孤立性肺结节质子磁共振波谱的初步研究

目的:研究孤立性肺结节氢质子波谱(1H-MRS)的特征及其代谢物变化规律,探讨MRS在孤立性肺结节鉴别诊断中的应用价值.方法:应用Siemens Vision 1.5T超导磁共振机对69例孤立性肺结节行常规MRI检查和MRS测量,观察记录所有孤立性肺结节MR波谱特征及各代谢物参数值.10例手术标本行MRS检查,并将其结果与术前结节的MRS结果对照分析.结果:恶性结节组患者胆碱含量(Cho)、胆碱与肌酸比值(Cho/Cr)及乳酸含量(Lac)明显高于炎性结节、结核球及错构瘤组(P<0.01,P<0.05, P<0.01).10例手术标本MRS检测结果与术前MRS检测结果行配对t检验,两者之间无显著性差异.结论:Cho升高、Cho/Cr值的增加和出现异常Lac峰是恶性结节的波谱特征,其对良恶性肺结节的鉴别诊断有重要的辅助诊断价值.     

原发颈胸段骨肿瘤的MRI诊断及临床意义

目的：分析原发颈胸段骨肿瘤的MRI表现。材料与方法；采用美国GE公司2.0tsl扫描仪，扫描序列包括，矢状位，冠状位，横轴位T1WI。选择26例经术后病理和临床证实的颈胸段肿瘤，分别观察椎体，附件，椎间盘病变情况。椎体溶骨及软组织肿块MRI情况。结果：颈胸段原发肿瘤溶骨破坏均为T1WI高信号，软组织阴影T2WI为高信号，各种肿瘤又有不同影表现。结论：MRI对颈胸段原发肿瘤具有订前判断诊断价值。     

Difference in microvascular structure between benign and malignant pulmonary nodules and its relationship with CT enhancement

Objective: To investigate the enhancement basis and the mechanisms of solitary pulmonary nodules (SPNs) by comparing the differences in microvascular structure between benign and malignant lesions. Methods: Dynamic contrast-enhanced CT scan was performed on 53 patients with SPNs (diameter<3 cm. 38 peripheral lung cancers, 5 hamartomas, 10 inflammatory lesions) using a Siemens Plus S or a Marconi MX8000 multi-slices spiral CT scanner. The time-attenuation curves were interpreted. The microvascular density (MVD) and the continuity of the microvessels' basemental membrane in the dissected specimens were observed with the ABC (avidin-biotin-complex) immuno-histochemical method in all patients. ResultS:The CT enhancement values of lung cancer (49. 05±16. 08 HU) and inflammatory lesions (49. 59±21. 30 HU) were significantly higher than those of hamartoma (8. 98±4. 56 HU) (t = 7. 48. P<0. 05; t = 8. 35, P<0. 05). But the enhancement of lung cancer was similar to that of inflammatory lesions (t = 0. 76. P>0. 05). The time-attenuation curve of inflammatory lesions tended to increase faster and reached a higher peak compared to the lung cancer, and both of them maintained a high plateau after crossing. The hamartoma showed a slight increase in the time-attenuation curve and demonstrated a low-plateau curve. The MVD of SPNs was positively correlated with CT enhancement (r=0. 8051). The microvascular counts of peripheral lung cancer (48. 45±10. 09) and inflammatory lesions (19. 60±19. 94) were significantly higher than those of hamartoma (8.70±7.30) (t = 11.64, P<0.001;t = 6. 09. P< 0. 001). but no significant difference was found between lung cancer and inflammatory lesions (t= -0. 26, P = (). 799). There was no difference in the continuity of basement membrane between nodules with an enhancement less than 30 HU and those with an enhancement higher than 30HU (x2 = 3. 13, P>0. 05 ). Conclusion: The microvascular counts mainly contribute to the enhancement value of SPNs. The basement membrane is not related to nodule enhancement, but it might influence the pattern of the time-attenuation curve.     

CT在评价肿瘤血管生成中的作用

在过去的 10年中 ,有多种技术被用来对肿瘤血管生成进行定量及定性评价 ,包括微血管密度记数 ,正电子发射体层摄影 (ＰＥＴ)、彩色多谱勒超声、磁共振成像 (ＭＲＩ)、增强ＣＴ等。近年来对动态增强ＣＴ的研究日益增多。现将ＣＴ在评价肿瘤血管生成中的作用作一综述。1　ＣＴ在评价肿瘤血管生成中的作用肿瘤血管生成就是新生血管在肿瘤现有血管上形成的过程[1] 。这些新生血管不仅能促进肿瘤的生长和转移[2 ] ,还会引起血容积、灌注量及毛细血管通透性的变化[3 ] ,这构成了ＣＴ强化的基础[4 ] 。影像学技术的进步使ＣＴ从单纯提供形态学信息…     

MRI在脊柱肿瘤结核鉴别诊断中的价值

[目的]评价磁共振成像（MRI）在脊柱肿瘤、结核鉴别诊断中的价值。[方法]回顾分析经病理证实的63例脊柱病变（31例结核，32例肿瘤）MRI资料。[结果]32例肿瘤椎间盘均未受累，其中10例仅累及椎体，20例椎体、附件均受累，2例仅累及附件。31例结核软组织均受累，附件均未见受累，其中29例椎间隙狭窄或消失。无论结核，还是肿瘤，T1WI以低信号为主，T2WI以高信号为主。[结论]MRI有助于脊柱肿瘤、结核鉴别诊断，椎间盘未受累为肿瘤特点，椎间盘、软组织受累及附件完整为脊柱结核的特点。     

MDCTP对肝硬化门脉高压侧支循环血管的显示价值

目的:评价16排螺旋CT门静脉血管成像(MDCTP)技术在显示肝硬化门脉高压侧支循环血管方面的应用价值。方法:对38例临床诊断肝硬化门脉高压的患者行上腹部MDCTP检查。采用MIP、MPR、VR等三维重组技术进行图像后处理,获得门静脉系统及侧支循环血管图像。结果:38例中显示食管胃底粘膜下静脉曲张31例,食管旁静脉曲张10例;胃左静脉曲张29例,胃短静脉曲张26例;脐静脉与腹壁静脉曲张7例;脾-肾或胃-肾分流6例;腹膜后分流2例。结论:MDCTP能显示肝硬化患者门-体侧支循环开放部位、范围及程度,有重要的临床应用价值。