MRI诊断乳腺炎性病变的价值

目的 探讨乳腺炎性病变的MRI影像特点,提高乳腺炎性病变的诊断率.方法 回顾性分析经手术病理证实为乳腺炎性病变15例,术前均行常规MRI平扫和动态增强扫描.分析病灶MRI平扫及增强后形态学、血流动力学改变特点.结果 15例中,4例平扫病灶未见显示;10例表现为局灶或弥漫性不均匀信号,T1WI呈稍低信号,T2WI信号稍高;1例表现为多发结节,T1WI、T2WI均呈等信号;6例病灶伴脓腔形成,腺体结构紊乱、皮肤增厚、胸壁水肿、腋窝淋巴结增大.增强后3例表现为多发斑点状、结节状强化,5例表现为分隔、小环形强化,6例表现为多发结节状、斑片状、环形强化,1例表现为均匀结节状强化.其中7例急性乳腺炎与1例结核的早期强化率及峰值强化率高,时间-信号强度曲线表现为平台型;7例乳腺导管扩张症早期强化率较高,5例时间-信号强度曲线表现为流入型,余2例表现为平台型.结论 乳腺炎性病变MRI形态学及血流动力学具有一定的特征性,MRI增强扫描在乳腺炎性病变中具有较大的应用价值.     

MR-DWI对非哺乳期乳腺炎与非肿块强化乳腺恶性肿瘤的鉴别诊断

目的：探讨 MR-DWI 及其表观弥散系数（ADC）值对乳腺炎性病变与非肿块样强化乳腺恶性肿瘤鉴别诊断价值。方法：回顾性分析2013年1月-2014年2月经手术或穿刺活检病理确诊的乳腺炎性病变患者共32例与同时期非肿块样强化的乳腺恶性病变45例的乳腺 MR-DWI 表现及 ADC 值。32例炎性病变中12例为超声引导下穿刺活检病理证实,20例行手术病理证实,恶性病变均行手术治疗,获得组织病理结果证实。分析所有患者的术前 MRI 表现,包括 DWI图像中病变形态、信号表现,并测定 ADC 值,以探讨 MR-DWI 对乳腺炎性病变与非肿块强化恶性病变的鉴别诊断价值。结果：32例乳腺炎性病变 DWI 上全部检出,其中23例含脓肿或微脓肿病例,DWI 均可见不均匀高信号,部分可见显著高信号灶,边界清晰。与乳腺恶性肿瘤相比乳腺炎病例较多表现为 DWI 及 STIR 均呈高信号（P ＜0．01）;乳腺恶性肿瘤病例较乳腺炎病例多表现为 DWI 高信号、STIR 稍低信号（P ＜0．01）。32例乳腺炎病例的周围炎性渗出或增生肉芽组织ADC 值为（1．48±0．21）×10-3 mm2/s,其中23例含脓腔或微脓腔的乳腺炎性病变,其显著高信号脓腔的 ADC 值为（0．91±0．19）×10-3 mm2/s。45例乳腺恶性肿瘤实性成分的 ADC 值为（1．15±0．23）×10-3 mm2/s。结论：MR-DWI 联合 STIR 及 ADC 值对于非哺乳期乳腺炎性病变与非肿块样强化的乳腺恶性病变的鉴别诊断具有较大价值。     

颅内表皮样囊肿的非典型CT和MRI表现

目的 探讨颅内表皮样囊肿的非典型CT和MRI表现,提高对本病的认识.方法 收集经手术病理证实的8例表皮样囊肿,术前均行MRI平扫,其中2例行扩散加权成像(difussion weighted imaging,DWI)检查,CT检查5例.MRI增强扫描4例.结果 8例表皮样囊肿发生于桥小脑角2例,大脑纵裂2例,脑实质2例,颅骨2例.CT显示囊肿表现为均匀高密度2例;混杂密度1例;囊壁及囊内钙化2例.MRI平扫2例T1WI呈均匀高信号,T2WI呈稍高、高信号;3例T1WI和T2WI呈混杂信号;3例T1WI呈不均匀低信号,T2WI呈高信号;其中1例DWI表现为高信号.4例MRI增强扫描显示囊壁显著环形强化和囊内不均匀强化2例,囊壁轻度强化2例.结论 颅内表皮样囊肿的CT和MRI非典型表现主要包括CT呈高密度、混杂密度、囊壁和囊内钙化,MRI T1 WI、T2WI呈高信号、混杂信号,增强扫描显著环形强化,在诊断时应充分结合DWI检查,以提高术前诊断准确性.     

