神经梅毒的MRI表现（2例报告并文献复习）

目的：探讨神经梅毒的MRI表现。方法：1例血清和脑脊液密螺旋体抗体检测阳性,经青霉素治疗后临床症状消退。另1例血清密螺旋体抗体阳性手术后病理证实为脊髓梅毒树胶样肿。2例均行MRI检查。结果：1例脑实质性梅毒表现为右侧颞叶内侧T1WI呈略低信号,T2WI呈均匀高信号,DWI及FLAIR呈高信号。1例脊髓树胶样肿表现为T1WI为低信号或等、低混杂信号灶,呈类圆形,T2WI为等高混杂信号灶;钆喷替酸葡甲胺（Gd-DTPA）增强T1WI示病灶呈不规则环形强化,并与背侧脊膜以钝角相交。结论：神经梅毒的MRI表现多种多样,对其的认识很重要以达到早期诊断和治疗的目的。     

新生儿胆红素脑病脑损伤的MRI诊断价值

目的 :探讨新生儿胆红素脑病(NBE)脑损伤的MRI诊断及应用价值。方法 :回顾性分析45例NBE患儿头部MRI表现及临床资料。结果:45例中33例颅脑MRI表现为双侧苍白球区对称性T1WI高信号,17例T1WI高信号同时累及底丘脑或丘脑腹外侧;T2WI均呈等信号,T2FLAIR呈等或稍高信号;DWI均未见明显异常信号改变。12例1~3个月随访复查颅脑MRI,4例T2WI呈对称性稍高信号,临床上有脑损伤后遗症改变;8例颅脑MRI检查未见明显异常,临床上也未见明显神经异常症状。结论:新生儿NBE颅脑MRI苍白球区有特征性表现,即急性期为苍白球对称性T1WI高信号,慢性期为对称性T2WI稍高信号,可为临床早期诊断及预后判断提供帮助。     

乳头状肾癌的CT和MRI诊断

目的：探讨乳头状肾癌的CT和MRI表现,提高其诊断符合率。方法：回顾性分析13例经手术和病理证实的乳头状肾癌的CT和MRI影像资料。结果：CT检查7例,平扫呈软组织密度,增强后轻度强化。MRI检查8例,信号明显不均,以正常肾皮质信号为基准,6例表现为T1WI等或低信号,T2WI低信号改变。2例呈T1WI、T2WI混杂高信号改变,其镜下表现为广泛出血坏死灶。结论：乳头状肾癌属少血供病变,CT强化表现配合MRI T2WI混杂低信号改变有助于乳头状肾癌的临床诊断。     

神经梅毒的磁共振成像表现(附二例报告)

目的：提高对神经梅毒MRI表现的认识。方法：1例血清密螺旋体抗体阳性的患者经手术后病理证实为脑梅毒树胶肿；另1例患者脑脊液梅毒抗体检测（PA法）阳性，经内科治疗后临床症状消退。2例均行MRI检查。结果：2例脑梅毒树胶肿的MRI表现较典型，T1WI示：病灶为低信号或等、低混杂信号灶，呈类圆形，直径约2．0－2．5cm，位于大脑皮层及皮层下，周围水肿明显；T2WI示：病灶为高信号或等、高、低混杂信号灶；钆喷替酸葡甲胺（Gd-DTPA）增强T1WI示病灶呈不规则环形强化，邻近脑膜强化，且最大病变层面显示病变的边缘与周围脑膜以钝角相交。结论：神经梅毒确诊一般需依赖实验室检查或病理组织学检查，但出现MRI高度怀疑的征象对早期发觉和诊断该病具有重要临床意义。     

视神经肿瘤的MRI诊断

目的:探讨视神经肿瘤的MRI表现。方法:回顾了18例经MRI检查并经临床病理确诊的视神经肿瘤的病例。结果:视神经脑膜瘤8例,表现为视神经增粗1例,梭形肿块5例,软组织肿块2例。MR T1WI呈等或稍低信号,T2WI呈高信号。视神经胶质瘤6例,表现为视神经梭形增粗2例,椭圆形肿块4例,MR T1WI呈等信号,T2WI呈高信号。视神经转移瘤4例,3例为视网膜母细胞瘤累及视神经,MRI表现为眼球内病变侵犯视神经和视交叉,T1WI呈稍低信号,T2WI呈稍高信号;1例为乳腺癌转移至视神经,MRI表现为视神经椭圆形增粗,T1WI呈等信号,T2WI呈高低混杂信号。结论:MRI是检查和诊断视神经肿瘤的重要检查手段,对大多数病变可做出明确诊断。     

