目的 探讨扩散峰度成像(DKI)对动态增强时间-信号曲线呈平台型的乳腺纤维腺瘤和乳腺癌的鉴别诊断价值.方法 选取DCE-TIC为平台型的20例(20个病灶)乳腺纤维腺瘤患者和61例(64个病灶)乳腺癌患者.测得病变的平均扩散峰度系数(MK)和平均扩散系数(MD)以及ADC值,观察病变形态和强化特征.以病理结果为金标准,采用x2检验比较两类病变间形状、边缘、背景实质强化、内部强化特征、早期强化率的差异;采用两独立样本t检验比较DKI、DWI参数的差异,绘制ROC比较其诊断效能.结果 DCE-TIC呈平台型的乳腺纤维腺瘤及乳腺癌,形状、边缘、内部强化特征以及早期强化率差异均有统计学意义(P＜0.05),背景实质强化差异无统计学意义(P ＞0.05);MK、MD、ADC值的差异均有统计学意义(P＜0.05),联合MK、MD和ADC,ROC下面积为0.991,敏感度、特异度和准确度分别达0.922、1.000和0.922.结论 DKI对DCE-TIC呈平台型乳腺纤维腺瘤及乳腺癌具有良好的鉴别诊断意义,将DKI和DWI联合应用可获得更高的诊断效能.

目的 探讨扩散峰度成像(DKI)对老年乳腺癌的诊断效能并对比DKI和DWI参数鉴别诊断效能的差异.方法 回顾性分析2018年11月～2020年9月就诊于潍坊市人民医院行乳腺MRI检查,后经手术或病理证实的57个良性病灶,42个老年乳腺癌病灶和71个非老年组乳腺癌病灶,观察记录其磁共振影像学表现,测量病灶的扩散加权成像(DWI)参数ADC值以及扩散峰度成像参数平均扩散峰度系数(MK)和平均扩散系数(MD).以病理结果为金标准,分别将老年乳腺癌与良性病灶和非老年组乳腺癌进行对比分析,采用x2检验比较乳腺的纤维腺体组织量以及强化后病灶的形状、边缘、早期强化率以及延迟期强化类型的差异;采用两独立样本t检验比较MD、MK、ADC的差异,绘制ROC比较其诊断效能.结果 老年乳腺癌患者和乳腺良性病变患者的纤维腺体组织量,强化后病灶的形状、边缘、早期强化率以及延迟期强化类型差异均有统计学意义(P＜0.05);MK、MD、ADC值的差异均有统计学意义(P＜0.05).老年乳腺癌和非老年组乳腺癌的纤维腺体组织量差异有统计学意义(P＜0.05),强化后病灶的形状、边缘、早期强化率以及延迟期强化类型差异均无统计学意义(P＞0.05),MD、MK值差异有统计学意义(P＜0.05),而ADC值差状、边缘、早期强化率以及延迟期强化类型差异均无统计学意义(P＞0.05),MD、MK值差异有统计学意义(P＜0.05),而ADC值差异无统计学意义(P＞0.05).结论 DKI对老年乳腺癌具有良好的诊断效能.异无统计学意义(P＞0.05).结论DKI对老年乳腺癌具有良好的诊断效能.

我馆珍藏的每份地图档案背后都有一个曲折的故事,有的记载着历史的发展过程,有的见证着伟大的历史时刻,有的能还原事件的真相……其中,馆藏资料编号为37、68号的两幅1∶10000的单色地形图就是在述说着中国人民的屈辱历史:东史郎日记案——“邮袋事件”.

