目的:探讨含肿瘤外缘5 mm移行带的影像组学模型对预测肺腺癌病理分级的诊断效能.方法:回顾性搜集173例经手术病理证实的肺腺癌患者的胸部增强CT薄层图像及临床病理资料.其中女96例,男77例;年龄33～84岁,平均(60.0±1.2)岁;病灶直径6.0～30.0 mm,平均(18.0±1.6) mm;实性结节102例,亚实性结节71例;Ⅰ期134例,Ⅱ期18例,Ⅲ期21例;病理分级为1级51例,2级114例,3级8例.病理分级按最主要亚型分为1级(原位腺癌、微浸润腺癌和贴壁为主型腺癌)、2级(包括腺泡或乳头为主型腺癌)和3级(包括实性或微乳头为主型腺癌).根据结节可见边缘(瘤内组)和自动外扩5 mm(含瘤周组)对结节进行分割并使用软件自动提取影像组学特征.训练集与验证集比例为7∶3,使用随机森林构建影像组学模型,并利用混淆矩阵的准确性来评价瘤内及含瘤周影像组学模型预测肺腺癌病理分级的效能.结果:每例患者共提取病灶的385个影像组学特征,其中瘤内组中8个影像组学特征和含瘤周组中12个影像组学特征与肺腺癌的病理分级显著相关.瘤内影像组学模型及含瘤周影像组学模型预测肺腺癌病理分级的准确性在训练集为90.83％ vs.92.61％(P＞0.05),在验证组为90.74％vs.94.44％(P＞0.05).结论:与瘤内组影像组学模型相比,含5 mm瘤周影像组学模型可略提高对肺腺癌病理分级预测的准确性.

目的采用CT和MRI图像融合技术评价帕金森病（PD）患者深部脑电刺激（DBS）术后电极位置准确性的应用价值。方法收集接受双侧DBS疗法的32例PD患者,采用术后颅脑薄层CT和术前MRI图像融合（融合组）技术并与常规术后复查MRI图像（常规组）比较,分析电极位置精确度及检查耗费时间。结果融合组与常规组测量的电极位置相关性较好（P均＜0.008）;融合组与常规组电极尖端位置比较,除左侧电极y轴、z轴方向差异有统计学意义外（t=-2.34、-3.08,P均＜0.05）,余差异均无统计学意义（P均＞0.05）。术后复查MR检查时间为（7.65±0.33）min,术后复查CT时间为（2.85±0.29）min,差异有统计学意义（P＜0.05）。结论 DBS术后应用头部薄层CT与MRI图像融合能精确定位电极位置,并可避免PD术后复查MRI的潜在风险,缩短术后复查的时间。

Objective:To study the diagnostic value of quantitative T1WI MR parametric perfusion-weighted imaging based on DCE-MRI in duct-borne breast cancer.Methods:16 cases of female were performed the DCE-MRI examination before surgical operation,and the time-intensity curve(TIC) were acquired,then the parameters perfusion images of Wash-in,Wash-out,TTP,MIPt and PEI were drawn out by the special software for breast.And then measured the parameters of perfusion,analyzed the features of perfusion of duct related breast cancers.Results:13 cases invasive ductal carcinoma and 3 cases ductal carcinoma in situ were confirmed by pathology in the 16 cases.13 cases were non-mass-like enhancement,such as 7 cases duct-like,5 cases patchy,1 case spot-like.Another 3 cases were mass enhancement.All of the 16 cases TIC were the type II.13,10,9,15 and 16 lesions were found in the five kinds of parametric images.The detection rates were 81.25%,62.50%,56.25%,93.75% and 100%,respectively.We found the parameters between lesions and normal breast tissue were significant difference(P0.001).Moreover,the parameters between periphery and centre of lesions was also significant(P0.001),except in the TTP.But there's no significant difference between the invasive ductal carcinoma and the ductal carcinoma in situ.Conclusion:Quantitative T1WI MR parametric perfusion-weighted imaging based on DCE-MRI has a high detection rate of the duct-borne breast cancers,and might provide important additional information for its diagnosis and differential diagnosis.

Objective To explore the MRI characteristics of carotid atheromatous plaque, in order to improve the understanding of the disease. Methods The MRI features of 13 cases(from2013.11 to 2014.5) of surgically and athologically were reviewed retrospectively, summarized the signal characteristics. Results MRI found 18 carotid atheromatous plaques in 13 patients; 13 atheromatous plaques were obtained by carotid endarterectomy, lipid necrotic core was found in 13cases;intraplaque hemorrhage was found in 7cases;fibrous cap rupture was found in 6cases; calcification was found in 11cases; inflammatory cells infiltration was found in 4 cases. Conclusion MRI signal features of carotid atheromatous plaque are characteristic for the diagnosis, MRI can effectively assess the stability of the plaque.

Objective To evaluate the diagnostic value of MRI in solid-pseudopapillary tumor of the pancreas(SPTP).Methods MRI features of 9patients with histopathologicaly proved SPTP were retrospectively analyzed.All 9cases underwent MRI plain and contrast enhanced examination.Results 8cases were cystic-solid mass.1case was pure solid mass.7cases had complete capsule.8cases of the tumors showed mixed signals.6cases had hyper intense on T1WI.In post-contrast scan,solid portions appeared mild heterogeneous enhancement on arterial phase and progressive fill-in during the portal venous and equilibrium phases.Conclusion The MRI features of SPTP are characteristic.MRI is valuable for the diagnosis and differential diagnosis.

