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Objective ToevaluatethepredictivevalueofpreoperativeMRIsignalintensityindifferenttexturesofpituitaryadenoma (PA).Methods Accordingtotheinclusioncriteria,47casesofPA werecollected,including37softcasesand10firmcases.Different texturesofPAonMRIsignalintensityanddynamicenhancementcharacteristicswereanalyzed.Results T2WIintensitybetweentwo texturegroups(T2PA/T2WM、T2PA/T2GM、T2PA/T2CSFandSER)hadsignificantstatisticaldifferences(P＜0.05).T1WIintensity betweentwotexturegroups(T1WIPA/T1WIPN )hadnosignificantstatisticaldifference(P＞0.05).TheT2signalintensity(T2PA/T2WM、T2PA/T2GM、T2PA/T2CSF)andSERinsoftgroupwashigherthanthatinthefirmgroup.Predictivevalueofthetextureof PAbyusingtheROCcurveofT2PA/T2WM,T2PA/T2GM,T2PA/T2CSF,T1PA/T1PNandSER wereobtained,andtheareasunder theROCcurvewere0.857,0.835,0.856,0.630and0.781respectively.ThelargestareaundertheROCcurvewasT2PA/T2WM (P＜0.05).Conclusion MRIT2signalintensityisrelatedtothetextureofPAandthoseindexescanbeusedtojudgethetextureofPA.
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Objective To investigate the effect of color magnetic resonance imaging (MRI) combined with serum levels of carbohydrate antigen 153 (CA153),carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) on the diagnostic efficacy of breast cancer patients.Methods From December 2015 to December 2017,80 cases of breast cancer in our hospital were selected as the observation group.Another 98 patients with benign breast diseases as control group A,and 94 healthy women as control group B.The serum levels of CA153,CEA and CYFRA21-1in the three groups were measured by electrochemiluminescence and the level of the above serum indexes in patients with different disease stages (stage Ⅰ to Ⅱ,Ⅲ to Ⅳ) in the observation group were compared.The 3 groups were examined by color Doppler high frequency ultrasound.The specificity,sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 or detecting alone in the diagnosis of breast cancer analyzed.Results There were significant differences in the levels of serum CA153,CEA and CYFRA21-1 in the 3 groups (P ＜0.05),and the level of serum CA153,CEA and CYFRA21-1 in the observation group was higher than that in the control group A and the control group B (P ＜ 0.05).The levels of serum CA153,CEA and CYFRA21-1 in patients in stage Ⅲ to Ⅳ of the observation group were higher than those in patients in stage Ⅰ to Ⅱ (P ＜ 0.05).The sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 in the diagnosis of breast cancer were 96.25％ (77/80) and 84.93％ (231/272),respectively,which were all higher than those of serum CA153,CEA and CYFRA21-1 alone (P ＜ 0.05).And the sensitivity of combined diagnosis was higher than that of color Doppler high frequency ultrasound alone (P ＜ 0.05).Conclusions Color Doppler ultrasound combined with serum levels of CA153,CEA and CYFRA21-1 can significantly improve the sensitivity and accuracy of breast cancer diagnosis,reduce the risk of missed diagnosis,and provide a strong basis for diagnosis and treatment of breast cancer.
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Objective To study the distribution characteristics of myocardial fat infiltration and to analyze the function of the left ventricle (LV).Methods The images of patients who performed coronary CT angiography (CTA)in Siemens DSCT were reviewed retrospectively.The imaging characteristics and location of myocardial fat infiltration were recorded and the LV function was analyzed by Siemens Syngo.via software.Results Totally 4 477 patients were enrolled in this study.Among them,myocardial fat infiltration of the LV was found in 94 (accounting for 2.1%)patients.The fat infiltration was mainly located underlying the endocardium,including the inferior,anterior,lateral and posterior walls of the LV,as well as the inferior part of the interventricular septum.The enhancement image showed low intensity in the myocardium with fat infiltration.Conclusion The characteristics of myocardial fat infiltration can be well displayed by DSCT,as well as the LV function.DSCT can provide both morphological and functional information of the heart via one scan.
