16层螺旋CT冠状动脉成像对冠状动脉狭窄和冠状动脉粥样硬化斑块的评价

几十年来，对冠状动脉病变的设备检查，一直靠有创的插管法造影和靠心电波形的心电图检查，前者为有创检查，危险性高，痛苦性大，病人不易接受，后者不能直接显示病变，而且存在着局限性。随着多层螺旋CT的问世，尤其是16层螺旋CT冠状动脉成像技术在临床上的应用，对冠状动脉的早期发现和预防治疗提供了崭新的检查手段，有十分重要的临床应用价值，越来越受到人们的关注和认可。     

CR、CT、MRI在脊柱结核诊断中的临床价值

[目的]评价计算机X线摄影(CR)、计算机断层成像(CT)、磁共振成像(MRI)在脊柱结核诊断中的临床价值。[方法]回顾分析经病理证实的41例脊柱结核的影像学资料。41例做了CR,22例做了CT,31例均做了MRI。[结果]41例中38例CR片清晰显示骨质改变及椎间隙狭窄或消失,30例CR片可看到软组织阴影。22例CT均清晰显示了钙化,22例CT检查附件均未见明显异常,21例CT清晰显示椎体骨质改变,20例CT显示了软组织阴影。31例MRI均显示软组织均受累,附件均未见受累,其中29例椎间隙狭窄或消失。病变T1WI均以低信号为主,T2WI均以高信号为主。[结论]CR片仍为脊柱结核的基本检查方法,CT较好显示了结核的破坏范围及细微钙化,MRI对显示结核的侵犯范围、软组织异常及椎间盘异常有明显优势。三者相结合有助于脊柱结核的诊断。     

T2翻转序列MRI在中枢神经系统中的应用

高场强磁共振设备的发展,为MRI提供了更高的信噪比,因此T2WI也可以提供清晰的解剖结构以及较高的空间分辨力.T2WI可以通过灰阶的转换以及灰阶窗的扩展产生T2翻转序列.它不仅具有T2WI的所有优点,同时还可以提供更加细致的空间分辨力,因此可以提高中枢神经系统疾病的诊断效率.具有方法简便、无创伤等优点.主要综述T2翻转序列的基本原理、主要技术参数以及在中枢神经系统中的临床应用.     

肾移植术后动脉吻合13狭窄二次断血灌注再植成功1例

移植肾动脉狭窄临床较多见，但在肾移植术后7天行二次断血灌注再植成功报道甚少，笔者处理1例，效果较好，现报告如下。     

国家食品药品监督管理局认定并公布具有药物临床试验资格的机构

根据《中华人民共和国药品管理法》的有关规定，依据《药物临床试验机构资格认定办法(试行)》，经资料审查和现场检查，中国人民解放军第三0二医院等17家医疗机构基本具备承担药物临床试验的条件，     

肾动脉三维对比增强磁共振血管成像的研究进展

肾动脉3D CE-MRA已在高场MR设备下得到广泛应用,是筛选肾动脉狭窄的可靠方法;对于活体供肾者,其可为外科医师提供所需要的有价值信息,但可能漏检小直径血管.从与血管轴正交截面观察可提高MRA对肾动脉狭窄程度评估的准确度,降低阅片者间差异度.MRA可对铂合金支架腔内成像.尚缺乏采用平行采集技术利用3.0 T MR设备对活体供肾者进行的评价研究.应用低剂量对比剂降低MRA费用是发展趋势.血池对比剂有潜力使MRA更上新台阶.     

原发性胆囊癌的影像学诊断(附52例分析)

目的:探讨超声、CT和MRI在胆囊癌诊断中的临床应用价值。方法:回顾性分析52例经手术及病理证实的胆囊癌的超声、CT和MRI资料。结果:52例胆囊癌术前超声诊断符合率为73.1%(38/52),CT诊断符合率为75%(39/52),MRI符合率为83.3%(15/18)。其中合并慢性胆囊炎伴胆囊结石21例(40.4%)。影像表现为4种类型:胆囊壁增厚型(16例),乳头结节型(15例),混合型(壁厚和结节8例),实体型(13例)。结论:超声、CT和MRI对胆囊癌的诊断具有重要的临床价值,合理的应用能更好地指导临床治疗和术后疗效观察。     

Long-term application of diethylstilbestrol upregulates expressions of μ- and m-calpains in pituitary intermediate lobe of female Wistar rats

