目的 探讨3D STIR SPACE序列MRI增强扫描技术(CE-MRI)腰骶神经成像在腰椎间盘突出疾病中的应用价值.方法 收集39例拟诊腰椎间盘突出,行常规MRI序列扫描和3D STIR SPACE序列MRI增强扫描技术检查,对腰骶神经的显示图像进行分析.结果 对39例患者的腰骶神经增强前和增强后进行比较,3D STIR SPACE序列MRI增强前评为1分有22例,评为2分有18例,评为3分有9例.3D STIR SPACE序列MRI增强后评为1分有5例,评为2分有10例,评为3分有24例.其中2例常规MRI序列上显示正常,仅腰骶神经成像显示局部轻度受压;6例腰椎术后神经根图像清晰显示手术部位神经根情况.结论 3D STIR SPACE序列MRI增强扫描技术能准确、直观显示腰骶神经根的解剖关系,及其完整性和信号变化,对腰椎间盘突出的临床诊治具有指导意义.

Objective To evaluate dynamic contrast-enhancement combined with intravoxel incoherent motion ( IVIM) diffusion-weighted ( DW) MRI for differentiating benign from malignant breast lesions. Methods The clinical data of 60 cases of breast diseases confirmed by pathology in our hospital from October, 2016 to September, 2017 were retrospectively analyzed ( benign: 25 cases, malignant: 35 cases). Conventional MRI, dynamic contrast enhancement and IVIMDWI ( b = 0-1 200 s/mm～2) examination were performed in all patients. Lesion morphology, enhancement pattern, time signal curve and the relevant parameters of IVIM model were analyzed to evaluate the differential diagnostic value between breast benign and malignant lesions respectively. Results The irregular margin with or without spiculation and heterogeneous enhancement were mostly seen in breast cancer ( P = 0.003, 0.004, respectively). TIC type Ⅲ was mostly seen in breast cancer, TIC type Ⅰ and Ⅱ were mostly seen in breast benign ( χ～2= 19.272, P＜ 0.01). Except D*value, there were statistically significant differences among the IVIM related parameters ( t = 3. 301, -5. 247, 3. 899, all P＜ 0.05).ROC analysis showed that the AUC of D value was 0.873 which was the highest one. AUC was increased to 0.941 by combining D with f value for diagnosis. Conclusion Magnetic resonance dynamic contrast enhancement combined with IVIM model related parameter values can improve the value of differentiating benign from malignant breast lesions, and shows a higher diagnostic efficiency.

Objective Through the adjustment of controllable factors, to improve the diffusion weighted imaging and dynamic enhanced imaging image quality. Methods 305 cases of female breast lesions were selected, and subjected to cross sectional T1WI, T2WI, diffusion weighted imaging with saturated fat technology, dynamic enhanced scan. Using GE with analysis software, we selacted ROI in abnormal strengthening lesions and drew the time signal intensity curve (TIC). The factors that affected image quality were compared and analyzed. Results 283 images had enough signal to noise ratio, the T1 perfusion time signal intensity curve resolution was reasonably good. Conclusion By optimizing the controllable factors, making the procedural breast magnetic resonance imaging technology can obtain higher quality of magnetic resonance imaging.

目的 探讨磁敏感加权成像(SWI)在新生儿颅内出血的诊断价值,并比较早产儿与足月儿间的差别.方法 对115例怀疑脑损伤的新生儿行常规MRI、DWI和SWI检查,明确有无颅内出血并记录各序列出血灶个数,比较3种方法在颅内出血检出率、分布区域及病灶检出个数的差异,并比较早产儿与足月儿间颅内出血分布区域及病灶检出个数的差异.结果 115例新生儿中,SWI的颅内出血检出率高于常规MRI及DWI(检出率分别为32.2％、26.1％、12.2％,P＜0.05),常规MRI亦较DWI高(P＜0.05).37例颅内出血新生儿,常规MRI、DWI及SWI检出颅内出血灶分别为66、33、125个,SWI较常规MRI及DWI、常规MRI较DWI显示更多出血灶(均P＜0.05).出血灶主要位于生发基质-脑室、大小脑半球(分别为33、34、25个),SWI较常规MRI及DWI显示更多这些部位的出血灶(均P ＜0.05);常规MRI及SWI较DWI更敏感地显示蛛网膜下腔出血及硬膜下出血(P＜0.05),但常规MRI与SWI相仿.早产儿出血灶总数及生发基质-脑室出血灶数目均多于足月儿(P＜0.05),而其他部位出血灶数目差异无统计学意义(P＞0.05).结论 SWI对新生儿颅内出血检出优于常规MRI及DWI,但各序列显示不同部位颅内出血差异存在统计学意义,对怀疑有颅内出血的新生儿,应行上述序列检查以综合判断有无颅内出血及出血数目.上述结果可为新生儿颅内出血的临床诊断、治疗及预后评估提供重要依据.

