目的探討在3.0 T MRI中運(yùn)用氫質(zhì)子波譜成像(1H-MRS)技術(shù)評(píng)估脂肪肝治療效果的可行性。方法收集臨床確診并治療的脂肪肝患者26例，分別于治療前、治療后3和6個(gè)月各行1次 1H-MRS檢查，測(cè)得 1H-MRS的水峰峰值和脂肪峰峰值、水峰峰下面積和脂肪峰峰下面積，計(jì)算肝細(xì)胞相對(duì)脂肪含量1(RLC1)及相對(duì)脂肪含量2(RLC2); 同期測(cè)量患者的甘油三酯、γ-谷氨酰轉(zhuǎn)肽酶、腹圍及體重指數(shù)，將其擬合成臨床脂肪肝指數(shù)(fatty liver index，F(xiàn)LI)。以FLI為參照標(biāo)準(zhǔn)，對(duì)不同時(shí)間點(diǎn) 1H-MRS所測(cè)得肝臟脂肪含量進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果采用配伍設(shè)計(jì)的方差分析，治療前、治療后3和6個(gè)月的RLC1、RLC2值比較差異有統(tǒng)計(jì)學(xué)意義(Plt;0.05); 用SNK法做兩兩檢驗(yàn)，治療前RLC1、RLC2值均分別明顯高于治療后3個(gè)月或治療后6個(gè)月的RLC1、RLC2值(Plt;0.05)。RLC1、RLC2與FLI進(jìn)行秩相關(guān)性分析，均呈正相關(guān)性(r=0.476，Plt;0.001; r=0.475，Plt;0.001)?？煽啃苑治鲲@示，治療前的組內(nèi)相關(guān)系數(shù)均≥0.75，可重復(fù)性好。結(jié)論1H-MRS定量分析評(píng)估脂肪肝治療效果具有可行性，并且是一種無創(chuàng)的定量監(jiān)測(cè)方法。
目的 總結(jié)各種磁共振（MR）功能成像的原理及在胰腺癌及腫塊型慢性胰腺炎診斷中的應(yīng)用價(jià)值。方法 回顧分析國(guó)內(nèi)、外近年來關(guān)于MR波譜成像、MR彌散成像及MR灌注成像在胰腺癌及慢性胰腺炎診斷和鑒別診斷中應(yīng)用的文獻(xiàn)。結(jié)果 胰腺癌與慢性胰腺炎在分子擴(kuò)散、生化代謝、組織灌注等方面存在差異，MR功能成像方法能反映這些差異而用于鑒別診斷。結(jié)論 MR功能成像作為一種非侵入性的影像檢查方法，能夠提供鑒別胰腺癌與腫塊型慢性胰腺炎有價(jià)值的信息。
目的 觀察盲眼患者視覺傳導(dǎo)通路中視神經(jīng)和視放射磁共振擴(kuò)散張量（MR-DTI）掃描像特征。方法 對(duì)20例盲眼患者（盲眼組）和20名正常健康者（對(duì)照組）行視神經(jīng)和視放射MR-DTI掃描。應(yīng)用Volume one 1.72軟件進(jìn)行后處理，獲得黑白各向異性(FA)和方向編碼彩色(DEC)圖。觀察視神經(jīng)和視放射在FA和DEC圖中的信號(hào)表達(dá)。在DEC圖上分別測(cè)量并對(duì)比分析盲眼組和對(duì)照組受檢者雙側(cè)視神經(jīng)和視放射的FA、平均擴(kuò)散率（MD）、本征矢量lambda;∥及l(fā)ambda;perp;值。結(jié)果 對(duì)照組雙側(cè)視神經(jīng)在FA和DEC圖均呈高信號(hào)，盲眼組雙側(cè)視神經(jīng)在FA和DEC圖均呈明顯低信號(hào)。盲眼組視神經(jīng)FA和lambda;∥值均較對(duì)照組明顯降低，差異有統(tǒng)計(jì)學(xué)意義（t=16.294，14.660；P值均=0.000）；MD和lambda;perp;值均較對(duì)照組明顯升高，差異也有統(tǒng)計(jì)學(xué)意義（t=8.096，8.538；P值均=0.000）。兩組受檢者雙側(cè)視放射在FA和DEC圖均呈高信號(hào)。盲眼組與對(duì)照組雙側(cè)視放射FA和MD值比較，差異均無統(tǒng)計(jì)學(xué)意義（左側(cè)：t=1.456、1.811，P=0.152、0.076；右側(cè)：t=0.779、0.073，P=0.440、0.942）。結(jié)論 盲眼患者雙側(cè)視神經(jīng)MRDTI呈低信號(hào)，雙側(cè)視放射MR-DTI呈高信號(hào)。
