BackgroundInflammation has an important impact on the pathological progression associated with ischemic stroke. Serum uric acid (UA) to lymphocyte ratio (ULR) is a biomarker that responds to the level of inflammation but is not definitively associated with the clinical outcomes in patients with acute ischemic stroke (AIS).MethodsThe data were obtained from the Third China National Stroke Registry (CNSR-III). Enrolled AIS patients were grouped by ULR quartiles at admission. The outcomes were poor functional outcomes (modified Rankin Scale [mRS] score of 3–6 or 2–6) and all-cause mortality at 3 months and 1 year. The associations of ULR with the risk of poor functional outcome and all-cause mortality were analyzed by multivariable logistic regression and Cox proportional hazards regression.ResultsA total of 8,241 patients were included from the CNSR-III study. After adjusting for confounders, it was found that patients in the highest ULR quartile had higher mRS scores of 2–6 (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.15–1.53) and 3–6 (OR, 1.35; 95% CI, 1.16–1.57) at the 3-month follow-up. Additionally, the highest ULR quartile was associated with an increased risk of all-cause mortality at the 3-month follow-up (hazard ratio [HR], 1.97; 95%CI, 1.22–3.18). Similar results were observed at the 1-year follow-up.ConclusionElevated ULR increased the risks of poorer functional outcomes and all-cause mortality in the AIS patients. However, this observational study was limited by potential unmeasured confounders, selection bias, residual confounding, and restricted generalizability to other populations.

INTRODUCTION:To investigate MRI fractional order calculus model (FROC) on distinguishing different pathological grades of endometrial carcinoma (EC). METHODS:Fifty patients with pathologically-confirmed EC and normal volunteers were enrolled for analysis of parameters β, μ, and D. RESULTS:The parameters β, μ, and D of the EC group were all significantly (P<0.05) lower than the normal controls. Parameters β, μ, and D had high diagnostic efficacy in distinguishing EC, with the AUC of β, μ, and D being 0.777, 0.660, and 0.809, respectively. The β Energy and Total Energy were significantly (P<0.05) different between G1 and G3 pathological grades of EC. The β Energy, Kurtosis, and Total Energy were significantly (P<0.05) different between G2 and G3 pathological grades and had AUCs of 0.730, 0.795, and 0.812, respectively. The D Entropy, Total Energy, and Energy showed a significant (P<0.05) difference between G2 and G3 grades and had AUCs of 0.724, 0.761, and 0.756, respectively. The μ Energy, Entropy, and Total Energy showed a significant (P<0.05) difference between G2 and G3 grades. DISCUSSION:The use of parameters of the FROC model is effective for the diagnosis of endometrial carcinoma. Nonetheless, the limitations should be properly addressed, with validation of the model in a larger, multi-center cohort, incorporating second-order and high-order texture features. CONCLUSION:The use of parameters of the FROC model is effective for the diagnosis of EC, and the first-order statistical parameters have high clinical value in differentiating high- and low-grade EC.

OBJECTIVES:To establish an intracranial vessel wall enhancement (VWE) scoring system and evaluate its potential as a protocol for monitoring systemic lupus erythematosus (SLE) disease activity and neuropsychiatric impairment. MATERIALS AND METHODS:In this retrospective study, fifty patients with SLE underwent conventional MRI and high-resolution magnetic resonance vascular wall imaging (HR-VWI) at three tertiary hospitals between August 2022 and December 2023. We analyzed VWE distribution in intracranial arteries, developed a scoring system based on enhancement patterns, and examined the relationship between VWE scores, disease activity, and cognitive function. Univariate analysis and logistic regression were utilized to identify clinical and imaging characteristics associated with sustained lupus low disease activity state (LLDAS) and central nervous system (CNS) neuropsychiatric impairment. RESULTS:SLE patients exhibited multi-segmental intracranial vessel wall thickening with concentric or double-track enhancement. VWE scores positively correlated with disease activity and negatively with cognitive function (both P < 0.001). High VWE scores was negative predictors for achieving sustained LLDAS (OR, 1.52; 95 % CI: 1.01-2.28; P = 0.043). Logistic regression confirmed VWE scores as independent predictors of CNS neuropsychiatric impairment (OR, 1.92; 95 % CI: 1.03-3.60; P = 0.04). A VWE score > 4.0 demonstrated high sensitivity (96 %) and moderate specificity (65 %) for diagnosing CNS impairment (AUC = 0.82; P < 0.001). CONCLUSION:The VWE scores system can serve as a valuable protocol for monitoring disease activity and detecting CNS neuropsychiatric impairment in SLE, offering a potential tool for early diagnosis and prognosis evaluation.

