影像学检查在儿童过敏性紫癜的临床价值

目的探讨儿童过敏性紫癜的影像学特点及其临床价值。方法回顾性分析32例过敏性紫癜并发肠套叠患儿的临床及影像学资料。结果出现并发症之前过敏性紫癜的腹部X线主要表现为局限性小肠充气扩张，粘膜增粗，肠间隙增宽，可伴有液平；B超显示为不同程度的多发节段性肠壁水肿增厚，肠管狭窄等表现；出现并发症后，其X线表现加重，部分病例伴有肠穿孔；B超及X线监视下空气灌肠可以明确是否并发肠套叠，部分病例可通过空气灌肠达到复位治疗的目的。结论影像学检查的重要临床价值在于能与需要手术治疗的其他急腹症相鉴别，同时可以了解其是否并发常见的并发症，为临床确定治疗方案提供可靠的信息。     

New insights on COPD imaging via CT and MRI

Multidetector-row computed tomography (MDCT) can be used to quantify morphological features and investigate structure/function relationship in COPD. This approach allows a phenotypical definition of COPD patients, and might improve our understanding of disease pathogenesis and suggest new therapeutical options. In recent years, magnetic resonance imaging (MRI) has also become potentially suitable for the assessment of ventilation, perfusion and respiratory mechanics. This review focuses on the established clinical applications of CT, and novel CT and MRI techniques, which may prove valuable in evaluating the structural and functional damage in COPD.     

MRI evaluation of bulky tumor masses in the mesentery and bladder involvement in peritoneal carcinomatosis

AIM: Peritonectomy procedures with intraperitoneal chemohyperthermia are an effective but costly treatment for peritoneal carcinomatosis (PC). Consequently a proper selection of patients is necessary. We evaluated the benefit of MRI prior to surgery, in the detection of two of the main surgery contraindications: bulky mesenteric tumors and bladder implants. METHODS: Three experts retrospectively reviewed abdominal and pelvic MRI from 19 cases of surgically proved PC (ovary: 7; colorectal: 7; gastric: 2; pseudomyxoma peritonei: 2; appendix: 1). RESULTS: Mesenteric tumors were always identified as hypersignal masses on axial and coronal fat suppression gadolinium-enhanced T1 images (n=3). Three out of five bladder implants were detected. The two cases of bladder implants that were not detected on MRI were missed because the bladder was not filled. The best sequence for the detection of bladder involvement was axial T2-weighted images with bladder filling. CONCLUSIONS: Evaluating the preoperative resectability of PC is crucial for patient management. MRI seems to reliably detect bulky mesenteric tumors and bladder implants on condition the bladder is filled and appropriate sequences are used.     

常见眼眶病变的MRI诊断与鉴别诊断

目的：探讨眼眶病变的MRI诊断与鉴别诊断价值。方法：对29例经临床病理确诊的眼眶病变的病例进行回顾性分析，重点观察该类疾病的MRI表现。结果：眼眶病变29例，包括肿瘤10例。炎症10例，血管性病变3例，眼肌病变6例。其在MRI表现各具有影像学特征，眼眶肿瘤多表现为位于眼眶内、外的局限性软组织肿块，MR T1WI呈等或稍低信号，T2WI呈高或等信号多见；炎性假瘤则表现为眶内局限性软组织肿块或弥漫性异常信号．MR T1WI呈低信号，T2WI呈高信号，常伴有眼肌肥大或眼环增厚，泪腺肿大等。结论：MRI检查能显示眼眶病变的影像学特征，对其诊断及鉴别诊断具有重要价值。     

Parental alcohol use and brain volumes in early- and late-onset alcoholics.

BACKGROUND: Studies have shown that alcoholics have smaller brain volumes than non-alcoholic cohorts, but an effect of family history (FH) of heavy drinking on brain volume has not been demonstrated. We examined the relationship between an FH of heavy drinking and both brain shrinkage as measured by the ratio of brain volumes to intracranial volume (ICV) as well as maximal brain growth as measured by ICV in early-onset and late-onset alcoholics. METHODS: With T1-weighted resonance imaging, we measured ICV, brain volume, and white and gray matter volume in adult treatment-seeking late-onset and early-onset alcoholics with either a positive or a negative FH of heavy alcohol use, and in healthy control subjects. We also calculated brain shrinkage using a ratio of soft tissue volumes to ICV. RESULTS: The FH positive alcoholic patients had significantly smaller ICVs than FH negative patients, suggesting smaller premorbid brain growth. Brain shrinkage did not correlate with FH. Late-onset alcoholics showed a greater difference in ICV between FH positive and FH negative patients than early-onset alcoholics. Late-onset FH positive patients also had significantly lower IQ scores than late-onset FH negative patients, and IQ scores were correlated with ICV. CONCLUSIONS: These data provide evidence that parental alcohol use might increase risk for alcoholism in offspring in part by a genetic and/or environmental effect that might be related to reduced brain growth.     

