Mechanism of obesity affecting periodontal tissue regeneration and therapeutic strategies / 中华口腔医学杂志

Obesity is an important health problem in our society today, which can lead to the chronic low-grade inflammation state, to be an inducement for many chronic diseases such as hypertension, type 2 diabetes and non-alcoholic fatty liver disease. As a common oral chronic infectious disease, periodontitis is mainly characterized by gingival inflammation, periodontal pocket formation, alveolar bone resorption and tooth mobility. The ultimate goal of periodontitis treatment is to achieve periodontal tissue regeneration in the defect area. As a major risk factor for periodontitis, obesity can alter the periodontal inflammatory microenvironment in multiple ways, affecting the effects of periodontal tissue regeneration ultimately. Therefore, this paper will review the relationship between obesity and periodontal tissue regeneration, mechanism of obesity affecting periodontal tissue regeneration and the therapeutic strategies of periodontal tissue regeneration, providing new ideas for periodontal tissue regeneration treatment in obesity.

Effects of the kynurenine pathway on the osteogenic differentiation of periodontal ligament stem cells / 中华口腔医学杂志

Objective: To explore the effect of kynurenine pathway on the osteogenic differentiation of periodontal ligament stem cells (PDLSC). Methods: Unstimulated saliva samples were collected from 19 patients with periodontitis (periodontitis group) and 19 periodontally healthy individuals (health group) in Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University from June to October of 2022. Contents of kynurenine and the metabolites in saliva samples were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry. The expressions of indoleamine 2, 3-dioxygenase (IDO) and aryl hydrocarbon receptor (AhR) were further detected by immunohistochemistry in gingival tissues. The PDLSC used in this study were isolated from extracted teeth for orthodontic treatment in Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University from July to November of 2022. Experiments were then conducted using the cells by incubating with (kynurenine group) or without kynurenine (control group) in vitro. Seven days later, alkaline phosphatase (ALP) staining and assays of ALP activity were performed. Real-time fluorescence quantitative PCR (RT-qPCR) was utilized to detect the expressions of osteogenic related genes ALP, osteocalcin (OCN), runt-related transcription factor 2 (RUNX2), collagen type-Ⅰ (COL-Ⅰ) as well as the kynurenine pathway-associated genes AhR, cytochrome P450 family (CYP) 1A1, CYP1B1. Western blotting was used to detect the expression levels of RUNX2, osteopontin (OPN) and AhR proteins on day 10 and alizarin red staining was performed to observe the formation of mineral nodules on day 21 in control group and kynurenine group. Results: Salivary concentrations of kynurenine [8.26 (0, 19.60) nmol/L] and kynurenic acid [11.4 (3.34, 13.52) nmol/L] were significantly higher in the periodontitis group than in the health group [0.75(0, 4.25) nmol/L, 1.92(1.34, 3.88) nmol/L] (Z=-2.84, P=0.004; Z=-3.61, P<0.001). The expression levels of IDO (18.33±2.22) and AhR (44.14±13.63) in gingival tissues of periodontitis patients were significantly higher than that of the health group (12.21±2.87, 15.39±5.14) (t=3.38, P=0.015; t=3.42, P=0.027). In vitro, the ALP activity of PDLSC in the kynurenine group (291.90±2.35) decreased significantly compared with the control group (329.30±19.29) (t=3.34, P=0.029). The mRNA expression levels of ALP, OCN and RUNX2 in the kynurenine group (0.43±0.12, 0.78±0.09, 0.66±0.10) were decreased compared with the control group (1.02±0.22, 1.00±0.11, 1.00±0.01) (t=4.71, P=0.003; t=3.23, P=0.018; t=6.73, P<0.001), while the levels of AhR and CYP1A1 were increased in the kynurenine group (1.43±0.07, 1.65±0.10) compared with those in the control group (1.01±0.12, 1.01±0.14) (t=5.23, P=0.006; t=6.59, P<0.001). No significant difference was observed in COL-Ⅰ and CYP1B1 mRNA levels between groups. The protein levels of OPN, RUNX2 (0.82±0.05, 0.87±0.03) were reduced and that of AhR (1.24±0.14) was increased in the kynurenine group compared with those in the control group (1.00±0.00, 1.00±0.00, 1.00±0.00) (t=6.79, P=0.003; t=7.95, P=0.001; t=3.04, P=0.039). Conclusions: Over-activated kynurenine pathway in periodontitis patients can promote upregulation of AhR and suppress the osteogenic differentiation of PDLSC.

