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Humans , Acupuncture Points , Acupuncture Therapy , Arthralgia/therapy , Meridians , ShoulderABSTRACT
Objective To investigate the reliability of MRI classification and clinical significance of deep gray matter injury(DGMI)in children with cerebral palsy(CP).Methods We made a retrospective assessment of 14 children with gross motor function classification system(GMFCS),manual ability classification system(MACS)and MRI classification system of deep gray matter injury.Based on T2WI,two radiologists worked independently and graded MRI pictures according to three-grading system and four-grading system.To evaluate the reliability of different grading systems,intra-observer and inter-observer agreements were tested by Kappa test.Spearman correlation analysis was performed to analyze the MRI classification system with GMFCS and MACS.Results The Kappa value of the intro-observer and inter-observe agreement of three-grading system was 0.873 and 0.873,respectively (P＜0.001).The Kappa value of the intro-observer and inter-observe agreement of four-grading system was 0.901 and 0.611(P＜0.001).Three-grading system had no significant correlation with GMFCS(r=0.053,P＞0.05)or MACS(r=0.128,P＞0.05).Four-grading system had a significant positive correlation with GMFCS(r=0.605, P＜0.05)and MACS(r=0.779,P＜0.05).Conclusion In the two grading systems,four-grading system is a more repeatable approach for detecting deep gray matter,gross motor function and manual function injuries in children with cerebral palsy.
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Objective To explore developmental states on the preterm and term neonatal brain white matter based on the co-variation of metrics derived from diffusion tensor imaging(DTI).Methods This work enrolled 66 neonates,consisting of 33 preterm(21 males and 12 females;gestational age:30.143-36.286 weeks)and 33 full-term neonates(22 males and 11 females;gestational age:37.000 -41.429 weeks).DTI derived metrics included axial diffusivity(AD),radial diffusivity(RD),and fractional anisotropy(FA).Spearman's rank correlation between metrics and postmenstrual age was analyzed in the preterm and term neonates.Developmental states were evaluated according to the method proposed by Dubois:fiber organization was associated with increased AD, decreased RD and increased FA;pre-myelination was related to decreased AD,decreased RD and unchanged/increased FA;myelination was revealed by unchanged AD,decreased RD and increased FA.Mann-Whitney U test was used to compare DTI metrics between the preterm and term neonates.Results According to the method proposed by Dubois,posterior limb of internal capsule and corpus callosum underwent myelination in the preterm-neonate period.Cerebral peduncle started myelination in the term-neonate period.Superior corona radiate,inferior fronto-occipital fasciculus and external capsule underwent pre-myelination on preterm and term neonates.FA values were higher in term neonates than those in preterm neonates in all the selected regions(P＜0.05).AD and RD values were lower in term neonates than those in preterm neonates in the selected regions except for cerebral peduncle(P＜0.05).Conclusion Changes in DTI metrics and the method of Dubois can be used to quantitatively evaluate developmental states of the neonatal brain white matter.The changes coincided with DTI variations associated with pre-myelination and myelination.White matter development is delayed in preterm neonates compared with term neonates.
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The number of preterm neonates appears to remain high in China in recent years.These subjects are vulnerable to pathogenic factors and have brain lesions easily.Punctate white matter lesions(PWML)are very common(the incidence＞20%).The degeneration in the brain associated with PWML is harmful to the outcomes and hard to be detected.Early diagnosis and prediction of PWML are focuses for pediatric researchers.This paper describes the change patterns and spatial distributions associated with PWML.The factors of individual differences and development during the diagnosis and prognosis are discussed as well.Finally,the paper points out the core problems in developmental brain template construction,individualized diagnosis,and early prediction.
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Objective To analyze the relation between ~(99)Tc~m-DTPA renal dynamic imaging and pathological changes in patients with lupus nephritis (LN).Methods Ten normal control and 29 patients with LN underwent ~(99)Tc~m-DTPA renal dynamic imaging.The LN patients were divided into two groups:silent LN (SLN) group,18 patients;and obvious LN (OLN) group,11 patients.For each case,glomerular filtration rate (GFR),peak time (t_p),half excretion time (t_(1/2)) and the excretion rate at 20 min (R_(20)) were calculated.Assessment of renal function on the scintigraphic images was evaluated by nuclear medicine physicians.The t-test,Fisher'exact probability and R×C association were used for data analysis.Results There were significant differences between normal people and two goups of LN in tp(t=5.3,9.3,both P＜0.05),t_(1/2)(t=6.9,12.0,both P＜0.05)and R_(20)(t=10.1,12.1,both P＜0.05).As to GFR,there was significant decrease in OLN patients(t=4.1,P＜0.05),but not in SLN patients(t=1.7,P＞0.05).Diagnoses of renal function by renal dynamic imaging were compared with the renal pathological changes (r=0.2273,P＜0.05).Conclusions ~(99)Tc~m-DTPA renal dynamic imaging is useful for evaluation of the early stage renal function for LN patients and to diagnose LN patients with no symptom of renal impairment.It may help to assess the degree of renal parenchymal damage while obviating the need for renal biopsy in these patients.