动态增强MRI在垂体微腺瘤诊断中的应用

目的 探讨了垂体动态增强扫描对垂体微腺瘤诊断价值。方法 选择2013年1月至2014年1月间我院疑诊为垂体微腺瘤患者88例为研究对象,所有患者均于入院后2d内行鞍区MR平扫、动态增强扫描及延迟扫描。以手术病理及临床证实结果为标准诊断,观察并比较MR平扫、动态增强扫描及延迟扫描对垂体微腺瘤诊断情况。结果 经病理或临床证实为垂体微腺瘤56例,均为单发,其中位于垂体前叶49例,左侧27例,右侧29例。长径2~10mm,平均5.3±2.2mm。MR平扫显示垂体内异常信号28例,动态增强扫描显示病灶55例,延迟增强扫描显示病灶32例。动态增强扫描对垂体微腺瘤显示率显著高于平扫及延迟增强,差异具有统计学意义(P0.05)。动态增强扫描对垂体微腺瘤诊断敏感性、特异性、阳性预测率及阴性预测率分别为94.6%、93.7%、96.4%、90.9%。结论 垂体动态增强扫描对垂体微腺瘤诊断价值高,值得临床推广应用。     

3.0T MRI多动态增强扫描在垂体微腺瘤检出中的应用

目的探讨3.0T MRI多动态增强扫描在垂体微腺瘤检出中的应用价值。方法使用3.0T MRI对50例垂体微腺瘤患者进行平扫、多动态增强扫描及延迟扫描。结果垂体微腺瘤平扫多只能看到垂体形态的轻微改变,T2WI有时可见到稍长T2信号,多数病灶信号改变不明显。多动态增强扫描增强早期,肿瘤强化程度明显低于正常垂体实质,肿瘤呈稍低信号,境界清楚;中晚期及延时期,肿瘤信号逐渐缓慢增高,部分病灶延时信号高于正常垂体。结论 3.0T MRI多动态增强扫描垂体微腺瘤检出信号具有特征性,可作为临床垂体微腺瘤排查首选。     

磁共振动态增强扫描对诊断垂体微腺瘤的价值

目的评价磁共振动态增强扫描诊断垂体微腺瘤的价值。方法对26例垂体微腺瘤患者的磁共振平扫、动态增强扫描、常规延迟增强扫描影像学资料进行回顾性分析。结果磁共振平扫、动态增强扫描和常规延迟增强扫描微腺瘤检出率分别为53．85％（14／26），100％（26／26），和73．08％（19／26），三种不同的扫描方法微腺瘤检出率有显著差异（P〈0．01）。结论磁共振动态增强扫描能明显提高垂体微腺瘤的捡出率，对垂体微腺瘤的诊断有重要价值。     

MRI半剂量动态增强在垂体微腺瘤中的诊断价值

目的 评价MRI 半剂量动态增强对垂体微腺瘤的诊断价值.方法 对32 例经实验室、影像学及临床诊断的垂体微腺瘤患者的影像资料进行回顾性分析.结果 平扫的阳性率为53.13%,半剂量动态增强扫描垂体微腺瘤检出率为100.0%,延迟后检出率为75.0%.结论 半剂量动态增强扫描对垂体微腺瘤的检出具有良好的敏感性和特异性,可...     

磁共振3D CUBE T_2WI脂肪抑制序列对视神经病变的诊断价值

目的应用磁共振3DCUBE T2WI脂肪抑制序列对视神经病变的进行诊断及研究。方法回顾分析23例临床诊断为视神经病变的患者眼眶常规MR扫描,MR 3DCUBE T2WI脂肪抑制序列扫描,运用AW4.4后处理工作站,对3D CUBE T2WI脂肪抑制序列进行多平面重组,观察视神经眶内段、管内段及颅内段显示情况及病变。结果 MR诊断结果与临床诊断结果对比,常规眼眶MR扫描序列显示视神经信号明显异常56.5%（13/23）,轻度异常17.4%（4/23）,未见异常26.1%（6/23）,3DCUBE T2WI脂肪抑制序列显示视神经信号明显异常73.9%（17/23）,轻度异常13.0%（3/23）,未见异常13.0%（3/23）。结论 MR 3DCUBE T2WI脂肪抑制序列在较短扫描时间内获得3D容积图像,并可在后处理工作站上进行曲面重组,对视神经病变的检出率明显高于眼眶常规扫描序列。     

磁共振信号特征与垂体腺瘤质地的关系

目的探讨磁共振平扫的信号特征与垂体腺瘤质地的关系。方法112例经手术和病理确诊的垂体腺瘤根据手术中肿瘤的质地分为3组:质软组(A组,78例),质中等组(B组,15例)和质韧组(C组,19例),所有病例术前均行磁共振扫描,通过JW-PACS影像工作站测量MR值,分别计算T2加权成像的瘤体/灰质比值(T/G)和瘤体/脑脊液比值(T/C)。结果3组的T/G分别为1.643±0.079,1.328±0.086,0.973±0.050,其差异有统计学意义(P=0.000);T/C分别为0.755±0.052,0.623±0.047,0.472±0.050,其差异均有统计学意义(P=0.000)。结论术前磁共振T2WI的信号强度可区分垂体腺瘤的质地,对判断手术难度和预后及选择手术入路有重要意义。     

