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中国医学影像学杂志

中国医学影像学杂志

北大核心

CSCD

CSTPCD

Chinese Journal of Medical Imaging
本刊是由卫生部主管，中国医学影像技术研究会主办的全国性专业学术性刊物。1993年10月创刊，2000年改为大16开，页码80页，月刊。为中国科学技术部中国科技论文统计源期刊、中国科学引文数据库来源期刊、中国学术期刊综合评价数据库来源期刊。主要刊登常规X线、CT、MRI、超声、核医学、介入放射学、电镜、红外热成像、医学图像处理等方面的研究成果和进展。
  • 发文量：5293
  • 被引量：2802
  • H指数：3
  • 开始收录时间：1993,1(1)
  • CNKI综合因子：1.028
  • 维普期刊影响因子： 1.84
  • 万方期刊影响因子：1.64
  • 创刊时间：1993
  • 国内刊号/CN：11-3154/R
    国际刊号/ISSN：1005-5185
  • 发行周期：月刊
    邮发代号：82-712
  • 主管单位：中华人民共和国卫生部
    主办单位：中国医学影像技术研究会
中国医学影像学杂志-联系信息
  • 主编：马林;陈敏
  • 电话：
  • 邮箱：zyyz@j-medicalimaging.com
  • 地址：北京东单大华路1号《中国医学影像学杂志》杂志社
  • 邮编：100730
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  • 摘要：1病例简介 女,68岁,因腹部用力突发腹痛、呕吐胃内容物1 d就诊。体格检查：血压182/96 mmHg（1 mmHg=0.133 kPa）,意识清晰,心肺未见异常,中下腹部膨隆明显,上腹部空虚,压痛、肌紧张明显,无明显反跳痛;腹腔诊断性穿刺抽出血性液体。既往有肝炎病史。外院CT提示盆腔内见环形高密度影,腹部部分肠管扩张积液,盆腔少量积液,考虑节育环移位,粘连性肠梗阻可能。
  • 摘要：目的：针对细胞显微图像分割和计数困难的问题，提出一种基于清晰度的细胞显微图像分割和计数方法。资料与方法首先对细胞显微图像进行预处理，然后对图像进行离散余弦变换，并截断高频信号部分，再与原图做差以区分清晰部分和模糊部分，结合细胞图像局部聚合度较高的特性，利用区域生长方法提取完整目标，最后进行分析和计数。结果实验结果表明，针对细胞显微图像分割和计数不准确、速度慢的问题，利用该方法分割计数的准确率>90%，平均一幅图片的处理时间<100 ms。结论用清晰度的方法可以快速、准确地分割细胞显微图像并进行分析计数，对快速、准确地掌握细胞个数及密度有重要意义。%Purpose To propose a definition based algorithm for segmenting and counting cell microscopic images. Materials and Methods Cell microscopic images were first pretreated and then transformed using discrete cosine transformation (DCT). The high frequency part was truncated and re-converted to differentiate clear and blurred images. The clear foreground regions were obtained. The intact objective was extracted using region growing method. Statistics and analysis of cell number were then conducted. Results This algorithm showed good performance in cell microscopic image counting with accuracy of over 90% at less than 100 ms/image. Conclusion Definition based method is fast and accurate in cell microscopic image segmentation and counting.
  • 摘要：目的探讨肺局限性磨玻璃结节（GGN）的高分辨率CT（HRCT）征象与国际肺癌研究协会/美国胸科学会/欧洲呼吸学会病理的相关性。资料与方法选取121例GGN患者，按病理结果将其分为良性组（22例）、浸润前病变（PIL）组（21例）、微浸润癌组（26例）和浸润癌组（52例），总结患者肺GGN的影像、病理及预后资料，分析不同病理类型GGN间的差异。结果 GGN的最大径、边缘、空泡征、实性成分、形状及是否有血管穿行在4组间差异均有统计学意义（χ2=9.945~31.068， P<0.05）。浸润癌组的最大径、边缘与良性组、PIL组、微浸润癌组比较，差异有统计学意义（P<0.008）；良性组空泡征与PIL组、微浸润癌组、浸润癌组比较，差异有统计学意义（P<0.008）；是否含有实性成分、形状在浸润癌与微浸润组间差异有统计学意义（P<0.008）；是否有血管穿行在良性组与浸润癌组间差异有统计学意义（P<0.008）。仅1例浸润癌出现远处转移。结论当GGN的最大径≥16.35 mm、出现毛刺征或分叶征提示浸润癌；当GGN内部出现空泡征则提示其为恶性；GGN内部含有实性成分或其形状不规则，可以鉴别浸润癌与微浸润癌；GGN内部有血管穿行可以用于鉴别浸润癌与良性病灶；GGN的预后好，仅0.83%病例出现远处转移。%Purpose To evaluate the correlations between high resolution CT (HRCT) findings and IASLC/ATS/ERS pathological classification of ground glass nodule (GGN). Materials and Methods 121 patients with confirmed GGN were selected, and divided into benign group (22 cases), PIL group (21 cases), microinvasive carcinoma group (26 cases) and invasive carcinoma group (52 cases), then the imaging, pathology and prognosis data of patients with pulmonary GGN were reviewed, and the differences among GGN of different pathological types were analyzed.Results Maximum diameter, margin, vacuole sign, solid component, shape and blood vessels through of GGN were significantly different among the four groups (χ2=9.945-31.068,P<0.05). Maximum diameter and margin were significantly different between invasive adenocarcinoma and other groups (P<0.008); vacuole sign of the benign group was significantly different with other groups (P<0.008); the existence of solid component and shape were significantly different between invasive adenocarcinoma and minimally invasive adenocarcinoma (P<0.008); there was significant difference of blood vessels through between invasive adenocarcinoma and benign lesions (P<0.008). Among the 121 lesions, no metastasis except one invasive adenocarcinoma case complicated with distant metastasis.Conclusion Maximum diameter of GGN greater than 16.35 mm, with spiculation or lobulation represent invasive adenocarcinoma; vacuole sign within the GGN represent malignancy; with solid component and irregular shape can be used to identify invasive adenocarcinoma from minimally invasive adenocarcinoma; while blood vessels through can be used to identify invasive adenocarcinoma from benign lesions; the prognosis of GGNs is well with only 0.83% probability of distant metastasis.