Application of acellular dermal matrix in periodontal soft tissue augmentation surgery / 中华口腔医学杂志

The substitute materials of autologous tissue graft for periodontal soft tissue augmentation surgery develop rapidly. The use of substitute material can avoid the second operation area, shorten the operation time, reduce the postoperative reaction and pain, and is not limited by the quantity, suitable for a wide range of cases. In this paper, the characteristics, histological study, clinical application and therapeutic effect of acellular dermal matrix as a substitute material for autologous tissue transplantation were introduced to provide reference for clinical work.

Accuracy of paralleling technique in measuring the depth of approximal infrabony pocket / 华西口腔医学杂志

OBJECTIVE@#To assess the accuracy of paralleling technique in measuring the depth of approximal infrabony pocket after periodontal flap surgery by comparing the measured and actual depths.@*METHODS@#The study population included 26 patients with infrabony defects who had undergone periodontal flap surgery, bone graft surgery, and guided tissue regene-ration. The measured and actual depths of approximal infrabony pocket after periodontal flap surgery were compared. The 26 infrabony defects were categorized into the following groups according to tooth position: anterior teeth, premolar, and molar groups, and according to type of infrabony pocket: one-walled, two-walled, and three-walled infrabony pocket groups. Paired t-test was used to detect the difference between the two values.@*RESULTS@#Depth measurements of the approximal infrabony pocket depth of the anterior teeth and premolar were not significantly different (P>0.05), whereas those of the molar group were significantly different (P0.05), whereas those in the three-walled infrabony pocket group were significantly different (P<0.05).@*CONCLUSIONS@#Paral-leling technique can accurately measure the depth of approximal infrabony pockets of anterior teeth and premolar teeth that are one- or two-walled. However, this method cannot accurately measure the approximal infrabony pockets of molar teeth and three-walled infrabony pockets as indicated by significant differences in their depth measurements.

Time lapse between endodontic and periodontal treatments of combined periodontal-endodontic lesion: a systematic review / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to evaluate the time lapse between the endodontic and periodontal treatments of the combined periodontal-endodontic lesion to guide the clinical treatment.</p><p><b>METHODS</b>A systemic literature search was performed in articles published from 1980 to March 2017 using the electronic databases, including PubMed, EMbase, Cochrane, Web of Science, CNKI, CBM, and Wanfang Databases.</p><p><b>RESULTS</b>After screening, two randomized controlled trials, two prospective case series studies, and eight case reports were ultimately included. All clinical studies and case reports were treated with root canal therapy and periodontal nonsurgical or periodontal surgical treatment, with root canal therapy as the initial treatment step. Changes in the periodontal probing depth and attachment loss were reported in all clinical studies and case reports.</p><p><b>CONCLUSIONS</b>An observational period between the endodontic and periodontal nonsurgical treatments may not be required. However, given that the quality of several included studies was limited, and the number of randomized controlled trials was small, a large number of randomized controlled trials are needed to verify this result.</p>

Expression of triggering receptors expressed on myeloid-1 in innate response to Porphyromonas gingivalis in macrophages / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the role of triggering receptors expressed on myeloid-1(TREM-1) in innate response to Porphyromonas gingivalis(Pg) in mice macrophages and its potential role in periodontitis development.</p><p><b>METHODS</b>Peritoneal macrophages from mice were harvested, separated and cultured, then challenged with viable Pg. Transcription and protein expression in macrophages were assessed with real time PCR and flow cytometry respectively.LP-17 peptide (10, 100 and 1000 µg/L) was utilized to block TREM-1, and tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by enzyme linked absorbent analysis.</p><p><b>RESULTS</b>At 2 h after Pg challenge, transcription of TREM-1 was significantly up-regulated after Pg challenge[(7.99 ± 1.11) fold vs blank]. At 24 h after bacteria infection, increased TREM-1 expression was demonstrated by flow cytometry, with mean fluorescent intensity increasing from (7.05 ± 1.85) in blank group to (13.17 ± 2.33) in experimental group. Proinflammatory cytokine (TNF-α and IL-6) production was significantly decreased after blocking TREM-1 by LP-17 peptide(100 and 1000 µg/L).</p><p><b>CONCLUSIONS</b>TREM-1 enhanced innate immune response to Pg in macrophages, which may facilitate periodontitis development.</p>

