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...     

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，...     

磁共振胆道造影在胆道梗阻定位和定性诊断中的价值

目的：通过ＭＲＩ胆道造影（ＭＲｃｈｏｌａｎｇｉｏｇｒａｐｈｙ，ＭＲＣ）与ＣＴ、ＵＳ、经皮穿刺胆道造影术（ＰＴＣ）或内窥镜逆行胰胆管造影术（ＥＲＣＰ）及手术、病理的对照研究，评价ＭＲＣ显示胆道梗阻部位，确定梗阻原因的能力。材料与方法：３０例梗阻性黄疸的患者在ＧＥＳｉｇｎａ１．５Ｔ超导系统上进行了ＭＲＣ检查，并与ＰＴＣ或ＥＲＣＰ、ＣＴ、ＵＳ、手术及病理对照。结果：本组资料中，ＭＲＣ显示胆道梗阻的部位准确性达１００％，优于有损伤性的ＰＴＣ或ＥＲＣＰ。ＭＲＣ确定梗阻原因的准确性达７０％，类似于ＰＴＣ或ＥＲＣＰ、ＣＴ、ＵＳ。结论：初步研究结果表明，无损伤性的ＭＲ胆道造影在梗阻性黄疸的定位和定性上具有很高的敏感性、准确性，对于梗阻性黄疸，特别是行ＥＲＣＰ失败和不宜行ＰＴＣ或ＥＲＣＰ的病人是最有效的替代方法。     

HISTOLOGICAL CHARACTERISTICS OF HEALING OF INJURED AVASCULAR PORTION OF MENISCUS UNDER DIRECT MICROCUR-RENT STIMULATION

ＨＩＳＴＯＬＯＧＩＣＡＬＣＨＡＲＡＣＴＥＲＩＳＴＩＣＳＯＦＨＥＡＬＩＮＧＯＦＩＮＪＵＲＥＤＡＶＡＳＣＵＬＡＲＰＯＲＴＩＯＮＯＦＭＥＮＩＳＣＵＳＵＮＤＥＲＤＩＲＥＣＴＭＩＣＲＯＣＵＲ┐ＲＥＮＴＳＴＩＭＵＬＡＴＩＯＮＬＩＵＪｉｎ－ｃａｉ（刘晋才），ＨＵＡ...     

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...     

快速动态增强MR多期扫描技术在小肝癌诊断中的应用

研究动态增强ＧＤ－ＦＭＰＳＰＧＲ多期扫描在肝癌诊断中的价值小肝癌的ＭＲＩ表现,材料与方法：３５例ＳＨＣＣ患者进行了前瞻性ＭＲＩ研究,所有病例均行ＳＥ序列及动态增强的ＦＭＰＳＰＧＲ序列多期扫描,并经手术病理证实。     

EXPERIMENTAL STUDY ON EARLY REPAIR OF MANDIBULAR DEFECT FOLLOWING HIGH VELOCITY MISSILE WOUND

ＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＮＥＡＲＬＹＲＥＰＡＩＲＯＦＭＡＮＤＩＢＵＬＡＲＤＥＦＥＣＴＦＯＬＬＯＷＩＮＧＨＩＧＨＶＥＬＯＣＩＴＹＭＩＳＳＩＬＥＷＯＵＮＤＬＩＵＹａｎ－ｐｕ（刘彦普），ＬＥＩＤｅ－ｌｉｎ（雷德林），ＺＨＡＮＧＨａｉ－ｘｉａ（张...     

OSTEOCLASTIC RESORPTION OF CANCELLOUS BONE TISSUES OF FEMORAL NECK IN HIP FRACTURE PATIENTS (A SCANNING ELECTRON MICROSCOPIC STUDY)

ＯＳＴＥＯＣＬＡＳＴＩＣＲＥＳＯＲＰＴＩＯＮＯＦＣＡＮＣＥＬＬＯＵＳＢＯＮＥＴＩＳＳＵＥＳＯＦＦＥＭＯＲＡＬＮＥＣＫＩＮＨＩＰＦＲＡＣＴＵＲＥＰＡＴＩＥＮＴＳ（ＡＳＣＡＮＮＩＮＧＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＩＣＳＴＵＤＹ）ＣＨＡＩＢｅｎ－ｆｕ（...     

