目的 探讨膝关节后外侧结构慢性损伤的MRI表现.方法 20例膝关节损伤患者均行高场MRI检查.总结膝关节后外侧结构(外侧副韧带、腘肌腱、腘腓韧带)损伤后的形态、长度、宽度及信号特点.结果 20例患者5例合并胫骨外侧平台边缘骨质增生,20例合并关节周围软组织肿胀,8例合并关节腔及髌上囊内积液,6例合并股骨远端外髁骨髓水肿,8例合并前交叉韧带慢性撕裂,5例合并后交叉韧带慢性撕裂,3例合并前后交叉韧带慢性撕裂.MRI信号特点:后外侧结构损伤呈不均匀长T1、长T2信号;组成膝关节后外侧结构的韧带及肌腱完全或部分肿胀,部分肌腱或韧带完全断裂,周围合并出血,出现不均混杂信号.外侧副韧带平均长度(68.74±4.56)mm、平均宽度(8.37±2.75)mm;腘肌腱平均长度(59.82±5.41)mm、平均宽度(12.58±1.43)mm;腘腓韧带平均长度(13.87±1.39)mm、平均宽度(6.23±1.02)mm.结论 韧带及肌腱肿胀、后期部分或完全断裂、韧带及肌腱信号增高等是膝关节后外侧结构慢性损伤的特征性表现.

宫颈癌是最常见的女性恶性肿瘤之一,仅次于乳腺癌.目前临床常用的治疗方法除广泛子宫切除术和盆腔淋巴结清扫术外,还有放疗及化疗.正确治疗方法的选择,是以宫颈癌准确的诊断及分期为依据.而临床常用的分期方法主要依靠妇科检查及活体组织检查,由于二者均存在不同的局限性,临床分期准确率不高,文献报道为61％～66％[1],不利于治疗计划的制定.本研究的目的旨在探讨MRI在宫颈癌诊断和分期在治疗前评估中的临床价值.

布鲁杆菌脊柱炎临床症状与影像表现都与脊柱结核类似，综合医院接诊此类患者少，当以慢性腰痛、发热为主诉的患者，影像检查显示椎体、椎间盘破坏时，常被误诊为脊柱结核。笔者回顾性分析误诊患者的磁共振影像，以提高诊断的正确率。

目的:对磁共振应用常规及特殊成像序列诊断三叉神经痛(TN)及面肌痉挛(FS)的价值进行评价.方法:TN及FS患者52例,行SE T1WI、T2WI扫描,排除占位后再行3D-TSE序列和3D-VIBE序列扫描.经3D MRP、MIP、min-MIP后处理图像,观察神经与周围血管的关系.结果:16例TN和8例FS为肿瘤引起,行切除术;23例TN和5例FS为血管压迫所致,行微血管减压术.3D-VIBE、3D-TSE序列综合判断血管压迫性三叉神经痛及面肌痉挛的阳性预测值、阴性预测值、敏感性、手术符合率分别为92％(23/25)、33.3％(1/3)、96％(24/25)、85.7％(24/28).结论:磁共振扫描对明确三叉神经痛及面肌痉挛的病因具有重要价值,3D-TSE序列和3D-VIBE序列是显示血管神经空间关系的敏感方法,对TN和FS的术前评估具有较高的价值.

目的 探讨磁共振3D-TSE序列和3D-VIBE序列对于血管压迫性三叉神经痛的诊断价值.方法 采用3D-TSE序列和3D-VIBE序列扫描28例临床拟诊为血管压迫性三叉神经痛的患者.经3DMRP、MIP、min-MIP后处理图像,观察三叉神经与周围血管的关系.结果 28例患者手术证实26例存在血管神经接触或压迫,3D-VIBE、3D-TSE序列综合判断血管压迫性三叉神经痛的阳性预测值、阴性预测值、敏感性、手术符合率分别为92.0％ (23/25)、33.3％ (1/3)、92.0％(23/25)、85.7％(24/28).而且MRI所显示的责任血管与神经的相对位置关系与术中所见具有高度的一致性(K=0.81).结论 3D-TSE序列和3D-VIBE序列结合可以清楚显示脑池内血管和三叉神经的空间关系并辨认责任血管的来源,对血管压迫性三叉神经痛的术前评估具有较高的价值.

Objective To investigate CT features of subconjunctival fat prolapse and lipoma.Materials and Meth-ods CT findings and clinical data of 38 patients(including 16 cases with 30 eyes of subconjunctival fat prolapse and 22 cases with 22 eyes of subconjunctival lipoma) were retrospectively analyzed.Results CT features of subconjunctival fat prolapse included a crescent-shaped or horn-shaped fat density mass continuous with the orbital fat in the superior temporal quadrant of the orbit.CT features of subconjunctival lipoma included a crescent-shaped or triangle fat density mass incontinuous with the orbital fat in the temporal side.There were significant differences in the morbidity age,sex,single or double eyes involved and whether or not with dislocation of lacrimal gland between subconjunctival fat prolapse and lipoma.Conclusion CT is helpful to distinguish subconjunctival fat prolapse and subconjunctival lipoma.

