STIR序列在脊柱MRI检查中的临床应用

目的探讨短T1反转恢复（Short TI Inversion-Recovery,STIR）成像技术在脊柱MRI检查中的应用价值。方法对73例脊柱病变患者（其中，转移瘤50例，血管瘤10例，脂肪瘤8例，急性外伤5例）进行常规MRI平扫、STIR扫描，分析病变的检出情况、病变形态及信号的显示效果。结果在病变的检出，病变形态及信号的显示方面，STIR扫描明显优于平扫各图像。结论脊柱MRI平扫中STIR成像的应用对病变的检出，病变形态、信号的显示具有明显优势，能提高MRI对疾病诊断准确性。     

磁共振STIR序列在早期股骨头缺血性坏死诊断中的应用

目的评价磁共振STIR序列对股骨头缺血性坏死(ANFH)早期诊断的临床应用价值。方法对经MRI普查后STIR序列显示不同程度骨髓水肿及关节积液,而常规T1WI及T2WI未明确提示ANFH特征性改变的18例临床高危患者4～6个月后复查,对其影像征象进行分期和对比性分析。结果复查后有14例患者(共25部位股骨头)可诊断为Ⅰ～Ⅱ期ANFH,病变部位与MRI初次检查时STIR序列所显示的骨髓水肿部位基本一致。结论 MRI在检测ANFH病变中具有较高的敏感性,尤其STIR序列对ANFH的早期诊断具有极高的应用价值。     

快速STIR序列与全身MR检查

概述了快速STIR序列的基本技术及临床应用,讨论了全身MR检查对肿瘤和非肿瘤性病变的作用,展望了该技术对儿童病变的评价以及与PET等不同影像学方法进行图像融合的前景。     

快速STIR序列与全身MR检查

概述了快速STIR序列的基本技术及临床应用,讨论了全身MR检查对肿瘤和非肿瘤性病变的作用,展望了该技术对儿童病变的评价以及与PET等不同影像学方法进行图像融合的前景.     

STIR技术在诊断早期股骨头缺血性坏死中的临床应用

早期股骨头缺血性坏死是临床上十分常见的骨科多发病。近年来,随着人们生活水平的提高以及生活习惯的改变,发病率有上升趋势。传统诊断技术包括X线平片、CT,随着MRI技术的临床应用,MRI已经成为诊断早期股骨头缺血性坏死最敏感的方     

扩散加权MRI在软组织肿瘤中的应用

为了探讨扩散加权MRI对软组织肿瘤的诊断价值,作者对23例软组织肿瘤病人(男11例,女11例,年龄11～70岁,其中1例患两种肿瘤)行扩散加权MRI,MR场强为1.5T,最大梯度场强为23mT/m。采用表面线圈,TR=2-RR,TE=70ms,翻转角为90°,FOV 200～300mm,b=0、176、     

STIR在低场强MRI诊断脊柱转移瘤中的应用价值

目的 探讨低场强磁共振成像(MRI)应用短时反转恢复(STIR)序列对脊柱转移瘤的诊断价值。方法 回顾性分析34例脊柱转移瘤的MRI表现及相关临床资料。结果 (1)34例共检出141个椎体转移。(2)STIR像上5例为等高混杂信号，29例为高信号。结论 STIR在低场强MRI诊断脊柱转移瘤中，对早期发现病灶及了解肿瘤的侵袭范围、脊髓受累情况具有重要的意义。     

定量动态增强磁共振成像在骨与软组织肿瘤中的应用

【摘要】定量动态增强MRI（DCE-MRI）作为一种MRI功能成像技术,能有效评价肿瘤微血管状态,反映肿瘤组织灌注情况,对骨与软组织肿瘤的诊断及疗效评估有重要意义。本文就定量DCE-MRI的技术概况及其近年来在骨与软组织肿瘤中的应用进展进行综述。     

Whole-body FSE STIR MR imaging of lymphoma

Purpose

To evaluate the role of FSE STIR whole body MRI in diagnosis and initial staging of malignant lymphoma, and can FSE STIR whole body MRI replace conventional staging procedures including computed tomography and bone marrow biopsy in initial staging of lymphoma.

Materials and methods

Twenty one newly diagnosed histologically proven lymphoma patients underwent whole body MR imaging and conventional staging procedures including computed tomography and bone marrow biopsy for initial staging of lymphoma using Modified Ann Arbor staging system. Both methods evaluated positive involvement by lymphoma to the nodal and extra-nodal sites including parenchymal organs, serosal cavities and bone marrow. The numbers of involved nodal and extra-nodal sites detected by both methods were compared, then agreement and disagreement between whole-body MRI and conventional procedures regarding lesions detection and staging according to the Ann Arbor staging system were calculated, along with binomial exact 95% confidence intervals (CIs).

Results

Twenty one patients had a total of 145 abnormalities. One hundred and twenty four were correctly diagnosed by conventional staging procedures, however, FSE STIR whole body MRI correctly diagnosed all the 144 abnormalities with 1 false negative and 3 false positive abnormalities with a total of detected abnormalities of 147 lesions. FSE STIR whole body MRI was significantly more accurate than conventional staging procedures in the diagnosis of positive lymphoma lesions [(99.3%; 95% CI: 95.6-100.0%) versus (85.5%; 95% CI: 78.5-90.6%)]. FSE STIR whole body MRI correctly staged 20 out of 21 patients, Kappa test 0.93 (P < 0.001) while conventional staging procedures correctly staged 17 and incorrectly staged 4 cases, Kappa test 0.74 (P < 0.001).

Conclusion

Whole body MR imaging can replace conventional staging procedures in the diagnosis and initial staging of malignant lymphoma as it offers a whole body overview of the lymphoma infiltration through the lymph node stations, parenchymal organs, serosal cavities and bone marrow.     

