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Objective To explore the feasibility of in-flow inversion recovery (IFIR)sequence of magnetic resonance imaging (MRI)at 1.5T in diagnosis of Budd-Chiari syndrome (BCS).Methods A total of 45 patients with Budd-Chiari syndrome diagnosed by surgery or interventional surgery in our institution were enrolled.The prerequisite of the study was that all medical imaging data including MRI and digital subtraction angiography (DSA)should be integrated.Then,the diagnostic accuracy rates between IFIR sequence and DSA were analyzed and compared.Results Of all 45 patients with BCS,40 (88.9%)were diagnosed accurately by IF-IR sequence,including typeⅠa in 10,typeⅠb in 14,typeⅡ in 10 and type Ⅲ in 6.Meanwhile,41 (91.1%)were diagnosed accu-rately by DSA,including typeⅠa in 8,typeⅠb in 14,typeⅡ in 13 and type Ⅲ in 6.No significant difference was showed in diag-nostic accuracy between two imaging methods (P >0.05).Spearman rank correlation analysis revealed that the diagnostic accuracy of IFIR sequence was highly consistent with that of DSA(r =0.853,P <0.001 ).However,there existed significant difference be-tween two methods in accurate diagnosis of typeⅠa and typeⅡ BCS (P <0.05).Conclusion MRI IFIR sequence at 1.5T is highly consistent with DSA in diagnosis and classification of BCS,which can be used as a reliable method of preoperative screening for BCS diagnosis.
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ObjectiveTo compare the diagnostic value of magnetic resonance imaging (MRI),computed tomography (CT) and radiography in the early detection of arthropathies of haemophilia.Methods Prospective studies of 21 joints in 11 patients were studied with X-ray,CT and MR examination. The 21 joints with haemophilia arthropathies were divided into three groups according to Pettersson scoring system.0 point were the first group,＜4 points were the second group,≥4 points were the third group.Abnormal imaging findings of osteoporosis,enlarge epiphysis,erosion of cartilage,irregular subchondral surface,narrowing of joints space,joint deformity,subchondral cyst formation,effusion/haemarthrosis of joint,synovial hypertrophy with haemosiderin,deformity of joints were used for all imaging comparison.The results were analysis with Chi-square test.To compare the first group,irregular subchondral surface and the number of subchondral cyst formation of all symptomatic joints were detected by CT and MR,the results were analysis with pair-sample t test.ResultsModerate and severe hemophilic joints were found in 80.95％ (17/21)of twenty-one symptomatic joints,and mild hemophilic joints were found in 19.05％ (4/21).The detected results were the same in enlarge epiphysis,narrowing of joints space,joint deformity in all joints by radiography,CT and MR.Significant difference in detection of irregular subchondral surface,subchondral cyst formation,effusion/haemarthrosis of joint,were found between radiography with either CT (x2 value 19.06,16.70,4.84,P ＜0.05 ) or MRI (x2 value 19.06,16.70,7.76,P ＜0.05),Significant difference in detection of the first group joint irregular subchondral surface and the subchondral cyst formation total number were found between CT and MR ( x2 =3.29,P ＜ 0.05 ). Conclusions MR and CT were superior in detection of the early abnormal changes in evaluating hemophilic arthropathies,however CT could detect more smaller irregular subchondral surface and subchondral cyst formation than MR.
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ObjectiveTo evaluate the role of perfusion weighted magnetic resonance imaging ( PWMRI ) in distinguishing brain glioma recurrence for postoperative radiotherapy patients.Methods Thirty-five patients with suggested recurrent brain glioma (20 true,15 false) were examined by conventional MRI and PWMRI.Regions of interests (ROI) were manually drawn in contrast-enhancing lesion,surround edema region and normal white matter of contra-lateral brain on regional cerebral blood volume (rCBV) images.rCBV values of ROI and rCBVmax were measured,the standardized rCBV ratios were calculated,The mean rCBVmax ratio were compared between two lesion types with group t-test.The rCBVmax ratios of contrastenhancing regions was analyzed by the receiver operating characteristic curve.ResultsThe mean rCBVmax ratio of contrast-enhancing lesion in tumor recurrence was higher than those in non tumor recurrence (4.36vs 1.28,t =3.00,P =0.005 ).The mean rCBVmax of edema regions in tumor recurrence was also higher than those in non tumor recurrence ( 1.79 vs 0.85,t =2.41,P =0.026).Four patients with recurrent tumor and three with non tumor recurrence were wrong diagnosed when set the recurrent tumor rCBVmax ratio ＞2.15.The diagnostic sensitivity,specificity and accuracy for recurrent tumor by PWMRI were 80％respectively.Conclusion PWMRI examination is a useful method for distinguishing brain glioma recurrence.
