MRI诊断小脑蚓部肿瘤

目的分析小脑蚓部肿瘤的MRI特点及诊断价值.方法回顾性分析经手术病理证实49例小脑蚓部肿瘤的MRI表现,所有病例均行横、冠、矢状面三维的MR平扫及增强扫描.结果 49例病例中包括髓母细胞瘤20例,星形细胞瘤12例,血管母细胞瘤9例,转移瘤4例,室管膜瘤2例,脉络丛乳头状瘤、海绵状血管瘤各1例.MRI可准确地显示肿瘤的位置及邻近情况.小脑蚓部肿瘤大部分有特征性的MRI表现.结论 MRI是检查小脑蚓部肿瘤的首选方法,对小脑蚓部肿瘤的诊断和鉴别诊断有重要的价值.     

小脑发育不良性节细胞瘤的MRI 表现特征

目的 探讨小脑发育不良性节细胞瘤的MRI表现特征。方法 对经手术病理证实的7例小脑发育不良性节细胞瘤的MRI材料进行回顾性分析。研究小脑发育不良性节细胞瘤的T1加权，T2加权，液体衰减恢复成像（FLAIR）和增强后的MRI表现。结果 7例患者中，4例病变累及右侧小脑半球和蚓部，1例仅累及右侧小脑半球，2例肿瘤位于左侧小脑半球，全部肿瘤于T1加权成像呈条纹状相间的等，低信号，T2加权及FLAIR成像呈条纹状相同的等。高信号；增强后肿瘤无强化，结论 MRI呈条纹状改变是小脑发育不良性节细胞瘤的特征性表现。     

小脑梗死的CT表现

目的通过总结12例小脑梗死的cT表现，探讨其影像学表现特点及鉴别诊断。方法12例小脑梗死患者，均行普通平扫后，加做后颅凹薄层扫描。结果较大面积（区域性）梗死5例，较小面积（直径＜2cm）梗死7例，梗死区呈片状低密度影，较大面积的梗死范围与小脑动脉供血区相吻合（主要是小脑后下动脉供血区），直径＜2cm的梗死灶，边缘较模糊，有2例多发。行增强扫描4例。结论小脑梗死CT表现有一定特征，但伴有占位征象时，需与其他占位性病变相鉴别。     

小脑血管母细胞瘤MRI特征探讨

目的：探讨小脑血管母细胞瘤的MRI表现,以提高小脑血管母细胞瘤术前MRI的诊断正确率。方法：对经手术及病理证实21例小脑血管母细胞瘤患者的MRI资料进行回顾性分析。所有病例均行MRI平扫、增强扫描、液体衰减反转恢复成像（FLAIR）。结果：右侧小脑半球8例,左侧小脑半球7例,小脑蚓部3例,小脑扁桃体区3例。囊性型18例（85.7%）,其中囊性内壁光整,囊液呈长T1、长T2信号,FLAIR上呈稍等、稍高信号。实性成分呈等T2、等T1信号,FLAIR呈稍高、等信号。强化后囊壁未见强化10例,囊壁强化8例,2例强化后结节与邻近囊壁衔接处可见“尾巴”征,瘤体实质部分均明显强化,6例瘤体周围水肿。实质型3例（14.2%）,实质肿瘤呈稍长混杂T2、等T1信号,T2WI上均未见流空血管信号影,2例瘤体周围水肿。结论：本研究将小脑血管母细胞瘤MRI表现分为多囊型、单囊型、大囊小结节型、囊旁结节型、单发实质型及多发实质型。充分了解小脑血管母细胞瘤MRI的不同表现形式,以提高小脑血管母细胞瘤术前诊断的正确率。     

小脑囊性肿瘤的MRI影像学分析

分析不同性质的小脑囊性肿瘤的MRI影像表现,旨在提高对小脑囊性肿瘤的诊断水平。方法:对35例在我院经手术病理证实的小脑囊性肿瘤的临床资料与MRI影像进行回顾性分析。结果:毛细胞型星形细胞瘤12例,血管母细胞瘤11例,髓母细胞瘤5例,转移瘤7例。它们在MRI影像中有一定的共性,也有各自的特性,主要表现在肿瘤的形态、瘤周水肿的程度和对比剂增强征象上的各异。结论:小脑囊性肿瘤各自特殊的MRI表现以及好发年龄和部位是诊断和鉴别小脑囊性肿瘤的依据。     

