目的 探讨多参数磁共振成像对T1高信号间隔与非T1高信号间隔的原发性鼻腔鼻窦黑色素瘤（PSM）的鉴别价值。方法 回顾性分析经病理证实的 PSM 44例,术前均接受常规,DWI 和DCE-MRI检查。通过单因素和多因素Logistic分析评估T1高信号间隔与非T1高信号间隔PSM各MRI参数的差异。结果 44例PSMs 中,T1高信号间隔PSMs 25例,非T1高信号间隔PSMs 19例。两者在多参数MRI中,仅T2低信号间隔,ADC值、达峰时间（Tp）及最大相对增强率（MRER）在单变量分析中差异存在统计学意义（均P<0.05）,在多因素Logistic分析中差异均无统计学意义（P均>0.05）。结论 多参数MRI对区分T1高信号间隔与非T1高信号间隔的PSM具有一定的指导价值,但并不能作为区分两者的独立预测指标。
Objective To evaluate the diagnostic value of multi-parameter MRI in differential diagnosis of primary sinonasal melanoma（PSM）with high- and non-high-T1 signal septa．Methods Forty-four patients pathologically confirmed with PSMs underwent conventional,DWI and DCE-MRI examinations before operation．Univariate and multivariate Logistic analyses were used to evaluate the differences of MRI parameters between high- and non-high-T1 signal septa in PSMs．Results Among 44 PSMs,25 cases had high T1 signal septa and 19 cases had non-T1 high signal septa．In multi-parameter MRI,only T2 low signal septa,the value of ADC,peak time（TP）and maximum relative enhancement rate（MRER）were significantly different in univariate analysis（P<0.05）,but not in multivariate Logistic analysis（P>0.05）．Conclusions Multi-parameter MRI has some value in differentiating PSM with high-T1 and non-high-T1 signal septa,but it can not be used as an independent predictor to distinguish them．
目的 对比磁敏感加权成像（SWI）、磁共振成像（MRI）、第3代双源电子计算机断层扫描（CT）三种方式在急性缺血性脑卒中（AIS）患者血管内治疗后诊断出血灶以及碘对比剂外渗中的临床价值。方法 选取2022年1月—2023年2月在新乡医学院第一附属医院接受血管内治疗的80例AIS患者作为研究对象,所有患者均接受MRI、SWI、第3代双源CT检查,经综合分析后确定诊断结果,对比三种检查方法对治疗后早期出血灶的鉴别效能,同时以治疗72 h后的常规CT结果作为诊断金标准,评价三种检查方法诊断早期出血灶与碘对比剂外渗的效能。结果 MRI的阳性预测价值为90.32%、阴性预测价值为88.00%,SWI的阳性预测价值为93.55%、阴性预测价值为92.00%,第3代双源CT的阳性预测价值为93.75%、阴性预测价值为95.83%,其中第3代双源CT与金标准的一致性更高（Kappa=0.891）。与治疗72 h后的常规CT结果对比,MRI的曲线下面积（AUC）为0.907,诊断灵敏度为90.32%、特异度为88.00%、准确度为89.29%;SWI的AUC为0.937,诊断灵敏度为93.55%、特异度为92.00%、准确度为92.86%;第3代双源CT的AUC为0.971,诊断灵敏度为96.77%、特异度为92.00%、准确度为94.64%,第3代双源CT的诊断效能最高。结论 AIS血管内治疗后,采用SWI、MRI、第3代双源CT三种检查方式均能有效区分出血灶与碘对比剂外渗情况,且临床诊断价值较好。
目的 分析CT+MRI在原发性肝癌诊断与介入治疗预后评估中的临床意义。方法 选定本院2019年1月—2021年1月住院治疗的150例原发性肝癌患者,入院后均接受介入治疗,分别予以CT、MRI检查,将手术病理检查结果作为本次研究的金标准,比较CT、MRI、CT+MRI诊断效能,Kappa检验CT、MRI、CT+MRI与金标准的一致性,比较CT、MRI、CT+MRI介入术后病灶检出率。结果 CT+MRI诊断准确率(98.67%)、特异度(75.00%)、灵敏度(99.32%)均高于CT(86.00%、25.00%、87.67%)、MRI(90.67%、91.78%、50.00%),P＜0.05(差异均有统计学意义),CT+MRI与金标准的一致性较好(Kappa值为0.779),CT、MRI与金标准的一致性一般(Kappa值为0.527、0.596)。CT+MRI介入术后病灶总检出率(12.00%)高于CT(2.00%)、MRI(4.00%),P＜0.05(差异有统计学意义)。结论 CT+MRI可提高原发性肝癌患者介入术后病灶检出率,弥补了单一CT、MRI检查的不足。
Objective To evaluate the clinical significance of CT + MRI scans in diagnosis of primary liver cancer and prognosis evaluation after interventional therapy. Methods A total of 150 cases of patients with primary liver cancer admitted to our hospital from January 2019 to January 2021 were selected. They all received interventional treatment, and were examined by CT and MRI. The results of pathological examination were taken as the gold standard in this study to compare the diagnostic efficacy of CT, MRI and CT+MRI.Kappa value was used to compare the consistency of CT, MRI, CT+MRI scans with gold standard, and compared the detection rate of lesions after CT, MRI and CT+MRI interventional surgery. Results The diagnostic accuracy (98.67%), specificity (75.00%) and sensitivity (99.32%) of CT + MRI scans were higher than those of CT (86.00%, 25.00%, 87.67%) and