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Objective Toexploretheimagingfeaturesofextramedullarydisease(EMD)in multiplemyeloma(MM).Methods Theclinicalandimagingdataof17patientswithpathologicallydiagnosedMMcombinedwithEMDwereanalyzedretrospectively.Results EMDhadcertainpredilectionsites,Centralnervoussysteminvasion (6):meningealinvasion (3:1 multiple,2focal),spinalcanal invasion (1focal),thelefttemporalpoleinvasion(1focal),theleftsideforeheadinvasion(1focal);Headandneckinvasion(3:allfocal);Thoraxinvasion(8):pleuralinvasion(6:5 multiple,1focal),intrapulmonaryinvasion(1focal),anteriormediastinalinvasion(1focal);Subcutaneoussofttissueinvasion(5:allmultiple);Muscleinvasion(2focal);Lymphnodeinvasion (1 multiple).BothCTand MRI showedsofttissuenodulesormasses.ThevaluesofCTwereabout30~70HU,especiallyin30~45HU,whileMRIpresentedequal orslightlylowsignalonT1WI,equalorslightlyhighsignalonT2WI,andhighsignalinthesequenceofDWIcombinedwithmoderate toobviousenhancement,Generally,theboundaryofEMDwereclearandtheshapeoftheselesionswereregular,However,theinvasion tomuscleinsomelesionsshowedthepatternofinvasivegrowth.Conclusion EMDofmultiplemyelomamayhappenanywhere,and thepleural,meningesandsubcutaneoussofttissuesarethemostcommonlocation.CTandMRIcanshowtheEMDverywell.Thelocation, size,shapeandrelationshipwithsurroundingtissuesoftheselesionshavecertainreferencevaluesforthediagnosisanddifferential diagnosisofEMD.
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Objective To determine the diagnostic value of plain CT in tuberous goiter and thyroid papillary carcinoma.Methods The CT images including 63 lesions from 58 patients with thyroid papillary carcinoma and 103 lesions from 86 patients with tuberous goiter proven by pathology were reviewed retrospectively.The analyses were mainly focus on the internal density,the presence of calcification, andthe relation of the lesion with the normal thyroid and adjacent tissue.Results There were statistically significant differences in the internal density,the morphology of calcification and the relation of the lesion with normal thyroid and adjacent tissue between the papillary carcinoma and tuberous goiter lesions.The common CT appearances of papillary carcinoma included uniform density,crab pattern change,micro calcifications and unclear boundaries of the lesion.Focal necrosis and cystic changes were also occasionally found in papillary carcinoma and usually occured at the peripheral area.Tuberous goiters usually manifested as mixed density with macro or eggshell calcifications as well as clear boundaries both with normal thyroid tissue and adjacent tissue.Conclusion The plain CT helps for the preliminary distinction of tuberous goiter and thyroid papillary carcinoma.
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Objective To investigate the relationship between cognitive function and magnetic resonance imaging (MRI) manifestations in patients with secondary hyperparathyroidism (SHPT) by analyzing brain MRI diffusion-weighted imaging,diffusion tensor imaging,serological markers,and cognitive function.Methods We evaluated 49 random patients with SHPT.We adopted two functional scales to evaluate cognitive function and performed MRI fractional anisotropy (FA) and apparent diffusion coefficient (ADC) to evaluate white matter function of brain functional areas.We recorded serological markers,and conducted statistical analysis to analyze correlation among cognitive function scores,brain MRI in white matter functional areas,and biochemical parameters.Results We found that at the frontal area,the FA and ADC values were correlated with the MMSE language and memory function scores;at the parietal area,the FA and ADC values were correlated to the MoCA visuospatial executive function scores;the other areas had no significant correlation with cognitive function scale score.Cognitive function was negatively correlated with immunoreactive parathyroid hormone (iPTH) levels but positively correlated with education level,while it was not correlated with sex,age,blood pressure,and serum calcium levels in patients with SHPT.Conclusion In patients with SHPT,cognitive function is correlated with iPTH level and education level.The FA and ADC values of brain MRI in the frontal and parietal lobes might play a diagnostic role in evaluating cognitive function and locating injury for patients with SHPT,which requires clinical attention.
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Objective To investigate the value of MR T2* in evaluation of liver iron overload caused by long term blood transfusion.Methods Thirty one patients with long term blood transfusion were collected.Both serum ferritin(SF)and CRP levels were measured and the adjusted serum ferritin(ASF)concentration was calculated.MRI of the maximum cross-sectional liver was performed using a 1.5T scanner (Siemens Avanto).The T2* value of the liver was measured,and the correlation analysis was carried out.Twenty one normal volunteers served as controls.The transfusion group was divided into iron overload group and non overload group,and differences between groups were analyzed.Results The correlation coefficient in 31 patients between liver T2* value and SF,ASF and blood transfusion volume was-0.695,-0.728 and -0.657 respectively,and the difference was statistically significant(P<0.05).The correlation coefficient between SF and blood transfusion volume was 0.518,and the difference was statistically significant(P<0.05).There was difference in T 2* value between three groups.Conclusion MR T2* has some practical value in the evaluation of liver iron overload in patients with long term blood transfusion.
