颈椎的MR成象:神经血管的解剖

高分辨率的表面线圈MR成像揭示了颈椎椎管和其内的神经血管复杂的解剖细节。该部正常的MR各种层面成像与相应的大体冰冻切片法之所见相似。以往CT检查静脉内团注造影剂可良好显示硬膜前静脉丛这一主要结构,T_1加权法MR旁矢状面和轴位成像也可在椎管的前侧隐窝内恒定地见到。当颈椎间盘病变时有大范围的静脉网扭曲。轴位成像还能使走行于蛛网膜下腔的神经根腹、背侧得以显示,但MR成像可能难以确定明显的神经孔病变,因而它作为灶性神经根病变的手段仍有争议。颈椎间盘突出在CT上常见到硬膜前静脉丛移位,作者的实验中有10例急性椎间盘突出的MR出现类似表现。T_1加权法成像上静脉丛的强信号与     

肝微粒血管造影术

本报告叙述了肝微粒血管造影术在评价肝病变中的作用。一个51岁的老年妇女,在右上腹部有一个无痛性肿块,已确诊为不能手术的肝脏腺癌。肝病变的治疗为间歇性动脉内化疗,药物是通过经外科手术     

原发性痛经患者神经血管耦合功能的MR研究

目的 探讨原发性痛经(PDM)患者神经血管耦合功能的变化.方法 纳入PDM患者31例和健康女性37例(健康对照组).收集2组的人口统计学数据及临床资料,并行功能磁共振成像(fMRI)检查.分别应用低频振荡振幅(ALFF)和脑血流量(CBF)2个影像学指标分析2组间CBF/ALFF比值的差异,提取组间显著差异脑区的CBF...     

正常前列腺周围血管神经束的MR解剖研究

目的 探讨前列腺两后外侧血管神经束(neurovascular bundle,NVB)的磁共振影像解剖,从而为避免下尿路手术所导致的并发症提供参考价值.方法 选择20例成年健康男性志愿者,无基础疾病及下腹部手术史,采用3.0T磁共振行常规前列腺成像,分析T1WI与T2WI对NVB的显示情况并对其分组,采用Wilcoxon秩和检验,P<0.05认为结果有统计学意义.NVB显示评分为:1分显示不清,2分显示良好,3分显示佳.结果 前列腺后外侧NVB于T1WI与T2WI序列上均呈低信号改变,以T1WI显示更为清晰(P=0.002),并根据MRI上20例40侧NVB的显示情况将其分为3组,A组:前列腺后外侧明确见NVB共31(31/40)侧为3分,B组:前列腺后外侧隐约可见走行的NVB共5(5/40)侧为2分,C组:NVB未在前列腺后外侧明确显示共4(4/40)侧为1分.结论 MRI可清晰显示大多数前列腺后外侧血管神经束的走行区域,能够为临床下尿路手术提供重要的解剖学借鉴.     

儿童脑神经血管病变的MR血管成象检查:31例表现

作者对31例临床疑为颅内病变或血管畸形的儿童进行了MR血管成象检查。应用1.5T MR装置,使用直径30cm的圆形头极化线圈。先摄矢状象,而后应用自旋回波技术获得横断T_1、T_2加权象。横断成象时需在层面下预置一饱和层,以消除运动性伪影。扫描野为20cm。其中11例颅内肿瘤患儿静注Gd-DTPA后行T_1加权检查。MR血管成象采用三维傅立叶转换、梯度重复回波序列。其中稳定进动三维快速成象法(FISP)用于显示流速快的血管;二维或三维快速小角度脉冲序列(FLASH)用于显示流速慢的血管。成象参数:TE=7ms,TR     

MR灌注成像在评价神经胶质瘤肿瘤血管中的价值

目的　运用磁共振灌注成像 (PWI) ,探讨肿瘤血流容积在术前评估胶质瘤组织学分级中的价值。并与微血管密度 (MVD)对照 ,评估二者的相关性。方法　共搜集了 3 2例神经胶质瘤 ,均系常规MR扫描后 ,在首过期间行PWI ,通过非弥散示踪模式 ,获得局部相对脑血流容积 (rCBV)彩图 ,并计算肿瘤局部血容量。用免疫组织化学检测技术测量MVD ,以判断血管形成活性。将rCBV、rCBV比值与术后病理分级 ,以及rCBV与MVD进行统计学分析。结果　分级高的胶质瘤 ( 18例 )rCBV比值在 5 3 0～ 14 80之间 ,均值为 8 3 2± 1 68。分级低的胶质瘤 ( 14例 )rCBV比值在 0 89～ 5 40之间 ,均值为 2 93± 1 19。经组间t检验 ,两组rCBV比值均数差异有非常显著性意义 (t=9 618,P =0 0 0 0 )。分级高的胶质瘤rCBV值在 43 55～ 2 90 54之间 ,中位数为 113 60。分级低的肿瘤rCBV值在 9 66～168 76之间 ,中位数 2 8 84。经组间Wilcoxon检验 ,两组rCBV值差异有非常显著性意义 ( |Z| =4 0 2 7,P =0 0 0 0 )。rCBV和MVD的关系用线性回归分析 ,二者密切相关 (r =0 87,P <0 0 0 1)。结论　胶质瘤MR灌注成像与病理分级和MVD有良好的相关性 ,和常规MR联合应用 ,可显著提高胶质瘤术前分级的准确性 ,有效指导治疗方案的选择 ,有助于判断预后     

