非脑膜瘤脑膜异常强化的MRI与病因对比研究

目的：分析不同脑膜病变的强化特征，探讨脑膜强化形式与病因诊断的关系。材料与方法：回顾性分析资料完整的异常脑膜强化２６例，根据脑膜受累层次、范围将强化形式分为四种：（１）弥漫性脑膜强化；（２）弥漫性硬膜强化；（３）弥漫性软膜强化；（４）局限性硬膜强化。依病因不同将脑膜病变分为三组：（１）肿瘤组；（２）炎症组；（３）反应组。结果：２６例中，肿瘤组８例，其中弥漫性硬膜、软膜强化各３例，弥漫性脑膜强化、局限性硬膜强化各１例。炎症组８例，弥漫性软膜强化７例，局限性硬膜强化１例。反应组１０例，８例呈局限性硬膜强化，２例呈弥漫性硬膜强化。结论：不同的脑膜病变可表现不同的强化特征，但离开临床，仅根据强化特征尚难做出定性诊断。     

Diagnostic value of MRI in tuberculous meningitis

In this study 15 patients with clinical findings and positive cerebrospinal fluid analyses for tuberculous meningitis were evaluated with magnetic resonance imaging (MRI). Tuberculous meningitis was diagnosed in 11 cases when thick meningeal enhancement was present after intravenous injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) in T1-weighted images. Intra-axial tuberculomas were present in 8 patients, 2 of whom had intra-axial tuberculomas without MRI evidence of meningitis. Tuberculomas showed ring or nodular enhancement in postcontrast T1-weighted images, but the most significant MR feature of intraparenchymal tuberculomas was the hypointense appearance of the lesions on T2-weighted images.Correspondence to: C. Tayfun     

Acute epiglottitis: MRI

We report the MRI findings in an adult with epiglottitis. There was thickening of the epiglottis and left aryepiglottic fold. Management of this life-threatening condition requires imaging only when the diagnosis is uncertain or when an abscess or other complication is suspected.     

Sydenham's chorea: MRI and proton spectroscopy

We present the MRI and proton spectroscopy findings in a child with clinical diagnosis of Sydenham's chorea. MRI showed high signal in the caudate nuclei and putamina on T2-weighted images. We believe that the spectra showed an abnormality in the number and/or function of neurons, lipids from cellular breakdown (cytolytic effect of antibodies), aminoacids (related to the presence of antibodies in the neostriatum), and sugars (also related to the presence of antibodies). The spectroscopy features correlate well with the histopathology and biochemistry of this rare disorder. Received: 27 November 1998 Accepted: 5 April 1998     

各向同性容积扫描增强技术对儿童化脓性脑膜炎的诊断价值

目的 通过比较增强各向同性三维快速自旋回波脉冲（3D-FSE-CUBE,简称CUBE）序列T ₁WI和增强FLAIR序列T ₂WI对化脓性脑膜炎（PM）脑膜增厚强化的显示能力,探讨增强CUBE序列T ₁WI对PM的临床应用价值。 方法 搜集首都医科大学附属北京儿童医院2016年8月至2017年1月,35例临床确诊为PM的患儿,其中男16例、女19例,年龄2个月至3岁,中位年龄8个月。所有患儿均行常规MR平扫及增强扫描,增强后对CUBE序列T ₁WI和FLAIR序列T ₂WI进行随机先后采集。以增强FLAIR序列T ₂WI为标准,评价增强CUBE序列T ₁WI序列对硬脑膜和柔脑膜增厚的显示率,将强化灶的检出数目采用四格表χ ²检验。 结果 增强FLAIR序列T ₂WI可显示21例硬脑膜强化,显示率为60.0%;增强CUBE序列T ₁WI可显示31例硬脑膜强化,显示率为88.6%;两者间差异具有统计学意义（χ ²=6.058. P<0.01）;增强FLAIR序列T ₂WI可显示16例柔脑膜强化,显示率为45.7%;增强CUBE序列T ₁WI可显示19例柔脑膜强化,显示率为54.3%;增强CUBE序列T ₁WI对柔脑膜强化显示较增强FLAIR序列T ₂WI更清晰,但两者间差异无统计学意义（χ ²=0.229, P>0.05）。 结论 增强CUBE序列T ₁WI对脑膜增厚强化的显示优于增强FLAIR序列T ₂WI,对于儿童PM的诊断有较大的临床应用价值。     

