宫颈癌功能磁共振成像研究进展

宫颈癌是女性生殖系统最常见的恶性肿瘤,早期诊断和治疗是防治的关键。MR成像尤其是功能MR成像技术在宫颈癌的早期诊断、生物学评价、疗效和预后评估等方面具有明显的优势。综述宫颈癌的功能MRI研究进展,重点分析各种功能成像技术的临床应用价值及其不足,以期为临床工作中根据具体情况和技术条件选择和组合多种功能MRI技术提供有益提示,从而提高宫颈癌的诊断准确率。     

前列腺癌功能磁共振成像诊断研究

近年来,随着MR技术的发展,一些功能成像技术,如扩散加权成像、动态增强MRI和MR波谱技术也越来越多地应用于前列腺研究。通过其对组织生理、病理和血供改变的观察,获悉活体器官功能状态,为前列腺癌早期发现,正确的诊断、分期和鉴别诊断提供了依据。     

肾脏磁共振功能成像的研究进展

随着磁共振设备及序列的不断发展，磁共振功能成像在腹部脏器的应用成为现实。肾脏的磁共振功能成像近年来发展迅速，就其研究现状、存在的问题及其发展方向予以综述。     

肾脏磁共振功能成像的研究进展

随着磁共振设备及序列的不断发展,磁共振功能成像在腹部脏器的应用成为现实.肾脏的磁共振功能成像近年来发展迅速,就其研究现状、存在的问胚及其发展方向予以综述.     

磁共振功能成像不同联合方法诊断乳腺良恶性病变的价值

目的 探讨MR动态增强扫描(DCE)与扩散加权成像(DWI)不同联合方法鉴别乳腺良恶性病变的价值.方法 65例乳腺病变患者行3.0 T MR动态增强扫描与DWI检查,所有病例经穿刺活检或手术病理证实.动态增强扫描以Fischer评分表及影像报告数据系统判定良恶性;DWI b值设定为50 ～ 850 s/mm2,以恶性病变表观扩散系数平均值95％可信区间上限为鉴别良恶性病变的阈值.以病理结果为金标准,分别计算DCE、DWI的独立诊断效能与不同联合方法的诊断效能.联合方法包括平行试验、系列试验、积分累计法、DCE为主DWI为辅法.结果 病理结果示良性病变30例,恶性病变35例.DCE病灶检出率98.5％,1例导管内原位癌漏诊;DWI病灶检出率95.4％,3例导管原位癌漏诊;DCE诊断敏感性、特异性、准确率分别为85.7％、80％、83.1％,DWI分别为80％、83.3％、81.5％.DCE与DWI联合诊断效能:平行实验94.3％,66.7％,81.5％,系列实验77.1％,96.7％,86.2％,积分累计法80％、86.7％、83.1％,DCE为主DWI为辅法88.6％,90％,89.2％.结论 DCE与DWI不同联合方法鉴别乳腺良恶性病变的诊断价值不同.DCE为主、DWI为辅法可作为—种联合诊断方法.     

卵巢良恶性病变的磁共振扩散加权成像分析及应用

目的 探讨卵巢良、恶性病变磁共振扩散加权成像(DWI)的特征.方法 回顾分析117个经手术病理证实的卵巢良、恶性病灶的影像资料,测量b值＝50、400、800 s/mm2 时良、恶性病变软组织成分的信号强度, 比较对比噪声比(CNR)和ADC值,分析不同囊性成分常规图像、DWI特征及ADC值均值.结果 显示病变最佳b值＝800 s/mm2.恶性病变软组织成分b值＝800 s/mm2对比噪声比(CNR)高于良性病变,ADC值低于良性病变.ADC值可以预测但不能确定囊性成分性质.结论 结合常规MRI,DWI有助于卵巢良、恶性小病灶显示及鉴别诊断.     

功能磁共振成像在乳腺癌诊断中的应用

乳腺癌作为一种常见的恶性疾病,其早期诊断及疗效评价对病人的预后至关重要,以磁共振质子波谱分析、扩散加权成像、灌注加权成像为主要方式的功能磁共振成像对乳腺癌的诊断及早期评价化疗效果起重要作用,就各种功能磁共振成像的原理、技术参数及临床应用价值进行综述.     