Objective To study the diagnostic value of intravoxel incoherent motion (IVIM) diffusion-weighted MRI in differentiating benign from malignant breast lesions.Methods 50 female patients with lesions verified by pathology were included in this study,all of them underwent multi-b value (b=0-2000s/mm2) DWI scanning.Tissue diffusivity (D),pseudo-diffusivity (D*),perfusion fraction (f) and apparent diffusion coefficient (ADC) were acquired using IVIM model.The difference of these parameters in benign and malignant breast lesions was analyzed statistically.The diagnostic performance of these parameters was evaluated by ROC analysis.Results In benign lesions,D,D*,f and ADC value was (1.31±-0.47) ×10-3 mm2/s,(26.47±13.81) ×10-3 mm2/s,(17.35±3.78)％,(1.37±0.37)×10-3 mm2/s,respectively.In malignant lesions,D,D*,f and ADC value was(0.95±0.28)×10-3 mm2/s,(24.58±14.62)×10-3 mm2/s,(23.69±4.35)％,(1.03±0.14)×10-3 mm2/s,respectively.There were statistically significant differences between benign and malignant lesions in D,f and ADC value (t=3.203,-5.139,3.991,P＜0.05).There was no statisticaly significant difference in D* value (P＞0.05).ROC analysis showed that AUC of D value was 0.866,which was the highest one.AUC was increased to 0.934 by combining D with f value for diagnosis.Condusions The parameters acquired from IVIM model are useful to differentiate benign from malignant breast lesions.D value obtained from IVIM model may have relatively high sensitivity and specificity,D Combined with f value can obtain the best diagnostic performance.

Objective To compane and explore the magnetic sensitive weighted imaging ( SWI) in the diagnosis of premature infant brain damage value .Methods 50 cases of clinical examination of premature infant brain injury patients (1 w after birth), line T1 WI, T2 WI, FLAIR, DWI and SWI axis can scan , assessment record low signal on the sequences of different parts and the number and area .Results In 50 cases of premature infants , T1 WI, T2 WI, FLAIR, DWI, SWI can find the number of lesions , respectively 108, 82, 123, 82, 204, SWI was more sensitive than conventional sequence to display hemorrhage stove , difference was statistically significant.In the same place for displaying the lesion size range , SWI was best (0.72 ±0.58), compared with T1 WI, T2 WI, (0.50~0.48) was clearly apparent , difference was statistically significant .Conclusion SWI sequence is easier to find lesions than others micro hemorrhage stove , SWI can also detect premature deep brain marrow venous duct , incomparable advantages with other methods .

