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201.
单/双期静脉团注法给药对造影剂分布的影响研究 总被引:1,自引:0,他引:1
笔者研究了20例正常成人单/双期静脉团注(相同碘含量造影剂)的脑质及血管时间-密度曲线,为床渐进静脉团注动CT扫描方案的实施提供理论依据,对于脑内疾病的诊断、鉴别诊断及术前方案具有重要意义。 相似文献
202.
D. G. Kim C.-Y. Kim S. H. Paek D. S. Lee J.-K. Chung H.-W. Jung B.-K. Cho 《Acta neurochirurgica》1998,140(7):665-674
Summary
Background To determine its roles in the diagnosis and the systemic evaluation of metastatic brain tumours, whole-body positron emission
tomography (PET) using [18F]FDG was performed in 20 consecutive patients.
Methods
All patients were thought to be suffering or needing to be differentiated from metastatic brain tumours. Nine patients had
multiple brain lesions; six were older and showed a rim-enhancing lesion with surrounding oedema; seven had homogeneously
enhancing periventricular lesion(s) on computed tomography (CT) and/or magnetic resonance (MR) imaging, thought to be central
nervous system lymphomas. Two patients had skull mass(es) and two patients had a solid mass suspected to be, respectively,
a haemorrhagic metastasis and a metastatic malignant melanoma. All of them received whole-body [18F]FDG PET and conventional systemic work-up for metastasis in order to compare the results of the two methods.
Results
Metastatic brain tumours were diagnosed on whole-body [18F]FDG PET in eleven patients who had extracranial and intracranial hypermetabolic lesions. In nine of these, a conventional
work-up also detected primary lesions which on whole-body [18F]FDG PET were seen to be hypermetabolic foci. Systemic lymph node metastases were detected by whole-body [18F]FDG PET only in two patients and histological diagnosis was possible by biopsy of lymph nodes rather than of brain lesions.
In the remaining nine patients who had only intracranial hypermetabolic foci, histological diagnosis was made by craniotomy
or stereotactic biopsy. It was confirmed that seven of nine patients were suffering from a primary brain tumour and two from
metastatic carcinoma. None of the nine showed evidence of systemic cancer on conventional work-up. Histological diagnoses
of the primary brain tumours were four cases of primary central nervous system lymphoma and one each of multifocal glioblastoma,
Ewing's sarcoma, and cavernous angioma.
Patients felt no discomfort during the whole-body [18F]FDG PET procedure and there were no complications. The false negative rate in [18F]FDG PET and in conventional work-up was 15.4% and 30.7% respectively. There were no false positives on either [18F]FDG PET or conventional work-up.
Conclusion
It is suggested that whole-body [18F]FDG PET is a safe, reliable, and convenient method for the diagnosis and systemic evaluation of patients thought to be suffering
or needing to be differentiated from a metastatic brain tumour. 相似文献
203.
204.
Istvn . Mrocz Kullervo Hynynen HLkon Gudbjartsson Sharon Peled Vincent Colucci Ferenc A. Jlesz 《Journal of magnetic resonance imaging : JMRI》1998,8(1):136-142
The aim of this study was to investigate a potential technique for image-guided minimally invasive neurosurgical interventions. Focused ultrasound (FUS) delivers thermal energy without an invasive probe, penetrating the dura mater, entering through the cerebrospinal fluid (CSF) space, or harming intervening brain tissue. We applied continuous on-line monitoring by MRI to demonstrate the effect of the thermal intervention on the brain tissue. For this, seven rabbits had a part of their skull removed to create access for the FUS beam into the brain through an acoustic window of 11 mm in diameter. Dura was left intact and skin was sutured. One week later, the rabbits were sonicated for 3 seconds with 21 W acoustic power, and the FUS focus was visualized with a temperature-sensitive T1-weighted MRI pulse sequence. The tissue reaction was documented over 7 days with T2-weighted images of the brain. The initial area of the central low signal intensity in the axial plane was .4 ± .3 mm2, and for the bright hyperintensity surrounding the lesion, it was 2.3 ± .6 mm2 (n = 7). In the coronal plane, the corresponding values were .4 ± .1 mm2 and 3.4 ± .9 mm2 (n = 5). The developing brain edema culminated 48 hours later and thereafter diminished during the next 5 days. Histology revealed a central necrosis in the white matter surrounded by edematous tissue with inflammatory cells. In summary, the image-guided thermal ablation technique described here produced a relatively small lesion in the white matter at the targeted location. This was accomplished without opening the dura or the need for a stereotactical device. MRI allowed on-line monitoring of the lesion setting and the deposition of thermal energy and demonstrated the tissue damage after the thermal injury. 相似文献
205.
