强直性脊柱炎骶髂关节影像学分析：附24例骶髂关节平片,CT和MR…

目的：旨在评估强直性脊柱炎（ＡＳ）患者骶髂关节炎的ＭＲ影像特征，并比较Ｘ线平片、ＣＴ和ＭＲ影像在诊断骶髂关节炎中的作用。材料与方法：搜集２４例ＡＳ患者，分别行Ｘ线平片、ＣＴ和ＭＲＩ检查。增强前ＭＲ扫描序列包括ＳＥ Ｔ１ＷＩ、ＦＳＥ Ｔ２ＷＩ和梯度回波的准Ｔ２ＷＩ（ＧＲ Ｔ２＾＊ＷＩ）。增强后ＭＲ扫描序列参数与增强前ＳＥ Ｔ１ＷＩ相同。另选９例志愿者，行ＭＲ平扫检查。结果：８例志愿者１６个骶髂关节的     

磁共振动态增强和脂肪抑制技术在胰腺癌诊断中的价值

目的 了解磁共振动态增强和脂肪抑制技术在胰腺诊断中的价值。材料与方法 １８例经手术病理证实的胰腺癌患者进行了磁共振检查,采用在磁共振序列分别为：ＳＥＴ１ＷＩ、ＦＳＥＴ２ＷＩ、脂肪抑制技术ＳＥＴ１ＷＩ和动态增强ＦＭＰＳＰＧＲ等。结果 １８例胰腺癌肿瘤病灶,在ＳＥＴ１ＷＩ上呈低信号者１０例,等信号者６例,高信号者２例;ＦＳＥＴ２ＷＩ上高信号者８例,等信号者６例,低信号者４例;脂肪抑制技术ＳＥＴ１ＷＩ上     

MR T_1WI抑脂及MR胰胆管造影术用于梗阻性黄疸的诊断

目的：探讨Ｔ１ＷＩ抑脂技术（ＦＴ１ＷＩ）和ＭＲ胰胆管造影术（ＭＲＣＰ）对梗阻性黄疸的诊断价值。方法：回顾４７例不同病因所致梗阻性黄疸的ＭＲＩ征象。应用ＧＥＳｉｇｎａ１．５Ｔ超导ＭＲ机,除常规的Ｔ１ＷＩ、Ｔ２ＷＩ序列外,还采用ＦＴ１ＷＩ和ＦＭＰＳＰＧＲ造影增强及ＭＲＣＰ技术。结果：恶性病变均可见大小不等的肿块,ＦＴ１ＷＩ序列对肿块的显示最清楚,为明显的低信号。良性病变均无肿块。ＭＲＣＰ可以明确梗阻的部位及阻塞端的形态。结论：根据ＭＲＣＰ所示胆道梗阻的部位和形态,结合轴位各序列,尤其是ＦＴ１ＷＩ显示的病灶特点,能更加准确地诊断梗阻性黄疸的病因。     

正常胰腺快速MR成像序列的比较研究

目的选择最适当的胰腺快速ＭＲ成像序列。材料与方法对２０例胰腺正常者行六种快速ＭＲ成像序列检查,其中包括四种快速自旋回波序列（ＴＳＥ—Ｔ１ＷＩ、Ｔ１ＦＳ、Ｔ２ＷＩ、Ｔ２ＦＳ）和二种梯度回波序列（ＧＲＥ—ＴＦＥ、ＦＦＥ）,然后对所得图像进行定量、定性分析。结果定量分析表明,Ｔ１ＦＳ有最高的胰腺信噪比。定性分析表明,Ｔ１ＷＩ显示脾静脉最好,且能同时清楚显示肠系膜上血管、门静脉和腹腔动脉。Ｔ１ＦＳ的伪影最少,且能同时清楚显示胰——十二指肠分界、胰一胃分界及肠系膜上静脉。Ｔ２ＷＩ的图像质量及对胰一十二指肠分界显示最好,且能同时清楚显示胆总管、肠系膜上血管、门静脉和腹腔动脉。Ｔ２ＦＳ显示胆总管最好,显示胰一十二指肠分界的能力同Ｔ２ＷＩ,同时能清楚显示门静脉。ＴＦＥ和ＦＦＥ无明显的优点。六个序列中任何一个,均不能使正常胰管成像。结论在正常胰腺快速ＭＲ成像序列中,Ｔ１ＦＳ和Ｔ２ＷＩ优于其它序列。     