Objective To investigate the application value of multi-detector computed tomography (MDCT) examination in the preoperative assessment of adenocarcinoma of esophagogastric junction (AEG).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 91 AEG patients who were admitted to the Second Affiliated Hospital of Wenzhou Medical University between January 2011 and December 2015 were collected.All the patients received plain and enhanced scans of MDCT,and they underwent operation under the consent of patients and his family members after preoperative relevant examinations and then received postoperative pathological examination.Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence and metastasis up to December 2015.Observation indicators included:(1) imaging features of MDCT,(2) comparison between preoperative MDCT examination and postoperative pathological examination,(3) treatment and prognosis.Measurement data with normal distribution were represented as x ± s.Consistency analysis between stage of MDCT examination and pathological stage was done using the chi-square test.Results (1) Imaging features of MDCT:MDCT findings in 91 AEG patients were heterogeneously thickened wall at esophagogastric junction and cauliflower-like local soft tissue mass,and enhanced scan findings were obviously heterogeneous enhancement,clear periphery fat gap and most of lymph nodes enlargement between liver and stomach.(2) Comparison between preoperative MDCT examination and postoperative pathological examination:preoperative MDCT examination in 91 AEG patients showed that invasion of the esophagus was found in 88 patients,with a infiltration length of (3.1 ± 1.1) cm.Postoperative pathological examination in 91 AEG patients showed that invasion of the esophagus was found in 68 patients,with a infiltration length of (3.5 ± 1.3) cm.The sensitivity,specificity and accuracy of invasion of the esophagus were respectively 95.6％,85.0％ and 92.0％,and these of invasion of the serosa were 96.8％,84.2％ and 95.5％,with aκ=0.9.Preoperative enhanced scans of MDCT of gastric wall showed that the single-layer structure was detected in 22 patients and multi-layer structure in 69 patients (double-layer structure in 34 patients and 3-layer structure in 35 patients).Detection rate of AEG through preoperative MDCT examination was 96.7％ (88/91).One,18,53 and 16 patients was in T1,T2,T3 and T4 stages and 3 had false negative results.Postoperative pathological examination showed that 2,17,55 and 17 patients were in T1,T2,T3 and T4 stages.Accuracy of T stage through preoperative MDCT examination was 85.4％,with a κ =0.7.N0,N1,N2,and N3 stages were respectively detected in 25,43,18,5 patients through preoperative enhanced scans of MDCT and in 29,32,22,8 patients through postoperative pathological examination.Accuracy of N stage through preoperative MDCT examination was 58.0％ and κ was 0.4.Preoperative Siewert type of 91 patients:Siewert type Ⅰ,Ⅱ and Ⅲ were detected in 5,46 and 40 patients,respectively.Postoperative pathological examination:4 and 87 patients were respectively in the early and advanced AEG by Borrmann type (4 in Borrmann type Ⅰ,15 in Borrmann type Ⅱ,54 in Borrmann type Ⅲ and 14 in Borrmann type Ⅳ).(3) Treatment and prognosis:of 91 AEG patients,5 in Siewert type Ⅰ underwent the lower esophageal and proximal gastrectomy via chest wall approach,46 in Siewert type Ⅱ underwent gastrectomy via transabdominal esophageal hiatus approach (28 using epigastric midline incision approach,15 using left thoracic incision approach and 3 using thoracoabdominal incision approach),and 40 in Siewert type Ⅲ underwent transabdominal total gastrectomy.All the 91 patients were followed up for 5-6 months with a median time of 4 months.During the follow-up,there was no death,and lymph node metastases were respectively detected in 3 of 5 patients with Siewert type Ⅰ AEG,6 of 46 patients with Siewert type Ⅱ AEG and 24 of 40 patients with Siewert type Ⅲ AEG.Conclusion Result of preoperative MDCT examination for AEG is highly consistent with postoperative pathological result,and MDCT examination can also improve the diagnostic rate of AEG and accuracy of T stage.

OBJECTIVE:To detect cerebral microbleeds by susceptibility weighted imaging and explore the relationship between intracerebral hemorrhage, cerebral microbleeds and risk factors of cerebral vascular disease.METHODS:A retrospective analysis was conducted for 70 patients from August 2012 to June 2013 undergoing susceptibility weighted imaging (SWI). The average age was (68 ± 14) years. Their demographic and clinical profiles were recorded. Conventional magnetic resonance imaging (MRI) and SWI images were performed and images analyzed by an experienced radiologist. The occurrence of infarction, hemorrhage and number of microbleeds were recorded. Then regression analysis with SPSS 13.0 was used to define the relationship between the existence of infarction, hemorrhage and the number of microbleeds.RESULTS:There were 0-65 microbleeds in brains on SWI. There were infarction (n = 44) and chronic intracranial hemorrhage (n = 7). The binary Logistic regression analysis showed that intracranial hemorrhage was associated with hyperlipidemia (P = 0.01).Linear regression analysis showed that the number of microbleeds was related with intracranial hemorrhage (P = 0.02).CONCLUSION:Evaluation of microbleeds in brain by SWI may help to assess the possibility of intracranial hemorrhage so as to provides rationales for clinical therapeutics.

Objective To investigate the correlation between the elderly low bone mineral density (BMD) and coronary heart disease (CHD), to provide new ideas for clinical prevention and treatment of coronary heart disease. Methods 213 elderly patients underwent selective coronary angiography were included in the study, male 104 cases, female 109 cases. According to the result of angiography, the patients were divided into CHD group and control group, and al patients underwent BMD determi-nation in the lumbar spine(L1-4) and the left femoral neck. According to the results, the value of BMD of two groups were compared and analyzed with age, body mass index, blood pressure, serum calcium, phosphorus, total cholesterol,triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol index and other indicators. Multi- factor unconditioned logistic regres-sion was used to analyze the correlation between BMD and CHD. Results The differences of the CHD group and control group in lumbar spine(L1-4) BMD and left femoral neck (BMD) were statistically significant(P<0.05), BMD in patients with CHD is lower than that of control group. At the same time the CHD group's low bone density(including osteopenia and osteoporosis) was higher than that of control group, there were statistical y significant differences (P<0.05).Logistic regression analysis demonstrated that there were significant correlation between low BMD and CHD. Conclusion There is a correlation between the elderly low BMD and CHD, and it is an independent predictors of CHD.

