〔目的〕通过对比体外冲击波作用于髌韧带腱骨组织前后MRI信号值,探讨MRI评估体外冲击波作用腱骨组织伤病疗效的敏感性及促进腱骨愈合的意义.〔方法〕选择10名健康成人志愿者,以右侧膝关节髌韧带与髌骨下极、胫骨结节移行区为腱骨交界观察区域,仅将体外冲击波干预因素作用于髌韧带胫骨结节移行区,另一腱骨交界区作空白对照,分别于体外冲击波干预前、干预后1 h、24 h、7 d行3.0T MRI扫描.对MRI进行阅片,于四个不同时间节点分别应用图像处理程序软件,测定MRI扫描图像压脂T2WI像在矢状位和横轴位腱骨移行区设定窗口内信号值,使用SPSS 19.0统计软件对获得的数据进行对比分析.〔结果〕于体外冲击波干预前、干预后1h、24h及7d时间节点,髌骨下极移行观察区皮下软组织和腱骨组织压脂T2WI像方差分析F值分别为:矢状位0.356、1.939,横轴位0.209、0.541,均P>0.05,无统计学意义.髌韧带胫骨结节移行观察区皮下软组织和腱骨组织压脂T2 WI像方差分析F值分别为:矢状位2333.355、522.171,横轴位1772.229、482.754,均P<0.05,差异具有显著统计学意义.〔结论〕体外冲击波作用于肌腱骨骼移行区后可在MRI上表现出信号值变化,证实MRI可作为评估体外冲击波作用于腱骨组织伤病疗效的一种敏感而有效的影像学检查方式,同时也提示体外冲击波可造成移行区皮下软组织和腱骨组织的微损伤,损伤后反应可能是促进腱骨愈合作用的原因之一.

目的 探讨膝关节后外侧结构慢性损伤的MRI表现.方法 20例膝关节损伤患者均行高场MRI检查.总结膝关节后外侧结构(外侧副韧带、腘肌腱、腘腓韧带)损伤后的形态、长度、宽度及信号特点.结果 20例患者5例合并胫骨外侧平台边缘骨质增生,20例合并关节周围软组织肿胀,8例合并关节腔及髌上囊内积液,6例合并股骨远端外髁骨髓水肿,8例合并前交叉韧带慢性撕裂,5例合并后交叉韧带慢性撕裂,3例合并前后交叉韧带慢性撕裂.MRI信号特点:后外侧结构损伤呈不均匀长T1、长T2信号;组成膝关节后外侧结构的韧带及肌腱完全或部分肿胀,部分肌腱或韧带完全断裂,周围合并出血,出现不均混杂信号.外侧副韧带平均长度(68.74±4.56)mm、平均宽度(8.37±2.75)mm;腘肌腱平均长度(59.82±5.41)mm、平均宽度(12.58±1.43)mm;腘腓韧带平均长度(13.87±1.39)mm、平均宽度(6.23±1.02)mm.结论 韧带及肌腱肿胀、后期部分或完全断裂、韧带及肌腱信号增高等是膝关节后外侧结构慢性损伤的特征性表现.

目的 探究3.0T MRI常规序列联合扩散加权成像(DWI)对胃癌术前T、N分期的诊断价值.方法 回顾性分析2015年5月—2016年11月38例确诊为胃癌患者的临床资料.所有患者行3.0T MRI常规序列联合DWI检查,以手术病理结果 为金标准,将MRI常规序列、MRI常规序列联合DWI检查的T、N分期结果与病理结果进行一致性检验,并比较两种方法的诊断价值.结果MRI常规序列与MRI常规序列联合DWI对胃癌术前T分期的诊断准确率分别为83.55％与91.45％,对胃癌术前N分期的准确率分别为77.19％与85.96％,均与病理结果比较一致性较好.MRI常规序列联合DWI对胃癌术前T、N分期的检测效果优于MRI常规序列(P<0.05).结论 3.0T MRI常规序列联合DWI对胃癌术前T、N分期的诊断效果更好.

Hypoperfusion following acute stroke is common in the infarct core and periphery tissues. The present study evaluated the efficacy of salvianolic acid (SA) on the cerebral perfusion of patients who had suffered from acute stroke using perfusion-weighted magnetic resonance imaging (PWI) to examine the blood perfusion of the affected brain tissue prior to and following treatment. Patients who were admitted to PLA 153 Central Hospital within 72 h of acute stroke symptom onset and had a Glasgow coma scale ≥5 were randomized into two groups: SA and control groups. Patients in the SA group were administered SA 0.13 g/day for 14 days. PWI was performed for all patients at admission and post-treatment. The National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were applied to assess neurological function at admission and 3 months post treatment. A total of 159 patients were enrolled (85 patients in the SA group and 74 patients in the control group). A total of 62 patients in the SA group and 51 patients in the control group exhibited hypoperfusion in the ipsihemisphere of the diffusion-weighted magnetic resonance imaging (DWI) lesion. In addition, relative cerebral blood volume (rCBV), a ratio of the signal value of the region of interest in the same hemisphere of the DWI lesion to that of its mirror in the PWI CBV map, decreased significantly following treatment with SA compared with the control group in patients with hypoperfusion (P=0.02), which were indicated by PWI images at admission, in the DWI lesions or the surrounding areas. Additionally, there was no significant difference in patients with normal perfusion at admission in rCBV in DWI lesions or its surrounding area between the two groups at day 15. However, a significant improvement in NIHSS (P=0.001) and mRS (P=0.005) was indicated in the SA group compared with the control at day 90. The present study indicated that SA may improve the neurological dysfunction of patients with acute stroke, which may be explained by the increased perfusion of hypoperfused brain tissues.

