介入治疗在神经、血管和乳腺等手术中广泛使用。在影像学检查引导下,机器人辅助的介入治疗可以有效提高介入治疗的精准性和安全性,已成为当前介入手术的重要发展方向。与其他介入成像方法相比,磁共振介入成像(interventional magnetic r...介入治疗在神经、血管和乳腺等手术中广泛使用。在影像学检查引导下,机器人辅助的介入治疗可以有效提高介入治疗的精准性和安全性,已成为当前介入手术的重要发展方向。与其他介入成像方法相比,磁共振介入成像(interventional magnetic resonance imaging, i-MRI)具有高软组织对比度、多对比度、可定量成像、无电离辐射等优点,在介入治疗的引导中具有巨大优势。然而,磁共振成像(magnetic resonance imaging,MRI)的成像速度相对较慢,对介入器械的兼容性要求高,是当前i-MRI引导治疗中面临的主要挑战。得益于快速i-MRI以及磁兼容介入设备等技术的发展,i-MRI在神经介入、心血管介入、前列腺介入以及乳腺介入等临床手术中发挥了重要的作用。本文总结i-MRI技术的发展现状及i-MRI的临床应用现状,分析i-MRI目前所面临的成像速度慢和时空分辨率难以平衡等挑战,并对i-MRI在多模态成像、实时MRI以及i-MRI引导下的介入机器人手术等方面的发展机遇进行展望。展开更多
Background Cushing＇s disease （CD） presents a remarkable preponderance in female gender,and a significant minority of patients with CD presented with negative magnetic resonance imaging （MRI） findings.The aim of t...Background Cushing＇s disease （CD） presents a remarkable preponderance in female gender,and a significant minority of patients with CD presented with negative magnetic resonance imaging （MRI） findings.The aim of this study was to evaluate gender-related and MRI classification-related differences in clinical and biochemical characteristics of CD.Methods We retrospectively studied 169 patients with CD,comprising 132 females and 37 males,and 33 patients had no visible adenoma on MRI.Results We observed that male and MRI-positive patients presented with high adrenocorticotropic hormone （ACTH） values （P ＜0.05）.Female patients presented with higher prevalence of hirsutism and hyperpigmentation and lower prevalence of purple striae （P ＜0.05）.The prevalence of buffalo-hump and hypertension was greater in MRI-negative patients （P ＜0.05）.In addition,male patients with CD presented at a younger age compared with females （P ＜0.05）.Patients with fatigue and hypokalaemia presented significantly higher urinary-free cortisol,ACTH and cortisol levels compared with patients without these symptoms （P ＜0.05）.The prevalence of LH reduction,hyper total cholesterol （TC） and hyper low-density lipoprotein was more frequent in MRI-positive patients （P ＜0.05）.Hyper-TC levels and PRL reduction were more frequent in males （P ＜0.05）.T3,T4 and FT3 levels negatively correlated with age at diagnosis （r=-0.310,P ＜0.01; r=-0.191,P ＜0.05; r＝-0.216,P ＜0.05）.T3,T4,FT3 and FT4 levels significantly negatively correlated with 8-am plasma cortisol levels （r=-0.328,P ＜0.01; r=-0.195,P ＜0.05; r=-0.333,P ＜0.01; r＝-0.180,P ＜0.05）.Females presented higher total protein level （P ＜0.01） and lower blood urea nitrogen and serum creatinine levels （P ＜0.01）,compared with male patients.Conclusions Carefulness and caution are required in all patients with CD,because of the complexity of clinical and biochemical characteristics in CD patients of different gender and MRI classification,particularly male patients and MRI-negative patients.展开更多
基金This work was supported by grant from the National Natural Science Foundation of China （No. 81270856 and No. 81270867）.
文摘Background Cushing＇s disease （CD） presents a remarkable preponderance in female gender,and a significant minority of patients with CD presented with negative magnetic resonance imaging （MRI） findings.The aim of this study was to evaluate gender-related and MRI classification-related differences in clinical and biochemical characteristics of CD.Methods We retrospectively studied 169 patients with CD,comprising 132 females and 37 males,and 33 patients had no visible adenoma on MRI.Results We observed that male and MRI-positive patients presented with high adrenocorticotropic hormone （ACTH） values （P ＜0.05）.Female patients presented with higher prevalence of hirsutism and hyperpigmentation and lower prevalence of purple striae （P ＜0.05）.The prevalence of buffalo-hump and hypertension was greater in MRI-negative patients （P ＜0.05）.In addition,male patients with CD presented at a younger age compared with females （P ＜0.05）.Patients with fatigue and hypokalaemia presented significantly higher urinary-free cortisol,ACTH and cortisol levels compared with patients without these symptoms （P ＜0.05）.The prevalence of LH reduction,hyper total cholesterol （TC） and hyper low-density lipoprotein was more frequent in MRI-positive patients （P ＜0.05）.Hyper-TC levels and PRL reduction were more frequent in males （P ＜0.05）.T3,T4 and FT3 levels negatively correlated with age at diagnosis （r=-0.310,P ＜0.01; r=-0.191,P ＜0.05; r＝-0.216,P ＜0.05）.T3,T4,FT3 and FT4 levels significantly negatively correlated with 8-am plasma cortisol levels （r=-0.328,P ＜0.01; r=-0.195,P ＜0.05; r=-0.333,P ＜0.01; r＝-0.180,P ＜0.05）.Females presented higher total protein level （P ＜0.01） and lower blood urea nitrogen and serum creatinine levels （P ＜0.01）,compared with male patients.Conclusions Carefulness and caution are required in all patients with CD,because of the complexity of clinical and biochemical characteristics in CD patients of different gender and MRI classification,particularly male patients and MRI-negative patients.