Different expression of cytokines induced by Actinobacillus actinomycetemcomitans lipopolysaccharide in monocytes/macrophages from different organs of rabbits / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the expression of cytokines induced by Actinobacillus actinomycetemcomitans lipopolysaccharide (Aa-LPS) in monocytes/macrophages from different organs of rabbits.</p><p><b>METHODS</b>The peripheral mononuclear cells (Mo), alveolar macrophages (AM), peritoneal macrophages (PM) and Kupffer cells (KC) from five New Zealand rabbits were isolated respectively. Then the cells from different organs were stimulated with Escherichia coli (Ec)-LPS or Aa-LPS at the dose of 1 mg/L. After culture for 24 hours, the expression of tumor necrosis factor-α (TNF-α), interleukin (IL)6, IL-1β, IL-8 mRNA and protein were determined by real-time PCR and enzyme-linked immunosorbent assay respectively.</p><p><b>RESULTS</b>The monocytes/macrophages challenged by Ec-LPS or Aa-LPS expressed more cytokines both in mRNA and protein levels compared with the controls (P < 0.05). Among them, AM displayed the highest respond when encount with Aa-LPS, with the TNF-α, IL-6, IL-1β, IL-8 mRNA relative levels were (0.4719 ± 0.0171), (2.7895 ± 0.0669), (5.1527 ± 0.1190), (3.6785 ± 0.1836) and the proteins concentrations were (82.2 ± 5.4), (40.2 ± 2.0), (50 308.3 ± 445.0), (35 305.3 ± 1480.9) ng/L respectively. And the inducibility of Aa-LPS was stronger than that of Ec-LPS (P < 0.05). Meanwhile the cells from different organs showed discrepant response when exposed to Aa-LPS (P < 0.05). The results showed their abilities to secrete cytokines were in the sequence of AM > Mo > KC > PM.</p><p><b>CONCLUSIONS</b>Aa-LPS influenced the expression of cytokines in monocytes/macrophages from different organs of rabbits.</p>

Transient expression of exogenous human platelet-derived growth factor-B in gingival fibroblasts of dog / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore transient expression of the eukaryotic expression plasmid carrying human platelet-derived growth factor-B (hPDGF-B) in gingival fibroblasts of Beagle dog.</p><p><b>METHODS</b>Plasmid carrying hPDGF-B (EX-A0380-M03) was amplified and identified, and then transfected into gingival fibroblasts of Beagle dog. Reverse transcription polymerase chain reaction (RT-PCR), immunocytochemistry, enzyme-linked immunosorbent assay (ELISA) and Western bolt were choose to detect the expression of hPDGF-B.</p><p><b>RESULTS</b>Target gene carried by EX-A0380-M03 was hPDGF-B. Green fluorescence protein (GFP) expressed by transfected gingival fibroblasts was observed under inverted phase contrast fluorescence microscope (IPCFM) (after 24 hours) and the transfection efficiency was 18%-38% (after 48 hours). Serials other methods (RT-PCR, immunocytochemistry, and ELISA) mentioned above also convinced that cells expressed hPDGF-B, and the protein that was a kind of fusion protein composed of PDGF-BB and GFP was identified by Western blot.</p><p><b>CONCLUSION</b>Eukaryotic expression plasmid carrying hPDGF-B was transfected into gingival fibroblasts successfully, and a kind of fusion protein was expressed.</p>

