目的 探讨腰椎间盘突出症患者的椎旁肌面积及T2WI信号强度变化,为腰椎间盘突出症的评估及康复治疗提供参考.方法 收集43例L4-5椎间盘突出患者、45例腰椎间盘正常体检者,采用GE/HDXT/1.5T T2WI序列分别测量L4-5中心层面双侧椎旁肌(多裂肌、竖脊肌、腰大肌)横截面积、T2WI信号强度,比较椎间盘突出组和正常组在椎旁肌横截面积、T2WI信号强度的差异,组间采用两独立样本t检验、组内采用配对样本t检验.结果 腰突组和正常组比较,L4-5右侧多裂肌T2WI信号强度比值、右侧竖脊肌T2WI信号强度比值差异有统计学意义(P<0.05);椎旁肌横截面积及T2WI信号强度绝对值差异无统计学意义(P>0.05);43例腰突组组内比较,L4-5两侧竖脊肌面积、两侧多裂肌T2WI信号强度比值、两侧竖脊肌T2WI信号强度比值差异有统计学意义(P<0.05);17例旁中央型腰突组内比较,腰突侧与非腰突侧的椎旁肌横截面积、T2WI信号强度比值差异无统计学意义(P>0.05).结论 腰椎多裂肌、竖脊肌T2WI信号强度可为腰椎间盘突出症的评估及康复治疗提供参考.

目的 探讨深度学习模型在儿童应用TW3法进行骨龄评估的临床效能.方法 回顾性收集180例儿童左手X线片.评估基于Tanner-WhitehouseⅢ(TW3)法的掌指骨和腕骨骨龄.以3位高年资主任医师的评估均值为金标准组,计算并比较深度学习模型(模型组)及2位低年资医师(医师组,分别记作医师1、医师2)与金标准组评估时间差异,掌指骨骨龄、腕骨骨龄的均方误差(MSE)及平均绝对误差(MAE);采用组内相关系数(ICC)分析模型组和医师组与金标准组结果一致性.结果 骨龄评估所用时间模型组明显少于医师组(P<0.05).掌指骨骨龄评估,模型组和医师1、医师2与金标准组相比MSE、MAE差异有统计学意义(P<0.05).腕骨骨龄评估,模型组和医师1、医师2与金标准组相比MSE、MAE差异有统计学意义(P<0.05).掌指骨骨龄评估,模型组与金标准组ICC为0.988,医师1、医师2与金标准组的ICC分别为0.986、0.977.腕骨骨龄评估,模型组与金标准组ICC为0.971,医师1、医师2与金标准组ICC分别为0.970、0.953.结论 对于儿童,应用TW3法深度学习模型在评估掌指骨和腕骨骨龄有临床价值.

慢性疼痛作为一种常见病症,因其病因复杂、反复发作、疗效难以持久,严重影响患者身心健康[1-2].准确的疼痛测量有助于早期诊断、病情进展监测和疗效评价,是提高慢性疼痛治疗疗效的关键.基于功能磁共振成像技术(fMRI)的相关研究证明,疼痛可致大脑血流动力学发生改变,量化分析变化数据,并与患者自我报告的疼痛程度相对照,可客观评价患者的临床疼痛状态,从而为疗效评估提供参考依据.

目的 通过分析强直性脊柱炎(AS)活动期患者及骶髂关节表观扩散系数(ADC值)及加拿大脊柱关节炎评分(SPARCC),探讨弥散加权成像技术(DWI)ADC值及SPARCC评分在评估AS活动期中的价值.方法 选取临床确诊为AS活动期患者17例,同时收集19例健康体检者作为正常组.对两组进行骶髂关节横断位及斜冠状位扫描.通过DWI序列及ADC图,测量患者与正常组骶髂关节(左、右髂侧及骶侧)ADC值,同时测量L5椎体中央区ADC值,比较两组骶髂关节相对ADC值(rADC)变化.同时对活动期AS患者骶髂关节行SPARCC评分,并对rADC与SPARCC评分之间的相关性进行分析.结果 DWI可显示骶髂关节炎活动期骨髓水肿情况;活动期双侧骶髂关节rADC值大于正常志愿者.活动期AS患者髂侧ADC多大于骶侧ADC,两组差异均有统计学意义(均P<0.05),活动期骶髂关节平均rADC值与SPARCC评分呈正相关(r=0.827,P<0.05).结论 ADC值在评价AS患者病情活动性中具有一定价值,可以对病变进行定量评估,从而可以成为判断AS活动性的重要指标.

