Effects of Structural Changes in Subchondral Bone on Articular Cartilage in a Beagle Dog Model / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Using MR T2-mapping and histopathologic score for articular cartilage to evaluate the effect of structural changes in subchondral bone on articular cartilage.</p><p><b>METHODS</b>Twenty-four male Beagle dogs were randomly divided into a subchondral bone defect group (n = 12) and a bone cement group (n = 12). Models of subchondral bone defectin the medial tibial plateau and subchondral bone filled with bone cement were constructed. In all dogs, the left knee joint was used as the experimental sideand the right knee as the sham side. The T2 value for articular cartilage at the medial tibial plateau was measured at postoperative weeks 4, 8, 16, and 24. The articular cartilage specimens were stained with hematoxylin and eosin, and evaluated using the Mankin score.</p><p><b>RESULTS</b>There was a statistically significant difference (P < 0.05) in Mankin score between the bone defect group and the cement group at postoperative weeks 16 and 24. There was a statistically significant difference in the T2 values between the bone defect group and its sham group (P < 0.05) from week 8, and between the cement group and its sham group (P < 0.05) from week 16. There was significant difference in T2 values between the two experimental groups at postoperative week 24 (P < 0.01). The T2 value for articular cartilage was positively correlated with the Mankin score (ρ = 0.758, P < 0.01).</p><p><b>CONCLUSION</b>Structural changes in subchondral bone can lead to degeneration of the adjacent articular cartilage. Defects in subchondral bone cause more severe degeneration of cartilage than subchondral bone filled with cement. The T2 value for articular cartilage increases with the extent of degeneration. MR T2-mapping images and the T2 value for articular cartilage can indicate earlycartilage degeneration.</p>

Comparing the effect of An's Shaobei Injection (symbols; see text) with Xiaozhiling Injection (symbols; see text) in patients with internal hemorrhoids of grade I-III: a prospective cohort study / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the effect of An's Shaobei Injection ([symbols; see text]) with Xiaozhiling Injection ([symbols; see text]) in patients with internal hemorrhoids of grade I-III.</p><p><b>METHODS</b>This cohort study included 1,520 internal hemorrhoids patients with grade I-III who were scheduled for liquid injection treatment from July 2003 to July 2009. The cohort included patients who underwent either An's Shaobei Injection treatment (the treatment group, 760 cases) or Xiaozhiling Injection treatment (the control group, 760 cases). All patients were followed up regularly for 3 years; the observing indices included anal function recovery and clinical response after operation.</p><p><b>RESULTS</b>Among the 1,520 patients, 1,508 (99.2%) completed the 3-year follow-up. The efficacy rate was 97.5% in the treatment group, significantly higher than the control group (91.8%, P<0.01). The recurrence rate in the treatment group was 0.5%, significantly lower than that of the control group (1.3%, P<0.01). In addition, perianal callosity occurred in 8 cases (1.1%) and anorectal stricture in 26 cases (3.5%) after operation in the control group. There was no perianal callosity and anorectal stricture in the treatment group.</p><p><b>CONCLUSION</b>The treatment with An's Shaobei Injection demonstrated superior clinical effect to Xiaozhiling Injection with fewer adverse effects.</p>

Assessment of the right and left ventricular function in patients with cor pulmonale using high-definition CT / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cor pulmonale is often associated with changes of structure and function of the right ventricle (RV) and thus further affects functional changes of the left heart. Our study aimed to assess the left ventricular (LV) and RV function in patients with cor pulmonale using high-definition CT (HDCT).</p><p><b>METHODS</b>We prospectively studied 18 cor pulmonale patients determined by the pulmonary function test, clinical examination, chest radiograph, electrocardiogram, and echocardiogram. The subject group was compared to a control group consisting of 18 subjects. The RV and LV functions and RV myocardial mass (MM) were obtained by HDCT in the two groups. The results were compared between the two groups using the independent sample t test. Echocardiographic examination for cardiac function analysis was performed on the same day.</p><p><b>RESULTS</b>The RV end-diastolic volume (EDV), RV end-systolic volume (ESV) and RV myocardial mass were significantly larger in the 18 cor pulmonale patients than in the control group (P < 0.05). The right ventricular ejection fraction (RVEF) was significantly lower in the 18 cor pulmonale patients than in controls (P < 0.01). The left ventricular EDV (LVEDV) and LVEF were significantly lower in cor pulmonale patients than in controls (P < 0.01). There were strong correlations between MDCT and echocardiography, rRVEF = 0.839 and rLVEF = 0.916, respectively.</p><p><b>CONCLUSIONS</b>HDCT can accurately quantify RV and LV function. The right ventricular function is impaired in patients with cor pulmonale, while at the same time the left ventricular function is also impaired.</p>

