目的 探讨基于磁共振弥散张量成像(DTI)引导下的软通道置管引流术在深部脑出血患者中的应用价值.方法 收集47例未发生脑疝的深部脑出血患者,按手术方式不同分为A组和B组,A组22例采用开颅显微镜下血肿清除术,B组25例采用软通道脑内血肿置管引流术.患者术前及术后2周检测DTI,术后随访6个月,术后2周及术后6个月按照NIHSS评分评估患者的预后.结果 两组术前rFA值、平均出血量、平均GCS评分差异均无统计学意义(均P＞ 0.05).术后2周,A组rFA值0.43±0.04,B组rFA值0.51±0.06,差异有统计学意义(P＜0.05).B组术后2周及6个月NIHSS评分均低于A组(均P＜0.05).结论 通过DTI可以客观评估深部脑出血后患者皮质脊髓束继发受损情况,软通道置管引流联合DTI能改善深部脑出血患者的神经功能障碍.

目的:研究基于动机行为转化的认知干预及护理对磁共振放射检查患者的心理状况及检查结局的影响.方法:选择我院2020年1月至2020年12月接诊的80例行磁共振放射检查患者进行研究.根据随机数表法,把患者均分为对照组和实验组.对照组给予常规护理,实验组给予基于动机行为转化的认知干预及护理.比较两组干预前后的心理状况以及检查结局.结果:干预前两组焦虑、抑郁评分差异无统计学意义(P>0.05);干预后实验组焦虑、抑郁评分均显著低于对照组(P<0.05).实验组图像清晰率明显高于对照组,检查完成时间明显短于对照组(P<0.05).结论:基于动机行为转化的认知干预及护理可以改善磁共振放射检查患者的心理状况及检查结局,值得临床上应用及推广.

目的 探讨胰腺肿瘤相关性区域性门静脉高压症(pancreatic tumor-related segmental portal hypertension,PTSPH)的临床和影像特点.方法 分析PTSPH患者的临床和影像学资料,总结该病的特点.结果 共搜集胰腺肿瘤患者312例,其中存在区域性门静脉高压20例.PTSPH组和非PTSPH组患者的年龄、性别差异无统计学意义(t=-0.69,P =0.50;x2=2.25,P=0.13),但肿瘤大小、发病部位和类型差异有明显统计学意义(t=2.82,P=0.01;x2 =7.67,P=0.01;x2 =4.55,P=0.03).PTSPH患者静脉曲张发生率以脾门(100％)和胃底(95％)为主,食道下段仅为20％,脾脏增大发生率95％.其他少见征象包括脾静脉-左肾静脉的门体分流、脾静脉栓塞、脾静脉瘤样扩张等.结论 多种胰腺肿瘤均可引起PTSPH,体尾部肿瘤、导管腺癌和体积较大肿瘤更易发生PTSPH.脾脏增大伴脾门和胃底静脉曲张是该病常见的影像征象,其他少见征象包括食管下段静脉曲张,左肾静脉曲张等门体分流现象.

Objective To investigate the application value of MR SWI and DWI in the diagnosis of liver lesions.Methods 1 300 patients underwent 1.5T MRI scan of liver,no pathology or follow-up examination results of patients with focal liver lesions were excluded,147 patients were included and underwent conventional magnetic resonance(MRI),DWI and SWI.By 2 senior radiologists with double blind method of conventional MRI and MRI combined with DWI and SWI image reading,the feature and enhancement pattern of signal intensity were evaluated.Kappa test was used to evaluate the consistency of the diagnosis of 2 physicians.The pathological examination and comprehensive follow-up results were used as the gold standard.The diagnostic accuracy of the two groups was compared.Results 2 doctors had good consistency in the image diagnosis of the two groups.The Kappa values of conventional MRI and conventional MRI combined with DWI and SWI images were 0.912 and 0.936,respectively.The conventional MRI diagnosed primary hepatocellular carcinoma(HCC) in 40 cases,bile duct cancer cells (ICC) in 13 cases,liver metastasis (HMs) in 14 cases,cavernous hemangioma of the liver (CHL) in 17 cases.The conventional MRI combined with DWI and SWI diagnosed HCC in 50 cases,ICC in 20 cases,HMs in 20 cases,CHL in 24 cases,the differences were statistically significant (x2 =5.660,5.250,5.560,6.640,all P ＜ 0.05).Conclusion Conventional MRI combined with DWI and SWI can provide additional valuable information and improve diagnostic performance for liver lesions.