SWI对脑创伤性轴索损伤的诊断价值

目的:探讨磁敏感加权成像(SWI)对弥漫性轴索损伤(DAI)的诊断价值.方法:对40例临床诊断为DAI病例常规T1WI,T2WI液体衰减反转恢复(FLAIR)序列和磁共振弥散加权(DWI)及磁敏感加权(SWI)扫描.结果:SWI可清楚显示31例DAI的颅内异常小出血灶,为点状、条索状、类圆形或串珠状的低信号影,检出率77.5%,分别同常规T1WI,T2WI序列检出率15%,32.5%(χ2=31.43,P=0.01,χ2=16.36,P=0.01),同FLAIR序列检出率50%,DWI序列57.5%(χ2=6.54,P0.05,χ2=3.65,P0.05).结论:SWI能非常敏感地检出外伤后弥漫性轴索损伤患者的脑内小出血灶,对弥漫性轴索损伤有很高的诊断价值.     

CADASIL的临床特点、磁共振特征及NOTCH3基因突变分析

目的:探讨伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病(CADASIL)的临床、磁共振及基因突变特征,加深对CADASIL的认识,提高诊疗水平.方法:回顾性收集15例CADASIL患者的临床资料、磁共振及NOTCH3基因突变结果,统计分析其临床特点,磁共振特征及基因突变比例;并将患者分为NOTCH3 R544C突变与其他突变两个亚组,比较两组间临床表型差异.结果:15例CADASIL患者中,临床表现为脑卒中12例(80%);认知功能减退8例(53.3%);头晕7例(46.7%);偏头痛5例(33.3%);情感障碍4例(26.7%).12例脑卒中患者中包括3例脑出血.15例患者均携带NOTCH3基因突变,共发现8个已知突变位点.突变位点位于外显子11为10例,外显子11中的R544C突变患者7例(46.7%),其中6例患者为广东籍;突变位点位于外显子4为3例;突变位点位于外显子3为2例.CADASIL在磁共振最特征性的表现为白质高信号,携带R554C突变患者脑白质病变颞极受累率低,与其他突变比较具有统计学差异(P0.05).10例患者行SWI序列扫描,8例发现脑微出血病灶,病灶在皮质-皮质下区、丘脑分布最高,其次为脑干.其中3例脑出血患者,均伴高血压病史,并可见广泛分布的脑微出血灶.结论:本研究中NOTCH3 R544C是最常见的突变位点,并多见于广东地区人群,该突变患者较少出现颞极白质高信号;脑微出血灶是CADASIL常见的影像学表现之一.     

用于腹部CT肝脏分割的边界监督模型

针对肝脏分割影像中模糊的肝脏边界,提出了一种新颖的用于腹部CT肝脏分割的边界监督模型.该模型包括肝脏区域分割模块和边界分割模块,其中边界分割模块使用肝脏边界进行监督训练,输出精准的肝脏边界.模型将肝脏区域分割输出与边界分割输出融合在一起,得到最终的肝脏分割预测.肝脏区域分割模块与边界分割模块分别设置了相应的损失函数进行监督训练.模型使用腹部器官分割挑战提供的数据集进行了消融实验并与先进模型进行了评估.结果证明该方法的有效性和优异性,提出的边界分割模块有助于保留肝脏的边缘信息,提高了肝脏分割的性能.     

PPY@Fe_3O_4的制备及其磁共振成像和光热性能

通过合理转化残余铁(Fe)在聚吡咯(PPY)纳米粒子原位生产了磁性四氧化三铁(Fe_3O_4)晶体,从而合成PPY@Fe_3O_4纳米粒子.得到的PPY@Fe_3O_4纳米粒子具有突出的横向弛豫时间(T_2)加权磁共振成像(MRI)效果和良好的光热性能,在肿瘤的诊断和治疗中具有良好的应用前景.     

