Objective:To analyze the value of magnetic resonance T 2 mapping in the diagnosis of early cervical disc degeneration in adolescents. Methods Patients who underwent cervical MRI examination and magnetic resonance T 2 mapping in Wenzhou Hospital of Traditional Chinese Medicine between November 2019 and September 2020 were included in this study. They were divided into observation and control groups ( n = 50 per group) according to the time of lowering their heads (≥ 2 hours) every day. The T 2 values corresponding to the nucleus pulposus of cervical intervertebral disc in each segment was compared between the two groups. Cervical disk degeneration was graded using the Pfirrmann classification. T 2 value was compared between different Pfirrmann disc grades. The efficacy of T 2 value in the diagnosis of early cervical disc degeneration in adolescents was evaluated using the receiver operating characteristic curve. The specificity and sensitivity of T 2 value in the diagnosis of early cervical disc degeneration in adolescents and the area under the receiver operating characteristic curve were calculated. Results:T 2 value measured in each cervical intervertebral disc segment in the observation group was significantly greater than that in the control group ( t = 5.06, 4.47, 3.57, 2.93, 4.98 for C2-3, C3-4, C4-5, C5-6, C6-7 segments, all P < 0.05). In the observation group, the number of patients with Pfirrmann grade II cervical intervertebral disc degeneration was highest, accounting for 42% (21/50). There was a significant difference in cervical intervertebral disc segment T 2 value between different Pfirrmann disc grades ( t = 2.62, P = 0.018, vs. Pfirrmann disc grade I ; t = 2.12, P = 0.045, vs. Pfirrmann disc grade II; t = 2.24, P = 0.049, vs. Pfirrmann disc grade III). The higher Pfirrmann grade, the lower T 2 value of cervical intervertebral disc nucleus pulposus. The receiver operating characteristic curve showed that the sensitivity and specificity of T 2 value in the diagnosis of early cervical disc degeneration and the area under the receiver operating characteristic curve were 81.2%, 79.8% and 0.756, respectively. Conclusion:T 2 mapping imaging technology can predict early cervical intervertebral disc degeneration in adolescents by quantitatively analyzing the T 2 value of cervical intervertebral disc nucleus pulposus and has a high value in the diagnosis of cervical intervertebral disc degeneration. This achievement is of innovation and science.

目的:探讨磁共振T2-mapping成像技术诊断青少年颈椎间盘早期退变的价值.方法:2019年11月至2020年9月招募100位青少年志愿者,采用GE Signa1.5 T超导磁共振系统进行颈椎常规磁共振和磁共振T2-mapping检查.按照Pfirrmann分级标准对所有志愿者的C4～5椎间盘退变程度进行分级,并测定C4～5椎间盘髓核的T2值.结果:共纳入100位志愿者,男48位、女52位;年龄13～18岁,中位数15岁.100个C4～5椎间盘中,PfirrmannⅠ级25个、Ⅱ级52个、Ⅲ级18个、Ⅳ级5个,4个级别C4～5椎间盘髓核的T2值总体比较,差异有统计学意义(79.82±20.56,72.26±18.35,56.62±15.78,46.26±12.58,F=6.172,P=0.000);PfirrmannⅠ级椎间盘髓核的T2值高于Ⅱ级(P=0.015),PfirrmannⅡ级椎间盘髓核的T2值高于Ⅲ级(P=0.028),PfirrmannⅢ级椎间盘髓核的T2值高于Ⅳ级(P=0.038).按照PfirrmannⅡ级以上为椎间盘退变标准进行受试者操作特征曲线(receiver operating characteristic curve,ROC)分析,结果显示磁共振T2-mapping成像技术诊断青少年颈椎间盘退变的ROC曲线下面积为0.798(P=0.013),最佳诊断分界点为T2值为76.53.结论:应用磁共振T2-mapping成像技术诊断青少年颈椎间盘早期退变具有一定的价值.

目的 研究CT纹理分析联合CT值在输尿管结石狄激光碎石术疗效评估中的应用价值,为临床诊疗提供指导.方法 选取本院2018年1月至2020年1月经狄激光碎石术治疗的输尿管结石106例患者进行研究,在术前测量其CT值,根据CT值将患者分为观察组(CT值>1000 HU)和对照组(CT值≤1000 HU),各53例.通过Mazda软件于结石最大横截面处选取兴趣区,提取CT纹理参数灰度值,观察组的CT纹理参数平均灰度值为(1723.39±177.43),对照组的CT纹理参数平均灰度值为(1872.59±192.56).观察并比较两组的碎石成功率,手术时间、术后3个月清石率、术后并发症发生率等情况,评估输尿管结石狄激光碎石术的疗效.结果 观察组碎石成功率、术后3个月清石率明显高于对照组,观察组的手术时间以及术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05).结论 CT纹理分析联合CT值在输尿管结石狄激光碎石术疗效评估中具有一定价值.

