肝泡状棘球蚴病脑播散的MRI表现

目的分析肝泡状棘球蚴病脑播散的MRI表现,评价MRI在诊断中的应用价值。资料与方法回顾分析10例经手术证实肝泡状棘球蚴病患者因出现神经系统症状经检查发现合并脑内多发播散灶的MRI表现。结果 10例中,8例MRI表现为脑内多发肿块,其内蜂房状或筛孔状密集的细小囊泡影,T1WI病灶信号略高于脑实质,T2WI呈明显低信号,增强扫描周边见环状强化,其内强化浅淡,并见细小针孔状不强化区。另2例MRI表现为囊泡较大,且数十个聚集呈葡萄串状,囊壁T1WI略高于脑实质,T2WI呈明显低信号,增强扫描囊壁明显强化,其内囊液不强化。结论脑内病灶多分布在双侧大脑半球,尤其是大脑中动脉血供区的大脑半球后部。MRI不仅能明确病变部位和形态特点,而且病灶囊壁及基质在T2WI具有典型低信号特征,是诊断肝泡状棘球蚴病脑转移的安全可靠的方法之一。     

肝泡状棘球蚴病的CT表现

目的：分析肝泡状棘球蚴病的CT表现。方法：回顾分析38例肝泡状棘球蚴病的CT征象。包括肝脏形态、大小、轮廓、密度、钙化及合并症等。结果：38例中，肝脏增大变形28例，38例中均有不同程度的钙化。结论：肝脏增大、肝内有界限不清、形态不规则、密度不均匀的低密度浸润伴有大量不规则的钙化为肝泡状棘球蚴病的主要CT表现。     

多器官泡状棘球蚴病5例

肝泡状棘球蚴病（Alveolar echinococcosis,AE）是临床上较为罕见的一种特殊类型的棘球蚴病,发病率约占3％左右,人群发病率约百万分之一。肝AE合并多器官AE的病例较为少见,首发症状差异较大,临床诊断和及时治疗较为困难。我院自．1990—07～2006—07共收治肝AE31例,其中多器官AE5例,现报道如下。     

肝泡状棘球蚴病CT影像学分析

１　临床资料本组５例,男３例,女２例,年龄最小者２１岁,最大者５０岁,平均３１５岁。主要临床症状：间断性右上腹胀痛,食欲不振,消瘦,肝区不适有叩击痛,病史最短者３个月,最长者１６个月,ＣＴ表现为单发及多发,圆形、卵圆形低密度影,边界清楚。多发者病灶常大小不一,病变部位组织密度严重不均匀,内显示斑片状钙化灶。病变中心坏死液化呈水样密度改变,周边见“晕影征”（图１）。　　增强后扫描时病灶强化不明显,而正常肝组织显示增强与病灶境界明显（图２）。当病变侵犯肝内胆管或门静脉分支时,可引起胆道梗阻或静脉阻…     

脑泡状棘球蚴病CT和MRI表现及诊断

目的 总结脑泡状棘球蚴病的影像特征,探讨CT和MRI的诊断价值.方法 回顾性分析经手术病理和临床随访证实的17例脑泡状棘球蚴病患者的CT和MRI表现,观察病灶的数目、部位、形态、边界、大小、密度及灶周水肿.结果 单发病灶6例,多发病灶11例.病灶数目共51个,位于额顶叶占66.6%(34/51),位脑皮层区占73.1%(37/51);病灶0.5～5.0 cm直径大小,CT平扫呈结节状或团块状高或稍高密度占86.3%(44/51),边缘粗糙,增强后大多呈环状强化,小病灶可呈结节样强化;MRI的T1WI平扫病灶大多呈稍高信号,T2WI及液体衰减反转恢复序列(FLAIR)呈"黑洞"或"煤饼"样均匀或不均匀低信号,增强后病灶强化表现与CT相仿,但强化的灰阶对比度高于CT;病灶占位效应明显,灶周均有水肿表现,常呈现"烘托效应";肝脑肺"三联征"占70.6%(12/17);CT综合MRI并以灰阶高低统一描述,则有"两等和(或)两高两低"征象.结论 脑泡状棘球蚴病CT和MRI表现具有特征性,CT和MRI联合应用和综合评价对该病具很高的诊断价值,流行病学及相关免疫学检查仍不可忽视.     

