MRAP的临床应用进展

经动脉门静脉造影磁共振成像 (magneticresonanceimag ingduringarterialportography ,MRAP)是在经动脉门静脉造影CT(computedtomographyduringarterialportography ,CTAP)的基础上发展起来的一项磁共振介入性检查方法。它是意大利Pavone等[1] 于 1991年首创并应用于临床 ,此后 ,法国、日本、美国、韩国的研究人员陆续进行了这方面的研究 ,并且取得了很好的临床应用效果。1　背景肝脏的恶性肿瘤是危害人民生命的常见原因 ,如何用现代影像技术早期检出病变 ,是当前影像学医师面临的任务。在常用的一系列方法中 ,MR技术是最新、发展最快…     

小脑幕裂孔下疝的CT诊断（附20例报告）

小脑幕裂孔下和（DTH）又名预叶钩回颓，是最常见的一种脑办‘’。以前临床主要根据瞳孔、神志及锥体束征来诊断。随着CT影像学的发展，头颅CT扫描能够早期诊断该病，显示了较大的临床诊治价值．笔者回顾分析了我院自三995年8月至1997年6月经CT证实的20例患者，总结DTH的CT诊断经验．l临床资料及方法1．是本组患者男性14名，女性6名，年龄16～用岁。伤因：车祸！五例，铁器伤2例，跌伤7例。入院时GCS计分3～4分10例，5～6分8例，7～8分2例。临床表现：一侧瞳孔散大，对光反射消失，对例已彬氏征阳性。预后；死亡7例，植物生存3例，遗…     

腹膜后恶性化学感受器瘤

患者女性，57岁，右上腹鸡蛋大肿块20年，近1年半增大伴疼痛，夜尿增多，食欲下降。体检：右中上胶局限性隆起，可把及－20cm×18cm肿物，周围边界尚清，推之不动，质略软，轻度压痛，其余腹部无压痛及反跳痛，肠鸣音正常，未叩出移动性浊音。CT表现：右侧腹膜后巨大肿块，大小     

胎盘血管三维模型构建用血管灌注技术

有关胎盘血管网的研究,曾有学者[1～3]利用胎盘铸型标本做了大量工作.胎盘血管铸型虽然可以观测一、二、三级胎盘血管形态,但由于受测量工具限制,四到七级的微小血管管径无法测量,而用CT扫描三维重建的方法,则可以对胎盘血管网进行全面而精细的研究.本文旨在为CT扫描三维重建用建立一种胎盘血管灌注铸型技术.     

膝关节软骨MR成像序列对比研究

目的：通过20名青年志愿者膝关节MRI检查来探讨显示膝关节软骨的最佳序列。方法：利用3D-FS-SPGR、FS-GRE、FS-FSE序列测量软骨、软骨下骨、肌肉及滑液的信噪比（SNR）、信噪比效率,并测量软骨与其他组织的对比噪声比（CNR）。结果：①SNR：除滑液在3D-FS-SPGR序列与FS-GRE序列间无统计学差异外,其他组织在三种序列间存在统计学差异。3D-FS-SPGR序列软骨SNR最高。②信噪比效率：除肌肉在3D-FS-SPGR序列与FS-GRE序列间无统计学差异外,其他组织在三种序列间存在统计学差异。软骨下骨在FS-FSE序列上SNR效率最低,在FS-GRE序列上SNR效率最高。③对比噪声比：除软骨/肌肉在3D-FS-SPGR序列与FS-FSE序列间无统计学差异外,其他组织间对比噪声比在三种序列间存在统计学差异。软骨与周围组织的CNR最高。结论：3D-FS-SPGR序列是显示关节软骨的最佳序列。     

青光眼视通路的磁共振扩散张量成像研究进展

磁共振扩散张量成像(DTI)可以无创追踪脑内白质纤维束走行,可用于研究视通路的形态和功能改变。研究发现青光眼不仅局限于眼部视网膜变性,中枢神经系统视通路同样也受到影响,视神经直径、视交叉、外侧膝状体、视辐射及视皮质均存在形态和功能的改变,且功能的改变出现较早。应用DTI技术可以早期发现青光眼视通路改变,为临床治疗提供依据。     

