目的 根據MRI頸脊髓信號異常平面決定椎板切除減壓范圍，觀察側塊螺釘固定結合不同范圍全椎板切除減壓治療在頸脊髓損傷的臨床療效。 方法 2008年9月-2011年12月收治頸脊髓損傷患者16例。其中男10例，女6例，高處墜落傷5例，車禍11例，MRI顯示脊髓損傷信號改變波及2個節段3例，3個節段9例，4個節段4例，椎間盤損傷變性12例，椎間盤輕度突出4例，均診斷為頸脊髓損傷伴高位截癱，均行后路手術治療。根據手術方式將16位患者分為觀察組（9例）及對照組（7例），均采用后路側塊螺釘固定結合全椎板切除減壓治療，觀察組減壓范圍以MRI提示頸脊髓信號異常為中心，對照組減壓范圍均為頸3～頸7。比較兩組治療前后的ASIA評分改變。 結果 16例患者均得到隨訪，隨訪10～48個月，平均17個月，脊髓神經恢復功能按照ASIA運動評分，平均增長值：對照組（42.75 ± 12.56）高于觀察組（20.52 ± 11.60），差異有統計學意義（P＜0.05）。觀察組患者ASIA分級分布：術前A級4例，B級4例，C級1例，末次家庭隨訪時A級4例，B級3例，C級2例；對照組術前A級3例，B級3例，C級1例，末次家庭隨訪時A級2例，B級1例，C級2例，D級2例，對照組ASIA分級術前與術后比較，差異有統計學意義（P＜0.05）；觀察組ASIA分級術前與術后比較，差異無統計學意義（P＞0.05）；比較兩組ASIA分級改善率，對照組明顯優于觀察組（P＜0.05）。 結論 根據MRI提示的頸脊髓信號異常平面決定側塊螺釘固定及頸椎板切除范圍治療頸脊髓損傷療效不佳，減壓范圍擴大至頸3-頸7療效較好。
Objective To evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in obstructive jaundice. Methods Forty eight consecutive patients with obstructive jaundice were examined by MRCP, all results were testified during and /or after operation. Results Different causes of obstruction had their own characteristic manifestations. Level of obstruction was accurate in 100%, the accuracy in distinguishing obstructive causes was 93.8%. Conclusion MRCP is quite effective, safe and reliable in diagnosis of obstructive jaundice.
【摘要】 目的 探討粟粒性腦結核及與其需要鑒別疾病的MRI特點。 方法 2007年12月-2009年10月，對11例粟粒性腦結核患者的MRI平掃及增強表現進行分析，總結其MRI特征性表現。 結果 病史上粟粒性腦結核多存在血行播散型肺結核，平掃表現為多發小片影，增強后表現為彌漫分布的小環狀或結節狀強化灶，大小趨向一致，多為2 mm左右，可合并結核性腦膜炎及腦積水。 結論 粟粒性腦結核的MRI平掃表現不典型，增強表現有一定特征性，認識其特點可以和其它常見的顱內多發病變進行鑒別。【Abstract】 Objective To analyze the MRI appearances of cerebral military tuberculosis and other diseases that need to differentiate. Methods From December 2007 to October 2009, the MRI appearances of 11 cases on the plain scan and the enhanced MRI scan after injection of Gd-DTPA were reviewed and summarized. Results The cases of cerebral military tuberculosis usually had the history of military pulmonary tuberculosis, showed multiple lesions in fragments on plain scan, and the lesions distributed diffusely after enhancement, showed as ring form or nodosity. The size tended to be uniform, often 2 mm in diameter approximately. Tuberculosis meningitis and hydrocephalus could accompany. Conclusion The manifestation of plain MRI is not typical, and the enhancement MRI is imperative. Some characteristic appearances can be found after injection of Gd-DTPA, and these characteristic appearances could be helpful to differentiate with other multiple intracranial diseases.
The portable light-weight magnetic resonance imaging system can be deployed in special occasions such as Intensive Care Unit (ICU) and ambulances, making it possible to implement bedside monitoring imaging systems, mobile stroke units and magnetic resonance platforms in remote areas. Compared with medium and high field imaging systems, ultra-low-field magnetic resonance imaging equipment utilizes light-weight permanent magnets, which are compact and easy to move. However, the image quality is highly susceptible to external electromagnetic interference without a shielded room and there are still many key technical problems in hardware design to be solved. In this paper, the system hardware design and environmental electromagnetic interference elimination algorithm were studied. Consequently, some research results were obtained and a prototype of portable shielding-free 50 mT magnetic resonance imaging system was built. The light-weight magnet and its uniformity, coil system and noise elimination algorithm and human brain imaging were verified. Finally, high-quality images of the healthy human brain were obtained. The results of this study would provide reference for the development and application of ultra-low-field magnetic resonance imaging technology.