三维稳态破坏性梯度回返采集在颅脑疾病诊断中的应用(兼与二维自旋回波T1WI对比研究)

目的前瞻性探讨三维稳态破坏性梯度回返采集（ｔｈｒｅｅｄｉｍｅｎｓｉｏｎａｌｓｐｏｉｌｅｄｇｒａｄｉｅｎｔｒｅｃａｌｅｄａｃｑｕｉｓｉｔｉｏｎｉｎｓｔｅａｄｙｓｔａｔｅ,３ＤＳＰＧＲ）在颅脑疾病中的应用价值,并且增强后与二维自旋回波（２ＤＳＥ）Ｔ１ＷＩ作对比分析。方法１７例病变,采用ＧＥ１．５Ｔ扫描机,增强后行２ＤＳＥＴ１ＷＩ及３ＤＳＰＧＲ轴面扫描,并进行对比研究。结果⑴除动脉瘤外,２ＤＳＥＴ１ＷＩ较３ＤＳＰＧＲ多发现１３个病变,且两者描述主体病变强化程度相当;⑵２ＤＳＥＴ１ＷＩ的信噪比、对比度及对比噪声比分别是３ＤＳＰＧＲ的１．５７、１．２及１．９７倍;⑶３ＤＳＰＧＲ图像后处理技术能显示２０例病变累及血管的各种表现;⑷３ＤＳＰＧＲ显示大动脉瘤较ＭＲ血管造影更完美。结论在颅脑疾病增强检查中,３ＤＳＰＧＲ具有许多２ＤＳＥＴ１ＷＩ无法比拟的优越性,有取代２ＤＳＥＴ１ＷＩ的可能。     

中场强磁共振尿路水成像技术与临床应用初探

目的 评价中场强（０．５Ｔ）磁共振单激发快速自旋回波９ＳＳＦＳＥ０尿路水成像（ＭＲＵ）技术及其临床应用价值。材料与方法 ４２例正常和悄路梗阻患者,在ＧＥ ０．５Ｔ超导ＭＲ成像仪上采用ＳＳＦＳＥ进行ＭＲＵ成像;３８例加作２Ｄ ＦＳＥ重Ｔ２ＷＩ,经最大信号强度投影（ＭＩＰ）重建ＭＲＵ图像。结果 采用ＳＳＦＳＥ所得ＭＲＵ图像可清晰显示正常尿路,效果比２Ｄ ＦＳＥ重Ｔ２ＷＩ经ＭＩＰ重建所得ＭＲＵ钉佳,尿路     

视神经、眼运动神经和后组颅神经的MRI与解剖学对照研究

目的 通过ＭＲＩ与解剖学对照研究,探讨视神经,眼运动神经和后组颅神经ＭＲＩ的表现和限度,探索其各对神经常规ＭＲ检查的方法,方法 １５例健康志愿者和４例头颅标本分别于０．５ＴＭＲ扫描仪上行ＭＲ检查。扫描平面除常规平面,还包括特定的斜平面。扫描序列包括ＳＥ Ｔ１ＷＩ,快速自旋回波（ＦＳＥ）Ｔ２ＷＩ,射频稳态傅立叶采集（ｒａｄｉｏ－ｆｒｅｑｕｅｎｃｙ Ｆｏｕｒｉｅｒ ａｃｑｕｉｒｅｄ ｓｔｅａｄｙ－ｓｔ     

MRI快速自旋回波序列和盆腔相控线圈对前列腺癌的诊断价值

评价快速自旋回波序列和盆腔相控线圈在前列腺癌ＭＲＩ诊断的价值。方法１４６例进行前殂朱ＭＲＩ检查,其中２４例应用常规ＳＥＴ２ＷＩ和体线圈;７０例应用ＦＳＥＴ２ＷＩ和体线圈;５２例应用ＦＳＥＴ２ＷＩ和盆腔相控线圈;比较３种扫描方法所获图像质量之间的差异和对前列腺癌诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值。     