新型MR对比剂长循环超顺磁氧化铁脂质体纳米微粒的体内外实验研究

目的 评价自制新型MR对比剂:长循环超顺磁性氧化铁(superparamagnetic iron oxide,SPIO)脂质体纳米微粒的药代动力学.方法 以加入SPIO为对照组,加入长循环SPIO脂质体纳米微粒为实验组.(1)巨噬细胞的体外吞噬实验:将巨噬细胞株RAW 264.7经复苏、培养,细胞达到80%～90%融合后,以每孔2.5×105个细胞接种于培养板,对照组和实验组细胞与不同浓度药物孵化后,分别测定细胞中Fe浓度和Fe染色情况,并用析因设计的方差分析对结果进行统计学处理.(2)小鼠体内药物分布实验:C57BL/6J雄性小鼠6只,每组2只,设为空白对照组、对照组、实验组,经尾静脉分别注射生理盐水、SPIO以及长循环SPIO脂质体后牺牲动物,经病理检查观察2组药物在体内的分布情况.(3)荷肺癌裸鼠MR成像实验:建立20只BALB/c裸鼠移植型肺癌模型,分为对照组和实验组,每组10只,分别经尾静脉注入SPIO和长循环SPIO脂质体纳米微粒后行MR扫描,测量增强前后2组实验动物各时间点肝脏和肿瘤ROI的信号强度,绘制信噪比(SNR)时间动态变化曲线,采用协方差分析比较2组动物肝脏及肿瘤增强12 h 后SNR差异有无统计学意义.(4)细胞毒性实验(噻唑蓝,MTT法):检查2种药物对人肝细胞株HL-7702细胞的毒性作用,用析因设计的方差分析对结果进行统计学处理.结果 (1)巨噬细胞的体外实验:析因分析结果表明,对照组细胞内Fe含量明显高于实验组,差异有统计学意义(F=296 839.9,P=0.000).普鲁士蓝染色显示对照组巨噬细胞染色较深,实验组巨噬细胞染色较浅.(2)小鼠体内药物分布实验:对照组肝、脾、肺、肾组织内蓝染颗粒多于实验组.(3)荷肺癌裸鼠MR成像实验:平扫对照组肝脏SNR为31.47±0.56,实验组为30.89±1.41;增强扫描12 h后对照组为17.00±0.96,实验组为22.29±0.73.平扫对照组肿瘤SNR为58.41±0.61,实验组为58.44±1.08;增强扫描12 h后对照组为58.50±0.63,实验组为52.47±1.18.经协方差分析表明增强12 h后对照组肝脏SNR显著低于实验组(F=167.022,P=0.000);而实验组肿瘤 SNR显著低于对照组(F=266.106,P=0.000).(4)细胞毒性实验:随着培养液中Fe浓度的增加,HL-7702细胞生存率均有下降趋势,但析因分析结果表明,实验组药物的细胞毒性较对照组低(F=2256.204,P=0.000).结论 长循环SPIO脂质体纳米微粒在体内外均有较好的抗巨噬系统吞噬功能,在体内实现了长循环,对非网状内皮系统的肿瘤也具有良好的T2负性被动靶向强化效果;同时还降低了SPIO对细胞的毒性作用.

