肝豆状核变性脑部MRI与临床相关性探讨

目的 :探讨肝豆状核变性脑部 MRI改变及其与临床的关系。方法 :对 9例经临床及化验证实的肝豆状核变性患者的脑部 MRI表现进行了分析。结果 :发病部位依次为壳核 10 0 % ;苍白球 88.8% ;红核 77.7% ;黑质 77.7% ;丘脑 6 6 .6 % ;齿状核 33.3% ;桥脑 2 2 .2 %。脑部 MRI主要改变为铜沉积所致的继发性长 T1 低信号和长 T2 高信号 ,由铜沉积顺磁作用直接引起的短 T2 低信号出现较少。结论 :肝豆状核变性脑部改变以继发为主 ,MRI表现与临床症状具有一定相关性意义。 FSEIR是显示病灶的最佳序列     

获得性肝性脑部变性的影像学诊断及临床分析

目的 研究获得性肝性脑部变性(AHCD)的CT和MRI表现.方法对20例经临床、CT和MRI诊断后随访确诊的病例进行分析,其中10例同时行腹部MRI或CT扫描.结果 20例 AHCD中,MRI均示有异常改变:主要显示基底节及脑干区快速自旋回波(TSE)T1WI对称性高信号,其中双侧苍白球19例,壳3例,尾状核5例,中脑红核周围15例,大脑脚5例、脑桥3例,垂体前叶8例.TSE T2WI信号正常12例,稍高信号6例,高信号2例,扩散加权信号正常15例,高信号5例.结论 MRI T1WI双侧基底节及中脑等部位出现高信号影,是AHCD较为特征性的影像学表现,MRI是发现这些病变最敏感的方法.结合临床病史,绝大部分病例可明确诊断.     

肝豆状核变性的颅脑MRI表现及临床应用

目的 分析肝豆状核变性的颅脑MRI表现,评价MRI对肝豆状核变性的临床应用价值.资料与方法 回顾性分析经临床证实的82例肝豆状核变性患者的颅脑MRI资料,其中22例行DWI检查,12例行增强扫描.结果 颅脑MRI无异常发现12例,有异常发现70例,阳性率为85.4%.脑MRI异常信号发病部位依次为豆状核(63/70)、中脑(23/70)、丘脑(21/70)、桥脑(21/70)、尾状核头(15/70)、额叶(5/70)、齿状核(5/70)、胼胝体压部(4/70)、小脑中脚(1/70)、枕叶(1/70).病灶以长T1、长T2信号为主,有4例双侧苍白球等部位显示短T1、短T2信号;1例脑内广泛受累;13例显示软化灶;脑萎缩54例,其中5例仅表现为脑萎缩.结论 MRI对肝豆状核变性有很高的诊断价值,可为临床提供早期诊断和治疗依据.     

磁共振壳核面积测量对帕金森病和纹状体黑质变性的鉴别诊断意义

目的通过MRI壳核面积测量为纹状体黑质变性(SND)和帕金森病(PD)两种临床容易混淆的疾病提供了一个可靠的鉴别方法。方法回顾性分析经临床诊断为SND 9例,PD17例和正常人17例常规磁共振成像资料,通过MRI对壳核面积进行测量。结果 SND患者的壳核面积较PD患者及正常组均显著降低(P﹤0.05),而PD患者和正常组壳核面积差别无显著意义。SND主要表现为在T2加权像可见壳核边缘高信号和壳核萎缩,部分患者可见桥脑十字征。轴位T1加权像可见小脑中脚萎缩等MRI表现,矢状位T1加权像可见小脑、桥脑和延髓萎缩等MRI表现。结论MRI壳核面积测量有助于SND和PD两种疾病的鉴别诊断。     

有机磷中毒性脑病恢复期MRI表现(附4例报告)