肝硬化结节自然病程的磁共振功能成像研究进展

肝硬化结节性病变经过肝硬化再生结节(RN)、低级别退变结节(DN)、高级别DN、DN癌变,最终演变成小肝癌.鉴别肝硬化结节病变病程的不同阶段对临床早期检测癌变结节,进行早期干预、提高病人生存率具有重要意义.介绍肝脏RN、DN及其癌变结节病理学特点及常规MRI影像学特点,并着重对磁共振功能成像的原理及其在肝硬化结节的应用现状及前景予以综述.     

肝硬化结节自然病程的磁共振功能成像研究进展

肝硬化结节性病变经过肝硬化再生结节(RN)、低级别退变结节(DN)、高级别DN、DN癌变,最终演变成小肝癌.鉴别肝硬化结节病变病程的不同阶段对临床早期检测癌变结节,进行早期干预、提高病人生存率具有重要意义.介绍肝脏RN、DN及其癌变结节病理学特点及常规MRI影像学特点,并着重对磁共振功能成像的原理及其在肝硬化结节的应用现状及前景予以综述.     

磁共振扩散加权成像在诊断卵巢恶性肿瘤中的价值

目的：探讨磁共振扩散加权成像（DWI）在诊断卵巢恶性肿瘤中的价值。方法56例经病理证实的卵巢肿瘤患者（33例卵巢恶性肿瘤,23例卵巢良性肿瘤）行M RI及DWI检查,测量良恶性肿瘤的囊、实性部分的ADC值并进行分析。结果卵巢恶性肿瘤实性部分ADC值[（1．68±0．37）×10－3 mm2／s]明显低于卵巢良性肿瘤实性部分[（3．51±0．53）×10－3 mm2／s]（P＜0．05）;而卵巢恶性肿瘤囊性部分ADC值[（5．34±0．54）×10－3 mm2／s]与卵巢良性肿瘤囊性部分[（5．89±0．37）×10－3 mm2／s]没有显著性差异（P＞0．05）。结论磁共振DWI的定量分析有助于卵巢恶性肿瘤的诊断及鉴别诊断。     

64 Multidetector CT with multiplanar reformation in evaluation of bilateral ovarian masses

Purpose

To evaluate the role of 64 multidetector CT (MDCT) with multiplanar reformation in evaluation of bilateral ovarian masses and to correlate the findings with histopathological results and surgery.

Material and methods

MDCT was performed to 23 patients with sonographically detected bilateral ovarian masses. All scans were performed on a 64 row CT scanner at the oncology center, Mansoura University. The axial and reformatted images were evaluated for lesion characterization and the relationship to adjacent structures. The radiological findings were correlated with operative and pathological findings.

Results

There were 11 bilateral malignant lesions and 9 bilateral similar benign lesions. Three cases showed different benign lesions in both sides.All malignant lesions were read by MDCT as malignant, also all benign lesions were read by MDCT as benign except for one case with endometrioid cyst which was diagnosed as malignant tumor by CT.

Conclusion

64 Multidetector CT with MPR in different planes allows good visualization and characterization of bilateral ovarian masses with greater diagnostic accuracy and improves the detection of peritoneal metastases.     

Ultrasonographic diagnosis of extremity masses

Radiographic examination of soft tissue extremity masses is frequently inconclusive. In 18 patients with normal or nonspecifically abnormal radiographs, gray scale ultrasonography provided useful additional information. It was possible to distinguish fluid collections from solid masses, and recurrent venous thrombosis from hematoma in anticoagulated patients. Occasionally, specific diagnoses were suggested on the basis of ultrasonic morphologic characteristics. Diagnoses included soft tissue neoplasms, hematomas, aneurysms, synovial cysts, abscesses, and a lymphocele.Ultrasonically guided percutaneous needle aspiration was diagnostic in two cases. Features of differential diagnostic value relative to extremity solid masses and fluid collections are discussed. Ultrasonography is useful in evaluating these soft tissue masses.     

