多孔碳酸化羟基磷灰石水泥修复双侧股骨髁骨缺损：同体随机对照16周组织学结果验证*☆

背景：课题组采用发泡剂成孔技术,制成了有知识产权的新型骨修复材料多孔碳酸化羟基磷灰石,既保留了碳酸化羟基磷灰石骨水泥原位固化性能等所有的优点,同时又形成多孔结构。 目的：通过动物实验进一步验证制备的新型骨修复材料多孔碳酸化羟基磷灰石水泥修复骨缺损的效果。 设计、时间及地点：同体对比观察实验,于2000-01/2002-08在解放军总医院骨科研究所及医学动物实验中心完成。 材料：以碳酸钙、磷酸氢钙等化学试剂为原材料,通过高温烧结合成碳酸化羟基磷灰石粉体,粉体与固化液相混合原位固化形成碳酸化羟基磷灰石;在碳酸化羟基磷灰石粉体中加入成孔剂,成孔剂在骨水泥固化过程中发生化学反应产生二氧化碳气体,由此形成多孔碳酸化羟基磷灰石。 方法：采用10只新西兰大白兔在双侧股骨髁制备直径为5.5 mm、深12 mm的骨缺损动物模型,随机选择一侧作为实验组,调和多孔碳酸化羟基磷化石,迅速将其置于特制的注射器中,注入骨缺损。另一侧为对照组,骨缺损直接填充碳酸化羟基磷化石。 主要观察指标：分别于术后2,4,8,12,16周分批处死动物。通过X射线和组织学观察其修复效果。 结果：实验组骨缺损逐渐被新生骨填充,骨组织逐渐改建,趋于成熟。对照组材料的边缘区有新骨生长,并随时间呈递增趋势,材料的中央区未见新骨组织。术后16周影像学检查,实验组材料与周围正常骨的密度相当,很难区分界线,对照组材料的可视面积明显减少。 结论：多孔碳酸化羟基磷灰石水泥具有原位固化性能和良好的生物相容性,能作为自体骨移植的一种替代物修复骨缺损。 关键词：多孔碳酸化羟基磷灰石水泥;骨缺损;组织学     

多孔碳酸化羟基磷灰石水泥植入修复兔包容性骨缺损的力学分析

背景：采用发泡剂成孔技术,制成了有知识产权的新型骨修复材料多孔碳酸化羟基磷灰石,既保留了碳酸化羟基磷灰石骨水泥原位固化性能等所有的优点,同时又形成多孔结构。 目的：通过动物实验观察新型的骨修复材料多孔碳酸化羟基磷灰石水泥修复骨缺损的力学效果。 方法：30只新西兰大白兔,手术组25只在双侧股骨髁制备直径为5.5 mm、深12 mm的骨缺损动物模型,左侧植入多孔碳酸化羟基磷灰石骨水泥为实验组,右侧植入碳酸化羟基磷灰石骨水泥为对照组。非手术组5只,用于正常力学对照。将多孔碳酸化羟基磷灰石骨水泥和碳酸化羟基磷灰石骨水泥试件经模仿体液浸泡,检测力学强度。同时在手术组背肌内分别植入多孔碳酸化羟基磷灰石骨水泥和碳酸化羟基磷灰石骨水泥标准试件。分别于术后2,4,8,12,16周分批处死动物,进行试件骨内和肌内植入的力学实验分析和试件在模仿体液中浸泡后的抗压强度测试。 结果与结论：多孔碳酸化羟基磷灰石骨水泥：2周时的骨内力学强度较低,4周时降到最低,8周时接近正常松质骨强度,12周时超过正常松质骨强度,16周时恢复到正常松质骨水平。碳酸化羟基磷灰石骨水泥：2周时骨内植入强度较多孔碳酸化羟基磷灰石骨水泥略高,4周时有所降低,8,12,16周时略升高,但是始终低于正常松质骨的强度。多孔碳酸化羟基磷灰石骨水泥和碳酸化羟基磷灰石骨水泥在SBF中浸泡的抗压强度变化不大。试件植入肌内后抗压强度变化非常显著。结果表明,多孔碳酸化羟基磷灰石水泥具有原位固化性能和一定的力学支撑作用,能作为自体骨移植的一种替代物修复骨缺损。 关键词：多孔碳酸化羟基磷灰石水泥;骨缺损;生物活性材料;兔;生物力学 doi:10.3969/j.issn.1673-8225.2010.16.003     

