脑白质疏松与老年性运动功能障碍相关性的MR研究

目的：探讨年龄大于65岁的老年人运动功能障碍在有脑白质疏松患者及正常老年人中的发生率，可能的发病机制及临床意义。方法：将年龄大于65岁的210例患者行MR检查发现脑白质疏松患者110例作为异常组，无脑白质疏松者100例为对照组，然后按照Stabilogram分析法行运动功能检查，将二组运动功能障发生率进行对比。结果：异常组中运动功能障碍发生率为69．1％，明显高于正常组发生率14％。结论：脑白质疏松与老年性运动功能障碍有明显正相关性。     

SWI在糖尿病患者伴发脑内微出血中的诊断应用

目的：通过磁敏感加权成像（SWI）检查,探讨糖尿病患者伴发脑内微出血（CMBs）的发生率,以及其与血糖水平、急性脑卒中、白质疏松程度等的相关性。方法：61例糖尿病患者中单纯糖尿病21例,糖尿病合并高血压40例。患者均行T2wI、T1wI、DwI及ESWAN序列SWI扫描,统计CMBs发生率、数目、分布。分析CMBs与其它,临床表现和影像学表现的相关性。结果：61例中有15例检出CMBs（发生率24．6％）,均发生在糖尿病合并高血压组,单纯糖尿病组未发现CMBs。糖尿病伴有急性脑卒中患者33例,其中13例发生CMBs（发生率为39．4％）。15例脑内有CMBs组与46例脑内无CMBs组的血糖水平（最高值、最低值、控制值）、年龄和病程采用t检验进行比较,发现有CMBs组平均空腹血糖最低值低于无cMBs组,且差异有统计学意义（t=0．046,P〈0．05）;61例患者按脑白质疏松程度分为4组,采用Fisher’s精确概率法检验,发现各组的CMBs发生率不N,且差异有高度统计学意义（P〈0．01）。结论：swI能清晰显示糖尿病患者CMBs;单纯糖尿病患者不易发生CMBs,糖尿病合并高血压CMBs发生率明显增加;糖尿病患者伴有急性脑卒中和脑白质疏松时易发生CMBs。     

脑白质疏松MR成像与临床对照研究

目的；探讨脑白质疏松的ＭＲＩ表现并与临床对照分析。材料与方法：搜集资料完整经ＭＲＩ诊断为脑白质疏松者１００例，男７１例，女２９例，年龄４９￣８０岁，平均６６岁。根据ＭＲＩ所见和病壮部位，将脑白质疏松分为两大类、０￣Ⅲ级。比较临床症状、脑血管病变与脑白质 的关系。     

中枢神经系统结核的CT及MRI诊断：附67例报告

本文报道了６７例中枢神经系统结构的ＣＴ及ＭＲＩ表现，其中结构性脑膜炎３８例，脑结核瘤１８例，结核性脑膜炎合并结核瘤５例、合并脊髓蛛网膜炎６例。头颅ＣＴ对病变显示率不８４．６％。病损类型有基底池渗出物、脑积水、结核瘤、脑梗塞、脑萎缩及基底池钙化等。增强ＣＴ扫描应列为常规检查。４例结核性脊髓蛛网网ＭＲＩ扫描，显示蛛网膜下腔闭塞消失，髓内外结核瘤、脊髓受压或肿胀及晚期空洞形成，此类影像表现既往国内文献无     

脑白质稀疏症的影像诊断

作者分析１００例脑白质稀疏症的临床、ＣＴ、ＭＲＩ及ＳＰＥ ＣＴ影像资料。发现其临床特征：为卒中反复发作并呈进行性进展（占４２％）、高血压（占６５％）、感觉或（和）运动障碍（占６３％）、智力及精神障碍（占２１％）。ＣＴ表现为大脑白质深部弥漫性不均匀低密度区，累及额叶（１００％）、枕叶（８５％）、顶叶（７０％）、半卵圆中心（６３％）及脑干（３％），并伴有不同程度脑室扩大、脑萎缩和多发性脑梗塞。在ＭＲＩ     

