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实用磁共振乳腺成像

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实用磁共振乳腺成像

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《实用磁共振乳腺成像》中将对乳腺带有植入物的患者进行磁共振乳腺成像的基本原理及其典型并发症的影像归于一章中阐述。《实用磁共振乳腺成像》除了对磁共振乳腺成像的美好未来和对磁共振乳腺成像内容进行结论性讨论外,对于偶尔需要迅速明确影像诊断的M R引导下介入技术的现行标准,以及磁共振乳腺成像质量保证的评价等方面都进行了阐述。
Catalogue

1 磁共振乳腺成像的历史
2 患者的准备与告知
3 技术与方法
磁共振成像的基本原理
诊断设备
磁共振乳腺成像的诊断系统
成像序列同义词
表面线圈
检查时间
患者体位
乳腺加压
场强
2D与3D技术
定义
2D与3D技术的比较
4 肿瘤血管生成
基本原理
5 诊断标准
平扫检查
对比剂增强后T1加权检查
形态学
形状
边缘
表现形式
6 伪影与错误根源
体位错误
对比剂注射方式不恰当
运动伪影
去相位成像
发射与接收装置的失调
供学习的扫描协议
最高扫描协议(IIBM提出的供学习的扫描协议)
超快技术
高分辨率(HR)技术
脂肪饱和技术
T2加权序列
时间分辨率
空间分辨率
层面方向
顺磁性对比剂
图像后处理
自动图像后处理与分析
肿瘤血管生成与磁共振乳腺成像
动力学
动力学
初始期的信号升高
初始期后的信号变化
恶性标准
评估分数
磁敏感伪影
心脏血流流动伪影
线圈伪影
兴趣区(ROI)选取不正确
诊断性操作后的信号变化
7 磁共振乳腺成像的正常表现
形态学
血供
实质与年龄
实质的不对称性,附属腺体组织
乳头与乳头后区域
8 良性变化
乳头状瘤
腺瘤
纤维腺瘤
纤维腺瘤的亚型
良性叶状肿瘤
(又称为叶状纤维腺瘤)
脂肪瘤
纤维囊性乳腺病变
腺病(又称为腺病乳腺)
单纯性囊肿
复杂性囊肿
放射状瘢痕
(又称为硬化性乳头状增生、硬化性乳腺病、放射状硬化性病变)
9 恶性变化
导管内肿瘤的分类
导管原位癌(DCIS)
文献调查结果
小叶原位癌(LCIS)
浸润性肿瘤分类
浸润性导管癌
文献调查结果
浸润性小叶癌
文献调查结果
髓样癌
10 男性磁共振乳腺成像
男性乳腺发育
11 磁共振乳腺成像的指征
没有明确表现患者的磁共振乳腺成像
个体问的变异
个体内的波动
激素替代治疗
妊娠与哺乳期乳腺
错构瘤
(形象性的称呼:“乳腺中的乳腺”
KronsbeinBassler1982)
急性乳腺炎
慢性非产褥期乳腺炎
乳腺内的淋巴结
脂肪坏死
(又称为脂性坏死伴微囊性钙化)
术后改变
血清肿
血肿
脓肿
瘢痕组织
放疗后改变
黏液癌
浸润性乳头状癌
小管癌
其他类型的肿瘤
炎性癌
乳头Paget病
恶性叶状肿瘤
肉瘤
乳腺转移瘤
男性乳腺癌
术前分期
肿瘤大小
大量导管内成分(EIC)
多病灶
多中心性
同时发生的双侧乳腺癌
淋巴结分期
磁共振乳腺成像对治疗策略的重要性
12 鉴别诊断与策略性思考
局灶性增强
圆形或卵圆形的边界清晰的均匀
强化病灶
多发性的圆形或卵圆形的边界清晰
的均匀强化病灶
圆形或卵圆形的边界不清晰的均匀
强化病灶
13 假体诊断学
检查技术
测量协议
正常表现
并发症
囊状挛缩变形
14 MR引导下的介入放射学
MR引导下的介入放射学指征
立体定向装置
哥廷根(G0ttingen)介入放射学装置
活检装置(哈莱,Halle)
活检装置(波恩,Bonn)
活检装置(莱比锡,Leipzig)
15 质量评估
磁共振乳腺成像的检查清单
磁共振乳腺成像报告
16 磁共振乳腺成像目前的地位和展望
目前的地位
新辅助化疗
原发灶不明的癌瘤(CUP综合征)
瘢痕与癌的区别
局部病灶切除术后的随访
乳腺植入物重建后的随访
增加的乳腺癌风险
线性对比增强
树枝状对比增强
毛刺状对比增强病变
环形病灶即周围增强病变
弥漫性增强
单侧性弥漫性对比增强
双侧弥漫性对比增强
硅胶流出(硅胶浸出)
囊内破裂
囊外破裂
硅胶肉芽肿(“硅胶瘤”)
自体乳腺成形术
活检装置(蒂宾根,Tubingen)
MR乳腺活检系统
MRI兼容性活检器械
MRI兼容性定位器械
病变完全切除的确认
结果
MR乳腺模型
展望
参考文献
磁共振乳腺成像的历史,患者的准备
与信息、技术与方法
肿瘤血管生成
诊断标准
错误根源
正常表现
良性变化
恶性变化
男性乳腺
指征
乳腺植入物与整形外科
M R引导下的介入放射学
质量保证/展望
Book Abstract