Objective To investigate the application value of MR diffusion weighted imaging(DWI)in diagnostic sensitivity,staging accuracy,detective rate and qualitative accuracy of pelvic metastatic lymph nodes of uterine cervical cancer(UCC).Methods Radiology materials of 98cases of UCC diagnosed by postoperative pathology were analysed retrospectively and differences between DWI combined with routine MRI sequences and routine MRI sequences alone in UCC were compared.Results The misdiagnostic rate(1/20)of DWI combined with routine MRI sequences was lower than that(5/ 20)of routine MRI sequences alone.Accuracy(21/23)of DWI combined with routine MRI sequences in IIb-stage staging was higher than that(14/23)of routine MRI sequences alone;No significant differences were found in other stages' staging.Both detective rate(135/148)and qualitative accuracy(76/82)of DWI combined with routine MRI sequences in pelvic metastatic lymph nodes were higher than that(101/148)and(56/82)of routine MRI sequences alone.ConclusionCompared with routine sequences,DWI combined with routine MRI sequences is more sensitive in diagnosis of UCC,more accurate in staging of IIb-stage,more reliable in detective rate and qualitative accuracy of pelvic metastatic lymph nodes.

OBJECTIVETo investigate the clinical application of multi-slice computed tomography angiography (MSCTA) low-dose scan in pulmonary veins and left atrium and to reduce the radiation dose.METHOD100 middle-sized patients underwent pulmonary veins and left atrium MSCTA were collected and randomly divided into five groups averaged. The tube current were 250 mAs (conventional dose), 200, 150, 100, and 80 mAs (low dose), respectively. The CT scan length (L), volume CT dose index (CTDIvol) and dose length product (DLP) of five groups were recorded automatically, and the effective dose(ED) was measured. The signal to noise ratio (SNR) and the contrast to noise (CNR) of thoracic aorta at the middle level of left atrium were measured to evaluate the image quality objectively. The image quality of pulmonary veins and left atrium MSCTA was evaluated by two experienced radiologists using double-blind method. The results were analyzed by statistics.RESULT(1) The CTDIvol(mGy), DLP(mGy*cm) and ED decreased evidently with the scan dose reduced, and the difference had statistical significance. (2) The image quality was mainly excellent and good in 100 mAs and the above, and it was mainly good in 80 mAs group. The image quality decreased with mAs reduced. The difference of SNR and CNR within five groups had statistical significance. The satisfaction degree of subjective evaluation on image quality of the five groups was up to 100%.CONCLUSIONOn the premise that the image quality confirmed to the clinical diagnosis, the low dose scan in pulmonary veins and left atrium SCTA can obviously reduce radiation dose, and it had important clinical significance.

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.

目的 探讨多层螺旋CT(MSCT)及多维重组(MDR)对肺动静脉畸形(PAVM)的诊断价值.方法 搜集经手术或临床及影像学检查确诊的PAVM 17例,均行CT平扫,其中13例CT增强检查,回顾性分析其MSCT及MDR表现特点.结果 17例中,右下叶6例,左上叶4例,左下叶7例;6例PAVM由胸主动脉供血,11例由肺动脉供血;1例PAVM引流至下腔静脉,16例至肺静脉.CT平扫PAVM诊断准确率88.2%,增强100%,MSCT及MDR能多方位及多角度显示病灶、供血及引流血管.结论 MSCT增强扫描对典型PAVM基本可作出诊断,MDR能较全面提供病灶信息,MSCT是PAVM一种理想和无创性的检查方法。

