乳腺导管内乳头状瘤的MRI诊断价值探讨

目的 :探讨乳腺导管内乳头状瘤的MRI表现及其诊断价值。方法 :回顾性分析22例经手术和病理证实为乳腺导管内乳头状瘤的影像学资料。结果 :本组病例主要MRI表现可归纳为4种类型:边缘光滑结节型(45.4%,10/22)、不规则结节型(27.3%,6/22)、囊内结节型(18.2%,4/22)、导管扩张型隐匿性病变(9.1%,2/22)。乳腺导管内乳头状瘤的MRI形态学与血流动力学特点多样,部分与恶性肿瘤难以区分,但也具有一定特征性。结论 :MRI能较准确地发现与定位BIDP病灶,对临床诊断与术前评估具有重要意义。     

乳腺浸润性癌超声特征与腋窝淋巴结转移的关联性研究分析

目的：研究乳腺浸润性癌超声特征与腋窝淋巴结转移(ALNM)的关联性。方法：选取西安高新医院从2020年7月～2022年7月收治的113例乳腺浸润性癌患者开展试验。将其是否发生ALNM分作ALNM组(n=48例)及无ALNM组(n=65)例。对所有患者均开展超声检查,对比两组临床资料(涵盖年龄、绝经、肿瘤直径、临床分期及分化程度)及超声特征(涵盖形状、毛刺征、后方回声、微钙化、血流分级、腋窝淋巴结纵横径比及腋窝淋巴结皮质厚度)。以多因素Logistic回归分析明确乳腺浸润性癌ALNM的影响因素。结果：ALNM组肿瘤直径≥3cm及低分化人数占比为33.33%、41.67%,均高于无ALNM组的16.92%、18.46%(均P<0.05)。ALNM组毛刺征、血流分级2～3级人数占比分别为52.08%、72.92%,均高于无ALNM组的27.69%、36.92%,且腋窝淋巴结纵横径比、皮质厚度分别为(0.59±0.12)、(5.10±1.05)mm,均高于无ALNM组的(0.48±0.10)、(2.88±0.56)mm(均P<0.05)。经多因素Logistic回归分析证实,肿瘤直...     

膝周慢性骨髓炎与骨肉瘤的低场MRI鉴别诊断

目的:探讨低场MRI对膝周慢性骨髓炎与骨肉瘤的鉴别诊断价值。方法:回顾性分析临床证实的膝周长骨慢性骨髓炎(15例)和骨肉瘤(6例)0.35T MRI资料并复习文献。结果:两组均有骨破坏及骨硬化。病变散在条片状分布,半影征、骨周大量积液征、窦道征为慢性骨髓炎较为特异的征象;而病变较连续分布并呈僵硬征及Codman三角征更多见于骨肉瘤。结论:熟悉膝周慢性骨髓炎与骨肉瘤的低场MRI表现特点有助于诊断及鉴别诊断。     

不同肿块类型MDE与IDC,DCIS的彩超影像分析

目的 分析不同肿块类型乳腺导管扩张症(MDE)与浸润性导管癌(IDC)、导管原位癌(DCIS)在彩色多普勒超声(CDFI)下的影像表现.方法 回顾性分析我院2017年4月至2019年3月收治的经病理证实为MDE的62例患者的临床资料进行研究(MDE组).另分析同期经病理证实为乳腺癌患者95例的临床资料,其中IDC51例...     

纵隔支气管源性囊肿的CT特征及鉴别诊断

目的:分析纵隔支气管源性囊肿(Mediastinal bronchogenic cyst,MBC)的CT特征及鉴别诊断依据。方法:分析18例经病理检查确诊的MBC患者临床及影像资料,分析病变部位、CT平扫及增强扫描表现、误诊情况,据此总结MBC的CT特征与鉴别诊断依据。结果:误诊13例,误诊率为72.22%。MBC病灶最大径19~85 mm,平均(36.02±10.81)mm,均为单发病变,其中7例位于前纵膈,4例位于中纵膈,7例位于后纵膈。内部密度分型:液性密度4例,软组织密度14例(球灶型8例,不确定型6例)。增强扫描示:仅1例可见囊壁强化。18例病灶中,13例边缘清晰、完整,其余5例边缘欠光滑;不确定型病灶中,6例CT值超过60 Hu,其CT值分布范围为65~137 Hu,1例CT值未超过60 Hu的病灶可见囊壁与周围实变肺组织紧密相连,囊内密度不均匀并可见点状钙化,囊壁强化呈条片状。结论:MBC的术前误诊率较高,根据囊肿边缘光滑、密度均匀及增强扫描一般无强化的CT特征,综合与周围解剖结构的关系及临床表现,一般可达到定性诊断。     

