高级别胶质瘤治疗后DWI新技术评估的进展

高级别胶质瘤（HGG）术后治疗主要采用放疗或联合放化疗，肿瘤复发与治疗反应是影响其术后生存最重要的因素，治疗反应包括假性进展和治疗后坏死。治疗后监测需要及早、有效地鉴别真性进展与治疗反应。DWI是目前最常用于HGG治疗后评估的功能MRI技术。近年来开发的平均及最小ADC值、ADC直方图和功能扩散图等DWI新技术对HGG治疗后评估具有独特作用。     

合成MRI在高级别胶质瘤中的应用进展

MRI是高级别胶质瘤（HGG）诊治决策的重要评估手段。合成MRI定量参数值能够随组织物理特征变化而改变,据此可反映胶质瘤微细结构和功能异常。近年来,合成MRI已被广泛应用于脑胶质瘤的诊治研究。现就合成MRI定量参数对胶质瘤分级、基因表型预测、肿瘤范围界定、术后真性进展和假性进展的鉴别、早期进展评估的研究进展进行综述。     

胰腺外分泌功能的MRI研究进展

胰腺外分泌功能检查对胰腺生理功能研究及胰腺外分泌功能不全相关性疾病的诊断及疗效评估有十分重要的意义。近年来,多种MRI技术用于检测胰腺外分泌功能,如胰泌素刺激增强MR胆胰管水成像（s-MRCP）可进行功能诊断及分级,基于扩散加权的磁共振成像（DW-MRI）能够对主胰管内胰液的流速进行半定量检测,基于空间选择反转恢复脉冲的电影胆胰管水成像（CINE-MRCP）可直接观察胰管内胰液流动。综述常用胰腺外分泌功能MRI检查技术及应用进展。     

功能MRI在评价对比剂诱导急性肾损伤中的研究进展

对比剂诱导急性肾损伤（CI-AKI）是注射碘对比剂后严重的并发症之一,早期诊断和治疗可以改善或延缓肾损伤。目前多种功能MRI（fMRI）技术可用于肾损伤后肾脏微循环和病理生理学的评估,包括扩散加权成像（DWI）、体素内不相干运动（IVIM）成像、扩散张量成像（DTI）、扩散峰度成像（DKI）、血氧水平依赖（BOLD）成像、动脉自旋标记（ASL）成像等。这些技术不但可以对肾功能损害进行定量分析,还可以在肾损伤的早期诊断和监测方面提供更多信息。就CI-AKI的发病机制及fMRI评价CI-AKI的研究现状做一综述。     

空气粉尘污染对大脑影响的MRI研究进展

空气粉尘污染会对大脑结构与功能产生损害。MRI技术可用于观察空气粉尘污染对脑结构与功能的影响,包括基于T₁加权的三维磁化强度预备快速梯度回波（T₁WI-3D-MPRAGE）、液体衰减反转恢复（FLAIR）、扩散加权成像（DWI）、扩散张量成像（DTI）、血氧水平依赖成像（BOLD）和MR波谱成像（MRS）等序列。MRI不仅能观察到空气粉尘对大脑整体形态、灰白质以及脑深部核团等重要解剖结构的影响,还能反映大脑神经纤维发育、脑网络功能连接和神经元代谢方面的功能改变。就MRI用于空气粉尘污染对大脑影响的研究及进展作一综述。     

高级别胶质瘤治疗后的DWI新技术评估进展

高级别胶质瘤(HGG)术后治疗主要采用放疗或联合放化疗,肿瘤复发与治疗反应是影响其术后生存最重要的因素,治疗反应包括假性进展和治疗后坏死。治疗后监测需要及早、有效地鉴别真性进展与治疗反应。DWI是目前最常用于HGG治疗后评估的功能MRI技术。近年来开发的平均及最小ADC值、ADC直方图和功能扩散图等DWI新技术对HGG治疗后评估具有独特作用。     

MRI在子宫肉瘤和子宫肌瘤鉴别诊断中的应用进展

子宫肉瘤与子宫肌瘤的治疗方案和预后管理完全不同,对两者的鉴别诊断至关重要。MRI是诊断子宫肿瘤的重要影像方法,尤其是扩散加权成像（DWI）、扩散张量成像（DTI）、扩散峰度成像（DKI）、灌注加权成像（PWI）、MR波谱成像（MRS）、增强梯度回波T₂*加权血管成像（ESWAN）等功能MRI及影像组学,在子宫良恶性肿瘤鉴别、病理分型分级和分子变化等方面可以进行量化分析,从而提供更多有价值的信息。就MRI在鉴别子宫肉瘤和子宫肌瘤中的应用进展作一综述。     

