目的 应用定量动态增强磁共振成像(DCE-MRI)评估子宫肌瘤射频治疗术后的疗效.方法 回顾性分析在我院经射频治疗的52个子宫肌瘤病例,利用定量磁共振参数Ktrans、Ve、Vp、Kep,分别对入组病例进行术前与术后进行对比分析,再根据疗效分为:完全消融组、不完全消融组,依据上述参数进行组间对比分析,评估疗效.结果 Ktrans、Ve、Kep在术前、术后对比中P<0.001具有统计学意义,Vp统计结果为P=0.181,无统计学意义;组间分析方面,术前Ktrans、Kep、Ve与Vp这4项参数皆未见统计价值,术后Ktrans、Ve与Vp这3项指标的检验结果为P<0.001,即存在统计学意义;Kep统计结果为P=0.246,无统计学意义.结论 DCE-MRI定量参数对子宫肌瘤射频治疗评估具有参考价值.

目的:探讨胆管细胞癌的CT与MRI的影像诊断价值比较.方法:回顾性分析60例疑似胆管细胞癌患者临床资料,均接受64层螺旋CT及MRI检查,观察比较两种检测方式诊断结果.结果:CT、MRI检出率比较无显著差异(P>0.05);C T平扫,病灶以低密度为主,增强期病灶以周边薄环状增强为主要改变,可见高密度或无增强呈等密度;MRI平扫,T1W1为低信号,T2W1为略高或高信号,动态增强扫描,病灶缓慢增强型45例,快速增强型12例.结论:胆管细胞癌螺旋CT及MRI诊断均有较高检出率,,能够作为与其他肝内病变诊断鉴别的重要手段.

目的:评价早期宫颈癌诊断中应用磁共振联合经阴道超声的诊断价值,为早期宫颈癌诊断工作提供参考.方法:选择我院2016年8月—2018年3月期间经术后病理确诊的早期宫颈癌患者(n=50),分别采取超声诊断(超声诊断组)、磁共振诊断(磁共振诊断组)、磁共振联合经阴道超声诊断(联合组),3组诊断结果准确率以及联合诊断、术后病理分期结果进行比较.结果:联合组诊断结果准确率明显高于其他2组P<0.05,其他2组比较P>0.05,联合诊断与术后病理分期结果比较P>0.05.结论:对比磁共振或经阴道超声单一诊断,联合诊断基础上可以提高诊断准确率、疾病检出率,为疾病早期治疗提供有效参考.

AbstractObjective:To evaluate the immediate value of dynamic contrast-enhanced MRI(DCE-MRI)quantitative parameters after HIFU treatment of uterine fibroids. Materials and Methods:Thirteen patients with uterine fibroids were scanned with DCE-MRI before and after HIFU ablation. They were grouped into two groups, the complete ablation group and the non-complete ablation group according to appearance of DCE-MRI.Mann-Whitney U test andSpearman's correlations were applied to ifnd the association between quantitative parameters and grouping.Results:Ktrans(after treatment), Ve (after treatment) and Vp (after treatment) were positively correlated with the grouping, and correlation coefifcents were 0.713 , 0.757 and 0.668 respectively. Ktrans(rate of change)and Ve (rate of change) were negatively correlated with the grouping,and correlation coefifcients were both -0.802.Conclusion:DCE-MRI quantitative parameters have reference value in HIFU treatment's immediate effect evaluations for uterine ifbroids.

Objective Investigate the MR-DWI and PWI were used in ischemic penumbra of cerebral infarction and assess the prognosis.Methods 41 cerebral infarction cases with MRI scaned were inclused,get the NIHSS by Nerve physician at were admitted to hospital,one months and three months of inhospital.Application ??the area of difference of DWI and PWI,combined with NIHSS to assess the prognostic value of IP in cerebral infarction.Results 39 IP were measured,for IP/PWI and the NIHSS difference correlation analysis,a positive correlation between the two,IP/PWI ratio hinger the prognosis is better.Conclusion DWI and PWI measurement and assessment of cerebral infarction prognosis IP has a certain value.

Objective:To explore effect and possible mechanism of two rehalibitation treatment for patients with subcortical stroke by BOLD-fMRI.Methods:A total of 10 cases with subcortical stroke were randomly divided into two groups:constraint-induced movement therapy(CIMT)group and neurodevelopmental treatment(NDT)group.Blood oxygenation level dependent functional magnetic resonance imaging(BOLD-fMRI)was employed before and after treatment,and clinical evaluation was carried out.Results:Activation mode of healthy hand was similar to healthy person's.The motor area showd extensive activation as the ill hands moving.After treatment,the amount of activated voxel in bilateral cerebral hemisphere declined and was prone to normal activation mode.The evaluation showed more effective result in CIMT group.Conclusions:Rehabilitative treatment can promote cerebral functional reorganization.And CIMT is more effective than NDT in treating patients with subcortical stroke 3 to 9 months after stroke.

