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1.
目的 :探讨非压迫性腰椎神经根炎经CT导向下微创治疗后神经根病理转归及神经根DTI的各向异性分数(FA)值的变化。方法:巴马小型猪9只经CT导向下非压迫性神经根炎造模成功14 d后,根据治疗药物不同随机分为3组。分别于实验猪L_(2~3)、L_(3~4)及L_(4~5)双侧神经根旁注入相应药物进行治疗。每组分别于术后3、7及14 d行DTI扫描,扫描完成后处死实验动物,取相应双侧神经根行免疫组织化学检查。采用单因素方差分析术后3、7、14 d神经根FA值及神经根TNF-α平均光密度值的组间、组内差异;Spearman相关性分析神经根FA值与神经根TNF-α平均光密度值之间的关系。结果:消炎液治疗组神经根FA值及TNF-α平均光密度值治疗后下降趋势最明显;脉络宁治疗组于治疗后14 d神经根FA值及TNF-α平均光密度值与生理盐水组比较差异均有统计学意义(均P0.05)。神经根FA值与TNF-α平均光密度值之间呈负相关。结论:CT导向下硬膜外注射消炎液可改善实验猪非压迫性神经根炎的炎症程度,且FA值可作为无创性客观评价其病理转归的手段。  相似文献   

2.
目的:探讨腰骶神经根扩散张量成像(DTI)及纤维示踪成像(FT)的可行性,同时评定健康志愿者及腰椎间盘突出引起单侧坐骨神经痛患者的腰骶神经根 DTI 参数不同层面数值的连续性变化。方法:将20例腰椎间盘突出引起单侧坐骨神经痛的患者及20例与患者年龄相仿的健康志愿者同时纳入研究。所有检查均在 Siemens 3.0T MR 上进行,采用3D T1-VIBE 及 DTI 融合图像,分别在神经根(L5和 S1)的三个不同层面测量左右两侧神经根的各向异性分数(FA)值和 ADC 值,同时进行 L4、L5、S1神经根 FT。结果:20例健康志愿者 L5和 S1神经根左、右两侧 FA 值分别为0.319±0.019和0.320±0.019,ADC 值分别为1.427±0.171和1.416±0.185,左右两侧差异无统计学意义(P >0.05);不同层面神经根两两之间的 FA 及 ADC 值差异无统计学意义(P >0.05)。20例患者的患侧神经根 FA 值低于健侧,分别为0.285±0.026和0.319±0.019,差异有统计学意义(P <0.05);患侧神经根近端至远端 FA 值逐层递减(P <0.05),ADC值逐层递增(P <0.05);健侧不同层面 FA 值无明显差异(P >0.05)。结论:DTI 结合常规 MRI 对定量评价病变神经根及定位诊断腰骶神经根卡压有一定的应用价值。  相似文献   

3.
【摘要】目的:利用磁共振弥散张量成像(DTI)技术测量正常腰神经、椎间盘突出受压腰神经的FA值及ADC值,探讨腰神经根受压损伤的定量评估方法。方法:选择健康志愿者50例作为对照组,51例椎间盘突出症患者作为实验组。测量正常腰神经根及受压腰神经根的FA值及ADC值。比较对照组与实验组FA值及ADC值。保守治疗前后FA值及ADC值。对照组与保守治疗后的FA值及ADC值。所测数据使用SPSS 17.0软件进行数据分析,若P<0.05认为差异有统计学意义。结果:对照组与实验组:FA值比较,t=12.172,P=0.000。ADC值比较,t=-5.673,P=0.000。P<0.05,认为两组数据有明显差别。保守治疗前后:FA值比较,t=-10.221,P=0.000,ADC值比较,t=4.671,P=0.000。两组数据P<0.05,有明显差别。对照组与保守治疗好转后:FA值比较,t=1.344,P=0.182;ADC值比较,t=-1.532,P=0.129。P>0.05,认为两组数据无差异。结论:磁共振DTI成像测量FA值及ADC值与椎间盘突出压迫神经根的临床表现是一致的,可以用于定量评估腰神经的受压损伤。  相似文献   