脑梗死患者的颅外颈动脉超声与CT血管造影的比较

目的:比较颈部超声检查与颈部CTA对颅外颈动脉硬化性狭窄斑块的敏感性。方法:对比分析我科住院的61例脑梗死患者的双侧颈总动脉、颈动脉分叉处、颈内动脉超声检查和CTA检查结果。结果:61例患者中,超声发现斑块110处,CTA发现斑块124处,两者对于颈动脉的斑块检出率差异无显著性意义,两者狭窄程度的一致性是55%,但CTA对颈动脉分叉处斑块敏感性高于超声波检查,对钙化斑更敏感。超声检查血管狭窄的程度高于颈部CTA的结果,超声未能显示椎动脉异常。结论:脑梗死患者的颈部CTA检查优于超声检查,特别适用于椎基底动脉供血不足患者。     

颈动脉硬化斑块内新生血管的超声造影评价及其与脑梗死患者病情严重程度及预后的关系

目的利用超声造影(CEUS)评价急性脑梗死患者颈动脉硬化斑块内的新生血管,研究其与患者病情严重程度及预后的相关性。方法选取北京大学人民医院神经内科收治的急性脑梗死患者。根据患者有无颈动脉斑块分无斑块组和斑块组。斑块组患者行颈动脉CEUS,根据IPN情况将斑块分为0级、Ⅰ级、Ⅱ级、Ⅲ级,0级及Ⅰ级的患者为稳定斑块组;Ⅱ级及Ⅲ级为易损斑块组。比较无斑块组、稳定斑块组和易损斑块组患者的NIHSS评分和发病后90 d mRS评分。结果无斑块组患者NIHSS评分、发病后90 d mRS评分与稳定斑块组比较无统计学差异(P 0. 05);易损斑块组患者NIHSS评分、发病后90 d mRS评分显著高于无斑块组及稳定斑块组(P 0. 01)。急性脑梗死患者颈动脉斑块内的新生血管分级与NIHSS评分、发病后90 d mRS评分具有相关性(P=0. 441、0. 404,均P 0. 01)。结论急性脑梗死患者颈动脉硬化斑块内的新生血管分级越高,其NIHSS评分和发病后90 d mRS评分越高。颈动脉斑块内新生血管分级可为预测急性脑梗死患者的病情危重程度及预后提供参考。     

血管内超声与冠状动脉造影在冠状动脉支架置入中的应用比较

目的：冠状动脉支架置入已成为治疗冠状动脉狭窄性病变的主要方法,支架治疗策略的选择成为主要技术问题,文章对冠脉造影后的血管狭窄分析和血管内超声成像的血管分析应用效价进行探讨。 方法：根据文献报道对冠状动脉造影血管狭窄分析及血管内超声在冠脉支架置入前后的应用,结合南昌大学第二附属医院冠状动脉支架置入前后的血管造影及血管内超声的应用进行对比分析。 结果：冠状动脉造影对支架置入前后的影像学造影检查,只能观其血管外壁形态、血流变化。对管腔黏膜病变情况、内支架贴壁情况,支架是否完全对称性扩张,以及支架对病变段的覆盖情况,不能精确显示。血管内超声对靶血管的狭窄程度、血管内斑块及黏膜病变情况能够精确实时显示,可实时显示支架是否完全扩张,支架扩张是否均匀对称,支架对血管壁斑块的挤压支撑情况如何。 结论：血管内超声在冠脉支架置入前后的应用,较冠状动脉造影更能全面的评价血管内病变情况,对支架的选取策略及支架释放后的评价与指导,防止血管内再狭窄具有重要的意义。     

经颅多普勒与核磁共振血管造影对比检测颅内大动脉的临床价值探讨

目的 比较经颅多普勒(transcranial Doppler，TCD)与核磁共振血管造影(magnetic resonance angiography，MRA)检测颅内大动脉的特点，探讨其临床应用价值。方法 应用TCD和MRA检测16例患共32根大脑中动脉，比较其检测结果。结果 TCD检查显示，大脑中动脉闭塞3根，狭窄16根，流速增快9根，正常4根；MRA显示，大脑中动脉闭塞4根，狭窄13根，正常15根。TCD与MRA检查的符合率于大脑中动脉闭塞时为75．0％(3／4)，狭窄时为81．3％(13／16)，正常时86．7％(13／15)。结论 TCD与MRA对颅内大动脉的检测具有较高的一致性，TCD较MRA方便、迅速、经济，MRA较TCD直观、全面，二联合检测可比较准确地提供颅内血管情况。     

