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.

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3.0T MR扩散张量成像(DTI)定量诊断外伤后视神经挫伤的价值.方法 对15例单侧眼眶外伤、临床诊断为外伤后单侧视神经挫伤的患者行常规眼眶MRI扫描及视神经DTI扫描.分别测量患侧与健侧眶内段视神经的各向异性分数(FA)值、表观扩散系数(ADC)值.采用配对样本t检验统计分析患侧与健侧视神经FA值与ADC值的差异,P<0.01为有统计学差异.结果 常规MRI可以清晰显示患侧与健侧视神经,部分患侧眶内段视神经稍增粗、T2 WI信号稍增高,未见明显断裂和移位征象.患侧视神经FA及ADC值分别为0.34±0.07、(1.34±0.19)×10-3 mm2/s,健侧视神经FA及ADC值分别为0.57±0.09、(0.95±0.17)×10-3 mm2/s,患侧较健侧FA值显著降低(t=8.0,P<0.01)、ADC值显著升高(t=3.2,P<0.01).结论 MR DTI可以定量视神经挫伤改变,有望成为视神经挫伤早期诊断和疗效随访的重要检查手段.

Objective To explore the value of R2* value of 3.0T magnetic resonance IDEAL-IQ sequence in assessing the pathological grade of hepatocellular carcinoma (HCC).Methods The imaging data of 32 patients who underwent liver 3.0T MRI (including IDEAL-IQ sequence) and were surgically resected and pathologically confirmed as HCC were retrospectively analyzed.On the R2* relaxation rate map of the IDEAL-IQ sequence,the R2* values of the HCC lesion and its background liver tissue were measured with the technique of region of interest (ROI).32 cases of HCC were divided into three groups according to the degree of postoperative pathological differentiation:poor,medium,and well;32 cases of HCC were divided into cirrhosis group and non-cirrhosis group according to postoperative pathology of background liver tissue.Independent sample t test was used to compare the difference of R2* between HCC and its background liver tissue;Spearman correlation was used to analyze the correlation between R2* value of HCC and pathological grade;single factor variance LSD method was used to test the difference of R2* values among different pathological differentiation groups of HCC;the ROC curve was used to assess the R2* value for predicting different pathological grades of HCC and to determine the cut-off values.Results There were statistically significant differences in the R2* values between HCC and background liver tissue in the cirrhosis group (n=25) and non-cirrhosis group (n--7) [cirrhosis group:(28.28±6.26) Hz vs.(62.15±22.07) Hz;non-cirrhosis group:(23.73±5.64) Hz vs.(40.21±10.13) Hz] (P＜0.05).The R2* value of HCC was lower than its background liver tissue in both two groups.The R2* value of HCC was moderately correlated with its pathological grade (rs=0.476, P＜0.05).The R2* values of well (7 cases),medium (14 cases),and poor (11 cases) HCC differentiation groups were (36.13±5.48) Hz,(31.38±6.17) Hz,(20.24±5.75)Hz,respectively.There was statistically significant difference in the overall R2* value among the three groups (P＜0.001).With the decrease of pathologic differentiation degree of HCC,the R2* value of HCC tended to decrease.The area under the curve (AUC) of the poorly differentiated HCC was estimated to be 0.843 using the R2* value,with the R2* value of 21.38 Hz as the cut-off value,the sensitivity was 83.6％,and the specificity was 74.8％.Conclusion The R2* value obtained by 3.0T MR DEAL-IQ sequence was moderately correlated with the pathological grade of HCC,and could accurately predict the degree of pathological differentiation of HCC before operation.

目的 探究糖尿病合并冠心病患者行冠脉CTA检查的护理体会.方法 以2016年5月―2018年5月收治的60例高血压合并冠心病患者为研究对象,采用随机数字表法进行分组,分成观察组(综合护理)与对照组(常规护理)各30例.探讨实施不同护理对护理效果的影响.结果 观察组3～5级占比(90.00％)与对照组相比(66.67％)显著较高,差异有统计学意义(P<0.05),观察组依从性、检查成功率(96.67％、96.67％)与对照组相比(80.00％、76.67％)显著较高,差异有统计学意义(P<0.05).结论 将综合护理应用于行冠脉CTA检查的糖尿病合并冠心病患者时,提升检查依从性、检查成功率,改善检测CTA成像质量,此方法值得应用与推广.

目的 探讨护理安全管理在CT室的应用价值.方法 选取2017年4月至2018年5月广东药科大学附属第一医院CT室接受增强CT检查的100例患者,按随机数表法分为对照组(50例)和观察组(50例).对照组患者接受常规护理,观察组患者接受护理安全管理.比较两组患者不良反应发生率和护理满意度.结果 在CT室检查过程中,对照组和观察组患者不良反应发生率分别为34.0％、14.0％.对照组和观察组患者护理满意度分别为74.0％、94.0％.观察组患者不良反应发生率低于对照组,护理满意度高于对照组,差异有统计学意义(P<0.05).结论 CT室中应用护理安全管理可有效减少不良事件发生,对改善护患关系有积极作用.

[目的]探究护理干预对64排螺旋CT冠状动脉血管成像(CTA)检查病人影响.[方法]选取我院2015年5月-2016年11月行64排螺旋CT冠状动脉血管成像检查病人207例,按随机数字表法分组,对照组103例予以常规护理,研究组104例于对照组基础上予以针对性、个性化护理干预,比较两组CTA成像质量.[结果]两组CTA成像质量相比差异具有统计学意义(P＜0.05).[结论]对64排螺旋CT冠状动脉CTA检查病人予以针对性、个性化护理干预可显著提高成像质量.

临床所见急性子宫内翻是一种罕见的产科严重并发症, 结合病史诊断不难.由子宫粘膜下肌瘤等所致的慢性完全性子宫内翻更加罕见, 影像上容易因认识不足而误诊、漏诊,需与子宫内膜肿瘤、粘膜下病变、阴道肿瘤等加以鉴别,临床报道基本为个案报道[1,4-7],而影像MR检查国内外罕见报道,现结合文献,报道如下.

目的 探讨MRI诊断早期强直性脊柱炎的价值.方法 搜集30例经临床表现、实验室检查和影像学检查诊断为早期强直性脊柱炎患者的全脊柱及骶髂关节MRI检查资料,分析其好发部位、MRI表现、脊柱附属结构改变及发生率.结果 30例患者均出现骶髂关节炎的MRI改变及不同程度的脊柱及其附属结构改变.脊柱及其附属结构病变中,前纵韧带起止点炎出现较早,发生率较高(66.7％,20/30).结论 MRI是诊断早期强直性脊柱炎的首选检查方法,除显示骶髂关节改变外,还可显示脊柱及其附属结构的早期改变.