Intracranial malignant meningioma with cerebrospinal fluid dissemination: a case report / 中华医学杂志(英文版)

Malignant meningiomas are uncommon intracranial tumors. The metastasis of malignant meningiomas to distant extracranial sites are well known. However, dissemination of the tumours in the cerebrospinal fluid (CSF) is rare and few cases have been reported. We present a case of histologically proven malignant meningioma with CSF dissemination at the remote intracranial area and into the spinal canal detected with magnetic resonance imaging.

Dysembryoplastic neuroepithelial tumors: magnetic resonance imaging and magnetic resonance spectroscopy evaluation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Dysembryoplastic neuroepithelial tumor (DNT) is a rare benign neoplasm of the central nervous system affecting young people. A correct preoperative diagnosis is helpful for planning surgical strategies and improving prognosis. The purpose of this study was to characterize DNTs using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) and to analyze the value of these two techniques in the diagnosis of DNTs.</p><p><b>METHODS</b>MR images of 13 patients with DNTs were reviewed retrospectively; and five of the patients also underwent MRS. Tumors were confirmed by surgery. The distribution, extension and signal features of the lesions were assessed, and the MRS results were analyzed.</p><p><b>RESULTS</b>All tumors were supratentorial. The cortex was the main area involved, with nine tumors located in the temporal lobe, three in the frontal lobe, and one on the boundary between the temporal and occipital lobes. All cases had decreased signal intensity on T1-weighted MR images and increased signal intensity on T2-weighted images. On fluid attenuated inversion recovery weighted images, the hyperintense "ring sign" and internal septation of the lesion were seen in 9 cases. Eight tumors had well-demarcated borders. Peritumoral edema or mass effect was absent in all cases. A contrast enhancement examination was performed in 9 cases. Contrast enhancement was absent in five cases, and four cases showed significant enhancement. The MRS showed a low N-acetylaspartate peak and a lack of elevated choline-containing component (Cho) or Cho-Cr ratio (Cho/Cr) in five patients.</p><p><b>CONCLUSIONS</b>The MRI findings of DNTs were stereotypical. The combination of MRI and MRS techniques were helpful in making a correct presurgical diagnosis.</p>

Lipid signal in evaluation of intracranial meningiomas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Using magnetic resonance imaging, diagnosis of malignant meningioma from benign meningioma with atypical features is uncertain. We evaluated the value of lipid signal in differentiating intracranial meningiomas.</p><p><b>METHODS</b>1H-magnetic resonance spectroscopy (MRS) using a point resolved spectroscopy (TR/TE 1000/144 ms) sequences were performed on 34 patients on a 3.0 T scanner. Lipid peak located at 1.3 ppm was evaluated. MRS data from these tumours were compared with histopathological findings (including hematoxylin and eosin staining and KP-1 staining).</p><p><b>RESULTS</b>Twenty-nine meningiomas were histologically benign (eleven meningothelial, thirteen fibrous, four transitional and one microcystic), three were atypical, and two were anaplastic. Lipid signal was detected in ten cases: two anaplastic, three atypical, two fibrous and three meningothelial meningiomas. All voxels with lipid peak in the spectrum from the tumour were evaluated. With creatinine peak in the normal white matter chosen as internal standard, lipid/creatinine ratios of anaplastic, atypical and benign meningiomas were 0.844 +/- 0.027 (range from 0.725 to 0.994), 0.465 +/- 0.023 (range from 0.239 to 0.724), and 0.373 +/- 0.016 (range from 0.172 to 0.571) respectively. Highly significant differences were noted between anaplastic and the other two subtypes. Patchy necrosis was observed in anaplastic meningioma, while focal necrosis was noted in atypical meningioma with HE stain. However, no necrosis was found in benign group. KP-1 stain demonstrated histocytes containing lipids in the necrotic region of anaplastic and atypical meningioma.</p><p><b>CONCLUSION</b>The lipid signal at 1.3 ppm is a useful marker in evaluating the malignancy of intracranial meningiomas, especially in the differential diagnosis of anaplastic meningioma.</p>