4.
目的 研究MR单指数扩散加权成像(DWI)表观扩散系数(ADC)值及双指数DWI真实扩散系数(D)值、相关扩散系数(D*)值、灌注分数(f)值对血管内皮生长因子(VEGF)表达水平的评价价值.方法 采用免疫组织化学染色方法检测28例胃癌组织切片及周围正常胃壁的VEGF表达并进行分级,分别分析ADC值、D值、D*值、f值在不同VEGF表达组间及胃癌不同分级间的差异.结果 不同VEGF分级间的ADC值、D值、f值差异有统计学意义,VEGF分级越高ADC值、D值越低,f值越高;高低分化胃癌的ADC值、D值、f值差异有统计学意义(P<0.05).结论 单指数模型DWI ADC值、双指数模型DWI D值、f值对评价胃癌VEGF表达有价值,可以反映胃癌血管生成.  相似文献   

5.
脑出血DWI的诊断价值   总被引:7,自引:0,他引:7  
目的探讨脑出血过程中扩散加权成像(DWI)信号演变规律及其诊断价值。方法32例自发性脑出血患者在1.5T磁共振仪行常规MRI和DWI检查。结果DWI在脑出血急性期(<24h)主要表现为高低混杂信号;亚急性早期(2~7d)主要表现为中央低边缘高信号的“晕征”;亚急性晚期(2~3周)表现多样;慢性期(>3周)表现为含铁血黄素低信号环或低信号。结论DWI在脑出血的不同时期、不同成分的信号表现不同,有助于出血的早期诊断和与脑梗塞的鉴别诊断。  相似文献   

6.
李冲  朱恂  赵彦胤  刘含秋 《放射学实践》2018,(11):1124-1127
【摘要】目的:探讨腰骶丛神经DTI对慢性炎性脱髓鞘性多发性神经根神经病(CIDP)的诊断价值。方法:采用3.0T MR仪对11名健康志愿者及16名CIDP患者进行腰骶丛常规MRI扫描和腰骶丛神经DTI扫描。其中DTI扫描范围包括L3~S1神经根,在DTI参数图上行FA、λ1、λ2、λ3的参数值测量,通过所得测量值计算出FA、AD、RD、MD参数值。健康志愿者组及CIDP组对应的FA、AD、RD、MD参数值行两独立样本t检验。结果:健康对照组FA、AD、RD、MD值分别为0.263±0.091、(4.993±0.647)×10-3mm2/s、(4.435±0.745)×10-3mm2/s、(4.672±0.642)×10-3mm2/s;CIDP组FA、AD、RD、MD值分别为0.225±0.053、(5.261±0.365)×10-3mm2/s、(5.657±0.292)×10-3mm2/s、(4.872±0.312)×10-3mm2/s。CIDP组与健康对照组相比FA及ADC值明显下降,AD、RD、MD值明显升高(P<0.05)。结论:CIDP患者的腰骶丛神经DTI参数的变化对CIDP早期诊断和分期具有重要价值。  相似文献   

7.
目的:探讨磁共振扩散加权成像(DWI)及表观扩散系数(ADC)对胰腺癌诊断价值。方法:搜集胰腺癌患者35例,正常对照组共32例。DWI选用b值分别为50、400、700s/mm^2,分别测量胰腺癌组织、癌周胰腺组织及正常对照组的ADC值,并进行对比分析;分别测量胰腺癌组织在T2WI,DWI(b=400s/mm^2)及磁共振增强扫描图像中病灶最大直径,并进行分析。结果:3组b值所测得ADC值统计结果示胰腺癌组织与正常对照组、癌周胰腺组织之间均有统计学意义;正常对照组与癌周胰腺组织之间均无统计学意义。胰腺癌组织在T2WI,DWI(b=400s/mm^2)及动态增强图像中最大直径测量无统计学差异。结论:DWI可以较清楚地显示胰腺癌病灶,b值为400s/mm^2时图像效果最佳,与ADC值测定共同分析对胰腺癌病灶的检出有价值。  相似文献   

