主动脉夹层几种磁共振影像的评价和比较

目的：评价和比较ＭＲＩＳＥ常规序列、电影（ｃｉｎｅ）ＭＲＩ及ＭＲ血管造影（ＭＲＡ）对主动脉夹层的诊断价值。材料和方法：对２５例主动脉夹层进行了３１人次ＭＲ检查。其中包括胸腹主动脉ＳＥ序列３１人次，胸主动脉ｃｉｎｅＭＲＩ２３人次及腹主动脉二维时间飞跃（２ＤＴＯＦ）ＭＲＡ２１人次。将ｃｉｎｅＭＲＩ及ＭＲＡ分别与其相应ＳＥ序列ＭＲ表现进行比较。结果：胸主动脉ｃｉｎｅＭＲＩ２３例与相应ＳＥ序列比较，两者所有病例均显示内膜片及真假两腔，但显示破口分别为１４和９例。显示头臂血管受累分别为７和２条。腹主动脉ＭＲＡ２１例与相应ＳＥ序列比较，两者均显示内膜片和真假两腔，但显示破口或再破口者分别为４和２例，腹主动脉分支血管受累分别为３９和１４条。结论：ＭＲ是诊断主动脉夹层的最佳影像学方法之一。在常规ＳＥ序列基础上，辅以ｃｉｎｅＭＲＩ和ＭＲＡ技术将大大提高ＭＲ总体观察夹层范围、内膜破口以及分支受累的能力，给临床提供更多的信息。     

磁共振成像在主动脉疾病中的应用(附29例分析)

目的：评价ＭＲＩＳＥ序列，梯度回波（ＧＲＥ）及磁共振血管成像（ＭＲＡ）对主动脉疾病的诊断价值。材料和方法：２９例主动脉疾患，其中主动脉夹层２１例，胸、腹主动脉瘤８例。全部病例采用ＭＲＩＳＥ常规序列及ＧＲＥ技术，４例行ＭＲＡ检查。结果：在ＳＥ及ＧＲＥ序列上２１例胸、腹主动脉夹层均显示真假两腔，其内膜片分别为１９和２１例。破口分别为５和８例。ＭＲＩ及ＭＲＡ能清晰地显示主动脉瘤和瘤体内结构。结论：ＭＲＩ对主动脉疾患具有肯定的诊断价值。以常规ＳＥ序列为基础，辅以ＧＲＥ及ＭＲＡ技术将能对主动脉疾病提供更多的诊断信息。     

动脉导管未闭伴肺动脉高压的SE,Cine,MRI和MRA诊断

目的：报道ＳＥ、ＣｉｎｅＭＲＩ和ＭＲＡ对动脉导管未闭（ＰＤＡ）伴肺动脉高压的诊断价值。材料和方法：６例心超诊断ＰＤＡ不明确女性行ＭＲＩ检查。均采集横断、冠状、矢状、主动脉和左室长轴ＳＥＴ１Ｗ像，４例尚获斜冠／矢状面ＳＥＴ１Ｗ像；ＣｉｎｅＭＲＩ采集主动脉、左室长轴和斜冠／矢状面像，１例还获冠状面像；２ＤＰＣ结合ＥＣＧ门控采集主动脉长轴或矢状面像，４例同时获３ＤＰＣ像。结果：６例ＰＤＡ均经手术或造影证实。横断面ＳＥ未能直接显示ＰＤＡ，４例斜冠状面（平行于肺动脉主干）ＳＥ显示ＰＤＡ；５例ＣｉｎｅＭＲＩ直接显示ＰＤＡ，１例ＣｉｎｅＭＲＩ间接提示ＰＤＡ；２Ｄ／３ＤＰＣ则全部显示；５例伴肺动脉高压者ＳＥ和ＣｉｎｅＭＲＩ均显示其征象，且以后者为佳；对伴随的主动脉瓣和／或二尖瓣返流仅ＣｉｎｅＭＲＩ显示。结论：初步经验表明斜冠状面ＳＥ、ＣｉｎｅＭＲＩ和ＰＣＭＲＡ对ＰＤＡ伴肺动脉高压病例具有重要诊断价值。     

A Comparison in Healing of Skull Defect Repaired with Four Different Kinds of Graft Materials in Rabbits

ＡＣＯＭＰＡＲＩＳＯＮＩＮＨＥＡＬＩＮＧＯＦＳＫＵＬＬＤＥＦＥＣＴＲＥＰＡＩＲＥＤＷＩＴＨＦＯＵＲＤＩＦＦＥＲＥＮＴＫＩＮＤＳＯＦＧＲＡＦＴＭＡＴＥＲＩＡＬＳＩＮＲＡＢ┐ＢＩＴＳＤＩＮＧＺｈｅｎ－ｑｉ（丁真奇）１，ＴＡＮＦｕ－ｓｈｅｎｇ（谭富生）２，...     

