Magnetic Resonance Imaging Features and Their Pathological Mechanisms of Hashimoto's Encephalopathy / 中国医学科学院学报

Objective To analyze the routine and functional magnetic resonance imaging(MRI) features and their potential pathological mechanisms of Hashimoto's encephalopathy(HE). Methods The clinical data and routine and functional MRI images of 30 HE patients who were treated in our center from January 2010 to April 2017 were retrospectively reviewed. Among them,15 patients were examined with contrast-enhanced MRI,16 with diffusion-weighed imaging(DWI),8 with magnetic resonance angiography,2 with magnetic resonance spectroscopy,and 1 with both arterial spin labeled perfusion imaging and diffusion tensor imaging. Seven patients had consecutive clinical and imaging data. The distribution,MRI signals,and functional MRI features of HE were analyzed. Results Among 30 HE patients,routine MRI showed negative results in 8 cases and abnormal findings in 22 cases. Among 22 abnormal cases,9 were characterized by small cerebral vascular disease and 13 had non-specific abnormalities;of these 13 cases,12 had lesions mainly located at the supratentorial white matter,11 had multiple lesions,and 2 had lesions complicated with cerebellum atrophy. The lesions were focal or confluent,punctate or small patchy,showing abnormal signal intensity with iso-or hypo-intensity on T1-weighed imaging,hyper-intensity on both T2-weighed imaging and fluid-attenuated inversion recovery. Most of the lesions had no enhancement(12/15). Among 7 cases with abnormalities on DWI,hyper-intensity on DWI and hypo-intensity on apparent diffusion coefficient were seen in 3 sudden acute cases and hyper-intensity on DWI and increased apparent diffusion coefficient value in 4 sub-acute or slow onset cases. Three cases showed localized intracranial artery stenosis. In 2 cases,magnetic resonance spectroscopy revealed significant lower N-acetylaspartate peak,higher choline peak,and visible lactate peak or lipid peak. Of 7 cases with follow-up data,3 cases had no change,4 cases had changes including softening lesions(2/4),remitted and relapsed lesions(1/4),and rapid progression of brain atrophy with negative finding on the initial MRI(1/4). Conclusion Routine MRI combined with functional imaging can show the features of HE from different perspectives. Routine MRI shows multifocal or confluent lesions in the white matter,mostly without enhancement,while functional imaging may reveal pathological characteristics of different phases of acute or chronic ischemia and demyelinating changes of HE. Combined with clinical data,MRI can differentiate HE from other diseases based on routine and functional MRI appearances.

Influencing factors for duration of viral nucleic acid shedding in children with influenza A / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the features and duration of viral nucleic acid shedding in children with influenza A.</p><p><b>METHODS</b>The clinical data of 90 children with influenza A with positive influenza A virus nucleic acid in nasopharyngeal swab detected by PCR were collected, and these children were divided into simple influenza A group (n=10), influenza A-pneumonia group (n=61), influenza A-nervous system damage group (n=10), and influenza A-underlying disease group (n=9). A retrospective analysis was performed for clinical features, treatment process, duration of viral nucleic acid shedding, and prognosis.</p><p><b>RESULTS</b>The most common symptoms in these children were fever (89/90, 99%), cough (89/90, 99%), running nose (69/90, 77%), shortness of breath (26/90, 29%), and myalgia (23/90, 26%). The mean duration of viral nucleic acid shedding in 90 children was 9.4±2.9 days. The simple influenza A group had a significantly shorter duration of viral nucleic acid shedding than the influenza A-pneumonia, influenza A-nervous system damage, and influenza A-underlying disease groups (p<0.05), while there were no significant differences between the influenza A-pneumonia, influenza A-nervous system damage, and influenza A-underlying disease groups (p>0.05). The children who received antiviral therapy within 48 hours after disease onset had significantly shorter duration of viral nucleic acid shedding and time to body temperature recovery than those who received antiviral therapy more than 48 hours after disease onset (p<0.05). Of all the children with body temperature recovery, 83% still tested positive for viral nucleic acid.</p><p><b>CONCLUSIONS</b>Complications, underlying diseases, and timing of antiviral therapy are influencing factors for the duration of influenza A virus nucleic acid shedding, and whether body temperature returns to normal cannot be used to decide whether to continue antiviral therapy.</p>

BOLD-fMRI in sensory area and motor hand functional area with brain tumor in the central area / 中南大学学报(医学版)