脑胶质肉瘤的MRI表现及临床病理对照研究

目的 评价MRI对脑胶质肉瘤的诊断价值. 资料与方法 经病理证实的脑胶质肉瘤8例,回顾分析其MRI表现及病理学表现. 结果 病灶基本上表现为长T1 、长T2信号,边界不清,多数形态不规则,伴有囊变和坏死,个别可见瘤内出血,生长具有侵袭性,少数为结节状.周围脑组织水肿较轻,占位效应明显.增强扫描7例明显强化,1例轻中度强化,5例呈不规则环状强化,2例呈结节状强化,3例内部可见丝瓜瓤样不规则条状强化;2例直接侵犯邻近脑叶,3例发现瘤内出血,5例发生于脑凸面,1例发生于深部脑白质,1例发生于左侧侧脑室. 结论 脑胶质肉瘤通常发生于额、顶叶脑凸面,MRI能够清楚地显示病变及其边界,但信号改变易与多形胶质母细胞瘤、恶性胶质瘤、转移瘤等相混淆.确诊仍依赖于组织病理学诊断.     

喉气囊肿的MRI诊断

目的探讨喉气囊肿的临床和MRI表现.资料与方法搜集喉气囊肿2例,均为男性,年龄分别为23岁和50岁.以颈前肿块就诊,均经MRI检查,并经手术和病理证实,结合文献进行讨论.结果例1为混合型,囊肿大小为6cm×5cm×4cm;例2为喉内型,囊肿大小为2cm×2cm×1cm,MRT1WI、T2WI均呈极低信号,边缘光整.例2可见与喉室通道,例1X线平片示左颈部椭圆形囊状透亮影.结论喉气囊肿MRI诊断比较容易,能达到定位和定性诊断.     

乳腺疾病的MRI研究进展

MRI具有极佳的软组织分辨率,近年来,该技术越来越广泛的应用于乳腺疾病的诊断.乳腺动态增强成像和灌注加权成像可从不同角度反映乳腺组织及病灶的血供灌注情况,弥散加权成像和磁共振波谱分析则从分子水平提供乳腺病变组织信息,磁共振乳腺导管成像为导管内病变提供了新的影像诊断方法.随着MRI技术的成熟、软硬件的迅速发展,MRI在乳腺疾病的检出和诊断方面显示出其独到的优势.     

Contrast enhancement of the cerebrospinal fluid on MRI in two cases of spirochaetal meningitis

We report two patients with meningitis due to spirochaetal infection, both of whom showed diffusely enhancing meninges around the brain and spinal cord. In addition, there was enhancement of the cerebrospinal fluid after intravenous administration of Gd-DTPA. Received: 1 March 1998/Accepted: 21 August 1999     

Whole-body MRI at high field: technical limits and clinical potential

This review seeks to clarify the most important implications of higher magnetic field strength for clinical examinations of the whole body. An overview is provided on the resulting advantages and disadvantages for anatomical, functional and biochemical magnetic resonance examinations in different regions of the body. It is demonstrated that susceptibility-dependent imaging, chemical shift selective (e.g., fat-suppressed) imaging, and spectroscopic techniques clearly gain from higher field strength. Problems due to shorter wavelength and higher radio frequency energy deposition at higher field strength are reported, especially in examinations of the body trunk. Thorax examinations provided sufficient homogeneity of the radio frequency field for common examination techniques in most cases, whereas abdominal and pelvic imaging was often hampered by undesired dielectric effects. Currently available and potential future strategies to overcome related limitations are discussed. Whole-body MRI at higher field strength currently leads to clearly improved image quality using a variety of established sequence types and for examination of many body regions. But some major problems at higher field strength have to be solved before high-field magnetic resonance systems can really replace the well-established and technically developed magnetic resonance systems operating at 1.5 T for each clinical application.     

