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Objective:To investigate the effect of SCN1A gene polymorphism (SCN1A-rs3812718) on the alterations of spontaneous brain activity using amplitude of low-frequency fluctuations (ALFF) of MR in patients with temporal lobe epilepsy (TLE).Methods:A total of 37 TLE patients (TLE group) admitted to the Epilepsy Center of the 900th Hospital of Joint Logistic Team from March 2018 to August 2019 were retrospectively analyzed, and another 28 healthy volunteers matched for gender, age, and years of education with the TLE group were selected as the healthy control group (HC group). Sixty-five subjects were divided into four groups by genotype and diagnosis: 34 cases in AA/AG-TLE subgroup, 3 cases in GG-TLE subgroup, 20 cases in AA/AG-HC subgroup and 8 cases in GG-HC subgroup. All subjects underwent sagittal 3D-T 1WI and resting-state functional MRI using a Siemens 3.0 T Trio Tim MR scanner. Then ALFF values of the four groups were calculated using DPABI by the MATLAB 2010 platform. The ALFF values between two groups were compared by independent samples t-test. The ALFF values of different genotypes at rs3812718 locus in TLE and HC group were analyzed by multivariate analysis of variance to find out the corresponding brain regions with interaction, and then post hoc simple effect analysis was performed. Results:The ALFF values in TLE group significantly increased in left marginal lobe, left parahippocampal gyrus, left fusiform gyrus, left hippocampus, right insular lobe and right inferior temporal gyrus (Alphasim corrected P<0.001) and decreased in the left superior frontal gyrus, left middle frontal gyrus, left inferior frontal gyrus, right middle frontal gyrus, right precuneus, left precuneus, bilateral cingulate gyrus and right angular gyrus (Alphasim correction P<0.05) compared with HC group. Subjects carrying the non-risk G allele had higher ALFF values in the right inferior temporal gyrus, right fusiform gyrus, and right cerebellum than subjects carrying the risk A allele ( t=3.30, Alphasim corrected P=0.002). There was a significant interaction effect on posterior cerebellar lobe, left anterior cerebellar lobe, left inferior temporal gyrus, left superior parietal lobule and right precuneus of TLE patients with SCN1A-rs3812718 genotype. Post-hoc simple effect analysis showed that ALFF significantly increased in the left posterior cerebellar lobe, left anterior cerebellar lobe, left inferior temporal gyrus and left fusiform gyrus in GG-TLE subgroup ( t=5.97, P<0.001), but significantly decreased in the right superior parietal lobule, right precuneus, right posterior cerebellar lobe in AA/AG-TLE subgroup compared to the HC group. Compared with GG-TLE subgroup, ALFF in left posterior cerebellar lobe, left fusiform gyrus and left inferior temporal gyrus decreased in AA/AG-TLE subgroup. Conclusion:SCN1A gene polymorphism in the rs3812718 locus affects spontaneous neural activity in resting state, which may be one of the pathophysiological mechanisms of TLE.
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Objective:To analyze the function of essential hypertension′s working memory network by using task-fMRI and independent component analysis (ICA).Methods:According to the enrollment criteria, 24 hypertensive patients and 23 healthy controls (May 2016 to January 2017) in the 900 Hospital of the Joint Service Support Force were collected, who underwent task-state functional MRI data acquisition of N-back by using Siemens 3.0 T MRI. All subjects completed neuropsychological cognitive tests, blood pressure measurements and biochemical tests before MRI. Task-state functional MRI was analyzed by SPM 12, and independent component analysis was performed by GIFT 4.0 software. The independent-samples t-test was used to analyze the maps of the two groups′s task-state fMRI and ICA. The results were adjusted by multiple comparison correction of Alphasim, P<0.05 showed that the difference was statistically significant. Results:Compared with the healthy group, the activation of left superior frontal gyrus and left middle frontal gyrus in hypertension group was enhanced ( P<0.05), but there was no obvious weakened activation area. In the independent component analysis, the functional connectivity of left middle frontal gyrus and left anterior central gyrus in hypertension group was significantly lower than that in healthy control group ( P<0.05), and there was no significant enhancement of functional connectivity. Conclusions:The working memory network of patients with essential hypertension may change abnormally due to the influence of long-term hypertension. This kind of damage can compensate through the functional enhancement of brain regions, thus maintaining the normal cognitive level of hypertensive patients.