  • 摘要：Purpose To compare the difference of CT coronary artery imaging quality under highflow oxygen uptake and normal breathing, and to investigate the effect of high flow oxygen uptake on the quality of CT coronary artery imaging.Materials and Methods 132 patients underwent coronary CTA examination using 256-slice CT (Philips), among them 71 patients were supplied with highflow oxygen, and the other 61 were asked to breathe normally. Coronary arteries were post-processed and reconstructed on AW 4.4 workstation. Scanning completion rate, signal to noise ratio (SNR), contrast to noise ratios(CNR) and image quality score ofcoronary segment using these two prospective ECG-gating techniques were compared.Results The scanning completion rate and image quality score of the highflow oxygen uptake group were significantly superior to those of the normal breathing group (P<0.05). However, there was no statistically significant difference of SNR and CNR between the two groups (P>0.05).Conclusion Imaging quality of coronary CTA can be improved using highflow oxygen uptake with reduced patient radiation dose, thus worth being used clinically as a simple and practicable method.%目的比较高流量吸氧与正常呼吸状态下CT冠状动脉成像质量的差异，探讨高流量吸氧对CT冠状动脉成像质量的影响。资料与方法132例患者采用Philips 256 CT行CT冠状动脉成像，其中71例给予高流量吸氧，61例正常呼吸。采用AW 4.4工作站行后处理冠状动脉血管重建。比较两组前瞻性心电门控完成扫描比例及图像的信噪比、对比噪声比和冠状动脉各节段图像质量评分。结果给予高流量吸氧患者的前瞻性心电门控完成扫描比例及图像质量评分明显高于正常呼吸者（P<0.05），但两组图像信噪比及对比噪声比差异无统计学意义（P>0.05）。结论高流量吸氧可以在降低患者受辐射剂量的同时提高CT冠状动脉成像的质量，该方法简单易行，值得临床推广使用。
  • 摘要：目的探讨经阴道子宫输卵管三维超声造影（3D-CEUS）评价输卵管通畅性的临床应用价值。资料与方法对33例临床诊断不孕症患者采用3D-CEUS评估输卵管通畅性，以腹腔镜下通染液检查作为对照，评价3D-CEUS判断输卵管通畅性的敏感度、特异度、阳性似然比、阴性似然比。结果应用3D-CEUS诊断输卵管通畅20条，通而不畅10条，阻塞36条。腹腔镜通染液检查输卵管通畅23条，通而不畅7条，阻塞36条。3D-CEUS检测输卵管通畅性的总符合率为86.4%（57/66），敏感度为93.0%（40/43），特异度为73.9%（17/23），阳性似然比为7.15，阴性似然比为0.20。结论3D-CEUS可准确快速地评估输卵管通畅性，值得临床推广应用；但对输卵管阻塞或通而不畅的患者需进一步行腹腔镜检查。%Purpose To investigate the clinical value of three-dimensional hysterosalpingo-contrast-sonography (3D-HyCoSy) in the assessment of fallopian tubal patency.Materials and Methods Fallopian tubal patency of 33 infertile women was assessed using transvaginal 3D-HyCoSy, and the results were compared with laparoscopically salpingoraphy, the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of 3D-HyCoSy were evaluated.Results 3D-HyCoSy showed 20 passable fallopian tubes, 10 partially passable fallopian tubes and 36 obstructed tubes, while lapascopically salpingoraphy showed 23 passable fallopian tubes, 7 partially passable fallopian tubes and 36 obstructed tubes. The total coincidence rate of 3D-HyCoSy to assess the fallopian tubal patency was 86.4% (57/66), with the sensitivity of 93.0% (40/43), specificityof 73.9% (17/23), positive likelihood ratio of 7.15, and negative likelihood ratio of 0.20.Conclusion Tubal patency can be efficiently and accurately assessed using 3D-HyCoSy, but patients with obstructed or partially passable fallopian tubes should undergo laparoscopy to clarify.
  • 摘要：Purpose To probe into the value of M-mode echocardiography and spectral Doppler echocardiography in diagnosing fetal atrial premature beats.Materials and Methods Echocardiography examinations were given to the seventy-three fetuses around 16-40 gestational weeks which were found suffering from fetal arrhythmia in the clinical examinations by using M-mode echocardiography and spectral Doppler. Thirty-two of them were screened out with fetal atrial premature beats, and their ultrasonic cardiograms were analyzed. The follow-up visits were later conducted.Results Among the thirty-two cases with fetal atrial premature beats, fourteen were attacked frequently, and the other eighteen were attacked accidentally. Two cases were documented with muscular ventricular septal defect. Apart from two missing cases, the rest thirty cases were found to be recovered from arrhythmia before or after birth in the follow-up visits. The disappearance rate of atrialpremature beats in the fetuses attacked frequently by the disease before birth was clearly lower than that in those attacked accidentally (P<0.05). Muscular ventricular septal defect in the two cases were found closed after birth. Conclusion M-mode echocardiography and spectral Doppler echocardiography, as non-invasive imagining techniques to take antenatal examination of fetal arrhythmia, have advantages such as reliable, direct, convenient and can be used repetitively, therefore can provide important information for clinical treatment and prognosis.%目的探讨M型超声及频谱多普勒超声心动图对胎儿房性期前收缩的诊断价值。资料与方法利用M型及频谱多普勒超声，对73例孕16~40周临床发现有胎儿心律失常的孕妇进行超声心动图检查，检出胎儿房性期前收缩32例，分析其超声心动图特征并进行追踪随访。结果32例胎儿房性期前收缩中，频发房性期前收缩14例，偶发18例，其中2例合并肌部室间隔缺损。32例胎儿除2例失访外，随访30例胎儿房性期前收缩在分娩前或出生后心率恢复正常，频繁发作的胎儿房性期前收缩产前消失率明显低于偶发房性期前收缩胎儿（P<0.05），2例肌部缺损于出生后闭合。结论 M型超声及频谱多普勒超声心动图作为产前检查胎儿心律失常的可靠无创影像技术，具有直观、简便、重复性好等优点，为指导临床治疗和判断预后提供重要信息。