目的:探讨多层螺旋CT(MSCT)及重组技术对先天性主动脉缩窄(CoA)和离断(IAA)的诊断价值.方法:搜集CoA和IAA患儿18例,均行心脏大血管薄层增强扫描.所得数据传至工作站进行曲面重组(CPR)、容积再现技术(VRT)及最大密度投影(MIP),以DSA及手术结果为金标准,与超声心动图(UCG)对比分析CoA和IAA的影像学特点.结果:18例中CoA 13例(单纯型7例,复杂型6例,其中导管前型4例,导管后型2例),IAA 5例(A型3例,BV2例),合并动脉导管未闭(PDA)II例,室间隔缺损(VSD)14例,房间隔缺损(ASD)7例.大动脉转位(TGA)2例.永存动脉干(PTA)I例,Taussig-Bing综合征(TBS)1例,主动脉瓣狭窄(AVS)1例,肺动脉瓣狭窄(PVS)2例.MSCT及重组技术对CoA及IAA诊断准确率为100%,伴发畸形ASD漏诊2例,主动脉瓣及肺动脉瓣狭窄均未检出.UCG检出CoA 11例,误诊双主动脉弓1例,疑诊1例;检出IAA 3例,误诊右位主动脉弓1例,PDA漏诊1例;UCG对CoA及IAA诊断准确率分别为84.6%及60.0%.结论:MSCT及重组技术是一种无创性检查方法,对CoA及IAA心外畸形较UCG有一定优势,结合UCG可以进一步提高合并心内畸形的诊断.

目的 探讨多层螺旋CT螺距对CT图像噪声和辐射剂量的影响.方法 利用Philips Brilliance 16螺旋CT机和圆柱体体模(30 cm),使用成人胸部扫描方案,螺距分别使用0.188(准直16×0.75最小螺距 )、0.313、0.438、0.563 、0.688 、0.813 、0.938、1.063、1.188、1.313、1.438、1.563(准直16×0.75最大螺距)等12组进行螺旋扫描,每组取5幅图像,设图像中心为感兴趣区,测量CT值标准差及噪声水平,记录不同螺距下扫描时间、mAs值和容积CT剂量指数(CTDIvol),并进行比较分析.结果 当螺距＜1.188时,CTDIvol无明显变化,螺距＞1.188时,CTDIvol降低较明显.螺距从0.188～1.063逐渐增大过程中,图像噪声水平从0.49%逐渐增加至0.55%,增加幅度不大,而螺距从1.063～1.563时,图像噪声水平增大幅度相对明显,从0.55%逐渐增加至0.66%.但螺距在1.438即约2时,图像噪声水平比其前后2组螺距图像噪声水平有所降低,而此螺距时CTDIvol与最高值相比下降19%.结论 螺旋CT扫描参数螺距设为2左右时是比较适当的,能兼顾扫描剂量和图像质量.

目的:探讨MSCT低张水灌肠技术在大肠癌诊断中的应用价值.方法:选取临床和/或纤维结肠镜检查拟诊大肠癌患者70例作为研究对象(排除严重肠梗阻患者),所有患者均行MSCT低张+水灌肠+体位扫描+三期动态增强扫描.由2名高年资放射科医师阅片,重点观察病变部位、大小、形态、肠壁厚度及分层情况,病变强化特征,浆膜面改变,肠周脂肪间隙,邻近血管,淋巴结及远处脏器,防止遗漏小病灶.以术后病理TNM分期为金标准,采用诊断性试验,判断MSCT对大肠癌分期的敏感性、特异性及准确度.结果:70例大肠癌MSCT全部检出,病变位于升结肠13例,横结肠2例,降结肠3例,乙状结肠21例,直肠31例.本组61例低张水灌肠效果满意,较好显示病变部位、形态、长度及肠壁侵犯深度,9例肠管未充分扩张,肿瘤境界显示不满意,其中升结肠3例,肝曲结肠1例,直肠下段5例.病变处肠壁不规则增厚,部分肿块形成,最大约12.5cm×10.3cm,病变最长约15.0cm.病变不同程度强化,明显强化者占82.86%(58/70),强化幅度平均为(43.5±15.7)HU.大肠癌TNM分期准确度为87.14%(61/70),其中T分期准确度为88.57%(62/70),N分期准确度为87.14%(61/70),M分期准确度为90%(63/70).结论:MSCT低张水灌肠技术能较清楚的显示病灶部位、大小、形态、长度、肠壁浸润深度,对大肠癌术前分期准确度较明显提高.但对于升结肠近端及直肠下段肿瘤病变显示有一定限度.