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Objective@#To analyze the function of essential hypertension′s working memory network by using task-fMRI and independent component analysis (ICA).@*Methods@#According to the enrollment criteria, 24 hypertensive patients and 23 healthy controls (May 2016 to January 2017) in the 900 Hospital of the Joint Service Support Force were collected, who underwent task-state functional MRI data acquisition of N-back by using Siemens 3.0 T MRI. All subjects completed neuropsychological cognitive tests, blood pressure measurements and biochemical tests before MRI. Task-state functional MRI was analyzed by SPM 12, and independent component analysis was performed by GIFT 4.0 software. The independent-samples t-test was used to analyze the maps of the two groups′s task-state fMRI and ICA. The results were adjusted by multiple comparison correction of Alphasim, P<0.05 showed that the difference was statistically significant.@*Results@#Compared with the healthy group, the activation of left superior frontal gyrus and left middle frontal gyrus in hypertension group was enhanced (P<0.05), but there was no obvious weakened activation area. In the independent component analysis, the functional connectivity of left middle frontal gyrus and left anterior central gyrus in hypertension group was significantly lower than that in healthy control group (P<0.05), and there was no significant enhancement of functional connectivity.@*Conclusions@#The working memory network of patients with essential hypertension may change abnormally due to the influence of long-term hypertension. This kind of damage can compensate through the functional enhancement of brain regions, thus maintaining the normal cognitive level of hypertensive patients.
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Objective@#To investigate the predictive value of CT evaluation of fatty liver for the severity of acute pancreatitis(AP).@*Methods@#The clinical and imaging data of 325 patients with AP from January 2013 to December 2017 were retrospectively analyzed. The demographic characteristics, etiological types, AP severity classification, persistent organ failure and death were collected. According to the ratio of the CT value of the liver and spleen (CT valueratio), whether the patients had fatty liver and the severity of fatty liver were determined. The incidence of persistent organ failure and mortality in AP patients with or without fatty liver and between the different severity grades of fatty liver were compared. Univariate and multivariate Logistic regression analysis was used to assess the independent risk factors for persistent organ failure in AP.@*Results@#Among the 325 AP patients, 86 (26.5%) patients were in line with the CT diagnostic criteria for fatty liver and 239 (73.5%) patients did not meet the CT diagnostic criteria of fatty liver. The incidence of persistent organ failure in AP patients with fatty liver (CT valueratio<1.0) was significantly higher than that without fatty liver (CT valueratio=1.0):17.4%(15/86) vs. 7.5%(18/239), P<0.05. The rate of persistent organ failure in AP patients increased proportionally with the severity grades of fatty liver [7.5% in patients without fatty liver, 7.5%(18/239) in mild (0.7<CT valueratio<1.0), 18.5%(5/27) in moderate (0.5<CT valueratio ≤ 0.7), and 7/19 in severe (CT valueratio ≤ 0.5) fatty liver], P<0.05. Single factor analysis showed that sex, body mass index (BMI, ≥ 25 kg/m2), etiological type, combined fatty liver were associated with persistent organ failure in AP (P<0.05 or<0.01). Multiple factor Logistic regression analysis showed that the elderly (≥60 years old), high BMI (≥ 25 kg/m2) and combined fatty liver were independent risk factors for persistent organ failure in AP (P<0.05 or<0.01).@*Conclusions@#Assessment of fatty liver and its severity in AP patients by CT is valuable to predict the risk of persistent organ failure.