  • 摘要：正电子发射型计算机体层摄影术/计算机辅助断层（positron emission computed tomography/computed tomography, PET/CT）作为一种代谢/解剖于一身的高级显像手段，可以从分子水平无创地定量显示人体内的生理、生化过程。核心脏病学已成为放射性核素显像中一门独立的医学分支学科。早在20世纪70年代，PET 显像已先后用于心肌血流灌注、心肌葡萄糖代谢、脂肪酸代谢及心脏受体功能等研究[1]。在国外，核素心肌显像，包括PET 或PET/CT 显像，被广泛应用于心血管疾病的诊断、疗效评价及预后判断等[2]。82Rb、13N-NH3、15O-H2O 等传统PET 心肌灌注显像剂由于半衰期较短等因素，临床应用受到一定的限制，而18F 由于物理半衰期适中，可以采用配送的方式送达使用科室，所以18F 标记的新型正电子心肌灌注显像剂成为目前国内外研究的热点。
  • 摘要：目的通过多层螺旋CT血管造影评价年龄相关的颈动脉弹性。资料与方法对34例心血管健康人群进行多时相心电门控多层螺旋CT血管造影，测量不同时相颈内动脉、颈动脉球和颈总动脉的横截面，结合不同时相颈动脉横截面积以及脉压计算颈内动脉、颈动脉球部和颈总动脉的弹性。结果颈内动脉、颈动脉球部和颈总动脉的弹性与年龄之间均呈显著线性负相关（r=－0.73、－0.74、－0.64, P<0.01）。结论作为一种新的方法，心电门控多层螺旋CT血管造影可以可靠地定量评价颈动脉弹性。在心血管健康人群，随着年龄增加颈动脉弹性降低。%Purpose To evaluate the correlation between carotid elasticity and age using electrocardiogram (ECG)-gated multi-detector CT angiography (MDCTA).Materials and Methods ECG-gated multiple phases MDCTA was performed on 34 vascular health subjects. Cross-section of the internal carotid artery (ICA), carotid bulb (CB) and common carotid artery (CCA) were measured at different phases. Carotid elasticity at ICA (EICA), CB (ECB) and CCA (ECCA) was calculated based on the carotid cross-sectional area changes and pulse pressure (PP).Results The EICA, ECB and ECCA showed significantly negative linear correlation with age (r=-0.73,-0.74 and-0.64,P<0.01). Conclusion The ECG-gated MDCTA is a novel method to evaluate carotid elasticity quantitatively and reliably. Carotid elasticity decreases with aging in vascular health population.
  • 摘要：目的探讨纵隔支气管囊肿的CT表现特点及其诊断价值。资料与方法回顾性分析14例经手术病理证实的纵隔支气管囊肿患者的临床及CT表现，其中12例行CT平扫和增强扫描，另外2例仅行CT平扫或增强扫描。结果14例支气管囊肿均为含液囊肿，其中3例CT值<20 HU，7例CT值20~60 HU，4例CT值>60 HU；囊肿位于前、后纵隔各4例，均在左侧；中纵隔6例，其中5例位于右侧；1例后纵隔囊肿恶变为腺癌。结论纵隔支气管囊肿可发生于纵隔的任何部位，中纵隔支气管囊肿好发于右侧，而前、后纵隔支气管囊肿有左侧发病倾向，CT图像上类圆形无强化的均匀软组织密度或水样密度囊肿为其典型表现。%PurposeTo explore the CT features and its diagnostic value of mediastinal congenital bronchogenic cysts.Materials and MethodsThe clinical findings and CT manifestations of 14 patients with mediastinal bronchogenic cysts confirmed by surgery and pathology were retrospectively analyzed, among which 12 were performed by both plain and enhanced CT scan, and the other 2 only received either plain or enhanced CT scan.ResultsAll the patients presentedfluid-filled cysts, and 3 of them had CT number lower than 20 HU, 7 cases from 20 to 60 HU, and 4 more than 60 HU. Four patients had lesions in anterior mediastinum, 4 others in posterior mediastinum, and all the 8 lesions were on the left side; 6 patients had lesions in middle mediastinum, among which 5 lesions were on the right side; and 1 case of posterior bronchogenic cysts cancerated into adenocarcinoma.ConclusionMediastinal bronchogenic cysts can appear in any part of mediastinum; lesions in middle mediastinum are more likely to occur on the right side, whilst lesions in anterior and posterior mediastinum are often located on the left side. The typical CT manifestations show well-defined round or oval masses of homogeneous soft-tissue or cysts with watery density.
  • 摘要：Purpose To observe the characteristics of coronary artery lesion in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) using virtual histology intravascular ultrasound (IVUS-VH).Materials and Methods A total of 199 patients with angina pectoris were enrolled and divided into SAP group (101 cases) and UAP group (98 cases) according to clinical symptoms, ECG and myocardial enzyme level. All the patients underwent coronary angiography to determine the "criminals" vessels, grayscale intravascular ultrasound was used to measure and compare the external elastic membrane area (EEMA), lumen cross-sectional area (lumen CSA), plaque area (PA), plaque burden (PB), remodeling index (RI), plaque eccentricity index (EI) of the "criminals" vessels. IVUS-VH method was used to measure and compare the area and percentage of calcified tissue,fibrous tissue, lipid