螺旋CT动脉门脉造影在小肝癌诊断中的价值

目的：用螺旋ＣＴ动脉门脉造影（ＳＣＴＡＰ）评价肝癌并与超声（ＵＳ）及螺旋ＣＴ双期扫描进行检出敏感性和定性准确性比较研究。方法：肝癌４１例,行ＳＣＴＡＰ后分析病灶灌注特征,统计各种方法病灶检出数,计算检出敏感性及定性准确性并行统计学处理。结果：４１例共检出≤３ｃｍ病灶４５个,ＳＣＴＡＰ检出敏感性为９５．５％,双期扫描肝动脉期、门静脉期及双期合计的检出敏感性分别为：８８．８％、６８．８％、９１．１％,ＳＣＴＡＰ与ＵＳ（６６．６％）和双期扫描门脉期相比有显著性差异（ｐ＜０．０１）。其定性准确性为（９５．３％）,明显高于ＵＳ（８０．０％）。结论：ＳＣＴＡＰ能可靠反映小肝癌、肝实质血流灌注特征,明显提高病灶检出敏感性及定性准确性。螺旋ＣＴ动脉造影（ＳＣＴＡ）显示病变动脉血管最佳,两者结合可增加诊断特异性。     

CLINICAL AND EXPERIMENTAL STUDIES ON RENAL INJURIES AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

ＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＩＥＳＯＮＲＥＮＡＬＩＮＪＵＲＩＥＳＡＦＴＥＲＥＸＴＲＡＣＯＲＰＯＲＥＡＬＳＨＯＣＫＷＡＶＥＬＩＴＨＯＴＲＩＰＳＹＦＡＮＧＹｕ－ｈｕａ（方玉华），ＪＩＡＮＧＪｕｎ（江军），ＤＵＷｅｉ－ｇｕｏ（都卫...     

螺旋CT,动态MR及US在小肝癌诊断中的比较研究

目的：本文对资料完整的41例小肝癌（SHCC）患者进行SCT、MR及US三种无创伤性影像学技术的比较研究。材料和方法：SCT采用双期动态扫描，MR采用SE序列加FMPSPGR序列，而US采用常规US和彩色多普勒US相结合，对SHCC和微小肝癌（MHCC）的病灶检出率和定性准确率做一统计和分析。结果：SCT、MR及US的检出敏感性分别为：91．18％、94．12％和61.76％，而定性准确率分别为90．32％、96．91％及73．81％，SCT和MR之间无显著性差异而这两者和US之间均存在显著性差异。结论：对SHCC和MHCC的检出，MRSE序列加FMPSPGR序列和SCT双期动态扫描的结果相似，但两者均优于US。对于SHCC和MHCC的定性，MR稍优于SCT。鉴于三者各自的优点和限度，US、SCT及MR两者或三者的结合或联合应用必将有利于SHCC和MHCC的检出和定性能力的提高。     

肝脏MRI动态增强扫描技术

目的：对照研究动态增强FMPSPGR与常规SE序列，探讨新的MRI扫描技术在肝肿瘤检查中的作用。材料和方法：45例HCC病人进行了前瞻性MRI研究。所有病例均行SE序列及动态增强的FMPSPGR序列扫描，从图像质量的定量指标、目测结果和病灶检出方面进行对照。结果：动态增强FMPSPGR序列对比噪声比（CNR）较常规SE序列明显提高，图像的总体质量评估优于SE序列，SE序列结合动态增强FMPSPGR序列对HCC检出的敏感性和准确性明显优于常规SE序列（P＜0．05）。结论：FMPSPGR序列扫描速度快、图像质量好，配合GD－DTPA动态增强扫描可动态的观察病灶血供的特点，特别有利于肝肿瘤的检出和定性。     

MRI对胰腺癌胰周血管侵犯的手术可切除性评价

目的对胰腺癌胰周血管侵犯判断的最佳序列进行评价,并探讨MRI判断胰腺癌胰周血管侵犯的敏感性、特异性及准确性。资料与方法搜集22例经手术病理证实的胰腺癌病例,所有患者均行平扫的SET1WI、FSE T2WI、SE T1WI＋FS序列扫描,同时行动态增强GRE（DCE FMPSPGR）序列的三期扫描。对该22例患者术前胰周血管侵犯情况进行回顾性分析：（1）按照肿瘤对周围血管侵犯的程度,采用0～3级的等级法进行术前盲法评分,统计血管侵犯及无侵犯的支数,并同手术结果对照。分析0～3各级别对于血管侵犯与否判断其敏感性。（2）统计SE T1WI及DCE FMPSPGR两序列分别及结合起来评价胰周血管侵犯敏感性、特异性、阳性预测值、阴性预测值及准确性。结果22例患者7段共154支血管中,术中发现51支有侵犯,103支无侵犯。其中WE T1WI术前诊断45支受侵．109支无侵犯,漏诊6支,误诊3支。DCEFMPSPCR诊断43支受侵．111支正常,漏诊8支,误诊2支。WE T1WI和DCE FMPSPGR分别及两者相结合判断血管受侵的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为：88．2％、97％、93．8％、94．3％、94．2％;84．3％、98．0％、95．5％、92．7％、93．5％;92．1％、98．0％、95．9％、96．2％、96．1％。结论MRI判断胰周血管侵犯的敏感性为92．1％,特异性为98．0％,诊断准确性96．1％。以SE T1WI和DCE FMPSPGR两序列较优,两者结合起来可以提高判断的准确性。     

