目的 探讨体素内不相干运动扩散加权磁共振成像(IVIM-DWI)在心脏成像的应用效果.方法 选取12例健康志愿者行多扩散敏感因子(b值)DWI序列扫描.采用双指数模型,b值序列是:0、20、60、80、120、200、600 s/mm2,在心脏短轴位2、3、5、8、9、11节段分别测量室间隔前部、后部及侧壁的扩散系数(D值)、灌注系数(D*值)和灌注分数(f值),统计分析比较各节段不同供血区心肌的D值、D*值、f值的差异.结果 健康志愿者12例,第5、11节段心肌D值较2、3、8、9心肌节段低,两两比较差异具有统计学意义(P均<0.05),第5、11节段心肌D值差异无统计学意义(P>0.05);第5、11节段心肌D*值和f 值较2、3、8、9心肌节段高,两两比较差异具有统计学意义(P均<0.05),第5、11节段心肌D*值和f值差异无统计学意义(P均>0.05).结论 IVIM-DWI技术能定量反映心肌的扩散状态及血流灌注状态.

目的 探讨对比增强心血管磁共振成像(CE-CMR)在肥厚型心肌病、高血压及主动脉瓣狭窄性心脏病、心肌淀粉样变性及扩张型心肌病失代偿期鉴别诊断中的作用.方法 回顾性分析2010年1月～2016年5月收治56例左室肥厚患者的MRI表现,所有病例均行CE-CMR检查,定量测量各节段舒张末期室壁厚度,观察心肌延迟强化的部位、程度及范围.结果 36例肥厚型心肌病,其中27例表现为非对称性左室肥厚,9例表现为对称性左室肥厚;20例高血压及主动脉瓣狭窄性心脏病、心肌淀粉样变性及扩张型心肌病失代偿期均表现为左室壁弥漫性增厚.延迟增强MRI 36例肥厚性心肌病组共有28例患者可见左心室壁延迟强化,其中25例为局限右心室游离壁与室间隔的连接处、或心室最厚处的斑片状强化;13例高血压及主动脉瓣狭窄组有6例可见左心室壁斑片状延迟强化;6例心脏淀粉样变性组均有左心室壁弥漫延迟强化;1例扩张性心肌病失代偿期表现为室壁间条片状强化.结论 对比增强心血管磁共振成像能够为左室肥厚病变提供有价值的资料,钆对比剂延迟强化能够为病变提供有效的鉴别诊断信息.

目的 研究分析在颞叶癫痫(TLE)患儿中弥散张量成像(DTI)参数情况,探讨在对TLE病灶定侧诊断工作中DTI的作用.方法 选取TLE患儿20例,再选取20例健康志愿者作为对照组,均实施MRI以及DTI检查,分析两组ADC(海马的平均弥散系数值)、FA(各向异性分数)值差异.结果 对照组中常规MR下双侧海马大小一致,未存在信号异常现象,两侧的各参数情况差异无统计学意义(P＞0.05),TLE患者中患侧海马的ADC值明显比对照组以及对侧海马值高(P＜0.05),同时对侧海马ADC值显著高于对照组(P＜0.05),患侧海马FA显著比对侧以及对照组低(P＜0.05),而对侧海马FA值和对照组无显著差异(P＞0.05).结论 临床上针对TLE患者可使用DTI反应海马弥散变化,FA值降低以及ADC值升高可以被用于诊断病灶定侧,在儿童颞叶癫痫中DTI有较高的定侧诊断价值.

目的 探讨环形强化的单发脑转移瘤和胶质母细胞瘤高场强MRI强化特征对二者的鉴别诊断价值.方法 回顾性分析经手术病理证实为单发脑转移瘤和胶质母细胞瘤且术前行MRI增强检查表现为环形强化的病例,包括25例胶质母细胞瘤,9例单发脑转移瘤.结果 单发脑转移瘤与胶质母细胞瘤在是否囊实性、囊变数目、 部分均匀囊壁占周长的比率、囊壁均匀性、囊壁厚薄、有无分隔方面差异均无统计学意义(P>0.05);胶质母细胞瘤内壁不光滑、外壁不光滑、轮廓不平滑、无张力的比例高于单发脑转移瘤,差异均有统计学意义(P<0.05).结论 与胶质母细胞瘤相比,内壁光滑、外壁光滑、轮廓平滑、有张力这些征象更多见于单发脑转移瘤,从而有助于二者鉴别.

Objective To investigate the effect of rosuvastatin intervention on blood lipid level,carotid artery plaque and cerebral ischemic events in patients with hypertension and carotid atherosclerosis.Methods A total of 255 hypertensive patients with carotid plaques in our hospital between May,2013 and May,2015 were prospectively included,and randomly divided into control group,low dose rosuvastatin group(observation group 1)and routine dose group(observation group 2),with 85 cases in each group.All the three group were given antihypertensive therapy and lifestyle intervention,while the control group received 1 tablet of placebo which had the same the appearance of rosuvastatin,the observe group 1 received rosuvastatin 5 mg/day,and the observe group 2 received rosuvastatin 10 mg/day.The follow up was 6 months.Before and after the treatment,the blood lipids levels,blood pressure and carotid artery intima media thickness(IMT),plaque area and Crouse plaque score were detected.The incidence of ischemic events after 6 months of treatment was compared.Results The indexes of the control group showed no significant difference before and after treatment(P ＞ 0.05);after treatment,the systolic blood pressure and diastolic blood pressure observation of group 1 and observation group 2 decreased compared with prior treatment,but there was no statistical significance(P ＞ 0.05);the level of TC,LDL-C in Observation group 1,Observation group 2 was declined than before;the level of IMT,plaque area,Crouse plaque score,The rate of vulnerable plaque were elevated than before,with statistical significauce(P ＜ 0.05).The index improvement is obvious in Observation group 2 than Observation group.Conclusion In addition to hypolipidemic effects,Rosuvastatin can also reverse and stabilize the plaque,rednce the incidence of ischemic stroke,and is positively correlated with the dose.