肉芽肿性乳腺炎的MRI诊断

目的:探讨肉芽肿性乳腺炎(GM)的MRI诊断价值。方法:回顾性分析34例经病理证实的GM的临床及MRI资料。结果:34例病灶在T1WI上呈等、低信号,32例在抑脂T2WI上呈略高信号,2例呈等信号。增强扫描显示强化病灶呈不规则形态肿块样分布11例(占32.4%),非肿块形式分布23例(占67.6%),其中呈段样分布15例(占44.1%),呈区域样分布8例(占23.5%)。34例增强后病灶内部表现为均匀强化3例、厚壁环形强化10例及薄壁环形强化21例,31例厚壁及薄壁环形强化病灶内均可见脓肿形成,且脓肿内壁光滑。34例病灶时间-信号强度曲线(TIC)呈流入型、平台型和流出型分别为17、9和8例。13例病灶周围腺体呈网格样改变,对应皮肤受牵拉,21例周围组织未见受累,腋下淋巴结增大10例。血管减影图显示30例患乳病灶旁血管增加。结论:GM的MRI具有一定的特征,特别是当病灶内出现脓肿且内壁光滑时,有助于GM的诊断。     

非特异性肉芽肿性乳腺炎与非肿块样强化乳腺癌的MRI征象及临床分析

目的 探讨临床和MRI表现在非特异性肉芽肿性乳腺炎(IGM) 和非肿块样强化乳腺癌鉴别诊断中的价值.方法 回顾性分析经病理证实的45例IGM与57例非肿块样强化乳腺癌的临床、MRI资料,所有患者均行常规MR扫描和扩散加权成像(DWI)及动态增强扫描.χ2检验比较2组患者的临床和MRI特征差异.单因素方差分析比较不同部位表观扩散系数(ADC)值的差异.结果 2组患者的发病年龄、强化方式、乳房疼痛、乳头凹陷、皮肤增厚的征象差异有统计学意义(P<0.01).IGM病灶脓肿区DWI呈明显高信号,非脓肿区呈高信号;非肿块样强化乳腺癌的病灶DWI呈高信号.非肿块样强化乳腺癌的病灶与IGM非脓肿区ADC值间差异有统计学意义(P<0.01).结论 临床特征及MRI表现在鉴别IGM与非肿块样强化乳腺癌中具有一定的价值.     

浆细胞性乳腺炎的MRI表现

目的:探讨浆细胞性乳腺炎的MRI表现.方法:51例经临床病理证实的浆细胞性乳腺炎患者纳入研究,全部病例进行MRI检查,包括T1WI、T2WI压脂平扫和动态增强3D T1WI压脂扫描;2位资深放射科医生共同分析其MRI表现并进行分型.结果:浆细胞性乳腺炎的MRI表现可分为炎症型、脓肿型和混合型;炎症型13例(25.5%),病灶局限在乳晕周围(11/13),斑片样或结节样,T1WI呈等低信号(8/13)或等高信号(5/13),压脂T2WI呈高信号(9/13)、高等信号(3/13)或等信号(1/13),增强后不均匀强化(11/13)或结节样均匀强化(2/13);脓肿型34例(66.7%),多数多发(32/34),似卷发样或蜂窝状,境界模糊不清,少数单发(2/34),结节或囊状,T1WI呈等、低信号(30/34)或等高信号(4/34),压脂T2WI呈高等信号(29/34)、高低信号(4/34)或等信号(1/34),增强后脓肿壁呈环状强化;混合型4例(7.8%),脓肿伴细管状低信号的窦道瘘管.结论:浆细胞性乳腺炎的MRI表现具有一定特征性,MRI检查有助于明确诊断.     

