韧带样纤维瘤的影像表现与病理对照

目的回顾分析韧带样纤维瘤(desmoid-type fibromatoses,DF)的CT和MRI表现及其病理基础,探讨其影像学诊断价值。资料与方法搜集经手术病理证实的DF患者20例,男8例,女12例。9例进行CT检查(增强7例),9例行MRI检查(增强8例),2例行CT、MRI平扫及增强扫描。分析其CT及MRI表现,并与组织病理学进行对照分析。结果 20例中共检出25个病灶,其中腹部外型18个,腹壁型4个,腹内型2个,骶骨1个;17个病灶形态不规则,8个呈椭圆形。CT平扫均表现为均匀软组织密度。与肌肉信号相比,MR T1WI上呈等信号7个,稍低信号6个;T2WI呈高或稍高信号9个,2个呈混杂信号,1个呈低信号。所有病灶内均可见条索状、片状T1WI及T2WI上均呈低信号改变的区域;增强扫描10例均呈中等以上强化。结论 DF的CT和MRI特征较明显,对多数病变术前进行定性诊断是可能的。     

软骨黏液样纤维瘤综合影像分析

目的 探讨影像学检查对软骨黏液样纤维瘤的诊断价值.方法 对18例病理证实的软骨黏液样纤维瘤影像学资料进行回顾性分析,其中行X线检查18例,CT检查6例,MRI检查6例,另有4例同时行CT及MRI检查.结果 18例中,15例发生于长骨干骺端,另外骶骨、肋骨及颅底各1例.X线及CT病变表现为偏心囊性骨质破坏区,有硬化边,骨皮质膨胀变薄,CT显示病变内细小钙化灶5例.MRI表现为病变信号不均匀,在T1WI上呈低及中等信号,在T2WI以高及中等信号为主,亦可见部分低信号,行Gd-DTPA增强扫描后病灶实性部分呈不均匀强化,囊性部分强化不明显.结论 软骨黏液样纤维瘤的X线、CT与MRI影像表现均有特征性,其综合影像对诊断与鉴别诊断有重要价值.     

韧带样纤维瘤病MRI特征表现及其病理基础

目的：探讨韧带样纤维瘤病（DF）的MRI特点,重点分析MRI特征影像及其病理基础,评价MRI在DF诊断中的价值。方法回顾性分析经手术病理证实14例韧带样纤维瘤病的MRI表现（14个病灶均行M RI增强及延迟扫描）,与术后病理结果进行比较,并探讨M RI特征影像的病理基础。结果14例均为单发病灶（腹外型7例、腹壁型4例、腹内型3例）,其中有2例为术后复发,肿瘤沿着肌肉长轴生长。T1 WI呈等或稍低于肌肉的信号,T2 WI呈高于肌肉信号,增强扫描病灶均呈不均匀强化,以延迟强化为明显,病灶内可见条状或带状 T1 WI及 T2 WI低信号,增强后未见强化。14例病灶内均未见坏死、囊变及瘤周水肿。病理组织学上肿瘤由不同比例的成纤维细胞、纤维组织和胶原纤维束组成,纤维细胞及成纤维细胞密集区域T2 WI信号增高,而肿瘤内胶原纤维区域在 T1 WI、T2 WI均为低信号。肿瘤内见较多血管壁完整的毛细血管,这是病灶延迟强化的病理基础。结论病灶内可见T1 WI、T2 WI均呈带状低信号且增强扫描不强化以及病灶延迟强化是DF的特征性MRI表现。MRI可以很好评估肿瘤侵犯范围及其与周围结构的关系,有助于DF的诊断和鉴别诊断。     

颅骨韧带样纤维瘤的影像学表现

目的 探讨颅骨韧带样纤维瘤的影像学特点,提高对其诊断正确率.方法 回顾性分析经手术病理证实的5例颅骨韧带样纤维瘤患者的影像学表现.结果 5例均为单发病灶,3例发生在顶骨,2例发生在额骨,病灶均呈膨胀性骨质破坏,内见残存骨嵴及钙化灶,骨皮质可中断,无明显软组织肿块,病变在MRI T1 WI上呈混杂低信号,在T2 WI上呈以高信号为主的混杂信号,增强后呈明显不均匀强化.结论 颅骨韧带样纤维瘤多见于顶骨及额骨,以板障内膨胀性骨质破坏伴有粗大结节样钙化为其特征性表现.     