脑泡状棘球蚴病误诊一例分析

患者女,２６岁,汉族教师。１９９７年３月始右半身麻木、右侧肢体无力,５月作头颅ＣＴ示左颞顶区占位。同年９月因症状进行性加重入院。体检：心肺正常。右侧躯体感觉减退,右侧肌力４级,肌张力正常,无病理征。实验室检查：常规检查结果均在正常范围。血嗜酸粒细胞为０－０８。包虫试验强阳性,即往有与狗接触史１０年。Ｂ超发现肝囊性占位病变,即行手术摘除。术后５个月因右侧肢体轻偏瘫而复查头颅ＣＴ,１个月后再行手术摘除颅内占位病变。１－影像学检查：肝脏Ｂ超：左肝内见一约１６－６ｃｍ×８－７ｃｍ无回声区,向上膨出,边缘…     

肝泡状棘球蚴病特征性钙化CT扫描分析

肝泡状棘球蚴病(以下)简称泡肝，是肝包虫病的一种类型，几乎全都发病于农牧区，以西北部为主。笔者收集本院5例手术病理证实的病例。报告分析如下。     

50例肝泡状棘球蚴病的CT征象分析

目的 探讨肝泡状棘球蚴病的CT表现特征。资料与方法 50例经手术病理或穿刺活检证实的肝泡状棘球蚴病行常规CT或螺旋CT双期动态扫描，分析其CT表现。结果 50例中单发病灶38例，多发病灶12例，钙化发生率为93%。根据CT表现可分巨块型（包括实性肿块型，肿块液化型，钙化型），结节型和混合型，肿块和结节呐出现直径0.2-0.8cm小囊泡。病灶侵犯肝门6例。4例出现肝外转移。结论 肝泡状棘球蚴病CT表现有一定特征性，结合临床，诊断不难，CT分型将有利于临床治疗。     

多模态影像技术在脑泡状棘球蚴病中的诊断价值

目的 探讨多模态影像技术在脑泡状棘球蚴病(cerebral alveolar echinococcosis,CAE)中的诊断价值。方法选取20例诊断为CAE患者行头颅CT平扫、常规头颅MRI、DWI、扩散峰度成像(diffusion kurtosis imaging,DKI)以及三维动脉自旋标记(three dimensional-arterial spin labeling,3D-ASL),对比分析常规CT、MRI平扫对病灶数量、大小、水肿体积及水肿指数,囊泡及钙化检出率,以及MRI序列(DWI、DKI、3D-ASL)对病灶实质区、边缘区、水肿区的诊断价值。结果常规MRI检查对CAE患者病灶的检出率优于CT平扫,差异有统计学意义(P <0.05)。MRI-T2WI对囊泡的检出率优于CT(P <0.001)。MRI对水肿体积及水肿指数的显示优于CT,差异具有统计学意义(P <0.001)。CAE病灶边缘区ADC及平均扩散系数(MD)值低于实质区、水肿区和正常区(P <0.01); CAE病灶边缘区的平均峰度(MK)、各向异性(FA)、脑血流量(CBF)值高于实质...     

MR水成像技术诊断泡状棘球蚴病的价值

目的 探讨MR水成像(MRH)技术在泡状棘球蚴病临床诊断中的作用.方法 搜集34例临床怀疑为泡状棘球蚴病的患者,其中32例经手术和病理证实为泡状棘球蚴包虫病,均行常规MR和MRH检查,以病理结果为金标准,比较两种方法 的灵敏性、特异性和准确性.2种方法 结果符合率的比较采用U检验.结果32例泡状棘球蚴病患者的128个病灶中,常规MRI检查发现68个、MRH发现108个.常规MRI检查泡状棘球蚴的灵敏性为(53.13±0.04)%,特异性为(92.59±0.05)%,符合率为(60.00±0.03)%;MRH检查泡状棘球蚴病灶的灵敏度为(84.38±0.03)%,特异度(81.48±0.08)%,符合率为(83.87±0.03)%,常规MRI和MRH符合率比较,差异具有统计学意义(U=5.44,P<0.01).结论MRH技术可以提高泡状棘球蚴病病灶检出的灵敏性和符合率.     