胸部孤立性纤维瘤的CT表现与鉴别诊断

目的:观察胸部孤立性纤维瘤(pleural solitary fibrous tumor,PSFT)的CT表现,总结鉴别诊断策略。方法:分析24例PSFT患者CT平扫和增强征象以及病理表现。结果:均为胸腔内单发肿块,CT平扫可见软组织肿块且边缘光滑,与胸壁或纵膈间夹角呈钝角,可见胸膜轻微局限掀起,呈胸膜尾征;19例肿瘤密度相对均匀,5例瘤体较大者,肿瘤内部密度欠均匀。12例增强扫描可见不均匀强化,以肿瘤中心点状、条状、斑片状不明显强化为主;10例肿瘤不同区域可见轻度、中度、显著强化同时存在,以轻度、中度强化为主;9例肿瘤内部可见血管影像,局部血供丰富;3例瘤体增强无特殊变化。22例肿瘤边缘与周围组织界限清晰,肿瘤包膜完整,周围组织受压明显,1例肿瘤可见瘤蒂,1例肿瘤因侵犯纵膈、心包局部致使界限不清。病理结果显示24例中18例来源于脏层胸膜,6例来源于壁层胸膜。结论:PSFT的CT表现具有较高特征性,结合肿瘤定位及其与周边组织结构的关系有助于本病的鉴别诊断。     

3.0T MRI诊断糖尿病肌梗死与病理对照一例并文献复习

目的 探讨MRI在糖尿病性肌梗死中诊断价值.资料与方法 分析我院收治的1例糖尿病性肌梗死患者的MRI表现,与经皮穿刺活检病理结果进行对照.本例患者男性,53.0岁,因10天前无明显诱因下左髋部出现肿块伴疼痛不适入院.结果 受累左臀肌明显肿胀增厚,邻近皮下组织水肿.MRI示T1WI呈低信号,T2WI信号增高,STIR-T...     

仔猪腹泻与猪痢疾的鉴别诊断

仔猪腹泻和猪痢疾为养猪生产中的多发病,基层养殖户诊断疾病缺乏检验设备仅凭临床症状做初步诊断,导致两种疾病误诊率颇多,延误诊治时机,给猪场造成严重的经济损失。作者在文献查阅的基础上,结合临床诊疗实践,建议从发病年龄、粪便性状、剖检变化、用药效果等方面作对比分析,详细要点逐一介绍,以供参考和借鉴。     

超声联合弹性成像诊断甲状腺微小乳头状癌的临床价值研究

目的 :探究超声联合弹性成像诊断甲状腺微小乳头状癌的临床价值。方法 :常规超声及弹性成像检查资料完整的129枚甲状腺微小结节,将影像学检查结果与术后病理组织学检查结果进行对比,分析超声联合弹性成像诊断微小乳头状癌的灵敏度、特异性,总结其声像图特征。结果 :术后病理组织学检查共检出恶性结节57枚,占44.19,良性结节占55.81%(72/129)。微小乳头状癌与良性结节常规超声边界、内部回声、纵横比、微小钙化表现比较,差异有统计学意义(P<0.05),其血流分布比较,差异无统计学意义(P>0.05)。联合检查诊断的灵敏度、特异性、阳性预测值均高于常规超声、弹性成像单项检查。结论 :超声联合弹性成像诊断微小乳头状癌具有较高的灵敏度、特异性。     