螺旋CT血管造影与颈部血管超声对急性脑梗死患者动脉系统检测结果比较

目的探讨螺旋CT血管造影(SCTA)与颈部血管超声(CVUS)对急性脑梗死患者颈动脉检查的临床价值。方法选取2010—2014年收治的急性脑梗死患者102例,均进行SCTA、CVUS检查,对比2组患者颈动脉情况。结果 102例脑梗死患者中颈动脉狭窄检出率为80.39%(82/102),颈动脉狭窄率两种检查方法无显著差异(P0.05),SCTA颈动脉斑块检出率为58.81%,相比CVUS显著提高(P0.05)。两种检查方式轻中度颈动脉狭窄无显著差异,3例患者SCTA检查为颈动脉闭塞,CVUS检查为中度狭窄。结论 SCTA与CVUS检查颈动脉血管狭窄具有较高的一致性,SCTA评价颈动脉闭塞具有更高的准确性。     

羟基磷灰石材料义眼台植入25例：传统与改良方法的比较

摘要 背景：随着义眼台植入材料的逐渐改善,义眼台植入方法成为义眼台是否暴露的关键。 目的：通过对比改良的羟基磷灰石义眼台植入而减少常规术式植入后的并发症,探讨眼内容物剜出联合羟基磷灰石义眼台植入后义眼台暴露的机制,以提高治疗水平。 方法：纳入患者25例,按照不同的手术方式将患者随机分配,其中采用传统术式14例(14只眼),手术眼均行眼内容物剜出加羟基磷灰石义眼台植入;改良术式11例(11只眼),手术眼均行眼内容物剜出加肌锥内义眼台植入双层巩膜加固。观察义眼台暴露情况以及材料宿主反应情况。 结果与结论：传统手术组共暴露8例,改良手术组共暴露1例,经校正卡方检验差异有显著性意义(χ2=4.264,P=0.039 < 0.05)。结果提示：改良羟基磷灰石义眼台植入,术式简单,明显减少了义眼台暴露问题。 关键词：羟基磷灰石;义眼;双层巩膜;植入方法;材料 doi:10.3969/j.issn.1673-8225.2010.47.040     

超声血管增强成像技术联合脉冲多普勒检查对椎动脉近端狭窄的诊断价值

目的探讨超声血管增强成像(Clarify VE)技术联合脉冲多普勒(PW)对椎动脉近端狭窄的诊断价值。方法对202例椎动脉近端狭窄患者行PW、Clarify VE及DSA检查。结果 PW共检出185例近端狭窄,其中轻度狭窄85例,与DSA符合率为91.4%;中度狭窄42例,与DSA符合率为91.3%;重度狭窄58例,与DSA符合率93.2%。PW联合Clarify VE共检出192例椎动脉近端狭窄,其中轻度狭窄86例,与DSA符合率为91.6%;中度狭窄44例,符合率为95.6%;重度狭窄62例,与DSA符合率为98.6%。PW检查对椎动脉近端狭窄诊断敏感性为91.5%,与DSA诊断符合率为91.5%;Clarify VE与PW联合检查对椎动脉近端狭窄诊断敏感性95.0%,与DSA诊断符合率为95.0%。与Clarify VE联合PW检查比较,PW检查的总体符合率及敏感性显著降低(均P0.05)。结论 Clarify VE联合PW技术更能够清晰显示椎动脉近端斑块及残余管腔,可快速有效诊断椎动脉狭窄程度,具有较高的临床应用价值。     