AbstractObjective:To discuss the changes of the brain metabolites on the bilateral hippocampus of different age groups and parts in normal chinese middle-aged group by using magnetic resonance spectroscopy (MRS), to provide reference for early clinical diagnosis and treatment of hippocampal-related diseases.Materials and Methods: From community healthy volunteers, we selected 276 according to the standards, who were divided into three groups according to age, A group: prime period, 41 to 48 years, B group: steady period, 49 to 55 years, C group: adjustment period, 56 to 65 years, with about 100 subjects for each, underwent conventional cerebral MR scans, bilateral hippocampal MRS scans. The parameters of NAA/Cr, Cho/Cr, NAA/(Cho+Cr) ratio were measured. To analyse the differences of the parameters between different genders, sides, groups and parts, and discuss the correlation between the parameters and age.Results:The ratios of NAA/Cr, Cho/Cr, NAA/(Cho+Cr) had no signiifcant difference between genders and left-right sides (P>0.05). The ratios of metabolites had statistically significant difference among age groups (P<0.05), the ratio of NAA/Cr, NAA/(Cho+Cr) was higher in group A, B than that in group C (P<0.05), the ratio of Cho/Cr was lower in group A than that in group C (P<0.05). The ratio of NAA/Cr, Cho/Cr had statistically significant difference between different parts (P<0.05). But, the ratio of NAA/(Cho+Cr) had no signiifcant difference (P>0.05). The ratios of NAA/Cr, NAA/(Cho+Cr) were negatively correlated with age (r value:-0.486,-0.653, P<0.05), the ratio of Cho/Cr was positively correlated with age (r value: 0.482,P<0.05).Conclusions:MRS could relfect varieties of hippocampal metabolites in normal chinese middle-aged people noninvasively, their combination could ifnd potential changes in micro metabolism and micro structure of normal brain and provide references for early clinical diagnosis of various diseases associated with hippocampus.

目的 探讨膝关节内侧半月板半脱位对诊断后根部撕裂的价值.方法 回顾性分析经关节镜证实的120例内侧半月板撕裂患者的MRI图像,将其中60例后根部撕裂患者作为后根部撕裂组,其他撕裂的60例作为对照组,于MRI图像上测量半月板突出长度,将半月板突出长度≥3 mm定义为半月板半脱位,比较两组半月板半脱位的发生率.结果 后根部撕裂组中,合并半月板半脱位者56例(56/60,93.33％),对照组中合并半月板半脱位者13例(13/60,21.67％),差异有统计学意义(x2=60.15,P＜0.01).内侧半月板半脱位提示后根部撕裂的敏感度、特异度及阳性似然比分别为81.16％(56/69)、92.16％(47/51)及10.35.结论 膝关节内侧半月板半脱位可用以提示后根部撕裂.

Objectives: To study and measure the prechiasmatic interspaces on the images in human beings, in order to provide imaging evidence for sellar region neurosurgery operation and basic research for neuroantomy.Materials and Methods:Totally 165 volunteers (87 males and 78 females, age 18 to 80 years, mean 44.6 years), who were divided into three groups by age, young(18—40 years), 60, middle-age (41—60 years), 60 and elderly age group (61—80 years), 45 underwent optic chiasm MR scan with T1 weighted MP-RAGE and T2 weighted TSE sequence. The reconstructed images of axial section parallel with optic nerve were obtained with MPR analysis software on midsagittal images. The length of the intracranial optic nerves and anterior horn of optic chiasma were measured, the area of prechiasmatic interspace was calculated as well. The difference between genders, ages and the left and right intracranial optic nerves were compared.Results:In our studies, mean values of the length of intracranial optic nerves were (18.3±3.3) mm, (18.2±3.1) mm for left and (17.3±3.3) mm for right, (17.6±3.1) mm, (18.3±3.0) mm, (17.3±3.2) mm in young, middle-age and elderly age group. the prechiasmatic interspace was triangular shape for163, trapezoid shape for 2 and its area was (44.7±7.7) mm2,(47.1±6.5) mm2, (45.6±6.9) mm2, (43.7±7.0) mm2 in young, middle-age and elderly age group. the anterior horn of optic chiasm was (72.7±7.4) degree, (69.5±7.9)°, (72.5±7.8)°, (72.3±8.0)° in young, middle-age and elderly age group. All the results did not show signiifcant differences between male and female (P>0.05). The length of both intracranial optic nerves had statistical signiifcance difference between age groups (P<0.05). There were no statistically signiifcant difference of the anterior horn of optic chiasm and the area of prechiasmatic interspace between age groups (P>0.05). There were no statistically signiifcant difference of intracranial optic nerves length between left and right (P>0.05).Conclusions:The characteristics of the prechiasmatic interspaces and its adjacent anatomical structures can be well shown on MR images and measure and establish reference values of parameters for clinical diagnosis and neurosurgery.