MRI scans (90.67%, 91.78%, 50.00%),P<0.05 (which differences were statistically significant). The consistency of CT + MRI scans with gold standard was good (kappa value was 0.779), but the consistency of CT/MRI scans with gold standard were not satisfying (kappa value were 0.527, 0.596). The total detection rate of lesions after CT + MRI interventional surgery (12.00%) was higher than that of CT (2.00%) and MRI (4.00%, which P<0.05). Conclusion CT + MRI scans can improve the detection rate of lesions in patients with primary liver cancer after interventional therapy, and make up for the deficiency of only CT or MRI scans.
目的 研究磁共振成像(magnetic resonace imaging, MRI)检查颈椎病患者椎间盘及颈髓病变的检出率。方法 选取2017年3月—2019年3月我院颈椎病患者216例,均行MRI检查、CT检查。比较MRI检查、CT检查颈椎病的检出率、颈椎病影像征象的检出率及神经根型、脊髓型颈椎病的检出率。结果 MRI检查颈椎病患者椎间盘膨出及突出、椎间盘变性、椎间盘纤维环病变、颈髓缺血性损伤、后纵韧带病变、颈椎病椎间隙狭窄、钩突增生、椎体后缘骨赘、小关节突增生、骨性椎管狭窄、颈椎曲度异常检出率均高于CT检查(P＜0.05);MRI检查、CT检查颈椎病患者椎间孔狭窄、椎管狭窄检出率比较,差异无统计学意义(P＞0.05);MRI检查椎间盘钙化、椎小关节骨质增生、椎间盘积气检出率低于CT检查,椎间盘突出、黄韧带增厚、脊髓变性、硬膜囊受压、神经根受压检出率高于CT检查(P＜0.05);MRI检查神经根型颈椎病检出率94.44%、脊髓型颈椎病检出率88.89%高于CT检查检出率75.00%、25.25%(P＜0.05)。结论 MRI检查颈椎病患者能提高椎间盘及颈髓病变的检出率,对多种颈椎病变征象显著,有助于颈椎病分型的鉴别诊断,从而为临床治疗方案的制定提供科学依据。
Objective To study the detection rate of cervical disc and spinal cord lesions in patients with cervical spondylosis by magnetic resonance imaging (MRI). Methods A total of 216 patients with cervical spondylosis in our hospital from March 2017 to March 2019 were selected, all of them underwent MRI and computed tomography (CT) examination. The detection rate of cervical spondylosis, imaging signs of cervical spondylosis, and cervical spondylosis of nerve root type and spinal cord type by MRI and CT were compared. Results The detection rates of cervical spondylosis patients with disc herniation and protrusion, disc degeneration, disc annulus fibrosus disease, cervical spinal cord ischemic injury, posterior longitudinal ligament disease, cervical intervertebral space stenosis, uncinate process hyperplasia, vertebral posterior margin osteophyte, facet hyperplasia, bony spinal stenosis, abnormal cervical curvature by MRI examination were higher than that by CT examination (P<0.05). There were no significant differences in the detection rates of foramen stenosis and spinal canal stenosis between MRI and CT examination (P>0.05); the detection rates of intervertebral disc calcification, vertebral facet joint hyperosteogeny and intervertebral disc pneumatosis by MRI examination were lower than that by CT examination; the detections rates of intervertebral disc herniation, ligamentum flavum thickening, spinal degeneration, dural sac compression and nerve root compression by MRI examination were higher than that by CT examination (P<0.05); the detection rates of cervical spondylotic radiculopathy and cervical spondylotic myelopathy by MRI examination were 94.44% and 88.89%, which were higher than 75.00% and 25.25% of the detection rates by CT examination (P<0.05). Conclusion MRI examination of patients with cervical spondylosis can improve the detection rates of intervertebral disc and cervical spinal cord lesions, and has significant signs for a variety of cervical lesions, which is helpful for the differential diagnosis of cervical spondylosis classification, so as to provide scientific basis for the formulation of clinical treatment plan.