比较经颅超声造影和数字减影血管造影对大脑中动脉狭窄的诊断价值研究

目的 比较经颅超声造影（transcranial contrast-enhanced ultrasound,t-CEUS）和DSA在大脑中动脉 （middle cerebral artery,MCA）狭窄性疾病中的诊断价值。 方法 收集2017年12月-2019年4月疑似MCA狭窄或闭塞的患者197例,记录其225条狭窄或闭塞 的大脑中动脉的t-CEUS和DSA检查结果。根据MCA狭窄程度分为轻度狭窄（30%～50%）,中度狭窄 （50%～69%）,重度狭窄（70%～99%）和闭塞（100%）,以DSA为金标准,分析t-CEUS对轻、中和重度 MCA狭窄的诊断价值。 结果 197例疑似MCA狭窄闭塞患者中,男132例,女65例,年龄43～72岁,平均（58.4±4.6）岁。经 DSA确诊的狭窄和闭塞的225条MCA中,轻度狭窄16条,中度狭窄70条,重度狭窄121条,闭塞18条。 t-CEUS诊断狭窄和闭塞的共224条MCA,其中,轻度狭窄18条,中度狭窄76条,重度狭窄112条,闭塞18条。 t-CEUS和DSA诊断MCA狭窄和闭塞高度吻合（Kappa=0.91）。t-CEUS诊断轻度MCA狭窄的敏感度、特异 度和准确度分别为80%、80%和91%;诊断中度MCA狭窄的敏感度、特异度和准确度分别为83%、93% 和97%;诊断重度MCA狭窄的敏感度、特异度和准确度分别为83%、96%和96%。 结论 t-CEUS能够清楚地显示轻、中、重度MCA狭窄和闭塞,适用于MCA狭窄和闭塞类疾病患者的确 诊,尤其是适用于不适合DSA检查的疑似MCA狭窄和闭塞患者。     

Evaluation of postcontrast images of intracranial tumors at 7T and 3T MRI: An intra-individual comparison study

Aim

This study aimed to evaluate the diagnostic value of ultrahigh-field magnetic resonance imaging (MRI) for brain tumors in clinical practice.

Methods

Thirty patients with brain tumors underwent 7- and 3-T MRI. The performance and diagnostic confidence of 7- and 3-T MRI in the visualization of tumor details such as internal structure and feeding artery were evaluated by radiologists. Contrast-enhanced region performance and tumor detail diagnostic confidence score (DCS) were calculated and compared between 7 and 3T using Wilcoxon rank sum test.

Results

In 19 with obvious enhancement and 11 cases without obvious enhancement, 7- and 3-T MRI showed similar performance. The tumors' internal structure and feeding artery were more clearly depicted by 7-T MRI (62.2% and 54.4%, respectively) than by 3-T MRI (2.2% and 6.7%, respectively). Furthermore, the mean DCSs of both internal structure and feeding artery were higher at 7T than at 3T (internal structure: 16.29 ± 9.67 vs. −5.79 ± 4.12, p = 0.028; feeding artery: 21.96 ± 6.93 vs. 4.46 ± 7.07, p = 0.028). The DCS was more significantly improved in the senior radiologist group.

Conclusion

Better visualization of brain tumor details and higher tumor detail diagnostic confidence can be obtained with 7-T MRI.     

Detection of BBB disruption and hemorrhage by Gd-DTPA enhanced MRI after embolic stroke in rat

Thrombolytic therapy with rtPA increases the risk of hemorrhagic transformation (HT) after cerebral ischemia. We employed contrast enhancement MRI with Gd-DTPA to detect HT in a rat model of embolic stroke treated with rtPA and a glycoprotein IIb/IIIa receptor antagonist, 7E3 F(ab')2, at 4 h after embolic stroke. Male Wistar rats were subjected to embolic stroke and treated with the combination of rtPA and 7E3 F(ab')2 (n=12) or with saline (n=10) at 4 h after onset of stroke. MRI studies were performed immediately and at 24 h after embolization using a 7-T system. Histological measurements were obtained at 48 h. With Gd-DTPA, T1WI images and permeability related MRI parameters (the blood-to-brain transfer constant, Ki, and the distribution volume of mobile protons, Vp) of 15 out of 18 animals showed hyperintensity regions in gross or microscopic HT areas at 24 h, confirmed histologically at 48 h post stroke. Contrast enhancement MRI detected six of seven (86%) animals with gross HT and nine of eleven (82%) animals with microscopic HT at 24 h after ischemia. Two of eighteen animals with HT, had MRI indices of hemorrhage at 3 h post stroke. However, compared to HT data measured histologically at 48 h in embolic stroke rats, the enhanced areas by Gd-DTPA at 24 h were larger, and the patterns (time, intensity and region) did not directly correlate to the subtypes of HT, i.e., gross or microscopic hemorrhage. Contrast enhancement MRI using Gd-DTPA provides a method to detect gross and microscopic HT after stroke in rats.     

