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.     

翼管的高分辨率CT(HRCT)研究

目的：探讨翼管高分辨率ＣＴ（ＨＲＣＴ）正常及病理的表现。方法：回顾性分析１００例正常成年人翼管和７２例病变累及翼管的病例。结果：正常成年人右侧翼管长度１４．００ｍｍ（１７．０１～１１．００ｍｍ）,左侧翼管长度 １４．００ｍｍ（１８． ０５～１１． ０３ｍｍ）,男女两者无明显差异（ Ｐ＞０． ０５）;翼管前口宽度 ２．００ｍｍ（０．８０～４．００ｍｍ）,后口宽度１．４０ｍｍ（０．５０～２．８０ｍｍ）;８５％翼管向前内走向,两侧翼管前部距离２５ｍｍ（１７～３１ｍｍ）,后部距离２７ｍｍ（１９～３５ｍｍ）;翼管与蝶窦下壁前后的距离分别为２．４ｍｍ和３．０ｍｍ,以上三组数值均有显著差异（ Ｐ＜ ０． ０５）,但男女之间无明显差异（ Ｐ＞０． ０５）。正常成人翼管与鼻窦关系：位于有完整分隔的蝶窦下５５％,蝶窦内３１％,不对称分隔或无分隔下８％,上壁缺如与蝶窦交通６％。病变累及翼管病理改变分三种类型：扩大１０例（１３．９％）;狭窄１７例（２３,６％）。消失４５例（９９．５％）。结论：ＨＲＣＴ能很好显示翼管骨性结构,准确认识翼管正常表现及与邻近结构关系,可以发现翼管早期病变并指导临床治疗。     

鼻窦气房标本火棉胶包埋法探讨

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,方法：我们选取１０％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。 结果：在鼻窦气房火棉胶大切片制成之后,肉眼即可观察到许多重要结构的形态,大小,位置,毗邻,相互关系,如视神经、颈内动脉、垂体等。为临床放疗、手术提供了重要的不同方位的解剖结构。 结论：火棉胶包埋法的优点是：１．切片较薄,可达１００ｕｍ或更薄。每１０张取１张,每层标准间距为１ｍｍ,层厚１００ｕｍ,符合临床影像学（Ｃ…     

鼻眼相关疾病的CT扫描诊断

根据２８３例经临床或病理证实的鼻眼相关疾病的ＣＴ检查资料，探讨该疾病的影像学特点及其发生、发展的某些规律。方法主要是用骨窗和软组织窗技术要结合，层厚２ｍｍ，５ｍｍ，层间距５ｍｍ，必要时行增强扫描。结果示２３例累及眼眶的炎性病变中，各鼻窦均有累及，其中以筛窦最多，炎性病变鼻眼病变沟能芭眶壁骨质吸收破坏为主。１２８例肿瘤性病变全部累及眼眶、鼻窦，其中亦以累及筛窦为最多。恶性肿瘤鼻眼病变的沟通方式以骨质     

耳硬化症影像学研究

【摘要】耳硬化症是耳囊的一种骨营养不良性疾病,是传导聋、混合聋或感音聋的常见原因。影像学在耳硬化症的诊断和治疗中起着重要的作用,颞骨高分辨率CT片是评估耳硬化症的首选方式。磁共振成像对迷路受累显示有一定价值,尤其是对于人工耳蜗植入术前耳蜗管腔和迷路内病变评估是有必要的。新成像方式如CBCT、SPECT及新的MRI序列,对术后并发症的检出、疾病活动性判断和显示内淋巴液积水有着诸多优势,但在临床工作中影像学检查在该病的诊断、分期、指导治疗及术后评估等方面仍有诸多问题与不足。     

减重与代谢手术病人垂体磁共振检查临床适用性评价

目的 探讨垂体磁共振（MR）检查在减重与代谢手术病人中常规开展的必要性及其应用条件。方法 回顾性分析2016年1月1日至2019年12月31日首都医科大学附属北京友谊医院普通外科中心减重与代谢外科收治的行垂体MR检查的312例代谢综合征病人的临床资料。将MR检查结果根据影响临床决策的程度分为Ⅰ~Ⅴ类。统计垂体MR检查的整体阳性率、检查目的相关阳性率、影响临床决策阳性率。结果 垂体MR检查结果中Ⅰ类263例（84.3%），Ⅱ类15例（4.8%），Ⅲ类21例（6.7%），Ⅳ类3例（1.0%），Ⅴ类10例（3.2%）。整体阳性率为15.7%（49/312）；检查目的相关阳性率为7.7%（24/312）；影响临床决策阳性率为0.6%（2/312），包括垂体大腺瘤1例、脑肿瘤1例。 结论 对于减重与代谢手术病人，因垂体MR平扫检查阳性率低，为临床提供价值较小，极少影响临床决策，不推荐常规开展；对于临床怀疑垂体病变所致继发性肥胖或病人，推荐垂体MR增强检查；对于伴中枢神经系统症状病人，推荐颅脑MR增强检查。     

