联合应用DWI及1H-MRS技术对脑脓肿及脑转移瘤的鉴别诊断(附14例分析)

目的探讨联合应用磁共振DWI及MRS技术对脑脓肿及脑转移瘤进行鉴别诊断的价值。方法搜集经手术病理或临床证实的脑脓肿6例,脑转移瘤8例,行DWI及1H-MRS扫描,分析、比较脑脓肿及脑转移瘤在此两种扫描中的影像学表现。结果5例脑脓肿在DWI上呈高信号,1例呈稍低信号,7例环形脑转移瘤表现为低信号,1例表现为高信号;1H-MRS扫描发现:4脑脓肿中出现AA峰,其中2例出现Ac峰,8例脑转移瘤均不出现AA峰或Ac峰。结论联合应用DWI及1H-MRS扫描能提高对脑脓肿及脑转移瘤的鉴别诊断。     

颅脑不同区域磁共振波谱分析在精神分裂症中的价值

目的探讨质子磁共振波谱（1H—MRS）在精神分裂症中的诊断价值。方法采用点分辨解析采样方式对26例精神分裂症患者和25例健康志愿者的左右侧额叶、海马和丘脑行MRS检查,分析的代谢产物有N～乙酰天门冬氨酸（NAA）、肌酸（cr）、胆碱（Cho）及相互间比值在两组间的差别。结果精神分裂症患者在左额叶、右额叶、左海马、右海马、左丘脑和右丘脑的NAA／Cr分别为1．41±0．33、1．40±0．36、1．43±0．27、1．42±0．26、1．46±0．30、1．45±0．28,低于健康组对应位置,但差异无统计学意义（P〉0．05）;Cho／cr分另4为1．36±0．38、1．37±0．29、1．30±0．31、1．31±0．28、1．20±0．20、1．22±0．19,高于健康组对应位置,但差异无统计学意义（P〉0．05）;NAA／（Cho＋Cr）分别为0．60±0．14、0．61±0．16、0．62±0．20、0．63±0．23、0．66±0．18、0．66±0．21,明显低于健康组对应位置,且二组差异有统计学意义（P〈0．05）。精神分裂症患者NAA／Cr、NAA／（Cho＋Cr）的下降幅度和Cho／Cr的上升幅度,额叶〉海马〉丘脑。结论精神分裂症患者MRS改变,主要体现在NAA的下降和Cho的上升,对精神分裂症的诊断有一定的参考作用。     

氢质子磁共振波谱联合磁共振成像诊断脑胶质瘤的临床意义

目的：分析氢质子磁共振波谱（IH-MRS）联合磁共振成像（MRI）在脑胶质瘤中的效果。方法：选取该院2020年5月—2021年5月诊治的82例脑胶质瘤患者,按病理分型将患者分为低级别组（48例）与高级别组（34例）。所有患者均施行IH-MRS联合MRI检查,分析MRI扫描结果,并比较不同级别脑胶质瘤代谢物指标[胆碱（Cho）、肌酸（Cr）、N-乙酰天门冬氨酸（NAA）]。结果：MRI扫描显示,低级别脑胶质瘤与高级别的瘤周水肿区水肿情况及强化程度比较,差异无统计学意义（P>0.05）。高级别脑胶质瘤的脑肿瘤实质区与瘤周水肿区的Cho/Cr、Cho/NAA均高于低级别脑胶质瘤,差异有统计学意义（P<0.05）。结论：IH-MRS联合MRI在脑胶质瘤的鉴别诊断中具有较高的价值,可通过定量检测结果评估肿瘤的恶性程度。     

磁共振氢质子波谱成像对新生儿缺氧缺血性脑病的诊断价值

新生儿缺氧缺血性脑病(HIE)是指围生期时由于母亲因素、胎盘、脐带异常、分娩用药、产程延长、新生儿本身呼吸、循环、CNS疾病等所有引起窒息的原因导致的脑缺氧缺血性损伤,而临床出现一系列中枢神经异常的表现.因为缺血缺氧致使患儿留有不同程度的神经系统后遗症,如智力发育障碍、癫痫、脑瘫等.MRI以无创、无辐射及任意方位成像的手段不仅从解剖角度反映新生儿脑部变化,而且磁共振氢质子波谱成像(HMRS)从脑内代谢产物变化规律的角度反映病程的演变,此技术能在HIE早期从分子水平和代谢水平的方面反映其变化,进行HIE病变性质与程度评价.     