颅内表皮样囊肿的非典型CT和MRI表现

目的 探讨颅内表皮样囊肿的非典型CT和MRI表现,提高对本病的认识.方法 收集经手术病理证实的8例表皮样囊肿,术前均行MRI平扫,其中2例行扩散加权成像(difussion weighted imaging,DWI)检查,CT检查5例.MRI增强扫描4例.结果 8例表皮样囊肿发生于桥小脑角2例,大脑纵裂2例,脑实质2例,颅骨2例.CT显示囊肿表现为均匀高密度2例;混杂密度1例;囊壁及囊内钙化2例.MRI平扫2例T1WI呈均匀高信号,T2WI呈稍高、高信号;3例T1WI和T2WI呈混杂信号;3例T1WI呈不均匀低信号,T2WI呈高信号;其中1例DWI表现为高信号.4例MRI增强扫描显示囊壁显著环形强化和囊内不均匀强化2例,囊壁轻度强化2例.结论 颅内表皮样囊肿的CT和MRI非典型表现主要包括CT呈高密度、混杂密度、囊壁和囊内钙化,MRI T1 WI、T2WI呈高信号、混杂信号,增强扫描显著环形强化,在诊断时应充分结合DWI检查,以提高术前诊断准确性.     

骨梗死的X线、CT和MRI诊断

目的探讨骨梗死的影像学表现.材料和方法对10例累及28处骨骼的骨梗死患者行X线、CT及MRI检查,将骨梗死分为早、中、晚期,分析其影像学特征.结果病变主要累及股骨下段和胫骨上段,多双侧发病.骨梗死早、中期X线、CT表现为阴性和局部的骨质疏松及斑点状钙化,MRI表现为病变中心T1WI呈等或稍低信号,T2WI呈等或稍高信号,病灶边缘呈典型的地图样改变.晚期X线及CT呈不规则状、蜿蜒状骨质硬化,MRI T1WI及T2WI均呈低信号.结论MRI检查是诊断早、中期骨梗死最有效的方法,优于X线平片和CT;在晚期,X线平片和CT、MRI均有特征性表现,三者相结合可提高诊断准确率.     

血友病性关节病的MRI分析

目的:探讨血友病性关节病的MRI表现及临床价值.方法:回顾性分析11例22个膝关节血友病性关节病患者的MRI表现.结果:22个膝关节均有积血,表现为关节腔、骨骼和/或软组织血肿,早期血肿在T1WI为等信号、T2WI呈高信号;中期血肿在T1WI呈略高信号或混杂信号,T2WI呈高信号或混杂信号;晚期血肿在T1WI和T2WI均表现为混杂信号,血肿逐渐被吸收.病变早期关节结构基本保持正常,中晚期关节结构均有损害,表现为关节软骨、骨皮质破坏吸收,关节间隙狭窄,骨端或骨骺增大变形.早中期滑膜、关节囊、肌肉及韧带肿胀,而晚期则萎缩、退变.结论:MRI能准确显示血友病性关节病的病理改变,对疾病分期、指导临床治疗及同位素放射治疗效果评价具有重要意义.     

有诱因性和无诱因性骨梗死X线和磁共振成像表现的探讨

目的 探讨有无诱因性骨梗死的X线和磁共振成像(MRI)表现.方法 回顾性分析经临床MRI随访或手术病理证实的16例骨梗死患者的临床X线和MRI资料,分析其表现.所有患者均同期行X线片和MRI检查,二者检查间隔时间＜7 d.结果 6例骨梗死累及24个骨骼,包括肱骨2个、股骨14个和胫骨8个.临床上有大量激素应用史9例25灶,在MRI上T1WI和T2WI均表现为环状低信号带围绕的不同信号坏死区,相应X线片上19灶表现正常,6灶表现为地图状或环状骨质硬化.无明显诱因性骨梗死7例7灶,在MRI上T1WI呈不均匀低或等信号,T2WI呈低高混杂信号,周围绕环状低信号带,相应X线片上表现为局限性环状或地图状骨质硬化区.结论 有无诱因性骨梗死患者就诊时因所处的骨坏死时期不同,相应X线片和MRI表现也有所不同.     

脑实质海绵状血管瘤的MRI诊断

目的:探讨脑实质内海绵状血管瘤的MRI表现,以及对病理分型的MRI诊断价值.材料和方法:32例MRI平扫.18例行Gd-DTPA增强扫描,所有病例均经手术病理证实.并采用x2检验对病理分型与MR/表现进行分析.结果:32例共32个病灶.24例T1WI和T2WI均表现为高低混杂信号,呈网格状或桑葚样、结节状;5例TIWI呈团块状或完全高信号;T2WI等信号或低信号,3例T1WI等信号或低信号,T2WI稍高信号.23例T2WI显示病灶边缘呈完整低信号环.18例增强扫描中,3例基本无增强,7例轻度增强,8例点状或不规则增强.病理表现分为两型: Ⅰ型血管壁仅有菲薄的胶原纤维和内皮细胞,18个;Ⅱ型血管壁较厚,有薄层平滑肌,14个.Ⅰ型与Ⅱ型脑内海绵状血管瘤MRI表现没有统计学差异.结论:网格状或桑葚样、结节状高低混杂信号并伴有T2WI周围低信号环是CA的MRI的特征性表现,MRI表现与病理分型无关.     