目的 对比肺隔离症诊断中CT与高分辨率MRI序列的临床应用价值.方法 选定本院及温州医科大学附属第一医院2018年8月至2020年8月住院治疗的180例疑似肺隔离症患儿,将手术病理诊断作为金标准,对比CT、高分辨率MRI序列诊断效能,比较CT、高分辨率MRI序列病变位置检出率.结果 高分辨率MRI序列诊断准确率(97.22％)、灵敏度(97.74％)、特异度(66.67％)、阴性预测值(33.33％)均高于CT (88.89％、89.83％、33.33％,5.26％),p＜0.05;高分辨率MRI序列阳性预测值(99.43％)与CT (98.76％)比较,p＞0.05.高分辨率MRI序列右肺下叶基底段(40.00％)、左肺下叶基底段(56.67％)、左肺上叶舌段检出率(1.67％)与CT (37.78％、50.56％、0.56％)比较,p＞0.05;高分辨率MRI序列总检出率(98.33％)高于CT (88.89％),p＜0.05.结论 高分辨率MRI序列可提高肺隔离症诊断准确率、灵敏度、特异度,明确病变位置.

目的 探讨磁共振T2-mapping检查在青少年颈椎间盘退行性变中应用价值.方法 收集因颈部疼痛行磁共振检查的50例青少年患者,分为对照组与观察组,对照组采用常规颈椎磁共振检查,观察组采用T2-mapping进行扫描.比较两组颈椎间盘各兴趣区的T2值及不同解剖节段颈椎间盘髓核的T2值.结果 观察组前纤维环区、髓核区及全间盘区T2值均高于对照组(均P＜0.05),而两组后纤维环区T2值差异无统计学意义(P＞0.05).观察组不同解剖节段颈椎间盘髓核T2值均高于对照组(均P＜0.05).结论 磁共振T2-mapping检查可对颈椎间盘退变程度进行定量检测,对颈椎疼痛情况进行有效评估.

目的 探讨MRI对慢性失眠患者大脑皮层灰质体积的变化.方法 基于MRI体素形态学测量用于分析39例慢性失眠患者相对39例状态匹配的健康睡眠者大脑灰质体积变化.结果 相对健康睡眠组,慢性失眠组MRI灰质体积增加和减低的区域均位于右侧大脑半球.其中,灰质体积增加的区域主要包括右侧梭状回(BA 37),右侧小脑前叶突入右侧视觉联合皮层(BA18),右侧屏状核突入右侧岛叶(BA13),右侧初级听觉区(颞上回,BA22,BA42)和右侧辅助运动区(BA 6),灰质体积减低的区域位于右侧视觉联合皮层(BA18).结论 慢性失眠引起听觉系统、视觉系统、情绪系统相关脑区的过度觉醒,这种变化可能是失眠发生的结构基础.

Objectives. To investigate the classification performance of support vector machine in mild traumatic brain injury (mTBI) from normal controls. Methods. Twenty-four mTBI patients (15 males and 9 females; mean age, 38.88±13.33 years) and 24 age and sex-matched normal controls (13 males and 11 females; mean age, 40.46±11.4 years) underwent resting-state functional MRI examination. Seven imaging parameters, including amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), degree centrality (DC), voxel-mirrored homotopic connectivity (VMHC), long-range functional connectivity density (FCD), and short-range FCD, were entered into the classification model to distinguish the mTBI from normal controls. Results. The ability for any single imaging parameters to distinguish the two groups is lower than multiparameter combinations. The combination of ALFF, fALFF, DC, VMHC, and short-range FCD showed the best classification performance for distinguishing the two groups with optimal AUC value of 0.778, accuracy rate of 81.11%, sensitivity of 88%, and specificity of 75%. The brain regions with the highest contributions to this classification mainly include bilateral cerebellum, left orbitofrontal cortex, left cuneus, left temporal pole, right inferior occipital cortex, bilateral parietal lobe, and left supplementary motor area. Conclusions. Multiparameter combinations could improve the classification performance of mTBI from normal controls by using the brain regions associated with emotion and cognition.