摘要:目的: 探討臂叢神經(jīng)磁共振成像的技術(shù)方法及其可行性。 方法 :對(duì)15例正常志愿者行雙側(cè)臂叢神經(jīng)成像:包括常規(guī)快速自旋回波序列T1加權(quán)(T1W/TSE)、快速自旋回波序列T2加權(quán)(T2W/TSE)、快速自旋回波序列T2加權(quán)加SPIR脂肪抑制(T2W/SPIR)冠狀位掃描以及彌散加權(quán)背景抑制成像序列(DWIBS)軸位掃描。 結(jié)果 :T1W/TSE、T2W/TSE、及T2W/SPIR對(duì)臂叢節(jié)后神經(jīng)同層顯示率分別為533%、567%和833%;DWIBS MIP重建圖像對(duì)臂叢神經(jīng)的全貌顯示較為完整、清晰、直觀;T1W/TSE、T2W/TSE、T2W/SPIR及DWIBS MIP重建圖像的對(duì)比噪聲比分別為109±09、107±13、185±68和299±133,T2W/SPIR序列和DWIBS MIP重建圖像的對(duì)比噪聲比明顯高于T1W/TSE和T2W/TSE序列。 結(jié)論 :T2W/SPIR序列對(duì)臂叢神經(jīng)的同層顯示率及圖像的對(duì)比噪聲比明顯高于常規(guī)T1W/TSE、T2W/TSE序列, DWIBS MIP重建圖像能夠顯示臂叢神經(jīng)的全貌,兩者為臂叢神經(jīng)成像較為有效的技術(shù)方法,對(duì)于臂叢神經(jīng)病變的診斷即具有十分重要的意義。Abstract: Objective: To determine the optimal sequences of brachial plexus with MRI. Methods : Fifteen volunteers were underwent MRI on 15T scanner, the Sequences of T1W/TSE/COR, T2W/TSE/COR, T2W/SPIR/COR and Diffusionweighted imaging with background body signal suppression were performed. Results : The display rates of brachial plexus postganglionic segment nerve showing at the same slice were 533%, 567% and 833% on T1W/TSE/COR, T2W/TSE/COR, T2W/SPIR/COR. Brachial plexus on DWIBS MIP were clear and complete. Contrastnoise ratio of four sequences was 109±09, 107±13, 185±68 and 299±133,respectively. Contrastnoise ratio of T2W/SPIR/COR and DWIBS MIP was significantly higher than that of the other two sequences. Conclusion : Display rate of brachial plexus and contrastnoise ratio of images on T2W/SPIR/COR were higher than those of routine sequences. Image of DWIBS MIP can show the outline of brachial plexus clearly. The two sequences were reliable and effetive techoniquic in diagnosis of brachial plexus lesion.
