食管癌切除术后乳糜胸的治疗及预防

目的：评价低位性结扎胸导管治疗食管癌术后乳糜胸的疗效及术中结扎胸导管对防止乳糜胸发生的效果。方法：对156例食管癌病人,术中常规行低位胸导管双重结扎,观察术后乳糜胸的发生情况,并与非结扎组172例作对比,对术后5例乳糜胸病人行手术治疗。结果：结扎组术后无1例发生乳糜胸,非结扎组术后5例发生乳糜胸,发生率为2．9％。乳糜胸病人二次开胸低位结扎胸导管,疗效显著。结论：中上段食管癌切除时,术中常规胸导管结扎可有效防止术后乳糜胸的发生。一旦发生乳糜胸,宜尽早开胸结扎胸导管。     

桥本脑病的MR1表现(附1例报告及文献复习)

目的 探讨桥本脑病的磁共振表现和文献复习.方法 回顾性分析1例临床确诊的桥本脑病资料,并复习国内外相关文献.结果 本例桥本脑病MRI表现为脑内弥漫分布长T1、长T2信号病灶,Flair上病灶呈高信号,双侧大脑及小脑半球病灶分布基本对称,增强扫描显示无强化.弥散加权成像上,病灶呈高信号,ADC图上呈等或稍高信号.结论 桥本脑病MRI表现缺乏特异性,其主要累及脑白质,病灶可在一段时间内消失,该病最终的确诊需要结合实验室检查及临床特点.     

胸部增强磁共振血管造影对比剂应用方案的优化

目的：探讨人胸部增强磁共振血管造影(contrast-enhanced MR angiography，CEMRA)的对比剂(钆喷酸葡胺)最佳应用方案。方法：无胸部疾病的自愿者61人，按0.08、0.17、0.25和0.33mmol／kg4种不同剂量分成4组，各组再分别以2、3、4ml／s的流速注射对比剂，应用Siemens Vision Plus 1．5T成像系统进行CEMRA检查，评价不同成像条件对人胸部CEMRA信噪比、信号强度、血管对比度等的影响。结果：从图像的主观评价看，对比剂在0.17mmol／Kg以下无论以何种速度都难以取得理想图像(相同剂量下低流速略好于高流速)，对比剂在0.25mmol／kg以上却无论何种速度都能获得较满意图像。血管的对比度也基本与剂量成正比，但肺动脉在对比剂剂量较大时，由于肺实质的强化，反而会引起血管肺组织对比度的下降。结论：胸部血管的动态三维增强MR血管造影效果主要与对比剂的注射剂量有关，与流速关系不大。推荐胸部增强MRA对比剂剂量为0.25mmol／kg，注射流速为2～3ml／s。     

多囊性脑软化一例

报道多囊性脑软化1例。磁共振表现为双侧额叶巨大囊性病变并胼胝体受累,病灶边缘扩散加权成像呈环形高信号,增强不均匀环形明显强化,磁共振波谱示病灶边缘强化部分胆碱峰稍升高,N-乙酰门冬氨酸峰稍减低。     

Trigeminal Ganglioneuroma in the Middle-posterior Cranial Fossa: a Case Report

GANGLIONEUROMA is considered as the most mature and noninvasive form of neuroblastic tumors. It derives from neural crest cells, and can arise from wherever sympathetic tissue exists,1 including neck, posterior mediastinum, adrenal gland, retroperitoneum and pelvis. The two most common locations for this tumor are retroperitoneum and posterior mediastinum; infrequently it occurs in the intracranial re-gion,2-8 with only three cases has been reported arising from trigeminal nerve.2-4 The current paper presents a 49-year-old male patient with a ganglioneuroma arising from right trigeminal ganglion and extending to the mid-dle-posterior cranial fossa.We summarized the clinical and diagnostic characteristics of this extremely rare tumor, in comparison with the three reported cases in literatures.     