The effects of oxymatrine on expression of interleukin-6 and interleukin-1beta mRNA of human periodontal ligament cell stimulated by lipopolysaccharides / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To observe the effects of oxymatrine on the expression of interleukin-6 (IL-6), interleukin-1beta (IL-1beta) mRNA of human periodontal ligament cell (PDLC) stimulated by lipopolysaccharides (LPS), and to discuss oxymatrine's inhibition mechanism on periodontal inflammation stimulated by LPS.</p><p><b>METHODS</b>Firstly, isolate PDLC externally and culture them; for oxymatrine experimental group we used different combination of LPS and oxymatrine in different concentration, and for the matched group we use DEME nutrient solutions of 1% FBS. Then reverse transcription-polymerase chain reaction (RT-PCR) for checking the level of IL-6 and IL-1beta mRNA.</p><p><b>RESULTS</b>25 microg x mL(-1) LPS can significantly enhance the expression of both IL-6 and IL-1beta mRNA's level, and oxymatrine could restrain above phenomena.</p><p><b>CONCLUSION</b>Oxymatrine can restrain the expression of IL-6 and IL-1beta mRNA of human PDLC stimulated by LPS.</p>

Preliminary study on MR colonography with air enema in detection of colorectal neoplasms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The few studies on MR colonography with air enema involved feasibility of bowel distention and imaging quality and lacked detection sensitivity of colorectal neoplasms. The purpose of this prospective study was to assess the detection sensitivity of colorectal neoplasms with the three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema.</p><p><b>METHODS</b>A total of 30 patients scheduled for optical colonoscopy due to rectal bleeding, positive fecal occult blood test results or altered bowel habits were recruited and successfully underwent entire colorectal examinations with three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography and subsequent optical colonoscopy on the same day. Detection sensitivity of colorectal neoplasms with MR colonography was statistically analyzed on a per-neoplasm size basis by using findings from optical colonoscopy and histopathological examinations as the reference standards.</p><p><b>RESULTS</b>Seventy-six neoplasms were detected with optical colonoscopy, consisting of 1 mm-5 mm (n = 11), 6 mm-9 mm (n = 29) and ≥ 10 mm (n = 36) in diameter. Detection sensitivities of 1 mm-5 mm, 6 mm-9 mm, ≥ 10 mm and ≥ 6 mm colorectal neoplasms with MR colonography were 9.1%, 75.9%, 100% and 89.2%, respectively; overall detection sensitivity for all sizes colorectal neoplasms was 77.6%.</p><p><b>CONCLUSIONS</b>Detection sensitivity of three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema is low for 1 mm-5 mm colorectal neoplasms, but the detection sensitivity is 89.2% for ≥ 6 mm neoplasms, and all ≥ 10 mm neoplasms could be detected.</p>

Diagnostic methods for initial evaluation of primary gastrointestinal stromal tumors

To describe the imaging features of gastrointestinal stromal tumors [GISTs] at initial presentation with clinical, surgical, and pathologic correlation, and to evaluate values of various techniques in GISTs. This retrospective study recruited 70 patients with histologically proved GISTs between December 2004, and May 2009 in the Department of General Surgery, Zhongshan Hospital, Fudan Univeristy, Shanghai, China. Each patient underwent CT scanning, 39 patients underwent simultaneous endoscopy, 12 patients underwent endoscopic ultrasound [EUS], and 36 patients underwent transabdominal ultrasonography [TAUS] simultaneously. Features of GISTs were assessed. Computerized tomography findings showed an eccentric mass in 44 patients, an intraluminal component in 24, and a transmural distribution in 2. Forty-two tumors were dumbbell-shaped, 2 were round, while 26 were irregular. Forty-three tumors presented with well-defined masses, while 27 with unclear borders. The arterial phase attenuation showed the continuous enhancement. The portal-venous phase attenuation was heterogeneous in 26 and homogeneous in the other 44. There was a significant correlation between certain CT features and tumor risk stratification. Gastrointestinal stromal tumors were characterized by a smooth shape and normal overlying mucosa in endoscopy, hypoechoic, and solid in TAUS. Imaging examinations are pivotal in the management of GISTs. The CT scan is valuable in the diagnosis, staging, and treatment planning of GISTs. Endoscopy and EUS contribute to the detection of mucosal lesions. Other methods including TAUS, fluorodeoxyglucose positron emission tomography, CT gastrography, and MRI help in specific cases