Objective To evaluate the various CT features in different orbit diseases invasion to eyeballs.Materials and Methods The CT features of 60 cases including 67 eyes of orbit diseases invasion to eyeballs confirmed by operation and/or pathology were studied.Related-samples Chi-squaer test and bidirectional disorder grouped data correletion test were calculated.Results(1)Eighteen cases of orbit lesions invaded the inner side of the eyeballs.(2) Benign tumors and inflammatory lesions involved one side of the eyeballs,while malignant tumours could involve two sides of the eyeballs.It had relevance between the nature of lesions and the locations(P=0.001 and C=0.438).(3)There was always an acute angle between benign lesion and eyeball,and an obtuse angle between inflammatory lesion or malignant tumour and eyeball(P=0.000 and C=0.759).Conclusion(1) The orbit lesions mostly involved the inner side of the eyeball.(2) There is always an acute angle between benign lesion and eyeball,and an obtuse angle between inflammatory lesion or malignant tumour and eyeball,otherwise malignant tumours could invloved two sides of the eyeballs.

目的探讨以改良的血管腔内激光治疗为主要手段的综合外科治疗下肢浅静脉曲张并血栓形成的临床疗效。方法对2007年8月～2010年12月收治的196例下肢浅静脉曲张并血栓形成,彩超显示血栓在浅静脉大腿中段以下的患者,采取大隐静脉高位结扎曲张静脉腔内激光闭锁,部分血栓取出等综合性微创外科治疗。结果 196例均得到回访,随访时间6～72月。196例完全愈合,无一例发生肺栓塞。结论下肢浅静脉曲张并血栓形成可用改良的血管腔内激光治疗,适用于血栓在大腿中段以下,血栓相对稳定,向心进展较慢者。

Objective To explore the modality and technique of 64-slice spiral CT (MSCT) angiography in diagnosing lower extremity arterial diseases. Methods Ninety-two patients with clinically suspective lower extremity arterial diseases underwent MSCT angiographies. All the imaging procedures were performed on a TOSHIBA Aquillion 64-slice spiral CT scanner through slice thickness=0.5-1.0 mm, pitch=12.7, interval=0, and using smooth function. Results Following workstation reconstruction the images of 98% patients were satisfactory, which could clearly show the normal anatomy, involved site and extent, and important collateral circulation path of lower extremity arterial system. Among 40 patients who underwent digital subtraction angiography (DSA) and surgery, the accuracy of MSCT angiography in diagnosing lower extremity arterial diseases was 98%. Conclusion MSCT angiography can accurately show the lower extremity arteries and their branches, while the imaging quality mainly depends on accurately determing postcontrast scanning times, reasonably selecting scanning parameters, and technologic level of the operators, of those, proper match between injecting velocity and total amount of contrast medium are key factors for acquire successful MSCT angiography.

Objective:The purpose of this study was to evaluate the value of 64-slice CT in the preoperativ evaluation of living renal donors.Methods:Sixty living renal donors underwent four-section(unenhanced,arterial phase,venous and excretory phase) 64-slice CT scanning before operation.Image processing included curved planar reformation(CPR),maximum intensity projection(MIP),and 3D volume rendering(3DVR).All the findings of CT were compared with intraoperative findings for 56 donors,so as to investigate the value of 64-slice CT in assessing renal vascularity,urinary tract and lesinons of renal parenchyma.Results:The CTA findings of the 56 donors were in accordance with intraoperative findings in demonstrating the anatomy of renal arteries and renal viens,accesary arteries,early branching of renal artery,urinary tract and renal parenchyma except one accesary artery.Conclusion:64-slice CT can directly and correctly show the details of renal vascularity,urinary tract and renal parenchyma and it has high value in the evaluation of living renal donor before transplantation.

Objective:To evaluate the role of 64-slice multidetector CT angiography(CTA) in detecting the cause and determining the treatment of patients with acute subarachnoid hemorrhage(SAH) strategy.Methods:Sixty-eight patients underwent CTA to make the early diagnosis and to find the cause of acute SAH.Treatment decision was based on CTA and the clinical efficacy was also evaluated.Image processing included multiplanar volume reformatted(MPVR),maximum intensity projections(MIP) and 3D votume-rendered reconstructions.Results:All the CTA findings were confirmed by DSA or neurosurgical operation.Among them,45 had aneurysmal SAH,1 had vasculitis,2 had arterial sclerosis,1 had arterial dissection and 19 had no underlying abnormality.Correct diagnosis was made with CTA in 64 out of the 68 patients(accuracy 94.1%,sensitivity 91.8%,specificity 100%,positive predictive value 100%,negative predictive value 82.6%).CTA rerealed the aneurysm in 43 of 45 patients,1 of 1 vasculitis and 1 of 1 dissection.Of the 43 patients with aneurysm,42(97.7%) were referred for treatment based on CTA.29 were referred to endovascular treatment and successful coiling was achieved in 26(89.7%),and 13 were refered for surgical clipping.Conclusion:64-slice CTA is an accurate tool for detecting the cause and characterizing aneurysms in acute SAH.It is helpful in determing whether to coil or clip an aneurysm.

本文收集我院骨外骨软骨性肿瘤3例,就其X线、CT、MR影像资料并结合手术病理进行分析,以加强对本病影像学表现更全面的认识.