目的 提高对肾上腺囊肿的认识及影像诊断水平.方法 对术前误诊、术后经病理证实的13例肾上腺囊肿患者的CT影像资料进行回顾性分析,总结误诊原因.结果 7例术前CT误诊为肾上腺腺瘤,直径均＜3.0 cm,呈圆形或椭圆形均匀低密度灶,边缘光滑,囊壁显示不清,其中1例病灶边缘伴点状钙化;病理显示假性囊肿、内皮性囊肿和上皮性囊肿各2例、单纯性囊肿1例.3例误诊为肝或肾囊肿,直径均＞8.0 cm且压迫肝或肾形成深大压迹;病理显示假性囊肿1例、单纯性囊肿2例.3例误诊为其他类别的肾上腺肿瘤,均表现为厚壁囊肿,其中2例病灶囊壁伴"蛋壳"样或不规则形钙化,囊内密度均匀或不均;病理均为假性囊肿.结论 肾上腺病变过小导致细节显示欠佳,过大挤压邻近肝肾以及合并钙化、感染及出血等并发症是导致肾上腺囊肿误诊的常见原因,影像诊断应提高警惕.

Objective To investigate the diagnostic value of digital mammography and magnetic resonance imaging (MRI) in ductal carcinoma in situ (DCIS) .Methods The digital mammography and MRI features of 39 cases with histo-logically DCIS were retrospectively analyzed .Results Among the 39 patients ,28 cases were correctly diagnosed by the digital mammography (71 .8% ) ,while ,32 cases by the MRI (82 .0% ) and 36 cases by combined digital mammography and MRI (92 .3% ) .Conclusion Digital mammography and MRI play important roles in the diagnosis of DCIS ,and the combination of the two methods can improve the diagnostic accuracy .

Objective To investigate the characteristic of MRS in patients suffered diffuse axonal injury (DAI)in acute and suba-cute stage,and the correlation between MRS changes and the severity of disease.Methods We reported MRI and proton magnetic resonance spectroscopy studies of 3 6 head-inj ured patients in acute and subacute stage.Proton magnetic resonance spectra were ac-quired from the white matter and gray matter of bibateral frontal lobe that on conventional MRI appeared normal by using 2D MRSI at 3.0T MRI .30 volunteers as contronl were studied at the same time.Results In patient group,N-acetylaspartate/creatine ratios were (2.14±0.15)and (1.71±0.08)choline/creatine ratios were(1.35±0.13)and (1.03±0.08)for the white matter and the gray matter,respectivily.The brain N-acetylaspartate/creatine ratio was reduced and the choline/creatine ratio was increased in pa-tient group compared with the controls.The increase in the choline/creatine ratio was significant even in the moderate and severe in-j ured groups.Furthermore,there was a significantly correlation between the severity of head inj ury and the N-acetylaspartate/cho-line ratio,and changes in patients with metabolite ratios of the GCS score had a strong correlation.Conclusion We conclude that DAI patients with normal conventional imaging manifestations of the frontal lobe appear metabolite ratio change,suggesting the existence of local cerebral inj ury,and it has a strong correlation between the prognosis and MRS changes.MRS may provide an useful method that can tell us the severity of the brain inj ury in patients with DAI .

目的:探讨磁共振扩散张量成像（DTI）在急性弥漫性轴索损伤中的应用价值。方法:对36例弥漫性轴索损伤患者在急性期（1～18d）行磁共振扩散张量成像检查,测量脑内不同部位的FA值,明确FA值的变化情况;并对患者急性期外伤严重程度行GCS评分,评估患者病情严重程度;将患者FA值与GCS评分进行相关性分析。30名健康志愿者作为对照组。结果:患者内囊后肢、胼胝体压部及半卵圆中心FA值在急性期较对照组降低（P＜0.05）,并且在上述部位患者急性期FA值的变化与GCS评分有较强的相关性（P＜0.05）。结论:常规影像学表现正常的脑白质出现FA值的改变,提示局部脑损伤的存在;FA值的变化与患者的病情严重程度具有较强的相关性,DTI检查可作为评估弥漫性轴索损伤患者病情严重程度的重要工具。

Objective:To evaluate the value of multi-voxel magnetic resonance spectroscopy(1H-MRS) in the peritumoral region of glioblastoma.Methods:Thirty patients with glioblastoma underwent conventional MRI,1H-MRS and contrast-enhanced MRI before surgical resection.Metabolite ratios of Cho/Cr,Cho/NAA NAA/Cr in areas of edema region adjacent to tumors and NAA/nCr in normal-appearing region were obtained respectively.The student t test was used to determine if there was a statistically significant difference in metabolic ratios between edema region and normal-appearing region adjacent to tumor(and contralateral normal-appearing region).Results:Cho/Cr,Cho/NAA in edema region and normal-appearing region adjacent to the tumors were higher than those in contralateral normal region,and there were significant differences between them(P0.05).NAA/Cr in edema region were lower than those in contralateral normal region,and showed significant differences between them(P0.05).NAA/Cr in normal-appearing region adjacent to the tumors were lower than those in contralateral normal region,but there were no significant differences between them(P0.05),while NAA/nCr in normal-appearing region adjacent to the tumors were lower than those in contralateral normal region(P0.05).Conclusions:1H-MRS may be helpful for evaluating infiltrating tumor cells that usually invade along the white matter tracts in peritumoral edema of glioblastoma.