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Objective To compare the diagnostic value of DWI and ultrasound elastography(UE) in staging hepatic fibrosis in patients with chronic viral hepatitis B(CHB). Methods Fifteen healthy volunteers (control group) and 69 patients with CHB (disease duration more than 1 year) (patient group) were prospectively recruited. All of the subjects underwent DWI and UE experiments twice with the interval of less than 3 days. Liver ADC and shear wave velocity(SWV) values were obtained for subsequent analysis. Sixty?nine patients who had biopsy were grouped according to their pathological grading of fibrosis, from S0 to S4. One?way ANOVA was used to compare the ADC and SWV values between the five different fibrosis groups and control group. Spearman correlation analysis was used to analyze the correlations between the ADC and SWV values and those staging factors. Finally, receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of ADC and SWV values in discriminating different stages of hepatic fibrosis. Results Based on the pathological results, the 69 patients were reclassified to five subgroups with 11, 13, 12, 15 and 18 patients in the S0, S1, S2, S3 and S4 groups respectively. ADC values were(1.39±0.09)×10-3,(1.39±0.08)×10-3,(1.38±0.10)×10-3,(1.20±0.06)×10-3,(1.12±0.07)×10-3 and(1.01±0.07)×10-3mm2/s for the control group and stages S0 to S4 respectively.SWV values were(1.17±0.07),(1.16±0.08),(1.23±0.10),(1.48±0.14),(1.85±0.14)and(1.97±0.12)m/s for stages S0 to S4 and the control group respectively. Statistically significant differences were observed among them (P<0.01). Both ADC (r=-0.894,P<0.01) and SWV (r=0.904,P<0.01) values were highly correlated with the stages of liver fibrosis. The area under ROC(AUC) for predicting fibrosis stages (≥S1, ≥S2, ≥S3 and S4) with ADC values was 0.893, 0.991, 0.966 and 0.952 respectively. Accordingly, the AUC for SWV values were 0.937, 0.993, 0.994 and 0.914. Conclusions The two imaging methods of DWI and UE showed good and similar diagnostic performance in discriminating the different stages of hepatic fibrosis.
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Objective To investigate the diagnostic value of ADC histogram obtained from MR DW imaging for stage ⅠB cervical cancer. Methods Seventy three patients diagnosed by cervical smear screening as cervical cancer without priortreatment were included prospectively in the patient group, and staged according to the international federation of gynecology and obstetrics (FIGO) staging system. Forty three patients with uterine leiomyoma detected by gynecologic examination, ultrasonography or CT and with negative result of cervical smear screening who were scheduled for hysterectomy were included prospectively in the control group. The patients of both groups underwent routine pelvic MR sequences, dynamic contrast enhanced imaging and DWI before hysterectomy. ADC histograms of the entire tumor and cervix volume were generated by post-processing software. Features of ADC histogram for the 2 groups were observed. Histogram parameters such as mean ADC (ADCmean), median ADC (ADCmedian), the 25th percentile of ADC (ADC_25th), the 75th percentile of ADC (ADC_75th), skewness and kurtosis were recorded. Student's t test or Mann-Whitney U test depending on homogeneity of variance was employed for the comparison of those parameters. ROC analysis was employed for assessing the diagnostic performance of ADC histogram in distinguishing the 2 groups. Results Thirty five patients in the patient group were staged as FIGO IB. Five patients in the control group ended up with pathologic findings of cervical intraepithelial neoplasia grade 3. Therefore 38 patients in the control group were investigated. ADC histograms of the patient group were mostly skewed positively, while the curves were largely skewed negatively. ADCmean, ADCmedian, ADC_25th, ADC_75th, skewness and kurtosis for the IB stage patient group were (1.10±0.21)×10-3mm2/s, (1.05±0.21)× 10-3 mm2/s, (0.90 ± 0.19) × 10-3mm2/s, (1.26 ± 0.23) × 10-3mm2/s, 0.83 (median) and 1.25 (median) respectively. ADCmean, ADCmedian, ADC_25th, ADC_75th, skewness and kurtosis for the control group were (1.62 ± 0.25)×10-3mm2/s, (1.64±0.24)×10-3mm2/s, (1.42±0.24)×10-3mm2/s, (1.84±0.27)×10-3mm2/s,-0.11(median) and 0.29 (median) respectively. All parameters showed statistically different (t values were -9.693,- 11.117, -10.255, and -9.988 for ADCmean, ADCmedian, ADC_25th and ADC_75th respectively;Z values were -6.360 and -4.445 for skewness and kurtosis respectively; P< 0.01). ROC analysis indicated that ADCmedian had the highest diagnostic accuracy for differentiating the 2 groups, with the area under the curve being 0.97, a cutoff value of 1.21×10-3mm2/s, and a sensitivity of 95.6%and a specificity of 89.3%. Conclusion ADC histogram of DWI may be valuable for diagnosing stage IB cervical cancer by distinguishing stage IB cervical cancer from normal cervix or cervical benign lesions.