摘要:目的: 分析肝臟局灶性結(jié)節(jié)增生(FNH)的MRI表現(xiàn)和病理特點(diǎn),探討兩者的相關(guān)性,提高FNH診斷的準(zhǔn)確率。 方法 :回顧性分析23例(共28個(gè)病灶)經(jīng)手術(shù)切除病理證實(shí)為FNH的MRI平掃及增強(qiáng)表現(xiàn),與其病理特點(diǎn)進(jìn)行對(duì)照。 結(jié)果 :25個(gè)病灶在平掃T1WI上呈等或稍低信號(hào),T2WI上呈等或稍高信號(hào),3個(gè)病灶在平掃T1WI及T2WI上均呈稍高信號(hào),增強(qiáng)后所有28病灶動(dòng)脈期可見明顯強(qiáng)化,門脈期及延遲期呈稍高、等或稍低信號(hào),其中12個(gè)病灶可見中心纖維瘢痕延遲強(qiáng)化。FNH組織病理上表現(xiàn)為富血供的實(shí)質(zhì)性腫塊,腫物內(nèi)部組織較均勻,沒有異型細(xì)胞,中心可見纖維瘢痕。 結(jié)論 :肝臟MRI平掃及增強(qiáng)檢查能很好的反映FNH的組織病理及血供特點(diǎn),能為FNH的診斷及鑒別診斷提供可靠證據(jù)。Abstract: Objective: To analyze the MRI manifestations and pathology characteristic of hepatic focal nodular hyperplasia(FNH),and to investigate their correlation. Methods : A retrospective analysis was made on the unenhanced and dynamic enhanced MR images of 23 patients (totally 28 lesions) with surgical and pathological proved FNH. Results :25 FNH lesions demonstrated isointensity or slightly hypointense on unenhanced T1WI,and isointensity or slightly hyperintense on unenhanced T2WI,3 FNH demonstrated hyperintense on both unenhanced T1WI and T2WI. 28 FNHs were markediyhyperintense in the arterial phase of dynamic contrast enhanced MRI, and isointense or slightly hyperintense in the portal and delayed phase．The seals were shown in 12 lesions, and enhanced in delayed phase．FNH is solid mass with vast blood supply,its inside structure is homogemeous. Typical seal can be found by microscopic examination．〖WTHZ〗Conclusion : MRI could disclose the pathologic features of FNH and its blood supply and improve the accuracy 0f its diagnosis．
摘要:目的:探討平山病的MRI影像特點(diǎn)及其臨床應(yīng)用價(jià)值。方法:5例臨床確診平山病病例組和10例正常對(duì)照組進(jìn)行頸椎自然位及屈頸位MRI檢查,矢狀位T1WI、T2WI及軸位T2WI,觀察頸髓、蛛網(wǎng)膜下腔及硬膜外腔變化情況。結(jié)果:病例組的5例平山病均系16~20歲男性。自然位:5例下位頸髓均萎縮變扁,硬膜外間隙未顯示增寬。屈頸位:5例C5~7頸髓前移變扁中,將變扁頸髓又分為上中下三段,以中段最窄,上下段漸移行至正常;C5~7蛛網(wǎng)膜下腔亦變窄,硬脊膜伴隨前移;而C4~7硬脊膜后間隙則增寬,呈新月形影,增寬程度分為輕、中、重三度,最重者位于C6椎體平面,T2加權(quán)像及T1WI增強(qiáng)呈高信號(hào),其中1例內(nèi)見血管流空信號(hào)影。對(duì)照組為10例志愿者,自然位: 4例C3~7頸髓形態(tài)、大小基本一致,6例頸髓自頸3逐漸移行與胸1脊髓其大小一致;屈頸位:頸髓和蛛網(wǎng)膜下腔大小與自然位比較無明顯變化,硬膜后間隙自C3平面向下延至T1平面,T2WI上呈均勻線樣高信號(hào)影。結(jié)論:下位頸髓萎縮變扁,屈頸位頸髓及硬脊膜前移、硬脊膜后間隙增寬呈新月形影等,是臨床診斷平山病較特征性的MRI表現(xiàn)。Abstract: Objective: To evaluate clinical value and MRI features of Hirayama disease. Methods: Five cases of hirayama disease, which had been clinically confirmed using siemens sonata 1.5T MRI scan, physiological condition and flexional condition, Sagittal view T1WI, T2WI and Axial View T2WI, and GdDTPA enhanced examination, for MRI changes of spinal cord, subarachnoid cavity, duramater of spinal membrae and extra dural space, etc were studied. Results: In case group of 5 cases of hirayama disease, age was mainly in 16–20 years old, All of 5 cases were men. Which were pressed and become thinner of spinal cord, strictic changes of subarachnoid cavity, new moony shape and enlargement changes and pushed forward of extra duramater space, and higher intensity signal of GdDTPA enhancement, and vascular flow effect (one case ) in C5–C7. but also, for contrast group 10 cases of normal volunteer, physiological condition:4 cases in cervical spinal cord with shape and structure were uniformity, and duramater, subarachnoid cavity, extra duramater space etc in C3–C7 were abnormal. Six cases in cervical spinal cord with shape and structure gradully changed from C3 to T1; flexional condition: 10 cases of MRI changes of spinal cord, subarachnoid cavity were as same as it in physiological condition,all of T2 WI, higher intensity signal were homogeneous of extraduramater space in C3–T1. Conclusion: The feature findings of cervical spinal cord became thinner, and cervical cord, durameter pussed forward, new moony shape and enlargment of extradurameter space, vascular flow effusion, etc in MRI were useful value for clinical diagnosis.
