MRI常规序列、SWI序列及DWI在脑外伤微出血患者诊断中的应用研究

目的 探究MRI常规序列、SWI序列以及DWI序列在脑外伤微出血患者诊断中的应用价值。方法 选取2019年8月～2020年4月我院收治的71例脑外伤微出血患者作为观察对象,所有患者在入院3天后行头部MRI常规序列(T₁WI、T₂WI、T₂FLAIR)、扩散加权成像(DWI)序列及磁敏感加权成像(SWI)序列检查。观察脑外伤微出血病灶在不同扫描序列中的影像学表现,对比不同扫描序列对脑外伤微出血病灶的检出率。结果 微出血病灶在T₁WI序列中多表现为大小不等的斑片状、条状等、低信号影,T₂WI、T₂FLAIR序列中多为稍高信号或等信号,DWI序列中多表现为低信号或等信号。微出血病灶在SWI序列中多为点状、斑片状、类圆形或环形低信号影,与T₁WI、T₂WI、T₂FLAIR等MRI常规序列以及DWI序列相比,SWI对微出血病灶的显示更加明显,所显示的微出血病灶更多,病灶边缘更加清晰,病灶范围更大。71...     

宫颈平滑肌瘤的不典型磁共振成像表现与病理分析

目的 探讨宫颈平滑肌瘤的不典型磁共振成像(MRI)表现与病理特征。方法 搜集本院2016年3月至2021年12月经手术和病理证实的7例宫颈不典型平滑肌瘤患者的临床、MRI和病理资料,2例行MRI增强扫描,回顾性分析其MRI表现及病理学特征。结果 1例为宫颈环壁生长型病灶,6例为宫颈单发肿块型病灶,其中3例肿块巨大,直径>10 cm。位于宫颈肌壁间4例,可见深达黏膜下的粗蒂与肌层相连;浆膜下2例,浆膜层受压向侧后方移位。位于宫颈前壁1例,后壁4例,侧壁1例。1例环壁生长型肌瘤表现为宫颈肥大,肌层明显增厚,呈T₁加权成像(T₁WI)等信号,T₂加权成像(T₂WI)低信号;2例富细胞性平滑肌瘤表现为T₁WI等信号T₂WI稍高信号,信号较均匀,增强扫描呈渐进性明显强化;4例伴不等量黏液变性的平滑肌瘤表现为T₁WI等信号T₂WI低信号,肿块内可见T₁WI低信号T₂WI高信号...     

结节性硬化症的磁共振影像学表现

目的　分析结节性硬化症TSC的MRI表现。方法　 13例经临床证实的TSC病例 ,分析其头部MRI特征性改变。结果　MRI主要征象包括 :①室管膜下结节 :13例均发现病灶 ,T1WI发现 71个 ,T2 WI 39个 ,PDWI 5 6个 ;②皮层及皮层下结节 :11例有阳性发现 ,T2 WI和PDWI各发现 114个病灶 ,T1WI 72个 ;③脑白质异常信号 :5例发现白质病变 ,T2 WI和PDWI各发现 10个病灶 ,T1WI无明确显示 ;④室管膜下巨细胞星形细胞瘤 :仅 1例发现。结论　MRI对TSC的中枢神经系统改变敏感 ,是诊断此病的首选影像学检查方法 ,其中T1WI观察室管膜下结节敏感 ,T2 WI和PDWI观察皮层下及白质病变敏感     

磁共振磁敏感加权序列对儿童脑内海绵状血管瘤的诊断价值

目的 探讨磁共振磁敏感加权(SWI)序列对儿童脑内海绵状血管瘤的诊断价值。方法 回顾性分析2017年8月至2018年8月河南省儿童医院经病理证实并于术前进行颅脑磁共振常规及SWI序列扫描的颅内海绵状血管瘤患者22例,分析其磁共振常规序列及SWI序列影像表现。结果 22例患儿于T₁加权序列(T₁WI)发现病灶数28个,病灶直径为0.5～11.2 mm,平均(6.4±1.8)mm;于T₂加权序列(T₂WI)发现病灶数35个,病灶直径为0.5～14.6 mm,平均(7.1±1.7)mm;于SWI序列发现病灶数为66个,病灶直径为0.5～25.8 mm,平均(14.3±1.8)mm;T₁WI与T₂WI序列病灶平均直径相比较,差异无统计学意义(P>0.05),SWI与T₁WI、T₂WI序列病灶平均直径相比较,差异有统计学意义(P<0.05)。结论 磁共振SWI序列较常规序列更能清楚显示儿童颅内海绵状血管瘤病灶。     