OBJECTIVE@#To explore the geomorphological performance, the characteristics of volume, and the largest signal intension of blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) in brain tumors located in or closed to the central area.@*METHODS@#We recruited 13 normal volunteers and 31(13 benign tumors and 18 malignant tumors) patients with brain tumor located in or closed to the central area, to examine both side hand motor and tactile function by BOLD-fMRI and obtained the activation map and its superposition image with T1 imaging, the volume, and the largest signal intension of the functional area by SPM software which manipulated the raw data in the off-line work station. The volume and the largest signal intension data of the functional area were statistically analyzed by SPSS 13.0.@*RESULTS@#The volume and the largest signal intension of the activation map in the normal functional area had hemisphere advantage. There was difference in the activated signal pixel number and the largest signal intension of the functional area between the benign brain tumors, malignant brain tumors, and the normal volunteers (P < 0.05). The shape, anatomic location, the volume, and the largest signal intension of the functional area were changed in the patients with brain tumors.@*CONCLUSION@#BOLD-fMRI is a valid method to assess the pre-surgical risk of patients with brain tumors, which can get the volume, the largest signal intension, the basic shape,and the anatomic location of the functional area.

Value of proton magnetic resonance spectroscopy with two-dimensional chemical-shift imaging in evaluating brain gliomas / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the value of proton magnetic resonance spectroscopy ((1)H-MRS) with two-dimensional (2D) chemical-shift imaging (CSI) in evaluating brain gliomas.</p><p><b>METHODS</b>Thirty-six patients with gliomas received examinations with 2D-CSI. The VOI of MRS included the tumor, peritumoral edematous and nonedematous areas, and the contralateral normal tissue. The changes of the metabolites in different areas were determined using 2D-CSI (1)H-MRS with SE sequence and the metabolite ratios were calculated.</p><p><b>RESULTS</b>Significant differences were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho between low-grade gliomas and contralateral normal brain tissue, and between high-grade gliomas and the contralateral normal tissue (P<0.01). The low-grade gliomas and high-grade gliomas differed significantly in the ratios of NAA/Cr, Cho/Cr and NAA/Cho (P<0.05). These ratios also showed significant differences between peritumoral edematous area and the glioma tissue, between the peritumoral edematous area and contralateral normal brain tissue (P<0.05), and between the peritumoral nonedematous area and the glioma tissue (P<0.05). Between the peritumoral nonedematous area and contralateral normal brain tissue, NAA/Cr and NAA/Cho ratios were significantly different (P<0.05) but the Cho/Cr ratio was similar (P>0.05).</p><p><b>CONCLUSIONS</b>MRS with 2D-CSI can provide precise and effective evidences with high time resolution for glioma grading, assessment of peritumoral involvement and glioma therapies.</p>

Oral ferric ammonium citrate solution in MRCP for diagnosing low-level obstructive jaundice / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the value of oral ferric ammonium citrate solution as a gastrointestinal contrast agent in diagnosing low-level obstructive jaundice.@*METHODS@#Thirty-six patients who were suspected of low-level obstructive jaundice were performed with magnetic resonance cholangiopancreatography (MRCP) and conventional MRI before and after the administration of oral ferric ammonium citrate solution. The diagnostic accuracy for evaluating the site and the cause of obstruction was compared with other diagnostic modalities.@*RESULTS@#The image qualities of single-slice and multi-slice MRCP were improved markedly. The accuracy of MRCP for evaluating the site of obstruction was 97.22%, which was superior to US (P<0.05). There were no significant differences among the MRCP, CT, and ERCP.@*CONCLUSION@#Oral ferric ammonium citrate solution can significantly improve the image quality of MRCP. FAC-MRCP is a simple, safe, and noninvasive technique with excellent accuracy in the diagnosis of low-level obstructive jaundice.

Expression of Ang2 and Tie2 and their relation with the angiogenesis of hepatocellular carcinoma in rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the relationship between the expression of Ang2, Tie2 and the angiogenesis of hepatocellular carcinoma in rats.@*METHODS@#Thirty-eight healthy male rats were randomly divided into 3 groups: 5 rats in the control group; 25 rats in the experimental group were equally divided into 5-day, 10-day, 15-day, 20-day, and 25-day groups; the other 8 rats were used as the supplement of the experimental group. An allogenic transplanted rat model of CBRH-7919 hepatocellular carcinoma in situ was established by immunosuppression. The expressions of Ang2 and Tie2 were detected by immunohistochemical staining in cancerous tissues of different developmental stages and liver tissues of the control group. At the same time, microvessel density was determined by anti-CD31 immunohistochemical staining.@*RESULTS@#CBRH-7919 hepatocellular carcinoma models were successfully set up in 24 rats. The expression level of Ang2 and Tie2 in cancerous tissues was much higher than that of liver tissues of the control group (P <0.05). The overexpression of Ang2 was pristine and continuous in different developmental stages. The expressions of Ang2 and Tie2 positively correlated with microvessal density in hepatocellular carcinoma (P<0.05).@*CONCLUSION@#The up-regulation of Ang2 and Tie2 may play important roles in the angiogenesis of hepatocellular carcinoma. Ang2 may participate in the start of angiogenesis of hepatocellular carcinoma.