目的 探讨多参数磁共振成像-经直肠超声(mpMRI-TRUS)认知融合技术引导前列腺穿刺活检的临床应用价值。方法 选取2018 年1月—2020年12月就诊于本院且为前列腺癌疑似患者作为研究对象,分为mpMRI-TRUS组与TRUS组。mpMRI-TRUS组所有病例穿刺活检前均行mpMRI检查,根据MRI结果确定靶向病灶,行mpMRI-TRUS认知融合靶向活检和系统10针活检。TRUS组患者只行系统13针活检,比较两组间前列腺癌的检出率,同时比较mpMRI-TRUS组中靶向活检和系统活检在前列腺癌检出率方面的差异,并对穿刺病理结果进行观察和分析。结果 mpMRI-TRUS组穿刺活检阳性率为43.59%,TRUS组穿刺活检阳性率为33.07%,两组前列腺癌检出率差异无统计学意义。mpMRI-TRUS组中靶向穿刺的单针阳性率、靶向穿刺组织前列腺癌组织占比高于系统穿刺;mpMRI-TRUS组中靶向穿刺阳性率为38.46%,系统穿刺阳性率为42.30%,两者差异无统计学意义。结论 mpMRI-TRUS认知融合技术在前列腺穿刺活检能够以较少的穿刺针数检出前列腺癌,靶向穿刺能提供更多前列腺癌组织,降低前列腺癌穿刺活检的漏诊率。
Objective To explore the clinical application value of multi-parameter magnetic resonance imaging-transrectal ultrasound (mpMRI-TRUS) cognitive fusion technology to guide targeted prostate biopsy. Methods The research objects were patients suspected of prostate cancer from January 2018 to December 2020 and the patients were divided into mpMRI-TRUS group and TRUS group. All cases in the mpMRI-TRUS group underwent mpMRI examination before needle biopsy. The targeted lesions were determined according to the MRI results.And mpMRI-TRUS cognitive fusion targeted biopsy and system 10-needle biopsy were performed. Patients in the TRUS group only underwent a systematic 13-needle biopsy. The detection rate of prostate cancer between the two groups was compared. At the same time, the difference in the detection rate of targeted biopsy and systematic biopsy in the mpMRI-TRUS group was also compared. The pathological results of puncture were observed and analyzed. Results The positive rate of needle biopsy in the mpMRI-TRUS group was 43.59%, and the TRUS group was 33.07%. There was no significant difference in the detection rate of prostate cancer between the two groups. In the mpMRI-TRUS group, the single-needle positive rate and the proportion of prostate cancer tissue were higher than that of system puncture. The positive rate of targeted puncture in the mpMRI-TRUS group was 38.46%, and the system puncture was 42.30%. The difference between the two groups is not statistically significant. Conclusion The mpMRI-TRUS cognitive fusion technology can detect prostate cancer with fewer needles in prostate biopsy. Targeted biopsy puncture can provide more prostate cancer tumor tissues and reduce the missed diagnosis rate of prostate cancer biopsy.