磁共振FSE三维容积成像序列在视神经炎诊断中的价值

目的探讨磁共振FSE三维容积成像序列对视神经炎的诊断价值。方法收集临床诊断视神经炎患者32例,行视神经冠状位T2WI脂肪抑制、3DFSE T2WI脂肪抑制扫描,对3DT2WI脂肪抑制图像后处理及重建,分析视神经各段是否异常及受累范围、程度。结果采用双盲法对诊断结果与MR检查结果进行对比分析,其中临床诊断视神经炎41条视神经,23条正常(2组MR检查结果正常)。视神经冠状位T2WI脂肪抑制信号明显增高46.3%(19/41),轻度增高36.6%(15/41),未见增高17.1%(7/41),3DT2WI脂肪抑制扫描信号明显增高56.1%(23/41),轻度增高29.3%(12/41),未见增高14.6%(6/41)。结论磁共振三维容积成像序列扫描速度快,可获得薄层容积图像,提高视神经炎的诊断水平及检出率。     

低场FLAIR技术在急性脊髓炎中的诊断价值

目的 探讨快速液体衰减反转恢复(FLAIR)技术在急性脊髓炎中的应用价值. 方法 用0.5T超导磁共振(MR)机对52例健康者和33例急性脊髓炎患者行MR检查,扫描序列为TlM.T2WI,FLAIR序列,33例患者中23例作了T1WI增强扫描,比较FLAIR和TSE-T2WI两种序列对病灶的显示能力. 结果 33例患者33处病灶,FLAIR发现病灶33处,检出率100%,TSE-T2WI发现病灶23处.检出率69.7%:在显示病灶边缘情况方面,FLAIR显示清楚者32例,T2WI显示清楚者13例.在发现病灶及显示病灶边缘方面两者差异有统计学意义(P<0.01). 结论 FLAIR技术在脊髓炎的诊断中有较高的临床应用价值.应作为本病检查的常规方法.     

垂体微腺瘤的影像学特点和诊断(附36例报告)

目的探讨垂体微腺瘤的影像学特点和诊断.方法回顾性分析36例经手术证实的垂体微腺瘤病人的影像学特征和临床特点.结果均有内分泌功能紊乱症状及血泌乳素(PRL)和(或)促肾上腺皮质激素(ACTH)升高.MRI平扫或强化扫描示＜1.0 cm低信号占位35例,其中6例通过动态强化扫描确诊;无占位1例,为ACTH微腺瘤.垂体左右不对称27例,垂体上缘膨隆24例,垂体柄偏斜11例,鞍底骨质局部下陷、变薄7例.结论垂体PRL、生长激素(GH)微腺瘤的诊断需结合临床表现、内分泌检查和影像学特征综合考虑;磁共振间接征象及动态强化扫描对提高微腺瘤的检出率有帮助;ACTH微腺瘤的诊断应结合临床症状、实验室检查和影像学诊断,并以内分泌诊断为主.     

MR评价垂体腺瘤质地及与其胶原含量的关系

目的利用MR测量垂体腺瘤不同质地的信号强度,并分析其与肿瘤胶原含量间的关系。方法57例经手术证实的垂体腺瘤标本,术前均行MR检查,根据术中肿瘤硬度分为质地韧组(8例)与质地软组(49例),标本行天狼猩红染色检测其胶原含量。结果纤维化与非纤维化组T1WI瘤体/灰质信号强度比分别为1.31±0.31、1.16±0.26;T1WI瘤体/白质信号强度比分别为1.01±0.25、0.91±0.18,两组间差异无统计学意义(P(0.05);T1+WI瘤体/灰质信号强度比分别为1.83±0.28、1.84±0.51;T1+WI瘤体/白质信号强度比分别为1.56±0.24、1.46±0.37,两组间差异无统计学意义(P(0.05);T2WI瘤体/灰质信号强度比分别为1.15±0.26、1.57±0.46(P(0.05);T2WI瘤体/白质信号强度比分别为1.48±0.39、2.10±0.61,两组间有统计学意义(P(0.01);胶原含量分别为20.03%±7.99%、7.87%±4.82%,两组间有统计学意义(P<0.01);且T2WI瘤体/灰质、T2WI瘤体/白质与胶原含量呈显著负相关(r=-0.531、r=-0.726,P均(0.01)。结论术前MR可以预测垂体腺瘤的质地;其中以T2WI瘤体/白质为预测指标为最佳。胶原含量影响垂体腺瘤质地,MRI上T2WI可以反映其胶原含量的多少。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。     

Effect of high simple dose of cisplatinum and of radiation on the brain of rabbit

Abstract

In former studies of intracarotid and intravenous administration of cisplatinum, separate and combined with brain irradiation, we found no cerebral damage. In this study! gradually increasing high doses (above the therapeutic ones) of cisplatinum were administered intravenously to one series of rabbits arid increasing high amounts of irradiation (above the therapeutic amounts) were given to another series. Although the rabbits that received highest doses of irradiation developed areas of alopecia and skin ulcers on the head! the general clinical and histopathologic examination of the rabbits brains in both series was normal. The purpose of this study was to establish the effects of high doses of intravenous cisplatinum and irradiation on the rabbits brains. [Neural Res 1997; 19: 216–218]