Objectives Isolated vertigo induced by posterior circulation ischemia (PCIV) can further progress into posterior circulation infarction. This study aimed to explore the diagnostic values of three-dimensional pseudo-continuous arterial spin labeling (3D-PCASL) combined with territorial arterial spin labeling (t-ASL) and magnetic resonance angiography (MRA) in visualizing and evaluating PCIV, seeking improved diagnostic tools for clinical guidance. Methods 28 PCIVs (11 males, 17 females, aged from 55 to 83 years, mean age: 69.68 ± 9.01 years) and 28 healthy controls (HCs, 12 male, 16 female, aged from 56 to 87 years, mean age: 66.75 ± 9.86 years) underwent conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), MRA, 3D-PCASL, and t-ASL. We compared the incidence of anatomic variants of the posterior circle of Willis in MRA, cerebral blood flow (CBF) and anterior collateral blood flow on postprocessing maps obtained from 3D-PCASL and t-ASL sequence between PCIVs and HCs. Chi-square test and paired t-test were analyzed statistically with SPSS 24.0 software. Results 7 PCIVs (7/28, 25%) and 6 HCs (6/28, 21%) showed fetal posterior cerebral artery (FPCA) on MRA, including 1 HC, and 6 PCIVs with FPCA appeared hypoperfusion. 18 PCIVs (64%) and 2 HCs (7%) showed hypoperfusion in the posterior circulation (PC), including 1 HC and 7 PCIVs displayed anterior circulation collateral flow. Chi-square analyses demonstrated a difference in PC hypoperfusion between PCIVs and HCs, whether in the whole or FPCA-positive group assessment (P < 0.05). Paired t-test showed that the CBF values were significant difference for the bilateral PC asymmetrical perfusion in the PCIVs (P < 0.01). When compared to the bilateral PC symmetrical non-hypoperfusion area in the PCIVs and HCs, the CBF values were not significant (P > 0.05). The CBF values of the PC in PCIVs were lower than in HCs (P < 0.05). The reduction rate in the hypoperfusion side of the bilateral PC asymmetrical perfusion of the PCIVs ranged from 4% to 37%, while the HCs reduction rate was 7.7%. The average PC symmetrical perfusion average reduction rate of the PCIVs was 52.25%, while the HCs reduction rate was 42.75%. Conclusion 3D-PCASL is a non-invasive and susceptible method for detecting hypoperfusion in PC, serving as a potential biomarker of PCIV. The suspected hypoperfusion in PC may be attributed to the emergence of FPCA and the manifestation of anterior collateral flow when combining t-ASL and MRA sequences. These findings demonstrated that 3D-PCASL combined with t-ASL and MRA sequences are the potential method to identify PCIV, leading to early diagnosis of PCIV and reducing the risk of progressing into infarction.

目的 探讨三维伪连续动脉自旋标记(3D-pCASL)灌注成像联合供血区动脉自旋标记(t-ASL)成像对表现为孤立性眩晕的后循环缺血(PCI)的诊断价值.方法 对29例表现为孤立性眩晕的PCI患者(PCI组)及28例健康对照(HC)(HC组)行常规MRI扫描、磁共振血管成像(MRA)、扩散加权成像(DWI)及3D-pCASL灌注成像、t-ASL成像扫描.比较PCI组及HC组MRI表现及后循环灌注差异.采用配对样本t检验及两独立样本t检验进行分析.结果 MRA显示胚胎型大脑后动脉(f-PCA)13例,其中PCI组7例(7/29,24％),合并低灌注6例;HC组6例(6/28,21％),合并低灌注1例.3D-pCASL灌注成像上,PCI组中62％见双侧后循环低灌注或单侧后循环低灌注;HC组中双侧后循环低灌注及单侧后循环低灌注各1例(2/28).t-ASL成像上,18例有低灌注的PCI组中7例有前循环侧支血流,而2例后循环低灌注的HC组中1例见前循环侧支血流.结论 3D-pCASL灌注成像可以为表现为孤立性眩晕的PCI提供诊断参考依据,结合t-ASL成像可成以为疗效评估的常规影像检查方法.