MRI诊断中枢神经系统脱髓鞘性假瘤的价值分析

目的探讨磁共振成像技术(Magnetic Resonance Imaging,MRI)对中枢性神经系统脱髓鞘性假瘤(Demyelinating Pseudo Tumor Lesion,DPT)的诊断价值.方法选取本院2019年1月—2022年1月接诊的疑似DPT患者120例,收集其治疗前后MRI(平扫+增强)影像资料,以病理结果为标准,分析MRI检查的诊断效能,并总结DPT的影像特点.结果120例患者MRI共检出162个病灶,其中单发患者101例,多发患者19例.治疗前MRI检测出145个DPT病灶;MRI平扫显示脑部局部肿块,112个病灶长度均一的长.T1长T2,47个病灶呈不均匀长T1长T2,3个呈等长T1长T2,122个病灶增强扫描显示不同程度的强化,可呈条状、火焰状、环状、非闭合环形强化等,40个病灶未见明显强化.MRI诊断DPI的敏感性为97.30%,特异性为77.78%,准确率为95.83%,阳性预测值为98.18%,阴性预测值为70.00%.结论DPT的增强MRI扫描图像具有一定的特点,如非闭合环形增强和垂直于侧脑室的线性增强,有利于DPT和颅内肿瘤的鉴别.MRI检查,尤其是增强扫描,具有较高的临床价值,可用于DPT的术前诊断和术后复查.     

Multiparametric high-resolution imaging of barley embryos by multiphoton microscopy and magnetic resonance micro-imaging

Nonlinear optical microscopy and magnetic resonance imaging (MRI) address different properties of the sample and operate on different geometrical scales. MRI maps density and mobility of molecules tracking specific molecular signatures. Multiphoton imaging profits from the nonlinear absorption of light in the focus of a femtosecond laser source stimulating the autofluorescence of biomolecules. As this effect relies on a high light intensity, the accessible field of view is limited, but the resolution is very high (a few hundred nanometers). Here, we aim to link the different accessible scales and properties addressed in the different techniques to obtain a synoptic view. As model specimen we studied embryos of barley. Multiphoton stimulated autofluorescence images and images of second harmonic generation are achieved even down to low magnification (10x), low numerical aperture (N.A. 0.25) conditions. The overview images allowed morphological assignments and fluorescence lifetime imaging provides further information to identify accumulation of endogenous fluorophores. The second, complementary contribution from high-resolution MR images provides a 3D model and shows the embedding of the embryo in the grain. Images of the proton density were acquired using a standard 3D spin-echo imaging pulse sequence. Details directly comparable to the low magnification optical data are visible. Eventually, passing from the MR images of the whole grain via low magnification to high resolution autofluorescence data bridges the scale barrier, and might provide the possibility to trace transport and accumulation of, e.g., nutrients from large structure of the plant to the (sub-) cellular level.     

脑功能的核磁共振成像

功能性磁共振成像技术是研究大脑认识思维活动过程的强有力工具。本文阐述了ｆＭＲＩ信号变化的物理基础和ｆＭＲＩ的成像新技术,分析了ｆＭＲＩ中的硬件特点,并展望了ｆＭＲＩ成像方法的前景。     

The application of nanoparticles in gene therapy and magnetic resonance imaging

The combination of nanoparticles, gene therapy, and medical imaging has given rise to a new field known as gene theranostics, in which a nanobioconjugate is used to diagnose and treat the disease. The process generally involves binding between a vector carrying the genetic information and a nanoparticle, which provides the signal for imaging. The synthesis of this probe generates a synergic effect, enhancing the efficiency of gene transduction and imaging contrast. We discuss the latest approaches in the synthesis of nanoparticles for magnetic resonance imaging, gene therapy strategies, and their conjugation and in vivo application.     