烟雾病的磁共振成像诊断

目的：回顾分析８例烟雾病的磁共振成像表现，探讨磁共振成像对烟雾病的诊断价值。方法：８例烟雾病中男女各４例。年龄４～４９岁，平均２０．４岁。磁共振成像应用Ｓｉｅｍｅｎｓ１．０ＴＭＲ系统和头表面线圈。均有ＳＥ序列Ｔ１ＷＩ和Ｔ２ＷＩ，７例有三维时间飞跃法磁共振血管造影（３Ｄ－ＴＯＦＭＲＡ），１例有ＤＳＡ。结果：ＳＥ序列ＭＲＩ均见丘脑－基底节区（单侧２例，双侧６例）有扩张的烟雾血管，其中以Ｔ１ＷＩ显示更为清楚直观。７例３Ｄ－ＴＯＦＭＲＡ和１例ＤＳＡ均见ＩＣＡ上端、ＭＣＡ和ＡＣＡ近端闭塞以及丘脑－基底节区的烟雾血管。这些病理血管分布侧别与ＳＥ序列磁共振成像所见一致。结论：ＳＥ序列磁共振成像和３Ｄ－ＴＯＦＭＲＡ是诊断烟雾病的有效方法。Ｔ１ＷＩ显示丘脑－基底节区烟雾血管优于Ｔ２ＷＩ。３Ｄ－ＴＯＦＭＲＡ尚适用于烟雾病血管旁路术后随诊及其高危人群普查。     

MRI in nonketotic hyperglycinaemia: case report

We present a girl with proven nonketotic hyperglycinaemia. The pathological findings on MRI were brain atrophy with thinning of the corpus callosum and delayed myelination of the cerebral hemispheres, particularly the parietal lobes. Received: 5 July 2000/Accepted: 27 September 2000     

Tay's syndrome: MRI

Tay's syndrome is a trichothiodystrophy associated with congenital ichthyosis. We report the findings on MRI and spectroscopy in a young girl with sparse, short, ruffled hair, dry skin and delayed milestones. T2-weighted images showed prominent diffuse confluent increase in signal symmetrically in all the supratentorial white matter. These findings are similar to those in a previously described case, and consistent with dysmyelination. Spectroscopy showed increased myoinositol and decreased choline. Received: 7 March 2000 Accepted: 13 April 2000     

Spinal MRI in vacuolar myelopathy, and correlation with histopathological findings

We correlated MRI features with histopathological findings in an HIV-positive patient with vacuolar myelopathy. On MRI symmetrical nonenhancing high-signal areas in the posterior columns on T2-weighted images result from extensive vacuolation visible on histological sections. Received: 18 November 1997 Accepted: 23 March 1997     

Proteus syndrome: craniofacial and cerebral MRI

The Proteus syndrome is a rare hamartoneoplastic syndrome that may affect the brain, skull, and extracranial head and neck. We present a case with severe, characteristic findings. Brain abnormalities are not common in Proteus syndrome; when present, hemimegalencephaly and migrational disorders are typically seen, commonly with an associated seizure disorder. Maxillary and mandibular dysmorphism may occur, including unilateral condylar hyperplasia. Subcutaneous fatty, fibrous, lymphangiomatous masses commonly seen in this syndrome may involve the neck and face, leading to disfigurement and potential airway compromise. Received: 9 September 1998 Accepted: 28 December 1998     

颅内节细胞胶质瘤的MRI特征分析

目的 分析颅内节细胞胶质瘤的MRI特点. 资料与方法 对16例经手术病理证实的节细胞胶质瘤的MRI表现进行总结分析. 结果 12例位于大脑半球,其余4例分别位于脑干、小脑、鞍上及丘脑区.2例表现为囊性肿块,增强后囊壁强化并有明显强化的瘤结节.6例表现为囊实性肿块,8例为实性肿块,增强后实性成分强化. 结论 节细胞胶质瘤的MRI表现无特征性,但颞叶均匀强化的肿块并不伴明显瘤周水肿或囊性肿块伴明显强化的瘤结节提示本病.     