MRCP单次激发快速自旋回波成像的临床价值

作为一种非创伤性的新技术 ,单次激发快速自旋回波 (ＳＳ ＦＳＥ)序列在我院应用于胆道成像已一年多 ,笔者通过该技术的临床应用探讨其扫描方法和临床价值。1　材料与方法1 1　一般材料　我院 2 0 0 0 0 9～ 2 0 0 0 12行胰胆管水成像(ＭＲＣＰ)检查的 5 6例患者。其中男 32例 ,女 2 4例 ,年龄 2岁～76岁 ,平均 5 2岁。1 2　扫描方法　应用ＧＥＳｉｇｎａＨｏｒｉｚｏｎＬＸ 1.5Ｔ超导ＭＲ机 ,先行快速自旋回波Ｔ2 加权 (ＦＳＥＴ2 ＷＩ)像轴位扫描 ,再在ＦＳＥＴ2 ＷＩ像上行ＳＳＦＳＥ序列的冠状定位。ＳＳＦＳＥ扫描参数 :ＴＲ 10 0 0 …     

三维增强减影MR血管造影在四肢肌肉骨骼疾病中的作用

目的 研究三维增强减影（３Ｄ ＣＥＳ）ＭＲ血管造影（ＭＲＡ）在诊断四肢肌肉骨骼疾患中的应用价值。方法 对１５例四肢肌肉骨骼病变行３Ｄ ＣＥＳ ＭＲＡ,并与病理结果对照。使用ＧＥ １．５Ｔ磁共振仪,用二维多相位快速梯度回波（２Ｄ ＦＭＰ ＳＰＧＲ）行矢状定位,采用三维快速梯度回波（３Ｄ ＦＳＰＧＲ）行冠状面平扫后,再注射钆喷替酸葡甲胺（Ｇｄ－ＤＴＰＡ）并用相同方式扫描,每次３２ｓ完成,最后在工作站进     

肝门胆管癌的磁共振诊断

评价磁共振成像在肝门胆管癌检查中的用途肝门胆管癌的ＭＲＩ表现与组织病理学的关系。材料与方法搜集２４例经手术和病理证实的肝门胆管癌,分析肿瘤在ＭＲＩ上的表现,包括肿瘤生长类型,自旋回波（ＳＥ）Ｔ１和Ｔ２ＷＩ上的信号特点以及动态增强规律,评价用ＭＲＩ判断肿瘤累及范围的准确性,研究肿瘤的组织病理学特点。     

急性胰腺炎的并发症:胰周血管疾病的MRI表现

目的探讨急性胰腺炎(AP)并发各类胰周血管疾病的MRI表现。资料与方法回顾性分析本院2009年6月至2010年9月期间122例AP患者资料,男73例,女49例,平均年龄(45±16)岁。所有病例均签署知情同意书。采用GE1.5TMR扫描:梯度回波T1加权,快速恢复快速自旋回波T2加权,单次激发快速自旋回波T2加权,MR胰胆管成像,动态增强扫描。观察:(1)动脉侵犯/动脉炎;(2)假性动脉瘤;(3)静脉炎、静脉血栓形成/静脉栓塞;(4)胰源性门静脉高压症/门静脉海绵样变。结果本组AP并发胰周血管病变的发生率为17.2%(21/122)。21例AP并发胰周血管病变患者中,动脉侵犯/动脉炎占16/21(脾动脉、肝总动脉、肠系膜上动脉、腹腔干受累率分别为16/16、13/16、12/16、7/16)。脾动脉假性动脉瘤占1/21。静脉炎占19/21(脾静脉、门静脉、肠系膜上静脉受累率分别为19/19、13/19、9/19),静脉血栓形成/静脉栓塞占2/21(1例脾静脉部分性栓塞,另1例门静脉、脾静脉、肠系膜上静脉广泛性栓塞)。胰源性门静脉高压症/门静脉海绵样变占2/21。结论 AP能并发多种胰周血管病变,每种血管病变都...     

Gadoxetic acid-enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Purpose:

To describe the imaging features of early hepatocellular carcinoma (HCC) on gadoxetic acid‐enhanced MRI (Gd‐EOB‐MRI) in comparison with multidetector computed tomography (MDCT) examinations.

Materials and Methods:

We analyzed imaging findings of 19 pathologically proven early HCC lesions in 15 patients who underwent both MDCT and Gd‐EOB‐MRI at 3.0 Tesla (T) units before surgery. MRI included in‐phase and out‐of‐phase T1‐weighted dual‐echo gradient‐recalled‐echo sequences, dynamic T1‐weighted images before and after bolus injection of gadoxetic acid disodium, fat‐saturated T2‐weighted fast spin‐echo sequences, and T1‐weighted hepatobiliary phase images 20 min after contrast injection. Two radiologists retrospectively evaluated the signal intensities and enhancement features on MRI and MDCT.