8.
9.
王立侠  刘佩芳  叶兆祥   《放射学实践》2014,29(2):136-139
目的:对宫颈癌组织、正常宫颈、放疗后宫颈癌组织的扩散加权成像(DWI)表现及表观扩散系数(ADC)值进行分析。探讨DWI在宫颈癌诊断以及放疗后疗效监测中的价值。方法:对177例宫颈癌患者、105例正常宫颈对照组和117例放疗后宫颈癌患者进行横断面/矢状面DWI扫描(b取0和500s/ram。),观察正常宫颈、宫颈癌及放疗后宫颈癌的DwI表现,并测量相应的ADC值,比较正常宫颈腺体和纤维间质的ADC值,宫颈癌与正常宫颈的ADC值,宫颈癌放疗后恢复正常或炎症反应、放疗后肿瘤残存分别与初诊宫颈癌及正常宫颈的ADC值,放疗后肿瘤复发与初诊宫颈癌及放疗后恢复正常或炎症反应的ADC值差异。结果:105例正常宫颈于DWI上呈高-低-稍高信号,宫颈腺体和纤维间质的ADC值差异具有统计学意义(P=0.025)。177例宫颈癌于DWI上呈高信号,其ADc值(1.08±0.36)×10-3mm2/s)低于正常宫颈(P=0.001)。b=500s/mm2时,诊断宫颈癌和正常宫颈的ROC曲线下面积(AUC)为0.806,95%可信区间为0.626~0.985。117例放疗后宫颈癌中,54例宫颈恢复正常或呈炎性反应,其ADC值较初诊宫颈癌高(P=0.000),与正常宫颈无明显统计学差异(P=0.056);46例宫颈癌组织残存,其ADC值与初诊宫颈癌无明显统计学差异(P=0.190),但低于正常宫颈(P=0.000),17例放疗后宫颈癌复发,其ADC值与初诊宫颈癌无明显统计学差异(P=0.060),但与放疗后恢复正常或呈炎性反应患者相比具有统计学差异(P=0.002)。结论:DWI能够区分宫颈癌组织和正常宫颈.可用于宫颈癌诊断及预后监测。  相似文献   

10.
原发性肝细胞癌是最常见的恶性肿瘤之一。目前经导管肝动脉化学栓塞(TACE)、射频消融术(RFA)及高能聚焦超声(HIFU)等非手术微创治疗已成为外科手术之外治疗肝癌的首选方法。但由于治疗方法的局限性,术后常出现肿瘤病灶的残存或复发,因此准确评价术后疗效非常重要。近年扩散加权成像(DWI)、灌注成像(PWI)、磁共振波谱(MRS)在对肝癌的早期诊断及术后评价中发挥了重要作用。  相似文献   

11.
正常腰椎骨髓的MRI分型及定量研究初探   总被引:18,自引:3,他引:15  
作者通过对320例正常腰椎MRI表现的分析,提出了中国人正常腰椎骨髓的MR分型(四型六分法分型)。并对268例进行了定量MRI研究(T1及T2值测定),对弛豫时间与年龄和性别的关系进行了统计学处理,并讨论了上述骨髓MRI分型及弛豫时间变化的组织学基础。  相似文献   

12.
目的探讨扩散加权成像(DWI)对于鉴别宫颈癌转移与非转移淋巴结的诊断价值。资料与方法 36例宫颈癌初诊患者于治疗前行常规MRI及DWI检查,观察并比较宫颈癌转移淋巴结与非转移淋巴结常规MRI及表观扩散系数(ADC)图表现,测量各淋巴结的长径(L)、短径(S)、T2信号强度、平均ADC值和最小ADC值,利用受试者工作特征(ROC)曲线下面积(Az)评价上述各项指标鉴别宫颈癌转移与非转移淋巴结的诊断效能。结果转移淋巴结短径和长径的平均秩次均大于非转移淋巴结,且两者差异具有统计学意义(均为P=0.000),而转移淋巴结与非转移淋巴结的L/S、S/L以及T2信号强度差异均无统计学意义(P=0.261;P=0.157;P=0.166);转移淋巴结的平均ADC值和最小ADC值均低于非转移淋巴结,且差异均具有统计学意义(均为P=0.000);短径、长径、平均ADC值和最小ADC值对鉴别宫颈癌转移与非转移淋巴结均有诊断意义(Az>0.5),其中最小ADC值的诊断效能最高,选取最小ADC阈值为0.983×10-3mm2/s时,其敏感性和特异性分别为94.6%和91.8%。结论 DWI有助于宫颈癌转移和非转移淋巴结的检出,最小A...  相似文献   

