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Objective ToinvestigatethevalueofDWIhyperintensityinvenoussinusindiagnosisandrecanalizationpredictionof cerebralvenoussinusthrombosis(CVST).Methods Clinicaland MRIdataof19patientswithCVST wereanalyzedretrospectively. BasedonDWIsignalcharacteristicsoftheCVST,thepatientsweredividedintoasthehyperintensegroupandthenon-hyperintense group.TheintervaltimebetweenthefirstMRIexaminationandtheonset,andtherecanalizationratewithin1 monthand3 months werecomparedbetweenthetwogroups.Results Therewere76 CVSTinthe19patients,withhyperintensein16venoussinus (21%)andin11patients(57.9%).Theintervaltimewaslongerinthehypertensegroupthanthenon-hypertensegroupbutnosta-tisticalsignificance[(12.81±11.10)daysversus(5.70±7.82)days,P=0.165].17patientsunderwentthesecond MRIexamination in1month,andtherecanalizationrateoftheobstructedsinuswaslowerinthehypertensegroupthanthenon-hypertensegroupwith nostatisticalsignificance(P=0.130).14patientsunderwenttheMRIexaminationafter3 months,andtherecanalizationrateofthe obstructedsinuswaslowerinthehypertensegroupthanthenon-hypertensegroupwithstatisticalsignificance(P=0.047).Conclu-sion ThehypertenseonDWIhashighsensitivityforthedetectionofsubacuteCVST.Thepresenceofhypertenseinoccludedsinus onDWIhasthepredictivevalueforvesselrecanalization.
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Objective To investigate the atypical MRI manifestations in patients with primary central nervous system lymphoma(PCNSL). Methods The clinical and MRI manifestations of 17 patients with pathologically confirmed atypical PCNSL in the First Affiliated Hospital of Henan University of Science and Technology (from May 2011 to Dec 2016) and Nanfang Hospital (from Sep 2003 to May 2009) were analyzed retrospectively in this study. Both conventional and contrast-enhanced MR images were acquired for each patient. The MRI manifestations including the number, location, size, shape, signal intensity, enhancement patterns of lesions were evaluated by two senior radiologists.Results Of the 17 cases,8 were solitary and 9 were multiple.Two types of atypical MR findings were found:(1)Atypical location:For the 9 patients showed atypical location,7 patients had solitary masses which were located in the brainstem(n=3), the supratentorial superficial parts(n=2), the cerebellum(n=1)and the sella(n=1). Two patients had multiple lesions, showing multiple subependymal nodules and no abnormalities in the brain parenchyma. Six of the 7 solitary lesions and the 2 multiple cases showed isointense or hypointense on T1-weighted scans and isointense or hyperintense on T2-weighted scans as well as significant homogenous enhancement on contrast-enhanced T1-weighted scans.(2)Atypical signal features:Ten cases were found with atypical signal features including:①Patchy lesions were observed in 6 patients( one patient with single lesion, and five patients with multiple lesions),appearing as hyperintense spots on T2-weighted image and subtle hypointense on T1-Weighted image. Corresponding contrast-enhanced T1-weighted MR image showed multiple patchy/linear enhancement. ②Two cases showed diffuse supratentorial periventricular and infra-tentorial white matter T2hyperintensity and absence of contrast enhancement. ③Nodular lesions with inhomogeneous internal signals were found in 2 cases with calcification(n=1) and cystic necrosis (n=1, ring-like enhancement).Conclusions The atypical imaging manifestations of PCNSL could lead to misdiagnosis or delay in the diagnosis.It is important to understand its atypical imaging features and combine with clinical manifestations to improve the accuracy of differential diagnosis of intracranial lesions.
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Objective To investigate the correlation between DWI value of cervical cancer in stage Ib1-II A2 and its pelvic lymph node metastasis. Methods 103 patients with cervical cancer of stage Ib1 - IIa2 confimed by surgery and pathology in our hospital from January 2014 to July2016 were retro-spectively studied,78 cases of cervical squamous cell carcinoma group(lymph node metastasis of 22 cases,non- lymph node metastasis 56 cases);25 cases of Cervical adenocarcinoma group(9 cases with lymph node metastasis,16 cases of no lymph node metastasis). All patients with preoperative were performed MR routine scan and DWI examination. The ADC value(meanADC,minADC and maxADC)between the two groups and between the groups with and without metastasis were statistically analyzed. Results The value of ADC staging of cervical carcinoma had no correlation with clinical FIGO stage(Pmean = 0.847、Pmin = 0.393、Pmax = 0.219). The meanADC values、minADC value、maxADC value[(0.84 ± 0.09)× 10-3mm2/s、(0.78 ± 0.09)× 10-3mm2/s、(0.86 ± 0.07)× 10-3 mm2/s]of Squamous cell carcinomas was lower than that of adenocarcinoma[(0.98 ± 0.04)× 10-3mm2/s、(0.93 ± 0.09)×10-3mm2/s、(0.97 ± 0.23)× 10-3mm2/s]and the difference was statistically significant(P <0.05). The meanADC values and minADC value of cervical cancer within each group in lymph node metastasis group was lower than that of non- lymph node metastasis group,the difference was statistically significant(P <0.05). The maxADC value had no significant difference(P > 0.05). Conclusion The ADC value of cervical cancer has some correlation with lymph node metastasis,which can be helpful to predict the risk of lymph node metastasis.