目的 通过MRI研究活体视交叉及其前间隙的立体形态,并测量相关参数.方法 对160名健康志愿者行视交叉区T1W MP-RAGE、T2W TSE序列扫描;采用MPR技术测量视神经颅内段、视交叉各径线长度、各角度、视神经与垂体柄夹角.比较男女、视神经颅内段左右侧之间及各年龄段间的差异.结果 视神经颅内段长度左侧为(18.23±3.12)mm,右侧为(17.27±3.31)mm(t=0.27,P＞0.05);视交叉前间隙大致呈三角形,面积为(44.04±7.73)mm2;视交叉轴位前后径为(8.81±1.14)mm,横径为(13.78±1.22)mm,厚度为(3.73±0.41)mm,前、后角度数分别为(70.72±7.38)°、(76.74±8.49)°,左、右侧角度数分别为(123.03±9.42)°、(124.18±10.31)°;视交叉与垂体柄的夹角为(46.54±10.29)°.男女间测量结果差异无统计学意义(P均＞0.05).各年龄段左右视神经颅内段、视交叉前后径、横径及厚度差异有统计学意义(P均＜0.05);视交叉各角、视交叉与垂体柄夹角、视交叉前间隙面积间差异无统计学意义(P均＞0.05).结论 MR成像及其后处理技术可清晰显示视交叉及其前间隙的立体形态,建立正常人群相关参数的标准参考值,可为临床诊断及手术提供基本影像学依据.

Objective To explore clinical observation of psychological intervention for Alzheimer disease de-mentia early mild depression.Methods Sixty patients with Alzheimer disease dementia early mild depression in our hospital from 2011 January to 2012 January in department and internal medicine diagnosis and treatment were divided in-to treatment group and control group with 30 cases in each group.Treatment group adopted conventional therapy and psy-chological intervention, Control group adopted conventional therapy only ( general support therapy and drug treatment) .After treatment about six month, clinical effects were observed and compared.Results The clinical effects of treatment group was better than that of control group, there was significant difference between two groups (0.01

血管性痴呆(VD)是脑血管病后产生的进行性智能障碍综合征,中国传统医药在治疗血管性痴呆中具有独到的优势.现就近年来对VD的中医药治疗的中医病因病机、临床治疗,以及实验研究新进展简介如下.

目的:研究通络益脑丸治疗血管性痴呆的临床疗效。方法:将92例肾虚血瘀型血管性痴呆患者随机分为治疗组和对照组各46例,治疗组予通络益脑丸口服,对照组予尼莫地平片及银杏叶片口服。两组均连续治疗3个月后观察临床疗效。结果:治疗组总有效率为82.6%,对照组总有效率为60.9%,治疗组疗效优于对照组,差异有统计学意义(P<0.05)。结论:通络益脑丸治疗血管性痴呆有较好临床疗效。

<正>血管性痴呆指脑血管病变引起的脑损害所致的痴呆。血管性痴呆不仅严重影响者患者的生活质量,而且给社会及家庭带来严重的经济及精神负担。为了探索防治脑血管性痴呆的有效方法,2010-01—2012-01,我们采用常规治疗的基础上加用患者记忆深处比较喜欢的轻松音乐欣赏进行辅助治疗缺血性血管性痴呆32例,并与常规治疗32例对照观察,结果如下。

