在颅内动脉瘤诊断和治疗中具有极其重要的作用，在敏感性和特异性方面优于MRA，不但可明确诊断，而且还有利于临床治疗方式的选择。     

磁共振成像在颈动脉狭窄中的诊断价值

目的探讨磁共振成像在颈动脉狭窄诊断中的价值。方法对30例患者行磁共振检查（MRA和MRI）,其中23例行数字减影血管造影（DSA）,以颈总动脉法（CC法）计算狭窄率。结果以DSA检查结果为金标准,磁共振诊断颈动脉狭窄及闭塞的敏感性、特异性、假阴性率及假阳性率分别为97.06%、70.59%、2.94%、29.41%。结论MRA结合MRI可作为诊断颈动脉狭窄的筛选检查。     

正常足部软组织的MRI解剖研究

目的研究正常足部的MRI解剖及MRI对足部软组织结构的显示能力，为足部软组织损伤的MRI诊断提供断层解剖学依据。方法选择40例正常足部MRI图像资料，参考足部断层解剖文献，确定各肌肉、肌腱、韧带以及软骨的MRI解剖表现。结果所有肌肉、肌腱在各MRI序列都能清楚分辨。跗部韧带大多能确切辨认。跗部少量短而薄的韧带及跖、趾部大多数韧带难以辨认。结论MRI是目前显示足部软组织活体断面解剖最好的手段，但对于细小结构的满意显示尚有待于技术和方法的改进。     

33例烟雾病的临床与MRA表现分析

目的 探讨烟雾患者的临床与MRA表现特征。方法 对33例烟雾病患者的临床及MRA资料进行全面的分析总结。结果 未成年患者以缺血性脑卒中为主要表现，成年患者以出血性脑卒中为主要表现，全部患者颈内动脉或分支均有狭窄或闭塞及异常血管形成，最常见的临床表现为脑卒中和头痛。结论 对于年轻患者反复头痛、有卒中史者，成年患者有脑出血史，MRI有异常血管信号者，可采用MRA技术除外烟雾病。     

3.0T 3D-TOF MRA对颅内动脉瘤检出率的临床应用研究

目的评价3.0 T时间飞跃法磁共振血管成像(3.0 T 3D-TOF MRA)对颅内动脉瘤的诊断价值。方法选择25例有颅内动脉瘤相关症状患者,其中男性14例,女性11例;年龄25～74岁,平均年龄57岁。对其3.0 T 3D-TOF MRA诊断为颅内动脉瘤患者的磁共振资料进行回顾性分析,并与数字减影血管造影(DSA)对照。结果3.0 T 3D-TOF MRA共显示28个动脉瘤,其中单发22例,3例为多发动脉瘤,起自颈内动脉系统25个;起自基底动脉系统3个;DSA检查共显示27个动脉瘤。结论3.0 T 3D-TOF MRA虽然对于直径≤3 mm的微小动脉瘤的诊断存在一定的误诊及漏诊率,但其诊断颅内动脉瘤时能比较全面地显示动脉瘤,三维信息对临床确立治疗方案有很大帮助。3.0 T 3D-TOF MRA不失为高危人群或临床怀疑颅内动脉瘤患者筛查及随诊观察的有效手段。     

全脊柱MRI对强直性脊柱炎急性炎症的诊断价值

目的 探讨全脊柱MRI在强直性脊柱炎（AS）急性炎症诊断中的应用价值。方法 选取2017年7月~2019年2月我院58例明确诊断为AS的住院患者,所有患者均行全脊柱MRI扫描,分析图像质量以及AS脊柱急性炎症的发病部位、数目及MRI特征。结果 全脊柱MRI图像分辨率高,能清楚显示椎体、椎间盘、椎小关节、肋椎关节等解剖结构。58例患者均出现脊柱急性炎症,包括44例椎角炎、12例椎间盘炎、44例肋椎关节炎、43例椎小关节炎、33例棘突附着点炎,其MRI表现为相应部位出现斑片状、条状或片状水肿信号。结论 全脊柱MRI能清晰显示AS脊柱急性炎症病灶,对治疗决策有重要价值。     