韧带样型纤维瘤的影像学特征

目的 探讨韧带样型纤维瘤(desmoid-type fibromatoses,DF)的影像学特征.方法 回顾性分析经手术及病理证实的20例DF患者的影像和临床资料,其中原发性DF 13例,复发性7例.探讨其CT和MRI影像学特征.结果 20例DF均单发,其中12例(60.0％)边界不清,9例(45.0％)包绕血管神经,8例(40.0％)有骨膜粘连.10例行CT检查,平扫呈稍低密度,密度均匀,瘤内未见钙化及坏死区.增强扫描6例表现为中度强化,延迟扫描5例呈渐进性强化.15例行MRI检查,T1WI呈等或稍低信号,T2WI呈高于肌肉低于脂肪信号,增强扫描11例呈中等或明显不均匀强化,并随着各期相渐进性强化.其中9例(81.8％)可见条索状或小斑片状T1WI及T2WI低信号,增强后未见强化.扩散加权成像(DWI)扫描2例呈高信号,表观扩散系数(ADC)图上呈等或稍高于肌肉信号.结论 DF的CT、MRI表现具有一定特征,MR增强、动态增强及DWI扫描对DF的诊断及预后监测具有重要价值.     

腹外韧带样型纤维瘤病的影像学表现

【摘要】目的：探讨腹外韧带样型纤维瘤病的MRI和CT表现。方法：回顾性分析82例经手术病理证实的腹外韧带样型纤维瘤病患者的影像资料。所有病例行MRI平扫,58例行增强扫描;37例行CT平扫,其中26例行增强扫描。结果：82例中单发病灶62例（76%）,多发病灶20例（24%）。原发性病灶35例（43%）,复发性病灶47例（57%）。75例（91.5%）病灶边界不清或部分不清,48例病灶（58.5%）包绕神经血管束,16例病灶侵蚀骨质,5例病灶压迫邻近骨质。所有病灶在T1WI上呈等信号或稍高信号,在T2WI上呈高信号,增强后呈中度或高度强化;75例（91.4%）病灶信号不均匀,其内部均可见条索状、条片状区,在T1WI和T2WI上呈低信号,增强扫描无明显强化;部分病灶周边可有水肿区。CT平扫示病灶呈等或稍低密度,增强后呈中度或高度不均匀强化。结论：腹外韧带样型纤维瘤病的影像学表现具有一定特征性,是该病变与软组织恶性肿瘤的重要鉴别要点。     

头颈部软组织韧带样纤维瘤病的MRI表现

目的 探讨头颈部软组织韧带样纤维瘤病的MRI表现.方法 回顾性分析经病理证实的11例头颈部韧带样纤维瘤病的MRI表现,分析肿瘤的位置、形态、大小、边界、信号强度及增强的特点.结果 11例韧带样纤维瘤病患者中,病灶位于椎旁间隙5例,颈动脉间隙4例,咀嚼肌间隙1例及下颌下间隙1例,最长径2.6～16.1cm,其中8例沿肌间隙呈狭长状生长,6例病灶边缘见脂肪环征.10例病灶在T1WI上呈等或稍低信号、T2 WI上呈稍高或高信号为主,内部均见条状、束状或分隔状低信号影,增强扫描病灶明显强化,其内低信号影无强化.另1例病灶在T1WI及T2WI上均呈低信号,增强扫描无强化.所有病例均未见明显坏死,除1例复发病例外周围肌肉均未见水肿.结论 头颈部软组织韧带样纤维瘤MRI表现有一定特征,多数病例术前能做出正确诊断.     