目的 綜合評(píng)述當(dāng)前各種磁共振成像（magnetic resonance imaging，MRI）技術(shù)在診斷肝臟纖維化中的應(yīng)用現(xiàn)狀。方法 收集國(guó)內(nèi)、外最新相關(guān)文獻(xiàn)，總結(jié)各種MRI技術(shù)在肝臟纖維化中的應(yīng)用及研究進(jìn)展。結(jié)果 用于評(píng)價(jià)肝臟纖維化的MRI技術(shù)包括常規(guī)增強(qiáng)掃描、雙對(duì)比增強(qiáng)掃描和各種功能性MR技術(shù)。常規(guī)增強(qiáng)掃描可以觀察纖維化引起的肝臟形態(tài)學(xué)改變，對(duì)分級(jí)價(jià)值不大; 雙對(duì)比增強(qiáng)掃描能顯著提高肝臟纖維化的對(duì)比-噪聲比（contrast to noise ratio,CNR）; 各種功能性MR技術(shù)除了能診斷肝臟纖維化外，還能對(duì)其嚴(yán)重程度進(jìn)行分級(jí)。結(jié)論 MRI尤其是功能性MRI技術(shù)發(fā)展迅速，在肝臟纖維化診斷和嚴(yán)重程度評(píng)價(jià)中具有廣闊應(yīng)用前景。
目的 探討高分辨MRI對(duì)直腸癌術(shù)前T、N分期及環(huán)周切緣評(píng)估的準(zhǔn)確性。方法 選取北京協(xié)和醫(yī)院2006年9月至2009年5月期間42例經(jīng)結(jié)腸鏡活檢并組織病理學(xué)證實(shí)的直腸癌患者，術(shù)前行MRI分期。檢查后1周內(nèi)，按照全直腸系膜切除原則行直腸癌切除手術(shù)。手術(shù)后標(biāo)本根據(jù)2002年美國(guó)癌癥學(xué)會(huì)(AJCC)結(jié)直腸癌分期標(biāo)準(zhǔn)行腫瘤及淋巴結(jié)病理學(xué)分期。影像學(xué)和病理學(xué)對(duì)腫瘤(T)分期、淋巴結(jié)(N)分期與環(huán)周切緣受累評(píng)估的一致性采用Kappa檢驗(yàn)。結(jié)果 對(duì)T分期，MRI正確分期36例，過低分期3例，過高分期3例，統(tǒng)計(jì)學(xué)分析顯示病理學(xué)和影像學(xué)對(duì)T分期具有較好的一致性(Kappa=0.731，P=0.000)。對(duì)N分期，術(shù)前MRI正確分期31例，過低分期5例，過高分期6例，統(tǒng)計(jì)學(xué)分析顯示兩者具有中度一致性(Kappa=0.410，P=0.009)。對(duì)環(huán)周切緣的評(píng)估，術(shù)前MRI能夠正確評(píng)估40例，統(tǒng)計(jì)學(xué)分析顯示兩者對(duì)直腸固有筋膜的評(píng)估具有很好的一致性(Kappa=0.829，P=0.000)。結(jié)論 高分辨MRI對(duì)直腸癌術(shù)前T分期具有較好的準(zhǔn)確性，對(duì)N分期具有中度的準(zhǔn)確性，對(duì)直腸固有筋膜能夠提供準(zhǔn)確的評(píng)估,有助于挑選出能夠受益于術(shù)前新輔助治療的患者。