脑动静脉畸形的MRI及MRA诊断价值

目的：研究脑动静脉畸形（ＡＶＭ）的ＭＲＩ特征,探讨其诊断价值。方法：使用ＧＥｓｉｇｎａ ｅｃｈｏ ｓｐｅｅｄ１．５Ｔ超导ＭＲ机对７１例ＡＶＭ患者分别行ＭＲＩ及ＭＲＡ检查。ＭＲＩ采用ＳＥＴ１和ＦＳＥＴ２加权序列,ＭＲＡ采用３Ｄ－ＴＯＦ序列。结果：ＭＲＩ及ＭＲＡ能显示ＡＶＭ的瘤巢,ＡＶＭ的继发改变ＭＲＩ能很好显示,ＭＲＡ能显示ＡＶＭ的三维解剖结果。结论：ＭＲＡ和ＭＲＩ是无创性评从脑ＡＶＭ的有效方法,两     

Moyamoya病的MRI和MRA诊断(附15例报告)

探讨ＭＲＩ和ＭＲＡ对Ｍｏｙａｍｏｙａ病的诊断价值。材料与方法；１５例Ｍｏｙａｍｏｙａ病患者中男６例，女９例。年龄４－４９岁２０岁以下者１１例。应用 Ｓｉｅｍｅｒｎｓ １．０Ｔ超导型ＭＲ系统行ＳＥ序列ＭＲＩ和三维时间飞跃法ＭＲＡ。均有ＳＥ序列Ｔ１Ｗ１和Ｔ２ＷＩ，１４例有３Ｄ－ＴＯＦ ＭＲＡ，１例有ＤＳＡ，６例有平扫ＣＴ。     

THE INJURIOUS EFFECTS OF HEMODYNAMIC CHANGES RESULTING FROM GUNSHOT WOUNDS ON REMOTE ORGANS

ＴＨＥＩＮＪＵＲＩＯＵＳＥＦＦＥＣＴＳＯＦＨＥＭＯＤＹＮＡＭＩＣＣＨＡＮＧＥＳＲＥＳＵＬＴ┐ＩＮＧＦＲＯＭＧＵＮＳＨＯＴＷＯＵＮＤＳＯＮＲＥＭＯＴＥＯＲＧＡＮＳＬＩＳｈｕ－ｇｕａｎｇ（李曙光），ＬＩＵＹｉｎ－ｑｉｕ（刘荫秋），ＷＡＮＧＪｉａｎ－ｍｉｎ...     

脑动静脉畸形的MRA初步研究

目的：分析脑ＡＶＭ３Ｄ－ＴＯＦ及３Ｄ－ＰＣ法ＭＲＡ表现,探讨其诊断意义。材料和方法：使用美国ＧＥＳｉｇｎａ１．５ＴＭＲ超导扫描仪对１４例患者分别行ＳＥ序列,３Ｄ－ＴＯＦ及３Ｄ－ＰＣＭＲＡ检查。结果：１４例患者ＡＶＭ位于颞顶叶２例,顶叶２例,颞枕叶２例,顶枕叶１例,枕叶３例,额叶３例,脑干１例;供血动脉来自大脑中Ａ５例,大脑前Ａ３例,大脑后Ａ１例,联合供血５例;引流Ｖ中６例引流入大脑深Ｖ,２例引流入乙状窦。结论：ＭＲＡ能准确显示畸形血管团及异常供血Ａ、引流Ｖ,结合ＭＲＩ可大大提高其诊断准确率,为临床筛选及术后随诊的首选方法。     