Results:

None of the lesions displayed arterial enhancement and washout on MDCT. On Gd‐EOB‐MRI, six (32%) lesions showed T2‐hyperintensity, five (26%) lesions showed signal drop on opposed‐phase. Three lesions (16%) showed arterial enhancement and washout. Twelve (63%), 13 (68%), and 15 (79%) lesions were hypointense on hepatic venous, equilibrium, and hepatobiliary phase, respectively.

Conclusion:

Most early HCCs did not show arterial enhancement and washout pattern on both MDCT and Gd‐EOB‐MRI. Gd‐EOB‐MRI may provide several ancillary findings for diagnosis of early HCC such as decreased hepatobiliary uptake, T2 hyperintensity and signal drop in opposed phase. J. Magn. Reson. Imaging 2012;393‐398. © 2011 Wiley Periodicals, Inc.     

MRI screening for acoustic neuroma: a comparison of fast spin echo and contrast enhanced imaging in 1233 patients

Gadolinium enhanced MRI is the gold standard investigation for the detection of acoustic neuroma. Non-contrast MRI sequences have been suggested as an alternative for screening examinations. In order to determine the utility of fast spin echo imaging, both gadolinium enhanced T1 weighted images and fast spin echo T2 weighted images were acquired in 1233 consecutive patients referred for exclusion of acoustic neuroma. Two radiologists independently recorded their findings. Fast spin echo T2 weighted images were evaluated with respect to the visibility of nerves within the internal auditory canals and allocated a confidence score for the presence or absence of acoustic neuroma. 33 acoustic neuromas were identified. Only 56% were confidently identified on fast spin echo T2 weighted images alone; gadolinium enhanced T1 weighted images were required to confirm the diagnosis in 44% of the cases, including 9 of the 10 intracanalicular tumours. However, when identification of two normal intracanalicular nerves is employed as the criterion of normality, the single fast spin echo T2 weighted sequence excluded acoustic neuroma in 59% of this screened population. It is concluded that an imaging strategy intended to identify small intracanalicular acoustic neuromas cannot rely on fast spin echo T2 weighted imaging alone. Gadolinium enhanced T1 weighted imaging could be restricted to patients where fast spin echo images do not exclude acoustic neuroma but this strategy requires continuous supervision by an experienced radiologist. In most practices the screening examination should continue to include a gadolinium enhanced sequence in order to optimize the detection of small acoustic neuromas.     

成人椎间盘炎的MRI诊断

目的 评价MRI对成人椎间盘炎的诊断价值。方法 搜集经临床证实的28例椎间盘炎患者的MR影像资料，分析其MRI表现，比较各种成像方法的敏感性与特异性及其在鉴别诊断中的价值。MRI检查使用1．0T超导机，T1、T2加权像及脂肪抑制T2加权像，2例进行了增强检查。结果 75％的病变椎间盘呈不均匀长T2高信号；全组病例均有相邻椎体受累，两个及两个以上受累者达89％。病变椎体均呈显著长T1低信号，25例呈不均匀长T1高信号，脂肪抑制T2加权像上高信号改变更明显。5例可见椎体边缘骨质增生。椎体受累范围大于二分之一者达78．5％。5例椎体边缘骨质破坏、不完整，而82．1％的病变椎体均无明显外形改变。12例椎旁或椎管内可见局限性脓肿影。2例行Gd—DTPA增强后均可见椎间盘及病变椎体内显著异常强化。结论 MRI对成人椎间盘炎具有极高的敏感性与特异性，可准确鉴别本病与椎体结核与肿瘤，是临床上应作为首选的影像检查方法。     

动态增强MR与PSA在前列腺癌诊断及鉴别诊断中的应用价值

目的：探讨MRI快速序列动态增强在前列腺癌(PC)诊断及鉴别诊断中的价值，并观察PSA在PC与前列腺增生(BPH)诊断中的作用。方法：对5例无泌尿系症状健康志愿者、经病理证实的13例前列腺癌和36例前列腺增生患者进行MR平扫、动态增强及延迟扫描，测量并计算病灶和正常组织的相对信号强度值，并绘制正常周围带(PZ)、PC与BPH三者的时间信号强度曲线。结果：PZ轻度强化，并缓慢上升至晚期达峰值；36例BPH早期明显强化并逐渐上升至中晚期达峰值后缓慢下降：13例PC9例早期明显强化，并快速下降，4例T2WI像上弥漫性病灶呈现中晚期强化。PC尤其是晚期患者的PSA值明显高于增生。结论：PZ、PC及BPH的动态强化方式明显不同，结合PSA可对PC的诊断与鉴别诊断起积极作用。     