Objective:To investigate the computed tomography (CT) features of gastric neuroendocrine neoplasm (GNEN).Methods:The retrospective and descriptive method was conducted. The clinicopathological data of 30 GNEN patients who were admitted to two domestic medical centers (13 cases in Wenzhou Hospital of Traditional Chinese Medicine and 17 cases in Wenzhou People′s Hospital) from January 2010 to December 2018 were collected. There were 23 males and 7 females, aged (62±4)years, with a range from 27 to 78 years. The patients underwent abdominal CT plain scan and dynamic enhancement scan. Two associate chief radiologists with more than 20 years of work experience observed and analyzed all the images respectively. Observation indicators: (1) CT examination; (2) treatment and postoperative pathological examination; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect the survival of patients up to December 2018. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Results:(1) CT examination: of the 30 patients, 14 had the tumor located in the fundus of stomach, 10 had the the tumor located in the body of stomach, and 6 had the tumor located in the antrum. The tumor was elliptical in 18 cases and irregular in 12 cases. There were 15 cases of endogenous type, 13 cases of exogenous type, and 2 cases of intramural type. Patients with G1 neuroendocrine tumor had the maximum diameter of (6.8±1.6)cm, of which 4 cases had the maximum diameter less than 5.0 cm and 4 cases had the maximum diameter of 5.0 to 10.0 cm. Patients with G2 neuroendocrine tumor had the maximum diameter of (8.3±2.7)cm, of which 1 case had the maximum diameter less than 5.0 cm, 4 cases had the maximum diameter of 5.0 to 10.0 cm, and 2 cases had the maximum diameter greater than 10.0 cm. Patients with G3 neuroendocrine carcinoma had the maximum diameter of (17.8±2.2)cm, of which 6 cases had the maximum diameter of 5.0 to 10.0 cm and 9 cases had the maximum diameter more than 10.0 cm. The tumor showed swelling growth in 14 cases and invasive growth in 16 cases. The tumor boundary was clear in 14 cases and unclear in 16 cases. CT plain scan showed homogeneous tumor density in 10 cases and heterogeneous density in 20 cases. Nine patients had iso-density in the tumor parenchymal part, and the CT value was (34.0±3.5)HU. In the 18 cases of low density, the CT value was (16.6±1.4)HU. In the 3 cases of high density, the CT value was (45.3±3.6)HU. Of the 30 patients, 21 cases had small punctate or small round necrotic cyst lesions in the tumor, 10 cases had mesenteric lymph node, peritoneum, liver metastasis and adjacent omentum invasion; 17 cases had abdominal effusion. In the CT enhancement examination, 12 cases showed mild enhancement, and the CT value was (56.5±6.3)HU; 15 cases showed moderate enhancement, and the CT value was (66.0±5.4)HU; 3 cases showed significant enhancement, and the CT value was (76.6±5.8)HU. Seven cases showed homogeneous enhancement and 23 cases had heterogeneous enhancement. There were 8 cases with tortuous vessels. (2) Treatment and postoperative pathological examination: of the 30 patients, 10 cases with mesenteric lymph nodes, peritoneum, liver metastasis and adjacent omentum invasion underwent radical total gastrectomy; 14 cases without surrounding tissue invasion or metastasis underwent radical subtotal gastrectomy; 6 cases with tumor diameter less than 4.0 cm and without surrounding tissue invasion or metastasis underwent endoscopic resection. All the 30 patients were confirmed GNEN by postoperative pathological examination, including 8 cases of G1 neuroendocrine tumor, 7 cases of G2 neuroendocrine tumor, and 15 cases of G3 neuroendocrine carcinoma. Results of immunohistochemical staining showed that 30 patients were positive for synaptophysin, 23 were positive for chromogranin A, and 9 were positive for cytokeratin. (3) Follow-up: all the 30 patients were followed up for 10-80 months, with a median follow-up time of 39 months. The 5-year survival rate of 30 patients was 43.3% (13/30). The 5-year survival rates were 6/8, 3/7 and 4/15 of patients with G1 neuroendocrine tumor, G2 neuroendocrine carcinoma, and G3 neuroendocrine carcinoma.Conclusions:GNEN has the main manifestation as abdominal pain, with G3 as pathological classification, which is common in fundus and body of stomach. The CT findings of GNEN are characterized by swelling or infiltrating growth and round or irregular low-density masses. Tumors are prone to cystic transformation, and showed the mildly to moderately heterogeneous enhancement.