Effects of Porphyromonas gingivalis lipopolysaccharide on apoptotic genes in foam cells / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) on apoptotic genes in foam cells.</p><p><b>METHODS</b>Macrophages from THP-1 monocytes and foam cells from macrophages by oxLDL inducement were treated with oxidized low density lipoprotein (oxLDL) or oxLDL+ Pg-LPS. Cell apoptosis was detected by acridine orange-ethidium bromide (AO-EB) staining. Eleven atherosclerotic related apoptotic genes were examined with polymerase chain reaction (PCR) array, and apoptotic gene p53, c-Myc and caspase-3 were evaluated with real-time PCR.</p><p><b>RESULTS</b>Pg-LPS enhanced cell apoptosis rate during and after foam cells formation [(5.47+/-0.93)% vs. (7.50+/-0.54)%]. PCR array demonstrated that it increased B-cell CLL-lymphoma 2 (BCL2) related protein A1 (BCL2A1) transcription during foam cells formation (>2 fold), and promoted BCL2 and BCL2A1 transcription after foam cells formation (>2 fold). It promoted p53 and caspase-3 transcription level (4.50x10(-3)+/-4.02x10(-4) vs. 5.30x10(-2)+/-4.58x10(-3)), whereas inhibited c-Myc transcription level (1.53x10(-2)+/-5.77x10(-4)) during foam cells formation. It promoted caspase-3 transcription (6.00x10(-2)+/-6.08x10(-3)), and inhibited p53 transcription (4.23x10(-3)+/-5.85x10(-4)) after foam cells formation.</p><p><b>CONCLUSIONS</b>Pg-LPS affected apoptotic gene transcription during and after foam cells formation and enhanced cell apoptosis.</p>

CT and MRI imaging features of peripheral primitive neuroectodermal tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the CT and MRI features of peripheral primitive neuroectodermal tumors (pPNETs) and evaluate its diagnostic value.</p><p><b>METHODS</b>The clinicopathological data of 9 surgically treated patients with peripheral primitive neuroectodermal tumors confirmed by pathology were collected, spiral CT (4/9) and MRI (6/9) plain scanning and dynamic enhancement scanning were performed preoperatively. Both CT and MRI scannings were performed in 1 case. Those CT and MR images were retrospectively reviewed and analyzed together with clinicopathological findings.</p><p><b>RESULTS</b>The 9 lesions were located in skeletal muscles (n = 6), pelvic cavity (n = 2) and thoracic cavity (n = 1). The tumor size was 7.4-18.3 cm in diameter with a mean diameter of 11.6 cm. The shape of those lesions was round or ellipse (4 lesions) and irregular (5 lesions). The tumor usually presented as ill-defined masses, with homogeneous (n = 2) or inhomogeneous density (n = 7). Seven cases, including the 3 lesions located in the chest and pelvis, showed obvious necrosis and multilocular cyst formation. The tumors showed iso-density as that of the adjacent muscles on CT plain scans and moderate heterogeneous enhancement after intravenous injection of contrast agents. The features of the tumors on the MRI including slightly low signal intensity on SE T1-weighted imaging, iso-signal intensity or slightly high signal intensity on FSE T2-weighted imaging and heterogeneous dynamic delayed contrast-enhancement with obvious necrosis in most of them. Six cases had a lesion in the skeletal muscles, presented as a giant ill-defined masse surrounding bone and extended along neural route with bone destruction to varying degrees.</p><p><b>CONCLUSION</b>Primitive neuroectodermal tumor is a kind of malignant tumor with proliferation of small, undifferentiated neuroectodermal cells, usually occurring in children or adolescent and frequently located in the extremities, chest cavity, pelvic cavity and chest wall. It typically presents as a large, ill-defined masse extending along neural route with heterogeneous and obvious enhancement after intravenous injection of contrast agents. The tumors located in the chest and pelvic cavities and some in the extremities show obvious necrosis and multilocular cyst formation, while some of the tumors in the extremities appear as homogeneous solid masses.</p>