25例结节性硬化患儿脑电图和影像学特征及临床疗效分析

目的：分析结节性硬化（TS）患儿的脑电图（EEG）、影像学特征及临床治疗效果。方法：对25例TS患儿的EEG、CT／MRI资料及抗癫痫药物（AED）的治疗效果进行回顾性分析。结果：TS患儿癫痫发生率为100％，3岁之前发病者20例（80％），主要发作类型为部分性发作13例（52％）。EEG异常21例（84％），其中19例（90％）有痫样放电。3例结节灶直径≥12mm者其位置与EEG主要放电部位相符，MRI对皮质结节及白质病灶的显示非常敏感。短期AED治疗14例（56％）有效，15例随访1～11年，4例加重。结论：癫痫始发年龄小，EEG有局限性改变，对首次药物治疗反应不良且伴有智能障碍特征者，以及MRI上表现大量皮质结节的患儿，癫痫发作较难控制，易发展成为难治性癫痫。     

磁共振检查对中央型支气管肺癌的诊断价值

目的：评价MRI在中央型支气管肺癌诊断中的价值。方法：分析了27例中央型肺癌的临床与MRI资料，并与普通X线及CT扫描比较。结果：MRI 能清楚显示肿瘤的大体形态特征，并在显示肿瘤内部结构、区别肿块与肺不张、观察肿瘤侵犯纵隔和淋巴结转移方面可提供更多诊断信息。结论：MRI对中央型肺癌的诊断具有重要价值。     

咪唑类驱虫药所致脱髓鞘性脑病的脑电图及MRI评价

目的：研究咪唑类驱虫药所致脱髓鞘性脑病患者的脑电图（EEG）及MRI特点。方法：分析18例咪唑类驱虫药所致脱髓鞘性脑病患者的EEG及MRI资料。结果：18例中急性期EEG异常15例，异常率为83％，入院后20天异常率为38％。18例MRI检查均有异常，异常率100％，显示双侧侧脑室周围及额、顶、颞叶自质区、基底节、小脑半球有多发、对称的长T1长T2信号，FLAIR像显示病灶更敏感。结论：MRI对咪唑类驱虫药所致脱髓鞘性脑病的诊断具有重要价值，EEG的动态变化可客观评估其预后。     

面肌抽搐与三叉神经痛的磁共振诊断价值

目的探讨3D—TOF序列和3DFIESTA序列联合应用对面肌抽搐及三叉神经痛患者血管压迫病因的诊断价值。方法回顾性分析了14例面肌抽搐及三叉神经痛患者磁共振表现。结果14例患者症状侧有神经血管压迫、接触或可疑接触者共有13侧，1侧为听神经瘤压迫。无症状侧只有2侧可疑神经血管接触，12侧无血管接触征象。统计学结果面肌抽搐及三又神经痛患者症状侧与无症状侧比较有显著性差异（P〈0．001）。结论3D TOF MRA和3D FIESTA成像结合不仅可以显示颅内段颅神经血管压迫情况，并可显示局部肿瘤性病变引起的继发性疼痛原因，为临床医师提供术前评估和指导治疗有极其重要的意义。     

3.0T磁共振血管造影普查对颅内动脉开窗畸形的诊断价值

目的通过大样本病例研究颅内动脉开窗畸形磁共振血管造影(MRA)的检出率、好发部位及其临床意义。方法2009年10月至2011年3月行MRA 2 036例患者,确诊动脉开窗畸形25例(开窗畸形组),其中男性14例,女性11例;年龄30~81岁,平均年龄60.5岁。全部行头颅三维时间飞跃MRA(3D-TOF MRA)扫描,将原始图像经工作站处理,得到最大密度投影(MIP)和容积重组(VR)图像,分析颅内动脉开窗畸形的影像学特点,与伴发动脉瘤之间的相关性。结果 2 036例患者中,发现动脉开窗畸形共计25例(检出率1.23%,25/2 036),其中位于基底动脉11例;位于椎动脉颅内段4例;位于前交通动脉区6例;位于大脑中动脉3例;位于大脑后动脉1例。25例开窗畸形中有6例合并动脉瘤,4例位于颈内动脉颅内段,2例位于大脑前动脉。结论 3D-TOF MRA检查能准确诊断、显示颅内动脉开窗畸形。     

