Histogram Analysis of Diffusion Kurtosis Magnetic Resonance Imaging for Diagnosis of Hepatic Fibrosis

OBJECTIVE: To investigate the diagnostic value of diffusion kurtosis imaging (DKI) histogram analysis in hepatic fibrosis staging. MATERIALS AND METHODS: Thirty-six rats were divided into carbon tetrachloride-induced fibrosis groups (6 rats per group for 2, 4, 6, and 8 weeks) and a control group (n = 12). MRI was performed using a 3T scanner. Histograms of DKI were obtained for corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC). Mean, median, skewness, kurtosis and 25th and 75th percentiles were generated and compared according to the fibrosis stage and inflammatory activity. RESULTS: A total of 35 rats were included, and 12, 5, 5, 6, and 7 rats were diagnosed as F0–F4. The mean, median, 25th and 75th percentiles, kurtosis of D map, median, 25th percentile, skewness of K map, and 75th percentile of ADC map demonstrated significant correlation with fibrosis stage (r = −0.767 to 0.339, p < 0.001 to p = 0.039). The fibrosis score was the independent variable associated with histogram parameters compared with inflammatory activity grade (p < 0.001 to p = 0.041), except the median of K map (p = 0.185). Areas under the receiver operating characteristic curve of D were larger than K and ADC maps in fibrosis staging, although no significant differences existed in pairwise comparisons (p = 0.0512 to p = 0.847). CONCLUSION: Corrected apparent diffusion of DKI histogram analysis provides added value and better diagnostic performance to detect various liver fibrosis stages compared with ADC.

Clinical analysis of coronary artery disease in elderly patients with sleep disordered breathing / 南方医科大学学报

<p><b>OBJECTIVE</b>To understand the prevalence of sleep disordered breathing (SDB) in elderly patients with coronary artery disease (CAD) and explore the relations between SDB and CAD.</p><p><b>METHODS</b>Sixty-two elderly patients with and 18 without CAD identified by coronary angiography underwent examinations by polysomnography (PSG). Left ventricular ejection fraction (LVEF) was measured by 99Tc equilibrium radionuclide angiography.</p><p><b>RESULTS</b>In the 62 elderly patients with CAD, 53.2% had SDB, a rate significantly higher that (22.2%) in the 18 non-CAD patients. The CAD patients with SDB had higher respiratory disturbance index (RDI) and body mass index (BMI) and lower arterial saturation of oxygen (SaO2) during sleep, with longer duration of low SPO2 (less that 90%). The incidence of hypertension was higher in CAD patients with SDB than in those without SDB. No significant correlation was found between the severity of coronary artery disease and RDI (r=-0.16, P>0.05).</p><p><b>CONCLUSION</b>The elderly patients with CAD have higher incidence of SDB, and appropriate interventions should be administered in those with severe SDB.</p>

Correlation between the Handedness and Clinical Findings in Children with Epilepsy / 대한소아신경학회지

PURPOSE: Some reports left handedness is more common in epileptic patients compared with normal populations, but the study on this topics are rare. This can be due to epilepsy itself or brain lesion in epileptic patients. The study about the handedness in epileptic patients may help identifying the relationship of handedness and epilepsy, symptomatic epilepsy, sites of brain lesion, age at first seizure attack, family history of epilepsy. METHODS: Subjects were 158 children with epilepsy who were admitted and able to describe the handedness at the Department of Pediatrics, Pusan national university hospital between January 1996 and August 1999. We reviewed their sex, age, handedness. At patient group, age at first seizure, age distribution, family history of epilepsy, seizure type, etiology of epilepsy, causes of symptomatic epilepsy, site of brain lesion, localization by EEG were analyzed. Control group is 158 children without neurologic problem. We analysed handedness according to its variables. RESULTS: There was no statistical significance in handedness between epileptic group and control group. There was no significant difference in handedness according to age at first seizure attack, seizure type, family history of epilepsy and age distribution. The left handedness is more common significantly in the group of symptomatic epilepsy, left side brain lesion and focal abnormality by EEG recording. CONCLUSION: We can find significant difference between symptomatic epileptic patient group and control group, especially in the case of the left brain lesion and focal abnormality by EEG recording. In the case of bilateral or diffuse brain lesion, most of patients showed right handedness(87.5%). Accordingly, we concluded that high prevalence of left-handedness in children with epilepsy is more related with left side brain lesion than epilepsy itself. We assumed the social factors strongly affect the handedness of epileptic patients when we see that most of patients show the right handedenss in the bilateral or diffuse brain lesions.