Diffusion tensor imaging in medial temporal lobe epilepsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diffusion tensor imaging (DTI) is a noninvasive imaging technique for the assessment of the integrity of cerebral tissues. This study was undertaken to assess the changes of diffusion indices of hippocampal formation (HF) in patients with medial temporal lobe epilepsy (MTLE).</p><p><b>METHODS</b>Fourteen patients with MTLE and 14 healthy subjects were evaluated. Mean diffusivity (MD) and fractional anisotropy (FA) from the symmetrical-voxel sampling regions of the anterior HF were calculated in all subjects. The MD and FA values were compared across the groups.</p><p><b>RESULTS</b>No significant differences of MD and FA values were noted between right and left HF in the controls. In the patient group, MD significantly increased in the HF ipsilateral to the lesioned side [(9.27 +/- 1.09) x 10(-4) mm(2)/s], compared with the values in the contralateral HF [(8.20 +/- 0.59) x 10(-4) mm(2)/s] (t = 4.479, P = 0.001) and healthy subjects [(7.58 +/- 0.51) x 10(-4) mm(2)/s] (P < 0.001), but no significant differences were found in FA. When compared with the controls, patients had a significantly higher MD in the contralateral HF (P < 0.05), but the difference in FA was not statistically significant.</p><p><b>CONCLUSIONS</b>DTI could detect hippocampal abnormality in patients with MTLE. This technique may be helpful for preoperative evaluation of such patients.</p>

Effects of electroacupuncture at neiguan (PC 6) and Shenmen (HT 7) on brain functional imaging / 中国针灸

<p><b>OBJECTIVE</b>To observe effect of electroacupuncture at Shenmen (HT 7) and Neiguan (PC 6) on brain functional imaging.</p><p><b>METHODS</b>The technique of functional magnetic resonance imaging was used to observe the activated state in different brain regions caused by electroacupuncture.</p><p><b>RESULTS</b>The frontal lobe was activated by electroacupuncture at Neiguan (PC 6) and the temporal lobe by Shenmen (HT 7).</p><p><b>CONCLUSION</b>Electroacupuncture at different acupoints can activate different brain regions, which provides objective basis for treatment of intellectual impairment by electroacupuncture at Neiguan (PC 6) and Shenmen (HT 7).</p>

Application of functional MRI in epilepsy / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the recent development of functional MRI application in epilepsy.</p><p><b>DATA SOURCES</b>Both Chinese and English language literatures were researched using MEDLINE/CD ROM (1996 - 2005) and the Chinese Biomedical Literature Disk (1996 - 2005).</p><p><b>STUDY SELECTION</b>Published articles about functional MRI application and epilepsy were selected.</p><p><b>DATA EXTRACTION</b>Data were mainly extracted from 38 articles which are listed in the reference section of this review.</p><p><b>RESULTS</b>fMRI can be used to localize seizure foci through detecting these cerebral hemodynamic changes produced by epileptiform discharges. EEG-triggered fMRI, which has higher spatial and temporal resolution, helps to detect the spatiotemporal pattern of spike origin and propagation, and define localization of the epileptogenic focus. fMRI is also useful in language and memory cognitive function assessment and presurgical assessment of refractory epilepsy. Atypically distributed cognitive function areas can be detected by fMRI, because of cortical language and memory areas reorganization during long-term epileptic activity in patients with epilepsy.</p><p><b>CONCLUSIONS</b>fMRI technique plays a very important role in cognitive function and presurgical assessment of patients with epilepsy. It is meaningful for understanding pathogenesis of epilepsy.</p>

