Idiopathic hypertrophic cranial pachymeningitis: a case report

Hypertrophic pachymeningitis is a rare fibrosing inflamatory process involving dura mater and tentorium. In this report we are presenting contrast enhanced MRI findings of an unusual case of pachymeningitis which presented with a periorbital mass due to dural sinuses occlusion and retrograde filling of periorbital veins through superior sagittal sinus.     

MRI对肥厚性硬膜炎的诊断价值观察

目的 探讨MRI在肥厚性硬膜炎诊断中的应用价值.方法 对海军总医院2009年9月-2014年12月收治的11例肥厚性硬膜炎患者的MRI图像进行回顾性分析,归纳其在MRI不同成像方法图像中的征象以及与肥厚性硬膜炎病理改变的联系.结果 11例肥厚性硬膜炎中8例累及硬脑膜,2例累及硬脊膜,1例同时累及硬脑膜及硬脊膜.MRI图像主要表现为硬膜增厚,增厚的硬膜在T1WI呈等或略低信号,与脑实质和脊髓信号差异较小,在T2WI表现为较明显低信号,与脑实质及脊髓对比显示清晰.9例硬脑膜受累者均进行了DWI扫描,增厚的硬膜呈较低信号,但显示的清晰程度及与周围的对比度不如常规T2WI.增强后T1WI扫描显示增厚的硬膜呈较明显强化,显示效果明显好于增强前.结论 MRI各种成像方法中,T2WI及增强后的T1WI对HP的显示和诊断比较有优势,其余成像手段可作为必要补充,以全面显示其他相关病变,提高诊断准确率和全面性.     

Idiopathic intracranial hypertension: orbital MRI

The case is reported of a patient with idiopathic intracranial hypertension examined with magnetic resonance imaging. Marked enhancement of the optic nerve heads was found, which might be related to blood-retinal barrier breakdown related to a sudden rise in intracranial cerebrospinal fluid pressure.     

肥厚型心肌病心肌MRI延迟强化特征分析

目的 搜集肥厚型心肌病患者心脏MRI资料,分析其受累心肌对比剂延迟强化特点.方法 应用心脏MR技术检查肥厚型心肌病患者,并行心肌对比剂延迟显像,依据9节段分析法分析受累心肌对比剂延迟强化节段范围及程度等.应用t检验对延迟与非延迟强化组数据进行统计学分析.结果 154例患者接受心肌对比剂延迟显像,其中受累心肌节段出现延迟强化的患者共95例,无延迟强化者59例.延迟与非延迟强化组受累节段厚度[分别为(24.8±5.5)和(20.4±3.8)mm,t=3.82,P<0.05]以及受累节段数[分别为(3.3±1.9)和(2.4±1.7)段,t=2.26,P<0.05]比较,前者均大于后者;而患者年龄比较,延迟强化组低于非延迟强化组[分别为(46.0±15.2)和(55.0±11.9)岁,t=-3.67,P<0.05].按照强化的形态,弥漫性强化62例,局限性强化33例.共14例患者接受了酒精消融术治疗,所有患者术后心肌延迟显像均可见明确的局限性强化影.结论 肥厚型心肌病MR对比剂延迟强化患者在受累节段厚度、数量以及年龄等各方面都明显不同于非强化患者.     

Idiopathic hypertrophic cranial pachymeningitis associated with an orbital pseudotumor

We report a case of idiopathic hypertrophic cranial pachymeningitis (IHCP) associated with an orbital pseudotumor and granulocytic thyroiditis of unknown origin. The patient suffered from progressive and finally complete loss of visual acuity, as well as from multiple cranial nerve dysfunctions. Medical treatment and radiation therapy were not beneficial. As reported in the literature, the CT and MRI findings of IHCP were non-specific; thus, diagnosis had to be made by exclusion and open biopsy was required. An inflammatory pseudotumor of the orbit is rarely found in patients with IHCP. Thyroiditis has not yet been reported in the context of IHCP. The patient also suffered from anosmia, which is an unusual feature of IHCP. Received: 12 May 1998; Revision received: 5 October 1998; Accepted: 4 November 1998     