<正>脑血管病是老年人的常见病、多发病,随着生活水平的提高,原发性高血压、糖尿病、高脂血症逐年增多,且逐渐年轻化,脑梗死的发病率也越来越高,较重者逐渐发展成血管性痴呆。中医中药是我国的一大资源宝库,且中医善治未病,运用中药防病治病有广阔前景。2011-05—

目的 观察全面干预治疗轻度老年抑郁症的疗效.方法 选取80位轻度老年抑郁症患者,随机分为对照组和治疗组,每组40人,对照组单纯采用选择性5-HT再摄取抑制剂等药物治疗；治疗组采用全面干预治疗,并根据病因将全面干预的内容作出相应的调整.治疗2个月观察两组的治疗效果.结果 治疗组治疗效果明显优于对照组,两组差异具有显著统计学意义(P＜0.05).结论 全面干预对治疗轻度老年抑郁症患者具有明显的疗效.

Purpose:The objective was to investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusion weighted imaging(DWI)in diagnosing BI-RADS category 4-5 breast mass-like lesions.Methods: Seventy patients with BI-RADS category 4-5 breast lesions were studied by DCE-MRI before histopathologic verification.The time-signal intensity curves(TIC) were obtained.The imaging features were statictically analyzed with chi square test or Fisher's exact test.The apparent diffusion coefficient(ADC) values were recorded and analyzed by t test and ROC analysis.Results: Pathologic diagnoses revealed 42 malignant lesions and 27 benign ones.Significant difference was found between malignant and benign lesions on the basis of spiculated margin,rim enhancement,and TIC of rush-out type for the BI-RADS 4-5 lesions(P 0.05).Significant difference wasn't found between malignant and benign lesions on the basis of the lesion shapes and the early enhancement rates for the BI-RADS 4-5 lesions(P 0.05).Significant difference was found between malignant and benign lesions on the basis of ADC values(t=4.903,P=0.000).The sensitivity(82.4%) and specificity(80.6%) were obtained with b value of 900 s/mm2 and threshold of 1.12×10-3 mm2/s.Fibroadenoma and intraductal papilloma were the usual lesions to produce false-positive results.Conclusion: Conjunction of DCE-MRI and DWI is helpful to improve the differential diagnosis between benign and malignant lesions,and it is useful to guide the clinical therapy.

Objective To explore Clinical observation of comprehensive intervention postnatal depression.Methods Sixty patients with postnatal depression were divided into treatment group and control group with 30 cases in each group.Treatment group adopted comprehensive intervention,control groups adopted medicine only.After treatment about one month,clinical effects were observed and compared.Results the clinical effects of treatment group was better than that of control group.There was significant difference between two groups ( P ＜ 0.05 ).Conclusions Comprehensive intervention has clinical effects on postnatal depression.

目的 研究磁共振T2WI饱和脂肪抑制和弥散加权成像(DWI)在视神经炎诊断中的作用.方法 回顾性分析经临床诊断为视神经炎患者17例,所有患者均行常规眼眶MRI轴位、矢状位成像及眶部冠状位T2WI脂肪抑制序列和横轴位DWI检查.结果 17例患者在眼眶常规MRI检查中视神经未发现病变,而在冠状位T2WI脂肪抑制序列中发现视神经信号增高,轴位DWI序列示视神经信号弥散受限.结论 冠状位T2WI脂肪抑制序列和轴位DWI是视神经炎无创易行、准确可靠的检查方法.