CT检查在胸壁肿物诊断中的应用价值

目的：探讨CT检查技术在胸壁肿物诊断中的应用价值。方法：回顾性分析和总结38例经手术病理和临床证实的胸壁肿物的CT表现，按病变的起源分为来源于胸壁软组织的Ⅰ型肿物和来源于胸壁骨性结构的Ⅱ型肿物。结果：Ⅰ型23例(60．5％)，包括脂肪瘤7例，结核5例，脓肿4例，纤维瘤3例，转移瘤3例，恶性纤维组织细胞瘤1例，其中以脂肪瘤和胸壁结核较有特点；Ⅱ型15例(39．5％)，包括软骨肉瘤3例，骨软骨瘤3例，骨纤维异常增殖症3例，骨转移瘤6例，CT具有很高的诊断准确率。结论：CT检查图像清晰无重叠，组织密度分辨率高，在各类胸壁肿物的影像学诊断中处于十分重要的地位。     

MRI of ovarian masses

MRI provides exquisite views of the pelvic anatomy through its high spatial resolution and tissue contrast, and as such plays a key role in the work up of ovarian lesions, identifying features that distinguish benign and malignant lesions. In the case of primary tumors it enables local staging and detection of metastatic disease to help guide management options such as complex surgery or the consideration of neoadjuvant chemotherapy. Functional MRI techniques such as diffusion‐weighted MRI (DW‐MRI), dynamic contrast‐enhanced MRI (DCE‐MRI) and tumor‐selective molecular imaging are currently being evaluated as possible predictive and prognostic biomarkers in the context of ovarian malignancy, and may play a larger role in routine clinical practice in the future. Herein we provide an overview of the conventional and advanced MRI techniques used to characterize ovarian masses and of the role that MR plays in the staging, treatment selection and follow up of patients with ovarian cancer. J. Magn. Reson. Imaging 2013;37:265–281. © 2012 Wiley Periodicals, Inc.     

CT、MRI在附睾肿块诊断中的应用价值

 目的 探讨附睾肿块的临床特点和CT、MRI表现.方法 回顾性分析42例经手术病理证实的附睾肿块的临床表现和CT、MRI特点.结果 附睾囊肿13例,附睾非特异性炎性肿块11例,结核8例,精子性肉芽肿4例,平滑肌瘤2例,纤维假瘤1例,腺瘤样瘤3例;附睾囊肿及结核的影像表现有一定特征性;MRI对于附睾炎性肿块、平滑肌瘤、纤维假瘤的诊断有较大帮助.结论 附睾肿块大多为良性病变;正确认识附睾肿块的CT、MRI表现,对附睾肿块的早期诊断及治疗有较高的临床价值,少数附睾肿块缺乏影像特征性,依赖病理确诊.     

纵隔低密度肿块病变的CT诊断

目的：提高纵隔低密度肿块病变的CT诊断水平。方法：回顾性分析52例经临床、手术及病理确诊的纵隔低密度肿块病例资料。结果：52例中皮样囊肿4例，畸胎瘤6例，胸腺囊肿3例，支气管囊肿5例，心包囊肿4例，脂肪瘤1例，胸内甲状腺肿囊变4例，胸腺瘤囊变5例，淋巴结肿囊变7例(淋巴瘤2例，淋巴结结核5例)，神经源性肿瘤囊变4例(神经节细胞瘤1例，神经鞘瘤2例，恶性神经纤维瘤1例)，纵隔血肿2例，纵隔脓肿6例。CT诊断正功率92．3％(48／52)。结论：纵隔低密度病变种类较多。CT检查可清楚显示病变的部位与特点，结合临床表现一般能作出准确的术前诊断。     