肥厚型心肌病心功能异常的磁共振电影成像分析

目的 应用磁共振电影成像（ｃｉｎｅ－ＭＲＩ）方法探讨肥厚型心肌病的左心室功能的变化。方法 １２例肥厚型心肌病患者,行ＭＲ快速自旋回波（ＴＳＥ）多层面平扫和ｃｉｎｅ－ＭＲＩ检查,用ＡＲＧＵＳ专用心功能分析软件分析射血分数、心肌增厚率、心腔（左心室）容积及时间－容积变化曲线等参数。结果 （１）肥厚型心肌病主要累及左心室前、侧壁及室间隔,肥厚心肌的心肌增厚率显著低于正常心肌（ｔ＝１５．１,Ｐ〈０．０１）     

MRI of cerebral rheumatoid pachymeningitis: report of two cases with follow-up

We report the clinical and neuroradiological features of cerebral rheumatoid pachymeningitis with 1 year follow-up in two patients. MRI of the head enabled noninvasive diagnosis of both the meningeal abnormality and its complications, consisting of hypertensive hydrocephalus and superior sagittal sinus thrombosis, respectively. Dural sinus thrombosis, very uncommon in rheumatoid arthritis, was confirmed by phase-contrast MRA. Worsening of the pachymeningitis at follow-up was observed in both patients despite regression or stability of the clinical picture and long-term therapy.     

MR纵向弛豫时间定量成像评价肥厚型心肌病心肌纤维化的初步研究

目的 探讨纵向弛豫时间定量(T1mapping)成像对肥厚型心肌病(HCM)纤维化的诊断价值.方法 按诊断标准入选48例HCM患者和18名健康志愿者,分别行常规延迟强化(LGE)检查与T1 mapping成像,按HCM LGE有无及程度,分为LGE远处正常区、LGE边缘区、LGE区(分为晕状LGE与典型斑片状LGE),分别测量2组心肌对比剂增强后T1值的变化率并进行卡方检验、两两对比及ROC曲线分析.结果 健康志愿者T1值变化率与HCM远离LGE区差异无统计学意义(3.98 ±3.19和3.36 ±2.77,=0.98,p＞0.05),与LGE周边区(13.51±5.67)、晕状区(17.70±5.57)、斑片区(36.62±8.03)比较差异有统计学意义(t值分别为15.28、17.13和47.48,P值均＜0.01);远处正常区(3.36 ±2.77)与LGE周边区、晕状区及斑片区比较差异均有统计学意义(t值分别为19.64、20.76和56.64,P值均＜0.01);LGE周边区与LGE晕状区和斑片区比较差异均有统计学意义(t值分别为6.12和39.90,P值均＜0.01);LGE晕状区与斑片区比较差异有统计学意义(t=25.63,P＜0.01).ROC曲线提示T1 mapping成像较传统LGE成像有更大的曲线下面积(0.974±0.050和0.751±0.180).结论 HCM纤维化常见,且受累心肌的纤维化程度不一,T1 mapping成像能对HCM患者心肌纤维化的严重程度进行评价,能够发现处于纤维化早期的病变.     

肥厚型心肌病的磁共振成像研究

作者分析了经ＭＲＩ诊断的１１９例肥厚型心肌病磁共振成像所见，主要有：室间隔或／和右室壁肌肥厚，肥厚心肌为均匀一致中等信号，向心腔内凸出，致室腔缩小、变形，收缩期增厚率下降。作者还对肥厚型心肌病的ＭＲＩ诊断价值和诊断标准进行了探讨。     

Idiopathic inflammatory-demyelinating diseases of the central nervous system

Idiopathic inflammatory-demyelinating diseases (IIDDs) include a broad spectrum of central nervous system disorders that can usually be differentiated on the basis of clinical, imaging, laboratory and pathological findings. However, there can be a considerable overlap between at least some of these disorders, leading to misdiagnoses or diagnostic uncertainty. The relapsing-remitting and secondary progressive forms of multiple sclerosis (MS) are the most common IIDDs. Other MS phenotypes include those with a progressive course from onset (primary progressive and progressive relapsing) or with a benign course continuing for years after onset (benign MS). Uncommon forms of IIDDs can be classified clinically into: (1) fulminant or acute IIDDs, such as the Marburg variant of MS, Baló's concentric sclerosis, Schilder's disease, and acute disseminated encephalomyelitis; (2) monosymptomatic IIDDs, such as those involving the spinal cord (transverse myelitis), optic nerve (optic neuritis) or brainstem and cerebellum; and (3) IIDDs with a restricted topographical distribution, including Devic's neuromyelitis optica, recurrent optic neuritis and relapsing transverse myelitis. Other forms of IIDD, which are classified clinically and radiologically as pseudotumoral, can have different forms of presentation and clinical courses. Although some of these uncommon IIDDs are variants of MS, others probably correspond to different entities. MR imaging of the brain and spine is the imaging technique of choice for diagnosing these disorders, and together with the clinical and laboratory findings can accurately classify them. Precise classification of these disorders may have relevant prognostic and treatment implications, and might be helpful in distinguishing them from tumoral or infectious lesions, avoiding unnecessary aggressive diagnostic or therapeutic procedures.     