目的 探讨腱鞘巨细胞瘤(giant cell tumor of tendon sheath,GCTTS)的MRI影像特点.方法 回顾性分析15例经手术和病理学检查确诊的GCTTS患者的临床资料,全部病例均行MRI平扫,其中9例行增强扫描,总结其影像学特点.结果 15例GCTTS患者中,局限型12例,弥漫型3例,其中2例术后复发;肿瘤发生于关节周围,T1WI上13例为低或稍低信号,2例为中等信号,T2WI上6例为高低混杂信号,5例为低信号,2例为中等信号,2例为高或稍高信号.结论 GCTTS多发生于手、足等小关节,MRI信号呈多样性,在T1WI呈特征性低信号,在T2WI呈高低混杂信号,具有较高的诊断及鉴别诊断价值.

Objective To investigate the diagnostic value of digital mammography and dynamic contrast-enhanced MRI in breast cancer.Methods 31 cases of breast cancer confirmed by pathology,and retrospective analysis of the digital mammography and dynamic contrast-enhanced MRI findings.Results In the 31 cases: digital mammography positive findings in 29 cases,and correctly diagnosed 24 cases,the accuracy was 77.4%(24/31);dynamic contrast-enhanced MRI positive findings in 31 cases,and correctly diagnosed 27 cases,the accuracy was 87.1%(27 /31),combination of the two positive findings in 31 cases,and correctly diagnosed 29 cases,the accuracy was 93.5%(29 /31).Conclusions The diagnosis of digital mammography and dynamic contrast-enhanced MRI both have advantages and disadvantages,their combination can improve the detection rate and the correct diagnostic rate of breast cancer.

To study preliminary idea of MRI booking system,The system could be applied by Internet,PACS and HIS.It has the ability of automatic appointment,remote appointment,appointment information,appointment remind and signature when take the report.The system may be used alone,access the internet,also can be integrated in PACS and HIS.

Objective To evaluate the angiographic manifestations and clinical value of therapeutic embolization in iatrogenic vascular injury.Methods 20 cases with vascular injuries were collected,which caused by surgical process or interventional punction.Arteriogrphy was performed in 19 cases,of which 11 cases underwent therapeutic embolization.Results In 19 cases,extravasation of contrast medium was found in 8 cases,pseudoaneurysm in 7 cases,arteriovenous fistula in 1 case,artery dissecting in 1 cases,and occlusion in 2 cases. The bleedings were stopped in 8 patients,and no rebleeding was observed during the 2 weeks-1 month follow-up duration.One patient died 40 hours after embolization from multiple organ failure.Rebleeding occurred 2 days and 9 days after embolization in 2 cases.One of them was treated by arterial embolization again,and another by surgical operation.Conclusion Angiography has great value in diagnosis and therapeutic choice,and artery embolization is effective and safe for treatment of the iatrogenic vascular injury.

Objective:To assess the value of MRI in resectability prediction of esophageal carcinoma.Methods:20 cases of esophageal carcinoma were performed MR scans by T_1WI serieses and T_2WI series and enhancement.MR imaging included axial and oblique coronal.Tracheobronchial invasion and aortic invasion were diagnosed.Results:Two patients had been proved unresectable tumors for aortic invasion.Three patients had false-positive findings about aortic invasion and the two about tracheobronchial invasion.All patients had no false negative findings.The sensitivity,specificity and accuracy rate of aortic invasion were 100%、 83%、85%,respectively.The sensitivity, specificity and accuracy rate of tracheobronchial invasion were 100%、89%、85%,respectively.Conclusion:It is fine for MRI to reveal esophageal carcinoma and the relation to adjacent structures.It plays an important role in resectability prediction of esophageal carcinoma.

Objective:To improve the early diagnosis of cerebral fat embolism (CFE) by analyzing the CT and MRI findings in CFE.Methods:The clinical manifestation and the CT and MRI findings of 3 cases with CFE were analyzed.The all three patients were male and the age ranged from 17 years old to 25 years old .Results:CT scans in three patients showed no abnormalities.MRI showed multiple lesions with abnormal signal intensity in subcortical white matter area of both frontal lobes,basal ganglion area,corona radiata and centrum semiovale in all three patients.Lesions showed low signal intensity on T 1WI in only one case,high signal intensity on T 2WI and DWI in all three cases.Conclusion:After trauma and fracture,once the patient shows CNS abnormality clinically,the diagnosis of CFE should be considered.It is necessary for them to undergo MRI examination early and the T 1WI,T 2WI and DWI should all be used routinely.

Objective:To study the value and limitation of various imaging methods in diagnosis of acute trauma of spine.Methods:252 cases with acute trauma of spine were performed radiography,CT and MRI 48 hours after trauma.The imaging findings were retrospectively analyzed.Results:In all cases 278 parts of the fractures of the vertebral body were detected,and the detectability of plain film,CT and MRI was the same in the demonstration of the fracture of vertebral body.The fracture detection rate of the appendage by plain film,CT and MRI,however,was 9.1%,23.4% and 14.3%,respectively,and the difference was statistically significant.152 cases showed spinal cord injury on MRI.Conclusion:In acute trauma of spine plain film is the first step of choice for screening.The fracture detection rate of CT is highest in the above imaging methods mentioned.MRI is the best of diagnosing spinal cord injury.The combined use of the three imaging methods may improve the diagnosis.

Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The rim enhancement sign might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.