目的通过功能磁共振检查,探讨皮层下卒中患者强制性治疗(CIMT)的康复机制。方法对5名皮层下脑卒中后3～9个月的患者,在CIMT前行一次脑功能性成像(BOLD-fMRI)、扩散张量成像(DTI)检查及两次临床评分,在治疗后再行一次BOLD-fMRI及临床评分。对实验数据行后处理。结果 5名患者的扩散张量纤维束成像(DTT)上可见皮质脊髓束部分中断。患侧与健侧皮质脊髓束的部分各向异性(FA)值和表观扩散系数(ADC)值有显著性差异(P<0.05)。BOLD-fMRI发现:患者CIMT前,患手与健手运动时激活体素数经配对t检验,显示差异有显著性(P<0.05)。患者CI-MT前、后,患手运动时激活体素数进行前后测量设计的方差分析显示差异有显著性(P<0.05)。在CIMT前:健手运动时,对侧感觉运动皮质及同侧小脑激活,部分患者运动前区及其他运动区激活;患手运动时,多数患者对侧感觉运动皮质激活,双侧次级运动区(运动前区、辅助运动区等)激活,双侧或同侧小脑激活。在CIMT后:健手运动时,与治疗前无明显变化;患手运动时,双侧大脑半球激活的体素数显著减少并向正常激活模式集中,伴双侧或同侧小脑激活。结论皮层下脑卒中后3～9个月的患者发生了脑功能重组。皮质脊髓系统完整性的损害与残余运动系统的重组有关。CIMT可以促进脑功能重组,并产生运动功能改善。

Objective To examine upper-limb hemiparetic patients with subcortical stroke with DTI.Methods BOLD-fMRI with a 1.5T scanner performed DTI,corresponding software was used to process the data of DTT.Results Interruption or impairment of corticospinal tract was seen in DTT picture of 8 patients.The results from FA maps and ADC maps at the level of lesion and cerebral peduncle showed that the value of FA in lesion was significantly lower than that in the region of opposite side(P<0.05)and the value of ADC in lesion was significantly higher than that in the region of opposite side(P<0.05).Conclusion In all patients with a subcortical stroke 3 to 9 months,the corticospinal tract of patients with subcortical stroke defect or interrupt at the level of lesion,and exist secondary damage such as degeneration in remote areas.DTI will play an important role in this field.

Objective Comparative analysis of the ultrasonic appearance and the pathological findings of the breast infiltra- ting ductal carcinomas(IDC).Try to investigate the relationship between the ultrasonic features and the expression levels of Id2mRNA and Id3mRNA.Methods The real-time fluorescent quantitative RT-PCR(FQ-RT-PCR)was used to detect the expression levels of Id2mRNA and Id3mRNA in 36 IDC.The results were compared with the ultrasonic features of IDC.Re- sults The expression of Id2mRNA was higher in normal tissues than that in carcinoma tissue(P0.05)and was lower in WHOⅢgrade than that in WHOⅠgrade(P0.05),Id3mRNA inversely(P0.01,P0.05,respectively).Id2mRNA has no statistically significant with the ultrasonic appearance(P0.05).Id3mRNA was high expression in spiculate margin and peripheral duct extension(P0.01).Conclusion Uhrasonographie morphologic manifestations are closely related to pathology in IDC.The expression level of Id3mRNA can be assessed according to ultrasonic features of IDC(spiculate mar- gin and disorder structure in duct)in certain degree.

[Purpose] To explore the value of two-dimension ultrasound(2D),color doppler flow imaging(CDFI),pulse wave doppler(PW) and three-dimension color power angiography(3D-CPA) in differentiating malignant from benign thyroid nodules.[Methods] The ultrasonography features including 2D,CDFI,PW and 3D-CPA finding in 89 cases with thyroid nodules were analyzed and compared with pathological results.[Results] There were significant difference between malignant and benign thyroid nodules in boundary,appearance,calcification,acoustic halo,blood grading,PSV and RI.3D-CPA combined with CDFI could clearly show the blood feature of thyroid nodules.[Conclusion] Combination of 2D,CDFI,PW and 3D-CPA images can improve the diagnostic accuracy for thyroid nodules.

