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Objective:To re-identify the anatomical features of singular nerve canal (SNC) through observing and measuring the morphological characteristics of SNC using ultra-high resolution CT (U-HRCT).Methods:The U-HRCT images of 52 human head specimens (104 ears) from December 2019 to January 2020 were obtained. The best standard cross-sectional and coronal images of SNC were reconstructed. The morphology of the main trunk and branches of the SNC were observed. According to the number of turning points, the trunks of SNC were divided into single turning point type, double turning point type and no turning point type. According to the branch morphology, the branched SNC were divided into bifurcated type, confluent type, side branch type and bilateral branch type. The diameter, angle and length of each section of the posterior canal ampulla (PCA) of the main trunk, the turning point and the internal auditory meatus (IAM) were measured. Independent sample t test or Mann-Whitney U test was used to test group differences of main trunk diameter of the SNC with or without branches. Results:Totally 104 ears of 52 cases were divided into single turning point type of 79 ears, double turning point type of 20 ears and no turning point type of 5 ears. The bilateral morphological classification was the same in 30 cases (60 ears), including 24 cases of single turning point type (48 ears), 5 cases of double turning point type (10 ears), and 1 case of no turning point type (2 ears). The ear morphology on both sides was different in 22 cases (44 ears). The diameters of the PCA, the turning point and the IAM of SNC with single turning point type were (0.31±0.07), (0.40±0.10), (0.46±0.10) mm, respectively, and the angles were 60.5°±7.8°, 120.3°±9.6°, 38.3°±7.5° respectively. And the length of the PCA and the IAM in the SNC with single turning point type were (1.95±0.38), (2.31±0.68) mm, respectively. The diameters of the PCA, the turning point near the PCA, the turning point near the IAM and the IAM of SNC with double turning point type were (0.32±0.09), (0.38±0.09), (0.47±0.12), (0.47±0.13) mm, and the angle were 60.9° (57.3°, 64.9°), 117.9°±12.3°, 129.6°±12.4°, 41.7° (32.9°, 79.5°), respectively. The length of the PCA, the IAM and the distance between these two turning points were (1.78±0.31), 0.65 (0.46, 1.15), 0.96 (0.80, 1.15) mm, respectively. The diameters of the PCA and the IAM of SNC without turning point type were (0.20±0.01) and (0.50±0.12) mm. The angles with the PCA and the IAM in these cases were 58.4°±9.6° and 46.2°±5.1°, and the length was (3.61±0.32) mm. A total of 48 ears had branches, including bifurcated type (36 ears), confluence type (4 ears), side branch type (5 ears) and bilateral branch type (3 ears). In the SNC group with single turning point, the diameter of the turning point in the cases without branches was wider than that of cases with branches ( t=2.11, P=0.039). However, there was no significant difference in the diameter of each section between these two subgroups of SNC cases with double turning point type. Conclusions:U-HRCT is able to clearly show the SNC, the imaging features of whom are variable and should be re-understood.
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Objective:To verify the ability of the newly developed ultra-high resolution CT (U-HRCT) for displaying the fine bony anatomy of temporal bone.Methods:The cone-beam CT architecture was used on U-HRCT. The focus size of X-ray generator was 0.27 mm × 0.29 mm, the rated tube voltage was 60-100 kV, and the unit size of flat panel detector was 0.074 8 mm×0.074 8 mm. From October to December 2019, 16 adult head specimens (32 temporal bones, provided by Huanghe University of Science and Technology) were imaged using U-HRCT. The scanning mode was small-field-of-view and high-resolution scanning for unilateral temporal bone. The scanning parameters were: voltage 100 kV, current 3.5 mA, rotation time 40 s, reconstructed field of view 65 mm×65 mm, voxel size 0.1 mm×0.1 mm×0.1 mm, layer number 370, slice thickness 0.1 mm, and slice interval 0.1 mm. The ultimate spatial resolution of the system was detected using a phantom with line pair card, after the scanning with the same parameters. Through multi-planar reconstruction and minimum intensity projection method, a total of 6 anatomical positions of 4 structures (stapes footplate, cochlear axis bottom, vestibular aqueduct internal orifice and isthmus, cochlear aqueduct internal orifice and auditory sac segment) were scored with 1-3 points. The Wilcoxon test was used to compare the difference of bilateral scores of each structure.Results:The phantom test results showed that the ultimate spatial resolution of the system was ≥4.0 lp/mm. The scores of stapes footplate, cochlear axis bottom and vestibular aqueduct internal orifice were ≥2 points, with a display rate of 100%. The display rates of vestibular aqueduct isthmus, cochlear aqueduct internal orifice and auditory sac segment were 87.5% (28/32), 71.9% (23/32) and 53.1% (17/32), respectively. There were no significant differences in left and right scores of all anatomical structures ( P>0.05). Conclusion:The newly developed U-HRCT has good display ability for fine bony anatomy of temporal bone and has great clinical application potential.
