低场MRI在鉴别脊柱转移瘤与骨质疏松压缩骨折中的作用

目的探讨椎体转移瘤与骨质疏松压缩性骨折的MRI特征及其对诊断与鉴别诊断的意义。方法 50例病理证实的椎体转移瘤及30例临床随访证实的骨质疏松压缩性骨折患者术前均经低场（0.35T）MRI平扫及Gd-DTPA增强扫描。全部MRI操作是采用T1与T2加权序列进行的。结果压缩椎体的信号对转移瘤与骨质疏松压缩性骨折的鉴别无特异性,但椎体内残留有正常骨髓信号者,多见于骨质疏松压缩性骨折,而压缩椎体后缘突出,椎管狭窄,椎弓受累,椎旁软组织肿块及增强后压缩椎体呈不均匀性强化多见于转移瘤。结论低场MRI对于椎体骨质疏松压缩骨折和转移瘤性骨折的鉴别具有重要的价值。     

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。     

MRI对单椎体转移瘤的早期诊断

骨骼是恶性肿瘤最常见的转移部位之一,脊柱最易受累,尸检证实70%的骨转移发生于椎体,而当获确诊时常伴有瘫痪等严重的并发症[1,2]。多发椎体异常信号改变是脊柱多发转移瘤最直接的MRI表现,病变椎体呈跳跃式分布,MRI诊断有一定的特征性。单个椎体转移瘤的MRI信号改变常缺乏特异性,本文回顾性分析单椎体转移瘤的MRI表现,探讨MRI对单椎体转移瘤的早期诊断价值。1材料与方法1.1一般材料收集我院1998年~2005年26例中,男性17例,女性9例,年龄34~82岁,平均58·6岁。病程1个月~半年,临床表现16例持续性腰、背部疼痛;余10例以原发病症状就诊。26…     

72例脊柱转移瘤的MRI诊断

目的：探讨ＭＲＩ对脊柱转移瘤的诊断价值。方法：包括７２例脊柱转移瘤，其中男４５例，女２７例，均有明确原发癌灶。使用安科ＡＳＰ－０１５型永磁型ＭＲＩ扫描机。结果：１８例为单椎体病变，５４例为多椎体病变。６８例在Ｔ１加权图呈低信号，Ｔ２加权图呈高信号。４例在Ｔ１及Ｔ２加权图均呈低信号。２１例附件受累，１９例有椎旁肿块，３５例有椎管受侵或脊髓受侵。７２例椎间盘形态及信号均大致正常。结论：ＭＲＩ在评价脊柱转移瘤方面优于Ｘ线平片及ＣＴ并可与核素骨扫描相互印证补充。     

经皮椎体成形术治疗脊柱转移瘤疗效的MRI评价

目的判断MRI检查结果能否为临床脊柱转移瘤患者经皮椎体成形术(PVP)术后疗效客观评价提供可靠的指标。方法回顾性分析36例患者75节椎体转移瘤采用单纯PVP治疗的临床及医学影像学检查资料。术前及术后进行疼痛视觉模拟评分(VAS)。根据MRI检查显示分为3组:病灶完全消失并持续12周为完全缓解(A组);病灶出现骨化或肿瘤体积缩小,无新转移灶出现并连续保持12周为部分缓解(B组);通过测量肿瘤体积反映病灶扩大,表示无效(C组)。然后比较3组术前、术后12周疼痛缓解程度。结果 3组间术前VAS差异无统计学意义(P>0.05),术后C组疼痛缓解不明显,A组比B组疼痛缓解程度大,疼痛缓解程度差异有统计学意义(P<0.05)。表明MRI客观检查结果与临床主观评价一致。结论 PVP是治疗脊柱转移瘤的有效方法,MRI检查能为临床脊柱转移瘤患者PVP术后疗效提供可靠的客观评价。     

多发椎体压缩骨折良恶性MRI鉴别诊断

目的MRI鉴别多发椎体良恶性压缩骨折。方法171个椎体压缩骨折（良性77个、恶性94个）,16个经椎体活检,其余经3～6个月MRI追踪确诊。行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。     

脊柱结核与转移瘤的MRI鉴别诊断

目的:分析脊柱结核与转移瘤的MRI表现并探讨其鉴别诊断价值。材料与方法:选择经临床或手术病理证实的40例结核与36例转移瘤,采用SIEMENS 1.0T超导型磁共振仪,快速自旋回波序列,矢状、冠位、轴位T_1WI和T_2WI检查。结果:脊柱结核和转移瘤均表现有多个椎体骨质破坏,结核累及椎体附件较转移瘤明显少。转移瘤一般不伴有椎间隙的狭窄。结核压迫硬膜囊和脊髓主要是由于楔状变形的椎体后移及寒性脓肿的形成。转移瘤压迫硬膜囊和脊髓主要是由于塌陷椎体前后径的加大以及椎旁硬膜外转移灶从硬膜囊后方压迫所致。结论:脊柱结核和转移瘤均有各自的特征性MRI表现,注意观察受累椎体形态、椎间盘和附件是否受累、有无脓肿和对脊髓及硬膜囊的压迫情况有助于病变的诊断和鉴别诊断。     