非典型性脑膜瘤与良性脑膜瘤MRI征象的对比分析

目的 对比分析非典型性脑膜瘤与良性脑膜瘤的MRI征象特点,提高对非典型性脑膜瘤的认识。方法 回顾性分析经病理证实的37例非典型性脑膜瘤与288例良性脑膜瘤的MRI征象。结果 非典型性脑膜瘤直径>6.5 cm比例、肿瘤呈分叶型比例、瘤脑界面不清晰比例、重度瘤周水肿比例、邻近骨质改变比例均明显高于良性脑膜瘤（P<0.05）。多因素Logistic回归分析显示,肿瘤较大及瘤脑界面不清晰为非典型性脑膜瘤的可能性显著增加,肿瘤大小每增加1.5 cm,非典型性脑膜瘤的概率是良性脑膜瘤的1.507倍,瘤脑界面不清晰为非典型性脑膜瘤的概率是良性脑膜瘤的2.605倍。结论 肿瘤大小及瘤脑界面对于非典型性脑膜瘤与良性脑膜瘤的鉴别诊断具有重要价值。     

Clinical and MRI Predictors of Outcome After Surgical Intervention for Cervical Spondylotic Myelopathy

BACKGROUND: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in older individuals. Controversy remains in terms of the optimal timing and indications for surgical intervention. In this context, it would be of benefit to define clinical and magnetic resonance imaging (MRI) predictors of outcome after intervention for CSM. OBJECTIVE: We studied subjects with clinically documented cervical myelopathy to evaluate the relationship among preoperative MRI signal change, clinical findings, and outcome after surgical intervention. METHODS: We performed a retrospective case study of 76 CSM patients who underwent cervical decompressive surgery and who had pre- and postoperative MRI studies available for review. Preoperative clinical findings and MRI abnormalities on T1- (T1WI) and T2-weighted (T2WI) images were correlated with outcomes (Nurick scores; Odom's criteria) following surgical intervention. Postoperative MRIs were performed 2-4 months postsurgery to assess for adequacy of decompression and resolution of preoperative signal changes. The pattern of spinal cord signal intensity was classified as: Group A (MRI N/N), no intramedullary signal intensity abnormality on T1WI or T2WI; Group B (MRI N/Hi), no intramedullary signal intensity abnormality on T1WI and high intramedullary signal intensity on T2WI; Group C (MRI Lo/Hi), low intensity intramedullary signal abnormality on T1WI and high intensity intramedullary signal abnormality on T2WI. Statistical analyses were performed using SAS (version 8.2). RESULTS: We evaluated 76 patients (57% males, mean age 62 years, range 30-89) who experienced preoperative symptoms for an average of 6.5 months (range 1 month to 9 years). Preoperative MRI studies demonstrated the following: Group A (MRI N/N) = 45; Group B (MRI N/Hi) = 23; and Group C (MRI Lo/Hi) = 8. The mean postoperative follow-up period was 2.5 years (range 2 months to 8.5 years). A positive Babinski sign and the presence of intrinsic hand muscle atrophy showed the greatest association with abnormal preoperative MRI signal change. High preoperative Nurick score, clonus, and leg spasticity were associated with a less favorable postoperative outcome. In Group B (MRI N/Hi), 11/23 (52.17%) patients had recovery to MRI N/N (P < .0001) at their follow-up scan. CONCLUSIONS: Patients with high intramedullary signal change on T2WI who do not have clonus or spasticity may experience a good surgical outcome and may have reversal of the MRI abnormality. A less favorable surgical outcome is predicted by the presence of low intramedullary signal on T1WI, clonus, or spasticity. These data suggest that there may be a window of opportunity to obtain optimal surgical outcomes in patients with CSM.     

脑内脱髓鞘假瘤病理、临床与磁共振成像对照分析

目的 探讨脑内脱髓鞘假瘤的MR影像学表现并分析其病理、临床与MRI影像三者之间的相关性. 方法 回顾性分析总结经病理证实的8例病例的病理、临床及MRI表现并加以对照. 结果 临床表现以肢体运动障碍和(或)肢体感觉障碍最常见,亦可见癫痫等少见症状.MRI影像显示病灶均单发、以侵犯皮层下白质为主,"瘤体"多为圆形或类圆形、边界多较清楚,信号多为T1均匀低信号、T2均匀高信号,多明显均一强化,多有明显占位效应及灶周水肿.病理上病变处脑组织脱髓鞘,轴索尚保存.见大量淋巴细胞在血管周围围绕浸润呈套袖现象,此外尚可见大量的巨噬细胞以及胶质细胞增生. 结论 脑内脱髓鞘假瘤病理、临床与MRI影像的相关性较好,MRI是其诊断的重要依据.其发生于幕上时与胶质瘤鉴别诊断相对较易,发生于幕下时与Ⅰ～Ⅱ级胶质瘤不易鉴别,此时应密切结合临床.对于临床与影像学诊断均较困难者,可行肾上腺皮质激素试验性治疗或脑组织活检.     

