目的 研究轻度认知功能损害(MCI)并发抑郁患者静息状态下脑区分数低频振幅(fALFF)的特点及脑功能情况,以期为MCI患者并发抑郁的早期诊断和临床治疗提供参考.方法 将34例MCI患者中16例并发抑郁者纳入D-MCI组,18例未并发抑郁者纳入nD-MCI组.于平静状态下分别进行3.0T脑部MRI检测并获取相关数据,采用双样本t检验分析两组相对应各体素的fALFF值差异,以寻找fALFF值存在差异的脑区.结果 与nD-MCI组比较,D-MCI组患者右侧中央后回的fALFF值降低(差异体素280个,t=-4.2889),而右侧丘脑的fALFF值显著增高(差异体素572个,t=2.7208).结论 MCI并发抑郁患者脑部右侧中央后回和右侧丘脑存在fALFF异常,提示情感及认知网络障碍可能参与其中.

Objective To investigate the value of 64 row CT low dose scanning technique in thyroid enhancement scanning.Methods From Jan.2016 to Dec.2017,152 patients with thyroid occupying lesions were studied in our hospital.All the patients underwent multislice spiral CT enhanced scan and pathological examination.The patients were divided into four groups according to the different current and voltage of multislice spiral CT.The significance of multi slice spiral CT scanning in the 4 groups was compared.Results There were no significant differences (U=0.1825,P=0.351 8＞0.05)among the four groups of multi-slice spiral CT in the detection rate of nodular thyroid lesions (96.21％,94.38％,85.71％,87.50％) or the detection rate of diffuse thyroid lesions (77.78％,83.33％,80.00％,83.33％).There were significant differences in CTDIvol,DLP and ED among the four groups (P＜0.05),and the radiation dose of group D was lower than that of group A and C.There were significant differences in thyroid CT value,background noise and background signal among the four groups (P＜0.05).The thyroid CT value,background noise and background signal in group D were higher than those in group A,B and C (P＜0.05).There was no significant difference in SNR and CNR among the four groups (P＞0.05).There was no significant difference in subjective evaluation of CT scan images between the four groups (P＞0.05).Conclusion The multislice spiral CT low-dose scanning technique used in thyroid enhanced scan can obtain satisfying scanning images,which is not only beneficial to the quality of the images,but also can improve the accuracy of the diagnosis and reduce the ionizing radiation damage to the patients.

Objective To explore the value of conventional and functional MRI image parameter in preoperative grade of pancreatic neuroendocrine tumours (pNET).Methods Data of 35 cases of pNET were retrospectively analyzed,including tumor size,intensity of T1WI's and T2WI's signal,enhancement feature,and apparent diffusion coefficients (ADC)value.All kinds of tumors were classified into G1 to G3 according to WHO's classification in 2010.Results There were 40 pNETs (mean size(4.2±2.9)cm) among the 35 patients (20 male,and 15 female).By WHO's tumor grading,the number of patients from G1 to G3 was 18(45％),12(30％),and 10(25 ％),respectively.A higher grade was associated with larger tumor size (P＜0.05).Intensity of T1WI and T2WI signal has no significance for predicting tumor grade.Enhancement feature had statistical significance on tumor's grade (P＜0.05).ADC value decreased with the increase of tumor's grade,(2.23±0.80) × 10-3,(1.80±0.73) × 10-3,(0.92±0.24) ×10-3 mm2/s respectively for tumors from grade G1 to G3.Conclusion Enhancement features of MRI image and ADC value are conducive to preoperative grading of pNET.

Objective To investigate the value of MR 3D CUBE T2WI sequence in displaying anatomical structure of knee joint.Methods Sixty cases of knee joints (30 cases in lesion group and 30 cases in control group) were scanned with conventional 2D and 3D CUBE T2WI sequence by HDXt 3.0T superconducting magnetic resonance of GE Signa imaging system and hased-array coil.The meniscus,articular cartilage,anterior and posterior cruciate ligaments demonstrated by two sequences were evaluated as excellent,good and poor grade,the results were comparatively analyzed by statistics.Results 3D CUBE T2WI was superior to conventional 2D sequence in displaying of articular cartilage,anterior and posterior cruciate ligaments,and inferior to conventional 2D sequence in displaying of meniscus(all P =0.000).When we put excellent and good levels of image quality as according with diagnostic requirement.The satisfaction rate demonstrating anterior and posterior cruciate ligaments by 3D CUBE T2WI sequence in lesion and control group were 100％,articular cartilage was 93.33％ in control group and 90.00％ in lesion group,while the meniscus was 30.00％ in control group and 33.33％ in lesion group.Conclusion MR 3D CUBE T2WI sequence is a sensitive technique in demonstrating ligaments and articular cartilage of knee joint,but it was inferior to conventional 2D sequence in displaying of meniscus.We should adopt it according to clinical diagnosis.

