目的 探讨心脏磁共振特征追踪(cardiac magnetic resonance feature tracking,CMR-FT)技术在急性心肌梗死(acute myocardial infarction,AMI)介入术后院内主要心血管不良事件(major adverse cardiovascular events,MACE)中的预后价值.材料与方法 招募自2019年01月至2022年11月收治的300例AMI患者为研究对象,根据是否发生MACE分为两组,即MACE组(n=79)和对照组(n=221).两组患者均在发病12 h内行经皮冠状动脉介入术(percutaneous coronary intervention,PCI),术后48～72 h行CMR检查,同时监测住院2周内MACE.比较两组基线资料和心肌应力参数,通过Cox回归分析心肌应变力参数中AMI介入术后院内MACE的独立预测因子,并绘制受试者工作特征曲线评估心肌应变力参数的诊断效能.结果 通过多因素Cox回归分析发现,心脏MRI应变力参数中左室整体纵向应变(global longitudinal strain,GLS)、左室整体周向应变(global circumferential strain,GCS)是AMI介入术后院内MACE的独立预测因子,风险比(hazard ratio,HR)分别为 1.24[95％置信区间(confidence interval,CI):1.09～1.37]、1.17(95％CI:1.08～1.22),P均＜0.001;其中GLS诊断效能最佳,曲线下面积(area under the curve,AUC)为0.882(95％CI:0.706～0.991),GLS 临界值选取-11.9％,当GLS＜-11.9％时(小于其绝对值),MACE发生率明显增加,敏感度为89％,特异度为82％,约登指数为0.80;GCS诊断效能次之,AUC为0.735(95％C7:0.631～0.958),GCS临界值选取-17.8％,当GCS＜-17.8％时(小于其绝对值),MACE发生率明显增加,敏感度为78％,特异度为65％,约登指数为0.75.Kaplan-Meier曲线分析发现,GLS＜-11.9％患者总生存率低于GLS≥-11.9％患者(P＜0.05),GCS＜-17.8％患者总生存率低于GCS≥-17.8％患者(P＜0.05).结论 CMR-FT技术对AMI患者PCI术后院内MACE具有较高的预后价值,可辅助临床早期预测和防治心肌梗死后院内MACE的发生,改善心肌梗死患者近期预后.

Objective To explore the characteristics of brain functional magnetic resonance imaging (MRI) in patients with acute ischemic stroke complicated with depressive disorder.Methods Twenty patients with acute ischemic stroke associated with depressive disorder who were treated in our hospital from August 2014 to August 2016 were enrolled in this study.A routine medical examination was conducted in our hospital during the same period.Of the 20 healthy subjects as the control group,the patients and the control group of patients with conventional MRI and rsfMRI scan,collected images,including sagittal T1WI,axial T1WI and rsfMRI images,etc.,the case group and the control group of local Consistency for comparative analysis.Results Compared with normal control group,the cases of double amount last time inside,left temporal gyrus,left hat with lobular and right cerebellum ReHo showed significantly decreased (P＜0.05),statistically significant;In the case group,the rehos were significantly higher than the normal control group (P＜0.05),which was statistically significant.Conclusion Functional magnetic resonance imaging (mri) technique of the brain is able to detect the abnormal and clinical value of multiple brain regions in patients with acute ischemic stroke.

Objective To investigate the alteration and possible compensation mechanism of the default mode network (DMN) in patients with subacute pontine infarction.Methods Rs-fMRI data were collected from 23 patients with subacute pontine infarction and 23 normal controls.The data was analyzed with the functional connectivity (FC) method and compared between subacute pontine infarction patients and controls.All imaging was performed on a Philips Achieva 3.0T MRI scanner.Posterior cingulated cortox (PCC) was used as seed points to analyze the FC changes in the brain regions between the pontine infarction group and the controls.The discrepancies of experiment data between two groups were compared by using two-sample t-test analysis.Results The FC of the DMN showed a significant increase in the right postcentral gyrus, left medial prefrontal cortex and left precuneus compared with normal controls and a significant decrease in bilateral insula,posterior lobe of the left cerebellum,right parahippocampal gyrus and left inferior occipital gyrus.Conclusion The DMN altered in patients with subacute pontine infarction and the changes of the FC suggested the plasticity of cortical or compensation in the relevant brain areas.

Objective To observe the changes in fiber number and structure of corpus callosum in patients with alco-hol dependence through fiber tractography of magnetic resonance diffusion tensor imaging.Methods T1 -weighted magnetic resonance imaging and diffusion tensor imaging were obtained from 48 alcohol-dependent patients (observation group)and 50 cases of age,sex,education year-matched normal controls (control group).The fiber number,fiber fractional anisotro-py (FA),and fiber apparent diffusion coefficient (ADC)of the corpus callosum between the two groups were calculated. Results The fiber number of total corpus callosum in the observation group was 2587 ±654,which was 2875 ±758 in the control group,and significant difference was found between these two groups (P <0.05).The fiber number in anterior one third of corpus callosum in the observation group was 782 ±254,which was 987 ±244 in the control group,there was sig-nificant difference between the two groups (P <0.01).The FA values of total corpus callosum in the observation group were 0.61 ±0.02,which were significantly decreased as compared with than that (0.62 ±0.02)of the control group (P <0.05).FA values of anterior one third of corpus callosum in the observation group (0.59 ±0.03)were decreased as com-pared with that (0.61 ±0.03)of the control group (P <0.01).Compared with the control group [(0.91 ±0.07)×10 -3 mm2 /s],the ADC values of total corpus callosum in the observation group [(0.94 ±0.07) ×10 -3 mm2 /s]were signifi-cantly increased (P <0.05).The ADC values of anterior one third of corpus callosum in the observation group [(0.94 ± 0.06) ×10 -3 mm2 /s]were increased as compared with that [(0.87 ±0.08) ×10 -3 mm2 /s]of the control group (P <0.01).Conclusion Fiber number and structure of the corpus callosum is abnormal in alcohol-dependent patients and this&nbsp;anomaly in the anterior one third of corpus callosum is more obvious.

