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1、第 1 页 共 3 页 Dalian Medical University大连医科大学硕士研究生专业课试卷 2010 年级 医学影像学（课程）试卷 学号 姓名 命题单位：附二 教研室： 放射 教研室主任审核签字： 阅卷人 ： 一二三四五总分分数一、简答题（每题 5 分，共 40 分）1. 简述肾细胞癌 MRI 影像学表现? 2. 简述结核性空洞与癌性空洞的鉴别。3. 周围型肺癌的 CT 表现。4. 对骨肿瘤影像诊断的要求有哪些？5. 简述胸腺瘤的 MR 诊断。6. 举例说明脑内病灶的强化类型。7. 大脑 Willis 环的组成是什么？8. 简述鞍区常见的肿瘤与起源。二、论述题（每题 12 分，
2、共 60 分）1. 试按照恶性程度对星形细胞瘤进行分类，并描述其一般 MR 表现。2. 试述 MRI 应用的新进展。 （至少写出 5 种新技术及其应用，新技术需写出中文名称及英文缩写）3. 试述良恶性骨肿瘤的鉴别诊断。4试述良、恶性梗阻性黄疸鉴别。5. 试述脑内出血灶成分的演变及相应时期 MRI 信号特点。考生须知1、检查所发试卷是否和自己所报科目一致，试卷有无缺页、漏印、字迹模糊，如有可举手请求换卷。2、必须将自己的学号、姓名、专业班级写在试卷指定位置上。3、在试卷密封线以外填写姓名、学号或写有与答题内容无关的语句和作其它标记的试卷一律作废，后果自负。第 2 页 共 3 页 Dalian M
3、edical University大连医科大学硕士研究生试卷 2010 年级专业外语试卷 学号 姓名 命题单位：附二 教研室：放射 教研室主任审核签字： 阅卷人 ： 一二三四五总分分数一、翻译以下专业文献摘要MR imaging of term infants with hypoxic-ischaemic encephalopathy as a predictor of neurodevelopmental outcome and late MRI appearances Abstract Background Morbidity attributable to hypoxic-ischaem
4、ic injury (HIE) in the perinatal period remains problematic, and timely and accurate assessment of the degree of injury is required for clinical management and prognosis. Conventional MR sequences typically appear normal in the first 48 h post HIE. While diffusion-weighted imaging (DWI) and apparent
5、 diffusion coefficient (ADC) maps register the injury earlier, perhaps within the first 24 h, it has been suggested that there may be a propensity at that early stage to underestimate the lesion severity or extent. Objective To assess whether MR imaging that included DWI, measured ADC values and T1-
6、 and T2-weighted sequences ultimately correlated with either neurodevelopmental outcome or with late MR imaging at 2 years of age. In addition, we wished to compare the performance of MR imaging with cranial US imaging. Materials and methods All infants presenting with HIE who had an MRI within 10 d
7、ays of life were eligible for enrollment and subsequently underwent a full neurodevelopmental assessment at 2 years of age. All children underwent repeat MRI at this time. All neonates had at least one cranial US study. The US findings were categorized as normal, abnormalities confined to the cerebr
8、al cortex and subcortical white matter, isolated central grey matter hyperechogenicity, and central hyperechogenicity combined with cerebral cortical/subcortical changes. All MRI studies were retrospectively reviewed by three radiologists. The patterns of injury on the early DWI and ADC maps and ear
9、ly T1- and T2-W studies were recorded as diffuse, central, watershed or atypical. The patterns of signal abnormality were assessed using a scoring system that yielded four separate scores basal ganglia (BG), watershed (W), BG/W and summation (S) for the three sets of images, a total of 12 scores in
10、all. The appearance of the posterior limb of the internal capsule (PLIC) on T1-W inversion recovery sequences and of the corpus callosum on all sequences was also documented. After detailed neurodevelopmental assessment at 2 years of age, infants were classified into two groups according to whether
11、they had a favourable or unfavourable outcome. Results Of the 26 infants, 6 infants died before formal assessment at the age of 2 years. A further 5 infants had moderate to severe cerebral palsy in addition to severe cognitive impairment. The remaining 15 infants were categorized in the favourable o
12、utcome group. The US appearance 考生须知1、检查所发试卷是否和自己所报科目一致，试卷有无缺页、漏印、字迹模糊，如有可举手请求换卷。2、必须将自己的学号、姓名、专业班级写在试卷指定位置上。3、在试卷密封线以外填写姓名、学号或写有与答题内容无关的语句和作其它标记的试卷一律作废，后果自负。第 3 页 共 3 页 Dalian Medical Universityperformed well in terms of predicting final outcome (P=0.005). The pattern of ischaemia seen on early MRI
13、 was a significant predictor of outcome (P0.0001). The BG, BG/W and S scores of the diffusion imaging were significantly associated with outcome (P0.0001, P0.0001 and P=0.0005 respectively). DWI was predictive of outcome group (P0.0001), as were the early T1- and T2-W sequences (P=0.002) and cranial
14、 US (P=0.005). Assessment of the PLIC in infants with watershed or atypical patterns of ischaemia was found to be less reliable in predicting outcome. The measured ADC value in the PLIC was significantly reduced in those children who had an unfavourable outcome (P=0.03). Conclusion While early MRI p
15、erformed better than cranial US, the sonography findings were useful. The pattern of ischaemia on early MRI was a good predictor of prognosis. All infants with watershed or atypical patterns had a favourable outcome. The majority of infants with central patterns of ischaemia had an unfavourable outcome and all infants with a diffuse pattern had an unfavourable outcome. DWI was predictive of outcome group, as were early T1- and T2-W sequences and cranial US.