MRI findings of hepatic alveolar echinococcosis

Diagnosis of liver infestation by alveolar echinococcosis (AE) is based on serologic, sonographic and computed tomography (CT) findings. Experience with magnetic resonance imaging (MRI) demonstrates that features of this disease are limited. CT and MRI findings of 14 cases with hepatic AE were compared in this report. We have described the MRI appearance of hepatic AE, which exhibits variable signal intensities on T1- and T2-weighted images. Fibrous and parasitic tissue showed low signal both on T1- and, generally, on T2-weighted images. In a few cases, a high signal on T2-weighted images may be observed, due either to central necrotic zones or to small peripheral cyst. MRI than by CT was more easily identified central necrosis. However, MRI seemed to be less effective than CT in allowing us to reach a positive diagnosis, due to its inability to show microcalcifications. In addition, MRI may not reveal small lesions. In most cases, T1-weighted images revealed more clearly than CT did the margins of the lesions and the hepatic extension, especially to hepatic veins, vena cava and perihepatic spaces.     

MRI of cerebral alveolar echinococcosis

Cerebral alveolar echinococcosis is rare. We report a case with multiple intracranial masses which show cauliflower-like contrast enhancement pattern on MRI. The lesions originated from hepatic involvement with invasion of the inferior vena cava. Received: 24 August 1998 Accepted: 24 December 1998     

DWI对儿童肝泡型包虫病生长活性的价值研究

目的 探讨扩散加权成像(DWI)及表观扩散系数(ADC)值对评估儿童肝泡型包虫病(HAE)生长活性的价值.方法 回顾性分析20例儿童(≤14岁)HAE患者,确定PNM分期,观察HAE病灶不同P分期DWI边缘带表现,并测量边缘带ADC值,比较泡球蚴病灶各分期DWI边缘带连续性及ADC值差异性,对其生长活性进行评估.结果 5例P1期病灶,7例P2期病灶,2例P3期病灶,6例P4期病灶.边缘带DWI特点:HAE病灶边缘与邻近正常肝实质间可见高信号环形带,P1期病灶显示基本完整的明显高信号边缘带,生长活性最强,P2、P3期病灶与肝实质间边缘带连续,仍具有明显的生长活性,P4期病灶边缘带不连续、信号减低,生长活性减低.P1期病灶组ADC值最高,P2期次之,P4期最低,P3期样本量较少,未做统计,3组ADC值间的差异均有统计学意义(P<0.05).结论 DWI边缘带图像特征可以一定程度上评估儿童HAE不同分期的生长活性,ADC值测量为病灶各分期的生长活性提供重要的参考价值.     

儿童肝泡球蚴病影像学分型、PNM分期及其生长特性的研究

目的 探讨儿童肝泡球蚴病(HAE)的影像学分型、PNM分期及边缘带表观扩散系数(ADC)值与正常肝组织的差异性,研究其生长特性.方法 分析31例儿童HAE的CT及MRI资料,了解患病时间,临床表现及相关实验室检查,根据HAE影像学特点对其进行分型,同时记录病灶的位置、数目、范围,根据侵犯和转移情况明确PNM分期;测量正常肝组织与病灶边缘带的ADC值.结果 31例患者发病时间为(2.45±1.44)年;23例出现腹痛、黄疸和不同程度肝功能损害.31例患者肝内病灶共43个,其中2例侵及全肝无法计数.分型:巨块型20例,液化坏死型9例,多发结节型2例.PNM分期:P4期15例(48.39％);N1 8例(25.8％);M113例(41.94％).侵犯情况:侵犯胆管23例(74.19％)、门静脉及肝静脉受侵均25例(80.65％),侵及下腔静脉8例,周围侵犯8例;正常肝组织、边缘带ADC值分别为(1.12±0.104)×10-3mm2/s、(0.877±0.137)×10-3mm2/s,ADC值存在统计学差异(t=5.612,P=0.001).结论 儿童HAE具有独特影像学特点,CT及MRI能直观地对儿童HAE进行评价;fMRI能从功能上反映出病灶的生长特性.     

