摘要
Objective:To evaluate the detective effect of double inversion recovery (DIR) sequence on cerebral white matter hyperintensities (WMH) in patients with acute ischemic stroke, and compare with those of T2WI and FLAIR sequences.Methods:Seventy-three acute ischemic stroke patients with WMH within 14 d of onset, admitted to Department of Neurology, Beijing Shijitan Hospital, Capital Medical University from November 2018 to March 2021, were chosen. MRI T2WI, FLAIR and DIR sequences were used to detect WMH. According to Fazekas scale, patients with periventricular white matter hyperintensities (PVWMH) or deep white matter hyperintensities (DWMH) were divided into mild group (score of 0-1) and moderate to severe group (scores≥2); the differences in WMH volume detected by T2WI, FLAIR and DIR sequences, and signal intensity, cross-sectional area and contrast of isolated lesions were compared.Results:(1) Seventy-three patients were with PVWMH (36 into the mild group and 37 into the moderate to severe group); in patients from the moderate to severe group, PVWMH volume detected by FLAIR sequence was statistically larger compared with that by DIR sequence, and PVWMH volume detected by T2WI sequence was significantly smaller compared with that by FLAIR sequence ( P<0.05). Fifty-seven patients were with DWMH (44 into the mild group and 13 into the moderate to severe group); the DWMH volume detected by FLAIR and T2WI sequences was significantly larger than that by DIR sequence ( P<0.05). (2) A total of 60 isolated lesions were detected, ranged 5.0-9.1 mm in length; isolated lesions enjoying significantly larger cross-sectional area, higher signal intensity, and lower contrast detected by FLAIR and T2WI sequences compared with those by DIR sequence ( P<0.05); isolated lesions enjoying significantly higher signal intensity and contrast detected by T2WI sequence compared with those by FLAIR sequence ( P<0.05). Conclusion:DIR sequence enjoys better effect in detecting WMH than FLAIR and T2WI sequences; the mismatch area of DIR sequence with FLAIR or T2WI sequences suggests WMH penumbra.
摘要
Objective To evaluate the effect of magnetic resonance thoracic ductography (MRTD)in the diagnosis of right thoracic duct.Methods MRTD data were analyzed retrospective,and the detection rate of right thoracic duct was summarized and compared with that of lymphoscintigraphy,direct lymphangiography and operation.Results 12 cases of right thoracic duct were detected in 1547 cases of MRTD.The detection rate was 0.78%,in which 1 case was complied with total internal organs inversion,and 1 case with right aortic arch.Lymphoscintigraphy were performed in all 12 cases and right thoracic duct were detected in 4 cases.Direct lymphangiography were performed in 4 cases and right thoracic duct were observed in all of them.7 cases of them received right lum-bar duct adhesiolysis.Conclusion MRTD is a noninvasive method for diagnosis of right thoracic duct,which providing useful guid-ance for surgical operation.Its detection rate and diagnostic accuracy are higher than those of lymphoscintigraphy.
摘要
Objective To evaluate the value of magnetic resonance thoracic ductography (MRTD)and magnetic resonance (MR) pelvic scanning in the chylous leakage of female reproductive system.Methods A retrospective evaluation of the imaging findings of MRTD and MR pelvic in 7 patients was performed,and compared with direct lymphangiography (DLG),lymphoscintigraphy and surgery.Results The rate of thoracic duct visualization in DLG was 71 .4% (5/7 ).The rate of venous angle visualization inlym-phoscintigraphy was 71.4% (5/7).The rate of thoracic duct visualization in MRTD was 100% (7/7).Except for 1 case withgeneral-ly normal findings,the remaining 6 cases showedobstruction of the thoracic duct in MRTD.Among those cases,bilateral drainage was found in 1 case,right thoracic ductwas seen in 1 case,multiple tortuous dilated lymphatic channelsaround the venous angle was detected in 4 cases,and multiple lymphangiomas was seen in 1 case.All of the 7 patients were conducted by surgery.6 cases were confirmed as obstruction of the thoracic duct.MRTD & MR pelvic found more multiple lymphangiomas lesions and detected 2 cases with bone abnormalities.Conclusion MRTD combined with MR pelvic could provide more comprehensive assessment of female re-productive system chylous leakage.It should be used as routine examination before operation.