MRI对头颈部淋巴瘤与鳞癌鉴别研究进展

淋巴瘤的早期确诊对治疗至关重要,而MRI常规扫描对该病的鉴别诊断存在一定的局限性。随着MR新技术的不断发展及新软件的开发,如磁共振波谱（MRS）、灌注加权成像（PWI）及扩散加权成像（DWI）等技术已广泛应用于淋巴瘤的诊断、鉴别诊断及疗效监测。就头颈部淋巴瘤与鳞癌的常规MRI表现及几种功能磁共振成像在其鉴别诊断中的应用予以综述。     

MRI在肠梗阻诊断中的进展

肠梗阻是常见的疾病,占急腹症的20%,有起病急、进展快、病死率高的特点,故早期诊断肠梗阻对愈后至关重要。常规MRI作为一种简便又无创的检查方法,多种成像技术,如MRI水成像(MRH)、MR胆胰管成像(MRCP)、MR肠道成像(MRE)、MR电影成像(Cine MRI)对肠梗阻的定位及病因诊断均较CT准确,而功能MRI的多种成像序列通过各自成像参数的特点能够反映不同的微观病变,对肠梗阻早期诊断有较高的价值。就MRI应用于诊断肠梗阻的技术及其进展予以综述。     

定量动态增强磁共振成像在骨与软组织肿瘤中的应用

【摘要】定量动态增强MRI（DCE-MRI）作为一种MRI功能成像技术,能有效评价肿瘤微血管状态,反映肿瘤组织灌注情况,对骨与软组织肿瘤的诊断及疗效评估有重要意义。本文就定量DCE-MRI的技术概况及其近年来在骨与软组织肿瘤中的应用进展进行综述。     

APT在胶质瘤假性进展与复发鉴别中的应用

目前,高级别胶质瘤术后常辅以放疗或同步放化疗。治疗后呈现的假性进展与肿瘤复发在常规MRI中表现极为相似,两者在临床上难于鉴别。酰胺质子转移（APT）技术通过检查组织中的酰胺质子含量对鉴别两者有较高的敏感性和特异性。就APT在胶质瘤假性进展与复发鉴别中的应用,以及相比动态磁敏感对比增强灌注加权成像（DSC-PWI）、磁共振波谱成像（MRS）、PET技术的优势予以综述。     

Guía SEOM-SERAM-SEMNIM sobre el empleo de las técnicas de imagen funcional y molecular en el cáncer de pulmón no microcítico avanzado

Imaging in oncology is an essential tool for patient management but its potential is being profoundly underutilized. Each of the techniques used in the diagnostic process also conveys functional information that can be relevant in treatment decision making. New imaging algorithms and techniques enhance our knowledge about the phenotype of the tumor and its potential response to different therapies. Functional imaging can be defined as the one that provides information beyond the purely morphological data, and include all the techniques that make it possible to measure specific physiological functions of the tumor, whereas molecular imaging would include techniques that allow us to measure metabolic changes. Functional and molecular techniques included in this document are based on multi-detector computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), magnetic resonance imaging (MRI), and hybrid equipments, integrating PET with CT (PET/CT) or MRI (PET-MRI). Lung cancer is one of the most frequent and deadly tumors although survival is increasing thanks to advances in diagnostic methods and new treatments. This increased survival poises challenges in terms of proper follow-up and definitions of response and progression, as exemplified by immune therapy-related pseudoprogression. In this consensus document, the use of functional and molecular imaging techniques will be addressed to exploit their current potential and explore future applications in the diagnosis, evaluation of response and detection of recurrence of advanced NSCLC.     

心脏MRI新技术

评述心脏功能性MRI、心肌灌注成像和冠状动脉MR成像的最新发展状况和临床应用，叙述有关各种技术的操作方法和所用序列特点，以及对各种心脏疾病的诊断价值。     

Various diffusion magnetic resonance imaging techniques for pancreatic cancer

Pancreatic cancer is one of the most common malignant tumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods are conducive to detecting small lesions. Compared to the other techniques, magnetic resonance imaging (MRI) has irreplaceable advantages and can provide valuable information unattainable with other noninvasive or minimally invasive imaging techniques. Advances in MR hardware and pulse sequence design have particularly improved the quality and robustness of MRI of the pancreas. Diffusion MR imaging serves as one of the common functional MRI techniques and is the only technique that can be used to reflect the diffusion movement of water molecules in vivo. It is generally known that diffusion properties depend on the characterization of intrinsic features of tissue microdynamics and microstructure. With the improvement of the diffusion models, diffusion MR imaging techniques are increasingly varied, from the simplest and most commonly used technique to the more complex. In this review, the various diffusion MRI techniques for pancreatic cancer are discussed, including conventional diffusion weighted imaging (DWI), multi-b DWI based on intra-voxel incoherent motion theory, diffusion tensor imaging and diffusion kurtosis imaging. The principles, main parameters, advantages and limitations of these techniques, as well as future directions for pancreatic diffusion imaging are also discussed.     