Objective This study aims to observe the correlation between infarction pattern and intracranial arterial stenosis (ICAS) on magnetic resonance and functional outcome in acute ischaemic stroke (AIS) patients after reperfusion therapy.Design This is a post hoc analysis of the Third China National Stroke Registry (CNSR-III) study.Setting The data was derived from the CNSR-III study, which was a nationwide clinical registry of ischaemic stroke or transient ischaemic attack based in China.Participants Patients with anterior circulation AIS who underwent reperfusion therapy were included for analysis. The patients were divided into single acute infarction and multiple acute infarctions (MAIs) based on the diffusion-weighted imaging findings. Additionally, patients were categorised according to the degree of ICAS assessed by magnetic resonance angiography as either ≥50% or <50%.Primary outcome measures The primary outcome of this study was poor functional outcome at 12 months, defined as a modified Rankin Scale of 3–6.Results In the included 796 patients, there were 152, 130 and 126 cases of unfavourable functional outcomes at 3 months, 6 months and 12 months, respectively. After adjusting for all potential confounding factors, MAIs were significantly associated with an increased risk of poor functional outcomes at 12 months (OR 1.96; 95% CI 1.27 to 3.02; p=0.0024). Similarly, ≥50% ICAS was also correlated with an increased risk of poor functional outcomes (OR 1.74; 95% CI 1.14 to 2.67; p=0.0110).Conclusions Both MAIs and ≥50% ICAS were associated with poor functional outcomes in patients with anterior circulation AIS who received reperfusion therapy.

BackgroundThe combined index (HALP) of hemoglobin, albumin, lymphocytes, and platelets is considered a novel scoring system that reflects systemic inflammation and nutritional status. This study aimed to investigate the relationship between HALP scores and poor outcomes in acute ischemic stroke (AIS) patients with type 2 diabetes mellitus (DM).MethodsPatients with AIS and type 2 DM were screened from the Third China National Stroke Registry (CNSR-III) and divided into quartiles based on their HALP scores at admission. Clinical outcomes were adverse functional outcomes (modified Rankin scale [mRS] score of 3–6 or 2–6) and all-cause mortality at 3 months and 1 year. The association of HALP with the risk of poor functional outcome and all-cause mortality were analyzed by multivariable logistic regression and Cox proportional hazards regression.ResultsA total of 3,603 patients were included in this study. After adjusting for confounders, it was found that patients in the highest HALP score quartile had lower mRS scores of 2–6 (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.51–0.80) and 3–6 (OR, 0.53; 95% CI, 0.51–0.82) at the 3-month follow-up. At the 1-year follow-up, a significant correlation was observed between HALP scores and mRS scores of 2–6 (OR, 0.65; 95%CI, 0.57–0.81) and 3–6 (OR, 0.64; 95%CI, 0.47–0.86). Additionally, the highest HALP score quartile was associated with a reduced risk of all-cause mortality at the 3-month follow-up (hazard ratio [HR], 0.35; 95%CI, 0.13–0.93). Similar results were observed at the 1-year follow-up (HR, 0.34; 95%CI, 0.18–0.63).ConclusionAt 3 months of AIS patients with type 2 diabetes and 1-year follow-up, lower HALP scores were associated with poorer functional outcomes and all-cause mortality.

INTRODUCTION:To explore the feasibility of applying computed tomography perfusion (CTP) imaging-guided mechanical thrombectomy in acute ischemic stroke patients with large vessel occlusion beyond the therapeutic time window.METHODS:The clinical data of acute cerebral infarction patients with large vessel occlusion who were beyond the therapeutic time window and admitted to Handan Central Hospital from January 2021 to March 2022 were retrospectively analyzed. All patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) and were examined by one-stop CTP imaging. The preoperative onset time of the disease was more than 6 h. Fourteen patients underwent magnetic resonance imaging examination at the same time. Fifty-four patients were retrospectively divided into two groups based on the treatment methods: the mechanical thrombectomy group had 21 patients and the conservative treatment group had 33 patients. NIHSS scoring and computed tomography scan were performed before treatment, 6 h, 24 h, 7 days, and 30 days after treatment.RESULTS:The NIHSS scores of the patients with acute cerebral large vessel occlusion who underwent CTP imaging-guided mechanical thrombectomy at 6 h, 24 h, 7 days, and 30 days after treatment were compared with those of the conventional treatment group. The NIHSS score of the mechanical thrombectomy group was significantly better, and the difference was statistically significant (P < 0.05). In terms of the prognosis rate and expansion rate of infarct core volume, the patients of the mechanical thrombectomy group had a better prognosis, and the difference was statistically significant (P < 0.05). Artificial intelligence-assisted CTP diagnosis can facilitate the automatic evaluation of diseases and enable quick judgments that are independent of radiologists' evaluation, but it may pose a problem in the determination of infarct core volume (either being too high or too low).CONCLUSION:It is of great significance to apply CTP imaging in guiding the mechanical thrombectomy procedure in acute stroke patients with large vessel occlusion who are beyond the therapeutic time window.