慢性低毒性不典型骨髓炎MRI表现分析

目的 探讨慢性低毒性、不典型骨髓炎的MRI表现及征象认证.方法 回顾性分析16例有外伤史的慢性低毒性、不典型骨髓炎的MRI征象.结果 16例有外伤史的慢性低毒性、不典型骨髓炎病人中,经MRI检查,T2WI上16例病变骨髓均见不同程度斑片状高信号,弥散加权成像(DWI)上为明显高信号,6例增强扫描后,虽明显强化高信号,骨皮质轻度增厚6例,组织肿胀8例.结论 MRI对慢性低毒性、不典型骨髓炎的诊断和指导治疗具有重要价值.     

不典型脑膜瘤MRI表现及误诊分析

目的探讨颅内不典型脑膜瘤的MRI表现特点并与组织病理对照,分析误诊原因,以提高脑膜瘤的MRI诊断准确率。材料与方法回顾性分析经手术病理证实的脑膜瘤22例,术前第一诊断均误诊为其他肿瘤,所有病例术前均行MRI平扫及增强扫描,将MRI表现与病理分级分型对照。结果 22例误诊病例MR征象:酷似脑内肿瘤的脑膜瘤8例,少见发病部位的脑膜瘤8例,常见部位的脑膜瘤6例;信号不均匀15例,形态不规则、具有侵袭性改变12例。术后病理特点:WHOⅠ级12例,WHOⅡ级4例,WHOⅢ级6例。结论因肿瘤组织学结构复杂、生物学特性差异及少见特殊发病部位,导致了脑膜瘤的不典型MRI表现,充分认识不典型脑膜瘤的MRI表现及其与病理分级分型的相关性,对提高诊断准确率具有重要价值。     

脑膜瘤的不典型MR表现

目的脑膜瘤的不典型ＭＲ表现。方法手术病理证实的脑膜瘤３０例,所有病例均行ＭＲ检查,并做增强扫描,其中部分病例还做了ＣＴ检查。结果①囊性脑膜瘤１５例;②多发脑膜瘤４例;③颅外脑膜瘤４例;④侧脑室区脑膜瘤４例;⑤完全钙化性脑膜瘤２例;⑥脑膜瘤伴发胶质瘤１例。结论绝大多数脑膜瘤具有典型ＭＲ表现,但也有极少数脑膜瘤表现不典型,在鉴别诊断时应引起注意     

膝关节周围骨梗死的低场MRI表现

目的探讨膝关节周围骨梗死的低场MRI表现特征。方法回顾性分析11例临床证实的膝关节周围骨梗死的临床及影像资料。结果 11例膝关节周围骨梗死累及20个骨(股骨11个,胫骨9个),同期X线检查中9例阴性。本组均具有典型MRI改变:病变中心呈短T1WI类似骨髓信号,周边环绕花边状混杂信号,T2WI可见双环靶征、三环靶征。结论低场MRI较X线平片能早期诊断骨梗死,值得应用。     

小脑囊性畸胎瘤不典型MRI表现1例

患者女,20岁.因"头痛伴呕吐2个月,行走不稳1个月"入院.MR检查:右侧小脑半球囊实性肿块,边界清,大小约7.2 cm×6.3 cm×8.0 cm;T1WI见实性部分呈等信号,伴边缘环形高信号,T2WI混杂信号,DWI等信号,FLAIR序列稍高信号,囊性部分T1WI等信号,T2WI、DWI及FLAIR序列均为极低信号;增强扫描肿块实性部分轻度强化,囊性部分及周围环状水肿带无强化;4脑室受压变形,幕上脑室扩张,双侧脑室旁间质性脑水肿.     

Acute-onset paraneoplastic cerebellar degeneration secondary to neuroendocrine carcinoma with atypical prognosis: a case report

Paraneoplastic cerebellar degeneration (PCD) is a neurological syndrome that is likely caused by tumor-induced autoimmunity against the cerebellum. Neuroendocrine carcinoma (NEC) is a type of neoplasm with high-grade malignant histology and biological behavior. The prognosis for both PCD and NEC is typically poor. We report a case of PCD secondary to metastatic NEC in the lymph nodes, with an unknown primary origin. The case presented acute cerebellar manifestations with typical neuroimaging findings, but with atypical prognosis after lymph node dissection. Neurological symptoms can provide clues to potential tumors, and early antitumor treatment may have contributed to the positive prognosis of PCD secondary to NEC in the present case.     