Objective:To investigate the clinical value of three-dimensional arterial spin marker imaging(3D-ASL) for evaluating collateral circulation compensatory status in patients with cerebral infarction.Methods:A total of 24 patients with cerebral infarction who were treated at Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Chinese Medicine from September 2017 to January 2019 were examined by 1.5-T high-field MR scanner.The changes of cerebral blood flow(CBF) between the infarcted area and the contralateral normal area were compared when the labeled delay time(PLD)=1.5s and PLD=2.5s, and the patients were divided into the group with strong collateral circulation compensation and the group with weak collateral circulation compensation according to the difference in lesion area measured by 3D-ASL(PLD=1.5s and 2.5s). The changes of national institutes of health stroke scale(NIHSS) score and Bathel index at admission and 15 days after admission were compared.Results:3D-ASL measurement of PLD=1.5s showed that the CBF value in the infarcted area was (33.70±20.83)mL/(100g×min), which was significantly lower than that in the contralateral normal area(PLD=1.5s)[(49.93±13.13)mL/(100g×min)]( t=3.229, P<0.05). When PLD=2.5s, ASL measurement results showed that the CBF value in the infarcted area increased significantly[(58.26±23.50)mL/(100g×min) vs.(33.70±20.83)mL/(100g×min)]( t=3.831, P<0.05), and the CBF value in the contralateral normal area also increased significantly[(68.29±14.03)mL/(100g×min) vs.(49.93±13.13)mL/(100g×min)]( t=4.681, P<0.05). At this time, the CBF value in the infarcted area was still significantly lower than that in the contralateral normal area[(58.26±23.50)mL/(100g×min) vs.(68.29±14.03)mL/(100g×min)]( t=1.795, P<0.05). On the day of admission, the BI index of patients in the weak collateral circulation compensation group(12 cases) was significantly higher than that in the strong collateral circulation compensation group(12 cases)[(90.42±10.50) vs.(67.92±27.57)]( t=2.642, P<0.05), and the NIHSS score was significantly lower than that in the strong collateral circulation compensation group[(1.25±1.01) vs.(3.83±3.62)]( t=2.378, P<0.05). After 15 d of admission, there were no significant differences in BI index and NIHSS score between the two groups(all P>0.05). Conclusion:3D-ASL with different delay time can effectively and intuitively reflect collateral circulation compensation of patients with cerebral infarction, and it has very important reference value for the evaluation of patients' disease and the formulation of clinical treatment plan.

investigate the clinical and imaging features of primary peripheral primitive neuroectodermal tumors (pPNETs) of bone. Methods Clinical and X-ray, CT and MRI findings of 6 cases of primary bone pPNETs in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang, Yueqing People′s Hospital of Zhejiang, and Wenzhou People′s Hospital of Zhejiang were retrospectively analyzed. Results There were 4 males and 2 females, aged from 2 to 38 years, with an average age of (18.5 ± 12.0) years old. Local pain was found in all cases, including 4 cases with mass, with an average survival of (22.2 ± 16.9) months. Iliac bone tumor was found in 2 cases, sacrum in 2 cases, scapula in 1 case and femur in 1 case. Digital radiography(DR) examination was performed in 4 cases:4 cases showed osteolytic destruction, including 1 case with mild swelling changes, 1 case with laminar periosteal reaction and radial bone needle, and 3 cases with soft tissue mass. CT examination was done in 4 cases, and there were 4 cases of osteolytic destruction accompanied by soft tissue mass without periosteal reaction. Among them, 1 case had irregular sclerosis at the edge of bone destruction and 2 cases had fine calcification in soft tissue mass. MRI examination in 4 cases:there were 3 cases with equal signal on T1WI and 1 case with moderate to high signal on T1WI, 3 cases with inhomogeneous medium and high signal on T2WI and STIR, and 1 case with homogeneous high signal on T1WI, and 4 cases with soft tissue masses and peritumoral edema. Conclusions Bone pPNETs is characterized by osteolytic destruction with soft tissue masses, periosteal reaction with or w ithout periosteal reaction, and intratumor al calcification. Im aging exam ination is helpful to under stand the extent of lesions, formulation of therapeutic measures and evaluation of therapeutic effect.