抑郁症的基础与认知激活脑SPECT显像 总被引:17,自引:6,他引:11
目的通过抑郁症患者基础和认知激活局部脑血流(rCBF)灌注显像的半定量分析,评估抑郁症患者的脑血流灌注异常。方法选择27例未经抗抑郁治疗、ICD10分类为中度抑郁发作伴躯体症状的患者,15例年龄匹配的健康人作正常对照。27例患者中21例、15例健康人中13例行双日法基础与认知激活脑rCBF显像;另6例患者及2例健康人仅行基础脑SPECT显像。认知激活采用Wisconsin卡片分类试验。半定量分析在横断面图像7~11帧上进行,将各ROI的平均计数与同侧小脑的最高计数相除,得到各ROI的rCBF比值。结果抑郁症左额叶和左颞叶的基础rCBF值均为0720,明显低于对照组(0764和0750,P<005);左额、左颞、左顶叶的认知激活rCBF值分别为0719、0690及0701,明显低于对照组(0782、0752和0766,P<001和P<005)。结论①抑郁症患者存在左额叶、左颞叶的局部血流低灌注。②额叶、颞叶皮层低灌注可能是引起抑郁症认知障碍、心境低落的原因。③Wisconsin卡片分类试验认知激活脑SPECT显像有助于提高抑郁症的诊断准确性 相似文献
206.
The aim of this study was to estimate the incidence of morbidity and mortality due to injuries in the population over the age of 14 years in Barcelona, Spain. Injury distribution according to sex, age, external cause, place of occurrence of the injury and severity was also obtained. A one-year survey was conducted in the emergency departments of the six main hospitals in Barcelona, based on a multistage sampling. Information was collected prospectively in emergency services by specially trained non-staff interviewers. Mortality data were drawn from death certificates. The incidence rate was 74.7 injury cases per 1,000 person-years over 14 years of age, higher in males than in females. Injury rates were highest in the youngest age-group and progressively lower until people over 75 years of age. Main external causes of injury were falls, being struck or caught by objects, and traffic-related injuries. The leading specific causes of injury mortality were traffic injuries, suicides and poisonings. While the overall admission incidence was 3.34 cases per 1,000 inhabitants, the proportion of hospitalized cases was 45.0 per 1,000 injury cases admitted to emergency rooms, higher for females, for traffic injuries and in the elderly population. Ninety-six percent of injury cases had an ISS value of 8 or less, mean ISS being highest for traffic injuries and falls. Injury morbidity and mortality amongst residents of Barcelona follow sex, age and cause of injury patterns which are, overall, comparable to those observed in other industrialized countries, suggesting that similar etiologic factors might be operating in those areas. The results should enable the orientation of injury prevention policies in the urban environment targeted on the young and the elderly population. 相似文献
207.
Noriko Aida 《Journal of magnetic resonance imaging : JMRI》1998,8(2):317-326
We reviewed neuroradiologic findings of Fukuyama congenital muscular dystrophy (FCMD) and correlated them with the known neuropathology. All patients showed thick and bumpy cortices with shallow sulci corresponding to polymicrogyria, and approximately half of the patients showed pachygyric cortex with smooth surface corresponding to type II lissencephaly. The two types of cortical dysplasias presented characteristic distributions: the former demonstrated frontal lobe involvement in all and parietotemporal lobe involvement in some, whereas the latter involved the temporo-occipital lobes. Most patients showed prolonged T1 and T2 signal in the white matter, which was indistinct in neonates and infrequently seen in adolescents. Cerebellar polymicrogyria depicted as disorganized cerebellar foliation accompanying cysts were found more than 90% of the patients. In conclusion, brain MRI demonstrates findings consistent with the known neuropathology of FCMD. The detection of the two types of cerebral cortical dysplasia with characteristic distribution and cerebellar abnormalities is helpful in the differential and early diagnosis. 相似文献
208.