Objective To investigate the relationship between the ultrasonic appearance of the breast infiltrating ductal carcino- mas(IDC)and the expression level of Id3mRNA.Methods The real-time fluorescent quantitative RT-PCR(RT-PCR)was used to detect the expression levels of Id3mRNA in 36 IDC.The results were compared with the ultrasonic features of IDC.Results The expres- sion of Id3mRNA was lower in normal tissues than that in carcinoma tissue(P0.01).Id3mRNA had high expression in tissue with ul- trasonic appearance of spiculate margin and peripheral duct extension(P0.01 ).Conclusion Ultrasonic appearance is closely related to pathology in IDC.The expression level of Id3mRNA can be assessed according to ultrasonic features of IDC in a certain extent.

Objective:To predict the clinical utility for bladder outlet obstruction (BOO) using ultrasound-estimated bladder weight (UEBW) and to reveal the correlation of UEBW with urodynamics tests. Methods:A total of 70 men with lower urinary symptoms were divided into BOO group, non-BOO group and control group. UEBW of the subgroups was compared with age, maximum flow rate, postvoid residual urine, and international prostatic symptoms scores (IPSS). Results:UEBW of Boo greup was statistical significance compared to non-Boo group and controegroup (P0.001). In a simple regression analysis, there was a statistically significant correlation between UEBW and postvoid residual urine (r=0.49;P0.001). It revealed a diagnostic accuracy of 87.1% (61/70) for bladder outlet obstruction with 11.4%(5/44) and 14.3% (3/21) false-positive and false-negative rates, respectively. Conclusion:UEBW may be used to predict BOO noninvasively and it has an extensive clinical utility.

目的探讨MRCP3D重建图像结合原始图像对胆系结石的诊断价值。方法回顾性分析98例经MRI及MRCP检查并经手术病例结果合临床最后诊断证实的胆系结石。结果MRCP3D重建图像结合原始图像诊断胆系结石准确率为97.96%,MRCP3D重建图像诊断胆系结石的准确率为87.76%,MRI平扫诊断胆系结石准确率为84.69%。MRCP3D重建图像结合原始图像与MRCP3D重建图像、MRI平扫诊断准确率比较,相差具有显著性差异(x12=6.23,P1<0.05;x22=9.27,P2<0.05)。结论MRCP3D重建图像结合原始图像对胆系结石有较高的检出率,可进一步提高胆系结石的诊断准确率。

目的 探讨脑弥漫性轴索损伤(DAI)的MRI诊断价值.方法 搜集经临床确诊的DAI22例,均做MRI扫描.结果 22例中共发现50个病灶,其中包括大脑白质32个病灶,小脑3个病灶,胼胝体8个病灶,脑桥2个病灶,大脑脚3个病灶,延髓2个病灶.T1WI呈低信号,T2WI为高信号.结论 MRI对DAI具有较高的诊断价值,对临床诊断和治疗具有重要价值.

Objective To study the diagnostic value of dynamic gadolinium-enhanced MR imaging in small hepotacellar carcinoma(SHCC).Methods The scan date by MRI of 16 cases(21 lesions)with SHCC confirmed by pathology clinic were reviewed,include plain scan and dynamic contrast-enhanced scan by manual injection.Results On plain scan,most SHCC showed hyperdensity on T2WI.Most SHCC showed hypodinsity and a few showed isodensity or hyperdensity on T1WI.Pseudocapsule can be detected in 23.81% cases.On dynamic-enhanced RMI,17 lesions were hypervascular and 4 lesions were pypovascular.Pesudocapsule can be detected in 57.14% cases.The diagnostic accuracy of plain MRI scan and the Gd-DTPA dynamic-enhanced MRI on SHCC were 66.67% and 95.24%(P0.05).Conclusions Compared with plain scan,Gd-DTPA dynamic-enhanced MRI can promote the diagnostic accuracy of SHCC.