Primary study on imaging in transient ischemic attacks / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although transient ischemic attacks (TIA) is a clinical diagnosis, imaging findings are important for its diagnosis and treatment. This study evaluated the value and limitations of conventional CT, CT cerebral perfusion imaging and transcranial Doppler sonography (TCD) in patients with TIA.</p><p><b>METHODS</b>Conventional CT, CT cerebral perfusion imaging and TCD were performed in 20 patients with TIA. After regular CT examination, 40-second dynamic scans were performed on selected slice, while 40 ml of non-ionic contrast materials was bolus-injected through antecubital vein with power injector. These dynamic images were processed with the perfusion software package on workstation. Cerebral blood flow (CBF) and time to peak (TTP) were measured in specific regions of the brain. TCD was also performed in 20 patients with TIA. Comparative analysis was made on the basis of the results of conventional CT, CT cerebral perfusion imaging and TCD.</p><p><b>RESULTS</b>In the 20 patients with TIA, conventional CT turned out to be normal. However, persisting abnormal perfusion changes corresponding to clinical symptoms were found in 13 cases with the prolonged TTP. The other 7 cases were normal. TTP of the affected side (11.6 +/- 3.0) s was significantly prolonged (t = 4.782, P < 0.01) in comparison with the contralateral side (8.8 +/- 1.5) s. The difference in CBF was not statistically significant (t = 1.912, P = 0.073) between the affected side [(223.9 +/- 19.6) ml.min(-1).L(-1)] and the contralateral side [(227.7 +/- 19.8) ml.min(-1).L(-1)]. TCD revealed severe stenosis or occlusion of the carotid artery in 10 patients, arteriosclerosis in 6 patients, blood speed decrease in 2 patients, vasospasm in 1 patient.</p><p><b>CONCLUSIONS</b>Conventional CT can exclude intracerebral diseases. Perfusion CT provides valuable hemodynamic information and shows the extent of perfusion disturbances. TCD can demonstrate abnormalities of the involved arteries in patients with TIA. The combination of these three imaging methods can provide more diagnostic information.</p>

MRI-guided stereotactic biopsy for questionable diseases in brain / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the accuracy and role of magnetic resonance imagine (MRI)-guided stereotactic biopsy for atypical diseases in brain.</p><p><b>METHODS</b>Using MRI volume scan and multiplane reconstruction, MRI-guided stereotactic brain biopsies were performed with CRW stereotactia frame in twenty-six patients whose lesions were atypical or unable to be detected by CT scanning.</p><p><b>RESULTS</b>No serious complication (intracranial hematoma, paralysis) caused by brain biopsy was found in all twenty-six patients. Definite pathologic diagnosis and appropriate treatment were given to these patients. The lesions included gliomatosis cerebri, brain cysticercosis and Krabbe's disease, et al.</p><p><b>CONCLUSIONS</b>MRI-guided stereotactic brain biopsy is more accurate for pathological diagnosis than CT-guided stereotactic brain biopsy. MRI-guided stereotactic biopsy can provide reliable diagnosis and treatment especially for the questionable lesions in brain.</p>

The application of the reduced dosage of the contrast medium with saline flush in cerebral and carotid angiography with 64-slice spiral CT / 中华放射学杂志

0. 05). Conclusion On the CTA exams with 64-slice spiral CT, good CTA image quality can be acquired with reduced contrast dose and saline flush, thereby we can afford reliable diagnostic information for the clinicians.

Glossopharyngeal neuralgia:MR findings / 中华放射学杂志

Objective To investigate the possibility of MRI on visualizing the relationship between glossopharyngeal nerve and surrounding vessels,and to evaluate the significance of MRI in the diagnosis and treatment of glossopharyngeal neuralgia.Methods MRI findings were analyzed retrospectively in 12 patients with glossopharyngeal neuralgia,and were compared with surgical findings and effect of pain relief.Results The artery compression or contact of the glossopharyngeal entry zone,as revealed during operation in l0 patients with glossopharyngeal neuralgia,was visualized on MRI in 9 and not seen in 1.The venous compression of the glossopharyngeal entry zone was not identified on MRI in 1.The conglutinative arachnoids of the glossopharyngeal entry zone was not visualized on MRI in 1.MRI demonstrated the affected glossopharyngeal nerve root entry zone was compressed or contacted by the posterior inferior cerebellar artery (PICA)in 8 patients and by the vertebral artery in 1 patient.One patient's offending vessel was confirmed to be the anterior inferior cerebellar artery(AICA)by the operation,and the surgical findings were corresponded with MRI in others.Vascular compression or contact of the affected glossopharyngeal nerve was not visualized on MRI in 3 patients,and operation confirmed that the glossopharyngeal nerve root entry zone was compressed by unknown artery in 1,by small vein in 1,and by eonglutinative araehnoids in 1, respectively.Eight patients presented with symptoms of the ipsilateral trigeminal neuralgia concurrently.The compression of the affected trigeminal nerve root by superior cerebellar artery(SCA)was visualized on MRI in 6 patients,and operation did not reveal the source of artery compression in 1 and corresponded with MRI findings in other 5 cases.Vascular compression of affected trigeminal nerve was not visualized on MRI in 2 patients,and intraoperative inspection revealed that trigeminal nerve root was compressed by draining vein of brainstem in 1 and not compressed by any vessels in 1.All patient's neuralgia resolved after microvascular decompression of glossopharyngeal nerve and trigeminal nerve.Conclusion It is possible to visualize the glossopharyngeal and surrounding arteries on MRI,and it is of great significance in the diagnosis and treatment of this kind of glossopharyngeal neuralgia.