氢质子波谱在阿尔茨海默病中的价值

目的探讨质子磁共振波谱（ZH—MRS）在阿尔茨海默病（AD）中的诊断价值。方法采用刺激激励回波采样方式对29例AD患者和20例老年健康者的海马、颞顶叶和扣带回行MRS检查;分析的代谢产物有N－乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、肌醇（mI）,并比较分析其相互间比值在两组间的差异结果AD患者在海马、颞顶叶和扣带回的NAA分别为（0．40±0．06）、（0．42±0．06）、（0．43±0．08）,与健康组比较差异无显著性（P〉0．05）;mI分别为（0．25±0．08）、（0．23±0．06）、（0．21±0．05）,与健康组比较差异有显著性（R0．05）NAA／Cr分别为（1．30±0．10）、（1．40±0．11）、（1．42±0．12）,与健康组比较差异无显著性（P〉0．05）;mI／Cr分别为（0．81±0,07）、（0．78±0．08）、（0．70±0．06）,与健康组比较差异有显著性（P〈0．05kmI／NAA分别为（0．61±0．06）、（0．55±0．08）、（0．49±O．07）,与健康组比较差异有显著性（P〈O．05）。AD患者NAA、NAA／Cr的下降和mI、mI／Cr、mI／NAA的上升,海马〉颞顶叶〉扣带回。结论AD患者MRS改变,主要体现在NAA的下降和mI的上升,对AD的诊断有一定的参考作用。     

海马磁共振波谱分析在颞叶癫痫症中的价值

目的探讨海马氢质子磁共振波谱分析（1H—MRS）在颞叶癫痫症中的应用价值。方法采用PhihpsAchieva1．5T双梯度磁共振扫描仪,对38例颞叶癫痫患者和20例健康志愿者行颅脑MRI和海马’H—MRs检查,观察NAA、Cr、Cho浓度和NAA／（Cho＋Cr）、NAA／Cr和NAA／Cho值。分别对癫痫患者病灶侧与正常侧,病灶侧与正常对照组海马的NAA／（Cho＋Cr）、NAA~r和NAA／Cho值进行t检验,分析两者之间差异有无显著性。结果癫痫患者组癫痫侧、正常侧和对照组海马的NAA／（Cho＋Cr）值分别为（O．424-0．06）、（0．67±0．09）、（O．72±0．07）,癫痫组癫痫侧与正常侧、对照组比较差异有显著性（尸〈0．05）,而正常侧与对照组比较差异无显著性（尸〉0．05）。以NAA／fCho＋c0来检出癫痫,灵敏度曲线呈现低一高一低的变化,在0．60时,灵敏度最高。结论-H—MRS不仅能早期诊断海马硬化,而且可进一步提高术前癫痫灶定位的准确性。     

兔VX2软组织肿瘤在体与离体氢质子磁共振波谱特征

目的 研究兔正常肌肉及VX2软组织肿瘤在体与离体氢质子磁共振波谱(1 H-MRS)特征,探讨1 H-MRS用于诊断软组织肿瘤的可行性.方法 20只新西兰大白兔,肌肉注射VX2肿瘤组织悬液制成肿瘤模型.行正常兔肌肉组织及VX2肿瘤MRI和在体1 H-MRS成像.观察正常肌肉与VX2肿瘤组织1 H-MRS表现,测量Cho/Cr及Lip/Cr比值.正常肌肉与VX2肿瘤组织新鲜标本行离体1 H-MRS成像研究,并将离体与在体1 H-MRS结果作对照研究.结果 所有兔正常肌肉及VX2肿瘤在体1 H-MRS可见Cho峰、Cr峰及Lip峰.与正常肌肉组织相比,VX2肿瘤组织Cho峰明显增高,Lip峰降低.肿瘤组织与正常肌肉Cho/Cr及Lip/Cr比值差异显著(P＜0.01).VX2软组织肿瘤在体波谱Cho峰及Lip峰变化趋势与离体波谱具有较高的一致性.结论 兔VX2软组织肿瘤与正常肌肉的在体与离体1 H-MRS表现明显不同,在体1 H-MRS能较准确地反映软组织肿瘤组织代谢变化信息,有望用于软组织肿瘤的诊断.     