中枢神经系统结核的CT及MRI诊断

本文报道了６７例中枢神经系统结核的ＣＴ及ＭＲＩ表现，其中结核性脑膜炎３８例，脑结核瘤１８例，结核性脑膜炎合并结核瘤５例、合并脊髓蛛网膜炎６例。头颅ＣＴ对病变显示率为８４．６％，病损类型有基底池渗出物、脑积水、结核瘤、脑梗塞、脑萎缩及基底池钙化等。增强ＣＴ扫描应列为常规检查。４例结核性脊髓蛛网膜炎ＭＲＩ扫描，显示蛛网膜下腔闭塞消失、髓内外结核瘤、脊髓受压或肿胀及晚期空洞形成，此类影像表现既往国内文献无系统报道。ＣＴ及ＭＲＩ各有长短，其定性价值仍需密切结合临床及脑脊液检查     

AIDS相关性脑炎的CT及MR影像对照分析

目的探讨AIDS相关性脑炎的CT和MR表现及两种检查方法在诊断中的敏感性及一致性差异。方法回顾性分析我院近3年来31例AIDS相关性脑炎的影像学资料。全部病例均行螺旋CT平扫及MR平扫,其中5例同时做MR加做增强扫描。比较两种方法对AIDS相关性脑炎的征象显示能力。结果在31例AIDS相关性脑炎病例中,CT扫描提示单纯脑萎缩8例,单纯脑白质病变2例,脑萎缩合并脑白质病变21例;MR扫描提示单纯脑萎缩2例,单纯脑白质病变2例,脑萎缩合并脑白质病变27例。结论对于脑萎缩的显示,CT和MR敏感性无明显差异;而对于脑白质病变的显示,MR敏感性优于CT,二者呈中度一致性。     

皮层下动脉硬化性脑病的CT诊断

目的探讨皮层下动脉硬化性脑病的CT诊断价值。方法回顾分析50例经我院CT诊断并治疗的皮层下动脉硬化性脑病。结果50例均呈弥漫性脑白质对称性低密度改变，并不同程度脑萎缩，48例伴腔隙性脑梗塞。结论皮层下动脉硬化性脑病是中老年人的常见脑血管病病，CT表现具有特征性，可明确诊断，可早期发现该病，是目前诊断本病的首选方法。     

小脑卒中的MR表现及价值（附36例分析）

本文报告３６例小脑卒中，其中梗塞３０例，出血６例。本组临床诊断率１９％，ＣＴ诊断率２６％，ＭＲ均做出正确诊断。小脑梗塞最易发生在小脑后下动脉供应区，常合并幕上脑梗塞、脑干梗塞及脑萎缩。ＭＲ的典型表现为Ｔ１加权像呈低、Ｔ２加权像呈高信号强度灶。小脑出血在亚急性期呈特征性的分层结构。     

动脉硬化性脑白质病的CT表现与临床分析

目的 :探讨动脉硬化性脑白质病的临床与CT表现特点。方法 :收集 10 0例动脉硬化性脑白质病的临床与CT资料进行综合分析。结果 :10 0例的CT表现为 :弥漫性脑白质低密度改变 ,主要分布在双侧脑室旁及半卵圆中心白质区 ,病灶多呈条带状及月晕状。合并脑萎缩 90例 ;脑梗塞 76例 ,其中 2 5例有大的梗塞灶 ,其余为腔隙性梗塞 ;脑出血 9例 ,其中位于壳核 5例 ,丘脑 3例 ,小脑 1例 ;有 15例伴发基底节区软化灶。增强扫描 8例 ,显示病灶无明显增强。结论 :动脉硬化性脑白质病是发生于老年人的缺血性脑血管病 ,高血压动脉硬化是其主要发病因素。     