Comparison of Gadomer-17 and Gd-DTPA in image quality of contrast-enhanced MR angiographies using flow phantom model

The purpose of this study was to compare the image quality of 3D-TOF MR angiography (MRA) using Gadomer-17 with that using Gd-DTPA in a flow phantom model, and to present preliminary data about the proper dose concentration of Gadomer-17. In the visual analysis of vessel conspicuity, we compared the quality of pre- and post-contrast MIP images. For quantitative analysis, the signal intensities were measured in the axial base 3D-TOF images, and then the relative contrast enhancement was calculated. The results of our studies were that: 1. Maximal signal intensities were obtained at 1 mmol/L of Gadomer-17 and 4 mmol/L of Gd-DTPA. 2. Flow-related signal loss was decreased by Gd-DTPA proportional to the concentration, but Gadomer-17 did not show such a dose accumulative effect. In conclusion, after comparing the results of Gd-DTPA, it was clear that improved MRA images and higher signal intensities of vessels were obtained when lower concentrations of Gadomer-17 were used.     

Improved target volume characterization in stereotactic treatment planning of brain lesions by using high-resolution BOLD MR-venography.

In this methodological paper I report the stereotactic correlation of different magnetic resonance imaging (MRI) techniques [MR angiography (MRA), MRI, blood bolus tagging (STAR), functional MRI, and high-resolution BOLD venography (HRBV)] in patients with cerebral arterio-venous malformations (AVM) and brain tumors. The patient's head was fixed in a stereotactic localization system which is usable in both MR-systems and linear accelerator installations. Using phantom measurements global geometric MR image distortions can be 'corrected' (reducing displacements to the size of a pixel) by calculations based on modeling the distortion as a fourth-order two-dimensional polynomial. Further object-induced local distortions can be corrected by additionally measured field maps. Using this method multimodality matching could be performed automatically as long as all images are acquired in the same examination and the patient is sufficiently immobilized to allow precise definition of the target volume. Information about the hemodynamics of the AVM was provided by a dynamic MRA with the STAR technique, leading to an improved definition of the size of the nidus, the origin of the feeding arteries, whereas HRBV imaging yielded detailed and improved information about the venous pattern and drainage. In addition, functional MRI was performed in patients with lesions close to the primary motor cortex area, leading to an improved definition of structures at risk for the high-dose application in radiosurgery. In patients with brain tumors the potential of HRBV to probe tumor angiogenesis and its use in intensity-modulated treatment planning is still hampered by the open question of how to translate a BOLD signal pattern measured in the tumor to a dose distribution, which should be addressed in future studies.     

A1 segment hypoplasia accompanied by AcomA aneurysms assessed with magnetic resonance angiography

Purpose

This study is to evaluate the use of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) at 3.0 T for the detection and classification of A1 segment hypoplasia based on a large case series and investigates the potential links with AcomA aneurysm occurrence.

Methods

Between January 2009 and June 2012, 8,013 patients underwent MRA examination at 3.0 T in our hospital. MRA was performed using 3D-TOF with volume rendering technique. The presence and location of A1 segment hypoplasia and AcomA aneurysm was reviewed.

Results

Among the 8,013 patients examined, 138 patients were identified with AcomA aneurysms. 425 patients were defined with A1 segment hypoplasia, among whom 303 right-sided A1 hypoplasia and 122 left-sided A1 hypoplasia. 60 of these 425 patients were confirmed with AcomA aneurysms, among them were 49 right-sided A1 hypoplasia. The prevalence of AcomA aneurysm with A1 segment hypoplasia was 14.1 %, which was much higher compared with that (1.0 %) of AcomA aneurysm without A1 segment hypoplasia (P < 0.001).

Conclusions

The incidence of right-sided A1 segment hypoplasia either accompanied with AcomA aneurysm or not was much greater than that of left-sided. Intracranial AcomA aneurysm development appeared to be associated with A1 segment hypoplasia.     