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Objective To improve the diagnostic accuracy of pulmonary mucormycosis(PM) by investigating imaging appearances of PM,including CT and PET-CT.Methods A retrospective analysis of unenhanced MSCT(n=14),dynamic enhanced MSCT(n=10) and 18F-FDG PET-CT(n=3) examinations was conducted in 14 patients with surgically and pathologically proven PM.Results CT findings:13 patients had multiple patchy consolidation.Nine had thick-walled cavitiess(n=26) and 4 had pulmonary embolism,1 had solitary irregular masses,3 had adjacent bronchus invasion,4 had pleural effusion,14 had no mediastinal adenopathy.All the patients after renal transplantation had varied ground-glass opacifications and interlobular septal thickenings.The solid portion of lesions had strong enhancement with CT attenduation of (25±8) HU.PET-CT findings:3 cases were found with homogeneously or inhomogeneously increased 18F-FDG uptake(SUVmax 6.2,4.6,3.6).Conclusions PM presents with widespread but lacked specific imaging features.A suggestive diagnosis could be made in some patients with imaging appearances of multiple thick-walled cavities,rapid changes,and complicated with pulmonary embolism or invaded bronchus and sleevelet sign.
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Objective To evaluate the rehabilitating effect of hyperbaric oxygen on visual pathway lesions with blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI). Methods Sixteen patients with visual pathway lesions (the study group) and twelve healthy volunteers (the control group) were assessed using BOLD-fMRI and DTI. After hyperbaric oxygen therapy, the patients in the study group were again assessed using BOLD-fMRI and DTI. The activated regions of the BOLD-fMRI scan and the fractional anisotropy (FA) value determined from the DTI were calculated. Results Before hyperbaric oxygen treatment, there were significant differences between control and study groups in their BOLD-fMRI activated regions and the FA values of their radiation optics (P≤0.01). After hyperbaric oxygen treatment, there were no significant differences. Conclusion Combining BOLD-fMRI with DT1 could be used to evaluate the rehabilitation effect of hy-perbaric oxygen treatment in patients with visual pathway lesions.
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Objective To study the value of CT and barium radiograpy in diagnosis of gastric schwannoma.Methods A retrospectiveanalysis was made on imaging of 8 patients with pathologically approved gastric schwannoma.Plain abdominal CT scan was performed in all patients, additional enhanced CT scan was carried out in 6 cases and barium radiography of upper digestive tract was carried out in 5 cases. Results The lesions localized in fundus ventriculi in 2 cases, curvatura ventriculi minor in 4 cases and pars pylorica in 2 cases. Three main types were seen: localized mass type (n=4), localized thickening of gastric paries type (n=2) and huge mass type (n=2).Conclusion In comparison with barium radiography of upper digestive tract, CT can accurately demonstrate the shape, the location and internal structure of lesions.Three main patterns of this lesion also can be showed clearly by CT scans and suggestive diagnosis can be made in some patients combined with barium radiography of upper digestive tract images.