ABSTRACT
Objective To explore the clinical applicability of diffusion kurtosis imaging (DKI)in children with spastic hemiplegic cerebral palsy.Methods 22 children with spastic hemiplegic cerebral palsy and age-matched 22 normal children were selected in this study,and were treated with routine brain MRI and DKI to test the white matter area of tractus corticospinalis on brainstem plane, anterior limb of internal capsule,posterior limb of inter capsule,genu of corpus callosum and the splenium of corpus callosum.The fractional alanisotropy(FA)value and mean kurtosis (MK)value of deep gray nuclei area in thalamus,lenticular nucleus and head of caudate nucleus were examined.Furthermore,gross motor function classification system (GMFCS)was performed for the children in research group.Two independent sample t test was applied in the comparison of groups.The correlation between DKI parameters and cerebral palsy gross motor function was analyzed by Spearman analysis.Results As for MK value,there were statistically significant differences in all different brain areas between the research group and the control group(P<0.05).And for FA value,there was statistically significant difference only in white matter area between the research group and the control group (P<0.05).However,there was no statistically significant difference in cerebral deep gray nuclei area (P>0.05).The GMFCS score was negatively correlated with the FA value,and was positively correlated with the MK value.Conclusion DKI can reflect the damaged situation of gray matter in children with cerebral palsy,and its parameter values can be used to monitor the children with cerebral palsy as evaluation indicators.
ABSTRACT
Objective To observe the value of dual-source CT energy spectral imaging in qualitative evaluation of metastatic lymph nodes in patients with gastric cancer.Methods Data of patients with pathologically diagnosed gastric cancer were collected,who underwent both dual-source CT abdomen plain scanning and energy spectrum double-phase enhanced scanning.The long diameter,short diameter,short length-diameter ratio,arterial phase and venous phase standardized iodine concentration of lymph nodes were measured and recorded.Energy spectrum attenuation curves were drawn,and the slopes were calculated.Parameters with statistical significant differences between metastatic and non-metastatic lymph nodes were used to plot ROC curves,and the thresholds for diagnosing metastatic lymph nodes of gastric cancer,and their diagnostic sensitivity and specificity were calculated.Results There were significant differences in short axis,short aspect ratio,normalized iodine concentration in arterial phase and venous phase between metastatic and non-metastatic lymph nodes in patients with gastric cancer (all P＜0.05),the area under the curve of ROC curve was 0.601 (P=0.006),0.881 (P＜0.001),0.865 (P＜0.001) and 0.834 (P＜0.001),respectively.When the short length to diameter ratio was 0.730,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 75.72％ and 93.64％.When standardized iodine concentration was 0.223 in arterial phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 69.81％ and 91.20％.When the standardized iodine concentration was 0.392 in the venous phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 78.33％ and 85.63％.Dual-phase energy spectrum curve of both gastric metastatic lymph nodes and non-lymph node decreased.Taken the arterial curve slope k=6.860 as the threshold,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 83.24％ and 84.72％.When the threshold venous phase slope k was set at 6.660,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 64.62％ and 97.70％,respectively.Combining arterial phase length-to-diameter ratio,arterial phase standardized iodine concentration and spectral curve slope,the sensitivity and specificity in diagnosing metastatic lymph nodes was 97.34 ％ and 87.83 ％,which was 80.13 ％ and 90.31％ when combining venous phase short length-diameter ratio,venous phase standardized iodine concentration and spectral curve slope.Conclusion The short-length-to-diameter ratio,arterial-venous phase standardized iodine concentration and arterial-venous phase slope of lymph nodes are the main parameters for evaluating metastatic lymph nodes in patients with gastric cancer.Combination of the above three parameters can obviously improve the sensitivity and specificity in diagnosis of metastatic lymph nodes in patients with gastric cancer.