目的 探讨B超与MRI、宫腔镜联合诊断对宫腔占位性病变的临床意义。方法 选择2017年1月1日— 12月31日我院收治的108例疑似宫腔占位性病变患者为研究对象。所有患者均于宫腔操作前行阴道彩色多普勒超声(以下简称B超)检查、MRI检查及宫腔镜检查。与病理检查结果对比,分别分析其灵敏度、特异度。结果 108例患者中宫腔无病理变化者27例,子宫内膜息肉39例,子宫内膜增生27例,子宫黏膜下肌瘤10例,子宫内膜癌5例。B超、MRI、宫腔镜诊断灵敏度分别为72.84%、71.60%、75.31%,特异度分别为62.96%、85.19%、66.67%。B超+MRI诊断子宫黏膜下肌瘤和子宫内膜癌灵敏度100%,特异度分别为87.76%和99.03%。B超+MRI+宫腔镜诊断子宫内膜增生、子宫黏膜下肌瘤、子宫内膜癌灵敏度均为100%。结论 宫腔占位病变以良性病变居多,B超联合宫腔镜和MRI检查可提高诊断率。对子宫内膜癌高危人群应进行B超与MRI联合检查,宫腔镜定位活检仅在必要时实施。
Objective To explore the clinical significance of B-ultrasound, MRI and hysteroscopy in the diagnosis of uterine space occupying lesions. Methods 108 patients with suspected uterine space occupying lesions admitted to our hospital from January 1 to December 31 2017 were selected as the study objects. All patients were examined by vaginal color Doppler ultrasound, MRI and hysteroscopy before uterine operation. Compared with the results of pathological examination, the sensitivity and specificity were analyzed. Results Among the 108 patients, 27 had no pathological changes in uterine cavity, 39 had endometrial polyps, 27 had endometrial hyperplasia, 10 had submucous myoma, and 5 had endometrial cancer. The sensitivity of B-ultrasound, MRI and hysteroscopy were 72.84%, 71.60% and 75.31% respectively, and the specificity were 62.96%, 85.19% and 66.67% respectively. The sensitivity of B-ultrasound+MRI in the diagnosis of submucous myoma and endometrial carcinoma was 100% and the specificity was 87.76% and 99.03%, respectively. The sensitivity of B-ultrasound+MRI+hysteroscopy in the diagnosis of endometrial hyperplasia, submucous myoma and endometrial carcinoma was 100%. Conclusion Most of the uterine space occupying lesions are benign. B-ultrasound combined with hysteroscopy and MRI may improve the diagnosis rate. The high-risk group of endometrial cancer should be examined by B-ultrasound and MRI, and hysteroscopic biopsy would be performed only when necessary.
目的 对我院43例经临床诊断及随访证实的足底筋膜炎患者MRI诊断资料进行回顾性研究,总结其MRI特征。方法 选取2016年8月—2017年8月因足底疼痛就诊的43例患者为本次研究对象,对患者进行彩超及MRI诊断,对比诊断患侧及健侧足底筋膜厚度及评测者间相关系数。结果 经临床及随访证实足底筋膜炎患者43例。MRI诊断结果:43例患者中最常见表现为足底筋膜周围软组织水肿,32例患者表现为跟骨骨髓水肿,17例患者观察到足底筋膜内肌腱信号改变。彩超及MRI诊断患侧、健侧足底筋膜厚度均有差异,MRI诊断优于对照组,组间差异有统计学意义(P＜0.05);彩超及MRI评测者间相关系数有差异,MRI诊断优于对照组,组间差异有统计学意义(P＜0.05)。结论 足底筋膜炎采用MRI诊断可观察到足底筋膜厚度及信号改变,对跟骨骨髓水肿、筋膜周围软组织肿胀改变程度有良好诊断表现,临床可作为足底筋膜炎诊断的首选方法。
Objective The MRI diagnostic data of 43 patients with plantar fasciitis confirmed by clinical diagnosis and follow-up were retrospectively studied. Methods Selection in August 2016 to August 2017 because of a foot pain clinic of 43 patients as the research object, to colour to exceed and MRI in the diagnosis of patients with diagnosed with lateral contrast and health parapodum bottom thickness of the membrane and the correlation coefficient between the reviewers. Results 43 cases of plantar fasciitis were confirmed by clinical and follow-up. Of MRI diagnosis results: 43 cases of plantar fascia around the most common soft tissue edema, 32 patients were characterized by calcaneal bone marrow edema, 17 patients were observed in the plantar fascia tendon signal change. There were significant differences in the diagnosis and treatment of the lateral and healthy side of the MRI diagnosis, and the MRI diagnosis was significantly better than the control group, and the difference between the groups was statistically significant (P< 0.05). There was significant difference in correlation coefficient between color ultrasound and MRI. MRI diagnosis was significantly better than the control group, and the difference between groups was statistically significant (P< 0.05). Conclusion Plantar fasciitis plantar fascia was observed by MRI in the diagnosis of thickness and signal change, soft tissue around the heel bone marrow edema, fascia swelling degree of change has a good diagnosis performance, clinical can be used as the preferred methods for the diagnosis of plantar fasciitis.