MR R2*map for tracing superparamgnetic ironoxides labeled endothelial progenitor cells in vitro / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the value of R2*map for quantitatively tracing superparamgnetic ironoxides (SPIO) labeled endothelial progenitor cells (EPCs).</p><p><b>METHODS</b>The EPCs were isolated from Balb/c mice bone marrow and cultured in vitro. After 7 days, expression of acetylated low-density lipoprotein (acLDL) and Ulex europaeus agglutinin-1 (UEA-1), two markers of EPCs, was observed by double staining using fluorescence microscope, the expression of stem cell antigen-1 and vascular endothelial growth factor receptor-2 (VEGFR-2) was confirmed by flow cytometry. EPCs were labeled by incubating with 50 microg/ml SPIO and 6 microl/ml lipofectamine2000, SPIO labeled EPCs were observed under transmission electron microscope (TEM). Labeled and unlabeled EPCs were mixed with 10 g/L agarose and scanned using a 3.0T MR scanner, R2* map and R2 map images were obtained on workstation.</p><p><b>RESULT</b>After 7 days of in vitro culture, most of the cells showed characteristics of EPCs. There was no morphological difference between SPIO labeled EPCs and unlabeled EPCs. R2* and R2 values exhibited a linear correlation with the number of labeled cells in the agarose gel. Compared to R2, R2* was a better indicator of the number of labeled cells.</p><p><b>CONCLUSION</b>MR R2* map can be used to trace SPIO labeled EPCs quantitatively.</p>

Determination of benzopyrene in red clover extract by high performance liquid chromatography with spectrofluorescence detector / 中国中药杂志

<p><b>OBJECTIVE</b>To establish a high performance liquid chromatography method with spectrofluorescence detector for the quantitative analysis of benzopyrene in red clover extract.</p><p><b>METHOD</b>Analysis was performed on Hypersil C18 column (4. 6 mm x 200 mm, 5 microm) with acetonitrile and water (70: 30) as mobile phase; The excitation wavelength and emission wavelengh were 368 nm and 405 nm, respectively; Flow rate was 1.0 mL x min(-1).</p><p><b>RESULT</b>The linear range was 0.93-37.2 ng x mL(-1), and r = 0.9992 (n = 5). The average recovery of benzopyrene was 85.2% (n = 9).</p><p><b>CONCLUSION</b>The method was convenient and accurate with good recovery.</p>

A comparative study of MRI manifestations and pathological changes in hepatocellular carcinoma treated by transcatheter arterial chemoembolization with lipiodol / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To analyze the MRI manifestations and pathological changes of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) with lipiodol.</p><p><b>METHODS</b>23 patients with 31 HCC lesions treated by TACE underwent MRI examination within 1 week before their surgical resections. MRI was performed with SE sequence (T1WI and FSE T2WI) and FMPSPGR sequence dynamic multi-phase contrast scans. All resected specimens were cut into 5-10mm thick slices, corresponding to the same plane as that of MRI scans. The specimens were wholly embedded in paraffin, serial sections made and stained with hematoxylin and eosin. The MRI findings were thus compared with the pathology of the specimen sections.</p><p><b>RESULTS</b>(1) MRI findings: In all 31 lesions, the signal intensity of lesions varied and was mostly heterogeneous on SE T1WI and T2WI images. Three lesions were inhomogeneous hyper-intensity and the other 28 lesions were iso- or hypo-intensity on FMPSPGR plain scannings. Twenty-two lesions were enhanced on early-phase dynamic scanning, and no enhancement was found in the other 9 lesions. Partial enhancement was also seen in 6 lesions on delay-phase dynamic scanning. (2) Pathologically, no coagulation necrosis was found in 2 specimens, but 6 lesions showed complete coagulation necrosis and 23 showed various degrees of it. The other pathological changes found included intra-tumoral hemorrhage (n=10), intra-lesional fibrotic septa formation (n=5), capsule-like fibrotic tissue proliferation around the lesions (n=12), inflammatory infiltration (n=28), focal mucoid degeneration (n=2), focal hyaline degeneration (n=2), and lipiodol retention (n=6). (3) Radiological-pathological correlation study: hyper-intense areas on T1WI corresponded to areas of coagulation necrosis with or without hemorrhage and of residual viable tumor; iso- and hypo-intense corresponded to areas of coagulation necrosis or residual viable tumor. Hyper-intense areas on T2WI corresponded to those of residual viable tumor or coagulation necrosis with hemorrhage, and iso-intense areas corresponded to those of coagulation necrosis, small residual viable tumor or intra-lesional fibrotic septa formation, and hypo-intense areas corresponded to those of coagulation necrosis or intra-lesional fibrotic septa formation. Areas of enhancement within the lesions on the early-phase dynamic-contrast images corresponded to areas of residual viable tumors, while areas of no enhancement were those of coagulation necrosis, hemorrhage, intra-lesional fibrotic septa formation or small residual viable tumors. Areas of enhancement on the delay-phase dynamic scanning were those of residual viable tumors or intra-lesional fibrotic septa formation, while no enhancement corresponded to the areas of residual viable tumors, coagulation necrosis, and hemorrhage. Areas of enhancement on the delay-phase dynamic scanning corresponded to those areas of fibrosis tissue or residual viable tumors. Inflammatory infiltration was found in areas of different signal intensity on MRI images.</p><p><b>CONCLUSIONS</b>(1) Different pathological changes in HCCs after TACE are represented by various signal intensities on SE sequence images. The only area of hypo-intensity on T2WI has a specificity in representing coagulation necrosis. (2) FMPSPGR sequence dynamic MRI is superior to SE sequence in demonstrating and determining the necrosis and residual viable tumor. Enhanced areas within the lesions on the early-phase dynamic-contrast images represent residual viable tumors and the enhancement of capsule on early-phase dynamic-contrast images also represent subcapsular residual viable tumors. (3) MRI can demonstrate accurately the areas of necrosis and residual viable HCC tissues after TACE and evaluate the effect of TACE.</p>

