脉络膜血管瘤的MRI表现及动态增强研究

Objective To characterize the regular and the dynamic contrast enhancement MR imaging in choroidal hemangioma.Methods MR imaging findings of 30 cases (31eyes, 32 lesions) with choroidal hemangioma confirmed by follow-up results were retrospectively analyzed.Among them, postcontrasted T1-weighted imaging was performed in 30 patients and dynamic contrast enhancement scanning was performed in 26 cases.MRI findings and the time-intensity curve of dynamic contrast enhancement were analyzed.Results Among the 32 choroidal hemangiomas, 26 of them were at the temporal side of optic disc and 28 lesions were fusiform.Before enhancement, 23 lesions showed isointense T1-weighted signal and 31 lesions were isointense on T2-weighted imaging.All the lesions showed strong enhancement on postcontrast T1-weighted imaging, including 31 homogenously enhanced lesions and one heterogeneously enhanced lesion.Retinal detachments were found in 18 eyes.Fill-in sign were observed in 12 lesions during dynamic contrast enhancement.The time-intensity curve of dynamic contrast enhancement in 28 lesions suggested a pattern with rapid enhancement and slow washout, time to peak (91.00±25.27) s, slope ratio 3.03±1.13, the median of washout ratio 17.06%, enhancement ratio 2.87±0.79.Conclusion MRI showed a few features of the location, shape, signal characteristics, and enhancement pattern in choroidal hemangioma, which may contribut to diagnosis and treatment plan of this disease.     

颅盖骨转移瘤的CT诊断（附23例分析）

目的：探讨颅盖骨转移瘤的CT表现及诊断价值。方法；对经临床工病理证实的23例颅盖骨转移瘤病人进行回顾性分析，23例均作有CT及X线平片检查。结果：CT表现主要呈溶骨性骨质破坏18例（78．3％），也可见成骨性2例（8．7％）或混合性3例（13％）骨质改变。X线平片阳性14例（60．9％）。转移部位以顶骨（40．7％）和枕骨（27．1％）常见，颞骨（11．9％）较少。结论：CT扫描显示病变明显优于X线平片，具有特征性，能对多数病变作出正确诊断。     

侧颅底巨细胞修复性肉芽肿的影像学研究

目的　分析发生于侧颅底的巨细胞修复性肉芽肿（giant cell reparative granuloma,GCRG）的影像学表现,以提高对该病的认识及诊断准确率。方法　回顾分析经病理确诊为侧颅底GCRG的9例患者CT和MRI资料,提取侧颅底GCRG的影像学特征。结果　9例患者均为单侧病变,以侧颅底颞骨鳞部为中心生长;CT表现为软组织密度,4例病变内及边缘可见点条状高密度钙化、骨化或残存骨,9例显示膨胀性骨质破坏,8例并可见骨质增生硬化;MRI表现为T2WI低信号为主的混杂信号,其内可见高信号的囊变坏死区,T1WI呈等、低信号,增强后不均匀轻中度强化。结论  侧颅底GCRG有特征性影像学征象,术前能够提示诊断。     

人工耳蜗植入术前的影像学评估

目的分析人工耳蜗植入(CI)术前颞骨MRI及CT表现,并探讨术前影像学对人工耳蜗植入的价值。方法拟行CI的160例患者均行高分辨率CT扫描,64例同时行横、冠状面扫描,119例行MR检查。结果320耳乳突均气化良好,乳突蜂房向后超过乙状窦前壁206例。左、右侧乳突长度分别为(2.34±0.42)、(2.25±0.40)mm(U=1.887,P<0.05),宽度分别为(1.57±0.30)、(1.50±0.27)mm(U=2.35,P<0.05)。中耳炎8耳,CT示鼓室及乳突蜂房不含气,MRI为长T1,长T2信号。颈静脉球窝扩大或高位18耳,蜗窗龛狭窄2耳。迷路炎9耳,8耳CT表现耳蜗、半规管及前庭不同程度的骨化,MRI表现为长T1,短T2及短T1、等T2信号,并且T2WI信号不连续。1耳膜迷路闭塞,CT为阴性,MRI表现为等T1、等T2信号。耳蜗完全未发育1耳,耳蜗发育周数不足6耳,Mondini畸形5耳。前庭导水管扩大40耳,前庭、半规管发育畸形10耳,内耳道狭窄5耳。结论术前的颞骨影像学诊断,对于CI成功实施能够提供重要信息。     

葡萄膜转移瘤的MRI表现

目的探讨葡萄膜转移瘤的MRI表现特点。方法回顾性分析20例经病理或临床随访证实的葡萄膜转移瘤的MRI表现。1例仅行平扫，19例同时行平扫和增强扫描，其中4例行动态增强扫描。结果20例葡萄膜转移瘤中，位于虹膜和睫状体2例，18例位于脉络膜；2例表现为略长T1、等T2信号，9例表现为等T1、等T2信号，3例表现为等T1、略长T2信号，3例表现为等T1、略短T2信号，2例表现为略短T1、略短T2信号，1例表现为略短T1、略长T2信号；8例表现为眼球壁轻度增厚，3例呈新月形，7例呈梭形，2例呈结节状。19例呈中度至明显强化；行动态增强扫描的4例时间-信号强度曲线均呈速升、缓降型。伴有视网膜脱离11例和玻璃体信号异常2例。结论MRI能显示葡萄膜转移瘤的部位、形态、信号及强化特点，有助于葡萄膜转移瘤的诊断与鉴别诊断。     