十字交叉心的MRI诊断

目的探讨十字交叉心（CCH）在MR平扫及增强血管成像（MRA）的影像特点及其诊断价值。方法对4例CCH的患者行MR检查，按照节段分析的方法和思路，多序列多角度多体位成像，充分显示CCH的解剖畸形。结果所有心脏球室袢和内脏一心房位置关系均相适应。4例形态学右心室位于形态学左心室之上，水平室间隔，合并巨大室间隔缺损。2组房室瓣均呈前上-后下垂直排列，两心室流人道血流在空间位置上呈十字交叉。心室一大动脉连接关系异常，完全性大动脉错位1例；右室双出口3例。此外，3例合并肺动脉瓣及瓣下狭窄；1例合并肺动脉高压；1例并存房间隔缺损；1例右位主动脉弓及降主动脉。结论MRI诊断CCH具有很高的准确性，有重要的临床应用价值。     

穴位和非穴位电针镇痛的脑功能磁共振对照研究

目的:用功能磁共振成像(fMRI)方法研究穴位和非穴位电针(EA)镇痛时脑功能区变化,了解穴位对电针镇痛的影响.材料和方法:采用穴位深刺、非穴位深刺不同的针刺方法,分别电针20例健康右利手志愿者左侧足少阳胆经的阳陵泉(GB34)和悬钟穴(GB39),同时行全脑fMRI扫描;SPM99软件进行图像后处理,t检验(P<0.01)分析得出不同针刺方法的脑功能图像.结果:20例受试者中有16例完成穴位深刺,18例完成非穴位深刺.穴位深刺与非穴位深刺引起的脑功能区的变化有显著差别.穴位深刺组表现为中脑导水管周围灰质(PAG)、双侧豆状核区等信号升高;双侧扣带前回(BA24、32区)、左侧杏仁体(NA)、双侧海马结构等信号降低.这些发生明显变化的脑功能区被认为可能与针刺镇痛有关.非穴位组双侧扣带前回(BA24、32区)等信号升高,双侧豆状核等信号降低.结论:fMRI方法研究表明,穴位深刺电针镇痛的作用可能是通过抑制和兴奋与痛觉调制相关的多个脑功能区而实现的.非穴位深刺可能更多的是一种不良的刺激.穴位的准确定位对电针镇痛有明显影响.     

自闭症的常规MRI和1H-MRS表现

目的 探讨常规MR成像和1H MR波谱(MRS)在自闭症诊断中的价值.资料与方法 回顾性分析12例自闭症患者的全脑常规MR扫描及其中8例患者额叶和海马的多体素2D 1H MR波谱扫描表现.结果 常规MR扫描发现3例患者的顶叶白质在FLAIR上出现斑片状高信号.1H MRS分析发现5例患者额叶的NAA/Cho明显下降(NAA/Cho<1),其中1例患者的左侧额叶出现Lac峰;另外有2例患者海马的NAA/Cho出现下降(NAA/Cho<1).结论 常规MR成像和1H MRS可发现部分自闭症患者脑组织异常.     

成软骨细胞瘤的MRI表现特点

目的 分析成软骨细胞瘤的MRI表现特点.方法 对经病理证实的20例成软骨细胞瘤的MRI信号特点、病灶形态和生长方式,以及周围骨髓和软组织有无水肿、有无骨膜反应、相邻关节有无积液等征象进行分析.结果 20例病灶在T1WI和T2WI上表现为不均质的混杂信号,病灶形态为分叶状;16例病灶呈膨胀性生长;18例病灶周围出现骨髓水肿;14例病灶周围软组织水肿;6例病灶周围有骨膜反廊;7例病灶突破骨皮质向周围突出;6例棚邻的关节有关节积液.结论 成软骨细胞瘤在MRI上多表现为分叶状和膨胀性生长,病变呈不均质混杂信号,病灶周围有明显的骨髓水肿和邻近软组织水肿.