横纹肌样脑膜瘤的MRI表现

目的:探讨横纹肌样脑膜瘤(RM)的MRI表现,并结合文献讨论其病理特点。方法:回顾性分析我院经手术病理证实的3例RM病例。3例患者术前均行MRI平扫、增强及DWI序列检查。结果:3例RM中,2例为实性,1例为囊实性。2例实性病灶中,1例呈等T1等T2信号,DWI呈高信号,增强扫描病灶呈花环形强化;1例呈等T1稍短T2信号,DWI呈低信号,增强扫描病灶呈团块状均匀强化,矢状面可见脑膜尾征。囊实性病灶的实性部分呈等T1等T2信号,DWI呈稍高信号,增强扫描呈不均匀强化;囊性部分呈长T1长T2信号,DWI呈低信号;增强扫描未见明显强化。3例均未出现瘤周水肿。结论:横纹肌样脑膜瘤的MRI表现缺乏特征性,最终确诊需行病理学检查。     

腹壁子宫内膜异位症的MRI诊断

目的探讨腹壁子宫内膜异位症(abdominal wall endometriosis,AWE)的MRI表现及特点,为临床诊断提供依据。方法回顾性分析经手术病理证实的9例AWE患者的MRI资料,分析其MRI平扫及增强扫描的特征,辅以研究其DWI图像。结果 9例AWE患者中,7例单发,2例多发,9例患者共发现11处病灶;2例患者的病灶位于皮下脂肪组织内,6例患者的病灶位于腹直肌内,1例患者的病灶同时侵及皮下脂肪组织及腹直肌;实质型3例、囊肿型1例、囊实混合型5例。与周围肌肉组织相比,MRI平扫表现实质型,T_1WI呈等信号或等低信号,T_2WI脂肪抑制序列呈高低混杂信号,DWI呈略高信号;囊肿型T_1WI呈以高信号为主的高低混杂信号,T_2WI脂肪抑制序列呈高信号,DWI呈高信号;囊实混合型T_1WI呈等信号,其内混杂点状高信号,T_2WI脂肪抑制序列呈高低混杂信号,DWI呈混杂高信号。增强扫描:实质型明显强化;囊肿型未见明显强化;囊实混合型呈明显不均匀强化。AWE病灶的平均ADC值为1.29×10~(-3)/mm~2/s。结论MRI表现结合病史能对腹壁子宫内膜异位症作出明确诊断,在其定性、定位及鉴别诊断中具有重要价值。     

原发性肝脏神经内分泌癌的MRI表现与病理对照研究

目的：探讨原发性肝脏神经内分泌癌（PHNEC）的MRI表现及其病理基础,旨在提高其影像诊断水平。方法：回顾性分析8例经手术病理证实的PHNEC患者的MRI资料,分析其影像特点并与病理对照。结果：1例为单发结节型,病灶边界清晰,T1wI上呈低信号、T2wI上呈稍高信号,DWI上呈显著高信号,增强后动脉期有明显强化,门脉期及延迟期呈等信号;7例为巨块结节型,表现为巨大主灶伴周边卫星结节灶。主灶信号于T1wI上呈低信号、T2wI上呈稍高信号,DWI上呈显著高信号,增强后动脉期有明显强化,门脉期对比剂迅速廓清,延迟期周边可见环形强化的包膜影。卫星结节灶数目不等,大小不一,T1wI上呈低信号、T2wI上呈稍高信号,DWI上呈显著高信号,呈环形强化或均匀强化。结论：PHNEC的MRI表现具有一定特征性,常表现为不均质巨块结节型富血供病灶伴门脉期对比剂快速廓清及延迟期包膜强化。     

脑包虫病的MRI表现及诊断

目的 分析脑包虫病的MRI特征性表现.方法 回顾性分析18例经手术病理证实脑包虫病患者的MRI表现,总结脑包虫病的MRI诊断与鉴别诊断要点.结果 18例脑包虫病患者中囊性包虫病和泡型包虫病各9例.囊性包虫病表现为脑内大小不等的圆形长T1、长T2信号病灶,内部信号均匀一致,液体衰减反转回复(FLAIR)序列扫描其内囊液信号可被抑制;DWI序列病灶为低信号;6例病灶周围无水肿带,3例破裂包虫囊肿病灶周围有水肿带;6例病灶见囊壁显示,3例病灶囊壁显示不明显;增强扫描3例破裂包虫囊肿有环形强化,6例病灶无强化;泡型包虫病表现为脑内多发等T1、短T2簇状异常信号,病灶周围通常有类似脑肿瘤样的水肿带.病灶T2WI信号似"煤炭样"黑色的低信号,内见无数密集稍高信号的小囊泡影,小囊泡直径约1～10 mm为其特征性表现.DWI序列病灶为低信号;Gd-DTPA增强扫描后病灶均见不规则的异常环形强化.2例脑灌注成像病变为低灌注改变.结论 MRI以多方位、多参数成像的优势显示脑包虫更准确,术前诊断率更高,对临床诊治具有重要意义.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).