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Objective To establish clinical quality control method with testing the birdcage head coils and setting up the action limits.Methods Three different MR devices (GE 1.5T HDi,GE 3.0T HD and GE 3.0T 750W) and corresponding birdcage coils were tested.Axial T1WI was performed to scan ACR phantom.SNR,percent image uniformity (PIU) and percent signal ghosting (PSG) were measured for six times,and the mean values and standard deviations (SD) were calculated.Based on the results,the action limits for each parameter were set.Results The mean value of SNR for the three devices was 262.14,280.47 and 474.24,and SD was 18.43,29.67 and 29.95,respectively;the action limits were ≥225.28,≥221.13 and ≥414.34,respectively;the mean value of PIU for the three devices was 95.00％,83.17％ and 84.33％,SD was 0.63％,1.17％ and 0.82％,respectively;the action limits were ≥93.74％,≥82.00％ (corrected) and ≥82.69％,respectively.The mean value of PSG for the three devices was 0.11％,0.07％ and 0.14％,SD was 0.12％,0.03％ and 0.11％,respectively;the action limits were ≤0.35％,≤0.13％ and ≤0.36％,respectively.Conclusion All of SNR,PIU and PSG for three MR devices were consistent with the action limits in this study.
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Objective To test the central frequency (CF) and transmitter gain(TG) of MRI scanners,and set up their action limits.Methods Three different MRI devices (GE 3.0T HD,GE 1.5T HDi and GE 3.0T 750W) were tested by scanning American College of Radiology (ACR) phantom with the axial T1WI series.In the pre-scanning of T1WI series for the ACR phantom,the CF and TG were recorded.It was tested for eight times when MRI scanners were in good condition.The action limits of CF and TG were calculated based on mean values and standard deviations.Results The mean values of CF for three devices were (127 725 772.38±39.68)Hz,(63 875 740.13± 34.15)Hz,and (127 771 958.38±12.19)Hz,respectively.Their action limits were ≤119.04 Hz,≤68.30 Hz,and ≤36.57 Hz,respectively.The mean values of TG for three devices were (125.25±1.28)dB,(101.75±1.98)dB,and (113.25±0.89)dB,respectively.Their action limits were (125.25±2.56)dB,(101.75±3.96)dB,and (113.25±1.78)dB,respectively.Conclusion The CF and TG for three MRI scanners are all consistent with the action limits in this study.The CF and TG action limits will provide criterions for the clinical quality control.
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Clinical quality control of MRI equipment is a significant part of quality assurance.The purpose of quality control is to assure the performance and specification stability of MRI scanner,and to provide high quality images for clinical diagnosis.Many foreign countries have already developed and established highly sophisticated quality control procedure and regulation for MRI system,and the application is also relatively popular.However,this work has just begun in China,need to be further developed.The current status and future trend of clinical quality control procedure as well as regulation for MRI equipment were reviewed in this article.