骨梗死的X线、CT和MRI诊断

目的探讨骨梗死的影像学表现.材料和方法对10例累及28处骨骼的骨梗死患者行X线、CT及MRI检查,将骨梗死分为早、中、晚期,分析其影像学特征.结果病变主要累及股骨下段和胫骨上段,多双侧发病.骨梗死早、中期X线、CT表现为阴性和局部的骨质疏松及斑点状钙化,MRI表现为病变中心T1WI呈等或稍低信号,T2WI呈等或稍高信号,病灶边缘呈典型的地图样改变.晚期X线及CT呈不规则状、蜿蜒状骨质硬化,MRI T1WI及T2WI均呈低信号.结论MRI检查是诊断早、中期骨梗死最有效的方法,优于X线平片和CT;在晚期,X线平片和CT、MRI均有特征性表现,三者相结合可提高诊断准确率.     

腹壁外韧带样瘤MRI诊断探讨

目的：讨论腹壁外韧带样瘤的MRI平扫及增强扫描的表现，评价MRI对该病的诊断价值。方法：回顾分析5例经手术切除及病理证实的腹壁外韧带样瘤的术前MRI平扫及增强扫描表现，其中2例同时行CT平扫，3例同时行血管造影。结果：5例腹壁外韧带样瘤均位于四肢肌肉及软组织，年龄11岁～28岁，其病灶MRI表现为在T1WI上，肿物呈中等信号，其间可见条片状及斑点状低信号，在T2WI上则呈高信号，其间夹杂中等、稍低及更低的条片状、斑点状信号，后与在T1WI上所见的低信号相吻合。增强扫描后在平扫中呈等T1、长T2或长T1、长T2信号改变的区域均强化非常明显，而在T1WI及T2WI上均呈条片状、斑点状低信号区域则未见强化，5例病灶周围组织均未见水肿，3例邻近骨出现压迫性改变，2例CT显示病灶密度欠均匀，边界清晰，3例血管造影可见肿瘤染色明显。结论：MRI可以较为精确的显示腹壁外韧带样瘤的病灶形态及范围，对韧带样瘤的诊断与鉴别诊断有重要价值，是目前最好的影像学检查方法。     

钙化性腱膜纤维瘤的MRI诊断（附5例报道并文献复习）

目的:探讨钙化性腱膜纤维瘤(CAF)的MRI表现,提高对该病的影像学诊断水平.方法:回顾性分析经手术及病理证实的5例钙化性腱膜纤维瘤的临床及MRI表现,所有腱膜纤维瘤患者均行MRI检查,其中2例加行MRI增强扫描.结果:5例CAF中3例病灶位于手部,1例位于肘窝,1例位于跟腱,所有病例均可见软组织肿块,病灶紧贴肌腱生长并向邻近软组织浸润.T1WI上4例病灶呈与肌肉等同的信号,1例信号比肌肉稍低;T2 WI上5例CAF均呈不均匀高信号或混杂信号,即高信号背景下可见点片状低信号;2例病灶内可见团状T1 WI、T2 WI均呈低信号的钙化灶;2例增强扫描病灶呈中等强化,低信号区不强化.结论:MRI可以完整显示钙化性腱膜纤维瘤的部位、大小、信号特点,可为术前诊断提供重要信息.     

Gleichzeitige Darstellung von EsD,DIA, GLO und UDPGP in einem Stärkeblock

Zusammenfassung Es wird über die gleichzeitige Darstellung von 4 Enzymsystemen aus menschlichen Hoden berichtet. GLO- und Diaphorase-Typen waren sehr gut reproduzierbar. Das gilt prinzipiell auch für EsD; dabei sollte eine Inkubationszeit von 2–3 min nicht überschritten werden, weil sich die Untergrundfluoreszenz zunehmend intensiviert. Von der UDPGP wurden 2 differente Muster angezeigt; jedoch gelang ihr Nachweis nicht regelmäßig.     