Objective:To observe the changes and to explore its possible neural mechanisms in brain networks after brainstem infarction by using resting-state functional MRI ( fMRI ) techniques.Methods: Nineteen patients diagnosed with isolated pontine infarction ( IPI ) by clinic were selected as brainstem infarction group, while nineteen healthy volunteers matched the age and gender were selected as the normal control group.Resting-state fMRI data was obtained using Philips Achieva 3.0 Tesla MRI scanner.DPARSFA software was used for data processing, Cerebra functional connectivity was observed by using amplitude of low-frequency fluctuation( ALFF) and the differences between the two groups were compared by using two-sample t-test analysis.Results:Compared with normal control group, significant decreased areas by using ALFF in brainstem infarction group include cingulate gyrus, inferior parietal lobule on both sides, the front side precuneus, and cerebellum, right hippocampus;significantly increased areas include the amount of both sides of the back/medial frontal gyrus( dorsal prefrontal lobe ) , left thalamus and caudate nucleus.Conclusion: Abnormal activities of brain network after brainstem infarction are observed.Increased activities in dorsal frontal anterior lobe and thalamus maybe prompt reconstruction or compensatory function of the network after brainstem infarction.

Objective To detect the fiber structure and volume differences in frontal lobe between patients with amnestic mild cognitive impairment (aMCI) and normal control.Methods T1 -weighted magnetic resonance imaging and diffusion tensor imaging were obtained in 28 aMCI patients and 25 normal controls.Volumes,fiber fractional anisotropy (FA),fiber apparent diffusion coefficient (ADC),fiber number,and average fiber length of frontal lobe in the two groups were measured.Results Volumes of left frontal lobe ( ( 337.35 ± 20.45 ) cm3 ) in aMCI group were smaller than control ( (358.54 ± 27.26) cm3 ) ( t =- 3.223,P =0.002 ).Numbers of short range fiber in left frontal lobe ( 16985 ± 892) were significantly increased relative to control ( 16387 ±752) ; while numbers of long range fiber (3214 ± 185 ) were reduced compared with control (3425 ± 277 ),and ADC values increased ( t =2.621,P =0.012; t =-3.714,P =0.001 ; t =17.595,P=0.000).In aM CI group,numbers of long range fiber in right frontal lobe were reduced (2895 ± 343 vs.3451 -± 230,t =- 7.011,P =0.000),and ADC values were increased ( t =4.443,P =0.000).In aMCI group,numbers of long range fiber in left frontal lobe were positively correlated with scores of mini-mental state examination ( MMSE ) ( r =0.457,P =0.015 ),while ADC values of long range fiber in left frontal lobe were negatively correlated with scores of MMSE ( r=-0.415,P=0.028).Conclusion The structure and fiber connectivity are affected in aMCI patients and the lesion of connectivity in left frontal lobe are related to the severity of symptom.

Objective To compare the MSCTA imges of ruptured anterior communicating artery aneurysm with neurosurgery findings.Method The CTA images of 30 patients presented with acute subarachnoid hemorrhage(SAH)which were caused by ruptured cerebral aneurysm were analyzed.All the patients underwent neurosugery of aneurysm clip.Three kinds of restructive methods were used to reformate the cerebral arteriograms.The cerebral arteriograms were observed from multi-directions to show the shape,size and the neck of the anterior communicating artery aneurysm,as well as the relationship with the carrier artery and,the surrounding vessels and the bone structure.To guide the operation,a simulating surgical approach was also done with the computer workstation.Results 31 aneurysms were surgically confirmed,and 30 of them were found by CTA.The sensitive and specificity rate of CTA were 96.7 and 100%respectively.In addition,9 case with intra-aneurysmal thrombosi(s9/9)and 6 case(6/8)with perforating arteries were detected with CTA.The pre-operative CTA signs showed clearly the spatial relationship of the aneurysm with its carrier arteries and the neighboring bony structures.These signs were highly consistent with the relative surgical findings.Conclusions CTA played an important guiding role in making the surgical treatment schedule for acute case of ruptured anterior communicating artery aneurysms.

目的探讨MR弥散加权成像(DWI)在肝脏局灶性病变中的临床应用价值。方法对37例肝脏局灶性病变的弥散加权成像表现进行回顾性分析,其中肝癌13例,肝转移瘤11例,肝血管瘤8例,肝囊肿5例。进行常规平扫、动态增强扫描,加做DWI序列,采用单次激发回波平面成像(EPI)技术,弥散敏感度b值取100s/mm2、300s/mm2、500s/mm2、800s/mm2、1000s/mm2,屏气扫描,计算指数表现弥散系数(eADC)、表现弥散系数(ADC)值,绘制表现弥散系数/弥散敏感度(ADC/b)值变化曲线。进行比较、判断。结论肝脏占位性病变在DWI中具有不同的特征,结合eADC、ADC值的量化特征,对肝脏占位性病变的鉴别有一定的参考价值。