Objective:To explore the value of 3.0T multi-parameter magnetic resonance imaging (Mp-MRI), namely T2 weighted imaging (T2WI) combined with diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE) in the diagnosis and differential diagnosis of chronic prostatitis (CP) of peripheral zone.Methods:The Mp-MRI data of 23 patients with CP of peripheral zone and 38 patients with prostate cancer (PCa) of peripheral zone who underwent prostate Mp-MRI examination and were pathologically confirmed in The First Affiliated Hospital of Guangdong Pharmaceutical University from July 2016 to December 2021 were retrospectively analyzed. The age of the CP group was (64.3±7.8) years old, and that of the PCa group was (73.7±8.5) years old. According to the pathological results and the lesion range of peripheral zone of prostate on Mp-MRI, all the selected cases were subdivided into four subgroups: diffuse CP (CP1), focal CP (CP2), diffuse PCa (PCa1), and focal PCa (PCa2). One way ANOVA or independent sample t-test was used to compare the differences of apparent diffusion coefficient (ADC) values among normal tissues, CP, and PCa in the peripheral zone and among subgroups of CP and PCa. Fisher's exact test was used to compare the distribution of signal intensity-time (SI-T) curve types among CP, PCa, and their subgroups. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of ADC value in diagnosing CP of peripheral zone and determine the optimal cut-off value. The sensitivity, specificity, and accuracy of Mp-MRI (T2WI+DWI-ADC+DCE) in the diagnosis of CP were calculated. Results:Among the 23 cases of CP, there were 16 cases in the CP1 subgroup and 7 cases in the CP2 subgroup; among the 38 cases of PCa, there were 21 cases in the PCa1 subgroup and 17 cases in the PCa2 subgroup. There was a statistically significant difference in the ADC value among CP of peripheral zone, PCa, and normal tissues [(1.15±0.23) ×10 -3 mm 2/s vs. (0.85±0.28) ×10 -3 mm 2/s vs. (1.54±0.19) ×10 -3 mm 2/s] ( F=14.27, P<0.01). There was a statistically significant difference in the ADC value among CP1, CP2, PCa1, and PCa2 subgroups [(1.17±0.11) ×10 -3 mm 2/s vs. (1.10±0.18) ×10 -3 mm 2/s vs. (0.81±0.17) ×10 -3 mm 2/s vs. (0.89±0.21) ×10 -3 mm 2/s] ( F=9.76, P<0.01). There were statistically significant differences in the ADC value between the CP group and the PCa group [(1.15±0.23) ×10 -3 mm 2/s vs. (0.85±0.28) ×10 -3 mm 2/s], between the CP1 subgroup and the PCa1 subgroup [(1.17±0.11) ×10 -3 mm 2/s vs. (0.81±0.17) ×10 -3 mm 2 /s], between the CP2 subgroup and the PCa2 subgroup [(1.10±0.18) ×10 -3 mm 2/s vs. (0.89±0.21) ×10 -3 mm 2/s] ( t=4.23, 7.48, and 2.31; all P<0.05). There were no statistically significant differences in the ADC value between the CP1 subgroup and the CP2 subgroup, between the PCa1 subgroup and the PCa2 subgroup ( t=1.16 and 1.30; all P>0.05). Taking ADC value >1.02×10 -3 mm 2/s as the diagnostic criteria for CP, the sensitivity, specificity, and accuracy were 86.96%, 89.47%, and 88.52% respectively. There were statistically significant differences in the distribution of DCE SI-T curve types between the CP group and the PCa group, between the CP1 subgroup and the PCa1 subgroup, between the CP2 subgroup and the PCa2 subgroup (all P<0.01). Compared with the surgical pathology, the sensitivity, specificity, and accuracy of Mp-MRI (T2WI+DWI-ADC+DCE) in the diagnosis of CP of peripheral zone were 91.30%, 92.11%, and 91.80%, respectively. Conclusion:Mp-MRI has a high diagnostic efficiency for CP of peripheral zone, and can more accurately distinguish CP from PCa, which can be used as an important method for non-invasive diagnosis of CP of peripheral zone.