BACKGROUND:Magnetic resonance imaging (MRI) reference ranges for ventricular morphology and function in the Chinese population are lacking. PURPOSE:To establish the MRI reference ranges of left and right ventricular (LV and RV) morphology and function based on a large multicenter cohort. STUDY TYPE:Prospective. POPULATION:One thousand and twelve healthy Chinese Han adults. FIELD STRENGTH/SEQUENCE:Balanced steady-state free procession cine sequence at 3.0 T. ASSESSMENT:Biventricular end-diastolic, end-systolic, stroke volume, and ejection fraction (EDV, ESV, SV, and EF), LV mass (LVM), end-diastolic and end-systolic dimension (LVEDD and LVESD), anteroseptal wall thickness (AS), and posterolateral wall thickness (PL) were measured. Body surface area (BSA) and height were used to index biventricular parameters. Parameters were compared between age groups and sex. STATISTICAL TESTS:Independent-samples t-tests or Mann-Whitney U test to compare mean values between sexes; ANOVA or Kruskal-Wallis test to compare mean values among age groups; linear regression to assess the relationships between cardiac parameters and age (correlation coefficient, r). A P value <0.05 was considered statistically significant. RESULTS:The biventricular volumes, LVM, LVEDD, RVEDV/LVEDV ratio, LVESD, AS, and PL were significantly greater in males than in females, even after indexing to BSA or height, while LVEF and RVEF were significantly lower in males than in females. For both sexes, age was significantly negatively correlated with biventricular volumes (male and female: LVEDV [r = -0.491; r = -0.373], LVESV [r = -0.194; r = -0.184], RVEDV [r = -0.639; r = -0.506], RVESV [r = -0.270; r = -0.223]), with similar correlations after BSA normalization. LVEF (r = 0.043) and RVEF (r = 0.033) showed a significant correlation with age in females, but not in males (P = 0.889; P = 0.282). DATA CONCLUSION:MRI reference ranges for biventricular morphology and function in Chinese adults are presented and show significant associations with age and sex. LEVEL OF EVIDENCE:2 TECHNICAL EFFICACY: Stage 2.

Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor originating from peritoneal mesothelial cells. Here, we present a case of an 18-year-old male with right lower abdominal pain. Physical examination revealed a palpable mass with unclear boundaries. Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein. CT scan revealed a cystic mass in the ileocecal region with multiple septations. Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side. Immunohistochemistry confirmed BMPM diagnosis. BMPM, especially in the ileocecal region, is uncommon and presents diagnostic challenges. Differential diagnosis includes lymphangioma, peritoneal metastasis, and malignant mesothelioma. CT findings, such as thin cyst walls and septations, aid in diagnosis. Recognition of BMPM’s imaging features improves diagnostic accuracy. Surgical resection remains the primary treatment. This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.

目的 探讨后肾腺瘤的CT影像学特征,以提高对该病的认识.方法 回顾性分析8例经手术病理证实的后肾腺瘤CT影像学表现,与术后病理结果对比并复习相关文献,总结后肾腺瘤的CT影像学特征.结果 8例后肾腺瘤均为女性,年龄为34～65岁.CT平扫表现为类圆形单发肿块,直径2～6cm,5例其内密度均匀,未见囊变坏死区,3例呈混杂密度,可见囊变坏死区,2例可见斑点状或砂砾样钙化,增强扫描实性部分呈轻中度渐进性强化,3例可见假包膜征.结论 后肾腺瘤CT平扫多为等或稍高密度肿块,肿块密度比较均匀,增强扫描呈轻中度渐进性强化的特点,可伴有囊变或钙化,具有一定影像学特征,确诊需镜检及免疫组织化学检查.