Objective To investigate the clinical value of MRI whole body diffusion weighted imaging ( WBDWI) in the diag-nosis and follow-up of metastatic tumor. Methods 42 patients with metastatic tumor underwent WBDWI. The positive results were diagnosed and analyzed by double-blind method, and the apparent diffusion coefficient ( ADC) values of the lesions were measured on the ADC imagings. Results The WBDWI imaging of metastatic tumors showed multiple abnormal signal lesions in the whole body, including multiple lymph nodes enlargement in the body, multiple metastasis in the liver, spleen, adrenal glands and lungs, and the diffuse infiltration of bone marrow of skeletal system. The lesions showed mottled and patchy hyperintensity on MIP imaging, hypointensity on flipped imaging and ADC imaging. Of 7 cases with follow-up examination after treatment, 5 showed that the number of lesions reduced and the signal intensity decreased on MIP imaging, and the ADC values increased, one showed that the number of lesions increased and the signal intensity had any significant changes, and one had any changes in the number and signal intensity. Conclusion As a new functional MR-imaging technology, WBDWI has some application value in diagnosis and follow-up of metastatic tumors.

宫角妊娠与间质部妊娠发生率低,但后果严重,可导致子宫破裂、大出血等,临床诊断及治疗有一定难度[1-3].国内外关于宫角妊娠与间质部妊娠超声诊断较多,而关于MRI表现的文献很少.笔者回顾性分析本院2006-01-2011-06经临床病理证实的宫角妊娠与间质部妊娠9例,旨在探讨其MRI特征及应用价值.

Objective To investigate the clinical significance of a new method,axis-line-distance technique(ALDT),in scoliosis measurement.Methods Thirty cases with idiopathic scoliosis were measured on two separate occasions by six observers with the Cobb technique and the ALDT on PACS workstation.The interval time between two measurement occasions were three weeks.The data were analyzed statistically with the paired-sample t-test.Results(1)Concerning intraobserver variance in two measurement occasions,the minimum variance,the maximum variance and the average variance were 0, 24.00°,5.71°±1.54°for Cobb technique and 0,12.00 mm,(1.95±0.58)mm for ALDT.There were significant measurement differences for four observers with Cobb method 39.00°±10.69°versus 36.50°± 10.63°,31.73°±10.96°versus 37.30°±9.65°,32.03°±7.49°versus 27.86°±9.00°,29.77°±8.87° versus 34.20°±7.26°,all P0.05,except two attending physicians 36.63°±10.3°versus 37.13°± 10.22°,33.27°±10.09°versus 35.27°±9.71°.But there were no significant measurement differences for every observer with ALDT[(51.03±15.85)mm versus(50.73±15.50)mm,(52.40±14.88)mm versus(52.70±14.74)mm,(53.77±16.14)mm versus(53.60±5.33)mm,(54.07±15.36)mm versus(54.40±15.07)mm,(51.87±14.67)mm versus(51.77±14.46)mm,(52.93±13.88)mm versus(53.27±15.00)mm,all P0.05].(2)Concerning interobserver variances in six observers,the average measurement variance was 5.07°±0.35°for Cobb method,and(2.32±0.26)mm for ALDT. There were significant measurement differences for every observer using with Cobb method(36.63°±10.30° versus 33.27°±10.10°,39.00±10.69°versus 31.73°±10.96°,32.03°±7.49~ versus 29.78°± 8.87°,36.63°±10.30°versus 39.00°±10.69°versus 32.03°±7.48°,39.00°±10.69°versus 32.03°± 7.49°,all P0.05).The measurement difference from interobserver using with ALDT was significant(the first versus second or third observer,the third versus fifth observer),or no(the fifth versus first or sixth observer,the third versus fourth observer),which is not a direct relationship between the experience of the observer.Conclusion The ALDT is worth applying and spreading,because it is more simple,more reliable and less error than the Cobb technique,as well as showing better intraobserver or interobserver reproducibility.

目的:总结分析后颅窝肿瘤的MRI特征,以提高对后颅窝肿瘤的诊断和鉴别诊断水平.方法:62例患者均行MRI平扫,48例行增强扫描.其中57例经手术病理证实,5例经临床影像诊断.结果:听神经瘤17例,脑膜瘤10例,胶质瘤8例,转移瘤5例,髓母细胞瘤5例,三叉神经瘤4例,室管膜瘤4例,胆脂瘤3例,血管母细胞瘤3例,海绵状血管瘤2例,颈静脉体瘤1例.结论:后颅窝肿瘤有其好发部位,MRI可显示各种肿瘤的不同特征,具有较高的定位定性准确率,是诊断后颅窝肿瘤最重要的手段之一.增强扫描能提高定性准确率.