13.
目的:探讨磁共振扩散加权成像(DWI)对肝脏细粒棘球蚴病的临床应用价值。方法:对20例肝脏细粒棘球蚴病患者共29个病灶行MRI平扫及DWI检查(b值取0、100、500和1000 s/mm~2),分析病灶的MRI表现及其表观扩散系数(ADC)图,计算病灶和肝脏的ADC值并进行统计学分析。结果:20例中单发病例12例,多发病例8例;发生钙化14例。病变的ADC值平均为(3.74±0.46)×10~(-3)mm~2/s(b=100 s/mm~2)、(3.43±0.64)×10~(?)nm~2/s(b=500 s/mm~2)和(3.24±0.63)×10~(-3)mm~2/s(b=1000 s/mm~2)。正常肝组织的ADC值平均为(2.84±0.59)×10~(?)mm~2/s(b=100 s/mm~2)、(1.37±0.30)×10~(-3)mm~2/s(b=500 s/mm~2)和(1.35±0.69)×10~(-3)mm~2/s(b=1000 s/mm~2),病灶与正常肝组织之间ADC值的差异有显著性意义(P<0.05)。结论:肝脏细粒棘球蚴病灶DWI表现为随着b值的升高其信号减低,ADC值的测量对诊断肝脏细粒棘球蚴病有一定价值。  相似文献   

14.

Background

The purpose of our investigation was to compare quantitative T2 relaxation time measurement evaluation of lumbar intervertebral discs with morphological grading in young to middle-aged patients with low back pain, using a standardized region-of-interest evaluation approach.

Patients and methods

Three hundred thirty lumbar discs from 66 patients (mean age, 39 years) with low back pain were examined on a 3.0 T MR unit. Sagittal T1-FSE, sagittal, coronal, and axial T2-weighted FSE for morphological MRI, as well as a multi-echo spin-echo sequence for T2 mapping, were performed. Morphologically, all discs were classified according to Pfirrmann et al. Equally sized rectangular regions of interest (ROIs) for the annulus fibrosus were selected anteriorly and posteriorly in the outermost 20% of the disc. The space between was defined as the nucleus pulposus. To assess the reproducibility of this evaluation, inter- and intraobserver statistics were performed.

Results

The Pfirrmann scoring of 330 discs showed the following results: grade I: six discs (1.8%); grade II: 189 (57.3%); grade III: 96 (29.1%); grade IV: 38 (11.5%); and grade V: one (0.3%). The mean T2 values (in milliseconds) for the anterior and the posterior annulus, and the nucleus pulposus for the respective Pfirrmann groups were: I: 57/30/239; II: 44/67/129; III: 42/51/82; and IV: 42/44/56. The nucleus pulposus T2 values showed a stepwise decrease from Pfirrmann grade I to IV. The posterior annulus showed the highest T2 values in Pfirrmann group II, while the anterior annulus showed relatively constant T2 values in all Pfirrmann groups. The inter- and intraobserver analysis yielded intraclass correlation coefficients (ICC) for average measures in a range from 0.82 (anterior annulus) to 0.99 (nucleus).

Conclusions

Our standardized method of region-specific quantitative T2 relaxation time evaluation seems to be able to characterize different degrees of disc degeneration quantitatively. The reproducibility of our ROI measurements is sufficient to encourage the use of this method in future investigations, particularly for longitudinal studies.  相似文献   

15.

Background

Various MR methods, including MR-spectroscopy (MRS), dynamic, contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) have been applied to improve test quality of standard MRI of the prostate.

Purpose

To determine if quantitative, model-based MR-perfusion (MRP) with gadobenate dimeglumine (Gd-BOPTA) discriminates between prostate cancer, benign tissue, and transitional zone (TZ) tissue.

