慢性前列腺炎(CP)是一种老年男性常见泌尿系统疾病,无生命威胁但可能影响患者日常生活,并对患者心理造成负面影响,继而危及患者性功能,影响患者生活[1].前列腺癌(PCa)具有高发病率和高病死率的特点,严重威胁患者生命健康.目前,临床常用血清学和磁共振成像(MRI)诊断PCa.血清前列腺特异抗原(PSA)是一种特异性抗原,对PCa和CP均有敏感性,可能出现误诊现象[2].MRI鉴别两种疾病时可能均出现外周带T2WI低信号的现象,而磁共振扩散加权成像(DWI)可通过表观扩散系数(ADC)对两种疾病作进一步较为准确的判断[3].而CP不及时治疗也可能从炎症恶化发展成为PCa,或者误诊成为PCa[4-5].因此,本文利用DWI联合血清PSA进一步提高对外周带T2WI低信号CP患者鉴别能力,取得较好效果,现报道如下.

Objective:To investigate the clinical significance of quantitative detection of myocardial edema in acute myocardial infarction based on T 2 mapping. Methods:From July 2018 to February 2019, a total of 20 patients (observation group) who underwent cardiac MRI after interventional therapy in the People's Hospital of Wenzhou were enrolled.Another 20 healthy volunteers were selected as the control group.The image data of the observation group were collected, and the image data were post-processed.The T 2 value, edema area and microcirculation obstacle area of the infarcted myocardium and its contralateral normal myocardium were measured and recorded by the image information.The infarcted myocardium and the contralateral normal myocardium were recorded.The T 2 values were compared and the cardiac MRI, cardiac function, serological markers and heart failure related products of the two groups were compared. Results:The patients in the observation group underwent self-comparison between infarcted myocardium and normal myocardium.The T 2 value of the distal infarcted myocardium was (90.14±.51)ms, which was greater than that of the normal myocardium [(60.71±5.15)ms], the difference was statistically significant( t=8.49, P<0.05). The number of myocardial microvascular obstruction (MVO) in the observation group was 17 cases, which in the control group was 0 cases, the difference was statistically significant (χ 2=41.45, P<0.05). The left ventricular end-diastolic volume of the observation group[(88.5±16.2)mL] was higher than that of the control group[(72.4±15.1)mL], and the difference was statistically significant ( t=12.51, P<0.05). The ejection fraction of the observation group was (54.1±11.2)%, which was lower than that of the control group [(71.2±7.9)%], and the difference was statistically significant ( t=18.71, P<0.05). The T 2 value of the observation group was (69.4±6.4)ms, which was higher than that of the control group[(55.2±11.4)ms]( t=11.98, P<0.05). The degree of myocardial delayed imaging (LGE) in the observation group was 13%, which in the control group was 0%, the difference was statistically significant ( Z=27.62, P<0.05). T 2 mapping showed that myocardial infarction sensitivity and positive predictive value were higher, but its specificity was relatively low. Conclusion:Quantitative T 2 mapping has high clinical value in the evaluation of myocardial edema after acute myocardial infarction.T 2 mapping can be used to analyze the extent of lesions in patients with acute myocardial infarction.

目的:探究腕关节损伤中多层螺旋CT与核磁共振成像联合诊断的价值.方法:选取本院2016.12-2017.12收治的腕关节损伤患者84例,按照随机表法分为三组,各28例.按照不同诊断方式,命名组别.核磁共振组患者采用核磁共振检查关节脱位、骨折、隐匿性骨折和移位碎骨折片情况;多层螺旋CT组采用多层螺旋CT检验患者关节脱位、骨折、隐匿性骨折和移位碎骨折片情况,而联合检测组采用多层螺旋CT与核磁共振成像联合检测方式为患者检验关节脱位、骨折、隐匿性骨折和移位碎骨折片情况.结果:在关节脱位、骨折、隐匿性骨折和移位碎骨折片检测情况中,联合检测诊断组检测效果好于多层螺旋CT组,而核磁共振组检测效果最差.结论:使用多层螺旋CT与核磁共振成像联合诊断,具有良好的诊断效果,值得临床推广使用.