关于预防腹部手术切口裂开的护理调研

通过调研腹部手术后切口裂开的案例,总结出高龄、糖尿病、营养不良、腹内压增高等潜在的危险因素。在此基础上,提出通过针对性地采取围手术期的预防护理措施及健康指导,以降低腹部手术切口裂开的发生率,帮助患者术后恢复。通过对近几年有关腹部手术切口裂开的原因分析及其护理的文献进行调研,总结分析了预防腹部手术切口裂开的护理措施。     

有腹部手术史者行腹腔镜胆囊切除术98例体会

总结有腹部手术史患者行腹腔镜胆囊切除术的临床经验及体会。回顾性分析了2002年5月至2012年6月永登县人民医院为有腹部手术史的98例胆囊结石患者实施LC的临床资料。93例成功完成LC,5例中转开腹手术,成功率94.8%。LC组手术时间40~120min,平均70min,中转开腹组75~300min,平均180min;LC组术后住院时间3~7d,中转开腹组7~21d;LC组术后无并发症发生,中转开腹组发生切口感染2例,脂肪液化1例,无其他并发症;所有患者均在胆囊窝放置腹腔引流管,术后48~96h拔除,均治愈出院。灵活的选择第一个trocar的穿刺部位及置入方式,仔细剥离粘连,及时止血,充分显露胆囊后下三角,加上术者熟练的操作技巧,为有腹部手术史患者实施腹腔镜胆囊切除术是可行的,腹部手术史不应成为LC禁忌症。     

重度腹外伤后并发腹腔高压综合征的诊断及治疗

目的总结分析重度腹外伤后并发腹腔高压综合征的诊断及治疗经验.方法分析2例重度腹外伤伴失血性休克并发ACS病例,根据临床表现确定ACS诊断后,及时行腹腔减压,分别以腹壁覆盖及塑料袋缝合暂时性关腹.结果及时认识治疗ACS并行腹腔减压适量延长切口,结果满意,病患恢复平稳.结论对ACS的认识是及时诊断及治疗的关键,开腹减压以保证患者平稳渡过水肿期,选择合适的材料,有利于患者的康复.     

一种改进的分水岭人脑MR图像分割方法

针对传统分水岭算法分割图像后存在的细节不准确问题,提出了一种改进的分水岭算法.此算法将传统分水岭算法和概率相结合,通过有序队列来实现边界的计算,从而得到分水岭.实验证明,这种算法得到的结果更加准确,对人脑MR图像病灶区的分割非常重要.     

Big data analysis of the human brain’s functional interactions based on fMRI

The human brain is a huge, complex system generating brain activity. The exploration of human brain function using functional magnetic resonance imaging （fMRI） is a promising method to understand brain activity. However, the complexity of the big data generated by fMRI facilitates the analysis of various levels of human brain activity, such as the distribution of neural represen- tations, the interaction between different regions, and the dynamic interaction over time. These different levels can depict distinct prospects of the human brain activity, and considerable progress has been achieved. In the future, more big data analysis methods combining advances in computer science, including larger-scale computing, machine learning, and graph theory, will promote the understanding of the human brain.     

Multifractal analysis of resting state fMRI series in default mode network: age and gender effects

Age-related changes of resting state in default mode network （DMN） may provide new clues to the developing mechanism of normal brain as well as early diagnosis and therapy of some neuropsychiatric disorders. The application of multifractal theory to functional magnetic resonance imaging （fMRI） signals has recently raised increasing attention. We aim to explore the multifractal characteristics underlying the resting state functional magnetic resonance imaging （rs-fMRI） series extracted from DMN, and two issues are mainly discussed： （1） whether there exist multifractals in rs-fMRI series; （2） whether it is possible to distinguish between the different ages or genders by means of multifractal characteristics. Results demon- strated the existence of multifractals in rs-fMRI series in DMN. In addition, slight differences between young subjects and middle-aged or elderly subjects can be successfully detected by △asα, a modified measure we proposed. Furthermore, it is revealed that the rs-fMRI series from young subjects possess smaller averaged scale index and weaker long range correlation, while those from middle-aged or elderly people present increasing averaged scale index andstronger long range correlation. Whereas no significant statistical differences has been found between male and female group. Our results, therefore, highlight the potential useful- ness of multifractal analysis in fMRI series of a certain brain region, and provide important insights into healthy aging in DMN.