磁共振成像在老年心肌梗塞中的应用

对３２例老年急性心肌梗塞恢复期和陈旧性心肌梗塞患者行磁共振成像（ＭＲＩ）检查，并与心电图（ＥＣＧ）和超声心动图（ＵＣＧ）对比。ＭＲＩ可直观的显示出梗塞部位室壁变薄，信号减低，对心尖部梗塞的诊断优于ＥＣＧ。ＭＲＩ在室壁瘤中检出例数多于ＥＣＧ和ＵＣＧ。在急性心肌梗塞恢复期和陈旧性心肌梗塞患者中，当高度怀疑室壁瘤或心包积液而常规ＥＣＧ和ＵＣＧ无阳性发现时，有必要行ＭＲＩ作为补充检查，以明确诊断。     

抑郁症患者认知功能与前额叶、海马质子波谱特点及其相关性

目的探讨抑郁症患者认知功能与前额叶、海马氢质子磁共振波谱(1H-MRS)特点及其之间的相关性。方法研究对象为2010-12—2012-11在我院住院的51例抑郁症患者(研究组)及附近社区的46例正常对照(对照组)。入组24 h内应用事件相关电位P300(P300)和威斯康星卡片分类测验(WCST)评估认知功能,采用多体素1H-MRS检测前额叶和海马N-乙酰基天门冬氨酸(NAA)、胆碱复合物(Cho)与肌酸复合物(Cr)。结果与对照组比较,研究组N2、P3潜伏期均延长,N2、P3波幅均降低,差异有高度统计学意义(t值分别为3.258、5.834、4.707和-4.968,P<0.01);Re、Rpe、Rf均高,Cc和Rf%均低,差异有高度统计学意义(t值分别为4.969、5.682、3.001、-3.649和-4.269,P<0.01)。研究组NAA/Cr值左侧和右侧前额叶、左侧海马均低于对照组,差异有统计学意义[(1.74±0.28)vs(1.87±0.16),t=2.767,P=0.007;(1.73±0.32)vs(1.89±0.15),t=2.315,P=0.023;(1.75±0.33)vs(1.87±0.27),t=2.641,P=0.001]。研究组左侧前额叶、左侧海马的NAA/Cr值与P3波幅、Cc、Rf%等均呈正相关(r=0.352,0.324,0.337;0.344,0.312,0.334,P<0.05),与P3潜伏期、Re、Rpe、Rf等均呈负相关(r=-0.354,-0.353,-0.370,-0.296;-0.352,-0.356,-0.364,-0.302,P<0.05)。结论抑郁症患者存在认知功能损害,可能与前额叶、海马的神经元低水平表达有关。     

单次激发厚层投射MRCP对肝外胆管梗阻性疾病的诊断价值

目的 :评价单次激发厚层投射磁共振胆胰管造影 ( SSFSE)对肝外胆管梗阻性疾病的临床诊断价值。方法 :32例肝外胆管梗阻性疾病 (肝外胆管结石 8例 ,恶性胆管梗阻 2 4例 ) ,全部病例均经手术和病理证实。结果 :全部 32例 MRCP检查均一次成功 ,胆胰管显示满意。MRCP对肝外胆管梗阻程度的判断和定位诊断准确率为 10 0 % ,结合常规 MRI图像定性诊断准确率为 90 .6 %。结论 :SSFSE检查成功率高 ,操作简单快速 ,对肝外胆管梗阻的定位诊断准确。结合常规 MRI扫描 ,对肝外胆管梗阻的定性诊断也有较高准确性     

电磁场促进下肢美容增高区骨愈合的临床观察

目的　研究脉冲电磁场刺激对美容增高骨延长区成骨的影响 ,寻求促进病人康复的有效治疗手段。方法　 30例双下肢延长美容增高志愿者 ,随机分为脉冲电磁场治疗组和对照组 ,每组15例 ,治疗组在术后第 2天给予脉冲电磁场刺激。术后定期复查X线片 ,采用平均延长指数评价延长区骨愈合。结果　术后身高增加 5～ 9cm ,平均增高 (6 .6± 1.2 )cm ,延长率平均 19.2 %。其中 ,治疗组分别延长 5～ 8cm ,平均延长长度为 (6 .2± 1.1)cm ;对照组分别延长 5 .2～ 9cm ,平均延长长度为 (6 .8± 1.6 )cm。治疗组肢体水肿消退时间 (10 .4± 2 .6 )d ,对照组为 (16 .3± 3.6 )d。治疗组平均延长指数为 (32 .82± 2 .76 )d/cm ,对照组为 (39.6 6± 3.86 )d/cm ,经t检验 ,其结果差异具有显著性意义 (P <0 .0 5 )。结论　脉冲电磁场刺激能促进骨延长区新骨的生成与成熟 ,促进延长区骨愈合 ,可作为加速美容增高病人康复的辅助治疗手段。     

超急性期自发性脊髓硬膜外血肿的磁共振诊断及误诊分析

目的分析超急性期自发性脊髓硬膜外血肿(SSEH)的临床特点及磁共振(MRI)表现,降低误诊率。方法回顾性分析经手术病理证实7例超急性期SSEH的临床及MRI资料,讨论误诊原因,鉴别诊断。结果首发症状均出现典型脊背部突发胀痛,继之出现进行性下肢麻木,活动功能障碍。2例既往有高血压病,7例均无明确外伤和凝血机制障碍病史,1例手术中发现蔓状扩张动静脉血管。7例SSEH,发生于颈椎1例、胸椎2例、颈胸交界部2例、胸腰段2例,均位于硬膜外腔的侧后方或正后方,血肿呈梭形。在T1加权序列(T1WI)矢状面6例表现为等信号,1例表现为略高信号;在T2加权序列(T2WI)矢状面和轴面,7例表现为高信号或混杂高信号;血肿与脊髓间可见线条状低信号间隔。增强扫描2例血肿可见边缘斑点或环形强化。本组4例误诊的原因:平扫时血肿信号不具特征性;活动性出血所致血肿增强征象不典型。结论超急性期SSEH具有不典型MRI表现,容易误诊,但结合起病时间及血肿MRI信号进行分析,有利于对血肿的诊断和鉴别诊断。     