MnDPDP-enhanced MRI vs dual-phase spiral CT in the detection of hepatocellular carcinoma in cirrhosis

The objectives of this study were twofold: (a) to assess safety and tolerability of the hepatobiliary MR contrast agent MnDPDP; and (b) to investigate the sensitivity of MnDPDP-enhanced MRI, in comparison with dual-phase spiral CT, in the detection of hepatocellular carcinoma (HCC) in cirrhosis. Fifty patients with liver cirrhosis and histologically proven HCC were enrolled in a prospective phase-IIIB clinical trial. All patients underwent evaluation with dual-phase spiral CT and pre-contrast and post-contrast MRI at 1.5 T. The MR examination protocol included spin-echo (SE) and gradient-recalled-echo (GRE) T1-weighted images acquired before and 60–120 min after administration of 0.5 μmol/kg (0.5 ml/kg) MnDPDP (Teslascan, Nycomed Amersham, Oslo, Norway); and fast T2-weighted SE images obtained solely before contrast injection. Gold standard was provided by findings at Lipiodol CT in combination with follow-up spiral CT studies, which were repeated at 4-month intervals over a 10- to 27-month (mean ± SD 20.1 ± 5.1 months) follow-up period. No serious adverse event occurred. Eighty tumors ranging 0.8–9.1 cm in diameter (mean ± SD 3.2 ± 2.4 cm) were detected by Lipiodol CT or confirmed as cancerous foci by follow-up CT studies. Pre-contrast MRI detected 38 of 80 lesions (48 %); MnDPDP-enhanced MRI, 65 of 80 lesions (81 %); pre-contrast plus post-contrast MRI, 69 of 80 lesions (86 %); and dual-phase spiral CT, 64 of 80 lesions (80 %). The difference between unenhanced and MnDPDP-enhanced MRI was statistically significant (p < 0.001). The difference between MRI (pre-contrast plus post-contrast) and dual-phase spiral CT was not statistically significant (p = 0.33). The confidence in the final diagnosis, however, was significantly higher for MRI as compared with spiral CT (p < 0.001). MnDPDP is a safe and well-tolerated hepatobiliary MR contrast agent. Magnetic resonance imaging with use of MnDPDP is significantly more sensitive than unenhanced MRI and as good as dual-phase spiral CT for detection of HCC in cirrhosis. Received: 29 February 2000; Revised: 8 June 2000; Accepted: 9 June 2000     

Gd-BOPTA增强MRI对小肝癌的诊断价值

目的　比较Gd BOPTA增强MRI与MRI平扫、Gd DTPA动态增强MRI在诊断小肝癌 (SHCC)方面的差异 ,进一步提高小肝癌检出率和诊断准确性并观察其不良反应。资料与方法　手术或穿刺病理证实为SHCC患者 2 5例。采用GESigna 1.5T磁共振扫描仪。行SE序列T1WI、FSE序列T2 WI及Gd DTPA快速动态增强多期扫描。Gd BOPTA增强扫描亦采用静脉团注快速动态增强扫描 (同Gd DTPA) ,并在团注后 15min、6 0min行SE序列T1WI和FMPSPGR序列T1WI扫描各 1次。观察MRI平扫、Gd DTPA快速动态增强和Gd BOPTA增强扫描及延迟扫描对病灶的检出率、包膜显示情况以及病灶的强化特征并行统计学分析。观察其不良反应。结果　 2 5例患者共发现病灶4 2个。对SHCC病灶的检出率 ,MRI平扫为 6 9.0 5 % ,Gd DTPA增强为 85 .71% ,Gd BOPTA增强 (动态 延迟 )为95 .2 4 % ,和Gd DTPA增强之间无统计学差异 ,和MRI平扫有统计学意义。病理检查发现 30个病灶有包膜。Gd BOPTA增强对SHCC包膜的显示 ...     