tissue and necrotic tissue in the plague components of the "criminals" vessels between the two groups.Results There was no significant difference (t=1.392,-0.345, 1.921, 0.378 and 0.857,P>0.05) of EEMA, lumen CSA, PA, EI and RI measured at the location with smallest lumen area between the two groups. Necrotic core area and percentage of lesion composition in UAP group was significantly higher than that in SAP group (t=2.361,P<0.05). There was no statistically significant difference (t=1.045, 1.884 and 0.787,P>0.05) between the two groups on the area of fiber, lipid and calcification. On the distribution of plaque components, fibrous plaque area percentage of UAP group was lower than that in SAP group (t=-2.418, P<0.05), while the necrotic core area was significantly higher than SAP group (t=2.602, P<0.05), there was no significant difference (t=-0.551 and 0.085,P>0.05) between the two groups on lipid and calcification area.Conclusion Necrotic core area and percentage of plaque composition in the UAP group is larger than the other group. "Criminals" lesions are more unstable and more easily to be complicated with acute cardiovascular events.%目的应用血管内超声虚拟组织学（IVUS-VH）方法评价稳定型心绞痛（SAP）及不稳定型心绞痛（UAP）患者冠状动脉病变的特点。资料与方法将199例心绞痛患者按临床表现、心电图及心肌酶学分成SAP组101例和UAP组98例。所有患者行冠状动脉造影检查确定“罪犯”血管，采用灰阶血管内超声方法测量并比较两组“罪犯”血管的外弹力膜面积、管腔横截面积、斑块面积、斑块负荷、重构指数、斑块偏心指数。采用IVUS-VH方法测量并比较两组“罪犯”血管的斑块组成中钙化组织、纤维组织、脂质组织、坏死组织的面积及百分比。结果两组在最小管腔面积处测量的参数外弹力膜面积、管腔横截面积、斑块面积、斑块偏心指数、重构指数比较，差异均无统计学意义（t=1.392、－0.345、1.921、0.378、0.857，P>0.05）。在最小管腔面积处测量的斑块组成方面，UAP组坏死核心面积明显高于SAP组（t=2.361， P<0.05）。两组纤维面积、脂质面积、钙化面积之间比较差异无统计学意义（t=1.045、1.884、0.787，P>0.05）。在斑块成分分布方面，UAP组纤维斑块面积百分比明显低于SAP组（t=－2.418，P<0.05），坏死核心面积明显高于SAP组（t=2.602， P<0.05），两组脂质面积及钙化面积之间比较差异无统计学意义（t=－0.551、0.085， P>0.05）。结论 UAP组斑块构成中，坏死核心面积更大，坏死百分比更高。“罪犯”病变更加不稳定，更容易并发急性心血管事件。
  • 摘要：目的探讨产前超声诊断胎儿肢体-体壁综合征（LBWC）的价值，提高对LBWC的认识。资料与方法回顾性分析经产前超声诊断的20例胎儿LBWC的声像图表现及随访结果，分析胎儿LBWC的超声声像图特点。结果20例LBWC胎儿均有较大的体壁缺损及脊柱异常，其中16例腹壁缺损，4例胸腹壁缺损；脊柱异常中8例脊柱侧凸畸形，2例后凸畸形，3例扭曲成角，1例扭曲呈S形，6例椎体排列紊乱；脐带异常16例，11例脐带过短，1例无脐带，单脐动脉7例（3例伴脐带过短）；肢体异常5例，左下肢缺如2例，左上肢缺如1例，左足内翻、右足稍内翻1例，左足足尖下垂1例。结论产前超声检查可以及时发现并诊断胎儿LBWC，为临床早期干预提供依据。%PurposeTo explore the value of prenatal ultrasound in diagnosis of fetuses with limb body wall complex (LBWC).Material and MethodsThe ultrasound images and follow-up results were studied retrospectively in 20 cases of LBWC, and the ultrasonic features of LBWC were analyzed.ResultsAll 20 cases showed rather severe body wall defect and spinal abnormality, including 16 cases of abdominal wall defect, 4 cases of abdominal thoracoabdominal defect, 8 cases of idiopathic scoliosis, 2 cases of kyphosis, 3 cases of twist into a corner, 1 cases of distortion as S shape, and 6 cases of vertebral body arranged in disorder. Moreover, 16 cases presented abnormal umbilical cord,among which 11 had too short umbilical cord, 1 without umbilical cord, and 7 as single umbilical artery (3 cases with short cord). Five cases showed limb abnormalities, among which 2 cases were left lower limb absence, 1 cases as left upper limb absent, 1 cases as left foot varus and right foot slightly varus, and 1 cases as left foot drop.ConclusionPrenatal ultrasonography can accurately diagnose LBWC in time, so as to provide evidence for early clinical intervention.
  • 摘要：女，24岁，未婚。因会阴部肿物疼痛2 d 就诊，4年前发现会阴部米粒大小肿块，随年龄增长逐渐增大。妇科检查：于右侧大阴唇及小阴唇处见前后纵行排列的数个大小不等的肿块，位于阴阜至阴道口下方平齐，表面膨大呈褐色柔软皱襞状，似“鸡冠花”样，大小约2.5 cm×3.0 cm×13.5 cm，易变形，牵拉后可伸展。高频超声检查示右侧会阴处大小约2.4 cm×3.1 cm×14.0 cm 肿块，边界不清楚、形态不规则，内部低回声欠均匀（图1A），肿块轻压可变形，可探及内部细条状血流信号，肿块基底部组织可见枝状血流信号（图1B）。诊断会阴部实性肿块，考虑皮赘。行会阴部肿块切除术。
  • 摘要：目的探讨131I全身扫描（131I-WBS）及18F-FDG PET/CT在分化型甲状腺癌（DTC）术后转移诊治中的临床价值。资料与方法27例DTC术后需行131I初治或复治的患者，检测其131I治疗前1 d的血清甲状腺球蛋白（Tg），在131I治疗后3~5 d进行131I-WBS。根据Tg与131I-WBS阴性或阳性的情况，将患者分成4种类型：I型：Tg（+），131I-WBS（－）；II 型：Tg（+），131I-WBS（+）；III 型：Tg（－），131I-WBS （+）；IV型：Tg（－），131I-WBS（－）。在131I-WBS后1周内行18F-FDG PET/CT。以术后组织病理学或至少6个月的临床和影像学随访结果为诊断病灶性质标准。分析131I-WBS及18F-FDG PET/CT对DTC术后患者转移的检出情况。结果检查后发现有22例52处病灶发生了转移。131I-WBS检出其中的8例（36.4%）24处（46.2%）转移灶，与18F-FDG PET/CT检出的15例（68.2%）35处（67.3%）转移灶比较，差异均有统计学意义（χ2=4.46、4.74, P<0.05）。I型13例（100.0%）、II型5例（100.0%）、III型3例（100.0%）、IV型1例（16.7%）发生了转移。I型18F-FDG PET/CT的转移检出率（100.0%）与II型（20.0%）、III型（0%）比较，差异均有统计学意义（P<0.05），与IV型（100.0%）比较差异无统计学意义（P>0.05）。其中对13例I型和1例IV型转移患者调整了治疗方案。结论131I-WBS和18F-FDG PET/CT在DTC术后患者转移灶探测及决定下一步的治疗方案方面具有良好的互补性，特别是18F-FDG PET/CT在Tg（+）、131I-WBS（－）患者转移灶检出上更具有优势，有重要的临床指导意义。