Idiopathic granulomatous hypophysitis: clinical and imaging features

Idiopathic pituitary granuloma is a rare disorder similar to lymphocytic adenohypophysitis. Few cases have been reported. We report a new histologically case proven with MRI. The patterns of clinical and radiological presentation and the management of this disorder are discussed. MRI findings suggestive of this condition include an intensely enhancing pituitary mass, associated with dural enhancement. Steroid therapy may be suggested avoiding unnecessary surgery.     

法布里病累及心脏的临床及MR特征分析

目的:探讨法布里病（AFD）累及心脏的临床及心脏MR（CMR）特征。方法:回顾性纳入2018年1月至2021年3月阜外医院经基因检测或病理确诊的AFD患者8例（AFD组）,其中男3例、女5例,年龄26~60（50±11）岁;同时纳入性别、年龄匹配的肥厚型心肌病（HCM）患者16例（HCM组）和健康对照者16名（正常组）...     

Idiopathic hypertrophic cranial pachymeningitis: case report with 7 years of imaging follow-up

Idiopathic hypertrophic cranial pachymeningitis is a rare inflammatory disease with diffused involvement of the dura. Often, the definite diagnosis is made immediately with biopsy and the involved dura is removed surgically. Consequently, extensive preoperative imaging studies usually are not available. We reviewed a case of idiopathic hypertrophic cranial pachymeningitis and collectively summarized the interesting features from the 7 years preceding surgical treatment. These chronologic imaging findings with progressive intracranial involvement included dural thickening, dural mass, sinus thrombosis, and venous congestion constituted comprehensive pictures of idiopathic hypertrophic cranial pachymeningitis. The thickened dura may also at times mimic dural masses, such as en plaque meningioma.     

MRI demonstration of hypertrophic articular cartilage repair in osteoarthritis

Transection of the anterior cruciate ligament in the dog produces changes in the unstable joint typical of osteoarthritis, although full-thickness cartilage ulceration is rare. Information concerning the late fate of the cartilage after transection is meager. In the present study magnetic resonance imaging (MRI) was used to evaluate cartilage abnormalities 3 years after transection. Plain radiographs of the osteoarthritic and contralateral knees were obtained serially. MRI was performed 3 years after anterior cruciate ligament transection, at which time all three animals exhibited knee instability. Radiographs of the osteoarthritic knees showed osteophytes and subchondral sclerosis with progression between 2 and 3 years. On MRI, articular cartilage margins in the knee were indistinct, and the cartilage was thicker than that in the contralateral knee (maximum difference= 2.7 mm). This increase in thickness is consistent with biochemical data from dogs killed up to 64 weeks after creation of knee instability, which showed marked increases in cartilage bulk and in proteoglycan synthesis and concentration. The findings emphasize that increased matrix synthesis after anterior cruciate ligament transection leads to functional cartilage repair sustained even in the presence of persistent alteration of joint mechanics.     

肥大性下橄榄核变性的MRI表现

目的 总结肥大性下橄榄核变性(hypertrophic olivary degeneration，HOD)的MRI特征.方法 搜集继发于脑干和小脑病变的HOD病例15例，原发病变位于脑干9例，其中血管畸形出血4例，高血压脑干出血2例，梗死2例，脑干挫伤1例；原发病变位于小脑6例，其中小脑半球出血4例，小脑第4脑室肿瘤术后1例，小脑转移瘤1例。15例均做了MR平扫，2例做了增强扫描。结果 HOD表现为延髓腹外侧局部体积稍增大(共6例)，T1WI表现为等或稍低信号(15例)，在T2WI为高信号(15例)。原发性病变导致中脑红核或桥脑被盖束受损者，发生同侧HOD(8例)；原发病变导致小脑齿状核受损者并引起对侧HOD(4例)，双侧中央被盖束受损(1例)或双侧小脑齿状核受累及者(2例)，发生双侧HOD。结论 MRI能非常清晰地显示下橄榄核的继发性变性病变，可以提高对该变性的认识，避免误诊的发生.     