Objective To explore the impact of obesity on lumbar disc degeneration using magnetic resonance T 2‐map‐ping .Methods Thirty volunteers with simple obese and 30 healthy volunteers with normal body weight undwewent sagit‐tal lumbar conventional sequence M RI scan and magnetic resonance T 2‐mapping scan ,and then obtained original map and pseudo‐color map of T2‐mapping .T2 values of L1 ~S1 intervertebral disc nucleus pulposus of the two groups were meas‐ured respectively .ANOVA was used for hypothesis test on T2 values of nucleus pulposus from different levels within group ,LSD test was used for paired comparison .For T2 values of nucleus pulposus from corresponding levels between the two groups ,t test of two independent samples was used .Results Obesity group :T2 values of nucleus pulposus were from 79 .50 ms to 123 .50 ms;Mean T2 values of nucleus pulposus in each level of L1 ~S1 were from (89 .82 ± 6 .34) ms to (112 .65 ± 5 .75) ms .T2 values of nucleus pulposus were from 91 .70 ms to 145 .40 ms in normal group;Mean T2 values of nucleus pulposus in each levels of L1 ~S1 were from (108 .17 ± 10 .37) ms to (126 .65 ± 10 .22) ms .Significant differences were found in the paired comparisons of L1 ~S1 ( P <0 .05) in obesity group except the difference between L2~3 and L4~5 ( P>0 .05);No significant differences were found between L1~2 and L5 ~S1 ,between L2~3 and L4~5 ,and between L2~3 and L5 ~S1 in normal group ( P>0 .05) ,while other paired comparisons all showed statistically significant differences ( P<0 .05) .Significant differences of T2 values were found in the corresponding level ( P<0 .05) between obesity group and normal group except L1~2 ( P>0 .05) .Conclusion Magnetic resonance T2‐mapping can early detect changes of biochemi‐cal ingredients in early lumbar nucleus pulposus degeneration .Obesity may be one of the reasons for promotion or accelera‐tion of lumbar nucleus pulposus degeneration .

目的：探讨磁共振扩散加权成像在肝癌诊断的价值。方法采用DWI技术对肝良、恶性占位性病变患者进行了鉴别。结果肝转移瘤组（1．52±0．23）、肝血管瘤组（1．84±0．32）、肝囊肿组（3．32±0．60）的表观扩散系数（ADC）值明显高于肝细胞癌组（1．24±0．17），且差异具有统计学意义（ t ＝3．68、5．92、8．30，P ＜0．05）。结论通过DWI图像特点及量化分析ADC值，提高M RI对肝癌的诊断能力。

Objective To explore the relationship between serum creatinine ( Scr ) , blood urea nitrogen ( BUN) and lung image changes in uremic patients .Methods According to the chest CT ,X-ray and related findings , 256 patients with uremia were divided into 84 cases of uremia ( uremic lung group ) and non-uremic lung 172 cases ( non-uremic lung group ) .The chest CT and X-ray examination ,Scr and BUN levels were observed .Results Uremic lung group had five types of image findings,including alveolar edema (67.86%),pulmonary interstitial edema (16.67%),pulmonary congestion syndrome(8.33%),pleural effusion(4.76%) and pulmonary interstitial fibrosis (2.38%).The Scr[(1 145.6 ±236.4)μmol/L]and BUN [(38.9 ±6.1)mmol/L]levels in uremic lung group were significantly higher than those in the non-uremic lung group[(905.3 ±138.9)μmol/L,(23.8 ±5.6)mmol/L](t=8.128,4.782,all P<0.05).Conclusion The image of uremic lung is mainly pulmonary edema ,and radiological and pathological changes are closely related with Scr and BUN levels .

目的：分析多层螺旋C T和M RI在浸润性宫颈癌术前分期中的应用结果。方法对我院收治的56例经病理确诊为浸润性宫颈癌患者，行多层螺旋C T和M RI检测，比较分析二者术前分期结果。结果经多层螺旋C T诊断，II期为15例、III期为18例、IV期为15例；经M RI诊断，II期为22例、III期为19例、IV期为15例，多层螺旋C T对II期的误诊率为31．8％，对III期的误诊率为5．3％，对IV期的误诊率为0％，而M RI对II、III、IV期宫颈癌的误诊率均为0％。结论多层螺旋C T和M RI检测均浸润性宫颈癌的术前分期有一定差异，最好选择M RI。