Striated Enhancement Sign in Invasive Cerebral Fungal Granuloma by Aspergillus a Case Report

CEREBRAL aspergillosis is a rare and severe disorder with rapid progressive pathogenesis, and commonly seen in immunocompromised patients. 1 Typical cerebral aspergillosis presentsabscess with ring enhancement or cortical or subcortical infactions on magnetic resonance （MR） images. In this communication, we describe a rare cerebral aspergillosis with relative characteristic MR imaging findings.     

颅内硬膜内软骨瘤CT及磁共振表现一例

颅内软骨瘤较为罕见,关于其影像报道也较为少见。现报道颅内软骨瘤CT及磁共振影像表现1例,为临床提供诊断经验。     

鞍区室管膜瘤一例

室管膜瘤为起源于脑室内的室管膜细胞及脑室外白质的室管膜细胞巢,发病部位可以在脑室内、外,按解剖学又可分为幕上及幕下室管膜瘤。幕上室管膜瘤常见的发病部位为脑室外及脑室内,发生于鞍区的室管膜瘤极为罕见。中国人民解放军总医院海南医院经病理学确诊了1例鞍区室管膜瘤,其特征性影像学表现为塑形性生长、结节样钙化及流空血管影。     

Perfusion MR imaging and proton MR spectroscopy in a case of dysembryroplastic neuroepithelial tumor

Dysembryoplastic neuroepithelial tumors (DNTs), which were first described by Daumas-Duport in 1988, are one of rare benign tumors usually associated with medically intractable seizures which date from childhood. The clinical,pathologic and neuroradiologic findings of DNT havebeen described.Recent advances in magnetic resonance imaging (MRI) technology allow the acquisition of cerebral microcirculation parameters by perfusion weighted imaging (PWl) and brain metabolic indices by MR spectroscopy (MRS). Several studies have shown the utility of PWl and MRS can improve the diagnostic accuracy of brain tumor,we combine the two techniques to evaluate a case with DNT and suggest that wider application of these techniques is warranted.     

Imaging Diagnosis of Type III Choledochal Cyst: A Case Report

Choledochocele is a congenital abnormality of the biliary system, which characterized by a cystic dilatation of intramural segment of the distal common bile duct. Choledochocele manifests as cystic lesions in the duodenal lumen and resembles duodenal duplication cysts in imaging. We reported a patient with choledochocele. Magnetic resonance cholangiopancreatography showed a thin-walled sac in the duodenal cavity and a fine tubular structure connecting with the end of the common bile duct. Magnetic resonance cholangiopancreatography is a noninvasive and convenient technique in the diagnosis of choledochocele.     

Reversible Posterior Leukoencephalopathy Syndrome in Children with Nephrotic Syndrome:a Case Report

REVERSIBLE posterior leukoencephalopathy syn- drome （RPLS） is a rare neurological syndrome charac- terized by headache, altered mental status, seizures, and visual disturbance,associated with reversible white matter cnanges,- n been commonly reported in patients with severe hypertension and pre-eclampsia. Here we report a case with nephrotic syndrome complicated by RPLS.     

糖尿病性肌梗死的MRI表现并文献复习

目的探讨糖尿病肌梗塞的MRI表现和病理学基础,以提高对本病的认识。方法对1例确诊糖尿病肌病的患者的MRI表现及临床特点进行回顾性分析,并对相关文献进行复习。结果 MRI平扫质子密度加权压脂后示受累肌肉呈明显高信号,周围脂肪间隙模糊,并可见邻近筋膜下积液,增强后呈弥漫性明显强化。结论 DMI是一种继发于糖尿病Ⅰ型或是糖尿病Ⅱ型的少见并发症,MRI是此疾病诊断和随访的首选影像检查手段,MRI的影像表现结合临床特点可以使多数病例得到确诊,从而避免活检或是手术的有创不良后果。     