Material and methods

27 patients (age, 65 ± 4 years; PSA 11.0 ± 6.1 ng/ml) with clinical suspicion of prostate cancer underwent standard MRI, 3D MR-spectroscopy (MRS), and MRP with Gd-BOPTA. Based on results of combined MRI/MRS and subsequent guided prostate biopsy alone (17/27), biopsy and radical prostatectomy (9/27), or sufficient negative follow-up (7/27), maps of model-free, deconvolution-based mean transit time (dMTT) were generated for 29 benign regions (bROIs), 14 cancer regions (cROIs), and 18 regions of transitional zone (tzROIs). Applying a 2-compartment exchange model, quantitative perfusion analysis was performed including as parameters: plasma flow (PF), plasma volume (PV), plasma mean transit time (PMTT), extraction flow (EFL), extraction fraction (EFR), interstitial volume (IV) and interstitial mean transit time (IMTT). Two-sided T-tests (significance level p < 0.05) discriminated bROIs vs. cROIs and cROIs vs. tzROIs, respectively.

Results

PMTT discriminated best between bROIs (11.8 ± 3.0 s) and cROIs (24.3 ± 9.6 s) (p < 0.0001), while PF, PV, PS, EFR, IV, IMTT also differed significantly (p 0.00002-0.0136). Discrimination between cROIs and tzROIs was insignificant for all parameters except PV (14.3 ± 2.5 ml vs. 17.6 ± 2.6 ml, p < 0.05).

Conclusions

Besides MRI, MRS and DWI quantitative, 2-compartment MRP with Gd-BOPTA discriminates between prostate cancer and benign tissue with several parameters. However, distinction of prostate cancer and TZ does not appear to be reliable.  相似文献   

16.
目的 探索螺旋CT数据简易化处理在经皮腰椎间盘切吸术(PLD)中L5~S1椎间盘穿刺入路选择的价值.方法 搜集2007年6月至2010年6月于新乡医学院第一及第二附属医院行PLD的L5~S1椎间盘突出症患者196例.按不同L5~S1椎间盘穿刺路径选择将其分为A、B两组,A组为2009年6月以前根据既往常规穿刺点范围、穿刺参数,经皮椎间盘穿刺施术的病例,共115例;B组:为2009年6月以后经螺旋CT数据处理、选择的穿刺路径施术的病例,共81例.测量与穿刺路径相关的解剖结构数据,经相关统计学分析,探索其内在规律.分析A、B两组在穿刺点定位用时、穿刺到位用时、穿刺次数、术中X线用时之间的差异性.结果 穿刺深度、重组矢状面各层椎间隙宽度平均值、L5~S1椎间盘中心厚度、L5椎体中心厚度、L5两侧关节突最大距离、L5两侧横突最大宽度及最大距离、L5两侧横突最大距离、髂骨最高点与L5椎体终板上缘中心点高度差的标准差和变异系数偏大.定位用时分别为A组(1.09±0.22) min,B组(1.04±0.40) min(P >0.05);穿刺到位用时A组(3.29±1.53) min,B组(2.79±1.07)min(P <0.05);穿刺平均次数A组4.41±1.91,B组2.23±1.09(P <0.05);术中X线用时A组(11.9±5.2) min,B组(6.7 ±3.6)min (P <0.05).结论 穿刺前对与穿刺路径相关的解剖结构进行螺旋CT数据简易化处理不增加体表穿刺点定位用时,明显缩短经皮穿刺到位用时、穿刺次数及术中X线用时,并能最大程度减少并发症,值得临床推广.  相似文献   

17.
目的 探讨MRI检查对评价CT导向椎间孔镜技术(PTED)治疗腰椎间盘突出症术后疗效的应用价值.方法 回顾性分析接受PTED治疗腰椎间盘突出症175例患者MR图像.测量手术前及术后硬膜外压痕值、计算椎间隙高度率、对比手术前及术后椎间孔及侧隐窝狭窄发生率,相关数据进行统计学分析.结果 术前硬膜外压痕纵轴值(8.2±3.0)mm.术后6月硬膜外压痕纵轴值(2.0±2.7)mm,椎间盘还纳值(6.1±2.5)mm.术后12月硬膜外压痕纵轴值(1.7±3.2)mm,椎间盘还纳值(6.4±2.6)mm.术后椎间盘还纳值与日本骨科协会下腰痛评分标准(JOA评分)值呈正相关性.术前、术后椎间孔及侧隐窝狭窄发生率差异有显著性(P<0.01).术前、术后椎间隙高度率差异无显著性(P>0.05).结论 MRI检查能够有效评价PTED治疗椎间盘突出症临床疗效,具有重要指导价值.  相似文献   

