儿童侧脑室周围白质软化症 36例临床与磁共振成像特征

目的探讨儿童侧脑室周围白质软化症 (PVL)的临床和核磁共振 (MRI)特征。方法对 36例 PVL的临床资料进行回顾性分析。结果胎龄 30～ 37周 22例 , 38～ 42周 14例。临床表现 肢体 瘫痪 36例 , 皮质盲 2例 , 智力低下 9例 , 癫痫 10例。 MRI表现 病灶形态 斑片状 16例 , 斑点状 13例 , 条纹状 7例。部位 半卵圆中心及侧脑室周围白质。病灶信号 呈长 T1或等 T1, 长 T2变 化。其他 两侧侧脑室体部扩张 8例 , 三角区扩大 5例。结论 PVL是脑性瘫痪的一个主要原因 , MRI是早期诊断 PVL的一个主要方法。     

Color-Encoded Semiautomatic Analysis of Multi-Slice First-Pass Magnetic Resonance Perfusion: Comparison to Tetrofosmin Single Photon Emission Computed Tomography Perfusion and X-Ray Angiography

BACKGROUND AND PURPOSE: Cardiovascular magnetic resonance (CMR) perfusion can accurately detect coronary artery disease (CAD). However, the absence of efficient, easy-to-use and reliable image analysis software is an obstacle to its introduction into clinical practice. The aim of this study was to evaluate new color-encoded semiautomatic software for analysis of first-pass CMR perfusion in comparison to tetrofosmin myocardial single photon emission computed tomography (SPECT), using X-ray angiography as the standard of truth for the detection of CAD. METHODS: Thirty-two patients underwent both SPECT and CMR perfusion at rest and adenosine stress. Twenty of these patients also underwent X-ray angiography. Off-line CMR image analysis consisted of six steps to generate a color display of the myocardial perfusion reserve index (MPRI). The MPRI color-maps were analyzed visually and compared to SPECT. RESULTS: In comparison to X-ray angiography overall accuracy was 87% for CMR and 77% for SPECT perfusion to detect significant CAD (stenosis > or =70%). In comparison with SPECT sensitivity was 80%, specificity 91%, and the overall agreement 89% for CMR. CONCLUSIONS: Post-processing of CMR perfusion data using new semiautomatic software to generate and display the MPRI visually as color-encoded images is feasible and fast. In this study it yielded higher accuracy than SPECT to detect significant CAD on X-ray angiography. Correlation between SPECT and CMR accuracy for detection of perfusion defects was high. This method may accelerate the time-consuming analysis of CMR perfusion data, thus enabling a more widespread clinical utility.     

建立用户需求分析和图像质量评价规范促进磁共振技术创新发展

深入挖掘我国不同地区、不同级别医疗单位对医用MRI设备在临床功能、设备性能、使用体验、售后服务等方面的切实需求,为国产MRI设备的产品定义、产品开发和产品优化提供参考和指导。建立和健全医用MRI设备的临床应用评价规范和体系,并在规范合理的大数据样本集上进行科学统计验证,有助于规范MRI的临床应用,提高国产MRI产品的竞争力,推动我国MRI事业的发展。     

L4,5吻合棘并L5右侧浮动半椎板1例报告

正吻合棘(KS)是指腰椎相邻2个棘突相互靠近碰撞引起下腰痛,腰椎过伸时症状加重的一种疾病~([1])。本院2016年收治1例L_(4,5) KS并L_5右侧峡部裂及近横向脊椎隐裂致L_5右侧形成浮动半椎板的病例,现将诊疗过程报告如下。1一般资料患者,男,30岁,因"劳累后下腰部正中及右侧髂腰部疼痛加重1年"就诊。追问病史,12年前新兵训练5 km武装越野时曾出现类似症状,疼痛     

镜像疗法改善脑卒中后下肢功能障碍患者下肢功能和日常生活活动能力的Meta分析

目的 采用Meta分析软件分析镜像治疗对脑卒中后下肢功能障碍患者下肢运动功能和日常生活活动能力的影响，并评价镜像治疗对脑卒中患者的临床疗效。 方法 检索Medline、PubMed、OT seeker、Cochrane library、万方、维普和中国知网等数据库从2008年12月至2018年12月研究镜像疗法对脑卒中后下肢功能障碍患者下肢运动功能和日常生活活动能力的随机对照试验。按照Cochrane手册5.1.0版对符合纳入标准的文献质量进行评估，采取RevMan 5.2版软件进行分析。 结果 纳入研究14项，Meta分析结果显示，镜像疗法可改善脑卒中后下肢功能障碍患者简化Fugl-Meyer下肢评分 (SMD=0.80, 95% CI=0.53~1.07,P<0.01)、下肢功能性步行分级（FAC）(RR=2.02, 95% CI=1.53~2.67, P<0.01)和改良的Barthel指数得分(MBI)(SMD=0.83, 95% CI=0.67~1.00, P<0.00001)。 结论 镜像疗法可改善脑卒中后下肢功能障碍患者患侧的下肢运动功能及其日常生活活动能力。     

The Role of Appearance Schematicity in the Development of Adolescent Body Dissatisfaction

Although much is now known about the development of body image disturbance, relatively little is known about the role of cognitive processes. The aim of the present study was to examine longitudinally the role of appearance schemas as a predictor of body dissatisfaction change over 2 years among adolescent girls and boys. Participants were 54 Australian school students in Year 10 at Time 1 (M age = 15.1) who were assessed 2 years later when they were in Year 12 (Time 2). It was found that girls' body dissatisfaction worsened from Time 1 to Time 2 compared to boys, and that this change in girls' body dissatisfaction was related to initial appearance schematicity, but not to initial self-esteem. The results support the importance of cognitive processing models for understanding the development of body image disturbance.     