目的 分析磁共振成像(MRI)联合扩散加权成像(DWI)对胃间质瘤与胃癌的鉴别价值.方法 回顾性分析经手术病理证实并行MRI联合DWI检查的65例胃癌患者及21例间质瘤患者的影像资料.对比分析胃间质瘤和胃癌在MRI联合DWI检查中的影像学表现及ADC值,绘制ROC曲线分析ADC值鉴别诊断胃间质瘤与胃癌的价值,采用Kappa检验评价MRI联合DWI检查中的ADC值诊断结果与手术病理检查结果的一致性.结果 86例研究对象中T2WI压脂、DWI图像上均呈不同程度的高信号,虽然胃癌的图像信号强度总体上略高于胃间质瘤,但二者征象特征并不易准确区分;此外,可见胃间质瘤多发于胃体、胃底,胃癌多发于胃窦.胃癌患者ADC值为(1.05×10-3±0.27×10-3)s/mm2,显著低于胃间质瘤患者ADC值[(1.43×10-3±0.21×10-3)s/mm2](t=5.891,P<0.05).ADC值鉴别诊断胃间质瘤与胃癌的曲线下面积为0.865,约登指数为0.688,临界值为1.26×10-3s/mm2,此时对应的敏感度为83.08%,特异性为85.71%,准确度为83.72%,误诊率为14.29%,漏诊率为16.92%,阳性预测值为94.74%,阴性预测值为62.07%.MRI联合DWI检查中的ADC值诊断结果与手术病理检查结果比较,Kappa值为0.609(P<0.05),说明一致性较高.结论 MRI联合DWI检查作为一种无创的影像学检查技术,有助于鉴别诊断胃间质瘤与胃癌,具有一定的临床应用价值.

目的:探讨高分辨率磁共振血管壁成像(HRMR-VWI)在椎动脉夹层诊断中的应用价值.方法:搜集 2例经临床证实为椎动脉夹层病人的临床及影像资料,均获取磁共振时间飞跃法磁共振血管成像(TOF-MRA)、快速自旋回波 T1 加权成像(T1WI)、快速自旋回波 T2加权成像(T2WI)、三维可变反转角快速自旋回波(3D-SPACE)、T1WI常规剂量增强扫描(CE-T1WI)成像,分析椎动脉夹层的临床特点及影像特征.结果:椎动脉夹层临床无明显特异性,HRMR-VWI既可显示血管腔结构,又可以清晰显示血管壁,典型影像学表现为明显强化的内膜瓣征、真假两腔的双腔征、高信号的壁内血肿及动脉瘤样扩张等.结论:椎动脉夹层具有独特的影像特征,HRMR-VWI成像技术对椎动脉夹层具有重要诊断价值.

Although reference ranges of T1 and T2 mapping are well established for cardiovascular magnetic resonance (CMR) at 1.5T, data for 3T are still lacking. The objective of this study is to establish reference ranges of myocardial T1 and T2 based on a large multicenter cohort of healthy Chinese adults at 3T CMR. A total of 1015 healthy Chinese adults (515 men, age range: 19–87 years) from 11 medical centers who underwent CMR using 3T Siemens scanners were prospectively enrolled. T1 mapping was performed with a motion-corrected modified Look–Locker inversion recovery sequence using a 5(3)3 scheme. T2 mapping images were acquired using T2-prepared fast low-angle shot sequence. T1 and T2 relaxation times were quantified for each slice and each myocardial segment. The T1 mapping and extracellular volume standardization (T1MES) phantom was used for quality assurance at each center prior to subject scanning. The phantom analysis showed strong consistency of spin echo, T1 mapping, and T2 mapping among centers. In the entire cohort, global T1 and T2 reference values were 1193 ± 34 ms and 36 ± 2.5 ms. Global T1 and T2 values were higher in females than in males (T1: 1211 ± 29 ms vs. 1176 ± 30 ms, p < 0.001; T2: 37 ± 2.3 ms vs. 35 ± 2.5 ms, p < 0.001). There were statistical differences in global T2 across age groups (p < 0.001), but not in global T1. Linear regression showed no correlation between age and global T1 or T2 values. In males, positive correlation was found between heart rate and global T1 (r = 0.479, p < 0.001). Using phantom-validated imaging sequences, we provide reference ranges for myocardial T1 and T2 values on 3T scanners in healthy Chinese adults, which can be applied across participating sites. Trial registration URL: http://www.chictr.org.cn/index.aspx . Unique identifier: ChiCTR1900025518. Registration name: 3T magnetic resonance myocardial quantitative imaging standardization and reference value study: a multi-center clinical study.