Small hepatocellular carcinoma: multiphase hepatic CT scan with a multidetector row helical CT scanner / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To evaluate multiphase hepatic CT scan using multidetector row helical CT (MDCT) in detecting hypervascular small hepatocellular carcinoma (SHCC).</p><p><b>METHODS</b>Multiphase hepatic CT scan in 75 patients with SHCC was carried out with Marconi MX8000 multidetector row helical CT scanner. The early arterial phase scan started at the 21th second after the injection of contrast medium, the late arterial phase scan started at the 34th second, and the portal venous phase started at the 80tieth second, six seconds every time.</p><p><b>RESULTS</b>The study showed that the density values of 71 lesions between liver and SHCC were different significantly among the early arterial phase, the late arterial phase and the portal venous phase (F=3.327, P<0.05). Among the 91 lesions, the detectable rates of the early arterial phase and the late arterial phase were 45.1% and 83.5%, respectively. The rate of double arterial phases was 92.3%. The rates increased to 94.5% and 97.8%, when the late arterial phase combined with the portal venous phase and the double arterial phase combined with the portal venous phase.</p><p><b>CONCLUSION</b>The utility of MDCT with faster speed, thinner slice and multiphases scanning has improved the opportunity of detecting hypervascular hepatocellular carcinoma.</p>

The value of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography in the evaluation of hepatic arterial anatomy / 中华放射学杂志

Objective Compared with digital subtraction angiography(DSA),to evaluate the value of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography(3D MRA) in defining hepatic arterial anatomy.Methods The data about abdominal high-resolution contrast-enhanced 3D MRA and DSA of 26 patients (24 patients with primary liver cancer,2 patients with metastatic liver tumor) was retrospectively analyzed.The display quality of different segmental hepatic artery was scored with 4 grades and the agreement between high-resolution 3D MRA and DSA was determined with the weighted Kappa statistic.The depiction of hepatic arterial anatomy/anomalies and vascular pathology on high- resolution 3D MRA was assessed and compared with DSA.Results With respect to display quality,there was good or fair correlation between high-resolution 3D MRA and DSA for the common hepatic artery (the mean score respectively was 3.96,3.96 and Kappa value 0.99),gastroduodenal artery (the mean score respectively 3.85,3.88 and Kappa value 0.85 ),right hepatic artery(the mean score respectively 3.92, 3.96 and Kappa value 0.65 ),left hepatic artery (the mean score respectively 3.77,3.92 and Kappa value 0.43 ),left gastric artery(the mean score respectively 3.73,3.85 and Kappa value 0.43 ),right anterior artery (the mean score respectively 3.35,3.70 and Kappa value 0.53),right posterior artery (the mean score respectively 3.31,3.73 and Kappa value 0.46)and 1V segment artery (the mean score respectively 2.92,3.46 and Kappa value 0.51 );Poor correlation was found for the Ⅱsegment artery (the mean score respectively 2.15,3.35 and Kappa value 0.18)and Ⅲsegment artery (the mean score respectively 2.19, 3.35 and Kappa value 0.21 ).Compared with DSA,18 normal hepatic arterial anatomy and 7 arterial anomalies were accurately demonstrated(accuracy ratio 96.1% (25/26)),the obliteration of gastroduodenal artery correctly depicted in 1 patient on high-resolution 3D MRA image.Conclusions High-resolution 3D MRA can provide accurate evaluation of hepatic artery and has the capacity of depicting hepatic segment artery.

