磁共振静脉血管成像在脑静脉窦血栓形成诊断中的应用

目的 评价2D-TOF法磁共振静脉血管成像(MRV)在脑静脉窦血栓形成(CVST)诊断中的价值。方法 对10例CVST患者进行2D-TOP法MRV检查，并与MRI和数字减影血管造影(DSA)结果进行对照研究。结果 10例患者均为多发性CVST，最常累及上矢状窦和横窦。在MRV上CVST的直接征像为发育正常的静脉窦不显影、狭窄或再通后的模糊影，间接征像为病变以远侧枝血管形成、深部静脉明显扩张或其他引流静脉显现。本组MRV结果与DSA比较具有较高的一致性，且在血管变异的鉴别及对血栓的动态观察上要优于DSA。结论 MRV可替代DSA作为CVST诊断和随访的首选检查方法。     

上矢状窦血栓的病因及诊断

目的 探讨上矢状窦血栓的病因及诊断方法。方法 分析34例上矢状窦血栓患者的病因、临床表现、影像学特征，其中3例无明确诱因所致上矢状窦血栓患者，利用化学分光法检测其血清中的雌二醇（E2）、睾酮（T）水平。结果 上矢状窦血栓最常见的病因是产褥期血液高凝状态。3例未查到明确诱因的青年男性患者，血清中E2↑、E2／T↑。上矢状窦血栓的临床表现以头痛最常见，在意识清楚的30例患者中发生率为100％。影像学检查：CT检出率仅为65．4％，磁共振成像（MRI）、磁共振静脉血管造影（MRV）检出率为100％。结论 各种原因造成的血液凝固性增高是上矢状窦血栓最常见的病因，男性高雌激素血症是其发病的一个重要的危险因素。MRI和MRV技术相结合是诊断上矢状窦血栓的最佳方法。     

小鼠轮状病毒的形态发生及感染MRV乳鼠小肠上皮细胞超微病变的观察

本文研究了小鼠轮状病毒(MRV—北京株)感染BALB/c乳鼠的超微病理学改变及MRV形态发生过程。MRV在小肠绒毛上皮细胞质内合成,由内质网装配外膜,形成完整的MRV。观察了包涵体的构成成分。MRV引起小肠上皮细胞胞质内出现大小不等形态各异的空泡和脂类物质沉积以及包涵体,微管样结构的出现等超微结构的改变。     

Clinical evaluation and follow-up outcome of presurgical plan by Dextroscope: a prospective controlled study in patients with skull base tumors

Background

Patient-specific approach design, comprehensive evaluation on perioperative data, and follow-up of postoperative life quality (KPS) were carried out to evaluate the application of VR technology of Dextroscope in procedures of patients with skull base tumors.

Methods

Eighty-four patients with skull base tumors involved in this research were randomized into 2 groups (test group and control group), each with 42 patients. Before operation, image data such as MR, MRA, or CTA of head were collected and imported into the Dextroscope workstation. The detailed preoperative plans were made in the test group, but no Dextroscope plans in control group. The resection rate of tumors, preoperative evaluation including the duration of operation, total blood loss, the postoperative LOS, the number of cases with cerebrovascular injury complications in operation, and postoperative KPS of patients on discharge and the sixth month follow-up in the 2 groups were recorded and compared.

Results

The total resection rate of tumors was 83.33% in test group and 71.42% in the control group (P > .05). The total resection rate of meningioma was 86.67% in test group and 76.47% in control group. The total resection rates of trigeminal Schwannoma in the 2 groups were all 100% (P > .05). The duration of operation and the postoperative LOS of each patient were 5.25 ± 0.64 hours and 8.50 ± 1.10 days in the test group and 7.36 ± 0.87 hours and 12.50 ± 1.52 days in the control group, respectively (P < .05). Total blood loss of each patient was 456.75 ± 55.76 mL in the test group and 523.85 ± 66.78 mL in the control group (P > 05). There were 3 cases with complications of cerebral vessels injury in the test group and 7 cases in the control group (P < .05). During follow-up, KPS of patients in the test group on discharge (85.75 ± 9.68) was significantly superior to that in the control group (81.66 ± 9.24; P < .05). The KPS of patients on the sixth-month follow-up in the test group was 92.35 ± 9.95, which was significantly superior to that in the control group (85.6 ± 9.34; P < .05). Karnofsky performance scores of patients in the test group improved significantly from discharge to the sixth month after procedure (P < .05), whereas there were adverse results in the test group (P < .05). The 2 cases with CSF leakage were cured completely.

Conclusion

The preoperative plans with VR technology in patients with skull base tumor or CSF leakage operations can help certain the diagnosis, individually locate the position of skull base lesions, and design patient-specific approach, which also facilitate to shorten operation duration and the postoperative LOS, reduce total blood loss and injury of vessels in operation, and improve the postoperative KPS.     

磁共振成像对脑静脉畸形的诊断价值

目的 探讨磁共振成像各种方法对脑静脉畸形的诊断价值。方法 收集本院6例脑静脉畸形病例，均进行过磁共振T1WI、T2WI扫描，其中部分病例做过DWI、T2FLAIR、MRA、MRV、T1WI增强扫描及DSA。结果 幕上4例，幕下2例，T1WI、T2WI表现：引流静脉均为流空的低信号，深髓静脉为细条状长T1、长T2信号。其中1例DWI引流静脉及深髓静脉区域低信号；1例T2 FLAIR引流静脉流空的低信号，深髓静脉高信号；2例MRA均阴性，但MRV显示深髓静脉汇入引流静脉；2例T1 WI增强扫描：深髓静脉呈轮辐状汇入引流静脉；1例DSA：动脉期阴性，静脉期见典型的“海蛇头”征。结论 磁共振能明确诊断脑静脉畸形，T1WI增强扫描及MRV均较敏感，DSA为诊断脑静脉畸形金标准。     

Thromboembolic complications in children with cancer

Thrombosis is a significant problem in patients with cancer. The impact of thromboembolism in association with childhood cancer is not clearly defined. Similarly the information of prevention and management of thromboembolic events in children receiving cancer-therapy is limited. This review aims to examine current knowledge regarding the epidemiology, pathophysiology and management of thrombosis in association with cancer in children.     

A quantitative and semi-automatic measurement of transverse sinus stenosis improves idiopathic intracranial hypertension diagnostic accuracy

We propose a new reliable transverse sinus stenosis (TSS) index based on magnetic resonance venography (MRV) for the diagnosis of idiopathic intracranial hypertension (IIH). Our quantitative semi-automatic measurement analysis based on segmentation and cross-sectional TS diameter from 48 IIH patients and controls matched for age and sex, had a good inter-observer agreement (κ = 0.729) compared to a visual examination (κ = 0.467). A cut-off point ≥ 2 discriminate IIH patients from controls, with a sensitivity and specificity of 100%.     

Risk of cerebral venous thrombosis in oral contraceptives pills users

The aim of this study is to assess the relative risk of cerebral venous sinus thrombosis (CVST) in Oral contraceptive pills (OCP) users compared with a control group of non-hormone users.