目的 利用全脑磁共振血管壁成像(magnetic?resonance?vessel?wall?imaging,MR?VWI)研究单发皮层下梗死(single?subcortical?infarction,SSI)患者早期神经功能恶化(early?neurological?deterioration,END)与豆纹动脉(lenticulostriate?artery,LSA)的关系.方法 回顾性分析邯郸市中心医院神经内二科2020年10月—2022年1月连续住院的不伴有脑大动脉狭窄的SSI患者,根据有无发生END分为END组和非END组,通过全脑MR?VWI影像学方法评估LSA可视化程度,基底节区无法看到LSA记为LSA可视化差,LSA覆盖不到一半的基底节区域记为LSA部分可视化,LSA覆盖基底节区域一半以上的区域记为LSA可视化好.研究SSI患者发生END与LSA可视化程度之间的关系.结果 本次研究共纳入77例患者,其中END组16例(20.78％),非END组61例(79.22％).患者平均(62.21±11.03)岁,男性51例(56.7％).END组入院时NIHSS评分[(6.13±2.09)分vs.(5.08±1.76)分,P=0.046]、TC[(4.93±1.17)mmol/L?vs.(4.34±0.76)mmol/L,P=0.018]、LDL-C[(2.92±0.69)mmol/L?vs.(2.28±0.53)mmol/L,P=0.003]和LSA可视化差(50.0％?vs.?18.0％,P=0.026)均高于非END组.多因素logistic回归分析显示,高LDL-C水平?(OR?5.008,95％CI?1.305～19.224,P=0.019)和LSA可视化差(OR?8.673,95％CI?1.094～68.788,P=0.041)是患者发生END的独立危险因素.结论 高LDL-C水平和LSA可视化差是SSI且无脑大动脉狭窄患者发生END的独立危险因素.

患者 男,53岁.无意中发现左侧软腭肿物,无明显不适.查体:肿物表面光滑,质韧,无触痛及破溃.实验室检查:嗜酸性粒细胞计数1.81×109/L,嗜酸性粒细胞百分比31.4％.MRI检查显示左侧软腭团块状长T,长T2信号影,内见点条状T2低信号,DWI稍高信号(图1A～1C),增强扫描肿块明显强化,内见点状无强化(图1D,1E);左侧颈动脉鞘区见肿大淋巴结(图1F).MRI诊断考虑恶性病变.病理诊断:鳞状上皮下淋巴组织增生伴淋巴滤泡形成,伴大量嗜酸性粒细胞浸润,血管增生,符合Kimura病.

患者 男,56岁.主因活动后心前区不适1年,间断发作近10天再次出现不适症状入院.体格检查:体温36.4℃,脉搏60次/min,血压145/95 mmHg.心前区无隆起,未见异常心尖搏动,心界向左下扩大,心尖部可闻及收缩期杂音.生化检验:尿酸460.0 μmol/L,甘油三脂2.09 mmol/L,白蛋白(澳甲酚绿法)37.8 g/L.心脏彩色超声诊断:节段性室壁运动异常,左心大,二尖瓣前叶关闭不全伴中量返流.

目的 探讨卵巢非肿瘤性病变的MRI特征及诊断要点.方法 回顾性分析87例经手术病理或临床证实的卵巢非肿瘤性病变的MRI表现,观察病灶为实性、囊性、是否合并出血、与卵巢关系及特殊临床病史等,总结其影像特点.结果 卵巢实性病变主要为卵巢扭转(2例),MRI表现为单侧卵巢增大,T2WI呈低信号为主,典型"果盘征";卵巢囊性病变主要功能性囊肿分为滤泡囊肿(15例)、黄体囊肿(18例)、出血性囊肿(12例);非功能性囊肿分为巧克力囊肿(22例)、卵巢冠囊肿(4例)、多囊卵巢综合征(6例)、卵巢过度刺激综合征(3例),卵巢输卵管脓肿(4例)以及卵巢异位妊娠(1例).根据囊液中是否有出血及出血的不同时期,MRI表现多样:T1WI、T2WI可表现为低、等、高信号,部分可见液-液平面,囊壁厚薄不一,正常卵巢与囊肿分离为卵巢冠囊肿典型征象;卵巢过度刺激综合征及卵巢异位妊娠诊断应密切结合临床病史.结论 MRI可清晰显示卵巢非肿瘤性病变成分、囊液是否合并出血以及病变与卵巢关系,仔细分析其MRI特征并密切结合临床可减少误诊.