EMG与颈椎MRI在神经根型颈椎病中的相关性分析

目的:探讨肌电图(EMG)与颈椎磁共振成像(MRI)在神经根型颈椎病(CSR)中定位诊断价值的相关性.方法:选择2014年7月～2015年7月在我院神经内科、骨科门诊及住院患者中确诊为CSR者80例;均给予颈椎MRI和EMG检查.结果:颈椎MRI累及4个以上节段者34例(占43％);累及3个节段者26例(占32％),累及2个节段者14例(占18％),仅累及1个节段者46例(占7％);EMG报告累及4个神经根者6例(占7％),累及3个神经根者8例(占10％),累2个神经根者20例(占25％),累及1个神经根56例(占58％).颈椎MRI所见累及颈4-5间盘者占50％,而EMG所见累及相应颈5神经根者占16％,差异有统计学意义;颈椎MRI所见累及颈5-6间盘者占57％,EMG所见累及颈6神经根占55％,差异无统计学意义;颈椎MRI所见累及颈6-7间盘者占36％,EMG累及颈7神经根占31％,差异无统计学意义;颈椎MRI所见累及颈7-胸1间盘者占4％,EMG累及颈8神经根占7％,差异有统计学意义.结论:EMG对CSR的定位诊断意义与颈椎MRI高度相关,且定位更加具体、精确.EMG与颈椎MRI联合检查可更加精确定位,对需要外科手术患者具有重大的指导意义.     

Differentiation between glioblastomas and brain metastases and regarding their primary site of malignancy using dynamic susceptibility contrast MRI at 3T

BackgroundDifferentiation between glioblastoma and brain metastasis may be challenging in conventional contrast-enhanced MRI.PurposeTo investigate if perfusion-weighted MRI is able to differentiate glioblastoma from metastasis and, as a second aim was to see if it was possible in the latter group, to predict the primary site of neoplasm.Material and methodsHundred and fourteen patients with newly discovered tumor lesion (76 metastases and 38 glioblastomas) underwent conventional contrast-enhanced MRI including dynamic susceptibility contrast perfusion sequence. The calculated relative cerebral blood volumes were analyzed in the solid tumor area, peritumoral area, area adjacent to peritumoral area, and normal appearing white matter in contralateral semioval center. The Student t-test was used to detect statistically significant differences in relative cerebral blood volume between glioblastomas and metastases in the aforementioned areas. Furthermore, the metastasis group was divided in four sub groups (lung-, breast-, melanoma-, and gastrointestinal origin) and using one-way ANOVA test. P-values < 0.05 were considered significant.ResultsRelative cerebral blood volume (rCBV) in the peritumoral edema was significantly higher in glioblastomas than in metastases (mean 3.2 ± 1.4 and mean 0.9 ± 0.7), respectively, (P < 0.0001). No significant differences in the solid tumor area or the area adjacent to edema were found, (P = 0.28 and 0.21 respectively). There were no significant differences among metastases in the four groups.ConclusionIt is possible to differentiate glioblastomas from metastases by measuring the CBV in the peritumoral edema.It is not possible to differentiate between brain metastases from different primaries (lung-, breast-, melanoma or gastrointestinal) using CBV-measurements in the solid tumor area, peritumoral edema or area adjacent to edema.     

胼胝体病变的临床与CT、MRI表现

目的：分析胼胝体病变临床表现及CT、MRI影像学特征。材料与方法：搜集经CT、MRI检查后发现胼胝体病变37例（其中15例经手术及定向穿刺后病理证实）。结果与结论：37例胼胝体病变包括所胼胝体发育不全6例、脂肪瘤5例，外伤及脑血管意外致血肿11例、肿瘤13例（胶质母细胞瘤3例、Ⅰ～Ⅱ级星形细胞瘤5例、淋巴瘤3例、转移后2例）、血管畸形及多发性硬化各1例。除8例脑外伤以外，其他病人临床上均有长期头晕、头痛、突发意识障碍、癫痫等表现、但非特征性改变。CT、MRI对胼胝体病变（无论是原发或是继发）的发现、诊断及鉴别诊断均有重要的价值，MRI在定位上较CT更为精确．从而为术前手术方式的选择，术后放疗的定位准确提供更多有用信息。