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Objective To detect the cross-talk RF signal interference of three MRI scanners,in order to deepen the understanding of cross-talk RF signal interference.Methods Three different GE magnetic resonance imaging scanners (GE 1.5T HDi,installation time:2012;GE 3.0T HD,installation time:2006;GE 3.0T 750W,installation time:2016) were tested.The axial T1-weighted sequence was used to scan ACR phantom.Slice gaps with 5.0 mm,1.0 mm,0.5 mm and 0 were performed,respectively.SNR values were also recorded.Based on the results,the percentage change charts of SNR with slice gaps were made.Test standard was set as SNR decreased less than 20 ％ when the slice gap reduced from 5 mm to 0.Results When slice gap was reduced from 5 mm to 0,SNRs for three scanners decreased by 18.16 ％,23.57％ and 10.75％,respectively.Both the results of cross-talk obtained with GE 1.5T HDi and GE 3.0T 750W scanner met the test standard,while the result obtained with GE 3.0T HD (used for more than 10 years) was below the standard.Conclusion The cross-talk RF signal interference still exists for three MRI scanners.The test result of the scanner used for the longest time is unqualified.The quality control test of cross-talk should be done in the daily work.
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Objective To explore the evaluation methods of magnetic field uniformity and the practical operations,in order to provide references for clinical quality control.Methods Based on MRS phantom and 32 cm uniform spherical phantom,the evaluation methods of magnetic field uniformity were used to detect MRI equipment in department of radiology,including spectral peak and the bandwidth difference.Results The full width at half maximum (FWHM) of MRS phantom was 0.08 ppm,the inhomogeneity values on coronal,sagittal and axial detected by the bandwidth difference method was 0.15 ppm,0.08 ppm and 0.18 ppm,respectively.Conclusion The magnetic field homogeneity of the above mentioned MRI equipment is favorable,which accords with magnetic field uniformity detection standard.
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Objective To explore the role of serotonin(5-HT) in obsessive compulsive disorder(OCD) and the difference in platelet 5-HT content between OCD and healthy controls, the obsession and the compulsion subgroup. Methods The concentration of serotonin (5-HT) in twenty-seven patients with OCD and twenty-seven patients without OCD were detected in the study. Results Platelet serotonin level in patients with OCD ( ( 139 ±172 ) μg/L) was lower than that in patients without OCD ( ( 248 ± 215 ) μg/L), and the differences were significant (P＜0.05). Conclusion The present results support the hypothesis that 5-HT hypofunctionality contribute to OCD. And the differences between the obsession and the compulsion subgroup in the role of 5-HT are significant.
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BACKGROUND: Neuroprotective role of hypothermia on cerebral ischemic-reperfusional impairment has been long acknowledged. Since general hypothermia is complicated and unfit for observing postoperative consciousness and neurological function, it is of important significance to explore novel methods of focal cerebral hypothermia.OBJECTIVE: To study the neuroprotective effect of lateral ventricle infusion of low-temperature fluid on ischemic neurons of middle cerebral artery (MAC) occlusion models established on New Zealand rabbits.DESIGN: A randomized case-control study based on experimental animal models.SETTING: Neurosurgical department and pathological department of a general military hospital of Chinese PLA.MATERIALS: This study was carried out at Neurosurgical Laboratory of Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Altogether 18 healthy New Zealand male rabbits, weighing from 2. 8 to 3.2 kg, were selected 4 - 6 months after birth, and randomly divided into occlusion group, hypothermia group and control group.INTERVENTIONS: Cerebral focal ischemic-reperfusional model was established on the New Zealand rabbits through MCA occlusion for 2 hours followed by reperfusion for 24 hours.MAIN OUTCOME MEASURES: Scores for neurological function, water content in the left and right brain, pathological changes of nerve cells in the left MCA supplying region.pothermia group, significantly higher than that in occlusion group(7.58 ± 0.58 )( P ＜ 0.01 ), but no significant difference could be observed in contrast with brain was(81.64 ± 0.82)% and (79.26 ± 1.30)% in occlusion and hypothermia groups with significant difference between them( P ＜ 0.05), and it was significantly different between the left side [ (81.64 ± 0. 82 )% ] and opyknosis and deep staining could be observed in nerve ganglion cells in occlusion group under optical microscope, but no obvious pathological changes were observed in MCA supplying brain regions in hypothermia group.CONCLUSION: Permanent infusion of low-temperature fluid into the lateral ventricle plays an important neuroprotective role by attenuating cerebral ischemic-reperfusional impairment and improving post-ischemic neurological functions.