肾血管畸形MR血管成像

肾脏动静脉畸形比较少见,然而却可造成持续性大量血尿,需要手术治疗。MR血管造影为非损伤性方法,可以显示畸形血管巢及测量动静脉的血流。作者使用0.5T超导型MR机检查了22例有肉眼血尿的患者,年龄18～52岁,排除肾病综合征和其它肾病。先行常规或数字减影血管造影及CT检查,证实没有肿瘤和尿路结石。膀胱镜检证实血液是从两侧     

Perthes病的血管造影术

作者对30例Perthes 病患者(男27例,女3例,年龄4～13岁)进行了选择性血管造影或经腰部主动脉造影,有2例对正常髋及患髋均进行选择性动脉造影,还有4例为双侧病变,行主动脉造影使两侧髋部血管均显影,通过对较小动脉如旋股内、外侧动脉插管行选择性造影,使一侧髋部的小血管较清晰地显影。作者见到,主动脉造影发现患髋的动脉血管网显影不良,血管减少。但双侧病变者无意义。动脉血管网造影剂充盈和排空延迟,提示血流动力的减弱。严重者还发现血管口径变细。还可出现旋股内     

MR 间接关节造影术诊断肩袖病变

目的：回顾性研究评价肩袖(RM)病变MR间接关节造影术的价值,并与关节镜检相比较。方法：对疑有肩部病变的63例病人检查：斜冠状位和轴位T1序列平扫、轴位FLASH-2D序列以及斜冠状位T2W和PDW序列。静脉内给予0.1mmol Gd-DTPA/kg体重后,肩部主动活动和重复T1序列,借助感兴趣区(ROI)技术定量测量肌腱内的信号强度(SI)和衡量对比剂增强CE。在32例病人其结果经关节镜证实。结果：冈上肌腱的平均信号强度(SI),在给对比剂前后,在各种病变(退化、撞击、不完全撕裂和完全撕裂)明显高于正常结果(P＜0.05)。同样,按百分比计算的对比增强(CE)也是如此(P＜0.05)。检出了9例完全撕裂和3例撞击综合征患者(平扫/增强后二者敏感性100％)。诊断了6例不完全破裂,其中3例假阳性,1例假阴性;敏感性75％,特异性50％。结论：MR间接关节造影术改善了RM病变的影像表现。然而用它探查不完全撕裂也有欠缺,因为要确切区分肌腱的退变与不完全撕裂还很困难。 华中科技大学同济医学院附属同济医院汪玲译胡国栋校 摘自 Fortschr Rontgenstr 2000,172:686-691     

并行采集技术MR血管成像对内脏动脉的评估:与常规MR血管成像和64层CT的比较

<正>本研究的目的是用64层CT血管成像(MDCTA)作为参考标准,回顾性比较三维钆增强MR血管成像(常规MRA)与加速并行采集技术的MRA(快速成像MRA)对内脏动脉评估。18例病人在腹部和盆腔分别进行快速成像MRA(成像时间17s)、常规成像MRA(成像时间29s)和MDCTA。分别由2名阅片者独立评估主观影像     

颈内动脉虹吸段常规MR成像

作者回顾了三年期间100例连续检查的头部MR病例,均于MR检查的一周内作了至少颈内动脉一段的选择性动脉造影,采用DSA或传统的胶片减影技术。年龄14—86岁。MR用0.5T(78例)或1.5T(22例)装置,短TR/TE矢状扫描(600-800/24-30)和长TR(2000—2800/80)双回波横断扫描,第一回波以24—30获取。用0.5T者,层厚10mm,用1.5T者,层厚5mm,间隔2mm,矩     

数字减影肺血管造影术

作者等所作的2,110例数字减影血管造影(D-SA)中,220例(10.5%)为肺动脉的静脉数字减影血管造影(IVDSA)检查。其中206例(94%)用于肺动脉栓塞的诊断,其他为肺动脉的扩张、肿瘤、气胸、Blalock-Taussig 术后和肺动脉高压等。以离子型和非离子型造影剂20～25毫升以每秒15毫升的速度自肘静脉注入。应用导管自中心静脉     