结节性硬化症脑部CT和MRI表现(附12例报告)

目的:分析结节性硬化症脑部CT和MRI表现,以提高对本病的认识。方法:回顾性分析12例经临床证买为结节性硬化症患者的CT和MRI脑部影像学表现。结果:TSC脑部主要影像学改变包括:①室管膜下结节(12例),CT 上表现为多发高密度钙化结节,MRI上表现为T1WI高信号、T2WI低信号7例,T1WI和T2WI上均为低信号1例,T1WI 上呈等信号、T2WI上呈低信号4例;②皮层及皮层下结节(9例),其CT表现为高密度钙化灶3例、低密度灶6例,MRI上呈T1WI低信号、T2WI高信号9例;③脑白质异常(6例),CT上表现为多发低密度灶4例,MRI上表现为T1WI低信号、 T2WI高信号6例。5例行MRI增强扫描,示室管膜下结节呈中等强化,皮层及皮层下结节和脑白质异常信号均未见强化。结论:CT和MRI能较好显示结节性硬化脑部改变,CT对显示钙化结节较敏感,MRI对显示皮层及皮层下结节和脑白质改变较敏感。     

磁共振成像多序列联合扫描在前列腺癌定性诊断中的临床意义

目的 分析前列腺癌(PCa)定性诊断中3.0 T磁共振成像(MRI)多序列联合扫描的准确率。方法 回顾性研究本院2019年1月至2022年1月接诊的60例高度疑似PCa患者,给予3.0 T MRI多序列检查,分别是T₁加权成像(T₁WI)、T₂加权成像(T₂WI)、弥散加权成像(DWI),将病理活检穿刺结果作为本次研究的金标准,对比T₁WI、T₂WI、DWI单独与联合诊断准确率、灵敏度、特异度,Kappa检验T₁WI、T₂WI、DWI单独及联合诊断与金标准的一致性,对比良性前列腺增生(BPH)组、PCa组表观扩散系数(ADC值)、多模态MRI参数。结果 T₁WI、T₂WI、DWI联合诊断准确率(96.7%)、灵敏度(88.9%)均高于T₁WI(76.7%、22.2%)、T₂WI(76.7%、31.2%)、DWI单独诊断(71....     

磁共振在眼球常见恶性肿瘤诊断中的价值

目的通过分析眼球常见恶性肿瘤的磁共振影像学表现特征,以提高对眼球恶性肿瘤的认识。方法回顾分析经手术病理及临床证实27例眼球恶性肿瘤病例的磁共振影像表现。结果总计眼球恶性肿瘤27例,其中葡萄膜黑色素瘤19例,表现为突向眼球内结节状、蘑菇状影,多数T₁WI呈高信号、T₂WI呈低信号,增强后病灶轻度或中度强化;葡萄膜黑色素细胞瘤恶变1例,表现为突向眼球内结节状影,T₁WI呈高信号、T₂WI呈低信号,增强后病灶中度强化;视网膜母细胞瘤4例,表现为眼球内突向玻璃体内肿块状影,T₁WI呈等信号、T₂WI呈等低信号,增强后病灶轻度或中度强化;脉络膜转移瘤2例,表现眼球后壁半球、扁平样突起影,T₁WI呈稍高信号,T₂WI呈稍低信号,增强后病灶中度强化,边缘强化明显。眼球内淋巴瘤1例,表现为眼内T₁WI信号增高,眼球内软组织结节影,T₁WI呈等信号、T₂WI呈等低信号,增强后病灶轻度强化。结论磁共振检查能够准确反映眼内常见恶性肿瘤的发生部位、大小及范围等影像特征,为临床治疗方法的选择提供重要的影像学依据。     

