【摘要】 目的 探討肝臟血管平滑肌脂肪瘤（hepatic angiomyolipoma，HAML）的多層螺旋CT影像學表現特征及其與病理學基礎的相關性，以進一步提高CT診斷的準確性。 方法 收集2008年11月-2010年12月經手術病理證實的16例HAML患者。所有患者均行螺旋CT平掃及動脈期、門脈期增強檢查，重點觀察HAML的分型及其相應CT表現及影像-病理的相關性。 結果 16例患者共20個病灶，19個為稍低密度病灶，其中11個病灶內可見明顯的脂肪密度影；1個為稍高密度病灶。動脈期所有病灶均有不同程度的強化表現，15個病灶內可見到較明顯條狀及扭曲的血管影。門脈期15個病灶有持續強化。 結論 多層螺旋CT能準確反映HAML的分型及其病理特征，對臨床表現不典型患者的診斷和鑒別診斷有較大診斷價值。【Abstract】 Objective To discuss the correlation between the features of multislice spiral CT results for hepatic angiomyolipoma (HAML) and their pathological basis, and to further improve the diagnostic accuracy through CT examination. Methods Sixteen HAML patients diagnosed pathologically between November 2008 and December 2010 in our hospital were enrolled in our study. All patients underwent multi-slice spiral CT scanning of pre-and post-contrast arterial phase, and portal venous phase. Focus was put on observation of HAML types and their corresponding manifestations, and the correlation between CT imaging and the pathologic basis. Results There were 20 lesions in the 16 patients. Among the 19 hypodense lesions, 11 were clearly seen with fat density shadow. One out of the 20 lesions showed as slightly hyperdense. On the arterial phase scanning, all lesions showed enhancement, and obvious vascular shadow could be seen in15 lesions. On the portal venous phase, 15 lesions continued to strengthen. Conclusions Multi-slice spiral CT can accurately reflect the classification of HAML and its pathological features. It has a great value in the diagnosis and differential diagnosis of patients without typical clinical manifestations.
目的 對邊緣性腦炎患者磁共振（MR）影像學表現進行探討，以明確急性邊緣性腦炎的特異性磁共振影像學征象，了解磁共振成像（MRI）在急性邊緣性腦炎患者診斷以及病情評價中的應用價值。 方法 通過對2008年12月-2010年1月間臨床收集的8例邊緣性腦炎患者進行MRI檢查，并回顧性分析不同序列磁共振影像學表現，總結MRI征象，評價MRI檢查在急性邊緣性腦炎的臨床診治中的作用。 結果 邊緣性腦炎患者顯示特異性的雙側邊緣系統腫脹及信號異常，呈T1WI低信號影；T2WI及FLAIR成像為高信號影像；增強掃描未見確切異常強化；FLAIR成像是檢測病變最敏感的序列。部分患者可見累及邊緣系統外結構。隨訪病例影像學改變可有明顯好轉。 結論 邊緣性腦炎特異性損傷邊緣系統，以雙側海馬為主，MRI影像可直觀反映邊緣性腦炎早期及隨訪期改變，能直接了解邊緣性腦炎顱內受累范圍、程度及治療后恢復情況等，可為其臨床及時診斷及治療評估提供有利信息。
ObjectiveTo explore the value of gadobutrol enhanced magnetic resonance angiography (MRA) in abdominal artery angiography.MethodsThe patients were prospectively included for gadobutrol enhanced MRA examination from December 2014 to December 2015. The image quality was assessed by two radiologists. The subjective score and signal intensity were measured for the large and medium arteries, and the subjective score for the small artery was recorded. The Kappa consistency analysis was used to assess the two radiologists’ subjective score.ResultsAll 112 patients were enrolled in this study, 96 of whom were included for the physical examination, 16 of whom were included for the liver tumors. No adverse reactions were found in these patients. The MRA images of 2 patients were affected by the severe respiratory artifact. The MRA images of the other 110 cases were clear and could well show the origins, shapes of large and medium arteries and small arteries. The subjective scores were 21.22±1.93 and 6.24±1.33 of the large and medium arteries and small arteries, respectively. The values of signal noise ratio and contrast signal noise ratio of the large and medium arteries were 1 093.27±331.71 and 897.27±333.29, respectively. The Kappa values of the two radiologists’ subjective score were 0.782 and 0.772 for the large and medium arteries and small arteries, respectively.ConclusionsGadobutrol enhanced MRA can clearly display large and medium arteries, and can also display some small arteries. It has a good application value in abdominal artery angiography.