%Purpose To explore the clinical value of131I-whole body scan (131I-WBS) and 18F-FDG PET/CT on the metastatic management of patients with differentiated thyroid cancer (DTC) after operation.Materials and Methods Serum thyroglobulin (Tg) of 27 patients after DTC surgery was measured one day before131I therapy, and the patients underwent131I-WBS on 3-5 days after131I therapy. According to the results of Tg and 131I-WBS, all the patients were divided into 4 types as follows: type I: Tg (+),131I-WBS (-); type II: Tg (+),131I-WBS (+); type III: Tg (-),131I-WBS (+); and type IV: Tg (-), 131I-WBS (-). Then the patients received18F-FDG PET/CT scan within a week after 131I-WBS. The results of131I-WBS and18F-FDG PET/CT scan were analyzed according to histopathologic findings or clinical and imaging follow-up of at least 6 months as diagnosis standard.Results The examinations uncovered that metastasis occurred in 52 lesions of 22 cases out of the 27 cases.131I-WBS revealed 24 metastatic lesions (46.2%) in 8 cases (36.4%), and18F-FDG PET/CT showed 35 metastatic lesions (67.3%) in 15 cases (68.2%), the difference with statistic significance (χ2=4.46 and 4.74,P<0.05). Metastasis were confirmed in 13 type I cases (100.0%); 5 type II cases (100.0%); 3 type III cases (100.0%) and 1 type IV case (16.7%), respectively. The rate of detecting metastasis by 18F-FDG PET/CT was 100.0% in type I, 20.0% in type II, 0% in type III respectively, the difference with statistic significance (χ2=9.14 and 10.11,P<0.05); and 100.0% in type IV, the difference without statistic significance (χ2=1.25,P>0.05). Based on that, therapeutic plans were modified for 13 patients with type I metastasis and 1 patient with type IV metastasis.Conclusion131I-WBS and18F-FDG PET/CT are complementary for detecting metastatic lesion and help to decide the following treatment of DTC patients after surgery. Moreover,18F-FDG PET/CT shows advantages in detecting metastatic lesion in Tg-positive and negative131I-WBS type of DTC patients after surgery, thus can provide an important clinical guidance for this type of patients.
  • 摘要：CT 引导下经皮穿刺活检过程中对穿刺针进针角度的把握是穿刺成功的关键因素，为此已有不少学者采用各种方法制作了不同的穿刺引导架或角度定位器来引导穿刺时的进针角度[1-4]。笔者于2012年2月设计直接在CT 扫描孔上标注角度值的方法来引导穿刺进针角度，以提高活检穿刺的成功率，经过实践取得良好效果，现将设计原理、应用方法和实践结果报道如下。
  • 摘要：肺隔离症（pulmonary sequestration, PS）是由体循环供血无正常肺功能的肺组织。通常由胸内降主动脉的异常分支供血，仅10%-15%为腹主动脉和腹腔动脉发出的异常分支[1]，由腹腔干的异常分支供血更为罕见。本文回顾性分析经术后病理证实的4例由腹腔干异常分支供血的PS 患者的资料，总结腹腔干供血的肺隔离症的CT 血管成像（CTA）特征。
  • 摘要：目的采用CT能谱模式对周围动脉闭塞性疾病患者行下肢动脉造影检查，探讨宝石CT能谱提高下肢动脉造影图像质量的可行性。资料与方法前瞻性地连续选择临床拟诊为下肢动脉闭塞性疾病的48例患者，随机分为研究组和对照组。研究组24例采用CT能谱模式行下肢动脉造影，对照组24例采用多层螺旋CT模式行下肢动脉造影。对两组图像中的髂总动脉、腘动脉、胫前动脉及其分支进行测量，并计算对比噪声比，由2名影像诊断医师采用5分制独立评价两组图像质量。结果研究组患者髂总动脉、腘动脉、胫前动脉的CT值及对比噪声比均大于对照组（t=8.7、7.9、12.6、17.2, P<0.01），背景噪声小于对照组（t=1.5, P<0.01）。医师1、医师2对研究组和对照组图像质量评分分别为110分、90分和111分、93分，差异均有统计学意义（Z=－7.6、－8.0,P<0.01）。结论下肢动脉造影中使用CT能谱最佳千电子伏的单能量图像质量明显优于多层螺旋CT混合能量模式的图像质量。%Purpose To implement lower artery angiography in patients with peripheral arterial occlusive disease, and to investigate the feasibility of lower extremity gemstone spectral CT angiography in improving image quality.Materials and Methods Forty-eight patients suspected with lower extremity arterial occlusive diseases were randomly divided into research group and control group. Research group (24 cases) were carried out gemstone spectral CT angiography (CTA) scan and control group (24 cases) were scanned with multi-slice spiral CT (CTA). The CT value of the common iliac artery, popliteal artery and its branches was measured and contrast to noise ratio (CNR) were calculated in both groups. The images were evaluated independently by 2 senior physicians based on a 5-level evaluation standard.Results The CT value of common iliac artery, popliteal artery, anterior tibial artery and the CNR in research group were all higher than those in control group (t=8.7, 7.9, 12.6 and 17.2,P<0.01), but the background noise was lower than that in control group (t=1.5,P<0.01). The scores of two image quality accessed by physician 1 and 2 were 110:90 and 111:93 respectively with statistical difference (Z=-7.6 and-8.0, P<0.01).Conclusion The image obtained by gemstone spectral CT optimal single energy image technique is much better than that by conventional multi-slice spiral CT in lower extremity angiography.