脊柱转移瘤MRI诊断(附45例报告)

目的　探讨MRI对脊柱转移瘤的敏感性 ,以提高脊柱转移瘤MRI表现的认识。方法　回顾性分析 45例脊柱转移瘤的MRI表现 ,结合文献进行讨论。结果　 45例中共累及 14 9节椎体 ,累及椎弓根 19例 3 2根 ,棘突及横突 7例 11处。椎体压缩呈盘状 8例 2 1节 ,呈楔状 7例 11节 ,病椎轻度膨胀 4例 ,有软组织肿块 18例 ,硬膜囊、脊髓受压 15例 ,脊髓受侵 2例。病椎信号均匀 2 8例 ,不均匀 17例。T1WI为明显低信号 15例 ,略低信号 2 7例 ,等信号 3例。T2 WI为明显高信号 17例 ,略高信号 2 5例 ,等信号 3例。增强 18例 ,病灶明显强化 11例 ,轻度强化 6例 ,不强化 1例。软组织肿块边缘水肿、受压和受侵脊髓在MRI上均显示阳性。结论　MRI检查脊柱转移瘤的敏感性明显优于CT和X线平片 ,尤其肿瘤浸润椎骨尚属水肿、出血、坏死阶段时。     

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     

对良、恶性椎体压缩性骨折MRI鉴别诊断的再认识

目的：提高对椎体压缩性骨折定性征象的认识。方法：回顾性分析经临床确诊的椎体压缩性骨折56例78个椎体，外伤性骨折11例15个椎体；非外伤性骨折17例25个椎体；恶性压缩性骨折28例38个椎体，MRl分别重点观察了椎体骨髓信号、椎体后缘的形态、MRI增强的强化方式、椎弓根的形态及椎旁软组织的形态。结果：恶性压缩性骨折较特异性的MRI征象有：(1)L1WI像上椎体呈广泛均匀低信号；(2)椎体后缘呈球形凸出；(3)T2WI像上椎弓根膨大且可见高信号；(4)T2WI／I像受累椎体的不均一强化；(5)瘤样椎旁软组织肿块。结论：MRI的特征性改变能准确地鉴别良、恶性椎体压缩性骨折。     

经皮椎体成形术在椎体压缩性骨折治疗中的应用

由外伤或骨质疏松导致的胸、腰椎体压缩骨折相当常见,患者的主要症状是顽固而严重的腰背疼痛。以往传统的保守与外科疗法有一定疗效,但均存在治疗周期长与疗效欠佳的缺点,我们利用由德国引进的经皮穿刺椎体成形(PVP)技术,自2002年10月至2003年10月间,为12例胸、腰椎压缩骨折的患者进行了治疗,并获得满意效果,现报道如下。资料与方法一、一般资料2002年10月至2003年10月间,我院共收治12例胸、腰椎椎体压缩骨折的患者,其中男4例,女8例;年龄38~72岁,平均60岁。病史8h至半年不等,有明显外伤史者4例,轻微外伤史者6例,自诉无明显外伤史者2例;伴…     

良恶性多椎体压缩性骨折的MRI诊断

目的:探讨良、恶性多椎体压缩性骨折的MR影像学特征。方法:回顾220例(良性104例,恶性116例)460个压缩椎体,比较病变椎体排列特性及MRI征象。结果:恶性多椎体压缩骨折,椎体跳跃式侵犯多见,66%的病灶集中在椎体后2/3髓质,T1WI呈穿凿样、片状低信号,并椎弓根、椎板表现膨胀性骨质破坏,椎间盘形态正常;良性多椎体压缩性骨折,椎体连续性病变多见,终板表现带状异常信号,常伴椎间盘撕裂、椎间隙狭窄或增宽,椎体碎裂,但无软组织肿块。结论:MR的特征性改变能准确鉴别良、恶性压缩骨折。     

膝关节滑膜骨软骨瘤病X线诊断(附38例分析)

滑膜骨软骨瘤病是一种较少见的关节疾病，系滑膜良性肿瘤，是关节滑膜化生、滑膜内软骨或骨软骨结节形成关节游离体的慢性关节病。本文重点分析我院2004～2008年收集的膝关节滑膜骨软骨瘤病的X线表现。以探讨本病的病因及鉴别诊断。     

椎体压缩性骨折的磁共振诊断

目的分析椎体良、恶性压缩性骨折的MRI表现.材料和方法22例椎体良性压缩性骨折及49例病理性压缩性骨折患者,男43例,女28例,年龄34～76岁,平均58.3岁.全部行MR平扫+增强扫描.结果压缩椎体的信号改变对骨折甚为敏感,但对良、恶性骨折的鉴别缺乏特异性.压缩椎体残留有正常的骨髓信号者多见于良性骨折(P＜0.001).压缩椎体后缘膨出、椎管狭窄常见于病理性骨折(P＜0.001).椎弓根受侵(P＜0.001)及椎旁软组织肿块(P＜0.001)是病理性骨折所特有的征象.增强后椎体信号均匀与否对诊断有帮助(P＜0.001).结论病理性压缩性骨折多表现为椎弓根信号异常,椎体后缘明显膨隆,椎管狭窄,椎旁软组织肿块及增强后压缩椎体不均匀强化.椎弓根变形膨大一般不出现于良性骨折.     