短暂性单眼视野缺损眼部动脉血流动力学改变及颅内段颈内动脉狭窄特点

目的探讨短暂性单眼视野缺损眼部动脉血流动力学改变规律及颈内动脉狭窄的特点。方法采用回顾性病例对照研究。收集因短暂性单眼视野缺损(TMVL)就诊患者(共30例)的临床资料(TMVL组)。同时采集非视网膜缺血性病变的正常志愿者临床资料作为正常对照组。两组均行眼动脉、视网膜中央动脉、睫状后动脉超声检查,测量参数包括收缩峰流速、舒张峰流速、阻力指数及搏动指数,同时行头颈部CT血管成像检查,测量颈内动脉颅内段狭窄程度。结果 TMVL组眼动脉收缩峰流速较正常对照组明显下降(28.40±3.69 cm/s比32.58±2.75 cm/s P=0.000),舒张峰流速较正常对照组明显下降(6.10±1.70 cm/s比7.35±1.49 cm/s,P=0.001);TMVL组视网膜中央动脉收缩峰流速较正常对照组明显下降(8.38±1.68 cm/s比9.92±2.30 cm/s,P=0.005),舒张峰流速较正常对照组明显下降(2.35±0.80 cm/s比2.88±0.62 cm/s,P=0.007);TMVL组睫状后动脉收缩峰流速较正常对照组收缩峰流速明显下降(10.01±2.25 cm/s比11.43±1.69 cm/s,P=0.008),舒张峰流速较正常对照组明显下降(3.30±1.16 cm/s比4.14±1.06 cm/s,P=0.006)。TMVL组阻力指数、搏动指数在眼动脉、视网膜中央动脉及睫状后动脉较正常对照组均无统计学差异。TMVL组颈内动脉中、重度狭窄患者比例(约占63.33%)较正常对照组(10.00%)明显增高,差异有统计学意义(P=0.000)。结论 TMVL患者较正常对照组眼部血流明显下降,而颈内动脉发生中、重度狭窄概率较正常对照组明显升高。     

误诊为蝶窦肿瘤的垂体腺瘤1例

患者 女,66岁.无诱因左眼视力下降半年,伴间断性头痛,以额顶颞部为主,无复视,无恶心、呕吐.     

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.     

鼻腔鼻窦神经鞘瘤的CT和MRI表现

目的 探讨鼻腔鼻窦神经鞘瘤的CT和MRI表现,并评价2种影像检查方法的临床应用价值.方法 回顾性分析12例经组织学证实鼻腔鼻窦神经鞘瘤的影像资料,12例均做cT检查,10例做MR检查.结果 12例神经鞘瘤中良性11例,低度恶性1例;发生于鼻筛区4例,上颌窦3例,上颌窦、筛窦及蝶窦2例,上颌窦、鼻腔1例,蝶窦1例,后鼻孔1例;病变边界清楚,呈椭圆形4例,不规则形8例.CT表现:病变区轮廓扩大,相应鼻腔鼻窦骨质受压、变薄、移位,其中8例伴局部吸收,1例伴轻微侵蚀性破坏;平扫病变密度均匀10例,另2例其内可见低密度区,增强后2例病变显示不均匀强化.MRI表现:与脑实质比较,T1WI呈等信号,其中3例可见片状及结节状低信号,2例伴有片状高信号;T2WI呈不均匀等信号7例,稍高信号3例,其中2例伴有片状低信号;9例病变内可见点、片状高信号,其中6例伴有规整的结节状高信号,1例显示液-液面;增强后9例显示中度或显著不均匀强化,1例较均匀显著强化.2例行MR动态增强扫描,时间.信号强度曲线为平台型.6例伴有阻塞性鼻窦炎,T1WI为低信号,T2WI为高信号,增强后其内部不强化,边缘可见线状强化.MRI均清楚显示病变的范围和伴发的炎症.结论 骨质变形、变薄、吸收和MR T2WI所示斑片、结节状高信号并且增强后无强化为该病特征性表现;CT和MR两种影像检查方法联合使用能够对该病的诊断、治疗提供更全面的信息.