CT引导下经皮穿刺活检对纵隔占位病变的诊断价值

目的评价CT引导下经皮穿刺活检术在纵隔占位病变中的应用价值和安全性。方法采用弹簧式自动活检枪,在CT精确定位下对纵隔内占位病变行经皮穿刺活检,所获标本送病理组织学检查,并对穿刺准确性、病理确诊率和并发症发生情况进行分析。结果本组33例病灶穿刺成功率100%,病理确诊率85%,无一例发生并发症。结论CT引导下经皮穿刺活检术是一项操作方便,定位精确,穿刺准确率和病理确诊率高,安全可靠的介入放射诊断技术,对纵隔占位病变的定性诊断很有价值,值得临床推广应用。     

二维及彩色多普勒超声诊断乳腺包块的临床价值

目的：探讨二维及彩色多普勒超声诊断乳腺包块的临床价值。方法应用高频探头对85例各种原因引起的乳腺包块进行检查,所有病例均经手术及病理证实,并与超声诊断对照分析。结果85例乳腺包块经病理证实良性者32例,二维＋多普勒超声准确诊断30例,诊断符合率为93．8％;恶性者53例,二维＋多普勒超声准确诊断50例,诊断符合率为94．3％,且无论良性或恶性,二维＋多普勒超声诊断符合率均较单纯二维声像图诊断率高。结论二维声像图结合彩色多普勒检查可大大提高诊断的正确率,对乳腺疾病的早期发现及良恶性鉴别具有重要意义。     

Role of novel magnetic resonance imaging sequences in characterization of ovarian masses

Introduction

Differentiating a benign from a malignant adnexal mass would provide a basis for optimal preoperative planning and may also reduce the number of unnecessary laparotomies patients undergoing treatment for benign disease. MRI provides additional information on the composition of soft-tissue masses using differences in MR relaxation properties seen in various types of tissue. More recently developed MRI sequences, like diffusion weighted, susceptibility weighted, and dynamic contrast enhancement sequences provided additional capacities for adnexal lesion tissue characterization.

Aim of the work

The aim of this work was to study the role of MRI including the novel sequences, namely dynamic contrast enhanced MRI (DCE–MRI), diffusion weighted images (DWI) and susceptibility weighted images (SWI) in the characterization of ovarian masses.

Patients and methods

This study included 25 patients having indeterminate adnexal masses at ultrasound. They were subjected to pelvic MRI, including T1, T2, T1 fat sat sequences, as well as the DWI, SWI, and DCE sequences. Final diagnosis was reached through histopathological data, or therapeutic response.

Results

All endometriomas showed blooming on SWI. All malignant lesions showed restricted diffusion and type III DCE curves.

Conclusion

MRI, especially the more recent sequences (DWI, SWI and DCE) allows accurate characterization of ovarian lesions.     

MR动态增强成像在诊断良恶性骨病中的应用价值

目的:探讨MR动态增强成像在诊断良恶性骨病中的应用价值。方法:36例骨病患者(良性14例,恶性22例)行DCE-MRI检查。于动态增强图像上测量信号增强幅度(SEE)、早期动态增强斜率值(Slope值)、向心性增强率(DER),判断TIC曲线类型,采用受试者操作特征(ROC)曲线选择良恶性病变鉴别诊断的阈值,计算各参数对病变潜在恶性估计的敏感度、特异度和准确度。结果:①36例病例中,恶性病变组共22例,均为Ⅲ型(100%);良性病变组共14例,呈Ⅲ型者2例(14.29%),呈Ⅱ型者5例(35.71%),Ⅰ型者7例(50%)。若以Ⅲ型为恶性病变,Ⅰ、Ⅱ型均视为良性病变为诊断标准,则TIC类型对病变潜在恶性评估的准确度为94.3%;②良恶性两组间SEE、Slope值、DER分别为227.96±172.08、325.6±125.86(P0.05);(0.97±0.67)%/s、(2.53±0.91)%/s(P0.05);0.2043±0.0487、0.2267±0.0402(P0.05)。Slope值对病变潜在恶性估计的准确度为91.4%。结论:DCE-MRI可以反应病变组织的血管化与灌注,有助于鉴别骨骼系统病变的良恶性,且以TIC类型准确度最高,最有价值。