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Purpose To investigate the diagnostic value of parameters derived from intravoxel incoherent motion (IVIM) model for benign and malignant breast lesions,and to provide reference for the identification of breast lesions.Materials and Methods 27 cases with 28 benign breast lesions and 34 cases with 35 malignant breast lesions were collected and analyzed retrospectively.All of the patients were examined with IVIM-DWI scans.GE AW 4.4 workstation was used to calculate the value of ADC,D,D* and f.The diagnostic performance of different parameters was evaluated by receiver operating characteristic curve (ROC curve).The ADC,D,D* and f value of malignant group and the benign group were compared,respectively.Results The value of ADC and D were significantly lower in malignant group than in benign group (P＜0.05),and the value of D* and fwere significantly higher in malignant group than in benign group (P＜0.05).The cutoff value of D was 0.74× 10-3 mm2/s,and the AUC were 0.907,the specificity,sensitivity in the diagnosis of malignant breast lesions was 0.86,0.95,respectively.Conclusions Parameters of IVIM-DWI are helpful in the differential diagnosis of benign and malignant breast lesions.
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Purpose To investigate MRI features of encephalitis in children with severe hand-foot-mouth disease (HFMD). Materials and Methods The MR images of 85 cases of clinically diagnosed encephalitis in severe HFMD patients were retrospectively reviewed. Results In 85 patients, plain MRI was negative in 28;57 cases were positive including 10 cases showing punctate or patchy lesions in cerebral hemisphere, callosum, thalamus and cerebellar vermis with isointensity or slightly hypointensity on T1WI, isointensity or slightly hyperintensity on T2WI, and hyperintensity on T2FLAIR and DWI. In 47 cases, the lesions were located in the brainstem, tegmentum of pons and medulla oblongata. MRI features included symmetric high signal on DWI in posterior portions of brainstem, hypointensity or isointensity on T1WI and hyperintensity or isointensity on T2WI and T2FLAIR (n=17);patchy long T1, long T2 signal in posterior portions of brainstem, normal or mild hyperintensity on DWI, hyperintensity on T2FLAIR (n=30); lesion extending around the fourth ventricle in 9 patients, one of which involved bilateral cerebral peduncles. Conclusion Encephalitis in children with severe HFMD has characteristic MRI features. The lesions are mostly located in the posterior portion of the brainstem. DWI and T2FLAIR can better detection lesions.
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Objective To study the conventional MRI features of adult Japanese encephalitis (JE)and explore the early features of diffusion weighted imaging(DWI).Methods Thirty-two patients with adult JE were included.MR scanning including T1 WI,T2 WI and FLAIR were done in all patients,and DWI in 28 patients.Twenty-three patients received DWI in the early stage (within 1 to 7 days),in which the appearances of DWI were analyzed,ADC graphs were obtained and the signal noise ratio and the ADC values of lesions were calculated.Results Twenty-eight cases were abnormal on MRI,and 4 patients were normal.The lesions of JE involved the thalamus in 22 cases,the substantia nigra of midbrain in 13,kellogg’s seahorse in 9,the basal ganglia in 7,the splenium corpo-ris callosi in 4,the pons in 6 and the insular lobe in 2,extensive cerebral edema in 2.The early features of DWI in 23 patients showed cytotoxic edema in 2,vasogenic edema in 12,both two edemas existing in 5,and normal in 3.DWI were superior to T2 WI in 6 cases,and T2 WI were superior to DWI in 9 cases,DWI was similar to T2 WI in 5 cases on showing the size and signal of the le-sions.Conclusion Adult JE often occurs in the thalamus,substantia nigra of midbrain and kellogg’s seahorse.DWI shows vasogenic edema in the early stage.Comprehensive analysis of DWI,ADC and T2 WI details helps to early detection and qualitative adult JE le-sions.