18.
目的 与三维动脉自旋标记(3D ASL)对照,探讨体素不相干运动(IVIM)在胶质瘤分级中的应用价值.方法 搜集胶质瘤患者24例,其中高、低级别胶质瘤患者分别为13例和11例.受试者术前行多b值DWI(MBDWI)和三维伪连续动脉自旋标记(3D PCASL)序列扫描,MB-DWI采用0~3500 s/mm2间共20个b值,采用双指数模型软件处理获得快扩散系数D*(fast ADC),慢扩散系数D(slow ADC)以及快速扩散所占的容积分数f(fraction of fast ADC)三种参数化图像;ASL数据经工作站处理产生的脑血流量(CBF)图.分别测量肿瘤实质区最大CBF值及其相应区域的D*、D、f值,以对侧正常半卵圆中心白质做对照,计算其比值rTBF,rD*,rD,rf.所得数据经统计软件进行组间比较并对CBF值与D *、f值进行相关性分析,P<0.05具有统计学意义.结果 高级别胶质瘤组的TBF值、rTBF和D*值显著高于低级别胶质瘤组,f值、rf值和D值、rD值正好相反,rD *值无统计学差异;相关分析结果显示肿瘤TBF值与D*值呈正相关性,而与f值呈负相关(P<0.05);对侧正常半卵圆中心CBF值和D*值呈正相关性(P<0.01),而与f值无相关性(P>0.05).结论 IVIM双指数模型所得D*值、D值及f值在高、低级别胶质瘤中存在统计学差异,在评估脑胶质瘤血流灌注方面D*值与ASL结果之间有较好的相关性.  相似文献   

19.
20.

Objectives

To obtain perfusion as well as diffusion information in normal breast tissues and breast lesions from intravoxel incoherent motion (IVIM) imaging with biexponential analysis of multiple b-value diffusion-weighted imaging (DWI) and compare these parameters to apparent diffusion coefficient (ADC) obtained with monoexponential analysis in their ability to discriminate benign lesions and malignant tumors.

Materials and methods

In this prospective study, informed consent was acquired from all patients. Eighty-four patients with 40 malignant tumors, 41 benign lesions, 30 simple cysts and 39 normal breast tissues were imaged at 1.5 T utilizing contrast-enhanced magnetic resonance imaging (MRI) and DWI using 12 b values (range: 0–1000 s/mm2). Tissue diffusivity (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) were calculated using segmented biexponential analysis. ADC (b = 0 and 1000 s/mm2) was calculated with monoexponential fitting of the DWI data. D, f, D* and ADC values were obtained for normal breast tissues, simple cysts, benign lesions and malignant tumors. Receiver operating characteristic analysis was performed for all DWI parameters.

Results

There was good interobserver agreement on the measurements between the 2 observers. D values were significantly different among malignant tumors, benign lesions, simple cysts and normal breast tissues (P = 0.000) and it was the same result for f, D* and ADC values. Further comparisons of these 4 parameters between every single pair were as the following. D and ADC values of malignant tumors were significantly smaller than those of benign lesions, simple cysts and normal tissues (P = 0.000, respectively). The f value of malignant tumors was significantly higher than that of benign lesions, simple cysts and normal breast tissues (P = 0.001, P = 0.000, and P = 0.000). D and ADC values demonstrated higher sensitivity and specificity in differentiating benign lesions and malignant tumors, with area under the curve (AUC) of 0.952 and 0.945, respectively, while f and D* with the lower AUC of 0.723 and 0.630, respectively. Combining f and D values had a sensitivity up to 98.75%.

Conclusion

DWI response curves in malignant tumors, benign lesions and normal fibroglandular tissues are found to be biexponential fit in comparison with the monoexponential fit for simple cysts. IVIM provides separate quantitative measurement of D for cellularity and f and D* for vascularity and is helpful for differentiation between benign and malignant breast lesions.  相似文献   

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