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The incidence of metabolic rheumatism gout has been increasing with a trend of more younger patients and atypical symptoms. Typical gout is easy to be diagnosed, but it is difficult for atypical cases. Finding uric acid crystal in articular fluid by polarizing light microscope is a gold standard of diagnosis, but it is an invasive diagnostic method and difficult to be widely used. The patients need further imaging examination for assistance of diagnosis and guide of follow-up treatment. This article reviews the research progress of different imaging methods used for diagnosis of gouty arthritis.
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Purpose To detect the distribution of cerebral microbleeds (CMB) in patients with hypertension and evaluate its related risk factors in order to reduce long-term risk of cerebral hemorrhage in large areas. Materials and Methods A consecutive 110 patients of hypertension and 50 patients of non-hypertension in the departments of cardiovascular medicine and neurology were enrolled. All the patients underwent T2 star weighted angiography (SWAN) sequence scan of head. The location and quantity of CMB and other related information of patients were recorded. The distribution of CMB in patients with hypertension and correlation between CMB and age, sex, level of hypertension, duration of time, hemoglobin, platelets, smoking, diabetes, hyperlipidemia were also analyzed. Results A total of 472 CMB were detected in the hypertension group, of which 212 CMB (44.9%) were found in deep brain, 149 (31.6%) were in cortical and subcortical region, 111 (23.5%) under the tentorium. The highest distribution of CMB was in thalamus (98, 20.8%), followed by basal ganglia (78, 16.5%), temporal lobe (64, 13.6%) and brainstem (62, 13.1%). The univariate analysis showed that CMB group had significantly higher rate of hypertension and diabetes than that without CMB and the average age in CMB group was also higher (P0.05). Conclusion Hypertension and age are independent risk factors for CMB. Patients aged 45 and older, with more than 5 years duration of hypertension, or with hypertension at class II and III, should be paid more attention in clinic. If necessary, magnetic resonance examination is suggested to be used, in order to reduce long-term risk of cerebral hemorrhage.
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BACKGROUND: The imaging technique of CT and MRI has lower diagnostic accuracy in analyzing lymph node location due to the nonspecific diagnostic criteria. However, this situation can be improved with Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), especially the use of lymphatic targeting contrast agent. OBJECTIVE: To prepare DTPA-coupled human serum albumin (HSA) labeled with gadoliniumion, and to investigate the enhancement for the lymph node in animal experiment, in further, to explore the potential value of its application. DESIGN, TIME AND SETTING: The randomized grouping, controlled animal experiment was performed at the laboratory of Medical Imaging Center, Nanfang Hospital from December 2008 to April 2009. MATERIALS: GdCI3 was prepared with Gd2O3 reacted with 0.1mol/L HCI for 10 minutes. Then, DTPA cyclic anhydride and HAS solution were mixed together at the ratio of 200:1 or 100:1. The product was divided into 4 equal portions, which was reacted with 5.0, 6.0, 7.0, 8.0 pH values at room temperature for 30 minutes. At last, GdCI3 was added. The complexation reaction was completed within 1 minute. The Gd-DTPA-HAS was dried and prepared for Gd-DTPA-HAS solution with concentration of 0.50 mmol Gd/L.METHODS: Six New Zealand rabbits were undergone the MRI examination, followed by subcutaneous injection of 0.2 mL with Gd 0.50 mmol/L HSA-Gd-DTPA solution. And contrast scanning was performed at minutes 30, 60 and 180 after injection. The signal intensity of popliteal lymph node was measured and the enhancement rate was obtained. MAIN OUTCOME MEASURES: The number of combined Gd-DTPA per HSA at different reaction conditions was measured, and coupling efficiency of HSA-DTPA was calculated. The enhancement rates of lymph node, as well as dynamic changes were observed. RESULTS: ①The number and coupling efficiency of HSA-coupled of gadolinium ions were increased with the pH value of the reaction system at the same DTPA-to-HSA molar ratio. ②At the same pH value of the reaction system, the number of HSA-coupled of gadolinium ions increased with the DTPA-to-HSA molar ratios while the coupling efficiency of HSA-coupled of gadolinium ions decreased.③After subcutaneous injection, HSA-Gd-DTPA entered the lymphatic vessel, which resulted in obvious homogeneous enhancement of the lymphatic vessels and popliteal lymph nodes. CONCLUSION: The number and coupling efficiency of HSA-coupled of gadolinium ions can be increased in pH=8.0, 0.1 mol/L NaHCO_3 reaction system. HSA-Gd-DTPA is an effective contrast agent targeted for lymph node after subcutaneous administration.
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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.