可逆性后部白质脑病综合征的CT及磁共振成像表现

目的探讨可逆性后部白质脑病综合征（PRES）的CT及磁共振成像（MRI）表现。方法回顾性分析8例可逆性后部白质脑病综合征患者的影像学特征,其中女性7例,男性1例。8例患者行MRI扫描,包括T₁WI、T₂WI、液体衰减反转恢复序列（FLAIR）成像及扩散加权成像（DWI）,其中2例同时行增强MRI及MRI血管成像（动脉及静脉成像）;其中4例行CT平扫。结果病灶累及双侧顶枕叶白质区4例,额颞叶白质区3例,其中累及灰质者5例,基底节区、脑干、小脑受累1例。病变CT表现为白质区多发斑片状低密度,MRI呈对称性T₁低T₂高信号,FLAIR呈高信号,DWI等低信号,表观扩散系数（ADC）图呈高信号6例,ADC图等信号2例,颅内动脉纤细2例,MRI增强显示病灶部位脑膜线样强化1例。结论 PRES的典型影像学征象是双侧顶枕叶白质区多发对称性血管源性水肿,灰质也可受累,FLAIR是显示病灶的最佳序列。     

1.5 T磁敏感加权成像在新生儿颅内微出血中的应用

目的 探讨1.5 T磁敏感加权成像(SWI)在扫描新生儿颅内微出血中的应用价值。方法 本组研究收集500例临床表现怀疑有颅内损伤的患儿进行头颅磁共振成像(MRI)常规序列[T₁加权成像(T₁WI)、T₂加权成像(T₂WI)、T₂水抑制成像技术(T₂Flair)]和SWI序列的扫描。结果 500例新生儿中常规MRI序列扫描检出颅内出血83例,应用SWI序列扫描则检出116例;其中常规MRI序列扫描检出颅内微出血23例,而应用SWI序列扫描检出微出血50例。结论 1.5 T SWI对新生儿颅内微出血的检出率优于常规头颅MRI序列。     

结节性硬化的影像学表现

目的 探讨结节性硬化的影像学表现.方法 分析13例临床证实的结节性硬化的影像学表现,13例均行CT检查,4例同时行MRI检查.结果 13例CT均可见室管膜下结节,大部分以钙化为主.4例MRI检查同样均发现室管膜下结节,且数目较CT多.CT只发现3例脑实质结节,4例MRI均发现脑实质结节.脑实质内斑片状病灶,CT及MR T1WI均未见明确显示,4例T2WI均有显示.结论 结合CT及MRI能对结节性硬化提供更多的诊断依据.     

结节性硬化神经影像表现的再认识

分析结节性硬化的ＣＴ和ＭＲＩ影像表现特征。材料与方法，经临床诊断为结节性硬化患者中，２０例经ＣＴ检查，４例ＭＲＩ检查，其中２例既有ＣＴ又有ＭＲ检查。结果结节性硬化的影像表现主要征象有（１）皮层结节病灶，其表现有脑回核心样病灶，Ｈ型病灶。     

结节性硬化症的MR诊断

目的探讨TS的MR影像特征.材料和方法本组17例.采用MR T1WI横断面、矢状面及T2WI横断面扫描.结果室管膜下结节17例,共119个结节,主要分布于侧脑室前角、体部及三角区外侧壁上,T1WI以等信号、高信号为主(91/119),T2WI以混杂高信号最多见.皮质结节12例,共120个结节,主要分布于额叶、顶叶(93/120).白质病灶8例,病灶呈放射带状、楔形及非特异性病灶,T1WI呈等低信号,T2WI呈高信号.室管膜下巨细胞星形细胞瘤3例,均位于室间孔区,T1WI呈等低信号,T2WI呈混杂高信号,增强后明显均匀强化.结论MRI是结节性硬化症最好的检查方法之一,其MR影像表现具有特征性.     