BACKGROUND: During formation of prolactin neoplasia, how cells and its structure in adenohypophysis affect prolactin cells should be further studied. Intermediate lobe can be regarded as a driving region to release prolactin (PRL) and may promote formation of prolactin neoplasia in pituitary anterior lobe. OBJECTIVE: To observe the effect of diethylstilbestrol (DES) on the expressions of μ and m-calpains in pituitary intermediate lobe of female Wistar rats. DESIGN: Observational contrast animal study. SETTING: Beijing Neurosurgical Institute. MATERIALS: A total of 21 female Wistar rats, 3 weeks old weighing 70–80 g were housed with free access to tap water and standard pellet food. They were kept in a CL-grade condition, at (24±1)℃ and a humidity of (55±5)%, and with a 12 hours day-night cycle. Caprine anti-μ- and m-calpains antibodies were provided by Santa Cruz Biotechnology, CA, USA; rabbit-anti-PRL antibodies by Dako, Denmark; rabbit-anti-ACTH antibody by Boster Company, Wuhan. METHODS: The experiment was carried out in Pathophysiological Department and Animal Laboratory, Beijing Neurosurgical Institute from August 2006 to January 2007. ① Rats were randomly divided into groups with 7 in each group, including vehicle control group, in which rats were injected intraperitoneally with sun-flower seed oil (1 mL/kg, twice a week) for 16 weeks; DES group, where animals were administered with DES (5 mg/kg, twice a week) for 16 weeks; DES + vehicle control group, in which DES was administered for 12 weeks at the same dose with those in DES group, and then was discontinued and replaced by sun-flower seed oil (1 mL/kg, twice a week) for the following 4 weeks. ② At 16 weeks later, pituitary tissue was dealt with HE staining and PRL immunohistochemical examination to observe evoke of tumor; meanwhile, immunohistochemical examination was used to observe expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. MAIN OUTCOME MEASURES: ① Expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. ② Morphological observation of pituitary tissue. RESULTS: All 21 rats were involved in the final analysis. ① Results of immunohistochemical examination: Morphological changes of neoplasia in DES group were strongly positive to PRL, and this suggested that formation of prolactin adenoma was observed in pituitary tissue. As compared with vehicle control group, expression of adrenoeorticotropic hormone (ACTH) was increased in both DES group and DES + vehicle control group. In addition, expressions of μ- and m-calpains in pituitary intermediate lobe were higher in DES group than that in vehicle control group. Otherwise, expressions of m-calpains in pituitary intermediate lobe was decreased in DES + vehicle control group, but expression of μ-calpains was still increased. ② Morphological observation of pituitary tissue: Gland tubes were orderly arranged in rats in vehicle control group. Anterior pituitary gland in rats of DES group demonstrated an apparent disappearance of gland tubes and a relatively large-scaled vasculature formation, namely the vascular lake lined by tightly arranged endothelial cells. Local integrated tumor cell arrangements were also detected. In addition, the border between the IL and the anterior lobe was locally blurred. The definite tumor-like changes in pituitary tissues were confirmed in 6 of 7 female Wistar rats in DES group, and one spontaneous occurrence of tumor formation was found in vehicle control group. In DES + vehicle control group, DES withdrawal led to the subtile emergence of gland tube cavity, although tumor-like cells still existed in 4 of 7 rats, suggesting occurrence of the tumor regression due to the withdrawal of DES. CONCLUSION: A long-term application of DES can enhance the expressions of ubiquitours neutral cysteine protease in pituitary intermediate lobe and this suggests that both of them play a key role in release of hormone and formation of prolactin neoplasia through directly promoting PRL expression and release of neighboring pituitary intermediate lobe.     

头颅MRI诊断结核性脑膜炎的价值

目的分析结核性脑膜炎的MRI表现,探讨MRI的诊断价值。方法回顾性分析34例经临床及实验室检查明确诊断的结核性脑膜炎患者的临床资料和MRI表现。结果MRI能清楚地显示结核性脑膜炎的病理改变（脑膜脑炎、脑积水、脑梗死）,具有特征性表现,为临床诊断、治疗及预后提供可靠的依据。结论MRI对于结核性脑膜炎的诊断具有重要价值。     

低场强2D-TOF法MRA在椎动脉供血不足中的临床应用

目的探讨低场强2D-TOF法磁共振血管成像（MRA）在椎动脉供血不足中的临床应用价值。方法对154例眩晕患者的低场强2D-TOF法MRA临床资料进行回顾性分析。结果154例中,椎动脉异常60例,表现为管腔狭小18例,管腔闭塞7例,局限性狭窄17例,椎动脉迂曲、折角18例;60例患者临床旋颈试验均为阳性。椎动脉正常94例,其中旋颈试验阳性5例。结论低场强MRA作为一种无创检查,能显示大部分椎动脉病变,对临床诊断和治疗椎动脉供血不足有较高的应用价值。