非典型囊性脑膜瘤一例

非典型囊性脑膜瘤因MRI表现不典型,诊断有时较为困难。本研究报道1例非典型囊性脑膜瘤,并详细描述其MRI表现,为诊断囊性脑膜瘤的定位及分型提供有价值的影像学证据。     

松果体区乳头状瘤一例

报道松果体区乳头状瘤1例,CT主要表现为稍高密度影,磁共振成像主要表现为短T1信号及囊性变,增强扫描显著强化。     

不典型三叉神经海绵状血管瘤一例

颅内脑外型海绵状血管瘤好发于中颅窝海绵窦区,典型病例磁共振表现为T1WI呈等或低信号,T2WI呈明显高信号,增强扫描明显强化,本文报道了1例不典型三叉神经海绵状血管瘤,磁共振成像下等及稍长T2信号、灶内点状短T1信号及增强扫描不强化是其不典型征象。     

少血供垂体转移瘤2例并文献复习

垂体转移瘤是一种少见的从全身各部位恶性肿瘤转移至垂体所致的颅内恶性肿瘤。常见垂体转移瘤为富血供,位于垂体后叶和/或垂体柄,病灶呈浸润生长,磁共振T1加权成像呈低信号,T2加权成像呈高信号,增强扫描多呈明显强化。而少血供垂体转移瘤在磁共振图像上与垂体大腺瘤相似,难以鉴别。现报道2例经病理确诊的少血供垂体转移瘤并复习相关文献,以期总结少血供垂体转移瘤的影像学鉴别要点。     

Laryngo-tracheobronchial Amyloidosis:a Case Report and Review of Literature

AMYLOIDOSIS is a benign process which can have systemic involvement. Though larynx is the common site of localized amyloidosis in the head and neck region,I it was seldom reported with heterochronous implication of bilateral ventricles. Here we report a case of laryngeal amyloidosis heterochronously localized at bilateral ventricles with tracheobronchial involvement. Combined with our experience we reviewed the literature, and discuss the pertinent managements of this condition.     

脑胶质瘤MRI诊断进展——基于脑胶质瘤生理代谢特征的MRI成像

脑胶质瘤属于神经上皮类肿瘤,是最常见的原发性颅内肿瘤,占脑实质肿瘤的40%～45%.依据病理组织学特征,2000年修订的WHO分级标准将脑内胶质瘤分为低级别(WHO、Ⅱ)和高级别肿瘤(WHO Ⅲ、Ⅳ).低级别胶质瘤占所有胶质瘤的20%～30%,5年生存率接近80%,高级别胶质瘤占脑胶质瘤的50%,其中间变型(WHO Ⅲ)胶质瘤术后生存时间接近2年,胶质母细胞瘤(WHO Ⅳ)的5年生存率仅为5%,多数生存时间少于1年.     

Early Diagnosis of Recurrent Optic Neuritis Using Contrast-Enhanced T2 Fluid-attenuated Inversion Recovery Imaging: a Case Report

The diagnosis of the recurrent optic neuritis is commonly established clinically, and sometimes it could be challenging because the involved optic nerve does not always show significant enhancement on conventional contrast enhanced-T1 weighted imaging (CE-T1WI). In this paper, we reported a middle-aged female with early diagnosis of recurrent optic neuritis using contrast-enhanced T2 fluid-attenuated inversion recovery imaging (CE-T2FLAIR). The involved optic nerve presented evident enhancement on CE-T2FLAIR and no enhancement on CE-T1WI. This case suggested that the CE-T2FLAIR may be a useful diagnostic tool specifically for the recurrent optic neuritis in clinical practice.     

MR胆胰管造影对胰腺病变的诊断价值

综合近年来有关MR胆胰管造影（MRCP）应用于胰腺疾病诊断方面的文献，目的在于探讨MRCP在评估胰腺（管）病变方面的应用价值。提供胰腺各种良恶性病变在MRCP上的诊断特征。并认为MRCP是胰管系统成像的一种合适方法，在临床上有着广泛的应用前景。