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Objective To analyze the relationship between the measured diameters of pituitary gland on MRI and peak-stimulated growth hormone(GH) in children with growth hormone deficiency (GHD).Methods A total of 46 children with GHD were included in this study, and 30 healthy children who were admitted to the hospital for health check-up were acted as the control group during the same period.The measured diameters of pituitary gland on MRI were compared between the two groups and the correlation between the diameters of pituitary gland on MRI and peak-stimulated GH were analyzed.Results ① The coronary and sagittal heights of pituitary gland on MRI were greater in children aged 7-10 years old and older than 10 years in control group and in children older than 10 years in observation group than those in children younger than 6 years (P<0.05).The anteroposterior diameter of pituitary gland on sagittal MRI in the control group was increased (P<0.05).The coronal height, sagittal anteroposterior diameter and sagittal height were lower in the observation group compared with age-and gender-matched controls(P<0.05).②The peak-stimulated growth hormone levels were higher in children aged 7-10 years old and older than 10 years in both groups compared with children younger than 6 years old (P<0.05).The peak-stimulated GH were lower in observation group compared with age-and gender-matched controls(P<0.05).③ The heights of pituitary gland on coronary and sagittal MRI in children with GHD were positively related to the peak-stimulated GH, and coronary height had the highest correlation(P<0.05).Conclusion The heights of pituitary gland on coronary and sagittal MRI in children with GHD are positively related to the peak-stimulated GH.The growth and development of children can be predicted by monitoring the changes of GH levels.
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Objective To evaluate the coronary microvascular dysfunction in patients with hypertrophic cardiomyopathy(HCM) by MR first-pass perfusion and late gadolinium enhancement. Methods From January 2011 to May 2015, 47 cases with HCM (HCM group) from the second affiliated hospital of Nanchang University were retrospectively analyzed. Additionally, 21 healthy volunteers were recruited as the control group. HCM group and control group underwent cardiac MR examinations at rest, including short axial cine, first-pass myocardial perfusion and late gadolinium enhancement scanning. Time to peak(tpeak), maximal upslope of time-intensity curve(Slopemax), peak signal intensity(SIpeak), myocardial thickening, and late myocardial gadolinium enhancement(LGE) were assessed for each myocardial segment. HCM group were divided into LGE segments group and non-LGE segments group. LGE segments group were divided into mild, moderate and severe LGE segments group. The SIpeak, Slopemax and tpeak in multiple groups were compared by one-way ANOVA and Kruskal-Wallis test. Spearman correlation tests were used to determine the relationships between perfusion parameter and LGE. Results The average values of tpeak in non-LGE segments group (527 segments), LGE segments group (225 segments) and control group (336 segments) were (67.0 ± 27.4), (79.4 ± 27.4), (59.7 ± 21.6)s, respectively. The average values of Slopemax in the three groups were 17.2±7.0, 16.4±7.4, 20.4±6.3, respectively. The average values of SIpeak in the three groups were 442.7 ± 143.2, 465.1 ± 138.4, 521.9 ± 146.7, respectively. Compared to the control group, tpeak increased and Slopemax, SIpeak decreased in non-LGE segments group and LGE segments group (P0.05). There were significant differences among LGE segments groups, as the tpeak and SIpeak increased with increasing degrees of myocardial LGE (P0.05). The degree of LGE were positively correlated with tpeak (r=0.237, P<0.01). Conclusions 3.0 T magnetic resonance myocardial perfusion imaging can show microvascular dysfunction accurately and reliably in non-LGE segments. It may be helpful in the early diagnosis of coronary microvascular dysfunction for HCM.