脉络膜血管瘤的MRI表现及动态增强研究

Objective To characterize the regular and the dynamic contrast enhancement MR imaging in choroidal hemangioma.Methods MR imaging findings of 30 cases (31eyes, 32 lesions) with choroidal hemangioma confirmed by follow-up results were retrospectively analyzed.Among them, postcontrasted T1-weighted imaging was performed in 30 patients and dynamic contrast enhancement scanning was performed in 26 cases.MRI findings and the time-intensity curve of dynamic contrast enhancement were analyzed.Results Among the 32 choroidal hemangiomas, 26 of them were at the temporal side of optic disc and 28 lesions were fusiform.Before enhancement, 23 lesions showed isointense T1-weighted signal and 31 lesions were isointense on T2-weighted imaging.All the lesions showed strong enhancement on postcontrast T1-weighted imaging, including 31 homogenously enhanced lesions and one heterogeneously enhanced lesion.Retinal detachments were found in 18 eyes.Fill-in sign were observed in 12 lesions during dynamic contrast enhancement.The time-intensity curve of dynamic contrast enhancement in 28 lesions suggested a pattern with rapid enhancement and slow washout, time to peak (91.00±25.27) s, slope ratio 3.03±1.13, the median of washout ratio 17.06%, enhancement ratio 2.87±0.79.Conclusion MRI showed a few features of the location, shape, signal characteristics, and enhancement pattern in choroidal hemangioma, which may contribut to diagnosis and treatment plan of this disease.     

鼻窦气房标本负压火棉胶包埋法探讨

为研究蝶窦外侧壁相关结构的形态、大小、位置、毗邻的相互关系 ,我们选取 1 0 %福尔马林固定的离体完整颅底正常的头颅标本 ,应用火棉胶包埋法和组织学切片方法对含气易碎标本做连续断层切片制作。1　材料和方法1 1　大体标本制作　选取经 1 0 %福尔马林多年固定的 1 2个全头     

多参数磁共振显示听神经瘤患者迷路信号改变的对比分析

目的　比较多参数磁共振显示听神经瘤患者患侧迷路信号改变的效能,寻找识别迷路信号变化的最佳MRI检查技术。方法　回顾性分析2019年9月～2022年7月就诊于首都医科大学附属北京同仁医院的单侧听神经瘤患者的MRI资料,共39例。选择耳蜗为研究对象,由两名放射科医师共同进行患侧与健侧的耳蜗信号定性评估与定量测量,统计病变大小及位置,分别计算患侧与健侧的耳蜗信号强度/脑干信号强度的比值,采用独立样本t 检验进行分析,判断患侧与健侧耳蜗信号强度/脑干信号强度比值是否具有统计学差异。同时采用受试者工作特征（ROC）曲线评估在各序列在判断耳蜗信号强度变化的诊断效能。结果　T1WI（20.5%）、增强T1WI（30.8%）、T2WI（15.4%）及增强延迟3D-T2 FLAIR（100%）显示患侧耳蜗信号相对健侧为高信号,水成像（83.3%）显示患侧耳蜗相对健侧为低信号。除T2WI序列外,患侧与健侧的耳蜗/脑干信号强度比值在其他各序列均存在统计学差异（P<0.05）,增强延迟3D-T2FLAIR的曲线下面积（AUC=0.822）最高,其次为水成像。结论  增强延迟3D-T2 FLAIR在反映听神经瘤患者耳蜗信号变化更具优势,水成像同样也是必不可少的检查手段,为揭示听神经瘤引起迷路成分的病理生理改变提供新的无创检查方法。     

空蝶鞍综合征眼部特征分析

目的  探讨空蝶鞍综合征的眼部临床表现及预后。设计 回顾性病例系列。研究对象 在北京同仁医院就诊,经MRI检查诊断为空蝶鞍综合征的32例患者。方法  对这些患者的检查治疗资料及眼部表现进行分析。主要指标 视力、眼压、眼底、视野、房角。结果 32例患者中因明显视力下降就诊者20例（62.5%）。最佳矫正视力低于0.8者45眼,其中低于0.1者5眼,0.1~0.3者14眼,0.4~0.7者26眼。眼压在21~29 mm Hg者13眼（20.3%）。眼底检查13眼（20.3%）有视盘水肿,19眼（29.7%）有视神经萎缩。视野缺损48眼（75.0%）,其中9眼有类似青光眼的视野缺损,10例患者为双颞侧偏盲。房角开放者28例56眼（87.5%）,房角窄或可疑关闭者4例8眼（12.5%）。3例空蝶鞍综合征患者合并闭角型青光眼,1例合并开角型青光眼,2例合并正常眼压性青光眼。3例患者经神经外科手术治疗,最佳矫正视力好转。结论 空蝶鞍综合征的眼部表现可有视力下降、视盘水肿、视神经萎缩及视野缺损。对于不能由眼科疾病解释而怀疑本病者,应及时请相关科室会诊并协助治疗。（眼科, 2012, 21: 309-312）     

3D-FIESTA序列在先天性内耳畸形中应用

目的评估3D-FIESTA序列在先天性内耳畸形中的应用价值。方法采用3D-FIESTA序列对38例内耳畸形患者进行扫描,并进行多平面重组。结果 38例（62耳）内耳畸形中耳蜗畸形31耳,前庭畸形28耳,半规管畸形32耳,前庭水管及内淋巴囊扩大21耳,内耳道神经发育异常29耳。结论 3D-FIESTA序列可以清晰显示内耳道及内耳迷路的先天发育异常,具有较高的临床应用价值。