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Objective: To explore the effects of continuous trickle of low temperature liquids through the lateral ventricle on neural cell apoptosis after rabbit local cerebral ischemia/reperfusion. Methods:The middle cerebral artery (MCA) of New Zealand rabbit was clipped by micro aneurysm clip for 2 hours and reperfused for 24 hours. Immediately after clipping the MCA, we trickled the left lateral ventricle continuously with low temperature liquids(22℃) to decrease the brain temperature to mild hypothermia (33℃-35℃)and maintained for 2 hours. After reperfusion for 24 hours , we assessed TUNEL method to determine the apoptotic cell rate in the sham-operated group, the control group and the mild hypothermia group respectively. Results:The apoptotic cell rate of the cortex tissues accommodated by MCA in the mild hypothermia group was obviously lower than that in the control group(P0.05). Conclusion:Trickling ventricle with low temperature liquids could decrease the apoptotic cell rate and alleviate cerebral ischemia/reperfusion injury.
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Objective:To explore a simple and effective method of local hypothermia, and to testify its neuroprotective effects . Methods:This experiment adopts twelve adult and healthy New Zealand rabbits as experimental animals. These rabbits were randomly assigned to two groups : ① MCAO (n=6),② MCAO and hypothermia (n=6). The middle cerebral artery (MCA) was exposed through the left orbital approach, and was clipped 2 hours by a 3 mm straight aneurysm clip to establish the MCAO model. We assign 2 cavities ventricle tube to puncture the frontal angle of the lateral ventricle, then 22℃ physiological brine was dropped into the lateral ventricle to reduce the brain temperature in MCAO and hypothermia group. Temperature thermister probes were inserted for measuring the brain and rectal temperatures. The neurological deficits and histological changes of brain tissue were evaluated in all experimental animals.Results: Brain temperature below cortex was descend to 35℃within 20 minutes after hypothermia in MCAO and hypothermia group while rectal temperature has maintained normal. The neurological deficits and histological changes of brain tissue of MCAO and hypothermia group were better than those in MCAO group. Conclusion: The local intra-ventricle hypothermia model is a reliable, cooling rapidly and useful method for selective brain cooling.
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Objective:To discuss the diagnosis, treatment and outcome of patients with gliomatosis cerebri (GC). Methods:Retrospectively reviewed the clinical manifestations and radiological appearances of 6 patients with GC, which were diagnosed in our hospital between 1993 and 2003. We employed surgical treatment in three patients, stereotactic biopsy in two, and the other one received both biopsy and surgery. Results: The lesions of GC infiltrated more than two lobes in brain. CT studies showed diffuse hypodensity changes and enhancement was absent in four patients. MRI examinations revealed isointense or hypointense regions on T1WI, and uniformly high signal on T2WI. MRI also disclosed structural enlargement. All patients received radiotherapy after surgery and three patients underwent chemotherapy additionally. Five patients died during follow up with average course of 16.4 months. Conclusion:MRI examination is valuable in the diagnosis and the prognosis of GC is poor.
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Objective:To study the relationship between the recurrence of benign meningiomas and cell proliferation, and to find some parameters that can predict the recurrence of benign meningiomas. Methods:49 samples from 15 recurrent benign meningiomas and 22 non recurrent benign meningimas were immunohistochemically stained with PCNA antibody and Ki 67 antibody.The ratios of positive tumor cells were calculated,then PCNA LI and Ki 67 LI of different groups were compared. Results:PCNA LI or Ki 67 LI in recurrent benign meningiomas was significantly higher than non recurent benign meningiomas individually( P 0.05). Conclusion:The proliferative potential of recurrent benign meningiomas was higher than that of non recurrent benign meningiomas.When the PCNA LI was greater than 2.0%,the recurrent risk was high.The proliferative potential did not increase when benign meningiomas recurred.