目的:探讨有机磷中毒性脑病恢复期的MRI特征.方法:回顾性分析4例重度有机磷中毒慢性期脑结构变化.结果:双侧巴宾斯基征阳性4例,脑电图轻度异常4例.1例右侧小脑半球和中脑长T1长T2信号.1例双侧尾状核和壳核对称性长T2信号,T1WI高信号.1例双侧尾状核、壳核和苍白球对称性长T1长T2信号,侧脑室扩大,小脑萎缩.1例双侧尾状核、壳核和苍白球对称性异常信号,T1WI部分萎缩的小脑回呈高信号;脑室扩大,双侧枕叶内侧回、脑干和小脑萎缩.结论:有机磷中毒性脑病恢复期MRI表现主要累及尾状核、苍白球、丘脑、中脑和小脑;严重者皮质出现软化灶,伴有脑萎缩.     

正常人脑核团铁含量分布及年龄相关性MR磁敏感成像初步研究

目的 利用3.0T MRI的ESWAN相位值评估正常人脑各核团的铁含量,观察其分布规律及随年龄变化的趋势.方法 正常志愿者30例,按年龄分3组:第一组,11~30岁,共11例;第二组,31~60岁,共13例;第三组,61岁以上,共6例.各组均行MRI检查,包括横断位T2WI、ESWAN等,检查结束后手工绘出各核团的感兴趣区,测量其ESWAN相位值,采用单因素方差分析(LSD法)、配对t检验评价各核团间、核团的左右两侧间及各年龄组间的统计学差异.结果 ①苍白球、壳核、尾状核、黑质及红核等核团的均值分别为-0.192 0±0.066 92,-0.139 3±0.072 50,-0.149 4±0.041 73,-0.191 0±0.078 89,-0.128 6±0.077 82.②苍白球和黑质与壳核、红核及尾状核之间的差异性分别有统计学意义.③除红核外其余核团左右两侧均存在统计学差异.④壳核及尾状核在3个年龄组存在统计学差异(P＜0.05).结论 ESWAN相位值可评估苍白球、壳核、尾状核、黑质及红核等核团间、核团的左右两侧的铁含量的差异性及随年龄变化铁含量的变化趋势.     

获得性肝性脑部变性的MRI表现

目的探讨获得性肝性脑部变性的MRI影像学特征及原因。方法对23例有精神神经症状的慢性肝硬化患者进行头颅MRI扫描,其中1例并行增强扫描,4例同时进行腹部扫描,分析其MRI征象。结果23例患者,22例脑部MRI有阳性发现,1例MRI表现阴性。双侧苍白球(22/22),豆状核(13/22),红核(9/22),垂体前叶(7/22),大脑脚盖(2/22)在自旋回波(SE)序列T1WI表现为高信号,快速自旋回波(FSE)T2WI信号正常,病灶区脑结构的体积、形态无变化。结论双侧基底节等部位出现T1WI高信号是获得性肝性脑部变性较为特征性的影像学表现,结合临床慢性肝硬化病史可确定诊断。     

基于体素的形态学测量技术在运动障碍疾病中的应用进展

运动障碍性疾病曾称为锥体外系疾病,由锥体外系结构异常和功能障碍所致,主要表现为随意运动调节障碍,而对肌力、感觉和小脑功能无明显影响.临床症状分为肌张力增高-运动减少和肌张力降低-运动过多,前者以运动贫乏为特征,后者主要表现为异常不自主运动.主要包括帕金森病(Parkinson's disease,PD)、多系统萎缩(multiple system atrophy,MSA)、亨廷顿氏病(Huntington's disease,HD)、进行性核上性麻痹(progressive supranuclear palsy,PSP)、皮质基底节变性(corticobasal degeneration,CBD)和小脑脊髓共济失调(spinocerebellar ataxia,SCA).本组疾病源于基底核功能紊乱,基底核具有复杂的纤维联系,主要构成三个重要的神经环路:(1)皮质-皮质环路:大脑皮质-尾壳核-内侧苍白球-丘脑-大脑皮质;(2)黑质-纹状体环路:黑质与尾状核、壳核间往返联系纤维;(3)纹状体-苍白球环路:尾状核、壳核-外侧苍白球-丘脑底核-内侧苍白球.     