目的 研究针药结合药物治疗不稳定型心绞痛的临床疗效.方法 选取2013年9月-2014年9月间邯郸市中心医院收治的80例不稳定型心绞痛患者,随机分为对照组和试验组,每组各40例.对照组患者接受常规治疗,试验组患者接受针药结合药物治疗.比较两组患者的治疗效果,并对两组患者治疗后平均心肌缺血时间进行比较.结果 试验组患者的治疗总有效率较对照组明显更高,差异有统计学意义(P<0.05).试验组患者治疗后动态心电图平均心肌缺血时间少于对照组,差异有统计学意义(P<0.05).结论 针药结合药物治疗不稳定型心绞痛的效果显著,能明显改善患者心肌缺血状况,具有较高临床价值.

Objective To explore the diagnostic value of 3‐Dimensional pseudocontinuous arterial spin labeling in pediat‐ric brain tumors .Methods Twenty‐five pediatric patients (16 boys and 9 girls) with Brain Tumors ,who were been histo‐logically proven ,were examined at a clinic with 3 .0T MR imaging .The 3D pseudocontinuous spin‐echo arterial spin‐labe‐ling technique was acquired at 3T MR imaging .Maximal relative tumor blood flow was obtained by use of the ROI method and was compared with tumor histologic features and grade .Results Tumors consisted of astrocytic tumor (10) ,embryo‐nal tumor (4) ,ependymal tumor (3) ,choroid plexus tumor (3) ,craniopharyngioma (2) ,lymphoma(2) ,glioblastoma (1) .The maximal relative tumor blood flow of high‐grade tumors (grades III and IV) was significantly higher than that of low‐grade tumors (grades I and II) ( P<0 .01) ,except lymphoma .In this patients ,relative tumor blood flow did not dis‐tinguish individual histology ;however ,among posterior fossa tumors ,relative tumor blood flow was significantly higher for medulloblastoma compared with pilocytic astrocytoma ( P <0 .017) .Conclusion 3‐Dimensional pseudocontinuous ar‐terial spin is a suitable method for assessment of pediatric brain tumors and allows distinction between high‐and low‐grade tumors .

Objective To investigate the feasibility of intravoxel incoherent motion (IVIM) for grading cervical cancer and evaluating effect of radiation treatment. Methods The imaging and pathological findings of 23 patients with cervical cancer were analyzed retrospectively. The standard apparent diffusion coefficient (ADCstandard), diffusion coefficient (D), perfusion coefficient (D*) and perfusion score (f) on double exponential function analysis of well-and poorly-differentiated cancer were compared using t test. These parameters were also compared in 12 patients before and after radiotherapy. Results The ADCstandard and D values of 13 poorly-differentiated tumors were significantly lower than that of 10 well-differentiated tumors (Z=-3.496, -2.660, P<0.05). There was no significant difference in the areas under the curves of ADCstandard (0.965) and D (0.854), D*and f (t=-0.184, 1.072, P> 0.05) between the two groups. Tumor size and D values were significantly reduced after radiotherapy (Z=-1.999, P<0.05) whereas the areas under the D, ADCstandard, D*and f value curves were not significantly different before and after treatment. Conclusions IVIM analysis is feasible for grading cervical cancer and assessing response of radiotherapy.

目的 探讨伪连续性动脉自旋标记技术对高级别胶质瘤(high-grade gliomas,HGG)与淋巴瘤的鉴别诊断价值.方法 选择HGG患者20例与淋巴瘤患者11例,均行常规磁共振(magnetic resonance imaging,MRI)扫描、伪连续动脉自旋标记灌注(pseudo-continuous ASL,pCASL)扫描及MRI增强检查,比较HGG与淋巴瘤的肿瘤平均血流量(mean tumor tissue blood flow,mTBF)和肿瘤相对血流量(relative tissue blood flow,rTBF)值,采用ROC曲线确定最佳临界值、敏感度和特异度.结果 HGG的mTBF值和rTBF值明显高于淋巴瘤(P＜0.01).mTBF鉴别HGG与淋巴瘤的最佳临界值为57.9 mL· min-1·(100 mg)-1,敏感度为90.0％,特异度为54.6％.rTBF鉴别诊断2种肿瘤的最佳临界值为141.1,敏感度为65.0％,特异度为100.0％.mTBF和rTBF的ROC曲线下面积比较差异无统计意义(P＞0.05).结论 mTBF及rTBF分别以57.9 mL·min-1·(100 mg)-1及141.1作为最佳临界值,可以有效鉴别HGG与淋巴瘤,并具有较高的诊断敏感度及特异度.