动态及延时增强磁共振成像对肝血管瘤诊断的评价

目的:研究动态增强及延迟增强扫描磁共振成像对肝血管瘤的诊断价值。材料和方法:34例肝血管瘤病人行常规MRT1WI、T2WI横断面扫描。经肘静脉手推团注0.1mmol/kg体重Gd-DTPA后,再推入10ml生理盐水冲洗后(推入时间5~6s)行射频毁坏傅立叶采集稳态技术T1WI动态增强扫描及延迟增强扫描,分析病灶及邻近肝实质增强。结果:共发现肝血管瘤病灶67个。动态增强见46个病灶呈边缘不连续样的结节样强化,21个病灶呈周边不规则强化或迅速强化充填;5个病灶动态增强早期见引流静脉强化,14个瘤周肝实质强化。延迟增强扫描见53个病灶完全充填强化,14个病灶显示斑片状或裂隙状的低信号未充填区。结论:在磁共振成像检查中,动态增强扫描能够显示肝血管瘤及邻近实质强化方式,延迟增强显示病灶的充填程度,两者结合更有利于肝血管瘤的诊断。     

膝关节类风湿关节炎的MRI

目的：评估MRI对膝关节类风湿关节炎（RA）各种病变的显示能力及其对临床诊治的意义。材料和方法：对24例RA患者的41个膝关节进行多种序列MR成像，分析其MR表现。结果：所有膝关节均发现存在不同程度MR异常改变（100％）。主要影像学表现包括滑膜增生与血管翳形成、关节囊积液、关节软骨与骨质受侵破坏、半月板与韧带异常、Guo窝囊肿及皮下结节形成等。MR尚能通过血管翳的信号和强化程度判断疾病是否处于活动期。结论：MRI能直接显示膝关节RA不同时期的各种病变。根据MRI表现进行分期不仅可为临床提供诊断依据，还可辅助临床选择适当的治疗方案。     

前列腺癌螺旋CT早期增强的初步研究

目的 初步探讨螺旋CT早期增强对前列腺癌的诊断价值。材料与方法 对11例活检或临床证实的前列腺癌行螺旋CT动态增强扫描。团注非离子型对比剂90－100ml,3ml/s,延时30s螺旋扫描,层厚5mm,Pitch1：1。结果 11例中4例显示早期较明显强化灶位于周围带,7例未见早期强化。前列腺分区显示较好有助于观察结节增生等情况。结论 螺旋CT团注动脉增强能够显示部分前列腺癌的早期强化,可提高检出率及分辨率。     

Dynamic sequential MR imaging of focal liver lesions: initial experience in 22 patients at 1.5 T

The feasibility of dynamic sequential magnetic resonance (MR) imaging of focal hepatic lesions using Gd-diethylenetriamine pentaacetic acid (DTPA) was evaluated in this study. Three patients with hepatocellular carcinoma, 12 patients with metastases, and 7 patients with hemangiomas were studied with pre- and postcontrast multislice spin echo (SE) images using a repetition time of 500 ms and an echo time of 15 ms. The dynamic distribution phase of Gd-DTPA (0.1 mmol/kg) was investigated by using a sequential, transverse partial flip imaging sequence [fast low angle shot (FLASH)] before and after intravenous administration of Gd-DTPA. The lesion-liver contrast-to-noise ratio showed a great variability in patients with metastases and was significantly improved following administration of Gd-DTPA in patients with hemangiomas, two patients with hepatocellular carcinoma, and eight patients with metastases both on FLASH and SE images. Hemangiomas appeared darker than liver parenchyma on precontrast SE and FLASH images, increasingly enhanced over 5 min postinjection (pi) on FLASH images, and were still greatly enhanced at 10 min pi on SE images. During the dynamic sequential image acquisition the contrast enhancement of hemangiomas was significantly different from the enhancement observed in malignant lesions. The results of this study indicate the clinical potential of dynamic sequential imaging for the MR assessment of focal hepatic lesions.