十六排螺旋CT血管造影对颅内病变的应用价值初探

目的：探讨十六排螺旋CT血管造影在颅内病变中的应用价值及其技术优势。材料和方法：采用GE公司的Lightspeed十六排螺旋CT对自发性脑内出血、动脉瘤、脑肿瘤等共76例病人行CTA检查，对血管显示情况进行评价。其中1例AVM和2例动脉瘤进行了DSA检查并与CTA结果比较，另外7例颅内及颜面部AVM及7例脑肿瘤病人与手术结果比较。结果：76例病人CTA检查结果如下：脑血管主干及其1～3级分支显示率为100％，大脑中动脉4～5级分支显示率为94．7％(72／76)。发现动脉瘤6例，清晰显示了瘤体、瘤颈、载瘤动脉及其详细关系；9例AVM，清楚地显示了AVM的畸形团及其供血动脉和引流静脉；7例脑肿瘤显示了肿瘤与周围血管、颅骨间的三维关系；Moyamoya病1例，清晰显示了基底节区的烟雾血管。结论：十六排螺旋CT血管造影重建图像质量明显提高，可显示更细小分支，对颅内各种血管性病变的诊断及显示血管与颅内其他病变三维空间关系具有重要价值，可作为动脉瘤等其他血管性病变筛选的首选方法。     

Acute massive subdural hematoma caused by rupture of internal carotid artery aneurysm during angiography: a case report

We present a case of acute, massive subdural hemorrhage caused by rupture of an internal carotid artery aneurysm during the procedure of cerebral angiography. To our knowledge, a case like the present one has been reported only once in the English-language literature. The incidence, mechanisms, treatment, and prognosis of (1) subdural hematoma, caused by rupture of cerebral aneurysm, and (2) re-rupture of aneurysm during the angiography procedure are discussed. Electronic Publication     

Measurement of regional cerebral blood flow and oxygen utilisation in patients with cerebral tumours using 15O and positron emission tomography: Analytical techniques and preliminary results

Summary Regional cerebral blood flow and oxygen utilisation have been studied in 8 patients with brain tumours using continuous inhalation of C¹⁵O₂ and ¹⁵O₂ and positron emission tomography. The methods used to analyse the regional cerebral pathophysiology are presented. A relative uncoupling between oxygen consumption and blood flow was observed in all tumours as indicated by a decreased regional fractional extraction of oxygen (rOER). This suggests that a major proportion of these tumours had sufficient blood supply to meet oxygen metabolic demand. A decrease of blood flow in grey matter was found both in the affected and contralateral hemispheres of the brain. Matched reductions of flow and oxygen utilisation were observed in oedematous tissue.     

Peripheral vascular gunshot bullet embolus migration to the cerebral circulation

Summary Bullet embolization to intracranial branches of the major cerebral arteries is a rare complication of gunshot wounds. A review of the literature on cerebral vascular bullet embolization from peripheral sources revealed a number of single case reports that included 12 cases involving the anterior cerebral circulation, and one which involved the posterior circulation. This communication details two additional subjects who were treated at our institution.     

新生儿缺氧缺血性脑病的MRI评价

目的：评价MRI对新生儿缺氧缺血性脑病（HIE）的诊断价值。资料与方法：采用SE序列对61例（65例次）HIE患儿进行了MRI检查，分析MRI表现。结果：56例新生儿期检查中脑水肿42例，内囊后肢信号异常22例，脑出血11例，脑室出血4例，脑室旁白质软化2例。9例婴儿期检查者中表现有脑室扩大7例，脑外间隙增宽9例，髓鞘发育延迟3例。结论：MRI有助于明确HIE的脑损伤情况，对于预后的评估有价值。     

脑血管病患者血清一氧化氮合酶水平变化的临床观察

 目的探讨血清中NOS水平的变化与脑血管病发病的关系.方法利用比色法测定27例脑梗塞、15例脑出血和30例健康人血清中NOS水平.结果脑梗塞组与对照组比较,脑出血组与对照组比较,血清中NOS均明显降低,经统计学处理有显著差异(P＜0.01);脑梗塞组与脑出血组比较则无明显差异(P＞0.05).结论脑血管病的发生与血清中NOS水平的降低有关.     