Feasibility of abdomino-pelvic T1-weighted real-time thermal mapping of laser ablation

PURPOSE: To prove the hypothesis that T1-weighted (T1W) thermal mapping is reliable and achievable in magnetic resonance (MR)-guided laser tumor ablation. MATERIALS AND METHODS: Near real-time gray and color-scale T1W thermal maps in 111 MR-guided laser thermal ablations (LTA) of liver, kidney, and uterine tumors were studied. After laser fiber placement, near real-time gray and color-scale thermal maps were produced. Previous work showed T1 signal is inversely proportional to temperature below 55 degrees C (the point of irreversible necrosis). RESULTS: Thermal mapping was successful in 84% of uterine, 74% of hepatic, and 20% of renal ablations. For hepatic and uterine tumors, size and conspicuity of thermal lesions were significantly greater on subtracted colorized images rather than gray-scale raw image mapping (P = 0.001, paired Student's t-test). Patient movement (N = 24), fiber charring N = 2), magnetic field distortion, and reconstruction errors (N = 2) caused mapping failure. For both renal and hepatic tumors, comparison of near real-time T1W colorized thermal map and follow up gadolinium-enhanced MR imaging revealed moderate correlation (Pearson correlation coefficient of 0.55 and 0.5, respectively). CONCLUSION: In hepatic, renal, and uterine thermal maps, the color scale produced significantly greater sized lesions with significantly greater conspicuity than the gray scale. T1W thermal mapping was reliable and successfully achieved in 73.7% of procedures, and predicted the ablated area of the tumor moderately well.     

Techniques to Form a Suitable Lipiodol-Epirubicin Emulsion by Using 3-Way Stopcock Methods in Transarterial Chemoembolization for Liver Tumor

Purpose

To compare physicochemical properties of emulsions of ethiodized oil (Lipiodol; Guerbet, Villepinte, France) and epirubicin prepared using different techniques for conventional transarterial chemoembolization.

Diffusion-Weighted MR Imaging to Evaluate Immediate Response to Irreversible Electroporation in a Rabbit VX2 Liver Tumor Model

PurposeTo evaluate the feasibility of diffusion-weighted imaging (DWI) in magnetic resonance imaging for quantitative measurement of responses following irreversible electroporation (IRE) in a rabbit liver tumor model.Materials and MethodsTwelve rabbits underwent ultrasound-guided VX2 tumor implantation in the left medial and left lateral liver lobes. The tumors in the left medial lobe were treated with IRE, whereas those in the left lateral lobe served as internal controls. DWI was performed before and immediately after IRE. Tumors were then harvested for histopathologic staining. The apparent diffusion coefficient (ADC) and change in ADC (ΔADC) were calculated based on DWI. Tumor apoptosis index (AI) was assessed by terminal deoxynucleotidyl transferase dUTP nick-end labeling. These measurements from DWI and histopathology were compared between untreated and treated tumors.ResultsThe ADC values, ΔADC, and AI showed statistically significant differences between treated and untreated tumors (P < .05 for all). ADC values were higher in treated tumors than in untreated tumors (1.08 × 10^?3 mm²/s ± 0.15 vs 0.88 × 10^?3 mm²/s ± 0.19; P = .042).ConclusionsDWI can be used to quantitatively evaluate treatment response in liver tumors immediately after IRE.     

Transarterial infusion chemotherapy with epirubicin in water-in-oil-in-water emulsion for recurrent hepatocellular carcinoma in the residual liver after hepatectomy

Purpose

To evaluate the midterm results of transarterial infusion (TAI) with water-in-oil-in-water (W/O/W) emulsion containing an anticancer agent for patients with recurrent hepatocellular carcinoma (HCC) after surgical resection.

Materials and methods

We retrospectively analyzed the results of TAI of W/O/W emulsion containing epirubicin for 18 consecutive patients with recurrent HCC after surgical resection. Fourteen patients were males and four were females; their ages ranged from 51 to 86 years (mean 69.8 years). TAI was repeated every 1–6 months based on the response of the tumor. A total of 41 TAI procedures were performed for 18 patients. Angiographically, recurrent HCC appeared a single nodule in nine patients and was multinodular in other nine patients. TAI was performed selectively in 27 procedures and non-selectively in 14 procedures. Maximum response within 3 months was rated as follows: a complete response (CR, complete disappearance of tumor and no evidence of new lesions); partial response (PR, a reduction of <50% in total volume of all tumors calculated from the two longest perpendicular diameters without a new lesion); no response (NC, a reduction of <50% in total volume or an increase of <25% without a new lesion); or progression of disease (PD, an increase of >25% in total volume or evidence of new lesions). Survival time was defined as the time from the date of first TAI to the date of death or last follow-up (median follow-up time: 17 months) and the survival curve was estimated using the Kaplan–Meier method.

