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BACKGROUND:Diffusion tensor imaging aad fiber tractography(DT-FT)is the only method to identify cerebral white matter fiber organization in vivo.OBJECTIVE:To observe the changes in brain areas with language function and the fiber stucture in patients with Broca aphasia.DESIGN,TIME AND SETTING:Comparative observation was performed at First Hospital of Kunming Medical College and Tiantan Hospital of Capital Medical University between November 2003 and February 2005.PARTICIPANTS:Thirty patients(9 females,21 males,aged 17-63 years)with Broca aphasia of different degree were selected.They were diagnosed by a set of Chinese aphasia examinations of Research Laboratory of Neuropsychology,First Hospital of Beijing Medical University,following by further classification according to the subitems.METHODS:3T super-high field magnetic resonance scanner was used for the data collection and processing of the entire brain.Brodmann areas 45,44,areas 22 and 39(Wernicke area),and the corresponding brain areas in the right hemisphere are selected as areas with language function.The primary commissure,commissural fibers(arcuate fasciculus,internal capsule,external capsule)that are closely correlated with language function were regarded as region of interest of fiber tracking.The neural fiber tracking was conducted.MAIN OUTCOME MEASUIURES:The tracking and distribution of neural fiber tracts,and its correlation with other brain areas,and changes under pathological conditions.All data were compared with normal brain.RESULTS:Thirty patients with Broca aphasia were included in final analysis.The mean fractional anisotropy of fiber tracts in left Brodmann areas 45 and 44 was significantly lower than that in normal Brodmann areas(t=-2.683 65,-5.300 55,P＜0.05).The inferior fiber tracts in Broca area showed interruption or displacement,loosely connected even separate from the frontal arcuate fasciculus.The fibers of precentral gyrus and medial frontal lobe were decreased.The separation of arcuate fasciculus from Broca area caused by the integrity disruption and displacement of fiber tracts of arcuate fasciculus was the main alteration of arcuate fasciculus in Broca aphasia.The number of fiber tracts of left arcuate fasciculus and the mean fractional anisotropy in Broca aphasia were significantly less than normal people(P＜0.05).CONCLUSION:The lesions of cerebral cortex and its fiber pathway in Broca area can result in Broca aphasia.
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Objective To review the MR image findings in patients with neurofibromatosis type 1 (NF1) and to analyze the MR sequences and their diagnostic value so as to establish an adequate MR imaging protocol to supply the valuable imaging data for the diagnosis of NF1 Method Thirty patients fulfilling the NIH diagnostic criteria for NF1 were examined with the following MR imaging protocol, which mainly included: Axial SE T 2WI; Sagittal SE T 1WI without contrast; Axial or Sagittal SE T 1WI with contrast; Axial or Coronal FLAIR At the same time the characteristics of the disease including sites, numbers, shapes, and changes of intensity and enhancement of the lesions were recorded and analyzed Results There were three forms of lesions being demonstrated on MRI: (1) Multiple intracranial hamartomas: Hyperintense lesions on T 2WI and FLAIR images in 25 out of 30 patients (83%), which mainly located in the globus pallidus, cerebellums, and brainstems There was no definite enhancement with Gadolinium 20 out of 25 patients (80%) showed diffuse higher intensity in the region of hippocampus or parahippocampus gyrus, thalamus, and around the aqueduct (2) Optic pathway or hypothalamus glioma: Enlargement or/and elongation of the optic nerves and optic chiasms on STIR images; Masses in the region of the optic chiasm or hypothalamus with mixture high intensity on T 2WI and FlAIR images Significant and irregular enhancement was seen on SE T 1WI (3) Multiple neurofibromas in the spine: Multiple bulky tumours extending along the spinal nerves were shown on SE T 2WI and STIR images with higher signals Conclusion MR is suitable for routine imaging investigation in diagnosis and follow up of NF1 Our MR imaging protocol for NF1 could show multiple abnormalities of NF1 better
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Objective To discuss the clinical values of virtual endoscopy (VE) using multislice computed tomography (MSCT) in diagnosis of the aorta and iliac artery diseases.Methods MSCT angiography in 36 cases suspected of the aorta and iliac artery diseases and 40 cases underwent abdominal examination were performed, then all CT virtual endoscopy (CTVE) were obtained at the vessel with suspected lesions on work-station, and the relations between the quality of images and scanning parameters were observed.Results All internal and dual-cavity were seen in 10 cases of aortic dissection; enlarged cavity of aneurysm were showed in 16 aortic aneurysms. Calcification plaques were displayed in 48 cases. One endograft and one postoperative aorta were seen the morphology and the location of stenosis. One case of iliac artery obstruction was displayed obstructive cavity on the image of CT virtual endoscopy.Conclusion The quality of CT virtual endoscopy is related to the scanning technique,scanning parameters, motion aritiact. CT vitrtual endoscopy is the important complementary to maximum intensity projection, multiplannar reformation, surface shadow display, and axial images, and has high value in the diagnosis, treatment, and follow-up of the aortic diseases
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Objective To assess the value in detecting the tracheobronchial tree invasion by central lung cancer (CLC)using MSCT axial images and 4 kinds of images post-processed techniques.Methods 38 cases with CLC identified by fibrobrochoscopy or operation were scanned using MX8000 scanner with slice thickness of 3.2 mm, overlapping interval of 1.6 mm, pitch of 1.0. Multiplanar reformation(MPR), shaded surface display(SSD), volume rendering (VR) and virtual endoscopy(VE) were performed in all cases. Two radiologists assessed the invasion of tracheobronchial tree by CLC together.The imaging findings were compared with the data of surgery in 12 cases who were undergone operation.Results 38 cases of CLC, 0 grade to Ⅳ grade were assessed in 0,8,14,11 and 5 cases respectively by MSCT axial images, while in 0,10,11,12 and 5 cases by MSCT post-processing images. The concordance rate was 75% for MSCT axial images(n=9), and 100% for MSCT post-processing images(n=12) among 12 cases performed operation(? 2 test,? 2=6.0,P