多层螺旋CT血管造影术

198 9年 ,单层螺旋ＣＴ(ＳＣＴ)应用于临床 ,开创了ＣＴ容积扫描模式 ,在此基础上开发的图像后处理软件 ,实现了ＣＴ血管造影术 (ＣＴＡ)。ＣＴＡ是一种非创伤性的评价血管系统的检查方法。ＳＣＴ对主动脉、肺动脉等大血管的检查已部分取代了常规血管造影术 ,但在较大范围的中小血管应用有一定的局限性 ,主要原因有 :(1)图像的Ｚ轴分辨率低 ,难以克服部分容积效应和阶梯状伪影 ;(2 )扫描速度相对较慢 ,图像伴有运动伪影 ;(3)球管热容量低 ,限制了扫描范围。ＳＣＴ的设计特点决定了ＣＴＡ的上述特性。通常ＳＣＴ是采用扇形射线束 ,探测器为单…     

常规MRI和三维对比增强MR血管成像对门肠系膜静脉血栓的诊断

目的 探讨常规MRI和三维对比增强MR血管成像(3D CE MRA)在门肠系膜静脉血栓诊断中的价值.资料与方法 回顾性分析经临床、手术证实的14例门肠系膜静脉血栓的平扫、增强MRI和3D CE MRA资料.结果 14例中,门肠系膜静脉及分支累及10例,门静脉及分支累及2例,2例仅累及肠系膜上静脉及分支;其中5例并发侧支血管形成.3D CE MRA准确地显示了相应病理解剖改变;平扫MRI能够显示门静脉、肠系膜上静脉主干内的血栓,但难以确切显示门肠系膜静脉属支、门静脉肝内分支血栓和较小血栓;增强后快速扰相稳态梯度回复采集序列(FSPGR)图像由于血管内和血管壁的强化及更高信噪比可更好地显示血栓.结论 平扫时重视对血管形态的观察有利于发现血栓,同时行3D CE MRA及增强后FSPGR,可以准确地诊断门肠系膜静脉血栓,为临床提供重要的诊断信息.     

非增强SSFP MR血管成像与常规增强MR血管成像对于胸主动脉疾病的成像质量和诊断准确性的对比性研究

<正>目的评价三维(3D)非增强稳态自由进动序列(SSFP)MRA对胸主动脉疾病的影像质量和诊断准确性。方法应用1.5T MR设备对50例确定或怀疑为胸主动脉疾病的病人行胸部自由呼吸心电门     

钆增强MR血管造影

作者用Gd-DTPA分别对为脑膜瘤、松果体瘤和突出之颈静脉球各1例作增强检查。采用1.5T超导MRI装置,三维速率补偿稳态进动快速成象(FISP)。序列参数包括翻转角20°,TR/TE=40/8msec,一次采集,矩阵256×256,有效截面厚度为1.25～3.125mm,象素1×1mm。全部病例均采用头部接收线圈。增强时,一般Gd-DTPA用量为0.2mmol/kg,10min内间歇注入。注完     

肺血管MR成像研究进展

磁共振血管成像是研究血管的成像技术,通过显示正常和异常的血管结构可以对心脏病、中风和血管性病变进行检测、诊断和辅助治疗.随着MRI成像技术的快速发展,MRA在肺部的应用越来越多.本文主要针对MRA成像方法的发展、在肺部疾病中的应用现状、MRA的优缺点及其发展方向等方面作一综述.     

颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

目的 探讨颅神经血管压迫症的MR血管断层成像(MRTA)的表现与微血管减压术疗效之间的相关性.方法 回顾性分析223例行颅神经微血管减压术的患者,根据患者MRTA中的血管对神经的压迫程度和术后疗效进行分组、分级.223例患者分为无压迫组、轻度压迫组及重度压迫组;微血管减压术疗效分为3级,Ⅰ级为完全缓解、Ⅱ级为基本缓解,Ⅲ级为无缓解.用秩和检验的Kruskal-Wallis法比较无压迫组、轻度压迫组及重度压迫组各组间的手术疗效有无统计学差异;用Nemenyi法作各组间手术疗效优劣的两两比较.结果 微血管减压术后缓解程度,无压迫组Ⅰ级为31例,Ⅱ级为13例,Ⅲ级为9例;轻度压迫组Ⅰ级为95例,Ⅱ级为11例,Ⅲ级为4例;重度压迫组Ⅰ级为48例,Ⅱ级为7例,Ⅲ级为5例.三组之间手术疗效的差异具有统计学意义(秩和检验值χ2=16.84,P<0.05).无压迫组、轻度压迫组与重度压迫组的平均秩次分别为134.21、102.37及110.04.轻度压迫组、重度压迫组与无压迫组的平均秩次之差分别为31.84、24.17,P值均<0.05.结论 微血管减压术疗效与术前MRTA的表现具有密切相关性;轻度压迫组和重度压迫组的手术疗效优于无压迫组;MRTA对于微血管减压术适应证的选择及手术预后有指导作用.     

颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.     

颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.