磁共振动态增强和脂肪抑制技术在胰腺癌诊断中的价值

目的 了解磁共振动态增强和脂肪抑制技术在胰腺诊断中的价值。材料与方法 １８例经手术病理证实的胰腺癌患者进行了磁共振检查,采用在磁共振序列分别为：ＳＥＴ１ＷＩ、ＦＳＥＴ２ＷＩ、脂肪抑制技术ＳＥＴ１ＷＩ和动态增强ＦＭＰＳＰＧＲ等。结果 １８例胰腺癌肿瘤病灶,在ＳＥＴ１ＷＩ上呈低信号者１０例,等信号者６例,高信号者２例;ＦＳＥＴ２ＷＩ上高信号者８例,等信号者６例,低信号者４例;脂肪抑制技术ＳＥＴ１ＷＩ上     

胰岛素瘤的MRI诊断

目的：探讨胰岛素瘤的MRI表现及最佳检查序列。资料与方法：分析经手术、病理证实6例胰岛素瘤的MRI表现，检查序列包括SE T1WI、FSE T2WI、预饱和脂肪抑制T1WI，常规增强和动态增强检查。其中4例行CT平扫和双期增强检查。比较增强前后MRI不同序列胰岛素瘤的检出率，并与CT检查进行对照。结果：MRI检出了所有6例胰岛素瘤，其中预饱和脂肪抑制T1WI的检出率最高（6／6），其次是常规SE T1WI（5／6），而FSE T2WI（2／6）、常规增强T1WI（2／5）和动态增强检查（2／3）的显示率较低，但增强检查尤其是动态增强检查有助于显示肿瘤的富血供特征。CT对胰岛素瘤的检出率（平扫1／4，双期增强2／3）要低于MRI。结论：对于胰岛素瘤，MRI是一种较佳无创性检查方法，能够检出双期增强CT检查漏诊的肿瘤。MR预饱和脂肪抑制T1WI是最佳检查序列，增强尤其是动态增强则能反映肿瘤的富血供特征。     

Hepatocellular carcinoma in cirrhotic patients: prospective comparison of US, CT and MR imaging

Objectives

To prospectively compare the diagnostic performance of ultrasound (US), multidetector computed tomography (MDCT) and contrast-enhanced magnetic resonance imaging (MRI) in cirrhotic patients who were candidates for liver transplantation.

Methods

One hundred and forty consecutive patients with 163 hepatocellular carcinoma (HCC) nodules underwent US, MRI and MDCT. Diagnosis of HCC was based on pathological findings or substantial growth at 12-month follow-up. Four different image datasets were evaluated: US, MDCT, MRI unenhanced and dynamic phases, MRI unenhanced dynamic and hepatobiliary phase. Diagnostic accuracy, sensitivity, specificity, PPV and NPV, with corresponding 95 % confidence intervals, were determined. Statistical analysis was performed for all lesions and for three lesion subgroups (<1 cm, 1-2 cm, >2 cm).

Results

Significantly higher diagnostic accuracy, sensitivity and NPV was achieved on dynamic + hepatobiliary phase MRI compared with US, MDCT and dynamic phase MRI alone. The specificity and PPV of US was significantly lower than that of MDCT, dynamic phase MRI and dynamic + hepatobiliary phase MRI. Similar results were obtained for all sub-group analyses, with particular benefit for the diagnosis of smaller lesions between 1 and 2 cm.

Conclusions

Dynamic + hepatobiliary phase MRI improved detection and characterisation of HCC in cirrhotic patients. The greatest benefit is for diagnosing lesions between 1 and 2 cm.

Key Points

? US, CT and MRI can all identify HCC in cirrhotic patients ? US has good sensitivity but suffers from false-positive findings ? Dynamic CT and MR have similar diagnostic performance for diagnosing HCC ? Dynamic + hepatobiliary phase MRI significantly improves detection and characterisation of HCC ? The greatest benefit is for the diagnosis of lesions between 1 and 2 cm     

Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas

The efficacy of dynamic sequential CT with table incrementation during arterial portography (DSCTI-AP) in the detection of small hepatocellular carcinomas (HCC) (less than 3 cm in diameter and less than three in number) was analyzed in comparison with other imaging methods including radionuclide (RN) liver scans, ultrasound (US), CT, selective celiac angiography (SCA), and infusion hepatic angiography (IHA). The sensitivity of each study in detecting 19 cases of small HCC was as follows: RN, 16%; US, 63%; CT, 58%; SCA, 58%; IHA, 83%; and DSCTI-AP, 95%. Three of 19 cases were diagnosed only by DSCTI-AP and one case that could not be visualized by DSCTI-AP was opacified by IHA. Dynamic sequential CT with table incrementation during arterial portography was superior to IHA in visualizing small HCCs.