静脉注射Gd－DTPA在三维TOF法磁共振脑血管成像中的应用价值

为了降低饱和作用, 提高单体积三维TOF法静脉血管及动脉小分支的显示能力, 我们采用了静脉注射造影剂(Gd-DTPA)的方法缩短血液的T1值, 减少饱和作用影响。结果表明, 增强MRA不但动脉小分支显示能力提高, 而且扫描层面内的重要脑内静脉血管结构显示很清楚, 血管的CNR提高。增强MRA短时间内同时显示高分辨率的动静脉血管结构将明显提高MRA的临床应用价值, 减少对静脉血管疾病的遗漏。     

两种上肢磁共振血管成像检查方法的对比分析

目的：对比磁共振血管成像（ MRA）检查上肢血管疾病的2种方法,探讨移床技术的优势。方法对20例临床诊断有上肢血管疾病的患者分2组进行非移床血管示踪三维动态MRA和移床血管示踪三维动态MRA检查。结果20例均显示出清晰的上肢病变血管（动静脉畸形、血管瘤等）。其中8例显示全程上肢血管影像,供血走向清晰。结论上肢移床血管示踪MRA与非移床MRA比较,具有更好的连续性,能更全面地判定上肢血管病变性质,是更值得推广的检查方法。     

颈动脉体瘤的MR诊断

目的:探讨MR诊断颈动脉体瘤(CBT)的价值。材料与方法:4例经手术病理证实的CBT进行MRI和MRA检查。结果:4例CBT MR检查均显示颈总动脉分叉(common cartid artery bifurcation,CCAB)处类圆形或椭圆形肿瘤,包绕颈内、外动脉,T_1WI呈等或略高信号,T_2WI呈高信号;包膜完整。T_1WI、T_2WI均呈低信号。肿瘤中见多发蜿蜓纡曲的肿瘤小血管。MRA均示CCAB角杯状扩大及肿瘤血管丛。结论:MR不仅能直接显示肿瘤部位、形态、大小及颈动脉关系,也能显示肿瘤血管及CCAB角扩大,是CBT诊断与鉴别的理想方法。     

乳腺癌的动态增强MRA的特点研究

目的探讨乳腺癌的动态增强MRA特点。方法选取2009年7月到2014年3月期间行乳腺常规MRI及动态增强MRA检查的51例乳腺病变患者,扫描序列有T1WI、T2WI-STIR及dyn-THRIVE动态增强,动态扫描时间间隔46 s。连续扫描12个时相,获取动脉早期、动脉晚期及静脉期3期图像。手术病理证实乳腺癌14例共16个病灶。观察乳腺的动态增强MRA特点及动态增强MRA动脉早期、动脉晚期、静脉期乳腺癌与邻近正常乳腺实质或健侧乳腺实质的信号比值差异。结果乳腺癌动态增强MRA特点:瘤体动态显现,自动脉早期信号明显增强,周围有多支或粗大供血血管,动脉晚期可见增粗回流静脉。动脉早期、动脉晚期、静脉期乳腺癌与邻近正常乳腺实质或健侧乳腺实质的信号比值分别约1.56±0.32、1.48±0.35、1.45±0.30。结论结合动态增强MRA的恶性新生肿瘤血管、瘤体染色特点,有助于诊断乳腺癌。     

Variable Significance of Brain MRI Findings in Infective Endocarditis and Its Effect on Surgical Decisions

ObjectiveTo determine how brain magnetic resonance imaging (MRI) findings impact clinical outcomes in patients with infective endocarditis (IE) and to propose a management algorithm for patients with neurologic symptoms who are candidates for valve surgery (VS).Patients and MethodsData from our center were retrospectively reviewed for patients hospitalized with IE between January 1, 2007, and December 31, 2014. Outcomes were postoperative intracerebral hemorrhage (ICH), 6-month mortality, and functional outcome at last follow-up as described by the modified Rankin Scale (mRS) score. Good outcome was defined as an mRS score of 2 or less.ResultsA total of 361 patients with IE were identified, including 127 patients (35%) who had MRI. One hundred twenty-six of 361 patients (35%) had neurologic symptoms, which prompted MRI in 79 of 127 patients (62%); 74 of 79 (94%) had acute or subacute MRI abnormalities. One patient with subarachnoid and multifocal ICH on MRI developed postoperative ICH. Patients with VS despite MRI abnormalities had lower 6-month mortality (odds ratio [OR], 0.17; 95% CI, 0.06-0.48; P<.001) and better functional outcome (OR, 4.43; 95% CI, 1.51-13.00; P=.005). Irrespective of VS, lobar or posterior fossa ICH on MRI was associated with 6-month mortality (OR, 3.58; 95% CI, 1.22-10.50; P=.02) and territorial ischemic stroke was inversely associated with good mRS (OR, 0.29; 95% CI, 0.13-0.66; P=.002). In neurologically asymptomatic patients who had VS, MRI findings did not impact 6-month mortality or functional outcomes.ConclusionMagnetic resonance imaging detects a large number of abnormalities in patients with IE. Preoperative lobar hematoma and large territorial stroke determine outcome irrespective of VS. When indicated, VS increases the odds of a good outcome despite MRI abnormalities.     

CTA与MRA在头颈部动脉狭窄中的诊断比较及符合率观察

目的:探讨对头颈部动脉狭窄使用CTA与MRA诊断的效果。方法:对2019年1月-2019年12月一年时间内进行回顾性分析,选择63例我院收治的手术病理确诊为头颈部动脉狭窄的患者,对所有患者进行CTA与MRA诊断,分析CTA诊断、MRA诊断以及CTA联合MRA诊断的准确率,动脉狭窄程度检出率,以及图像的质量。结果:CTA联合MRA诊断头颈部动脉狭窄的准确率比CTA诊断、MRA诊断均较高(P<0.05),且CTA与MRA诊断没有差异(P>0.05),CTA联合MRA诊断头颈部动脉狭窄程度的准确率比CTA诊断、MRA诊断均较高(P<0.05),且CTA与MRA诊断没有差异(P>0.05),CTA与MRA诊断的图像质量没有差异(P>0.05)。结论:对头颈部动脉狭窄使用CTA与MRA诊断,可明确判断狭窄程度,诊断准确率高,图像清晰,为临床治疗提供依据,具有较高的临床诊断价值。