Combined use of T1-weighted MRI and MRA for stereotaxic lesioning of the nonhuman primate brain: application to the rhinal cortex

 Stereotaxic brain lesioning is widely used to develop experimental models of human brain disease in the nonhuman primate. To avoid intraoperative vascular complications such as intracranial hemorrhage, we developed a methodology that is easy to implement. This method combines T1-weighted magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). This technique is applied to produce bilateral neurotoxic lesions of the rhinal cortex, a structure located medially in the temporal lobe, in eight baboons (including five sham-operated animals with needle descents but no ibotenic acid injection). Two other baboons were lesioned before the MRA technology was available. The MRA sequence (two-dimensional time-of-flight, axial acquisition) was used to localize the blood vessels in the needle trajectories, i.e., the highly vascularized sylvian fissure and temporal gyri. The vessel coordinates were transposed onto the coronal MRI-T1 images, onto which the injection sites were determined and the planned needle tracks drawn. In the eight baboons that had MRA, 26.8% of these needle tracks had to be slightly displaced because of the presence of blood vessels. The stereotaxic coordinates of the final target sites were then calculated with respect to six skull landmarks that also served as a reference during surgery. No intracranial hemorrhage occurred in any of the eight baboons in which MRA was performed, in contrast to one of the two baboons not studied with MRA. The histological analysis showed a good extent of the rhinal lesions in all lesioned animals, with minimal damage to areas other than those that were targeted. Thus, combined use of MRI-T1 and MRA proved to be reliable in reducing vascular complications, affording new advances for stereotaxic surgery in nonhuman primates. Received: 16 June 1998 / Accepted: 13 November 1998     

Application of magnetic resonance imaging and magnetic resonance angiography as diagnostic measures for the first attack of suspected cerebrovascular diseases in Korea

Purpose

No precise data are available showing how magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) can be applied to diagnosis for the first attack of a suspected cerebrovascular disease in Korea. The purpose of this study was to evaluate the application level of MRI and MRA as diagnostic tools and the related factors to the use of these techniques.

Materials and Methods

This study used the health benefit claim data of 89,890 patients who were hospitalized for the first time due to suspected cerebrovascular disease in 2007 without having visited medical institutions as an outpatient or inpatient from 2003 to 2006.

Results

Of the 89,890 cases, 28.4% took both MRI and MRA, 10.7% took only MRI and 6.9% took only MRA. The related factors identified in the multivariate logistic regression analysis were gender, type of insurance, type of medical institution, type of department, duration of hospitalization, and type of disease.

Conclusion

This study showed that the application level of MRI and MRA as diagnostic measures for the first attack of a suspected cerebrovascular diseases varied depending on several factors. It is necessary to study more accurate levels of computerized tomography (CT), computerized tomography angiography (CTA), MRI or MRA as measures to diagnose a first attack of suspected cerebrovascular disease.     

1.5T 3D-TOF-MRA与DSA诊断颅内动脉瘤的 研究价值对比

目的 探讨三维时间飞跃法磁共振血管成像（3D-TOF-MRA）与数字减影血管造影（DSA）诊断颅内动脉瘤的研究价值。方法 收集20例经DSA及手术确诊为颅内动脉瘤患者,术前均行MRA及DSA检查。MRA检查后经MRP、MIP及VR法重建并与DSA结果进行对比。结果 20例患者DSA检查出23个动脉瘤,MRA VR重建检查出21个动脉瘤,检出率为91.30%,MPR及MIP检查出20个,检出率为87.00%。结论 1.5T 3D-TOF-MRA对颅内动脉瘤有较高的敏感性和准确性,为临床诊断及治疗提供了详细的参考价值,但对于微小动脉瘤存在一定的漏诊现象,应选择DSA进行进一步检查。     

椎动脉颅内段重复变异MR血管成像的观察分析

目的:探讨椎动脉颅内段重复变异的发生率、磁共振血管成像（MRA）表现特点及其临床意义。方法:回顾性研究。纳入2011年1月—2020年12月聊城市人民医院38 503例患者和体检者的头颈联合或颅脑三维（3D）时间飞跃法（TOF）MRA扫描及最大密度重建（MIP）资料,其中男21 048例、女17 455 例,年龄2～9...