超短TE成像在肌骨系统中的应用

超短回波时间(UTE)脉冲序列可激发短T2成分并在其衰减之前快速采集其信号,它是直接显示短T2成分的一种成像方法。综述UTE脉冲序列成像的原理及其显示组织内短T2成分的优势,并介绍该脉冲序列成像在肌骨系统中的应用前景。     

三维超短回波时间MR成像检测犬肺栓塞的实验性研究

正摘要目的评估自由呼吸状态三维(3D)径向超短回波时间(UTE)MR成像检测肺栓塞(PE)的同时高质量评价肺实质的可行性。材料与方法该研究获得了动物保护委员会的许可。共12只猎兔犬在用自体血凝块诱发肺栓塞前后均进行了MRI及CT检查。在3 T MR进行了屏气3D血管成像及自由呼吸状态3D径向超短回波时间成像(1.0 mm各向同性空间分辨率;回波时间为0.08 ms)。2位放射医师采用盲法将MR血管成像及UTE成像获得的所有肺栓塞进行标记并按     

活体肝脏捐献者的肝脂肪变性:利用三回波MRI和~1H-MRS进行术前评估

正目的运用组织学结果作为参考标准来评估屏气T2*校正三回波损毁梯度回波水-脂分离MR成像(三回波)和T2校正多回波1H-MRS对活体肝脏捐献者的大泡性肝细     

超短TE成像在肌骨系统中的应用

超短回波时间（UTE）脉冲序列可激发短T2成分并在其衰减之前快速采集其信号，它是直接显示短T2成分的一种成像方法。综述UTE脉冲序列成像的原理及其显示组织内短T2成分的优势，并介绍该脉冲序列成像在肌骨系统中的应用前景。     

使用3.0T磁共振成像技术二维反转恢复超短回波时间和三维超短回波时间对半月板钙化形态和定量评价的可行性研究

摘要目的评价超短回波时间(UTE)MRI技术对不同类型半月板钙化的形态评估效果,将这些序列与标准的临床序列进行比较并测量半月板钙化的T2*值。方法该研究由机构审查委员会豁免,知情同意不是必需的。10具尸体的半月板行高空间分辨力X线摄影和3.0T的磁共振形态成像[T1加权快速自旋回波序列(FSE),T2加权FSE序列,质子密度加权(PD)的FSE序列,二维(2D)快速毁损梯度回波序列(FSPGR),三维(3D)FSPGR序列和3DUTE序列]以及定量成像[2D反转恢复(IR)UTE序列和3DUTE序列]。     

MRI超短回波时间序列评价关节软骨的研究进展

关节软骨损伤、变性是骨关节炎(OA)的首要因素,OA早期软骨生化成分最先发生改变,软骨结构逐渐破坏。传统MRI序列的回波时间(TE)较长,采集不到短T_2/T_2~*软骨组织的信号,而超短回波时间(UTE)序列采用超短TE可实现对短T_2/T_2~*的深层软骨和软骨钙化层的直接观察及对其生化组成的定量研究,在探讨OA发生机制及早期诊断中有较好的应用前景。对UTE序列在关节软骨变性早期的定量研究进行综述。     

MRI三维超短回波时间双回波脉冲序列在骨与关节成像中的初步应用

目的 探讨MR三维超短回波时间(UTE)的双回波脉冲序列成像在骨与关节中的应用.方法 分别对7名健康志愿者和1名可疑左膝关节外侧半月板撕裂志愿者的胫骨干、膝关节、踝关节、腕关节及一段离体猪腓骨行MR三维UTE的双回波脉冲序列成像.将原始双回波图及多平面重组后的双回波图的前后2个回波相减获得相减后的差异图,比较2种图像处理方法的信噪比.将踝关节跟腱的UTE双回波成像的第1个回波时间(TE1)分别设置为0.08、0.16、0.24、0.35 ms,对比不同TE1时间2个原始回波相减所得的差异图的图像质量.对踝关节肌腱的TE1为0.08 ms的原始回波图相减后的差异图行最大强度投影获得肌腱的三维空间图.对获取的数据进行单因素方差分析和配对资料t检验.结果 通过对原始回波图相减后的差异图行最大强度投影显示了肌腱的三维空间分布图.8名志愿者的骨皮质、骨膜、肌腱和半月板在超短TE的双回波脉冲序列成像上表现为高信号.将原始双回波图(信噪比为2.82±0.75)行多平面重组后再减影(信噪比为3.76±0.88)可增加图像信噪比(t=-4.851,P<0.01).踝关节跟腱的不同TEl成像的图像质量不同,TE1为0.08 mg的图像质量最高,在TE1分别为0.08、0.16、0.24、0.35 ms时,对比噪声比分别为1.74±0.54、1.35±0.60、1.20±0.48、0.89±0.24,差异有统计学意义(F=3.681,P<0.05).随着成像时间的延长,伪影逐渐增多.结论 三维超短TE的双回波成像能显示传统的临床MR成像序列不能显示的主要含短T2成分的组织,为对这些组织的进一步量化研究奠定了基础.     