氢质子波谱在阿尔茨海默病中的价值

Objective To study the diagnosis value of proton magnetic resonance spectroscopy(1H-MRS)in Alzheimer disease(AD).Methods Using stimulated echo acquisition mode,29 AD patients and 20 elderlv healthy ones as control group were underwent with Magnetic ResonaJlce Spectrum (MRs)examination in hippocampus,temporal parietal cortex and cingulate gyrus,the metabolites of MRS were analvzed to have N-aeetyl aspartate(NAA),creatine(Cr),choline(Cho),myo-inositol (mI),and comDarle the ratio of each other as well as the difference between the two groups.Rmulta NAA of AD patients in hippocampus,temporal parietal cortex and ringulate gyrus were(0.40±0.06),(0.42±0.06),(0.43±0.08),respectively, and have no significant difference to the healthy group(P＞0.05);mI were(0.25±0.08).(0.23±0.06),(0.21±0.05),respectively,and have significant difference to the healthy group(P＜0.05):NAA/Cr werle(1.30±O.10),(1.40±0.11),(1.42±0.12),respectively,and have no significant differenoe to the healthy group(P＞0.05);mI/Cr were,(0.81±0.07),(0.78±0..08),(0.70±0.06),respectively,and have significant difference to the healthy group(P＜0.05);mI,NAA were(0.61±0.06),(0.55±0.08),(0.49±0.07),respeetively,and have significant difference to the healthy group(P＜0.05).In AD patients,NAA,NAA/Cr decrease and mI,mI/Cr,mI/NAA increase,and the value in hippocampus＞temporal parietal cortex＞cingulate gyrus.Conclusion The changes of MRS in AD patients,mainly reflected a decline in NAA and rise in mI,which has some reference in the diagnosis in AD.     

氢质子波谱在阿尔茨海默病中的价值

Objective To study the diagnosis value of proton magnetic resonance spectroscopy(1H-MRS)in Alzheimer disease(AD).Methods Using stimulated echo acquisition mode,29 AD patients and 20 elderlv healthy ones as control group were underwent with Magnetic ResonaJlce Spectrum (MRs)examination in hippocampus,temporal parietal cortex and cingulate gyrus,the metabolites of MRS were analvzed to have N-aeetyl aspartate(NAA),creatine(Cr),choline(Cho),myo-inositol (mI),and comDarle the ratio of each other as well as the difference between the two groups.Rmulta NAA of AD patients in hippocampus,temporal parietal cortex and ringulate gyrus were(0.40±0.06),(0.42±0.06),(0.43±0.08),respectively, and have no significant difference to the healthy group(P＞0.05);mI were(0.25±0.08).(0.23±0.06),(0.21±0.05),respectively,and have significant difference to the healthy group(P＜0.05):NAA/Cr werle(1.30±O.10),(1.40±0.11),(1.42±0.12),respectively,and have no significant differenoe to the healthy group(P＞0.05);mI/Cr were,(0.81±0.07),(0.78±0..08),(0.70±0.06),respectively,and have significant difference to the healthy group(P＜0.05);mI,NAA were(0.61±0.06),(0.55±0.08),(0.49±0.07),respeetively,and have significant difference to the healthy group(P＜0.05).In AD patients,NAA,NAA/Cr decrease and mI,mI/Cr,mI/NAA increase,and the value in hippocampus＞temporal parietal cortex＞cingulate gyrus.Conclusion The changes of MRS in AD patients,mainly reflected a decline in NAA and rise in mI,which has some reference in the diagnosis in AD.     

MRI和~1H-MRS在脑胶质瘤诊断中的价值

目的探讨MRI影像结合氢质子磁共振波谱（1H-MRS）在胶质瘤诊断、分级和鉴别诊断中的价值。方法对30例MRI符合胶质瘤患者配合1H-MRS检查[测N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（Cr）、乳酸（Lac）、脂质（Lip）、肌醇（mI）值]进行综合分析。结果 1H-MRS显示病变区与正常脑实质比较NAA下降、Cho升高、Cr总量变化不大且无规律性和部分出现异常Lac和（或）Lip峰,mI含量表现为轻度下降,同时可显示肿瘤周边区域的Cho升高等异常。结论 MRI影像结合1H-MRS分析对颅脑胶质瘤分级、诊断、范围确定和鉴别诊断有重要价值,能有效提高脑胶质瘤的诊断正确性。     

Medline中磁共振成像杂志文献搜索引擎的研究

目的：为了方便放射学磁共振工作者怏捷、准确地查阅有关核磁共振成像杂志文献,开发和利用NCBI的Medline数据库的核磁共振成像杂志文献资源。方法：从Medline(PubMed)中检索并列出18种有关核磁共振成像的杂志名录,制作了每种杂志及部分杂志年份相应的超级链接,组成一个有关核磁共振成像杂志文献的搜索引擎。结果和结论：此搜索引擎能快捷、准确、动态地检索18种有关核磁共振成像杂志全部文献题录及部分杂志各年的文献题录,并可在PubMed中进一步检索出文献的摘要和部分全文。     