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Objective To evaluate the differentiated effectiveness of two-dimensional proton MR spectroscopy (2D~1H-MRS) to post-operative recurrent glioma and radiation injury. Methods Conventional MR and 2D~1H-MRS examinations were performed with Siemens 3.0T MR system for patients with recurrent contrast-enhancing lesions at the site of the treated glioma. The metabolite peaks were measured at the regions of enhanced nodule and edema, including N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine (Cr), while the Cho/Cr, Cho/NAA, NAA/Cr ratios were calculated. The new lesions were proved with histo-pathologic examination in 23 patients and clinical-imaging following-up in 12 patients. Recurrent gliomas were found in 20 patients, and radiation injury in 15 patients. Each mean metabolite ratio above was compared between two lesion types. Results At contrast-enhancing regions and edema regions, the mean Cho/Cr and Cho/NAA ratios were all significantly higher in patients with tumor recurrence compared with those with radiation injury. Tthe mean NAA/Cr ratio was significantly lower in patients with tumor recurrence compared with that with radiation injury at contrast-enhancing regions, but no significant difference was found at edema regions. Taking Cho/Cr and (or) Cho/NAA ratios >1.77 based on ROC curves of metabolite ratios as standards, the diagnostic sensitivity, specificity and accuracy was 90.00% (18/20), 93.33% (14/15) and 91.43% (32/35), respectively. Conclusion 2D~1H-MRS is a valuable method to distinguish postoperative recurrent glioma and radiation injury.
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Objective To explore the MRI appearances of tuberculosis of myelon and spinal meninges,and to study the value of MRI in diagnosis of this disease.Methods The imaging appearances of tuberculosis of myelon and spinal meninges tuberculosis in 8 cases were reviewed.All cases underwent plain MRI and contrast-enhanced MRI examinations.Results In 8 cases,there were myelonic tuberculosis in 3,myelonic tuberculosis accompanied with spinal meninges tuberculosis in 2 and spinal meninges tuberculosis in 3.Myelonic tuberculosis appeared as intramedullary tuberculous granuloma in 2,granulitis in 1 and tuberculous myelitis in 2.The appearances of MRI were spinal cord swelling,low signal intensity on T1WI and high signal intensity on T2WI.On contrast-enhanced MRI,the lesions were circular enhancement,military nodules or non-enhancement.The typical MRI appearances of spinal meningeal tuberculosis showed spinal meninges generally thickened,narrowing or closing of subarachnoid cavity,on contrast-enhanced MRI,the lesions were tubiform enhancement of sagittal images or circular enhancement of axial images.All cases had active tuberculosis in neighbourhood organ or tissue.Conclusion The MRI appearances of tuberculosis of myelon and spinal meninges are representative,the definite diagnosis of which can be made when the MRI appearances in combination with the history of the patients and the active tuberculosis of neighbourhood organ or tissue.
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Objective To study the manifestations and diagnostic value of MRI for cavernous hemangioma in maxillofacial region.Methods Thirty-one cases of cavernous hemangioma in maxillofacial region proved pathologically were retrospectively analyzed.Results The lesions localized in parotideomasseteric region in 13 cases,in buccal and zygomalicotemporal region in 12 cases,in orbital area in 3 cases and labium in 3 cases.The lesions appeared as ellipse or round-like in 3 cases,fusiform in 2 cases,mass or flat irregular shape in 26 cases.On MRI,20 cases showed long T1 signal intensity,4 cases were slight long T1 and 7 cases were equal T1;on T2WI,27 cases showed high signal intensity and 4 were slight signal intensity.Conclusion The diagnosis of cavernous hemangioma in maxillofacial region can be verified and the shape,the extent of lesion can also be showed by MRI.It provides a reliable basis for clinical diagnosis and operative plan.
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Objective To sum up MRI and MR venography features of the dural sinus thrombosis (DST).Methods The findings of MRI and MR venography in 20 patients with DST were retrospectively analysed.Results MRI showed the normal flowing void of the dural sinus disappeared,instead of the abnormal high signal intensities.The easily involved positions respectively were transversal - sigmoid, superior sagittal and straight sinuses. Some cortical drainage and large internal cerebral veins were also involved . MR venography demonstrated that there were no blood flowing in these involved dural sinuses or veins . The locations of these lesions in MRI were same as that in MRV.Conclusion Because the DST can be directly displayed in MRI and MR venography,they are the most reliable methods of non- invasive diagnosis of DST.
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Objective To describe the MR appearancses of growth-plate of the developmental long bones,and to study the correlativity of MRI with the anatomy and histology findings.Methods 40 pigs with normal knees were examined by 1.0 T scanning system with various orientations and sequences,MR imagings were compared with the results of sectional anatomy and histology.Results According to MRI,we divided the evolution of growth plate into four developmental stages;the earlier forming stage of growth plate(aged the 80～95 days of pregnancy),the forming stage(aged the 95 days of pregnancy-2 months),the maintaining stage (aged 2 months-3.5 years),the closing stage(aged 3.5～4.5 years).The MRI manifestations of growth plate of knees reflected the findings of sectional anatomy perfectly and histology to a certain extent in each developmental stage.Conclusion MRI is very useful and helpful in dividing the developmental stages of growth-plate,guessing the foundation of anatomy and histology,diagnosing and differentiating all kinds of growth plate lesions.