磁共振短返转时间序列在软组织肿瘤诊断中应用的研究

评价磁共短转返转时间序列在软组织肿瘤诊断中的作用。材料与方法，３２例肿瘤均经ＳＥ和ＳＴＩＲ序列扫描，比较两者图像的肿瘤对比度，信噪比和是征象的检出产价对恶性肿瘤诊断价值。结果：肿瘤对比度在ＳＴＩＰ序列上为０．７０７４±０．０４７０，     

MRI of soft tissue tumors

Magnetic resonance imaging (MRI) is the only noninvasive method of defining a soft tissue tumor. The extent of the tumor and the question of involvement or noninvolvement of various adjacent tissues and structures can be determined. This information, determination of lymphatic and distant metastatic spread, is invaluable for staging and management of the disease. Whether or not the tumor type can be reliably determined, or even whether the malignant or benign nature of the tumor can be ascertained on MRI examination, is open to question. Review of the literature indicates proponents on both sides of the issue. This review illustrates the imaging features that are relevant to suggesting a histologic diagnosis, and the pitfalls that are encountered in trying to determine the malignancy or benignity of a lesion. The clinical significance of these determinations is also discussed.     

Use of limited MR protocol (coronal STIR) in the evaluation of patients with hip pain

Objective To assess the role of a limited MR protocol (coronal STIR) as the initial part of the MR examination in patients with hip pain.Design and patients Eighty-five patients presenting with hip pain, and normal radiographs of the pelvis, and who underwent our full MR protocol for hips were included retrospectively in the study. The full protocol consists of coronal T1-weighted and short tau inversion-recovery (STIR), and axial T2-weighted sequences. Ninety-three MR examinations were performed. Two radiologists interpreted the STIR (limited) examinations and the full studies separately, masked to each other's findings and to the final diagnosis. Comparison between the two protocols was then undertaken.Results For both readers, all normal MR examinations on the coronal STIR limited protocol were normal on the full protocol, with an interobserver reliability of 0.96. The STIR protocol was able to detect the presence or absence of an abnormality in 100% of cases (sensitivity). The STIR-only protocol provided a specific diagnosis in only 65% of cases (specificity).Conclusion A normal coronal STIR study of the hips in patients with hip pain and normal radiographs precludes the need for further pelvic MR sequences. Any abnormality detected on this limited protocol should be further assessed by additional MR sequences.     

Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children

Our objective was to compare fast spin-echo (FSE) short inversion time inversion recovery (STIR) whole-body MR imaging with standard procedures in staging children with lymphoma. Eight children (age range, 2–16 years) underwent multi-station FSE STIR whole-body MR at initial staging (n=5) or for restaging following completion of therapy (n=5). Whole-body MR and conventional staging procedures, including CT (n=10), gallium-67 scintigraphy (n=9), bone scintigraphy (n=3) and bone marrow biopsy (n=7) were retrospectively compared for detection of sites involved by lymphoma and for the assigned stage. FSE STIR whole-body MR detected more sites of possible lymphomatous involvement at initial staging (87/88) and at restaging (5/5) than did conventional imaging (74/88, 3/5). MR was more sensitive than conventional imaging in detecting bone marrow involvement at initial staging. Following treatment, however, residual and therapy-induced bone marrow signal abnormalities could not be differentiated from lymphomatous involvement. Detection of nodal and visceral involvement correlated well. Our results suggest that FSE STIR whole-body MR imaging is a sensitive technique for evaluating lymphomatous involvement of bone marrow as well as non-marrow sites. Larger prospective trials are needed to determine if FSE STIR whole-body MR can replace standard radiographic procedures for initial staging and contribute in the follow-up of lymphoma in children.     

Soft tissue sarcomas or intramuscular haematomas?

Haematomas are common and sarcomas are rare. However the absence of trauma or a light trauma should alert the clinician to the possibility that the abnormality may represent haemorrhage into a tumor and not just haematoma, even in a haemophilic patient. Clinical findings, sonography with Doppler assessment and magnetic resonance images with contrast administration will help in the differential diagnosis. The diagnosis of a high grade sarcoma must be considered in these patients and any doubt should be resolved with a biopsy to avoid tragic consequences of missed sarcoma.     

STIR序列在外伤性骨髓水肿的应用

目的分析STIR序列对骨关节外伤后骨髓水肿的显示。方法外伤后骨髓水肿患者28例,除常规SE序列T1WI、FSE序列T2WI、GE序列T2WI扫描外,均行STIR序列扫描。结果28例共发现骨髓水肿36处,T1WI显示24处(67%),T2WI12处(33%),T2WI29处(80%),STIR36处(100%)。T1WI呈低信号;T2WI低信号8处,稍高信号4处;T2WI低信号14处,高信号15处;STIR脂肪抑制序列呈对比明显的高信号。结论SRIR序列能精确显示骨关节外伤性骨髓水肿。     

快速FLAIR技术在脑部疾病诊断中的应用

目的探讨快速液体衰减反转恢复(FAST FLAIR)序列在脑部疾病诊断中的应用价值. 资料与方法对76例脑部疾病患者进行FAST FLAIR序列及常规快速自旋回波(FSE)序列扫描,比较两种序列对病灶的显示情况. 结果在76例脑部疾病中,FLAIR共显示病灶172个,而T2WI只显示123个.FAST FLAIR显示病灶较T2WI清楚明确.在FAST FLAIR上病灶与正常脑组织的对比度更高. 结论 FLAIR技术对颅脑病变的显示优于FSE序列T2WI, 特别是对脑表面或脑室周围病灶的显示, FLAIR有很高的临床使用价值,应成为颅脑常规扫描序列.