Unbiased estimation of human body composition by the Cavalieri method using magnetic resonance imaging

The classical methods for estimating the volume of human body compartments in vivo (e.g. skin-fold thickness for fat, radioisotope counting for different compartments, etc.) are generally indirect and rely on essentially empirical relationships — hence they are biased to unknown degrees. The advent of modern non-invasive scanning techniques, such as X-ray computed tomography (CT) and magnetic resonance imaging (MRI) is now widening the scope of volume quantification, especially in combination with stereological methods. Apart from its superior soft tissue contrast, MRI enjoys the distinct advantage of not using ionizing radiations. By a proper landmarking and control of the scanner couch, an adult male volunteer was scanned exhaustively into parallel systematic MR ‘sections’. Four compartments were defined, namely bone, muscle, organs and fat (which included the skin), and their corresponding volumes were easily and efficiently estimated by the Cavalieri method: the total section area of a compartment times the section interval estimates the volume of the compartment without bias. Formulae and nomograms are given to predict the errors and to optimize the design. To estimate an individual's muscle volume with a 5% coefficient of error, 10 sections and less than 10min point counting (to estimate the relevant section areas) are required. Bone and fat require about twice as much work. To estimate the mean muscle volume of a population with the same error contribution, from a random sample of six subjects, the workload per subject can be divided by √6, namely 4 min per subject. For a given number of sections planimetry would be as accurate but far more time consuming than point counting.     

A review of magnetic resonance imaging compatible manipulators in surgery

Developments in magnetic resonance imaging (MRI), coupled with parallel progress in the field of computer-assisted surgery, mean that an ideal environment has been created for the development of MRI-compatible robotic systems and manipulators, capable of enhancing many types of surgical procedure. However, MRI does impose severe restrictions on mechatronic devices to be used in or around the scanners. In this article a review of the developments in the field of MRI-compatible surgical manipulators over the last decade is presented. The manipulators developed make use of different methods of actuation, but they can be reduced to four main groups: actuation transmitted through hydraulics, pneumatic actuators, ultrasonic motors based on the piezoceramic principle and remote manual actuation. Progress has been made concerning material selection, position sensing, and different actuation techniques, and design strategies have been implemented to overcome the multiple restrictions imposed by the MRI environment. Most systems lack the clinical validation needed to continue on to commercial products.     

核磁共振兼容手术机器人的驱动方式分析

核磁共振兼容手术机器人的驱动问题是研究图像导航手术机器人的一个重要内容。首先分析了核磁共振兼容手术机器人存在的问题,介绍了国内外研究者关于核磁共振兼容手术机器人驱动方式的使用情况,探讨了各种驱动方式的特点,得出了各项驱动方式在核磁共振环境下的使用性能,并对其发展方向作出了展望。     

New imaging modalities: positron emission tomography and nuclear magnetic resonance

Positron emission tomography and nuclear magnetic resonance represent two new imaging modalities that utilize computer technology to provide tomographic images of the body. Positron emission tomography uses special metabolic imaging agents, which are positron emitters, to provide information on the metabolic processes that take place within the liver, kidney, and brain, and to allow study of physiologic changing systems such as blood flow. Nuclear magnetic resonance is used to evaluate the chemical constituents and the chemical composition of select tomographic areas within organs of interest. Both methods show great promise for the diagnosis and management of disease.     

Unbiased stereological estimation of the number and volume of nuclei and nuclear size variability in invasive ductal breast carcinomas

The application of design-based stereological methods for estimating nuclear features quantitatively in invasive ductal breast cancer is described. Nuclear number, size and size variability are explored in relation to the tumour grade and patient prognosis. The study includes an examination of the efficiency in estimating different nuclear volumes, and two different estimators of the nuclear size variability are contrasted. Forty-two invasive ductal breast carcinomas diagnosed and graded by two pathologists were used. Both 5-μm and 25-μm-thick sections were obtained from paraffin blocks for stereological study. More undifferentiated tumours show significantly larger nuclei than low-grade tumours. The estimates based on the disector method demonstrate a decrease in the number of tumour cell nuclei per unit volume of tissue from grades 1 to 2 and especially from grades 2 to 3. The univariate survival analysis shows a high prognostic value of the nuclear volume estimates. The study shows that an efficient sampling procedure was performed, particularly when estimating volume-weighted mean nuclear volume using the point-sampled intercepts method. This method is more efficient than estimation of the number-weighted mean nuclear volume using the selector method; however, the latter provides paired estimates of volume- and number-weighted mean nuclear volume, as well as an estimate of the coefficient of variation of nuclear volume in the number distribution of the same cells.