Silent microemboli related to diagnostic cerebral angiography: a matter of operator’s experience and patient’s disease

Introduction The aim of the present investigation was to elucidate in a large consecutive patient cohort whether the level of training has an effect on the number of microemboli detected by diffusion-weighted imaging (DWI) and which additional risk factors can be identified.Methods A total of 107 consecutive patients in whom a diagnostic cerebral angiography had been performed were prospectively investigated with DWI; 51 angiographies were performed by experienced neuroradiologists, 56 by neuroradiologists in training. Results In 12 patients (11.1%), a total of 17 new lesions without any clinically overt neurological symptoms were identified. Of these, 12 patients, 11 (91.7%) with 16 lesions were investigated by junior neuroradiologists. In 11 of 12 patients with DWI abnormalities (91.7%), risk factors could be identified (atherosclerotic vessel wall disease, vasculitis, hypercoagulable states). Experienced neuroradiologists performed 21 of 48 angiographies (43.8%) on patients with the above-mentioned risk factors, whereas junior neuroradiologists performed 27 angiographies in this subgroup (46.2%). The rate of diffusion abnormalities in patients with risk factors was 11/48 (22.9%)—considerably higher than in patients without risk factors (1/59; 1.7%).Conclusion The level of experience and the nature of the underlying disease are predictors of the occurrence of cerebral ischemic events following neuroangiography. Alternative diagnostic modalities should be employed in patients who are investigated for diseases with the highest risk of angiographic complications (i.e., vasculitis, and arteriosclerotic vessel wall disease). If diagnostic angiography remains necessary in these patients, the highest level of practitioner training is necessary to ensure good patient outcome.     

脑分水岭梗死血管造影分析

目的:分析脑分水岭梗死(CWI)血管造影的表现,探讨脑分水岭梗死与脑血管狭窄的相关性。方法:回顾性分析32例经CT或MR证实的CWI患者的脑血管造影表现。结果:32例CWI患者中发现28例(87.5%)有脑血管狭窄或者闭塞,4例(12.5%)血管造影正常。前循环大脑中动脉和颈内动脉受累最为常见。后循环受累的血管中以椎动脉最为常见。结论:脑分水岭梗死血管造影显示大部分患者有肯定的脑血管狭窄或者闭塞,及时行脑血管造影检查有利于指导治疗,判断预后。     

瘀血性脑血管病的脑血流灌注改变:初步经验

目的:探讨瘀血性脑血管病(CCVD)的脑血流灌注变化特点。方法:收集2006年~2009年间在我院经MR增强扫描和临床其他检查确诊的CCVD病例13例,其中颅内静脉窦血栓形成(DVT)8例,有脑水肿并发症的脑发育性静脉异常(DVA)5例,伴有静脉性脑梗死6例(均为DVT病例)。脑血流灌注成像采用磁共振动态磁敏感对比增强灌注加权成像(DSC-PWI),原始数据传送至GE AW4.3工作站做图像后处理,得到平均通过时间(MTE)、负性增强积分(NEI)、达谷时间(TTM)和最大下降斜率(MSD)伪彩图。将脑病变分为两组,即静脉性梗死(VI)组和脑水肿(BE)组,比较两种不同病灶的血流灌注参数的异同。收集同期急性动脉性脑梗死(AI)病例9例,用同样方法比较AI与VI病灶血流灌注变化的异同。结果:在CCVD,VI和BE灶的MTE和TTM均增大,两组间差别无显著意义;但NEI和MSD两组间存在显著差异,在VI灶两参数均显著降低,而BE灶则有的升高,有的降低,改变不一致。在VI和AI的对比中,各灌注参数的变化趋势是一致的,虽然AI的MTE延长和NEI降低幅度更大,但统计学上差别无显著意义。结论:在CCVD,VI和BE灶的血流灌注值有显著差异,NEI和MSD的显著降低可能是脑血流灌注失代偿的反映。无论是VI还是AI,其血流灌注参数呈相同的变化趋势,提示脑血流灌注失代偿期的相同结果。     

Neoplastic encephalopathy: dynamic CT of cerebral gliomata

Summary Intravenous contrast enhanced dynamic computed tomography of cerebral gliomata reveals a spectrum of patterns which reflect different degrees of neovascularity as well as a variable breakdown in the blood-tumor-barrier both intratumorally as well as between individual tumors. Phenomena not generally associated with gliomas including intrinsic neoplastic and peripheral cerebral hypoperfusion, hyperperfusion, and indications of vascular stealing are also demonstrated with this technique which conceivably explain and are partially responsible for certain aspects of the encephalopathy accompanying cerebral neoplasia. A comparison of the dynamic sequences with conventional selective cerebral angiography further indicates that the more contrast-sensitive dynamic method is potentially superior in the detection of subtle neovascularity.