先天性主动脉缩窄的磁共振成像诊断

目的研究先天性主动脉缩窄（ＣｏＡ）的磁共振成像（ＭＲＩ）征象并与超声心动图（Ｅｃｈｏ）和手术对照，探讨其在诊断中的意义和作用。方法ＣｏＡ１２例，单纯型１０例，复杂型２例。１０例经手术证实，１例行ＤＳＡ，１例行血管造影和经皮主动脉球囊成形术。ＭＲＩ均行ＳＥ序列成像，其中８例兼作梯度回波（ＧＲＥ）的电影（ｃｉｎｅ）ＭＲＩ或（和）ＭＲ血管造影（ＭＲＡ）。所有病例均有经胸Ｅｃｈｏ检查。结果９例（７５％）ＭＲＩ显示为局限性膜状或嵴状狭窄，３例（２５％）呈长管状狭窄。８例ｃｉｎｅＭＲＩ或（和）ＭＲＡ均能显示狭窄段和扩张的肋间动脉和乳内动脉等侧支循环。１２例ＣｏＡ，ＭＲＩ均获得正确诊断，Ｅｃｈｏ８例（６６．７％）获正确诊断。结论ＭＲＩ是检查ＣｏＡ的一种优良的无创性方法，能准确判断狭窄部位、形态、范围和程度，显示狭窄前、后主动脉及头臂血管改变，以及侧支循环情况。对ＣｏＡ的诊断优于Ｅｃｈｏ，基本上可取代血管造影检查。     

EFFECTS OF NIMODIPINE ON CALCIUM CURRENTS IN CORTICAL NEURONS AFTER IMPACTING BRAIN INJURY

ＥＦＦＥＣＴＳＯＦＮＩＭＯＤＩＰＩＮＥＯＮＣＡＬＣＩＵＭＣＵＲＲＥＮＴＳＩＮＣＯＲＴＩＣＡＬＮＥＵＲＯＮＳＡＦＴＥＲＩＭＰＡＣＴＩＮＧＢＲＡＩＮＩＮＪＵＲＹＮＩＮＧＫｅ（宁可），ＷＡＮＧＺｈｅｎｇ－ｇｕｏ（王正国），ＣＨＥＮＣｈａｎｇ－ｃａｉ（陈长才...     

马凡综合征心血管病变的MRI诊断

目的 研究马凡综合征（MS）心血管病变及其并发症的MRI表现。材料与方法 符合MS诊断标准的患者20例,行胸部MRI检查,采用自旋回 （SE）序列及梯度回波（GE）快速扫描序列。结果 升主动脉瘤样扩张20例,其最宽处位于升主动脉根部（窦部）18例（90％）,范围从根部至升主动脉 远段（弓前）最常见（10例）。主动脉瓣环不同程度扩大（100％）,MRI电影准确显示主动脉瓣返流。左心增大20例（100％）,其中心胶主地心肌肥厚7例（35％）,单纯心腔扩大12例（60％）,仅心肌厚1例（5％）。动脉夹层Ⅰ型5例,其中3例累及腹主动脉,肺淤血6例,胸腔积液7例,心包积液4例,肺动脉高压4例,左心房受压变扁14例。结论 MS的MRI征象具有特征性,可以准确判断心血管病理、病理生理及心功能状况,能代替心血管造影检查制定手术方案。     

Cine-MR in dissection of the thoracic aorta

Magnetic resonance imaging (MRI) of the thoracic aorta, including cine-MRI, was performed in 25 patients suspected of having dissection of the thoracic aorta. MRI was correlated with echocardiography, CT and angiography. The sensitivity of MRI (100%) was most closely followed by CT and angiography (83% and 77% respectively). The specificity of MRI and angiography was equally good, at 100% each. MRI was able to demonstrate the intimal flap in all 9 cases of aortic dissection, and there were no false-positive results. Differentiation of thrombosis and slow flow was possible on proton density images, gradient echo images permitted detection of the entry and re-entry sites. The nature of the dissection was determinated correctly in 8 out of 9 cases. MRI is capable of providing all the relevant parameters necessary to decide appropriate treatment of dissecting aneurysms of the thoracic aorta.     