电刺激小脑顶核对脑梗死患者神经功能恢复的疗效观察

SinceJanuary２００１，wehavetreated３６cerebralinfarctionpatientswithcerebralcirculationfunctiontreatmentdevicemadebyshanghairenhemedicalequipmentcompany（CVFT－０１０Mtype）andgaingoodeffects，reportasfollow．１Subjectandmethod１．１SubjectAllthese７１patientswerein－patientsofourde－partment，whofitthecriterionpassedbythe４th．Nationalcerebralvasculardiseaseacademicconference犤１犦．Thesepatientswerediag－nosedbycerebralCTorMRIscan．Inthese７１patients，３６casestreatedbycerebralcircul…     

CT及MRI在肝叶型肝梗死诊断中价值

目的探讨CT及MRI在肝叶型肝梗死诊断中的应用价值。方法回顾性分析6例肝叶型肝梗死患者的CT和／或MRI影像学资料。结果CT和／或MRI显示病灶均呈楔形,沿肝脏边缘分布、尖端指向肝门,其内血管影走行自然、部分稍变细;CT平扫显示病灶呈低密度;MRI平扫显示T1WI呈低信号,T2WI呈高信号。结论CT及MRI对肝叶型肝梗死均有重要诊断价值。     

电刺激小脑顶核治疗脑梗死70例

目的观察电刺激小脑顶核治疗脑梗死的疗效。方法将140例脑梗死偏瘫患者随机分为治疗组和对照组各70例。治疗组给予常规药物治疗同时用脑循环功能治疗仪电刺激小脑顶核;对照组给予常规药物治疗。观察两组患者治疗后肢体运动功能及日常生活活动能力的改善情况。结果治疗21 d后,治疗组的Fugl-Meyer评分(39.2±7.7)分与对照组的(26.3±8.1)分有非常显著性差异(t=4.22,P<0.01),Barthel指数评分(43.8±8.4)分亦与对照组的(29.7±7.5)分有非常显著性差异(t=4.97,P<0.01)。结论电刺激小脑顶核是治疗脑梗死偏瘫的有效方法。     

Sudden deafness as a prodrome of cerebellar artery infarction: Three case reports

BACKGROUNDTo summarize the clinical characteristics of acute cerebral infarction (ACI) in patients with sudden deafness (SD) as the first symptom, improve the awareness of the disease, and help diagnosis and treatment.CASE SUMMARYFrom 2019 to 2020, three patients with ACI with SD as the first symptom were admitted to our hospital. Pure tone audiometry, head magnetic resonance imaging (MRI), vertebral artery and carotid artery B-ultrasound, head and neck computed tomography angiography, and other examinations were performed. Following the treatment of SD, hearing and dizziness were not significantly improved. Then, the patients developed symptoms of related cranial nerve injury, and brain MRI showed cerebral infarction in the cerebellopontine angle area. All three cases were transferred to the neurology department for relevant conservative treatment. CONCLUSIONPatients with ACI with SD as the first symptom usually attend the otolaryngology clinic. Here a diagnosis of SD, which is based on an audiological examination, is made and the corresponding treatment is administered. To reduce the misdiagnosis of this disease, close attention should be paid to the changes in the patient''s clinical symptoms and related auxiliary examinations should be performed, such as brain MRI and cerebrovascular imaging. Otolaryngologists should pay attention to the type and severity of hearing loss, the accompanying symptoms, age, high-risk factors for cerebral infarction, and related cranial nerve symptoms in patients with SD. If the patient''s early brain MRI does not show abnormalities, monitoring remains essential. The head MRI should be analyzed quickly based on the changes in the symptoms of the patient, to make an accurate diagnosis and provide the timely and correct treatment for the patients.     