Background: This study was to investigate the prevalence of preoperative rim enhancement, and its association with clinicopathological features, relapse, and survival profiles in Chinese basal-like breast cancer (BC) patients. Materials and Methods: The preoperative breast magnetic resonance imaging images of 145 basal-like BC patients who underwent surgical excision were obtained to determine rim enhancement. Besides, based on disease status and survival status during follow-up, the 1-year relapse rate/mortality, 3-year relapse rate/mortality, 5-year relapse rate/mortality were calculated; disease-free survival (DFS) and overall survival (OS) were determined. Results: There were 51 (35.2%) patients with rim enhancement and 94 (64.8%) patients without rim enhancement. Furthermore, rim enhancement was associated with larger tumor size and advanced T stage, whereas it did not associate with age, pathological differentiation, N stage, or TNM stage. In addition, rim enhancement was associated with higher 1-, 3-, and 5-year relapse rate and shorter DFS; meanwhile, rim enhancement was associated with increased 1-, 3-, and 5-year mortality rate and decreased OS. By multivariate Cox's regression analyses, rim enhancement, pathological differentiation, and N stage independently predicted reduced DFS; T stage independently predicted declined OS. Conclusion: Preoperative rim enhancement on MRI might be a possible noninvasive indicator for guiding personalized treatment strategies and improving prognosis in Chinese basal-like BC patients.

患儿 男,5 岁.因 1 周前无明显诱因出现右侧腹股沟区触痛,外院腹部彩色多普勒超声考虑右侧腹股沟皮下肿物,急诊入院.查体:腹平坦,未见胃肠型及蠕动波,腹软,右侧腹股沟区触痛,似可触及一范围约4 cm×2 cm肿物,无反跳痛及肌紧张,余腹部正常.腹部彩色多普勒超声:右侧腹股沟区不规则低回声,右侧腹股沟区多发淋巴结.CT扫描:右下腹阑尾增粗,其内可见"螺丝钉"样金属致密影(图 1,2),右侧腹股沟区可见囊状低密度影(图 3),周围脂肪间隙模糊.诊断:考虑阑尾"螺丝钉"异物,右侧腹股沟区脓肿可能性大.

目的 观察320排容积CT全脑灌注成像(CTP)在缺血性脑血管病变(ICVD)中的应用价值.方法 选取2017年1月—2018年12月72例拟诊ICVD病人,入院24 h内均行常规CT检查、320排容积CTP检查,获得脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)等灌注参数及动态CT血管成像图(4D-CTA),分析常规CT平扫、全脑CTP、4D-CTA结果.结果 72例病人CT平扫中43例未见明显异常,29例发现37个脑缺血病灶,全脑CTP灌注异常51例,共发现76个病灶;异常灌注区灌注参数CBF值低于健侧镜像区(P<0.05),MTT值、TTP值均高于健侧镜像区(P<0.05);4D-CTA图像提示59例存在不同程度血管狭窄或闭塞,其中轻度11例,中度18例,重度21例,闭塞9例;脑血管重度狭窄或闭塞灌注异常占比93.33％,高于脑血管无狭窄或轻中度狭窄的16.67％(P<0.05);颅内动脉、颈动脉狭窄程度与MTT、TTP呈正相关(P<0.05),与CBV、CBF无相关性(P>0.05).结论 320排容积CTP能同时获得常规CT扫描、全脑CTP、4D-CTA图像,全面显示脑缺血病灶、脑血流灌注参数及脑血管狭窄程度,为ICVD诊疗提供影像学依据.

患者女性,64岁.因阴道排液,发现宫腔积液入院.查体:脉搏:70次/min,呼吸:19次/min,血压:120/78 mmHg,心脏各瓣膜听诊区未闻及杂音.心电图:1)窦性心律;2)下壁异常q波;3)TII、III、aVF、V5～V6低平.彩色多普勒提示先天性心脏病:1)左侧三房心(右肺静脉及左上肺静脉开口副房,左下肺静脉开口真房);2)三尖瓣少量返流;3)左室舒张功能减低.