2018年 · 第52卷第01期

In the past four decades, imaging medicine has undergone earth-shaking changes and made great progress, making great contributions to the correct analysis and diagnosis of diseases. In the image information data acquisition technology, new imaging equipment such as CT, MRI, PET and hybrid PET-CT and PET-MRI are constantly emerging, pushing the imaging technology revolution to a climax again and again; In terms of working mode, the progress of computer and network technology has completely changed the traditional way of data circulation, and the way of data flow, processing and storage has been revolutionized; In training and learning mode, gradually from one-way classroom transmission mode to problem-oriented theoretical learning and case-oriented clinical training. Imaging examination has become an indispensable means in clinical practice, and the status of imaging doctors is constantly improving, so they are called "doctor's doctor".

primary central nervous system lymphoma (PCNSL) usually presents as single or multiple intracranial mass-like lesions with some enhancement. In very rare cases, PCNSL manifests as a diffuse invasive lesion without the formation of a local mass, which is called lymphomatosis cerebri (LC). Bakshi et al.^[1]This disease was first proposed in 1999, and it is mostly reported as individual cases at present. Cerebral lymphomatosis is considered a variant type of PCNSL^[2]The typical clinical manifestations are progressive dementia and gait instability, and the typical MRI manifestation is diffuse leukoencephalopathy in bilateral cerebral hemispheres, sometimes involving the basal ganglia, thalamus and brainstem, usually without enhancement of the lesions. Due to the lack of characteristics of clinical and neuroimaging findings, it is easily confused with Binswanger's disease, encephalitis, diffuse glioma, or other white matter lesions, which makes diagnosis difficult and may delay treatment^[3,4,5,6]。 The author collected 6 cases of cerebral lymphomatosis confirmed by operation and pathology in many hospitals, and analyzed their MRI manifestations to improve the understanding of this disease.

Castleman's disease (CD) is a rare chronic lymphoproliferative disease^[1]。 It mostly occurs in the chest, abdomen and neck, and is extremely rare in the eyes. Recently, a case of Castleman's disease located in the right orbit was treated in our hospital, which is reported as follows.

A 41-year-old male was admitted to the hospital on September 17, 2016 because the right thoracic cavity was found to be occupied by physical examination. The patient had chest tightness after strenuous exercise, without fever, chest pain, dyspnea and other discomfort. Denial of smoking history. Physical examination: bilateral thoracic symmetry, right lower lung percussion turbidity, auscultation breathing sound slightly thickened, no dry and wet rales heard. The results of bronchoscopy showed that the middle lobe and the dorsal segment of the lower lobe of the right lung had extrabronchial pressure stenosis, with patent lumen and smooth mucosa.

The child was a 8-year-old girl. The right eye was red and painful, the vision was blurred for 2 weeks, and the mouth was crooked for 1 month. He was diagnosed with facial nerve paralysis in the local hospital. On November 1, 2016, for further diagnosis and treatment, he was admitted to our hospital with "right corneal ulcer and facial nerve paralysis". Physical examination: mixed conjunctiva congestion of the right eye, ulcer focus visible in the center of the cornea, intraocular transposition, limited abduction.

A 65-year-old female was admitted to hospital in November 2016 due to upper abdominal discomfort accompanied by chest tightness and asthma for 3 years, aggravated for more than 1 month. The patient underwent cardiac ultrasound in a local hospital 1 year ago, which revealed apical cystic mass and pericardial effusion. The anterior mediastinal tumor was resected for more than 20 years, and the pathology was unknown (self-reported as benign lesion). Physical examination: A postoperative scar about 25 cm long in the right rib and supraclavicular lymph nodes (-) were seen. There was no bulge in the precordial area, and the apical pulsation was located near the midline of the left clavicle in the fifth intercostal area, with limited extent. There were no obvious abnormalities in blood routine and tumor markers.

Gynecological surgery and radiotherapy are the main causes of bladder fistula, among which vesicovaginal fistula (VVF) is more common^[1]Surgical repair is the main method for treating VVF^[2,3]。 However, VVF caused by radiotherapy is prone to repair failure, and the operation needs to be operated under general anesthesia, which is difficult for patients with advanced tumors to tolerate. The author successfully treated a patient with VVF with a comprehensive interventional method, which is reported below.

The patient was a 41-year-old male. Two hours ago, he fell at a height of more than 1 m. The specific force of his body was unclear. He had pain in his right forehead, abdomen and arms accompanied by mobility impairment, and bleeding on his right forehead continued. After 10 minutes, the patient became unconscious and refused to respond to the call. Physical examination: blood pressure 86/56 mmHg (1 mmHg =0.133 kPa), red blood cell count 3.13×10¹²/L, hemoglobin 95 g/L, platelet count 175×10⁹/L.

imaging genetics is a new interdisciplinary subject formed by combining imaging medicine and genetics. It has developed rapidly in recent years, and many large-scale imaging genetics research programs have been launched internationally^[1,2,3,4,5]。 Although imaging genetics has applications in other fields such as tumors^[6,7,8,9,10], but this technique is mainly used to reveal the pathogenic mechanism of neuropsychiatric disease risk genes^[11,12], understanding individual differences in human brain structure, function, and connectivity, among other research areas^{[13,14,15,16]}, also known as neuroimaging genetics. Therefore, the author will introduce neuroimaging genetics from seven aspects: concept, research significance, development course, common research methods, research status, challenges and research prospects, so that readers can have a comprehensive understanding of this emerging interdisciplinary subject.

basilar artery trunk large and giant aneurysms (BTLA) are aneurysms located in the basilar artery with a maximum diameter of ≥15 mm, and those with a maximum diameter of>25 mm are called giant aneurysms^[1,2]。 Large and huge aneurysms may appear in all segments of the basilar artery, and their main etiologies and treatment modes are quite different. Because the basilar artery runs below the pons and supplies blood to the brainstem and cerebellum, BTLA is likely to cause severe subarachnoid hemorrhage (SAH) and ischemic stroke, with high disability and mortality rates^[2]。 The author reviewed the clinical and imaging characteristics, diagnosis and treatment progress of BTLA in the basilar artery trunk, aiming at improving the diagnosis and treatment level of this disease.