目的探讨磁共振成像(MRI)中结合带区异常增厚、T_1加权像(WI)和(或)T_2WI高信号改变对子宫腺肌症的诊断价值。方法回顾性分析海军军医大学(第二军医大学)长海医院2013年1月至2016年1月收治的37例经病理证实为子宫腺肌症患者的MRI资料,...目的探讨磁共振成像(MRI)中结合带区异常增厚、T_1加权像(WI)和(或)T_2WI高信号改变对子宫腺肌症的诊断价值。方法回顾性分析海军军医大学(第二军医大学)长海医院2013年1月至2016年1月收治的37例经病理证实为子宫腺肌症患者的MRI资料,随机选取37例同期行MRI检查的子宫及卵巢正常者作为对照。测量并比较两组患者的子宫结合带厚度最大值(JZm a x)、结合带厚度最大值与最小值的差值(JZd i f f)、JZm a x与肌层厚度最大值的比值(JZm a x/Mm a x),并比较两组JZm a x、JZ_(diff)和JZ_(max)/M_(max)的差异。绘制受试者工作特征(ROC)曲线,计算JZ_(max)、JZ_(diff)和JZ_(max)/M_(max)诊断子宫腺肌症的曲线下面积(AUC)、截断值、灵敏度、特异度及准确度。观察患者T_1W I和(或)T_2W I上子宫壁内有无高信号及其类型。结果子宫腺肌症组与对照组的JZm a x、JZd i ff和J Zm a x/Mm a x差异均有统计学意义(P均<0.01)。JZ_(max)、JZ_(diff)、JZ_(max)/M_(max)诊断子宫腺肌症的AUC分别为0.95、0.90、0.85,当JZ_(max)≥10 mm时其灵敏度、特异度和准确度分别为78.8%、97.3%和88.6%,JZ_(diff)≥3.4 mm时分别为81.8%、91.9%和87.1%,JZ_(max)/M_(max)≥61%时分别为72.7%、83.8%和78.6%。18例(48.6%)子宫腺肌症患者仅见T_2WI高信号,14例(37.8%)可见T_1WI、T_2WI均高信号,多呈飘雪征改变;线状条纹征5例(13.5%),微囊征5例(13.5%),浆膜下囊性出血征1例(2.7%)。结论 JZ_(max)≥10 mm、JZ_(diff)≥3.4 mm、JZ_(max)/M_(max)≥61%对子宫腺肌症具有较好的诊断价值,其中JZ_(max)的诊断效能最佳。T_1WI和(或)T_2WI中的飘雪征、线状条纹征、微囊征、囊性出血征诊断子宫腺肌症具有独特性。综合评估这些征象可以提高MRI的诊断价值,为早期准确诊断子宫腺肌症提供可能。展开更多
BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic ute...BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea,menorrhagia, anemia, and other symptoms.CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea,hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved.CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.展开更多
目的探究子宫内膜纤维化的子宫结构改变在MRI上的表现。材料与方法前瞻性纳入53例经宫腔镜证实子宫内膜纤维化的不孕症患者和34名健康的育龄期女性。所有参与者均在围排卵期进行MRI常规序列的扫描。测量患者组和对照组的子宫内膜厚度(en...目的探究子宫内膜纤维化的子宫结构改变在MRI上的表现。材料与方法前瞻性纳入53例经宫腔镜证实子宫内膜纤维化的不孕症患者和34名健康的育龄期女性。所有参与者均在围排卵期进行MRI常规序列的扫描。测量患者组和对照组的子宫内膜厚度(endometrial thickness,EMT)、结合带厚度(junctional zone thickness,JZT)及宫腔长径(length of uterine cavity,LUC)并进行统计分析。使用二元Logistic回归分析对单因素分析有统计学意义的指标建立联合模型用于预测子宫内膜纤维化。结果患者的EMT[(7.46±1.14)mm]明显低于正常志愿者[(11.09±2.26)mm](P<0.01),患者的LUC[(30.79±4.15)mm]明显低于正常志愿者[(36.50±3.25)mm](P<0.01),患者的JZT[(6.39±1.80)mm]明显高于正常志愿者[(3.98±1.16)mm](P<0.01)。EMT、LUC、JZT以及联合模型对子宫内膜纤维化均具有很好的诊断效能,其AUC值分别是0.917、0.853、0.883和0.974,联合模型的诊断效能明显高于单独参数(P均<0.05)。结论MRI可以对子宫内膜纤维化患者的子宫整体形态的改变进行直观和动态地评估,方便临床随诊,可以协助临床医生掌握子宫内膜纤维化的疾病变化。展开更多
The mechanisms that regulate neural stem cell(NSC)lineage progression and maintain NSCs within diffe rent domains of the adult neural stem cell niche,the subventricular zone are not well defined.Quiescent NSCs are arr...The mechanisms that regulate neural stem cell(NSC)lineage progression and maintain NSCs within diffe rent domains of the adult neural stem cell niche,the subventricular zone are not well defined.Quiescent NSCs are arranged at the apical ventricular wall,while mitotically activated NSCs are found in the basal,vascular region of the subventricular zone.Here,we found that ADAM 10(a disintegrin and metalloproteinase 10)is essential in NSC association with the ventricular wall,and via this adhesion to the apical domain,ADAM10 regulates the switch from quiescent and undiffe rentiated NSC to an actively prolife rative and differentiating cell state.Processing of JAMC(junctional adhesion molecule C)by ADAM 10 increases Rap1 GAP activity.This molecular machinery promotes NSC transit from the apical to the basal compartment and subsequent lineage progression.Understanding the molecular mechanisms responsible for regulating the proper positioning of NSCs within the subventricular zone niche and lineage progression of NSCs could provide new targets for drug development to enhance the regenerative prope rties of neural tissue.展开更多