磁共振成像的基本原理
自从PaulLauterbur在30年前发表了他的第一篇关于磁共振成像(MRI)的报告后,现在,MRI已经发展成为成熟的具有多种成像方式的技术(Lauterburl973)。磁共振成像的方法运用的是核磁共振(NMR)的物理学原理,该成像原理已经由包括诺贝尔奖获得者IsidorRabi、EdgarPurcell、FelixBloch和RichardErnst在内的许多化学家和物理学家描述过了。按照电磁学定律,荷电微粒的旋转运动可以在微粒周围产生一局部的磁场。某些核一质子(氢核)和那些具有奇数质子和中子的核具有其固有的角动量,或自旋。
对磁共振成像而言,氢核,或称质子,由于其在生物组织(水,脂肪)中的高浓度而受到偏爱。此外,由于其丰度高,在自然界的所有同位素中,氢核的磁矩最高。在没有外部磁场时,磁自旋的方向是任意分布的,因此,它们的磁偶极子没有净外作用力。当氢核被放置于一强大的外在磁场中时,这些原子核按照静磁场B.的两个方向中的一个排列(排列方向依不同方向磁力线的数量而决定):平行于磁场,即“向上自旋”(低能量状态);或与磁场反方向平行,即“向下自旋”(高能量状态)。由于这两种状态的能量差别小,两种方向排列的可能性基本相同。对于在所用的1.5 T(tesla)的磁场中的质子而言,每100000质子中仅仅只有一个质子是处于较低能量状态的。此外,由于每个质子的自旋是环绕其自身的轴,并且暴露在磁场中时会经历了一扭力矩,自旋矢量被迫成环状,或者说进动方向与按地球的重力场方向白旋顶部的方向相同。质子磁力矩的进动频率o)也称为Larmor频率,与磁场强度B。呈线性相关:
正比常数Y对不同类别的核来说是特异性的,也称为磁旋比。在磁场中的自旋矢量的协同作用,产生了肉眼可见的磁力矩或称为磁化强度M,这是在接收线圈中产生MR信号起作用的净磁力矩。
在恰当的物质依赖性(materjaldependent)共振频率(1T的质子是42MHz)激发下的短时间射频脉冲(RF)的爆发导致磁场纵轴排列方向以外的质子磁矢量的重新定向,即宏观的磁化,在RF脉冲场的扭力矩作用下而被迫作环磁场纵轴的旋转。位移角即翻转角旺,依赖于激发脉冲的幅度和持续时间,并以角度的形式表示。在RF脉冲关掉后,质子恢复到原来与静止磁场纵向排列方向一致的位置,即弛豫。在弛豫过程中,氢核吸收的能量以RF脉冲的形式重新释放出来或通过分子间的如电磁偶极偶极问的相互作用和热耗散方式消散。释放的电磁信号(MR信号)能被特殊的接收线圈探测到而作为感应电压,并转换成图像。
磁矢量恢复到原来方向的过程是一指数的过程,可描述为纵向平面(自旋晶格作用或T1弛豫时间)的增加,同时横向磁化衰减(白旋自旋作用或T2弛豫时间)。横向磁化作用的衰减是由导致进动自旋矢量去相位的分子偶极场的波动引起的。场的不均匀性引起成直线排列的自旋质子产生额外的去相位,以在T2弛豫时间加一个星(T2+)来表示。弛豫时间指的是RF信号以指数方式上升(T1)或衰减(T2)至其最大值一半的时问。值得庆幸的是,对于MR图像的对比度而言,各种组织的T1弛豫时间和T2弛豫时间具有惟一性的特征。
对产生图像而言,释放的信号或RF回波必须在三维矩阵中进行特异性定位。空问定位是通过在x、y、z空间方向上运用线性磁场梯度而获得的。然而,空间编码中的2D和3D技术在运用中是不同的。在2D技术中,层面选择只是同时转换层面选择梯度和RF激发,然后在该平面内进行相位和频率编码即可。在3D技术中,容积是由RF激发,并且第二次相位编码与第一次相位编码是成直角的。
Introduction