一氧化碳中毒脑损伤的CT、MRI研究

目的　评估CO中毒脑损伤的CT、MRI表现并比较其发现病变的能力。方法　对 5 2例CO中毒脑损伤患者行CT、MRI扫描 ,分析比较CT、MRI所见。结果　CT诊断苍白球变性坏死 9例 ,脑白质脱髓鞘 3例 ,脑萎缩 3例。CT的阳性检出为 15例 ,阳性率 2 8.8%。MRI诊断苍白球变性坏死 2 4例 ,脑白质改变 10例 ,其中苍白球变性伴脑白质脱髓鞘 7例 ,海马区改变 8例。MRI的阳性检出为3 1例 ,阳性率为 5 9.6% ,MRI的阳性率高于CT。 2组检出率对比有显著性差异。结论　CT、MRI对CO中毒脑损伤诊断均有意义。MRI对CO中毒诊断优于CT ,MRI能显示比CT更多的病变     

脑基底节区对称性低密度病变的CT诊断

目的：为提高CT对双侧脑基底节区对称性低密度病变的诊断水平。方法：我们对14例资料完整的病例进行回顾性分析。肝豆状核变性3例，脑炎、脑外伤、脑梗塞与维生素B1缺乏症各2例，霉变甘蔗中毒、一氧化碳中毒与甲醇中毒各二例。结果：CT表现为双侧脑基底节区对称性低密度，呈片状、椭圆形或扇形，可伴有其他部位的低密度区、脑萎缩、脑软化灶、儿童脑发育不全、脑梗塞。结论：强调诊断结合临床病史和其他检查的重要性。肝豆状核变性有肝肾的损害，维生素B1缺乏症用VitB1诊断性治疗有效，脑外伤、一氧化碳及霉变甘蔗中毒等均有明确的病史。一氧化碳中毒常伴脑白质脱髓鞘改变。苍白球黑质色素变性MR检查有特征性，呈短T2低信号。     

Infantile neuroaxonal dystrophy: neuroradiological studies in 11 patients

We report the imaging findings in 11 patients with infantile neuroaxonal dystrophy. Ten patients underwent 15 MRI examinations; one patient had only CT. Of the ten patients who underwent MRI, eight had cerebellar atrophy and mildly increased signal from the cerebellar cortex on T2-weighted images. With T2 weighting there was slightly increased signal from the dentate nuclei in two patients and from the posterior periventricular white matter in three. We saw four patients with a thin optic chiasm. The only two brothers in the series had markedly low signal from the globus pallidus and substantia nigra on 1.5 T T2-weighted images, as seen in Hallervorden-Spatz disease (HSD). Abnormalities of the globus pallidus may be related to a protracted course of the disease. However, an overlap with HSD should be considered. Received: 9 April 1998 Accepted: 5 October 1998     

大转子疼痛综合征的MRI表现

目的:探讨大转子疼痛综合征(GTPS)患者的MRI表现。方法:回顾性分析2018年1月-2020年4月在本院经临床诊断为GTPS的20例患者的临床及MRI资料。MRI扫描序列主要有冠状面和横轴面T₁WI、T₂WI和STIR序列。结果:20例患者累及26髋。主要MRI表现:臀中肌或臀小肌肌腱增厚或信号增高(n=9);臀中肌或臀小肌肌腱纤维局灶性缺失(n=16);臀中肌或臀小肌肌肉萎缩、脂肪浸润、肌肉肌腱钙化(n=1)。多伴有周围软组织水肿(n=26)和转子区滑囊扩张、积液(n=26),可伴有肌肉肌腱“羽翼状”水肿信号(n=4)及股骨大转子骨髓水肿(n=8)。结论:MRI可较为直观显示GTPS的影像学特征,为临床干预提供客观依据。     