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<p><b>OBJECTIVE</b>To investigate whether DTI abnormalities in patients with nondemented subcortical ischemic vascular disease (SIVD) are correlated to general cognitive function and executive function independent of conventional MRI parameters.</p><p><b>METHODS</b>Sixty-six SIVD patients including 30 with cognitive impairment without dementia (VCIND) and 36 with normal cognition (NCI) underwent DTI and cognitive assessment of the general cognitive function and executive function. Conventional MRI parameters and DTI parameters were measured within the white matter lesions (WMLs), normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM). The independent predictors of general cognitive function and executive function in SIVD patients was analyzed.</p><p><b>RESULTS</b>NCI and VCIND patients showed significant differences in the periventricular WMLs, ADC valus in NAWM and WMLs of the centrum semiovale, and FA values in NAWM of the anterior periventricular. Except for ADC values of the caudate nucleus, ADC and FA values in the subcortical NAGM showed significant difference between the two groups. After controlling for age and education, PVLs and ADC values in the WMLs and NAWM of the centrum semiovale and putamen, and FA values in the anterior periventricular NAWM, WMLs and putamen showed significant correlations to MMSE; the number of lacunar infarcts, ADC values in posterior periventricular NAWM and caudate nucleus, and FA values in anterior periventricular NAWM and thalamus showed significant correlations to CDT. Multivariate analysis showed independent correlations of the ADC values in WMLs and NAWM of the centrum semiovale to MMSE, and demonstarted correlations of the ADC values of the caudate nucleus and number of lacunar infarcts to CDT.</p><p><b>CONCLUSION</b>In nondemented SIVD subjects, the integrity of the white matter in the centrum semiovale strongly correlates to the general cognition, and the microstructural damage of the caudate nucleus head predicts executive function impairment independent of other MRI variables.</p>
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Humans , Brain Ischemia , Pathology , Psychology , Case-Control Studies , Caudate Nucleus , Pathology , Cerebral Cortex , Pathology , Cognition , Physiology , Cognition Disorders , Pathology , Diffusion Tensor Imaging , Magnetic Resonance ImagingABSTRACT
Objective To evaluate the value of diffusion.weighted imaging(DWI)in the differential diagnosis of benign and malignant breast lesions with Meta.analysis.Methods English and Chinese articles published from 1997 to 2007 were searched in Cochrane library,Pubmed,Ovid.Elsevier.Springer databases and Chinese National Knowledge Infrastructure(CNKI),and selected according to the criteria for diagnostic research recommended by Cochrane Method Group.The characteristics of selected articles including the study background,design,results and diagnostic indicators were analyzed.Statistical analysis was performed with Meta-test version 0.9.Results Six articles were included with a total of 479 lesions.The sensitivity and specificity of DWI for breast 1esions ranged from 64.0% to 92.8% and from 45.8% to 96.7% respectively. All groups had homogeneity.and a fixation effects regression Was developed.The pooled weighted sensitivity and specificity with 95% CI and Az Was 86%(76%-92%).80%(61%-91%)and 92.19% respectively.Sensitivity analysis demonstrated no remarkable change on heterogeneity.Condnsion The value of ADC in DWI can help to differentiate the benign breast lesions from the malignant with good sensitivity and specificity.The further study is needed to assess the clinical aplication of the b-value and diagnostic threshold.
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Objective To determine the diagnostic value of diffusion-weighted imaging(DWI)in hyperacute and acute cerebral infarction by using Meta-analysis.Methods Based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic,studies in English and Chinese from 1 997 to 2007 were selected from Medline,Cochrane,Springer,Ovid,Elsevier,LWW and CNKI(China National Knowledge Infrastructure).The characteristics of the included articles were appraised and extracted. Statistical analysis was performed with the software Meta-test 0.6 and Comprehensive meta-analysis 2.0.Heterogeneity of the included articles was tested.which was used to select proper effect model to calculate pooled weighted values of sensitivity and specificity and the corresponding 95% CL Summary receiver operating characteristic(SROC)curve was performed and the area under the curve(Az)was calculated.Publication bias was analyzed by Funnel Plot in Comprehensive Meta.analysis 2.0.A sensitivity analysis was performed.Results Twelve articles meeting inclusion criteria were analyzed for the value of DWI in hyperacute cerebral infarction.The pooled seusitivitv.specificity and diagnostic odds ratio was 92%,87%,180.37 respectively,Az=0.9717.Novice is a main factor for total diagnostic effect(Q=4.34,P>0.05).Non-asymmetric funnel plot suggested the publication bias.Fifteen articles meeting inclusion criteria were analyzed for the value of DWI in both hyperacute and acute cerebral infarction(≤24 h).The pooled sensitivity,specificity diagnostic odds ratio was 92%、91%. 623.62 respectively.Az=0.9659.Fixed effects model used in Meta-analysis for database suggested homogeneity(Q=2.70,P>0.05).Nonasymmetrie funnel plot suggested the publication bias.Conclusions As a noninvasive method,diffusion-weighted imaging is valuable in detecting hyperacute and acute cerebral infarction.More support from multi-center prospective researches is desirable.
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Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).
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Objective: To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods: Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results: The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion: Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).