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Objective To investigate the effects of exercise on knee cartilage tissue structure using quantitative MR T2 mapping. Methods Sagittal T2 maps of the knee joints of 26 healthy volunteers were obtained by using 3.0T MR before,immediately after, and 1 5 min after running.The original images were classified into three terms of knee cartilage T2 map after postreconstruction.The T2 values of regions of interest (ROC)(T2 pre ,T2 post ,T2 delay )in the superficial,middle and deep cartilage of femoral and tibial joint were measured.Statistical differences of cartilage T2 values of three terms after running were analyzed.Results For the tibial joint cartilage,the T2 pre ,T2 post ,T2 delay were (49.71 ± 1.95)ms,(44.30 ± 2.56)ms,(49.41 ± 1.62)ms in the superficial layer,respectively.The three terms T2 were (42.43 ± 2.23)ms,(39.01 ± 2.37)ms,(41.90±2.28)ms in the middle layer,respectively.The differences were statistically significant(F=55.673,16.759 respectively.P<0.001).While the three terms T2 were (19.39±2.13)ms,(19.20±2.22)ms, (19.49±2.05)ms in the deep layers cartilage,respectively.The differences were not statistically significant(F =0.122,P =0.886).And the differences between T2 pre and T2 post ,T2 post and T2 delay were statistically significant (all P <0.001)in superficial and middle alyers,but there were no significant difference between the T2 pre and T2 delay (P =0.610,0.403,respectively).For the femoral joint cartilage,the T2 pre ,T2 post ,T2 delay were (50.22 ± 1.47)ms,(45.60 ± 2.82)ms,(49.84 ± 1.84)ms in superficial layers,respectively.The three terms T2 were (42.67±2.23)ms,(39.36 ± 1.98)ms,(42.40 ± 2.57)ms in the middle layer,respectively.The differences were statistically significant (F=37.976,16.987 respectively,P<0.001).While the three terms T2 were (20.30±2.73)ms,(20.60±2.44)ms,(20.51± 2.24)ms in the deep layer,the differences were not statistically significant (F =0.098,P =0.907).And the differences between T2 pre and T2 post ,T2 post and T2 delay were statistically significant (all P <0.001)in superficial and middle layers,but there were no significant difference between the T2 pre and T2 delay (P=0.520,0.679,respectively). Spatial distribution of T2 values of articular cartilage from deep to superficial layers showed a ascending trend.T2 maps showed the spatial distribution trend of T2 value change.Conclusion T2 mapping can monitor quantitatively the changes of articular cartilage molecular structure after running.The change of articular cartilage T2 value after exercise is uneven and the change of articular cartilage structure after exercise is reversible.
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Objective To investigate the clinical feasibility of contrast?enhanced three dimensional T2WI turbo?spin?echo sequence with short?term inversion recovery and sampling perfection using different flip angle evolutions (3D STIR T2WI SPACE) sequence in the brachial plexus neurography. Methods Thirty two patients were prospectively chosen and performed with brachial plexus plain scanning on a 3.0 T MR scanner by using plain and contrast?enhanced 3D STIR T2WI SPACE sequence. Thirteen of them underwent plain scan, 9 of them underwent contrast?enhanced scan, and 10 of them underwent both plain scan and enhanced scan. The visibility of the brachial plexus were scored and contrast to noise ratio (CNR) were measured by two experienced radiologists. The results between plain and contrast?enhanced imaging were compared by t test. The 10 subjects received both enhance and plain imaging, were performed with paired t test. Results In 32 patients, the visibility score of brachial plexus nerve and CNR were 7.8 ± 1.3 and 24.97±3.41 in the plain scan group, and 13.1±1.7 and 38.49±4.95 in enhanced scan group, respectively. There were statistically significant differences in the two groups(t=-11.72,P<0.01;t=-10.47, P<0.01). In 10 cases with plain and enhanced brachial plexus imaging, the average score of the brachial plexus were 7.4 ± 1.7 and 13.3 ± 1.6, the average CNR were 26.23 ± 4.43 and 38.19 ± 5.03 respectively. There were statistically significant differences (t=- 8.22, P<0.01; t=- 5.64,P<0.01). The score results were analyzed for consistency. Plain images Kappa value was 0.684, which shows moderate consistency and enhanced images Kappa value= 0.822, which shows excelent consistency. Conclusions The contrast?enhanced 3D STIR T2WI SPACE sequences may suppress background tissue signals, which is helpful to display brachial plexus, therefore it is of important value for the early diagnosis of brachial plexus neuropathy.
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Objective To assess the value of the dynamic enhanced MR (DE-MRI)morphological features in diagnosis of non lac-tation mastitis.Methods We retrospectively studied the breast DE-MRI image data of 1 5 patients with non lactation mastitis con-firmed by pathology were retrospectively studies and the lesion morphological features and distribution were analyzed.Results Amonge 1 5 patients with non lactation mastitis,6 cases were the plasma cell mastitis,5 cases were granulomatous mastitis,2 cases were abscess,and 2 cases were cyst associated with inflammation.The typical features of non lactation mastitis on DE-MRI were fast wash-in,centrifugal enhancement sign,blur boundaries between lesions and normal breast tissue,increasing unilateral vessel sign in diseased breast.Conclusion Breast DE-MRI can show typical morphological features of non lactation mastitis.When dynam-ic information is obtained inconveniently,these are helpful in diagnosing and differential diagnosing non lactation mastitis.