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Objectives:To explore the protective effects of continuous trickle of low temperature liquids through the lateral ventricle on neurons after rabbit local cerebral ischemia reperfusion. Methods: The middle cerebral artery (MCA) of New Zealand rabbit was clipped with micro aneurysm clip for 2 hours and reperfused for 24 hours. Immediately after clipping the MCA, we trickled the left lateral ventricle continuously with low temperature liquids to decrease the brain temperature to mild hypothermia(32-35℃) and maintained for 2 hours. After reperfusion for 24 hours, we assessed the animal's neural deficits, observe the pathology of the ischemic brain tissues dyed by HE and determined the dry wet ratio for brain edema in the sham operated group, the control group and the mild hypothermia group respectively.Results:①The grades of neural deficits in mild hypothermia group were obviously lower than that in the clipping group( P 0.05 );②The dry wet ratios were obviously different in the mild hypothermia group and clipping group;③ Pyknosis and dense dying by HE were observed in the neural nuclei of ischemic cortex tissues of the clipping group, but no obvious changes were observed in the mild hypothermia group. Conclusions:Trickling ventricle with low temperature liquids could alleviate cerebral ischemia reperfusion injury, ameliorated neural deficit after ischemia reperfusion and were protective on the brain.
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Objective:The aim of the current study was to investigate the expression of nuclear factor-?B(NF-?B) and metalloproteinase-9(MMP-9) in the small intestine and to explore the potential role of NF-?B and MMP-9 in the damage of gut mucosal barrier after traumatic brain injury.Methods:The trauma was produced by a free-falling weight on the exposed dura of right parietal lobe.The rats were randomly divided into control group and traumatic brain injury groups at hours 3,12,24 and 72,and on day 7.NF-?B binding activity in the small intestine was studied by electrophoretic mobility shift assay(EMSA),and the expression of MMP-9 was studied by immunohistochemistry.Results:The results showed that NF-?B binding activity and MMP-9 expression in the small intestine was progressively increased,reached the maximum at 72 h and kept at high level up to 7 d after TBI.Concomitant upregulation of NF-?B~()and MMP-9 was observed.MMP-9 positively immunostained cells were mainly located at villous interstitium,lamina propria,crypt and submucosal layer,including endothelial cells,lymphocytes and neutrophils.Conclusion:It was concluded that cortical contusion trauma could induce a concomitant and persistent upregulation of NF-?B binding activity and MMP-9 expression in the small intestine which might play a central role in the~()damage of gut mucosal barrier.
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Objective:To discuss the surgical outcome of pediatric intractable temporal epilepsy. Methods:This observation included 34 pediatric patients with intractable temporal epilepsy who were admitted to our hospital from 1990 to 2001.CT or MRI,EEG and neuropsychological examinations were taken to determine the situations of the patients.They all underwent improved anterior temporal lobectomy. Results:The patients have been followed up for 2-13 years.According to Engel's classification,the achieved outcomes were seizure-free in 22(65 %) patients,apparently improved in 3(9 %) patients,improved in 3(9 %) patients,no effect in 2(6 %) patients,and lost of follow-up in 4(12 %) patients,respectively. Conclusion:Surgical treatment to pediatric intractable temporal epilepsy is safe and effective.The most common pathological causes for pediatric epilepsy are tumor and hippocampus sclerosis.Early surgery of pediatric temporal epilepsy could improve the life qualities of patients.
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Objectives:To explore the antiepileptic cellular mechanism of chronic vagus nerve stimulation (VNS). Methods: The rats were kindled by intraperitoneal injection of pentylenetetrazol (PTZ) (45mg/kg weight), and chronic VNS was applied to the kindled-rats. The effects of glutamate (Glu) on the intracellular free calcium (［Ca2+］i) of cortical and hippocampal neurons of normal, PTZ-kindled and VNS-treated rats were examined with fluorescence spectrophotometry respectively. The behavioral changes of all rats were observed. Results: The neuronal ［Ca2+］i of the VNS-treated rats were significantly lower than that of the PTZ-kindled rats. VNS could significantly inhibit the augmentation of neuronal ［Ca2+］i induced by Glu. Behavioral changes demonstrated that VNS could significantly reduce the severity and prolong the latency of seizures of PTZ-kindled rats. Conclusions: VNS could significantly inhibit the kindling effect of PTZ and reduce the excitability of neurons induced by Glu. VNS might exerted the antiepileptic effects by influencing the activation of neural receptors.