Frequenzen von Gm 1, 2, 3, 5, 10, 21 und Km 1, 3 in Portugal und Schleswig-Holstein

Zusammenfassung Es wurden 1000 Schleswig-Holsteiner und erstmalig 562 Portugiesen auf die Gm-Faktoren 1, 2, 3, 5, 10 und 21 sowie die Km-Faktoren 1 und 3 untersucht und die Phänotypen mit ihren Genfrequenzen für diese Kollektive bestimmt. Die Frequenzergebnisse wurden miteinander verglichen und Unterschiede herausgestellt.Ausführliche Darstellung siehe Dissertation Zippel, Lübeck (1981)     

Invited. Hepatitis,cirrhosis, and hepatoma

Virus hepatitis and liver cirrhosis are found at high incidence in Asia, and they require not only biochemical examination of blood but also subsequent imaging, because they are often complicated by hepatocellular carcinoma (HCC). It is, therefore, very important to know the specific appearances of hepatitis, liver cirrhosis, and HCC when we diagnose these diffuse liver diseases. Liver necrosis due to severe hepatitis is seen as high intensity on T2-weighted spin echo images. Regeneration is seen as low intensity on T2-weighted images. Morphologic and pathologic changes of cirrhotic liver are well demonstrated by MR imaging techniques. Fibrotic septum with inflammatory cell infiltration or rich pseudo bile duct show high intensity on T2-weighted images, and regenerating nodules shows low intensity. Gradient echo images show regenerating nodules with iron deposition as low-intensity nodules due to susceptibility artifact. MRI also has the potential to evaluate function of diffuse liver disease, cirrhosis, and hepatitis. MRI can visualize and diagnose HCC objectively. Dynamic MRI is very useful for diagnosing HCC. It is also applied for evaluation of effect after transcatheter arterial chemoembolization, because it shows enhancement only in the viable region at an arterial phase. MRI is less invasive and is thus an extremely important form of liver imaging.     

Renal Colic Imaging: Myths,Recent Trends,and Controversies

There has been a substantial increase in the utilization of imaging, particularly of multi-detector computed tomography (MDCT), for the evaluation of patients with suspected urolithiasis over the past 2 decades. While the diagnostic accuracy of computed tomography (CT) for urolithiasis is excellent, it has also resulted in substantial medical expenditures and increased ionizing radiation exposure. This is especially concerning in patients with known nephrolithiasis and in younger patients. This pictorial review will focus on recent trends and controversies in imaging of patients with suspected urolithiasis, including the current roles of ultrasound (US), MDCT, and magnetic resonance imaging, the estimated radiation dose from MDCT and dose reduction strategies, as well as imaging of suspected renal colic in pregnant patients. The current epidemiological, clinical, and practice management literature will be appraised.     

Accuracy and precision of MR velocity mapping in measurement of stenotic cross-sectional area,flow rate,and pressure gradient

Reliability of magnetic resonance (MR) velocity mapping to assess severity of stenosis was assessed in vitro. Steady flow at different flow rates through five stenoses with a central orifice area ranging from 17 to 176 mm² was measured with velocity mapping performed perpendicular to the stenotic jet. Besides determination of the stenotic cross-sectional area and flow rate, the pressure gradient was calculated with the modified Bernoulli equation and compared with manometer measurements. Cross-sectional areas were measured with an accuracy of ?76%, a precision of ?91%, and an error of ?19 mm². Flow rates had an accuracy of ?72%, a precision of ?94%, and an error of ?1.4 L/min. The modification of the Bernoulli equation limited its reliability to stenoses with areas of 35-113 mm². Pressure gradients were calculated with an accuracy of ?80%, a precision of ?88%, and an error of ?15 mm Hg. The method was applied in a single patient with aortic stenosis and gave estimates that agreed with those obtained by heart catheterization.     

Software-annotated, digitally photographed, and printed MR images: suitability for publication

RATIONALE AND OBJECTIVES: The authors performed this study to evaluate whether digitally photographed, computer-annotated MR images produced by clinical radiologists and printed with an inexpensive photo printer are suitable for publication. MATERIALS AND METHODS: Laser prints of 20 magnetic resonance images of the brain were photographed with a 3-megapixel digital camera and annotated with arrows, arrowheads, and asterisks by using graphics software that incorporates vector support. Then, 5 x 7-inch glossy prints with white borders were made by using an inexpensive photo printer. These prints were compared with those produced of the same 20 images by members of the medical center's graphics department with professional scanning and printing equipment and annotated with conventional rub-on symbols. Eight radiologists evaluated image and annotation quality and overall suitability for publication. RESULTS: In all three categories, the images produced by radiologists outscored those produced by the graphics department. CONCLUSION: Digitally photographed, software-annotated MR images printed with an inexpensive photo printer are suitable for publication.     