This paper introduces a teaching experiment research on the application of Flipped Classroom in a college computer experiment course. The participants are college students majoring in Educational Technology, and "Database Foundation" is an experiment course for them. The research group was made up of a teacher and five assistants. The teaching content was "Basic Operation on Microsoft Access Database". Some micro videos were made and uploaded to a network platform by the research group before experiment. Before class, students were asked to learn the content with videos and do some exercises. In class, the teacher answered the questions of students and guided students' operations on computers. Students can communicate with teachers and other students online whenever they want. After the experiment, an investigation was made on the effect.

目的 通过分析强直性脊柱炎(AS)患者及正常志愿者骶髂关节DWI?ADC值的变化,探讨DWI?ADC值在量化评估AS活动性中的价值.方法 根据AS病情活动指数(BASDAI)评分选取临床确诊为强直性脊柱炎活动期患者25例,同时收集20例健康志愿者.对两组行骶髂关节横断位及斜冠状位扫描,序列包括T1WI、FSE/T2WI、fs/DWI(b=0,600s/mm2),通过DWI序列及表观弥散系数(ADC)图,测量患者与正常志愿者骶髂关节(左、右髂侧及骶侧)ADC值,同时测量L5椎体中央区ADC值,比较两组人群骶髂关节平均ADC值及相对ADC (rADC)值(骶髂关节ADC值/L5椎体ADC值)变化.?结果 DWI可显示骶髂关节炎活动期骨髓水肿情况,活动组平均ADC值及rADC值大于正常志愿者.?结论 ADC值对评估AS患者活动性具有重要价值,可以对病变进行定量分析.

This study explored the predictive values of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in evaluating the efficacy of transcatheter arterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC). A total of 118 HCC patients treated with TACE were selected from April 2013 to November 2015. T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI), DWI, and PWI were performed on all patients before and after TACE. Efficacy was evaluated according to modified Response Evaluation Criteria in Solid Tumors 1.1. Receiver operating characteristic curve was used to evaluate the diagnostic power of quantitative DWI and PWI parameters in evaluating the efficacy of TACE for HCC patients. Among the 118 HCC patients, there were 17 cases (14.4%) with complete response, 50 cases (42.4%) with partial response, 28 cases (23.7%) with stable disease, and 23 cases (19.5%) with progressive disease. There were 67 patients in the effective group (complete response + partial response) and 51 patients in the ineffective group (stable disease + progressive disease). Before TACE, there were significant differences in maximum tumor diameter (MTD), apparent diffusion coefficient (ADC), slow ADC (Dslow), fast ADC (Dfast), transfer constant of vessel at the maximum level (Ktrans), and rate constant of backflux (Kep) between the effective and ineffective groups (all P<0.05). After TACE, the effective group exhibited lower MTD, Dfast, and Kep and higher ADC and Dslow than the ineffective group (all P<0.05). Tumor regression rate negatively correlated with MTD, Ktrans, Kep, and Dfast but positively correlated with ADC and Dslow. Receiver operating characteristic curve analysis suggested that the area under the curve of ADC, Dslow, Dfast, Ktrans, and Kep were 0.869, 0.833, 0.812, 0.802, and 0.809, respectively. In conclusion, these results suggest that quantitative DWI and PWI parameters might be useful in evaluating the efficacy of TACE in the treatment of HCC patients.