Magnetization transfer in the investigation of patients with tuberous sclerosis

We examined 21 patients aged 5 months to 19 years, on a 1.5 T magnet. T1-weighted spin-echo images, proton density and T2-weighted images with spin-echo and turbo spin-echo sequences, and contrast-enhanced magnetization transfer (MT) T1-weighted images were obtained in all cases. MT T1-weighted images were performed before injection in 9 patients. Subependymal nodules were found in 14, and cortical and subcortical tubers in 20 of the 21 patients. MT T1-weighted images showed tubers and subependymal nodules as higher signal than normal gray matter and revealed more tubers than conventional sequences in 11 cases. High signal intensity lesions of the white matter were found in 19 patients but were seen only on MT images in 9 cases. When MT images both before and after injection were available, tubers and white matter lesions were more easily recognised on unenhanced MT images because of their higher contrast. Received: 27 September 1996 Accepted: 27 September 1996     

结节性硬化的影像学诊断

目的总结结节性硬化的影像学表现特征。方法回顾分析20例经临床、影像及病理证实的结节性硬化患者的脑部CT和MRI表现。结果20例中CT表现为沿侧脑室壁分布的多发室管膜下钙化结节16例,其中多发结节14例,单发结节2例,室管膜下等密度未钙化结节2例,结节大小介于2~12mm。未见明确异常2例。MRI显示多发室管膜下结节19例,单发结节1例,T1WI结节呈等信号或低信号,T2WI呈低信号、等信号或稍高信号。MRI显示脑皮质及皮质下病变19例,呈局限脑回样异常信号;脑白质异常信号7例,分别呈线状、楔形及不规则形。9例MRI增强扫描室管膜下结节多呈轻中度强化,脑实质内结节多不强化。结论结节性硬化的CT和MRI表现均具有特征性。     

MR imaging of intracranial tuberous sclerosis

The role of MR in evaluating tuberous sclerosis is reviewed in 15 patients. These studies were compared with CT scans, which were available in 14 patients. Four characteristic findings were noted on the MR images obtained. Subependymal nodules projecting into the lateral ventricles were seen in 12 of 15 patients on T1-weighted images. This was the most specific finding. Distortion of the normal cortical architecture was seen in 10 of 11 patients in whom T1-weighted images were obtained using a 256 X 256 matrix. These foci corresponded to multiple cortical areas of increased signal on T2-weighted images. Dilated ventricles were seen in five patients. In one patient, a known astrocytoma showed increased signal on the T2-weighted images, allowing differentiation from a benign subependymal nodule. MR depicted the cortical hamartomas more completely than did CT. The MR scans were abnormal in all cases, and a diagnosis could be confidently made in all 11 cases scanned using a 256 X 256 matrix. Our preliminary experience suggests that MR will at least equal and probably exceed CT, both for sensitivity and specificity, given the use of a 256 X 256 matrix.     

结节性硬化的MRI诊断

目的：报导11例脑结节性硬化并总结本病MRI特点。材料和方法：11例儿童结节性硬化患者。年5个月～14岁.均以癫痫为主要症状就诊，8例合并皮肤病变．2例胸部和肾脏分别受累，4例智力低下。采用Toshiba 0.35T超导型MRI系统以自旋回波T3加权T1 WI)500／25及T2加权(T2 WI)2000／80．横断面及矢状面平扫，层厚5-10mm.结果：MRI特点：(1)室管膜下结节11例，共55个结节．以侧脑室外侧壁分布最多51个，第三脑室旁1个，第四脑室旁3个，T1 WI上结节与脑实质呈等信号．与脑脊液形成对比，是发现室管膜下结节的最好办法。(2)皮层与皮层下结节10例，9例分布于额顶叶，1例以脑干小脑为主。在T1WI及T2Wl上结节均呈等信号．但在T2WI上结节周围有高信号环围绕（7例70%)具诊断特征性。结论：脑结节性硬化MRI检查中有典型征象，在本病协断中起重要作用。     

Gadolinium-DTPA enhanced MR imaging in tuberous sclerosis

Summary Ten patients with clinical tuberous sclerosis were examined with CT and MR imaging, before and after IV contrast in order to determine the role of Gd-DTPA. Gd-DTPA enhancement occured in eleven subependymal nodules which did not enhance on CT after IV contrast. As illustrated by previous CT and pathologic observations and related to the histologic similarity of the subependymal nodules and giant-cell astrocytomas, these hyperintense nodules could represent active lesions with the potential to evolve. Four giant-cell astrocytomas were detected both with CT and Gd-DTPA-enhanced MRI; tumor conspicuity and size assessment were improved by postcontrast MRI in two cases. No cortical tuber or heterotopic cluster enhanced; T2-weighted sequences therefore remain necessary for their detection. If pre and post-Gd-DTPA T1-and T2-weighted imaging is negative, CT is clearly the most sensitive modality in the detection of the small calcified subependymal nodules.     

