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Objective To analyse the routes and MRI characteristics of disseminated intracranial gliomas after operation. Methods 10 patients of intracranial gliomas confirmed by pathology and intracranial dissemination after operation underwent MRI examina-tions including T_1 WI, FSE T_2 WI, FLAIR and fat-suppressed T_1 WI after intravenous injection of Gd-DTPA. In addition, 4 cases were also examinated with DWI, 1 case with SWI and DTI. Results In 10 cases,there were glioblastoma in 7 cases,grade Ⅱ astro-cytoma in 2 and grade Ⅲ astrocytoma in one. The disseminated tumors were found by MRI in 4 to 56 months after operation. The le-sions in all patients were confirmed with the comparison of contrast-enhanced MRI positive signs between preoperation and post-operation. Plain MR scanning showed line-like thicking with isointensity in 1/7 case/time (C/T)and multiple noduli in 5/7 (C/T) on T_1 WI respectively;shallowed cortical sulci and cistern in 2/7(C/T) and nodular in 5/7(C/T) on T_2 WI;shaUowed cortical aulci and cistern in 2/7 (C/T) and nodular in 6/7(C/T) on FLAIR. The signal intensity of noduli of disseminated tumors in 7 cases were in complete consistency with that of primary neoplasm , however, in 3 cases, it was inconsistent. Enhanced scanning showed 7 ca-ses with the signs of line-like thicking, 7 cases with noduli , 6 cases with :cast-like shape" sign and 6 cases with different extent of hydrocephalus. Conclusion Enhanced MRI can be used as a most useful and reliable monitoring tools for detecting dissemination of brain glioma.
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Objective To evaluate T2WI sequence and liver acquisition with volume acceleration (LAVA) technique in the diagnosis of early endometrial carcinoma on 3.0 T MR scanner. Methods Twenty-seven patients with endometrial carcinoma confirmed by pathology were retrospectively analyzed. MRI sequences included axial T1WI and sagittal T2WI with fat saturation, axial and sagittal LAVA scanning including four phases: early arterial phase, late arteral phase, parenchymal phase and delayed phase. The tumor location, signal features, and myometrial infiltration by tumor were recorded and preoperative staging was compared with pathologic results. The sensitivity, specificity, accuracy of T2WI and LAVA in diagnosing endometrial carcinoma was assessed. The accuracy of the evaluation of the deep myometrium infiltration was compared between the two sequences using Fisher's exact test. Results According to Federation International of Gynecologie and Obstetrigue (FIGO) standard, 27 patients with endometrial carcinoma were classified as: stage Ⅰ in 22 cases, stage Ⅱ in 5 cases. The sensitivity, specificity, positive and negative predictive values in assessing deep myometrium infiltration were 70.0% (7/10), 94. 1% (16/17), 87. 5% (7/8), 84. 2% (16/19) respectively for T2WI sequence. Its accuracy in assessing myometrium invasion was 85.2% (23/27). The sensitivity, specificity, positive and negative predictive values were 80. 0% (8/10), 94. 1% ( 16/17 ), 88. 9% (8/9), 88. 9% ( 16/18 ) respectively for LAVA sequence, and the accuracy was 88.9% (24/27). There was no statistical difference of accuracy between two techniques( P = 1.00). Conclusion 3.0 T MR T2WI sequence has important role in diagnosing early endometrial carcinoma, and LAVA technique is highly valued in preoperative diagnosis and staging in early endometrial carcinoma for myometrium infiltration.
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Objective To compare and evaluate the defect-repaired capabilities of human bone morphogenetic protein-2(hBMP-2) gene modified tissue engineered bone in the segmental bone defect model of rabbit's radius.Methods Rabbit's bone mesenchymal stem cells (BMSCs)were transferred with hBMP-2 gene through Adeno-XTM adenoviral expression systems,then seeded onto the compound scaffold of calcium phosphate cemept(CPC)and fibrin glue(FG)to construct a new kind of gene modified tissue engineered bone after proliferation in vitro for three weeks(Group A).Meanwhile,the compound scaffold of calcium phosphate cement(CPC)and fibrin glue(FG),which were seeded by rabbit's bone knesenchyrmal stem cells(BMSCs) after proliferation in vitro for three weeks(group B)and the compound scaffold without cells(Group C)acted as control groups.Then,three kinds of reconstructive modalities were implanted into segmental bone defect of donator rabbit's radius.Besides these three groups,bone defect model of rabbit's radius without treatment(Group D)represented blank group.The defect-repaired capabilities were assessed by gross observation,radiograph,Single Photo Emission Computed Topography (SPECT)and histological analysis in the 4th week,8th week and 12th week after operation.The rates of bone healing in the different groups were compared each other.Results All defects that had been treated with implants(Group A,B,C)exhibited new bone formation and could attain osseous tissue healing 12 weeks after operation,but defects in blank group(Group D)were repaired only by fibrous tissue.The defects in the Group A regenerated more new bone,bridged earlier and stronger than those in the Group B and Group C.The quantity and rate of new bone formation in the Group B and Group C had no significant difference and the rates of bone healing in different groups showed the same results.Conclusion hBMP-2 gene modified tissue engineerod bone have better potential to form new bone and the rate of bone healing in repairing bone defects is higher,so this way is an optimal kind of material for artificial bone graft.
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Objective To investigate the clinical effect of arthroscopic anterior cruciate ligament(ACL) reconstruction using autologous multi-strands of hamstring tendon.Method From May 2002 to Dec.2006,arthroscopic reconstruction of the anterior cruciate ligament using multi-strands of hamstring tendon was performed on 39 patients.Among them,28 cases were followed up for 7 to 48 months(average 13.5±2.3 months).Result The median Lysholm knee score was improved from 47.3±3.6 to 91.3±2.9 after operation.Conclusion Arthruscopic reconstruction of the anterior cruciate ligament using muhi-strands of hamstring tendons is a good alternative method with minimal invasion and convenient tendon harvesting and fewer complication and reliable clinical effect.