Results

The CR rate was 33% and the effective response rate (CR rate + PR rate) was 78%. Survival from the time of initial TAI was 94% at 1 year, 76% at 2 years, and 76% at 3 years.

Conclusions

TAI of W/O/W emulsion may be an effective treatment for patients with recurrent HCC after surgical resection.     

The scintigraphic findings in Paget's disease of bone.

Bone scans and radiographic skeletal surveys have been done in 41 patients who had Paget's disease. The scintigraphic findings are consistent with what is known of the pathophysiology of Paget's disease. Diseased bone demonstrates increased vascularity, an increased degree of uptake of bone-seeking radiotracers and, in appropriate bones, evidence of marrow replacement. The bone scintiscan is a more sensitive indicator of the extent of polyostotic Paget's disease than conventional radiograph, demonstrating 34% more lesions. Because it reflects shorter term changes in osteoblastic activity the bone scan is of some value in providing immediate objective evidence of the therapeutic effectiveness of Mithramycin which has been used in this study in the treatment of the minority of patients with pain in Pagetoid bone. A technique for documenting alterations in uptake by diseased bone numerically is presented. Upon treatment with Mithramycin the ratio of abnormal uptake in relation to normal bone fell from 8.7 to 3.9.     

经皮经肝和经颈静脉行肝静脉成形术

肝静脉闭塞的再通是布－加综合征介入治疗的难题之一。我们采用经皮肝和经颈静脉穿刺成功地开通７例肝静脉开口处膜性闭塞，其中肝右静脉５例，肝中静脉２例；３例合并下腔静脉闭塞者又给以下腔静脉开通。     

用左旋T4建立大鼠甲状腺功能亢进模型的实验研究

目的：用含左旋T4的药物（优甲乐）灌胃建立大鼠甲状腺功能亢进（甲亢）模型。方法：每天以两种不同剂量（60μg/100g体重，30μg/100g体重）的优甲乐灌胃，定期记录大鼠的心率（尾动脉脉搏）、收缩压、体重，放免法测定大鼠血清T3、T4。取大鼠心脏称重及HE染色做组织病理检查。结果：甲状腺功能亢进大鼠的血清T3、T4水平较对照组明显升高（P〈0．01），该组动物的心率、心脏重量，心肌细胞大小也显著高于对照组（P〈0．05）。结论：优甲乐是一种有效建立大鼠甲亢模型的药物。     

海水冬泳对中老年人免疫功能的影响

选择中老年长期坚持冬泳者（常年游泳）３０名（持续组），夏秋季游泳、寒冬不游泳者２６名（暂停组），分别与条件相似的未游泳者３２名（对照组）进行比较。受试者当年初冬采血后，次年春末（前两组）采血复查。分别查周围血象、免疫球蛋白（Ｉｇ）、淋巴细胞亚群、ＮＫ细胞。经统计学处理后显示：持续组冬泳后比冬泳前中性粒细胞降低，淋巴细胞增高，差异具显著性（绝对值）和非常显著性（百分率）。暂停组停止冬泳后也有类似变化，但仅百分率具显著性差异。ＩｇＧ持续组和暂停组春末复查均有增加，差异具显著性和非常显著性。ＩｇＡ持续组冬泳后降低，差异显著。冬泳后，持续组和暂停组Ｔ３均略降低，Ｔ４、Ｔ８和ＮＫ细胞均上升。Ｔ４／Ｔ８比值，冬泳前持续组和暂停组两组无显著差异，冬泳后持续组升高，暂停组降低，差异显著。     

地震伤磁共振检查扫描方案的探讨

目的：探讨地震伤MRI检查的扫描时间、序列和成像平面在快速显示病变中的作用,提出地震伤MRI检查的合理扫描方案。方法：用1．5TMR根据临床要求和伤情,对20例汶川地震伤员分别行横轴位和冠状位的T1WI、T2WI及T2WI＋FS扫描,评价显示病变的效果和成像时间。结果：T2WI＋Fs序列对病变的显示范围优于T2WI,但显示解剖结构比T2WI差。轴位显示病变与周围组织清晰,但成像时间成倍增加;冠状位能在很短时间内完成较大范围扫描。结论：T1WI、T2WI及T2WI＋FS为必须扫描序列,轴位和冠状位为必须基本扫描平面;增加重BWI水成像和GRE快速序列,以显示继发脏器损伤。