The effects of left- and right-sided hemispheric brain infarction on variability in circadian blood pressure and cardiovascular measures were investigated in 35 patients to test for asymmetry of the sympathetic consequences of stroke. No significant differences regarding age, size of infarction or extent and frequency of damage to the insular cortex could be detected between the two groups. Patients with right-sided infarction showed a significantly reduced circadian blood pressure variability [diastolic: -1% (95% CI -4 to 1) vs -6% (-9 to -2);P < 0.05] and a higher frequency of nocturnal blood pressure increase (47% vs 35%;P < 0.05) as compared with patients with left-sided infarction. Right-sided infarction was also associated with higher serum noradrenaline concentrations [546 pg/ml (95% CI 415–677) vs 405 pg/ml (266–544);P < 0.05], and ECG more frequently showed QT prolongation (53% vs 35%;P < 0.05) and cardiac arrhythmias (67% vs 20%;P < 0.005). However, irrespective of the hemisphere damaged, patients with insular infarction showed the most pronounced changes of these parameters. In addition, two patients with right-sided strokes (13%) involving the insula, but none with a left-sided infarction, developed myocardial infarction. These findings suggest lateralization of sympathetic activation with right-sided dominance for sympathetic effects following hemispheric stroke.Supported by the Friedrich-Schiedel-Stiftung 相似文献
209.
Recent interest in the neurotoxicity of haloperidol is based on its oxidation in rodents to the pyridinium derivative, HPP+, a structural analog of the neurotoxin, 1-methyl-4-phenylpyridinium (MPP+). Recently, we reported that HPP+ and a newly identified reduced pyridinium, RHPP+, were present in blood and urine of haloperidol-treated schizophrenics and that the concentrations of RHPP+ exceeded those of HPP+. In this study, we examined pathways for formation of RHPP+ in subcellular fractions of human liver (n=5) and brain (basal ganglia;n=5). The major pathway was reduction of HPP+ (20 µM) to RHPP+ in cytosol (0.17–0.39 and 0.03–0.07 µM RHPP+/g cytosolic protein per h in liver and brain, respectively). The reactions were inhibited significantly by menadione and in brain also by daunorubicin. The inhibition profile, cytosolic location and strict NADPH dependence suggest that the enzymes involved are ketone reductases. A second pathway was oxidation of reduced haloperidol (50 µM), a major metabolite of haloperidol in blood and brain, to RHPP+. In liver microsomes, 0.17–0.63 µmol RHPP+ was formed /g microsomal protein per h. A potent inhibitor of the pathway was ketoconazole (IC50, 0.8 µM), which suggests that P-450 3A isozymes could be involved. In brain mitochondria but not microsomes, reduced haloperidol (120 µM) was oxidised to RHPP+ at a small but significant rate (0.005–0.020 µmol RHPP+/g mitochondrial protein per h) which was not attenuated by SKF 525A, quinidine, ketoconazole, or monoamine oxidase inhibitors. Further studies are warranted to establish the biological importance of these metabolites in vivo. 相似文献
210.
Neuropathology in non-human immunodeficiency virus-infected drug addicts: hypoxic brain damage after chronic intravenous drug abuse 总被引:3,自引:0,他引:3
Neuropathological studies were carried out on 180 human immunodeficiency virus-seronegative intravenous drug addicts. The
findings in victims of acute heroin intoxication (n = 116) were congestion (99.1%), capillary engorgement (68.1%), and/or perivascular bleeding (68.1%) – hemodynamic processes
attributable to toxic primary respiratory failure. In a high percentage of these cases (88%), cerebral edema was also present.
In 18 cases of acute heroin intoxication who survived for periods of hours or days, the sole postmortem finding was ischemic
nerve cell damage, resembling that typically seen in systemic hypoxia. Semiquantitative analysis revealed nerve cell loss
in the hippocampal formation and/ or Purkinje cell layer in 26% of the 162 chronic drug abusers. By contrast, in nearly 80%
of these cases, the hippocampus showed enhanced expression of glial fibrillary acid protein by astrocytes and/or a proliferation
of microglia, demonstrated by CD68 expression. Since such reactive processes are produced by primary neuronal damage, it can
be assumed that chronic intravenous drug abuse results in obviously ischemic nerve cell loss. This could be demonstrated in
the hippocampus, but it must also occur throughout the whole brain. The demonstration of ischemic nerve cell damage and neuronal
loss or secondary reactive alterations has not been described previously.
Received: 31 March 1995 / Revised, accepted: 27 November 1995 相似文献