Abstract：

Objective To evaluate pharmacodynamics of prepared long-circulating superparamagnetic iron oxide (SPIO) liposomes. Methods Control and experimental groups were established after adding SPIO or long-circulating SPIO liposomes as agents. (1)Macrophages experiment in vitro: the RAW 264.7 macrophage cell strains were recovered, cultured and seeded in the culture plate at a density of 2.5×105 cells/well until they reached 80%-90% confluence. The intracellular Fe uptake of control and experimental group cells were quantified by Ferrozine assay after incubation with different concentrations of drugs. Factorial design analysis of variance was used as statistics method. Prussian blue staining method was used to detect staining of experimental cells.(2)Drug biodistribution in mice: C57BL/6J(n=6) were classified into blank control group (n=2), control group(n=2) and experimental group(n=2).Saline, SPIO and long circulating SPIO were injected via the tail vein in the blank control group, control group and experimental group respectively. Then distribution of drugs in the body was observed by pathological examination.(3) MR imaging of tumor-bearing nude mice: 20 BALB/c nude mice bearing lung cancer models were established and classified into control group and experimental group. After administration of drugs, all animals underwent MR scanning. Signal intensities of livers and tumors were measured, SNR-time dynamic curves were drew. Covariance analysis was used to compare post-enhanced SNR at the 12th hour. (4)Cytotoxicity studies (MTT): cytotoxicity of both drugs on human liver cell line HL-7702 was studied, and statistically analyzed using factorial design analysis of variance. Results (1) Macrophages experiment in vitro: The nanoparticle uptake by macrophage cells evaluated by ferrozine assay showed the uptake of blank SPIO was higher than long-circulating SPIO liposomes. Compared with the blank control group, there was strong blue staining in the macrophages with Prussian staining in the control group and little blue staining in the experimental group. (2) Drug biodistribution in mice: for blue stained cells composed of iron particles, the amounts in the liver, spleen, lung, kidney of the control group were more than those in the experimental group. (3) MR imaging of tumor-bearing nude mice: the non-enhanced SNR of livers and tumors in the control group and experimental group were 31.47 ± 0.56, 30.89 ± 1.41, 58.41 ± 0.61, 58.44 ± 1.08, respectively. After injecting of contrast agents, SNR of livers and tumors in the control group and experimental group were 17.00 ± 0.96, 22.29 ± 0.73, 58.50 ± 0.63, 52.47 ± 1.18, respectively. The covariance analysis showed that SNR of the livers in the control group after 12 hours was significantly lower than the experimental group (F=167.022, P=0.000); while the SNR of the tumors in the experimental group was significantly lower than the control group (F=266.106, P=0.000).(4) Cytotoxicity of nanoparticles by MTT method: the viability of HL-7702 cells tend to decrease with the increase of Fe concentration. Cytotoxicity in the long-circulating SPIO liposomes was lower than the SPIO(F=2256.204,P=0.000). Conclusions Long-circulating SPIO liposomes we prepared reveal suitable sizes, even distribution, and good anti-macrophage ability in vitro and in vivo. They have long circulation characteristic and T2 negative enhancement effect in the transplanted lung cancers, while they still maintain low cytotoxicity.     

脾脏血管肉瘤的CT表现（附1例报告）

脾脏原发性恶性肿瘤非常少见。脾脏原发性血管肉瘤,又称恶性血管内皮细胞瘤,是一种高度恶性的血管源性肿瘤。迄今为止,据文献报告约140余例。我院偶遇一例,现报告如下: 病例资料:患者,女必,40岁。自觉上腹部疼痛不适,伴乏力、心悸、消瘦二月余。体检:左中上腹扪及一包块,表面光滑,质偏硬,活动性差。实验室检查提示中度贫血。     

四肢肌间海绵状血管瘤的MRI诊断

目的：探讨MRI对四肢肌间海绵状血管瘤的诊断价值。方法：经手术病理证实的四肢肌间海绵状血管瘤13例,术前行MRSET1WI、T2WI及动态增强扫描。回顾性分析其MRI表现并总结其特征。结果：13例中3例肿瘤位于上肢,10例位于下肢,其中有4例位于膝关节附近。12例表现为单发的团块状病灶,1例为多个病灶。病灶大小不等,最长径1.5～20.1cm。T2WI上瘤灶呈均匀或混杂高信号;T1WI上5例呈低信号,5例呈等信号,3例呈稍高信号。增强扫描示病灶呈不均匀明显强化。近关节者与远离关节者表现有较大差异,1例位于膝关节附近者导致膝关节广泛受损,另1例位于腘窝者导致邻近软骨组织增生并致膝关节挛缩畸形,余11例无周围组织明显受累征象。结论：四肢肌间海绵状血管瘤的MRI表现有一定特征性,结合临床症状及体征,可对其做出定位及定性诊断。