摘要:目的: 探討臂叢神經磁共振成像的技術方法及其可行性。 方法 :對15例正常志愿者行雙側臂叢神經成像:包括常規快速自旋回波序列T1加權(T1W/TSE)、快速自旋回波序列T2加權(T2W/TSE)、快速自旋回波序列T2加權加SPIR脂肪抑制(T2W/SPIR)冠狀位掃描以及彌散加權背景抑制成像序列(DWIBS)軸位掃描。 結果 :T1W/TSE、T2W/TSE、及T2W/SPIR對臂叢節后神經同層顯示率分別為533%、567%和833%;DWIBS MIP重建圖像對臂叢神經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重建圖像的對比噪聲比明顯高于T1W/TSE和T2W/TSE序列。 結論 :T2W/SPIR序列對臂叢神經的同層顯示率及圖像的對比噪聲比明顯高于常規T1W/TSE、T2W/TSE序列, DWIBS MIP重建圖像能夠顯示臂叢神經的全貌,兩者為臂叢神經成像較為有效的技術方法,對于臂叢神經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.
ObjectiveThe purpose of this study was to better delineate the clinical spectrum of periventricular nodular heterotopia (PNH) in a large patient population to better understand social support in people with PNH and epilepsy in west China. Specifically, this study aimed to relate PNH subtypes to clinical or epileptic outcomes and epileptic discharges by analyzing anatomical features. MethodsThe study included 70 patients with radiologically confirmed nodular heterotopias and epilepsy. We also recruited healthy controls from nearby urban and rural areas. People with PNH and epilepsy and healthy controls were gender-and age-matched. Two-sided Chi-square test and Fisher's exact t-test were used to assess associations between the distribution of PNHs and specific clinical features. ResultsBased on imaging data, patients were subdivided into three groups: (a) classical (bilateral frontal and body, n=25), (b) bilateral asymmetrical or posterior (n=9) and (c) unilateral heterotopia (n=36). Most patients with classical heterotopia were females, but were mostly seizure-free. Patients with unilateral heterotopia were prone to develop refractory epilepsy. ConclusionsEach group's distinctive genetic mutations, epileptic discharge patterns and overall clinical outcomes confirm that the proposed classification system is reliable. These findings could not only be an indicator of a more severe morphological and clinical phenotype, but could also have clinical implications with respect to the epilepsy management and optimization of therapeutic options.
【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.
Because of the long acquisition time and spin-echo planar imaging sequence, diffusion weight magnetic resonance image (DWI) should be denoised effectively to ensure the follow-up applications. The commonly used denoising methods which induced from gray level image lack the use of the specific information from multiple magnitude directions. This paper, therefore, proposes a modified linear minimum mean square error (LMMSE) denosing method used for DWI. The proposed method uses the local information to estimate the parameter of the Rician noise and modifies the LMMSE using the information of multiple magnitude directions synthetically. The simulation and experiment of the synthetic DWI and real human brain DWI dataset demonstrate that the proposed method can more effectively remove the Rician noise compared to the commonly used denoising method and improve the robustness and validity of the diffusion tensor magnetic resonance image (DTI).
【摘要】 目的 探討MRI動態增強掃描在子宮內膜癌手術前診斷中的價值。 方法 回顧分析2008年2月-2010年3月38例經手術病理證實為子宮內膜癌患者的動態增強MRI檢查資料，判斷內膜癌子宮肌層和宮頸浸潤情況，與病理結果對照，計算T2WI及動態增強序列診斷肌層及宮頸浸潤的敏感度、特異度、準確度等，分析兩種序列診斷準確度有無差異；計算內膜癌組織與子宮肌層在動態增強各期的對比信噪比，并分析其在各期間有無差異。 結果 動態增強序列診斷內膜癌肌層和宮頸受侵的敏感度、特異度、陽性預測值、陰性預測值分別為96.8%、85.7%、96.8%、85.7%和85.7%、91.7%、85.7%、91.7%；動態增強序列診斷內膜癌深肌層浸潤的準確度為94.7%，顯著高于T2WI診斷深肌層浸潤的準確度78.9%（Plt;0.05）；平衡期內膜癌組織與子宮肌層的對比信噪比顯著高于動脈期和靜脈期（Plt;0.01）。 結論 MRI動態增強掃描能夠在手術前準確的判斷內膜癌肌層及宮頸浸潤，有助于子宮內膜癌治療方式的選擇。【Abstract】 Objective To investigate the role of dynamic-enhanced MRI in the diagnosis of endometrial carcinoma. Methods Thirty-eight patients with endometrial carcinoma confirmed by surgicopathology undergone dynamic-enhanced MRI scans were analyzed retrospectively. The invasion in myometrium and uterine cervix were analyzed. The tumor and myometrium contrast-to-noise ratios during different phases of dynamic imaging were calculated. MR imaging findings were compared with pathologic findings. Sensitivity, specificity, diagnostic accuracy, positive and negative predictive values of MR imaging in depicting myometrial and cervical infiltration were calculated. Results Respective sensitivity, specificity, and positive and negative predictive values in assessing myometrial infiltration were 968%,85.7%,96.8%,85.7%;those for cervical infiltration were 85.7%,91.7%,85.7%,91.7%,respectively. The diagnostic accuracy (94.7%) of dynamic imaging in depicting deep myometrial infiltration were significantly higher than that of T2WI (78.9%) (Plt;0.05).There was a significant improvement in tumor and myometrium contrast-to-noise ratios during the equilibrium phase compared with the arterial and venous phases (Plt;0.01). Conclusion Dynamic-enhanced MRI is highly accurate in preoperative diagnosis of endometrial carcinoma, which will benefit for the treat of endometrial carcinoma.
Cryptogenic stroke (CS) accounts for 25% of ischemic stroke. The etiology of undetermined stroke is unclear leading to untargeted secondary prevention, high recurrence rate, so the clinical burden of cryptogenic stroke is substantial. Cardiac magnetic resonance (CMR) imaging can identify more occult cardiac embolism that cannot be identified by standard cardiac assessment based on its excellent spatial resolution and contrast, three-dimensional imaging capacity and ability to depict soft tissues, to accelerate the initiation of optimal secondary prevention and improve the prognosis of patients. This review summarizes the application of CMR in the field of CS in recent years. Based on the latest evidence of diagnosis and management strategies, this paper proposes a cardiac diagnostic examination plan for CS patients, thereby improving the secondary prevention strategy of CS patients and improving their quality of life.