目的 比较3种常见MRI序列对于新生儿臂丛神经损伤的显示率。方法 采用1.5TMR对两组共25名受试对象进行双侧臂丛神经扫描,扫描序列包含单方向背景抑制弥散加权成像序列(DWIBS)、重T2脂肪抑制序列(STIR/long TE)和脊髓造影序列(MYELO-3D),各序列所用扫描层厚、层间距、扫描范围均相同。分别统计出3种序列单独、3种序列进行两两组合运用和3种序列共同运用的诊断效能。结果 DWIBS序列对于新生儿臂丛神经损伤无诊断作用。MYELO-3D序列优于STIR/long TE序列,而MYELO-3D序列与STIR/longTE序列联合应用优于3种序列单独运用。结论 MYELO-3D序列与STIR/longTE序列联合应用对于显示新生儿臂丛神经损伤效果较佳。
目的 探讨CT、MRI影像学表现对原发性肝细胞癌（HCC）微血管侵犯（MVI）的诊断价值。方法 选取2018年1月—2024年7月江门市第二人民医院（江门市中心医院蓬江分院）和江门市中心医院120例（共158个病灶）HCC患者，均行上腹部CT、MRI平扫+增强及弥散加权成像（DWI）检查；以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能；分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性；比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数（ADC）值。结果 DWI检查对HCC MVI的诊断效能（灵敏度、特异度、准确度、阳性预测值、阴性预测值）均显著性高于CT、MRI平扫+增强（P＜0.05）；CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较，差异均无统计学意义（P＞0.05）。在HCC MVI诊断效能中，CT、MRI影像学表现与术后病理确诊结果之间为中度一致性；DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者（P＜0.05）。在不同b值（400、800、1 000、1 500 s/mm2 ）下，HCC MVI患者的ADC值均显著性高于无HCC MVI患者（P＜0.05）。结论 CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能，而MRI诊断结果与病理诊断一致性更佳，尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯，有助于指导临床医生建立“个体化”精准诊疗策略。
Objective To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion（MVI）in primary hepatocellular carcinoma（HCC）．Methods A total of 120 patients（158 lesions in total）with HCC in the Second People’s Hospital of Jiangmen（Pengjiang Branch of Jiangmen Central Hospital）and Jiangmen Central Hospital were selected from January 2018 to July 2024，all underwent CT and MRI plain + enhanced and diffusion-weighted imaging（DWI）of the upper abdomen；postoperative pathology results was used as the diagnostic gold standard．The diagnostic efficacy of CT，MRI plain + enhanced and DWI for HCC MVI was compared．The concordance among CT，MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI．Imaging manifestations and apparent diffusion coefficient（ADC）values in patients with and without HCC MVI were compared．Results Diagnostic effectiveness of DWI examination for HCC MVI（sensitivity，specificity，accuracy，positive predictive value，negative predictive value）were all significantly higher than those of CT and MRI plain + enhanced（P＜0.05）；none of the differences were statistically significant（P＞0.05）in the comparison of diagnostic effectiveness of CT，MRI，and DWI for the diagnosis of MVI in patients with primary HCC．In HCC MVI diagnostic effectiveness，moderate concordance was found among CT，MRI imaging phenotypes and postoperative pathology results；high concordance was found between DWI and postoperative pathology results．In HCC MVI patients，the proportion of non-marginal arterial reinforcement，enhanced envelope，halo reinforcement，nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI（P＜0.05）．At different b-values（400，800，1 000，1 500 s/mm2 ），ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI（P＜0.05）．Conclusions CT，MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI，while MRI diagnostic results are in better concordance with pathologic diagnosis．In particular，ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC，which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies．