早期腔隙性脑梗死行 CT 和 MRI 检查的临床诊断价值

目的：调查分析早期腔隙性脑梗死影像特点,探讨 CT 与 MRI 两种检查方法诊断腔隙性脑梗死的临床价值。方法选择2012年1月-2012年12月入住院神经内科的早期腔隙性脑梗死患者82例,回顾性收集患者的临床资料,CT 和 MRI 检查结果,分析两种检查方法的检出情况。结果CT 和 MRI 方法均可以检出早期腔隙性脑梗死病灶,其中 CT 检出145个病灶,MRI 检出742个病灶,MRI 检出的病灶数目是 CT 的5．12倍;病灶直径＞5 mm 时,CT检出142个,MRI 检出的病灶486个,检出直径＜5 mm 的病灶,CT 检出率为2．07％（3/145）,MRI 检出率为34．50％（256/742）,差异有统计学意义（P ＜0．05）;腔隙性脑梗死的不同病灶部位两种检查方法检出率有差异（χ2＝147．02,P＜0．05）。结论CT、MRI 影像学检查可应用于早期腔隙性脑梗死的诊断,MRI 方法较 CT 更清晰准确发现腔隙性脑梗死患者的早期、微小病灶,是临床诊断早期腔隙性脑梗死的重要方法。     

核磁共振成像诊断脑梗死的临床价值分析

目的:观察并探讨核磁共振成像诊断脑梗死的临床价值。方法:利用Excel表格将2016年6月至2019年6月间来我院进行检查的364例脑梗死患者平均分为对照组和研究组,各182例,给予对照组患者CT检测,给予研究组核磁共振成像检测,对两组诊断结果进行对比分析。结果:研究组各项准确率均高于对照组,核磁共振成像检测准确率为97.80%,显著高于CT检测的86.26%(P<0.05)。结论:相较于CT检测,对脑梗死患者采用核磁共振成像检测准确率更高,能帮助医生快速诊断病情并予以有效治疗,可进行推广。     

三维动脉自旋标记成像对亚急性单侧幕上脑梗死交叉性小脑失联络的诊断价值

目的探讨MRI三维动脉自旋标记（3dimensional-arterial spin labeling,3D-ASL）成像对亚急性单侧幕上脑梗死患者交叉性小脑失联络（crossed cerebellar diaschisis,CCD）现象的检出价值。方法单侧幕上脑梗死患者44例,于亚急性期行全脑3D-ASL成像,通过GE工作站Functool 4.5版本处理得出对应的脑血流（cerebral blood flow,CBF）伪彩图,测量幕上梗死病变对侧及同侧小脑半球脑血流量,计算不对称指数（asymmetric index,AI）评判小脑低灌注程度,以AI〉10%为CCD阳性标准,比较CCD阳性组与阴性组AI值、幕上梗死灶分布差异。结果 44例患者中CCD阳性23例,CCD阳性组AI值（（19.57±6.10）%）高于CCD阴性组（（0.57±7.70）%）（P〈0.05）;2组幕上梗死灶在额叶、顶叶、颞叶、枕叶、基底节区、放射冠区、丘脑、边缘系统及岛叶分布上差异无统计学意义（P〉0.05）。结论 3D-ASL成像具有简便、无创的优势,有助于亚急性脑梗死患者CCD的检出及随访。     

Vanishing cerebellar infarcts in a migraine patient

Recent population-based studies have suggested that migraine is a risk factor for the development of infarct-like lesions in the territory of the posterior circulation. These lesions are thought to be true vascular infarcts based on their size, location and magnetic resonance imaging (MRI) characteristics. However, as there are no postmortem studies identifying the pathology of these MRI findings, their true aetiology is unknown. A case patient with migraine is presented, who developed what appeared to be cerebellar infarcts on MRI, but these lesions vanished on repeat imaging 16 days later, questioning their aetiology as vascular ischaemic based infarcts.     

小心肌梗死的MRI诊断

目的：探讨小心肌梗死的MRI诊断价值;材料和方法：对12例心绞痛患者进行MRSE和MR电影成像,分析MRI表现与心肌核素显像（单光子发射计算机断层,SPECT）、冠状动脉狭窄和临床表现的关系;结果：12例心绞痛中MRI（T2WI和Gd－DTPAT1WI）发现5例有高信号的小心肌梗死灶（≤2cm）,与无高信号病冽（7例）相比,其心绞痛持续时间长、硝酸甘油效果差,冠状动脉狭窄严重,SPECT有明显局限性灌注缺损或稀疏区,心酶谱阳性率高,心电图有缺血表现（P＜0.05）;结论：MRI是检测小心肌梗死敏感而有效的方法。