Objective To observe the changes of cerebral perfusion parameters in ischemic lesion and its surrounding area, and to explore the possible targets for clinical intervention in acute ischemic stroke.Methods Consecutive in-patients with acute ischemic stroke with less than 72 hours of symptom onset from March 2015 to March 2016 were enrolled and all patients received magnetic resonance perfusion weighted imaging within 24 to 48 hours after being admitted to hospital.Cerebral perfusion parame-ters includedcerebral blood volume (CBV),cerebral blood flow (CBF),mean transit time (MTT)and time to peak (TTP).All pa-tients were divided into normal perfusion group and abnormal perfusion group according to the result of visual assessment.Image fusion technique and concentric circle calibration method were used to localize the region of interest (ROI)and itsmirror of interest (ROM)and then the values of them were automatically calculated.ROI/ROM (rCBV,rCBF,rMTT,rTTP)regarded as relative value was compared.Results Of the included 158 cases,113 cases presented abnormal perfusion and 45 casespresented normal perfusion diagnosed by visual assessment,with an abnormal perfusion rate of 72%.Either ischemic lesion or its surrounding area showed increase of rCBV,reduction of rCBF and extension of both rMTT and rTTP in the abnormal perfusion group,all of which displayed statistical differences compared with the normal perfusion group (all P<0.01).It suggested that hypo-perfusion existed in ischemic lesion or its surrounding area in the abnormal perfusion group because of the reduction of CBV and blood stasis oc-curreddue to the extension of both MTT and TTP.Conversely,the normal perfusion grouppresented hyper-perfusion and no obvi-ous stasis.As a result,improvement of CBV inischemic lesion or its surrounding area might become a possible target for clinical in-tervention.Conclusion Improving CBV in ischemic lesion or its surrounding area may be a possible target for clinical intervention and a promising criterion of obj ective j udgment for clinical treatment.

胚胎期移行的神经母细胞受损引起的神经元移行异常可导致胎儿先天性畸形，包括多小脑回畸形、无脑回畸形、分裂脑畸形、巨脑回畸形以及灰质异位等[1]。脑部先天性疾病中神经元移行异常并不多见，由其引起的先天性畸形病例较少，常造成诊断和治疗的不及时。研究发现，妊娠早期和中期全面而仔细的超声检查可以发现此类疾病，并避免由其所致的畸形儿出生[2]。无脑回畸形是神经元移行障碍性疾病中最严重的一种，其由于形成大脑皮质表面层的神经元移行时出现障碍，不能通过深层的神经元[3]。本研究对近期我院收治的1例无脑回畸形患者的临床资料进行了回顾性分析，现报道如下。

宫颈癌是最常见的女性恶性肿瘤之一,仅次于乳腺癌.目前临床常用的治疗方法除广泛子宫切除术和盆腔淋巴结清扫术外,还有放疗及化疗.正确治疗方法的选择,是以宫颈癌准确的诊断及分期为依据.而临床常用的分期方法主要依靠妇科检查及活体组织检查,由于二者均存在不同的局限性,临床分期准确率不高,文献报道为61％～66％[1],不利于治疗计划的制定.本研究的目的旨在探讨MRI在宫颈癌诊断和分期在治疗前评估中的临床价值.

布鲁杆菌脊柱炎临床症状与影像表现都与脊柱结核类似，综合医院接诊此类患者少，当以慢性腰痛、发热为主诉的患者，影像检查显示椎体、椎间盘破坏时，常被误诊为脊柱结核。笔者回顾性分析误诊患者的磁共振影像，以提高诊断的正确率。

目的 探讨磁共振3D-TSE序列和3D-VIBE序列对于血管压迫性三叉神经痛的诊断价值.方法 采用3D-TSE序列和3D-VIBE序列扫描28例临床拟诊为血管压迫性三叉神经痛的患者.经3DMRP、MIP、min-MIP后处理图像,观察三叉神经与周围血管的关系.结果 28例患者手术证实26例存在血管神经接触或压迫,3D-VIBE、3D-TSE序列综合判断血管压迫性三叉神经痛的阳性预测值、阴性预测值、敏感性、手术符合率分别为92.0％ (23/25)、33.3％ (1/3)、92.0％(23/25)、85.7％(24/28).而且MRI所显示的责任血管与神经的相对位置关系与术中所见具有高度的一致性(K=0.81).结论 3D-TSE序列和3D-VIBE序列结合可以清楚显示脑池内血管和三叉神经的空间关系并辨认责任血管的来源,对血管压迫性三叉神经痛的术前评估具有较高的价值.

Objective This study aims to evaluate the clinical value of MR-DTI in optic radiations of glaucoma. Methods MR-DTI was performed in 20 patients suffering from unilateral glaucoma and 15 healthy subjects. The parameters of MR-DTI,including fractional anisotropy( FA),apparent diffusion coefficient( ADC) value of optic radiations of glaucoma were evaluated. The average length of fibers and mean fibers / voxel,ADC and FA values in healthy subjects,affected nerve and unaffected nerve in glaucoma were compared. Results The ADC values in affected optic radiations were higher and FA values were lower than that in unaffected optic radiations and control optic radiations,which had statistically significant difference( P < 0. 01). Average fiber length and mean fibers / voxel in affected optic radiations were lower than that in unaffected optic radiations and control optic radiations( P < 001). Conclusion Potential neuropathology changes occurr in the optic radiations of patients with glaucoma. MRI-DTI is a useful method in studying optic radiations damage of glaucoma which provides more information for guiding the clinic diagnosis of glaucoma.