  • 摘要：青光眼是一组以视神经萎缩和特征性视野缺损为共同特征的疾病，是世界上第二位不可逆性致盲眼病[1]。在全球范围内，大约有6000万青光眼视神经损害的患者，约840万人因此而失明，预计到2020年，青光眼的患病和失明人数将分别增长到8000万和1120万[2]。因青光眼导致的视功能损害不可逆，其早期检测和早期诊断就显得尤为重要。传统的青光眼诊断方法以眼压、视野与视盘改变为依据，但这些检查具有主观性和变异性等不足，因此眼科医师需寻求更为客观、定量的诊断标准。光学相干断层扫描技术（optical coherence tomography, OCT）是一种非接触性、高分辨率的生物组织结构显像技术，可以对角膜、巩膜、虹膜、房角及视网膜进行高分辨率的活体断层成像，本文对OCT 在青光眼早期诊断中的应用作一综述。
  • 摘要：《中国医学影像学杂志》是由中华人民共和国国家卫生和计划生育委员会主管、中国医学影像技术研究会主办的全国性专业学术期刊，是中国科技核心期刊、中国科学引文数据库来源期刊、《中文核心期刊要目总览》收录期刊。办刊宗旨：贯彻党和国家的卫生工作政策，坚持理论与实践、普及与提高相结合的方针，反映我国医学影像学领域的重大临床和科研工作进展，致力于各种医学影像技术的基础与临床研究成果的推广和传播，为从业人员建立继续教育和技术交流的平台，促进国内外医学影像学学术交流。
  • 摘要：目的探讨PET/CT偶发甲状腺局灶性FDG高代谢灶摄取程度对甲状腺良恶性疾病的鉴别诊断价值。资料与方法回顾性分析40例PET/CT意外探测到甲状腺局灶性高代谢灶的病例，依据病理及随访结果将其分为生理性摄取组18例、良性病变组16例和恶性病变组6例，比较各组病灶最大标准摄取值（SUVmax）的差异，并应用ROC曲线分析SUVmax判断甲状腺良恶性病变的价值。结果生理性摄取组、良性病变组、恶性病变组的SUVmax分别为3.7±1.1、4.9±2.3、9.5±4.8，3组比较差异有统计学意义（F=13.070, P<0.01）；恶性病变组的SUVmax明显高于生理性摄取组和良性病变组（P<0.05），生理性摄取组和良性病变组间SUVmax差异无统计学意义（P>0.05）。ROC曲线分析显示，当SUVmax为8.5时，对甲状腺恶性病灶的诊断灵敏度及特异度分别为100.0%和87.2%。结论18F-FDG PET/CT在甲状腺病灶的良恶性鉴别诊断上有重要价值，但其对生理性摄取和良性病变的鉴别价值不大。%Purpose To investigate the significance of PET/CT in differential diagnosis of incidental thyroid benign or malignant lesions with high fluorodeoxyglucose (FDG) uptake.Materials and Methods Forty cases with focal high FDG uptake lesion in thyroid accidently detected by PET/CT were retrospectively collected. The subjects were dived into physiological uptake group (n=18), benign lesion group (n=16) and malignant lesion group (n=6) according to the pathology or follow-up examinations. The average SUVmax of different groups was analyzed, and ROC curve was used todetect benign or malignant lesions.Results The average SUVmax was 3.7±1.1 in physiological uptake group, 4.9±2.3 in benign lesion group and 9.5±4.8 in malignant lesion group. Significant difference was noticed among the three groups. The average SUVmax in malignant lesion group was higher than that of the other two groups with statistical difference (P<005). No significant difference was observed between physiological uptake group and benign lesion group (P>0.05). ROC analysis showed that the sensitivity and specificity for thyroid malignant tumor were 100.0% and 87.2% at SUVmax of 8.5.Conclusion18F-FDG PET/CT plays an important role in differentiating benign lesions of thyroid from malignance, but it is not helpful to identify benign lesions from physiologic uptake.
  • 摘要：目的探讨64层螺旋CT冠状动脉成像与冠心病的共性及差异，为临床诊断提供依据。资料与方法49例拟诊为冠心病的患者先后行64层螺旋CT冠状动脉成像机冠状动脉造影检查，依据美国心脏病学会15段分段法，评价所有有效节段，并将两者进行对比分析。结果共评价493段冠状动脉血管，其中29段血管CT冠状动脉成像与CAG结果不符；以CAG作为“金标准”，CT冠状动脉成像检出冠状动脉狭窄的敏感度、特异度、阳性预测值和阴性预测值分别为91.6%、95.4%、91.0%和95.7%。结论64层螺旋CT冠状动脉成像与CAG在诊断冠心病方面有较高的一致性，64层螺旋CT冠状动脉成像可以对斑块性质做出评价，但对小血管狭窄的评估不及CAG。%Purpose To explore the commonality and disparity between 64-slice CT coronary artery imaging and coronary angiography (CAG) for the diagnosis of coronary heart disease, and to provide evidence for clinical diagnosis.Materials and Methods Forty-nine patients with suspected coronary heart disease (CHD) underwent both 64-slice CT coronary artery imaging and conventional coronary artery angiography, all available coronary segments were evaluated using a 15-segment modified AHA classification, and the results of both methods were compared and analyzed.Results 493 segments of coronary artery were evaluated, results of 29 segments were incongruent between 64-slice CT coronary artery imaging and CAG. With CAG as the gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of CT coronary artery imaging for the diagnosis of coronary artery stenosis were 91.6%, 95.4%, 91.0% and 95.7% respectively.Conclusion There is a high consistency between 64-slice CT coronary artery imaging and CAG for diagnosing CHD, 64-slice CT coronary artery imaging can be used to evaluate the nature of artery plaque, but it is inferior to CAG in diagnosing small angiostenosis.