目的 评价磁共振扩散张量成像(DTI)及2D多体素氢质子磁共振波谱成像技术(1H-MRS)在胶质母细胞瘤瘤周显示正常区中的应用价值.方法 对35例胶质母细胞瘤患者行常规MRI、DTI及1H-MRS检查,所有患者均行增强扫描.测量肿瘤瘤周显示正常区的ADC值、FA值、Cho/Cr、Cho/NAA、NAA/Cr的比值,并且计算相应区域NAA/nCr的比值,并与对侧正常区域的相应比值比较,分析其差异是否有统计学意义.结果 (1)瘤周显示正常区的ADC值略高于对侧,但差异无统计学意 义(P=0.195);瘤周显示正常区的FA值较对侧降低,差异有统计学意义(P<0.05);(2)瘤周显示正常区的Cho/Cr、Cho/NAA的比值较对侧明显升高,其差异有统计学意义(P<0.05);瘤周显示正常区NAA/Cr值较对侧亦有降低,但差异无统计学意义(P=0.177),NAA/nCr值较对侧明显降低,差异有统计学意义(P=0.023).结论 MRI扩散张量成像技术FA值的变化及2D多体素1H-MRS成像技术对肿瘤周围区代谢物变化的检测可以为推断胶质母细胞瘤瘤周区肿瘤细胞的浸润范围提供依据.

Objective:To analyze the significance of MRI on living animals treated by liver cancer DC vaccine and evaluate the effect of liver cancer DC vaccine on cases with liver cancer.Methods:Rabbit liver cancer animal model(n=40) was established.The research group(n=30) was treated by liver cancer DC vaccine.The control group(n=10) was not treated by DC vaccine.The size of the tumor,form and signal change were observed through MRI.Results:Inoculation with tumor for 14 days later,cancer detection rate was 94.44 %(34/36),and all lesions were displayed by enhancement scan.After DC vaccine injection,the tumor volume was not enlarged,and some tumor shrunk,no spread and metastasis.But there were no significant difference in different injection ways.The tumor volume was still enlarged and tumor wall increased unequally after inoculated tumor for 21 days.Some tumors appeared liver or lung shift,T2 signal increased.Conclusion:MRI on living animals treated by liver cancer DC vaccine has the vital significance.

Objective To evaluate the diagnostic value of diffusion-weighted imaging(DWI) for hepatic cancer by comparing the sensitivity,specificity,positive predictive value,and negative predictive value of DWI and multi-phase enhanced MSCT scan for the detection of hepatic cancer.Methods 55 patients with suspected hepatic cancer detected by CT scan received MRI scan plus DWI and conventional multi-phase enhanced MSCT scan.The results were read by two senior titles diagnostic imaging physicians under the method of double-blind.The sensitivity,specificity,positive predictive value,and negative predictive value of the two methods for the detection of small hepatocellular carcinoma(diameter≤3 cm) and non-small hepatocellular carcinoma(diameter > 3 cm) were compared;and the subjects ability to line working curve(ROC) analysis was assigned to evaluate these two kinds of inspection methods for the diagnosis of small hepatocellular carcinoma.Results For small hepatocellular carcinoma,the sensitivity,specificity,positive predictive value,and negative predictive values of DWI were 94.4%,50.0%,94.4%,and 50.0%,while those of multi-phase enhanced MSCT scan were 55.6%,50.0%,90.9%,and 11.1%;as for non-small hepatocellular carcinoma,those of DWI and multi-phase enhanced MSCT scan were 89.4%,66.7%,97.2%,33.3%,and 92.3%,33.3%,94.7%,25.0%,respectively.The mean area under the ROC of DWI and multi-phase enhanced MSCT scan were 0.944 and 0.889,respectively,for small hepatocellular carcinoma(P < 0.05).Conclusion DWI could improve the sensitivity,positive predictive value and negative predictive value of the detection of hepatic cancer,especially small hepatocellular carcinoma.

【Objective】to high-intensity focused ultrasound(HIFU) in treatment of rabbit VΧ2 carcinoma after perfusion weighted magnetic resonance imaging(PWI) imaging techniques and characteristics were analyzed and evaluated.【Methods】of random sampling of 30 New Zealand rabbits,30 rabbits on the implementation of tissue mass planting operation,in the form of 30 rabbit VΧ2 liver cancer model,on which30 rabbits using high-intensity focused ultrasound(HIFU) was performed after treatment on MRI,perfusion weighted magnetic resonance imaging(PWI) imaging technique as well as the characteristics are summarized and analyzed.【Resluts】The results by analysis results found in 30 rabbits before and after treatment of rabbit liver VΧ2 tumor of central and peripheral zone exists between the SRSmax difference is statistically significant(P0.05);tumor adjacent liver parenchyma exists between the SRSmax and the difference is not significant statistically(P0.05).【Conclusion】using 1.5TMR scanner on rabbit liver VΧ2 tumor attention imaging treatment has certain feasibility,is worth the clinical to its attention.