PSA灰区值时MRI+MRS在早期诊断前列腺癌中临床意义

目的：探讨PSA 灰区值时,MRI+MRS 在早期诊断前列腺癌中临床意义。方法对92例PSA4-10ng/ml 患者行MRI+MRS检查,对MRI 异常和（或）MRS 检查(胆碱+肌酸)/枸橼酸盐(Cho+Cre/Cit)≥0.75患者进行前列腺穿刺活检,MRI+MRS无异常者,有手术指征行前列腺电切术,术后行病理检查,无手术指征定期随访。结果73例MRI异常和（或）Cho+Cre/Cit≥0.75穿刺后,12例前列腺癌,其中1例前列腺癌患者MRI示前列腺肿瘤已侵及前列腺包膜,19例MRI+MRS无异常者术后病理1例前列腺癌。阳性组(前列腺癌组）Cho+Cre/Cit值与阴性组（前列腺增生）相比差异显著（P＜0.05)。结论 PSA4-10ng/ml前列腺增生患者,常规行MRI+MRS,有助于前列腺癌早期诊断及临床分期,以Cho+Cre/Cit≥1.29为穿刺的最佳临界值,但有待大样本研究进一步证实及界定。     

急性脊髓炎的MRI诊断与鉴别诊断

目的探讨急性脊髓炎的MRI特征性表现及其鉴别诊断。方法对临床诊断为急性脊髓炎的10例患者,进行常规及增强MRI扫描。结果所有患者病变段脊髓均出现不同程度增粗,T1WI呈等低信号,T2WI呈高信号;增强扫描,6例病变区内未见明显强化,3例出现细条状强化,1例出现斑片状强化。结论MRI对急性脊髓炎的定位及定性诊断有很大帮助。     

Adolescent escitalopram administration modifies neurochemical alterations in the hippocampus of maternally separated rats

Early life stress is a potential precursor of eventual neuropsychiatric diseases and may result in altered neurodevelopment and function of the hippocampus, which thus provides a site at which potential interventions to modify the effects of early life stress may act. In this study, Sprague–Dawley rat pups comprising male and female animals underwent maternal separation (MS) for 180 min from postnatal days (PND) 2 to 14, or were left with their dams. They subsequently received daily administration of saline (0.9%), escitalopram (10 mg/kg), or no treatment during adolescence (PND 43–60). All adult animals underwent brain magnetic resonance imaging (MRI) and bilateral hippocampal proton magnetic resonance spectroscopy (¹H-MRS). Neither MS nor escitalopram treatment had a significant effect on hippocampal volume. Adult rats that experienced MS displayed significantly increased choline-containing compounds (Cho) and decreased N-acetylaspartate (NAA), glutamate (Glu) and Myo-inositol (MI) relative to the stable neurometabolite creatine (Cr) in hippocampus. Administration of escitalopram during adolescence could modify the alterations of NAA/Cr, Glu/Cr and MI/Cr. The effects of MS on hippocampal neurochemistry were most significant in the right hippocampus. These results indicate that MS in rats has long-term consequences on hippocampal neurochemistry reflective of neural density/functional integrity, especially on the right hippocampus, and adolescent administration with escitalopram can at least partially ameliorate these neurochemical alterations. Furthermore, these metabolite changes seem to be more sensitive indicators of the results from early life stress than volume changes.     

Synaptic and cellular events: the last frontier?

The use of functional magnetic resonance imaging (fMRI) to follow random or serial sequences of neural activity is explored and illustrated with examples that include auditory hallucinations and a short-term memory paradigm. Despite the availability of ultra-high-speed fMRI sequences, the inherent latency of the haemodynamic response limits the time resolution of fMRI studies. To access finer time-scales, it can be combined with electromagnetic techniques (MEG or EEG). Functional magnetic resonance spectroscopy (MRS) studies, in which infusion of [1-¹³C]glucose enables rates of the tricarboxylic acid cycle to be determined, demonstrates substantial (50%) increases in this flux on visual activation. Not only does this provide a quantitative estimate of the energy cost of brain activation, it also shows that the extra glucose is consumed essentially oxidatively. In the same studies, measurements of the rate of glutamine synthesis, enable the rate of recycling of neurotransmitter glutamate to be estimated.     

椎管内神经鞘膜瘤13例的MRI分析

目的:探讨MRI对神经鞘膜瘤的诊断价值.方法:对13例椎管内神经鞘膜瘤的影像资料进行分析.其中颈段5例,胸段6例,腰段2例.13例术后均行病理检查.结果:所有病例在T2WI上均呈高信号,T1WI上略高信号4例,等信号9例.Gd-DTPA增强明显均匀强化8例,明显不均匀强化5例.有椎弓根骨质压迫局限吸收5例,8例明显均匀强化大体病理呈灰白色,5例明显不均匀强化呈灰黄色,所有病例均有包膜.结论:MRI、CT、X线平片比较:(1)显示肿瘤病变MRl优于CT及X线平片.(2)显示椎弓根局限骨质吸收CT优于MRI.(3)术前评估肿瘤范围,MRI有明显优势.