  • 摘要：小肠冗长纡曲、易重叠、蠕动快，小肠疾病起病隐匿，临床表现缺乏特异性，易漏诊、误诊。传统的X 线小肠造影仅能显示肠黏膜、腔内病变及肠管形态改变，对小肠疾病检出的敏感性及特异性均不高。胶囊内镜能直观显示小肠黏膜，因价格昂贵、不能取活检组织、不能在内镜下治疗以及易在肠腔狭窄处嵌顿而使临床应用受限[1]。CT 小肠造影（CT enterography, CTE）通过引入足够对比剂、充分扩张肠管，利用多层螺旋增强CT 快速、薄层扫描和强大的后处理功能来清晰勾勒肠壁、肠腔及肠管外病变，能对病变范围、性质和分期作出全面准确的评价，将小肠疾病的诊断提高到一个新水平。本文就多层螺旋CT 口服低张小肠造影（MSCTE）的最新进展作一综述。
  • 摘要：医学科技论文摘要撰写要求：摘要应具有独立性和自含性，即不阅读论文全文就能获得必要的信息。结构式 摘要由目的、资料与方法、结果、结论4个要素组成。目的中需简要交代研究的前提（问题的提出）、研究目的及其重要性；资料与方法中需简述研究类型（如回顾性研究、前瞻性研究）、人口学（研究对象）或材料、分组、采用的研究方法及观察指标，摘要方法中不需要指明具体使用的统计学方法；结果中针对研究方法及观察指标简要列出主要的、有意义的或新发现的研究结果，指出临床与统计学的意义和价值；结论是针对结果的分析、评价和应用，肯定经过科学分析的研究结果及其获得的某些结论，但不能超出研究结果的范围而过度推论，同时指出这些结论的理论或实用价值。摘要中不列图表，不引用参考文献，英文缩略语首次出现需注明中文全称。中文摘要以350字左右为宜，英文摘要需与中文摘要对应。
  • 摘要：Purpose To assess the clinical application of non-contrast-enhanced MR angiography (NCE-MRA) using flow sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for displaying hand arteries of patients with rheumatoid arthritis. Materials and Methods Twenty-two patients with rheumatoid arthritis were recruited in this study. All the patients undertook hand NCE-MRA and three-dimensional dynamic CE-MRA on a 1.5T MR scanner. The informed consent was obtained from each subject. Image quality was assessed independently by two experienced radiologists at three arterial segments (wrist arteries, palm arteries, andfinger arteries) with a four-point scale. Signal to noise ratio (SNR), contrast to noise ratio (CNR), and vessel sharpness were evaluated by a magnetic resonance physicist. The results and image quality were statistically compared between the two MRA techniques.Results Twenty-two patients of 24 hands successfully underwent NCE-MRA and CE-MRA scan. Among 72 vascular segments, 69 segments of NCE-MRA were diagnostic, which was higher than that of CE-MRA (96% vs 83%,P<0.05). Otherwise, the image quality, SNR, CNR and vessel sharpness of NCE-MRA were all superior to those of CE-MRA (P<0.05).Conclusion NCE-MRA using FSD-prepared SSFP allows clear depiction of the hand arterial tree, and the image quality is superior to that of dynamic CE-MRA. It is a potential tool for evaluating the disease of hand arteries.%目的初步探讨基于血流敏感散相（FSD）和平衡稳态自由进动（SSFP）的非增强磁共振血管成像（NCE-MRA）技术在显示类风湿性关节炎患者手动脉的临床应用价值。资料与方法22例类风湿性关节炎患者采用1.5T成像系统进行手动脉NCE-MRA和增强磁共振血管成像（CE-MRA）检查。对手动脉（划分为腕部、掌部和指部3个血管节段）的图像质量进行评分，并对图像信噪比（SNR）、对比度噪声比（CNR）和血管边缘锐利度进行测量。将NCE-MRA和CE-MRA的图像质量和测量值进行统计学比较。结果22例患者24只手均成功完成NCE-MRA和动态CE-MRA检查。72个血管节段中，NCE-MRA有69个动脉节段的图像质量具有诊断意义，明显高于CE-MRA（96%比83%，P<0.05）。此外，NCE-MRA在手动脉各个部位的图像质量以及SNR、CNR和血管锐利度均优于CE-MRA（P<0.05）。结论 NCE-MRA能清楚地显示手动脉的各个分支，图像质量优于动态CE-MRA，对手动脉病变的诊断具有较好的临床应用潜力。
  • 摘要：目的采用经会阴超声评价肌电刺激盆底治疗的疗效，为产后盆底康复提供指导。资料与方法选择进行产后盆底康复的31例产妇作为研究组，同时选择30例非妊娠年轻女性作为对照组，研究组进行盆底肌电治疗，并于治疗前、治疗5次后及治疗10次后，采用经会阴超声于安静状态及压力状态下（Valsalva动作时）分别测量患者的膀胱颈至耻骨联合下缘的距离（Dr、Ds）、膀胱颈角度（θr、θs）、膀胱颈旋转角度（θ），并进行组间比较。结果①研究组Dr及Ds均小于对照组（P<0.05），θr、θs及θ均大于对照组（P<0.05）；②在肌电治疗前、治疗5次后及治疗10次后Dr、Ds依次增大（P<0.05），θr依次减小（P<0.05）。结论自然分娩会对盆底功能造成损伤，肌电刺激盆底治疗对产后盆底康复有较好的疗效，经会阴超声检查能够客观地评估肌电刺激盆底治疗的疗效。%Purpose To assess the effect of pelvicfloor electrical stimulation treatment by transperineal sonography, so as to provide guidance for postpartum pelvic floor rehabilitation.Materials and Methods Thirty-one delivery women who received postpartum pelvicfloor rehabilitation were selected as research group and 30 non-pregnant young women as control group in the study. Pelvicfloor electromyography treatment was taken in research group, and transperineal sonography was undergone in quiet state and pressure state (Valsalva operation) before treatment, after the fifth treatment and after the tenth treatment respectively to measure the bladder neck to the public symphysis edge distance (Dr, Ds), bladder neck angle (θr,θs) and bladder rotation angle (θ). A comparison was made between the research group and control group.Results①Dr and Ds in research group were both lower than those in control group (P<0.05), butθr,θs andθ were all higher than those in control group (P<0.05).②Dr and Ds showed a gradual increase (P<0.05) whilstθr presented a gradual decrease before the treatment, after the fifth treatment and after the tenth treatment (P<0.05).Conclusion Natural childbirth may damage the function of pelvicfloor; electrical stimulation of pelvic therapy is effective on postpartum pelvicfloor rehabilitation; and transperineal sonography can objectively assess the effect of this therapy.
  • 摘要：宫颈癌及卵巢癌都是目前严重威协女性健康的妇科恶性肿瘤，发病呈日益年轻化且发病率有逐年上升趋势。有数据统计，全世界每年约有宫颈癌新发病例50万，约有2313万妇女死于该病，其中80％的新发病例是发生在发展中国家，而我国每年宫颈癌新发病例约占全世界发病人数的1／3。
  • 摘要：目的 探讨帕金森病认知功能障碍患者扣带回后部(PCC)的脑功能连接模式改变及其病理意义.资料与方法 收集29例帕金森病(PD)患者,包括10例认知功能正常患者(PD-CN组)和19例认知功能障碍患者(PD-CI组),以23例健康志愿者(HC组)作对照,对其进行功能MRI扫描,并用功能连接方法对结果进行分析.得到组间及患者亚组间全脑中与PCC功能连接改变的区域,并分析PD组的功能连接强度与蒙特利尔认知评估量表(MoCA)评分的相关性.结果 与PD-CN组相比,PD-CI组与PCC连接减弱的脑区分布在右侧内侧额上回及双侧顶下小叶,连接增强的脑区主要分布在小脑、右侧额上回及右侧枕叶舌回(P＜0.05).PD组PCC与双侧顶下小叶(右:r=0.838,P＜0.05;左:r=0.776,P＜0.05)、右侧内侧额上回(r=0.839,P＜0.05)及颞上回(r=0.840,P＜0.05)的功能连接强度与MoCA评分呈正相关,而PCC与右侧背外侧额上回(r=-0.785,P＜0.05)的功能连接强度与MoCA评分呈负相关.结论 PD-CI患者静息状态下PCC与右侧内侧额上回、双侧顶下小叶、右侧颞叶功能连接受损,而右侧背外侧额上回、右侧舌回及小脑可能参与了代偿,这些功能连接模式改变可能与帕金森病痴呆的发生相关.