目的 MRI双回波稳态(We DESS)及T2-mapping序列在鉴别踝关节撞击综合征(AIS)关节软骨退变早期的价值.方法 回顾性分析收治的AIS患者30例,均给予MRI常规FS-T2WI序列、WeDESS及T2-mapping序列检查,比较3种扫描序列对关节软骨退变早期诊断的敏感度、特异度及准确度,同时比较软骨退变早期与未退变 T2-mapping序列T2值.结果 30例患者最终经经踝关节镜取组织行病理检查后发现关节软骨退变早期14例,未退变16例.We DESS、T2-mapping序列的敏感度、特异度及准确度明显高于FS-T2WI序列(均P＜0.05),但We DESS与T2-mapping序列诊断敏感度、特异度及准确度差异均无统计学意义(均P＞0.05).软骨退变早期患者平均T2值与未退变患者差异有统计学意义(P＜0.05).结论 WeDESS及T2-mapping序列对AIS关节软骨退变早期的鉴别有较高价值,且T2-mapping序列检查可进行定量评估,值得临床应用.

Objective To explore the correlations between the brain metabolites and the development quotient in the preterm infants, thus to provide a important informations for the early diagnosis and prediction of nervous system development delayed in the preterm infants .Methods Total of 45 cases with preterm and 30 cases with full-term underwent 1 H-MRS scan within 1 week of birth to collect their brain metabolite data , including the NAA/Cr, Cho/Cr, Lac/Cr, Glx/Cr and MI/Crr.The Gesell examina-tion was performed at postnatal 40~52 weeks.The values of the development quotient and its five functional areas were recorded . The correlations between the brain metabolites and the development quotient were analyzed by Multiple linear regression analysis . Results The value of NAA/Cr in the premature infant was lower than that of the full term infant , the difference was statistically significant ( t =-6.202, P <0.001).The values of Cho/Cr, Lac/Cr and Glx/Cr were higher than that of the full term infant , the difference was statistically significant ( P <0.001).The multiple linear regression analysis demonstrated that the develop-ment quotient had significant correlations with the values of NAA /Cr and Lac/Cr (determination coefficient was 0.418).Conclu-sion There was significant correlation between the brain metabolites ( NAA and Lac ) in the early 1 H-MRS and the Gesell devel-opmental quotient in the preterm infants suggests that the NAA and Lac may be an early predictive indicator in the nervous system development delayed in the preterm infants .

目的：探讨多层螺旋 CT(MSCT)鉴定细微肋骨骨折最佳检查时间，避免漏诊、误诊，减少患者多次复查的 X 射线辐射剂量。方法回顾性分析温州市人民医院152例肋骨骨折患者，患者均行 MSCT 检查，首次检查在1周内，于第2~8周内第2次复查，部分患者8周后继续随访。薄层轴位图像并结合容积再现技术(VRT)、多平面重建(MPR)等后处理方法进行观察。统计复查与首次检查或者多次复查间肋骨数有差异的细微肋骨骨折患者归入差异组，比较差异组不同检查时间检出肋骨骨折数的差异。使用配对 t 检验进行统计学分析。结果39例患者归入差异组，最终诊断肋骨骨折为231根，第1周仅诊断134根。伤后第1周及第2周与之后不同检查周复查患者肋骨骨折数比较差异均有统计学意义(P <0.05)。第3周与之后不同检查周比较均差异无统计学意义(P >0.05)。第3~8周复查骨折数与大于8周复查骨折数比较有统计学意义(P =0.013)。结论伤后3~8周为鉴定细微骨折确定最终骨折根数最佳检查时间，可有效减少漏诊、误诊，在医学鉴定工作中有重要意义。