OBJECTIVE:To provide quantitative foundation for the diagnosis of atlanto-axial rotatory subluxation by analyzing the various imaging features of normal atlanto-axial joints in neutral position and rotary functional position on the MSCT images.METHODS:Forty-one normal volunteers were examined by CT on the atlanto-axial joint in neutral position and rotary functional position. By the observation and measurement of atlanto-dental interval (ADI), lateral atlanta-dental space (LADS), VBLADS and rotating angle of atlas on dentate (RAAD), the imaging manifestations and anatomical characteristics were analyzed and compared. In order to compare VBLADS and RAAD and make a correlation analysis between different age groups, 51 normal volunteers were divided into two groups: age younger than 45 years old group and age older than or equal to 45 years old group.RESULTS:The dens in neutral position deviated in an angle range of (3.22±0.89)°. The articular facets of lateral atlantoaxial joint in rotary functional position had rotatory displacement and the range of the relative rotation angle was (33.85± 2.79)°. Through the correlation analysis of matching data, it could be concluded that there was no correlation between atlantoaxial relative rotation angle and VBLADS within a certain range. There were statistically differences of atlantoaxial relative rotation angle in rotary functional position between two groups.CONCLUSION:MSCT imaging in rotary functional position can clearly show the anatomical structure and rotation function of a normal atlanto-axial joint, so as to provide a theoretical basis for the diagnosis of atlanto axial rotatory subluxation.

目的：通过分析比较正常人群和寰枢关节旋转固定患者在多层螺旋CT（multislice CT，MSCT）中立位及旋转功能位下的各种影像征象，探讨MSCT旋转功能位在正确诊断寰枢关节旋转半脱位中的价值。方法：随机选取101例正常人群行MSCT中立位扫描，将其分为≤50岁及＞50岁两组，旨在比较不同年龄段人群寰齿前间隙（atlanto－dental interval，ADI）及齿突侧块间距差值绝对值（丨VBLADS丨）变化。对其中38例正常志愿者及20例临床拟诊寰枢关节旋转半脱位患者行MSCT中立位及旋转功能位检查，观察分析两组人群在不同旋转状态下ADI及丨VBLADS丨变化及寰枢外侧关节面移位情况。结果：通过对101例正常志愿者中两个年龄组中立位ADI及丨VBLADS丨分别进行独立样本t检验，P＜0．05，≤50岁年龄组在ADI及丨VBLADS丨较＞50岁组具有更大的变异性。20例患者中立位及左、右尽力旋转位丨VBLADS丨呈相对固定状态，寰枢外侧关节面不同程度移位。38例正常志愿者在不同旋转状态下，寰枢外侧关节面呈旋转性移位改变。患者与正常志愿者中立位及旋转功能位 ADI、丨VBLADS丨分别采用独立样本t检验，P＜0．05。结论：MSCT中立位及旋转功能位检查能客观反映寰枢关节动态变化情况，在诊断寰枢关节旋转半脱位中具有重要临床应用价值。

Objective To apply 3D- arterial spin labeling (3D- ASL) MRI for analysis of normal posterior cerebral circula-tion. Methods 3D- ASL MRI scan was performed in 60 healthy subjects for analysis of posterior cerebral circulation. The param-eter maps of cerebral blood flow(CBF) was acquired,and the mean CBF was measured and analyzed. Results The mean CBFs of the occipital lobe, temporal lobe, cerebel ar hemisphere and brain stem were 64.45±12.72 ml/ (min·100g), 63.28±14.97ml/(min·100g), 61.75±13.54ml/ (min·100g) and 53.64±12.71 ml/ (min·100g), respectively. There was statistical difference in mean CBFs among different locations and ages, but no difference between males and females. Conclusion The results indicate that as a non- invasive technique ASL can provide useful perfusion information and would be used for pathophisiological study in pa-tients with cerebral infarction.