  • 摘要：目的 对比分析微囊型脑膜瘤(WHO I级)与非典型性脑膜瘤(WHOⅡ级)的影像征象,提高对两者的鉴别诊断水平.资料与方法 收集经手术病理证实的13例微囊型脑膜瘤与28例非典型性脑膜瘤的临床及影像学资料,对两种病理亚型脑膜瘤的分叶状、肿瘤囊变、强化均匀性、瘤周水肿、瘤脑界面、脑膜尾征、邻近颅骨改变征象进行回顾性分析.结果 13例微囊型脑膜瘤与28例非典型性脑膜瘤相比,分叶状(x2=6.034,P＜0.05)、肿瘤囊变(xZ=9.784,P＜0.01)、瘤周水肿程度(x2=7.336,P＜0.01)、瘤脑界面(x2=11.490,P＜0.01)、邻近骨质改变(x2=10.134,P＜0.01)5项影像学征象差异有统计学意义;强化均匀性、脑膜尾征差异无统计学意义(x2=2.259、0.196,P＞0.05).结论 微囊型脑膜瘤与非典型性脑膜瘤在肿瘤分叶状、肿瘤囊变、瘤周水肿程度、瘤脑界面、邻近骨质改变方面存在差异,能为两种病理亚型脑膜瘤的鉴别诊断提供参考.
  • 摘要：目的 探讨CT衰减校正(CTAC)对SPECT心肌灌注显像图像质量的影响.资料与方法 99Tcm-甲氧基异丁基异腈SPECT/CT心肌灌注显像110例,均重建CTAC和无衰减校正(NOAC)图像,观察CT和SPECT图像的配准情况,对配准不良者进行重新配准.比较CTAC和NOAC图像及配准前后CTAC左心室各壁段放射性计数的差异和图像差异,并进行性别和体重指数分层比较.结果 CTAC图像左心室下后壁、间壁和侧壁的放射性计数百分比明显高于NOAC图像(t=21.68、9.265、5.067,P＜0.01),心尖部则明显低于NOAC图像(t=-12.834,P＜0.01).其中,男性下后壁CTAC和NOAC放射性计数百分比的差异明显高于女性(t=6.922、4.583,P＜0.01);高体重指数者心尖部放射性计数百分比的差异明显高于正常体重指数者(t =2.621,P＜0.05).与NOAC图像比较,CTAC图像有63.6％出现下后壁放射性明显增加,男性明显高于女性(x2=17.267,P＜0.01);有38.2％出现心尖部放射性明显减低,高体重指数者明显高于正常体重指数者(x2=4.864,P＜0.05).110例受检者中有52.7％出现不同程度的图像配准不良,重新配准后前壁、心尖部和侧壁的放射性明显增加(t=7.931、2.385、8.32,P＜0.05).结论 CTAC可明显改善左心室下后壁、间壁和侧壁的放射性分布,但对心尖部的补偿相对不足;CT和SPECT图像配准不良可明显影响前壁、心尖部和侧壁的放射性分布.
  • 摘要：目的 应用速度向量成像(ⅤⅥ)技术测定心肌梗死患者心肌各节段心内膜和心外膜的旋转角度和旋转速度,评价其在定位左前降支病变中的价值.资料与方法 选取25例ST段抬高型心肌梗死、冠状动脉造影示罪犯血管为左前降支闭塞的患者和24例冠状动脉造影正常的患者.超声检查均在冠状动脉介入术后l周内进行,记录心脏心底水平和心尖水平左心室短轴切面,并脱机分析左心室心肌各节段心内膜和心外膜收缩期旋转角度和旋转速度.结果 心肌梗死组心底水平前间隔、后间隔心内膜收缩期旋转速度和后间隔心外膜旋转角度与对照组比较,差异有统计学意义(P＜0.05、P＜0.01).心肌梗死组心尖水平前间隔、前壁、前侧壁和后间隔心内膜收缩期旋转速度及前壁收缩期旋转角度均低于对照组(P＜0.05、P＜0.01).心肌梗死组前间隔和前壁心外膜收缩期旋转速度、下壁和后间隔心外膜收缩期旋转角度与对照组比较,差异有统计学意义(P＜0.05、P＜0.01).左心室心尖水平心内膜前间隔、前壁、前侧壁、下侧壁、下壁和后间隔的收缩期旋转速度均能定位左前降支病变(AUC=0.70～0.88).前壁心内膜收缩期旋转速度≤ 45.86°/s定位左前降支病变的敏感度和特异度分别为88％和79％.左心室心尖水平心外膜前间壁和前壁收缩期旋转速度能定位左前降支病变(AUC=0.69、0.74).左心室前壁心外膜收缩期旋转速度≤ 43.8°/s定位左前降支病变的敏感度和特异度分别为92％和54％.结论 心尖收缩期旋转速度与靶血管病变有直接关系,并且有望成为一项新的指标准确定位左前降支病变.
  • 摘要：1病例简介女,78岁,因腹围进行性增加伴纳差8年余入院。8年前出现不明原因的腹围增加,后开始出现腹胀并进行性加重,进食减少,进餐后腹胀明显。2年前因腹胀于外院就诊,给予利尿等对症处理,2次腹腔穿刺未能抽出积液。1年前大便次数明显增多,多者3次/d,偶伴黑便。体格检查：腹稍膨隆,触诊腹肌紧张,移动性浊音（＋）。

    中国医学影像学杂志的期刊信息

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    中国医学影像学杂志的获奖情况

    中国医学影像学杂志的收录情况

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