Follow-up of patients with previous treatment for coarctation of the thoracic aorta: comparison between contrast-enhanced MR angiography and fast spin-echo MR imaging

Regular follow-up is required in patients with previous intervention for coarctation of the aorta to detect recoarctation or aneurysm formation. In this study we describe the findings encountered on routine follow-up exams and we compare the use of contrast-enhanced 3D MR angiography (CE MRA) with fast spin-echo MRI (FSE) to study the thoracic aorta after previous intervention. In 51 consecutive patients previously treated for aortic coarctation, 74 MR studies of the thoracic aorta were performed during a 2-year period using CE MRA and FSE MRI. The thoracic aorta was evaluated for abnormalities of course, caliber, shape, and pathology of side branches. The CE MRA and FSE MRI studies were evaluated side by side by consensus of two reviewers evaluating which MR technique depicted the abnormalities of the thoracic aorta the best. Of 74 exams, six clinically important abnormalities were found: four aneurysms and two restenoses. Two small pseudoaneurysms were missed on the FSE studies. Contrast-enhanced MRA was judged to visualize aortic abnormalities better than FSE (47 of 74 MR studies) especially for the transverse aortic arch, coarctation site, left subclavian artery, and aortic arch configuration. For the ascending aorta and distal descending aorta, CE MRA and FSE performed equally well. Aortic diameters measured at four levels in the first 18 MRI studies showed no significant differences in diameter when measured by FSE or CE MRA (p = not significant). Clinically important abnormalities, such as aneurysm formation and restenosis, can be present years after treatment for aortic coarctation. In the regular follow-up of these patients, CE MRA may provide additional diagnostic information compared with FSE and should be included as part of the routine exam. Received: 3 April 2000; Revised: 5 July 2000; Accepted: 7 July 2000     

磁共振新技术在诊断主动脉夹层中的应用

目的：探讨MR新技术在主动脉夹层（AD）中的应用及其价值。资料与方法：62例AD均进行MRI自旋回波（SE）序列、电影（cine-MRI)检查，其中32例行二维磁共振造影（2D MRA）检查；20例行三维动态增强磁共振造影（3D DCE MRA)检查，20例中有12例用血管追踪扫描技术（Bolus track).23例行速度编码（VEC）电影血流速度测定，6例行动态网格标记技术检查。结果：3D DCE MRA提高了内膜破口的显示率；Bolus track扫描准确、可靠，图像质量更佳；VEC鉴别真、假腔有较大的价值；动态网格标记技术对壁内血肿的识别有优势。结论：MR新技术对AD的诊断有较大的价值。     

Breath-hold gadolinium enhanced tree-dimensional MR angiography: personal experience in the thoracic-abdominal area

PURPOSE: To investigate different clinical applications of gadolinium-enhanced MR angiography (Gd MRA) using three-dimensional breath-hold GE sequences, without bolus time calculation, in patients with vascular diseases. MATERIAL AND METHODS: Forty-seven patients were examined (49 studies in all). Eleven of them had an abdominal aortic aneurysm, 6 surgical bypass, 7 renal artery stenosis, 3 aortoiliac Wallstent, 7 aortic stent-graft; 11 patients had a suspected condition in the thoracic aorta and pulmonary arteries, 1 had subclavian artery stenosis and 1 suspected axillary artery compression. All patients were submitted to breath-hold Gd MRA, after 30-40 mL Gd, with a 1.5 T magnet (Gyroscan ACS-NT, Philips, The Netherlands) and a standard body coil. The GE sequences were acquired with TR = 8.8, TE = 2.7, FA = 60 degrees, matrix = 163 x 512, with 28 seconds acquisition time. Digital subtraction angiography and intraoperative findings were the reference standards to evaluate the results. RESULTS: Thoracopulmonary district: metastatic compression of axillary vessels was found in 1 breast cancer patient; the true and the false lumens and the intimal flap were identified in 2 patients with chronic aortic dissection (Stanford A), and graft patency and complete resolution of the aortic dissection was seen in the patient operated on for acute aortic dissection (Stanford A). The thrombus, lumen, extent and diameter were studied in 2 patients with thoracic aortic aneurysms. Subclavian artery stenosis was demonstrated in 1 patient, which was treated with transluminal angioplasty and stenting. The other 6 patients had normal findings. Abdominal aortic aneurysms (AAA): as for disease extent, breath-hold Gd MRA had 100% sensitivity and specificity compared with surgical findings. Juxtarenal aneurysm extent, which had been missed at DSA, was detected in 1 patient and then confirmed at surgery. Stenosis: comparing DSA and MRA findings in the whole series of patients we had 97.4% agreement (155/159 arteries), that is 76.4% (13/17) arteries) considering only stenoses > 50%. Breath-hold Gd MRA sensitivity and specificity were 100 and 87.5%, respectively, in our 28 stenoses. Bypass, aortoiliac stent, vascular endograft: patency was demonstrated in all the 6 surgical bypass patients, and there was agreement with color Doppler findings in 5 of 6. Breath-hold Gd MRA seems to have no possible applications in the follow-up of percutaneously implanted iliac stents, but we had excellent findings about patency and position of nichel-titanium endografts used for AAA treatment. CONCLUSIONS: We optimized breath-hold 3D MRA without bolus transit time calculation and with high-dose Gd in different clinical vascular conditions. In our opinion, 3D GE sequences can replace DSA in selected cases, providing a fast, accurate and noninvasive examination.     