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@#Objective To explore the mechanism of the nerve growth factor (NGF) accommodated by electro-acupuncture in rats with diabetes peripheral neuropathy (DPN).MethodsThe rat DPN model was established with streptozotocin (STZ). The rats were randomly divided into the normal group, model group, western medicine group and electro-acupuncture group. The animals of the electrol-acupuncture group were treated with electrol-acupuncture on "Zusanli" and "Shenshu" after DPN model established. The nervous tissues of all animals were examined with the techniques of immunity and fluorescent quantitation PCR to detect the albumen and mRNA expression of NGF.ResultsThe albumen and mRNA expression of NGF of the animals in the model group, western medicine group and electro-acupuncture group were significantly lower than that in the normal group ( P<0.05～0.01), and the albumen and mRNA expression of NGF was up-regulation in the electro-acupuncture group after electro-acupuncture treatment and was significantly higher than that in the model group ( P<0.01).ConclusionElectro-acupuncture on "Zusanli" and "Shenshu" can up-regulate the albumen and mRNA expression of NGF, and improve reparation of the sciatic nerve in DPN animals.
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Objective: To investigate the effect of moxibustion on telomerase activity and genes expression in tissues of senescent rats. Methods: Subacute aging rats model were established by injection with D-gal solution. Points Shenshu (BL 23) were treated with moxibustion in treatment group, contrasting with a model group and a normal group. Enzyme-Linked Immunosorbent Assays(ELISA) was used for the level oftelomerase activity in liver tissues, and In Situ Hybridization(ISH) was used for the condition of expression of telomerase genes in liver tissues. Results: The level of telomerase activity in the aging model group was obviously lower than that in normal control group (P＜0.01), the level in moxibustion group was obviously higher than that in model group(P＜0.05). In comparison with normal rats, the positive-expressed areas and photodensity of telomerase genes in aging model group were all significantly lower (P＜0.01,P＜0.01), and the positive-expressed areas in moxibustion group was significantly higher than that in model group (P＜0.01). Conclusions: Moxibustion could regulate telomerase activity of senile rats, hence delaying aging.
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The article reviews the development of patterns of stroke unit, the roles of different types of stroke unit, the mechanisms of stroke unit in improving prognosis, and the prospect of stroke unit.
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Parkinson's disease is a commonly encountered central nervous retrograde affection in elder persons. According to the theories of traditional Chinese medicine, Parkinson's disease is characterized by deficiency in the Ben (root) and excess in the Biao (branch). The Ben (root) is insufficiency of liver and kidney and deficiency of qi and blood; and the Biao (branch) is wind, fire, phlegm and stasis. Good therapeutic effects have been obtained by treatment based on syndrome differentiation, treatment with specific prescriptions and acupuncture. The further study on literatures, standardized criterion of symptoms differentiation and therapeutic effect determination as well as the screening and further research on the effective prescriptions and herbs should be paid more attention, meanwhile, the integration of herbs and acupuncture will be conducive to raise the therapeutic effect.
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Objective To increase the ability to recognize the characteristic MRI features of multiple sclerosis (MS) in the spinal cord. Methods Fifteen patients with MS underwent MR examination of the cervical spine. The MS plaques were evaluated for lesion location, length,size on cross-section and lesion enhancement. MRI features of intraspinal tumor of spinal cord, cervical spondylopathy of myeloid form and transverse myelitis were analyzed and compared. Results The lesion mainly developed in cervical cord in the 15 patients. The lesions were less than five vertebra body in length. MRI features showed that involved cord segment was mild swollen with smooth periphery in sagittal section;the plaques showed iso-mild hypointense on T 1WI and hyperintense on T 2WI; the plaques were located peripherally and occupied less than 50%of the cross-sectional area of the cord; the lesions in active stage were enhanced by Gd-DTPA or no enhancement, the enhanced size of plaque was smaller than the extent showing hyperintense on T 2WI. The case of several onset showed various enhancement. Conclusion MS of spinal cord has characteristic feature on MRI, this can provide reliable proof for clinical diagnosis.
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Objective To analyse the features of vertebral hemangioma and inaging diagnostic value of vertebral hemangioma.Methods There were 14 cases with hemangioma proved by clinic and pathology.X-ray plain was performed in all cases,of which 9 cases were performed by CT scan and,only 6 cases were taken MR,and 2 cases had both CT and MR scan.Results The tumors were located in thoracic spine in 10 cases,in lumbar spine in 3 cases and in cervical spine in 1 case.8 cases showed typically fence-like or nest-like;the verterea were irregularly destroyed in 5 cases,of which 2 cases were associated with vertebrea collapsing.According to the features in plain film and CT scan,there were 2 cases misdiagnosed,but 6 cases were all made a correct diagnosis on the base of MR before surgry.Conclusion Typical vertebral hemangima can be diagnosed correctely according to plain film or CT while MR plays an important role in atypical cases.