文摘目的探讨磁共振成像(MRI)中结合带区异常增厚、T_1加权像(WI)和(或)T_2WI高信号改变对子宫腺肌症的诊断价值。方法回顾性分析海军军医大学(第二军医大学)长海医院2013年1月至2016年1月收治的37例经病理证实为子宫腺肌症患者的MRI资料,随机选取37例同期行MRI检查的子宫及卵巢正常者作为对照。测量并比较两组患者的子宫结合带厚度最大值(JZm a x)、结合带厚度最大值与最小值的差值(JZd i f f)、JZm a x与肌层厚度最大值的比值(JZm a x/Mm a x),并比较两组JZm a x、JZ_(diff)和JZ_(max)/M_(max)的差异。绘制受试者工作特征(ROC)曲线,计算JZ_(max)、JZ_(diff)和JZ_(max)/M_(max)诊断子宫腺肌症的曲线下面积(AUC)、截断值、灵敏度、特异度及准确度。观察患者T_1W I和(或)T_2W I上子宫壁内有无高信号及其类型。结果子宫腺肌症组与对照组的JZm a x、JZd i ff和J Zm a x/Mm a x差异均有统计学意义(P均<0.01)。JZ_(max)、JZ_(diff)、JZ_(max)/M_(max)诊断子宫腺肌症的AUC分别为0.95、0.90、0.85,当JZ_(max)≥10 mm时其灵敏度、特异度和准确度分别为78.8%、97.3%和88.6%,JZ_(diff)≥3.4 mm时分别为81.8%、91.9%和87.1%,JZ_(max)/M_(max)≥61%时分别为72.7%、83.8%和78.6%。18例(48.6%)子宫腺肌症患者仅见T_2WI高信号,14例(37.8%)可见T_1WI、T_2WI均高信号,多呈飘雪征改变;线状条纹征5例(13.5%),微囊征5例(13.5%),浆膜下囊性出血征1例(2.7%)。结论 JZ_(max)≥10 mm、JZ_(diff)≥3.4 mm、JZ_(max)/M_(max)≥61%对子宫腺肌症具有较好的诊断价值,其中JZ_(max)的诊断效能最佳。T_1WI和(或)T_2WI中的飘雪征、线状条纹征、微囊征、囊性出血征诊断子宫腺肌症具有独特性。综合评估这些征象可以提高MRI的诊断价值,为早期准确诊断子宫腺肌症提供可能。
文摘BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea,menorrhagia, anemia, and other symptoms.CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea,hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved.CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.
文摘目的探究子宫内膜纤维化的子宫结构改变在MRI上的表现。材料与方法前瞻性纳入53例经宫腔镜证实子宫内膜纤维化的不孕症患者和34名健康的育龄期女性。所有参与者均在围排卵期进行MRI常规序列的扫描。测量患者组和对照组的子宫内膜厚度(endometrial thickness,EMT)、结合带厚度(junctional zone thickness,JZT)及宫腔长径(length of uterine cavity,LUC)并进行统计分析。使用二元Logistic回归分析对单因素分析有统计学意义的指标建立联合模型用于预测子宫内膜纤维化。结果患者的EMT[(7.46±1.14)mm]明显低于正常志愿者[(11.09±2.26)mm](P<0.01),患者的LUC[(30.79±4.15)mm]明显低于正常志愿者[(36.50±3.25)mm](P<0.01),患者的JZT[(6.39±1.80)mm]明显高于正常志愿者[(3.98±1.16)mm](P<0.01)。EMT、LUC、JZT以及联合模型对子宫内膜纤维化均具有很好的诊断效能,其AUC值分别是0.917、0.853、0.883和0.974,联合模型的诊断效能明显高于单独参数(P均<0.05)。结论MRI可以对子宫内膜纤维化患者的子宫整体形态的改变进行直观和动态地评估,方便临床随诊,可以协助临床医生掌握子宫内膜纤维化的疾病变化。
基金National Institutes of Health(NIH)Grants R01 RMH099384(to AA)and T32GM008444(to NM)。
文摘The mechanisms that regulate neural stem cell(NSC)lineage progression and maintain NSCs within diffe rent domains of the adult neural stem cell niche,the subventricular zone are not well defined.Quiescent NSCs are arranged at the apical ventricular wall,while mitotically activated NSCs are found in the basal,vascular region of the subventricular zone.Here,we found that ADAM 10(a disintegrin and metalloproteinase 10)is essential in NSC association with the ventricular wall,and via this adhesion to the apical domain,ADAM10 regulates the switch from quiescent and undiffe rentiated NSC to an actively prolife rative and differentiating cell state.Processing of JAMC(junctional adhesion molecule C)by ADAM 10 increases Rap1 GAP activity.This molecular machinery promotes NSC transit from the apical to the basal compartment and subsequent lineage progression.Understanding the molecular mechanisms responsible for regulating the proper positioning of NSCs within the subventricular zone niche and lineage progression of NSCs could provide new targets for drug development to enhance the regenerative prope rties of neural tissue.