Ultrasound-guided computed tomography angiography for the diagnosis of rotational vertebral artery occlusion: 2 case reports and technical notes

Rotational vertebral artery occlusion is a rare cause of ischemic stroke in the vertebrobasilar arteries. While computed tomography angiography (CTA) is less invasive for the diagnosis of rational vertebral artery occlusion than digital subtraction angiography and more useful for elucidating the correlation between vertebrobasilar arteries and the surrounding structure, carotid ultrasound is noninvasive and more beneficial for the real-time evaluation of the hemodynamic change with neck rotation compared to CTA. Here, we reported 2 cases of rotational vertebral artery occlusion in patients aged 81 and 38 years and proposed a novel technique for its diagnosis using ultrasound-guided CTA. We suggest that the combination of ultrasound and CTA is useful for diagnosing rotational vertebral artery occlusion, which would compensate for the disadvantages of CTA alone.     

Positive effect of intravenous iron-oxide administration on left ventricular remodelling in patients with acute ST-elevation myocardial infarction – A cardiovascular magnetic resonance (CMR) study

Objectives

This study investigated the safety profile and potential “therapeutic” effect of intravenous ultrasmall superparamagnetic iron-oxide (USPIO)-based iron administration regarding infarct healing in patients with ST-elevation myocardial infarction (STEMI). USPIO-administration was recently shown to enable an improved characterization of myocardial infarct pathology in acute STEMI patients.

Materials and Methods

Seventeen study patients (IRON, 54 ± 9 yrs, 88% male) and 22 matched controls (CONTROL, 57 ± 9 yrs, 77% male) both with primary reperfused STEMI underwent multi-parametric CMR studies in the first week and three months after acute MI. Only IRON patients received a single intravenous bolus of 510 mg elemental iron as ferumoxytol (Feraheme^TM) within four days following acute MI.

Results

Three months later, all patients were alive and there were no adverse cardiac events. Significant improvement in left ventricular (LV) ejection fraction (IRON: 53 ± 10% to 59 ± 9%, p = 0.002; CONTROL: 54 ± 6% to 57 ± 10%, p = 0.005) as well as shrinkage of infarct size were seen in both groups at follow-up. There was a more pronounced decrease in infarct size in the IRON group (IRON: − 10.3 ± 5.4% vs. CONTROL: − 7.0 ± 8.4%, p = 0.050) in addition to a significant decrease in both endocardial extent and prevalence of transmural infarctions in IRON but not in CONTROL patients. A significant decrease in LV end systolic volume was only seen in the IRON group (71 ± 25 mL to 59 ± 25 mL, p = 0.002).

Conclusions

Intravenous iron administration in acute STEMI patients seems to be associated with an improved infarct healing and a beneficial global left ventricular remodelling. These findings together with the good safety profile make USPIO-based iron administration a promising future candidate as a “diagnostic” and “therapeutic” adjunctive solution in acute MI management.     

磁性氧化铁纳米粒子的神经毒性研究进展

磁性氧化铁纳米粒子（MION）作为一种重要的纳米材料,因其特殊性质（如磁性、较好的生物相容性）在生物医药领域应用广泛,在与人脑相关的疾病诊断和治疗方面发挥重要作用。然而,MION在脑内的蓄积可能会导致潜在的神经毒性。从MION的表征、入脑方式、神经毒性效应以及神经毒性机制等方面概述了MION的神经毒性研究进展。目前,研究者对纳米毒理学中的神经毒理学还了解甚少,轻度或中度的神经毒性可能很微妙且难以检测。因此,对于MION这类可能入脑或用于诊断和治疗神经系统疾病的纳米药物,应深入探究其神经毒性作用机制,进而建立有效的安全性评价方法和策略,以指导临床合理用药。     

The role of MRI in the diagnosis of MS

Magnetic resonance imaging (MRI) is the most widely used imaging technique in the investigation of multiple sclerosis (MS). Although MS remains a clinical diagnosis, MRI has become an invaluable tool in understanding and monitoring the disease, and is commonly used to confirm the clinical diagnosis. Various imaging techniques can be used but T2-weighted brain imaging remains the standard tool. The officially endorsed imaging criteria for MS places greater emphasis on the spatial and temporal distribution of lesions than on their individual appearance. This review focuses on the more typical findings in MS, and considers the current role of MRI in the diagnosis.     

免疫磁珠法分离纯化人牙周膜干细胞

目的：建立免疫磁珠法体外分离纯化人牙周膜干细胞的方法。方法：采用STRO-1作为磁珠分离细胞的表面标志,利用间接法免疫磁珠分离细胞,描绘其生长曲线及免疫组化染色检测抗波形丝蛋白（Vimentin）、骨粘连素（ON）、骨桥蛋白（BSP）的表达。结果：通过免疫磁珠法获得了人牙周膜STRO-1^＋细胞,观察其生长曲线表明其为慢周期性;该细胞抗波形丝蛋白（Vimentin）、骨粘连素（ON）、骨桥蛋白（BSP）弱阳性表达。结论：免疫磁珠法是有效分离纯化牙周膜干细胞的方法,该方法分离的人牙周膜STRO-1^＋细胞具有干细胞的超微结构、细胞周期及表型特点。