产后抑郁症的MRI研究进展

产后抑郁症（PPD）为常见的产后精神障碍,其发病机制尚不清楚。基于体素的形态学分析、基于表面的形态学测量、扩散张量成像、扩散峰度成像、血氧水平依赖功能MRI、MR波谱成像等多种MRI技术已广泛用于探究PPD病人的脑结构、功能和代谢中发生的异常改变,这些技术使得明确PPD的神经生物学机制成为可能,也可为该病的早期诊断和预后判断提供客观的影像依据。就MRI在PPD中的影像学研究进展予以综述。     

Clinical decision support systems for brain tumor characterization using advanced magnetic resonance imaging techniques

In recent years, advanced magnetic resonance imaging (MRI) techniques, such as magnetic resonance spectroscopy, diffusion weighted imaging, diffusion tensor imaging and perfusion weighted imaging have been used in order to resolve demanding diagnostic problems such as brain tumor characterization and grading, as these techniques offer a more detailed and non-invasive evaluation of the area under study. In the last decade a great effort has been made to import and utilize intelligent systems in the so-called clinical decision support systems (CDSS) for automatic processing, classification, evaluation and representation of MRI data in order for advanced MRI techniques to become a part of the clinical routine, since the amount of data from the aforementioned techniques has gradually increased. Hence, the purpose of the current review article is two-fold. The first is to review and evaluate the progress that has been made towards the utilization of CDSS based on data from advanced MRI techniques. The second is to analyze and propose the future work that has to be done, based on the existing problems and challenges, especially taking into account the new imaging techniques and parameters that can be introduced into intelligent systems to significantly improve their diagnostic specificity and clinical application.     

Role of advanced magnetic resonance imaging in the assessment of malignancies of the mediastinum

In the new era of functional magnetic resonance imaging (MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, “do not touch lesions” could be identified with the associated impact in the management of those patients. One of the hot-spots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free survival. Therefore, in this review we will analyze the current functional imaging techniques available (¹⁸F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.     

MRI全景矩阵成像技术在全身骨转移瘤诊断中的价值

目的 探讨全景矩阵成像(TIM)技术对全身骨转移瘤的诊断价值.资料与方法 对25例恶性肿瘤患者采用单光子发射计算机断层显像(SPECT)进行全身骨扫描与TIM技术全身MRI扫描,对两种检查方法进行评价比较.结果 25例中,MRI-TIM及SPECT共检出23例63个病灶,其中恶性54个、良性9个,TIM正确诊断50个转移瘤病灶,敏感度为93%(50/54),特异度为67%(6/9),阳性预测值为94%(50/53),阴性预测值为60%(6/10).SPECT正确诊断47个病灶,敏感度为87%(47/54),特异度为56%(5/9),阳性预测值为92%(47/51),阴性预测值为42%(5/12).两种检查方法的敏感度与特异度之间的差异均无统计学意义(P值分别为0.077和0.643).全身MRI的诊断准确率为89%(56/63),SPECT的诊断准确率为83%(52/63),两者之间的差异有统计学意义(P=0.000).结论 SPECT与TIM能有效地检出全身骨转移癌灶,但TIM对骨髓病变有较高的空间分辨率,比SPECT的诊断正确率更高.     

Brain metastases: the role of clinical imaging

Imaging of brain metastases (BMs) has advanced greatly over the past decade. In this review, we discuss the main challenges that BMs pose in clinical practice and describe the role of imaging.Firstly, we describe the increased incidence of BMs of different primary tumours and the rationale for screening. A challenge lies in selecting the right patients for screening: not all cancer patients develop BMs in their disease course.Secondly, we discuss the imaging techniques to detect BMs. A three-dimensional (3D) T1W MRI sequence is the golden standard for BM detection, but additional anatomical (susceptibility weighted imaging, diffusion weighted imaging), functional (perfusion MRI) and metabolic (MR spectroscopy, positron emission tomography) information can help to differentiate BMs from other intracranial aetiologies.Thirdly, we describe the role of imaging before, during and after treatment of BMs. For surgical resection, imaging is used to select surgical patients, but also to assist intraoperatively (neuronavigation, fluorescence-guided surgery, ultrasound). For treatment planning of stereotactic radiosurgery, MRI is combined with CT. For surveillance after both local and systemic therapies, conventional MRI is used. However, advanced imaging is increasingly performed to distinguish true tumour progression from pseudoprogression.FInally, future perspectives are discussed, including radiomics, new biomarkers, new endogenous contrast agents and theranostics.