Magnetic resonance angiography with contrast media bolus in the evaluation of aneurysms of the abdominal aorta

PURPOSE: To investigate the potentials of 3D breath-hold contrast-enhanced Magnetic Resonance Angiography (MRA) in the diagnosis, follow-up and treatment planning of abdominal aortic aneurysms. MATERIAL AND METHODS: Twenty-four patients with infrarenal aortic aneurysm underwent MRA. We used a 1.5 T unit (GE Horizon, Echospeed 8.2), a phased array surface coil and 3D Fast SPGR T1-weighted sequences acquired on the coronal plane during patient breath-hold and after contrast agent i.v. administration. A bolus-test was done before angiography to optimize imaging delay time. After 3D MRA a Fast-SPGR T1-weighted sequence was acquired on the axial plane. The 3D MRA source images were processed with the MIP algorithm. Qualitative and quantitative analyses were carried out. Helical CT was performed in 6 cases and DSA in 7 cases. Surgery was the reference standard in 15 patients. RESULTS: MRA depicted aneurysm thrombosis in 22 cases, carrefour involvement in 18 cases and iliac arteries involvement in 3 cases. Accessory renal arteries were shown in 4 cases; iliac artery stenosis was associated in 5 cases. There was agreement between MR and Helical CT and DSA findings: surgery confirmed MRA results in 15/15 cases. CONCLUSIONS: 3D contrast-enhanced MRA can be considered the method of choice in the follow-up and treatment planning of abdominal aortic aneurysms, because it provides both angiographic and tomographic images: this allows to obtain more information, noninvasively and without the use of ionizing radiations.     

颈位主动脉弓伴动脉瘤的MRI及MRA表现

目的：分析颈位主动脉弓伴动脉瘤的MRI及MRA表现，初步探讨两种方法对其诊断价值。方法：3例颈位主动脉弓伴动脉瘤均作MRI检查，其中1例作时间飞跃法磁共振血管成像（2-dimensional time-of-flightMRA,2DTOFMRA)检查，1例作3DDCEMRA检查，另1例同时作2DTOF MRA及3DDCEMRA检查。结果：MRI与MRA均能明确诊断颈位主动脉弓，对弓上分支血管的显示，MRA优于MRI，3DDCEMRA优于2DTOFMRA，对动脉瘤的显示，MRI与3DDCEMRA优于2DTOFMRA，结论：对于颈位主动脉弓伴动脉瘤的显示，应选用3D DCEMRA及MRI两种检查方法。     

MRI of thoracic vascular lesions with emphasis on two-dimensional time-of-flight MR angiography

MRI is a valuable method for evaluating thoracic vascular lesions by virtue of its non-invasiveness and multiplanar capability. In addition, ionizing radiation and iodinated contrast medium are not required. Electrocardiographically gated T1 weighted spin echo MRI remains the principal technique for demonstrating the anatomy and morphology of thoracic vascular diseases. Cine MRI allows dynamic evaluation of vascular flow, whereas MR angiography is particularly useful in the two-dimensional (2D) or three-dimensional (3D) display of vascular anatomy. This pictorial review illustrates the use of 2D time-of-flight MR angiography in the assessment of various thoracic vascular conditions including aortic arch and great vessel anomalies, heterotaxic syndromes, aortic dissection, aortic or arch vessel aneurysms, pulmonary embolism, pulmonary sequestration, axillofemoral bypass and tumour/vessel relationships.