Objective To investigate the diagnostic value and the economic value of the identification of benign and malignant ovarian tumors by magnetic resonance imaging(MRI)and transvaginal ultrasonography(TVS).Methods 51 cases of suspicious ovarian cancer patients were checked by MRI and TVS.The two results were contrasted.The costs of the two inspection methods were analyzed the costs-effect.Results The sensitivity of the diagnosis of malignant ovarian tumors by MRI was 88.2%,the specificity was 97.6%,the accuracy was 94.9%,the positive predictive value was 93.8%,and the negative predictive value was 95.3%.The sensitivity of the diagnosis of malignant ovarian tumors by TVS was 94.1%,the specificity was 95.2%,the accuracy was 94.9%,the positive predictive value was 88.9%,and the negative predictive value was 97.6%.The unit costs of correct diagnosis of benign and malignant ovarian tumors by MRI and TVS was$879/754 and$197/169,respectively.Conclusion Diagnostic value of ovarian tumors is similar by MRI and TVS.TVS is more economical and effective than MRI.

目的通过三维时间飞越法磁共振血管成像(3D-TOF-MRA)与数字剪影血管造影(DSA)对照分析,探讨MRA对颅内动脉瘤的诊断价值。方法30例颅内动脉瘤均经血管造影和手术证实,所有病例均作3D-TOF-MRA和DSA检查,对其影像学特征进行比较研究。结果30例颅内动脉瘤患者共有34个动脉瘤,MRA+原始图像对动脉瘤的检出率为94.12%,MRA对动脉瘤的检出率为88.24%,MRA+原始图像及MRA与DSA对颅内动脉瘤检出率比较差异无显著性。结论3D-TOF法MRA能无创有效地诊断颅内动脉瘤,在检查颅内动脉瘤时是一种非常有价值的方法。

Objective To investigate the value of MR perfusion weighted imaging(PWI) to the evaluation of radiotherapeutic effect on gliomas. Methods MR PWI and conventional MRI examinations were performed respectively before radiotherapy and 3 and 6 months after radiotherapy in 25 patients with gliomas. The perfusion dada were deconvoluted to get color maps of cerebral blood volume (CBV) and cerebral blood flow (CBF). The relative values of regional CBV (rCBV) and regional CBF (rCBF) of the gliomas and cerebral tissues opposite to the gliomas were computed. Results In the gliomas and the cerebral tissues opposite to the gliomas to the gliomas, the rCBV were 6.32±2.14 and 2.58±1.21 respectively, and rCBF were 5.49±1.98 and 2.17±1.19 respectively before the radiotheraphy. The rCBV and rCBF of the gliomas increased before the radiotherapy in 25 patients compared to the cerebral tissues opposite to the gliomas (P0.01). Three and six months after the radiotherapy, rCBV and rCBF significantly decreased in 11 patients (P0.01), of whom, 5 had cerebral radionecrosis and 6 did not. The rCBV and rCBF of the gliomas increased to different extents after radiotherapy in 14 patients, of whom, 7 had the tumors with regional radionecrosis and 7 not. Conclusion MR PWI is a good method to evaluate the radiotherapeutic effect on the gliomas.

Objective To evaluate MR perfusing weighted imaging in differentiating of necrosis and recurrence of glioma after radiotherapy.Materials and Methods 32 patients with glioma(18 cases with recurrence and 14 cases with necrosis) having radiotherapy after surgery had MR perfusion imaging and MR conventional imaging.The color map of CBV and CBF were obtained from perfusion data.The maximal rCBV and rCBF ratios of each lesion and the normal side grey were calculated.Results PWI in 18 cases with recurrence of glioma exhibited increased rCBV and rCBF ratios.The maximal rCBV and rCBF ratios of recurrence of glioma were 6.23±2.23,5.21±1.55 respectively,each of the mormal side grey were 3.26±1.03(P0.01),2.41±1.15(P0.01) respectively;PWI in 14 cases with necrosis after radiotherapy exhibited decreased rCBV and rCBF ratios.The maximal rCBV and rCBF ratios of necrosis of radiotherapy were 1.90±0.53,1.21±0.32 respectively,each of the mormal side grey(matter) were 4.26±1.13(P0.05),3.36±1.24(P0.05);The maximal rCBV and rCBF ratios of recurrence of glioma were statistically different from those of necrosis after radiotherapy(P0.01).There was obvious correlation between the maximal rCBV and rCBF ratios(r=0.795 P0.05).Conclusion MR perfusion imaging is useful in differentiating of necrosis and recurrence of glioma after radiotherapy,especially using the maximal rCBF ratio with the maximal rCBV ratio.

患者 , 22岁 , 三月前化验尿 HCG( + ) , 在其他医院临床诊断为早孕 , 未经超声探查而直接 进行药物流产 . 10余天 ,因尿 HCG持续阳性行吸宫术 3次 , 将取出物做病理 , 结果不详 . 现仍为 尿 HCG( + ) , 血 HCG为 89 3U, 遂来我院就诊 .