心尖肥厚型心肌病的MRI诊断

目的：评估MRI诊断心尖肥厚型心肌病的应用价值。方法：应用MR检测心尖肥厚型心肌病。所有患者均行超声心动图和心电图检查，其中16例患者行核素心肌显像，34例患者行冠状动脉及左室造影。另取26名正常人为对照组进行对比分析。结果：共发现心尖肥厚型心肌病116例，占同期肥厚性心肌病的21．2％（116／547），其中典型心尖肥厚型心肌病（T—AHCM）65例，早期心尖肥厚型心肌病（P．AHCM）51例。T—AHCM组和P—AHCM组的心尖部室壁厚度分别为（18．6±2．7）max与（13．6±1．0）mm；心尖部室壁厚度／基底段后壁厚度的比值分别为2．2±0．5与1．6±0．3，均显著高于正常组的（9．5±1．7）mm和1．1±0．1，T—AHCM组与P—AHCM组比较差异有统计学意义（t值分别为4．23和7．55，P值均〈0．05）。室壁增厚率T—AHCM组为（27．7±6．7）％，P-AHCM组为（41．2±9．2）％，对照组为（80．6±6．6）％，患者组与对照组比较差异有统计学意义（t值分别为9．45和7．18，P值均〈0．05）。胸前超声心动图T—AHCM组漏诊率为76．9％（50／65），P—AHCM组的漏诊率达90．2％（46／51）。结论：MRI能够准确诊断心尖肥厚型心肌病，对早期轻型患者的诊断价值优于超声心动图。     

肥大性下橄榄核变性的MRI表现

目的:探讨肥大性下橄榄核变性(HOD)的MRI表现特征.方法:回顾性分析14例HOD患者的临床及影像学资料.14例均行常规磁共振平扫(T1WI、T2WI、T2FLAIR),8例行DWI检查,2例行扩散张量纤维束成像(DTT)检查.结果:14例HOD中6例为单侧(左侧5例,右侧1侧)发病,8例为双侧发病.12例原发病变为桥脑出血,1例为单侧小脑梗死,1例为双侧小脑萎缩.MRI表现为下橄榄核T2WI呈高或稍高信号,T1WI呈等或稍低信号,DWI呈等信号.7例下橄榄核存在不同程度的肿胀、肥大.1例DTT示患侧神经纤维束减少.结论:HOD多继发于齿状核-红核-下橄榄核环路病变,有特定的发病部位和较为特征性的MRI表现,结合其原发病变可对HOD作出正确诊断.     

Idiopathic hypertrophic spinal pachymeningitis: report of two cases with typical MR imaging findings

SUMMARY: Two patients with a chronic progressive myelopathy were successfully surgically treated and idiopathic hypertrophic spinal pachymeningitis (IHSP) was found on histology. In both patients, an extensive extramedullary mass of low T2 signal with peripheral contrast enhancement was compressing the spinal cord on MR imaging. This imaging appearance in patients with chronic progressive myelopathy should suggest the diagnosis of IHSP.     

Seizure-induced brain lesions: A wide spectrum of variably reversible MRI abnormalities

Introduction MRI abnormalities in the postictal period might represent the effect of the seizure activity, rather than its structural cause.     

磁共振血管成像对烟雾病诊断价值的探讨

目的:探讨MRA和MRI对烟雾病的诊断价值。方法:回顾性分析18例烟雾病MRA和DSA表现,18例中5例同时行DSA,采用2.0T超导高磁场MR扫描仪,MRA采用3D-TOF或3D-PC法。DSA采用GE Advantx心血管造影系统。结果:MRA显示狭窄或闭塞的血管,表现为多支、双侧受累。MRI平扫表现脑基底部狭窄、闭塞血管的流空效应减弱甚至消失,侧支循环血管形成所致的点状、条状迂曲低信号影。8例颅内可见血肿。结论:MRA作为一种无创伤的血管成像技术,能准确诊断moyamoya病可以与DSA媲美,结合MRI平扫可同时显示脑组织病变。