Magnetic resonance imaging of pancreatic carcinoma

The authors have used MRI for investigation of 41 patients with pancreatic tumours. MR examinations were performed with 0.5 T superconductive equipment. Short TR, short TE spin echo (SE) sequences were obtained with 8 averages and 256×256 matrix. T2-weighted sequences were also acquired. T1-weighted SE sequences provided more detail, with high intrinsic contrast between the tumour and the normal pancreas; small lesions (19 smaller than 3 cm in diameter) were always detected on these images. T2-weighted SE sequences were not useful for lesion detection, due to the lower intrinsic contrast and the number of artefacts. T2-weighted sequences proved helpful for lesion characterisation in two cases of cystoadenocarcinoma only. Staging of the tumour was possible with MRI, with good assessment of local spread, lymphoadenopathy, vascular involvement and hepatic metastases. MRI of the pancreas at medium field strength can be an alternative to CT in selected cases. Offprints requests to: P.Pavone     

Magnetic resonance imaging of thehand and wrist

The application of magnetic resonance imaging (MRI) to the hand and wrist has lagged behind its use in larger joints. Recent advances in hardware and software technology have allowed faster imaging with excellent anatomic resolution. After routine radiography, MRI is the imaging procedure of choice for evaluation of chronic wrist pain. The most common indications for MRI within the hand and wrist include scapholunate-lunate ligament tears, triangular fibrocartilage complex (TFCC) tears, avascular necrosis, and soft tissue masses. MRI may occasionally help evaluate tendon abnormalities, atypical or postoperative recurrent carpal tunnel syndrome, and complications of inflammatory arthritides. Future applications of MRI will likely include improved anatomic imaging of smaller structures such as the lunatotriquetral ligament and the extrinsic ligaments, as well as MR angiography (MRA).     

骨水泥混合与注射一体化装置行经皮椎体成形术治疗椎体压缩性骨折

目的探讨骨水泥混合与注射一体化装置行经皮椎体成形术治疗椎体压缩性骨折的操作技术、临床疗效。方法2002～2004年间共计治疗了108例诉有严重疼痛的椎体压缩性骨折患者,其中骨质疏松性压缩性骨折85例,椎体恶性肿瘤31例。穿刺入路采用双侧椎弓根穿刺法,所有患者均在透视监视下双侧注射聚甲基丙烯酸甲酯(polymethylmethacrylate,PMMA),注射设备为骨水泥混合与注射一体化装置。术后随访患者6个月。结果共计注射116个椎体(腰椎69个,胸椎47个),双侧穿刺和骨水泥注射成功率100％,99例患者(91．7％)术后疼痛明显缓解,6个月内疼痛无复发95例(95．6％),9例患者(8．3％)术后疼痛无缓解。发生骨水泥外漏12例(11％),有临床症状5例(4．6％)。结论骨水泥混合与注射一体化装置行经皮椎体成形术创伤小、并发症少,而且止痛疗效显著,是一种非常有前景的治疗椎体压缩性骨折的介入手术方法。     

Magnetic resonance imaging of the kidneys

MR images of the kidney have been reported in a variety of diseases. The images have been proton scans, usually produced with pulse sequences that have provided a variety of T₁- and T₂-weighted images. Anatomy is well depicted: renal parenchyma can be easily separated from adjacent organs and surrounding fat, cortex and medulla are distinguishable, and renal vessels and calyces can be identified and distinguished. Focal diseases can be diagnosed: cysts can usually be distinguished from tumors, and varying degrees of hemorrhage in the former may be detected. Renal carcinoma can be staged relatively well and distinguished from angiomyolipomas. Generalized parenchymal diseases may be detected, but data is scanty. There is promise that ATN and rejection may be distinguishable in transplanted kidneys. Changes have been seen in acute vascular diseases, but extensive experience in man is lacking.     

Magnetic resonance imaging of the craniocervical junction in rheumatoid arthritis: value,limitations, indications

The cervical spine is the second most common location for manifestation of rheumatoid arthritis (RA). Symptoms are typically related to involvement of the craniocervical junction. Unfortunately, conventional radiographic examination is often unable to demonstrate that RA is the cause of such symptoms. Magnetic resonance imaging (MRI) provides an unique opportunity to visualize nerves, connective tissue, and bone in all planes without the use of contrast agents. These features suggest that MRI could provide important information related to RA of the cervical spine. The possibilities and limitations of MRI were therefore evaluated in 60 patients with cervical RA. The main objective of this study was to correlate symptoms and clinical findings with MRI results to establish indications for this imaging procedure.