腔隙性脑梗死的MRI与CT的诊断价值

目的:探讨腔隙性脑梗死的影像学特点及其临床意义,比较MRI和CT的诊断价值。方法:对120例经临床、MRI诊断明确为腔隙性脑梗死患者的病灶形态大小、部位、数量进行统计。结果:①120例行MRI检查患者共发现病灶890个,最多见于豆状核(占40.8%),其次为放射冠、丘脑、内囊、尾状核、桥脑,可为圆形、椭圆形、条索状病灶。②32例既做CT,又做MRI患者中,MRI检出的病灶数为CT的5.1倍,其中绝大多数CT漏检病灶直径≤5mm或位于幕下。结论:①腔隙性脑梗死常为多发,且第一次临床发病时多数患者颅内已存在无症状性腔隙性脑梗死病灶;②腔隙性脑梗死灶易为CT忽略,尤其是幕下病灶或≤5mm的病灶,这是造成既往文献报道腔隙性脑梗死好发部位差异较大的一个主要原因;③尽管腔隙性脑梗死病灶较小(≤10mm),但大部分(60.0%)急性期存在在周边水肿,需要相应的临床治疗。     

CT、MRI对肾上腺病变的诊断分析

目的:分析探讨CT、MRI诊断对肾上腺病变的作用与价值。方法:MarconiMX8000 4层螺旋CT机,增强造影剂使用非离子型制剂,常规扫描及增强。应用西门子MAGNETOM1.5T磁共振机,增强造影剂使用Gd-DTPA制剂,常规T1WI、T2WI、脂肪抑制、化学位移同反相位及增强。对25例经手术及病理资料诊断证实的肾上腺病变进行CT、MRI诊断回顾性分析。结果:可清楚显示肾上腺病变的侧别、数目、大小、范围及可能的性质。结论:CT是肾上腺病变最佳影像检查方法,MRI具有重要辅助及补充诊断价值。     

腮腺多形性腺瘤与沃辛瘤MRI表现对照分析

目的:探讨磁共振成像检查对腮腺多形性腺瘤与沃辛瘤的鉴别诊断价值。方法:回顾分析经病理证实的8例腮腺多形性腺瘤及10例腮腺沃辛瘤的磁共振成像检查表现,并作统计学处理。结果:腮腺多形性腺瘤为单侧腮腺单发病灶(8/8),沃辛瘤可单侧单发(5/10),亦可双侧或多发(5/10)(P<0.05);沃辛瘤多位于腮腺浅叶(13/17),腮腺多形性腺瘤可位于浅叶(6/8),亦可位于深叶或占据深浅叶(2/8)(P<0.05);多形性腺瘤在T2WI中以高信号多见(5/8),沃辛瘤以等信号或低信号为主(17/17)(P<0.05);性别分布上腮腺多形性腺瘤女性多见(6/8),沃辛瘤男性多见(7/10)(P<0.05);年龄分布上沃辛瘤为50岁以上者多见(6/10),多形性腺瘤中50岁以上与50岁以下者分布相近,各为4例(P<0.01)。结论:磁共振成像检查的特征表现和临床资料相结合对腮腺多形性腺瘤与沃辛瘤可正确诊断。     

MR显微成像检测活体阿尔茨海默病转基因小鼠老年斑沉积的效果

目的利用MR显微成像技术研究阿尔茨海默病转基因小鼠老年斑的沉积情况。方法2只17个月龄阿尔茨海默病转基因[V717I]小鼠和2只野生型小鼠，行活体T2WI，然后对照影像定位结果进行组织学切片及免疫组织化学染色。观察T2WI中老年斑的沉积情况以及其与免疫组织化学染色结果的对应关系。结果转基因小鼠T2WI上显示大脑皮层和海马区可见点状低信号，且部分低信号可以和组织学切片所显示的老年斑相对应；野生型小鼠T2WI未见明显的低信号，免疫组织化学染色也未见到染色阳性的斑块。结论MR显微成像技术检测老年斑的沉积是可行的，且可用来特异性地诊断阿尔茨海默病。