干细胞移植治疗缺血性脑梗死后脑内迁移的MRI监测

传统观点认为神经元在出生前或出生后不久即失去再生能力,中枢神经损伤后神经细胞为不可逆性死亡。随着干细胞生物学特性研究的深入,冲破了成年生物体内神经细胞不可再生的传统观念。干细胞移植治疗逐渐成为近年研究的热点,迄今已有多篇有关干细胞移植治疗缺血性脑梗死动物模型的文献报道［1-7］。     

养血清脑颗粒联合石杉碱甲治疗血管性痴呆的效果

目的分析养血清脑颗粒联合石杉碱甲治疗血管性痴呆(VD)的效果。方法选取2018年1月至2019年1月永城市人民医院收治的86例VD患者,按照随机数表法分为两组,各43例。对照组接受石杉碱甲治疗,研究组接受养血清脑颗粒联合石杉碱甲治疗。比较两组疗效、治疗前后简易智能精神状态检查量表(MMSE)评分与健康调查简表(SF-36)评分。结果治疗8周后,研究组总有效率(93.02%)高于对照组(74.42%)(P<0.05);研究组MMSE、SF-36评分较对照组高(P<0.05)。结论养血清脑颗粒联合石杉碱甲治疗VD,能显著提高治疗效果,改善认知功能,提高生活质量。     

桥脑出血或梗死继发双侧小脑中脚Wallerian变性及肥大性下橄榄核变性的MR浅析(附5例报告)

目的探讨继发于桥脑出血或梗死并同时继发双侧小脑中脚Wallerian变性(WD)及肥大性下橄榄核变性(HOD)的发病机制、MRI特征及其与原发病灶关系,以期提高对该病的认识。方法回顾性分析5例继发于桥脑出血或梗死同时继发双侧小脑中脚WD及HOD的MRI表现,同时根据MRI表现和解剖结合文献对其进行分析。5例均行MRI常规序列和DWI、SWI或T2*WI序列扫描。结果 5例中3例桥脑基底部背侧出血,均继发双侧HOD及双侧小脑中脚WD。1例桥脑右背侧出血继发右侧HOD及双侧小脑中脚WD,1例桥脑左背侧梗死继发左侧HOD及双侧小脑中脚WD。HOD表现为单侧或双侧下橄榄核体积增大,T1WI呈等或稍低信号,T2WI呈稍高或高信号,FLAIR呈等或稍高信号,DWI呈等或稍高信号,ADC图呈等或稍高信号,SWI或T2*WI呈等或稍高信号,其对原发出血病灶显示最好。双侧小脑中脚WD早期表现为对称性DWI图高信号,ADC图低信号,T2WI稍高信号,T1等信号;中后期表现为DWI图等或稍低信号,ADC图稍高信号,T1WI稍低信号,T2WI稍高信号。结论肥大性下橄榄核变性多继发于桥脑背盖部病变,并且有特定的发病部位和较为特征的MRI表现;双侧小脑中脚对称性异常信号不难发现,但当同时存在桥脑出血或梗死、HOD及双侧小脑中脚对称性异常信号时要考虑到是桥脑出血或梗死同时继发HOD及双侧小脑中脚的WD,而不要盲目的把它们误认定为是三个原发孤立病变。     

脊柱骨巨细胞瘤的CT及MRI表现

目的探讨脊柱骨巨细胞瘤的影像学特征,并与病理对比,旨在提高对本病的认识。方法回顾性分析18例经手术及病理证实的影像及病理结果。结果脊柱骨巨细胞瘤以骶椎发生率最高,病变可侵犯单一或多个椎体,骶椎病变均侵犯多椎体。CT可见椎体呈中心性骨质破坏10例,偏心性骨质破坏8例,8例病变内可见骨嵴或骨性间隔。12例伴有软组织肿物,合并椎体压缩骨折10例,4例增强扫描呈中-重度强化。MRI扫描显示病变T1WI呈等低信号,T2WI呈等低信号或混杂为主,STIR呈不均匀高或稍高信号。结论脊柱骨巨细胞瘤影像学表现具有一定特征,CT与MRI有重要诊断价值。     

34例急性酒精中毒合并脑出血患者的治疗体会

目的：总结急性酒精中毒合并脑出血的患者诊断和治疗的经验.方法：回顾分析我们收治的34例患者的临床资料.结果：我们对患者进行止吐、促醒、降颅压和保护脑细胞等治疗,34例患者死亡5例,基本治愈6例、显著进步12例、进步7例、无变化4例.结论：急性酒精中毒合并脑出血的患者治疗重点是保持呼吸道通畅,积极行血肿处理,保护脑细胞,降低颅内压,防止脑疝形成.     