目的 探讨螺旋CT CARE DOSE 4D功能与图像噪声和辐射剂量的关系.方法 使用圆柱体体模(ψ30cm)、成人胸部扫描方案,在关闭和打开CARE DOSE 4D功能时,分别使用1.0 mm、1.5 mm、2.5 mm、4.0 mm准直宽度进行螺旋扫描,取各组相同层面的四幅图像存储并测量、记录不同准直宽度的扫描时间,有效mAs,实际mAs值和容积CT剂量指数(CTDIvol)及图像的噪声,并进行统计学分析.结果 (1)扫描剂量设定80 mAs,使用CARE DOSE 4D功能时,各组准直宽度扫描的有效mAs均为30,实际mAs分别为35、35、37、38,是原来设定值80 mAs的43.75%、43.75%、46.25%、47.50%.图像噪声随着准直宽度的增加而下降,SD值的均数从8.31下降到7.38,标准差从1.30下降到0.95,但经方差分析后无统计学意义(P>0.05).(2)与不使用CARE DOSE 4D功能相比,使用该功能时图像噪声有所增加(P<0.05).(3)打开和关闭CARE DOSE 4D功能时,有效mAs前者仅为后者的37.50%,实际mAs为43.75%～47.50%,CTDIvol为37.50%～37.90%.结论 使用CARE DOSE 4D功能能够有效降低扫描剂量,显著减少辐射剂量,且对图像噪声影响较小.

目的 探讨多层螺旋CT不同准直宽度对图像质量和辐射剂量的影响与关系.方法 使用Philips Brilliance 16螺旋CT机及随机水模(头模直径20cm,体模直径30cm),分别使用头模准直16×0.75(总准直宽度12 mm)和16×1.5(总准直宽 度24 mm)轴扫;体模准直4×0.75(总准直宽度3 mm)、4×1.5(总准直宽度6 mm)、16×0.75(总准直宽度12 mm)、16×1.5(总准直宽度24 mm)、4×3(总准直宽度12 mm)及8×3(总准直宽度24 mm)螺旋扫描,取各种准直规格扫描图像各8幅,设中心及相当于3、6、9、12点位置距水模边缘下方2 cm处为感兴趣区,测量、记录各感兴趣区的CT值标准差(SD)及各种准直规格扫描的容积CT剂量指数(CTDIvol)值,所得数据进行统计学处理.结果 头颅轴 扫模式的2种准直规格CTDIvol分别为91.3 mGy和83.0 mGy,图像噪声分别为2.948±0.283和2.833±0.721.体模螺旋扫描,准直4×0.75与4×1.5 2种准直规格,其CTDIvol分别为25.4 mGy和18.3 mGy,图像噪声分别为14.874±3.571和14.594±3.265;16×0.75、16×1.5 2种准直规格,其CTDIvol分别为15.5 mGy和14.1 mGy,图像噪声分别为16.918±3.235和15.776±3.130;4×3、8×3 2种准直规格,其CTDIvol分别为15.5 mGy和14.1 mGy,图像噪声分别为17.276±3.564和16.722±3.366.各组准直规格扫描图像噪声无显著性差异(P>0.05).结论 准直宽度与辐射剂量成反比关系,对图像质量无显著影响,建议尽可能采用较大准直宽度扫描以降低辐射剂量.

目的探讨新生儿缺氧缺血性脑病(HIE)的MRI表现。方法回顾性分析110例新生儿HIE初期的MRI表现。结果110例患儿中,脑水肿102例(92.8%),皮层、皮层下及深部白质T1WI呈高信号90例(81.8%),T1WI两侧侧脑室周围深部白质内对称性点状高信号56例(50.9%),基底节、丘脑T1WI异常高信号及内囊后肢高信号消失23例(20.9%),颅内出血42例(38%),T2WI灰白质分界不清19例(17.5%),弥漫性脑实质出血12例(10.1%),腁胝体水肿或梗死19例(17.3%),大面积脑梗死5例(占4.6%)。轻、中度HIE患儿预后较好;重度预后较差,常常留下后遗症。结论MRI可以客观反映新生儿窒息后脑损伤情况,对新生儿HIE的诊断具有较高的特异性和敏感性。

<正>1病例患儿,女,7岁。患儿1岁时,因发热、咳嗽于医院就诊时发现心脏杂音,查心脏超声示"先天性心脏病、动脉导管未闭",无活动后气促,无发绀,无咳粉红色泡沫样痰,无多汗,无平卧不能,无夜眠不安,无晕厥,但有反复上呼吸道感染病史,生长发育同正常儿童。现拟先天性心脏病、"动脉导管未闭"收住入院。