ABSTRACT
Objective To investigate the value of MR intravoxel incoherent motion (IVIM)imaging and dynamic susceptibility contrast-enhanced(DSC)perfusion imaging in astrocytoma grading.Methods 22 patients with high grade astrocytoma and 28 patients with low grade astrocytoma underwent conventional MRI and IVIM,DSC scanning before operation.Parameters of IVIM included standard diffusion coefficient(ADCstandard ),slow diffusion coefficient(D),fast diffusion coefficient(D? ),fractional perfusion-related volume (f)values,and parameters of DSC included relative blood volume(rCBV),relative blood flow(rCBF)values of tumor solid part were measured quantitatively.The values between the two groups were compared by two samples t-test.By using ROC curve to evaluate the diagnostic efficacy of using IVIM and DSC alone or jointly.Results The ADCstandard ,D,rCBV,rCBF values of tumor solid part had significant differences between the groups(P<0.01).The D? and f values were no significant differences (P=0.130,P=0.379).The area under the ROC curve of the values showed that ADCstandard (0.823),D(0.854),rCBV(0.858),rCBF(0.871),D+rCBV(0.952),D+rCBF(0.953).Conclusion The D,rCBV,rCBF values are helpful to determine the grade of astrocytomas.The use of IVIM in combination with DSC may improve the diagnostic accuracy of astrocytoma grading.
ABSTRACT
Objective To assess the value of combination of susceptibility weighted imaging (SWI)and dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion-weighted magnetic resonance imaging in astrocytoma grading.Methods SWI and DSC scans were performed in 82 patients with pathologically confirmed astrocytoma.The patient group consisted of grade Ⅱ (15),grade Ⅲ (10),and grade Ⅳ (57).The intratumoral susceptibility signal intensity (ITSS) and relative cerebral blood volume (rCBV) max were used to determine the grade of astrocytomas by Kruskal Wallis test,Welch test,Spearman correlation coefficients,Pearson correlation coefficients,and receiver operating characteristic curve (ROC)statistic methods.Results There were no ITSS in 14 cases of low-grade astrocytomas,the degree of ITSS were grade 1 to 3 in anaplastic astrocytomas,the degree of ITSS were grade 3 in all of the glioblastomas,the degree of ITSS were significant difference in all grades (H =71.96,P ＜ 0.01).rCBV max in grade Ⅱ,grade Ⅲ and grade Ⅳ astrocytomas were 1.26 ± 0.42,3.59 ± 2.09 and 8.34 ± 1.16 respectively,rCBV max were significant difference in all grades (F' =681.72,P ＜ 0.01).ITSS showed significant correlation with rCBV max (r =0.72,P ＜0.01) and tumor grades (r =0.89,P ＜0.01),and rCBV and tumor grades showed significant correlation (r =0.78,P ＜ 0.01).Area under the ROC curve application SWI,DSC,SWI and DSC in differentiation of the grade Ⅱ and grade Ⅲ astrocytomas were 0.99,0.93,1.00,differentiate grade Ⅲ from grade Ⅳ were 0.70,0.94,0.94,and differentiate high-grade from low-grade astrocytomas were 1.00,0.99,1.00.Conclusions ITSS is helpful to determine the grade of astrocytomas.The use of SWI in combination with DSC may improve the diagnostic accuracy of astrocytoma grading.
ABSTRACT
Objective To investigate the effect of palato-pharyngo-plastry on patients with coronary heart disease (CHD) plus obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The 113 OSAHS patients with CHD after palato-pharyngo-plastry from January 2001 to December 2006 were enrolled and followed up. The other 125 cases treated with continuous positive airway pressure (CPAP) were as control group. Results The fundmental factors of CHD including cholesterol, triglyeride, fasting blood glucose and body mass index (BM1) showed no statistical differences between two groups (x2 or t= 4.788, 0.479, 0.541, all P>0.05) . Only the oxyhemoglobin saturation during sleep was higher in study group than in control group [(91.2± 2.5)% vs. (87.6±4.2)%, P=0.046]. The angiography showed that 87 cases (77.0%) retained stable, 24 cases (21.2%) became severe in study group. As compared with control group, there were no statistical differences (both P>0.05). 37 cases (32.7%) in study group and 58 cases (46.4%) in control group who suffered from angina became severe with statistical differences between two groups (x2=4.615, P=0.032). The incidences of myocardial infarction and sudden death were lower in study group (3.5% and 0.8%) and in control group (5.6% and 2.4%), showed no statistical, difterences be tween twogroups. x2=0.571 and 0.495, P>0. 05). Conclusions Compared with CPAP, the palato-pharyngo-plastry can improve oxyhemoglobin saturation and reduce angina symptom, but has no better effect on progress of coronary atherosclerosis and acute coronary disease than CPAP.