Digital photography: a primer for pathologists

The computer and the digital camera provide a unique means for improving hematology education, research, and patient service. High quality photographic images of gross specimens can be rapidly and conveniently acquired with a high-resolution digital camera, and specialized digital cameras have been developed for photomicroscopy. Digital cameras utilize charge-coupled devices (CCD) or Complementary Metal Oxide Semiconductor (CMOS) image sensors to measure light energy and additional circuitry to convert the measured information into a digital signal. Since digital cameras do not utilize photographic film, images are immediately available for incorporation into web sites or digital publications, printing, transfer to other individuals by email, or other applications. Several excellent digital still cameras are now available for less than 2,500 dollars that capture high quality images comprised of more than 6 megapixels. These images are essentially indistinguishable from conventional film images when viewed on a quality color monitor or printed on a quality color or black and white printer at sizes up to 11x14 inches. Several recent dedicated digital photomicroscopy cameras provide an ultrahigh quality image output of more than 12 megapixels and have low noise circuit designs permitting the direct capture of darkfield and fluorescence images.There are many applications of digital images of pathologic specimens. Since pathology is a visual science, the inclusion of quality digital images into lectures, teaching handouts, and electronic documents is essential. A few institutions have gone beyond the basic application of digital images to developing large electronic hematology atlases, animated, audio-enhanced learning experiences, multidisciplinary Internet conferences, and other innovative applications. Digital images of single microscopic fields (single frame images) are the most widely utilized in hematology education at this time, but single images of many adjacent microscopic fields can be stitched together to prepare "zoomable" panoramas that encompass a large part of a microscope slide and closely simulate observation through a real microscope. With further advances in computer speed and Internet streaming technology, the virtual microscope could easily replace the real microscope in pathology education. Later in this decade, interactive immersive computer experiences may completely revolutionize hematology education and make the conventional lecture and laboratory format obsolete. Patient care is enhanced by the transmission of digital images to other individuals for consultation and education, and by the inclusion of these images in patient care documents. In research laboratories, digital cameras are widely used to document experimental results and to obtain experimental data.     

用于肿瘤调强放射治疗影像分析与转换的深度学习方法

癌症已成为严重威胁人类健康的主要公共卫生问题。60%~70%的癌症患者需要进行放射治疗。调强放疗是当前主要的临床放疗技术。对近几年基于深度学习的影像分析与转换方法在肿瘤调强放疗计划中的应用进展及关键技术进行综述,包括计算机断层扫描(CT)、锥形束CT(CBCT)、磁共振成像(MRI)、正电子发射断层扫描(PET)引导的肿瘤调强放疗技术应用现状与发展趋势,肿瘤CT/CBCT/MRI/PET影像放疗靶区分割、影像配准以及转换深度卷积神经网络、生成对抗网络的有监督或无监督学习方法,并对未来的研究方向进行展望。     

Hallux Valgus Evaluation on MRI: Can Measurements Validated on Radiographs Be Used?

Hallux valgus (HV) is a common deformity of the great toe affecting >23% of adults in the United States. The severity of the deformity is traditionally analyzed using radiographs to determine measurements such as the HV and intermetatarsal angles. We sought to determine the relationship between the radiographic and magnetic resonance imaging (MRI) measurements because this is not yet known. Two of us analyzed a series of 56 consecutive patients who had had radiographs and MRI performed on the same foot between April 27, 2015 and March 9, 2016 and who satisfied all other inclusion and exclusion criteria (age 18 to 100 years, no history of recent foot trauma, and no metal hardware in the foot). We found excellent interreader reliability (intraclass correlation 0.89 to 0.96) and intermodality agreement (intraclass correlation 0.83 to 0.91). The HV angle measured 15.0°?±?8.8° on the MRI scans and 13.8°?±?8.7° on the radiographs (mean difference ?1.15°?±?3.89°), and the intermetatarsal angle was 9.0°?±?3.1° on the MRI scans and 8.8°?±?2.9° on the radiographs (mean difference ?0.22°?±?2.10°). The HV measurements were reliable on both radiographs and MRI for the range of values tested. Small intermodality statistically significant differences in HV angle measurements were found; however, these might not be enough to be clinically significant.     

Motion correction for three-dimensional chemical exchange saturation transfer imaging without direct water saturation artifacts

In chemical exchange saturation transfer (CEST) MRI, motion correction is compromised by the drastically changing image contrast at different frequency offsets, particularly at the direct water saturation. In this study, a simple extension for conventional image registration algorithms is proposed, enabling robust and accurate motion correction of CEST-MRI data. The proposed method uses weighted averaging of motion parameters from a conventional rigid image registration to identify and mitigate erroneously misaligned images. Functionality of the proposed method was verified by ground truth datasets generated from 10 three-dimensional in vivo measurements at 3 T with simulated realistic random rigid motion patterns and noise. Performance was assessed using two different criteria: the maximum image misalignment as a measure for the robustness against direct water saturation artifacts, and the spectral error as a measure of the overall accuracy. For both criteria, the proposed method achieved the best scores compared with two motion-correction algorithms specifically developed to handle the varying contrasts in CEST-MRI. Compared with a straightforward linear interpolation of the motion parameters at frequency offsets close to the direct water saturation, the proposed method offers better performance in the absence of artifacts. The proposed method for motion correction in CEST-MRI allows identification and mitigation of direct water saturation artifacts that occur with conventional image registration algorithms. The resulting improved robustness and accuracy enable reliable motion correction, which is particularly crucial for an automated and carefree evaluation of spectral CEST-MRI data, e.g., for large patient cohorts or in clinical routines.