目的總結(jié)1例冠狀動(dòng)脈造影基本正常診斷急性心肌梗死的病例，探討心臟增強(qiáng)MRI在冠狀動(dòng)脈造影基本正常心肌梗死患者中的應(yīng)用。 方法2013年10月17日，1例老年男性患者于在局部麻醉下行冠狀動(dòng)脈造影術(shù)，術(shù)中見左右冠狀動(dòng)脈輕度狹窄，但患者心電圖動(dòng)態(tài)演變及心肌標(biāo)志物異常，符合急性心肌梗死的臨床演變過程，結(jié)合患者病程第6天行心臟增強(qiáng)MRI確診急性心肌梗死，檢索國(guó)內(nèi)外期刊數(shù)據(jù)庫(kù)，探索心臟增強(qiáng)MRI在急性心肌梗死診斷中應(yīng)用價(jià)值及意義。 結(jié)果作為冠狀動(dòng)脈病變?cè)\斷金標(biāo)準(zhǔn)的冠狀動(dòng)脈造影對(duì)于一些冠狀動(dòng)脈偏心狹窄、邊支血管狹窄及冠狀動(dòng)脈痙攣等造成的心肌梗死診斷有一定局限性，心臟增強(qiáng)MRI具有可精確測(cè)量心肌梗死后心肌變薄的程度、良好顯示缺血心肌的功能性改變等優(yōu)勢(shì)。 結(jié)論心臟增強(qiáng)MRI檢查對(duì)診斷冠狀動(dòng)脈造影正常的心肌梗死具有重要意義。
為研究不同濃度(25、50、100 μg/mL)超順磁性氧化鐵粒子(SPIO)標(biāo)記對(duì)大鼠骨髓間充質(zhì)干細(xì)胞(rMSCs)生物學(xué)活性、體外MRI成像效應(yīng)的影響,采用多聚賴氨酸(PLL)包被的SPIO (PLL-SPIO)標(biāo)記原代分離培養(yǎng)的rMSCs,24 h后分別進(jìn)行陽(yáng)性標(biāo)記率、MRI成像效應(yīng)、細(xì)胞增殖凋亡以及干細(xì)胞細(xì)胞分化能力的綜合評(píng)價(jià)。PLL-SPIO標(biāo)記陽(yáng)性率、鐵含量測(cè)定結(jié)果顯示:鐵標(biāo)記率可達(dá)75%~100%。透射電鏡觀察,可見100 μg/mL組rMSCs細(xì)胞質(zhì)內(nèi)濃聚細(xì)小鐵顆粒的囊泡樣包涵體。采用T1WI、T2WI和T2*WI序列MRI成像掃描顯示:25 μg/mL組即可引起信號(hào)的明顯降低。與未標(biāo)記的對(duì)照組細(xì)胞相比,25 μg/mL和50 μg/mL組細(xì)胞增殖活力、凋亡、干細(xì)胞分化能力檢測(cè)結(jié)果差異皆無統(tǒng)計(jì)學(xué)意義(P＞0.05),而100 μg/mL組的差異均有統(tǒng)計(jì)學(xué)意義(P＜0.05)。結(jié)論:25、50 μg/mL SPIO可有效標(biāo)記rMSCs,100 μg/mL的SPIO對(duì)rMSCs增殖活性和分化能力有抑制作用,這為SPIO進(jìn)一步的體內(nèi)及臨床MRI分子影像應(yīng)用提供了基礎(chǔ)。