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BACKGROUND: Mesenchymal stem cells (MSCs) are capable of differentiating into a variety of lineages, including bone, cartilage, or fat, depending on the inducing stimuli, specific growth and differentiation factors.Recombinant human bone morphogenetic protein 2 (rhBMP-2) produced by gene engineering has an obvious osteoinductive activity and can induce undifferentiated mesenchymal cells into cartilage and bone irreversibly, resulting in new bone formation. Basic fibroblast growth factor (bFGF) modulates chondrogenic and osteogenic differentiation of MSCs.OBJECTIVE: To investigate the effect of bFGF and rhBMP-2 on the differentiation and proliferation of cultured rabbit mesenchymal stem cell in order to find out an optimal way of osteogenesis instead of conventional osteogenic supplements (OS).DESIGN: A randomized and controlled trial.SETTING: General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA.MATERIALS: The subjects were rabbit mesenchymal stem cells cultured by the author.METHODS: This experiment was conducted at the Center of Orthopaedic Surgery, General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA from June 2004 to December 2004. ①Rabbit MSCs cultured in vitro were treated with different growth factor (100 μg/L rhBMP-2, 100 μg/L bFGF, 10 μg/L rhBMP-2and 100 μg/L bFGF and OS; ②The proliferation and differentiation of MSCs were observed through activity of MTT, expression of alkaline phosphatase(ALP), and von Kossa staining.MAIN OUTCOME MEASURES: the rate of proliferation and the activity of ALP.RESULTS: ①rhBMP-2 could promote the proliferation and differentiation of MSCs, especially the cell differentiation; ②bFGF could stimulate the proliferation , the cellular proliferation rate increased 100% as compared with control group, and has no effect on differentiation of MSCs , but it could enhance effect on the cell proliferation of rhBMP-2.CONCLUSION: bFGF and rhBMP-2 are effective induction factors for MSCs. Both of them can stimulate the proliferation and differentiation of MSCs in vitro. bFGF and rhBMP-2 exerted a synergetic action in speeding up the pace of osteoinduction and osteogenesis and can be used to differentiate seed cells for tissue engineering bone.
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<p><b>BACKGROUND</b>To explore the application value of MR dynamic time-resolved subtracted imaging in qualitative and quantitative assessment of blood supply by systemic artery in patients with lung cancer.</p><p><b>METHODS</b>A prospective study using MR FSPGR pulse sequence dynamic scan after contrast enhancement was undertaken in fifty-one patients with lung cancer which were proved by cytology or/and histology. The time-resolved subtracted imaging were acquired using the pre- and post-enhanced images in different phases of pulmonary circulation during the first-pass period (FPP) of contrast agent. The time-signal curves of FPP at four ROI placed on pulmonary artery (PA), descending aorta (DA), mass (M) and contralateral pulmonary parenchyma (PP), and the ST (start-time) and PT (peak-time) of those four ROI were measured. The enhancement ratio of the signals of M/PP at PA/DA peak time (E MP , E MA , E PP , E PA ) were calculated.</p><p><b>RESULTS</b>According to the time-resolved subtracted imaging during PA phase, intensity of the signal was low in 7 cases, medium in 2, but not enhanced in other 42 cases. All the 51 cancer masses were remarkably enhanced during DA phase. During FPP, the ST [(5.90±0.51)s] and PT [(12.75±0.67)s] of PP were slightly later than the ST [(4.19±0.43)s] and PT [(10.59±0.66)s] of PA, while the ST [(11.03±0.80)s] and PT [(33.62±3.06)s] of cancer masses were later than ST [(9.43±0.59)s] and PT [(19.81±4.14)s] of DA. E MA was significantly higher than E MP (91.47%±18.83% vs 15.38%±11.03%, P < 0.001), while E PP were remarkably higher than E PA (273.83%±48.60% vs 140.65%±24.40%, P < 0.001).</p><p><b>CONCLUSIONS</b>MR dynamic time-resolved subtracted imaging is feasible to be a non-invasive technique in qualitative and relatively quantitative assessment of blood supply by systemic artery in patients with lung cancer.</p>
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<p><b>BACKGROUND</b>To explore the application of MR time-resolved subtracted perfusion imaging to qualitatively and partially quantitatively evaluate blood supply by pulmonary artery in patients with peripheral type lung cancer.</p><p><b>METHODS</b>Twenty-three patients with peripheral type lung cancer proved cytologically or/and histologically underwent MR perfusion study. The time-resolved subtracted imaging which provided the perfusion images in different phases were performed. First-pass time-signal intensity curves of pulmonary artery, descending aorta, lung mass were obtained respectively, and start-time and peak-time of them were compared. The signal enhanced ratio of the masses in pulmonary artery and aorta perfusion phases were calculated respectively.</p><p><b>RESULTS</b>Fourteen masses began to enhance during pulmonary circulation phase and reached peak value during systematic-circulation phase, and the average signal change ratio during pulmonary circulation phase was much smaller than that during systematic-circulation phase, indicating their blood supply came both from pulmonary and systematic blood circulation, but mainly from the latter. Seven masses began to enhance and reached peak value during systematic-circulation phase, indicating their blood supply came mainly from systematic blood circulation. Two masses began to enhance and reached peak value during pulmonary-circulation phase, indicating their blood supply came mainly from pulmonary blood circulation.</p><p><b>CONCLUSIONS</b>MR dynamic time-resolved subtracted perfusion imaging is feasible to qualitatively and relatively quantitatively evaluate blood supply of pulmonary artery for peripheral type lung cancer.</p>