摘要
Objective To analyze the risk factors of cortical micro-infarcts (CMIs) in patients with acute ischemic stroke and to evaluate the diagnostic value of 3.0 Tesla (T) magnetic resonance imaging (MRI) using double inversion recovery (DIR) sequence and 3-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence in CMIs in vivo.Methods One hundred and ten consecutive patients with acute ischemic stroke within 7 d of onset were chosen from August 2014 to July 2015;these patients were classified into CMIs group and non-CMIs group by results of 3.0 conventional T MRI,DIR-MRI and 3D-FLAIR-MRI.Baseline characteristics and risk factors were analyzed to investigate the independent risk factors of CMIs.The presence of CMIs was evaluated based on conventional T MRI,DIR-MRI and 3D-FLAIR-MRI.Results Of the 110 enrolled patients with acute ischemic stroke,CMIs were presented in 23.6％ patients (26/110).The age of patients from the CMIs group was significantly older as compared with that of patients from the non-CMIs group (67.65±10.37 vs.58.52± 11.24 years old,P=0.009).Patients from the CMIs group had significantly higher percentages of age＞65 years,age of 76-80 years,hypertension,history of cerebral ischemia and intracranial atherosclerosis than patients from non-CMIs group (P＜0.05).Multivariate Logistic regression analysis indicated that age＞65 years (OR=1.982;95％CI:1.362-2.889,P=0.010) and hypertension (OR=1.326;95％CI:1.022-1.682,P=0.026) were the independent risk factors of CMIs.The prevalence of CMIs detected by conventional sequence (10.9％) was significantly lower than that detected by DIR sequence (23.6％) or 3D-FLAIR sequence (20.9％,P=0.013 and P=0.043).Conclusions Age＞65 years and hypertension are independent risk factors of CMIs.DIR and 3D-FLAIR sequences at 3.0 T MRI substantially improve the sensitivity of detection of CMIs as compared with conventional MRI sequence.
摘要
Objective To analyze the typical clinical and imaging characteristics of epileptic nystagmus (EN) to provide a reference for better diagnosis and treatment of EN.Methods Three patients with EN,admitted to our hospital from 2008 to 2010,were chosen; the clinical presentations and ictal epileptiform discharges by magnetic resonance imaging (MRI) or transcranial cerebral Doppler (TCD) were studied retrospectively.Results All patients showed a binocular syntropy horizontal nystagmus and conjugate eye deviation on onset.Among all the three,two had head deviation,one visual hallucination and one vertigo; during onset,altered mental state and/or impaired consciousness were noted.The ictal EEG revealed that the 11-14 Hz spike waves mainly originated from the temporal-parietal-occipital border area was opposed to the direction of the nystagrnus (one left and two right).Diffusion-weighted imaging (DWI) abnormal high signal and high signal of fluid-attenuated inversion recovery sequences were located at left parietal-occipital region (n=1),right temporal-parietal-occipital region (n=1) and right occipital-temporal region (n=1) in the 1.5 T MRI.TCD indicated an elevated flow velocity in the ipsilateral middle/posterior cerebral artery during status epilepticus.Conclusions The epileptic nystagrnus as a prominent symptom in status epilepticus is a rare type of status epilepticus.Video-EEG is the key method in the diagnosis of the disease.The direction of the nystagrnus usually is contralateral to the brain lesion and/or the ictal discharges.The frequent seizures induce DWI abnormality.Epileptogenic zone is localized to the temporal-parietal-occipital region.
摘要
Objective To describe the MRI findings in patients with Acquired hepatiocerbral Degeneration(AHCD) and evaluate the role of MRI in dignosis of AHCD. Methods 26 patients with chornic hepatic failure under went brain MRI scan. Eight of these patients had abdominal MR digital subtract angiography(MRDSA) examnation. 25 patients had plasma ammonia levels test two weeks after MR exmnation. Results 22 patients had abnormal MRI findings, T 1WI demonstrated incresed signal in the globus pallidus (22/26), putmen (4/26), mesencephalon surrounding red nucleus(15/26),and in the anterior pituitary (12/26). While T 2WI demonstraied no corresponding alteration in signal intensity. Eight patients which had MRDSA showed obvious portal systemic shunts. There was positive correlation between plasam ammonia level and abnormal signal( r = 0.521 6, P