多发性骨髓瘤MRI和X线诊断价值

目的　进一步研究多发性骨髓瘤 (multiplemyeloma ,MM )的MRI表现特点并与X线检查相比较其优缺点 ,同时探讨MRI分型与临床分期的联系。材料与方法　选择 19例经骨髓穿刺证实的MM患者的下胸椎至股骨上段行X线与MRI检查 ,对相同患者相同时间相同部位的X线平片与MRI表现、临床分期、MRI分型与骨髓浆细胞百分比进行比较。结果　MM的MRI据T1 WI骨髓信号减低的形态分为以下类型 :正常型 ,弥漫型 ,局灶型 ,混合型 ,“盐和胡椒”型。腰椎以弥漫型多见占 47.3% ,局灶型、混合型各占15 .8% ;骨盆及股骨近段以局灶型多见占 5 7.9% ,弥漫型占 2 1.1% ,无混合型。MM的X线表现 :未见异常 7例 ,骨质疏松的基础上病理性骨折或骨质破坏 12例。腰椎、骨盆及股骨近段各部位检查的阳性率MRI均为 84.2 % ,X线平片分别为 63.2 %、42 .1%和31.6%。MRI表现 :正常型及“盐和胡椒”型的病例其骨髓浸润较轻 ,均见于临床Ⅰ期MM ,其骨髓浆细胞的百分比较低 ( 8.4± 2 .5 ) ;而弥漫型、局灶型、混合型均见于Ⅱ、Ⅲ期MM ,其骨髓浸润程度相对较重 ,骨髓浆细胞的百分比较高 ( 30 .5± 6.7、45 .2± 11.2 )。结论　MM的MRI表现可分为正常型、弥漫型、局灶型、混合型、“盐和胡椒”型。MRI对MM的敏感性明显高于X线检查 ,但两者的特异性较差     

Magnetic resonance imaging findings of endometrioid adenocarcinoma of the ovary

PURPOSE: We assessed magnetic resonance imaging (MRI) features and clinical characteristics of ovarian endometrioid adenocarcinoma. MATERIALS AND METHODS: A total of 31 patients with 39 surgically proven ovarian endometrioid adenocarcinomas were analyzed retrospectively. Histologically, 13 lesions in 12 patients arose from proven endometriomas (group A), and 26 lesions in 19 patients did not coexist with endometrioma (group B). The morphological pattern of the lesion on MRI was classified as a solid or a cystic type: A solid type was defined as a solid component occupying more than half of the lesion; and a cystic type was a cystic lesion with one or more mural nodules. RESULTS: Altogether, 11 lesions in group A were the cystic type on MRI, whereas 24 lesions in group B were the solid type (P < 0.0001). Among the 11 cystic-type lesions in group A, the cysts of 5 lesions were hypointense on T1-weighted images, and the cysts of 6 lesions were hyperintense on T1- and T2-weighted images without "shading." The nuclear grade was higher (P = 0.0028) and the clinical stage more advanced (P = 0.0018) in group B compared to group A. CONCLUSION: MRI of ovarian endometrioid adenocarcinomas revealed two types: a solid type and a cystic type. The lesions arising from endometriomas tended to be the cystic type on MRI and have a good prognosis. Preexisting endometrioma in this entity rarely showed "shading" on T2-weighted images.     

可逆性脑后部白质病变综合征的临床和MRI表现

目的:探讨可逆性脑后部白质病变综合征的临床和MRI特点。材料和方法:回顾性分析2例可逆性脑后部白质病变综合征患者的临床和MRI资料。结果:2例中,1例严重的肾病综合征,1例造血干细胞移植后使用免疫抑制药物,均急性起病,以头痛、癫痫发作为首发症状。头颅MRI检查均显示以大脑半球顶枕部白质为主的片状对称性长T1长T2信号、FLAIR高信号病变,额叶也有相同性质的小片状病灶受累。4周后临床症状基本消失,复查头颅MRI原有病灶明显减小或消失。结论:可逆性脑后部白质病变综合征是一种预后良好的疾病,结合病史和MRI特征可以早期诊断。     

MR imaging of a group I case of Hallervorden-Spatz disease

Magnetic resonance (MR) imaging of a case of Hallervorden-Spatz disease (HSD) using a 1.5 T system is described. The patient showed progressive spastic diplegia with equinovarus deformity of the feet, dystonic postural movements, dysarthria, dysphagia, mental deterioration, optic nerve atrophy, and peripheral neuropathy. These clinical features were compatible with HSD. Symmetrical, decreased signal intensity was seen on both proton density weighted and T2-weighted spin echo images in the globus pallidus as well as in the substantia nigra (Group I). This MR finding suggests an increased iron deposition in these subcortical nuclei, which is characteristic of HSD. The characteristic MR imaging, together with the relevant clinical features, was considered to be useful for establishing the diagnosis of HSD.     