Objective To explore the sensibility of radiation-induced normal brain injury in different regions at acute stage after all cranial radiotherapy by MR diffusion tensor imaging (DTI).Methods A total of 44 patients with brain tumors undergoing whole cranial radiotherapy were examined with convention and enhancement magnetic resonance imaging and diffusion tensor imaging before and three weeks after radiotherapy.The apparent diffusion coefficient ( ADC ),fractional anisotropy ( FA),relative anisotropy (RA) and volume ratio(VR) of DTI in contralateral brain hemisphere after radiotherapy with the dose of 27 Gy were measured and analyzed in different regions.Results No abnormal signal intensities were revealed in convention and enhancement MRI.ADC values in superficial cerebral convolution gray matter,ADC and VR values in deep gray nucleus were increased(t =- 3.321,- 2.810,P ＜ 0.05 ),while FA and RA values in deep gray nucleus were descended( t =2.906,2.349,P ＜0.05 ).There was no statistically significant difference among DTI index in other regions.Conclusions The brain gray matter more sensitive to radiation-induced brain injury in than white matter at acute stage of radiation.DTI could be used to evaluate the functional changes at the histocytology level of radiation-induced brain injury,and to explain the early clinical reactions after radiotherapy.

目的 分析脑膜瘤各亚型的氢质子磁共振波谱(1H-MRS)表现以及其临床意义.方法 病理证实的脑膜瘤72例,按照WHO标准分为4类,其中良性脑膜瘤55例,包括纤维型30例,脑膜内皮型12例,沙粒体型13例;间变型脑膜瘤(恶性脑膜瘤)17例.采用多体素扫描,点分辨选择波谱法,检测瘤区代谢物变化.检测N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸与磷酸肌酸之和(Cr+PCr,简称Cr)的相对浓度,并计算NAA/Cr、Cho/Cr、NAA/Cho比值,以病理结果进行分组对照研究.结果 良性与恶性脑膜瘤相比,Cho浓度、Cho/Cr较低,而Cr浓度较恶性脑膜瘤为高.良性脑膜瘤3个亚型间NAA及Cho均无显著性差异;脑膜内皮型与纤维型及沙粒体型的NAA/Cr、Cr浓度有显著性差异;纤维型与沙粒体型的NAA/Cho、Cho/Cr间有显著性差异;脑膜内皮型与沙粒体型的NAA/Cho、脑膜内皮型与纤维型的Cho/Cr间有显著性差异.结论 1H-MRS在脑膜瘤各亚型中代谢产物有其特异性,对各病理亚型有鉴别作用,与常规MRI相结合能提高脑膜瘤的诊断水平.

目的 探讨双源CT各向同性技术在内听道解剖研究中的价值.方法 应用双源CT对402例正常志愿者行颞骨薄层扫描,多平面重建,观察内听道的形态,并对各相关径线进行测量.结果 经两位从事影像阅片工作多年医师评估,所有图像内听道结构显示清晰,内听道形态中平行管状699耳,喇叭口状53耳,壶腹状50耳,不规则型2耳.内听道长度为(9.81±1.83)mm,内听道底管径(最大径×最小经)为(5.08±0.74)mm×(3.25±0.61)mm,中段管径(最大径×最小经)为(5.04±0.96)mm×(4.23±0.79)mm,内耳门区前后径(5.05±1.05)mm,内耳门区上下径(5.66±1.20)mm.结论 DSCT在各向同性方面的优势,能够从不同角度多方位观察内听道的空间立体形态,在此基础上对其相关径线进行精确测量,真正实现了活体观测.

目的 研究磁共振梯度回波反相位T1W1在显示椎间盘向上脱出中的诊断价值.方法 回顾性分析经临床手术和病理证实为椎间盘向上脱出患者19例,所有患者均行常规TSE序列T1W1和T2W1、矢状位和冠状位水成像序列及梯度回波反相位T1W1检查.其中有10例患者平扫后做增强扫描.结果 19例患者均能在梯度回波反相位T1W1上根据独特的信号特点清楚的看到脱出的椎间盘组织与供体椎间盘的关系,所有诊断与临床手术及病理相吻合.结论 MR梯度回波反相位T1W1可清楚地显示向上脱出的椎间盘组织与供体椎间盘的关系,此序列对椎间盘脱出的诊断优于常规序列,诊断准确率高,降低检查费用,其无与伦比的优越性,为临床患者所接受.