清醒状态下大鼠脑震荡动物模型的建立

目的 :建立简单实用的大鼠脑震荡动物模型 ,为其损伤规律和机制的研究奠定基础。方法 :采用自制装置 ,分别利用不同重量 (2 0 0g,10 0g和 5 0g)砝码 ,从 1m高度对大鼠造成脑损伤 ,选择合适的砝码重量制作脑震荡动物模型 ,动态观察伤后大鼠意识状态、行为学及病理学变化。结果 :大鼠受到撞击后 ,呈现典型的“先昏迷再清醒”的脑震荡临床表现 ,病理学显示顶枕部、额叶、颞叶出血 ,迷宫实验显示其学习记忆能力下降。结论 :该装置较好地复制了脑震荡模型 ,且与临床上造成脑震荡的表现相似 ,有助于进行不同程度脑损伤后继发病理生理变化的机制和相应的治疗研究。     

Computed tomography and magnetic resonance imaging findings in cerebral hydatid disease

Purpose: The purpose of this study was to describe the discriminative computed tomography (CT) and magnetic resonance imaging (MRI) features of cerebral hydatid disease.Methods: The CT and MRI findings of four cases of surgically proven cerebral hydatid cysts were retrospectively reviewed. Results: CT demonstrated well-defined cystic lesions with no perilesional oedema and no contrast enhancement in all cases except one recurrent disease that showed both peripheral oedema and rim enhancement. MR images revealed well-defined cystic lesions with a quite clear rim that showed relative hypointensity limited to some aspects of the cyst walls on T2-weighted images. The cysts were spherical and obvious mass effect was observed on both CT and MR examinations. Conclusions: Although the cystic nature of intracranial hydatid disease could be equally well demonstrated on CT and MR examinations, CT is superior in detecting calcification of the cyst wall or septa, when present, and MR is better in demonstrating cyst capsule, detecting multiplicity and defining the anatomic relationship of the lesion with the adjacent structures and helps in surgical planning.     

Contribution of Sinerem® used as blood-pool contrast agent: Detection of cerebral blood volume changes during apnea in the rabbit

The authors suggest that ultra-small paramagnetic iron oxide (USPIO) particles used as blood pool contrast agents may increase the sensitivity of midfield MRI (i.e., less than 1.5 Tesla) to physiological variations in cerebral blood volume. This hypothesis was tested on a rabbit model of apnea which increases pCO₂ and cerebral blood volume. Using Sinerem® as the USPIO at a blood concentration of 60 μmol iron/kg body weight, an 8% T₂*-weighted signal decrease could be observed at 1.0 T with 25–33% increase in pCO₂. Comparatively, in the absence of USPIO, T₂*-weighted signal dropped only 4% during apnea and after mild hyperoxygenation beforehand, due to increased deoxyhemoglobin content. These preliminary data suggest that USPIOs could play an important role in functional MRI at midfield strength, by sensitizing the signal to cerebral blood volume changes.     

脑静脉窦栓塞动物模型的建立方法

目的:探讨经皮穿刺静脉插管静脉窦内弹簧圈或/和明胶海绵植入致脑静脉窦急性栓塞动物模型的建立方法,评价其有效性、可行性、优缺点。方法:采用经静脉插管的介入方法将弹簧圈和/或明胶海绵放置在实验小型猪脑静脉窦的不同位置达到静脉窦完全或不完全栓塞的效果。结果:9例实验动物均成功的完全或不完全栓塞上矢状窦、直窦、乙状窦。右侧乙状窦栓塞1例,上矢状窦中后1/3 Rolandic静脉前1~2cm处1例,Rolandic静脉处栓塞3例,Rolandic静脉后1~2cm处栓塞2例,直窦栓塞1例,窦汇和直窦栓塞1例。结论:经皮穿刺静脉插管脑静脉窦内弹簧圈、明胶海绵植入致脑静脉窦急性栓塞动物模型的实验方法有效可行,此方法不开颅,脑组织无人为损伤,更加接近实际发病状况。