ObjectiveTo construct a map of cerebral cortex thickness in Idiopathic Generalized Epilepsy (IGE) diagnosed at the first visit, using T1-weighted brain magnetic resonance imaging and advanced image analysis software. MethodsHigh-resolution three-dimensional T1 images were obtained from 27 IGE patients diagnosed at the first visit and 29 normal controls in Shouguang People's Hospital from January 1, 2022 to December 31, 2021. The location recognition calculation system of the Freesurfer software was used to calculate the values of cortical thickness in each brain region, and the cortical thickness values were transformed into a brain atlas using the image analysis software. A differential brain atlas was generated using the two-sample t-test to analyze the difference in cortical thickness between IGE patients and normal controls. Paired t-test was used for within-group comparison to explore changes of cortical thickness laterality. ResultsIn the IGE brain atlas, the brain regions with higher cortical thickness were the right left temporal pole, the right left entorhinal cortex, the head of the right anterior cingulate gyrus, the right and left insular lobe, the right and left middle temporal gyrus, the right inferior temporal gyrus, the head of the left anterior cingulate gyrus, the left tail of the anterior cingulate gyrus, the left inferior temporal gyrus, the left and right fusiform gyrus, and the left frontal pole. The areas with lower cortical thickness were the right and left paracalcaric gyrus, the right and left cuneiform lobe, the left and right lingual gyrus, the left and right posterior central gyrus, the left lateral occipital gyrus, and the right and left superior parietal gyrus. The distribution of cortical thickness of the IGE group was comparable to the cortical thickness atlas of the normal control. Compared with normal control, the areas with changes of cortical thickness in the IGE group were bilateral superior frontal gyrus, bilateral posterior central gyrus, bilateral anterior central gyri, bilateral lingual gyri, left cuneiform lobe, bilateral entorhinal cortex and temporal pole. The brain areas with laterality of cortical thickness between hemispheres in the IGE group were the tail of anterior cingulate gyrus, cuneiform lobe, inferior parietal gyrus, lateral occipital gyrus, posterior central gyrus, head of anterior cingulate gyrus, and superior marginal gyrus. Compared with normal control, the IGE group has decreased number of brain regions with laterality of cortical thickness. ConclusionThe present study revealed the distribution and laterality of cerebral cortical thickness map in early idiopathic generalized epilepsy, which provides imaging structural basis for brain research in the future.
ObjectiveTo explore the value of 3.0 T MRI functional imaging in differential diagnosis of radiation brain injury and recurrence of glioblastoma multiforme.MethodsFrom March 2017 to January 2018, 31 patients diagnosed with brain glioblastoma multiforme in Peking University International Hospital were collected continuously, including 14 cases of tumor recurrence and 17 cases of radiation-induced brain injury. All the patients routinely underwent conventional MRI head scan, three-dimension arterial spin labeling (3D-ASL), dynamic susceptibility contrastperfusion weighted imaging (DSC-PWI), and enhanced MRI scan sequence; related parameters were recorded and compared.ResultsCerebral blood flow (CBF) value of abnormal enhanced area in the recurrence group was significantly higher than that in the brain injury group with 3D-ASL scan (t=3.016, P=0.005), and no difference was found in edema area between the two groups (P>0.05). In the recurrence group, CBF value of abnormal enhanced area was significantly higher than that of the normal area (t=2.628, P=0.014); however, there was no significant difference in the CBF value between the abnormal enhancement foci and the normal areas in the radiation brain injury group (P>0.05). Relative cerebral blood volume (rCBV) ratio (t=2.894, P=0.007) and relative cerebral blood volume (rCBF) ratio (t=2.694, P=0.012) of abnormal enhanced area, as well as rCBV ratio (t=2.622, P=0.013) and rCBF ratio (t=2.775, P=0.010) of edema area in the recurrence group were significantly higher than those in the brain injury group with DSC-PWI scan. No differences were found in relative mean transit time (rMTT) ratio and relative time to peak (rTTP) ratio between the two groups (P>0.05). In the brain injury groupr, CBV ratio (t=2.921, P=0.008) and rCBF ratio (t=3.100, P=0.004) of abnormal enhanced area were significantly higher than those of the edema area, and no difference was found in rMTT ratio or rTTP ratio (P>0.05). In the recurrence group, no difference was found in all focal parameters between abnormal enhanced area and edema area (P>0.05). In diagnosis value analysis, the areas under the curve of CBF in 3D-ASL scan, and rCBF ratio, rCBV ratio in DSC-PWI scan were 0.752, 0.675, and 0.645, respectively; the cut-off values were 34.59, 1.48, and 1.67, respectively; the sensitivities were 79.2%, 61.5%, and 58.3%, respectively; and the specificities were 44.4%, 32.8%, and 22.4%, respectively.ConculsionThe diagnostic value of functional MRI imaging in distinguishing glioblastoma multiforme recurrence and radiation-induced brain injury is high recommendated; further research and clinical application should be needed.
目的探討磁共振成像(MRI)檢查對骶前囊腫術前診斷的價值。方法回顧性分析2010年2～9月期間南京市中醫院收治的12例骶前囊腫患者的臨床資料。患者術前均行肛門指檢、腔內B超及MRI檢查，以術后病理檢查結果為標準，比較術前MRI檢查與肛門指檢及腔內B超檢查的結果。結果術前MRI檢查結果中10例與病理檢查結果相符，2例與病理結果基本相符； 而肛門指檢及腔內B超檢查結果中與病理檢查結果相符者為6例。結論MRI檢查能多方位顯示骶前囊腫本身特點及其周圍的解剖結構，對提高手術的成功率有重要指導意義。