Asymmetric-Echo,Short TE,Retrospectively gated MR imaging of the heart and pulmonary vessels

Although retrospectively cardiac-gated (cine) magnetic resonance imaging has shown promise for large-vessel pulmonary vascular imaging, it has not been able to depict the peripheral pulmonary vasculature, where signal is dephased because of susceptibility and/or motion artifacts. The authors developed a cine pulse sequence that uses asymmetric echoes and radio-frequency envelopes to achieve reduced gradient moments and a short TE, thereby reducing signal losses due to disordered flow and susceptibility effects. The effects of TE (2.8–12 msec) and the degree of echo symmetry as measured by the echo symmetry fraction (ESF) (0.6–1.0) are considered in the pulmonary vasculature and the heart. In pulmonary vessels, the signal-to-noise ratio nearly doubled as TE was decreased from 12 to 2.8 msec, but there was only about a 15% difference as the ESF decreased from 1.0 to 0.6, consistent with T2* losses dominating gradient moment dephasing. At a TE of 2.8 msec, the sequence improves visualization of pulmonary vessels and may be helpful for diagnosing pulmonary emboll. In the heart, however, the contrast-to-noise ratio between blood and cardiac tissue decreased by 30% as TE decreased from 12 to 2.8 msec and was not affected by changes in ESF. Flow artifacts in the cardiac blood pool, including those that can aid in diagnosis (eg, signal loss due to “jet” flow), are much less pronounced when a small ESF and short TE are used, making this sequence less attractive for investigation of cardiac flow irregularities. The reduced flow artifacts in this case, however, permit excellent depiction of gross cardiac anatomy.     

Comparison of Ultrasound,CT, and MR Imaging in the Evaluation of Candidates for TIPS

To compare ultrasound (US), CT, and MRI in the evaluation of hepatic vascular anatomy, portal and splenic venous flow, and collateral pathways (varices and spontaneous shunts) in candidates for transjugular intrahepatic portosystemic shunting (TIPS), 17 patients with history of refractory variceal bleeding or intractable ascites underwent duplex US, contrast-enhanced CT, and MRI before TIPS. The appearance of portal and hepatic anatomy was graded from 1 (not visible) to 4 (excellent visualization) independently by four radiologists. Presence and direction of portal and splenic venous flow, and presence and location of varices and spontaneous portosystemic shunts were also assessed. Results and effects of interobserver variation were assessed for significance using Friedman's ANOVA and Wilcoxon's signed-rank test. MRI yielded higher scores than CT or US for hepatic veins (P <.0001) and inferior vena cava (P <.0001). MRI and CT scored better than US for portal vein branches (P =.012) and splenic vein (P =.0038). All tests demonstrated the main portal vein well, with no statistically significant difference. US and MRI were more sensitive than CT for detecting portal vein flow and direction (US 76%, CT 0%, MRI 82%). MRI was most sensitive for splenic vein flow and direction (US 41%, CT 0%. MRI 76%). CT and MRI were more sensitive than US in detecting varices (US 5%, CT 50%, MRI 58%) and spontaneous shunts (US 13%, CT 75%, MRI 75%). Interobserver variation did not influence results significantly P =.3691). MRI provides the most useful information and may be the preferred single imaging test prior to TIPS.     

Intraarterial ethanol as a long-term occlusive agent in renal,hepatic, and gastrosplenic arteries of pigs

The renal, hepatic, or gastrosplenic arteries of eleven juvenile pigs were selectively injected intraarterially with 95% ethanol to evaluate its efficacy as an agent for use in permanent occlusion and infarction of the vascular bed supplied by the injected artery. A dose of 2.2 cc/5 kg (1 cc/5 lb) of 95% ethanol was injected over 30–45 sec. The animals were then killed at 1 to 91 days and all pigs demonstrated tissue infarction and vascular occlusion. Our results confirm that ethanol is an effective agent for the infarction of organs and that complications can result if catheter placement is not precise and normal tissue is inadvertently perfused.