An investigation of magnetic resonance imaging features in 14 patients with synovial chondromatosis of the temporomandibular joint

OBJECTIVES: To show the characteristic MRI features of synovial chondromatosis (SC) of the temporomandibular joint (TMJ). METHODS: All patients with histologically proven SC of the TMJ who underwent MRI at our clinic were examined. In 14 patients (male-to-female ratio, 2:12; average age 46+/-14 years), clinical and conventional radiographic findings were reviewed. In addition, the MRI findings of articular disc and condyle position, shape and signal intensity of the joint spaces, and bone changes of surrounding structures were analysed. RESULTS: The main symptoms were pain (in 93% of the patients) and limitation of mouth opening (64%). Two cases showed typical multiple calcifications around the TMJ on conventional radiography. On MRI, the disc position was normal in 12 (86%) patients and the condyle was inferiorly displaced in 9 (64%) patients. 11 (79%) patients showed enlargement of the joint space, with either a "dumbbell" shape or bulging. SC in the upper compartment showed various degrees of bone changes of the articular eminence and fossa. SC in the lower compartment showed concavity or hypertrophy of the condyle. The severity of the bone changes progressed with duration of symptoms. CONCLUSIONS: About 0.3% of the patients complaining of TMJ pain and dysfunction were found to have SC. There was great variation in the MRI features of the TMJs with SC. More severe destruction of surrounding bone structures with features resembling a tumour were found in patients with a longer duration of symptoms.     

Relationship of MRI and clinical staging to outcome in invasive bladder cancer treated by radiotherapy

AIM: To compare MRI and clinical staging of invasive bladder cancer prospectively and identify additional prognostic features on MRI before radiotherapy. METHODS AND MATERIALS: 143 patients with a pathological diagnosis of transitional cell carcinoma underwent MRI (1.0 T) of the abdomen and pelvis before radical radiotherapy. Tumour size, site, degree of infiltration, presence of adenopathy and hydronephrosis were assessed and an appropriate radiological stage assigned. Following radiotherapy all patients received regular cystoscopic follow-up. Date of first relapse and date of death were recorded. RESULTS: The median follow-up was 2.8 years for survivors. Those patients upstaged from T2a clinically to T3b on MRI had a significantly worse outcome (P = 0.0078). In univariate analysis a number of MRI features were significantly associated with adverse outcome: tumour size, circumferential tumour extent, and presence of hydronephrosis (all P < 0.05). After adjustment for clinical T stage and histological grade, all these MRI features and the MRI T stage were found to confer additional prognostic information in predicting early disease relapse and death (P < 0.05). CONCLUSION: This study demonstrates that MRI before radiotherapy provides valuable additional prognostic information compared to clinical staging.     

下视丘胶质瘤的临床与MRI诊断

目的:探讨下视丘胶质瘤的临床及MRI表现,提高对此病的认识.方法:回顾性分析5例经手术病理证实的下视丘胶质瘤患者的影像及临床资料.结果:MRI平扫,病变多位于鞍上,呈分叶状肿块,T1WI上多表现为低信号或等低混杂信号,T2WI上大多表现为高或等高混杂信号.增强扫描,肿瘤可见明显或轻度不均匀强化.结论:下视丘胶质瘤的影像及临床表现有一定的特点,MR检查对诊断有重要帮助.     

Hepatic Sinusoidal Obstruction Syndrome Caused by Herbal Medicine: CT and MRI Features

Objective

To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum.

Materials and Methods

The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images.

Results

Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565).

Conclusion

Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.