近年来,动态磁共振乳腺成像更加确立了其作为女性乳腺诊断检查成像方法中的地位。作为补充诊断方法,它填补了乳腺X射线摄影术和超声波检查领域中尽管已经经历大量技术改进和发展后仍留下的重要空白。通过该方法,特别是对比增强磁共振乳腺成像,可以看到病理组织的血管过度生成,这样可以很灵敏地检测到浸润性乳腺癌。
尽管在对乳腺进行M R检查的初期,在围绕M R检查的方法上存在激烈的争论,但近年来在欧洲共同体范围内已经在标准化检查策略上达成共识。当前的检查的指导方针是Deutsche Rontgenesellschaft(DRG)一德国放射学会以推荐方法的形式发表的,代表着许多研究小组的一致意见。事实上,个别研究者的测量协议仍然在某些参数上显示出某些不同,与该指导方针并不矛盾。相反,我们应当把这点认为是磁共振成像(M R I)应该提供多方面可能性的一种表现。
乳腺M R I是放射学家可运用的额外补充诊断手段,如果选择运用的话,它可以改进乳腺癌的诊断成像。如果注意遵守确定了的磁共振乳腺成像适应证的话,一些学者对乳腺M R I检查花费昂贵的担心是可以避免。相反,也可以认为磁共振乳腺成像的选择性使用能够更早地发现肿瘤和肿瘤的复发,也可以更好地针对肿瘤的分期来安排后续治疗计划和治疗方案的实施。
本书的目的在于对磁共振乳腺成像进行介绍并给以简要说明,并使之有助于磁共振乳腺成像常规工作的开展。本书以短小、简练的形式叙述了磁共振乳腺成像的重要技术及其方法等各方面,有一章专门讨论了评估的标准,通过对乳腺生理变化的描述、潜在伪影和缺陷的讨论而完善了对乳腺疾病的治疗。
本书的重点在于对乳腺的变化以及乳腺相关疾病的诊断进行系统阐述。作为介绍,其最重要的信息除了其他的乳腺成像方法外,还包括关于乳腺疾病的历史、流行病学、预后及临床意义。在本书对乳腺简短的概括中,没有对特殊表现进行详细论述,但可以当作是对乳腺的简短综述。如想获得更详细的信息,尚需要查阅相关文献。下面的章节主要是对行增强磁共振乳腺成像广泛接受的适应证进行详细的说明,并且在插图中列出了使人印象深刻的图像作为举例进行说明。
本书单独用了一章的篇幅将乳腺M R I表现与其他乳腺成像方式的表现放在一起进行详细分析。本书中提出有关磁共振乳腺成像的诊断和治疗策略的建议,目的在于为日常常规工作提供实用性指导,并不是让人必须严格遵循的条条框框。对于具有较多经验的读者而言,由于本书的介绍过于简短,可能会对本书不满意,或对这一章节的某些部分感到不满。然而,正是本章采用的注重实效的方法,对于获得正确的诊断起着有价值的帮助作用,本章未将最少遇见的鉴别诊断考虑在内。
本书中将对乳腺带有植入物的患者进行磁共振乳腺成像的基本原理及其典型并发症的影像归于一章中阐述。本书除了对磁共振乳腺成像的美好未来和对磁共振乳腺成像内容进行结论性讨论外,对于偶尔需要迅速明确影像诊断的M R引导下介入技术的现行标准,以及磁共振乳腺成像质量保证的评价等方面都进行了阐述。

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Return Policy

You may return product within 30 days upon receiving the product. Items returned must be new in it's original packing, including the original invoice for the purchase. Customer return product at their own expense.

Sold by JD@CHINA

Service Guarantee

Yami Cross-store Free Shipping over $69
Yami 30-days Return

Yami-China FC

Yami has a consolidation warehouse in China which collects multiple sellers’ packages and combines to one order. Our Yami consolidation warehouse will directly ship the packages to your door. Cross-store free shipping over $69.

Return Policy

You may return products within 30 days upon receiving the products. Sellers take responsibilities for any wrong shipment or missing items. Packing needs to be unopened for any other than quality issues return. We promise to pack carefully, but because goods are taking long journey to destinations, simple damages to packaging may occur. Any damages not causing internal goods quality problems are not allowed to return. If you open the package and any quality problem is found, please contact customer service within three days after receipt of goods.

Shipping Information

Yami Consolidation Service Shipping Fee $9.99(Free shipping over $69)

Sellers in China will ship their orders within 1-2 business days once the order is placed. Packages are sent to our consolidation warehouse in China and combined there. Our Yami consolidation warehouse will directly ship the packages to you via UPS. The average time for UPS to ship from China to the United States is about 10 working days and it can be traced using the tracking number. Due to the pandemic, the delivery time may be delayed by about 5 days. The package needs to be signed by the guest. If the receipt is not signed, the customer shall bear the risk of loss of the package.

Sold by JD@CHINA

Service Guarantee

Free shipping over 69
Genuine guarantee

Shipping

Yami Consolidated Shipping $9.99(Free shipping over $69)


Seller will ship the orders within 1-2 business days. The logistics time limit is expected to be 7-15 working days. In case of customs clearance, the delivery time will be extended by 3-7 days. The final receipt date is subject to the information of the postal company.

Yami Points information

All items are excluding from any promotion or points events on Yamibuy.com

Return Policy

You may return product within 30 days upon receiving the product. Items returned must be new in it's original packing, including the original invoice for the purchase. Customer return product at their own expense.

Yami

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About the brand

Jingdong book

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About the brand

Jingdong book