胰腺MRI:技术及诊断研究

目的 :探讨MR不同序列在胰腺病变诊断中的应用价值。方法 :84例胰腺检查包括 5 0例正常胰腺及 3 4例临床怀疑有病变的胰腺 ,其中包括 15例胰腺癌 ,2例胰岛细胞瘤 ,1例粘液性囊腺瘤 ,4例胰周肿瘤 ,12例胰腺炎。MR扫描序列包括常规SET1WI ;FSET2 WI ;增强前、后的脂肪抑制T1WI和GRE。结果 :3 4例异常胰腺中的 2 7例 ,增强前、后T1WI脂肪抑制像提供了最好的诊断信息 ,其次为增强后立即扫描的GRE像。未增强的GRE像极好地显示了急性胰腺炎的特征 ,SET2 WI像对胰岛细胞瘤及胰腺癌的肝转移显示较为敏感。结论 :增强前、后T1WI脂肪抑制序列及动态增强的GER序列 ,应为胰腺MRI的标准序列。     

MR imaging of tuberous sclerosis in neonates and young infants.

BACKGROUND AND PURPOSE: The MR imaging appearance of intracranial manifestations in tuberous sclerosis varies with age. The aim of this study was to specify MR characteristics in a coherent group of neonates and infants in order to distinguish them from the mature pattern. METHODS: The MR studies of seven patients under 3 months old were reviewed retrospectively. Imaging appearance, number, and distribution of tubers, white matter anomalies, subependymal nodules, and subependymal giant cell astrocytomas were analyzed. RESULTS: All patients had more white matter anomalies, subependymal nodules, subependymal giant cell astrocytomas, transmantle dysplasias, and left-hemispheric and temporal lesions, but less cortical tubers than did older patients in previous series. The lesions were easy to detect as hyperintense foci on T1-weighted images. Visibility as hypointensities on T2-weighted images was comparatively poor. CONCLUSION: The nodular subependymal and linear parenchymal tuberous sclerosis lesions in infants under 3 months old are hyperintense on T1-weighted images and hypointense on T2-weighted images as opposed to the reverse pattern of signal intensity in older persons. The scarce myelination helps to identify white matter anomalies, which become less visible as myelination progresses. Conversely, purely intracortical tubers are more difficult to diagnose in infants. Because the overall number and conspicuity of all other lesions in our series were greater than in previous series with older subjects, our findings indicate that infant age does not compromise, but facilitates, the correct MR diagnosis of tuberous sclerosis. Therefore, if tuberous sclerosis is clinically suspected within the first 3 months of life, imaging should not be delayed.     

3.0T磁共振磁敏感加权成像诊断脑发育性静脉畸形

目的 评价磁敏感加权成像(SWI)在诊断脑发育性静脉畸形(DVA)中的临床应用价值.方法 选取采用3.0T超高场磁共振的SWI及常规MR序列(包括自旋回波T_1加权像、快速自旋回波T_2加权像)诊断为脑发育性静脉畸形的24例患者,对SWI及常规MR序列进行分析.结果 24例脑发育性静脉畸形中发生于额叶白质11例,顶叶白质6例,颞叶2例,小脑半球5例.MR平扫显示DVA病灶11例,其中表现为条状流空信号者4例,表现为T_2WI放射状高信号者7例;MR增强检查显示所有病灶,表现为"海蛇头"样强化特征.SWI检查清晰显示所有病灶,表现为"海蛇头"样低信号影.结论 SWI对小静脉病变较敏感,能取代MR增强检查用于脑发育性静脉畸形的诊断和随访.