In vivo tracing of superparamagnetic iron oxide-labeled bone marrow mesenchymal stem cells transplanted for traumatic brain injury by susceptibility weighted imaging in a rat model

Objective：To label rat bone marrow mesenchymal stem cells （BMSCs） with superparamagnetic iron oxide （SPIO） in vitro, and to monitor the survival and location of these labeled BMSCs in a rat model of traumatic brain injury （TBI） by susceptibility weighted imaging （SWI）sequence.Methods：BMSCs were cultured in vitro and then labeled with SPIO. Totally 24 male Sprague Dawley （SD） rats weighing 200-250 g were randomly divided into 4 groups： Groups A-D （n=6 for each group）. Moderate TBI models of all the rats were developed in the left hemisphere following Feeney＇s method. Group A was the experimental group and stereotaxic transplantation of BMSCs labeled with SPIO into the region nearby the contusion was conducted in this group 24 hours after TBI modeling. The other three groups were control groups with transplantation of SPIO, unlabeled BMSCs and injection of nutrient solution respectively conducted in Groups B, C and D at the same time. Monitoring of these SPIO-labeled BMSCs by SWI was performed one day,one week and three weeks after implantation.Results： Numerous BMSCs were successfully labeled with SPIO. They were positive for Prussian blue staining and intracytoplasm positive blue stained particles were found under a microscope （×200）. Scattered little iron particles were observed in the vesicles by electron microscopy （×5000）. MRI of the transplantation sites of the left hemisphere demonstrated a low signal intensity on magnitude images,phase images and SWI images for all the test rats in Group A, and the lesion in the left parietal cortex demonstrated a semicircular low intensity on SWI images, which clearly showed the distribution and migration of BMSCs in the first and third weeks. For Group B, a low signal intensity by MRI was only observed on the first day but undetected during the following examination. No signals were observed in Groups C and D at any time points.Conclusion：SWI sequence in vivo can consecutively and noninvasively trace and demonstrate the status and distribution of BMSCs labeled with SPIO in the brain of TBI model rats.     

大面积脑梗死患者血清Visfatin、TN-C、IL-17水平与神经功能缺损程度的相关性及对预后的预测价值

目的 探讨大面积脑梗死(LHI)患者血清内脂素(Visfatin)、肌腱蛋白C (TN-C)、白介素-17 (IL-17)水平与神经功能缺损程度的相关性及对患者预后的预测价值。方法 前瞻性选取2020年1月至2023年1月平顶山市第一人民医院收治的80例LHI患者作为LHI组,另选取同期80例非大面积急性脑梗死(ACI)患者作为非LHI组,同期80例健康志愿者作为对照组。比较三组研究对象入院(体检)时的血清Visfatin、TN-C、IL-17水平,并比较LHI组不同神经功能缺损程度患者的血清Visfatin、TN-C、IL-17水平,采用Spearman相关系数分析血清Visfatin、TN-C、IL-17水平与LHI神经功能缺损程度的相关性。比较LHI组不同预后患者入院时血清Visfatin、TN-C、IL-17水平,通过受试者工作特征曲线(ROC)分析血清Visfatin、TN-C、IL-17水平预测预后的价值,采用KM生存曲线分析不同血清Visfatin、TN-C、IL-17水平患者3个月存活情况。结果 LHI组患者入院时的血清Visfatin、TN-C、IL-17水平分别为(...     

磁共振尿路成像诊断儿童先天性肾发育不良

目的 探讨磁共振尿路成像(MR urography,MRU)在诊断儿童先天性肾脏发育不良中的应用价值. 方法 对患有先天性肾发育不良并患肾无功能的13例患儿采用常规MRI平扫及MRU(重T_2加权半傅立叶采集单次激发快速自旋回波序列)检查. 结果 13例病例中,常规MRI检查有1例发育不良并异位于盆腔内的小肾未被检出;在MRU原始图像上有1例位于脊柱旁肾窝下方的发育不良的小肾未被发现;MRU MIP重建图像可清晰显示出多房性囊性发育不良的肾脏,对单纯性肾盂呈杵状改变的肾脏显示不佳.全部病例及其伴发病变均被常规MRI结合MRU原始图像、MRU MIP重建图像正确诊断.结论常规MRI结合MRU对诊断儿童先天性肾发育不良有重要价值.