Fluid-attenuated inversion recovery vascular hyperintensity: Correlation with other radiologic findings in acute ischemic stroke with middle cerebral artery occlusion

Objective: To assess fluid-attenuated inversion recovery (FLAIR) vascular hyper-intensity (FVH) and explore its relationship with CT perfusion (CTP) penumbral/infarct core mismatch ratio and diffusion weighted imaging (DWI) final infarct volume in acute ischemic stroke (AIS) patients with middle cerebral artery occlusion (MCAO). Methods: The CTP and MRI images of 38 AIS patients with MCAO were reviewed. The FVH score (longitudinal direction) [FVH score (L)] and FVH score (transverse direction) [FVH score (T)] were quantified on the FLAIR images. The FVH score (L) (range, 0-16) was based on a rostrocaudal extension of FVH and the FVH score (T) (range, 0-3) was based on FVH supply of the occluded MCA territory. The mismatch ratio was calculated from the ratio of the [mean transit time - cerebral blood volume (CBV)] lesion/CBV lesion on the CTP images. The DWI infarct volume was measured on the DWI images. Results: The mismatch ratio was larger for the group of FVH score (L)=7~8 than those of FVH score (L)=5~6 and FVH score (L)=3~4 (p=0.03), whereas the DWI infarct volume was smaller (p=0.04). Similarly, the mismatch ratio of FVH score (T)=2~3 group was larger than FVH score (T)=1 group (p=0.01), whereas the DWI infarct volume was smaller (p=0.02). Both FVH score (L) and FVH score (T) correlated positively with mismatch ratio (P=0.02, P=0.001, respectively), but negatively with DWI infarct volume (P=0.03, P=0.004, respectively). Conclusions: Higher FVH score is associated with larger mismatch ratio and smaller DWI infarct volume in AIS patients with MCAO. FLAIR vascular hyperintensity may represent collateral arterial circulation, and may play a role in protecting the ischemic penumbra.

Prognostic value of the ABCD2 score on long-term follow-up of transient ischemic attack using the new tissue-based definition

The ABCD2 score is validated for evaluating short-term stroke risk after transient ischemic attack (TIA); however, whether it is able to predict the long-term risk of vascular outcome remains uncertain. Recently a new tissue-based definition of TIA has been proposed. The ABCD2 scores of 145 TIA patients admitted to our hospital were retrospectively calculated and stratified into two categories: ≤ 3 points (low risk); 4-7 points (moderate-high risk). At a median follow-up of 81 months, new vascular events were recorded. Follow-up data were available in 107 patients. Seventy one patients had a moderate-high ABCD2 score. Sixty six patients experienced a cerebral ischemic event; 8 a myocardial infarction; 7 died of cerebrovascular or cardiovascular cause. Moderate-high ABCD2 score was significantly associated with the further cerebral ischemic events (hazard ratio [HR], 1.755; 95% confidence interval [CI], 1.019 to 3.024) and with the combined endpoint (HR, 1.818; 95% CI, 1.079 to 3.063). Our study shows that the ABCD2 score may also be used to predict long-term vascular outcome after tissue-based definition of TIA. Moderate-high ABCD2 score is associated with an increased general vascular risk in the long-term follow-up after TIA.

Report of a case with Joubert syndrome and literature review / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical feature, imaging and their diagnostic value for Joubert syndrome (JS).</p><p><b>METHOD</b>The clinical data, imaging feature, and 31 references from China Biomedical literature database (CBMdise) were reviewed and analyzed.</p><p><b>RESULT</b>The age of onset of 32 patients including male 20 and female 12 ranged from 3 days to 6 years (mean 2.2 years). All the 32 patients with Joubert syndrome showed "slow growth" and "reduced muscle tension", 26 cases (81.3%) showed "gasp for breath", 26 cases (81.3%) showed "unusual motion of eyeball", 2 cases (6.3%) showed additional fingers (toes), 6 cases (18.8%) showed stretching tongue with agape. The typical imaging features of Joubert syndrome included "molar tooth sign", "midline cleavage" between cerebellar hemispheres and "bat-wing" like fourth ventricle, all the 32 patients with Joubert syndrome showed "midline cleavage", "molar tooth sign" was present in 29 cases (90.1%), and "bat-wing" like fourth ventricle in 30 cases (93.8%).</p><p><b>CONCLUSION</b>Joubert syndrome is a rare congenital brain malformation. The typical clinical manifestations included "gasp for breath", "reduced tension of muscle", "slow growth" and "unusual motion of eyeball", and at the same time the patients had the following typical imaging features of brain: "molar tooth sign", "midline cleavage" and "bat-wing" like fourth ventricle.</p>

The study on the relationship between Rsa I, Alu I polymorphism of the estrogen receptor beta gene and unknown aetiology hypomenorrhea / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the relationship between estrogen receptor beta gene (ER beta) polymorphism and unknown aetiology hypomenorrhea in Southwestern China .</p><p><b>METHODS</b>One hundred eumenorrhea women were chosen as control group and another 100 hypomenorrhea patients as case group from Southwestern China. Restriction fragment length polymorphism (RFLP) of the Rsa I and Alu I in ER beta gene was analysed. The ER beta gene polymorphism genotype distribution in case group and control group was compared.</p><p><b>RESULTS</b>R allele frequency in case and control groups was 37.5% and 48.5% respectively, the OR was 0.64 (95%CI: 0.42-0.97), P= 0.026. A allele frequency in case and control groups was 18.0% and 11.5% respectively, the OR was 1.69 (95%CI: 0.93-3.09), P= 0.07. RFLP of Rsa I and Alu I in both groups were distributed with polymorphism.</p><p><b>CONCLUSION</b>ERbeta gene polymorphism has a relation with unknown aetiological hypomenorrhea. R allele may be the guard factor, and A allele may be its risk factor.</p>

Characteristic magnetic resonance enhancement pattern in cerebral schistosomiasis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To describe the characteristic magnetic resonance imaging (MRI) appearance of cerebral schistosomiasis.</p><p><b>METHODS</b>Twenty-five patients whose diagnosis of central nervous system (CNS) schistosomiasis had been pathologically (n = 8) and clinically (n = 17) confirmed were randomly selected. MRI was performed on a Signal 1. 5T MRI scanner before and after the intravenous administration of gadopentetate dimeglumine constrast medium. We reviewed the MRI studies obtained at the time of initial presentation, as well as follow-up studies obtained during and after medical treatment.</p><p><b>RESULTS</b>Immunological tests in 15 patients indicated schistosomiasis haematobium. Contrast-enhanced T1-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which appeared "arborized". Through operation and pathological examination, 8 cases had the granuloma formation of schistosomal eggs extensive surrounded by inflammation and venous congestion. And 17 cases were treated with praziquantel and corticosteroid therapy. And they were followed up for 2 months by taking MRI, which turned out to be complete resolution of the enhancing structure and edema. At follow-up, all the patients' initial symptoms also resolved.</p><p><b>CONCLUSION</b>The specified MRI enhancement pattern of cerebral schistosomiasis is common in most cases of CNS schistosomiasis, so it should be taken account into the diagnosis of cerebral schistosomiasis.</p>