软骨终板:短回波时间定量MRI-方向依赖性及与生化组成的关系

摘要目的以短回波时间MR成像测量人软骨终板的T2*,并确定终板的方向对T2*和T2*与生化组成间关系的影响。材料与方法本研究不需要经机构伦理委员会批准,无需     

脊椎关节炎病人的跟腱成像:超声与增强前、后的常规以及短和超短回波时间MRI的比较

目的比较常规、超短回波时间MRI和超声评估脊椎关节炎病人跟腱病变的范围。方法应用MRI和超声研究25例脊椎关节炎并有跟腱症状的病人。静脉注射对比剂前后分别使用T1加权自旋回波、梯度回波和超短回波时间序列(TE选择0.07～16ms)来获得跟腱的MR影像。同时也进行     

7 TMRI~(23)Na抑水反转恢复序列评估软骨修复组织初步研究

正摘要目的使用7T径向三维(3D)超短回波时间(UTE)23Na MR序列评价软骨修复组织及原有组织,评价方法包括使用及不使用抑水反转恢复(IR)序列。方法本研究由机构审查委员会批准。连续11例[(41.5±11.8)岁]接受过膝关节软骨修复术的矫形骨科病人被纳入研究,术后(中位时间为26周)     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

多虑平、雷尼替丁治疗消化性溃疡81例临床观察

1995年 1月～ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (ＰＵ) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1　临床资料1 1　一般资料　本组 81例ＰＵ均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月～ 5ａ,平均 1 7ａ。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8～ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9～ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2…     

臭氧治疗船员下肢损伤89例

2006年10月至2007年4月,我科采用引进的德国赫尔曼Medozon型臭氧发生装置系统产生的臭氧治疗船员下肢损伤89例,疗效满意.现报告如下.     

Tumor Burden Assessment with Positron Emission Tomography with

Objective: In patients with advanced cancer, total tumor burden affects the likelihood of tumor response and has important implications for prognosis. The aim of this study was to select the optimum 2-[F-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) tumor uptake parameter to accurately measure tumor burden in advanced metastatic renal cell cancer, in comparison with volumes measured with computed tomography (CT), as a reference test.Materials and Methods: Six patients with metastatic renal cell carcinoma measurable on CT were studied. CT and FDG PET scans were carried out on all patients within 4 weeks prior to their entry into a phase I-II radioimmunotherapy trial. CT-based evaluation of disease extent (tumor volume) and 4 PET-based measurements (standardized uptake value[SUVmax], SUVav, volume, and total lesion glycolysis [TLG]) were performed independently by a radiologist (VN) and a nuclear medicine physician (TA). The degree of correlation between conventional (CT) extent of disease and parameters describing tumor concentration of FDG was then determined.Results: Fifty-seven CT-measurable metastatic lesions in lung, abdomen, and scalp were evaluated in 6 patients. There was a high correlation between CT and FDG PET volume estimates for lesions greater than 5 cm(3) in size. However, a PET-derived parameter that embodies both FDG uptake and lesion size, the TLG, correlated better with CT-derived tumor volume than did FDG PET volume alone.Conclusion: Using CT volume as a gold standard, the optimal PET-based estimate of total tumor burden in patients with metastatic renal cancer is the sum over all lesions of the total lesion glycolysis.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。