The comparative study of the imaging features of chromophobe cell renal carcinoma with pathologic findings / 中华放射学杂志

Objective To analyze and compare the imaging features of chromophobe cell renal carcinoma(CCRC)with pathologic findings in order to improve the diagnostic accuracy.Methods The data of CT and MRI of 12 patients with CCRC were reviewed retrospectively.Ten patients underwent CT examination,including precontrast scan,the contrast eortieomedullary phase scan and the parenchymal phase scan(one patient without corticomedullary phase scan).Two patients underwent MR examination including precontrast T_1WI,T_2WI and enhanced T_1WI of the corticomedullary phase and the parenchymal phase.Results Four lesions located in left kidney and eight in right kidney.Maximum diameter of lesions ranged from 24 mm to 125 mm,average 56.7 ram.Homogenous density was observed in six lesions of ten on unenhanced CT scan and five lesions had homogenous enhancement on enhanced CT scan,which was due to the less incidence of necrosis,liquefaction and hemorrhage on pathologic findings.Nine Lesions showed hyperdense compared with renal medulla but the density was lower than renal cortex on the corticomedullary phase.The enhanced degree was positively correlated with microvessel density(MVD).All ten lesions became hypodense compared with renal medulla on the parenchymal phase scan.Central stellate scar was found in two big lesions and psudocapsula were observed in four lesions confirmed by pathology.Two patients underwent MRI examination.Compared with medulla,the two lesions showed hyperintense on unenhanced T_1WI and obviously hypointense on unenhaneed T_2WI.The enhancement pattern of them was similar to CT. Conclusion The imaging features of CCRC,such as homogeneity,special enhancement pattern and distinct hypointensity on T_2WI,help to differentiate CCRC from other renal tumors.

The comparative study of diffusion-weighted MR imaging with modified sensitivity encoding technique for small hepatocellular carcinoma lesions / 中华放射学杂志

Objective To prospectively evaluate whether DWI with mSENSE(mSENSE-DW1)can help to improve image quality and affect the calculation of lesion's ADC,compared with DWI with conventional phase encoding(conventional DWI)in patients with small HCC lesions.Methods Thirty-two patients with 47 small HCC lesions underwent single-shot spin-echo echo-planar.(SE-EPI)DWI with conventional phase encoding and mSENSE.Three b values of 300,500 and 800 s/mm~2 were used.Image quality and CNR between conventional DWI and mSENSE-DWI group were compared with different b value. Lesion's ADC were also calculated and compared.Matched-pairs Wilcoxon signed rank test and Friedman test were used to test statistical significance.Results The image quality was assessed with a five-point scale.For conventional DWI group,image quality score of 2 was assigned in 5 cases,score of 3 in 24 cases, score of 4 in remaining 3 eases with b=300 s/mm~2,score of 2 in 9 eases,score of 3 in 22 cases,score of 4 in remainingl cases with b=500 s/mm~2,score of 1 in 2 cases,score of 2 in 24 cases,score of 3 in remaining 6 cases with b=800 s/mm~2.For mSENSE-DWI group,image quality score of 3 was assigned in 4 cases,score of 4 in 25 cases,score of 5 in 3 eases with b=300 s/mm~2,score of 3 in 10 cases,score of 4 in 20 cases,score of 5 in remaining 2 cases with b=500 s/mm~2,score of 2 in 7 cases,score of 3 in 23 eases, score of 4 in remaining 2 cases with b=800 s/mm~2.Higher image quality scores were achieved at mSENSE- DWI group than conventional DWI group(Z=-5.578,-5.488,-4.796 respectively,P