目的 利用MR供血区动脉自旋标记技术(t-ASL)研究正常成人脑侧支循环的情况,并探讨其价值.方法 对30例无中枢神经系统症状的健康成人行3.0TMR平扫、DWI、MRA、3D-ASL及t-ASL扫描,t-ASL扫描分别标记左、右颈内动脉以及椎-基底动脉.分析MR平扫及DWI上有无异常信号,对照MRA及3D-ASL全脑血流量灌注图所见,分析t-ASL上左右颈内动脉、椎-基底动脉各供血区的灌注变异及侧支循环情况.结果 所有受试者的常规MR平扫、DWI均无阳性发现.MRA提示大脑前动脉A1段左共干1例,其t-ASL提示为左颈内动脉优势型,相应右侧颈内动脉灌注图提示右侧大脑前动脉供血区灌注减低.3D-ASL提示后循环部分脑区灌注减低2例、相应t-ASL椎-基底动脉灌注图显示后循环相应脑区灌注减低,而左、右颈内动脉灌注图无后循环代偿灌注.t-ASL提示左颈内动脉优势型2例、右侧颈内动脉优势型16例、双侧颈内动脉交叉灌注2例,其余10例未见双侧颈内动脉跨脑区灌注;所有椎-基底动脉均未见跨脑区灌注.结论 正常成年人大多数通过Willis环存在一级侧支循环,以保证额叶的血流灌注.t-ASL可以直观地显示标记血管供血区的脑血流量灌注,评估大脑侧支循环的代偿情况.

目的:探讨磁敏感加权成像(Susceptibilitg weighted imaging,SWI)相位值变化在脑型肝豆状核变性(hepatolenticular degeneration,HLD)中的应用.方法:回顾性分析2016年12月-2018年6月我院收治的经颅脑MR检查确诊的24例脑型HLD患者(观察组)及22例健康志愿者(对照组)临床资料,使用3.0T MR系统对所有受检者进行SWI序列扫描,并采用SPIN软件测量其各脑灰质核团相位值,对脑型HLD患者脑灰质核团相位值变化特点进行分析.结果:观察组红核、黑质及壳核平均相位值均低于对照组,差异有统计学意义(P＜0.05).结论:相比于健康者,脑型HLD患者红核、黑质及壳核相位值均较低,通过分析SWI相位值能够对其脑内铜的异常沉积做出较为准确判断.

目的:探讨血管瘤型脑膜瘤的CT及MRI表现特征.方法:回顾性分析24例经手术及病理证实的血管瘤型脑膜瘤的CT及MRI表现,并与病理对照分析.结果:24例均为单发肿块,边界清楚光整,22例呈圆形或类圆形,2例呈分叶状;直径23～57 mm,平均45 mm;20例密度或信号均匀,4例见散在囊变,2例见小斑片状钙化;24例均表现为CT低密度,20例行MRI检查,均表现为T1WI低信号、T2WI高信号,增强扫描均显著强化,22例肿瘤内见多发血管影,其中16例肿块内血管呈"烟花样"分布;2例较小病灶瘤周水肿较轻,余22例肿瘤占位效应显著,瘤周水肿明显.病理上肿瘤组织中含大量扩张、充血的血管.结论:血管瘤型脑膜瘤的CT及MRI表现密度或信号、肿瘤内"烟花样"血管分布及瘤周水肿均具有一定的特征性,对该病的诊断具有非常重要的价值.

目的:探究磁共振波谱成像对颅内异常强化病灶的诊断价值.方法:将我院患者作为主要的研究对象,患者的选取时间在2018年5月-2019年5月,本研究共选取患者100例,患者均为颅内肿瘤患者,给予所有患者磁共振波谱成像技术检查,对其检查结果进行研究.结果:本研究中,100例颅脑肿瘤患者中,经过病例确诊为颅内胶质瘤的患者有25例,占总人数的25.00％,为颅内脑膜瘤的患者有34例,占人数的34.00％,颅内转移瘤患者41例.同时,在对其脑膜瘤,脑部胶质瘤和脑部转移瘤的实质区和邻近组织水肿区的NAA/Cr、Hho/Cr和NAA/Cho水平情况进行比较时,可以得出,其差异存在统计学意义(P＜0.05).结论:针对颅内异常病灶患者,给予其磁共振波谱成像技术,能够对患者的病情进行有效鉴定,其应用效果显著,值得临床进行推广使用.