The application of 64 multidetector CT angiography in the evaluation of carotid stenosis and followup of carotid endarterectomy and percutaneous transluminal stenting / 中华放射学杂志

Objective To evaluate the diagnostic value of 64 multidetector-row CT angiography for internal carotid artery(ICA)stenosis and the application in the follow-up of carotid endarterectomy and percutaneous transluminal stenting.Methods Forty transient ischemie attack(TIA)patients with interpretable CTA and DSA of the cervical carotid arteries were selected from May 2005 to December 2005. This yielded a total of 80 vessels.The CTA curved planar reformations(CPR)and DSA images referenced to the distal cervical internal carotid were graded by two senior neuroradiologists blindly,according to the North American Symptomatic Carotid Endarterectomy Trial(NASCET)guidelines.The paired-t test was used to verify the statistical significant difference between pre-operating and post-operating of carotid endarterectomy or percutaneous transluminal stenting in measuring the vascular diameter and area of cross section using CTA.Results When the 70% stenosis was used as the cut-off value,the seasitivity,specificity,negative predictive value,and the positive predicting value were 97%,95%,95%,and 98%,respectively.There was statistically significant difference in measuring the vascular diameter(P

Application of triple rule-out with 64-slice spiral CT in the diagnosis of acute chest pain / 中华放射学杂志

Objective To investigate the performance of triple rule-out with(M-slice spiral CT in the combined examination of pulmonary artery,thoracic aorta and coronary artery for patients with acute chest pain.Methods Seventy patients who presented with acute chest pain were included in the study.All of the patients underwent retrospective ECG-gated 64-slice computed tomography triple rule-out examination to evaluate the pulmonary arteries,thoracic aorta and coronary arteries.Multi-planar reconstruction(MPR), maximum intensity projection(MIP),curved-planar reconstruction(CPR)and volume rendering(VR) were used to display pulmonary arteries,thoracic aorta and coronary arteries.We evaluated the image quality of coronary artery and the enhancement of the pulmonary artery and thoracic aorta to estimate if the examination can fulfill the clinical demand for the differential diagnosis of acute chest pain.Results The mean scan time was(8.5?1.0)s,and the dose of contrast medium injected was 100 ml.There were 95.7%(67/70)of patients whose CT values detected in the pulmonary artery and thoracic aorta after enhancement were ≥200 HU.The image quality of 85.8%(720/839)coronary segments was classified as excellent,8.6%(72/839)as good,and 5.6%(47/839)as poor.There were 20 cases with coronary stenoses≥50%,2 cases with pulmonary embolism,and 2 cases with aortic dissection.Conclusion The triple ride-out examination with 64-slice spiral CT could depict pulmonary artery,thoracic aorta,and coronary artery in 8 s with good image quality.It has great potential in the etiological diagnosis for the patients with acute chest pain.

A study on the application of CT perfusion and CT angiography with 64-slice spiral CT in the evaluation of internal carotid artery and middle cerebral artery stenosis and occlusion / 中华放射学杂志

0.05),the MTT values were(5.2?1.1)and(10.9?2.6)s, respectively(t=7.24,P

Diffusion tensor imaging of brain in relapsing neuromyelitis optica / 中华放射学杂志

Objective To investigate the presence of occult brain tissue damage in patients with relapsing neuromyelitis optica(RNMO)and its possible mechanism by using diffusion tensor imaging (DTI).Methods DTI scans were performed in 16 patients with RNMO and 16 sex-and age-matched healthy controls.Histogram analysis of mean diffusivity (MD)and fractional anisotropy (FA)was performed in brain tissue (BT),white matter (WM)and gray matter (GM)to detect the presence of occult brain tissue damage in RNMO patients.Region of interest(ROI )analysis of MD and FA was also performed in 6 dedicated regions with or without direct connection with spinal cord or optic nerve to determine the relationship between occult brain tissue damage and the damage of spinal cord and optic nerve.Results Patients with RNMO had a significantly higher average MD of the BT[RNMO(0.95?0.02)? 10~(-3)mm~2/s,controls (0.91?0.03)?10~(-3)mm~2/s,t = 3.940,P